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 explore the effects of fast-track surgery (FTS) combined with acupuncture at Neiguan acupoint on stress indicators and recovery quality in patients during anesthesia of craniocerebral surgery.Methods:According to block randomization method, 120 patients with craniocerebral trauma meeting inclusion criteria in the hospital were divided into three groups between January 2018 and December 2020, 40 in each group. The control group was given routine awakening intervention, intervention 1 group was given routine awakening intervention and acupuncture at Neiguan acupoint, and intervention 2 group was given FTS and treatment of intervention 1 group. At 10 min after entering the room, immediately after tracheal intubation and immediately after extubation, level of serum cortisol (COR) was detected by electrochemical luminescence apparatus. The level of serum dopamine was detected by ELISA. The blood pressure and heart rates were recorded. The recovery quality during anesthesia was compared, including recovery time, recovery time of spontaneous breathing, extubation time and recovery time of orientation. The cognitive function of patients was evaluated by Neurobehavioral Cognitive Status Examination (NSCE). The incidence of intestinal paralysis, nausea and vomiting, and hospitalization time were observed and recorded during treatment.Results:Immediately after tracheal intubation and extubation, systolic blood pressure in intervention 2 group, intervention 1 group and control group were significantly decreased ( F=12.03, 13.96), levels of serum COR ( F=91.40, 53.76), and dopamine ( F=29.72, 69.39) were significantly decreased ( P<0.01). The recovery time of orientation during anesthesia [(39.09±3.12)min vs. (41.57±3.54)min, (43.84±3.28)min, F=34.65] in intervention 2 group was significantly shorter than that of the intervention 1 group and control group ( P<0.01), and hospitalization time [(9.36±1.78)d vs. (10.92±1.81)d, (12.10±1.95)d, F=1.44] was significantly shorter than that of the intervention 1 group and control group ( P<0.05). Conclusion:The FTS combined with acupuncture at Neiguan acupoint can reduce stress level during anesthesia, improve recovery quality and relieve postoperative cognitive dysfunction in patients undergoing craniocerebral surgery.

Objective: To investigate the clinical effects of primary revision after artificial hip replacement and causes of revision surgery. Methods: A total of 344 patients who underwent revision surgery after total hip arthroplasty (THA) and artificial femoral head replacement from January 2010 to December 2016 were retrospectively analyzed. There were 141 males and 203 fe-males, with a mean age 65.64±10.81 years (28-87 years). A total of 351 hip revisions were performed in 344 patients with 7 pa-tients in bilateral revisions. All patients were followed up for 60.38±22.75 months (24-105 months). All patients with periprosthet-ic infection underwent two-stage revision after prosthesis placement, and all others underwent one-stage revision. The clinical out-comes of revision surgery were assessed with the Harris hip score and the survival rate of the revision prosthesis. According to the duration from artificial hip replacement to revision surgery, all patients were divided into early revision (less than 5 years) and late revision (more than 5 years) groups. They were also divided into two groups according to the age of the patient in revision sur-gery: >55-year-old and ≤55-year-old groups. The causes of revision, hip reoperation and re-revision were recorded. Results: In the 351 hip revisions, a total of 238 (67.8%) had aseptic loosening, 41 (11.7%) periprosthetic fractures, 30 (8.5%) periprosthetic infection, 23 (6.6%) recurrent dislocation and 19 (5.4%) the eccentric liner wear. The infection rate was significantly higher in the early revision group (21.1%) than that in the late revision group (4.2%) (χ²=24.443, P<0.001). The aseptic loosening rate was sig-nificantly higher in the late revision group (72.4%) than that in the early revision group (54.4%) (χ²=9.899, P=0.002). Sixteen pa-tients underwent hip surgery after revision, including 6 recurrent dislocations, 4 aseptic loosening, 3 periprosthetic fractures, and 3 periprosthetic infections. Eight of them underwent revision surgery, including 4 cases of aseptic loosening, 2 cases of periprosthet-ic fractures, and 2 cases of recurrent dislocation. The duration from the primary revision to the second revision was 22.1±10.0 months (1-75 months). The 5-year and 8-year survival rates of the revision prostheses were 99.3%[95%CI(98.3%, 100.3%)] and 92.6% [95%CI(87.1%, 98.1%)], respectively. The proportions of prosthetic infection and eccentric liner wear in the ≤55-year-old group were significantly higher than those in the >55-year-old group (χ²=3.981, P=0.046; χ²=5.226, P=0.022), while the propor-tion of aseptic loosening in the >55-year-old group was significantly higher than that in the ≤55-year-old group (χ²=5.254, P=0.022). The 8-year survival rates of the revision prostheses of ≤55-year-old group and >55-year-old group were 76.8% [95%CI(50.5%, 103.1%)] and 95.4% [95%CI(91.1%, 99.7%)], respectively. Conclusion Young patients have a higher risk of re-revi-sion after revision THA.

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 diagnostic value of knee skin temperature and serum soluble intercellular adhesion molecule-1 (sICAM-1) level in peri-prosthetic infection after total knee arthroplasty (TKA).Methods Thirty patients (11 males and 19 females,aged 59.3±9.5 years old) underwent primary TKA during November 2012 and October 2015.Ten patients with peri-prosthetic infection (3 males and 7 females,aged 60.9±8.2 years old) underwent two-stage revision TKA from November 2012 to October 2015.The interleukin-6 (IL-6),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),sICAM-1 in serum and the skin temperature in knee joint were recorded preoperatively (revision patients on diagnosis),at days 1,7 and at 1,3,6,12 months post-operatively.Results All of the 40 patients were followed up for 12 months.The serum CRP,IL-6 and ESR levels in the primary TKA group were normal preoperatively and increased after operation,reaching their peaks at 1-7 days postoperatively.These indexes then returned slowly to the normal levels within 3 months.The serum sICAM-1 level in the primary TKA group did not change significantly during the follow up.The serum levels of CRP,IL-6,ESR,and sICAM-1 in the revision group were significantly higher than that in the primary TKA group preoperatively (P＜0.05),IL-6,CRP,ESR returned slowly to the normal levels within 3 months after the second-stage revision,while the level of sICAM-1 returned to normal within 3 months after the first-stage revision.During whole follow-up after the second-stage revision,the level of sICAM-1 didn't change significantly.The preoperative mean differential temperature (MDT) in the primary TKA group was 0.73±0.62 ℃ preoperatively and elevated to 4.37±1.06 ℃ at 7 days postoperatively,which returned to the baseline within 6 months after primary TKA.The preoperative MDT in the revision group was 5.03±0.81 ℃,which was significantly higher than that in the primary TKA group (P＜0.05).The MDT returned to the normal level within 6 months after the second-stage revision TKA.Conclusion The change of MDT is in accordance with serum CRP,IL-6,and ESR,which together may predict the occurrence of infection.Serum sICAM-1 level may also be valuable in the diagnosis of peri-prosthetic infection.

Objective To explore the effect and factors of patellofemoral arthroplasty (PFA) for isolated patellofemoral osteoarthritis.Methods Data of 18 patients (3 males,15 females) with isolated patellofemoral osteoarthritis underwent PFA from March 2006 to December 2014 were retrospectively analyzed.There were 3 males and 15 females with a mean age of 54 years (range,46-74 years).It was strict to grasp the surgical indications according to the clinical symptoms,signs and imaging data preoperatively.11 patients were operated with AVON patellofemoral prosthesis (Stryker Inc.) and the other 7 patients were operated with the Gender Solutions patellofemoral prosthesis (Zimmer Inc.).Active and passive functional rehabilitation exercise was encouraged at the early stage after operation.Visual analogue scale (VAS) was 5.33±0.99 (range,4-7) and hospital for special surgery knee score (HSS) was 53.28±5.71 (range,44-63) before operation.Results The mean duration of follow-up was 63.98 months (range,6-104 months).VAS after operation for 1 and 3 months were 1.17±0.79 (range,0-3) and 0.72±0.67 (range,0-2),and the pain was almost relieved after 9 months.HSS after operation for 1,3,9 months were 70.06±6.33 (range,61-80),86.06±5.12 (range,77-95) and 91.39±4.83 (range,82-97).HSS score of the latest follow-up was 92.06±4.05 (range,84-97),which was improved obviously from the preoperative ones.The excellent and good rate was 100％ (excellent 15 cases,good 3 cases).The satisfactory rate was 94.4％ (17/18).Only one case got slightly knee pain when walking up and down the stairs after 2 years,and the pain was relieved after being administered with NSAIDs and rest.No incision infection,rupture,prosthesis supported bone fracture,prosthesis loosening and other complication was occurred during the follow-up period in the other patients.Conclusion The clinical outcomes of PFA are strictly related to surgical indications,implant design and appropriate surgical technique.Therefore,based on the appropriate PFA implants,strict surgical indications,appropriate patients,excellent operation skills and actively functional rehabilitation exercise,PFA could treat the isolated patellofemoral osteoarthritis effectively.

Objective :To explore the change of the indexes of platelet activation in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effect on patients’ prognosis .Methods :Eighty patients with AECOPD were enrolled .Among them ,there were 40 cases accompanied by pulmonary hypertension (22 moderate to severe cases ,18 mild cases) and thirty three cases accompanied by respiratory failure .And thirty healthy controls were included .Platelet activation factor (PAF) ,11-dehydro-thromboxane B2 (11-DH-TXB2) ,and P-selectin (CD62P) levels were detected by ELISA method . Results :PAF ,11-DH-TXB2 and CD62P levels in AECOPD group were significantly higher than those in healthy control group (P< 0 .05) .And PAF ,11-DH-TXB2 ,and CD62P levels in patients with AECOPD accompanied by pulmonary hypertension were obviously higher than those in AECOPD patients without pulmonary hypertension (P< 0 .05) .And PAF ,11-DH-TXB2 and CD62P levels in AECOPD patients accompanied by moderate to severe pulmonary hypertension ,were obviously higher than those in patients accompanied by mild pulmonary hypertension ( P < 0 .05) .Furthermore ,PAF ,11-DH-TXB2 and CD62P levels in AECOPD patients accompanied by respiratory failure were obviously higher than those in AECOPD patients without respiratory failure (P< 0 .05) .Analysis of prognostic correlation factors indicated that PAF ,11-DH-TXB2 and CD62P levels in the patients who suffered two or more times from AECOPD per year were higher than those in patients who suffered less than two times (P< 0 .05) .Conclusions :The degree of platelet activation in patients with AECOPD is higher ,especially in the patients accompanied by pulmonary hypertension and/or hypoxemia .The degree of platelet activation is closely correlated with the recurrence of AECOPD .