OBJECTIVES: Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies. METHODS: We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan version 9.5 to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort. RESULTS: The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system. CONCLUSIONS The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.

OBJECTIVES: Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies. METHODS: We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan version 9.5 to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort. RESULTS: The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system. CONCLUSIONS The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.

OBJECTIVES: Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies. METHODS: We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan version 9.5 to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort. RESULTS: The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system. CONCLUSIONS The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.

OBJECTIVES: Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies. METHODS: We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan version 9.5 to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort. RESULTS: The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system. CONCLUSIONS The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.

Objective:To investigate the safety, economic effect, and short-term clinical efficacy of ambulatory total hip arthroplasty (THA) in the treatment of hip osteopathy within.Methods:This study retrospectively reviewed patients who underwent 48-hour outpatient THA and conventional primary THA from July 2020 to July 2021. Gender, age, body mass index (BMI), clinical diagnosis, place of resident, length of hospital stay, duration of the surgery, hemoglobin, albumin, C-reactive protein (CRP) and D-dimer before and 1 day after surgery, the visual analogue scale (VAS) was obtained postoperative day 2, hip joint modified Harris score before and 1 month after surgery, readmission and reoperation within 1 month after operation as the data of evaluations were extracted and compared in this study.Results:A totally of 150 cases were involved in this study, which including 75 cases with 48-hour outpatient primary THA and 75 cases with conventional primary THA. There was no significant difference between the two groups in terms of age, sex, BMI, education level, preoperative diagnosis, and preoperative Harris score ( P>0.05), but a significant difference was found in term of residence (χ 2=6.29, P=0.043), that the patients in the outpatient group were all from Zhejiang Province and 48% (36/75) of them were from Hangzhou City. While, in the conventional group, 6 patients were from other provinces. The length of stay was 2.13±0.52 days and operation time was 59.73±18.91 minutes in the outpatient group, which were both shorter than those (6.71±1.44 days and 66.91±22.40 min) in the conventional group ( t=25.91, P<0.001 for the length of hospital stay; t=2.12, P=0.036 for operation time). Compared with the conventional group, outpatient group saved the average hospital cost (4.60±0.44 vs. 5.20±0.72 ten thousand yuan, t=6.16, P<0.001). The VAS on the second day after surgery 3.45±0.75 was higher in the outpatient group than in the conventional group (3.45±0.75 vs. 3.16±0.94 points, t=2.09, P=0.039). The modified Harris score was without statistical significance ( t=0.42, P=0.677) 1 month after surgery in both groups. 75 patients in the outpatient group, 7 patients delayed discharge (were not discharge within 48 hours), and the rate of delayed discharge was 9.3%. Reasons for delayed discharge included poor pain control in two cases, one case had postoperative nausea and vomiting, one case had failed to meet rehabilitation standards, hypotension in one case, the intraoperative infection in one case and postoperative fever within 48 hours in one case. Conclusion:Outpatient THA can reduce the length of hospital stay, operative time and total cost of hospitalization. It has similar safety and early clinical efficacy as conventional THA. However, a small proportion of patients would delay discharge.

Objective:To evaluate the detection accuracy of hepatitis B virus (HBV) serological markers among grassroots medical institutions in the demonstration areas of infectious diseases.Methods:A fixed sampling method was used among the followed-up hepatitis B cohort in general population of six infectious disease demonstration areas nationwide. Blood samples of chosen objects were collected, in which HBsAg and anti-HBs were tested by grassroots medical institutions and were also parallely tested by the third-party platform. The test results were compared between the two groups. Statistical analyses were conducted by SAS 9.4 software.Results:A total of 5 756 and 5 263 samples of HBsAg and anti-HBs were successfully tested, respectively. Comparing the results of HBsAg and anti-HBs from grassroots medical institutions with the results from the third platform, the agreement of HBsAg and anti-HBs was 97.13% and 77.33%, respectively. The Kappa value was 0.56 (95% CI 0.50-0.62) for HBsAg and 0.54 (95% CI 0.52-0.56) for anti-HBs, respectively; and the McNemar tests indicated the difference between the results (all P<0.01). There were also significant differences in agreement of testing results with the third platformin among different regions ( P<0.05 or <0.01). The Kappa values indicated that Jiangsu province and Guangdong province had high accordance rates of HBsAg (0.87 and 0.81, respectively), and Gansu province and Guangdong province had high accordance rates of anti-HBs (Both were 0.74). Regarding the results from the third platform as the standard, the sensitivity of HBsAg testing in grassroots medical institutions was moderate (40.51%) and the specificity was well (99.96%). The sensitivity of anti-HBs testing was substantial (73.18%) and the specificity was well (84.31%). Guangdong province (Youden index: 0.69) and Jiangsu province (Youden index: 0.80) had high identification ability for HBsAg, and for indicator of anti-HBs, Gansu province (Youden index: 0.78) and Guangdong province (Youden index: 0.76) had high identification ability. Conclusion:There are certain differences in results of HBV serological markers tests between the grassroots medical institutions in the demonstration areas of infectious diseases and the third platform. Current testing strategies in grassroots medical institutions are suitable for identifying people without hepatitis B infection, while it is necessary to pay attention to the situation of potential false negative error.

Although the flu vaccine is the most effective strategy for preventing influenza currently,the population incidence and mortality of influenza present an unstable trend.Due to the rapid variability of influenza virus,the conventional flu vaccine components and dominant lineage are not matching;more importantly,trivalent influenza vaccine (T IV) contains only A/H3N2,A/H1N1 and B/Victoria lineage,which does not match the B/Yamagata lineage that have prevailed in recent years.Quadrivalent influenza vaccine (QIV) adds the B/Yamagata lineage,and it has been used abroad for susceptible populations.Compared with TIV,QIV provides better protection for susceptible populations and is considered to have better public health benefits.This article reviews the history of development and current status,the safety,immunogenicity,efficacy of prevention and control and cost-effectiveness of QIV,to provide reference for the promotion and implementation of influenza vaccination.

s] Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District,Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human,cattle,sheep and Oncome-lania hupensis snails,and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44％ in 2006 to 0.59％ in 2012(F = 14.501,P =0.013). After removal of all the cattle and sheep in 2013,the prevalence of schistosome infection in the residents decreased to zero in 2016(F=14.148,P=0.033). The density of living snails decreased from 0.8833/0.1 m2 in 2006 to 0.3088/0.1 m2 in 2012(F=76.250,P=0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.

Objective To investigate the functional activity and connectivity of the insular cortex at rest in persons with low back pain (LBP).Methods Twelve healthy subjects (male 6,female 6 ; age 24.8 ± 3.3 years) were given fMRI 3.0T scans at rest.Back muscle pain was then induced with an intramuscular injection of 3％ hypertonic saline solution and a second scan was performed.The pain-free and in-pain fMRI data were compared using paired t-tests to highlight any changes in the functional connectivity of the anterior and posterior insular cortex on both sides.Pain severity was quantified using a visual analogue scale (VAS).Results Ratings of LBP severity peaked at 6.02 ± 1.96 on the VAS.The functional connectivity of the inferior insular cortex with the frontal cortex,the thalamus and the parahippocampal gyrus was enhanced when the subjects were in pain,but connectivity with the posterior cingulate cortex,the precuneus,the temporal cortex,the paracentral lobule and the cerebellar tonsil was reduced.The inferior parietal lobule exhibited significantly enhanced connectivity with the anterior insular cortex,but reduced connectivity with the posterior insular cortex.In addition,the medial cingulate cortex displayed decreased functional connectivity with the anterior insular cortex,but increased functional connectivity with the posterior insular cortex when the subjects were in pain.Conclusion This study has revealed impeded functional connectivity of the insular cortex when experiencing LBP at rest.This may possibly be related to pain's disruption of cognition and emotion.

Objective To investigate technique and clinical effect of total en bloc spondylectomy for thoracic and lumbar chondrosarcoma.Methods From January 2010 to March 2012,6 patients with thoracic or lumbar chondrosarcoma underwent total en bloc spondylectomy.There were 4 males and 2 females,aged from 25 to 54 years (average,38 years).The tumor ranged from T3 to L3; 1 located in T3 and T4,1 in T7,1in T11,1 in L1,1 in L2 and 1 in L3.According to Tomita surgical classification system,there was 1 case of type 2,1 case of type 4,3 cases of type 5 and 1 case of type 6.One patient underwent tumor resection through single posterior approach,while the other 5 patients underwent anterior dissection and posterior resection of tumor.All spines were reconstructed by posterior fixation with pedicle screws and anterior interbody fusion with titanium mesh cages or artificial vertebrae.Results The average amount of blood loss was 3200 ml (range,2100 to 6300 ml).The duration of operation ranged from 3.5 to 12 hours (average,5.5hours).Two patients obtained wide resection,3 obtained marginal resection,and 1 had intralesional margin.The complications included 2 cases of cerebrospinal leak,1 case of pleural effusion and 1 case of pulmonary infection.There was no wound infection and death during peroperative period.All patients were followed up for 6 to 32 months (average,19 months).The neurological function improved from preoperative Frankel C to postoperative Frankel E in 2 cases.All patients obtained bone union 6 to 12 months (average,8 months) after operation.At final follow-up,all patients could walk without aid,and there was no recurrence.Conclusion The total en bloc spondylectomy is an effective method for thoracolumbar chondrosarcoma,which could provide a satisfied tumor control and neurological function improvement.