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Objective To understand the epidemiological characteristics of scrub typhus disease and to provide a scientific basis for the prevention and control of scrub typhus disease. Methods Descriptive epidemiological methods were used to analyze the population and regional distribution of scrub typhus. Seasonal characteristics were analyzed using concentration method and circular distribution method, and incidence trend was analyzed using joinpoint regression model. Results The annual incidence rate of scrub typhus was 0.95/100 000 from 2010 to 2022. The incidence rate of male was 0.77/100 000, lower than that of female 1.12/100 000 (χ2=18.89, P-=-62.3728, S=20.8960. The circular distribution results indicated that the peak day was October 19th, and the peak period was between October 7 to December 19. The average annual percentage change (AAPC) of the incidence rate from 2010 to 2022 was 13.70%, 95% CI (-8.62%~41.48%), and the incidence rate showed an upward trend (t=1.15, P=0.249). Conclusion The incidence of scrub typhus disease is strictly seasonal, and the incidence rate over the years shows an upward trend. It is necessary to strengthen monitoring and take various intervention measures to reduce the risk of scrub typhus disease.
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Objective To evaluate the quality of infectious disease surveillance data and provide scientific basis for improving data quality and health decision-making. Methods The comprehensive index of infectious disease monitoring system evaluation and the integrity, accuracy and reliability of infectious disease report data were used to evaluate the quality of infectious disease monitoring data in multiple dimensions. Results In 2021, The comprehensive evaluation index of infectious disease surveillance system was 98.40%. In terms of data integrity, 1 105 data were missing, and the incomplete rate was 1.46%; In terms of data accuracy, 1978 cases were not accurately, rate of accuracy was 26.72%; In terms of data reliability, the card reporting rate of tertiary medical institutions accounted for 67.05%, the diagnosis rate of confirmed cases was 27.74%, and the correction rate of report card was 28.48%. Conclusion The accuracy and reliability of infectious disease data are insufficient, and new methods for infectious disease monitoring data quality are expanded to make up for the lack of data quality evaluation of the current national epidemic system.
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Objective:To explore the necessity and feasibility of introducing the courses of dental practice management in the undergraduate education of stomatology under the background of the undergraduate entrepreneurship education reform.Methods:In the School of Stomatology of Zhejiang Chinese Medical University, the entrepreneurial course dental practice management was set-up for the junior undergraduate students. CBL, PBL, teacher's lecture, student's lecture on the stage and PPT demonstration, role-play, and team cooperation were taken in the course. And the questionnaires were used to investigate the course setting, necessity, teaching forms and satisfaction from multiple groups. SPSS was performed for data analysis, and the teaching effect was evaluated through the data results.Results:The scores of 108 students in the study [(75.99±5.76) points] were roughly distributed as normal functions. The results of the survey showed that the number of students who planned to have their own private clinics after the course increased by 41 (37.96%) compared with that before the course. All instructors and 33 (78.57%) active dentists thought that the course was reasonable in the undergraduate courses.Conclusion:It is necessary and feasible to introduce the dental practice management course in undergraduate education of stomatology, which will have a certain guiding effect on the long-term development of dentists, and is also beneficial to the reform of innovation and entrepreneurship courses in medical universities.
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Objective:To explore the feasibility of CT angiography (CTA) in investigating vascular dilatation of anterior choroidal artery (AChA) and posterior communicating artery (PComA) in patients with Moyamoya syndrome (MMS).Methods:From July 2017 to July 2018, the clinical and imaging data of MMS patients with brain CTA and DSA performed were analyzed retrospectively. According to DSA results, 71 MMS patients were divided into unilateral MMS group (20 cases, 20 hemispheres) and bilateral MMS group (51 cases, 102 hemispheres). There were 20 cases in unilateral MMS group, 10 males and 10 females, with an average age of (45±9) years; 51 cases in bilateral MMS group, 24 males and 27 females, with an average age of (44±12) years. The hemispheres were divided into dilated group and non-dilated group according to the dilatation of AChA or PComA. Kappa analysis was used to evaluate the consistency of two inspection methods to judge the expansion of AChA. The lumen diameters of PComA, P1 and P2 segments of posterior cerebral artery were measured on CTA images, and the ratio of PComA/P1 and PComA/P2 were calculated. The repeatability of CTA measures was evaluated by intra-group correlation coefficient. Independent sample t-test was used to compare CTA measurement results between PComA dilated group and non-dilated group, and ROC curve was drawn to calculate the best threshold for diagnosis of PComA expansion. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA measures were calculated. Results:The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA diagnosis of AChA expansion inunilateral MMS were all 100.00%. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA diagnosis of AChA expansionin bilateral MMS were 90.00%, 93.90%, 93.14%, 78.26% and 97.47%. Compared with DSA, there was no significant difference in the diagnostic performance of AChA expansion between single and bilateral MMS diagnosed by CTA ( P>0.05). The two methods had strong consistency (Kappa value was 1.00 and 0.79 respectively, P<0.01). A total of 46 patients (69 cerebral hemispheres) were included in the evaluation of PComA. PComA/P1 (1.09±0.41) and PComA/P2 (0.86±0.13) in the dilated group were significantly higher than those in the non-dilated group (0.71±0.21 for PComA/P1 and 0.75±0.23 for PComA/P2). The differences were statistically significant ( t=-4.59, -2.50, P<0.05). The best threshold in diagnosing PComA expansion was 0.87 (PComA/P1) and 0.76 (PComA/P2), and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 84.62%, 83.33%, 84.06%, 86.84%, 80.65% and 79.49%, 60.00%, 71.01%, 72.09% and 69.23%, respectively. Compared with DSA, the Kappa value of CTA measures in diagnosis of PComA expansion was 0.68 (PComA/P1) and 0.40 (PComA/P2), respectively, and the difference was statistically significant ( P<0.05). Conclusions:CTA has a strong consistency with DSA in evaluating the AChA expansion in MMS. When the PComA/P1 ratio on CTA is greater than 0.87, it can be used as the diagnosis criterion for PComA expansion.
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Objective To study the clinical curative effect of transvaginal and laparoscopic operation methods for treating exogenous uterine cesarean scar pregnancy.Methods Sixty patients with exogenous uterine CSP in our hospital from August 2013 to August 2016 were selected and divided into the two groups with 30 cases in each group.The control group adopted laparoscopic lesion resection,while the observation group adopted transvaginal lesion excision of lower uterine segment.Then the operation situation,postoperative VAS score,β-HCG levels and traumatic response indexes were compared between the two groups.Results The hospitalization time had no statistical difference between the two groups(P＞0.05).The hospitalization cost,blood loss volume and anal exhaustion time in the observation group were less than those in the control group(P＜0.05).The β-HCG level before and after operation had no statistical difference between the two groups (P＞0.05).The VAS score and traumatic response indexes in the observation group were better than those in the control group(P＜0.05).The complication occurrence rate in the observation group was lower than that in the control group(P＜0.05).Conclusion Transvaginal lesion excision of lower uterine segment in the treatment of exogenous uterine CSP has better curative effect and safety.