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 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.

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.

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。

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。

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.

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.

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。

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。

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.

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.

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。

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。

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.

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。

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 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。

Objective To explore the prevalence and influencing factors of thyroid nodules among residents aged 50 years and above in Jinshan District and to put forward corresponding health intervention measures and prevention and treatment suggestions. Methods Stratified random cluster sampling was used to select 2,362 residents aged 50 years and above inthirteen residential committees or villages of five towns in Jinshan District of Shanghai from January to December in 2013. A questionnaire survey and thyroid ultrasonography screening were conducted, and statistical analysis was performed using SPSS 22.0 software. Results A total of 960 (40.64%) patients with thyroid nodules were detected. The prevalence rate was higher in females than in males (45.45% vs. 32.97%, χ²=36.16, P<0.001); moreover, the prevalence rate of females gradually increased with the increasing age (χ² tendency=4.44,P=0.035). Logistic regression analysis showed that the risk of suffering from thyroid nodules inresidents aged 70 years and above was 1.32 times (OR 95%CI:1.02-1.70) that of residents aged 50-60 years, and of male residents aged 60-70 years and ≥70 years respectively 1.69 times (OR 95%CI:1.11-2.57) and 1.69 times (OR 95%CI:1.06-2.69) those of male residents aged 50-60 years. The risk of male residents who ate kelp and seaweed less than 3 times per week was 1.46 times (OR 95%CI:1.01-2.10) that of male residents who did not eat, and the risk of female residents with drinking was 3.72 times (OR 95%CI:1.19-11.64) that of female residents without drinking. Conclusions Health administrative departments and medical institutions should pay more attention to elderly people, especially residents with advanced age and women, so as to detect more potential patients. It is necessary to strengthen community health publicity and education, advocate healthy life style, avoid excessive intake of iodine food, and restrict alcohol consumption or quit drinking among women.