ObjectiveTo analyze the incidence rate and mortality of acute myocardial infarction (AMI) and their changing trends among the registered residents in Xiaoshan District, Hangzhou City from 2017 to 2023, so as to provide references for formulating policies related to AMI prevention. MethodsThe morbidity and mortality data of AMI among the registered residents in Xiaoshan District from 2017 to 2023 were collected through the Hangzhou Chronic Disease and Death Cause Monitoring System. Software such as Excel 2019, SPSS 25.0 and Joinpoint 4.9.1.0 were used to calculate the incidence rate, mortality, and average annual percentage change (AAPC) of AMI. ResultsFrom 2017 to 2023, the average annual crude incidence rate, age-standardized incidence rate using China standard population (ASIRC), and the age-standardized incidence rate using World standard population (ASIRW) of AMI in Xiaoshan District were 48.25/100 000, 29.14/100 000, and 21.64/100 000, respectively, and, from which the AAPCs were 5.495%, 6.010%, and 6.533%, respectively, all showing an upward trend. The average annual crude mortality rate, the age-standardized mortality rate using China standard population (ASMRC), and the age-standardized mortality rate using World standard population (ASMRW) were 11.76/100 000, 6.52/100 000, and 4.71/100 000, respectively, from which the AAPCs were -9.669%, -10.433% and -9.615%, respectively, all showing a downward trend. The average annual crude incidence rate of AMI was higher in males (65.87/100 000) than that in females (31.31/100 000). Moreover, the average annual crude mortality rate of AMI was higher in males (14.08/100 000) than that in females (9.52/100 000), and the difference was statistically significant (all P<0.001) .After age grouping, the crude incidence rate of AMI among the residents aged 35-, 45-, 55-, and 65- years in Xiaoshan District from 2017 to 2023 showed an upward trend over time, with AAPCs of 16.993%, 17.149%, 8.523%, and 5.002%, respectively. While the crude mortality rate in residents aged 35-, 75-, and 85-102 years showed an decreasing trend over time, with AAPCs of -23.977%, -15.467%, and -17.415%, respectively, but there was no statistically significant difference in the trends in incidence rate and mortality of other age groups (all P>0.05). ConclusionThe situation of AMI prevention and control among the registered residents in Xiaoshan District is not optimistic, and targeted measures should be strengthened for the male residents aged ≥35 years old.

Objective To investigate the detection rate,epidemiology and resistance mechanism of methicil-lin-resistant Staphylococcus aureus(MRSA)in a hospital in recent 5 years.Methods A total of 762 strains of non repetitive Staphylococcus aureus detected from 2016 to 2020 in a hospital were collected retrospectively.Methicillin-sensitive Staphylococcus aureus(MSSA)was 392 strains(MSSA group)and 370 strains caused by MRSA(MRSA group),and 95 strains of MRSA isolated in 2020 were further used for resistance mechanism.Staphylococcus aureus was identified and tested for drug sensitivity by Vitek 2 automatic microbial system.Molecular epidemiological typing was determined by multilocus sequence typing.The biofilm formation was performed by crystal violet staining.PCR amplification was used to detect drug resistance genes,virulence genes and biofilm related genes,and logistic regression analysis was used to investigate the independent risk factors of its occurrence.Results The detection rate of MRSA in past five years was 48.56％,mainly was from pus samples and secretion samples(38.38％,33.51％respectively).MRSA was found in the general sur-gery(18.65％)and otorhinolaryngology(12.70％).ST88 was the most common multilocus sequence typing(37.89％),and followed by ST951(24.21％).Moderate biofilm formation was the most common,accounting for 74.73％.Multivariate regression analysis showed that compared with MSSA group,hypoproteinemia,en-docrine system diseases,wound infection and history of antibiotic use within six months were the independent risk factors for infection in MRSA group.Compared with the control group,hospital transfer,wound infection and tumor were independent risk factors for infection in MRSA group(P＜0.05).Conclusion The detection rate of MRSA in a hospital is high,and the carrying rate of various drug-resistant genes is high.The hospital should pay attention to the prevalence of MRSA and related risk factors,so as to prevent it early.

Objective: To investigate the trend in mortality of malignant tumors in Xiaoshan District, Hangzhou City from 2017 to 2022, so as to provide insights into formulation of the malignant tumor control strategy. Methods: Data on mortality of malignant tumors in Xiaoshan District from 2017 to 2022 were collected through Hangzhou Municipal Chronic Disease Monitoring Management System, and the cause of death composition ratio and crude mortality were calculated. The mortality of malignant tumors was standardized by the population of the sixth National Population Census in China in 2010. The trend in mortality of malignant tumors were evaluated with average annual percent change (AAPC). Results: There were 13 301 malignant tumor deaths reported in Xiaoshan District from 2017 to 2022, accounting for 31.26% of the total cause of death and ranking the first among the causes of death. The crude mortality was 186.36/105 and standardized mortality was 106.63/105. There was no significant trend in the crude mortality of malignant tumors in Xiaoshan District from 2017 to 2022 (P>0.05), while the standardized mortality showed a tendency towards a decline (AAPC=-1.409%, P<0.05). The crude and standardized mortality of malignant tumors were higher in men than in women (241.40/105 vs. 133.37/105; 132.66/105 vs. 79.35/105; both P<0.05). There was no obvious trend in the crude mortality of malignant tumors in men (P>0.05), and the standardized mortality showed a tendency towards a decline (AAPC=-3.017%, P<0.05). While there was no obvious trend in the crude and standardized mortality of malignant tumors in women (P>0.05). The crude mortality of malignant tumors showed a tendency towards a decline among residents at ages of 15 to 44 years and 65 years and older (AAPC=-3.933% and -2.413%, both P<0.05). The crude mortality of malignant tumors was higher in men than in women among residents at ages of 0 to 14 years, 45 to 64 years and 65 years and older (all P<0.05). The five most common causes of death included lung cancer, colorectal cancer, liver cancer, gastric cancer and pancreatic cancer, accounting for 66.96% of all malignant tumors. The crude mortality of colorectal cancer from 2017 to 2022 showed a tendency towards a rise (AAPC=2.815%, P<0.05). Conclusions The standardized mortality of malignant tumors showed a tendency towards a decline in Xiaoshan District from 2017 to 2022. Management of malignant tumors should be given a high priority among men at ages of 45 years and older, and lung cancer, colorectal cancer, liver cancer, gastric cancer and pancreatic cancer were leading causes of death.

Objective: To investigate the mortality, probability of premature death and trends due to malignant tumors, cardio-cerebrovascular diseases, diabetes and chronic respiratory diseases in Xiaoshan District, Hangzhou City from 2015 to 2021, so as to provide the basis for the formulation of chronic diseases prevention and control strategies. Methods: The deaths of the four diseases in Xiaoshan District from 2015 to 2021 were collected from Zhejiang Provincial Chronic Diseases Surveillance Information Management System. The crude mortality, standardized mortality and probability of premature death were calculated. The trends in mortality and probability of premature death were analyzed using average annual percent change (AAPC), and the attainment of probability of premature death due to the four diseases was evaluated using the targets of probability of premature death control in 2025 and 2030. Results: Totally 36 130 deaths due to the four diseases were reported in Xiaoshan District from 2015 to 2021. The crude mortality and standardized mortality were 445.20/105 and 237.81/105, which appeared a tendency towards a decline (AAPC=-1.427% and -4.051%, both P<0.05), and the probability of premature death decreased from 9.99% to 7.82%, (AAPC=-4.123%, P<0.05). The standardized mortality of malignant tumors, cardio-cerebrovascular diseases and chronic respiratory diseases appeared a tendency towards a decline (AAPC=-3.017%, -4.999%, and -6.024%, all P<0.05), while there was no significant trend in the standardized mortality of diabetes (AAPC=-0.847%, P>0.05). The probability of premature death due to malignant tumors appeared a tendency towards a decline (AAPC=-4.167%, P<0.05), while there was no significant trends seen in the probability of premature death due to diabetes, cardio-cerebrovascular diseases and chronic respiratory diseases (AAPC=0.638%, -5.250% and -2.022%, all P>0.05). The average probability of premature death due to the four diseases decreased by 4.00% each year, and decreased by 6.64% in 2025 and 5.42% in 2030 as predicted, which were both lower than the target values of 7.99% and 6.99%. Conclusions The mortality and probability of premature death due to the four diseases appeared a tendency towards a decline in Xiaoshan District from 2015 to 2021, with the probability of premature death of malignant tumors decreased significantly. It is predicted that the probability of premature death of the four diseases can reach the target in 2025 and 2030.

Purpose To construct a benign and malignant prediction model of thyroid nodules based on ultrasound image features and clinical features,and to evaluate its diagnostic efficacy.Materials and Methods The data of 121 patients diagnosed with thyroid nodules admitted to the General Hospital of Northern Theater Command from September 2020 to March 2022 were retrospectively analyzed.Taken surgical pathology as the gold standard,there were 70 benign nodules and 51 malignant nodules.Logistic regression was used to analyze the ultrasound image characteristics and clinical data of thyroid nodules,and the characteristic indexes with statistical differences were obtained and a comprehensive prediction model was established.Results There were significant differences in the maximum diameter,morphology,calcification,capsule continuity,blood flow grade,elastography score and contrast-enhanced ultrasound characteristics between benign and malignant thyroid nodules(χ2=11.709,17.707,6.901,12.785,16.984,57.095,98.854,all P<0.05).There were significant differences in age,free thyroxine/free thyroxine ratio,and free thyroxine between the two groups(χ2/t=5.944,2.519,-2.468,all P<0.05).The sensitivity,specificity and accuracy of the clinical model,ultrasonic characteristic model and ultrasonic-clinical combined model were 55.7%,98.6%and 97.0%;72.5%,94.1%and 96.1%;and 61.9%,95.1%and 95.9%,respectively.The area under the curve of the three models were 0.619,0.991 and 0.994,respectively.The diagnostic efficiency of the ultrasonic characteristic model and the combined model was superior to the clinical model,and the difference was statistically significant(Z=-1.75,-2.25,P=0.039,0.012).The area under the curve of the combined model was greater than that of the multi-modal ultrasound model,however,the difference was not statistically significant(Z=-1.60,P=0.054).Conclusion Both the multimodal ultrasound model and the clinical model have certain diagnostic value in predicting benign and malignant thyroid nodules.The diagnostic efficiency of the multimodal ultrasound model is higher than that of the clinical model,and the combined prediction model of the two can improve the diagnostic value.

Objective: To understand the survival status and influencing factors of first-ever stroke patients, so as to provide evidence for improving the quality of life and prognosis of stroke patients. Methods: Demographic information, medical history, smoking history, and alcohol consumption history of newly diagnosed stroke cases first reported in 2017 in Xiaoshan District were collected through the Hangzhou Chronic Disease Surveillance and Management System. Patients were followed up for 5 years, with stroke death as the outcome event. The survival rate was calculated using the Kaplan-Meier method, and factors affecting survival time of first-ever stroke patients were identified using a multivariable Cox proportional hazard regression model. Results: A total of 3 886 patients first-ever stroke patients were included, the cases of cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, and stroke unspecified as to whether it was hemorrhagic or ischemic (unspecified) accounted for 86.93%, 11.45%, 1.06% and 0.57%, respectively. There were 2 047 males (52.68%) and 1 839 females (47.32%), with a mean onset age of (72.01±11.61) years. By the end of the follow-up on December 31, 2022, 906 patients died from stroke, with a median follow-up time of 62.00 (interquartile range, 35.00) months. The 1-year survival rate was 87.35% (95%CI: 86.30%-88.41%), the 3-year survival rate was 82.11% (95%CI: 80.88%-83.34%), and the 5-year survival rate was 76.64% (95%CI: 75.26%-78.02%), respectively. Multivariable Cox proportional hazard regression analysis showed that onset age of ≥75 years (HR=5.543, 95%CI: 3.822-8.039), being treated at township-level hospitals (HR=5.934, 95%CI: 4.027-8.743), history of hypertension (HR=1.566, 95%CI: 1.317-1.863), history of chronic ischemic heart disease (HR=1.611, 95%CI: 1.362-1.906), smoking history (HR=1.455, 95%CI: 1.190-1.778), alcohol consumption history (HR=1.323, 95%CI: 1.067-1.641), stroke subtype of intracerebral hemorrhage (HR=3.442, 95%CI: 2.923-4.053) and unspecified (HR=6.843, 95%CI: 4.353-10.756) were associated with higher mortality risk among first-ever stroke patients. Conclusion The 5-year survival rate of first-ever stroke patients was 76.64%, which was influenced by age of onset, hospital level for diagnosis and treatment, stroke subtype, medical history, smoking and alcohol consumption.

Objective:To summarize the clinical and genetic characteristics of children with Menkes disease(MD).Methods:The clinical manifestations, auxiliary examinations and genetic testing results of 15 MD children admitted to the Department of Pediatrics of the Third Affiliated Hospital of Zhengzhou University, Children′s Hospital Affiliated of Zhengzhou University and the First Affiliated Hospital of Zhengzhou University from June 2016 to October 2022 were analyzed retrospectively.These children were followed up.Results:All the 15 children were male.The age at onset was ranging from 9 days to 5.5 months.White skin, curly hair, skin laxity, hypotonia and severe developmental delay were found in all children, with epilepsy in 13 children, anemia in 11 children and granulocytopenia in 4 children.The concentration of ceruloplasmin in the serum of MD children was lower than that in healthy children of the same age.The concentration of ceruloplasmin in MD children younger than 3 months was significantly lower than that in healthy children of the same age and MD children older than 3 months.The brain magnetic resonance imaging showed abnormalities in all 15 children.Twelve children showed tortuous intracranial vessels in brain magnetic resonance angiography examinations.All the 15 children had ATP7A gene pathogenic variants, including 4 missense variants(2 cases with c. 2179G>A), 3 frameshift variants, 3 nonsense variants, 3 exon deletions and 2 splice site variants.Among these children, 1 had a novel gene variant that had not been reported so far(c.2968C>T). Conclusions:MD has early onset age and diverse clinical manifestations, but also has characteristic clinical manifestations and applicable auxiliary examinations.Its diagnosis depends on genetic testing.The c. 2179G>A and exon deletions may be hot mutations in Chinese MD patients.

Objective To systematically evaluate the efficacy and safety of Kangfuxin liquid combined with conventional treatment in postoperative patients with gastrointestinal endoscopy.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data,VIP databases were electronically searched to collect randomized controlled trials(RCTs)about Kangfuxin liquid combined with conventional treatment versus conventional treatment for postoperative complications of gastrointestinal endoscopy,from inception to December 31,2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias in the included studies.Meta-analysis was then performed by using RevMan 5.3 software and Stata 14 software.Results A total of 14 RCTs involving 1 359 patients were included.The results of Meta-analysis showed that compared with the conventional treatment group,the Kangfuxin liquid combination group could improve postoperative ulcer complete healing rate(RR=1.32,95％CI 1.07 to 1.61,P=0.009)and postoperative clinical symptomatic relief rate(RR=1.20,95％CI 1.13 to 1.27,P＜0.001),but there was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Subgroup analyses showed that the ulcer complete healing rate in the Kangfuxin liquid combination group was higher than that in the conventional treatment group at 2 weeks postoperatively(RR=1.56,95％CI 1.28 to 1.92,P＜0.001),but there was no statistically significant difference in ulcer complete healing rate between the two groups at 4 weeks postoperatively(P＞0.05);the efficacy of oral administration(RR=1.19,95％CI 1.11 to 1.27,P＜0.001)and transendoscopic topical spray administration(RR=1.23,95％CI 1.09 to 1.39,P＜0.001)of Kangfuxin liquid groups were better than those of the conventional treatment group in relieving postoperative clinical symptoms.Conclusion Combining Kangfuxin liquid treatment with conventional medication after gastrointestinal endoscopy may further improve clinical efficacy,especially in promoting the ulcer complete healing within 2 weeks after surgery and relieving postoperative clinical symptoms,but there is insufficient evidence on whether it reduces the incidence of adverse effects.Due to the limitations of the number and quality of included studies,the above conclusions are yet to be validated by more high-quality studies.

【Objective】 To analyze the current situation of direct exemption of clinical blood fess for voluntary blood donors and their family members in Henan Province, in order to improve and fully implement the policy. 【Methods】 According to the policy on blood fees exemption issued by China and Henan Province in 2019,the data of hospitals in 18 prefecture-level cities in Henan from 2020 to 2021 were continuously collected from the system of clinical blood fees exemption,including the way of exemption,the number of people (times) of exemption,exemption amount, the proportion of blood fees exemption and the total exemption rate. The experience gained in the past two years after the implementation of the policy was summarized,and the existing problems and causes were analyzed. 【Results】 The rates of direct exemption of blood fees in Henan Province in 2020 and 2021 were 34.53% (8 709/25 221) and 71.68%(23 587/32 906) (P<0.05) ,respectively. In 2021, the direct exemption rate of blood fees in 18 cities was 6.20% (83/1 370) to 88.50% (1 332/1 505) [ (47.35±41.15)%],and increased month by month from 43.19% (1 183/2 507) in January to 83.15% (2 097/2 522) in August, then remained stable at a similar level to August from September to December, with 83.43% (2 744/3 289) in December as the highest for the year. 【Conclusion】 The implementation of the policy of blood fees exemption showed significant effectiveness, which has effectively promoted the development of voluntary blood donation in Henan. However, there is still room for improving the policy in some cities, which is expected to further increase the direct exemption rate of the city and the whole province.

Objective: To investigate the trends in incidence of malignant tumors in Xiaoshan District, Hangzhou City from 2015 to 2020, so as to provide the evidence for improving the control strategy for malignant tumors. Methods: Data on incidence of malignant tumors in Xiaoshan District from 2015 to 2020 were collected through Hangzhou Municipal Chronic Disease Monitoring Management System. The crude incidence, Chinese population-standardized incidence, world population-standardized incidence, cumulative incidence for 0 to 74 years, and truncated age-standardized incidence for 35 to 64 years of malignant tumors were calculated, and the trends in incidence of malignant tumors were analyzed using average annual percent change (AAPC). Results: The crude incidence, Chinese population-standardized incidence, world population-standardized incidence, cumulative incidence for 0 to 74 years, and truncated age-standardized incidence for 35 to 64 years of malignant tumors were 476.95/105, 333.30/105, 257.01/105, 28.30% and 425.79/105 in Xiaoshan District from 2015 to 2020, which all appeared a tendency towards a rise (AAPC=4.36%, 3.82%, 3.99%, 3.79% and 5.20%, all P<0.05). The crude incidence, Chinese population-standardized incidence, world population-standardized incidence, cumulative incidence for 0 to 74 years, and truncated age-standardized incidence for 35 to 64 years of malignant tumors were 491.47/105, 313.31/105, 251.51/105, 28.78% and 338.82/105 among men, and both the crude incidence and truncated age-standardized incidence for 35 to 64 years appeared a tendency towards a rise (AAPC=3.00% and 1.73%, both P<0.05), while the crude incidence, Chinese population-standardized incidence, world population-standardized incidence, cumulative incidence for 0 to 74 years, and truncated age-standardized incidence for 35 to 64 years of malignant tumors were 462.98/105, 348.46/105, 262.13/105, 27.74% and 504.91/105 among women, which all appeared a tendency towards a rise (AAPC=5.77%, 5.72%, 5.79%, 5.65% and 7.48%, all P<0.05). The incidence of malignant tumors appeared a tendency towards a rise with age, and the crude incidence of malignant tumors showed a tendency towards a rise among people at ages of 15 to 44 years and 45 to 64 years (AAPC=9.85% and 4.88%, both P<0.05). Lung cancer, thyroid cancer, colorectal cancer, breast cancer and gastric cancer were the five most common cancers, accounting for 59.63% of all malignant tumors, and the incidence of lung cancer, thyroid cancer, colorectal cancer and breast cancer all showed a tendency towards a rise (AAPC=5.90%, 13.01%, 4.60% and 4.47%, all P<0.05). Conclusions The incidence of malignant tumors showed a tendency towards a rise in Xiaoshan District from 2015 to 2020. The rise in the incidence of malignant tumor was higher in females than in males, and malignant tumors tended to develop at a young age. Lung cancer, thyroid cancer, colorectal cancer, breast cancer and gastric cancer are major malignancies that threaten human health in Xiaoshan District.