Objective To understand the management status of emergency and life support medical equipment in town-ship health centers in Huazhou City,providing a reference for improving emergency service levels in grassroots medical institu-tions.Methods A convenience sampling method was used to conduct a questionnaire survey of physicians,nurses,medical technicians,public health personnel,and administrative and logistical staff in 24 township health centers in Huazhou City.The survey focused on seven aspects:procurement and configuration,upgrades,operational use,maintenance,emergency handling,management systems,and quality assessment and monitoring.Results Training on emergency and life support equipment was generally adequate in Huazhou City(65.2％).Health centers in northern and central Huazhou performed better than those in the urban and southern areas regarding equipment training,emergency handling procedures for equipment failures,regular emergency drills,meeting clinical treatment needs,management system completeness,routine maintenance and inspections,and regular quality assessments.Factor analysis revealed significant issues with equipment aging and quality in urban township health cen-ters,while northern township health centers urgently needed life-sustaining and therapeutic equipment.Conclusion There are regional disparities in the management levels of emergency and life support medical equipment in township health centers in Hua-zhou City.It is recommended to enhance the overall quality of personnel in township health centers,optimize"effective training"for staff,and improve annual management plans to further elevate grassroots emergency service capabilities.

Objective:To investigate the epidemiological and clinical characteristics of human parainfluenza viruses (HPIVs) infection among hospitalized children with community-acquired pneumonia (CAP) in China, and provide basic data for diagnosis, treatment and prevention of HPIVs infection.Methods:From November 2014 to February 2020, 5 448 hospitalized children with CAP were enrolled in 14 hospitals in 11 provinces and municipalities directly under the Central Government in southern China and northern China. Nasopharyngeal aspirates or throat swabs were collected, and the nucleic acids of 18 types respiratory viruses including HPIV1-4 were screened by suspension array technology. Demographic data and clinical information were collected for statistical analysis.Results:The total detection rate of HPIVs in 5 448 children with CAP was 8.83% (481/5 448), and the detection rate in males was higher than that in females (62.79% vs. 37.21%; χ2=0.000, P=0.992). The detection rate of HPIVs in 1~< 3 years age group was higher than that in other age groups, and the difference was statistically significant ( χ2=61.893, P<0.001). The detection rate of HPIVs in the northern region was higher than that in the southern region (9.02% vs 8.65%), but the difference was not statistically significant ( χ2=0.239, P=0.625). The prevalence of HPIV1-4 in northern and southern China was not completely same. HPIV1 was mainly prevalent in autumn in both northern and southern regions. HPIV2 was prevalent in summer in northern China, and the detection rate was low in southern China. HPIV3 reached its peak in both spring and summer in both northern and southern China, but its duration was longer in southern China than in northern China. HPIV4 is mainly popular in autumn in both southern China and northern China. Among 481 children infected with HPIVs, 58.42% (281/481) were infected with HPIV alone, and the main clinical manifestations were cough (90.75%) and fever (68.68%). Out of the HPIV-positive cases, 42.62% (205/481) were co-infected with another type of HPIV or a different virus, while 11.43% (55/481) had co-infections with two or more different viruses. HPIV3 was the most common type of co-infection with other viruses. HPIV3 infection accounted for the largest proportion (76.80%) in 47 HPIVs-positive children with severe pneumonia. Conclusions:HPIVs is one of the most important pathogens causing CAP in children in China, and children under 3 years of age are the main populations of HPIVs infection. The prevalence characteristics of all types of HPIVs in children in the north and south are not completely same. HPIV3 is the dominant type of HPIV infections and causes more severe diseases.

Objective:To investigate the etiology of necrotizing pneumonia (NP) in children and the clinical characteristics of NP caused by different pathogens in China.Methods:A retrospective, case-control study was performed in children with NP who were admitted to 13 hospitals in China from January 2008 to December 2019. The demographic and clinical information, laboratory data, etiological and radiological findings were analyzed. The data were divided into three groups based on the following years: 2008-2011, 2012-2015 and 2016-2019, and the distribution characteristics of the pathogens in different period were compared. Meanwhile, the pathogens of pediatric NP in the southern and northern China were compared. And the clinical characteristics of the Mycoplasma pneumoniae (MP) NP and the bacterial NP were also compared. T-test or Mann-Whitney nonparametric test was used for comparison of numerical variables, and χ 2 test was used for categorical variables. Results:A total of 494 children with NP were enrolled, the median ages were 4.7 (0.1-15.3) years, including 272 boys and 222 girls. Among these patients, pathogens were identified in 347 cases and the pathogen was unclear in the remaining 147 cases. The main pathogens were MP (238 cases), Streptococcus pneumoniae (SP) (61 cases), Staphylococcus aureus (SA) (51 cases), Pseudomonas aeruginosa (13 cases), Haemophilus influenzae (10 cases), adenovirus (10 cases), and influenza virus A (7 cases), respectively. MP was the most common pathogen in all three periods and the proportion increased yearly. The proportion of MP in 2016-2019 was significantly higher than that in 2012-2015 (52.1% (197/378) vs. 36.8% (32/87), χ 2= 6.654, P=0.010), while there was no significant difference in the proportion of MP in 2012-2015 and that in 2008-2011 (36.8% (32/87) vs. 31.0% (9/29), χ2=0.314, P=0.575).Regarding the regional distribution, 342 cases were in the southern China and 152 in the northern China. Also, MP was the most common pathogen in both regions, but the proportion of MP was higher and the proportion of SP was lower in the north than those in the south (60.5% (92/152) vs. 42.7% (146/342), χ 2=13.409, P<0.010; 7.9% (12/152) vs. 14.3% (49/342), χ 2= 4.023, P=0.045). Comparing the clinical characteristics of different pathogens, we found that fever and cough were the common symptoms in both single MP and single bacterial groups, but chest pain was more common (17.0% (34/200) vs. 6.1% (6/98), χ 2=6.697, P=0.010) while shortness of breath and wheezing were less common in MP group (16.0% (32/200) vs. 60.2% (59/98), χ 2=60.688, P<0.01; 4.5% (9/200) vs. 21.4% (21/98), χ 2=20.819, P<0.01, respectively). The white blood cell count, C-reactive protein and procalcitonin in the bacterial group were significantly higher than those in the MP group (14.7 (1.0-67.1)×10 9/L vs. 10.5 (2.5-32.2)×10 9/L, 122.5 (0.5-277.3) mg/L vs. 51.4 (0.5-200.0) g/L, 2.13 (0.05-100.00) μg/L vs. 0.24 (0.01-18.85) μg/L, Z=-3.719, -5.901 and -7.765, all P<0.01). Conclusions:The prevalence of pediatric NP in China shows an increasing trend during the past years. MP, SP and SA are the main pathogens of NP, and the most common clinical symptoms are fever and cough. The WBC count, C-reactive protein and procalcitonin in bacterial NP are significantly higher than those caused by MP.

Objective:To develop Frailty Assessment Scale for Elderly Trauma Patients and verify its reliability and validity, aiming to assess the frailty level of emergency elderly trauma patients within 24 hours of admission.Methods:From February to May 2019, the initial Frailty Assessment Scale for Elderly Trauma Patients was constructed through literature summary, team brain storming and Delphi expert consultation. From June to December 2019, a total of 190 elderly trauma patients who were admitted to Emergency Department of the Second People's Hospital of Yibin in Sichuan Province were selected by the convenient sampling method. The Initial Frailty Assessment Scale and Frailty Index Scale constructed in this study were used to investigate the frailty. The items of scales were screened by the correlation coefficient method and the critical ratio method, validity of scales was evaluated by the structural validity and the correlation degree of validity criterion, and reliability of scale was analyzed by the retest reliability and internal consistency.Results:The final version of Frailty Assessment Scale for Elderly Trauma Patients constructed in this study contained a total of 24 items. The exploratory factor analysis extracted a total of 5 common factors, and the cumulative variance contribution rate was 65.92%. After verification, the correlation coefficient between this scale and the Frailty Index Scale was 0.751, the test-retest reliability was 0.762, and Cronbach's α coefficient was 0.87.Conclusions:Frailty Assessment Scale for Elderly Trauma Patients compiled by this research has concise entries, good reliability and validity, which can be promoted and applied in emergency injury assessment of elderly trauma patients in China.

OBJECTIVE: To establish the norms of Sub-Health Measurement Scale (SHMS V1.0) for Chinese urban residents. METHODS: Using a multistage stratified sampling method, we conducted a large-scale epidemiological investigation among 15 066 urban residents sampled from 6 regions in China, including Tianjin City (north China), Guangdong Province (south China), Anhui Province (central south China), Sichuan Province (southwest China), Lanzhou City (northwest China) and Harbin City (northeast China). The mean, percentile and threshold norms were established based on the characteristics of SHMS V1.0 scores for Chinese urban residents. RESULTS: The mean and percentile norms of total, physical, mental and social sub-health of Chinese urban residents were established according to gender and different age groups (14-19, 20-29, 30-49, 50-64 and ≥65 years). The threshold norms of SHMS V1.0 divided 5 health states, namely disease, severe sub-health, moderate subhealth, mild sub-health and healthy states according to the ± and ±0.5 of the converted scores. CONCLUSIONS The norms of Sub-Health Measurement Scale (SHMS V1.0) for Chinese urban residents were established, which provides a reference for rapid screening and diagnosis of sub-health status in Chinese urban residents and facilitates further study of the prevalence and contributing factors of sub-health.
Asian Continental Ancestry Group ; China ; Health Status ; Humans ; Prevalence ; Surveys and Questionnaires ; Urban Health ; Urban Population

OBJECTIVE: To explore the direct relationship between personality (PN) and sub-health status (SHS) and their indirect association mediated by frustration quotient (FQ) and stress event (SE). METHODS: A multiple-stage stratified sampling method was used to choose the participants, and a total of 4517 eligible urban residents were selected.ANCOVA was used to analyze the independent association between personality and SHS after adjusting the demographic characteristics and lifestyle.A structural equation model was used to analyze the associations among personality, FQ, SE and SHS.Bootstrap method was used to test the direct and indirect association between personality and SHS. RESULTS: Personality was independently associated with total sub-health (=75.913, < 0.001), physical sub-health (=23.618, < 0.001), mental sub-health (=101.993, < 0.001) and social sub-health (=48.757, < 0.001).The urban residents with the personalities characterized by anger suppression, anxiety and irritability, and impatience and competitiveness had significantly lower health scores than those with a mature and steady personality ( < 0.05).Personality was associated with FQ and SE, and the indirect association between personality and physical sub-health was mainly mediated by FQ and SE (β=-0.110).Personality showed more a direct association (β=-0.172) with mental sub-health and a slightly less indirect association (β=-0.126) with mental sub-health.Personality showed a more indirect association (β=-0.113) with social SHS and slightly less direct association (β=-0.082) with social sub-health. CONCLUSIONS A mature and steady personality may help to promote the general health level, while the personalities of anger suppression, anxiety and irritability, impatience and competitiveness can be associated with the occurrence of sub-health.Building a mature and steady personality has positive effects on the health in general of an individual.
Adolescent ; Asian Continental Ancestry Group ; Health Status ; Humans ; Life Style ; Personality

Objective To investigate the predominant genotypes and epidemiological characteristics of human adenovirus (HAdV) in pediatric community-acquired pneumonia (CAP) in China.Methods This was a repeated cross sectional study.Between November 2014 and November 2016,nasopharyngeal aspirates (NPAs) or throat swabs from each hospitalized pediatric patients diagnosed as CAP in 12 hospitals in Northern and Southern China were collected.Respiratory specimens were screened for 18 respiratory viruses including HAdV by using Luminex xTAG RVP Fast V2 multiplex Assay.Typing of HAdV and analysis for the epidemiological characteristic of HAdV were performed.Results (1) A total of 2 723 hospitalized pediatric patients with CAP were enrolled in this study and 156 (5.7％,156/2 723) respiratory specimens were positive for HAdV,and 74 (6.6％,74/1 128) and 82 (5.1％,82/1 595) were in Northern and Southern China,respectively.There was no significant difference in the positive detection rate between the Northern and Southern China.(2) In Northern China,the HAdV positive rate of children at the age of ＜6 months,6 months-＜1 years,1-＜3 years,3-＜5 years and ≥5 years was 5.9％(6/101),6.7％(7/104),10.3％(34/331),4.1％(11/266) and 4.9％(16/326),respectively,and the incidence of HAdV infection peaked in children aged 1-3 years (x2=11.511,P=0.021).While in Southern China the HAdV positive rate of children at the age of ＜6 months,6 months-＜1 years,1-＜3 years,3-＜5 years and ≥5 years was 2.2％ (7/312),4.6％ (12/259),6.3％ (31/494),7.3％ (18/245) and 4.9％(14/285),respectively.There was no significant difference in the positive detection rate among age groups.(3) In 2015,the highest detection rate of HAdV in northern China was 12.5％ (25/200) in winter,and in Southern China was 6.7％ (35/525) in spring and 5.3％ (19/357) in summer.(4) In 108 cases of HAdV positive specimens typing was done and 80 in cases classification was successfully performed.Totally 7 genotypes of HAdV,including HAdV-3 (n=32),HAdV-7 (n=9),HAdV-1 (n=12),HAdV-2 (n=15),HAdV-5 (n=10),HAdV-6 (n=1) and HAdV-4 (n=1),were detected.The predominant HAdV genotypes were HAdV-3 (30.8％,8/26) and HAdV-7 (26.9％,7/26) in Northern China,while HAdV-3 (44.4％,24/54) and HAdV-2 (22.2％,12/54) were the most prevalent genotypes in Southern China.Conclusions HAdV is an important viral pathogen in pediatric CAP.The predominant HAdV genotypes and peak seasons of HAdV infections were different between Northern and Southern China.The predominant HAdV genotypes were HAdV-3 and HAdV-7 in Northern China,while HAdV-3 and HAdV-2 in Southern China.The peak season of HAdV infections was winter in Northern China.However,HAdV infections are more common in spring and summer in Southern China.

ObjectiveTo explore the influencing factors of health seeking behavior of delivery women in Guangdong province.MethodsStratified random sampling method was used,and 1491 delivery women from primary,secondary and tertiary hospitals were investigated with self-made maternal health seeking behavior questionnaire.Logistic regression analysis was used to analyze the impact of environmental factors and population characteristics on health seeking behavior.ResultsDelivery women with qualified health seeking behavior account for 83.4%.Present pregnancy was planned (OR=2.114),prenatal examination was needed when self-feeling good (OR=2.323),social medical insurance system was socialized medicine (OR=2.755) or medical insurance (OR=1.697),hospital level of secondary hospital (OR=1.568) or tertiary hospital (OR=1.800) were independent positive influencing factors of health seeking behavior.ConclusionThe qualified rate of health seeking behavior of delivery women in Guangdong province is low.Delivery women with the following characteristics of low educational level,low family income,uninsured,coming from rural area and delivery in primary hospital need to be guided scientifically at seeking for health.

Objective To evaluate the effects of urotensin Ⅱ on cell proliferation of and α-smooth muscle actin (α-SMA) expression in normal human dermal fibroblasts (NFs),and to explore their regulatory mechanisms.Methods NFs were isolated from foreskin tissues and subjected to primary culture in vitro.Reverse transcription PCR and Western blot analysis were performed to measure the mRNA and protein expression of urotensin Ⅱ and its receptor,respectively.Cell counting kit-8 (CCK-8) assay was conducted to estimate the proliferation of NFs,which were treated with urotensin Ⅱ at different concentrations of 0,10-10,10-9,10-8,10-7 and 10-6 mol/L for 0,6,12,24 and 48 hours separately,and then the optimal concentration and duration of urotensin Ⅱ exposure were selected to be 10-8 mol/L and 24 hours respectively.Some cultured NFs were divided into 5 groups:control group receiving no treatment,U Ⅱ group treated with 10-8 mol/L urotensin Ⅱ,U Ⅱ + nicardipine group treated with 10-8 mol/L urotensin Ⅱ and the calcium channel blocker nicardipine at the concentration of 10-5 mol/L,U Ⅱ + PD98059 group treated with 10-8 mol/L urotensin Ⅱ and the mitogen activated protein kinase (MAPK)inhibitor PD98059 at the concen-tration of 10-5 mol/L,and U Ⅱ + cyclosporine group treated with 10-8 mol/L urotensin Ⅱ and the calcium-dependent protein kinase (CaM PK) inhibitor cyclosporine at the concentration of 10-5 mol/L.After 24-hour treatment,CCK-8 assay was conducted to evaluate the proliferation of NFs in the above groups,real-time fluorescence-based quantitative PCR and Western blot analysis were performed to determine the mRNA and protein expression of α-SMA respectively.Results Urotensin Ⅱ receptor was expressed in NFs,but urotensin Ⅱ was not.The proliferative activity of NFs significantly differed among the control group,U Ⅱ group,U Ⅱ + nicardipine group,U Ⅱ + PD98059 group and U Ⅱ + cyclosporine group (the mean absorbance value at 405 nm:1.036 ± 0.046,1.405 ± 0.158,1.121 ± 0.109,1.192 ± 0.089 and 1.141 ± 0.056,respectively;F =9.587,P ＜ 0.01),and the U Ⅱ group showed significantly higher proliferative activity of NFs compared with the control group,U Ⅱ + nicardipine group,U Ⅱ + PD98059 group and U Ⅱ + cyclosporine group (q =8.263,6.355,4.774 and 5.912,respectively,all P ＜ 0.05).There were significant differences in the mRNA and protein expression of α-SMA among the 5 groups (F =6.351,7.045,both P ＜ 0.01),and the mRNA and protein expression of α-SMA was significantly higher in the U Ⅱ group than in the other 4 groups (all P ＜ 0.05).Conclusion Urotensin Ⅱ may induce the proliferation of and α-SMA expression in NFs through calcium channels,MAPK and CaM PK pathways.

Objective To establish the evaluation index system on maternal health seeking behavior with Delphi method.Methods Based on Andersen health service utilization models,literature analysis was used to establish evaluation index system on maternal health seeking behavior,then Delphi method was carried out to revise index system through two rounds questionnaire consulting from 24 experts.Results The confirmed index system of maternal health seeking behavior included 4 first-level index,12 second-level index and 57 third-level index.The average authority degree of experts were 0.869,and the coordination coefficients of expert in the total index were 0.195 and 0.166(P＜0.01).The weight coefficients of the indicators at first level were 0.1529,0.3403,0.2786 and 0.2281,respectively.Condusion The representativeness,authority degree and coordination of expert are good,and the tentatively established evaluation index system on maternal health seeking behavior is scientific and reasonable.