Objective:To analyze the temporal distribution characteristics of hand, foot and mouth disease (HFMD) in Beijing and provide reference evidence in HFMD prevention and control.Methods:The monthly incidence data of HFMD in Beijing from 2008 to 2023 were collected from Notifiable Disease Management Information System of the Chinese Information System of Disease Control and Prevention, and the epidemiological characteristics of HFMD were analyzed by the methods of time series seasonal decomposition graph, concentration degree, and circular distribution.The WPS office software 2019 was used to clean the data, Python software 3.12 was used to analyze and make statistical charts.Results:The monthly incidence fluctuation of HFMD in Beijing from 2008 to 2015 was higher than that from 2016 to 2022. From 2016 to 2022, the fluctuation range of monthly incidence showed a gradually decreasing trend.From 2008 to 2015, the concentration ( M) was 0.58, indicating a relatively strong seasonality; the mean angle ( α) calculated by the circular distribution method was 174.95°, and the mean angle standard deviation ( s) was 60.43°. The annual incidence peak occurred on June 27, and the incidence peak period was from April 27 to August 27. From 2016 to 2019 and 2023, the M was 0.57, indicating a relatively strong seasonality. The α was 228.05°, and s was 61.44°. The annual incidence peak occurred on August 20, and the incidence peak period was from June 18 to October 21. From 2020 to 2022, the M was 0.42, indicating a seasonality, the α was 238.27° and s was 76.35°. The annual incidence peak occurred on July 15, and the incidence peak period was from June 14 to November 14. The α of 2008-2015, 2016-2019 and 2023, and 2020-2022 were tested by the Watson-Williams method and the difference was statistically significant ( F=33 443.09, P<0.001). In 2023, the M was 0.77, indicating a strong seasonality. The incidence peak occurred on September 16, and the incidence peak period was from August 5 to October 28. Conclusions:The seasonality of HFMD in Beijing was obvious from 2008 to 2023, and the incidence peak day and peak period overall had rearward shifts. It is necessary to strengthen the comprehensive analysis of the distribution characteristics at different dimensions and the comprehensive prevention and control in key areas, places, and populations during the peak incidence period.

BACKGROUND: Management of gastric leak after sleeve gastrectomy (SG) is challenging due to its unpredictable outcomes. We aimed to summarize the characteristics of SG leaks and analyze interventions and corresponding outcomes in a real-world setting. METHODS: To retrospectively review of 15,721 SG procedures from 2010 to 2020 based on a national registry. A cumulative sum analysis was used to identify a fitting curve of gastric leak rate. The Kaplan-Meier method and log-rank tests were performed to calculate and compare the probabilities of relevant outcomes. The logistic regression analysis was conducted to determine the predictors of acute leaks. RESULTS: A total of 78 cases of SG leaks were collected with an incidence of 0.5% (78/15,721) from this registry (6 patients who had the primary SG in non-participating centers). After accumulating 260 cases in a bariatric surgery center, the leak rate decreased to a stably low value of under 1.17%. The significant differences presented in sex, waist circumference, and the proportion of hypoproteinemia and type 2 diabetes at baseline between patients with SG leak and the whole registry population ( P = 0.005, = 0.026, <0.001, and = 0.001, respectively). Moreover, 83.1% (59/71) of the leakage was near the esophagogastric junction region. Leakage healed in 64 (88.9%, 64/72) patients. The median healing time of acute and non-acute leaks was 5.93 months and 8.12 months, respectively. Acute leak (38/72, 52.8%) was the predominant type with a cumulative reoperation rate >50%, whereas the cumulative healing probability in the patients who required surgical treatment was significantly lower than those requring non-surgical treatment ( P = 0.013). Precise dissection in the His angle area was independently associated with a lower acute leak rate, whereas preservation ≥2 cm distance from the His angle area was an independent risk factor. CONCLUSIONS Male sex, elevated waist circumference, hypoproteinaemia, and type 2 diabetes are risk factors of gastric leaks after SG. Optimizing surgical techniques, including precise dissection of His angle area and preservation of smaller gastric fundus, should be suggested to prevent acute leaks.
Humans ; Male ; Retrospective Studies ; Diabetes Mellitus, Type 2/complications* ; Obesity, Morbid ; Anastomotic Leak/epidemiology* ; Gastrectomy/methods* ; Reoperation/methods* ; Registries ; Laparoscopy/methods* ; Treatment Outcome

Objective: To analyze the epidemiological characteristics of infectious diseases at schools in Beijing from 2010 to 2020, providing evidence for the prevention and control strategies in school infectious diseases. Methods: Information on public health emergencies was collected from Public Health Emergency Reporting System (the subsystem of Chinese Disease Prevention and Control Information System) reported from 2010 to 2020. Results: A total of 146 public health emergencies and 138 public health emergencies of infectious diseases in schools were reported in Beijing from 2010 to 2020, including 4 291 cases with the rate of 2.32% and affected or exposed 185 179 cases. There were significant difference in mean annual incidence rates( χ 2=782.46, P <0.01). There were 71 events of respiratory infectious diseases and 66 events of intestinal infectious diseases, accounting for 51.45% and 47.83%, respectively. The annual incidence peaks of public health emergencies of infectious diseases were during March-June and October-December. The events mainly occurred in kindergartens and primary schools among each stage of school periods with 51 and 46 incidences respectively, which accounted for 70.29% of the total number of public health emergencies in schools. The leading infectious diseases among all the reported events in kindergartens and primary schools were hand foot mouth disease and varicella. Varicella and other infectious diarrhoeal diseases were at the top lists of infectious disease outbreaks at the secondary and university stages. Conclusion Infectious diseases events were the major type of public health emergencies at schools in Beijing from 2010 to 2020. Respiratory infectious diseases and intestinal infectious diseases were the keys to the prevention and control of public health emergencies related to school. It is necessary to strengthen the surveillance for public health emergencies especially for symptom surveillance. The prevention and control measures should be taken according to the characteristics of different age groups. At the same time, the prevention and control of school infectious diseases and the drill of the plan during peak periods need to be particularly strengthened.

Objective:To investigate the application value of Laennec approach in laparoscopic anatomical right hemihepatectomy (LARH).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 2 female patients who underwent LARH via Laennec approach in the First Affiliated Hospital of Kangda College of Nanjing Medical University from May to July 2020 were collected. The two patients were 51 and 57 years old, respectively. Observation indicators: (1) surgical situations; (2) postoperative situations and follow-up. Follow-up using outpatient examination and telephone interview was conducted to detect post-operative survival and tumor recurrence of patients up to December 2020. Count data were repre-sented as absolute numbers.Results:(1) Surgical situations: 2 patients successfully underwent LARH via Laennec approach, without conversion to open surgery. The operation time was 180 minutes and 185 minutes, and the volume of intraoperative blood loss was 200 mL and 400 mL, respectively. No blood transfusion or gastrointestinal decompression was performed in either patient. (2) Postoperative situations and follow-up: 2 patients began to take liquid diet on the first day and out-of-bed activities on the postoperative second to third day. There was no postoperative bile fistula or bleeding, but different degrees of peritoneal and pleural effusion occurred to the 2 patients after operation. One case was improved after right-sided thoracentesis and chest tube drainage due to dyspnea, and the other case was cured after conservative therapy. There was no perioperative death. The duration of postoperative hospital stay of 2 patients was 13 days and 11 days, respectively. Results of pathological examination showed 1 case of hepatic hemangioma and 1 case of primary liver cancer, respectively. The Laennec capsule was observed on the hepatic vein branches of segment Ⅴ, Ⅵ, Ⅶ, Ⅷ, and the gap existed between the Laennec capsule and the hepatic vein. Two patients were followed up for 7 months and 5 months，respectively. They survived during the follow-up，without tumor recurrence.Conclusion:It is safe and feasible to perform LARH by Laennec approach.

Beijing ; COVID-19 ; Contact Tracing ; Humans ; Risk Factors ; SARS-CoV-2

Objective To understand the seasonal distribution of the clustering of fever and diarrhea.Methods Concentration degree and circular distribution methods were used to analyze the seasonal distribution of the clustering of fever and diarrhea in Beijing from 2009 to 2015.The information were collected from the Infectious Disease Surveillance Information System of Beijing.Results The M values of the clustering of fever and diarrhea were 0.57 and 0.47.Circular distribution results showed that the clustering of fever and diarrhea angle dispersion index R values were 0.57 and 0.46 respectively,the sample average angle of Rayleigh's test Z values were 414.14,148.09 respectively (all P＜0.01).The clustering of fever and diarrhea had seasonality.The incidence peak of fever was on October 13,and the epidemic period was during August 13-December 14.The incidence peak of diarrhea was on July 31,and the epidemic period was during May 20-October 11.Conclusion The clustering of fever had obvious seasonality in Beijing,which mainly occurred in auttmn and winter.The cluster of diarrhea had certain seasonality,which mainly occurred in summer and autumn.

Introduction of a new magnetic anastomosis device for colostomy including its design and operaging principal. The anastomosis device is composed of magnetic base and anastomosis ring. It is convenient for colon and abdominal subcutaneous tissue going together through the magnetic attraction. The colostomy completes with magnetic compression anastomosis. The device has the advantage of making operation easer, reducing the operation steps and can better solve the colostomy ischemic necrosis, colostomy retraction, colostomy joint complications of skin mucous membrane and the skin diease around the colostomy. Patients can real y benefit from this device.

Objective To explore the therapeutic strategy and clinical value of intraoperative chole-dochoscopy and electrohydraulic lithotripsy for refractory intrahepatic bile duct stones.Methods Liver pa-renchyma,intrahepatic bile duct and bile duct stones were explored under direct vision and intraoperative choledochoscope in 1 1 cases of refractory intrahepatic bile duct stones.Electrohydraulic lithotripsy and lithot-omy were performed to remove the stones and protect the liver parenchyma.If the stones could not be re-moved once,a secondary lithotripsy and lithotomy was performed through the fistula tract.Results All re-fractory calculi were crushed after one or two procedures and the clearance rate were 100%.No complica-tions occurred.Ten patients were followed up from 1 to 3 years except one.Three cases revealed recurrent stone during follow-up due to withdrawal of ursodeoxycholic acid capsules in 1 to 2 years.Seven others showed no stone recurrence within follow-up time.Conclusion Intraoperative choledochoscopy and electro-hydraulic lithotripsy is an easy technique and can effectively protect the liver parenchyma.The life quality of patients can be improved with low surgical risk and postoperative complications.

The 3D gait analysis system (Vicon) was used for the gait analysis of health persons and amputees who wear lower limb prosthesis. The result indicated that gait analysis can supply changes of kinematics and biomechanics; which can be used to analyze the difference of joint movement between the health persons and amputees. The 3D gait analysis is feasible for amputees in rehabilitation.

Objective To provide a new method for recognizing isotonic or isometric exercise in the rehabilitation of lower residual limbs for the patients after amputation. Methods The signs of surface electromyography (sEMG) of leg quadriceps of 10 amputees in rehabilitation were collected with EMG Sensor and analyzed. Results The absolute magnitude average (MAV)，variance (VAR) and power spectrum coefficient of sEMG can be used as the character value to establish the relation of the sEMG sign and lower limbs motor of rehabilitation. Conclusion A method recognizing the pattern of lower limbs motor in rehabilitation has been advanced, which may be used in further study for the systems controlling lower limbs in rehabilitation of residual limb.