Objective To explore the effect and critical period of pregnancy-related anxiety on internalization behavior of offspring. Methods A total of 3 474 pregnant women enrolled in Ma’anshan Birth Cohort （MABC） from May 2013 to September 2014 were included in follow-up study subjects. The information about demographic characteristics of pregnant was collected in early, second and third trimester of pregnancy. Used the completed self-made scale of pregnancy-related anxiety to assess pregnancy-related anxiety in each period, and the strength and difficulty questionnaire （SDQ） was used to assess internalization behavior of 4-year-old children. Results The detection rates of pregnancy-related anxiety in early, second and third trimester of pregnancy and internalization behavior of 4-year-old children were 19.9%（351/1 761）, 23.2%（559/2 410）, 22.6%（535/2 368） and 7.4%（185/2 513）, respectively. Student’s t-test analysis showed that internalization behavior score of offspring was significantly higher in the second and third trimester pregnancy-related anxiety group than that in the non anxiety group （both P<0.01）. Logistic regression analysis showed that pregnancy-related anxiety in third trimester of pregnancy was a risk factor for internalization behavior of offspring（OR=1.573）. Conclusion Pregnancy-related anxiety in third trimester of pregnancy is a risk factor for internalization behavior of offspring.

Objective To understand the status of rational drug use literacy and its influencing factors among residents in Huangpu District, Guangzhou City, and provide evidence for developing appropriate intervention measures and strategies of rational drug use literacy. Methods A multi-stage stratified sampling method was used to conduct a questionnaire survey among the permanent residents aged 18-69 in Huangpu District, Guangzhou City. The basic information of the respondents, their rational drug use literacy and needs for medication education were collected. Chi-square test and Logistic regression were used for statistical analysis. Results A total of 2 534 residents were surveyed, 1 082 males （42.7%） and 1 452 females （57.3%）. The household registration was mainly in Guangzhou, accounting for 80.8%. 30.6% of them were 25-34 years old, 46.6% with an average monthly personal income of 2 000-4 999 yuan, 36.8% with bachelor degree, 31.0% were personnel from enterprises and institutions. Most of the medical insurance was medical insurance for urban employees （69.8%）. There were 738 people with the literacy of rational drug use, accounting for 29.1%. Logistic regression analysis showed that people aged 25-34 years old （OR=1.645）, 35-44 years old （OR=1.620）, with junior college degree （OR=2.797）, bachelor degree （OR=3.675）, master degree or above （OR=5.448）, and medical personnel （OR=7.521） were more likely to have the rational drug use literacy. 97.5% （2 470/2 534） of the residents agreed on the importance of medication education, 82.8% （2 097/2 534） were willing to receive and 28.7% （728/2 534） had received medication education. Conclusion The rational drug use literacy level of Huangpu District residents is relatively low and the major influencing factors are age, education level and occupation. There is a large demand for medication education among residents. It is suggested to take targeted comprehensive intervention measures to improve the literacy level of rational drug use according to the common cognitive errors of residents and the population with low educational degree.

Objective To understand the cognition, intention to use and influencing factors of HIV pre-exposure prophylaxis（PrEP） among men who have sex with men（MSM） in Kunming Province, in order to provide evidence for PrEP program. Methods Quantitative and qualitative methods were carried out to investigate MSM patients aged ≥16 years, who had anal sex with men in the last year and HIV negative. Non-probabilistic “snowball” sampling was used in the quantitative survey, which included demographic characteristics, personal sexual behavior, PrEP awareness and usage intention, etc. Qualitative adopted the method of intention sampling, including cognition of PrEP, willingness to use when not free, psychological expectations, and prevention measures of HIV, etc. Results A total of 396 valid questionnaires were collected. 63.9%（253/396）had heard of PrEP, if the drug was free, 92.4%（366/396）were willing to take PrEP. Multivariate Logistic regression analysis showed that likely to be infected with HIV over the next five years（OR=14.192）, no worry about PrEP expensive cannot afford（OR=6.023）, had heard of PrEP（OR=3.291）, and non-marital cohabitation （OR=6.603） were independent protect factors to use PrEP. The against for PrEP by gay friend （OR=0.015） was independent obstructive factors. The qualitative showed that 8 out of 11 MSM had heard of PrEP, but 5 person did not know what is PrEP. When it was not free 8 out of 11 said would not use drug because of the high prices, side effects and efficacy was not 100%. They were willing to pay 945.5~1 000.0 yuan a month if needed in the future. Conclusion The willingness of HIV PrEP use among MSM in Kunming is high, but lack of cognition. Personal risk awareness, attitude of gay friend, have heard of PrEP and the price may be the influening factors of PrEP to use.

Objective To observe the etiological detection and characteristics of children with diarrhea and provide reference for prevention and treatment of diarrhea in children. Methods The data of children with diarrhea treated in a hospital in Qionghai City from September 2018 to September 2020 were collected, and the fecal specimens of children were taken for bacterial identification, virus antigen monitoring and drug sensitivity test. Descriptive epidemiological analysis was used to analyze. Results A total of 1 059 children with diarrhea were included in the study. The proportion of boys （59.0%） was higher than that of girls （41.0%）, and the proportion of children aged 1-3 years was the highest （57.0%）. The incidence of diarrhea was higher in summer and autumn （63.2%）. The main clinical symptoms were increased stool frequency and thin stool. Some children were accompanied by vomiting and dehydration. Six hundred and seventeen cases of pathogen were detected, and the detection rate was 58.3%. There were statistically significant differences in the detection rate of pathogen among children with different ages and seasons （P<0.05 or P<0.01）. The detection rate of pathogen was higher in children aged 1-3 years （61.4%） and in summer （64.0%）. A total of 793 strains of pathogens were detected, including 421 strains of viruses （53.1%） and 372 strains of bacteria （46.9%）. Rotavirus （27.2%） and Calicivirus （12.9%） were the main viral pathogens, and Salmonella （19.8%） and Shigella （13.9%） were the main bacterial pathogens. Salmonella and Shigella had higher resistance to ampicillin, cefazolin and penicillin, but lower resistance to imipenem, ceftazidime and gentamicin. Conclusion The proportion of diarrhea cases in children is high in boys and children aged 1-3 years, and the incidence is high in summer. Rotavirus and Calicivirus were the main viral pathogens, and Salmonella and Shigella were the main bacterial pathogens. The rational drug use should be based on the distribution characteristics of pathogens and the results of drug sensitivity test to improve the therapeutic effect.

Objective To analyze the disease spectrumand hospitalization expenses of inpatients withcardiovascular disease（CVD）, understand the rules and characteristics of disease composition, and provide reference for the diagnosis and treatment of CVD. Methods Retrospectively analyzed the relevant data of CVD inpatients in a tertiary hospital in Panzhihua, 2017-2019, and derived the data of the case entries, detailed medical records, and hospitalization expenses of cases diagnosed with CVD from the relevant management information system of the hospital. Descriptive epidemiological analysis method was used to analyze the data of inpatients with CVD. Results A total of 11 376 inpatients with CVD were included. From 2017 to 2019, there were 3 492, 3 815, and 4 069 cases were included, accounting for 30.7%, 33.5%, and 35.8%, respectively. The number of cases increased year by year. There was no statistically significant difference in the gender distribution of inpatients with CVDamongthe three years （P>0.05）, butthe difference in age distribution was statistically significant （P<0.01）.The onset age of inpatients with CVD tended to be younger. Coronary heart disease（CHD） and hypertension accounted for the largest proportion, accounting for 57.6% and 55.5% of inpatients with CVD in the same year, respectively, which increased to 62.8% in 2019.There was no significant difference in the proportion of inpatients with concomitant diseases （27.6%, 26.1%, 25.4%） amongthe threeyears （P>0.05）.There was statistical significancein the distribution of hospitalization days for patients with CVD （P<0.01）. In 2019, the proportion of patients staying<7 days increased. In 2017, 2018 and 2019, the out-of-pocket expenses for diagnosis and treatment of CVD inpatients were （5 925.6±285.7）, （5 904.2±264.3）, （5 890.9±230.8） yuan/person, and the difference was statistically significant （P<0.01）. Conclusion From 2017 to 2019, the number of inpatientswithCVD in a hospital in Panzhihua has increased, and the onset age of inpatients tend to be younger. The main diseases arestill CHD and hypertension, and the number of days of hospitalization and out-of-pocket expenses have showed a decreasing trend.

Objective To investigate the distribution and drug resistance of pathogenic bacteriaofnosocomial infections in respiratory inpatients. Methods The data of 982 inpatients who received treatment in the respiratory department of a hospital in Zhengzhou from March 2018 to January 2020 were retrospectively analyzed by consulting the inpatient medical records.The occurrence of nosocomial infection, the distribution of infective pathogens and drug resistance were statistically analyzed, and the influencing factors for the occurrence of nosocomial infection in respiratory inpatient cases were analyzed by univariate and multivariate Logistic regression. Results A total of 982 inpatient cases were included, 59 nosocomial infections occurred, and the infection rate was 6.01%, with lower respiratory tract infections predominating in22 cases （37.29%）.A total of 86 strains of pathogenic bacteria were isolated by co-culture, including 41 strains of Gram-negative bacteria （47.67%）, 12 strains of Gram-positive bacteria （13.96%）, and 33 strains of fungi （38.37%）.The Gram-negative bacteria were mainly Pseudomonas aeruginosa and Klebsiellapneumoniae （20 strains, 23.26%）, the Gram-positive bacteria were mainly Staphylococcus aureus （9 strains, 10.47%）, and the fungal infections were mainly Candida albicans （22 strains, 25.58%）.Pseudomonas aeruginosa was 100% resistant to ampicillin, ampicillin/sulbactam and tigecycline, more than 80.00% resistant to cefazolin, ceftriaxone and cefotetan, and susceptible to tobramycin.The resistance rate of Klebsiellapneumoniae to commonly used antimicrobials ranges from 12.50% to 25.00%.Staphylococcus aureus was 83.33% resistant to penicillin G, 50.00% resistant to erythromycin, and sensitive to rifampicin, linezolid, vancomycin, tetracycline, and tigecycline.Candida albicans was sensitive to fluconazole, itraconazole, amphotericin B, and voriconazole. Univariate analysis showed that age, comorbid underlying diseases, invasive procedures, unjustified antibiotic use, length of hospital stay, hormone and immunosuppressant use were associated with the occurrence of nosocomial infections in respiratory inpatient cases （all P< 0.05）.Multivariate Logistic regression analysis showed that age of 61-78 years old （OR=2.115）, length of hospital stay ≥15 d （OR=2.895）, comorbid underlying diseases （OR=1.636）, and invasive procedures （OR=3.267） were all independent risk factors for nosocomial infection in hospitalized respiratory patients. Conclusion Nosocomial infection of respiratory inpatients mostly occurs in the lower respiratory tract and are dominated by Gram-negative bacteria and fungi, which have some resistance to most drugs, while age 61-78 years, length of hospital stay ≥ 15 d, comorbid underlying diseases, and invasive procedures are all independent risk factors for the occurrence of nosocomial infections in respiratory inpatient cases.

Objective To clarify the pathogenic spectrum of respiratory tract infection in a hospital in Beijing from 2017 to 2020, and to provide pathogenic evidence for the prevention and treatment of respiratory tract infection. Methods The clinical inspection data of adult patients with respiratory tract infection in a hospital in Beijing from January 2017 to December 2020 were analyzed, and the distribution characteristics of pathogenic spectrum were analyzed. Results There were 8 026 patients with respiratory tract infection, including 5 200 males and 2 826 females, with an average age of （49.12±8.87） years.A total of 9 565 pathogens were detected, including 5 167 strains of bacteria （54.02%）, 1 435 strains of fungi （15.00%） and 2 963 strains of virus （30.98%）.There were statistically significant differences in pathogen distribution among different years, sample sources, gender, age and season （all P<0.01）.Conclusion The pathogenic spectrum of respiratory tract infection cases in a hospital in Beijing is mostly bacteria, followed by virus and fungi, with obvious age, gender, and seasonal characteristics. It is suggested to take effective preventive measures according to the above characteristics to reduce the risk of respiratory tract infection.

Objective To analyze the status and influencing factors of cervical vertebra discomfort in medical staff, so as to provide reference for its prevention and treatment. Methods Simple sampling method was used to select medical staff such as doctors, nurses, technicians and administrators in 2 tertiary hospitals and 2 secondary hospitals on August 23-30, 2020. The status of cervical vertebra discomfort among medical staff and its influencing factors were analyzed by the univariate and multivariate analysis. Results Among 1 058 medical staffs, there were 416 cases of cervical vertebra discomfort, the incidence rate was 39.3%. Multivariate Logistic regression analysis showed that female （OR=3.684）, age （OR=4.522）, less physical exercise （OR=4.221）, more insomnia （OR=3.706）, working at non-operating departments and operating departments （OR=2.782, 4.323）, the longer the working years （OR=4.655）, the more night shifts （OR=3.740）, the more overtime （OR=4.559）, the more forced postures at work （OR=4.865）, the higher the risk of cervical vertebra discomfort among medical staff. Conclusion The incidence rate of cervical vertebra discomfort in medical staff is high, which is affected by gender, age, physical exercise, insomnia, work unit, years of working, night shift, overtime, and forced posture at work. Effective intervention measures should be taken to promote the health status of medical staff by integrating the influence of various factors.

Objective To explore the impact of ambient temperature on the incidence of mumps in Dongguan, Foshan, Guangzhou and Shenzhen in Guangdong Province. Methods Daily meteorology data and mumps cases from 2005-2018 were collected in Dongguan, Foshan, Guangzhou and Shenzhen City. Then the city-specific relationship between ambient temperature and mumps was assessed based on distributed lag non-linear model, controlling the time trend, day of the week, relative humidity and pressure for confounding factors. Finally, the cold and heat effects of low temperature （the 5^th percentile of daily temperature） and high temperature （the 95^th percentile of daily temperature） on the incidence of mumps in different age and genders were compared.Results There were 212 109 mumps cases reported in four cities during 2005-2018. The daily median temperature was 23 ℃~25 ℃. The overall effect of ambient temperature on the incidence of mumps in four cities showed an inverted S-shape. The cold effect was slightly higher for male （RR=1.131, 95%CI： 1.018-1.256） than female （RR=1.093, 95%CI： 0.955-1.251）, while heat effect was slightly higher for female （RR=1.014, 95%CI： 1.001-1.026） than male （RR=1.009, 95%CI： 0.997-1.022）,but there were no statistical significance （P>0.05）. The cold effect （RR=1.476, 95%CI： 1.300-1.677） and heat effect （RR=1.020, 95%CI： 1.006-1.034） were higher for adolescents aged 6-17 years old, the difference was statistically significant （P<0.05）. Conclusion The relationship between ambient temperature and the incidence of mumps is non-linear. Ambient temperature may be an important predictor of the incidence of mumps. Adolescents aged 6-17 years old are more sensitive to ambient temperature, whom more attention should be paid to.

Objective To analyze the supply-demand of doctor resource in 21 prefecture cities in Guangdong, and forecast the change trend of supply-demand in 2022. Methods Based on the health service demand method and Holt exponential smoothing model, the inpatient and outpatient service data of each city in Guangdong Province from 2009 to 2019 were collected to fit and forecast the supply-demand relationship of doctors in 2022. Results It is predicted that in 2022, the demand for doctors in Guangdong will be 322 290, and the total number of medical practitioner and assistant medical practitioner will be 331 806. The supply situation of doctors in Guangdongis relatively sufficient. In 2019, Zhuhai（1.33）,Shantou（1.31） and Shanwei（1.31） had the highest supply-demand ratio, while Maoming （0.55）, Zhongshan （0.76） and Jiangmen （0.76） had the lowest one.It is predicted that in 2022, the supply-demand ratio in Shanwei（1.64）,Zhuhai（1.34） and Shenzhen（1.28） will be the highest, while Maoming （0.58）,Jiangmen （0.79） and Yunfu（0.90） will be the lowest ones. Conclusion The supply-demand of doctors in Guangdong will be good in 2022, and there will be an over supply of doctors. The supply-demand of doctors in most of 21 cities will be improved.

Objective To explorethe awareness of core knowledge on cancer prevention and treatment in high-risk population of lung cancer, and analyze its influencing factors. Methods A survey was carried out on the core knowledge of cancer prevention and treatment among residents who were screened and identified as high-risk lung cancer group after physical examination in a thoracic surgery of a hospital in Shanghai from March 2017 to December 2019.Descriptive epidemiological analysis was used to analyze the core knowledge mastery of cancer prevention and treatment, and univariate and multivariate analysis methods were used to analyze the factors affecting knowledge mastery. Results A total of 416 cases with high risk of lung cancer aged 40-72 years were included, including 269 males and 147 females, accounting for 64.66% and 35.34%, respectively. The core knowledge of cancer prevention and treatment was known in 326 cases, and the awareness rate was 78.4%.The highest awareness rates were 92.79%, 92.31%, 90.38%, respectively, on the following three topics： “Physical examination or cancer screening is conducive to early detection of cancer”, “Cancer is not infectious;The early stage of cancer may have no obvious symptoms;Cancer examination is not the higher the price, the better the effect ”, “Smoking cessation is conducive to the prevention of lung cancer”. The lowest awareness rates were 50.24%, 37.98% and 34.86%, respectively, on the following three topics： “Give birth at proper age, breastfeeding, more physical activity, proper weight, less alcohol consumption and regular physical examination are beneficial to the prevention of breast cancer”, “Effective methods for early screening of lung cancer” and “High risk factors leading to the development of cancer”. Binary Logistic regression analysis showed that aged 60-72 years （OR=0.418）, education level of junior college or above （OR=2.309）, occupation type of health care industry （OR=4.121） werethe influencing factors of core knowledge of cancer prevention and treatmentin high-risk population of lung cancer. Conclusion The overall knowledge of cancer prevention and treatment among the high-risk group of lung cancer is better, but it should also be aimed at the older age, lower education level and people in the non-medical and health industries to further enhance cancer prevention and treatment awareness, and continuously improve the knowledge level of cancer prevention perception among the general population.

Objective To explore the relationship between dietary patterns and morbidity in patients with new-onset colorectal cancer, and to provide scientific intervention methods for the prevention of colorectal cancer. Methods The newly colorectal cancer patients diagnosed by pathology in a cancer hospital in Liaoning Province from 2018 to 2019 were selected as the case group, and the healthy people who participated in the physical examination were selected as the control group according to the same gender and age of 1∶1. The dietary patterns of the survey objects were analyzed by principal component analysis. Logistic regression analysis was used to analyze the effect of different dietary patterns on the risk of colorectal cancer. Results A total of 232 new-onset colorectal cancer patients and 232 healthy persons were surveyed. There was no statistically significant difference between the two groups in gender, age, education level, per capita family monthly income and physical labor intensity （all P>0.05）. Multivariate Logistic regression analysis showed that nuts potatoes dietary pattern （OR=0.482）, aquatic dairy dietary pattern （OR=0.666） and fruit and vegetable vegetarian dietary pattern （OR=0.800） were protective factors for colorectal cancer; Western-style dietary pattern （OR=1.441）, spicy fumigation dietary pattern （OR =1.195）, meat dietary pattern （OR=1.397） and high-fat dietary pattern （OR=1.349） were risk factors for colorectal cancer. Conclusion Nuts and potatoes, aquatic dairy and fruit and vegetable diet are protective factors for the occurrence of colorectal cancer, and western style, spicy fumigation, meat and high fat diet are the risk factors. In the propaganda and health education of colorectal cancer prevention, diet health education should be strengthen to improve the awareness of disease prevention and effectively reduce the incidence of colorectal cancer.

The practice of prevention and control of COVID-19 in the early stage has proved that wearing a mask is an effective measure to reduce respiratory infectious diseases. This article analyzes the importance of taking the lead in establishing a mask emergency reserve system in Guangdong. Proposed to improve and perfect the mask emergency reserve legal system, formulate mask use guidelines and standards, establish a multi-layer mask emergency material reserve system and catalog management system, increase the special fund for mask emergency reserve,improve the information management level of emergency reserves,strengthen policy support and guide the healthy development of mask industry,and strengthen health education and foster a civilized lifestyle, etc. 8 suggestions.

Objective To investigate the knowledge, attitude, practice,and demands after returning to school on COVID-19 in college students, so as to provide a basis for the prevention and control in schools. Methods From February 29 to March 5, 2020, an online questionnaire survey was conducted among 7 731 college students in Gansu Province. Descriptive epidemiological analysis was used to analyze the data. Results A total of 7 705 valid questionnaires were collected, with an effective rate of 99.7%. The ratio of male to female students was 1∶3, the ratio of graduate, undergraduate and junior college students was 1∶10∶6, and the ratio of medical students and non-medical students was 4∶1. The average score of COVID-19 cognition was （58.15±13.67）, and the pass rate of cognition was 40.0%. The pass rates of infection source, transmission route, symptoms and protection were 93.9%, 66.4%, 35.7% and 22.2%, respectively. The pass rates of COVID-19 infection source, symptoms and protection in undergraduates were higher than that of junior college students and graduate students （P<0.05）. The cognitive pass rate of medical students was higher than that of non-medical students in terms of infection source and symptoms of COVID-19 （P<0.05）. However, the graduate students paid more attention to the trend of the epidemic, while undergraduates or above were more optimistic about the cure of COVID-19 than junior college students（P<0.01）. The formation rates of wearing masks when going out, covering mouth and nose when coughing or sneezing, not attending parties or going to places with poor air mobility, and frequent ventilation of rooms were all over 90.0%. 78.8% of students were very concerned about the COVID-19 epidemic. After returning to school, respondents' main needs were to provide prevention and control knowledge of COVID-19, stagger the meal times and daily temperature measurement, accounting for 98.0%, 96.7% and 94.9%, respectively. Conclusion College students with different characteristics have large gaps in COVID-19 knowledge, attitude and practice, and have different degrees of vulnerability. Therefore, targeted intervention measures should be taken in combination with individual and school control to prevent and control COVID-19 in schools.