Objective To analyze the epidemiological characteristics of varicella epidemic in kindergartens and schools in Jinshan District of Shanghai from 2015 to 2022，and to understand the varicella antibody level in students aged under 30 years old，to provide evidence for developing control and prevention strategies． Methods Data of varicella epidemic situation at schools and kindergartens and varicella cases were analyzed by descriptive methods．Collect serum from healthy individuals under 30 years old to detect IgG antibody levels of varicella zoster virus.Results From 2015 to 2022, a total of 91 cases of chickenpox were reported in kindergartens and schools in Jinshan District, Shanghai, involving 412 cases.The peak incidence occurs from October to December，kindergarten childcare and primary school children were at high risk of varicella .The incidence of fever(χ²=12.93，P＜0.001) and moderate to severe rash(χ²=28.79，P＜0.001) in patients with varicella vaccination was lower than that in patients without varicella vaccination. A total of 227 people were surveyed，the positive rate of varicella antibody was 62. 56%，the geometric mean titer ( GMT) was 2.22±0.68（165.96mIU/ml）．The difference of GMT(F=6.87，P＜0.001) and positive rate (χ²=29.14，P＜0.001)of antibody in different age groups was statistically significant，the positive rate was lowest in the age group of 1-3 years, and gradually increased with the increase of age. Conclusion Autumn and winter in Jinshan District are the seasons with high incidence of chickenpox in kindergartens and primary schools，two doses of chickenpox inoculation can not only reduce clinical symptoms, but also block the transmission of chickenpox epidemic，it is suggested schools and health facilities make chicken pox monitoring work, get the chickenpox vaccine on time.

Objective To observe value of thin slice CT multiple signs combined with multiplanar reformation(MPR)for diagnosing tracheobronchial tuberculosis(TBTB).Methods Data of 234 TBTB patients who underwent chest thin slice CT scanning were retrospectively analyzed.MPR was performed,the direct signs and indirect signs of TBTB were observed.The diagnostic efficacy of axial plain CT images(direct observation)and of MPR combined with the former(combined observation)were compared.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of direct observation was 38.88％(201/517),98.13％(1 789/1 823),85.53％(201/235),84.99％(1 789/2 105)and 85.04％(1 990/2 340),respectively,of combined observation was 91.10％(471/517),98.85％(1 802/1 823),95.54％(471/493),97.51％(1 802/1 848)and 97.14％(2 273/2 340),respectively.Significant differences of sensitivity,positive predictive value,negative predictive value and accuracy were found(all P＜0.001),whereas no significant difference of specificity was found between 2 methods(P＞0.05).Conclusion Thin slice CT multiple signs combined with MPR could be used to effectively diagnose TBTB.

Objective:To understand the status and related factors of emotional inhibition among women re-ceiving in vitro fertilization-embryo transfer(IVF-ET).Methods:A total of 791 women receiving IVF-ET from a specialized hospital in Changsha were selected,and surveyed with the General Questionnaire,Emotional Inhibition Scale(EIS),Locke-Wollance Marital Adjustment Questionnaire,Self-Compassion Scale and Medical Coping Mode Questionnaire.Results:The average score of EIS in women receiving IVF-ET was(28.0±6.4).Multiple linear re-gression analysis showed that the EIS scores in women receiving IVF-ET were negatively associated with infertility factors(β=-9.23,-4.56,-2.86),personality type(β=-1.11),and marital adjustment,confrontation and self-compassion scores(β=-0.03,-0.13,-0.05),and positively associated with residence and surrender di-mension scores(β=0.82,0.20).Conclusion:It suggests that women receiving IVF-ET have a certain degree of e-motional inhibition,which is related to infertility factors,residence,personality type,self-compassion,marital adjust-ment,confrontation,and surrender.

Objective To determine the epidemiological characteristics of measles in Jinshan District of Shanghai in 2002‒2019. Methods This study was a secondary data analysis using measles surveillance system and epidemiological case reports in Jinshan District from January 2002 through December 2019. Temporal characteristics of the disease onset was determined by a concentration method. ArcGis 10.4 and SaTScan 9.6 software were used for spatiotemporal clustering scanning analysis. Results From 2002 through 2019， a total of 289 cases of measles were reported in Jinshan District， Shanghai， with an average annual incidence of 2.24 per 10⁵. The annual incidence fluctuated from 0 to 11.27 per 10⁵. The highest incidence was recorded in 2005 （11.27 per 10⁵）， followed by a decline； however， there was a rebound in 2008 （5.26 per 10⁵） and 2015 （3.30 per 10⁵）. The concentration M was determined to be 0.62， showing a clear seasonality concentrated in February to May. The spatiotemporal scan found that spatial and temporal clusters were more likely to occur in the areas with higher population density such as Zhujing Town and Shihua Community and between 2002 and 2009. The majority of measles cases were infants and children under the age of 1 and adults aged 20‒39 years. Approximately 66.78% of measles cases reported unknown vaccination history. In addition， in children aged 8 month to 4 years， the vaccination rate of measles-containing vaccines in the domestic migrants was much lower than the local residents （χ²=4.44， P=0.035）. Conclusion The incidence of measles in Jinshan District presents a downward trend. The population affected has a "two-way displacement"， which is concentrated in the more populated areas. It is necessary to strengthen measles surveillance and implement supplementary immunization programs with measles-containing vaccines for at-risk populations.

ObjectiveTo determine the level of anti-measles antibody and its fluctuation trend in children under 8 months old， which may provide evidence for enhancing the measles immunization strategy. MethodsA cross-sectional study was conducted to collect the serum of the children aged 1‒8 months in a children’s medical center in Shanghai. Serum concentration of anti-measles IgG antibody was determined by enzyme-linked immunosorbent assay （ELISA）， and dynamics of IgG antibody level was compared. ResultsA total of 837 children aged 1‒8 months were tested for anti-measles antibody， and there was no statistical difference in the antibody level between boys and girls （P>0.05）. In the age of 1 month children， the average geometric antibody concentration （GMC） was 529.66 IU‧L^-1， and the antibody positive rate and protection rate were 86.07% and 29.51% respectively. After the age of 3 months， the antibody level dropped sharply in the age of 8 months children， the GMC decreased to 44.46 IU‧L^-1. The positive rate was 12.00%， and the protection rate was 1.00%. The mathematical model of GMC reduction trend in children aged 1‒8 months was Ŷ=-0.144 8X+2.640（R²=0.911 3， P<0.001）. ConclusionThe low level of mother-transmitted protective antibody and its downward trend with age are the important factors leading to the incidence of measles in children aged1‒8 months. It is suggested that intensive immunization should be carried out for women of childbearing age to improve the level of mother-transmitted antibodies in her baby.

Background::Sepsis, a serious condition with high mortality, usually causes sepsis associated encephalopathy (SAE) that involves neuronal cell death. However, the cell death programs involved and their underlying mechanisms are not clear. This study aimed to explore the regulatory mechanisms of different cell death programs in SAE.Methods::A neonatal rat model of SAE was established by cecal ligation and perforation. Survival rate and vital signs (mean arterial pressure and heart rate) were monitored, nerve reflexes were evaluated, and cortical pathological changes were observed by hematoxylin and eosin staining. The expression of pyroptosis, apoptosis, and necroptosis (PANoptosis)-related proteins, mitogen-activated protein kinase (MAPK), and its upstream regulator toll-like receptor 9 (TLR9) were detected. The expression of TLR9 in neurons was observed by immunofluorescence staining. The ultrastructure of neurons was observed by transmission electron microscope.Results::First, PANoptosis was found in cortical nerve cells of the SAE rats. Meanwhile, the subunits of MAPKs, p38 MAPK, Jun N-terminal kinase, and extracellular signal-regulated kinase (ERK) were activated. After pharmacologically inhibiting each of the subunits, only p38 MAPK was found to be associated with PANoptosis. Furthermore, blocking the p38 MAPK signaling pathway activated necroptosis but inhibited apoptosis and pyroptosis. When necroptosis was pharmacologically inhibited, apoptosis and pyroptosis were reactivated. Finally, we found that the expression of TLR9, a regulator of MAPKs, was significantly increased in this model. After down-regulation of TLR9, p38 MAPK, and ERK signaling pathways were inhibited, which led to the inhibition of PANoptosis. Further analysis found that down-regulation of TLR9 improved the survival rate and reduced the pathological changes in SAE rats.Conclusions::Our study showed that the programs comprising PANoptosis are activated simultaneously in SAE rats. TLR9 activated PANoptosis through the p38 MAPK signaling pathway. TLR9 may work as a potential target for SAE treatment.

Objective To investigate measles antibody levels in healthy people in Jinshan District and their willingness to inoculate measles containing vaccines, and to explore the feasibility of supplementary immunization with adult measles vaccine. Methods People from 4 randomly selected community health service centers were enrolled and divided into groups of 15-19, 20-29, 30-39, and 40 years old and above. Serum was collected for measles antibody level detection and analysis according to the city and foreign household registration. In addition, a questionnaire survey on measles knowledge and vaccination willingness was conducted. Results Of the 234 participants for serum testing, the overall positive rate of measles antibodies (IgG) was 85.47%, and the protection rate was 35.47%. The difference in the positive rate of antibodies in different age groups was statistically significant (χ²=9.78, P=0.02), and the difference in the protection rate was also statistically significant (χ²=14.97, P<0.0012). The positive rate and protection rate were lowest in the group of 20-29 years old, which were 74.19% and 24.19%, respectively. A total of 490 questionnaires were sent out, and 477 questionnaires were effectively returned. Among the 5 questions about measles knowledge, the lowest correct rate was for the transmission route of measles, which was only 48.64%. The willingness to measles vaccination was 85.12%. Multivariate analysis showed that the willingness to vaccination was related to the level of awareness and health education. Conclusion The level of protective antibodies against measles was low in adults in Jinshan District. Health education on measles was insufficient. It is necessary to conduct measles health publicity in institutions with more concentrated personnel. In addition, appropriate measles serological monitoring and supplementary immunization should be carried out for key populations to increase the level of measles antibodies.

To explore the correlation of quality of life with self-care efficacy and social support in patients with nasopharyngeal carcinoma after radiotherapy.
 Methods: A total of 179 patients with nasopharyngeal carcinoma at 3 months after radiotherapy were surveyed using self-designed general information questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30 V3.0), Chinese-version of Strategies Used by People to Promote Health (C-SUPPH), and Perceived Social Support Scale (PSSS).
 Results: The score of cognitive function was the highest, while the score of social function was the lowest. The score of related symptoms was 22.21±10.24, the overall score for quality of life was 52.46±17.96, the score of self-care efficacy was 62.14±14.50, and the score of social support was 56.03±7.63. Self-care efficacy of patients with nasopharyngeal cancer after radiotherapy was positively correlated with 5 functional areas of quality of life and overall quality of life, and negatively correlated with relevant symptoms (P<0.01). Social support was positively correlated with physical function, social function and overall quality of life (P<0.01), and negatively correlated with relevant symptoms (P<0.05). Multiple regression analysis showed that self-care efficacy could predict 5 functional areas of life quality, relevant symptoms, overall quality of life and social support predicted social function in quality of life.
 Conclusion: Self-care efficacy and social support for patients with nasopharyngeal cancer after radiotherapy can affect their quality of life. Nursing staff should pay attention to improving the self-care efficacy of patients, guide them to actively seek or obtain social support, and in turn to improve their quality of life.
Humans ; Nasopharyngeal Carcinoma ; radiotherapy ; Nasopharyngeal Neoplasms ; radiotherapy ; Quality of Life ; Self Care ; Social Support

Objective: To investigate the current situation of emotional and behavioral problems and analyze the influencing factors of middle school students. Methods: The general information questionnaire, the strengths and difficulties questionnaire (student version), and the illinois bullying scale were used to evaluate 680 students in two middle schools in Hunan province.Statistical analysis was performed using t test, analysis of variance, Pearson correlation analysis and stepwise multiple regression analysis. Results: (1) The detection rate of total difficulty (12.09±5.67), conduct problem (2.42±1.66), hyperactivity/attention defect (3.65±2.08), emotional (2.82±2.32), peer relationship problem (3.21±1.79) and pre-socialization behavior (7.02±2.39) were 11.2%, 11.2%, 7.7%, 6.9%, 11.0% and 14.5%.(2)The scores of total difficulties, conduct problem, hyperactivity/attention deficit and peer relationship problems of boys were higher than that of girls(t=2.79, 4.03, 2.44, 3.40, all P<0.05), while the score of pre-socialization behavior of boys was lower than that of girls (t=-5.29, P<0.05). (3) The scores of total difficulties, conduct and peer relations, pre-socialization of rural students were significantly different with those of urban students(t=-3.93, -2.55, -7.00, 5.26, all P<0.05). (4) The score of total difficulties, conduct problem, hyperactivity/attention deficit and emotional symptoms of left-behind students were higher than that of un-left-behind students (t=-3.18, -2.50, -2.67, -2.40, 2.19, all P<0.05). (5) Middle school students with different fathers' education levels showed different scores of total difficulties, peer relationship problem and pre-socialized behavior(F=3.84, 7.10, 6.20, all P<0.05), while middle school students with different mothers' education levels showed different scores of total difficulties and peer relationship problem(F=3.97, 7.38, both P<0.05). (6) The scores of total difficulties, emotional symptoms, conduct problems, and hyperactivity/attention deficit of the middle school students were significantly positively correlated with the total score of the bullying total scale, the bullish subscale, the bullying subscale, and the fighting subscale(r=0.165-0.430, P<0.05). (7) Gender, urban and rural areas, left-behind or not, maternal education level, bullying, being bullied, fighting were the influencing factors of middle school students' emotion and behavior problems(β=0.010-0.533, P<0.05). Conclusion Some middle school students in Hunan province have emotional and behavioral problems and more attention should bo paid to mental health education.

Objective To investigate the immunization coverage of oral live attenuated rotavirus vaccines and its influencing factors among children under 5 years old in Jinshan District of Shanghai in order to provide references for optimizing vaccination management in this area. Methods A cross-sectional study was conducted in 6 community vaccination clinics randomly selected from 12 vaccination clinics in Jinshan District. In each selected clinic,145 children under 5 years old were continuously recruited. Information on immunization status,demographics of children,family socioeconomic status and parents′knowledge of vacci-nation were collected through questionnaire interview. Logistic regression was used to analyze factors influen-cing immunization status by using SPSS22.0. Results Among the 863 participating children, the immuni-zation coverage rate of oral live attenuated rotavirus vaccines was 61.07%. Multivariate analysis revealed that children having an urban registration status (OR=2.21),better family income (OR=1.47) and par-ents with high recognition of rotavirus diarrhea (OR=8.56) and stronger intention to following "doctor′s suggestions" (OR=1.96) were more likely to accept oral live attenuated rotavirus vaccines, while those from families with a medical professional were less likely to be vaccinated (OR=0.57). Conclusion The immunization coverage rate of oral live attenuated rotavirus vaccines among children in Jinshan District were influenced by various factors such as children′s household registration status, household income, parents′knowledge regarding vaccination and doctors′suggestions. Health education on immunization should be strengthened and tailor-made to improve the coverage of oral rotavirus vaccination.