Sparganosis is a zoonotic parasitic disease caused by the parasitic presence of Sparganum in humans and animals during the middle tapeseed stage of Spirometra mansoni and other schizocephalus tapeworms. Two cases of liver sparganosis treated at First Hospital, Jinan Vniversity in August 2022 are reported in this paper. After the epidemiological history, clinical manifestations, parasite antibodies, CT and B ultrasound images, etc. were analyzed and an infectious disease doctor was consulted, the diagnosis of liver sparganosis was made. After oral quinolone treatment, the patients' clinical symptoms, such as abdominal pain and fever, disappeared. The follow-up after discharge showed that the lesions were reduced in CT images, and their eosinophil counts of blood and liver function returned to normal. Clinical attention should be paid to suspicious epidemiological history, and relevant examinations should be improved. Most importantly, early diagnosis and treatment should be performed.

BackgroundUntreated maternal postpartum depression (PPD) has consequences for children's physical growth, but no published study has evaluated changes in this effect over time. Here we therefore aimed to evaluate the dynamic effects of PPD on the physical growth of children in a prospective birth cohort. MethodsBetween 2015 and 2019, 960 mother-child pairs in Changsha, China were followed up when the child was aged 1-48 months. Data were obtained through household surveys. The mothers' depressive symptoms were measured using the Edinburgh Postpartum Depression Scale (EPDS) at 1 month postpartum. Linear mixed models were used to examine the changes in the association of PPD and EPDS scores with physical growth in six different age groups of children between 1 and 48 months. ResultsA total of 604 mother-child pairs completed the follow-up, and 3.3% of mothers reported PPD. No associations were found between PPD and weight or height growth at any age. While EPDS scores were associated with weight gain (& beta; = -0.014, 95% CI (-0.025, -0.002), P = 0.024) and height growth (& beta; = -0.044, 95% CI (-0.084, -0.004), P = 0.030) rates at 1-3 months, no associations were found in older children. LimitationsThe number of mothers who reported PPD was relatively small, and the measurement of PPD was not continuously taken. ConclusionsAfter adjustments for confounders, no dynamic association was found between PPD and children's weight and height growth. EPDS scores, in contrast, did negatively affect children's weight and height growth at age 1-3 months, but this effect was not long-lasting.

Objectives: This study aimed to explore the gender and residence (rural/urban) differences in the associations between the specific dimensions of social support and subjective well-being (SWB) among the Chinese oldest-old. Methods: This study included 12,989 individuals aged >= 80 from 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. SWB was measured by ten items covering self-rated life satisfaction, positive emotions (optimism, happiness, personal control, and conscientiousness), and negative emotions (loneliness, anxiety, uselessness, depression, and boring feelings). Social support included the variables of marriage quality, living arrangements, contacts with others, children's and siblings' frequent visits and telecommunications, children and siblings living nearby, the main source of financial support, adequate financial support, social security and commercialized insurances, community social services, the caregiver when sick, and main medical expenses payer. Generalized estimating equation models were used to determine the effects of social support on the SWB. Results: Gender differences were found in the associations of living arrangements, contacts with others, children's frequent visits and telecommunications, community social services, caregiver when sick, and main medical expenses payer with SWB. Residence differences were found in the associations of living arrangements, contacts with others, children's frequent visits and telecommunications, siblings' frequent visits, community social services, and main medical expenses payer with SWB. Conclusions: There are gender and residence differences in the relationships between many dimensions of social support and SWB. Gender and residence-tailored interventions for social support are necessary to promote the well-being of the oldest old.

The present study aimed to investigate the associations between the trajectory of blood pressure (BP) change and the risk of subsequent dementia and to explore the differences in age, gender, and hypertension subgroups. We included 10,660 participants aged ≥ 60 years from 1998 to 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Latent growth mixture models were used to estimate BP trajectories. Cox-proportional hazard models were used to analyze the effects of BP trajectories on the risk of dementia. According to the results, stabilized systolic BP (SBP) was found to be associated with a higher risk of dementia compared with normal SBP [adjusted hazard ratio (aHR): 1.62; 95% confidence interval (CI): 1.27-2.07] and elevated SBP (aHR: 2.22; 95% CI: 1.51-3.28) in and only in the subgroups of the oldest-old, women, and subjects without hypertension at baseline. Similarly, stabilized pulse pressure (PP) was associated with a higher risk of dementia compared with normal PP (aHR: 1.52; 95% CI: 1.24-1.88) and elevated PP (aHR: 2.12; 95% CI: 1.48-3.04) in and only in the subgroups of the oldest-old, women, and subjects with hypertension at baseline. These findings suggest that stabilized SBP and PP have predictive significance for the occurrence of dementia in late life, and the factors of age, gender, and late-life hypertension should be considered when estimating the risk of BP decline on dementia.

恙虫病又名丛林斑疹伤寒,为感染恙虫病立克次体而导致的急性传染病,为自然疫源性疾病,近年来发病率有所上升.本文报告了1例以发热、消化道出血、淋巴结肿大和焦痂为表现,同时合并EB病毒感染,伴心肝肾等多器官功能损害的恙虫病,经多西环素和抗病毒治疗,临床症状缓解.

目的 分析湖南省某三级甲等医院主要诊断与手术操作不一致的原因,并研究对DRGs相关医疗服务绩效的影响,为提高病案首页质量提供依据.方法 提取电子病历系统中2019年1月1日-2019年12月31日耳鼻喉科3978份出院病案首页信息,运用CN-DRG分组器系统,在未入组情况中查找主要诊断与手术操作不一致的病例,核查病案质量,对比分析校正前后耳鼻喉科4个亚专科DRGs相关医疗服务绩效变化.结果 共有114份病案因主要诊断与手术操作不一致导致未入组,主要原因有主要诊断填写不规范、主要手术操作填写不规范、编码错误、其他原因(分组器规则)等.矫正后耳鼻喉科入组病例数增加81例, CMI值增加0.0064,DRGs组数增加10组,总权重增加105.09.校正后入组率由97.13%提高到99.17%,不同亚专科呈现不同变化.结论 主要诊断与手术操作不一致直接影响 DRGs 分组和相关医疗服务绩效评价,提高临床医师病案书写质量、加强编码员的专科知识能力和编码水平、搭建全流程质控模式有利于减少缺陷情况,能够有效提高病案首页质量.

Background Untreated maternal postpartum depression has consequences for infant weight, which may vary with infant growth time and postpartum depression duration. Dynamic assessment of the association between maternal postpartum depression and infant weight growth is crucial for early detection of the suspicious abnormal effects of maternal postpartum depression on infant weight growth and taking corresponding intervention measures. But, none of published studies continuously and dynamically evaluated these effect changes on infant weight growth. This study was aimed to evaluate the dynamic effects of maternal postpartum depression on infant weight growth at a prospective birth cohort. Methods 960 mother-infant pairs between 2015 to 2018 in Changsha, China were followed up at ages of 1, 3, 6, 8, and 12 months. Data were obtained through household surveys. Depression of mothers was assessed at 1 month postpartum. Linear mixed models and generalized estimating equation models were used to test the connection and its changes between maternal postpartum depression and infant weight growth at five different periods of 1–12 months. Results 8.0% of mothers reported postpartum depression. Adjusted linear mixed models showed a negative association between maternal depression at 1-month postpartum and infant weight at 1 month, 1–3 months, 1–6 months, 1–8 months, and 1–12 months, in which infants with depressed mothers were the lighter weight of 0.14kg (95% CI :0.02, 0.25), 0.13kg (95% CI :0.02, 0.24), 0.13kg (95% CI :0.02, 0.24), 0.13kg (95% CI :0.02, 0.24), and 0.16kg (95% CI :0.04, 0.27) relative to not depressed respectively. Generalized estimating equation models showed a positive association between maternal depression at 1-month postpartum and infant underweight at 1 month and 1–3 months, in which infants of maternal depression had higher risk ratio of underweight in 3.19 (95% CI :1.38, 7.34) and 3.19(95% CI :1.32, 7.70) compared to those mothers were not depressed accordingly. Conclusions Maternal postpartum depression was continuously associated with a lighter weight of ifants from 1 to 12 months and higher risk of being underweight in infants from 1 to 3 months. It seems important to put early prevention, screening, diagnosis, and treatment of maternal depression into practice as soon as possible to avoid adverse consequences.

目的 对某三甲医院2014-2018年日间手术中心住院病人疾病谱的特征进行分析,了解疾病变化趋势,为医疗资源的合理配置提供参考依据.方法 对某院2014-2018年日间手术中心住院病人疾病构成、顺位、性别、年龄分布进行统计分析.结果 日间手术中心住院患者前十位病种占总人数的33.41％,前五位病种依次是胆管结石、并发性白内障、胆囊结石伴慢性胆囊炎、甲状腺癌、硅油眼.不同性别、年龄组的疾病构成有差别.结论 医院应根据日间手术中心疾病构成合理配置医疗资源,更好地为病人提供服务.

血行播散性肺结核是结核分枝杆菌(Mycobacteri-um tuberculosis,MTB)一次或反复多次进入血液循环,造成肺部弥漫性病变,甚至全身多脏器病变,是结核病中较为严重的一种类型,可由原发性肺结核发展而来,也可由其它结核干酪样病灶破溃到血液引起.由于血行播散性肺结核的临床和影像学表现均缺乏特异性,易造成误诊、漏诊及延误治疗.现分析1例血行播散性肺结核的临床诊治过程,以期提高临床医生对血行播散性肺结核的诊治水平.

目的 基于广义估计方程探讨幼儿屈光发育的现状及围产期相关因素对幼儿屈光发育的影响,为婴幼儿视力保健提供科学依据.方法 采用整群抽样的方法,选取湖南省长沙市开福区三个街道社区卫生服务中心的产妇及新生儿作为研究对象,建立前瞻性队列研究,婴幼儿定期在社区医院进行视力筛查,并应用广义估计方程探讨围产期相关因素对幼儿屈光发育的影响.结果 幼儿屈光异常的类型均以单纯性散光为主,近视性屈光次之.通过广义估计方程的结果可知,母亲为初产妇(OR=1.631,P=0,003)、妊娠合并原发性高血压(OR=4.843,P=0.026)和幼儿低出生体重(OR=3.752,P=0.023)是幼儿屈光异常的危险因素.结论 屈光异常的发生率越来越趋向低龄化,加强对婴幼儿屈光发育及其影响因素的探讨,重视围产期保健,对促进儿童视力健康具有重要作用.

Background: At present, whether to use the World Health Organization's (WHO) growth standards or native growth standards to assess the nutritional status in a given population is unclear. This study aimed to compare the differences between the WHO's growth standards and China's growth standards in assessing the nutritional status of children aged 0~36 months. Methods: We used z-scores to evaluate the nutritional status of children. The weight-for-age z-scores (WAZs), length/height-for-age z-scores (LAZ/HAZs), and weight-for-length/height z-scores (WLZ/WHZs) were calculated using the WHO's growth standards and China's growth standards. MeNemar's test was used to compare the nutritional status of children. Results: The results in this study showed that there were differences between the WHO's standards and China's standards in assessing children's nutritional status except for stunting and obesity. The prevalence of underweight assessed using China's standards was higher than when using the WHO's standards (except when 3 and 36 months old). The prevalence of wasting was significantly higher when assessed using China's standards than when using the WHO's standards from 12 to 36 months. The prevalence of overweight was higher when assessed using the WHO's standards from 3 to 8 months. Conclusions: Both the WHO's and China's growth standards are useful measures in assessing children's nutritional status but with key significant differences. Therefore, caution should be taken in selecting appropriate measures in a given population.

目的 探讨母亲体质指数(body mass index,BMI)从孕前到产后的变化轨迹及其与儿童超重或肥胖风险的关系.方法 采用整群抽样法,选取2015年1至12月在长沙市开福区三个社区卫生服务中心分娩的产妇及其子代作为研究对象,根据纳入排除标准,最终有688对母子纳入本研究.使用潜类别增长模型(latent class growth models,LCGM)来确定产妇BMI的轨迹.采用logistic回归模型研究母亲BMI轨迹与子代超重或肥胖之间的关系.结果 确定了三类产妇BMI轨迹.在调整后的模型中,与第3类轨迹相比,第1类轨迹与儿童期超重或肥胖的风险增加密切相关(aOR:2.86,95％CI:1.48～5.51).在孕前超重/肥胖亚组分析,与第3类轨迹相比,第1类轨迹(aOR:2.86,95％CI:1.48～5.51)与儿童期超重或肥胖风险增加相关,在孕期增重过度亚组分析中,与第3类轨迹相比,第1类轨迹(aOR:3.82,95％CI:1.43～10.20)与儿童期超重或肥胖风险增加相关.在高体重滞留亚组分析中,与第3类轨迹相比,第1类轨迹(OR:4.35,95％CI:1.98～9.56)和第2类轨迹(OR:1.78,95％CI:1.01～3.14)均与儿童超重或肥胖的风险增加相关.结论 产妇孕前至产后高BMI可能增加儿童超重或肥胖的风险,而这与孕前BMI、孕期增重和产后体重滞留有关.

炎症性肠病(inflammatory bowel disease,IBD)是一种主要累及消化道的慢性疾病,除了肠道症状以外还有肠道外其他临床表现.IBD继发机会性感染、穿孔、狭窄、癌变等已有诸多报道.随着IBD并发心血管事件报道越来越多,且研究存有争议,而临床医生也对其风险评估和重视不足.本文查阅国内外近年来发表的相关文献,就IBD心血管风险研究进展进行综述,旨在让临床医生对其风险熟悉并结合临床制定好个体化管理.

Background: With births generated with assisted reproductive techniques (ARTs) increasingly, the effect of ARTs on infant feeding behaviors is an essential topic to explore. However, limited literature focused on this topic. The objective of this study is to examine the effect of ARTs on infant feeding behaviors. Materials and Methods: Participants, including 41 mothers who conceived with ARTs and 935 conceived spontaneously, were drawn from a prospective birth cohort between January 2015 and December 2015. The participants were followed up at 1, 3, 6, 8, and 12 months postpartum at their residences through a face-to-face interview. Feeding behaviors, including breastfeeding initiation, partial/exclusive breastfeeding duration and formula introduction were assessed using World Health Organization-recommended definitions. Cox and logistic regression models were applied to examine the association of assisted conception with feeding behaviors. Results: Breastfeeding initiation rates were comparable between women who conceived with and without ARTs (70.7% versus 76.0%). Breastfeeding duration and formula introduction were significantly shorter and earlier in assisted conceptions in univariate analyses at 6 months postpartum [crude hazard ratios (HRs), 95% confidence intervals (CIs) 2.02 (1.03-3.84), and 1.63 (1.09-2.44)]. However, after controlling for covariates, assisted conception was only associated with shorter breastfeeding duration at 6 months postpartum [adjusted HR 1.99, 95% CI 1.05-3.80], no significant differences were found in infant feeding outcomes at 12 months postpartum among women with ART conception versus general conception. Mothers who conceived through ARTs with cesarean deliveries were at the highest risks of shorter breastfeeding duration and earlier formula introduction than mothers who conceived spontaneously with vaginal deliveries. Conclusions: Mothers who conceive through ARTs are associated with shorter breastfeeding durations for the first 6 months, compare to mothers who conceive spontaneously. Furthermore, cesarean delivery has a joint effect with the treatment of ARTs on promoting the development of poor feeding behaviors.

炎症性肠病(inflammatory bowel disease,IBD)主要包括克罗恩病和溃疡性结肠炎,是一种主要累及消化道的慢性炎症性疾病.近年来IBD在西发达国家的发病率趋于稳定,而亚洲国家和其他发展中国家呈上升趋势,其可能的相关病因和发病机制仍较为复杂.我国的IBD流行病学研究尚处于初始阶段,尚待更多临床医学中心获取更多的大样本IBD群体数据进行流行病学研究,从而做好我国IBD防治策略.

Background: The association of maternal parity, pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood weight status has been well studied; however, little is known about these factors with respect to the rate of weight changes in early childhood. Methods: This study was based on a prospective longitudinal study. The follow-up surveys were conducted at the ages of 1, 3, 6, 8, 12, and 18 months. Child weight was investigated twice at each wave. Data on maternal parity, pre-pregnancy weight and height were collected at baseline. The latent growth curve model was used to examine the effects of interested predictors on the trajectory of weight in early childhood. Results: Finally, 893 eligible mother-child pairs were drawn from the cohort. In adjusted models, multiparas were associated with higher birth weight (β = 0.103) and slower weight change rate of children (β = −0.028). Pre-conception BMI (β = 0.034) and GWG (β = 0.014) played important roles in the initial status of child weight but did not have effects on the rate of weight changes of the child. Conclusions: Multiparous pregnancy is associated with both higher mean birth weight and slower weight-growth velocity in early childhood, while pregravid maternal BMI and GWG are only related to the birth weight.

OBJECTIVE:To investigate the current status of the postpartum weight retention (PPWR) in Kaifu District of Changsha, and explore the influential factors with PPWR based on the generalized estimating equation model. Methods: A cluster sampling method was applied to select women who gave birth at the health service centers of 3 street communities in Kaifu District of Changsha during 2015. According to the inclusion and exclusion criteria, 783 cases were finally included in the study. Data on PPWR were collected prospectively by using the self-made questionnaire at 1, 3, 6 and 8 months after childbirth. Analysis were performed to investigate the associations between PPWR and its potential factors with generalized estimation equation model. Results: The mean PPWR of women was gradually decreased with the increase of postpartum time, and 34.6% of them have returned to the pre-pregnancy weight in the 8 months postpartum. Our findings revealed that gestation weight gain (GWG), pre-pregnancy body mass index, feeding patterns, and delivery mode were significantly associated with maternal PPWR (P<0.05). In contrast, maternal age, educational level, per capita income of family, parity and postpartum depression were not contributed to PPWR (P>0.05). Conclusion: GWG is one of the most important predictors for PPWR. The key to reducing PPWR is to control GWG systematically. Early targeted interventions and health education should be taken to prevent women from excessive PPWR at the first-year postpartum, in particular to the women who underwent cesarean deliveries and breastfed their infants. It is conducive to reduce the risks of overweight or obesity caused by PPWR.

Few prospective birth cohort studies are available on the effects of prenatal and early-life exposures on food allergy and eczema among Chinese children. The aim of this study was to evaluate the influence of prenatal and early-life exposures on food allergy and eczema during the first year of life in a prospective birth cohort study. This study was based on a prospective, observational birth cohort of 976 mother-child pairs in three Streets in Changsha, China from January to December 2015. Data on prenatal, early-life exposures and allergic outcomes were obtained from questionnaires collected at birth, and 1, 3, 6, 8, and 12 months of age. Multivariate logistic regression models were performed to estimate the effects of prenatal and early-life exposures on food allergy and eczema. Common risk factors for food allergy and eczema in infancy were parental history of allergy, while moderate eggs consumption (3–4 times/week) during pregnancy was protective for both of them compared with low consumption (≤ 2 times/week). Factors only associated with food allergy were maternal aquatic products consumption during pregnancy, number of older siblings and age of solid food introduction, whereas factors only associated with eczema were maternal milk or milk products consumption during pregnancy, maternal antibiotic exposure during pregnancy, season of birth and antibiotic exposure through medication during the first year of life. Our study suggests that factors associated with food allergy and eczema are multifaceted, which involving hereditary, environmental and nutritional exposures. Furthermore, differential factors influence the development of food allergy and eczema in infants.

Abstract Background The first few weeks after childbirth are critical, as women may encounter lactation problems and postpartum depression during this period. However, it is still unclear whether early breastfeeding behaviours are related to the symptoms of postnatal depression (PND) in Chinese populations. Therefore, the current study aimed to investigate the association between symptoms of PND and infant feeding practices based on a large-scale Chinese cohort. Methods A prospective study of the community-based cohort was conducted from January 2015 to December 2016. Infant feeding outcomes, including exclusive/partial breastfeeding and formula feeding, were assessed according to the WHO guidelines. Symptoms of PND were assessed by the Edinburgh Postnatal Depression Scale at 4 weeks postpartum. Multivariate generalized estimating equation models were applied to investigate the associations between depressive symptoms and infant feeding behaviours. Results A total of 956 mother-infant pairs were included. Fifty-six mothers presented screen-positive symptoms of PND with a cut-off ≥10. The percentage of early breastfeeding initiation was 75.8%, while the average duration of exclusive breastfeeding was 3.90 ± 2.33 months. Postnatal depressive symptoms were associated with a shorter breastfeeding duration (8.02 vs. 6.32 months, P < 0.05) and earlier formula introduction (4.98 vs. 3.60 months, P < 0.05). After adjustments were made for covariates, postnatal depressive symptoms were associated with an increased risk of the discontinuation of exclusive and partial breastfeeding (β = − 0.049, P = 0.047 and β = − 0.082, P = 0.006, respectively). Compared to mothers without symptoms of PND, mothers with depressive symptoms were more likely to supplement formula for their infants in the first year of life (β =0.074, P = 0.016). These associations were still significant in the sensitivity analyses, using an EPDS cut-off of ≥13. Conclusions Our findings indicate that depressive symptoms at 4 weeks postpartum are associated with the cessation of exclusive and partial breastfeeding duration and the introduction of formula in the 12 months of delivery. Early psychosocial assessment and social support should be offered to mothers in the early postpartum period to indirectly prevent adverse breastfeeding outcomes.

This study aimed to examine the associations between the duration of folic acid (FA) supplementation, gestational diabetes mellitus (GDM), and adverse birth outcomes. A total of 950 mother-offspring pairs participated in the cohort study during 2015 in Changsha, China. The data were collected through home visits and perfected by maternal and child healthcare handbooks. Generalized linear models and stratified analyses were used for statistical analyses. The incidence of GDM in our cohort was 10.2%. FA supplementation for ≥3 months before pregnancy was associated with an increased risk of GDM (adjusted relative risk (aRR): 1.72; 95% CI: 1.17-2.53) and decreased risk of small-for-gestational-age (SGA) birth (aRR: 0.40; 95% CI: 0.18-0.88). In the group of FA supplementation for ≥3 months during pregnancy, GDM was associated with an increased risk of cesarean delivery (aRR: 1.36; 95% CI: 1.06-1.75) and macrosomia (aRR: 2.11; 95% CI: 1.06, 4.20), but the aRRs were lower than the RRMH 1.53 (95% CI: 1.01-2.34) and 2.43 (95% CI: 1.27-4.66). Our study suggested that the longer duration of FA supplementation before pregnancy might increase the risk of GDM, but decrease the risk of SGA birth. Longer duration of FA supplementation during pregnancy had beneficial effects on birth outcomes in women with GDM. Further studies should consider a larger sample size to confirm these findings.