In 2022， Hainan provincial government launched the project for the prevention and control of viral hepatitis with the goals of a hepatitis B screening rate of 90%， a diagnostic rate of 90%， and a treatment rate of 80% among people aged 18 years and above by the year 2025， and the main intervention measures include population-based prevention， case screening， antiviral therapy， and health management. As of December 31， 2024， a total of 6.875 million individuals in the general population had been screened for hepatitis B， with a screening rate of 95.6%. A total of 184 710 individuals with positive HBsAg were identified， among whom 156 772 were diagnosed through serological reexamination， resulting in a diagnostic rate of 84.9%. A total of 50 742 patients with chronic hepatitis B were identified， among whom 42 921 had hepatitis B-specific health records established for health management， with a file establishment rate of 84.6%. A total of 31 553 individuals received antiviral therapy， with a treatment rate of 62.2%. A total of 2.503 million individuals at a high risk of hepatitis C were screened， among whom 4 870 tested positive for HCV antibody and 3 858 underwent HCV RNA testing， resulting in a diagnostic rate of 79.2%， and 1 824 individuals with positive HCV RNA were identified， among whom 1 194 received antiviral therapy， with a treatment rate of 65.5%. In addition， 159 301 individuals with negative HBsAg and anti-HBs and an age of 20 — 40 years were inoculated with hepatitis B vaccine free of charge. Through the implementation of the project for the prevention and control of viral hepatitis， a large number of hepatitis patients have been identified， treated， and managed in the province within a short period of time， which significantly accelerates the efforts to eliminate the crisis of viral hepatitis.

Background and Objectives: Patients with dilated cardiomyopathy (DCM) tend to be accompanied by biventricular impairment. We hypothesized that the combination of the aortic pulsatility index (API) and pulmonary artery pulsatility index (PAPI) could refine risk stratification in DCM. Methods: We studied 120 consecutive patients with advanced DCM who underwent right heart catheterization (RHC). The primary outcome was all-cause mortality within 1 year after RHC. We used the receiver operating characteristic curve to determine the optimal cut-off of API and PAPI to predict outcomes. Results: The optimal cut-offs of API (1.02) and PAPI (2.16) were used to classify patients into four groups. There were significant differences in left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) among the four groups (both p<0.05).When delineating API by LVEF above or below the median (28%), the cumulative rate of survival in patients with API <1.02 was lower than that of those with API ≥1.02 in both higher and lower LVEF groups (both p<0.05). Similar trends were observed when delineating PAPI using TAPSE higher or lower than the cut-off (17 mm) (both p<0.05). The cumulative rate of survival in the API <1.02 and PAPI <2.16 group was lower than that in the API ≥1.02 and/or PAPI ≥2.16 (all p<0.05). Conclusions API and PAPI could add additional prognostic value to LVEF and TAPSE, respectively. The combination of API and PAPI could provide a comprehensive assessment of biventricular function and refine risk stratification.

Background and Objectives: Patients with dilated cardiomyopathy (DCM) tend to be accompanied by biventricular impairment. We hypothesized that the combination of the aortic pulsatility index (API) and pulmonary artery pulsatility index (PAPI) could refine risk stratification in DCM. Methods: We studied 120 consecutive patients with advanced DCM who underwent right heart catheterization (RHC). The primary outcome was all-cause mortality within 1 year after RHC. We used the receiver operating characteristic curve to determine the optimal cut-off of API and PAPI to predict outcomes. Results: The optimal cut-offs of API (1.02) and PAPI (2.16) were used to classify patients into four groups. There were significant differences in left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) among the four groups (both p<0.05).When delineating API by LVEF above or below the median (28%), the cumulative rate of survival in patients with API <1.02 was lower than that of those with API ≥1.02 in both higher and lower LVEF groups (both p<0.05). Similar trends were observed when delineating PAPI using TAPSE higher or lower than the cut-off (17 mm) (both p<0.05). The cumulative rate of survival in the API <1.02 and PAPI <2.16 group was lower than that in the API ≥1.02 and/or PAPI ≥2.16 (all p<0.05). Conclusions API and PAPI could add additional prognostic value to LVEF and TAPSE, respectively. The combination of API and PAPI could provide a comprehensive assessment of biventricular function and refine risk stratification.

Background and Objectives: Patients with dilated cardiomyopathy (DCM) tend to be accompanied by biventricular impairment. We hypothesized that the combination of the aortic pulsatility index (API) and pulmonary artery pulsatility index (PAPI) could refine risk stratification in DCM. Methods: We studied 120 consecutive patients with advanced DCM who underwent right heart catheterization (RHC). The primary outcome was all-cause mortality within 1 year after RHC. We used the receiver operating characteristic curve to determine the optimal cut-off of API and PAPI to predict outcomes. Results: The optimal cut-offs of API (1.02) and PAPI (2.16) were used to classify patients into four groups. There were significant differences in left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) among the four groups (both p<0.05).When delineating API by LVEF above or below the median (28%), the cumulative rate of survival in patients with API <1.02 was lower than that of those with API ≥1.02 in both higher and lower LVEF groups (both p<0.05). Similar trends were observed when delineating PAPI using TAPSE higher or lower than the cut-off (17 mm) (both p<0.05). The cumulative rate of survival in the API <1.02 and PAPI <2.16 group was lower than that in the API ≥1.02 and/or PAPI ≥2.16 (all p<0.05). Conclusions API and PAPI could add additional prognostic value to LVEF and TAPSE, respectively. The combination of API and PAPI could provide a comprehensive assessment of biventricular function and refine risk stratification.

Background and Objectives: Patients with dilated cardiomyopathy (DCM) tend to be accompanied by biventricular impairment. We hypothesized that the combination of the aortic pulsatility index (API) and pulmonary artery pulsatility index (PAPI) could refine risk stratification in DCM. Methods: We studied 120 consecutive patients with advanced DCM who underwent right heart catheterization (RHC). The primary outcome was all-cause mortality within 1 year after RHC. We used the receiver operating characteristic curve to determine the optimal cut-off of API and PAPI to predict outcomes. Results: The optimal cut-offs of API (1.02) and PAPI (2.16) were used to classify patients into four groups. There were significant differences in left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) among the four groups (both p<0.05).When delineating API by LVEF above or below the median (28%), the cumulative rate of survival in patients with API <1.02 was lower than that of those with API ≥1.02 in both higher and lower LVEF groups (both p<0.05). Similar trends were observed when delineating PAPI using TAPSE higher or lower than the cut-off (17 mm) (both p<0.05). The cumulative rate of survival in the API <1.02 and PAPI <2.16 group was lower than that in the API ≥1.02 and/or PAPI ≥2.16 (all p<0.05). Conclusions API and PAPI could add additional prognostic value to LVEF and TAPSE, respectively. The combination of API and PAPI could provide a comprehensive assessment of biventricular function and refine risk stratification.

Objective: To evaluate the incremental vaccine effectiveness (VE) of two dose of the mumps containing vaccine (MuCV) in chidren, so as to provide a basis for optimizing mumps immunization strategies. Methods: A 1∶2 frequency matched case-control study was conducted by using reported mumps cases in childcare centers or schools from Lu an, Hefei, Ma anshan and Huainan cities of Anhui Province from September 1, 2023 to June 30, 2024, as a case group(383 cases). And healthy children in the same classroom were selected as a control group(766 cases). The MuCV immunization histories of participants were collected to estimate the incremental VE of the second dose of MuCV against mumps. Group comparisons were performed using the Chi square test or t-test. For matched case-control pairs, the Cox regression model was employed to calculate the odds ratio (OR) with 95% confidence interval (CI) for two dose MuCV vaccination and to estimate the incremental vaccine effectiveness (VE). Results: There were no statistically significant differences between the case and control groups regarding gender, age, dosage of MuCV vaccination and the time interval since the last dose vaccination( χ 2/t=0.05, 0.20, 0.94, -0.02, P >0.05). The proportions of the case and control groups vaccinated with two doses of MuCV were 26.63% and 29.37%, respectively, and the overall incremental VE of the second dose of MuCV was 40.73% (95% CI=3.03%-63.77%, P <0.05). Subgroup analyses revealed that the incremental VE for children with a period of ≥1 year between the two doses of MuCV was 54.13% (95% CI=1.90%-78.56%, P <0.05), while for children with a period of <1 year, it was 30.63% (95% CI=-28.59%-62.58%, P >0.05). The incremental VE of the second dose of MuCV was 30.36% (95% CI=-25.95%-61.50%, P >0.05) in kindergarten children and 66.73% (95% CI=14.92%-86.99%, P <0.05) in elementary and secondary school students. The incremental VE was 28.78% (95% CI=-27.46%-60.21%, P >0.05) within five years of the last dose of MuCV vaccination and 66.07% (95% CI=-41.56%-91.87%, P >0.05) for vaccinations administered beyond five years. Conclusions The second dose of MuCV may offer additional protection for children; however, extending the interval between two dose of MuCV (<1 year) has shown limited incremental protective effects. Therefore, it is crucial to consider optimizing current immunization strategies for mumps.

Objective: To understand the association of physical exercise willingness and insomnia with depressive symptoms among college students, so as to provide reference for improving depressive symptoms of college students. Methods: From October 2022 to April 2023, cluster sampling was used to recruit 11 101 college students from four colleges in Anhui Province. The questionnaire survey was conducted to investigate the willingness to engage in physical exercise, insomnia and depressive symptoms of college students. The multivariate Logistic regression model was used to analyze the association of physical exercise willingness and insomnia with depressive symptoms of college students. Results: The prevalence of depressive symptoms among college students was 9.24%. Multivariate Logistic regression analysis showed that college students who were passive participants/non participants in physical activity, or who experienced insomnia, had a higher likelihood of depressive symptoms compared to those who were active participants or did not experience insomnia ( OR =1.84, 2.07, 4.02, all P <0.01). College students who were passive participants or non participants in physical activity and concurrently experienced insomnia had a higher risk of depressive symptoms compared with those who were active participants or did not experience insomnia ( OR =1.87-8.39, all P <0.01). Gender stratified analysis showed that the combined effect of passive physical exercise and insomnia increased the risk of depressive symptoms in both male ( OR = 1.81 -9.87) and female college students ( OR =1.67-7.39) (all P <0.05). Conclusions Both physical exercise willingness and insomnia are associated with depressive symptoms in college students. In order to improve the depressive symptoms of college students, it is necessary to improve the enthusiasm of physical exercise and strengthen the education of sleep health awareness.

Kounis syndrome is an acute coronary syndrome triggered by an allergic reaction, which is clinically rare and frequently subject to misdiagnosis or missed diagnosis. This article presents a case report of a 70-year-old male patient who developed a rash, pruritus, and chest pain following colon polyp resection. Coronary angiography revealed occlusion of the left anterior descending artery, and blood flow was restored after stent implantation. However, the patient experienced recurrent symptoms accompanied by loss of consciousness. Drug skin tests confirmed positive reactions to chlorhexidine and fondaparinux sodium, leading to a diagnosis of type Ⅱ Kounis syndrome. By avoiding allergenic drugs and combining antihistamines with symptomatic treatment to correct myocardial ischemia, the patient′s clinical symptoms significantly improved, and he eventually recovered and was discharged from the hospital. This case underscores the importance of maintaining vigilance for this syndrome in patients with allergies accompanied by chest pain and promptly identifying and avoiding allergens.

Mitochondrial and peroxisome fission deficiency-related encephalopathy caused by DNM1L gene mutation is a rare and fatal epileptic encephalopathy, with clinical phenotype and genetic heterogeneity. The acute stage is drug-resistant epilepsy with poor prognosis and serious neurological sequelae. A case of genetically confirmed encephalopathy related to mitochondrial and peroxisome fission defects is reported, the clinical data, treatment process are summarized, and the previous literature is reviewed to improve the understanding of the rare disease.

Objective: To understand the association of maternal emotional symptoms and parent-child relationship with emotional and behavioral problems (EBPs) in primary school students, so as to provide a reference for the prevention of EBPs in primary school students. Methods: In May 2023, a convenient cluster sampling method was used to select 1 324 students from two primary schools in Hefei City, Anhui Province as the study subjects. The Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Family Adaptation and Cohesion Evaluation ScalesⅡ (FACES Ⅱ), and Strengths and Difficulties Questionnaire (SDQ) of parental version were used to investigate maternal emotional symptoms, parent-child relationship, and EBPs of primary school students, respectively. Multivariate Logistic regression analysis model was used to analyze the association of different maternal emotional symptoms and parent-child relationship with EBPs of primary school students. Results: The abnormal detection rates of emotional symptoms, conduct problems, hyperactivity disorder, peer problems, prosocial behavior and total difficulties in primary school students were 13.6%, 19.4%, 20.2%, 36.5%, 20.9% and 51.9%, respectively. Multivariate Logistic regression analysis showed that the detection rates of EBPs in primary school students whose mothers had anxiety and depression symptoms with low level of parent-child relationship increased ( OR=1.52-6.97, P <0.01). The combined effect of mothers who had anxiety and depression symptoms with low level of parent-child relationship increased the risk of EBPs in all dimensions of primary school students ( OR=4.07-10.14, P <0.01). After gender stratification, the combined effect of mothers who had anxiety and depression symptoms with low level of parent-child relationship increased the risk of EBPs in all dimensions of boys and girls ( OR=3.71- 10.95 , P <0.01). Conclusions Maternal emotional symptoms and parent-child relationship are associated with EBPs in primary school students. Reducing maternal anxiety and depression symptoms, and improving parent-child relationship are beneficial to reduce the incidence of EBPs problems in primary school students.