Objective To understand the characteristics and the predictors of the distribution of exercise behavior stages in COPD patients after discharge from the hospital,and to provide a reference basis for the implementation of the whole process and continuous rehabilitation care decision-making.Methods Using the convenience sampling method,380 COPD patients who were hospitalized in the departments of respiratory medicine or geriatrics in 2 tertiary-level hospitals in Chongqing from February 2022 to February 2023 were selected for the study,and were followed up until 6 months after the patients were discharged from the hospital.Questionnaires were administered using the self-designed General and Disease-Related Information Questionnaire,Exercise Stages of Change Scale,Exercise Benefits and Barriers Scale,Exercise Self-Regulatory Efficacy Scale,Social Support Rate Scale and Hospital Anxiety and Depression Scale.Characteristics and predictors of exercise behavior in COPD patients after hospital discharge were analyzed using univariate analysis and ordered multicategorical logistic regression.Results The included 380 COPD patients of post-discharge exercise behavior were 53 cases(14.0％)in the pre-intentional stage,97 cases(25.5％)in the intentional stage,103 cases(27.1％)in the preparatory stage,75 cases(19.7％)in the action stage,and 52 cases(13.7％)in the maintenance stage.The age,monthly household income,daily chores,sleep,exercise habits,and history of the current inpatient rehabilitation,number of acute episodes in the last year,whether home oxygen therapy and regular use of medication for respiratory diseases,degree of dyspnea,perceived exercise benefit/impairment,social support,and depression were the main predictors of the distribution of the stages of exercise behavior in COPD patients after discharge from the hospital.Conclusion Most COPD patients did not develop regular exercise behavior habits after discharge,and the level of their exercise behavior was affected by a variety of factors,including individual characteristics,disease factors,decision-making balance,social support,and psychology,suggesting that healthcare professionals should develop personalized early exercise interventions according to the characteristics of the behavioral stage in which the patient is located in order to increase the long-term effects of the intervention.

Objective To explore the association between malaria epidemic situation and some natural and social factors in high?incidence areas of Shandong Province,so as to provide evidences for malaria elimination in these areas. Methods Twenty towns of 10 counties(cities,districts,)in the high incidence areas of malaria in Shandong Province were selected as the study sites,and the residents in the study sites were investigated by questionnaires with one household as a unit,so as to understand the related natural and social factors. In addition,the malaria epidemic data in the study sites from 2006 to 2010 were collected, and the correlation between these factors and the epidemic situation of malaria was analyzed by Spearman rank correlation and multiple stepwise regression. Results The square root of malaria incidence rate(Y)was negatively related to the rate of house?holds using insecticide(X3),and the rate of households using screen doors and windows(X4)(both P<0.05),but was positive?ly related to the rate of housing surrounding water environment and exposure ratio(X6)(both P<0.05). The regression equa?tion established was Y=0.032X5+0.048X6-0.495,R2=0.973. Conclusions Malaria incidence is obviously associated with some natural and social factors. The measures such as clearing the breeding place of mosquito,protecting the exposure popula?tion at nightfall,as well as using door?window screen and repellents correctly,can effectively control malaria.

This paper reports one case of atypical falciparum malaria imported from Africa,whose blood smear contains many large trophozoites,with punctiform or massive brown pigment granules,the body shape of the plasmodium is similar to that of Plas-modium vivax and Plasmodium ovale. After the gene detection by PCR,the case was diagnosed as falciparum malaria. As large tro-phozoites were rarely seen in the peripheral blood of non-severe falciparum malaria cases,much attention should be paid to the identification of Plasmodium falciparum and other plasmodia in microscopic examinations.

Objective To understand the status of intestinal parasitic infections and the related knowledge and behavior in residents of Jiaodong area of Shandong Province,so as to provide the evidence for making an appropriate preventive and control strategy. Methods A total of 18 villages from 6 counties in Jiaodong area were selected as investigation sites according to the stratified sampling method. The feces samples of the permanent residents aged above 3 years were collected and examined by Kato-Katz technique to find the intestinal parasite eggs,and the children under 12 years old were examined by the method of cellophane anal swab to detect the Enterobius vermicularis eggs. In addition,50 households in each survey sites were randomly selected to in-vestigate the basic family situation and the condition of awareness on prevention knowledge and formation of correct behavior of res-idents by using a structured questionnaire. Results Totally 6 163 residents involved in the feces examinations,and the total in-fection rate of intestinal parasites was 6.91%. The infection rates of Trichuris trichiura,Ascaris lumbricoides and hookworm were 6.56%,0.62%and 0.21%,respectively. The infection rate of E. vermicularis in children under 12 years old was 0.51%. The eggs of Clonorchis sinensis and Taenia solium were not found in this survey. The awareness rate of knowledge about preventing parasitic diseases was 49.54%. The formation rates of washing hands before eating,washing hands after using the toilet,never eating raw fruit and vegetable without washing clean,never working in the field with bare feet,and never drinking unboiled water were 97.78%,91.95%,88.81%,92.42%and 86.48%respectively. Conclusions The infection rate of intestinal parasites is low in Ji-aodong area,but there is a significant difference among different counties. The awareness rate of knowledge about preventing para-sitic diseases is low,but the formation rate of healthy behavior is high. In the future,the health education and the strategy of tak- ing medicine among the key population should be enhanced,and the project of reconstructing safe water supply and lavatory should be advanced.

Objective To understand the malaria situation of Shandong Province in 2013,so as to provide the evidence for formulating targeted prevention and control strategy and measures. Methods The data of malaria cases of Shandong Province in 2013 were collected from the Information Management System for Infectious Diseases Report and Information Management Sys-tem for Parasitic Diseases Control and Prevention. The data of epidemiological characteristics of malaria situation and the diagno-sis and treatment of malaria cases were analyzed by Microsoft Excell2007. Results There were 131 malaria cases reported in 2013,all of them were imported cases,and 127 cases(96.95%)were imported from African countries. A total of 116 cases (88.55%)were falciparum malaria cases. Totally 97.71%of the cases were male and the average age of malaria cases was 39 years. A total of 61.83%of the cases were peasants and 65.65%of the cases only received junior high school education. The dis-tribution of malaria cases was concentrated in Tai’an City(32 cases),Yantai City(19 cases)and Weihai City(17 cases),total-ly acounting for 53.13%. There was no significant seasonal variation in the reporting time of the cases. The median time from on-set to seeing doctor was four days and the median time from seeing doctor to being diagnosed was one day. Totally 35.88%of the cases were misdiagnosed when the first visit to a doctor. All of the cases were laboratory confirmed and 100%of them received the standard treatment after diagnosis. Conclusions All of the malaria cases were imported cases in Shandong Province in 2013. To control the imported malaria in Shandong Province,it is necessary to further strengthen the multi-sectoral cooperation, health education,malaria screening and professional training.

Objective To understand the infection status of intestinal parasites and related knowledge and behavior factors of the residents in north-west Shandong Province,so as to provide the evidence for taking targeted preventive measures. Meth-ods Eighteen villages were randomly selected as survey spots by the stratified multi-stage sample method. The Kato-Katz tech-nique was used to detect intestinal parasite eggs among the residents and the cellophane tape anus test was used to detect Entero-bius vermicularis eggs among 3-12 years old children. Questionnaires were applied to investigate related knowledge and behavior factors about the intestinal parasite infections in the residents. Results Totally 6 366 residents were detected for intestinal para-sites and the infection rate was 0.28%(18 cases). Totally 895 children were detected for E. vermicularis and the infection rate was 5.70%(51 cases). Totally 2 915 residents were investigated by questionnaires and the awareness rate of knowledge about preventing parasitic diseases was 26.72%. The formation rates of washing hands before meal and after WC,washing fruit and vegetable before eating,never drinking unboiled water were 55.42%,42.87%,43.54%and 83.04%respectively. The aware-ness rate of knowledge about preventing parasitic diseases of 3-12 years old children was 12.24%;and the formation rates of washing hands before meal and after WC were 47.04%and 30.44%respectively. Conclusions The total infection rate of intesti-nal parasites is low but the E. vermicularis infection rate is high among children in north-west Shandong Province. The awareness rate of knowledge about preventing parasitic diseases and the formation rates of healthy behaviors are all low. Therefore ,the tar-geted health education should be taken to increase the awareness rate and guide the residents to develop their healthy behaviors.

Objective To understand the awareness status of malaria control knowledge of primary and secondary school stu-dents in malaria endemic areas of Shandong Province,so as to provide the baseline information for formulating the malaria control strategy. Methods A cross-sectional survey was conducted in 5 TypeⅡmalaria-endemic counties in Shandong Province. A struc-tured questionnaire survey was administrated to students in primary and secondary schools. Results A total of 1 884 students were completed with the questionnaires and all were effective. The total awareness rate of malaria control knowledge was 65.9%, and 54.7% of the students knew the transmission route of malaria and only 31.5% of the students were aware of the preventive methods of malaria. There were significant differences of the awareness scores of malaria control knowledge among different malar-ia endemic areas but there were no significant differences between the awareness rates of male and female students and between two different education levels. Conclusions The awareness of malaria control knowledge of primary and secondary school stu-dents in Shandong Province is poor;therefore,the health education of malaria control knowledge for primary and secondary school students should be strengthened.

Objective To explore the shape change characteristics of Oncomelania hupensis snail shell after the snails being passively migrated into Shandong intake area of the South-to-North Water Diversion Project. Methods The snails raised on the Dushan island in Weishan Lake region were captured,and 115 the first filial generation snails and 107 the second filial generation ones were selected. The length and width of shells and apertures,and the labial ridge thickness of those snails were measured,the longitudinal rib number of snail spiral was counted,and 107 parental snails were chosen as controls. Results The labial ridge thickness of the filial generation snail was significantly reduced with the increase of algebras,and the labial ridge thickness among the 3 generations had a significant difference(P<0.01). Both the length of snail shell and the width of snail apertures were de-creased,while the width of snail shell,the length of snail apertures,the multiplication product of snail aperture’s length and width and the longitudinal rib number of snail spiral were all increased. Conclusion The body size of Oncomelania snails in Weishan Lake region becomes smaller,and their shells become thinner,which indicates that the environment of the lake region is not suitable for snail breeding,and the snails have natural decay tendency with the extension of time.

Objective To understand the capacity of Plasmodium detection and helminth detection and the mastery degree of basic knowledge of parasitic diseases. Methods Three professionals from each city were selected as contestants. The content of the competition contained three parts. The first part included making blood slides and Giemsa staining of Plasmodium,and identifi-cation of species and number with microscopy,the second part included making stool slides with Kato-Katz technique and identifi-cation of common helminth eggs with microscopy,and the third part was basic knowledge of parasitic diseases. Results Totally 51 contestants took part in the competition. The average score of the test of making blood slides was 14.8±3.3,and the passing rate was 82.4%. The average score of the identification of species and number of Plasmodium with microscopy was 19.2 ± 9.3,and the passing rate was 29.4%. The average score of the test of making stool slides was 9.3±0.7,and the passing rate was 100%. The aver-age score of the identification of common helminth eggs with microscopy was 28.0±2.6,and the passing rate was 100%. The aver-age score of basic knowledge of parasitic diseases was 76.3±11.9,and the passing rate was 88.2%. The average score of the test of making blood slides in the female was higher than that in the male(15.7vs.13.5,P<0.05),and the average score of the test of making blood slides in the intermediate title contestants was higher than that in the junior title contestants(16.1vs.14.1,P <0.05). The average score of the basic knowledge of parasitic diseases in the contestants from cities was higher than that in the con-testants from towns(83.2vs.72.6,P<0.05),and the average score of basic knowledge of parasitic diseases in the contestants from high economic level cities was higher than that in the contestants from low economic level cities(82.4vs.71.5,P<0.01). Conclu-sions For professionals in Shandong Province,the capacity of helminth detection was strong and the basic knowledge of parasitic diseases was mastered well,while the capacity of Plasmodium detection was weak.

Objective To study the effect of Botulinum toxin type A (BTX-A) on lower limbs spasticity after stroke. Methods 109 convalescent patients after stroke were randomly divided into treatment group and the control group. All the patients accepted routine treatment and rehabilitation, the treatment group accepted BTX-A injected in spastic muscles in addition. They were assessed with Fugl-Meyer assessment (FMA), modified Ashworth scale (MAS), Berg Balance Scale (BBS) before, 4 weeks and 12 weeks after treatment. Results The scores of MAS, BBS and FMA improved more in the treatment group than in the control group (P<0.05) after treatment. Conclusion Combination of local BTX-A injection can significantly release the lower limbs spasticity, and improve the motor and balance ability for patients after stroke.