Abstract In November 2023, the Jinhua Center for Disease Control and Prevention received a report from a company indicating 3 cases of pulmonary tuberculosis. An on-site epidemiological investigation was immediately conducted. A total of 3 cases were reported, with an attack rate of 9.68%. The first case had cough and expectoration for more than a year, and diagnosed with rifampicin-resistant pulmonary tuberculosis on November 16, 2023, and the other 2 cases were his colleagues who were diagnosed with rifampicin-resistant pulmonary tuberculosis and etiology negative pulmonary tuberculosis on November 20 and 21, respectively. Based on the on-site investigation and laboratory test results, it was a cluster of rifampicin-resistant pulmonary tuberculosis. The likely cause of the spread might be the lack of timely medical attention for the first case, which led to the infection of other colleagues through contact transmission. Eight close contacts screened positive for purified protein derivative (PDD) or recombinantMycobacterium tuberculosisfusion protein skin test (EC-ST), given the injection of mycobaeterium vaccae vaccine, and no new cases of tuberculosis detected in the 3-month follow-up. The outbreak highlighted the necessity for the company to enhance health education concerning the prevention and treatment of pulmonary tuberculosis, implement regular health monitoring and enhance the physical examination for employee in order to increase sensitivity to pulmonary tuberculosis.

Objective:To compare the accuracy of dynamic navigation system,fully-guided and Pilot-drill guided implant surgery in anterior dental aesthetic area.Methods:45 patients underwent single tooth implantation in anterior dental aesthetic area were random-ly divided into 3 groups(n=15).Dynamic navigation system imlanting(A),3D printing fully-guided template with ASTRA EV assis-ted orthopedic implantation(B)and Pilot-drill guided implantation(C)were respectively used for the patients in group A,B and C.The deviation between the preoperative design and actual results were measured by CBCT and/or 3D reconstruction with navigation de-sign software or 3SHAPE software.SPSS 25.0 software package was used and(x)±s was used for descriptive analysis,results were pair-wise compared among the 3 groups using ANOVA.Results:Data were normally distributed and the variance of the data was homoge-neous.In group A,the distance deviation of implant top center was(0.571±0.196)mm,the horizontal deviation was(0.405±0.222)mm,the distance deviation of implant apical center was(0.449±0.267)mm,the vertical deviation was(0.312±0.223)mm,the de-viation of the connection angle between the two centers was 2.257°±0.989°.In group B,those were(0.520±0.242)mm,(0.219±0.201)mm,(0.643±0.284)mm,(0.464±0.292)mm and 1.272°±0.951° respectively.In group C those were(1.179±0.365)mm,(0.667±0.276)mm,(1.518±0.566)mm,(0.967±0.444)mm and 2.568°±0.632°.The deviation of all the measurments of group A and B was lower than those of group C(P＜0.05).The deviation of the connection angle between the 2 centers of group B was less than that of group A(P＜0.05),but no statistical significance(P＞0.05)was found in other 4 measured items.Conslusion:The accuracy of the dynamic navigation system and the fully-guided implantation is significantly higher than that of the Pilot-drill guided implantation,but is not statistically significant between dynamic navigation and the fully-guided system.

Patients with diabetic retinopathy often experience diabetes distress when facing the challenges of the disease, which has adverse effects on their health outcomes. This paper summarizes the current situation of diabetes distress in patients with diabetic retinopathy, and the assessment tools, influencing factors, and intervention measures, aiming to provide a reference for healthcare professionals to conduct intervention studies.

Objective To construct an intervention program for diabetic retinopathy(DR)patients undergoing surgery based on the theory of'Timing It Right'.Methods Guided by the theory of'Timing It Right',based on literature review and semi-structured interview,the first draft of the intervention program was formulated.From December 2022 to February 2023,15 medical and nursing experts in ophthalmology and endocrinology from 5 provinces(cities)in Zhejiang,Sichuan,Shanxi,Chongqing and Shanghai were interviewed by Delphi expert for 2 rounds to seek their advice and revision,and the final draft was formed.Results The effective recovery rate of 2 rounds of expert consultations was 93.75％and 100％.The authority coefficients were 0.87.The importance and feasibility of Kendall'W coordination coefficients were 0.325,0.138 and 0.193,0.141 in 2 rounds,respectively(P＜0.001).The finalized intervention program consisted of 6 months,which included 5 first-level items,18 second-level items and 43 third-level items.Conclusion The intervention program for DR patients undergoing surgery based on the theory of'Timing It Right'is reliable,scientific,feasible and practical,and it can meet the needs of such patients,providing a reference for improving their self-management ability,improving their negative emotions and delaying disease progression.

Znic (Zn) alloys with good cytocompatibility and suitable degradation rate have been a kind of biodegradable metal with great potential for clinical applications. This paper summarizes the biological role of degradable Zn alloy as bone implant materials, discusses the mechanical properties of different Zn alloys and their advantages and disadvantages as bone implant materials, and analyzes the influence of different processing strategies (such as alloying and additive manufacturing) on the mechanical properties of Zn alloys. This paper provides systematic design approaches for biodegradable Zn alloys as bone implant materials in terms of the material selection, product processing, structural topology optimization, and assesses their application prospects with a view to better serve the clinic.
Orthopedics ; Zinc ; Alloys ; Dental Materials ; Prostheses and Implants

The drafting of Zhejiang Mental Health Regulation has started since the promulgation of the Mental Health Law of the People's Republic of China in the year of 2013. Based on the preliminary investigation and the practice of mental health work in Zhejiang Province,this paper introduces the contents and characteristics of the regulation from six aspects,which are the legislative purpose and scope of application, the responsibilities of the government and departments, the construction of mental health service system,management of mental health services and consulting institutions,prevention,treatment and rehabilitation of mental disorders, and measures necessary to implement the regulation.

OBJECTIVE: To analyze the usage of mental health assistance hotline during COVID-19 in Zhejiang province from January 25th to February 29th 2020, and summarize the characteristics of the demand for mental health services and the dynamic changes of public mental health status during COVID-19 pandemic. METHODS: Both quantitative and qualitative methods were used. The calls related to pandemic were divided into four categories: medical, psychological, information and the others. The secondary categories of psychological calls were determined by text analysis. The number of calls were calculated weekly and the number of various types of calls over time were analyzed. We used stratified random sampling method to extract 600 cases of all kinds of calls related to pandemic and conducted a semantic analysis, through marking new, similar combination to form a feature set, then summed up the call content characteristics of each stage. Two hundred callers were followed up to understand how they felt about the call process in four aspects: the waiting time, call duration, the degree of problem-solving and the way to end the call. RESULTS: In a total of 13 746 calls, 8978 were related to pandemic, among which 12.59%(1130/8978) were about medical issues, 26.50%(2379/8978) were about mental health, 27.18%(2440/8978) were about information regarding the pandemic and 33.74%(3029/8978) were about other pandemic related issues. Pandemic situation, relevant policy release, frequency of advertising campaigns were predictors of the number of calls per day during the pandemic (<0.05 or <0.01). The number of calls differed by gender and identities of callers (both <0.05). Finally 181 callers accepted telephone follow-up. Among them, 51.38%(93/181) of the callers thought that the waiting time was too long, 33.15%(60/181) of the callers thought that the call time was insufficient, 80.66%(146/181) of callers believed that the hotline could partially or completely resolve their concerns, and 39.23%(71/181) of the callers said the operator proposed to end the call. CONCLUSIONS s The changes of the number and content of the mental health assistance hotline calls reflected that the public mental health status experienced four stages during the pandemic: confusion, panic, boredom, and adjustment. The specialized mental health assistance hotlines should be further strengthened, and the efficiency should be improved. Mental health interventions should be tailored and adopted according to the characteristics of the public mental health status at different stages of the pandemic.
China ; epidemiology ; Coronavirus Infections ; epidemiology ; Hotlines ; statistics & numerical data ; Humans ; Mental Health ; statistics & numerical data ; Pandemics ; statistics & numerical data ; Pneumonia, Viral ; epidemiology ; Public Health ; statistics & numerical data

Objective: To summarize the surgical results and experience of patients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets. Methods: From April 2013 to June 2017, 10 patients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets underwent biventricular repair at Guangzhou Women and Children Medical Center. Seven were male, and 3 were female. The age and body weight at surgery was 2 months to 13 years and 3.7-23.6 kg. Repair was performed with modified one-patch technique in 3 patients, modified two-patch technique in 6 patients, two-patch technique in 1 patient. Results: There was no hospital mortality. The ICU stay and hospital stay after operation were 2~5 days and 7~10 days. The follow-up duration was 16 to 65 months. All patients were alive and free from left ventricular outlet obstruction. The left atrioventricular valve function were normal in 2 patients, mild regurgitation in 6 patients, moderate regurgitation in 1 patient and severe regurgitation in 1 patient. Conclusion The outcomes of biventricular repair for patients with complete atrioventricular septal defect associated with Tetralogy of Fallot or double right ventricular outlets were satisfied, and long-term follow-up was demanded.

Objective To assess the application value of juxtaposition of the great vessels in diagnosis of right atrial isom-erism( RAI) by echocardiography.Methods We retrospectively analyzed 73 patients with right atrial isomerism in Guangzhou Women and Children's Medical Center from 2010-2017.All these patients were performed by echocardiography and compu-ted tomography(CT).We used the results of CT as the golden standard.Results 73 cases of RAI were diagnosed by CT.60 cases of RAI were diagnosed by echocardiography.Juxtaposition of the descending aorta(DAO) and inferior vena(IVC) was demonstrated in all these 60 patients.29 of 60 were on the left side of the spine(39.73％).31 of 60 were on the right side of spine(42.47％).In the other 13 patients of echocardiography missed diagnosis, the arrangement of the great vessels was nor-mal in 10 cases, and inverse in 3 cases.Conclusion Juxtaposition of the great vessels is one of the most important findings in patients with RAI.It is quick and simple and has a higher application value in diagnosis of RAI.

Objective To summarize the outcomes and experience of arterial switch operation (ASO) in the past 10 years in our center.Methods From September 2008 to July 2017,238 patients underwent ASO at Guangzhou Women and Children Medical Center for repair of transposition of the great arteries and Taussig-Bing anomaly.There were 193 male and 45 female.Median age at operation was 2 months (2 days to 10 years) and mean body weight was(4.2 ± 1.7) kg (1.8-20.6 kg).There were TGA and VSD 91 cases,TGA/IVS 110 cases,and Taussig-Bing anomaly 37 cases.Among them 24 patients had an aortic arch anomaly.Intramural coronary artery was found in 8 patients.Results All patients successfully completed the operation,one-stage ASO was perfonned in 232 patients.Two-stage ASO was performed in 6 patients.The mortality was 14.2％.The follow-up duration was 1-10 years (median time,46 mouths).There were 3 died.Two suffered sudden death,and another one arrhythmia.10-year survival rate was 92.8％.Conclusion The outcomes of ASO were satisfactory.The long-term reoperation rate was rare.