Objective: To analyze epidemiological characteristics of brucellosis in Shaoxing City, Zhejiang Province from 2005 to 2023, so as to provide the basis for developing targeted control measures. Methods: Data of brucellosis cases and epidemiological investigation in Shaoxing City from 2005 to 2023 were collected from the Monitoring and Reporting Management System of the Chinese Disease Prevention and Control Information System. The epidemiological characteristics of brucellosis were descriptively analyzed, the trend in incidence of brucellosis was analyzed using average annual percent change (AAPC). Results: A total of 270 cases of brucellosis were reported in Shaoxing City from 2005 to 2023, with an average annual incidence of 0.29/105. The AAPC was 0.812%, with no significant changing trend (P>0.05). The incidence of brucellosis peaked from February to March, with 80 cases (29.63%). The reported cases were mainly distributed in Shangyu District (139 cases, 51.48%) and Shengzhou City (74 cases, 27.41%). There were 188 male cases and 82 female cases, with a male-to-female ratio of 2.29∶1. The cases were primarily concentrated in the age group of 40 to <70 years, with 205 cases accounting for 75.93%. Among these, 86 cases were reported in the 50 to <60 years of age group, accounting for 41.95%. The majority of the cases were farmers, with 187 cases accounting for 69.26%. The median interval from onset to diagnosis was 22.73 (interquartile range, 39.97) days, with a delayed diagnosis rate of 62.96%. Infections through breeding, selling and transporting cattle and sheep resulted in 164 cases (60.74%), and through buying and slaughtering resulted in 36 cases (13.33%). An outbreak of brucellosis was reported in Xinchang County in 2018, with three confirmed cases. Conclusions The incidence of brucellosis in Shaoxing City had no significant change from 2005 to 2023. The peak period was from February to March. The cases were mainly distributed in Shangyu District and Shengzhou City. People aged 50 to <60 years, males, and farmers were the key groups for prevention and control.

Objective: To investigate the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Shaoxing City from 2006 to 2022, so as provide insights into improvements of the HFRS control strategy. Methods: Data pertaining to HFRS cases in Shaoxing City from 2006 to 2022 were captured from the Surveillance System of China Information System for Disease Control and Prevention. The temporal, population and regional distributions of HFRS were analyzed using the descriptive epidemiological method, and the trends in incidence of HFRS were evaluated using annual percent change (APC). Results: Totally 1 022 HFRS cases were reported in Shaoxing City from 2006 to 2022, with annual average incidence of 1.22/105 and three deaths. The incidence of HFRS appeared a tendency towards a decline in Shaoxing City from 2006 to 2022 (APC=-11.101%, t=-9.930, P<0.001), and the incidence of HFRS peaked from May to June and from November to January of the next year. A higher incidence of HFRS was seen in men than in women (1.76/105 vs. 0.68/105; χ2=201.361, P<0.001). There were 714 HFRS cases at ages of 30 to 59 years (69.86%), and farmers were the predominant occupation (78.18%). The three counties with the largest number of HFRS cases included Zhuji (366 cases), Xinchang (263 cases) and Shengzhou (134 cases). The incidence of HFRS was lower in urban districts (Yuecheng, Keqiao and Shangyu) than in counties (Zhuji, Shengzhou and Xinchang) (0.58/105 vs. 1.96/105; χ2=326.880, P<0.001). Conclusion The incidence of HFRS appeared a tendency towards a decline in Shaoxing City from 2006 to 2022, and the incidence was high in late spring, early summer and winter. The HFRS cases were mainly males, young and middle-aged people, and farmers, and predominantly distributed in counties. Targeted control measures are needed.

Objective: To investigate the epidemiological and etiological characteristics of viral diarrhea among children under 5 years of age in Shaoxing City, Zhejiang Province, so as to provide insights into management of viral diarrhea. Methods: The surveillance data on viral diarrhea among children under 5 years of age in Shaoxing City from 2019 to 2022 were collected, including demographics and stool testing results. The epidemiological and etiological characteristics of viral diarrhea were analyzed using a descriptive epidemiological method. Results: A total of 763 diarrheal children under 5 years of age were reported in Shaoxing City from 2019 to 2022, and 236 children were tested positive for virus (30.93%). The detection of virus was 49.01%, 31.61%, 20.43% and 21.89% from 2019 to 2022, which appeared an overall tendency towards a decline (P<0.05). The incidence of viral diarrhea peaked from November to March of the next year and from May to July, and the detection of virus was lower among children with diarrhea living in urban areas (Yuecheng District, Keqiao District and Shangyu District) than among those in suburb areas (Zhuji City, Shengzhou City and Xinchang County) (30.22% vs. 52.00%, P<0.05). There were 206 children tested positive for a single virus, and the detection rates of rotavirus (RV), enteric adenovirus (EAdV), norovirus (NoV), and sapovirus (SaV) were 9.57%, 8.91%, 8.39%, and 0.13%, respectively. There were 25 children with virus co-infections, and the positive rates of EAdV and NoV, RV and EAdV and RV and NoV co-infections were 1.31%, 1.18% and 0.79%, respectively. There were 5 children with triple infections of RV, EAdV and NoV (0.66%). The highest detection of EAdV was seen in April, the highest detection of RV and NoV was seen in January, while SaV was only detected in April. Conclusion The incidence of viral diarrhea among children under 5 years of age peaked in winter and spring in Shaoxing City from 2019 to 2022, and the cases predominantly occurred in urban areas. The detection of virus appeared an overall tendency towards a decline, with high detection of RV, EAdV and NoV.

Objective:To compare the efficacy and safety of transurethral thulium laser enucleation of prostate for benign prostatic hyperplasia (BPH) with laser controller and sheath.Methods:The clinical data of 128 BPH patients who underwent transurethral thulium laser enucleation of prostate (THuLEP) in our hospital from January to June 2020 were retrospectively analyzed. Prostatic enucleation by laser controller was performed in 66 patients (LC-THuLEP group). The prostatic urethral mucosa was cut into Ω shape at 0.5 cm in front of the verumontanum to expose the prostate capsule, and then the fiber was retracted into the laser controller. Push the gland directly between the prostate gland and the prostate surgical capsule and expand along the capsule by the laser controller. In case of bleeding or prostate adhesive cord, the fiber was extended to coagulate or cut off, and the prostate was eventually en bloc removed. THuLEP by sheath was performed in 62 cases (THuLEP group). The ages of patients in LC-THuLEP group and THuLEP group were (71.00±8.72) years and (70.32±7.80) years, respectively. The prostate volumes were (74.80±40.88) ml and (73.14±36.31) ml, respectively. Prostate specific antigen (PSA) was (4.67±4.99) ng/ml and (4.89±4.59) ng/ml, International Prostate Symptom Score (IPSS) was (19.48±5.30) points and (18.50±5.05) points, respectively. The quality of life (QOL) scores were (4.17 ± 0.78) points and (4.18± 0.67) points, the maximum urine flow rate (Q max) was (9.82± 2.58) ml /s and (9.98± 2.91) ml/s, respectively. Postvoid residual (PVR) was (60.20±39.19) ml and (61.11±52.83) ml, respectively. The international index of erectile function (IIEF-5) score was (5.58±4.50) and (5.60±4.16), respectively.There was no significant difference in preoperative baseline data between 2 groups ( P>0.05). The operation time, the reduced level of hemoglobin, the weight of removed tissue, The time to postoperative bladder irrigation, the time to indwelling catheter and complications were compared between the two groups. IPSS, QOL score, Q max, PVR, and complications were compared between the two groups at 1, 3 and 6 months after surgery, while IIEF-5 score were compared only at 6 months after surgery. Results:The operative time of LC-THuLEP group and THuLEP group was (71.85±25.68) min and (80.65±29.64) min, respectively, and the decrease of postoperative hemoglobin was (6.42±9.89) g/L and (9.47±10.79) g/L, respectively, the weight of the removed tissue was (56.73±31.21) g and (48.11±24.50) g, respectively, and the time to postoperative bladder irrigation was (14.73±2.71) h and (16.06±2.71) h, respectively, the time to indwelling catheter was (4.41±1.92)d and (4.31±1.66)d, respectively, with no statistically significant differences between the two groups. IPSS scores of LC-THuLEP group were (6.52±2.46) points, (5.83±2.43) points and (5.30±2.49) points at 1, 3 and 6 months after surgery, respectively. QOL scores were (2.36±0.85) points, (2.27±1.02) points and (1.98±0.77) points, Q max were (22.89±2.41) ml/s, (23.61±2.62) ml/s and (23.83±3.53) ml/s, respectively. In THuLEP group, IPSS were (7.60±1.89) points, (6.86±1.81) points and (6.44±1.78) points at 1, 3 and 6 months after surgery, and QOL scores were (2.68±0.67) points, (2.74±1.01) points and (2.35±0.68) points, respectively. Q max were (21.31±2.52) ml/s, (22.13±2.51) ml/s and (22.11±2.49) ml/s, respectively. Those indexes (except Qmax at 6 months)were better in LC-ThuLEP group than THuLEP group, and the differences were statistically significant ( P<0.05). PVR of LC-THuLEP group were (15.95±12.31) ml, (14.83±12.19) ml and (13.67±15.03) ml, respectively, PVR of THuLEP group were (21.89±21.14) ml, (20.03±21.51) ml and (19.69±21.19) ml, respectively, and there were no significant differences. There was no bladder injury, severe bleeding, blood transfusion or secondary operation. The incidence of urinary incontinence 1 month after surgery was 6.1% (4/66) in the LC-THuLEP group and 19.4% (12/62) in the THuLEP group, the difference was statistically significant ( P<0.05). There was no significant difference at 3 months (3/66 vs. 4/62) and 6 months (1/66 vs. 2/62) after surgery ( P>0.05). There were no significant differences in the incidence of epididymitis, urethral stricture and bladder neck contracture between the two groups ( P>0.05). Conclusion:Compared by sheath, THuLEP by laser controller could be a safe and effective surgical method with better curative effect and lower complication rate.

Objective: To understand the epidemiological characteristics of viral hepatitis B in Shaoxing from 2008 to 2018,so as to provide basis for formulating the viral hepatitis B prevention and control strategy. Methods: The data of viral hepatitis B cases in Shaoxing from 2008 to 2018 were collected from infectious diseases reporting and management system. Descriptive epidemiological method was employed to analyze the time,place and population characteristics of viral hepatitis B cases in Shaoxing. Annual percentage change（APC）was calculated to analyze the development trend of viral hepatitis B. Results : From 2008 to 2018,a total of 22 764 cases of viral hepatitis B were reported in Shaoxing,with an average annual incidence rate of 42.24/100 000 and a standardized incidence rate of 39.19/100 000. The incidence rate of viral hepatitis B decreased from 2008 to 2018,among which the APC from 2012 to 2018 was -18.00% with a significantly downward trend（P<0.05）. Six counties,cities or districts in Shaoxing reported cases of viral hepatitis B,of which Zhuji（49.40/100 000）,Yuecheng（44.17/100 000）and Xinchang（43.28/100 000）ranked top three in average annual incidence rate. The incidence rate of viral hepatitis B in men was 57.07/100 000,which was higher than 27.33/100 000 in women（P<0.05）.The age of onset was mainly 25-59 years old,with 16 941 cases（74.42%）reported. The top three occupations were farmers,workers and migrant workers,with 15 013（65.95%）,2 730（11.99%）and 1 121（4.92%）cases reported,respectively. Conclusions The incidence of viral hepatitis B in Shaoxing from 2008 to 2018 showed a downward trend. Farmers,workers and migrant workers aged 25-59 years were at high risk of hepatitis B infection.

Objective: To analyze the epidemiological characteristics of coronavirus disease 2019 ( COVID-19 ) in Shaoxing from January 23 to March 31, 2020, so as to provide basis for the prevention and control of COVID-19. Methods: The information of the COVID-19 cases in Shaoxing were collected from the National Diseases Prevention and Control Information System and the field investigation by CDCs. A descriptive analysis was used for the epidemiological characteristics, including time, spatial and population distribution, clinical features and exposure history. Results: Totally 42 confirmed cases of COVID-19 were reported by March 31, without deaths. The first case was reported on January 23 and the last one was on February 13. The onset of cases peaked in mid-to-late January. All the counties ( cities or districts ) had confirmed cases, 14 cases were reported in Yuecheng District. Twenty-five ( 59.52% ) cases were 45 years old or over. Thirteen ( 30.95% ) cases were engaged in business and eight ( 19.05% ) cases were unemployed. No cases were found among medical staff. The main clinical symptoms were fever, dry cough, fatigue and imaging features of pneumonia, with nine ( 21.43% ) severe cases and three ( 7.14% ) critical cases. There were 34 ( 80.95% ) imported cases, who mainly came from Hubei Province. Totally 1 955 close contacts were tracked down, among whom 4 cases were confirmed, with the infection rate of 0.20%. Conclusions The COVID-19 cases reported in Shaoxing were mainly aged 45 years or over, severe and imported from Hubei Province. There was no continuous transmission in the community, and no infection in medical staff or deaths.

Objective To explore the changes and significance of Klotho protein levels in different stages of chronic kidney disease (CKD). Methods From March 2015 to December 2017,176 patients with CKD admitted to nephrology department of Inner Mongolia People＇s Hospital were selected as the study object (CKD group), and 80 healthy patients in our hospital were selected as the control group in the same period. The serum Klotho levels of CKD patients and control group at different stages were detected by double antibody sandwich ELISA, and the differences between each group were compared. Results The serum Klotho level of CKD group (( 4. 84 ± 1. 87) μg／L) was significantly lower than that of the control group ((9. 11± 3. 14) μg／L) ( t＝ 13. 82, P＜0. 01) . One-way anova showed that estimated renal glomerular filtration rate (eGFR),serum albumin (ALB),hemoglobin ( Hb),blood calcium ( Ca) and serum Klotho were gradually decreased,while phosphorus (P) and creatinine (Cr) in serum were gradually increased,and the difference was statistically significant among the five stages( all P＜0. 01). Spearman correlation analysis showed that Klotho level was positively correlated with eGFR and Ca,and negatively correlated with CKD stage,Cr and P (r＝0. 369,0. 160,－0. 200,－0. 250,－0. 230,all P＜0. 05). The multiple linear regression equation showed that Klotho level was positively and independently correlated with eGFR ( t＝ 3. 89, P＜0. 001),and negatively correlated with CKD staging independently (t＝－4. 12,P＜0. 001). Conclusion The expression level of serum Klotho protein in patients with CKD is lower than that of healthy people,and it decreases with the increase of CKD stages,which is closely related to the deterioration of renal function. It can be used as a reference index to evaluate the incidence and severity of CKD.

Objective Evaluating the effects of Bushen-Gufeigao and breathing movements on the patients with chronic obstructive pulmonary disease of Lung and kidney deficiency TCM pattern. Methods The patients with chronic obstructive pulmonary disease of lung and kidney deficiency TCM pattern were recruited and randomly divided into two groups the treatment group (32 cases) and the control group (34 cases). The control group was treated with the conventional medicine, and the treatment group were added Bufei-Gushengao and breathing movements based on the treatment of control group. Both groups were treated for 1 month. The changes of the clinical symptoms, lung function and frequency of attack and duration of each attack in 10 months after treatment were observed. Results After the treatment, compared with the control group, the TCM patterns scores (5.32 ± 2.67 vs. 9.12 ± 4.11, t=4.424) of the treatment group significantly decreased, while the FVC (3.00 ± 0.49 L vs. 2.71 ± 0.47 L, t=2.408), FEV1 (2.27 ± 0.44 L vs. 1.85 ± 0.54 L, t=3.496), and the percentage of FEV1%(75.62 ± 6.84 vs. 66.86 ± 9.32, t=4.333) increased significantly. In the 10 mouths after the treatment, the treatment group showed significantly fewer patients who had attacked more than 6 times than that in the control group, and the duration of attacks showed significantly fewer minutes in the treatment group than the control group (5.56 ± 1.45 d vs. 8.06 ± 1.80 d, t=6.190). Conclusion Bushen-Gufeigao and breathing movements can effectively improve patient's lung function and symptoms.

Objective To explore the clinical significance of early invasive mechanical ventilation for acute respiratory distress syndrome (ARDS) caused by thoracic trauma.Methods We retrospectively analyzed the clinical data of 93 patients of invasive mechanical ventilation in those with ARDS caused by thoracic trauma,and divided them into delayed invasive mechanical ventilation group (n =45) and timely invasive ventilation group (n =48) by the time of invasive mechanical ventilation.We compared the blood gas analysis,oxygen index,heart rate,lactic acid,muscle use score of the two groups before and after invasive mechanical ventilation and the differences of mechanical ventilation time,incidence of complications,mortality and length of hospital stay between the two groups.Results Each index of the delayed invasive mechanical ventilation group and the timely invasive ventilation group was calculated:PaO2 (63.2 ± 12.3,74.2 ± 12.1)mm Hg,PaCO2 (39.4 ±8.7,38.9 +7.6) mm Hg,PaO2/FiO2 (196.2 ± 17.8,231.4 ± 18.2),respiratory rate (27.4 ±3.7,21.1 ± 3.4) beats/min,heart rate (117.2 ± 26.8,96.0 ± 25.1) beats/min,accessory muscle use score (2.69 ± 0.15,1.67 ± 0.10),lactic acid (4.23 ± 1.70,2.12 ± 0.80) mmol/L Except for PaCO2,the differences of each index were statistically significant (t values were respectively 4.346,9.420,3.949,5.436,38.809,7.736; P ＜ 0.05).The duration of mechanical ventilation treatment (10.21 ± 1.50,6.47 ± 1.20) d and the length of hospital stay (21.53 ± 1.90,16.32 ±2.10) d of the delayed group and the timely group were significantly different (t values were respectively 12.518,13.318; P ＜ 0.01).The timely group had significantly lower mortality rate (26.7％ (12/45),14.6％ (7/48)),VAP (46.7％ (21/45),22.9％(11/48)),acute gastric mucosal lesions (33.3％ (15/45),12.5％ (6/48)),MODS (40.0％ (18/45),16.7％ (8/48)) than the delayed group (x2 values were respectively 3.86,5.81,4.49,5.70; P ＜ 0.05).There is no significant difference on the incidence of pneumothorax between the two groups (11.1％ (5/45),8.3％ (4/48)).Conclusion Invasive mechanical ventilation is an effective treatment of ARDS caused by chest trauma.Early invasive mechanical ventilation can reduce the mortality rate and shorten the duration of mechanical ventilation and hospital stay of the patients with ARDS after severe thoracic trauma.

Objective To investigate the effects of Xuebijing on the regulations of tumor necrosis factor-α(TNF-α) 、von Wilebrand factor(vWF)、interleukin-6 (IL-6) and the treatment effectiveness in pulmonary contusion patients.Methods Fifty-one pulmonary contusion patients admitted into the hospital from January 2010 to January 2012 were enrolled in the study and were randomly divided into two groups (treatment group and control group).The levels of the TNF-α、vWF 、IL-6 in the pulmonary contusion patients were measured by enzyme linked immunosorbent assay to investigate the change of the inflammatory cytokines and the treatment effectiveness in treatment group and control group.Results The hospitalization time of treatment group and control group was (19.83 ± 2.35) d,(21.52 ± 2.73) d respectively,the hospitalization time of the treatment group was significantly shorter than the control group,the difference was statistically significant (t =2.38,P ＜0.05) ;The incidence of ARDS was 14.81％ and 41.67％ respectively,the incidence of ARDS of the treatment group was significantly lower,the difference was statistically significant (x2 =4.6,P ＜ 0.05) ;The inflammatory mediators index of the two groups showed as follws:the first day of the TNF-α(181.35 ± 14.25) ng/L,(179.17 ± 16.28) ng/L,the third day of the TNF-α(169.21 ± 16.42) ng/L,(179.18 ± 17.31) ng/L,the fifth day of the TNF-α(131.78 ± 13.02) ng/L,(140.84 ± 14.27) ng/L,the seventh day of the TNF-α (99.45 ± 16.02)ng/L,(110.56 ± 17.09) ng/L;The first day of the vWF (178.73 ± 22.09) ng/L,(177.73 ± 23.02) ng/L,the third day of the vWF (208.46 ± 14.13) ng/L,(220.53 ± 23.02) ng/L,the fifth day of the vWF (252.32 ±15.22) ng/L,(266.40 ±25.79) ng/L,the seventh day of the vWF(201.49 ±9.21) ng/L,(217.27 ±22.68)ng/L;The first day of the IL-6 (172.14 ± 12.41) ng/L,(169.53 ± 13.55) ng/L,the third day of the IL-6 (147.24 ± 16.33) ng/L,(158.41 ±21.04) ng/L,the fifth day of the IL-6(126.36 ± 11.37) ng/L,(137.21 ± 21.23) ng/L,the seventh day of the IL-6 (114.03 ± 10.26) ng/L,(122.16 ± 13.59) ng/L,the differences within the group and between the two groups were significant(within the group:F =206.58,218.57,198.35 respectively,P ＜ 0.01 ;between the groups:F =19.053,17.259,17.235 respectively,P ＜ 0.01).And in the third,fifth and seventh day,3 indicators of treatment groups were lower than the control group (P ＜ 0.01).Conclusion Xuebijing can inhibit inflammatory transmitters,relieve inflammatory reactions,decrease the rate of ARDS incidence,shorten the hospitalization time and help to improve the prognosis of the patients with acute pulmonary contusion.