Epidemiological Survey and Risk Factor Analysis of Recurrent Spontaneous Miscarriages in Infertile Women at Large Infertility Centers

Background：A higher frequency of spontaneous miscarriage has been observed in infertile couples,and there is a higher prevalence of infertility among patients with a history of recurrent spontaneous miscarriages （RSMs;〉2 miscarriages）.This study aimed to determine the proportion of infertile patients with RSM and examine risk factors associated in patients with RSM being treated with assisted reproductive technologies.Methods：This cross-sectional observational study was conducted at six reproductive medicine centers in three cities of China.Data of 751 patients with at least one spontaneous miscarriage were analyzed.Demographic data and etiological factors associated with infertility were compiled and compared between patients with a single spontaneous miscarriage （SSM） and those with RSM.Results：Two hundred （26.6%,95% confidence interval [CI]：23.50-29.95%） patients experienced RSMs and 551 （73.4%） had a single miscarriage.The odds of RSM increased with increasing age （odds ratio [OR] =1.06）,uterine disorders （OR =2.09）,endocrine disorders （OR =2.48）,and immune disorders （OR =2.98）.Higher education level,masters or above,and a pelvic cavity disorder were associated with lower risk of RSM （OR =0.27 and 0.46,respectively）.Late spontaneous miscarriages were more frequent in patients with RSM than in those with a SSM （31.5% vs.14.2%,respectively,P 〈 0.001） and were associated with a history of uterine cavity procedures （OR =2.095） and cervical factors related to infertility （OR =4.136,95% CI：1.012-16.90）.Conclusions：Compared to patients with only a SSM,the conditions of patients with RSM are more complicated.To increase the success rate of assisted reproductive technology,factors including uterus cavity adhesion,cervical relaxation,endocrine disorders,and immune disorders should be treated before assisted reproduction is initiated.These data may provide treatment guidance for infertile patients with a history of RSM.

Epidemiological survey of primary palmar hyperhidrosis in adolescents

Background Despite recent advances in recognition and treatment of primary palmar hyperhidrosis （PPH）, the epidemiological survey has hardly been conducted. The aim of this study was to investigate the prevalence and epidemiological characteristics of primary PPH among adolescents in three cities of southeast China. Methods Stratified-cluster sampling was carried out and cross-sectional epidemiological survey by questionnaire was applied among 33 000 college and high school students. Results The prevalence rate of PPH was 4.36% affecting both sexes equally. Prevalence rate of severe PPH was 0.27%. The average age of onset was 12.27±2,12 years. The peak age of onset was 6-16 years, accounting for 97.2% of PPH population. Positive family history was found in 17.9% PPH cases. Besides palms, axillae and soles can be also affected. Conclusions PPH affects a larger group of individual than previously reported. More measures should be taken to enhance the recoanition, diaanosis, and treatment of PPH.

Genetic epidemiological survey of esophageal cancer in one-tenth of the population of Yangquan city

To understand the role of genetic factors in the occurrence of esophageal cancer (EC) Methods A genetic epidemiological survey of 132?039 subjects, one tenth of the whole population of Yangquan city, Shanxi Province in Northern China, was conducted in 1994 A total of 228 families with at least one newly occurring EC patient in each family were matched with equal number of control families for a 1∶1 case control study Results The heritability of esophageal cancer among first degree relatives was 52 6%, that among second degree relatives was 31 2%, and the weighted average heritability was 49 2% The segregation ratio was 0 176±0 033, significantly less than 0 25, suggesting a multifactorial inheritance or decreased penetrance of a major locus EC patients in families did not fit the binominal distribution, suggesting evidently familial aggregation The relative risks among the first degree relatives were 10 49 for males, 7 69 for females, and 9 17 for combined data The attributive risks among first degree relatives were 62 13/100?000 for males, 99 94/100?000 for females and 75 15/100?000 for combined data All of these figures were higher than 40 17/100?000, the average of general population of the city Conclusion Genetic factors play an important role in the pathogenesis of esophageal cancer in this area

Epidemiological survey and genetic characterization of type 3 vaccine-derived poliovirus isolated from a patient with four doses of inactivated polio vaccine in Henan Province,China

Background:Vaccine-derived poliovirus(VDPV)is a potential threat to polio eradication because they can reintroduce into the general population and cause paralytic polio outbreaks,a phenomenon that has recently emerged as a prominent public health concern at the end of global polio eradication.This study aimed to describe the epidemiology and genetic characteristics of the frst VDPV identifed from a patient with acute faccid paralysis(AFP),with four doses of inactivated polio vaccine immunization in Henan Province,China in 2017.Methods:The patient was diagnosed with type 3 VDPV.Subsequently,a series of epidemiological approaches was implemented,including a retrospective search of AFP cases,rate of vaccination assessment,study of contacts,and supplementary immunization activities.Fecal samples were collected,viral isolation was performed,and the viral isolates were characterized using full-length genomic sequencing and bioinformatic analysis.Results:Phylogenetic analysis showed that the viral isolates from the patient were diferent from other reported genetic clusters of type 3 VDPV worldwide.They were identifed as a Sabin 3/Sabin 1 recombinant VDPV with a crossover site in the P2 region.Nucleotide substitutions,including U→C(472)and C→U(2493),have been identifed,both of which are frequently observed as reversion mutations in neurovirulent type 3 poliovirus.A unique aspect of this case is that the patient had been vaccinated with four doses of inactive polio vaccine,and the serum neutralizing antibody for Sabin types 1 and 3 were 1∶16 and 1∶512,respectively.Thus,the patient was speculated to have been infected with type 3 VDPV,and the virus continued to replicate and be excreted for at least 41 d.Conclusions:The existence of this kind of virus in human population is a serious risk and poses a severe challenge in maintaining a polio-free status in China.To the best of our knowledge,this is the frst report of VDPV identifed in the Henan province of China.Our results highlight the importance of maintaining a high-level vaccination rate and highly sensitive AFP case surveillance system in intercepting VDPV transmission.

An Epidemiological Survey on the Use and Abuse of Antianxiety Drugs among Beijing Residents.

A systematic field survey of 6,567 urban and rural residents out of 3.000 households, through cluster sampling among Beijing residents, was collaborativelv conducted. The results reveal that benzodiazepine has been widely prescribed and its rate of usage for 1 year is 61.82%. whereas rate of de-

Detection of ECTV,MHV and SV in Clean-grade Mice and Rats in East China

To study the epidemic status of Ectromelia virus （ ECTV）, Mouse hepatitis virus （MHV） and Sendai virus （SV） in clean-grade experimental mice and rats in East China, 30 individuals of ICR and/or C57BL/6 mice and 15 individuals of SD or Wistar rats were purchased from four major experimental animal supply bases in East China. Blood samples were collected by eyeball picking method, and serum was separated. ECTV, MHV and SV serum antibodies in mice were de- teeted using imported commercial ELISA kits. Since rats were not easily infected by MHV and SV, only the ECTV serum antibody was detected in rats. Survey re- suits revealed that clean-grade experimental mice and rats derived from three out of four major experimental animal supply bases were negative in detection, but the positive rates of MHV and SV serum antibody in clean-grade ICR mice in one supply base were 56.7% and 100.0%, respectively, while the positive rate of MHV serum antibody in C57BL/6 mice was 100%. Research results showed that most of the commercial experimental mice and rats in major experimental animal supply bases in East China were qualified in detection of above three kinds of diseases, but MHV and SV still existed in individual base, with severe infection status. Thus, active measures must be strengthened to purify mice and rats. Meanwhile, monitoring of mouse and rat diseases must be developed seriously to guarantee the quality of experimental mice and rats, so as to avoid adveme impacts on breeding and use of experimental rats and miee.

Diagnosis and treatment of sudden sensorineural hearing loss

Nationwide epidemiological surveys of idiopathic sudden sensorineural hearing loss(SSNHL) have been performed five times by the Research Committee of the Ministry of Health and Welfare or the Ministry of Health, Welfare and Labour in Japan. These surveys included patients who had SSNHL in 1972, 1987, 1993, 2001, and 2012. Using the criteria for the grading of hearing loss in SSNHL or the criteria for grading the degree of hearing recovery after SSNHL established by the Research Committee, we compared the outcomes of SSNHL between the five nationwide surveys. The results revealed that the outcomes of SSNHL have not changed in the past 40 years. In 1972, 88% of patients received steroids, but none received prostaglandin E1(PGE1). The use of PGE1 has increased since the 1980 s, but its effect on SSNHL may not be significant. Intratympanic steroid injection has been introduced recently for the treatment of SSNHL, but it does not seem to be used widely in Japan. Intratympanic therapy that can reduce the total amount of steroids administered will be used more frequently if the true effects and indications for this therapy are known. Elucidation of the etiologies of SSNHL and development of treatments specific for these etiologies are expected.

Activities of daily living and lesion position among multiple sclerosis patients by Bayes network

Magnetic resonance imaging is a highly sensitive approach for diagnosis of multiple sclerosis, and T2-weighted images can reveal lesions in the cerebral white matter, gray matter, and spinal cord. However, the lesions have a poor correlation with measurable clinical disability. In this study, we performed a large-scale epidemiological survey of 238 patients with multiple sclerosis in eleven districts by network member hospitals in Shanghai, China within 1 year. The involved patients were scanned for position and size of lesions by MRI. Results showed that lesions in the cerebrum, spina cord, or supratentorial position had an impact on the activities of daily living in multiple sclerosis patients, as assessed by the Bayes network. On the other hand, brainstem lesions were very unlikely to influence the activities of daily living, and were not associated with the position of lesion, patient＇s gender, and patient＇s living place.

Outbreak of Mycoplasma pneumoniae at a military academy

In 2019, an outbreak of Mycoplasma pneumoniae(M. pneumoniae) occurred at a military academy in China. The attack rate(10.08%, 60/595) was significantly different among the units. High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M. pneumoniae. In-time prevention and control measures effectively controlled the spread of the epidemic.

Risk factors for primary gout and hyperuricemia

Objective:Through epidemiological investigation,to investigate the etiology and influencing factors of primary gout and hyperuricemia(HUA).Methods:Using case-control methods,designed questionnaires on gout and/or HUA related factors(living habits,eating habits and environmental factors,etc).Logistic regression analysis of the survey results was performed with SPSS 19.0 software.Results:(1)Univariate Logistic regression analysis:11 risk factors with statistical significance(P<0.05),often eat sauce food,often eat Fried food,often eat asparagus,often eat nuts,often drink,smoking,drink water<1000ml per day,residential temperature≤17℃in winter,work environment average temperature≤17℃in winter,often exposure to toxic and harmful substances,often use induction cooker or microwave oven(P<0.05),the OR values were 2.063,1.701,3.242,1.560,2.055,1.338,5.700,5.330,2.305,2.821,1.701;3 protective factors,occasionally eat fresh fruit,wake up between 5 and 7 am,use the computer less than 1 hour per day(P<0.05),OR values were 0.723,0.611 and 0.558,respectively.(2)Multivariate Logistic regression analysis was performed for all factors:6 risk factors,The risk factors were often drink,drink water<1000ml per day,residential temperature≤17℃in winter,work environment average temperature≤17℃in winter,use mobile network cellphones and use unicom network cellphones(P<0.05),OR values are 2.008,4.240,4.034,1.889,2.207 and 1.891,respectively;2 protective factors:occasionally eat agaric and use the computer less than 1 hour per day(P<0.05),OR values were 0.551 and 0.536,respectively.Conclusions:Proper improvement of diet structure,adjustment of life and behavior,and avoidance of environmental risk factors can effectively reduce uric acid level,control the incidence of HUA and gout,and improve health level.

Oral health in China-trends and challenges

For a long time, oral disease is one of the major problems of the public health for its high prevalence and incidence throughout the world, which is especially true for low-income populations. Since China＇s economic reform in 1978, great changes have taken place in China. These changes have significant impact on and have been reflected in oral disease trends in China. This paper provides an overview and assessment of the oral health status in China. It focuses on changes in the nation＇s demographic profile, in the marketplace, the oral disease status and trends. The paper also suggests some possible measures and strategies for bettering oral health in future China.

Knowledge and preventive measures practiced by junior high school students from Mexico City regarding influenza A (H1N1)

Background: Influenza A (H1N1) is the most recent pandemic disease that has affected the human population. Objective: To evaluate knowledge and preventive measures related with this disease one year after the epidemic of Mexico- that took place in 2009. Material and methods: An epidemiologic survey regarding influenza A (H1N1) was conducted in June 2010 among 2541 students from the second grade of all public high schools in a borough in Mexico City. The questionnaire included items on the knowledge of the disease and practice of preventive measures. Results: Most students obtained the information from television, half of them from parents and only one fifth from teachers;72% of the participants had a favorable knowledge about the disease and the measures to avoid being infected. However, only 37% practiced such preventive measures. Conclusion: Knowledge has a positive influence on practices towards health. Parents and teachers have an important role in health education, thus efforts should be directed to involve them more intensely in health education.

Quality metrics and outcomes among critically ill patients in China:results of the national clinical quality control indicators for critical care medicine survey 2015-2019

Background:It is crucial to improve the quality of care provided to ICU patient,therefore a national survey of the medical quality of intensive care units(ICUs)was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to 2019.Methods:This was an ICU-level study based on a 15-indicator online survey conducted in China.Considering that ICU care quality may vary between secondary and tertiary hospitals,direct standardization was adopted to compare the rates of ICU quality indicators among provinces/regions.Multivariate analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia(VAP),catheter-related bloodstream infections(CRBSIs),and catheter-associated urinary tract infections(CAUTIs).Results:From the survey,the proportions of structural indicators were 1.83%for the number of ICU inpatients relative to the total number of inpatients,1.44%for ICU bed occupancy relative to the total inpatient bed occupancy,and 51.08%for inpatients with Acute Physiology and Chronic Health Evaluation II scores≥15.The proportions of procedural indicators were 74.37%and 76.60%for 3-hour and 6-hour surviving sepsis campaign bundle compliance,respectively,62.93%for microbiology detection,58.24%for deep vein thrombosis prophylaxis,1.49%for unplanned endotracheal extubations,1.99%for extubated inpatients reintubated within 48 hours,6.38%for unplanned transfer to the ICU,and 1.20%for 48-hour ICU readmission.The proportions of outcome indicators were 1.28‰for VAP,3.06‰for CRBSI,3.65‰for CAUTI,and 10.19%for in-hospital mortality.Although the indicators varied greatly across provinces and regions,the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 years.The overall mortality rate has dropped from 10.19%to approximately 8%.Conclusions:The quality indicators of medical care in China’s ICUs are heterogeneous,which is reflected in geographic disparities and grades of hospitals.This study is of great significance for improving the homogeneity of ICUs in China.

Allergic Constitution Theory of Chinese Medicine and its Assessment Criterion and Related Studies

Constitution factor plays an important role in the occurrence, development, and transformation of diseases. The occurrence of allergic diseases is mainly caused by the disorganized physiological function and suitability regulation of patients, except for their exposure to outside allergens. Moreover, it represents susceptibility and hypersensitivity to allergens. The currant study expresses the concept of allergic constitution from the perspective of Chinese medicine （CM） and presents the criterion of allergic constitution. In addition, the distribution of allergic constitution in population, its factors, and its relation to health-related quality of life （HRQOL） were investigated. The HRQOL scores of allergic constitution were found to be lower than those of the Pinghe constitution. After making a study on the gene expression profile of allergic constitution, the characteristics of up-regulated or down-regulated genes were found. Finally, CM drug was researched and developed to improve allergic constitution. Based on clinical trials and animal experiments, CM is found to have good regulatory effects on allergic constitution.