ObjectiveTo understand the seropositivity of neutralizing antibodies (NAb) and low-level NAb against SARS-CoV-2 infection in the community residents, and to explore the impact of COVID-19 vaccination and SARS-CoV-2 infection on the levels of NAb in human serum. MethodsOn the ground of surveillance cohort for acute infectious diseases in community populations in Shanghai, a proportional stratified sampling method was used to enroll the subjects at a 20% proportion for each age group (0‒14, 15‒24, 25‒59, and ≥60 years old). Blood samples collection and serum SARS-CoV-2 NAb concentration testing were conducted from March to April 2023. Low-level NAb were defined as below the 25^th percentile of NAb. ResultsA total of 2 230 participants were included, the positive rate of NAb was 97.58%, and the proportion of low-level NAb was 25.02% (558/2 230). Multivariate logistic regression analysis indicated that age, infection history and vaccination status were correlated with low-level NAb (all P<0.05). Individuals aged 60 years and above had the highest risk of low-level NAb. There was a statistically significant interaction between booster vaccination and one single infection (aOR=0.38, 95%CI: 0.19‒0.77). Compared to individuals without vaccination, among individuals infected with SARS-CoV-2 once, both primary immunization (aOR=0.23, 95%CI: 0.16‒0.35) and booster immunization (aOR=0.12, 95%CI: 0.08‒0.17) significantly reduced the risk of low-level NAb; among individuals without infections, only booster immunization (aOR=0.28, 95%CI: 0.14‒0.52) showed a negative correlation with the risk of low-level NAb. ConclusionsThe population aged 60 and above had the highest risk of low-level NAb. Regardless of infection history, a booster immunization could reduce the risk of low-level NAb. It is recommended that eligible individuals , especially the elderly, should get vaccinated in a timely manner to exert the protective role of NAb.

Objective Based on the limited time theory,taking tonsillectomy day operation as an example,the whole process nursing list of day operation was constructed,and its application effect was evaluated.Methods The nursing service list of tonsillectomy was constructed based on literature research,field observation and expert correspondence.A total of 197 patients who underwent tonsillectomy in the day ward of a tertiary A general hospital in Hangzhou,Zhejiang Province were selected.Among them,98 patients from April to June 2023 were taken as an experimental group and treated with the whole-process nursing list of daytime tonsillectomy constructed in this study,and 99 patients from January to March 2023 were taken as a control group and routine nursing was adopted.The anxiety degree,postoperative pain score,postoperative complication rate and patients'satisfaction with nursing service were compared between the 2 groups.Results Anxiety scores before operation and at discharge,pain scores at 6 h,12 h and 24 h after operation,and incidence of complications such as infection and gastrointestinal reaction within 14 days after operation in the experimental group were lower than those in the control group,with statistical significance(P＜0.05).The satisfaction of nursing service in the experimental group(99.40±0.69)score was significantly higher than that in the control group(90.36±1.04)score,and the difference was statistically significant(P＜0.001).Conclusion The use of tonsillectomy day whole-process nursing list can improve perioperative anxiety,relieve postoperative pain and reduce the incidence of postoperative complications,and improve patient satisfaction.

Objective:To analyze factors associated with timely vaccination of pertussis-containing vaccines in children born in Shanghai from 2019 to 2023.Methods:Children born in Shanghai between 2019 and 2023 were selected using a stratified random sampling method, and their vaccination data were obtained from the Shanghai Vaccine Management and Vaccination Service Information System. The vaccination rates, timely vaccination rates, and the proportions of diphtheria-tetanus-acellular pertussis-haemophilus influenzae type b combination vaccine (DTaP-Hib) and diphtheria-tetanus-acellular pertussis-inactivated poliovirus-haemophilus influenzae type b combination vaccine (DTaP-IPV-Hib) for the substitution of diphtheria- tetanus-acellular pertussis vaccine (DTaP) were calculated. Also, the factors associated with timely vaccination rate was analyzed with multivariate logistic regression analysis.Results:The average vaccination coverage rate of pertussis-containing vaccines in children born in Shanghai from 2019 to 2023 ranged from 94.71% to 99.53%. There were significant differences in the vaccination coverage of the 1 st-4 th doses of pertussis-containing vaccines among children born in different years (all P<0.05), but no gender and area specific significant differences were observed (all P>0.05). Non-national immunization program (non-NIP) vaccines were used to substitute DTaP vaccines in some children, with the proportion of DTaP-IPV-Hib vaccine accounting for 50.11%-52.69% and the proportion of DTaP-Hib vaccine accounting for 27.22%-28.43%. The proportions of DTaP-Hib and DTaP-IPV-Hib for the substitution of DTaP had increasing trends over the years. The overall timely vaccination rate of pertussis-containing vaccine vaccination was 84.09%. Analysis on the factors affecting the timely vaccination rate showed that the rate gradually decreased with the increase of the doses. Children who received the self-paid quadrivalent or pentavalent vaccines were less likely to have vaccination delays. Birth year had a significant impact on the timely vaccination rate, while the area had less impact. Additionally, the timely vaccination rate was also influenced by the degree of non-pharmaceutical intervention measures. Conclusions:The substitution of pertussis- containing vaccines with non-NIP vaccines was common in Shanghai. The coverage and timeliness of pertussis-containing vaccine vaccination were relatively high. The timely vaccination rate was significantly associated with gender, dose, vaccine type, and the degree of non-pharmaceutical interventions. There was a certain proportions of delayed and missed vaccinations, and it is necessary to pay attention to children who are not vaccinated timely and conduct high-quality catch-up vaccination to ensure timely and complete vaccination of pertussis-containing vaccines.

Objective: To investigate the effectiveness of normal limbs active exercise rehabilitation training in fear of falling and motor function in patients with cerebral infarction after intervention. Methods: A total of 74 cerebral infarction after intervention patients were enrolled in Wanbei Coal-Electricity Group General hospital from May 2016 to April 2018. Patients were randomly divided into the observation group 37 patients and the control group 37 patients according to the random number table method. The control group received routine rehabilitation training, normal limbs active exercise rehabilitation was carried out in the observation group. After 3 months of intervention, the fear of falling, activities of daily living, limbs motor function was assessed by short Falls Efficacy Scale International (FES-I), Barthel index, Fugl-Meyer motor function scoring, respectively. Results: Before intervention, the short FES-I score was (15.32±3.15) and (15.47±4.89) in the observation group and in the control group respectively, after intervention, the score was (10.21±2.67) and (12.28±4.05), respectively. There was no significant difference in short FES-I scores between the two groups pre-intervention (P> 0.05). However, the short FES-I scores were significantly decreased in the observation group compared to the control group at post-intervention (t value was 2.468, P<0.05). Before intervention, the scores of Barthel index, upper limb motor function, lower limb motor function were (33.15±7.08), (22.88±4.42), (15.31±3.38) in the observation group, and (33.40±3.78), (22.26±5.03), (16.04±3.30) in the control group, however, those index mentioned above were (47.96±8.45). There was no significant difference in Barthel index, motor function scores between two groups pre-intervention (P>0.05). However, those scores were significantly increased in the observation group compared to the control group at post-intervention (t value was 2.562, 2.878, 4.553, P<0.05). Conclusion Normal limbs active exercise rehabilitation training can alleviate the fear of falling and promote motor function and self-care ability of patients with cerebral infarction after intervention.

Objective:To investigate the risk factors of dysplasia in patients with ulcerative colitis (UC) in China.Methods:From March 1st, 2012 to December 30th, 2013, a total of 154 UC patients were prospectively enrolled from the following 11 hospitals, Xijing Hospital of Digestive Diseases, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Peking Union Medical College Hospital, Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Nanfang Hospital affiliated to Southern Medical University, China-Japan Friendship Hospital, The Second Hospital of Hebei Medical University, West China Hospital affiliated to Sichuan University, The Seventh Medical Center of PLA General Hospital, Zhongshan Hospital affiliated to Xiamen University, and the First Affiliated Hospital of Anhui Medical University. The patients were followed up till December 1st, 2017. All the UC patients underwent colon endoscopy and histopathological evaluation. T test and Chi-square test were used for statistical analysis. Cox proportional risk model was used for identifying the risk factors of dysplasia in UC patients. Results:Finally, 133 UC patients were enrolled, the age was (50.0±11.9) years, the diagnosis age was (35.5±11.6) years, the course of disease was (14.5±6.7) years, and the number of endoscopic examinations was (3.4±1.6) times. A total of 21 patients were detected with dysplasia. No patients were detected with colorectal cancer. The results of univariate analysis revealed that the diagnosis age (hazard ratio ( HR)=1.05, 95% confidence interval ( CI) 1.01 to 1.10, P=0.009) and extensive colitis ( HR=2.92, 95% CI 0.97 to 8.79, P=0.057) were factors with statistically significant difference. The results of multivariate analysis revealed that the old age at diagnosis ( HR=1.06, 95% CI 1.02 to 1.11, P=0.003) and extensive colitis ( HR=3.68, 95% CI 1.21 to 11.19, P=0.022) were independent risk factors of dysplasia in UC patients. The cumulative incidence of dysplasia of UC patients with extensive colitis was higher than that of patients with left-sided colitis (24.3%, 17/70 vs. 6.3%, 4/63), and the difference was statistically significant ( χ2=8.023, P=0.005). Conclusions:Extensive colitis and older age at diagnosis are two independent risk factors of dysplasia in UC patients of our country. The cancer monitoring should be strengthened in UC patients with long course of disease and extensive colitis.

Objective: To assess the clinical value of uterine curettage ultrasound in the evaluation of cesarean section scar pregnancy (CSP) after uterine arterial chemoembolization (UAE). Methods: Retrospective analysis were performed in 42 patients who took uterine curettage within 24-48 hours after UAE treatment in the Second Affiliated Hospital of Harbin Medical University from January 2015 to June 2018. The ultrasonic manifestations were graded and classified before UAE. The intraoperative and postoperative complications, time of β-human chorionic gonadotrophin declined to normal limits were evaluated, and the formation of hematoma and hematoma absorption time were followed up by ultrasound. Results: UAE was performed successfully in all patients. The ultrasound-guided scar pregnancy was successfully completed. The uterus was successfully retained in all patients.Among the 42 patients, 18 cases were 3 scores group, and 24 cases were 4 scores group according to the ultrasonic scoring system. Two cases were type Ⅰgroup, 25 cases were type Ⅱ group, and 15 cases were type Ⅲ group according to the ultrasonic classification. The amount of intraoperative complications, postoperative mass formation and absorption time were significantly different between 3 scores group and 4 scores group (P<0.05). No significant differences were found in intraoperative complications, postoperative complications, postoperative mass formation and β-human chorionic gonadotropin (β-hCG) value among different ultrasonic classification groups (P>0.05). Conclusions Ultrasonography has clinical application value in evaluating the prognosis of CSP treated with UAE. Ultrasonic scoring system can evaluate the efficacy and is helpful for predicting clinical outcome of CSP.

Objective:To classify the ultrasound features of ovarian tumors by modified gynecology imaging reporting and data system(mGI-RADS), and explore the clinical value of mGI-RADS in differentiating of benign and malignant tumors.Methods:The 242 ultrasound images of the adnexal mass from 221 patients with ovarian tumor who underwent ultrasound scan and proceeded surgeries in the Second Affiliated Hospital of Harbin Medical University from September 2017 and December 2019 were involved in the retrospective analysis and compared with the pathological results. According to the latest ultrasound terminology for adnexal masses proposed by the International Ovarian Tumor Analysis (IOTA), the adnexal masses were classified. The suspeted malignant sings were screened for mGI-RADS. Using GI-RADS and mGI-RADS classification systems, all the adnexal masses were double-blindly classified by two senior doctors and their diagnostic efficiencies were evaluated.Results:Among the suspected malignant signs proposed by IOTA, resistance index (RI)<0.5, central blood flow signal, ascites, irregular cystic wall with uneven thickness separation, mass composition (solid component ≥30% and silent shadow attenuation), and papillary structure≥7 mm, showed retatively higher OR values(14.282, 10.372, 9.653, 8.832, 5.851, 4.506, respectively. Using GI-RADS and mGI-RADS classification systems, the diagnostic consistency by the two senior doctors in differentiating benign and malignant ovarian neoplasms was good(Kappa=0.767, P<0.05). Grade Ⅳ was divided into three subtypes (Ⅳa, Ⅳb, Ⅳc) by the mGI-RADS, and their positive predictive values for malignant ovarian masses were 69.0%, 90.4% and 92.9% respectively. When a cut-off value >mGRⅣ was used to distinguish the benign and malignant adnexal tumors, the AUC was the largest, and its sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 93.4%, 93.1%, 90.4%, 95.2% and 93.2%, respectively. Conclusions:The mGI-RADS has a high clinical value in the differential diagnosis of ovarian tumors.

Objective:To evaluate the myocardial reserve effect in rabbits′ model of myocardial inshemia-reperfusion by layer-specific strain of speckle tracking imaging and low dose dobutamine stress echocardiography(LDDSE).Methods:Forty rabbits were randomly divided into two groups: ischemia-reperfusion group (IR group) and pharmacological postconditioning group (ATP-PostC group). Echocardiography examinations were performed at baseline, 60 min after ligation (before and after dobutamine stress), and 120 min after reperfusion (before and after dobutamine stress). The size of each chamber was measured and the left ventricular ejection fraction(LVEF) was calculated and the heart rate was recorded. The longitudinal strain of endocardium(SLsys-endo), longitudinal strain of myocardium(SLsys-mid), longitudinal strain of epicardium(SLsys-epi) were acquired. Triphenyl tetrazolium chloride(TTC) and Evans blue staining were applied in two rabbits randomly selected from each group at 60 min after ligation, dobutamine stress and 120 min after reperfusion, respectively.Results:①After coronary artery ligation, LVEF decreased in both groups( P<0.05), SLsys-endo, SLsys-mid, and SLsys-epi decreased in two groups( P<0.01). After low dose dobutamine stress, the SLsys-endo, SLsys-mid and SLsys-epi in the two groups increased, which was different from that after lagation( P<0.05). ②After 120 min reperfusion, the longitudinal strain of the myocardium of both groups increased compared with that after lagation( P<0.01, P<0.05), and the increase in ATP-PostC group was significantly higher than that in IR group( P<0.01). There was no significant difference between the IR group and the first LDDSE( P<0.05). After LDDSE again, the SLsys-endo and SLsys-mid in the two groups further increased, which was different from that after reperfusion ( P<0.05). And the SLsys-endo and SLsys-mid were higher in ATP-PostC group than those in IR group ( P<0.05). ③Pathological results showed that there was no significant difference in myocardial infarct size between IR group and ATP-PostC group at 60 min after ligation ( P>0.05). After 120 min reperfusion, the percentage of myocardial infarct size in the IR group was significantly higher than that in the ATP-PostC group ( P<0.05). Conclusions:Layer-specific strain of STI combined with LDDSE can early detect regional myocardial dysfunction and accurately assess myocardial reserve function, and with endocardial longitudinal strain being more sensitive.

OBJECTIVE： To investigate the pratice of pharmaceutical care provided by clinical pharmacists in orthopedics department. METHODS： Based on the characteristics of orthopedic diseases and clinical drug use， combined with case analysis， the content， work focus and working methods of pharmaceutical care provided by clinical pharmacists were summarized in orthopedics department of our hospital. RESULTS： Clinical pharmacists of our hospital provided basal pharmaceutical care， such as pharmacy consultation， drug reforming， medication education. Focusing on the application standardization of antibiotics in perioperative period， pain evaluation， analgesic regimen optimization， hemostasis and anticoagulation medication safety monitoring of patients undergoing orthopaedic surgery， clinical pharmacists went deep into ward work to assist physicians in formulating treatment plans. Results of case analysis showed that the work of clinical pharmacists was recognized by doctors and promoted rational drug use in clinic. CONCLUSIONS： Clinical pharmacists should combine different specialty characteristics to carry out pharmacy services for specific groups， continuously improve the professional level and their ability to work， and improve the level of pharmaceutical care.

Objective: To analyze the relationship between family behaviors and overweight/obesity in primary and junior school students aged 6-14 years in Xuzhou, and to provide a reference for a targeted measure to prevent and control overweight and obesity. Methods: Using multistage stratified cluster random sampling, a total of 6 220 students aged 6-14 years old from 10 primary schools and 10 junior schools were investigated by a self-designed questionnaire. Chi-square and multivariate Logistic regression models were used to explore the relationship between family behaviors and overweight/obesity in primary and junior school students. Results: The rate of overweight/obesity in primary and junior boys was higher than that in primary and junior girls. The rate of overweight/obesity in urban students was higher than that of rural students(P<0.05). The Chi-square analysis showed that overweight of parents, irregular breakfast, eating fast food, eating sweets, drinking sweetened beverage, long screen time and short sleep duration were risk family behavior factors of overweight/obesity in primary and junior boy students(P<0.05). The risk family behavior factors of overweight/obesity in primary and junior girl students were overweight of parents, irregular breakfast, eating fast food and eating sweets(P<0.05). The risk family behavior factors of overweight/obesity, such as drinking sweetened beverage and short sleep duration, were also related to primary girls(P<0.05), and long screen time was related to junior girls(P<0.05). The multivariate Logistic regression showed that such family behavior factors as irregular breakfast(OR-boy=1.58, OR-girl=1.74), eating fast food(OR-boy=1.37, OR-girl=1.11), eating sweets(OR-boy=1.85, OR-girl=1.52), drinking sweetened beverage(OR-boy=1.64, OR-girl=1.33) and short sleep duration(OR-boy=1.56, OR-girl=1.69) were positively correlated with the prevalence of overweight/obesity in primary students. Long screen time was also correlated to overweight/obesity primary boy students(OR=1.18). Family behavior factors for child overweight and obesity induded overweight of parents(OR-boy=1.29, OR-girl=1.23) and eating sweets(OR-boy=1.44, OR-girl=1.51). Irregular breakfast(OR=1.51), eating fast food(OR=1.22), drinking sweetened beverage (OR=1.75) and long visual screen time (OR=1.15) were also positively correlated with the prevalence of overweight/obesity in junior boy students. Conclusion Family behavior factors were positively correlated with the prevalence of overweight/obesity in primary and junior students. The influence of family behavior factors were different between primary and junior students. Behavioral interventions based on family should be adopted to prevent and control the overweight/obesity of children.