Objective To investigate the first lactation time and delayed lactation of parturient in the Zhumadian area, and provide a reference for the lactation guidance of parturient in this area. Methods The parturient who gave birth in the Department of Obstetrics and Gynecology of Zhumadian Second Hospital of Traditional Chinese Medicine and Zhumadian Central Hospital from March 1, 2021, to February 27, 2022, were selected as the survey subjects, and their prenatal conditions （including gestational diabetes mellitus, pregnancy hypertension, anxiety, depression, and prenatal breastfeeding education） and postpartum interventions （including mother-infant rooming, early mother-infant contact, early breast acupoint massage, breastfeeding guidance, breast stimulation with low-frequency pulse rehabilitation therapy instrument, and psychological intervention） were obtained by questionnaire. The descriptive analysis was performed on first lactation time and delayed lactation, and the effects of the prenatal condition and postpartum interventions on delayed lactation were analyzed by univariate and multivariate analysis methods. Results A total of 1 185 valid respondents were obtained. The first lactation time was less than 24 h in 352 cases, 24-47 h in 293 cases, 48-71 h in 272 cases, and ≥72 h in 268 cases. The incidence rate of delayed lactation was 22.62%. Multivariate Logistic regression analysis showed that anxiety （OR=2.438）, depression （OR=2.691）, prenatal breastfeeding education （OR=0.569）, early mother-infant contact （OR=0.953）, early breast acupoint massage （OR=0.689）, breastfeeding guidance （OR=0.559）, breast stimulation with low-frequency pulse rehabilitation therapy instrument （OR=0.463）, and psychological intervention （OR=0.723） were the influencing factors of delayed lactation. Conclusions The incidence of delayed lactation in the Zhumadian area is high, which is closely related to a variety of lactation interventions, such as prenatal breast education, early mother-infant contact, early breast acupoint massage, breastfeeding guidance, breast stimulation with low-frequency pulse rehabilitation therapy instrument, and psychological intervention. According to the individual situation of pregnant women, we can strengthen the lactation intervention during pregnancy and postpartum to promote the improvement of breastfeeding rate.

Objective To analyze the pure tone audiometry （PTA） results of the occupational health examinations for noise exposed workers, and to provide a scientific basis for the prevention and treatment of occupational noise-induced deafness. Methods A total of 6 614 noise exposed workers who underwent occupational health examination and PTA in Nanjing Hospital for Occupational Diseases Prevention and Treatment from January 1 to October 31, 2020 were enrolled in the study. Collected their general information, occupational history and medical history, and conducted physical examination, PTA, laboratory examination, etc. The thresholds of binaural frequencies were compared by Student's t test, and the abnormal detection rates of binaural frequencies were compared by Chi-square test. The risk factors of noise-induced hearing loss （NIHL） were analyzed by binary Logistic regression analysis. Results Among 6 614 noise exposed workers, 1 779 cases had abnormal hearing threshold test, accounting for 26.90%, 678 cases with NIHL, accounting for 10.25%. There were significant differences in the detection rate of NIHL among noise exposed workers of different gender, combined with harmful factors, smoking and drinking （all P<0.01）. The detection rate of NIHL increased with the increasing of age and noise exposure length of service （both P<0.01）, but there was no significant difference between normal blood pressure group and abnormal blood pressure group （P>0.05）. Binary Logistic regression analysis showed that male（OR=2.305）, age ≥ 31 years（OR=2.136, 5.839, 6.294）, working years exposed to noise ≥35 years（OR=1.994）, smoking（OR=1.259）, and exposure to welding dust（OR=1.906） were risk factors for NIHL. Conclusions Many factors causes hearing loss of noise exposed workers. People with hearing loss should be found as early as possible, and education on protection and tobacco control should be strengthened to reduce hearing loss.

Objective To analyze the sealing effect of the first permanent molar fossa and furrow in children aged 7-9 years in Conghua District, and explore its influencing factors. Methods Children aged 7-9 years who received the first permanent molar fossa and furrow sealing in the Fifth Affiliated Hospital of Southern Medical University from January 2019 to December 2020 were selected as the research objects. The sealing effect of the first permanent molar fossa and furrow was evaluated at 6 and 12 months after the sealing. Further univariate and multivariate analysis were used to analyze the influencing factors of occluder shedding. Results In this study, 873 patients （3 012 teeth） completed the first permanent molar fossa and furrow sealing, and the rate of occluder shedding was 10.13% and 11.95% at 6 and 12 months, respectively. Age, debris index （DI）, frequency of brushing teeth, frequency of eating desserts and carbonated drinks, and number of caries were related to occluder shedding in children aged 7-9 years in Conghua area （P < 0.05 or P < 0.01）. Multivariate stepwise Logistic regression showed that children aged 7-9 years with greater DI, frequency of taking desserts and carbonated drinks ≥ 2 times/day, and more caries surfaces had a higher risk of occluder shedding, while with older age and frequency of toothbrushing ≥ 2 times/day had a lower risk of occluder shedding after 6 months or 12 months of fossa and furrow sealing （P<0.05 or P <0.01）. Conclusions The effect of first permanent molar fossa and furrow sealing in children aged 7-9 years is related to age, oral hygiene, eating habits, number of caries, and frequency of toothbrushing. Good brushing habits and eating habits should be established to reduce the risk of occluder shedding.

Objective To explore the effects of birth weight on growth and development among infants aged 1-18 months. Methods A retrospective cohort study was conducted to collect the information on infants born and undergoing physical examination in the Maternal and Child Health Hospital of Huadu District, Guangzhou, from January 2018 to December 2019. The differences and the trends of the changes in weight, length, and ponderal index （PI） among infants with different birth weights from 1 to 18 months were analyzed by One way covariance analysis method and the Mann-Kendall trend test, respectively. The generalized estimation equation models were used to estimate the effect of birth weight on the changes in weight, length, and PI of infants aged 1-18 months. Results A total of 1 937 infants were included in the study, including 1 063 males （54.88%）. The average birth weight was （3.18±0.42） kg, the incidence of small for gestational age （SGA） was 7.95%, and that of large for gestational age （LGA） was 5.01% for all the infants. With the increase of month age, both weight and length increment of SGA, appropriate for gestational age （AGA）, and LGA increased （all P<0.01）, while PI increment decreased （all P<0.01）. After adjusting for related confounders, there were significant differences in body weight increment from 6 to 18 months, body length increment from 1 to 18 months, and PI increment at 1 month among SGA, AGA, and LGA （P <0.05 or P<0.01）. Generalized estimating equation models showed that compared to AGA, the weight increment （β=-0.15）, length increment （β=-0.79）, and PI increment （β=-0.03） of SGA were less, respectively, while the height increment （β=0.78） of LGA was higher. Conclusions The birth weight of infants influences the growth and development of infants aged 1-18 months. Medical staff should do an excellent job in maternal health care during pregnancy and dietary nutrition guidance for postpartum infants, strengthen early growth monitoring and intervention and improve the quality of infant development.

Objective To analyze the status and influencing factors of spastic pelvic floor syndrome （SPFS） in elderly parturient. Methods From December 2018 to May 2020, the elderly parturient who gave birth in Beijing Daxing District People's Hospital and underwent pelvic floor screening 6-8 weeks after delivery were investigated. The basic information, pregnancy and delivery related data of the subjects were collected by questionnaire survey. The influencing factors of postpartum SPFS were analyzed by univariate and multivariate analysis methods. Results The average age of 500 elderly parturient was （39.84±2.50） years, and the parity was 1 to 4 times, with an average of （2.16±1.04） times. The incidence rate of postpartum SPFS in elderly parturient was 20.60%. The results of multivariate analysis showed that vaginal delivery （OR=3.842）, history of constipation （OR=3.271）, abuse of laxatives （OR=3.656）, second stage of labor ≥2 h （OR=6.052）, local inflammation （OR=2.319）, weight gain during pregnancy ≥20 kg （OR=4.676）, and anxiety （OR=5.658） were risk factors for SPFS, while pelvic floor function exercise （OR=0.242） was a protective factor. Conclusions The risk of postpartum SPFS in elderly parturient is higher, and there are many influencing factors, which need to attract the attention of medical workers and individuals. Targeted measures can be taken to intervene the influencing factors leading to SPFS.

Objective To investigate the incidence of delayed initiation of stage Ⅱ lactation and analyze the related behavioral factors of mothers and infants, to provide reference for the guidance of lactation. Methods From June 2020 to December 2021, a questionnaire survey was conducted on 2 103 parturients in 2 hospitals in Zhengzhou to obtain their personal information, calculated the incidence of delayed initiation of stage Ⅱ lactation and analyzed the correlation between pregnancy and postpartum behavior and the delayed initiation of stage Ⅱ lactation. Results A total of 2 064 effective subjects were obtained. There were 456 cases of delayed initiation of stage Ⅱ lactation, and the incidence rate was 22.09%. Multivariate Logistic regression analysis showed that delivery modes （OR=2.438 ）, direct rooming-in （OR=0.393）, school study for pregnant women during pregnancy （OR=0.773）, prenatal breastfeeding guidance （OR=0.850）, postpartum mother-to-infant contact time （OR=0.640）, postpartum lactation （OR=0.723）, first breast sucking time （OR=2.021）, and daily breast sucking frequency （OR=0.693） were the influencing behaviors of delayed initiation of stage Ⅱ lactation. Conclusions The delayed initiation of stage Ⅱ lactation in Zhengzhou is related to a variety of behaviors during pregnancy and postpartum, such as delivery modes, direct rooming-in, school study for pregnant women, prenatal breastfeeding guidance, postpartum mother-to-infant contact time, postpartum lactation, first breast sucking time, and daily breast sucking frequency. Sufficient attention should be paid to the above behaviors to increase lactation promotion behaviors so as to improve breastfeeding rate.

Objective To analyze the case characteristics and etiological factors of premature coronary heart disease, to provide a reference for the prevention of premature coronary heart disease. Methods A total of 1 274 patients with premature coronary heart disease diagnosed and treated in two hospitals in Beijing from June 2020 to December 2021 were selected as the case objects, and healthy people with the age, gender, and body mass index of 1∶1 at the same time were selected as the control objects. The personal data of the two groups were investigated. The case characteristics of premature coronary heart disease were analyzed by descriptive analysis. The etiological factors of premature coronary heart disease were determined by univariate and multivariate Logistic regression analysis. Results In 1 274 patients with premature coronary heart disease, the male was more prominent than the female （62.09% vs. 37.91%）, the proportion of single vessel lesions was higher （51.10%）, and the lesion site was most common in the left anterior descending branch （53.69%）. Multivariate Logistic regression analysis showed that a family history of coronary heart disease （OR=2.812）, hypertension （OR=3.258）, diabetes （OR=1.691）, dyslipidemia （OR=3.184）, drinking （OR=1.774 ）, healthy diet （OR=0.773）, exercise habits （OR=0.209）, negative emotions （OR=2.212）, and health literacy （OR=0.693） were influencing factors of premature coronary heart disease. Conclusions The proportion of single vessel lesions in patients with premature coronary heart disease is high, and the lesion site is most common in the left anterior descending branch. The onset of the disease is affected by many factors. People with high-risk factors should be concerned, and targeted intervention measures should be taken to prevent and control the occurrence and development of premature coronary heart disease.

Objective To explore the characteristics and postoperative outcomes of hip fractures. Methods Taking patients with hip fracture diagnosed and treated in a hospital in Harbin from January 1, 2017 to December 31, 2020 as the research objects, the basic information and clinical data of patients were collected, and a follow-up investigation was conducted for 1 year after discharge. Descriptive analysis method was used to analyze the characteristics of patients and the 1-year postoperative mortality, and univariate and multivariate analysis methods were used to analyze the influencing factors of postoperative 1-year mortality. Results A total of 2 342 patients with hip fractures were included in this study for analysis, including 485 （20.71%） in 2017, 582 （24.85%） in 2018, 628 （26.81%） in 2019, and 647 （27.63%） in 2020, the number of admitted cases was increasing year by year. The gender ratio of male to female was 1∶1.53; the age group was 33-90 years old, among which the age group of 70-79 years old accounted for the highest proportion （26.35%）; the main fracture type was femoral neck fracture （48.96%）, followed by femoral intertrochanteric fracture （45.99%）, the femoral head fracture accounted for the lowest proportion （5.04%）; the season with the largest incidence was winter （27.67%）. There were statistically significant differences in the distribution of patients with different ages, treatment methods, and adjuvant traditional Chinese medicine treatment within 4 years （P<0.05 or P<0.01）, but there were no significant differences in the distribution of patients with different genders, fracture types, medical complications, and seasons of onset within 4 years （all P>0.05）. A total of 2 331 patients with hip fracture were followed up for 1 year after discharge, and the 1-year mortality rate was 2.66% （62/2 331）. The results of multivariate analysis showed that age （OR=2.063）, non-surgical treatment （OR=1.730）, albumin level <35 g/L （OR=2.048）, and medical complications （OR=2.330） were the risk factors for 1-year death in patients with hip fracture after discharge. Conclusions Hip fractures are more common in women and people over 60 years old. Femoral neck fractures are a common type, and most of them occur in winter. The clinical outcomes of patients with different characteristics are significantly different.

Objective To investigate the status of visual impairment in patients with type 2 diabetes mellitus （T2DM） in Enshi City and analyze its related factors, to provide a reference for the prevention of visual impairment in patients with T2DM. Methods The patients with T2DM in Enshi from January 2019 to December 2021 were selected as the research objects. The descriptive epidemiological analysis method was used to analyze the status of visual impairment in patients with T2DM. The personal related data of the patients with T2DM were obtained, and the influencing factors of visual impairment were analyzed by univariate and multivariate Logistic regression analysis. Results A total of 2 986 patients with T2DM were included in the effective study, and 679 cases of visual impairment were detected, with a detection rate of 22.74%. There were 265 cases of monocular visual impairment and 414 cases of binocular visual impairment. Among them, 187 cases were ametropia, 93 cases were cataracts, 308 cases were retinopathy, and 91 cases were other. Multivariate Logistic regression analysis showed that the older the patients with T2DM were （OR=1.439）, the longer the course of disease （OR=2.143）, unfulfilled blood glucose control （OR=2.366）, poor drug compliance （OR=2.956）, the worse their diet health （OR=1.937）, unfulfilled physical exercise （OR=1.783）, anxiety （OR=1.318）, and depression （OR=1.990） in Enshi, the higher the possibility of visual impairment. Conclusions The visual impairment of patients with T2DM in Enshi is more common in terms of binocular impairment, retinopathy, and ametropia, which are affected by many factors. We should pay attention to the relevant population and effectively intervene against such changeable factors as blood glucose control, drug compliance, diet health, physical exercise, and psychological health, to help patients with T2DM control blood glucose, and prevent and reduce visual impairment.