Objective　To timely understand the current status and distribution of nail snails (Oncomelania hupensis) in Tongjiang River channels in Zhenjiang City, providing a scientific basis for achieving the goal of eliminating schistosomiasis. Methods　From 2019 to 2023, nine Tongjiang River channels on the south bank of the Yangtze River under the jurisdiction of Zhenjiang City were selected as the monitoring area. Snail monitoring was carried out onshore and beach nail snails floats in the Tongjiang River channels, nail snails on attachments in hardened areas, snails induced by straw curtains, and snails carried by boats and domestic animals. Results　The monitoring results of shoreline snail from 2019 to 2023 showed that the snail situation in the Tongjiang River channel and its outer river bank remained relatively stable from 2019 to 2020; however, in 2021, under the influence of the Yangtze River flooding disaster in 2020, the area of snails increased significantly. In 2021, the area with snails in the Tongjiang River channel and the outer river bank increased by 45.70% (11.95/26.15) and 100.00% (20.00/20.00) compared to 2020; the average density of nails snails in the Tongjiang River channel and the outer river bank and the emergence rate of snail frames both showed a significant increase, rising by 94.73% (0.18/0.19) and 68.08% (8.68/12.75) compared to 2020, and by 122.73% (0.81/0.66) and 102.78% (43.26/42.09), respectively. The differences in the increase in the occurrence rate of spiked frames in the Tongjiang River channel Chili River and Renmin River were not statistically significant (χ2=0.329, P>0.05; χ2=0.646, P>0.05). From 2022 to 2023, the density of nail snails and the occurrence rate of framed snails in the Tongjiang River channel showed a decreasing trend (F=4.72, P=0.04 and χ2=372.58, P<0.01). The area of nail snails, density of live snails, and occurrence rate of framed snails in the outer river bank showed a decreasing trend (F=13.96, P=0.02; F=23.43, P<0.01; χ2=1 029.69, P<0.01). During the five years, no nail snails were detected in the ancient canal and 11 tributaries. From 2019 to 2023, 180 times of 3 003 kg of floating objects were salvaged, with a total of 148 live snails detected. A total of 17 live snails were captured on attachments in the hardened berm area; a total of 11 live snails were captured by straw curtain snail baiting;112 boats were inspected, and no snails were found; there were 112 boats surveyed, and no snails were found; 97 cattle were observed, and 2 cattle were found to carry 1 live snail on their hooves; 321 sheep were observed, and no snails were found on their hooves; and no infectious snails were found in the monitoring area in 5 years. Conclusions　Nail snails continue to exist in the Tongjiang River channel, and the risk factors for schistosomiasis transmission have not been completely eliminated. It is still necessary to carry out accurate monitoring of the snail situation in the Tongjiang River and the river bank, so as to grasp the risk of transmission in time and take emergency measures.

Objective:To explore the risk factors for death within 1 year after hip fracture surgery in the elderly.Methods:A case control study was made on the clinical data of 551 elderly patients with hip fracture treated in Second Affiliated Hospital of Soochow University from January 2019 to December 2020, including 182 males and 369 females; aged 65-100 years [80(73,86)years]. Joint replacement, cannulated screw fixation or proximal femoral nail fixation were performed. The patients were divided into survival group ( n=494) and death group ( n=57) based on the death within 1 year after surgery recorded at postoperative telephone follow-up. The gender, age, hypertension, diabetes, cardiovascular diseases, chronic respiratory diseases, neurological diseases, chronic renal failure, anemia on admission, fracture types, American anesthesiologist Association (ASA) classification, operative methods, preoperative waiting time, duration of operation and perioperative blood transfusion were recorded in two groups. Univariate Cox regression was used to analyze the correlation between the above indexes and death within 1 year after surgery. All indexes with P<0.2 in the univariate analysis were included in multivariate Cox regression analysis to clarify the independent risk factors for death within 1 year after surgery. Results:Univariate Cox regression analysis showed that death within 1 year after surgery correlated with gender, age chronic respiratory diseases, chronic renal failure and anemia on admission (all P<0.01), but not with hypertension, diabetes, cardiovascular diseases, neurological diseases, fracture types, ASA classification, operative methods, preoperative waiting time, duration of operation or perioperative blood transfusion (all P>0.05). Multivariate Cox regression analysis showed that male ( HR=2.08, 95% CI 1.20, 3.61, P<0.01), age ≥ 80 years ( HR=2.22, 95% CI 1.15, 4.28, P<0.05), chronic respiratory diseases ( HR=2.54, 95% CI 1.19, 5.40, P<0.05), chronic renal failure ( HR=4.57, 95% CI 1.27, 16.44, P<0.05), anemia on admission ( HR=2.82, 95% CI 1.38, 5.76, P<0.01) were significantly associated with death within 1 year after surgery. Conclusion:Male age≥ 80 years, chronic respiratory disease, chronic renal failure and anemia on admission are independent risk factors for death within 1 year after hip fracture surgery in the elderly.

Objective To explore and analyze the clinical effect of enhanced recovery after surgery to tibial plateau fractures patients applied arthroscopic minimally invasive treatment. Methods A total of 60 tibial plateau fractures patients were selected in our orthopedics department from January 2016 to July 2017 and who applied arthroscopic minimally invasive treatment, according to the last two-digit number of patient ID, divided them into observation group (n=30) and control group (n=30) randomly. The control group used regular perioperative strategies. The observation group used multidisciplinary cooperation fast track surgery idea, through preoperative assessment and education, nutrition and fasting, advance pre-rehabilitation and preventive analgesia; intraoperative optimization of anesthesia, body fluid management and body temperature control; postoperative nutritional support, multimodal analgesia, early ambulation and rehabilitation exercises, implied standardized and professional perioperative overall optimization management. The differences of the condition of 6 h, 12 h, 24 h after surgery, VAS score on discharge, time of first ambulation, active knee flexion 120°days; self-care ability at discharge and AKSS score one month after surgery between 2 groups were compared. Results The VAS scores 6 h, 12 h, 24 h after surgery and at discharge were 4.48 ± 1.18, 3.81 ± 1.68, 3.05 ± 1.63, 2.65 ± 1.65 in the observation group, and were 5.45±1.15, 4.15±1.05, 3.71±1.15, 3.23±1.68 in the control group. The differences were statistically significant (t=0.796~0.902 , P<0.05). The time of first ambulation, active knee flexion 120° days, self-care ability at discharge and AKSS scores one month after surgery were (5.61±1.4) hours, (4.01± 1.1) days, 80.22±3.6, 71.89±6.56 and 64.13±6.15 in the observation group, and (35.8±8.1) hours, (6.82± 1.6) days, 64.25±3.8, 63.45±8.36 and 60.95±8.98 in the control group. The differences were statistically significant (t=2.789~10.200, P<0.05). Conclusion Enhanced recovery after surgery to tibial plateau fractures patients applied arthroscopic minimally invasive treatment is worthy of being popularized as it’s beneficial to tibial plateau fractures patients. It can also fasten recovery and improve quality of life for postoperative patients.

Treatment of CIN2～3 includes cervical ablation,cervical local excision and hysterectomy,while cervical local excision is the standard procedure for CIN2～3.The recurrence rate was 0.7%～21% after surgery treatment of CIN2～3;The high risk factors of recurring are positive margin,serious lesion and age over 40.The follow-up items for postoperation involve cytology,colposcopy,ECC and HPV testing;If there were 2 LSIL or 1 HSIL for cytology,the patients should be given colposcopy examination and ECC.Retreatment must be clinically individual one.It is the same significance for follow-up and treatment of CIN2～3.