Objective: To investigate the status and influencing factors of influenza vaccination among the elderly, so as to provide insights into improving the strategies for influenza vaccination among the elderly. Methods: Elderly people aged 60 years and above were recruited from one community each in five sub-districts of Shihezi City, Xinjiang Uygur Autonomous Region using a random sampling method. Demographic information, knowledge about influenza and influenza vaccines, vaccine literacy and influenza vaccination status in the past year were collected through questionnaire surveys. Factors affecting influenza vaccination among the elderly were analyzed using a multivariable logistic regression model. Results: Totally 1 121 valid questionnaires were recovered, with an effective recovery rate of 95.08%. There were 417 males (37.20%) and 704 females (62.80%). The majority were aged 60-<81 years, accounting for 80.37% (901 individuals). The awareness of knowledge about influenza and influenza vaccines was 78.86%. Low vaccine literacy was observed in 786 individuals, representing 70.12%. The influenza vaccination rate was 20.96%. Multivariable logistic regression analysis showed that age (71-<81 years, OR=1.607, 95%CI: 1.041-2.479; ≥81 years, OR=1.719, 95%CI: 1.040-2.842), educational level (middle school/technical secondary school, OR=0.616, 95%CI: 0.416-0.911), medical expense payment (employee medical insurance, OR=6.531, 95%CI: 2.030-21.010; resident medical insurance, OR=3.385, 95%CI: 1.095-10.466; public expense, OR=4.828, 95%CI: 1.700-13.712), vaccination willingness (yes, OR=6.237, 95%CI: 3.277-11.871), influenza vaccination history (yes, OR=14.600, 95%CI: 8.733-24.408) and vaccine literacy (medium and above, OR=2.412, 95%CI: 1.636-3.555) were associated with influenza vaccination among the elderly. Conclusion The influenza vaccination rate among the elderly was relatively low, and was mainly affected by age, educational level, medical expense payment, vaccination willingness, influenza vaccination history and vaccine literacy.

Objective:To estimate the burden of influenza-associated outpatient consultations in China from 2011 to 2021 surveillance years to provide a reference for developing influenza prevention, control strategies, and vaccination policies.Methods:Data on influenza-like illness (ILI) and virological confirmation of sentinel specimens from 2011 to 2021 surveillance years were extracted from China's national sentinel surveillance system. Generalized additive models were fitted to estimate influenza-associated excess ILI outpatient burden, accounting for seasonal baselines and meteorological factors.Results:Influenza was associated with an average of 1.66 (95% CI: 1.51-1.80) excess ILI consultations per 1 000 person-years (py) in China each year from 2011 to 2021 surveillance years. The influenza-associated outpatient burden was similar across different virus types/subtypes. Influenza A(H1N1)pdm09 led to a higher rate of influenza- associated ILI consultations [0.65 (95% CI: 0.53-0.76) per 1 000 py] compared to other types/subtypes. The age groups with the highest burdens were children aged 0-4 years and 5-14 years, with excess outpatient consultation rates of 15.23 (95% CI: 13.73-16.73) per 1 000 py and 13.53 (95% CI: 12.49-14.52) per 1 000 py, respectively. Conclusions:Influenza caused many outpatient consultations in China, particularly among children aged 0-14. Continuous influenza monitoring and disease burden assessment should be conducted, and close attention should be paid to the changing trends of various influenza virus types/subtypes. When formulating vaccination strategies, priority should be given to recommending vaccination for high-risk populations, such as children.

Objective:Eosinophilic esophagitis (EoE), an allergen/immune-mediated chronic disorder of the esophagus, is witnessing an incremental rise in its global incidence. However, data in China are very limited. This study aimed to clarify the characteristics of EoE in Chinese adults at our medical center.Methods:We collected information, including clinical characteristics and endoscopic findings, relative to all cases of adult patients who met the pathological diagnostic criteria for EoE at our institution from January 2019 to May 2024. Patients diagnosed with reflux esophagitis (RE) were matched in a 1∶1 ratio based on age and sex, and comparisons were made between the two groups.Results:The overall detection rate of EoE in our hospital was approximately 0.05%, with a trend increasing yearly. In total, 61 patients met the diagnostic criteria for EoE, of whom 42 (68.9%) were male. The median age was 53 years. The clinical manifestations of EoE patients were diverse, with common symptoms including dysphagia, acid reflux, and upper abdominal pain. Serological examination revealed that 23.1% (9/39) of patients had increased absolute eosinophil counts. Allergic diseases were observed in 73.8% (45/61) patients. Most patients exhibited typical mucosal changes in the esophagus during endoscopy, the median EREFS score was 3 points. The most commonly administered treatment included proton pump inhibitors, and 13 patients received steroid treatment. During a follow-up period, 42 patients (68.9%) exhibited clinical symptom improvement or pathological remission. In comparison to Western countries, patients with EoE in China typically presented with milder disease severity and a more favorable prognosis. No significant differences were observed between younger and older adult groups regarding clinical symptoms, the proportion of comorbid allergic diseases, medications, or the rate of improvement ( P for all>0.05). Additionally, patients with EoE more commonly presented with dysphagia (29.5% vs. 1.6%, χ2=15.96, P<0.001), comorbid allergic diseases (73.8% vs. 13.1%, χ2=45.67, P<0.001), increased eosinophil counts (23.1% vs. 3.3%, χ2=7.61, P<0.01), and a positive response to corticosteroids when compared to patients with RE. Conclusions:This study systematically determined the clinical characteristics of adult EoE patients in China. Compared to Western countries, patients from China typically presented with milder disease severity and a more favorable prognosis. No significant clinical manifestations or prognosis differences were observed between younger and older patients. EoE can be differentiated from RE based on symptoms, the presence of comorbid allergic diseases, and the degree of serum eosinophil infiltration. For patients suspected of EoE, endoscopic esophageal biopsy will facilitate early diagnosis.

Objective To investigate the current situation of the attitude and practical ability of hospice care in the terti-ary cancer hospital of Zhejiang Province,so as to provide reference for managers to explore more effective hospice care support.Methods Using convenience sampling selected 278 clinical nurses from Zhejiang Cancer Hospital.From June to August 2024,the general data questionnaire,hospice care attitude scale and self-assessment practice scale of hospice care were used to survey nurses with questionnaires,and the related factors affecting practical ability and the correlation between attitudes and practical a-bility were analyzed.Results The hospice attitude score of 278 nurses in the hospice co-photography mode was(88.43±12.01),and the average score of entries was(3.54±0.48).The total score of the hospice Practical ability scale was(61.87±12.42),and the average score of the items was(3.64±0.73).Nurses'age,education background,previous experience in ca-ring for end-stage patients and their families,and self-assessment of competence in hospice care were the main influencing factors of nurses'practical ability score(all P＜0.05).There was a positive correlation between clinical nurses'practice ability score and hospice attitude score,the correlation coefficient r=0.176,P＜0.05.Conclusion Under the mode of hospice co-care,the attitude of nurses in Zhejiang Province is above the middle level,and the practical ability of nurses needs to be further improved,the higher the attitude of nurses,and the nurses'practical ability of hospice care is strong.Nursing managers should carry out professional training to promote the attitude of nursing staff,so as to improve the practical ability of nurses in hospice care.

Objective:To estimate the burden of influenza-associated outpatient consultations in China from 2011 to 2021 surveillance years to provide a reference for developing influenza prevention, control strategies, and vaccination policies.Methods:Data on influenza-like illness (ILI) and virological confirmation of sentinel specimens from 2011 to 2021 surveillance years were extracted from China's national sentinel surveillance system. Generalized additive models were fitted to estimate influenza-associated excess ILI outpatient burden, accounting for seasonal baselines and meteorological factors.Results:Influenza was associated with an average of 1.66 (95% CI: 1.51-1.80) excess ILI consultations per 1 000 person-years (py) in China each year from 2011 to 2021 surveillance years. The influenza-associated outpatient burden was similar across different virus types/subtypes. Influenza A(H1N1)pdm09 led to a higher rate of influenza- associated ILI consultations [0.65 (95% CI: 0.53-0.76) per 1 000 py] compared to other types/subtypes. The age groups with the highest burdens were children aged 0-4 years and 5-14 years, with excess outpatient consultation rates of 15.23 (95% CI: 13.73-16.73) per 1 000 py and 13.53 (95% CI: 12.49-14.52) per 1 000 py, respectively. Conclusions:Influenza caused many outpatient consultations in China, particularly among children aged 0-14. Continuous influenza monitoring and disease burden assessment should be conducted, and close attention should be paid to the changing trends of various influenza virus types/subtypes. When formulating vaccination strategies, priority should be given to recommending vaccination for high-risk populations, such as children.

Objective:To develop and validate a predictive model for delayed emergence in patients undergoing thoracoscopic radical lung cancer surgery with general anesthesia.Methods:A total of 1 468 patients admitted to the anesthesia recovery room after thoracoscopic radical lung cancer surgery at the First Affiliated Hospital of Zhejiang University School of Medicine from August 2020 to August 2021 were selected via convenience sampling. Patients who underwent surgery between August 2020 and June 2021 ( n=1 213) were assigned to the modeling group, while those from July to August 2021 ( n=255) were used as the validation group. Logistic regression analysis was used to identify risk factors for delayed emergence and to establish a predictive model. The performance of the model was evaluated using the area under the receiver operating characteristic curve ( AUC) and the Hosmer-Lemeshow goodness-of-fit test. Results:Among the modeling group, 200 patients experienced delayed emergence, with an incidence of 16.49% (200/1 213). Logistic regression analysis revealed that the use of reversal agents, use of neostigmine, albumin level, presence of shivering, pain score≥4 points, extubation time, partial pressure of CO 2, partial pressure of oxygen, serum potassium level, and intraoperative fentanyl dosage were significant influencing factors ( P<0.05). The predictive model demonstrated good performance with an AUC of 0.864 [95% CI (0.828, 0.899) ], a Hosmer-Lemeshow test χ 2=5.299 ( P=0.725), cut-off value of 0.442, sensitivity of 0.794, and specificity of 0.769. In the validation group, delayed emergence occurred in 44 cases (17.25%). The model showed good validation performance with an AUC of 0.852 [95% CI (0.826, 0.878) ], Hosmer-Lemeshow χ 2=5.912 ( P=0.336), cut-off value of 0.754, sensitivity of 0.674, and specificity of 0.877. Conclusions:The predictive model constructed in this study demonstrates strong performance and can assist clinicians in the early identification of patients at risk of delayed emergence following thoracoscopic radical lung cancer surgery under general anesthesia.

Objective To analyze temporal trends in infectious disease burden among Chinese elderly(≥60 years)using data from the Global Burden of Disease Study(GBD 2021),evaluate age-period-cohort effects on disease burden,predict trends through 2045,and propose evidence-based medication management strategies.Methods We conducted a threefold analysis of infectious disease burden from 1990 to 2021 using Joinpoint regression to identify temporal trends,Age-Period-Cohort(APC)modeling to disentangle epidemiological effects,and Nordpred projections for 2045 disease burden estimates.Results Over 32 years,all infectious disease categories except HIV/AIDS and sexually transmitted infections demonstrated significant declines.Enteric infections showed the most rapid reductions in mortality(AAPC=-7.85,P﹤0.001)and disability-adjusted life year rates(DALYR;AAPC=-7.18,P﹤0.001).We also found a significant decrease in the incidence of tropical diseases and malaria(AAPC=-6.77,P﹤0.001).APC analysis found that the age effect was mostly negative in terms of the annual percentage change in mortality and DALYR for each disease,except for HIV/AIDS,with an overall decline in period risk over time,and a generally higher risk of morbidity and mortality for the early birth cohort,and an overall decline in the risk of each disease as the year of birth progressed,but the risk of HIV/AIDS death and DALY period and cohort risks trended upward.While the overall risk for certain diseases was slightly higher in males compared to females,the trends were largely consistent across both sexes.In terms of projections,the absolute prevalence of respiratory infections and tuberculosis in terms of number of cases and age-standardized rates,and the growth of the disease burden of HIV/AIDS were particularly prominent,making them important health challenges for the future.The burden of disease in the elderly often results in issues such as potential polypharmacy,which must be addressed to improve medication management.Conclusions China has achieved remarkable progress in reducing infectious disease burdens among older adults,though HIV/AIDS and sexually transmitted infections present an escalating public health threat.These findings advocate for enhanced surveillance systems,age-specific prevention strategies,and precision medication protocols to optimize therapeutic outcomes in geriatric populations.

Objective:To design a set of new type of surgery instrument for pectus excavatum(PE),so as to improve safety and effectiveness of minimally invasive operation in surgery for PE.Methods:The design of the new type of surgical instrument for PE adopted multifunctional orthopedic board that combined both penetrating and supporting functions.The T type handle,special sealing screw for single hole,setscrew and stator,which were convenient for operation,were equipped for the orthopedic board.The new type of surgical instrument was applied in clinical PE surgery since November,2010,and a total of 1398 PE surgeries were conducted in the 10 years,which included 1078 surgeries with single hole,and 320 surgeries with multi holes.The success rate of PE surgery with single hole mode was assessed.Results:In 1398 PE surgeries,the number of PE patients,whose ages were less or equal to 12 years old,and who all adopted single hole mode,was 887 cases,and the success rate of surgery with single hole was 100%.In addition,the number of PE patients,whose age was larger than 12 years old,was 511 cases,and the surgery with single hole was successfully applied in 191 cases of them,and the success rate of surgery with single hole was 37.4%.Conclusion:The the new type of surgical instrument for PE by surgery with single hole and multi holes has mature technique,and it is safety and effectiveness,which has higher clinical application value.

Objective To explore the effect of psychological flexibility based psychotherapy model on cancer-related fatigue in lung cancer patients.Methods A total of 60 lung cancer patients admitted to Zhejiang Cancer Hospital from March 2022 to December 2023 were selected as research subjects.They were divided into control group(n=30)and study group(n=30)by using a random number table method.Control group received routine psychological intervention,while study group was treated with a psychological flexibility-based therapy model in addition to the routine intervention.The scores of anxiety self-rating scales,depression self-rating scales,perceived burden,coping strategies,and cancer-related fatigue were compared between two groups.Results After intervention,the self-assessment scale scores of anxiety and depression,self-perceived burden and cancer-related fatigue in both groups decreased,and the reduction was more significant in study group(P＜0.05).The coping style scores of both groups improved,and the improvement was more significant in study group(P＜0.05).Conclusion Intervention with a psychological flexibility-based psychotherapy model in lung cancer patients can reduce negative emotions,self-perception burden and cancer-related fatigue,and improve patients' coping style.

In order to solve the current problems in operation management and achieve the goals of improving operation management efficiency,strengthening refined management,optimizing resource allocation,and supporting decision-making.Based on the concept of business and finance integration,specific construction measures are proposed from four aspects:integration of business and finance organizations and personnel,clarifying the division of labor and cooperation mechanism;integration of core business and finance processes,realizing closed-loop management of operation activities;integration of business and finance scenarios,implementing key tasks of operation management;integration digital data of business and finance to build up the Operational Data Repository.The construction results in three aspects for hospitals,namely,building a digital financial standard system,a digital financial service system,and a digital operation value system,are summarized to provide reference for the construction of a smart operation management system for public hospitals.