To understand the influenza (flu) vaccination status and willingness and influencing factors among students in primary and secondary schools with flu outbreaks in Sichuan province and provide reference for formulating flu vaccination strategies.

This study was conducted in 7 primary and secondary schools where flu outbreaks occurred from February to April 2023 in Sichuan province. A total of 5 373 primary and secondary school students in classes with ≥ 2 confirmed cases of flu were selected by convenient sampling method for a questionnaire survey. To reveal the flu vaccination status in the 2020–2023 flu season and the willingness to receive flu vaccination in the 2023–2024 flu season, we employed multivariate unconditional logistic regression to analyze the influencing factors of flu vaccination willingness.

Among the 4 718 primary and secondary school students included in the analysis, 1 320 (28.0%) received flu vaccination in any season during the 2020–2023 flu season. Among them, the flu vaccination rates in the 2020–2021, 2021–2022, and 2022–2023 flu seasons were 10.4% (491/4 718), 14.0% (658/4 718), and 16.6% (785/4 718), respectively. The flu vaccination rates varied in different flu seasons (χ² = 77.076, P < 0.001). The primary motivations for parental consent to flu vaccination included awareness of vaccine benefits leading to a desire for comprehensive protection (60.5%), concern about severe influenza outbreaks and infection risk (12.9%), and school teacher recommendations (9.9%). Conversely, the main reasons for vaccine hesitancy were lack of knowledge about vaccine availability or annual vaccination requirements (33.5%), concerns about potential adverse reactions (21.2%), and perceived risk of post-vaccination infection (10.8%). During the 2023–2024 flu season, 4 113 (87.2%) students expressed willingness to receive flu vaccination. Multivariate logistic regression analysis identified that primary and secondary school students residing in City A and City B, receiving flu vaccination during the 2020–2023 flu season, being aware of annual vaccination requirements, believing in vaccination’s protective efficacy against infection, and concerning about potential transmission from infected classmates and friends demonstrated higher vaccination willingness. Conversely, students aged ≥ 16 years, secondary school attendees, residents of City B, and those concerned about adverse reactions showed lower vaccination willingness.

The flu vaccination coverage among students in primary and secondary schools affected by flu outbreaks in Sichuan province remained suboptima during the 2020–2023 flu seasons. However, vaccination willingness was higher in the 2023–2024 flu season. Key determinants of vaccination willingness included age and city of residence, vaccination history in the 2020–2023 flu seasons, awareness of annual vaccination requirements, perceived efficacy in reducing infection risk, concerns about adverse reactions, and apprehension regarding disease transmission from peers.

To explore the association between temperature and incidence of influenza-like illness (ILI) in Huai′an city, Jiangsu province and provide a scientific basis for the prevention and control of ILI.

The ILI surveillance data of two national influenza surveillance sentinel hospitals and meteorological data in Huai′an from January 1, 2015 to December 31, 2022 were collected from the Chinese Influenza Surveillance Information System and China Meteorological Data Service Center, respectively. The associations between the weekly incidence of ILI and meteorological factors were tested by Spearman correlation analysis. The distributed lag non-linear model (DLNM) was utilized to analyze the association between the average temperature and ILI incidence among residents in Huai′an. The confounding factors such as long-term trends and holiday effects were controlled to analyze the lag effect of average temperature on the incidence of ILI.

In the influenza surveillance sentinel hospitals in Huai′an from 2015 to 2022, the weekly average incidence of ILI was (527.88 ± 444.83) cases. Spearman correlation analysis indicated that weekly average temperature and weekly average air pressure were negatively associated with weekly average incidence (r = −0.24 and 0.19, respectively, both P < 0.001). The results of the DLNM demonstrated that at a lag of 0 week, the heat effect (30 °C) would increase the risk of ILI in the 5–14 (RR = 2.02, 95%CI: 1.03–3.98), 15–24 (RR = 2.25, 95%CI: 1.17–4.32), 25–59 (RR = 2.08, 95%CI: 1.13–3.83), and ≥ 60 (RR = 3.01, 95%CI: 1.04–8.74) age groups; at a lag of 1 week, the cold effect (1 °C) would increase the risk of ILI in the overall population (RR = 1.96, 95%CI: 1.35–2.84), 0–4 (RR = 1.39, 95%CI: 1.00–1.94), 5–14 (RR = 1.70, 95%CI: 1.04–2.89), 15–24 (RR = 3.88, 95%CI: 2.30–6.57), 25–59 (RR = 4.02, 95%CI: 2.46–6.57), and ≥60 (RR = 13.02, 95%CI: 5.97–28.42) age groups; at a lag of 2 weeks, the cold effect (1 °C) would increase the risk of ILI in the 25–59 age group (RR = 1.58, 95%CI: 1.01–2.48); at a lag of 0–1 week, the cold effect (1 °C) would increase the risk of ILI in the overall population (RR = 2.51, 95%CI: 1.83–3.46), 0–4 (RR = 1.61, 95%CI: 1.20–2.14), 5–14 (RR = 2.50, 95%CI: 1.55–3.77), 15–24 (RR = 5.01, 95%CI: 3.19–7.87), 25–59 (RR = 5.25, 95%CI: 3.45–8.00), and ≥ 60 (RR = 17.13, 95%CI: 8.89–32.90) age groups, and the heat effect (30 °C) would increase the risk of ILI in the ≥ 60 age group (RR = 4.68, 95%CI: 1.46–15.01); at a lag of 0–2 weeks, the cold effect (1 °C) would increase the risk of ILI in the overall population (RR = 3.21, 95%CI: 2.34–4.40), 0–4 (RR = 1.96, 95%CI: 1.47–2.62), 5–14 (RR = 3.07, 95%CI: 2.02–4.67), 15–24 (RR = 5.86, 95%CI: 3.76–9.11), 25–59 (RR = 8.32, 95%CI: 5.60–12.46), and ≥ 60 (RR = 15.87, 95%CI: 8.12–31.03) age groups, and the heat effect (30 °C) would increase the risk of ILI in the 15–24 age group (RR = 2.18, 95%CI: 1.08–4.38); at a lag of 0–3 weeks, the cold effect (1 °C) would increase the risk of ILI in the overall population (RR = 2.10, 95%CI: 1.54–2.88), 0–4 (RR = 1.90, 95%CI: 1.44–2.51), 5–14 (RR = 2.16, 95%CI: 1.43–2.37), 15–24 (RR = 2.42, 95%CI: 1.51–3.86), 25–59 (RR = 3.43, 95%CI: 2.45–5.25), and ≥ 60 (RR = 6.18, 95%CI: 3.07–12.44) age groups.

Temperature affects the risk of ILI in different age groups in Huai′an. The cold effect is the main risk factor and has a lag effect, demonstrating a greater effect on ILI in the elderly population, which suggests that more attention should be paid to the elderly in the future.

To understand the epidemiological characteristics of human rhinovirus (HRV) in influenza-like cases in Guizhou province, and analyze the VP4/VP2 gene features and variation patterns of HRV.

A total of 8 451 throat swabs were collected from influenza-like cases in Guizhou province from 2023 to 2024. Multiplex fluorescent quantitative PCR was employed to detect 11 common pathogens: HRV, influenza virus (IFV), respiratory syncytial virus (RSV), human parainfluenza virus (HPIV), adenovirus (ADV), human common coronavirus (HCoV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), human metapneumovirus (HMPV), enterovirus (EV), human bocavirus (HBoV), and Mycoplasma pneumoniae (MP). SPSS 22 was used for χ²/Fisher test on the detection rates of various pathogens. The HRV-positive samples were selected for VP4/VP2 gene sequencing, and MEGA was used for VP4/VP2 gene typing and phylogenetic analysis.

A total of 3 602 positive samples for 11 common pathogens were detected, with a total positive rate of 42.62%. SARS-CoV-2 showed the highest single-pathogen detection rate (6.63%), followed by HRV (6.41%). The detection rate of HRV varied among age groups (P < 0.001), being the highest in the age group of 0–4 years old (8.33%) and the lowest in the age group of ≥ 60 years old (2.02%). In addition, the detection rate of HRV varied among different seasons (P < 0.001), being the highest in autumn (9.20%) and the lowest in summer (4.03%). The detection rate of mixed infections of HRV was 1.93%, and the mixed infection of HRV and EV had the highest detection rate at 0.56%. A total of 42 HRV VP4/VP2 gene sequences were obtained, comprising 32 sequences of HRV-A, 2 sequences of HRV-B, and 8 sequences of HRV-C.

HRV is one of the main pathogens causing influenza-like cases in Guizhou province during 2023–2024, and HRV-A, HRV-B, and HRV-C coexist as the common species.

To evaluate the effectiveness of information interventions based on the social processes framework in promoting influenza vaccination acceptance among adults aged 18 years and older, and to explore the factors influencing the effectiveness of these interventions.

Between January 29 and February 4, 2021, an online survey was conducted among 3 345 adults aged 18 years and above in Guichi district, Chizhou city; Yuhuatai district, Nanjing city; and Changning district, Shanghai city. The survey collected data on sociodemographic characteristics, self-rated health status, perceived susceptibility to and severity of influenza, influenza vaccine awareness, and influenza vaccination history for the 2019–2020 and 2020–2021 influenza seasons. Participants were also exposed to an embedded, framework-based intervention containing information about influenza, and their intention to receive influenza vaccine in the next season was measured both before and after the intervention. McNemar-Bower tests and binary logistic regression were used to analyze the intervention′s effect and its factors.

Of the 3 345 participants, 89.30% rated their health as good; 15.81% perceived high susceptibility to influenza; 64.16% perceived influenza as a serious threat; 55.46% reported awareness of influenza vaccines; and 15.67% reported having received an influenza vaccine in the past two seasons. At the individual level, there was a statistically significant difference in the distribution of vaccination intentions before and after the intervention (P<0.01). At the population level, the proportion of adult participants willing to be vaccinated in the next influenza season increased from 40.93% to 63.38% after the intervention. Binary logistic stepwise regression analysis showed that residing in Chizhou city, being female, having an annual household income of 60 000 RMB or above, lower perceived susceptibility to influenza, lower influenza vaccine awareness, and no history of influenza vaccination were associated with increased acceptance to receive influenza vaccines after the intervention (P<0.05).

Information interventions based on the social processes framework can significantly improve influenza vaccination acceptance among adults. City of residence, sex, annual household income, perceived susceptibility to influenza, influenza vaccine awareness, and influenza vaccination history are factors influencing the effectiveness of these interventions.

To understand the current status of economic evaluation research on influenza vaccination in key locations, and to provide scientific evidence for residents and policymakers regarding influenza vaccination economics.

We searched the China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, Web of Science, and PubMed databases to collect relevant Chinese and English literature published between March 12, 1982, and November 5, 2024, on the economic evaluation of influenza vaccination in key locations. We conducted a systematic literature review to analyze the current research status of economic evaluations of influenza vaccines for populations in key locations.

This study included 21 studies, involving eight countries: the United States, Korea, the Netherlands, Mexico, the United Kingdom, Brazil, Finland, and Thailand. Seven studies focusing on hospitals indicated that influenza vaccination in hospitals is cost-effective. Five studies focusing on childcare facilities and primary/secondary schools showed that influenza vaccination for children in these settings is cost-effective. Three studies focusing on nursing homes demonstrated that influenza vaccination for the elderly in these settings is cost-effective. Of the four studies focusing on workplaces, three indicated that influenza vaccination for healthy employees is cost-effective. Additionally, one study from Thailand focusing on prisons found that influenza vaccination for inmates is cost-effective, while one study from Finland focusing on households found that influenza vaccination for housewives was not cost-effective.

Influenza vaccination in key locations is generally cost-effective. Economic evaluations of influenza vaccination in key locations should be conducted based on national influenza vaccination cost and influenza disease burden data to provide references for relevant decision-making.

To evaluate the effectiveness of hepatitis C elimination by medical and preventive integration in hospital for the screening, treatment, and follow-up of hepatitis C virus (HCV) antibody-positive cases and provide a scientific basis and reference for formulating simple, feasible, and promotable strategies for eliminating the hazard of hepatitis C in hospital.

A quasi-experimental before-after study was carried out in the People′s Hospital of Yuxi City in Yunnan province. The first phase was conducted from July to September 2023, led by the hospital to investigate 22 538 cases of HCV screening in the hospital. The second phase was conducted from October to December 2023 jointly by the hospital, center for disease control and prevention, civil affairs bureau to investigate 19 582 cases of HCV screening in the hospital. In this study, the data of HCV antibody screening, HCV RNA testing, HCV RNA positivity, HCV treatment completion for those receiving treatment, and follow-up 12 weeks post-treatment were collected regarding different genders, ages, and sample sources in the two phases. The effectiveness of HCV RNA testing, treatment, and follow-up were compared between the two phases.

In the People′s Hospital of Yuxi City from July to December 2023, the HCV antibody-positive rate was 0.79% (332/42 120) in HCV screening cases. The HCV RNA testing rate of HCV antibody-positive cases was 61.14% (203/332). The treatment rate of HCV RNA-positive cases was 64.42% (67/104), and the follow-up rate of 12 weeks post-treatment was 81.82% (54/66). The HCV antibody-positivity rate, HCV RNA testing rate of HCV RNA-positive cases, treatment rate of HCV RNA-positive cases, and follow-up rate of 12 weeks post-treatment in the first and second phases were 0.82% (185/22 538) and 0.75% (147/19 582), 36.76% (68/185) and 91.84% (135/147), 37.14% (13/35) and 78.26% (54/69), and 58.33% (7/12) and 87.04% (47/54), respectively. Excepted that the HCV antibody-positive rate showed no statistically significant difference between the two phases (P > 0.05), the HCV RNA testing rate of HCV RNA-positive cases, treatment rate of HCV RNA-positive cases, and follow-up rate of 12 weeks post-treatment in the second phase were higher than those in the first phase (all P < 0.05).

The hepatitis C elimination by medical and preventive integration in hospital can significantly increase the HCV RNA testing rate, treatment rate, and follow-up rate of HCV RNA-positive cases, thus helping eliminate the hazards of hepatitis C in hospital.

To systematically analyze the integrated surveillance data of hepatitis C (HC) in Shanghai and provide a scientific basis for the elimination of HC.

The reported HC cases, hepatitis C virus (HCV) genotypes, and sentinel surveillance data were collected based on the integrated HC surveillance work in Shanghai from 2020 to 2023. The incidence trend, distribution, HCV genotypes, and high-risk/key populations of HC in Shanghai were analyzed.

The reported incidences of acute and chronic HC in Shanghai from 2020 to 2023 were 0.04/100 000 and 6.93/100 000, respectively. The reported chronic cases were mainly males, middle-aged and elderly people, and downtown residents. Genotypes 1b (40.36%), 3b (14.80%), 3a (11.43%), 6a (10.09%), and 6n (6.05%) were the principal subtypes of HCV. The HCV antibody-positive rate in drug users, family members of HC patients, and people who died of liver disease were 31.88%, 10.00%, and 6.00%, respectively, which were significantly higher than that in other high-risk/key populations. The departments of hepatology (4.79%), traditional Chinese medicine/acupuncture and moxibustion (2.53%), general outpatient (1.85%), hemodialysis (1.58%), and infectious diseases (1.41%) were the key departments of medical institutions with higher HCV-antibody positive rates.

HC was low-epidemic in Shanghai from 2020 to 2023, with higher infection rates observed among drug users and family members of HC patients. Optimization of the integrated surveillance system for HC is of great value for understanding the epidemiological characteristics, infection status of high-risk/key populations, rational allocation of medical and health resources, and promoting the elimination of HC.

To investigate the genotype distribution and drug resistance of hepatitis C virus (HCV) among intravenous drug users (IDUs) in Guangzhou. Methods Plasma samples were collected from 99 IDUs diagnosed with HCV infection between August 2023 and January 2024. RNA was extracted, and the non-structural protein 5B (NS5B) region was amplified and sequenced. Phylogenetic trees were constructed via the maximum likelihood method in MEGA11.0.13 software, and the sequences were uploaded to the HCV resistance surveillance database for drug resistance site analysis.

Among the 99 HCV-infected IDUs, 86 were male and 13 were female, with 89.89% (89) of the cases aged over 50 years. A total of 96 NS5B sequences were obtained, revealing four genotypes: 6a, 3a, 1b, and 3b, which accounted for 45.83%, 30.21%, 20.83%, and 3.13%, respectively. The distribution of the four genotypes showed statistically significant differences among male IDUs. All 1b genotype sequences carried the clinically proven drug resistance mutation C316N.

The predominant HCV genotype among IDUs in Guangzhou is 6a, with complex sources of genotype introduction. The prevalence of genotypes differs between male and female IDUs, and middle-aged and elderly IDUs are a key population for HCV infection. Additionally, increased attention should be paid to the drug resistance of the 1b genotype.

To investigate the relationship between blood pressure levels and the incidence of acute myocardial infarction (AMI) in Chinese adults, and to provide evidence-based references for formulating targeted hypertension prevention strategies for populations with different blood pressure levels.

This study included a total of 36 426 adults aged 18 years and older without a history of AMI event. Participants were recruited from 60 monitoring sites in 11 provinces: Hebei, Jilin, Heilongjiang, Zhejiang, Jiangsu, Jiangxi, Henan, Hunan, Sichuan, Guizhou, and Shaanxi. Baseline systolic and diastolic blood pressure measurements were collected from September to December 2010 during the Third China Chronic Disease Surveillance Survey and were used to categorize participants into groups. Follow-up assessments for AMI incidence were conducted from October 2016 to April 2017. We analyzed the association between baseline blood pressure levels and AMI risk using a multivariable Cox regression model.

As of April 2017, 8 929 of the original 36 426 participants were lost to follow-up, resulting in a loss-to-follow-up rate of 24.51%. After excluding 541 deaths due to other diseases and 162 cases with missing body mass index (BMI) and waist circumference data, the final analysis included 26794 participants. A total of 160 386.38 person-years were observed, with an average follow-up period of 5.99 ± 0.89 years. During this period, there were 256 cases of AMI, resulting in an AMI incidence density of 159.60 per 100 000 person-years and a cumulative incidence of 955.40 per 100 000 person-years. The proportions of participants in the four blood pressure groups were as follows: 62.92% (16 858) had normal blood pressure; 14.56% (3 901) had isolated systolic hypertension (ISH); 3.81% (1 022) had isolated diastolic hypertension; and 18.71% (5 013) had systolic-diastolic hypertension (SDH). The cumulative counts of AMI events in these groups were 101, 62, 7, and 86, with respective incidence rates of 599.12, 1 589.34, 684.93, and 1 715.54 per 100 000 person-years. The differences in AMI incidence rates among the subgroups were statistically significant (χ² = 70.576, P < 0.001). In contrast, the proportions of participants in the four groups categorized by hypertension severity were as follows: 62.92% (16 858) had normal blood pressure; 22.07% (5 913) had stage 1 (mild) hypertension; 10.07% (2 699) had stage 2 (moderate) hypertension; and 4.94% (1 324) had stage 3 (severe) hypertension. There were 101, 76, 45, and 34 observed AMI events in these groups, with respective incidence rates of 599.12, 1 285.30, 1 667.28, and 2 567.98 per 100 000 person-years (χ² = 80.247, P < 0.001). After adjusting for confounders, including gender, age, education level, marital status, residence (urban or rural), annual household income, smoking status, alcohol consumption, inadequate fruit and vegetable intake, excessive red meat consumption, physical inactivity, diabetes, and dyslipidemia, a multivariable Cox regression analysis revealed that individuals with SDH had a 61% higher risk of AMI than individuals with normal blood pressure (hazard ratio [HR] = 1.61, 95% confidence interval [CI] = 1.17–2.21). The risk increased by 60% (HR = 1.60, 95%CI = 1.17–2.20) for stage 1 hypertension, 84% (HR = 1.84, 95%CI = 1.26–2.68) for stage 2 hypertension, and 120% (HR = 2.20, 95%CI = 1.43–3.38) for stage 3 hypertension.

For Chinese adults, SDH is an independent risk factor for AMI, and the risk of AMI increases with the severity of hypertension.

To analyze the implementation status of treatment-prevention integration for infectious diseases in public hospitals in China, providing decision-making reference for formulating and improving the policy of treatment-prevention integration for infectious diseases.

From March to June 2023, a questionnaire survey was conducted to investigate the current implementation status of treatment-prevention integration in 296 general hospitals and 15 infectious disease hospitals in 15 provinces (autonomous regions, municipalities) in eastern, central, and western China.

Among the surveyed hospitals, 45.37% established internal policies related to treatment-prevention integration, and 64.19% of general hospitals and 60% of infectious disease hospitals had independent public health departments. Among general hospitals, 56.76% had infection departments focusing primarily on treatment with limited prevention work, while 19.59% had infection departments with balanced treatment and prevention tasks (each 50%). Most (98.99%) of general hospitals and all infectious disease hospitals received supervision and guidance from disease control agencies for infectious disease prevention and control. The public health work in 65.20% of general hospitals and 66.67% of infectious disease hospitals was included in performance evaluation. A proportion of general hospitals (47.64%) and infectious disease hospitals (86.67%) participated in different types of medical alliances. Over 90% of hospitals had only partial or no functional linkage between their information systems and those of disease control agencies.

Medical institutions are increasingly emphasizing treatment-prevention integration, while there is a lack of top-level design and specific planning. The motivation for integration between institutions remains insufficient, and the fulfillment of public health responsibilities within institutions is inadequate. The functional roles of different organizational models for treatment-prevention integration for infectious disease need further clarification. The linkage in resource-sharing information systems requires improvement.

To investigate the roles of triglyceride glucose-body mass index (TyG-BMI) and retinol-binding protein (RBP) in the occurrence of fetal distress due to exposure to stressful life events in late pregnancy.

From December 2021 to June 2023, a cohort of 482 women in late pregnancy was recruited from the General Hospital of Ningxia Medical University. A self-designed questionnaire was employed to collect data of general maternal health. The Pregnancy Life Events Scale was adopted to quantify stressful life events, and blood samples were collected for metabolic biomarker measurement. Participants were followed through delivery, and the obstetric outcomes were recorded. R 4.3.0 was used for descriptive statistics, LASSO regression analysis, binary logistic regression analysis, and Spearman correlation analysis. A chain-mediated effect model was constructed in SPSS AU to evaluate the associations of exposure to stressful life events in late pregnancy, TyG-BMI, and RBP with fetal distress. Sensitivity analyses were performed to assess the robustness of the findings.

The incidence of exposure to stressful life events among women in late pregnancy was 31.54%, and that of fetal distress was 13.07%. Stressful life events, RBP, TyG-BMI, and anxiety were significant predictors of fetal distress. Logistic regression results showed that pregnant women exposed to stressful life events had a 2.10-fold higher risk of fetal distress compared with those without exposure (OR = 2.10, 95%CI: 1.06–4.16). For every one-unit increase in TyG-BMI, the risk of fetal distress increased by 1% (OR = 1.01, 95%CI: 1.01–1.02). For every 1 mg/L increase in RBP, the risk of fetal distress decreased by 5% (OR = 0.95, 95%CI: 0.92–0.98), indicating that RBP may have a protective effect against fetal distress. Spearman correlation analysis revealed a positive correlation between TyG-BMI and RBP (r = 0.177, P < 0.001). Chain-mediate effect analysis showed that TyG-BMI had a complete mediating effect on the impact of stressful life events on fetal distress through RBP, with a total indirect effect value of −0.001.

Exposure to stressful life events in late pregnancy has a complete mediating effect on fetal distress through TyG-BMI and RBP, and RBP may play a protective role between insulin resistance in late pregnancy and fetal distress.

To analyze the contamination status of human enteroviruses (HEVs) in untreated municipal sewage and identify viral serotypes based on the municipal sewage network in Guizhou province.

Influent sewage samples were collected from monitoring sites in Guiyang city (Nanming district), Zunyi city (Xinpu new district), Liupanshui city (Zhongshan district), and Tongren city (Bijiang district) in Guizhou province from November 2024 to January 2025. Ten virus-enriched sewage samples were processed by a combined anion-exchange membrane adsorption-elution and ultrasound-assisted elution method. The concentrated viral particles were then inoculated into human rhabdomyosarcoma (RD) cells and mouse L20B cells expressing the human poliovirus receptor. RNA was extracted from virus-positive isolates obtained through cell culture, followed by reverse-transcription polymerase chain reaction (RT-PCR) to amplify the VP1 gene of enteroviruses. Genetic sequencing and phylogenetic analysis were performed to characterize the obtained viral strains.

A total of 26 poliovirus (PV) vaccine-related strains and 11 non-polio enterovirus (NPEV) strains were isolated from the 10 sewage samples. Of the PV strains, 10 were of serotype I and 16 were of serotype Ⅲ. All the 26 PV vaccine-related strains exhibited fewer than 10 nucleotide variations in the VP1 region compared to the Sabin reference strains. The NPEV strains included seven echovirus 11 (E11) strains, one echovirus 6 (E6) strain, and one strain each of coxsackieviruses B2 (CVB2), B3 (CVB3), and B5 (CVB5). Phylogenetic analysis revealed that the seven E11 strains belonged to the genetic subcluster D5.

HEVs were detected in sewage samples from the municipal sewage system of Guizhou province, while no wild poliovirus or vaccine-derived poliovirus was identified. Viral surveillance data confirm the potential environmental contamination by HEVs and could inform the development of wastewater management policy standards.

To construct a healthy village monitoring index system in Zhejiang province and provide scientific reference for the competent departments to monitor the progress in healthy village construction.

From May to September 2024, one healthy village was randomly selected from each of the 11 prefecture-level cities in Zhejiang province for on-site research to assess the current status of healthy village construction, and a pool of indexes for monitoring healthy village in Zhejiang province was established by combining the analysis of the related policies and literature and the results of expert discussion. From October to December 2024, the Delphi method was employed to carry out two rounds of consultation with 20 experts in related fields to determine the monitoring index system. The analytic hierarchy process (AHP) was adopted to complete the weighting design of the index system.

The first and second rounds of Delphi expert consultation showed the positive coefficients of experts being 86.96% and 100%, the proportion of experts giving opinions being 70% and 20%, and the coefficients of expert authority being 0.848 and 0.878, the Kendall’s harmony coefficients of index importance being 0.386 and 0.419, and the Kendall’s harmony coefficients of index operability being 0.350 and 0.369 (all P < 0.05). The consistency ratio (CR) of the AHP judgment matrix was less than 0.1. Finally, a healthy village monitoring index system of Zhejiang province was formed, consisting of 6 first-level indicators, 17 second-level indicators, and 55 third-level indicators, which showed the weights of 0.073 8 to 0.253 5, 0.022 0 to 0.126 8, and 0.001 5 to 0.084 5, respectively.

The healthy village monitoring index system in Zhejiang province that is constructed in this study is in line with the characteristics of healthy village construction in Zhejiang province and can provide reference for the competent authorities to carry out the monitoring of construction progress.

To explore the impact of health resource allocation and health security on the choice of elderly care services among China's elderly population, and to provide insights for promoting healthy aging.

The panel data of 2 444 elderly people aged over 65 years old were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2011, 2014, and 2018. A mixed-effects logit regression model (MLR) with random effects was used to analyze the impact of health resource allocation and health security on the choice of elderly care services. Age heterogeneity was examined through subgroup analysis based on age and residence type. The robustness of the results was tested by comparing different link functions (logit and probit) using generalized estimating equations (GEE), which were chosen to account for potential model misspecification and to ensure the reliability of the results.

Health resource availability (β = 1.587, P < 0.05), health resource accessibility (β = 0.790, P < 0.05), and health security (β = 0.380, P < 0.05) were significantly associated with increased odds of the elderly choosing institutional care. Specifically, after exponentiating the beta coefficients, for each 1-grade increase in health resource availability, health resource accessibility, and health security, the odds of the elderly choosing institutional care increased by a factor of 4.89, 2.20, and 1.46, respectively (all P < 0.05). Heterogeneity analysis results indicate that both the availability (β = 1.729, P < 0.05) and accessibility (β = 0.832, P < 0.05) of health resources have a significant impact on the choice of elderly care services for the oldest elderly (≥ 80 years); the impact of health security on the choice of elderly care services for both the young elderly (β = 0.392) and the oldest elderly (β = 0.363) is significant (both P < 0.05); the availability of health resources (β = 1.433), accessibility of health resources (β = 0.619), and health security (β = 0.326) have a significant impact on the choice of elderly care services for the urban elderly population (all P < 0.05); availability of health resources (β = 1.850), accessibility of health resources (β = 1.084), and health security (β = 0.340) have a significant impact on the choice of elderly care services for the rural elderly population (all P < 0.05).

The allocation of health resources and health security significantly influence the choice of elderly care services. The allocation of health resources affects different age groups and residential types of the elderly population differently, while the impact of health security varies across residential types.

To construct a cross-regional transmission risk assessment model for respiratory infectious diseases, providing a theoretical basis, practical experience, and technical support for evaluating the risk of cross-regional transmission.

Data related to the COVID-19 epidemic in China from January 2020 to December 2022, officially released by the National Health Commission, Baidu Migration, and provincial statistical bureaus, were collected. Nine epidemic events were selected: the 2020 Wuhan, Hubei province epidemic; the 2021 Shijiazhuang, Hebei province epidemic; the 2021 Xi'an, Shaanxi province epidemic; the 2022 Shanghai epidemic; the 2022 Beihai, Guangxi Zhuang Autonomous Region epidemic; the 2022 Sanya, Hainan province epidemic; the 2022 Hohhot, Inner Mongolia Autonomous Region epidemic; the 2022 Zhengzhou, Henan province epidemic; and the 2022 Shijiazhuang, Hebei province epidemic. Principal component analysis (PCA) was used to construct a comprehensive input risk index formula for urban epidemics to quantitatively assess the comprehensive cross-regional epidemic input risk. The principal components with higher contribution rates were used as feature vectors for a support vector machine (SVM) model, with the actual intercity epidemic transmission status as the target variable. The SVM was used for model construction and prediction, and the Shapley Additive exPlanations (SHAP) method was used for model interpretability analysis.

Five factors were extracted by PCA: local socioeconomic activity factor (F₁), epidemic source socioeconomic activity factor (F₂), urban policy implementation factor (F₃), urban population inflow and geographical distance-related factor (F₄), and urban epidemic transmission index factor (F₅), with a cumulative variance contribution rate of 82.32%. Based on the principal component score coefficients and variance contribution rates, the formula for the comprehensive input risk index score was: F=0.2178×F₁+0.1841×F₂+0.1556×F₃+0.1419×F₄+0.1238×F₅. The SVM model achieved a prediction accuracy of 84.88%, precision of 75.00%, recall of 57.14%, and an F1-score of 64.86%. SHAP analysis showed that the SHAP values of F₁, F₂, F₃, F₄, and F₅ were 0.15, 0.09, 0.08, 0.08, and 0.12, respectively, contributing 29.23%, 16.72%, 15.26%, 16.09%, and 22.70% to the assessment of transmission risk.

The cross-regional transmission risk assessment model for respiratory infectious diseases constructed in this study, based on COVID-19 epidemic data, demonstrates good applicability and accuracy in quantifying the risk of cross-regional importation and predicting transmission, providing theoretical support and practical reference for the scientific formulation of respiratory infectious disease prevention and control strategies.

To analyze the trends in hepatitis A (HA) and hepatitis B (HB) incidence in China and provide evidence for scientific prevention and control.

Data on HA and HB incidence from 2004 to 2020 were collected from the Public Health Science Data Center for 31 provinces (autonomous regions and municipalities) in China′s mainland . Joinpoint regression and Bayesian Age-Period-Cohort (BAPC) models were used to analyze the overall trends, age, period, and birth cohort effects of HA and HB.

The overall incidence of HA showed a decreasing trend from 2004 to 2020 (AAPC= –11.23%, 95%CI: –13.32% to –9.09%), with decreasing trends observed in both 2004–2012 (EAPC= –15.47%, 95%CI: –18.57% to –12.24%) and 2012–2020 (EAPC= –6.79%, 95%CI: –10.21% to –3.23%). The overall incidence of HB showed no significant trend from 2004 to 2020 (AAPC= –0.43%, 95%CI: –2.95%–2.17%). From 2004 to 2020, the highest HA incidence rates were observed in the 5–9 (71 223 cases, 5.34/100 000), 0–4 (53 493 cases, 3.92/100 000), and 10-14 (48 481 cases, 3.49/100 000) age groups. The age group with the highest HA incidence shifted from younger age groups (≤14 years) in 2004 to older age groups (≥75 years) after 2017. From 2004 to 2020, the highest HB incidence rates were observed in the 25–29 (1 981 536 cases, 114.46/100 000), 30–34 (1 878 450 cases, 110.13/100 000), and 50–54 (1 500 335 cases, 99.61/100 000) age groups. The age group with the highest HB incidence shifted from the 15–24 age group in 2004 to the 50–59 age group after 2016. The birth cohort risk of HA showed an inverted "V" shape, with a decreasing trend in those born after 2000 (P<0.05). The birth cohort risk of HB also showed an inverted "V" shape, with a decreasing trend in those born after 1995 (P<0.05).

After the inclusion of HA and HB vaccines in the Expanded Program on Immunization (EPI) in China, the incidence rates in the target populations have decreased significantly. From 2004 to 2020, significant changes were observed in the high-risk populations for both HA and HB, with a trend towards higher age groups.

To analyze the content, characteristics, and public engagement of popular health information related to cervical cancer prevention and control on Chinese social media, and to explore the key factors influencing information dissemination and interaction, providing a basis for optimizing health communication strategies.

From Sina Weibo, a total of 591 popular posts related to cervical cancer prevention and control were selected, covering the period from January 1, 2022, to February 1, 2023. A combination of manual and computer-assisted coding methods was used to analyze the information content, dissemination patterns, public engagement, and emotional tendencies. Multivariate analysis of covariance (MANCOVA) and analysis of variance (ANOVA) were employed to explore the relationships between variables.

Authoritative media dominated the dissemination of cervical cancer prevention and control information (56.85%), and the proportion of factual information was high (91.4%). Discussions related to the human papillomavirus (HPV) vaccine (43.15%) were significantly more prevalent than those related to cervical cancer screening (8.63%), and the emphasis on male responsibility was insufficient (2.2%). The mean Weibo diffusion structure was close to 1 (M = 1.69, SD = 0.64), indicating that information dissemination exhibited a "one-to-many" broadcast structure rather than a "many-to-many" viral diffusion pattern. The source, topic, veracity, and gender orientation of the information significantly influenced some indicators of public engagement. The source significantly affected the diffusion scale (P = 0.047) and diffusion structure (P = 0.004), with media having a wider reach and tending towards viral dissemination. The topic significantly affected the diffusion scale (P = 0.008) and diffusion structure (P < 0.001), with topics related to vaccine controversies less likely to exhibit viral diffusion patterns. The veracity of information significantly affected the diffusion scale (P = 0.004), with false information having a wider reach. Gender orientation significantly affected the diffusion scale (P = 0.003) and the number of likes (P = 0.035), with male-oriented content being more likely to be reposted and liked. Furthermore, the source (P < 0.036), topic (P < 0.001), veracity (P < 0.001), and sentiment (P < 0.001) of the original Weibo post significantly predicted public sentiment, with vaccine controversies and negative sentiment tending to evoke negative emotions.

Authoritative media play a leading role in the dissemination of cervical cancer prevention and control information, but there is an imbalance in the ratio of discussions about HPV vaccination and screening, and insufficient emphasis on male responsibility. Information dissemination is mainly characterized by a broadcast structure, and the source, topic, veracity, and gender orientation of information are key factors influencing public engagement and sentiment.

To evaluate the clinical value of intravenous anesthesia with Esketamine in children undergoing surgery.

A total of 1 296 children undergoing surgery between January 1, 2020 and January 1, 2024 were selected by convenient sampling from two tertiary hospitals in Jinan, China. Participants were allocated into three groups: Esketamine (E) group (n = 447), Propofol (P) group (n = 411), and Sevoflurane (S) group (n = 438). Baseline characteristics, anesthetic efficacy (including anesthesia induction time, emergence time, emergence agitation, duration of emergence agitation, and crying), and adverse reactions were compared among groups.

The three groups were well-balanced in baseline characteristics, with mean age of (6.9 ± 2.8) years and mean body weight of (21.35 ± 8.24) kg. Significant differences were observed in anesthesia induction time [(45.73 ± 9.59) s, (50.36 ± 10.28) s, and (35.53 ± 8.76) s in E, P, and S groups respectively; F = 114.05, P < 0.001] and emergence time [(21.27 ± 4.63) min, (25.34 ± 5.18) min, and (15.42 ± 4.85) min; F = 134.65, P < 0.001]. The incidences of emergence agitation (χ² = 10.09) and crying (χ² = 13.42) showed differences among groups (P < 0.05). Regarding safety profiles, significant intergroup differences were observed in incidences of hypotension (χ² = 15.85), excessive sedation (χ² = 12.65), respiratory depression (χ² = 19.83), and pain (χ² = 9.83) (all P < 0.05).

Esketamine induces effective anesthesia with mild adverse effects in children undergoing surgery.