Objective: To describe the prevalence of myopia and pre-myopia among preschool children aged 5-6 years in ten provinces or municipalities (hereinafter referred to as province) of China, and to provide a reference for the prevention and control of myopia, and the allocation of related health resources.
Methods: Convenience sampling was used to select preschool children aged 5-6 years from 21 cities in 10 provinces (including 8 provinces and 2 municipalities) in China. Cycloplegic autorefraction was conducted. The distribution of myopia and pre-myopia was described using frequencies and percentages. The Chi-square test was used to compare the differences in the prevalence of myopia and pre-myopia between regions with different varying economic development levels and between boys and girls, with a significance level of α=0.05.
Results: A total of 12 926 preschool children aged 5-6 years were surveyed. The myopia prevalence was 5.5%, and the overall prevalence of myopia and pre-myopia was 43.4%. Boys had higher rates of myopia and overall prevalence of myopia and pre-myopia than girls (5.7% vs. 5.2%, 46.4% vs. 40.1%), though the difference in myopia prevalence was not statistically significant. Stratified analysis by the province, there was no statistically significant differences in the prevalence of myopia between boys and girls in any province (P>0.05), but in 8 provinces, the prevalence of myopia in boys was slightly higher than in girls. The overall prevalence of myopia and pre-myopia in boys was higher than in girls across all the 10 provinces, with 5 provinces showing statistically significant differences (P < 0.05). The investigated areas were divided into two categories, relatively more-developed areas and relatively less-developed areas, based on per capita gross domestic product (GDP). In 6 provinces, there was no statistically significant difference in the prevalence of myopia between the two categories of areas. In 2 provinces, the prevalence was higher in relatively more-developed areas, and in 2 provinces, it was higher in relatively less-developed areas. In 4 provinces, there was no statistically significant difference in the overall prevalence of myopia and pre-myopia between the two categories of areas with relatively more-developed and relatively less-developed areas. In 3 provinces, the prevalence was higher in relatively more-developed areas, and in 3 provinces, it was higher in relatively less-developed areas.
Conclusion: The prevalence of myopia and pre-myopia among preschool children aged 5-6 years is relatively high. Boys show higher overall prevalence of myopia and pre-myopia than girls, but there is no significant difference in the prevalence of myopia. There is no consistent association between the level of economic development and the incidence of myopia and pre-myopia in each province.
Objective: To develop outcome indicators for the implementation of comprehensive interventions targeting the multimorbidity of myopia and obesity in children and adolescents, providing a basis for the co-prevention of multimorbidity and the outcome measurement of implementation research in children and adolescents.
Methods: Based on the RE-AIM framework, a preliminary set of indicators was constructed. The Delphi method was employed, with experts scoring and providing feedback on the proposed indicators via questionnaires. After each round of consultation, expert enthusiasm index, authority coefficient, coordination degree, and consensus level were calculated. Expert opinions were collected and analyzed to modify, delete, or add indicators based on consultation results and screening criteria. Two Delphi rounds were conducted until consensus was achieved.
Results: A total of 28 experts participated actually in both rounds. The Kendall' s W coefficients for the two rounds of expert consultation were 0.352 (χ2=413.952, P < 0.001) and 0.499 (χ2=405.044, P < 0.001), both statistically significant. The final outcome indicators for implementation research on comprehensive interventions for myopia and obesity comorbidity in children and adolescents included five primary dimensions with 13 secondary and 20 tertiary indicators. The dimension of reach included the number of children and adolescents involved, participant representativeness, and full-course participation representativeness. The dimension of effectiveness included multimorbidity incidence, myopia incidence, spherical equivalent, body mass index (BMI), overweight and obesity prevalence, waist-to-height ratio, comprehensive health knowledge score, and comprehensive health behavior score. The dimension of adoption covered school representativeness and representativeness of school nurses and teachers involved in implementation. The dimension of implementation included fidelity, content modification, and cost. The dimension of maintenance included individual health outcomes and organizational sustainment.
Conclusion: This study developed implementation outcome indicators for comprehensive interventions targeting multimorbidity of myopia and obesity among the children and adolescents based on the RE-AIM framework. These indicators can serve as a reference for optimizing intervention research strategies related to common multimorbidity among children and adolescents in China.
Hip fractures are common in elderly patients and are associated with significant morbidity and mortality, often referred to as the "last fracture of life". These fractures frequently result in a loss of functional independence. Evidence suggests that early surgical intervention can reduce mortality. The selection of treatment modality should take into account factors such as the type of fracture, the patient' s age, and overall health status. This case report discusses an 88-year-old female patient who sustained an unstable intertrochanteric fracture of the left femur following a fall. She underwent closed reduction and internal fixation using an InterTAN intramedullary nail, resulting in a satisfactory postoperative recovery. Sixteen months following the surgical procedure, the patient presented with progressive pain in the left hip and ambulatory difficulties, absent from any evident trauma. Radiographic analysis identified a fracture of the left femoral neck accompanied by some degree of acetabular bone degradation attributable to the implant. Subsequently, the patient underwent removal of the internal fixation device and received a hemiarthroplasty. The postoperative course was uneventful, with marked improvements in both pain levels and functional capacity. This case underscored the intricate nature of femoral neck fractures following the internal fixation of intertrochanteric fractures. Contributing factors may include advanced age, osteoporosis, and stress shielding induced by the implant. In patients presenting with hip pain or gait disturbances months to years post-intertrochanteric fracture surgery, the potential for a new fracture should be consi- dered, even in the absence of an explicit traumatic incident. Radiographic imaging is imperative to exclude the presence of a fracture, particularly in individuals with high-risk factors such as advanced age, osteoporosis, alcohol abuse, and a history of hormone therapy. Management of such cases may necessitate the removal of internal fixation devices and the implementation of hemiarthroplasty or total hip arthroplasty, contingent upon the patient ' s surgical tolerance. Crucially, anti-osteoporosis therapy serves as a vital preventive strategy. Considering the high-risk profile of elderly patients with hip fractures, diligent follow-up and timely intervention are paramount to mitigating complications and mortality, thereby enhancing the quality of life for these patients. This case highlights the critical need for increased vigilance and comprehensive management of elderly patients with hip fractures to enhance treatment outcomes and improve prognosis.
Objective: To investigate the prevalence of asthenopia and dry eye, and to further explore the potential occupational hazard factors, so as to provide a theoretical basis for their prevention and control.
Methods: A cross-sectional survey was conducted on the selected respondents. For visual display terminal (VDT) workers in employing organizations such as banks, colleges, and government departments, an online questionnaire independently developed by the research group was used for population surveys. Information including general information, work-related situations, work environment, visual health, and ergonomic factors was collected. The respondents were analyzed according to whether they suffered from asthenopia and dry eye. Relevant factors of asthenopia and dry eye were screened through t-test and Chi-square test. Subsequently, binary Logistic regression analysis was carried out to determine the risk factors of asthenopia and dry eye among the VDT workers.
Results: The overall prevalence of asthenopia was 52.5% (235/448) and dry eye was 36.8% (165/448). There were no significant diffe-rences in the prevalence of asthenopia and dry eye among different genders, age groups, and groups of length of service in VDT work. However, the highest prevalence of dry eye was observed in underweight individuals (42.9%), followed by normal weight (40.6%), overweight (28.0%), and obese indivi-duals (17.4%). There was a significant difference in the prevalence of dry eye among different body mass index (BMI) groups (χ2=9.505, P=0.023). The lowest prevalence of asthenopia was observed among securities industry employees (22.6%), while higher rates were found in employees in companies (59.5%) and other employing organizations (68.8%). A significant difference in the prevalence of asthenopia among different employing organizations (χ2=14.832, P=0.022). The result of Logistic regression showed that a longer length of service in VDT work (OR=1.006, P < 0.001), a longer duration of VDT after working hours (OR=1.002, P=0.032), a too-bright monitor (OR=2.875, P=0.022), glare during work (OR=1.500, P=0.038), a louder noise in work environment (OR=1.586, P=0.012), work-related musculoskeletal disorders (WMSDs) (OR=4.366, P < 0.001) and other factors were independent risk factors of asthenopia, while wearing frame glasses (OR=0.452, P=0.037) was an independent protective factor. Glare during work (OR=2.198, P < 0.001), WMSDs (OR=2.226, P=0.001) and other factors were independent risk factors of dry eye, while overweight (OR=0.448, P=0.006), obesity (OR=0.228, P=0.032) were independent protective factors of dry eye.
Conclusion: The prevalence of asthenopia and dry eye among V
With the increasingly complex global health and safety situation, in order to establish a strong global health and safety governance system, promote international cooperation and ensure public health and safety, the member countries of the World Health Organization initiated the revision of the International Health Regulations (2005). After the amendment of the International Health Regulations (2005) was adopted on 1 June 2024, China, as one of the contracting parties, urgently needs to promote the domestic rule of law and the foreign-related rule of law as a whole, realise the effective connection between domestic law and this regulation, and promote the transformation and application of international law. Compared with the original regulations, the Amendment has adjusted and improved relevant health measures, strengthened the construction of the public health service system, and further clarified the responsibilities and obligations of both the World Health Organization and the Parties, which has led to the application of the amendment to the International Health Regulations (2005) in China. Therefore, it is necessary to improve the domestic health law and regulation system, strengthen domestic core capacity building, deepen international cooperation and promote global governance, and strive to promote the solution of these problems.
Objective: To describe the epidemiological characteristics and changes of febrile seizure (FS) among children under 6 years old in Ningbo City, Zhejiang Province from 2015 to 2021.
Methods: Based on the Ningbo Regional Health Information Platform, a dynamic cohort was established using vaccination registration information, and the cases of FS were identified by the diagnostic results of Chinese terms or International Classification of Diseases 10th revision (ICD-10) R56.0 code in the electronic medical records. The first visit of FS during the observation period was defined as a new case, and a recurrence case was defined as the case with a visit interval of more than 7 days. The 95% confidence interval (CI) of FS incidence density was calculated by the Poisson distribution.
Results: From January 2015 to June 2020, there were 1.3 million children under 6 years old in Ningbo, with male accounting for 52.87%. The median follow-up time was 2.83 (1.55-4.00) years. During the follow-up period, 12 776 new onset cases had FS, with more males than females, with an overall incidence density of 4.34 (95%CI 4.27-4.40)/1 000 person-years and a recurrence rate of 21.63%. There was a higher incidence density in children who were male, born in Ningbo and of non-mobility. The incidence density of FS was higher in urban areas than in rural and rural-urban fringe areas, and the incidence density was different among districts and counties. The peak density was found in children aged 18-23 months [8.42 (95%CI 8.11-8.74)/1 000 person-years]. From 2015 to 2019, the incidence density increased with calendar year (Ptrend < 0.001), and the highest was 5.62 (95%CI 5.43-5.81) /1 000 person-years. The incidence density of FS decreased significantly during the period between 2020 and 2021. The incidence density was higher in winter.
Conclusion: From 2015 to 2019, the overall incidence density of FS in children under 6 years old in Ningbo City presented an increasing trend. More attention should be paid to the health education, the improvement of the health maintenance model, the enhancement of the cognition of FS, the identification and treatment of FS among high-risk population and regions so as to prevent its recurrence and reduce the disease burden during the corona virus disease 2019 (COVID-19) epide-mic.
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