Owing to the increasing use of antibiotics in human beings and animals at present, the problem of microbial drug resistance has developed into one of the major global public health problems. As one of the largest producers and consumers of antibiotics, the transmission of drug-resistant genes is a cause for concern. Given the global attention towards probiotics, it is necessary to pay close attention to the transmission of drug-resistant genes that may be brought about by probiotics while fully affirming their health efficacy. Studies have shown that drug-resistant genes presented in probiotics can be transmitted to pathogenic bacteria in the human gut via horizontal gene transfer and lead to the development of drug-resistant infections. Hence it is imperative to further explore the mechanism of drug resistance and transmission characteristics of drug resistance genes in probiotics. In this review, we provide an overview of the composition and transmission mechanism of drug-resistant genome in human intestinal flora. Furthermore, we review the mechanism of drug resistance in probiotics and the development characteristics of drug resistance in probiotics driven by drug-resistant genes, and summarize the current research bottleneck of mechanism of drug resistance in probiotics and the safety evaluation of probiotics for future research.

Objective To perform nucleic acid tests on influenza-like illness (ILI) cases in Zhanjiang City, Guangdong Province during 2017-2022, to analyze the epidemiological characteristics of influenza, and to provide a basis for furtheroptimizing influenza prevention and control measures. Method The monitoring data from influenza sentinel posts from April 2017 to March 2023 were collected and statistically analyzed. Results A total of 87,946 ILI cases were cumulatively reported in Zhanjiang City during 2017-2022, and the annual ILI% in the 6 monitored years ranged from 1.71% to 3.53%, with an average ILI% of 2.55%. 6,518 samples of ILI were collected for influenza virus nucleic acid test, 782 of which were positive, with the positive rate of 12.00%. The positive rates for each monitored year were 17.07%, 18.75%, 17.65%, 0.18%, 10.12% and 8.70% respectively. The detection rate of influenza A virus H3N2 was the highest (39.6%), followed by influenza B virus Victoria, influenza A virus H1N1 and influenza B virus Yamagata. There were three influenza epidemic peaks in spring, summer and winter. Influenza A virus H1N1 and influenza B virus Yamagata were mainly detected in spring and winter, while influenza A virus H3N2 and influenza B virus Victoria were prevalent in summer. There were statistically significant differences in the positive rates among different age groups, and the positive rate was found to be the highest in the group aged 5-14 years (20.46%), followed by the group aged 15-24 years (19.94%) and the group aged 0-4 years (6.68%). No statistically significant difference was found in the positive rates between males and females (P=0.903). Conclusion Influenza was common in spring, summer and winter in Zhanjiang City during 2017-2022. The high-incidence people were concentrated in the group aged 5-24 years. Therefore, it is essential to strengthen the publicity and education on knowledge about influenza prevention and control and improve the activity of vaccination.

目的 分析影响精神分裂症患者病耻感的相关因素,为改善精神分裂症患者病耻感提供依据。 方法 选取2020年8月—2023年8月湖州市第三人民医院收治的585例精神分裂症患者为研究对象,对以上受试者进行病耻感问卷调查,并通过多元logistic回归分析精神分裂症患者病耻感的影响因素。 结果 经精神疾病内在病耻感量表(Internalized Stigma of Mental Illness Scale,ISMI)调查显示,585例精神分裂症患者存在病耻感有458例(78.29%),其中187例(31.97%)患者为中重度病耻感。病耻感总分平均为(2.38±0.45)分,其中ISMI量表中疏远、刻板印象认同、歧视经历、社交退缩、病耻感抵抗共5个条目均分分别为(2.36±0.41)分、(2.46±0.43)分、(2.31±0.35)分、(2.51±0.49)分、(2.36±0.39)分;多因素logistic回归分析显示,有工作能力(OR=0.360,95%CI:0.179～0.722)和高家庭收入(OR=0.255,95%CI:0.135～0.482)是精神分裂症患者病耻感的保护因素(P<0.05),精神分裂症阳性症状(OR=3.881,95%CI:1.677～8.979)、病程＞5年(OR=3.360,95%CI:1.461～7.729)、年住院次数≥3次(OR=3.177,95%CI:1.387～7.280)以及简明精神病评定量表(Brief Psychiatric Rating Scale,BPRS)评分≥35分(OR=3.370,95%CI:1.474～7.707)是精神分裂症患者病耻感的危险因素(P<0.05)。 结论 精神分裂症患者普遍存在病耻感,其中影响精神分裂症患者病耻感的影响因素涉及工作能力、家庭收入、精神分裂症阳性症状、病程、年住院次数以及BPRS评分,医护人员应重视此问题,并需对症实施一系列干预,以缓解病人的病耻感。

Objective One year after the outbreak of the SARS-CoV-2 infection, the composition of pathogenic spectrums of patients with respiratory tract infections in Wuhan in winter was clarified under non-drug intervention measures, and the etiological basis for prevention and treatment of respiratory tract infectious diseases was provided. Methods We collected throat swab samples from acute respiratory tract infection (ARTI) cases in fever clinics of eight large hospitals in Wuhan from December 28, 2020 to February 14, 2021.Nucleic acid extraction was performed using an automatic nucleic acid extractor, and real-time fluorescence quantitative PCR technology was used to detect 23 respiratory pathogens. Microsoft Office Excel 2016 was used to input and organize the data, and then a databasewas established. Statistical analysis was performed with SPSS 20.0 software. Results A total of 596 ARTI cases were collected, including 335 males and 261 females, with a male-to-female ratio of 1.28:1.The youngest was 5 months old and the oldest 91 years old. The total positive rate of 23 respiratory pathogens was 86.24% (514/596), and a total of 13 pathogens of 23 respiratory pathogens were positive. The top three pathogens wereStreptococcus pneumoniae (SPN) (30.47%, 323/1,060), Klebsiella pneumoniae (KPN) (24.25%, 257/1,060) and Haemophilus influenzae (HIN) (19.43%, 206/1,060). Among the 514 positive cases, 331 were mixed infections, accounting for 64.40% (331/514). The proportion of mixed infection between bacteria (54.68%, 181/331) was higher than that of bacteria and virus (45.01%, 149/331). Among the 331 cases of mixed infections, only one case of mixed infection betweenhuman metapneumovirus (HMPV) and respiratory syncytial virus (RSV)was detected, accounting for 0.30% (1/331) . There were statistically significant differences in the detection rates of HIN, KPN, SPN, HMPV, RSV, respiratory adenovirus (RA), human bocavirus (HBoV) and human enterovirus (HEV) in patients of different ages as well as in the detection rates of HIN, KPN, SPN, HMPV and RSV in patients of different body temperatures. No statistically significant differences were found in the detection rates of all pathogens between male and female patients. The detection rates of group A streptococcus (GAS) and RSV between national and non-national influenza sentinel hospitals showed statistically significant differences. Conclusion SPN, KPN, HIN, HMPV and Staphylococcus aureus (SA) were the main respiratory pathogens in Wuhan in winter under non-drug intervention measures. Strengthening monitoring and prevention of these pathogens is the focus of prevention and control of respiratory tract infections in Wuhan in winter.

Objective To analyze the epidemic features and trends of HIV/AIDS in Guangzhou City during 2008-2021, and to provide a scientific basis for formulating precise and high-efficient prevention and control measures. Methods The information about newly reported HIV/AIDS cases and population in Guangzhou from 2008 to 2021 was obtained from the China Information System for Disease Control and Prevention, and the incidence rates of HIV/AIDS in total population, different genders, age groups and urban and rural areas were calculated. Joinpoint regression analysis was used to establish a regression model to analyze the trend in the HIV/AIDS epidemic in Guangzhou City. Results A total of 16,280 HIV/AIDS cases were reported in Guangzhou City from 2008 to 2021, with the annual average incidence rate of 8.66/100,000. The ratio of male to female cases was 6.27:1, and the incidence rate was higher in males than in females (χ²=7,388.534, P<0.001). Joinpoint regression analysis revealed that the incidence rates increased annually from 2008 to 2015 (APC=20.87%, 95%CI:17.18%-24.67%), but showed no significant changing trend from 2015 to 2018 (APC=0.26%, 95%CI:-13.58%-16.32%) and a downward trend from 2018 to 2021 (APC=-8.58%, 95%CI:-14.94%--1.75%). The middle-aged and young (20-59 years old) were the highest incidence group for HIV/AIDS, with a total of 14,530 cases cumulatively reported, accounting for 89.25% of all cases. After a long-term increase, the incidence rates of HIV/AIDS in all age groups showed a downward trend from 2015, 2016 and 2017 respectively. The ratio of reported cases in the urban and rural areas was 14.07:1, and the incidence rate was higher in the urban areas than in the rural areas (χ²=842.866, P<0.001). The incidence rate in the rural areas continued to rise (APC=16.90%, 95%CI:13.67%-20.22%), and had a tendency to surpass the incidence rate in the urban areas. Conclusion The incidence rates of HIV/AIDS in Guangzhou City during 2008-2021 showed downward trends, but were still higher than the national average level. The prevention and control situation is still grim, and hence it is necessary to pay high attention to high-risk groups and the rural areas, raise the residents’ awareness of voluntary testing, and ensure timely self-testing to know the infection situation as soon as possible so as to play a role in promoting further control the epidemic of HIV/AIDS in Guangzhou City.

Maintenance hemodialysis (MHD) is currently the main clinical treatment method for patients with end-stage renal disease, and cardiovascular events are prone to occur during the treatment, which not only affect the prognosis and therapeutic effect of patients with MHD, but also are the main factors leading to the patients’ death. Therefore, identifying the occurrence risk of cardiovascular events in patients with MHD and taking preventive measures are of positive significance for prolonging their survival time and enhancing their quality of life.

目的 分析不同品牌血细胞分离机采集血小板冲红的原因,以保证单采血小板质量、确保临床输血安全。 方法 从2018年1月1日—2022年12月31日在本中心用的三种血细胞分离机(Trima、Amicus、MCS+)采集的血小板中收集冲红血小板,分析比较血小板冲红和未冲红献血者的各项指标,并对冲红血小板离心前后指标进行检测。 结果 84 260(人)份单采血小板中出现冲红的血小板共46(人)份(占比0.05%),血细胞分离机Trima、Amicus、MCS+的冲红数分别为4、10、32(人)份。冲红观察组的Hb、Hct、MCV、MCH、MCHC均低于未冲红对照组;冲红观察组的献血间隔期短于未冲红对照组;冲红观察组的一年内献血间次数多于未冲红对照组,差异有统计学意义。冲红血小板离心后外观、容量、血小板含量、白细胞混入量、红细胞混入量均符合《全血及成分血质量要求》的规定。 结论 血细胞分离机单采血小板冲红主要与献血者血常规个体差异有关,因此对单采献血者开展一定有针对性的体检筛查,能够减少单采血小板冲红的发生。

Objective To analyze the literatures related to osteoporosis and intestinal flora research based on Web of Science database, to clarify its research hotspots and trends, and to provide references for related research in future. Methods The Web of Science Core Collection database was searched by subject term fields. The time was set from the establishment of the database to 2022, and the search was completed on May 9, 2023. The bibliometric method and CiteSpace software were employed to statistically analyze the literature characteristics such as country/region, institution, journal and keywords. Results A total of 376 valid papers were obtained, including 247 papers and 129 reviews. The study started in 1998, and the overall number of studies kept growing, especially the most significant increase in the number of literatures after 2019. The research countries were mainly distributed in Asia, the United States and Europe, and the research institutions were mainly universities. The countries with the top 10 journals with published literatures were the United States and Switzerland. Nutrients (16 articles, 4.26%) published the largest number of articles, and Bone had the highest average citation frequency, with 36.17 times. Four of the top 10 cited studies were related to the role of probiotics in the prevention and treatment of postmenopausal bone loss, with the title of “sex steroid deficiency-associated bone lossis microbiota dependent and prevented by probiotics” being cited the most frequently and the number of citations being 96. Hot topics of research included the correlation between osteoporosis and gut flora (keywords: mineral density, health, bone density, bone loss, etc.) and the focus on potential targets of gut flora to prevent osteoporosis (keywords: gut permeability, gut-bone axis, short-chain fatty acids, etc.). The research trend was hip fracture. Conclusion The attention of osteoporosis and intestinal flora research has continued to increaseduring the past 20 years. It is recommended that multi-center and large-scale clinical studies should be conducted to validate and promote the relevant intestinal flora regulatory mechanisms and therapeutic targets.

Objective To analyze the epidemiological features of foodborne diseases and spatial clustering of the cases in Beijing from 2018 to 2022, to identify hot spots for case distribution, and to provide a basis for scientific and precise prevention and control. Methods Descriptive epidemiological methods were used to analyze the epidemiological characteristics of themonitoring data regarding foodborne diseases in Beijing from 2018 to 2022, and the Acrgic10.8 spatial autocorrelation method was applied to studying their spatial clustering. Results A total of 31,404 cases were reported in Beijing from 2018 to 2022, and the average annual reported incidence rate in the 5-year period was 28.89/100,000. The male to female ratio was 1.18:1.The group aged 20-39 years reported the most cases, with statistically significant differences (P<0.05). August had the highest number of reported cases, accounting for 13.64% (4,285/31,404). Among the self-reported suspicious exposure food, meat and meat products were the highest, accounting for 23.59% (5,403/22,901). Households were the most common places to eat, accounting for 71.73% (16,428/22,901). The highest incidence rate was reported in Huairou District, reaching 107.74/100,000. The results of spatial autocorrelation analysis displayed that the Moran's I values during the 5-year period ranged from 0.36 to 0.63, with statistically significant differences (P<0.05), indicating a spatial clustering of foodborne diseases. Hot spots were mainly distributed in Huairou District and Miyun District in the north, while cold spots in the central urban area of Beijing. Conclusion There was a significant spatiotemporal clustering of foodborne diseases in Beijing from 2018 to 2022. The high incidence areas were Huairou District and Miyun District, and August was the high incidence period. Therefore, prevention and control should be strengthened in the key districts and the high incidence period.

The public health industry has developed rapidly in China in recent years, which has greatly protected the health of our people. In order to coordinate with the sustained, long-term and effective development of public health, the emergency material reserves related to public health emergencies also need to be further strengthened to comprehensively improve the on-site disposal and support capabilities of disease prevention and control institutions and emergency teams at all levels in China. Based on the status quo of domestic health emergency material reserves and combined with foreign practice and case study, this paper draws on the experience of Chinese government’s medical reserve management system construction and the practical experience of China CDC’s health emergency reserve, and puts forward suggestions on strengthening and developing health emergency material reserves for public health emergencies.

目的 分析苏州市孕妇孕期增重和膳食摄入状况及孕期增重过多的影响因素,为孕期保健提供膳食营养方面的参考数据。 方法 以2022年8月—2023年8月在南京大学医学院附属苏州医院进行产检的孕妇作为研究对象,采用问卷调查的方法采集孕妇的基本信息,采用连续3 d 24 h回顾法,评估研究对象食物的摄入量。采用单因素χ²检验和多因素logistic回归分析孕期增重过多的影响因素。 结果 纳入研究的1 634名孕妇中孕期增重过多426例,占21.27%。其中孕妇年龄、孕妇教育水平、孕妇年人均收入、日均运动时间、生育次数以及孕前BMI与孕期增重过多相关,差异均有统计学意义(P<0.001);采用连续3 d 24 h回顾法,评估研究对象每日食物的摄入量,其中谷类、薯类、蔬菜、水果、牛奶、鸡蛋、肉类和鱼类摄入量分别为(366.38±195.27)g、(40.13±17.86)g、(349.19±188.19)g、(412.72±223.38)g、(116.76±60.18)g、(58.17±18.19)g、(84.76±39.11)g、(51.67±29.08)g ,谷类、水果的摄入量超过了中国营养学会的推荐范围上限,牛奶摄入低于中国营养学会推荐范围的下限。多因素分析结果显示,日运动超过1 h(OR=0.582,95%CI:0.394~0.860)、体重过低(OR=0.784,95%CI:0.633~0.971)、生育1次(OR=0.610,95%CI:0.394~0.945)和2次(OR=0.590,95%CI:0.456~0.762)以上是孕期增重过多的保护因素。谷物摄入量、水果摄入量和肉类摄入量增加是孕期增重过多的危险因素。 结论 苏州地区孕妇孕期增重过多的现象普遍。生育次数、孕前BMI、日均运动时间及谷类、水果和肉类的摄入过多是孕期增重过多的影响因素。应鼓励孕妇注意均衡膳食尤其是谷类、水果和肉类的摄入,控制能量摄入及适量体力活动,达到孕期体重适宜增加的目的。

Objective To investigate the status quo of breastfeeding amongst infants under 2 years old in Fangchenggang City, Guangxi Zhuang Autonomous Region, and to analyze its possible influencing factors. Methods A retrospective questionnaire survey was conducted on 592 children aged 2 to 2 years and 3 months and their parents from 28 community health service centers and township health centers in Fangchenggang City from June to December 2021 by a cluster sampling method. The status quo of breastfeeding in infants at 3, 6, 12, 18 and 24 months were investigated. The factors influencing exclusive breastfeeding at 6 months of age and continued breastfeeding at 12 and 18 months of age were surveyed. Results Of the 536 infants aged 2 to 2 years and 3 months, 466 were exclusively breast-fed at 3 months of age, and the rate of exclusive breastfeeding at 3 months was 86.9%. 329 were exclusively breastfed at 6 months of age, the rate of exclusive breastfeeding at six months of age was 61.4%, and the rates of continued breastfeeding at 12, 18 and 24 months were 29.9% (160/536), 4.3% (23/536) and 0.6% (3/536) respectively. Multifactor logistic stepwise regression model revealed that urban area as the family residence (OR=1.678, 95%CI:1.126-2.501), mother as the primary caregiver (OR=2.208, 95%CI:1.357-3.593) and breast milk as the first mouthful of food after birth (OR=2.417, 95%CI:1.482-3.942) were the factors influencing continued breastfeeding at 12 months of age among infants aged 2 to 2 years and 3 months. Time to initiation of breastfeeding less than or equal to 1 hour of birth (OR=3.005, 95%CI:1.203-7.504) and time to initiation of complementary food supplementation within 4 months (OR=4.392, 95%CI:1.479-13.039) were the influential factors for promoting continued breastfeeding at 18 months of age among infants aged 2 to 2 years and 3 months. Conclusion The rate of exclusive breastfeeding at 6 months of age has met the requirements of the Program for the Development ofChinese Children (2011-2020), and the breastfeeding rate decreases with the infants’ increasing age. The results suggest that the health policy and measures of exclusive breastfeeding under 6 months of age in Fangchenggang City are effective. Grass-roots health care workers should strengthen the publicity of importance of continued breastfeeding. Breastfeeding is recommended up to 2 years of age or above 2 years old.

目的 调查医养结合背景下合肥市老年人居家养老服务需求现状,为居家养老服务发展提供一定的依据。方法 2022年1—12月采用分层随机抽样方法选取合肥市9个区389名老年人作为研究对象。采用课题组自制的“医养结合养老服务现况调查问卷”调查其一般资料、健康状况、对居家养老服务的知晓和需求情况以及老年人居家护理服务需求得分情况,采用SPSS 20.0软件描述性分析合肥市老年人居家养老服务需求情况。结果 389名老年人中,有49.87%的老年人年龄在75~89岁,32.13%的老年人为未婚/离婚/分居/丧偶的状态,53.21%的老年人学历在中专及以上,家庭人均月收入3 000元以上者占85.86%,有40.87%的老年人有照护人员,生活经济来源97.94%的老年人有退休工资。有58.87%的老年人合并≥3种的慢性疾病,但仅有10.80%自觉健康状况很差,完全不能自理的老年人占16.20%。有20.82%的老年人不知道医养结合养老服务,而希望居家提供医疗保健相关养老服务的老年人则占68.89%,仅有3.08%的老年人不知晓哪些机构可以提供居家护理服务,有22.11%的老年人不知道居家护理服务有哪些项目。老年人在居家健康护理方面需求较高的两项分别为输液49.10%、抽血检验36.76%。389名调查对象,居家护理服务需求得分平均为(59.86±21.47)分。相较于其他情况,≥90岁、男性、未婚/离婚/分居/丧偶、文化程度小学及以下、家庭人均月收入≤2 000元、没有照护人员、生活来源为退休工资、合并慢性疾病情况≥3种、自觉健康状况很差、完全不能自理的老年人的居家护理服务需求得分相对更高,差异有统计学意义(P<0.05)。结论 合肥地区居家养老的老年人年龄普遍偏大,且大多患有多种慢性病,家庭收入较低、缺乏照顾、自理能力低下的老年人迫切需要居家养老护理服务,建议政府对应增加投入,卫生社区服务到位,加强宣传,增加老年人对医养结合养老服务的知晓率,同时针对居家养老老年人的需求,建立健全医养结合背景下的居家养老护理服务模式,帮助提高老年人居家养老的生活质量。

Objective To analyze the distribution characteristics of major acute infectious disease clusters/outbreaks in Changping District of Beijing from 2016 to 2021, and to provide a basis for early detection of the epidemics and taking targeted prevention and control measures in advance. Methods The epidemiological and pathogenic data about fever, vomiting/diarrhea, hand-foot-mouth disease (HFMD) clusters or outbreaks in Changping District from 2016 to 2021 were collected, and descriptive epidemiological methods were used to analyze the composition, time, place, etiology and other distribution characteristics of the epidemics. Results From 2016 to 2021, a total of 670 clusters/outbreaks were reported in Changping District, and most of them were clusters (95.22%). In the clusters reported, the proportion of HFMD was the highest (46.08%). In the outbreaks reported, the proportion of vomiting/diarrhea was the highest (50.0%). The median reporting interval for all the clusters/outbreaks was 2 days, and the duration of the epidemic 2 days. The reporting interval of the epidemic was positively correlated with the duration of the epidemics, with correlation coefficients being r_fever=0.426, r_{vomiting/diarrhea}=0.519, and r_HFMD=0.720 (all P<0.001) respectively. Childcare institutions and primary schools were the main places where the epidemic occurred, accounting for 55.07% and 27.91% of the total number of reported epidemics respectively. May-July and November-December were the peak periods for epidemic reporting each year, with 64.18% of fever outbreaks occurring from December to January of the next year, 77.88% of vomiting/diarrhea outbreaks occurring in November-December and March-June, and 50.0% of HFMD outbreaksconcentrating in May-July. Conclusion From 2016 to 2021, the clusters/outbreaks of key acute infectious diseases in Changping District were mainly influenza, HFMD and norovirus infection related fever, HFMD and vomiting/diarrhea. Early detection and timely reporting could shorten the duration of the epidemic. The epidemics were mainly occurred in primary and secondary schools as well as kindergartens.Targeted prevention and control measures should be taken in combination with seasonal characteristics.

Objective To analyze the factors influencing myopia and the interactions of outdoor activities and use of electronic products with myopia among pupils in Beijing in 2022. Methods A multi-stage cluster random sampling method was used to randomly select 6 districts in Beijing in July 2022, and then 11 primary schools were randomly selected from the 6 districts. A questionnaire survey was conducted on all pupils in Grades I-V from the selected schools. Univariate t test or χ² test and multivariate logistic regression analysis were performed to identify the factors influencing myopia and analyze the multiplicative interactions between outdoor activities and use of electronic products. Results A total of 15,033 pupils were surveyed in this study. The mean age was (9.12±1.35) years, and the overall prevalence rate of myopia 23.63%. The prevalence rate of myopia in girls was 24.91%, and that in boys was 22.42%. The proportion of Grade I-V pupils who spent >1 hour per day in outdoor activities after school decreased gradually (P_trend<0.001), while the proportions of pupils who spent > 30 minutes on use of electronic products (P_trend<0.001) or > 1 hour on using eyes at a close distance without screen per day after school increased gradually (P_trend<0.001). Older age (OR=1.872, 95%CI:1.810-1.936, P<0.001), girls (OR=1.160, 95%CI:1.068-1.260, P<0.001), myopic parents (father or mother with myopia: OR=2.268, 95%CI:2.020-2.547, P<0.001; father and mother with myopia: OR=5.053, 95%CI:4.485-5.694, P<0.001) and longtime using eyes at a close distance without screen (OR=1.224, 95%CI:1.095-1.368, P<0.001) were risk factors for myopia. Reading at a close distance (11-20 cm: OR=0.833, 95%CI:0.708-0.981, P=0.028; 21-30 cm: OR=0.609, 95%CI:0.514-0.721, P<0.001; > 30 cm: OR=0.558, 95%CI:0.457-0.681, P<0.001) and doing eye exercises once or twice a day (once a day: OR=0.853, 95%CI:0.761-0.957, P=0.007; twice a day: OR=0.880, 95%CI:0.796-0.973, P=0.013) were protective factors for myopia. There were multiplicative interactions between time of outdoor activity after school and time of using electronic products. With the increase of the time of outdoor activities, the effect of using electronic products on the prevalence rate of myopia was weakened (OR=0.803, 95%CI:0.666-0.969, P=0.022). Conclusion Outdoor activities can reduce the effect of using electronic products on myopia. It can be considered to increase children’s outdoor activity time so as to make up for the effect of longtime using electronic products on myopia.

Objective To analyze the features and potential life loss of injury-induced deaths among residents in Xi’an City during 2014-2020, and to provide a scientific basis for further conduct the work on injury prevention and control. Methods We collected the monitoring data and population data regarding causes of deaths based on the whole population in 2014-2021 from the Population Death Information Registration and Management System in Xi’an City. Microsoft Excel 2010 was employed to calculate the mortality rate, age-standardized death rate, constituent ratio of causes of death, potential years of life lost (PYLL), potential years of life lost rate (PYLLR), average years of life lost (AYLL) and other indexes. SPSS18.0 software was applied to statistical analysis of the data, and χ² test was used for comparing the rates. Results The average mortality rate of injuries among residents in Xi’an City during 2014-2021 was 29.08/100,000, and the age-standardized death rate 27.16/100,000. The injury-induced mortality rates in males and females were 37.29/100,000 and 20.41/100,000, respectively, and the rate in males was 1.83 times that in females. The injury-induced mortality rates in suburban counties and urban areas were 35.33/100,000 and 22.26/100,000 respectively, and the rate in suburban counties was 1.59 times that in urban areas. There were statistically significant differences in the injury-induced mortality rates between genders as well as between suburban counties and urban areas (χ²=1,907.990, χ²=1,141.569, both P<0.05). The top five causes of deaths due to injuries among residents in Xi’an City from 2014 to 2021 were road traffic injury, accidental fall, suicide, accidental poisoning and other accidental injuries, and the deaths owing to above-mentioned causes accounted for 89.09% of the total injury-induced deaths. The main causes of injury-induced deaths varied greatly among different age groups. The top five causes of injury-induced deaths among residents aged 0-14 years were road traffic injury, accidental suffocation, accidental fall, drowning and suicide. The top five causes of injury-induced deathsamong residents aged 15-44 years were road traffic injury, suicide, accidental fall, accidental poisoning and other accidental injuries. The top five causes of injury-induced deaths among residents aged 45-64 years were road traffic injury, accidental fall, suicide, other accidental injury and accidental poisoning. The top five causes of injury-induced deaths among residents aged 65 years and above were unintentional fall, road traffic injury, suicide, other unintentional injury and accidental poisoning. PYLLR caused by injuries among residents in Xi’an City during 2014-2021 was 4.82%, with the top three causes being road traffic injury, accidental fall and suicide. AYLL induced by injuries among residents in Xi’an City in 2014-2021 was 16.56, with the top three causes being homicide, drowning and electrocution. Conclusion The injury-induced mortality rate among residents in Xi’an City during 2014-2021 was high. Injuries have become an important public health problem that threatens the health and life safety of residents in Xi’an City. Road traffic injury is the main cause of deaths due to injuries. Corresponding injury prevention strategies and measures should be formulated based onthe population'sdifferent characteristics such as age, area and gender.

Objective To analyze the epidemiological features of measles in Fangshan District of Beijing from 2008 to 2021, and to provide a scientific basis for adopting targeted measures to control and eliminate measles. Methods Descriptive epidemiological methods were used to analyze the incidence of measles in Fangshan District of Beijing from 2008 to 2021. Results A total of 498 measles cases were cumulatively reported in Fangshan District during 2008-2021, with an average annual incidence rate of 3.29/100,000. The average annual incidence rate was higher in residents from other provinces (4.89/100,000) than in local residents (2.74/100,000). The incidence rates of measles in 2017-2021 fluctuated from 0/100,000 to 0.76/100,000, and showed a downward trend. The incidence of measles was mainly concentrated inMarch-May, accounting for 66.87% of the total cases. The age at onset showed a bimodal distribution, with peaks in children under 1 year old (with the incidence rate of 104.54/100,000) and adults aged 25-39 years (with the incidence rate of 5.37/100,000). Most of the cases were scattered children, the unemployed and cadres. Among the measles cases aged ≥8 months, 15.89% had immunization history, 30.32% had no immunization history, and 53.79% had unknown immunization history. Among the cases aged 8 months-19 years, the proportion of cases with immunization history was higher in local permanent residents than in floating population from other provinces, showing a statistically significant difference. Conclusion The incidence of measles in Fangshan District during 2008-2021 remained at a low level. It is an effective way to control and eliminate measles by establishing immune barrier for school-age children and encouraging the vaccination of measles containing vaccine in high-risk groups.

目的 分析1例接种卡介苗(bacille calmette-guérin vaccine, BCG)后发生播散性BCG病的原因,为处理类似疑似预防接种异常反应提供参考。 方法 对病例开展个案调查,收集患儿病历资料和接种资料。 结果 经过对该病例的调查和综合分析,苏州市医学会预防接种异常反应专家鉴定组认为该病属于预防接种异常反应。 结论 自身免疫缺陷可造成播散性BCG病。

Objective To understand the current status of cognitive impairment among the elderly population in Shenzhen City, to explore its potential influencing factors, and to provide a basis for dementia prevention among the elderly in Shenzhen City. Methods A total of 2,112 senior citizens aged ≥65 years in Shenzhen City were selected. One-on-one questionnaire interviews were conducted by trained investigators, and theAlzheimer’s Disease-8(AD8) was used to screen the senior citizens’ cognitive function. At the same time, demographic characteristics, lifestyle habits, and health status of the respondents were collected. AD8 score ≥2 served as the criterion for identifying cognitive impairment. Multivariate logistic regression analysis was performed to identify the factors influencing cognitive impairment among the elderly in Shenzhen City. Results The detection rate of cognitive impairment among the elderly in Shenzhen City was 30.35% (641/2,112), and the median AD8 score (P₂₅-P₇₅) was 1 (0-2). Chi-square analysis revealed that 12 factors like age, gender, educational level, marital status, income and pre-retirement occupation had significantly impacted on cognitive impairment among the elderly. Further multivariate logistic regression analysis displayed that lifestyle and history of chronic diseases had impacts on cognitive impairment among the elderly. Among them, the detection rate of cognitive impairment in smokers was 80% higher than that in non-smokers (OR=1.800, 95%CI:1.261-2.568), and high-frequency exercise (OR=0.640, 95%CI:0.459-0.891) was a protective factor. Having a history ofhyperlipidemia (OR=1.371, 95%CI:1.108-1.696) andhaving a history ofcoronary heart disease (OR=1.304,95%CI:1.041-1.634) were identified as risk factors for cognitive impairment among the elderly. In addition, age, gender, educational level and income were found to have impacts on cognitive impairment. Conclusions Cognitive impairment is common among the elderly in Shenzhen City, which is related to their ages, socio-economic status, lifestyle habits and history of chronic diseases. Physical and mental health services should be provided for elderly high-risk groups, which are conducive to reducing the risk of cognitive impairment, promoting their mental health, and enhancing their sense of happiness.

Objective To understand the prevalence rate of screening myopia and its influencing factors among primary and secondary school students in Jiangjin District, Chongqing Municipality, and to provide a scientific basis for formulating policies and measures for prevention and control of juvenile myopia. Methods A random cluster sampling method was used to select a total of 5,741 primary and secondary school students in Jiangjin District in February 2023. The content of the survey involved vision screening and questionnaire survey. Results The prevalence rates of screening myopia in primary, junior middle and high school students in Jiangjin District were 59.30%, 78.07% and 89.34% respectively, and the rates of wearing glasses in screening myopia students from primary, junior middle and high schools were 45.33%, 66.93% and 79.13% respectively. The prevalence rate of screening myopia was higher in female students than in male ones, and increased with school phase and grade level. Six factors, including female students, school phase, parents’ myopia, lack of eye exercises, intake of sugary drinks for 1 day/time and length of outdoor activities, were risk factors for myopia. Conclusion The prevalence rate of screening myopia among the primary and secondary school students in Jiangjin District of Chongqing Municipality was at a high level. A variety of factors affect the occurrence and development of myopia in the students, reminding parents and schools to carry out relevant interventions.

Objective To observe the pathological changes of renal tissue and laws of polarization of renal macrophages after acute renal injury in rats with sepsis. Methods Rat sepsis models were constructed by cecal ligation and perforation. Rats in the sepsis groups were euthanized at 12, 24, 48, 48 and 72 hours after surgery respectively, and then renal tissue samples were obtained. Rats in the sham-surgery group received the same treatment as the sepsis groups except cecal ligation and perforation, and then were euthanized at 24 hours after surgery for collecting renal tissue samples. The samples were stained by HE staining, and then the status of renal tissue edema was observed.Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect mRNA expression in M1 and M2 macrophages in renal tissues. The protein expression of M1-type marker CD86 and M2-type marker CD206 was observed by Western blotting, and semiquantitative analysis was conducted by Image-Pro Plus software. Results Compared with the sham-surgery group, the volume of glomerulus cavity at 12, 24, 48 and 72 hours after surgery in the sepsis groups decreased, and the edema degree was significantly aggravated. The mRNA expression of M1-type surface marker CD16 (10.39±0.67), CD86 (7.59±1.11) and iNOS (7.36±1.36) increased significantly at 12 hours after surgery, but gradually decreased over time (P<0.001). The mRNA expression of M2-type surface marker Arg1 (1.05±0.15), CD163 (1.56±0.36) and IL-4 (1.38±0.11) slightly increased at 12 hours after surgery, but the difference was not statistically significant (P>0.05). The mRNA expression of M2-type surface marker Arg1, CD163 and IL-4 gradually increased at 24 and 48 hours after surgery, with statistically significant differences (P<0.001). At 72 hours after surgery, the mRNA expression of Arg1 (4.88±0.53), CD163 (3.70±0.59) and IL-4 (4.94±1.10) maintained the rise, showing statistically significant differences (P<0.001). The detection results of Western blotting were consistent with those ofqRT-PCR, and Western blotting displayed that the expression of M1-type marker CD86 (4.44±0.12) increased in the early postoperative period after sepsis (within 24 hours), but the expression of M2-type marker CD206 (7.76±0.22) increased at 24-72 hours after surgery. Conclusion The laws of M1 and M2 macrophages polarization at different time points after sepsis-induced acute kidney injury provide a theoretical basis for the early intervention of renal injury after sepsis from the perspective of macrophage immune regulation.

Objective To explore the value and application of multiple nucleic acid tests in the early diagnosis of lower respiratory tract infections caused by pathogenic bacteria through a comparative study of multiple nucleic acid tests and traditional bacterial culture methods. Methods We collected the specimens undergoing nucleic acid tests for six kinds of pathogens in the lower respiratory tract from July 12, 2022 to July 26, 2023, and the specimens underwent traditional bacterial cultures during the same period. The differences in the detection rates of pathogens between the two methods were analyzed and compared. Results The detection rates of Haemophilus influenzae and Streptococcus pneumoniae in sputum specimensundergoing multiple nucleic acid tests were higher than those in sputum specimens undergoing traditional bacterial cultures (12.39% vs. 4.42%, P=0.012; 27.43% vs. 0.00%), but no statistically significant differences were found in the detection rates of Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae between the two methods (all P>0.05), with a fair to moderate concordance (kappa=0.328 & 0.387 & 0.490, all P<0.001). As for Klebsiella pneumoniae and Streptococcus pneumoniae in specimens of bronchoalveolar lavage fluid, the detection rates based on multiple nucleic acid tests were higher than those based on traditional bacterial cultures (29.87% vs. 14.29%, P<0.001; 14.29% vs. 0.00%), but no statistically significant differences were observed in the detection rates of Staphylococcus aureus and Pseudomonas aeruginosa between the two methods (P>0.05), with a fair to moderateconcordance (kappa=0.252 & 0.490, both P<0.05). The intra-laboratory turnaround time based on multiple nucleic acid tests was less than that based on traditional bacterial cultures (χ²=7,905.733, P<0.001). Conclusion Multiple nucleic acid tests are more advantageous in the detection of some lower respiratory tractpathogens. The detection of some bacteria based on multiple nucleic acid tests has a certain degree of consistency with that based on traditional cultures, moreover, multiple nucleic acid tests show a shorter intra-laboratory turnaround time, and can rapidly and accurately provide diagnostic and therapeutic information for clinical practice. There is a certain degree of complementarity between the two methods, and the combination of the two methods can effectively avoid the leakage of diagnosis and misdiagnosis.

Objective To analyze the current status of awareness of AIDS knowledge and sexual behavior characteristics among university students in Hunan Province, and to provide data support for improving AIDS prevention and control in universities in Hunan Province. Methods We conducted a network questionnaire survey on awareness of AIDS knowledge and sexual behavior characteristics among 10,011 students from 5 universities in Hunan Province. The awareness status of AIDS knowledge and its influencing factors among the university students were analyzed. Results A total of 9,991 valid questionnaires were retrieved, with the effective rate of 99.80%. The total awareness rate of AIDS knowledge was 86.34%. The awareness rates of male homosexual behavior as the main mode of AIDS transmission among young students in China and AIDS as an incurable disease were 73.15% and 70.36% respectively. There were statistically significant differences in the awareness rates of AIDS knowledge among university students of different genders (χ²=10.210, P=0.001), grades (χ²=109.836, P<0.001) and specialties (χ²=75.533, P<0.001). Multivariate analysis revealed that the awareness rate of AIDS knowledge was higher in female students than in male students (OR=1.16, 95%CI: 1.02-1.32), higher in sophomores (OR=1.98, 95%CI: 1.70-2.31) and juniors (OR=1.61, 95%CI: 1.33-1.95) than in seniors (OR=2.48, 95%CI: 1.70-3.63), and higher in students majoring in literature and history (OR=2.02, 95%CI: 1.60-2.56), science and technology (OR=2.18, 95%CI: 1.73-2.75) and medicine (OR=3.35, 95%CI: 2.31-4.84) than in students majoring in sports and arts. The awareness rate of AIDS knowledge was lower in students acquiring AIDS knowledge through other means (OR=0.70, 95%CI: 0.57-0.84) than in students acquiring the knowledge through school education. The awareness rates of pre-exposure and post-exposure prophylactic drug use were 55.90% and 45.56% respectively. In this study, 885 university students had sex (8.86%). The consistent condom use rate in premarital sex was lower in male students than in female ones (60.49% vs. 68.26%, χ²=5.546, P=0.019). The consistent condom use rate was higher in students with single sex partner than in students with multiple sex partners (69.17% vs. 36.84%, χ²=56.836, P<0.001) as well as higher in students with heterosexual behavior than in male students who had sex with men (64.68% vs. 52.56%, χ²=4.514, P=0.034). Conclusion The awareness rate of AIDS knowledge among the university students in Hunan Province needs to be further improved, the condom use rate in high-risk sexual behavior is low, and there is an obvious separation between knowledge and practice. Attention should be paid to improving the university students’ concept and awareness of safe sex behavior and enhancing the publicity and education on prevention and control knowledge before and after exposure.

目的 分析绝经后2型糖尿病患者发生骨质疏松的高危因素与其预防对策,为临床上防治绝经后2型糖尿病发生骨质疏松提供依据。 方法 回顾性收集2021年1月—2023年1月绍兴市柯桥区妇幼保健院收治的67例绝经后2型糖尿病未发生骨质疏松(未发生骨质疏松组)及43例绝经后2型糖尿病合并骨质疏松患者(发生骨质疏松组)的临床资料作为研究对象,统计两组的一般资料并进行绝经后2型糖尿病患者发生骨质疏松的单因素分析,采用多因素logistic回归分析影响绝经后2型糖尿病患者发生骨质疏松的高危因素。 结果 单因素分析结果显示,发生骨质疏松组中合并神经病变、未服用钙剂的患者占比与年龄、血清碱性磷酸酶(alkaline phosphatase,ALP)、肌酐水平均高于未发生骨质疏松组,体质量指数(body mass index, BMI)、血清25羟维生素D3[25 hydroxy vitamin D3, 25(OH)D3]水平则低于未发生骨质疏松组,绝经年限长于未发生骨质疏松组,差异有统计学意义(P<0.05);多因素logistic分析结果显示,合并神经病变、未服用钙剂、年龄越大、血清ALP、肌酐水平越高、绝经年限越长、BMI≤23 kg/m²、血清25(OH)D3水平≤35 nmol/ml均为绝经后2型糖尿病患者发生骨质疏松的高危因素,差异有统计学意义(OR=1.370、1.365、1.436、1.402、1.328、1.296、1.570、1.420,P<0.05)。 结论 影响绝经后2型糖尿病患者发生骨质疏松的高危因素包括合并神经病变、未服用钙剂、年龄较大、血清ALP、肌酐水平较高、绝经年限较长、BMI较低、血清25(OH)D3水平较低,临床可针对有以上特征的患者进行针对性干预措施,以降低绝经后2型糖尿病患者发生骨质疏松的概率。

目的 核实及查明百日咳聚集性疫情波及范围、探讨百日咳传播可能的影响因素,为下一步防控提供科学依据。方法 对病例开展流行病学调查及对其密切接触者进行疫苗接种史的调查。采集患儿及其密切接触者鼻咽拭子,采用荧光PCR方法进行百日咳鲍特菌核酸检测。结果 该起疫情共搜索到4例病例,均为确诊病例。首发病例为4月龄患儿,未接种疫苗,感染来源可能是广泛的人群接触,传播方式是儿童→成人。实验室结果显示,患儿父母和奶奶鼻拭子百日咳鲍特菌核酸阳性。结论 该起疫情为一起百日咳家庭聚集性疫情,由于对首发病例诊断不及时,及密接人员缺乏防护导致疫情传播。建议加强对百日咳病例主动监测,掌握百日咳真实的发病水平;增强医务人员和易感者对百日咳疾病的敏感性,及时诊断和报告病例、做好自我防护。

Objective To analyze the epidemiological features of other infectious diarrhea and long-term changing trends of their incidence rates in Fuling District of Chongqing Municipality from 2013 to 2022, and to provide a scientific basis for other infectious diarrhea prevention and control in Fuling District. Methods Data about other infectious diarrhea cases in Fuling District from 2013 to 2022 were collected from the China Information System for Disease Prevention and Control, and the time, regional and population distribution was analyzed through descriptive research. ArcMap 10.7 was used to draw point density map to visualize the regional distribution of the incidence. Excel 2019 and SPSS 20.0 were applied to calculating the age-standardized incidence rate of the Chinese population. Joinpoint regression model was employed to calculate annual percent of change (APC) and average annual percent change (AAPC), and then the long-term changing trends of the incidence rates were analyzed. Results A total of 11,380 cases ofother infectious diarrhea were reported in Fuling District from 2013 to 2022, with the average annual reported incidence of 1,138cases and the average annual reported incidence rate of 100.87/100,000. There were two incidence peaks in winter and summer. In the population distribution, the number of reported cases in males (n=6,359) was higher than that in females (n=5,021), the number of reported cases in 0-3 years old was 9,995 (accounting for 87.83%). As for the population classification, most of the cases were scattered children (n=9,797, 86.09%). As for the regional distribution, the cases were mainly distributed in Lizhi Street (n=2,485, 21.84%), Chongyi Street (n=2,355, 20.69%), Dunren Street (n=2,119, 18.62%), Ma’an Street (n=1,313, 11.54%) and Jiangdong Street (n=380, 3.34%). One outbreak was reported, whichoccurred in a primary school. Joinpoint regression analysis revealed that the overall trend of the age-standardized incidence rates in Fuling District from 2013 to 2022 showed an increasing trend, with statistical significant differences in the trend (AAPC=8.50%, 95%CI:3.98-13.22, P=0.002). The crude incidence rates of other infectious diarrhea in Fuling District from 2013 to 2018 presented an upward trend, with statistical significant differences in the trend (APC=16.75%, 95%CI:2.73-32.69, P=0.026), but the crude incidence rates from 2018 to 2022 showed a decreasing trend, without statistical significant differences in the trend (APC=-9.89%, 95%CI:-24.81-7.98, P=0.199). Conclusions Other infectious diarrhea in Fuling District during 2013-2022 mainly affected scattered children, and the incidence peak in winter was higher than that in summer. Most of the cases were scattered in the urban areas like Lizhi Street, Chongyi Street and Dunren Street, and schools (primary schools) were the high incidence places. The overall trend in the incidence of other infectious diarrhea in Fuling District from 2013 to 2022 showed a significant increasing trend, but the crude incidence rates from 2018 to 2022 showed a certain decreasing trend under the influence of the SARS-CoV-2 pandemic.Based on the epidemiological characteristics of other infectious diarrhea in Fuling District,targeted prevention and control measures should be taken for high incidence populations in different seasons and regions.

Objective To investigate the fluoride levels, distribution characteristics and influencing factors in drinking water in Hefei City, and to evaluate the potential health risks for different populations. Methods The fluoride concentration in drinking water during 2020-2022 was monitored. R 4.2.2 software was used for stratification and correlation analysis. The health risk assessment model recommended by the US EPA was applied to health risk assessment. Results The fluoride concentration in drinking water in Hefei City ranged from 0.03 mg/L to 1.35 mg/L, and the median was 0.29 mg/L, of which <0.5 mg/L accounted for 95.97%, 0.5-<0.7 mg/L 3.90%, 0.7-<1.0 mg/L 0.09%, and ≥1.0 mg/L 0.04%. There were statistically significantdifferences in the fluoride concentration among different years, water periods, water sample types, sampling types, disinfection modes, water source types, water supply scales and areas (all P<0.05). The fluoride concentration during 2020-2022 showed a downward trend, and it was higher in the high water period than in the low water period. The fluoride concentration in tap water was found to be the highest, followed by factory-treated water and secondary water supply. As for water treated with different disinfection methods, the fluoride concentration was higher in non-disinfected water, but lower in liquid chlorine disinfected water. The fluoride concentration was higher in rural water than in urban water. As for different water sources, the fluoride concentration was higher in water from lakes, but lower in water from reservoirs, showing an obvious regional difference. The fluoride in drinking water was positively correlated with 16 indexes like chloride, sulfate, total hardness, oxygen consumption, total dissolved solids and pH, and the largest correlation coefficient was chloride (r=0.533). The fluoride in drinking water was weakly and negatively correlated with chroma and nitrate nitrogen. The medians of non-carcinogenic risk (hazard quotient, HQ) of fluoride intake from drinking water in residents were between 0.086 and 0.201, all of which were less than 1. The non-carcinogenic risk of fluoride was significantly higher in infants aged 1-2 years than in children aged 4-5 and 6-9 years and adults, and also higher in male adults than in female adults. As for children aged 1-2, 4-5 and 6-9 years, the non-carcinogenic risk of fluoride was higher in girls than in boys. Conclusions The fluoride concentration in drinking water in Hefei City is relatively low. Many factors of water supply, such as water period and disinfection method, affect fluoride concentration. Moreover, fluoride concentration is related to chloride, total hardness and pH in water. The non-carcinogenic risk of drinking tap water is at an acceptable level, and the risk degree is related to age.

目的 分析2014—2023年永州市东安县狂犬病监测数据,探讨其狂犬病高发因素,为狂犬病防控提供参考依据。方法 对2014—2023年东安县狂犬病疫情资料进行描述性流行病学分析。结果 2014—2023年东安县累计报告狂犬病病例26例,年均发病率为0.48/10万,呈周期性波动小幅上升趋势。报告病例全部在乡镇农村,夏秋季高发;40岁以上中老年农民占88.46%;26例病例中,Ⅲ级暴露占50.00%,暴露后没有进行规范处置病例占92.31%;有明确暴露史的病例19例,犬伤暴露占94.74%。2016—2022年东安县狂犬病暴露预防处置门诊就诊者37 069人,年均暴露率为0.99/100人年,具有夏秋冬季高暴露特征。暴露后就诊者中全程接种率为99.85%,Ⅲ级暴露就诊者中被动免疫制剂注射率为39.53%;暴露后就诊者中由犬致伤占85.98%,所有暴露后就诊者经规范处置后无一人发病。结论 2014—2023年东安县狂犬病报告病例数呈周期性波动小幅上升趋势。加强农村地区宣传教育,规范犬只管理,减少人群暴露机会,强化疫点处置,规范暴露后伤口处置、全程接种狂犬疫苗,必要时注射狂犬病被动免疫制剂是防制狂犬病的有效措施。

Objective To explore the potential relationship between exposure to perfluoroalkyl substances (PFAS) and the risk of post-stroke depression, and to provide a basis for post-stroke depression prevention and management. Methods Statistical data during 2011-2020 based on the US National Health and Nutrition Examination Survey (NHANES) database were used to select 3,411 post-stroke survivors as the study subjects. We collected four types of PFAS, namely, perfluorooctanoic acid (PFOA), perfluorooctane sulfonates (PFOS), perfluorohexane sulfonate (PFHxS) and perfluorononanoic acid (PFNA). Multifactor logistic regression analysis was performed to identify the correlation between PFAS and post-stroke depression. Results Six hundred and sixteen patients with stroke were finally enrolled in the study, and the prevalence rate of post-stroke depression was 16.72%. The levels of PFOA, PFOS, PFHxS and PFNA exposure in the depression group were lower than those in the non-depression group, with statistically significant differences (Z=-4.901--3.488, P<0.05). The results of multifactor logistic regression analysis revealed that after adjusting for demographic characteristics like gender, age, race and body mass index as well as covariates like educational background, combined hypertension, diabetes, history of alcohol consumption, marital status, family income level and history of smoking, the higher the exposure levels of PFOA (OR=0.573, 95%CI:0.428-0.769), PFOS (OR=0.832, 95%CI:0.759-0.912), PFHxS (OR=0.710, 95%CI:0.559-0.901) and PFNA (OR=0.210, 95%CI:0.098-0.452), the lower the prevalence rate of depression in the post-stroke survivors (all P<0.05). Conclusions Exposure to PFOA, PFOS, PFHxS and PFNA is negatively associated with the risk of developing post-stroke depression. Further prospective cohort study is needed to validate these findings.

目的 分析家庭关系、生活方式、食物不耐受与儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)的关系以及对儿童智商的影响,以便为临床及时采取针对性干预措施提供依据。 方法 采用方便抽样方法,选取2021年1月—2022年1月在河北省儿童医院心理行为科门诊治疗的568名ADHD儿童为ADHD组,另随机选取该院儿童保健科门诊体检的健康儿童476名为对照组,采用一般资料调查问卷、家庭关怀度指数量表、生活方式指数等进行调查,多因素logistic回归分析ADHD患病的影响因素,并比较不同家庭关系、生活方式、食物不耐受的ADHD儿童智商(Wechsler Adult Intelligence Scale,C-WISC)评分情况。 结果 ADHD组与正常对照组两组儿童母亲文化程度、父亲文化程度、父亲性格是否急躁、父母婚姻状况、家庭平均月收入、家庭关系、生活方式评分、食物不耐受等情况相比,差异均有统计学意义(P＜0.05);多因素logistic回归分析显示,父亲性格急躁(OR=8.965,95%CI:4.092～19.629)、父母离异(OR=3.799,95%CI:1.668～8.655)、生活方式评分越高(OR=4.197,95%CI:2.442～7.206)、食物不耐受(OR=4.702,95%CI:2.482～8.908)是造成ADHD发病的危险因素,家庭关系评分越高(OR=0.377,95%CI:0.156～0.897)、家庭平均月收入越高(OR=0.424,95%CI:0.201～0.869)是其保护因素;生活方式＜6分的ADHD儿童C-WISC评分高于≥6分儿童,食物不耐受的ADHD儿童C-WISC评分低于无食物不耐受儿童,随着家庭关系评分升高,C-WISC评分存在升高趋势,差异均有统计学意义(P＜0.05)。 结论 家庭关系、生活方式、食物不耐受是ADHD发病的影响因素,且其对患儿智商同样存在一定影响作用。

Objective To investigate the willingness to receive influenza vaccination and its influencing factors among students' parents, and to provide references for improving the vaccination rate of influenza vaccines among students. Methods A stratified random cluster sampling method was used to conduct a questionnaire survey in Fuyang City, Bozhou City and Xuancheng City from June to October in 2022. The parents' willingness to vaccinate their children against influenza was analyzed. Univariate analysis and multivariate logistic regression analysis were performed. Results Among 2,637 parents in the study, 2,282 (86.54%) were willing to vaccinate their children against influenza, while 355 (13.46%) were unwilling to get the vaccine. The top three reasons for the parents' reluctance to receive influenza vaccines were fear of insecurity (61.56%), mild flu symptoms without vaccination (35.74%), high cost and low cost-effectiveness (27.93%). The results of multivariate logistic regression analysis revealed that the scores of the parents' influenza-related knowledge literacy (OR=1.064), whether the parents received health education (OR=2.240), parental educational background(OR=1.106) and the students' history of influenza vaccination (OR=1.685) were independent risk factors affecting willingness of the parents to vaccinate their children against influenza (P<0.05). Conclusion The parents had a high willingness to receive influenza vaccines, but still some parents were unwilling to receive them. Therefore, strengthening the parents' health education and publicity on influenza vaccines, improving the parents' flu awareness and expanding the benefits of vaccination are conducive to promoting the willingness of the parents to vaccinate their children against influenza.

Objective To evaluate the immunogenicity and immune persistence of recombinant novel coronavirus protein vaccine (CHO cells), ZF2001, at different doses and immunization procedures in healthy people aged 18-59 years. Methods We conducted a randomized, blind, placebo-controlled and phase II clinical trial. A total of 900 healthy participants aged 18-59 years were randomly assigned to two-doses of low-dose group, two-doses of high-dose group, two-doses of placebo group, three-doses of low-dose group, three-doses of high-dose group, and three-doses of placebo group at a ratio of 1:1:1:1:1:1 and received ZF2001 or placebo. All the participants’ blood samples were collected for SARS-CoV-2 neutralizing and receptor binding domain (RBD) protein-binding antibodies detection before vaccination, 14 days, six months, and 12 months after full vaccination. Results The geometric mean titers (GMTs) of neutralizing antibodies of two-doses of low-dose group, two-doses of high-dose group, two-doses of placebo group at 14 days after full vaccination were 17.7, 14.1 and 2.0 respectively, and those at 6 months after full vaccination were 3.6, 3.7 and 2.0 respectively. The GMTs of RBD protein-binding antibodies of the above-mentioned three groups at 14 days after full vaccination were 439.82, 338.04 and 5.98 respectively, and those at 6 months after full vaccination were 63.62, 50.42, and 5.67 respectively. The GMTs of neutralizing antibodies of three-doses of low-dose group, three-doses of high-dose group, and three-doses of placebo group at 14 days after full vaccination were 97.3, 68.4 and 2.0 respectively, those at 6 months after full vaccination were 19.3, 16.7 and 2.0 respectively, and those at 12 months after full vaccination were 7.4, 7.3 and 2.0 respectively. The GMTs of RBD protein-binding antibodies of the above-mentioned three groups at 14 days after full vaccination were 1,745.67, 1,107.36 and 5.84 respectively, and those at 6 months after full vaccination were 281.31, 212.41 and 5.80 respectively. Conclusions ZF2001 can induce high levels of neutralizing and RBD protein-binding antibodies in the healthy participants. The immune persistence of three doses is better than that of two doses, and the immunogenicity and immune persistence of low doses are superior to those of high doses. The neutralizing antibodies at 6 months after full vaccination show a decreasing trend. A low-dose and three-dose vaccination program is recommended, and booster vaccination at 6 months after full vaccination should be considered.

Objective To understand the epidemic characteristics of pertussis in Shaodong City, Hunan Province in 2019-2023, to analyze the monitoring data, and to provide a reference basis for improving prevention and control strategies. Methods The continuous monitoring data regarding pertussis incidence, epidemiological characteristics, vaccination status and vaccine protection effect in Shaodong City during 2019-2023 were analyzed with descriptive analysis, and the prevention and control strategies were proposed. Results The number of pertussis cases in Shaodong City in 2023 reached 151, and most of the cases were children, accounting for 99.34% of the total cases. The proportion of cases aged under 1 year old accounted for 30.46%, showing a decrease compared with those in 2019-2022. The proportions of cases aged 3-5 years and 6-12 years were 30.46% and 29.14%respectively, showing an increase compared with those in 2019-2022. The vaccination rates of most age groups were above 90%, but the vaccination rates of the third dose of basic immunization in the 1-year-old group and the booster immunization in the 2-year-old group and the 3-year-old group were all below 90%. Conclusion The infection rates of pertussis in Shaodong City during 2019-2023 showed an increasing trend year by year, and most of the cases were infants as well as young children. Immunization is the best way to protect, and the immunization program still needs to be further improved.

Objective To explore the factors affecting the onset of gestational diabetes mellitus (GDM), and to establish and validate the interactive nomogram model for the prediction of risk of GDM. Methods We retrospectively collected the clinical data about 2,279 pregnant women admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January to December 2021, and the dataset was randomly divided into the training set (80%) and the validation set (20%). χ² test and Wilcoxon rank sum test were used to analyze the factors affecting the risk of onset of GDM. Least absolute shrinkage and selection operator (LASSO) logistic regression analysis was performed to select the predictive variables for the establishment of interactive nomogram model, and then the model was validated. Receiver operating characteristic curve (ROC), calibration curve, clinical decision curve analysis (DCA) and clinical impact curve (CIC) were employed to evaluate the performance of the model. Results A total of 1,823 pregnant womenwere enrolled into the training set,and the prevalence rate of GDM was 16.84%. Multivariate LASSO logistic regression analysis was conducted to identify the predictors of risk of GDM, among which pregnancy age (OR=1.094, 95%CI:1.055-1.135), pre-pregnancy BMI (OR=1.177, 95%CI:1.126-1.230), rural registered residence (OR=0.242, 95%CI:0.073-0.805), bachelor degree or above (OR=2.003, 95%CI:1.291-3.106), history of diabetes mellitus (OR=6.516, 95%CI:4.034-10.525), primiparity (OR=0.600, 95%CI:0.430-0.837) and abortion (OR=1.905, 95%CI:1.642-2.704) were independently associated with GDM. The interactive nomogram model was constructed based on the above-mentioned factors, and the area under ROC (95% confidence interval) in the training set and the validation set was 0.747 (0.717-0.777) and 0.741 (0.679-0.802) respectively. Calibration curve and CIC revealed that the values predicted by the established model were in good agreement with the actual values. DCA indicated that the maximum net benefit value would be achieved by the nomogram modelwhen the threshold probability intervals for GDM were 0.10-0.65. Conclusion The nomogram predictive model for GDM has higher discrimination, calibration and clinical applicability, and is conducive to early identifying the high-risk population for GDM and taking preventive measures.

Objective To explore the epidemic characteristics of measles and the factors influencing measles incidence among children aged 0-14 years in Hebei Province from 2017 to 2022, and to provide a basis for scientific prevention and control of measles. Methods The data were collected from the Management System for Monitoring and Reporting, China InformationSystem for Disease Control and Prevention. The data were based on the information about measles surveillance cases in Hebei Province from January 2017 to December 2022. Descriptive analysis method was used to explore the epidemic characteristics of measles. Pair-matched case-control study was applied to exploring the factors influencing measles incidence among children aged 0-14 years. Results A total of 763 cases of measles were cumulatively reported in Hebei Province from 2017 to 2022, and the incidence was decreasing year by year. The ratio of male to female was 1.51:1.The age of onset of the cases mainly ranged from 8 months to 2 years. A total of 234 pairs of children were enrolled into the case-control study. Conditional logistic regression analysis revealed that having been vaccinated with measles-containing vaccine (OR=0.147, 95%CI:0.062-0.348) was the protectivefactor for measles incidence among children aged 0-14 years, whereas living at present address for less than 3 months (OR=11.638, 95%CI:1.269-106.692) and having been to a hospital 7-21 days before the onset of measles (OR=12.081, 95%CI:3.289-44.378) were the risk factors for the incidence. Conclusion The incidence rates of measles in Hebei Province from 2017 to 2022 showed a decreasing trend. Strengthening the vaccination of measles-containing vaccine, effectively managing children who live in their current homes for less than 3 months and adopting prevention measures against nosocomial infections are conducive to reducing the occurrence of measles among children aged 0-14 years.

目的 了解老年2型糖尿病患者流感疫苗接种犹豫状况及影响因素,为降低患者流感疫苗接种犹豫提供参考。方法 采用方便抽样法,选取丽水地区3家医院就诊的364名老年2型糖尿病患者作为调查对象。采用一般情况量表、流感疫苗接种犹豫量表、流感防治知识量表进行调查分析。结果 老年2型糖尿病患者流感疫苗接种犹豫得分为(75.68±12.84)分,流感防治知识得分为(5.22±1.82)分;不同性别、文化程度及流感疫苗接种史的老年2型糖尿病患者流感疫苗接种犹豫得分比较,差异均有统计学意义(P<0.05);老年2型糖尿病患者流感疫苗接种犹豫得分与流感防治知识得分呈负相关(r=-0.584,P<0.01);多元线性回归分析结果显示,老年2型糖尿病患者流感疫苗接种犹豫影响因素为性别、文化程度、流感疫苗接种史、流感防治知识得分(P<0.05)。结论 老年2型糖尿病患者流感疫苗接种犹豫水平较高,应针对患者的性别、文化程度、流感疫苗接种史、流感防治知识等因素采取相应的干预措施,降低流感疫苗接种犹豫,提高疫苗接种率。

Objective To analyze the epidemiological features, pathogenic bacteria distribution and drug sensitivity test results of pneumonia in children, and to provide references for prevention and treatment of pneumonia in children as well as rational drug use in clinical practice. Methods We retrospectively collected the clinical data, sputum culture results and drug sensitivity test results of 408 bacterial pneumonia children less than 5 years of age admitted to the general wards of Chengdu Pidu Maternal and Child Health Hospital and Chengdu Women’s and Children’s Central Hospital from November 2021 to June 2023. A descriptive analysis was performed on the detection of common pathogenic bacteria in different age groups and children of different genders as well as drug resistance of pathogenic bacteria. Results Among the 408 children with pneumonia, 368 (90.20%) were infected with one kind of pathogenic bacteria, and 40 (9.80%) with two or more kinds of pathogenic bacteria. 468 strains of pathogenic bacteria were detected in the sputum samples, including 165 (35.26%) strains of Gram-positive bacteria and 303 (64.74%) strains of Gram-negative bacteria. The main pathogenic bacteria detected were Streptococcus pneumoniae (31.41%), Haemophilus influenzae (24.79%), Moraxella catarrhalis (19.02%), Viridans streptococci (15.81%) and Staphylococcus aureus (3.85%). No statistically significant differences were found in the detection rates of 5 major pathogenic bacteria between children of different genders (P>0.05). The detection rate of Streptococcus pneumoniae was higher in 1-3-year-old group and >3-5-year-old group than in <1-year-old group, while the detection rates of Haemophilus influenzae and Staphylococcus aureus were lower in 1-3-year-old group and >3-5-year-old group than in <1-year-old group (P<0.05). The detection rate ofStreptococcuspneumoniae was higher in winter than in autumn, and the detection rate of Haemophilus influenzae was higher in spring than in summer, autumn and winter (P<0.05). The drug resistance rates of Streptococcus pneumoniae andMoraxella catarrhalis to co-trimoxazole were the highest, which were 53.74% and 22.47% respectively. The drug resistance rates of Haemophilusinfluenzae and Staphylococcus aureus to ampicillin were the highest, which were 67.24% and 83.33% respectively. The drug resistance rates of Viridans streptococcus to ampicillin and ceftriaxone were the highest, which were both 51.35%. Conclusion Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Viridans streptococcus and Staphylococcus aureus are main pathogenic bacteria of pneumonia in the children in this area. The distribution of pathogenic bacteria in the children of different ages and different seasons is diversity. Sensitive antibacterial drugs should be rationally selected and used based on drug resistance characteristics of pathogenic bacteria in clinical practice.

Objective To explore and evaluate the protective effect of trivalent inactivated influenza vaccine in primary and secondary school students, and to provide a basis for the government to formulate and improve influenza vaccination strategies for the students. Methods Combined with the number of influenza incidence from the National Monitoring System for InfectiousDisease, the number of influenza vaccination in the primary and secondary schools in 2022 and the number of students in each grade, we compared the incidence rates of influenza in each grade and the incidence rates of influenza in the vaccinated andnon-vaccinated groups, and calculated the vaccine protection rate of each group. Results The incidence rate of influenza was significantly lower in the vaccinated group than in the non-vaccinated group (4.54% vs. 6.02%, χ²=251.761, P<0.05). The overall protection rate offered by influenza vaccines in the primary and secondary schools was 24.55%. The primary and secondary schools were grouped according to the vaccination rates from high to low, the incidence rate of influenza in the low vaccination rate group of primary schools was 6.12%, and the vaccine protection rate -12.31%, with 95% confidence interval of -22.51%--3.02%, showing no protective effect. Other groups showed good protective effects after influenza vaccination. Conclusion Seasonal flu vaccination can effectively protect the primary and middle school students, and hence it is necessary to encourage the primary and middle school students to inoculate with seasonal flu vaccines in accordance with the technical guidelines for flu vaccination so as to prevent influenza. This study supports the current recommendation on inoculating with 2 doses of influenza vaccine in previously unvaccinated children. Multiple measures should be taken in parallel in newly-registered pupils from Grade 1 so as to protect their health.

目的 分析老年女性骨质疏松患者认知功能情况及危险因素,为提高老年人群生活质量,减少认知功能障碍发生提供依据。方法 选择2018年12月—2023年12月新疆某三甲医院收治的506例老年女性骨质疏松患者作为调查对象,调查其基本情况,通过简易精神状况量表(Mini Mental State Examination,MMSE)、匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)、老年抑郁量表(Geriatric Depression Scale,GDS)评估其认知功能、睡眠质量和心理状态。采用多因素logistic回归分析探讨老年女性骨质疏松患者认知功能的影响因素。结果 506例老年女性骨质疏松患者MMSE总分为(26.11±1.26)分,且认知功能障碍发生率为79.45%(402/506)。不同年龄、文化程度、有无记忆力下降、参加社区活动情况、是否经常体育锻炼、是否补钙、有无骨折史、高血压史、冠心病史、睡眠障碍、焦虑、抑郁的老年女性骨质疏松患者其认知功能障碍发生率差异有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄越大[OR(95%CI):3.781(2.015~7.093)]、文化程度越低[OR(95%CI):2.008 (1.397~2.885)]、记忆力下降[OR(95%CI):2.396(1.572~3.652)]、参加社区活动少[OR(95%CI):2.776(1.711~4.505)]、有高血压史[OR(95%CI):3.543(1.926~6.518)]、有睡眠障碍[OR(95%CI):2.096(1.439~3.054)]、焦虑[OR(95%CI):3.504(1.943~6.322)]、抑郁[OR(95%CI):3.804(2.024~7.150)]均为老年女性骨质疏松患者认知功能障碍发生的危险因素(P<0.05)。结论 老年女性骨质疏松患者认知功能障碍发生率较高,并且与年龄、文化程度、记忆力下降、社区活动、高血压史、睡眠障碍、焦虑状态、抑郁状态等因素相关。因此,临床尽早对老年女性骨质疏松患者认知功能进行筛查,同时根据其危险因素做好预防工作,从而提高生活质量,减少认知功能障碍发生率。

目的 探讨信息-知识-信念-行为(information-knowledge-attitude-practice,IKAP)理论指导下的健康教育模式在妊娠期糖尿病患者中的应用效果。 方法 选取2021年2月—2022年12月于树兰(杭州)医院就诊的妊娠期糖尿病患者94例,依照随机数字表法将其分为对照组与观察组,各47例。对照组给予常规健康教育,观察组给予IKAP理论指导下的健康教育,两组均干预至分娩后2个月。比较两组干预前后焦虑抑郁情绪、糖脂代谢指标、健康行为管理及干预后疾病知识掌握情况、依从性、妊娠结局。 结果 与干预前相比,干预后两组焦虑自评量表(Self-Rating Anxiety Scale,SAS)、抑郁自评量表(Self-Rating Depression Scale,SDS)评分、糖化血红蛋白、空腹血糖、餐后2 h血糖、空腹胰岛素、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、三酰甘油水平均降低,且观察组低于对照组,差异均有统计学意义(P<0.05);干预后两组血清高密度脂蛋白胆固醇水平、健康管理各项评分均增高,观察组高于对照组,差异均有统计学意义(P<0.05);干预后观察组糖尿病知识掌握总优良率、总依从率高于对照组,差异均有统计学意义(P<0.05);观察组不良妊娠结局总发生率为6.38%,低于对照组的21.28%,差异有统计学意义(χ²=4.374,P=0.036)。 结论 IKAP理论指导下的健康教育能够有效减轻妊娠期糖尿病患者焦虑抑郁情绪,改善糖脂代谢,提高患者对疾病相关知识掌握度,提升依从性,保障母婴安全。

The health problems of left-behind children in the rural areas have become one of the hot-spots of concern for social development in China. Besides lacking the parents’ love, the necessities of life such as food, medical care and education resources are relatively scarce with left-behind children; and hence, they are more prone to malnutrition, growth retardation and other health problems. This review aims at combing and integrating the relevant research Results of nutrition, growth and development of rural left-behind children in China so as to provide suggestions and evidence for future research and formulation of relevant policies.

Objective To investigate the status of mobile phone dependence and its influencing factors among undergraduates in three universities in Shaanxi Province so as to provide a basis for formulating targeted intervention measures. Methods A stratified cluster sampling method was used to select 838 undergraduates in three universities in Shaanxi Province to serve as the research subjects. The status of mobile phone dependence syndrome was surveyed based on the Criterion for Mobile Phone Dependence Syndrome, and multi-factor logistic regression analysis was performed to identify the factors influencing mobile phone dependence syndrome in the undergraduates. Results The detection rate of mobile phone dependent syndrome in the undergraduates was 27.2%, and the detection rate was significantly higher in males than in females, showing a statistically significant difference (χ²=44.109, P=0.000). The detection rate of mobile phone dependent syndrome was found to be higher in the urban students (χ²=18.025, P=0.000), students from families with high per capita income (χ²=6.775, P=0.000), literature, history and art majors (OR=1.437) and junior college students (OR=1.583). Students with frequent anxiety (OR=2.192), grief and helplessness (OR=1.976) had more pronounced symptoms of mobile phone dependence. Conclusions The detection rate of mobile phone dependence syndrome of the undergraduates inthreeuniversities in Shaanxi Province is higher. Universities should enhance the publicity and education about scientific use of mobile phone among the undergraduates, while the undergraduates should strengthen self supervision and management and form an attitude and habit of reasonable and scientific use of mobile phone.

Objective To study the effect of dietary nutrient intake on the contents of trace elements in hair of preschoolers aged 3-6 years in Nanning City, and to provide a basis for evaluating the preschoolers’ nutritional status and guiding their reasonable dietary. Methods A nutritional survey was conducted among 201 preschoolers aged 3-6 years in three kindergartens in Nanning City in December, 2016, and the contents of hair copper, zinc, iron, calcium and magnesium in the preschoolers were determined. Results The average contents of hair copper, iron, calcium, magnesium and zinc in the preschoolers were (19.48±7.80) μg/g, (28.04±15.36) μg/g, (419.18±175.48) μg/g, (33.48±18.52) μg/g and (151.12±57.10) μg/g respectively. Statistically significant differences were found in the contents of hair copper, iron, calcium, magnesium and zinc between male and female preschoolers (P<0.05) as well as in the content of copper among preschoolers of different ages(P<0.05). The protein, carbohydrate, thiamine, niacin, vitamin E, phosphorus, magnesium, iron, zinc and manganese in dietary were positively correlated with the content of hair copper (P<0.05). Carotene and manganese were positively correlated with the content of hair magnesium (P<0.05), while fat was negatively correlated with it (P<0.05). Energy, protein, carbohydrate, carotene, niacin, vitamin E, magnesium, iron, zinc and manganese were positively correlated with the content of hair zinc (P<0.05), while fat and vitamin C were negatively correlated with the content of hair calcium (P<0.05). Conclusions There is a correlation between dietary nutrient intake and hair trace elements in the preschoolers aged 3-6 years. Hair trace elements copper and zinc are susceptible to various dietary nutrients.

目的 探讨2型糖尿病肾病患者血清肾损伤分子-1(human kidney injury molecule 1,Kim-1)、尿N-乙酰-β-D-葡萄糖苷酶(N-acetyl-beta-D-glucosamidase, NAG)、血管紧张素原(angiotensinogen, AGT)水平的表达及临床意义。 方法 选取2014年4月-2015年4月期间同仁医院院收治的90例2型糖尿病肾病患者作为研究对象,依据尿白蛋白排泄率将其分为早期糖尿病肾病组(early diabetic nephropathy,EDN组)及临床糖尿病肾病组(diabetic nephropathy,DN组)各45例,并选取45例健康体检者作为正常对照组(normal control, NC组)。采用酶联免疫吸附法检测三组受试者血清Kim-1、尿NAG、AGT水平,分析其与2型糖尿病肾病的关系。 结果 EDN组及DN组血清Kim-1、尿NAG、AGT水平明显高于NC组,差异有统计学意义(P＜0.05),DN组高于EDN组(P＜0.05)。Kim-1、NAG、AGT检测对2型糖尿病肾病的预测/诊断灵敏度分别为0.702、0.615、0.718;特异度分别为0.616、0.577、0.597,但联合检测灵敏度为0.896,特异度为0.853;Kim-1、NAG、AGT水平异常是2型糖尿病肾病发生的危险影响因素(P＜0.05)。 结论 2型糖尿病肾病患者血清Kim-1、尿NAG、AGT水平呈高表达,Kim-1、NAG、AGT联合检测对于2型糖尿病肾病具有较高的预测/诊断价值,其水平的异常增加也是2型糖尿病肾病的危险影响因素。

Objective To explore the expression levels of thrombin-antithrombin III complex (TAT), D-dimer (D-D) and antithrombin Ⅲ (AT-Ⅲ) in patients with atrial fibrillation and their clinical values in forecasting thromboembolism. Methods We selected 110 atrial fibrillation outpatients/inpatients confirmed by electrocardiograph in Department of Cardiology, No. 163 Hospital of the PLA from January 2016 to October 2017. Transesophageal echocardiography (TEE) examination, left atrium and left atrial function detection and blood flow testing were performed to judge whether there was thrombosis or embolism. In addition, 40 healthy volunteers were enrolled in this study. The levels of plasma TAT, D-D and AT-Ⅲ activity were detected in the groups of atrial fibrillation and thromboembolism, atrial fibrillation without thrombus and healthy volunteers, and the differences in expression levels of the above-mentioned indicators in the three groups were analyzed. Results About 20.91% (23/110) atrial fibrillation patients with thrombosis or embolism were detected, and no thrombus was found in the rest 87 patients. Plasma levels of TAT and D-D were higher in atrial fibrillation patients than in the healthy group; moreover, plasma levels of TAT and D-D were higher in the thrombus-positive group than in the atrial fibrillation without thrombus group (P<0.05). Plasma level of AT-Ⅲ activity were lower in the atrial fibrillation and thrombus-positive group and the atrial fibrillation and thrombus-negative group than in the control group (P<0.05), but no statistically significant difference was found in plasma level of AT-Ⅲ activity between the atrial fibrillation and thrombus-positive group and the atrial fibrillation and thrombus-negative group (P>0.05). Conclusions The levels of TAT and D-D in peripheral blood of patients with thrombotic atrial fibrillation are high, but the level of AT-Ⅲ is low, which reflect the hemotological hypercoagulable state of the patients. It has a certain reference value for predicting the risk of thromboembolism in patients with atrial fibrillation.

目的 探讨多囊卵巢综合征不孕患者性激素与其外周血Th1/Th2的相关性。 方法 选择2016年1月-2017年9月宜昌市中心人民医院收治的多囊卵巢综合征不孕患者97例作为观察组,同期开展体检的健康女性80例作为对照组,分别检测两组外周血性激素水平、Th1型细胞因子(γ干扰素,TNF-α)、Th2型细胞因子(IL-4,IL-6)以及Th1/Th2水平,并分析Th1/Th2与对照组、观察组中高雄激素血症患者、观察组中非高雄激素血症患者性激素的相关性。 结果 观察组患者的雌二醇(E2)、睾酮(T)与黄体生成素(LH)分别为(162.79±58.92)pmol/L、(2.75±0.84 )nmol/L、(7.91±5.26)mIU/ml均明显高于对照组的(133.86±43.81)pmol/L、(1.50±0.76)nmol/L、(4.48±1.79)mIU/ml,差异均有统计学意义(P<0.05)。观察组患者的IFN-γ、TNF-α与Th1/Th2分别为(24.51±9.26)μmol/L、(2.18±0.12)μmol/L、(29.37±7.39),均明显高于对照组的(14.58±7.35)μmol/L、(1.75±0.09)μmol/L、(15.69±4.87),差异有统计学意义(P<0.05),两组IL-4、IL-6水平比较差异无统计学意义(P>0.05)。观察组患者中存在高雄激素血症51例(52.58%),非高雄激素血症46例(47.42%)。Pearson相关分析显示,对照组E2水平与Th1/Th2呈正相关(r=0.527,P<0.05),观察组中高雄激素血症患者E2、T与Th1/Th2呈正相关(r=0.426、0.643,P<0.05),观察组中非高雄激素血症患者E2水平与Th1/Th2呈正相关(r=0.368,P<0.05)。 结论 多囊卵巢综合征患者的免疫功能问题同其性激素表达具有相关性,其免疫功能失调是诱发不孕的原因之一,通过对其免疫细胞因子进行干预治疗可改善其不孕病情。

Objective To study the apoptosis of human hepatoma HepG2 cells induced by dichloroacetonitrile (DCAN) and its related mechanism. Methods Dimethyl sulfoxide (DMSO)-treated HepG2 cells were selected as the control group, while 50 μmol/L and 800 μmol/L DCAN-treated HepG2 cells served as the DCAN-treated groups. The cell proliferation was detected with Cell Counting Kit-8 (CCK-8 ). Cell cycle and apoptosis rate were analyzed by flow cytometry with annexin V-fluorescein isothiocyanate/propidium iodide (FITC/PI) double staining. The relative activity of caspase-3 in HepG2 cells was examined with fluorospectrophotometer assay. Results The interaction effect existed between DCAN concentration and treatment time (P<0.001). DCAN could significantly inhibit the proliferation of HepG2 cells in a dose- and time-dependent manner compared with the control group (P<0.05). The proportion of HepG2 cells in G₀/G₁ phase was decreased in the 800 μmol/L DCAN-treated group compared with the control group, while the proportion of HepG2 cells in G₂/M phase was increased. Under the DCAN concentrations, the apoptosis rate of HepG2 cells were increased in a dose-dependent manner, with the regressionequation =0.031x+5 (R²=0.915, F=64.782, P<0.001), while the caspase 3 activity was also increased in a dose-dependent manner, with regression equation =0.0016x+1 (R²=1.000,F=21,266.064,P<0.001). Conclusions DCAN can inhibit the proliferation of HepG2 cells and induce their apoptosis, and the mechanism may be related to the arrest of G₂/M phase, inhibition of RNA and protein synthesis and activation of caspase-3 pathway.

目的 探讨提高抗酸杆菌痰涂片镜检阳性率的方法,为发现更多传染源,减少结核病的传播提供科学依据。 方法 对标本分别采用直接法和消化离心沉淀法进行涂片,经萋-尼氏染色镜检,比较两法涂片阳性率。消化离心沉淀处理的标本再分别经荧光染色、LED镜检和萋-尼氏染色镜检结果对比,并对两法差异结果进行分析评价。 结果 158份唾液痰分别用直接涂片和消化离心沉淀法涂片,经萋-尼氏染色镜检,涂片阳性率分别为2.53%和10.76%,204份粘液痰阳性率分别为5.88%和13.73%,396份干酪痰阳性率分别为16.92%和19.19%,62份血痰阳性率分别为9.68%和14.52%。唾液痰与粘液痰阳性率结果差异有统计学意义(P<0.01),干酪痰与血痰阳性率差异无统计学意义(P>0.05),而两法合计阳性率结果差异有统计学意义(P<0.01)。上述标本全部经消化离心沉淀法处理后涂片,分别用萋-尼氏染色光镜镜检和荧光染色LED荧光镜检,唾液痰、粘液痰、干酪痰和血痰阳性率依次提高了5.06%、4.41%、5.05%与4.83%。每种不同性状标本两法阳性率结果差异无统计学意义(P>0.05),而两法合计阳性率结果差异有统计学意义(P<0.05)。对两法阳性差异结果比较,荧光染色1+,而萋-尼氏染色仅只能判为1+以下的标本27份,荧光染色判为2+,而萋-尼氏染色判为2+以下的标本30份,荧光染色判为3+,而萋-尼氏染色判为3+以下的标本18份。 结论 对痰标本采用消化离心沉淀法进行涂片,再配合荧光染色、LED荧光显微镜镜检是一种能提高抗酸杆菌涂片阳性率、且操作简单、适合基层开展的方法。

目的 探讨妊娠晚期孕妇B族链球菌(group B streptococcus,GBS)带菌情况对母婴结局的影响及耐药性监测。 方法 选取2015年5月-2017年5月安康市妇幼保健院接收的妊娠晚期孕妇800例,采用实时荧光定量PCR法对孕妇阴道或直肠分泌物进行GBS检测,同时对培养分离出的GBS标本进行临床常见的10种抗菌药物的药敏试验。观察所有孕妇及不同年龄、产次、流产史孕妇的GBS阳性率,将800例孕妇分为GBS阳性组和GBS阴性组,分析GBS阳性组与GBS阴性组的母婴结局。 结果 800例晚期孕妇GBS感染阳性率为9.88%(79/800),其中不同年龄分组、产次分组、流产史的孕妇GBS阳性率比较差异无统计学意义(均P＞0.05)。79株GBS对青霉素、万古霉素、头孢吡肟、头孢噻肟以及利奈唑胺的耐药率均为0.00%,对红霉素、氯霉素、左旋氧氟沙星、氨芐西林以及克林霉素的耐药率分别为62.03%、17.72%、34.18%、7.59%、58.23%。GBS阳性组的胎儿窘迫、早产、宫内感染以及胎膜早破发生率均明显高于GBS阴性组(P＜0.05)。GBS阳性组的病理性黄疸、新生儿肺炎、新生儿窒息发生率均明显高于GBS阴性组(P＜0.05)。 结论 实时荧光定量PCR法可用于晚期孕妇GBS感染的检测中,而青霉素、万古霉素、头孢吡肟、头孢噻肟以及利奈唑胺均为有效预防妊娠期GBS感染的理想抗生素。GBS感染会增加胎儿窘迫、早产、宫内感染以及胎膜早破发生率,以及新生儿病理性黄疸、新生儿肺炎、新生儿窒息,值得临床重点关注。

Objective To investigate the characteristics of population with HIV/AIDS voluntary counseling and testing (VCT) and the status of HIV infection in Jiangyin City, and to provide a basis for developing HIV/AIDS targeted prevention and control measures. Methods All data of outpatients with HIV/AIDS voluntary counseling and testing in Jiangyin City during 2014-2016 were collected and analyzed. Results A total of 4,702 outpatients received VCT service from 2014 to 2016, and most of them had non-marital heterosexual sex, accounting for 55.21%. The proportion of outpatients with history of commercial heterosexual sex behavior showed an upward tendency year by year (χ²_tendency=21.46, P<0.001), while the proportions of injection drug users (χ²_tendency=15.89, P<0.001) and HIV-positive spouse/fixed sexual partner (χ²_tendency=8.26, P=0.016) showed a downward tendency year by year. The positive rates of HIV and syphilis were 1.83% and 6.59% respectively, and the positive rate of HIV-syphilis co-infection was 0.68%. During the 3-year period, the positive rate of HIV decreased year by year, while the positive rate of syphilis increased year by year, without statistically significant difference in the trend (χ²_tendency=0.49, P=0.783;χ²_tendency=1.40, P=0.497). The positive rate of HIV was found to be higher in male outpatients (χ²=44.41, P<0.001), divorced or widowed outpatients (χ²=12.49, P=0.002), outpatients with college degree or above (χ²=45.11, P<0.001) and syphilis-positive outpatients (χ²=133.34,P<0.001). The positive rate of HIV was found to be the highest in men who have sex with men (MSM) (18.79%) followed by outpatients with HIV-positive spouse/fixed sexual partner (5.43%). The positive rates of HIV in MSM in 2014, 2015 and 2016 were 25.25%, 18.58% and 14.18% respectively, showing a gradually decreasing tendency (χ²_tendency = 4.51, P=0.105). The positive rates of HIV in outpatients with HIV-positive spouse/fixed sexual partner were 3.51%, 5.26% and 8.82% respectively, showing a gradually increasing tendency (χ²_tendency=1.11, P=0.573). But no statistically significant difference was found in either tendency. Conclusions Most of VCT clients in Jiangyin City during 2014-2016 were the young and middle-aged, the males and the married. VCT is an effective way to detect HIV-infected persons in time. It is necessary to strengthen HIV/AIDS detection and intervention in MSM and population with HIV-positive spouse/fixed sexual partner in future.

Objective To investigate the life style and dietary habit among high risk population for stroke in a hospital in Guilin region, and to analyze their risk factors. Methods We selected 683 physical examinees who met the criteria for high risk stroke population and received physical examination in Guilin People’s Hospital from January 2015 to October 2017 to serve as the high risk group, and 600 healthy physical examinees as the control group. In addition, 600 stroke patients treated in the same hospital during the same period served as the stroke group. General information, life style and dietary habit of the three groups were collected and investigated. Laboratory indicators of the three groups were compared. Multivariate logistic regression analysis was performed to identify the risk factors of high-risk stroke population in Guilin region. Results The proportions of males and patients aged ≥ 50 years in the high risk group and the stroke group were significantly higher than those in the control group, and body mass index (BMI) was higher in the stroke group than in the control group, showing statistically significant differences (all P<0.05). The proportions of patients with smoking, drinking and insufficient physical exercise in the high risk group and the stroke group were significantly higher than those of the control group, with statistically significant differences (all P<0.05). The proportions of patients with greasy taste, insufficient intake of vegetables, meat intake ≥3 times a week and sweet taste in the high risk group and the stroke group were significantly higher than those of the control group, and the differences were statistically significant (all P<0.05). The levels of uric acid, fasting blood glucose, triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the high-risk group and the stroke group were significantly higher than those of the control group, while the levels of high-density lipoprotein cholesterol (HDL-C) were significantly lower, and the differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that the risk factors for stroke in Guilin region included males (OR=1.031), advanced age (OR=1.894), drinking (OR=2.495), lack of physical exercise (OR=1.687), greasy taste (OR=1.822), insufficient intake of vegetables (OR=1.673), excessive intake of meat (OR=1.429), high uric acid (OR=2.916), high fasting blood glucose (OR=2.127) and high blood lipids (OR=1.709) (all P<0.05). Conclusions A variety of factors are closely related to high risk of stroke in Guilin region, including males, age, drinking, lack of physical exercise, greasy taste, insufficient intake of vegetables, excessive intake of meat, high uric acid, high fasting blood glucose and high blood lipids. Therefore, effective intervention measures in clinical practice should be formulated according to the above-mentioned factors so as to achieve the purpose of prevention and control of stroke.

目的 了解宝鸡市食品中食源性致病菌的污染状况,为监管部门采取有效的防范措施提供科学依据。 方法 2014-2016年采集宝鸡市部分市售食品842份,根据《全国食源性致病菌监测手册》对其进行检测。 结果 检测结果显示,在842份样品中,有153份样品检出致病菌,总检出率为18.17%。其中污染最为严重的是生肉及其生肉制品和调理肉制品(生肉添加调理料),检出率为66.67%和58.33%。三年间共检出7种食源性致病菌,分别为蜡样芽胞杆菌、金黄色葡萄球菌、沙门菌、单核细胞增生李斯特菌、铜绿假单胞菌、副溶血性弧菌、霍乱弧菌。 结论 宝鸡市部分市售食品受食源性致病菌污染严重,特别是生肉食品,因此要严格规范肉制品加工过程,防止生、熟交叉污染。同时,相关部门应做好动物的检疫工作。

Objective To analyze the changes of epidemic characteristics of mumps in different periods, and to provide evidence for formulating mumps control and prevention strategies. Methods Mumps incidence data in Xinxiang urban areas in 2004-2017 were described for three periods, the prophase of theExpanded Program on Immunization (prophase EPI) (2004-2007), the EPI period (2008-2012), and the period of booster vaccination (BV) ofmumps containing vaccine (MuCV) (2013-2017). The changes in mumps incidence of the three periods were compared. Results The average annual incidence rates of mumps in the three periods were 6.94/100,000, 4.38/100,000 and 6.01/100,000 respectively, with statistically significant differences (χ²=24.531, P<0.001). For the three periods, there were two incidence peaks, from March to June and from December to January. Students accounted for 62.33%, 54.25% and 63.48% respectively. Male to female ratios were 1.56:1, 1. 65:1 and 1.52:1 respectively. The cumulative incidence rates for the group aged 3-14 years were 40.98/100,000, 25.71/100,000 and 33.51/100,000 respectively. Conclusions The mumps incidence in Xinxiang urban areas during 2004-2017 declined after EPI. Due to the low vaccination rates of the second dose of MuCV, no colony immune protective barrier was formed to change the onset cycle of mumps. Therefore, two-dose routine MuCV immunization and other comprehensive control strategies are recommended for children under 6 years of age.

Objective To compare and analyze the reported incidence rates of syphilis and its estimated infection rates based on population in Wuhan City, and to evaluate the epidemiological characteristics and trend of syphilis in Wuhan City. Methods The data regarding the reported syphilis cases in Wuhan City during 2010-2015 were derived from China Disease Prevention and Control Reporting System, and the changing trend of online-reported incidence rates of syphilis was analyzed. The data related to population sizes and infection rates of four types of high-risk groups were obtained from Wuhan Municipal Center for Disease Control and Prevention. The data concerning syphilis screening tests in blood donors, inpatients, pregnant women and puerperae were collected from 21 medical institutions in Wuhan City. The workbook method was employed to estimate the infection rates of the whole population in Wuhan City, and the trends were analyzed. Results The reported incidence rates of expressive syphilis in Wuhan City during 2010-2015 showed a downward tendency (Z_tendency=-25.206, P<0.01), while the reported incidence rates of latent syphilis and the infection rates of syphilis in the whole population showed an upward tendency (Z_tendency= 8.639, P<0.01; Z_tendency=185.036, P<0.01). There was a statistically significant difference in the correlation between the reported incidence rates of latent syphilis and the infection rates of syphilis in the whole population (T=4.24, P=0.0133). Conclusions Estimating the infection rate of syphilis in the population is an important supplement to the data of online-reported syphilis incidence, which will contribute to objectively analyzing the changing trend of syphilis epidemic.

目的 了解湖北省手足口病例流行病学特征,为下一步制定防控措施提供科学依据。 方法 收集2016年湖北省手足口病的监测数据、实验室手足口监测数据、各级医疗机构报告的手足口病病例对2016年湖北省手足口病例进行流行病学和病原学分析。 结果 2016年湖北省手足口发病高峰分布在5月、6月、10月。从病例数来看,男女性别比为1.46:1;以0~5岁构成比最高,占发病总人数的95.64%;主要发病人群是托幼儿童和散居儿童。2016年实验室共确诊了手足口阳性普通病例10 200例,重症病例137例。普通病例流行主要以其他肠道病毒为主,重症以肠道病毒71型(enterovirus 71, EV 71)为流行株。对2016年重症病例进行了病毒分离,分离到毒株36株,均为EV71型,对毒株进行VP1区核苷酸序列测定和同源性比较及遗传进化分析,其VP1基因型测序结果与我国阜阳、江苏、深圳、北京等地的EV71毒株同源性较高,在96.8%~99.4%之间。 结论 2016年湖北省手足口病流行有明显的季节性、人群性,引起手足口病流行的主要病原体为其他型别肠道病毒,应特别重视对0~5岁年龄组人群手足口病防控工作, 同时加强手足口病监测工作。

目的 调查分析邯郸市居民两周患病率现状及流行特征,为今后社区卫生服务工作重点提供参考依据。 方法 采用分层整群随机抽样方法于2015年11月对邯郸市行政区划内居住的常住居民进行家庭询问调查,调查内容包括调查对象人口学信息、两周患病情况及相关因素信息。 结果 本次共调查邯郸市47个行政村(居委会),收集问卷共计41 229份,两周患病率为22.9％。在不同类型疾病的两周患病率中,慢性非传染性疾病的两周患病率最高(21.1％),在慢性非传染性疾病中,又以高血压的两周患病率最高(9.3%)。不同性别、年龄、文化程度、职业状况特征人群两周患病率差异均有统计学意义(均P<0.05)。 结论 2015年邯郸市居民两周患病率仍较高,应深化医疗保障体制改革,加强社区卫生服务工作,充分关注各个方面的居民卫生服务需要,降低两周患病率,全面提高居民健康水平。

目的 了解张家港市中小学生乙肝相关知识知晓率和健康教育需求情况,为今后有针对性开展健康教育和健康促进活动提供科学依据。 方法 2016年4-6月份,张家港市根据国家科技重大专项项目办公室提供的调查问卷,采用分层和整群抽样的方法在张家港市选择6所中小学校的1 200余名学生作为调查对象,由经过统一培训的专业人员进行问卷调查,根据调查对象乙肝相关知识得分情况,对不同性别、民族知识得分情况比较使用t检验进行分析、不同年龄和文化程度得分情况比较使用单因素方差分析、对单因素分析结果中有统计学意义的变量进行多元线性回归分析。 结果 张家港市中小学生乙肝相关知识总知晓率为48.63%;在乙肝基本知识方面,中小学生对“目前没有治疗乙型肝炎的特效药物”知晓率仅为25.51%;在乙肝传播途径方面,“纹身、修脚、穿耳洞等”知晓率最低,只有19.26%;在乙肝非传播途径方面,“一起吃饭,拥抱、握手”、“共用工作和学习用具”知晓率均在30%～50%;只有25.60%的中小学生认为乙肝携带者能正常学习和就业。中小学生乙肝相关知识得分情况单因素分析和多元线性回归分析结果显示年龄和户籍是影响中小学生乙肝相关知识得分的重要因素。 结论 2016年张家港市中小学生乙肝相关知识知晓率偏低,学校应加强乙肝相关知识的健康教育,保证中小学生能够获得专业的、正确的防治知识。

Objective To investigate and analyze two cases of brucellosis infection in hospital cleaners in Nanchang City during 2016-2017, and to explore whether brucellosis could be transmitted to hospital staff by nosocomial Brucella pollutants. Methods We analyzed the correlation between hospital staff with brucellosis infection and Brucella pollutants based on field epidemiological investigation and laboratory serological test. Results One case of brucellosis confirmed by laboratory serological test was treated in hospital B in Nanchang City during May 11 and May 28, 2016. One cleaner in hospital B presented with brucellosis-like symptoms on November 14, 2016, and the blood sample was Brucella culture positive. Hospital D in Nanchang City was a hospital specializing in infectious diseases, and its clinical laboratory carried out tests related to brucellosis detection all year around. Brucellosis cases were treated in hospital D separately on July 28 and October 13, 2016. One cleaner in hospital D had brucellosis-suspected symptoms in April, 2016, and the blood sample was Brucella culture positive. Investigation indicated that both sick cleaners in the two hospitals might contact Brucella pollutants and they did not receive professional training on self-protection. Conclusions The possible infection sources in two cases of brucellosis are from nosocomial Brucella pollutants and contaminated environment. Brucella pollutants can cause nosocomial infections; and hence, hospitals should enhance prevention and control of nosocomial infections and intensify propaganda concerning brucellosis prevention and treatment.

目的 调查新医改形势下东莞市社区居民对双向转诊的认知、意愿及态度现状,以及影响双向转诊顺利实施的因素,为提高双向转诊率,合理充分利用医疗资源提供参考。 方法 2016年11月-2017年1月选择东莞市樟木头医院、石新医院、社区卫生服务中心小区服务机构的100名医生和200名就诊居民为调查对象,采用自制《医务人员双向转诊认知、意愿、态度调查问卷》对上述人员一般资料、认知水平、对转诊态度、意见及建议进行调查,了解其对双向转诊相关制度、内容的认知情况,分析影响医生和居民对转诊认知水平的因素。 结果 医生对双向转诊相关知识的认知平均得分(4.29±0.57)分,对双向转诊相关知识认知合格者58人,不合格者42人。不同年龄、职称、教育程度、月均收入、所在科室不同的医务人员对双向转诊相关知识认知差异均有统计学意义(均P＜0.05),而不同性别医务人员对双向转诊相关知识认知情况差异无统计学意义(P＞0.05);居民对双向转诊的认知平均得分(0.58±0.18)分,合格者仅48人,不合格者为152人。年龄、教育程度、月均收入的居民对双向转诊相关知识认知情况差异有统计学意义(均P＜0.05),其中居民月均收入在3 001~5 000元之间双向转诊认知合格率最高,而不同性别医务人员对双向转诊相关知识认知情况差异无统计学意义(P＞0.05)。 结论 东莞市社区医生和居民对双向转诊相关制度及内容的认知水平还有较大的提升空间,医务管理者应根据医生和居民的特点制定有效宣教措施,提升医生和居民对双向转诊的认知水平,充分合理利用医疗资源,使有限的医疗资源合理服务居民,取得社会效益、经济效益的最大化。

Objective To investigate the pulmonary function of workers in cemented carbide production enterprises in Zhuzhou City, to explore the effect of cemented carbide dust on lung function of the workers, and to preliminarily discuss the setting of occupational health check items for in-service workers in cemented carbide production enterprises. Methods Four hundred and twenty-six in-service workers selected from two cemented carbide production enterprises in Zhuzhou City, Hunan Province in 2016 served as the research subjects. All the workers’ general information and history of occupation were collected through a questionnaire survey, and then their lung function was examined. All the workers were divided into the exposure group and the control group according to exposure and non-exposure to dust. The exposure group was subgrouped into the before sintering group and the sintering and after sintering group according to the properties of exposed-dust. We surveyed the current status of lung function of workers in each type of work in the two cemented carbide production enterprises in Zhuzhou City. Results Lung function test Results of the exposure group and the control group were within the normal range. After smoking, age and length of service and other mixed factors were controlled, pulmonary ventilation function indexes, VC/estimated value, FVC/estimated value and FEV₁/expected value in the exposure group were significantly decreased compared with the control group(t=-5.69,P<0.001;t=-6.54,P<0.001;t=-6.24,P<0.001), while FEV₁/FVC values(t=8.068,P<0.001) and MEF_25%/estimated value(t=2.79,P=0.005) were significantly increased. No statistically significant difference was found in MEF_50%/estimated value and MMEF/estimated value between the exposure group and the control group (t=-0.98,P=0.327;t=0.815,P=0.416). Compared with the workers engaging in jobs before sintering, pulmonary small airway function indexes, MEF_25%/predicted value, MEF_50%/expected value and MMEF/predicted value in the workers engaging in sintering and jobs after sintering were significantly increased(t=-2.177, P=0.030; t=-2.038, P=0.042; t=-2.321, P=0.021). Conclusions Tungsten cobalt dust and cemented carbide dust in the carbide production enterprises can lead to changes in the indicators of lung ventilation function. Pulmonary small airway function indicators may be sensitive indexes of early lung injury induced by cemented carbide, and pulmonary small airway function should serve as the necessary inspection items in the occupational health examination during the service.

Objective To explore the effect of fine particulate matter exposure on reducing the detection rate of EF slope of mitral valve. Methods Workers with health examination in Kailuan Group were selected during the same period. Workers with first-stage pneumoconiosis served as the exposure group, while workers without dust exposure history were considered as the control group. SPSS 17.0 software was used to statistically analyze the cardiac ultrasound Results of the two groups. Results Mitral valve EF slope rate was significantly lower in the exposure group than in the control group ((73.20±20.53) mm/s vs. (78.74±24.11)mm/s, t=14.521, P<0.001). The detection rate of mitral valve EF slope reduction was higher in the exposure group than in the control group (52.4% vs. 40.5%, χ²=22.874, P<0.001). Exposure to fine particulate matters was second only to age and systolic pressure in terms of the risk factors affecting the decrease of mitral valve EF slope, and the OR value was 1.744 (95%CI:1.395-2.180) after the factors such as body mass index (BMI ) were excluded. Conclusion Fine particulate matter exposure is an independent risk factor for the decrease of mitral valve EF slope.

Objective To conduct a benefit evaluation on the Results of bilateral capacity building activities in China-Vietnam, China-Laos and China-Myanmar border areas based on the Project of Joint HIV/AIDS Prevention and Control in China-Vietnam-Laos-Myanmar Border Areas launched by the National Health and Family Planning Commission of the People’s Republic of China, and to provide a basis for the sustainable development planning of this project and references for the promotion of cross-border cooperation on HIV/AIDS prevention and control in the border areas. Methods On the basis of the Project of Joint HIV/AIDS Prevention and Control in China-Vietnam-Laos-Myanmar Border Areas launched by the National Health and Family Planning Commission of the People’s Republic of China, a questionnaire survey was conducted among the administrators and participators in the bilateral projects in China, Vietnam, Laos and Myanmar from May to October in 2016, and then we conducted a comprehensive assessment on the acceptability of capacity building provided by the project, individual benefits from these capacity building activities and the effects of these activities on the cross-border cooperation for bilateral HIV/AIDS prevention and control. Results The acceptability of capacity building activities provided by the project in the China-Vietnam-Laos-Myanmar border areas was relatively good, and 66.4-89.6% participants gave a score of 4-5 on these trainings in satisfaction evaluation. Among all capacity building activities, the academic seminar/training course, sharing of epidemic and work experience in HIV/AIDS prevention, training about field operation skills and field investigation and communication were the most recognized approaches to capacity building in the bilateral cooperation for HIV/AIDS prevention and control. The capacity building demands in China-Vietnam-Laos-Myanmar border areas were different, but all of them called for the fund and equipment support for HIV/AIDS prevention and control. 76.9%-92.3% participants considered that although the effects of training on promotion of HIV/AIDS prevention and control were limited, the positive impacts could not be ignored, especially in the aspects of knowledge expansion, clearer working goals and improved service efficiency. Conclusions Multi-channel and multi-form bilateral capacity building activities on HIV/AIDS prevention and control have positive impacts on improving the bilateral mutual trust and enhancing the bilateral ability of joint HIV/AIDS prevention and control. However, with a view to meeting the long-term demands of cross-border cooperation on HIV/AIDS prevention and control, more effective input of bilateral resources should be motivated, more effective approaches to capacity building should be developed, and the sustainable development planning should be conducted in various aspects such as policies, funds, technologies and human resources.

Objective To preliminarily draft a scale for evaluating professional psychological quality in nursing students of vocational colleges, and to evaluate its reliability and validity. Methods A professional psychological quality scale for nursing students was preliminarily designed according to literature analysis, expert interview and semi-structural questionnaire investigation. 83 preliminary testing samples were selected for item analysis, while 441 formal testing samples were chosen for validity and reliability analysis, and 76 of them were retested after 4 weeks. Results Six factors and 26 items were identified based on factor analysis, and the cumulative contribution of variance was 47.8%. The Cronbach’s α coefficient, split-half reliability, test -retest reliability and criterion validity were 0.79, 0.82, 0.77 and 0.74 respectively. Conclusions The questionnaire is proved to be reliable and valid. It can be used to assess the level of professional psychological quality of nursing students in vocational colleges.

目的 探讨血清腺苷脱氨酶(adenosine deaminase,ADA)检测联合结核感染T细胞斑点试验(tuberculosis infection T cell spot detection kit,T-SPOT.TB)对肺结核的诊断价值。 方法 选取2014年2月1日-2017年2月28日平顶山市第三人民医院收治的肺结核患者300例,分为肺结核组(n=191)和非肺结核组(n=109),随机选取100名健康体检者作为对照组,检测各组受试者T-SPOT.TB斑点数和血清ADA水平,比较各组T-SPOT.TB的阳性率和ADA水平及其对肺结核诊断的灵敏性与特异性。 结果 肺结核组患者血清ADA水平高于非肺结核组和对照组(P＜0.05)。肺结核组患者T-SPOT.TB阳性例数多于非肺结核组和对照组(P＜0.05),肺结核组患者血清ADA阳性率为48.69%;T-SPOT.TB阳性率为87.43%;肺结核组2种检测方法阳性率明显高于非肺结核组和健康对照组(P＜0.017)。利用ROC曲线评价ADA对肺结核的诊断价值发现,以血清ADA水平和T-SPOT.TB联合诊断肺结核,敏感度为84.4%,特异度为75.3%。 结论 联合检测T-SPOT.TB斑点数及血清ADA水平,能够显著提高对肺结核的临床诊断。

目的 了解北京市朝阳区成人烟草的使用情况及影响因素,并揭示公共场所烟草暴露状况以及尝试戒烟的情况。 方法 采用分层多阶段抽样方法,于2016年6-9月抽取9个街道(乡镇)15岁及以上常住人口1 677人开展调查。采用χ²检验进行单因素分析,logistic回归方法进行多因素分析。 结果 朝阳区居民现在吸烟率为19.4%;男性吸烟率(38.1%)远远高于女性(1.6%)(χ²=356.974, P＜0.001);吸烟年龄大都集中在25~＜65岁之间;文化程度与吸烟的关系呈现初中、高中文化水平的人吸烟率高,分别为22.6%和24.6%;职业以从事企业、商业、服务业人员以及务农者的吸烟率高,为25.0%;公共场所中室内餐厅、工作区域以及室外排队烟草暴露率最高,分别为34.7%、22.5%和47.0%,公共交通工具内区域最低为2.7%,总的差异有统计学意义(χ²=853.862, P＜0.001);有戒烟意愿者占现在吸烟人数的31.4%;戒烟率为27.0%。多因素logistic回归分析显示,15~＜25、25~＜35、35~＜45、45~＜55、55~＜65、65~＜75岁年龄组人群吸烟的可能性分别是75~岁年龄组的5.999、3.514、4.071、4.189、5.749、3.675倍,OR95%CI分别为1.759~20.455、1.236~9.986、1.445~11.469、1.504~11.667、2.138~15.459、1.341~10.077;小学及以下、初中未毕业/初中、高中/中专/高职文化程度人群吸烟的可能性分别是本科/专科文化程度人群的2.811、2.122、1.978倍,OR95%CI分别为1.473~5.363、1.447~3.113、1.400~2.796;职业是政府事业单位工作人员、企业、商业、服务业、务农人员、教师及医务人员吸烟的可能性分别是学生的7.767、9.019、6.470倍,OR95%CI分别为1.554~38.821、1.877~43.334、1.176~35.580。 结论 北京市朝阳区成人吸烟现况仍为严峻,大部分居民没有戒烟意愿,应根据吸烟影响因素进行针对性的干预,探寻综合有效的控烟措施,以达到长远且有效的控制效果。

目的 调查老年脑卒中急性期焦虑患病率,探索其影响因素。 方法 对2016年10月-2017年6月就诊于清河县中心医院的老年脑卒中患者986例进行基本情况、焦虑自评量表(SAS)、日常生活活动能力(ADL)量表及社会支持量表(SSAS)调查。采用卡方检验及多因素非条件二分类logistic回归分析其急性期焦虑患病影响因素。 结果 老年脑卒中急性期焦虑患病率为26.27%,老年脑卒中焦虑的危险因素有女性(OR=1.141,P=0.012)、合并其它疾病(OR=1.901,P＜0.001)、生活不能自理(OR=13.152,P=0.017),焦虑的保护因素有家庭人均收入高(OR=0.164,P=0.021)和社会支持量表得分高(OR=0.926,P＜0.001)。 结论 清河县老年脑卒中后恢复期焦虑患病率较高,患病的影响因素有性别、家庭人均收入、合并其他疾病、日常生活活动能力以及社会支持度。

目的 观察分析水泥厂接触水泥粉尘人群呼吸系统损害情况。 方法 2015年1月-2017年1月来浙江省宁波市奉化区中医医院进行健康体检的水泥厂工人240例,根据工作环境不同分为熟料组(长期接触熟料)、生料组(长期接触生料)和对照组(不接触粉尘)各80例。比较三组呼吸系统症状阳性率、肺功能指标及胸片异常情况。 结果 熟料组和生料组咳嗽、咳痰、胸闷、胸痛和气短的比例均高于对照组(P＜0.05),熟料组和生料组间比较差异均无统计学意义(P＞0.05)。熟料组和生料组1 s用力呼气容积((forced expiratory volume in one second,FEV₁)、呼气峰流速(peak expiratory flow rate,PEFR)和50%肺活量时呼气流速(expiratory flow rate at 50% of the vital capacity,V₅₀)均低于对照组(P＜0.05)。熟料组和生料组胸片肺纹理改变、胸膜改变及其他改变的比例均高于对照组(P＜0.05),熟料组和生料组间比较差异均无统计学意义(P＞0.05)。 结论 水泥厂作业工人存在呼吸系统损害,熟料组和生料组损害发生率无差异。应注意个人防护,定期进行健康检查。

目的 探讨星状神经节阻滞(stellate ganglion block,SGB)对结核病患者细胞免疫功能的影响。 方法 选取2016 年1月-2017年5月在湖南省胸科医院确诊且需住院治疗结核病患者自愿行SGB 30例为观察组,连续5 d,选择同期住院结核病患者30例作为对照组。观察两组患者SGB前(T₀)、首次SGB第10 d(T₁)、首次SGB第20 d(T₂)外周血CD4^＋T、CD8^＋T比率及CD4^＋/CD8^＋T 比例。 结果 两组患者在T₀、T₁时刻,外周血CD4^＋T比率与CD4^＋/CD8^＋T 比例比较差异无统计学意义(P>0.05);两组患者CD8^＋T比率在T₀、T₂时刻,差异无统计学意义(P>0.05);在T₁时刻,CD8^＋T比率对照组明显升高,差异有统计学意义(t=-5.69,P<0.01);观察组患者外周血T₂ 时刻CD4^＋T比率明显升高,与对照组比较差异有统计学意义(t=7.25,P<0.01),CD4^＋/CD8^＋T比例上升,与对照组比较差异有统计学意义(t=3.64,P<0.01)。 结论 SGB能缓解结核病患者的免疫抑制。

目的 对随州市曾都区中心城区中老年人牙周健康状况进行调查并分析其影响因素。 方法 于2017年1-7月采用多阶段分层随机抽样的方法对随州市曾都区中心城区328例中老年人的牙周健康状况进行调查。采用湖北医药学院附属随州医院自制的问卷调查量表搜集研究对象的基本资料,以及中老年人的牙周健康、牙龈出血、牙周袋、附着丧失以及失牙情况。比较牙周健康与牙周非健康人员的年龄、受教育程度、月收入、吸烟与否、洗牙频率、刷牙频率、饮食习惯等情况。并应用多因素logistic回归分析方法对中老年人牙周健康的影响因素进行分析。 结果 328例研究对象中,牙周健康者95例,牙周非健康人员233例。不同性别中老年人牙周健康、牙龈出血、牙周袋、附着丧失以及失牙人数占比对比差异均无统计学意义(均P＞0.05)。年龄为45～<65岁、受教育程度为高中及以上、月收入≥2 000元、不吸烟以及刷牙频率≥2次/d的中老年人牙周健康人数占比均明显高于年龄为65～74岁、受教育程度为初中及以下、月收入＜2 000元、吸烟以及刷牙频率≤1次/d人群,组间对比差异有统计学意义(均P＜0.05),而中老年人牙周健康人数占比与洗牙频率、饮食习惯无关(P＞0.05)。经多因素logistic回归分析可得,年龄≥65岁(OR=1.321)、初中及以下受教育程度(OR=1.974)、月收入＜2 000元(OR=2.536)、吸烟以(OR=2.187)及刷牙频率≤1次/d(OR=1.321)均为中老年人牙周健康的危险因素(均P＜0.05)。 结论 2017年随州市曾都区中心城区中老年人牙周健康状况不理想,其中影响牙周健康的因素包括年龄、受教育程度为初中及以下、月收入＜2 000元、吸烟以及刷牙频率≤1次/d等。临床工作中应针对上述因素制定针对性干预措施,以改善中老年人的口腔健康状况。

目的 分析邢台市2012-2016年手足口病流行病学特征,为当地手足口病防治策略的制定提供参考依据。 方法 运用描述性流行病学研究方法,对邢台市2012-2016年手足口病疫情资料进行分析。 结果 邢台市2012-2016年共计报告手足口病病例20 128例,年均发病率54.26/10万,病死患儿8例,重症患儿139例,病死率和重症率分别为0.40‰和6.91‰。不同年份的发病率经比较,差异有统计学意义(χ²=236.4,P＜0.001);手足口病有季节性升高趋势,发病高峰多集中在4-5月份或9-10月份;病例以5岁及以下儿童为主,占92.91%,其中男女性别比为1.6:1.0;病原学检测以EV71和其他肠道病毒为主。 结论 邢台市手足口病发病高峰在4-5月份或9-10月份,5岁及以下儿童为主要的易感人群;主要的毒株是EV71和其他肠道病毒。