Objective To study the status and influencing factors of delayed initiation of lactation phase Ⅱ in parturients in Baoshan district of Shanghai. Methods Taking parturients who were hospitalized in a hospital in Shanghai from January to December 2020 as the research object to follow up the initiation of lactation phase II, the self-made questionnaire was used to collect postpartum depression, anxiety and fatigue. The descriptive epidemiological analysis method was used to analyze the occurrence of delayed initiation of lactation phase Ⅱ in parturients in Shanghai, and univariate and multivariate analysis methods were used to analyze the influencing factors of the delay. Results The average age of 1 188 parturients was （28.11 ± 3.48） years. The time of lactation phase II initiation was （74.67 ± 5.22） h. A total of 312 cases had delayed initiation of lactation phase Ⅱ, with an incidence rate of 26.26%. There was a higher incidence of delayed initiation of lactation phase Ⅱ in parturients with an age of ≥ 35 years, gestational hypertension, gestational diabetes, cesarean section, primipara, time from birth to lactation ≥ 30 min, postpartum depression, postpartum anxiety and postpartum fatigue （all P<0.05 or P<0.01）. Multivariate Logistic regression analysis showed that age ≥ 35 years old （OR=2.516）, complicated with gestational hypertension （OR=2.520）, complicated with gestational diabetes （OR=2.994）, cesarean section （OR=1.578）, primipara （OR=2.164）, time from birth to lactation ≥ 30 min （OR=1.091）, postpartum depression （OR=3.769）, and postpartum anxiety （OR=3.174） were risk factors for the delayed initiation of lactation phaseⅡ. Conclusion The incidence of delayed initiation of lactation phase Ⅱ is relatively high in Baoshan district, Shanghai. Age ≥35 years old, gestational hypertension, gestational diabetes, cesarean section, primipara, time from birth to lactation ≥ 30 min, postpartum depression, and postpartum anxiety were risk factors of delayed initiation of lactation phaseⅡ. The above risk factors should be identified and intervened to reduce the incidence of delayed initiation of lactation phase Ⅱ.

Objective To understand the occurrence and influencing factors of poor eyesight among primary and middle school students in Nansha District of Guangzhou, so as to provide reference for the prevention and control of poor eyesight. Methods By stratified cluster sampling method, students of 7 schools including primary and middle schools from Nansha District of Guangzhou were selected and investigated. Results A total of 1 861 questionnaires were distributed, and 1 842 valid questionnaires were collected, with an effective recovery rate of 98.98%. The detection rate of poor eyesight among primary and middle school students in Nansha District of Guangzhou was 63.63%, the detection rate of boys, junior high school students and boarding students was 59.51%, 82.50% and 76.53%, respectively. There were significant differences in the detection rate of poor eyesight among different gender, schooling grade and boarding situation （all P<0.01）. Multivariate Logistic regression analysis showed that junior high school and above （OR=3.32, 3.19）, girls （OR=1.42）, using mobile electronic devices every day （OR=1.39）, insufficient sleep （OR=1.52）, duration of homework ≥ 2 hours （OR=1.50, 2.05）, duration of close-range use of eyes ≥ 16 minutes （OR=1.48, 1.40, 1.47, 1.75, 2.15）, and parental myopia （OR=2.05, 2.01, 3.30） were risk factors for poor eyesight of primary and middle school students. Conclusion The poor eyesight of primary and middle school students in Nansha District of Guangzhou is severe, it requires the joint efforts of schools, families and society to prevent and control the poor eyesight of students.

Objective To analyze the high-risk status and influencing factors of cardiovascular disease among residents aged 35-75 in Zhongmou County, Henan Province, so as to provide reference data for prevention and control of cardiovascular disease. Methods Relying on the National Cardiovascular Disease Early Screening and Comprehensive Intervention Project, people aged aged 35-75 from the preliminary screening data of the cardiovascular disease project in Zhongmou County, Henan Province from January to December 2016 were used as research subjects to conduct questionnaire surveys, physical fitness inspection and blood biochemical index detection. According to the “China Cardiovascular Disease Report 2015” and applying the China-PAR risk assessment model for cardiovascular disease risk assessment, using descriptive epidemiological analysis method to analyze the high-risk status of cardiovascular disease in this population, and univariate and multivariate analysis methods were used to analyze the high-risk factors of cardiovascular disease. Results A total of 2 104 residents were studied, including 1 122 males and 982 females; aged 35-75 years, with an average of （59.3±6.4） years; body mass index （BMI） was 17.1 -27.4 kg/m², with an average of （22.6±3.1） kg/m². Among them, 228 cases of high-risk cardiovascular disease were detected, and the detection rate was 10.84%. Of which the high-risk of high blood pressure accounted for the highest proportion （36.84%）, followed by the high-risk of cardiovascular disease （26.32%）, the high-risk of disease risk ≥20% （20.18%）, and the high-risk of dyslipidemia （16.67%）. Multivariate Logistic regression analysis showed that male （OR=2.499）, older age （OR=2.795）, BMI≥24.0 kg/m² （OR=2.255）, rural residence （OR=2.044）, junior high school and below and high school education or technical secondary school （OR=1.866, 1.383）, excessive drinking （OR=1.994）, physical exercise 1-2 times/week （OR=0.581） and ≥3 times/week （OR=0.489） were influencing factors of high-risk of cardiovascular disease among residents aged 37-75. Conclusion The detection rate of high-risk population of cardiovascular disease among residents aged 35-75 in Zhongmou County, Henan province is relatively high, it is affected by gender, age, BMI, residence, education, occupation, drinking and physical exercise. It is necessary to strengthen education and focus on screening for the population with the above influencing factors, and do a good job in early prevention, early detection and early treatment to reduce the harm of cardiovascular disease.

Objective To investigate the first lactation time and related factors of parturients, so as to provide reference for postpartum lactation guidance. Methods A questionnaire survey was conducted on parturients who were hospitalized and delivered in two hospitals in Dazu District of Chongqing from January to December 2020. The basic situation and feeding related factors of parturients were collected, and the first lactation time of parturients was followed up. Descriptive epidemiological analysis method was used to analyze the time of postpartum first lactation, and univariate and multivariate analysis methods were used to analyze the influencing factors of postpartum first lactation time. Results A total of 671 parturients were included in the study, aged 21-43 years old, with an average of （31.6±2.9） years old. Among them, 438 were primipara and 233 were multipara; 642 were single births and 29 were twins; 512 were vaginal deliveries and 159 were cesarean deliveries. There were 329, 176, 105 and 61 parturients （49.03%, 26.23%, 15.65% and 9.09% respectively） had the first lactation time < 24 h, 24 - <48 h, 48- <72 h and ≥72 h. Ordered multiple logistic regression analysis showed that age ≥35 years old （OR=1.895）, multiparity （OR=0.689）, gestational week of delivery≥ 37 weeks （OR=0.498）, cesarean section （OR=1.637）, sunken/flat nipples （OR=2.565）, mother and baby in the same room （OR=0.520）, the first breast sucking time ≥30 min （OR=2.787）, and the more times of sucking breasts per day （OR=0.845） were the influencing factors of the first lactation time of parturients. Conclusion The proportion of postpartum first lactation time < 24 h in Dazu District of Chongqing is large. The first lactation time is affected by age, parity, gestational week of delivery, delivery method, sunken/flat nipples, the same room with mother and baby, the time of first breast sucking and times of sucking breasts per day. Pre-pregnancy and prenatal education should be strengthened to encourage vaginal delivery, early postpartum contact, early sucking, and more sucking, promote lactation and increase breastfeeding rate, and then promote maternal and infant health.

Objective To analyze the medical experience and its influencing factors of adult outpatients in general hospitals. Methods The medical experience questionnaire survey was conducted on patients ≥ 18 years of age who were in the outpatient clinic of a hospital in Zhengzhou from July 2020 to February 2021. The medical experience of the outpatients was analyzed by the descriptive epidemiological analysis method, and the influencing factors of the medical experience were analyzed by univariate and multivariate analysis methods. Results In this study, 659 outpatients were actually investigated, and 621 valid questionnaires were retrieved, with an effective rate of 94.23%. Among them, 579 cases （93.24%） were satisfied with the experience of this outpatient visit. Multivariate Logistic regression analysis showed that self-service convenience （OR=0.542, 0.493）, medical process information （OR=0.742）, waiting time for consultation （OR=0.645）, time to communicate with doctors （OR=0.318）, doctors didn't listen to the patient's self-reported condition （OR=0.613）, the doctor's service attitude （OR=0.562）, the doctor explained the condition to the patient （OR=0.512, 0.528）, and the doctor informed the patient of the examination results and treatment plan （OR=0.563, 0.518）, the total outpatient cost （OR=0.476, 0.493） were the influencing factors of medical experience in outpatients. Conclusion Medical order, medical process, waiting efficiency, doctor-patient communication, and actual medical expenses are influencing factors that affect the experience of outpatients. It is recommended to strengthen the management of hospital outpatient medical order, process, and medical expenses, and establish a patient-centered service concept, patiently listen to the demands of patients, promote communication between doctors and patients, and improve medical experience.

Objective To study the detection status and related factors of anemia among primary and middle school students in Baise City, so as to provide scientific basis for reducing the prevalence of anemia among primary and middle school students in Baise City. Methods From January to March 2021, a junior high school and a primary school in each of the 12 counties and districts of Baise City were selected by random cluster sampling method. All the students were investigated by questionnaire, physical examination and blood biochemical index tests. The content of hemoglobin was detected for anemia screening. The current situation of anemia among primary and middle school students in Baise City was analyzed by descriptive epidemiological analysis method, and univariate and multivariate analysis methods were used to analyze the influencing factors of anemia. Results A total of 30 248 primary and middle school students were included in this study, of which 4 295 cases of anemia were detected, and the prevalence rate of anemia was 14.20%, including 3 124 cases, 1 063 cases and 108 cases of mild, moderate and severe anemia, accounting for 72.74%, 24.75% and 2.51% respectively. There were significant differences in the prevalence of anemia among primary and middle school students in Baise City with different body mass index, mother's educational background, anemia history, dietary status and physical exercise （all P< 0.01）. Multivariate Logistic regression analysis showed that lean body mass index （OR=1.933） and anemia history （OR=2.282） were risk factors for anemia in primary and middle school students in Baise City. The higher the mother's education （OR=0.828, 0.662）, healthy diet （OR=0.670）, physical exercise up to standard （OR=0.592） were protective factors for anemia in primary and middle school students in Baise City. Conclusion The anemia status of primary and middle school students in Baise City is not optimistic, affected by many factors, effective intervention measures should be taken to strengthen scientific nutrition and diet management, promote primary and middle school students to enhance their physique, reduce the prevalence of anemia and improve their health level.

Objective To understand the exposure-lag-response associations between exposure to PM_2.5 and urinary leukocyte and white blood cell count in late pregnancy in Guangzhou, and identify the susceptible exposure windows. Methods According to a birth cohort study on Prenatal Environments and Offspring Health （PEOH） established in Guangzhou in the early stage, a spatiotemporal land-use-regression model was used to estimate a pregnant woman's weekly PM_2.5 exposure from 13 weeks before pregnancy to the sampling week in the late pregnancy. A distributed lag non-linear model incorporated with a Cox proportional hazard model was applied to assess the effect of weekly-specific maternal PM_2.5 exposure on the risk of urinary leukocyte positive, and a distributed lag non-linear model was applied to assess the exposure-lag-response associations between weekly PM_2.5 exposure and white blood cell count, respectively. Results The sample included 3 753 pregnant women. The risk of urinary leukocyte positive was positively associated with maternal PM_2.5 exposure during the 20th to 27th gestational weeks, and the strongest effect was observed in 24th gestational weeks （HR=1.030, 95% CI： 1.007-1.054, per 10 μg/m³ increment in PM_2.5）. Maternal exposure to PM_2.5 during the 5th week before pregnancy to 6th gestational week was positively associated with white blood cell count, and the strongest effect was observed in 0 gestational week, with a 10 μg/m³ increment of PM_2.5, white blood cell count increased 0.22% （95% CI： 0.10%-0.35%）. Conclusion Maternal exposure to PM_2.5 may increase the risk of urinary leukocyte positive and increase the white blood cell count in late pregnancy, the 20th to 27th gestational week and the 5th week before pregnancy to 6th gestational week may be the susceptible exposure windows, respectively.

Objective To investigate the nutritional status of elderly inpatients with diabetic foot ulcer （DFU） and analyze the related factors of malnutrition. Methods Inpatients aged ≥60 years old with newly diagnosed DFU who were admitted to the endocrinology department of a hospital in Xi'an from January 1, 2019 to December 31, 2020 were taken as the research subjects to carry out a nutritional status-related survey. The incidence of malnutrition in elderly DFU patients was analyzed by descriptive epidemiological analysis, and the influencing factors of malnutrition in DFU patients were analyzed by univariate and multivariate analysis methods. Results Among the 559 elderly inpatients with DFU included in the study, there were 321 males and 238 females, with a male-to-female ratio of 1.3∶1. The age ranged from 60 to 88 years old, with an average age of （71.57±4.39） years. The mini-nutritional assessment score of 559 elderly inpatients with DFU was （14.81±4.39）, and 387 were malnutrition, with a malnutrition rate of 69.23%. The results of multivariate Logistic regression analysis showed that for every 10 years of age increase （OR=2.344）, the course of diabetes mellitus>5 years （OR=2.179）, DFU infection （OR=1.728）, HbA1c>7.0% （OR=2.502）, C-reactive protein ≥10 mg/L （OR=1.850）, Wagner grade 3-5 （OR=8.406）, the higher the geriatric depression scale score （OR=6.013）, the higher the risk of malnutrition in elderly DFU patients; the higher the activity of daily living score （OR=0.106）, the lower the risk of malnutrition in elderly DFU patients. Conclusion Malnutrition is common in elderly inpatients with DFU, and there are many related factors affecting their nutritional status. Targeted prevention and intervention measures for improving their nutritional status need to be strengthened.

Objective To investigate the characteristics of intestinal flora in newly diagnosed cases of colorectal cancer in Liyang City. Methods One hundred and fifty cases of newly diagnosed colorectal cancer （colorectal cancer group） and 150 healthy persons （control group） were selected, DNA was purified from fresh feces and amplified by polymerase chain reaction. 16S rDNA high-throughput sequencing was performed, fecal samples were inoculated in the culture medium for bacterial culture, and the bacterial community was identified and counted. Results Among the patients with colorectal cancer, 84 were males and 66 were females, aged 32-75 years old, with an average age of （56.88±8.74） years old. NM staging： 26 cases in stage Ⅰ, 94 cases in stage Ⅱ, 30 cases in stage Ⅲb. In the control group, there were 79 males and 71 females, aged 30-68 years old, with an average age of （56.73±8.28） years old. There was no significant difference in gender and age between the two groups （both P>0.05）. The results of 16S rDNA high-throughput sequencing showed that the Shannon index and Chao index in the colorectal cancer group was significantly lower than that in control group, the difference was statistically significant （both P<0.01）. The abundance of Firmicutes in colorectal cancer group was lower than that in control group, the abundance of Bacteroidetes, Proteobacteria, Clostridium and Actinomycetes was higher than that in control group, the difference was statistically significant （all P<0.01）. Bacterial culture results showed that the number of Escherichia coli, Enterococcus and Staphylococcus in the intestinal tract of colorectal cancer group was significantly higher than that of the control group, the number of Bifidobacterium, Lactobacillus, Peptococcus and Yeast was significantly lower than that of the control group, the difference was statistically significant （all P<0.01）. Conclusion The diversity of intestinal flora in newly diagnosed colorectal cancer patients is significantly lower than that in healthy people in Liyang City, the abundance of Firmicutes decreased, while the abundance of Bacteroidetes, Proteobacteria, Clostridium and Actinomycetes increased, the number of probiotics such as Bifidobacterium and Lactobacillus decreased, and the number of opportunistic pathogens such as Escherichia coli and Enterococcus increased.

Objective To analyze seasonal variation and larval breeding characteristics in the density of Ae. albopictus in Longgang District, Shenzhen, 2017-2019, so as to provide a reference for the development of local dengue fever prevention and control measures. Methods From 2017 to 2019, surveillance points were set up in 11 sub-districts of Longgang District, the density of Ae. Albopictus larvae was evaluated by the Breteau index （BI）, and that of Ae. Albopictus adult was evaluated by the mosq-ovitrap index （MOI）. Analyze the mosquito density（BI, MOI） in different months and different environments and the correlation between BI and MOI. Results The average BI was 3.52 in 2017-2019. During the three years, the BI showed an increasing trend year by year. The BI of different years and of different months were statistically significant （P<0.01）. Of these, the BI peak in 2017 and 2018 were September （BI=6.09 and 5.81, respectively）, and in 2019 was May （BI=6.11）. The BI of different environments was statistically significant （P<0.01）, among which the BI of residential areas was the highest （BI=5.00）. The average MOI was 5.04 in 2017-2019. During the three years, the MOI showed a fluctuating trend. The MOI of different years were not statistically significant （P>0.05）, but the MOI of different months were statistically significant （P<0.01）. The MOI peak in 2017 was August （MOI=9.90）, in 2018 was September （MOI=8.82）, and in 2019 was June （MOI=9.83）. The MOI of different environments was statistically significant （P<0.01）, among which the MOI of park was the highest （MOI=5.49）. BI and MOI in the same period were positively correlated （P<0.01）. Conclusion The density of Ae. Albopictus in Longgang District was high and was obviously seasonality. Strengthen the monitoring and risk assessment of Ae. Albopictus will provide the reference for the scientific and reasonable mosquito control measures.

Objective To analyze the allergen-specific IgE test results and allergen characteristics in adult patients diagnosed with allergic diseases. Methods Adult patients with confirmed allergic diseases who were tested for allergen-specific IgE in a hospital in Beijing from January 1, 2019 to December 31, 2020 were taken as the research object, and the case characteristics and allergen situation were analyzed descriptively. Results The positive rates of allergen-specific IgE in the inhalation group and food group were 38.66% and 21.99%, respectively, and the difference was statistically significant （P<0.05）. The top 5 allergens in the inhalation group were Dermatophagoides pteronyssinus/Dermatophagoides farinae （D.p/D.f） （16.56%）, Artemisia argyi （15.92%）, House dust （10.97%）, Ragweed （7.29%） and Cockroach （6.39%）. The top 5 allergens in the food group were Cod/Lobster/Scallop （6.87%）, Soybean （5.64%）, Salmon/Perch/Carp （5.22%）, Crab （4.31%） and Shrimp （2.66%）, respectively. From August to October, the peak allergen-specific IgE positive rates of D.p/D.f and Artemisia argyi appeared in the inhalation group. From January to February, the peak allergen-specific IgE positive rates of Cod/Lobster/Scallop and Salmon/Perch/Carp appeared in the food group. There was no significant difference in the positive rates of serum allergen-specific IgE between different gender in both inhalation group and food group（all P>0.05）. In the inhalation group, except for Cockroaches, Dog epithelium and Mycosporium fumigatus/Aspergillus fumigatus/Alternaria alternata, the positive rates of allergen-specific IgE in young, middle-aged and old patients were significantly different （all P<0.05）. In the food group, there were no significant differences in the positive rates of allergen-specific IgE among young, middle-aged and old patients（all P>0.05）. Conclusion The main allergens of adult patients with allergic disease are inhalation allergens including D.p/D.f, Artemisia argyi, House dust, Ragweed, Cockroach, and food allergens including Cod/Lobster/Scallop, Soybean, Salmon/Perch/Carp. The differences of positive rates of allergen-specific IgE appear in different age groups and different time, but not gender.

Objective To investigate the reducing uric acid effect and its mechanism of solid beverage of Gynuraprocumbens （Lour.） Merr. in rats models of hyperuricemia. Methods Sixty male SD rats weighing 180-200 g were randomly divided into 6 groups, including negative control group, hyperuricemia model group, allopurinol 20 mg/（kg·BW） positive control group and solid beverage of Gynuraprocumbens （Lour.） Merr. 1.125, 2.250 and 4.500 g/（kg·BW） groups. The corresponding test substances were given by gavage for 10 days. Serum uric acid （UA）, creatinine （CRE）, urea nitrogen （BUN）, xanthine oxidase （XOD） and liver homogenate XOD levels were measured after 10 days. The mRNA expression levels of renal transporters urate anion transporter 1 （URAT1）, glucose transporter 9 （GLUT9）, sodium-dependent phosphate transporter 1 （NPT1）, ATP binding cassette super family G 2 （ABCG2） were detected by real-time quantitative PCR. Results Solid beverage of Gynuraprocumbens （Lour.） Merr. had no significant effect on body weight in rats. Compared with the hyperuricemia model group, the serum UA levels of rats in the low, medium, and high-dose groups of solid beverage of Gynuraprocumbens （Lour.） Merr. were significantly reduced, and the levels of serum CRE, BUN and XOD and the XOD levels of liver homogenate were also significantly decreased （all P<0.05）. The mRNA expression level of UA salt transporter URAT1 decreased in rats （P<0.05）. Conclusion Solid beverage of Gynuraprocumbens （Lour.） Merr. possesses a potential anti-hyperuricemic effect in rats, and the mechanism is related to decreasing the activity of serum and liver XOD, then interfering the production of UA, and down-regulating the mRNA expression of UA salt transporter URAT1, thereby reducing the reabsorption of UA.