Objective To explore risk factors of osteoporotic fracture in elderly women in Zhuhai in 2017.Methods A simple sampling method was used to select female patients with osteoporotic fractures aged 50-70 years in Zhuhai City as a case group and healthy women who underwent a physical examination as a control group to conduct a questionnaire survey. The survey contents included demographic characteristics, age, marital status, family income, education, outdoor activities, BMI, menarche age, menopausal age, number of pregnancies, number of fetuses, history of fractures, history of drinking, history of smoking, frequency of milk intake, etc. Univariate and multivariate logistic regressions were used to determine the factors affecting osteoporotic fractures in this age group.Results A total of 200 women aged 50-70 years with osteoporotic fractures were included in the study as the case group and 200 healthy women aged 50-70 years as the control group. In the case group, 75.0% were aged 60-70 years, 80.0% were married, 60.0% had family monthly income of less than 5 000 Yuan, and 60.0% had the educational level at junior college or above; in the control group, 66.5% were aged 60-70 years, 85.0% were married, 55.0% had family monthly income of less than 5 000 Yuan, and 57.5% had the educational level at junior college or above. The multivariate logistic regression showed that the history of fracture （OR=4.116）, history of smoking （OR=3.904）, and menopausal age <45 years （OR=4.229） were risk factors for osteoporotic fractures in women aged 50-70 years; while the amount of outdoor activity ≥60 min /day （OR=0.417） and milk intake frequency ≥3 times/week （OR=0.191） were protective factors for female fractures of this age group.Conclusion Outdoor activity, fracture history, smoking history, milk intake frequency and menopausal age are the influencing factors of osteoporotic fracture in women aged 50-70 years. The large amount of outdoor activities and high frequency of milk intake can reduce osteoporosis in women.

Objective To explore influencing factors of family and evaluate the efficacy of health education management on 6-14-year-old children with bronchial asthma in Nanping.Methods All the children with bronchial asthma who were treated at a hospital in Nanping City, Fujian Province from January to December 2017 were selected as the case group. Children who were in the same hospital for health checkup without bronchial asthma at the same time were randomly selected as the control group. Questionnaire survey was conducted to investigate effects of family factors on bronchial asthma in the two groups. The management of health education for the children in the case group was carried out. The self-administration scale score, the asthma control test （ACT） score and the changes of lung function indexes of the children in the case group were compared before and after the 6-month health education management.Results The study included 1 000 children with bronchial asthma （case group） and 500 healthy non-asthmatic children （control group）. There were 654 boys and 346 girls in the case group, aged 6-14 years, with an average age of （8.44 ± 1.43） years. The course of disease ranged from 6 months to 7 years, with average of （5.41 ± 1.37） years. There were 314 boys and 186 girls in the control group, aged 6-14 years, with an average age of （5.31 ± 1.06） years. There was no significant difference in gender and age between the two groups （P>0.05）. Children with passive smoking （OR=16.494）, non-respiratory allergies （OR=10.425）, family history of asthma （OR=3.548）, and raising furry pets at home （OR=1.361） had a higher risk of bronchial asthma. After 6 months of health education management, the children's self-management scale and total scores, ACT, FEV₁, and PEF were higher than those before the intervention （P<0.01 for all）.Conclusion Family history of asthma, non-respiratory allergies, raising pets at home, and passive smoking are risk factors for bronchial asthma in children. Management of health education can significantly improve the self-management ability of children and improve clinical symptoms.

Objective s To assess the epidemic risk of key infectious diseases in Guangdong Province in 2019 and analyze key risk factors.Methods Relevant information was collected and the epidemic risk was judged by semi-quantitative risk assessment and expert consultation method.Results The risk of importing dengue cases abroad to Guangdong Province will exist year round in 2019 and the local epidemic may begin in May and June. The human avian influenza epidemic may remain at a low level. The incidences of norovirus infection may be higher than those in winter and spring of 2017-2018. Seasonal influenza epidemics may peak in winter, spring and summer. The incidence of hand, foot and mouth disease may be higher than that in 2018 or remain flat, and the severity and mortality may be maintained at a lower level. The measles epidemic may increase slightly compared with 2018. The outbreaks of chickenpox and mumps may be lower than those in 2018. The risks of importing cases of Chikungunya and Zika virus disease persist. The risk of importing poliomyelitis, malaria, Middle East respiratory syndrome, and Ebola virus disease may not be excluded, which may have the possibility of local transmission.Conclusion sIn 2019, Guangdong Province should pay special attention to the dengue fever epidemic, focus on human avian influenza, norovirus infection, seasonal influenza, hand, foot and mouth disease, and need to pay attention to measles, chickenpox, mumps, and imported diseases such as Chikungunya fever.

Objective To investigate the sleep status of patients with septic cardiomyopathy in ICU in Guangzhou and analyze the related influencing factors.Methods Patients with septic cardiomyopathy in ICU of a hospital were selected as research subjects. Sleep Questionnaire Scale and ICU Sleep Quality Related Factors Questionnaire were used to assess the sleep quality of the patients, and the influencing factors of sleep status were analyzed.Results A total of 188 patients with septic cardiomyopathy were investigated, including 112 males and 76 females, with an average age of （65.96 ± 4.32） years. The average length of hospital stay was （6.85 ± 2.74） days, ranging from 3 to 15 days. Scores were （57.62 ± 13.51） for the sleep quality, （55.65 ± 9.87） for arousal, （56.05 ± 10.87） for sleep latency, （54.69 ± 12.39） for sleep efficiency, and （56.51 ± 17.60） for sleep depth. Multiple linear regression analysis showed that the pain and poor breathing reduced 5 points of the sleep scores （standardized coefficient [SC]： -0.365, -0.201）, and the transfer/walking/rescue noise reduced the patient‘s sleep quality, wakefulness and sleep depth scores （SC： -0.658, -0.336）, other discomforts reduced the patient’s sleep quality and sleep depth score （SC： -0.487, -0.207）, anxiety decreased sleep quality sleep latency score （SC： -0.665, -0.365）, sedatives reduced awakening score （SC： -0.147）.Conclusion Sleep status of patients with septic cardiomyopathy in ICU was generally poor. Noise, pain and negative emotions were the main factors influencing sleep quality.

Objective To study the risk factors and preventive measures of postoperative nosocomial infection of open fracture of the upper limb.Methods Patients who underwent open upper extremity fracture surgery in a hospital in Haidong City from November 2015 to April 2018 were enrolled in this study. The incidence of postoperative nosocomial infection and related factors were analyzed.Results A total of 386 open fracture patients undergoing surgery were analyzed in this study, including 217 males and 169 females, aged 20-74 years. Of all the patients, 163 （42.2%） were suffered from the unilateral humeral fractures of the upper limbs as the main type. According to Gustilo classification, 159 cases were Type III A, 197 were III B, and 30 were III C. There were 35 cases of postoperative nosocomial infection, with an incidence rate of 9.07%. In the multivariate logistic stepwise regression model, patients with smoking history （OR=4.461）, type 2 diabetes （OR=4.249）, pulmonary hypofunction （OR=5.687）, Gustilo type III C （OR=2.161）, general anesthesia （OR=5.185）, duration of surgery ≥2.5 hours （OR=4.951）, intraoperative blood transfusion （OR=4.574）, indwelling catheterization time ≥7 days （OR=4.212）, hemoglobin <90 g/L （OR=2.154）, albumin ≤35 g/L （OR =5.780）, CD4+/CD8+<1 （OR=4.236） had a higher risk of postoperative nosocomial infection.Conclusion The incidence of postoperative nosocomial infection of open fracture of the upper limb was relatively high and its risk factors were varied. Screening of risk factors from time to time and preventive measures against high-risk groups should be strengthened for reducing the rate of nosocomial infection.

Objective To understand the epidemiological characteristics and neurological recovery situation of stroke patients and analyze factors influencing the recovery of neurological function in northern China.Methods Demographic characteristics, disease information and neurological recovery status of stroke patients aged 18 years and older were investigated in Qiaoxi District using self-made questionnaire. Univariate and multivariate logistic regressions were used to analyze factors influencing the prognosis of neurological function in stroke patients.Results A total of 506 stroke patients were surveyed, with an average age of （64.9 ± 8.9） years. Among all the patients, 99.4% were Han nationality, 80.9% were married and only 5.9% had the educational level at senior high school or above; 62.8% had good recovery of neurological function （mRS score≤1） and 37.2% had poor recovery （mRS > 1）. Multivariate logistic regression analysis showed that the onset symptoms of paralysis （OR = 8.526）, slurring words （OR = 2.712）, and relapse （OR = 1.894） were risk factors for poor neurological recovery; while symptoms of vomiting （OR=0.387）, thrombolytic therapy （OR=0.219）, and neuroprotective therapy （OR=0.441） were protective factors for the recovery of neurological function.Conclusion The recovery of neurological function was related to symptoms, therapies, rehabilitation methods and relapse. Thus, more attention should be paid to the onset symptoms of high-risk groups as well as the timely treatment and active rehabilitation of stroke patients, to avoid the recurrence of stroke and promote the recovery of neurological function of patients.

Objective To systematically evaluate the impact of psychological intervention on negative emotions and quality of life in patients with gastrointestinal malignant tumors at home and abroad.Methods Papers published in the databases of Wanfang, WIP Chinese Sci-tech, China How Net, China Biomedical Literature Database, European PMC, Pubmed, EMbase and Web of science and Cochrane Central from January 2009 to now on the impact of psychological intervention on negative emotions and quality of life of patients with gastrointestinal malignant tumors were retrieved and screened, and the quality of literature was evaluated to conduct a meta-analysis.Results Nine literatures were extracted and they were all with high quality. A total of 896 subjects were enrolled, including 398 in the observation group and 398 in the control group. There were no significant differences in the heterogeneity test of SAS, SDS, EORTC QLQ-C30 and SF-36 scores after nursing （P > 0.05 for all）. Meta-analysis showed that the SAS scores of the observation group were significantly decreased （WMD=-20.63, 95% CI： -34.82 - -14.57, P<0.01）, SDS scores decreased significantly （WMD=-7.89, 95% CI：-10.02 - -5.63, P<0.01）, EORTC QLQ-C30 scores increased significantly （WMD=5.67, 95% CI： 2.18-7.12, P<0.01）, and SF-36 scores increased significantly （WMD = 3.63, 95% CI： 0.97-5.88, P<0.01）.No significant risk of bias was found among the literatures.Conclusion Psychological intervention can significantly reduce anxiety and depression in patients with gastrointestinal malignant tumors, and improve their quality of life.

Objective Understand the level of cognition and acceptance of noninvasive prenatal genetic testing （NIPT） for fetal chromosomal abnormalities among urban pregnant women.Methods A simple random sampling method was used to conduct a questionnaire survey on the pregnant women who were admitted to the obstetrics clinic of a hospital in Panzhihua City, Sichuan Province. Contents of the questionnaire included the basic information of the subjects, their cognition and acceptance level of NIPT related knowledge. Data were analyzed using the chi-square test or multivariate logistic regression model.Results A total of 1 156 pregnant women aged 20-45 years were investigated in this study. And 78.98% of them were the Han nationality and 52.51% had the educational level at high school/secondary school. Of the participants, the gestational age was mainly from 12 to 27 weeks, accounting for 51.04%; 39.01% had one pregnancy, 39.97% had 2 to 5 times of pregnancies; 51.04% had no parity and 30.36% had 1 parity. Among all the respondents, 42.04% （486 cases） had high cognitive level of NIPT and 48.01% were willing to accept or have accepted NIPT screening. About the NIPT related knowledge, the awareness rates of NIPT, NIPT method, NIPT and invasive diagnosis were 60.73%, 60.03%, and 58.04%, respectively. The awareness rate of screening at 12 weeks of gestation and factors affecting NIPT results were 30.02% and 19.98%, respectively. Multivariate logistic regression analysis showed that the pregnant women with older age （OR=1.303）, higher educational level（OR=1.191）, history of adverse pregnancy or delivery （OR=1.171）, higher monthly household income （OR=1.394） and NIPT cognitive level were more likely to accept or have chosen NIPT.Conclusion The cognitive level of NIPT technology for urban pregnant women was not ideal and the acceptance of NIPT was not high. Age, history of adverse pregnancy or childbirth, cognitive level, educational level and family income level were the main factors influencing pregnant women to choose NIPT.

Objective To explore the relationship between serum heart-type fatty acid binding protein （H-FABP） level and cardiac function parameters in the patients with acute myocardial infarction （AMI）.Methods Patients with AMI treated in a hospital in Zigong City from May 2015 to May 2017 were selected as the case group and individuals without cardiovascular disease who underwent a physical examination at the same hospital as the control group. H-FABP and major cardiac function indexes were analyzed at different time points and compared between the two groups.Results A total of 124 patients with AMI and 124 healthy people without cardiovascular disease were enrolled in this study, including 69 males and 55 females in the case group and the same in the control group. There were no significant differences in mean age and BMI between the two groups （P>0.05 for both）. The difference of H-FABP between the two groups at different time points （2, 4, 8, 12, 24 h） was statistically significant （P<0.01）. H-FABP gradually increased before 8 h, reached a maximum at 8 h, and then gradually decreased. The H-FABP concentration in the case group was higher than that in the control group at each time point （all P<0.01）. The LVEF, LVEDd and FMD were lower in the case group than those in the control group at 8 h after onset （P<0.01）, and EMCs was higher than that in the control group （P<0.01）. There were 43, 39, and 42 cases of Killip grades at levels II, III, and IV, accounting for 34.7%, 31.5%, and 33.9%, respectively. The higher the grade, the higher the detection value of H-FABP, LVEDd and EMCs, the lower the LVEF and FMD detection values （P<0.01）. Serum H-FABP levels were negatively correlated with LVEF and FMD levels （b=-2.764, -2.846）, and positively correlated with EMCs and LVEDd levels （b=2.294, 2.495）.Conclusion H-FABP has good correlation with cardiac function parameters in patients with AMI and can be used as an index for evaluation of early cardiac function.