Objective To assess the economic burden of influenza among preschool children in Yuexiu District of Guangzhou, and to carry out health economic evaluation on influenza vaccine, so as to provide a basis for the development of immunization planning strategies. Methods Taking the sick children of 9 influenza like outbreaks in childcare settings of Yuexiu District, Guangzhou from January to June 2019 as the research object, the economic burden was assessed by questionnaire survey. Based on an outbreak, SEIAR dynamical model was established to simulate the epidemic trend under different vaccination strategies and evaluate its economic effect. Results The total economic burden of the sick children per capita was 1293.56 yuan （95% UI : 1 096.23-1 592.84）, including 422.56 （95% UI: 320.71-555.29） yuan for direct medical expenses per capita, 125.95 yuan （95% UI: 82.41-188.80） for direct non-medical expenses per capita and 797.03 yuan （95% UI: 661.50-938.76） for indirect economic losses per capita. According to the evaluation, one dose of trivalent influenza vaccine before the epidemic season could reduce one influenza case with an investment of 226.19 yuan, and a profit of 5.72 yuan could be obtained with an investment of 1 yuan; Two doses of trivalent influenza vaccine could reduce one influenza case with an investment of 178.77 yuan, and a profit of 7.24 yuan could be obtained with an investment of 1 yuan; One case of influenza could be reduced by 315.83 yuan for the vaccination of tetravalent influenza vaccine, and a profit of 4.10 yuan could be obtained with an investment of 1 yuan. Conclusion The economic burden of influenza like outbreaks in childcare settings in Yuexiu District of Guangzhou is relatively high, but two doses of trivalent influenza vaccine before the epidemic season can achieve positive benefits and the best cost-benefit ratio.

Objective To understand the prevalence of dental fluorosis and dental caries among school-age children in high fluoride areas of Lintong District, Xi’an City from 2019 to 2020, and analyze its influencing factors, so as to provide basis for regional prevention and control. Methods Using the stratified cluster sampling method, three primary schools were selected in the high fluoride area of Lintong District, Xi’an City in 2019 and 2020. Students in one class of each grade were selected for oral examination to make statistics on dental fluorosis and dental caries. The influencing factors of dental fluorosis and dental caries among school-age children were analyzed by univariate and multivariate analysis methods. Results There were 1 006 primary school students, including 604 males （60.04%） and 402 females （39.96%）, aged 6-12 years, with an average age of （9.60±1.18） years old. Multivariate Logistic regression analysis showed that urine fluoride ≥2.39 mg/L （OR=16.651） was a risk factor for dental fluorosis in school-age children, while the school-age children whose mother had a high school education or above （OR=0.224） and whose annual family income was ≥ 100 000 yuan （OR=0.058, 0.083） had a lower risk of dental fluorosis. Eating sweets frequently （OR=4.022） was a risk factor for dental caries in school-age children, while the school-age children with urinary fluoride ≥ 1.28 mg/L （OR=0.460, 0.348）, brushing before bed （OR=0.075）, regular oral examination （OR=0.169） and parents’ concern for dental health （OR=0.269） had a lower risk of dental caries. Conclusion The detection rates of dental fluorosis and dental caries among school-age children in high fluoride areas of Lintong District, Xi’an City are relatively high. High urine fluoride is a risk factor for dental fluorosis, and eating sweets frequently is a risk factor for dental caries in school-age children. It is recommended to prevent the above risk factors to reduce the occurrence of dental fluorosis and dental caries.

Objective To analyze the risk factors of bronchopulmonary dysplasia （BPD） in premature infants with respiratory distress syndrome in Panzhihua-Xichang area, and to observe the brain function, respiratory diseases and pulmonary function of the children one year after discharge. Methods Premature infants with respiratory distress syndrome in Panzhihua-Xichang area hospitalized in Panzhihua Central Hospital from January 2016 to December 2019 were selected. The risk factors of BPD were analyzed. The brain function of the children was evaluated by amplitude integrated electroencephalogram （aEEG）. One year after discharge, the incidence of respiratory diseases and pulmonary function were followed up. Results Three hundred and twenty cases of premature infants with respiratory distress syndrome had 81 cases of BPD, the incidence rate was 25.31%. Multivariate Logistic regression analysis showed that gestational age<28 weeks （OR=3.443）, birth weight<1 500 g （OR=10.374）, 5 min Apgar score<7 points （OR=8.888）, mechanical ventilation time>7 days （OR=9.760）, oxygen concentration ≥ 40% （OR=7.354）, neonatal infection （OR=12.872） and prenatal infection （OR=6.155） were the risk factors of BPD in premature infants with respiratory distress syndrome. The background activity and sleep wake cycling （SWC） of children in BPD group were worse than those in non-BPD group （both P<0.01）. One year after discharge, the number of respiratory tract infections, wheezing and readmission in BPD group were more than those in non-BPD group （all P<0.01）. There was no significant difference in pulmonary function index between the two groups （all P>0.05）. Conclusion Gestational age<28 weeks, birth weight<1 500 g, 5 min Apgar score<7 points, mechanical ventilation time>7 days, oxygen concentration≥40%, neonatal infection and prenatal infection are the risk factors of BPD in premature infants with respiratory distress syndrome in Panzhihua-Xichang area. BPD will have a certain impact on the development of children‘s brain function, and will lead to respiratory tract infection and wheezing symptoms within 1 year old. The impact on children’s pulmonary function needs further long-term observation.

Objective To explore the multi-drug resistant organism （MDRO） infection at the surgical site and its risk factors, so as to provide evidence-based reference for the prevention and treatment of surgical site infection. Methods From 2019 to 2020, the adult patients who underwent surgical treatment in a hospital in Jiaozuo were selected as the research objects. The basic information and the condition of the patients were collected, and the patients' surgery and preoperative related test indicators and medication status were collected from the hospital medical record information system. Biological samples of infected sites were collected from patients with suspected infection symptoms and signs such as fever, incision redness and swelling, and abnormal drainage fluid for pathogen culture and detection. Descriptive epidemiological analysis method was used to analyze the MDRO infection, and univariate and multivariate analysis methods were used to analyze its influencing factors. Results A total of 250 MDRO infections occurred in 7 820 patients, and the MDRO infection rate was 3.20%. There were 6 cases of Staphylococcus aureus infection, 14 cases of Acinetobacter baumanii infection, 29 cases of Pseudomonas aeruginosa infection, 34 cases of Klebsiella pneumoniae infection, and 167 cases of Escherichia coli infection. Multivariate Logistic regression analysis showed that diabetes （OR=3.578）, tumor （OR=4.135）, anemia （OR=4.701）, admission to ICU （OR=5.045）, organ perforation （OR=2.414）, incision classification was class Ⅱ or Ⅲ （OR=2.284, 3.013）, risk surgery （OR=5.135）, application of antibacterial drugs ≥2 kinds （OR=2.340）, antibacterial treatment course ≥5 d （OR=4.759）, and reoperation （OR=2.036） were the risk factors of MDRO infection in adult surgical patients. Conclusion MDRO infection at the surgical site of adult surgical patients is common, and there are many related risk factors. Clinically, perioperative management can be strengthened according to the above factors to reduce the incidence of MDRO infection.

Objective To analyze the incidence and influencing factors of febrile convulsion （FC） in febrile children, so as to provide scientific basis for preventing FC in febrile children. Methods The incidence and influencing factors of FC in febrile children in a hospital in Shanghai from January 2019 to December 2020 were studied by prospective method. Results A total of 29 825 febrile children were included in this study, including 17 377 boys and 12 448 girls. The boy to girl ratio was 1.4∶1. The age ranged from 5 months to 12 years, with an average of （5.02±1.64） years. The peak temperature was 38.5 ℃~ 39.6 ℃, with an average of （39.08±0.21）℃. Two hundred and fifty-two FC occurred in febrile children, and the incidence rate of FC was 0.84%. Multivariate Logistic regression analysis showed that aged 3-<6 years （OR=0.879）, aged 6-12 years （OR=0.326）, boy （OR=1.219）, premature delivery （OR=1.553）, peak body temperature>39 ℃ （OR=5.801）, a family history of FC （OR=3.155）, within 2 weeks after specific vaccination （OR=1.486）, hypochromic microcytic anemia （OR=5.425）, hypocalcemia （OR=4.632）, hyponatremia （OR=4.473） were influencing factors for FC in febrile children. Conclusion Febrile children are at risk of FC, and there are many influencing factors. Countermeasures should be taken against the above risk factors to reduce the incidence of FC.

Objective To investigate the dietary phosphorus intake of patients with chronic kidney disease （CKD）, and to analyze the effect of dietary phosphorus intake on blood nutritional indicators and related indicators of calcium and phosphorus metabolism. Methods Patients with CKD diagnosed and treated in a hospital in Chengdu from December 2018 to November 2019 were taken as the research object. Basic data collection, 3 d 24 h diet survey, nutritional status assessment, and blood biochemical detection were carried out. Descriptive epidemiological analysis method was used to analyze the dietary phosphorus intake of patients with CKD. Results A total of 151 patients with CKD were studied, aged 25-75 years, mainly 60 - 75 years old, accounting for 64.9%. The male to female ratio was 1.25∶1. The disease stage was mainly stage 3, accounting for 49.0%; the primary disease was glomerulonephritis, accounting for 70.9%; and the SGA assessment result was mainly B grade （suspected malnutrition）, accounting for 86.1%. The dietary phosphorus intake was mainly at the medium level （600 - 800 mg/d）, accounting for 58.6%, followed by the high level （>800 mg/d）, accounting for 23.6%, and the low level （<600 mg/d） accounted for 17.8%. There were statistically significant differences in albumin, prealbumin, blood phosphorus, and blood phosphorus calcium product indexes among patients with CKD with different dietary phosphorus intakes （all P<0.01）, but there was no significant difference in transferrin and blood calcium levels among patients with CKD with different dietary phosphorus intake （both P>0.05）. Blood phosphorus and blood phosphorus calcium product were positively correlated with dietary phosphorus intake （r_s=0.736, 0.809, both P<0.05）. Conclusion Dietary phosphorus intake has a certain impact on the nutritional status and phosphorus metabolism of patients with CKD. Patients with CKD should pay attention to selecting foods with low potassium content according to the guidance of nutritionists, effectively control phosphorus intake and prevent hyperphosphatemia on the premise of ensuring the physiological needs of the body.

Objective To investigate the etiology and drug resistance of nosocomial infections after orthopedic joint surgery, and to provide reference for clinical selection of reasonable antibacterial drugs. Methods Descriptive epidemiological analysis method was used to analyze the patient's medical records, surgical infection, infection site and etiological test results after orthopedic joint surgery in the medical record management information system of a hospital in Beijing. Results A total of 628 cases of nosocomial infection were found in 8 798 patients after orthopedic joint surgery, and the infection rate was 7.14%. The main infection sites were surgical incision, upper respiratory tract and urinary tract（78.82%）. A total of 645 strains of pathogens were detected in 628 patients with nosocomial infection, including 354 Gram-negative bacteria, 248 Gram-positive bacteria and 43 fungi. The main pathogens of nosocomial infection after orthopedic joint surgery were Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Staphylococcus epidermidis（68.99%）. The resistance rates of Escherichia coli to ampicillin and amikacin were both higher than 75%, and the resistance rates of Pseudomonas aeruginosa and Klebsiella pneumoniae to ampicillin were as high as 100%. The resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to erythromycin and penicillin G were both 100%. Conclusion Nosocomial infections after orthopedic joint surgery are not optimistic. The main pathogens are Gram-negative bacteria, and the resistance rate to ampicillin and ceftriaxone is relatively high. It is recommended that clinicians do a good job of pathogenic bacteria detection and drug sensitivity test in patients during perioperative period, and targeted application of antibiotics to minimize hospital infections after orthopedic joint surgery.

Objective To analyze the frailty and cognitive frailty of elderly in Zhengzhou community and its influencing factors. Methods From August to December 2020, a convenient sampling method was used to set up a survey project volunteer recruitment station in one of the community service centers in the districts, counties, and county-level cities under the jurisdiction of Zhengzhou city to recruit residents aged ≥ 60 for survey. The Fried Frailty Phenotype （FP）, Clinical Dementia Rating Scale （CDR）, and the Chinese version of Montreal Cognitive Assessment Scale （MoCA） were used to assess frailty and cognitive frailty. Descriptive analysis was made on the current situation of frailty and cognitive frailty of residents aged ≥ 60, and the influencing factors of frailty and cognitive frailty were analyzed by univariate and multivariate analysis methods. Results A total of 2 596 elderly in the community were included for investigation and analysis, including 1 391 males and 1 205 females. The age ranged from 60 to 86 years old, and the proportion of 60 to 69 years old was the largest, accounting for 38.0%. Two hundred and forty-seven cases （9.5%） were frailty, 614 cases （23.7%） were pre frailty. There were 169 cases of cognitive frailty, and the incidence rate was 6.5%. Multivariate Logistic regression analysis showed that older age （OR=2.563）, BMI≥28.0 kg/m²（OR=2.447）, and underlying diseases （OR=2.765） were the risk factors for the frailty of the elderly in the community, living with their spouse and/or children （OR=0.442, 0.575） and the frequency of physical exercise>3 times / week （OR=0.629） were the protective factors for the frailty of the elderly in the community. Underlying diseases （OR=2.743） were the risk factors for the cognitive frailty of the elderly in the community, the longer the education years （OR=0.388）, living with their spouse and/or children （OR=0.452, 0.612）, and the frequency of physical exercise>3 times / week （OR=0.429） were the protective factors for the cognitive frailty of the elderly in the community. Conclusion Frailty and cognitive frailty are common among the elderly in Zhengzhou community, which are affected by many factors. It is necessary to pay attention to high-risk groups and take effective intervention measures to reduce or delay the occurrence of frailty and cognitive frailty and improve the quality of life of the elderly in the community.

Objective To explore the expression level and clinical significance of apoptosis molecules in peripheral blood mononuclear cells （PBMC） of patients with chronic hepatitis B （CHB）. Methods Taking CHB patients diagnosed and treated in the department of gastroenterology of a hospital in Zhengzhou from January 2018 to July 2020 as the research object, comparing the mRNA expression of apoptosis molecules （including Caspase-3, Caspase-6, Caspase-8） in PBMC, T Helper （Th） 1 cytokine levels [ including interleukin （IL） -2 and interferon-γ （IFN-γ）], and Th2 cytokine levels （including IL-4 and IL-10） among patients with different severity degree. Pearson correlation analysis method was used to analyze the relationship of apoptosis molecules to IL-2 / IL-10 and IFN-γ / IL-4. According to the average expression of apoptotic molecules, the patients were divided into low expression and high expression to compare the hepatitis B virus （HBV）-DNA load, and the relationship between apoptotic molecules and HBV-DNA was analyzed. Results A total of 116 patients with CHB were included in this study, including 83 males, accounting for 71.6%. The age of the patients was 27 - 78 years old, with the largest proportion of 45 - 59 years old, accounting for 50.9%. There were 36, 45 and 35 patients with mild, moderate and severe CHB, accounting for 31.0%, 38.8% and 30.1% respectively. The expression levels of Caspase-3 mRNA, Caspase-6 mRNA, and Caspase-8 mRNA in PBMC of CHB patients with different severity degree were significantly different （all P<0.01）. IL-2, IFN-γ, IL-2/IL-10, and IFN-γ/IL-4 in severe patients were lower than moderate and mild patients, IL-4 and IL-10 were higher than moderate and mild patients （all P<0.01）. The HBV-DNA load was equal to 1×10⁵ copy/mL as the boundary, Caspase-3 mRNA, Caspase-6 mRNA, and Caspase-8 mRNA in PBMC of patients with high HBV-DNA load were higher than those of patients with low HBV-DNA load （P<0.05）. Caspase-3 mRNA, Caspase-6 mRNA, and Caspase-8 mRNA was negatively correlated with IL-2/IL-10 and IFN-γ/IL-4 （P<0.05）, and positively correlated with HBV-DNA load （P<0.05）. Conclusion The expression of apoptotic molecules mRNA （including Caspase-3, Caspase-6, Caspase-8） in PBMC go up with the progression of CHB patients, and it has a correlation with Th1/Th2 imbalance and HBV-DNA load, inhibiting the expression of apoptotic molecules can provide a potential idea for correcting Th1/Th2 imbalance and controlling HBV replication.

Objective To analyze the characteristics of common rheumatic immune diseases such as rheumatoid arthritis （RA）, ankylosing spondylitis （AS）, osteoarthritis （OA） and the changes of T lymphocyte subsets and Treg cells. Methods The adult cases of RA, AS and OA in the clinic of immunology and rheumatology of a hospital in Zhengzhou from January 1, 2017 to December 31, 2019 were taken as the research object （case group）, and a healthy control group was established. The levels of T lymphocytes and Treg cells in the two groups were detected for comparative analysis, and the case characteristics of the case group were descriptive analyzed. Results A total of 1 486 adult cases of RA, AS and OA were included, with a male-female ratio of 0.56∶1, aged 18-67 years, 18- 44 years old accounted for 35.5%. There were 327, 270, and 889 cases of RA, AS, and OA, respectively. The differences in the gender, age, and family history of the three common rheumatic immune disease cases of RA, AS, and OA were statistically significant （P<0.05 or P<0.01）. The differences between T lymphocyte subsets and Treg cells in RA, AS, OA cases and healthy people were statistically significant （all P<0.01）. The CD4 and CD4/CD8 levels of RA, AS, and OA cases were all higher than those of healthy people, and the CD8 level was lower than that of healthy people. The CD4⁺T, CD25⁺T, CD4⁺CD25⁺T, and CD4⁺CD25⁺CD127-T levels of AS and OA cases were both higher than those of healthy people. Conclusion RA, AS and OA cases have certain characteristics of gender and age composition ratio. Different cases of rheumatic immune diseases have different levels of T lymphocyte subsets and Treg cells, and have varying degrees of immune dysfunction, which should be paid attention to.