Objective: To analyze the epidemiological characteristics and influencing factors of severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang Province from 2019 to 2023, so as to provide the reference for strengthening SFTS prevention and control. Methods: Data on laboratory-confirmed SFTS cases in Zhejiang Province from 2019 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Meteorological data, geographic environment and socioeconomic factors during the same period were collected from the fifth-generation European Centre for Medium-Range Weather Forecasts, Geospatial Data Cloud, and Zhejiang Statistical Yearbook, respectively. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of SFTS from 2019 to 2023, and a Bayesian spatio-temporal model was constructed to analyze the influencing factors of SFTS incidence. Results: A total of 578 SFTS cases were reported in Zhejiang Province from 2019 to 2023, with an annual average incidence of 0.23/105. The peak period was from May to July, accounting for 52.60%. There were 309 males and 269 females, with a male-to-female ratio of 1.15∶1. The cases were mainly aged 50-<80 years, farmers, and in rural areas, accounting for 82.53%, 77.34%, and 75.43%, respectively. Taizhou City and Shaoxing City reported more SFTS cases, while Shaoxing City and Zhoushan City had higher annual average incidences of SFTS. The Bayesian spatio-temporal interaction model showed good goodness of fit. The results showed that mean temperature (RR=1.626, 95%CI: 1.111-2.378) and mean wind speed (RR=1.814, 95%CI: 1.321-2.492) were positively correlated with SFTS risk, while altitude (RR=0.432, 95%CI: 0.230-0.829) and population density (RR=0.443, 95%CI: 0.207-0.964) were negatively correlated with SFTS risk. Conclusions SFTS in Zhejiang Province peaks from May to July. Middle-aged and elderly people and farmers are high-risk populations. Taizhou City, Shaoxing City, and Zhoushan City are high-incidence areas. Mean temperature, mean wind speed, altitude, and population density can all affect the risk of SFTS incidence.

Objective To explore the relationship between sarcopenia and related indicators and quality of life in the elderly hypertensive population.Methods A total of 104 elderly patients with hypertension who were hospitalized in the Second People's Hospital of Hefei from January to December 2024 were selected as research subjects.The general information,biochemical indicators,blood pressure variability,skeletal muscle mass index,grip strength and walking speed of patients were collected,and the quality of life was evaluated by World Health Organization quality of life-brief version(WHOQOL-BREF).Patients were divided into non-sarcopenia group(n=46)and sarcopenia group(n=58)based on the presence or absence of sarcopenia.The clinical data and quality of life of patients in two groups were compared.Results There were statistically significant differences in gender,age,body mass index,serum albumin,24-hour systolic blood pressure coefficient of vatiation(SCV),24-hour diastolic blood pressure coefficient of vatiation(DCV)and WHOQOL-BREF score between two groups of patients(P＜0.05).Sarcopenia was negatively correlated with the quality of life in the physical and psychological domains(P＜0.05),but not correlated with the quality of life in the social relationship and environmental domains(P＞0.05).Both 24-hour SCV and 24-hour DCV were risk factors for quality of life in the physiological and psychological domains,while serum albumin was a protective factor for the quality of life in the physiological and psychological domains(P＜0.05).Conclusion Sarcopenia,serum albumin,24-hour SCV and 24-hour DCV in elderly hypertensive population are all correlated with the quality of life in the physiological and psychological domains.Attention should be paid to the physical function training of such people,ensuring adequate nutritional intake,actively detecting and reducing blood pressure variability to improve the overall quality of life.

Objective To explore the relationship between sarcopenia and related indicators and quality of life in the elderly hypertensive population.Methods A total of 104 elderly patients with hypertension who were hospitalized in the Second People's Hospital of Hefei from January to December 2024 were selected as research subjects.The general information,biochemical indicators,blood pressure variability,skeletal muscle mass index,grip strength and walking speed of patients were collected,and the quality of life was evaluated by World Health Organization quality of life-brief version(WHOQOL-BREF).Patients were divided into non-sarcopenia group(n=46)and sarcopenia group(n=58)based on the presence or absence of sarcopenia.The clinical data and quality of life of patients in two groups were compared.Results There were statistically significant differences in gender,age,body mass index,serum albumin,24-hour systolic blood pressure coefficient of vatiation(SCV),24-hour diastolic blood pressure coefficient of vatiation(DCV)and WHOQOL-BREF score between two groups of patients(P＜0.05).Sarcopenia was negatively correlated with the quality of life in the physical and psychological domains(P＜0.05),but not correlated with the quality of life in the social relationship and environmental domains(P＞0.05).Both 24-hour SCV and 24-hour DCV were risk factors for quality of life in the physiological and psychological domains,while serum albumin was a protective factor for the quality of life in the physiological and psychological domains(P＜0.05).Conclusion Sarcopenia,serum albumin,24-hour SCV and 24-hour DCV in elderly hypertensive population are all correlated with the quality of life in the physiological and psychological domains.Attention should be paid to the physical function training of such people,ensuring adequate nutritional intake,actively detecting and reducing blood pressure variability to improve the overall quality of life.

Objective: To investigate the impact of temperature changes between neighboring days (TCN) on the mortality risk of respiratory diseases, so as to provide the evidence for the study of deaths from respiratory diseases caused by climate change. Methods: The monitoring data of deaths from respiratory diseases in Zibo City from 2015 to 2019 were collected from Shandong Provincial Management Information System for Chronic Diseases and Cause of Death Surveillance. The meteorological and air pollutant data of the same period were collected from China Meteorological Data Website and ChinaHighAirPollutants dataset. The effect of TCN on the risk of deaths from respiratory diseases was examined using a generalized additive model combined with a distributed lag non-linear model, and subgroup analyses for gender and age were conducted. The disease burden attributed to TCN at different intervals was assessed by calculating attributable fraction. Results: Totally 11 767 deaths from respiratory diseases were reported in Zibo City from 2015 to 2019, including 6 648 males (56.50%) and 5 119 females (43.50%). There were 1 307 deaths aged <65 years (11.11%), and 10 460 deaths aged 65 years and older (88.89%). A monotonically increasing exposure-response relationship was observed between TCN and deaths from respiratory diseases in the general population, females, and the population aged 65 years and older. The 95th percentile of TCN (P95, 3.84 ℃) reached the peak at a cumulative lagged of day 11 (RR=2.063, 95%CI: 1.261-3.376). The results of subgroup analyses showed greater impacts on females and the population aged 65 years and older, with cumulative lagged effects peaking at day 12 (RR=3.119, 95%CI: 1.476-6.589) and day 11 (RR=2.107, 95%CI: 1.260-3.523). The results of attributional risk analysis showed that next-day warming might increase the attributable risk of deaths from respiratory diseases, and next-day cooling might decrease the attributable risk. Conclusion Next-day warming may increase the mortality risk of respiratory diseases, and has greater impacts on females and the population aged 65 years and older.

Objective: To examine the impact of heat waves and cold spells on the incidence of hemorrhagic stroke, so as to provide insights into prevention of hemorrhagic stroke. Methods: Data pertaining to the incidence of hemorrhagic stroke in Zibo City from 2015 to 2019 were collected from Shandong Provincial Management Information System for Chronic Diseases and Cause of Death Surveillance, and the meteorological data during the period from 2015 to 2019 were captured from National Meteorological Information Center of China. The air quality index (AQI) was collected from the National Daily Report of Urban Air Quality in China. Heat wave was defined as the highest daily temperature that was no less than the 90th percentile (P90), P92.5, P95 and P97.5 of the highest daily temperature in the warm season for at least 2, 3 or 4 days, and cold spell was defined as the lowest daily temperature that was no more than the P10, P7.5, P5 and P2.5 of the lowest daily temperature in the cold season for at least 2, 3 or 4 days. The effect of heat waves and cold spells on the incidence of hemorrhagic stroke was evaluated using a generalized additive model and described with relative risk (RR) and its 95%CI. Results: A total of 8 844 case with first-onset hemorrhagic stroke were recorded in Zibo City from 2015 to 2019. The lowest daily temperature that was no more than P10, P7.5 or P5 of the lowest daily temperature in the cold season for at least two days, or that was no more than P10 or P7.5 of the lowest daily temperature for at least 3 days resulted a remarkably increased risk of hemorrhagic stroke (lowest RR=1.187, 95%CI: 1.031-1.366; highest RR=1.242, 95%CI: 1.042-1.480), and after adjusting the effect of daily mean temperature, the lowest daily temperature that was no more than P10 or P7.5 of the lowest daily temperature in the cold season for at least two days, or that was no more than P10 of the lowest daily temperature for at least 3 days resulted a remarkably increased risk of hemorrhagic stroke (lowest RR=1.236, 95%CI: 1.009-1.513; highest RR=1.274, 95%CI: 1.023-1.585). However, there was no significant association between heat waves and the risk of hemorrhagic stroke. Conclusion Cold spells may increase the risk of hemorrhagic stroke, while no significant association is examined between heat waves and the risk of hemorrhagic stroke.

Objective: To explore the relationship between group risk perception, self efficacy and attitudes among college students, and its associations with individual prevention and control behaviors regarding COVID 19 pandemic. Methods: From October to November 2021, data were collected among 4 092 undergraduate students from eight colleges and universities in Anhui Province,using a multi stage stratified cluster sampling method. A t test and analysis of variance were performed for comparison between groups, while multiple linear regression was employed to investigate group risk perception, self efficacy and attitudes among college students in terms of individual COVID 19 prevention and control measures. Results: The total scores of group emotional risk perception (ARP), cognitive risk perception (CRP), distance perception (DIP) and self efficacy were (19.72±4.01)(14.56±3.64)(18.04±5.33) and (27.27±6.74), respectively. The total score of attitudes and beliefs was (26.15±4.54), while individual prevention and control behavior was (25.67±4.45). Emotional risk perception ( β=0.16 ), cognitive risk perception ( β=0.08 ), attitudes ( β=0.23 ) and self efficacy ( β=0.13 ) were positively correlated with individual prevention and control behaviors of college students( P <0.05). However, distance risk perception had no significant effect ( P >0.05). Conclusion Risk perception, self efficacy and attitude of college students are correlated with individual COVID 19 prevention and control behaviors. Therefore, colleges and universities should strengthen general self efficacy and attitude,and improve risk awareness towards COVID 19 among college students, and promote the effective prevention and control of campus epidemic.

Objective: This study explored the relationships among psychological stress, achievement motivation and psychological capital in college students to provide a reference for improving the level of psychological capital in college students. Methods: A multi stage stratified cluster sampling method was used to select 9 940 college students from ten universities in Anhui Province. The achievement motivation scale (AMS), psychological stress scale (SRQ-20) and psychological capital scale (PPQ) were applied. The moderating effect of the questionnaire was analyzed with χ 2 tests, Spearman rank correlation and stratified regression. Results: Statistical differences were found in psychological stress according to major, whether students leader, family economic status and whether students had left behind experience ( χ 2=15.50, 10.25, 28.61, 25.55, P <0.05). The rank correlation results indicated that psychological stress was negatively correlated with the pursuit of success ( r =-0.27) and four dimensions of self efficacy,optimism,hope and resilence in psychological capital ( r =-0.43, -0.41,-0.36,-0.45)( P <0.05), and was positively correlated with the avoidance of failure ( r =0.25, P <0.05). The stratified regression model indicated that psychological stress in the dimensions of college students achievement motivation (pursuit of success: β =0.02, Δ R 2=0.01, P <0.01; failure avoidance: β = 0.03 , Δ R 2=0.01, P <0.01) played a moderating role in the relationship between psychological capital and psychological capital. Conclusion Being female, senior students, low household economic status, and left behind experience are associated with more psychological stress among college students. Psychological stress is correlated with achievement motivation and psychological capital, and has a moderating effect on the relationship between achievement motivation and psychological capital.

Objective: To explore the role of rejection sensitivity in the relationship between the psychological resilience and social adaptability of college students with left behind experience, so as to provide reference for college students to beffer adapt to the society. Methods: Self designed questionnaire, the Conor Davidson Resilience Scale(CD-RISC), the Chinese College Students Adaptation Scale(CCSAS), and the Rejection Sensitivity Questionnaire (RSQ) were administered among 3 418 college students from four universities in Anhui Province with the stratified cluster sampling method. This research investigation used AMOS version 21.0 to construct a structural equation model of rejection sensitivity, psychological resilience, and social adaptability, to analyze the mediation effect. Results: There were 1 324 college students with lefe behind experience. Compared with college students without left behind experience[(64.47±13.79)(197.90±25.57)(10.86±2.98)], students with left behind experience exhibited lower levels of psychological resilience, social adaptability, and rejection sensitivity[(63.26±13.69)(195.14±24.60)(10.45±2.91)](t=-2.50, -3.12, -3.87, P<0.05); Rejection sensitivity was negatively associated with social adaptability, and psychological resilience among college students with left behind experience(r=-0.24, -0.22, P<0.01), while social adaptability was positively correlated with psychological resilience(r=0.64, P<0.01). The results of the mediation model showed that psychological resilience affected the mediation path of social adaptability by rejection sensitivity (mediation effect value=0.02, 95%CI=0.01-0.05, P<0.05). Conclusion Left behind experience had a negative impact on the psychological resilience and social adaptability of undergraduates. With respect to the psychological resilience of undergraduates with left behind experience, rejection sensitivity played a mediating role in the social adaptability relationship.

Objective: To investigate clinical effects of middle and low peroneal artery perforator flap with pedicle on repairing skin and soft tissue defects of ankle. Methods: Twenty patients with skin and soft tissue defects of ankle and exposure of tendon and bone were admitted in our burn wards from April 2012 to December 2015. The size of skin and soft tissue defects ranged from 5 cm×4 cm to 23 cm×10 cm. Patients were treated with debridement and vacuum sealing drainage (VSD) after admission. After VSD treatment for 1 week, flap transplantation operation was performed. Middle and low perforating branches of peroneal artery were detected by portable Doppler blood flow meter before the operation. Flaps were designed and resected according wounds during the operation, with 1 or 2 middle and low perforating branches of peroneal artery in flaps. Seventeen patients were treated with middle and low peroneal artery perforator flap. Larger wounds with exposure of tendon and bone were repaired with middle and low peroneal artery perforator flap, and the other wounds were repaired with intermediate split-thickness skin graft of thigh on the same side in three patients. The size of flap ranged from 6 cm×5 cm to 25 cm×12 cm. The donor sites were sutured directly or repaired with intermediate split-thickness skin graft of thigh on the same side. Results: After operation, 1 patient with partial skin necrosis at the distal of the flap because of disorder of venous circulation healed after dressing change and physiotherapy, and flaps of the other 19 patients survived well. During follow-up of 3 to 36 months, flaps of all patients were in good appearance, with no obvious cicatrix, and the affected limbs and ankle joints functioned well. Conclusions Middle and low peroneal artery perforator flap with advantages of stable perforating branch, reliable blood supply, and large resected size, can repair skin and soft tissue defects of ankle.

Objective To analyze the epidemiological characteristics of mumps in 2012 and 2014,and to explore the preventive effect of the second dose of mumps-containing vaccine (MuCV) in mumps in Shandong province.Methods On the basis of certain model assumptions,a Space State model was formulated.Iterated Filter was applied to the epidemic model to estimate the parameters.Results The basic reproduction number (R0) for children in schools was 4.49 (95％ CI:4.30-4.67)and 2.50 (95％CI:2.38-2.61) respectively for the year of 2012 and 2014.Conclusions Space State model seems suitable for mumps prevalence description.The policy of 2-dose MuCV can effectively reduce the number of total patients.Children in schools are the key to reduce the mumps.