Objective To retrospectively analyze the prevention and control effect and epidemic characteristics of elderly tuberculosis in Hubei Province from 2016 to 2020, and to provide a scientific basis for the prevention and treatment of elderly tuberculosis in Hubei Province． Methods The data on tuberculosis patients aged 60 and above who registered their current address in Hubei Province from 2016 to 2020 were collected and analyzed. The registration rates and composition ratios were analyzed using χ² test and χ² test for trend. Results A total of 135 976 tuberculosis patients were reported in Hubei from 2016 to 2020. The annual average registration rate of elderly tuberculosis among the elderly registered residence population (referring to the registration rate of elderly registered residence population aged 60 and above as the denominator, and tuberculosis patients aged 60 and above as the numerator) was 263.51/100 000. The highest rate was 300.02/100,000 in 2017, and the lowest was 188.19/100,000 in 2020 (χ²=70,227.603, P<0.001). In terms of composition, the average annual proportion of tuberculosis patients in the 60-70 years old group was 59.60%, which decreased year by year (χ²_trend=40.448，P<0.001 ). The average annual proportion of males was 73.35%, which was significantly higher than that of females (26.65%). The average annual proportion of farmers was 62.03%. From the perspective of case management, the annual average proportion of major epidemic online reports was 85.17%. The classification of cases was mainly based on clinical diagnosis, accounting for 48.33% annually and showing a decreasing trend year by year (χ²_trend=740.911, P<0.001). The proportion of confirmed cases was 25.08%, which showed an increasing trend (χ²_trend=380.557, P<0.001). From 2016 to 2019, the delay rate of diagnosis and treatment of elder tuberculosis patients was 49.42% (67 876/135 967), and the delay rate decreased year by year (χ²_trend=323.764, P<0.001). Conclusion The elderly population with pulmonary tuberculosis in Hubei Province shows a downward trend. It is necessary to focus on the efforts of designated hospitals to proactively identify cases, increase the proportion of confirmed cases, maintain a high tracking in place, reduce medical delays, and ensure the effectiveness of tuberculosis prevention and treatment for the elderly.

Objective:To analyze the epidemic characteristics of brucellosis in China from 2004 to 2018, in order to understand the development trend of brucellosis.Methods:The surveillance data of brucellosis in China from 2004 to 2018 were collected from National Public Health Science Data Center. Joinpoint regression was used to analyze the trend of brucellosis incidence in China and various provinces. Overall trends were estimated by the average annual percentage change (AAPC). Seasonal and trend decomposition using loess (STL) was used to analyze the seasonal characteristics of brucellosis in China and various provinces. The age-related thermodynamic diagram of incidence rate was used to analyze the characteristics of age-onset changes.Results:From 2004 to 2018, a total of 524 980 brucellosis cases and 16 deaths were reported nationwide, with a incidence rate of 2.61/100 000 and a case fatality rate of (3.05 × 10 -3)%. The incidence of brucellosis in China was on the rise (AAPC = 11.58%, 95% CI: 7.91% - 15.25%, P < 0.001). There was no significant trend of change in Inner Mongolia Autonomous Region, Shanxi and Shaanxi provinces ( P > 0.05). Tibet Autonomous Region showed a downward trend (AAPC = - 55.19%, P < 0.001). All other provinces were showing an upward trend (AAPC > 0, P < 0.05). The peak incidence in China occurred from April to June. In terms of provinces, the peak incidence in Hainan, Sichuan, Guizhou, Fujian and Anhui provinces occurred from April to August, the peak incidence in Chongqing and Shanghai cities occurred from June to August, and the peak incidence in other provinces was generally from April to June. There were reports of brucellosis cases in all age groups nationwide, and the age distribution showed an inverted "V" shape. The peak incidence occurred in the 50 - 54 years old (5.43/100 000), followed by the 60 - 64 years old (4.94/100 000). From 2004 to 2018, the top 3 age groups of incidence rate changed from 40 - 44, 50 - 54 and 35 - 39 years old in 2004 to 50 - 54, 60 - 64 and 55 - 59 years old in 2018. Conclusions:The incidence of brucellosis is on the rise nationwide and in most provinces from 2004 to 2018. The high incidence age is gradually changing to the elderly population.

Objective:To learn about the age, period, birth cohort characteristics, and incidence trends of hemorrhagic fever with renal syndrome (HFRS) nationwide.Methods:HFRS monitoring data from 2004 to 2018 were collected from the National Public Health Science Data Center (https://www.phsciencedata.cn/). The trend of incidence rate of HFRS was analyzed by joinpoint regression, and the linear trend was estimated by annual percentage change (APC) and average annual percentage change (AAPC). Bayesian Age-Period-Cohort (BAPC) analysis of the effects of age, period, and birth cohort on HFRS cases was conducted, with age, period, and birth cohort used as reference for the 40 - 44 age group, 2011, and 1968, respectively, the RR and 95% CI were calculated. Results:From 2004 to 2018, a total of 190 197 HFRS cases were reported nationwide, with an average annual incidence rate of 0.95/100 000. Among them, the highest incidence rate of HFRS was 1.93/100 000 in 2004. Since 2007, it had continued to fluctuate below 1.00/100 000, ranging from 0.66/100 000 to 0.99/100 000. Joinpoint regression fitting results showed that the overall incidence of HFRS in China was declining (AAPC = - 7.33%, 95% CI: - 8.07% - - 6.58%, P < 0.001); the APCs from 2004 to 2007, 2007 to 2009, and 2012 to 2016 were - 32.00%, - 8.74%, and - 9.02%, respectively, all showed a downward trend( P < 0.05); the APCs from 2009 to 2012 and from 2016 to 2018 were 14.69% and 11.38%, respectively, both showed an upward trend ( P < 0.05). HFRS cases were reported in all age groups, and the reported incidence rate showed a unimodal distribution with age. Among them, the highest incidence rate was in the 50 - 54 age group (1.75/100 000), and the lowest incidence rate was in the 0 - 4 age group (0.03/100 000); the proportion of cases in the age group of 60 years and above increased from 9.75% in 2004 to 25.90% in 2018, showed an increasing trend year by year (χ 2trend = 9 210.90, P<0.001). The analysis results of the BAPC model showed that in the age effect analysis, compared with the reference age group, there was no significant difference in the incidence risk among the age groups of 15 - 79 years old ( P > 0.05), while the incidence risk was lower in the age groups of 14 years old and below, and 80 years old and above ( RR < 1, P < 0.05). In the analysis of period effects, compared with the reference year, the incidence risk was higher from 2004 to 2006 and from 2012 to 2014 ( RR > 1 , P < 0.05), and lower from 2008 to 2010 and from 2017 to 2018 ( RR < 1, P < 0.05); the overall trend was consistent with the descriptive analysis of onset period. In the analysis of birth cohort effect, compared with the reference cohort, the population born between 1920 - 1935 and 1970 - 2018 had lower incidence risk ( RR < 1, P < 0.05); but the risk of disease in the population born after 2003 showed an upward trend. Conclusions:The HFRS epidemic in China has decreased from 2004 to 2018, but the downward trend in recent years is not significant. The incidence risk has increased among people born after 2003. The population aged 60 and above is a key group for further controlling the HFRS epidemic in China.

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Objective:To establish and validate a nomogram model for early prediction of the risk of acute pancreatitis (AP) progressing to severe acute pancreatitis (SAP).Methods:CT signs and clinical laboratory parameters of 361 AP patients admitted to our Hospital from January 2016 to July 2022 were retrospectively collected. There were 221 males (61.2%) and 140 females (38.8%). According to the Atlantic score, all patients were divided into the SAP group (64 cases) and the non-SAP (NSAP) group (297 cases). Univariate analysis was used to screen out variables with statistically significant differences. Multivariate Logistic regression analysis was used to screen out the independent risk factors of SAP, and finally a nomogram prediction model was established. Receiver operating characteristic (ROC) curve, calibration curve and decision curve (DCA) were used to evaluate the predictive efficacy, accuracy and clinical practicability of the model, and Bootstrap method was used to verify the model internally.Results:Univariate analysis and multivariate Logistic regression analysis showed that pleural effusion ( OR=7.353, 95% CI: 3.344-16.170), posterior pararenal space (PPS) involvement ( OR=3.149, 95% CI: 1.314-7.527), serum creatinine concentration (Cr) ( OR=1.027, 95% CI: 1.017-1.038) and serum calcium concentration (Ca 2+) ( OR=0.038, 95% CI: 0.009-0.166) were independent risk factors for SAP ( P<0.05). A Nomogram model was established based on these four factors. The area under the ROC curve (AUC) of this model was 0.905 (95% CI: 0.869-0.933), indicating high predictive efficiency. Internal verification showed that the model had good accuracy in predicting SAP, and C-index was 0.90. DCA analysis showed that the model had high clinical practicability. Conclusions:The Nomogram model combining pleural effusion, PPS involvement, Cr and Ca 2+ had a good effect on early prediction of SAP, which could provide a new reference tool for clinical diagnosis and treatment.

Objective:To analyze the epidemic characteristics and periodicity of hemorrhagic fever with renal syndrome (HFRS) in Jingzhou City, Hubei Province, and provide a basis for scientific prevention and control of HFRS in Jingzhou City.Methods:Retrospective analysis was used to collect HFRS case data and population data of Jingzhou City and 8 counties (cities, districts) within its jurisdiction, including Shashi District, Jingzhou District, Gongan County, Jianli City, Jiangling County, Shishou City, Honghu City, and Songzi City from 1962 to 2020, from the Archives of the Jingzhou Center for Disease Control and Prevention and the Infectious Disease Report Information Management System of the China Disease Control and Prevention Information System; and the epidemic characteristics of HFRS was analyzed in Jingzhou City and 8 counties (cities, districts) within its jurisdiction. The periodicity of HFRS onset was determined using wavelet analysis.Results:From 1962 to 2020, 18 936 HFRS cases were reported in Jingzhou City, with an average incidence rate of 5.95/100 000. There were a total of three epidemic peaks, namely from 1972 to 1973 (24.82/100 000, 24.84/100 000), 1983 (60.08/100 000), and 1995 (14.57/100 000). According to different regions, the high incidence areas of HFRS showed a phased transfer trend: from the 1960s to the 1970s, the Jiangbei area (Honghu City, Jianli City) was the highest incidence area; in the 1980s and 1990s, the high incidence areas were transferred to Jiangnan area (Songzi City, Shishou City, and Gongan County); after 2005, high incidence areas were relocated to Jiangbei area (Honghu City, Jianli City, Jiangling County). The wavelet analysis results showed that there were 12.30 and 21.77 years of HFRS epidemic cycles in Jingzhou City before 2000 ( P < 0.05); among them, the periodicity of Shashi District, Gongan County, Jiangling County, Shishou City, and Honghu City was relatively consistent with that of Jingzhou City, with epidemic cycles of about 12 or 22 years ( P < 0.05). Conclusions:Jingzhou City is currently at the peak of a 22-year epidemic cycle of HFRS, with Jiangbei area as the high incidence areas. The 12-year epidemic cycle in Jingzhou City has ended after 2000.

Objective:To analyze the prognosis and influencing factors of acute necrotizing encephalopathy (ANE) in children.Methods:Clinical data of ANE patients admitted to Pediatric Intensive Care Unit, Beijing Children′s Hospital, Capital Medical University from March 2012 to February 2019 were retrospectively analyzed.Survivors were followed up by telephone or outpatient department, and the quality of life was evaluated by pediatric overall performance category scale.The t-test or rank sum test was used for comparison between groups, and the COX risk regression was used to analyze the influencing factors of prognosis. Results:A total of 38 patients were enrolled in this study with the male-to-female ratio of 1.24∶1.00, and median age of 29.5(10.0-130.0) months.They were followed up for the median of 27(15-96) months.The overall survival rate at 7 days, 14 days and 2 months after disease onset were 57.9%, 42.1%, and 34.2%, respectively.The mortality rate at discharge was 34.2%(13/38 cases), and the cumulative mortality rate at the 1 st, 3 rd and 12 th months after discharge was all 68.4%(26/38 cases). The complete reco-very rate was 10.5%(4/38 cases) after one-year follow-up.The univariate analysis indicated that cardiopulmonary resuscitation before admission, Glasgow coma score < 5 at admission, complication with shock/cerebral hernia/multiple organ dysfunction syndrome, creatine kinase isoenzyme> 100 U/L, lactate dehydrogenase>1 000 U/L, hypoalbuminemia, hyperglycemia, hyperurea, prolonged prothrombin time and elevated international standardized ratio were risk factors for the prognosis of ANE in children ( β=3.519, 6.967, 6.803, 3.000, 6.389, 3.471, 2.252, 1.616, 2.377, 3.092, 2.713, and 4.510, respectively, all P<0.05). Meanwhile, high-dose Methylprednisolone[20-30 mg/(kg·d)] and immunoglobulin (2 g/kg, divided into 2-5 days intravenous drip) treatment were protective factors ( β=0.625, 0.405, respectively, all P<0.05). The COX multivariate analysis showed that high-dose Methylprednisolone treatment [20-30 mg/(kg·d)] was an independent protective factor for the prognosis of children with ANE [95% CI: 0.449(0.213-0.944), P=0.035]. Conclusions:Early application of high-dose Methylprednisolone and immunoglobulin may contribute to the good clinical outcome.Children with neurological sequelae should be actively treated with rehabilitation, and the quality of life may be gradually improved.

Mori Cortex is sweet and pungent in taste， cold in nature， and has the tropism to the lung meridian. It has the functions of purging the lung and relieving asthma and can treat oliguria and edema， being one of the commonly used herbal medicines in clinical practice. The prescriptions with Mori Cortex， such as Sangbaipi Tang， Qingjin Huatanfang， and Qingfei Huatantang， are widely used in clinical practice. The main active components in Mori Cortex are the material basis for its efficacy. Owing to the mature methods for the identification of pharmacodynamic substances in Chinese herbal medicines， the research on the chemical components of Mori Cortex has been in-depth and systematic. This article reviews the recent studies about the chemical components and pharmacological effects of Mori Cortex， as well as the treatment of respiratory diseases by the prescriptions with Mori Cortex. On this basis， the effect and mechanism of Mori Cortex and related prescriptions in the treatment of respiratory diseases are summarized. Furthermore， this article analyzes the formulation compatibility and commonly used dosages of Mori Cortex-related prescriptions in clinical practice. It provides reference for the clinical application of Mori Cortex and related prescriptions in the treatment of respiratory diseases.

Objective:To investigate the amyloid precursor protein (APP) expression in brain glioma tissues and cerebrospinal fluid of glioma patients and their significances.Methods:(1) Fifty-six brain glioma specimens surgically resected and pathologically confirmed in our hospital from January 2015 to December 2020 were collected, including 9 with WHO grading I, 14 with WHO grading II, 18 with WHO grading III, and 15 with WHO grading IV. In addition, the necrotic brain tissues of 4 patients with hypertensive intracerebral hemorrhage during hematoma removal at the same time period were collected as controls. Western blotting and real-time quantitative PCR (RT-qPCR) were used to detect the APP protein and mRNA expressions in glioma tissues and control brain tissues, respectively. (2) The cerebrospinal fluid of above 56 patients with glioma, 4 patients with viral meningitis, 4 patients with bacterial meningitis, 4 patients with autoimmune encephalitis, 5 patients with epilepsy, 3 patients with migraine and 3 normal subjects were collected at the same time period, and the APP content in the cerebrospinal fluid of all subjects were detected by ELISA.Results:(1) Western blotting and RT-qPCR showed that the APP protein and mRNA expressions in glioma tissues of WHO grading I, II, III and IV were significantly higher than those in control brain tissues, and the APP protein and mRNA expressions in glioma tissues of WHO grading I, II, III and IV increased successively, with statistical differences ( P<0.05). There were no significant differences in APP protein and mRNA expressions between first-onset glioma and recurrent glioma in glioma tissues of WHO grading I and II ( P>0.05); while in glioma tissues of WHO grading III and IV, APP mRNA expression in recurrent glioma was statistically higher than that in first-onset glioma ( P<0.05). (2) ELISA results showed that APP content in patients with viral meningitis, bacterial meningitis, autoimmune encephalitis, epilepsy or migraine was not significantly different as compared with that in normal controls ( P>0.05). The APP content in cerebrospinal fluid of patients with WHO grading I, II, III and IV gliomas was significantly higher than that in normal controls, and the APP content in cerebrospinal fluid of patients with WHO grading I, II, III and IV gliomas increased successively, with statistical differences ( P<0.05). Conclusion:APP is highly expressed in glioma tissues and cerebrospinal fluid of patients with glioma, and its expression is significantly correlated with the pathological grades of glioma; the detection of APP expression in cerebrospinal fluid can be used as a new screening method for glioma patients.

Objective To analyze the global status of COVID-19 epidemics, so as to preliminarily forecast the epidemic trend. Methods The epidemiological data of 208 countries and the prevention and control policies implemented by typical countries from December 31, 2019 to December 14, 2020 were collected. We use the cumulative incidence rate, cumulative mortality, cumulative fatality and real-time dependent reproduction number (R_t) to analyze the epidemic status. We use the provenance package to group different countries and discuss the effect of prevention and control measures. Results As of December 14, 2020, a cumulative incidence of 93.49 per 10000, a cumulative mortality rate of 0.21‰, and a cumulative fatality rate of 3.1‰ had been reported globally.112 of the 208 countries still had R_t ≥ 1.0, and 96 countries had R_t <1.0. The grouping of 208 countries showed that countries from the same continent often gather together and were geographically adjacent. Countries that were geographically adjacent could easily be grouped together. Conclusion As of December 14, 2020, the epidemic situation in most countries had not been effectively controlled, and epidemic prevention and control are facing greater pressure. Sub-Saharan countries currently had a high R_t , and the government had adopted more relaxed epidemic prevention measures. The epidemic situation in this region may continue to deteriorate, and needs to be focused in the later period.