Objective To understand the impairment of ability in activities of daily living （ADL） and influencing factors in residents aged ≥60 years in urban and rural areas of Yunnan Province, so as to provide a basis for the development of prevention and control measures. Methods A multi-stage sampling method was used to investigate residents aged ≥60 years, living in certain urban and rural areas in Yunnan Province for more than 1 year and with local household registration. The contents included the basic situation, behavior and ability in ADL of the participants. Univariate and multivariate logistic regressions were used to analyze factors influencing the impairment of ability in ADL. Results A total of 3 978 residents aged ≥60 years were surveyed in this study, with an average age of （68. 5 ± 6. 6） years. The total score of activity in ADL was （15. 3 ± 4. 0） and the impairment rate of ability in ADL was 25. 6%. Multivariate logistic regression analysis showed that the residents aged 71-80 years （OR = 2. 48）, 81-93 years （OR = 7. 10）, with more chronic diseases （OR = 1. 27, 1. 90, 2. 35） were more likely to have higher risk of daily life impairment of ability in ADL, while those who were male （OR = 0. 77）, had higher education level （OR = 0. 46, 0. 34, 0. 21）, maintained marriage status （OR = 0. 69）, occasionally or frequently communicated with neighbors （OR = 0. 66, 0. 51）, occasionally or frequently participated in the community activities （OR = 0. 78, 0. 54）, exercised regularly （OR = 0. 68）, occasionally or frequently read books （OR = 0. 51, 0. 31）, occasionally or frequently played cards or Mahjong （OR = 0. 47, 0. 64）, and lived in urban area （OR = 0. 51） were more likely to have lower risk of impairment of ability in activities of ADL. Conclusion The elderly residents in urban and rural areas in Yunnan Province suffered from serious impairments of ability in activities of ADL, which were influenced by many factors. The fairness and accessibility of medical resource allocation in urban and rural areas should be improved. Propaganda and education of related health knowledge and healthy lifestyle should be strengthened and advocated.

Objective To evaluate the reporting quality of infectious diseases in medical institutions in cities in Guangdong and explore countermeasures to strengthen the reporting quality of medical institutions. Methods Using stratified sampling method, relevant indicators of the reporting quality of infectious disease in medical institutions were obtained through questionnaire survey and spot check. A chi-square test was used to analyze the differences in reporting quality at different levels and regions, Pearson correlation method was used to analyze the correlation between the comprehensive rate of reporting quality and GDP per capita, and weighted rank sum ratio（WRSR） method was adopted to comprehensively evaluate and grade the reporting quality of infectious diseases in 21 prefectural cities. Results During 2017-2019, the reporting quality of infectious diseases of medical institutions in Guangdong Province showed an overall upward trend （P<0. 01）. The reporting qualities of medical institutions at provincial-level were generally superior to those at other levels （P<0. 01）, the Pearl River Delta region was superior to eastern, western and mountainous areas of the province. The comprehensive rate of reporting quality in medical institutions around the province was moderately positively correlated with GDP per capita （r = 0. 608）. Using the WRSR method, 21 prefectural cities were divided into four grades： excellent, good, medium, and poor （P<0. 01）. Conclusion The reporting quality of infectious diseases in different regions of Guangdong Province is uneven, and the reporting rate in western and eastern regions of Guangdong Province has not reached the requirements of the “13th Five-Year Plan”. It is necesary to increasing funding for facilitating the electronic medical record system of medical institutions and strengthen administrative supervision to improve the reporting quality of infectious diseases.

Objective To explore the prospect of SARIMA-RBF combination model in fitting and predicting the epidemic tendency of mumps in China. Methods SARIMA model was established using the monthly incidence data of mumps from January 2005 to December 2015 in China. The fitted value based on the SARIMA model was taken as the input vector and the actual value was used as the output vector. Two SARIMA-RBF combination models were established according to the time factor as the input vector or not. The time factor was added as the combination model A, and the time factor was not added as the combination model B. Using SARIMA model and two SARIMA-RBF combination models, the incidence rates of mumps were predicted from July to December 2016, and compared with actual values. Three model fitting and prediction effects were evaluated by using mean absolute percentage error （MAPE）, mean error rate （MER）, mean square error （MSE）, and mean absolute error （MAE）. Results The SARIMA （0, 0, 1） （0, 1, 1）₁₂ was the optimal SARIMA model. Fitted by SARIMA model, combination model A and combination model B, MAPEs were 15. 724%, 12. 217%, and 13. 941%, the MERs were 15. 168%, 10. 179%, and 14. 042%, the MSEs were 0. 336, 0. 167, and 0. 713, and the MAEs were 0. 296, 0. 199, and 0. 274,respectively; the predicted MAPEs were 12. 069%, 7. 904%, and 9. 598%, the MERs were 12. 331%, 7. 872%, and 10. 636%, the MSEs were 0. 022, 0. 013, and 0. 025, and the MAEs were 0. 138, 0. 088, and 0. 119, respectively. Conclusion The SARIMA-RBF combination model considering time factor was the optimal fit and prediction model, with application value.

Objective To investigate the status of diabetes patients applying mobile health services （MHS） and its influencing factors. Methods From June to August 2019, diabetes patients were selected from three Level-3 Class-A hospitals in cities of Guangzhou and Bijie. A self-administered questionnaire was used to investigate demographic characteristics, MHS awareness, awareness way, utilization rate, choice of use channels, reasons for unusing MHS, and demand. Multivariate binary logistic regression was used to analyze the data. Results A total of 258 cases were included. Of the participants, 52. 7% were males, 89. 1% type 2 diabetes, and 71. 7% without complications. The usage rate of MHS was 19. 8%. There were differences in the usage rate of MHS among patients at different ages, education levels, monthly per capita income, type of diabetes, with or without complications, and occupation （all P<0. 01）. Multivariate binary logistic regression analysis showed that age and types of diabetes were influencing factors of applying MHS. The older the patients with diabetes, the lower the usage rate （OR_{51-60 years}=0. 206, OR_{>60 years}= 0. 143, both P<0. 05）. The usage rates of type 2 and gestational diabetes patients were lower than that of patients with type 1 diabetes （OR_{type 2 diabetes}=0. 118, OR_{gestational diabetes}=0. 040, both P<0. 01）. Patients who have used the MHS chose to use the channel mainly recommended by doctors, accounting for 56. 9%. The reasons for knowing but not using MHS were mainly because patients did not know the products （60. 5%） and did not know which one to choose due to too many products on the market （60. 5%）. Conclusion The usage rate of MHS for diabetes patients was low. It is necessary to strengthen publicity and education to improve patient cognition, especially for elderly patients.

Objective To investigate the prevalence of dental caries among children aged 2-4 years in Tongzhou District, Beijing and explore its influencing factors. Methods Physical examination records and birth information of children with full-term birth （37 weeks ≤ gestational week<42 weeks） from January 1, 2016 to December 31, 2017 were collected from the maternal and child health information system in Tongzhou District. The prevalence of dental caries was calculated, and multivariate logistic regression was used to determine factors influencing dental caries. Results A total of 12 555 children aged 2-4 years with full term were included. Of the participants, 51. 2% were boys, most （75. 1%） were aged 3 years, and 70. 2% had at least one parent’s domicile registered in Beijing. The overall prevalence rate of dental caries was 23. 7%. The prevalence rates of dental caries were 16. 9%, 25. 2%, and 48. 1% for children aged 2, 3, and 4 years, respectively, showing an upward trend with the increase of children's age （P <0. 01）. The binary logistic regression analysis showed that the children with increased age （OR_{3 years old}=1. 67; OR_{4 years old=}4. 58） and whose parents’ domiciles were registered in other places （OR=1. 13） had higher risks of dental caries. Conclusion The prevalence of dental caries was high for children aged 2-4 years in Tongzhou District, Beijing. The risks of dental caries were higher for the children with the increase of age and whose parents’ domiciles were registered in other places. Attention should be paid to the occurrence of dental caries in preschool children, and the oral health of preschool children should be monitored.

Objective To explore the subtype distribution characteristics and drug resistance of human immunodeficiency virus type 1 （HIV-1） among HIV-1-infected individuals in Dongguan. Methods Plasma samples of 50 HIV infected individuals without antiviral treatment were collected from October 2015 to February 2016 in Dongguan Municipal Center for Disease Control and Prevention. The viral RNA of HIV-1 was extracted, the pol gene was amplified by nest RT-PCR and the PCR products were sequencd. The obtained nucleic acid sequences were submitted to the Stanford University HIV Drug Resistance Database（http：//hivdb. stanford. edu）for drug resistance analysis. Results Among the 50 plasma samples, the pol gene sequences of 35 samples were successfully amplified. Of the 35 subjects, 88. 6% （31/35） were male and 65. 7% （23/35） were infected through the sexual transmission. Among the 35 pol gene sequences, 37. 1% （13/35） were CRF01_AE, 37. 1% （13/35） were CRF07_BC, 14. 3% （5/35） were subtype B, and 11. 4% （4/35） were CRF55_01B. Mutations related to drug resistance were found in 11 （31. 4%） of 35 pol gene sequences. Major mutation subtypes of HIV-1 were CRF01_AE and CRF55_01B. The rate of primary drug resistance was 11. 4%（4/35）. Conclusion The genetic subtypes of HIV-1 were diverse and the main recombinant subtypes were CRF01_AE and CRF07_BC in Dongguan City. More attention should be paid to the primary drug resistance mutations in gene sequence.

Objective To explore the association of sleep disorders with sleep beliefs and attitudes in patients with depression and influencing factors. Methods All patients diagnosed with depression and admitted to a hospital in Mianyang City were recruited from July 2018 to May 2019. Basic information of the participants was collected by trained doctors. The Pittsburgh Sleep Quality Index scale （PSQI） and Dysfunctional Belief and Attitude about sleep scale （DBAS-16） were completed by the participants under the guidance of the doctors. Descriptive epidemiological analysis methods were used to analyze the data. Univariate and multivariate logistic regressions were used to determine factors influencing the occurrence of sleep disorders. Results A total of 130 patients with depression were investigated. Of the participants, 40. 8% were men and 59. 2% were women; the ages were mainly 30-39 years old, accounting for 59. 2%; the education level was mainly college or above, accounting for 64. 4%; 57. 7% were married; 42. 3% had depression for more than 3 years; 35. 4% had family history. Seventy patients with depression suffered from sleep disorders, with an incidence of 53. 8%. The total score of DBAS-16 and the scores of all parts of DBAS-16 （estimation of consequences of insomnia, worry about sleep, prediction of sleep, understanding of medication） in patients with sleep disorder were significantly lower than those in patients without sleep disorder （all P<0. 01）. Multivariate logistic regression model showed that the patients with older age （OR=1. 049）, lower education level （OR=1. 064）, and longer duration of depression （OR=1. 350） were more likely to have higher risk of sleep disorders. Conclusion The incidence of sleep disorders is high in depression patients and significantly associated with their sleep beliefs and attitudes. Patients with older age, lower education level, and longer duration of depression are more prone to sleep disorders.

Objective To explore the value of cystatin C （Cys-C） and neutrophil gelatinase-associated apolipoprotein （NGAL） in early diagnosis of acute kidney injury （AKI） in patients with gestational hypertension. Methods Patients diagnosed with gestational hypertension in a hospital in Zigong City were recruited from 2015 to 2018 as 20 to 24 gestational weeks. At the time of diagnosis of gestational hypertension or first treatment for it in the hospital, after 4 weeks, 8 weeks, and within one week before delivery 5 ml of fasting venous blood was collected for Cys-C, Serum creatinine （SCr）, and NGAL detection. Patients with AKI and pregnancy-induced hypertension were selected as the case group, and patients with normal renal function and pregnancy-induced hypertension were the control group. The levels of Cys-C, SCr, and NGAL were compared between the two groups at different times, and the correlations between Cys-C and SCr, and NGAL and SCr were analyzed separately. Results A total of 488 patients with gestational hypertension were studied. The average age was （36. 2 ± 3. 8） years. The average BMI before pregnancy was （22. 45 ± 2. 26）. Of the participants, 44 （9. 0%） had abnormal childbearing history. At the end of pregnancy, AKI occurred in 39 patients （case group）, with an incidence rate of 8. 0%. There were statistically significant differences in the levels of SCr, Cys-C and NGAL in the case group at the time when gestational hypertension was diagnosed, 4 weeks of gestational hypertension, 8 weeks of gestational hypertension, and 1 week before giving birth （P<0. 01 for all）. At 4 weeks of pregnancy-induced hypertension and the end of pregnancy, the differences in Cys-C and NGAL levels between the case and control groups were statistically significant （P<0. 05 or P<0. 01）, and at 8 weeks of gestational hypertension and the end of pregnancy, the differences in SCr level between the case and control groups were statistically significant （P<0. 05 or P<0. 01）. In the case group, Cys-C level was positively correlated with SCr level at the time of diagnosis of gestational hypertension, 4 weeks of gestational hypertension, 8 weeks of gestational hypertension, and 1 week before the end of pregnancy （r=0. 075, 0. 145, 0. 256, 0. 365）, NGAL level was positively correlated with SCr level（r=0. 058, 0. 152, 0. 297, 0. 349）, and the correlation coefficient increased significantly with the development of AKI. Conclusion The detection of blood Cys-C and NGAL levels is highly sensitive to pregnancy-induced hypertension combined with AKI. The blood Cys-C and NGAL levels of can be used as routine testing items for the early diagnosis of AKI in this population.

Objective To explore the status of puerperal parenting competence and its influencing factors, so as to provide scientific basis for improving puerperal parenting ability. Methods A systematic sampling method was used to select the even-numbered puerperas for questionnaire survey during discharge follow-up. The content of the survey included basic information （including age, education background, family income, occupation, parity, delivery mode, and feeding mode）, Chinese version of Parenting Sense of Competence Scale （C-PSOC）, Perceived Social Support Scale （PSSS）, and Edinburgh Postpartum Depression Scale （EPDS）. Data were descriptively analyzed. Univariate and multivariate logistic regressions were used to determine factors influencing the scoring of parenting sense of competence. Results A total of 336 pregnant women were surveyed. Of the participants, 47. 9% were aged 26-29 years, 64. 3% had the college/university education, 48. 5% had the monthly family income of 5 000-7 999 Yuan, 63. 1% were employees of enterprises or institutions, 56. 8% gave the second births, 54. 2% had the delivery mode of cesarean section, and 47. 3% adopted mixed feeding. The total score of parenting sense of competence was （65. 98 ± 12. 91）, which was at the middle and high levels. The multiple linear regression equation showed that the participants who had higher educational level [standard regression coefficient （SRC）=0. 133], older age （SRC=0. 180） and higher support within the family （SRC=0. 159） were more likely to have higher scores of the parenting sense of competence, while those who had higher total depression score （SRC = -0. 372） were more likely to have lower scores of the parenting sense of competence. Conclusion The puerperal parenting sense of competence was at the middle and high levels in this area. Health providers should pay more attention to the puerperas at younger age group, with low education level, low level of family support, and high total score of depression.

Objective To investigate epidemiological characteristics of cluster outbreak caused by COVID-19 in Neijiang City. Methods According to the case epidemiological investigation plan from the COVID-19 prevention and control scheme （Fifth Edition） of the National Health Committee and using retrospective survey method, data were collected and descriptively analyzed by referring to medical records and combining with field epidemiological investigation. Results Six cluster outbreaks occurred from January 24 to February 11 in Neijiang City, with 18 confirmed cases and 261 exposed persons. The average attack rate was 6. 90%. Of the 6 outbreaks, 5 were family clusters and one occurred in a public place （teahouse）. Three clusters were intergenerational, with a median incubation period of 7. 5 days. Of all the cases, 44. 45% had fever as the first symptom, 44. 45% had dry cough, and 88. 89% had chest CT findings of COVID-19. Conclusion The outbreaks of COVID-19 occurring in Neijiang were mainly caused by the family gatherings. It should be emphasized to take measures for self-protection and isolation, avoid social activities such as family gatherings, so as to reduce the risk of COVID-19 outbreaks.

Objective To explore the association of inflammatory markers of interleukin-6 （IL-6）, serum amyloid A （SAA）, procalcitonin （PCT）, and C-reactive protein （CRP） with the severity of coronavirus disease 2019 （COVID-19）. Methods Clinical data of patients with COVID-19 from January 2020 to February 2020 in a hospital in Fuyang City, Anhui Province were collected for clinical analysis. Serum levels of IL-6, SAA, PCT, and CRP were compared between the severe and mild cases of COVID-19. The value of serum IL-6, SAA, PCT, and CRP in the identification of mild and severe cases of COVID-19 was explored, and their association with the severity of the COVID-19 were evaluated. Results A total of 70 patients with COVID-19 who met the criteria of this study were enrolled, including 19 cases of severe COVID-19 （severe group） and 51 cases of mild one （mild group）. Serum levels of IL-6, SAA, and CRP in the severe group were higher than those in the mild group （P<0. 05 for all）. The area under the curve of serum IL-6, SAA, and CRP combined to identify the mild and severe COVID-19 cases was 0. 817, which was greater than the single identification of each index. The optimal sensitivity of the combined identification was 78. 93% and the specificity was 80. 39%. The levels of serum IL-6 and CRP were positively correlated with the severity of the COVID-19 （P<0. 05）. Conclusion The serum levels of IL-6 and CRP are abnormally high in patients with severe COVID-19, and positively correlated with the severity of COVID-19, which is helpful to distinguish the severity of COVID-19.