Objective:To analyze the etiological features and clinical characteristics of herpes zoster cases under 20 years old in Beijing City from 2017 to 2021.Methods:Herpes zoster cases were collected from a surveillance system in Beijing City from December 2017 to April 2021. The cases included individuals under 20 years old from seven sentinel hospitals located in two districts (Miyun District and Changping District). The basic information, the rash date of rash onset and the location and number of lesions were investigated at the first visit to the hospital, and the lesion swab samples were collected for laboratory testing. A telephone follow-up was conducted 21 days after the onset of the rash to investigate the degree of pain, duration of the rash and duration of pain. The individuals who still experienced neuralgia were further investigated for their pain condition at 90 days after the onset of the rash, to discover cases with postherpetic neuralgia. DNA was extracted from the rash fluid, and the ORF62 gene region was amplified and sequenced to obtain the viral sequence. The wild-type strain or chickenpox vaccine strain was identified by using sequence alignment, and the clinical characteristics of cases with different varicella vaccinations were compared.Results:A total of 78 herpes zoster cases under 20 years old were investigated during 2017-2021 in Beijing City, and 61 cases completed the follow-up survey. The age range of 61 cases was 1.83 to 20.54 years with a median age of 17.50 years. There were 36 males (59.02%) and 25 females (40.98%). Among them, there were 29 cases with the chickenpox vaccine immunization history (18 cases with one dose, 5 cases with two doses and 6 cases with unknown doses), 13 cases with no vaccination history and 19 cases with unknown vaccination history. Among the 78 cases, the herpetic fluid samples of 64 cases were positive for VZV, including 62 cases identified as wild-type strains and two cases as vaccine strains. The two vaccine strain cases were both 2-year-old girls who had received one dose of varicella vaccine and developed herpes zoster 3 months and 13 months after vaccination. Among the 29 cases with chickenpox vaccine immunization history, the majority had 10 to 49 lesions, accounting for 58.62% (17 cases). The trunk was the most common site of lesions, accounting for 44.83% (13 cases). About 51.72% (15 cases) reported "no or mild" pain intensity. The median ( Q1, Q3) scores for the worst pain, duration of pain and the time to crusting of lesions in the herpes zoster cases were 3 (1.5, 5) points, 10 (1.5, 12.5) days and 10 (6.5, 13) days, respectively. There was no statistically significant difference in the constituent ratio of the location of lesions, number of lesions and pain degree among the cases with vaccination history, without vaccination history and with unknown vaccination history ( P>0.05). There was also no statistically significant difference in the distribution of pain score, duration of lesions and duration of pain across the three groups ( P>0.05). Conclusion:Wild strains are the predominant pathogens in herpes zoster cases under 20 years old in Beijing City during 2017-2021. The varicella vaccination has no significant impact on the clinical manifestations of herpes zoster cases.

Objective:To analyze the etiological features and clinical characteristics of herpes zoster cases under 20 years old in Beijing City from 2017 to 2021.Methods:Herpes zoster cases were collected from a surveillance system in Beijing City from December 2017 to April 2021. The cases included individuals under 20 years old from seven sentinel hospitals located in two districts (Miyun District and Changping District). The basic information, the rash date of rash onset and the location and number of lesions were investigated at the first visit to the hospital, and the lesion swab samples were collected for laboratory testing. A telephone follow-up was conducted 21 days after the onset of the rash to investigate the degree of pain, duration of the rash and duration of pain. The individuals who still experienced neuralgia were further investigated for their pain condition at 90 days after the onset of the rash, to discover cases with postherpetic neuralgia. DNA was extracted from the rash fluid, and the ORF62 gene region was amplified and sequenced to obtain the viral sequence. The wild-type strain or chickenpox vaccine strain was identified by using sequence alignment, and the clinical characteristics of cases with different varicella vaccinations were compared.Results:A total of 78 herpes zoster cases under 20 years old were investigated during 2017-2021 in Beijing City, and 61 cases completed the follow-up survey. The age range of 61 cases was 1.83 to 20.54 years with a median age of 17.50 years. There were 36 males (59.02%) and 25 females (40.98%). Among them, there were 29 cases with the chickenpox vaccine immunization history (18 cases with one dose, 5 cases with two doses and 6 cases with unknown doses), 13 cases with no vaccination history and 19 cases with unknown vaccination history. Among the 78 cases, the herpetic fluid samples of 64 cases were positive for VZV, including 62 cases identified as wild-type strains and two cases as vaccine strains. The two vaccine strain cases were both 2-year-old girls who had received one dose of varicella vaccine and developed herpes zoster 3 months and 13 months after vaccination. Among the 29 cases with chickenpox vaccine immunization history, the majority had 10 to 49 lesions, accounting for 58.62% (17 cases). The trunk was the most common site of lesions, accounting for 44.83% (13 cases). About 51.72% (15 cases) reported "no or mild" pain intensity. The median ( Q1, Q3) scores for the worst pain, duration of pain and the time to crusting of lesions in the herpes zoster cases were 3 (1.5, 5) points, 10 (1.5, 12.5) days and 10 (6.5, 13) days, respectively. There was no statistically significant difference in the constituent ratio of the location of lesions, number of lesions and pain degree among the cases with vaccination history, without vaccination history and with unknown vaccination history ( P>0.05). There was also no statistically significant difference in the distribution of pain score, duration of lesions and duration of pain across the three groups ( P>0.05). Conclusion:Wild strains are the predominant pathogens in herpes zoster cases under 20 years old in Beijing City during 2017-2021. The varicella vaccination has no significant impact on the clinical manifestations of herpes zoster cases.

Objective To construct a nomogram prediction model for the risk of mild cognitive impair-ment (MCI) in elderly people aged ≥ 60-year-old.Methods A total of 502 elderly permanent residents in Guangxi were selected as the research subjects by the multi-stage stratified random sampling method,and the general situation questionnaire and the Beijing edition of MoCA-BJ scale were used to investigate the elderly people,and their anthropometric indicators were collected.The minimum absolute shrinkage rate and selection operator (LASSO) regression were used to screen the characteristic variables.The MCI risk nomogram pre-diction model was constructed.The receiver operating characteristic (ROC) curve and calibration curve were adopted to conduct the fitting effect test on the prediction model.Results Among the 502 elderly people,244 cases (46.04％) had the normal cognition and 258 cases (48.68％) had MCI.The logistic regression analysis showed that the age,education background,month income,children support,calf circumference,BMI and body fat index were the influencing factors of MCI in the elderly people,and the nomogram prediction model of the MCI risk in the elderly people was constructed by these seven variables.The area under the ROC curve (AUC) of the model was 0.790 (95％CI:0.750-0.829),the sensitivity was 0.64,the specificity was 0.62,the C-index index was 0.790,and the model fitting x2=8.111,P=0.454,the predictive value was basically consistent with the actual value.Conclusion The nomogram prediction model of MCI risk in the elderly peo-ple is successfully constructed with good predictive effect.

Objective To explore the etiology,types,treatment,and prognosis of new-onset epilep-sy in elderly dementia.Methods A retrospective analysis was conducted on 45 new-onset epilepsy in elderly dementia admitted to our department from January 2017 to December 2023.According to their etiology,they were divided into a degenerative dementia group(with AD as the main cause,AD dementia group,24 cases,)and a non-degenerative dementia group(non-AD dementia group,21 cases).Seizure types and and electroencephalogram(EEG)findings were compared be-tween the two groups.The medication and efficacy were also compared between the two groups in 3 months after treatment with antiepileptic drugs.Results Each patient had at least one type of seizure.The AD dementia group had a lower incidence of generalized seizure,but higher incidences of focal seizure and non-convulsive seizure(NCS)when compared with the non-AD dementia group(P＜0.05,P＜0.01).At least one type of abnormal EEG findings was observed in each pa-tient,but there was no statistical difference in the occurrence of EEG abnormalities between the two groups(P＞0.05).Among the 45 patients,42(93.3％)received antiepileptic drugs,and 38(90.5％)patients were well controlled,with the AD dementia group having a higher effective rate of single antiepileptic drug than the non-AD dementia group(95.5％vs 85.7％,P＜0.05).Conclu-sion Dementia combined with epilepsy(especially NCS)is often hard to detect,and continuous EEG monitoring is essential for elderly dementia patients.Most new-onset epilepsy in elderly de-mentia can be effectively controlled through antiepileptic drug therapy.

Objective To explore the feasibility and rationality of advanced integrated two-stage laparoscopic simulation training course in standardized training of surgical residents.Methods From December 2019 to December 2021,the advanced integrated two-stage laparoscopic simulation training course was carried out among 2019-2020 surgical residents who received standardized training in our hospital.The course was divided into two stages.In the first stage,BEST(best essential surgical technology training)course,adopted Darwin? endoscopic training system,Tianyan? endoscopic training system,Microport? 3D laparoscopic training system and simple simulative models were used.The second stage,BEST PLUS course,same platform as that in BEST course and in vitro animal models were used.The questionnaire survey method(before and after class questionnaire)was adopted to evaluate the curriculum setting,such as curriculum form,simulators,teaching method,time arrangement,curriculum difficulty,training effect,curriculum satisfaction and so on.Results A total of 37 surgical residents completed the two-stage course training and the questionnaire survey.The overall satisfaction rate with the curriculum setting was 100%.There were 32 residents(86.5%)thought that first stage training course could significantly improve their clinical skills,35 residents(94.6%)thought that second stage training course could significantly improve their clinical skills,and 36 resident(97.3%)thought that the first stage curriculum could significantly help them improve performance in the second stage curriculum.Conclusions The trainees had a high degree of recognition and satisfaction for the advanced integrated two-stage laparoscopic simulation training course.The overall design of course was reasonable and feasible,and was attractive to trainees.

Objective:To analyze and summarize the implementation effect of basic essential surgical training (BEST) course of laparoscopic skills over the past 10 years and the practical experience in updating course content and models.Methods:The pre-class assessment questionnaires, basic laparoscopic operation assessment results, and post-class assessment questionnaires of the students who participated in the BEST course of laparoscopic skills were collected. According to the period of the course construction, the students were divided into two groups, namely students who used the course of single training system in the early stage (traditional group) and students who used the course integrating a variety of training systems after the course model was updated in the later stage (test group). The two groups were compared for the scores of track circle moving, tunnel crossing, and high and low columns, as well as their subjective evaluation of course setting and implementation effect. The t-test, Wilcoxon test, or chi-square test was conducted according to the data type using SPSS 13.0. Results:The time for 150 traditional group students to complete track circle moving, tunnel crossing, and high and low columns was 1.08 min (0.81 min, 1.60 min), 2.20 min (1.60 min, 3.27 min), and 4.86 min (3.28 min, 6.36 min), respectively, while the time for 75 test group students to complete the three operations was 1.27 min (0.87 min, 1.83 min), 2.57 min (1.58 min, 4.07 min), and 4.35 min (2.90 min, 6.42 min), respectively, with no significant difference between the two groups ( P>0.05). In terms of students' subjective evaluation of the course, a higher percentage of the test group students were satisfied with classroom environment, teaching method arrangement, training equipment, training opportunities, helping clinical work, and meeting pre-class expectations than those in the traditional group. Conclusion:The constantly updated BEST course can ensure the training quality of trainees and obtain their higher satisfaction. The benefits of this course in clinical practice can be further verified through long-term follow-up of these trainees.

Objective To investigate the number and categorical distribution of non-medical radiation institutions in Fujian Province, China, and to explore the current situation of radiation occupational hazards prevention and control and the occupational health management of radiation workers in employing units. Methods The industrial enterprises engaged in the application of nuclear technology in our province were investigated, and different types of employing units were selected to monitor the radioactivity level in the workplace. Results A total of 377 non-medical radiation institutions were reported in the province, with a total of 5221 radiation workers (except luggage detector units); 1246 radiation workers held radiation worker certificates, accounting for 23.87%; 5103 radiation workers carried out personal dose monitoring, accounting for 97.74%; 5061 radiation workers participated in radiation protection knowledge training, accounting for 96.94%; a total of 4895 (93.76%)radiation workers received physical examination. Conclusion Health supervision authorities in Fujian Province should strengthen the supervision of non-medical radiation institutions, further improve the level of occupational health management, and protect the health rights and interests of radiation workers to the maximum extent.

Humans ; Pulmonary Disease, Chronic Obstructive ; Smoke/adverse effects* ; Tobacco ; Tobacco Smoke Pollution

Objective To detect the levels of serum fatty factor complement C1q tumor necrosis factor-related protein (CTRP) 3 and CTRP9 in pre-eclampsia (PE) pregnant women,and to analyze their correlations with the levels of glucose metabolism and lipid metabolism indexes.Methods From January 2016 to March 2018,96 pregnant women with mild pre-eclampsia and 90 pregnant women with severe preeclampsia were selected,another 100 healthy pregnant women were selected as control group.The levels of serum CTRP3 and CTRP9 were detected by enzyme linked immunosorbent assay (ELISA);the levels of triglyceride (TG),cholesterol (TC),low density lipoprotein cholesterol (LDL),high density lipoprotein cholesterol (HDL),free fatty acid (FFA),and fasting blood glucose (FPG) were measured by automatic biochemical analyzer;fasting insulin level (FINS) was measured by automatic chemiluminescence instrument.The insulin resistance index (HOMA-IR) was calculated and the differences among the three groups were compared.Pearson was used to analyze the correlation between the levels of CTRP3 and CTRP9 and the indexes of glycolipid metabolism.Results The serum CTRP3 and CTRP9 levels of PE patients in severe group and mild group were significantly lower than those in control group (P ＜ 0.05),and serum CTRP3 and CTRP9 levels in severe PE patients were significantly lower than those in mild PE patients (P ＜ 0.05);the serum lipid metabolism indexes levels of FFA,TG,TC,and LDL of PE patients in severe group and mild group were significantly higher than those in control group (P ＜ 0.05),and HDL level was significantly lower than that of the control group (P ＜ 0.05);the levels of serum lipid metabolism indexes FFA,TG,TC,and LDL of PE patients in severe group were significantly higher than those in mild group (P ＜ 0.05),and the level of HDL was significantly lower than that in mild group (P ＜ 0.05).The levels of serum glucose metabolism indexes FPG,FINS,and HOMA-IR of PE patients in severe group and mild group were significantly higher than those in control group (P ＜ 0.05);the levels of FPG,FINS,and HOMA-IR in severe PE patients were significantly higher than those in mild PE patients (P ＜ 0.05).Pearson test showed that serum CTRP3 and CTRP9 levels in PE patients were negatively correlated with FFA,TG,TC,FPG,FINS,and HOMA-IR levels (P ＜ 0.05),and positively correlated with HDL level (P ＜ 0.05).Conclusions The levels of serum CTRP3 and CTRP9 are decreased in PE patients,which is negatively correlated with FFA,TG,TC,FPG,FINS,and HOMA-IR levels,and positively correlated with HDL level.They may be indirectly involved in the pathogenesis and progression of PE by affecting the glycolipid metabolism in pregnant women.

Objective: Using data of health information system (HIS) of medical institutions to study the incidence and hospitalization of herpes zoster in three districts of Beijing. Methods: According to the different level of economic development and geographical features in Beijing, 3 districts of Xicheng, Changping and Miyun were chosen and all 110 medical institutions of the first level and above in the 3 districts are included in the survey. All the outpatient and inpatient herpes zoster cases in 2015 were retrospectively reviewed by HIS system. After distinguishing the reduplicated cases, Using the first outpatient case as a molecule and the resident population as denominator to estimate the annual incidence rate, as well as the annual hospitalization rate was estimated based on primary diagnostic hospitalized cases as molecule and the resident population as denominator. Results: A total of 32 313 primary visit outpatient cases were investigated, of which 18 360 cases (56.8%) were women and 20 923 cases (64.8%) were ≥50 years old. The overall estimated incidence of the 3 districts was 8.8‰ with an increase trends with age and reached to the highest in ≥80 years old (30.5/1 000). The incidence of Xicheng, Changping and Miyun districts are respectively 16.2‰, 4.0‰ and 5.7‰. A total of 701 primary visit inpatient cases were identified, of which 366 cases (52.2%) were women and 651 cases (92.9%) were ≥50 years old. The estimated annual hospitalization rate was 19.4/100 000, with the primary and secondary diagnostic hospitalization rate are respectively 5.9/100 000 (212 cases) and 13.5/100 000 (489 cases). The disease types of secondary diagnostic inpatient herpes zoster cases were as follows: cardiovascular disease (19.0%, 93 cases), stroke (14.5%, 71 cases), pneumonia/chronic obstructive pulmonary disease (14.1%, 69 cases), tumor (12.5%, 61 cases) and diabetes (5.7%, 28 cases). Conclusion Most of the herpes zoster cases in Beijing are over 50 years old, and the incidence of female is slightly higher than male. This disease should become a public health issue of great concern.