河南省2010－2018年新报告HIV/AIDS流行特征分析

目的 分析2010-2018年河南省新报告HIV/AIDS流行特征,为艾滋病防控工作提供参考依据。方法 从我国艾滋病防治基本信息系统中下载2010年1月1日至2018年12月31日河南省新报告HIV/AIDS个案信息,应用Excel 2010软件整理数据、SPSS 23.0软件进行统计学分析。结果 2010-2018年,河南省新报告HIV/AIDS 41 223例,新报告HIV/AIDS数从2010年的3 087人逐年增加至2018年的5 910人。新报告HIV/AIDS以性传播为主,性传播构成比从2010年的50.6%(1 564/3 087)升至2018年的98.8%(5 839/5 910),异性性传播从2010年的44.9%(1 387/3 087)先升后降至2018年的65.7%(3 885/5 910),男男性行为传播从2010年的5.7%(177/3 087)升至2018年的33.1% (1 954/5 910)。异性性传播HIV/AIDS中有非婚异性性行为的比例从2010年的69.4%(962/1 387)升至2018年的91.7%(3 562/3 885)(趋势χ²=657.802,P<0.001)。15~24岁青年、≥ 60岁老年新报告HIV/AIDS数逐年增多,青年以男男性行为传播为主(52.7%,2 561/4 856),老年以异性性传播为主(86.4%,5 907/6 833),且老年异性性传播HIV/AIDS中,以男性为主,男性HIV/AIDS数从2010年的122例增加到2018年的738例,历年男性构成比在82.2%~91.0%之间,女性构成比从2010年的9.0%(12/134)增加到2018年的17.8%(160/898)。结论 2010-2018年河南省新报告HIV/AIDS数逐年增多,性传播成为主要传播途径,艾滋病防控重点应以控制非婚异性性行为传播和男男性行为传播为主,并关注青年和 ≥ 60岁老年人群的性传播。     

湖北省HIV/AIDS病例异性性接触传播特征分析

目的了解湖北省艾滋病病毒感染者和艾滋病患者(HIV/AIDS)异性性接触传播的流行特征,为制定艾滋病防制策略提供依据。方法从中国艾滋病综合防治信息系统导出湖北省2016—2017年报告的经异性性接触传播感染的HIV/AIDS病例资料,对不同性别HIV/AIDS病例的异性性接触传播特征进行描述性分析。结果湖北省2016—2017年共报告3 641例经异性性接触传播感染的HIV/AIDS病例(已排除异性性接触史分类不明12例),其中非婚非商业性性行为传播1 766例,占48.50%。男性HIV/AIDS病例2 508例,以商业性和非婚非商业性性行为传播为主,分别为1 344和1 092例,占53.59%和43.54%;女性HIV/AIDS病例1 133例,以非婚非商业性性行为和配偶/固定性伴传播为主,分别为674和333例,占59.49%和29.39%。随年龄增加,非婚非商业性性行为传播比例降低,男性经商业性性行为传播比例升高,女性经配偶/固定性伴传播比例升高;随文化程度降低,非婚非商业性性行为传播比例降低,男性经商业性性行为传播比例升高,女性经配偶/固定性伴传播比例升高(均P0.05)。结论湖北省2016—2017年报告的异性性接触传播感染HIV/AIDS病例以非婚非商业性性行为传播为主;高年龄、低文化程度的男性经商业性性行为传播风险较高,女性经配偶/固定性伴传播风险较高。     

2004-2019年成都市双流区艾滋病传播途径特征分析

目的分析2004-2019年成都市双流区艾滋病传播途径的特征及变化趋势,揭示双流区艾滋病流行形势。方法收集2004-2019年中国疾病预防控制信息系统报告现住址为双流区新发现艾滋病病毒感染者/艾滋病患者(HIV/AIDS)的传染病卡片及附卡信息,统计人口信息、感染途径,采用SPSS 21.0软件进行χ~2检验。结果 2004-2019年成都市双流区HIV/AIDS累计报告2 216例。报告传播方式从初期散发的性传播、注射途径、母婴垂直传播感染,到2008年以后主要经性传播,其中60岁以上年龄组感染人群只有性传播方式,并且此传播方式呈现上升趋势。经性传播占总感染途径98.42%,异性传播占性传播79.60%,非婚异性占异性传播89.35%。结论目前,性传播是双流区HIV/AIDS感染的最主要途径,其中非婚异性传播是造成双流区HIV/AIDS逐年上升的主要因素。     

我国50岁及以上艾滋病病毒感染者/艾滋病患者特征分析

目的 分析中国50岁及以上艾滋病病毒感染者/艾滋病患者(HIV/AIDS)人口学、行为学和时空分布特征。方法 通过全国艾滋病综合防治信息系统收集并分析我国50岁及以上HIV/AIDS人口学、行为学和首次CD₄⁺T淋巴细胞(CD₄)检测信息,并根据CD₄计数水平推算这些病例可能感染时间和感染年龄。结果 2008年以来,我国每年新发现的50岁及以上HIV/AIDS病例数逐年上升,2014年报告50岁及以上病例数是2008年的4.2倍,以异性性传播为主(占88.0%)。其中,83.9%自述有非婚异性性接触史,该比例逐年上升。其中男性病例以非婚异性传播为主(占95.1%),女性病例经非婚异性传播和配偶间传播分别占53.4%和46.6%。根据首次CD₄检测结果推测病例感染与发现时间间隔,估计近3年感染者比例为15.5%,从感染到被发现时间间隔在8年以上者比例为43.6%。新发现的年龄50岁及以上病例中,约有66.5%的病例可能是在50岁及以后感染,从感染到被检测发现的平均时间为(6.8±2.7)年。结论 50岁及以上HIV/AIDS病例数的增加是该年龄段高危行为暴露和既往感染晚期发现共同作用的结果,需以诊断病例为线索进一步开展溯源和专题调查,排查与控制影响该年龄段艾滋病流行的主要因素。     

深圳市HIV/AIDS病例经异性性传播方式分析

目的 了解深圳市HIV/AIDS病例经异性性传播方式的特征,为制定相应的预防控制措施提供依据。 方法 采用SPSS 13.0软件对深圳市2016—2018年新报告的经异性性传播感染的HIV/AIDS病例进行统计分析。 结果 2016—2018年,深圳市新报告经异性性传播感染的HIV/AIDS病例共2 935例,平均年龄(38.1±12.7)岁,男性病例占79.5%,未婚占46.7%,流动人口占83.7%。异性性传播方式中非商业非婚性传播占61.8%,商业性传播占30.7%。不同性别、年龄组、婚姻状况和文化程度的HIV/AIDS病例经异性性传播感染HIV的方式差异有统计学意义。 结论 深圳市异性性传播方式以非商业非婚性传播为主。今后应重点关注非商业非婚性传播,扩大艾滋病宣传教育范围,并对不同特征的高危人群采取有针对性的干预措施,控制HIV经异性性传播。     

青岛市2010-2014年新报告艾滋病病毒感染者/艾滋病患者病例特征分析

目的 分析青岛市2010-2014年历年新报告艾滋病病毒感染者/艾滋病患者(HIV/AIDS)病例流行病学特征,为青岛市有针对性开展艾滋病防控工作提供科学依据。方法 通过"艾滋病综合防治信息系统"收集青岛市2010-2014年HIV/AIDS报告病例及哨点监测资料,利用SPSS软件进行统计学分析。结果 2010-2014年,青岛市新报告HIV/AIDS病例数呈逐年增长趋势;男女性别比为10.8:1,20~39岁年龄组病例占77.1%;65.6%为未婚者;高中及以上文化程度者占67.6%;同性性传播为主要传播途径;MSM感染率呈逐年上升趋势(P<0.05)。结论 MSM人群为青岛市艾滋病流行的主要高危人群,同时需要加强对女性性乱人群的监测检测,开展有针对性的防控工作,探索适合的防控模式,有效遏制艾滋病在青岛市的传播和流行。     

2008-2014年红河州老年HIV/AIDS流行病学特征分析

目的 分析红河州老年人艾滋病流行病学特征,为制定老年人艾滋病防治措施提供科学依据。 方法 收集红河州2008-2014年≥50岁老年HIV/AIDS病例资料, 分析三间分布特点、传播途径构成、发现途径及相关信息。 结果 2008-2014年报告≥50岁老年HIV/AIDS病例3 138例（AIDS 1 623例,HIV 1 515例）,该年龄组在历年新检出报告病例中的构成比从9.8%上升至28.4%,平均为25.5%。男女比为2.6∶1,在婚的占69.7%,平均年龄（61.7±8.6）岁,小学及以下文化程度占72.0%,农民占55.6%。97.2%老年HIV/AIDS病例通过异性性途径感染HIV,其感染人数和构成比呈逐年上升趋势（χ2趋势＝512.1,P＜0.001）; 92.2%老年男性和50.1%老年女性HIV/AIDS病例通过非婚异性性行为感染HIV,49.2%老年女性HIV/AIDS病例通过配偶/固定性伴性行为感染HIV。老年男性病例中通过非婚异性性行为感染HIV的人数和构成比呈逐年上升趋势（χ2趋势＝337.8,P＜0.001）。 结论 开展艾滋病防治知识宣教活动,帮助老年人群掌握减少高危行为的技能,提高安全套使用率。进一步扩大监测检测覆盖面及覆盖人群,建议全面推行PITC 服务,在各乡镇卫生院、社区卫生服务中心整合公共卫生服务开展HIV筛查,尽早发现HIV感染者。     

2010—2021年重庆市涪陵区HIV/AIDS异性性传播病例特征分析

目的 分析2010—2021年重庆市涪陵区艾滋病病毒感染者/艾滋病病人（HIV/AIDS）异性性传播病例的构成及分布特征，为涪陵区艾滋病防控工作提供依据。方法 通过中国疾病预防控制信息系统统计2010—2021年新报告现住址为重庆市涪陵区、传播途径为异性传播的HIV/AIDS，采用SPSS 26.0软件对病例人口学特征和感染途径进行分析，检验水准α=0.05。结果 2010—2021年经异性性传播的HIV/AIDS为506例，男性以非婚非商业性传播为主（51.38%），女性以非婚非商业性传播和配偶/固定性伴间传播居多，分别占48.07%和45.86%；各年龄组均以非婚非商业性传播为主，0～24岁年龄组占91.18%,25～49岁年龄组占52.24%，≥50岁年龄组占41.85%；已婚有配偶、离异或丧偶和未婚均以非婚非商业性传播为主，分别占44.95%、54.26%和65.00%；文盲、小学、初中、高中或中专学历、大专及以上学历均以非婚非商业性传播为主，分别占40.74%、50.91%、43.75%、60.00%和69.57%；地区分布中均以非婚非商业性传播为主，重庆市涪陵区户籍占50....     

中国2008 - 2011年流动人群艾滋病疫情分析

目的分析近年来中国流动人群艾滋病疫情及相关特征。方法收集2008-2011年艾滋病病例报告中流动病例数据信息。利用2012年1月1日下载的艾滋病网络直报信息系统中截至2011年12月报告的艾滋病病毒感染者戊滋病患者(HIV/AIDS)定时数据库,采用SPSS15.0和Excel 2007软件进行分析。结果2008-2011年中国报告流动HIV/AIDS呈上升趋势,报告例数占当年报告总例数的比例亦有上升,即从2008年的10.2%增加至2011年的18.2%。其中以性传播为主要途径,同性性传播所占比例有所上升。流动人群HN/AIDS的流动方向是从疫情较高的中西部流向东部地区。结论2008 -2011年中国流动人群HIV/AIDS报告例数有所上升,其中部分人群有商业性行为等危险行为,需采取有效干预措施减少该人群的新发感染。     

河南省部分地区新报告经异性性传播HIV/AIDS病例确诊前后高危性行为变化及影响因素分析

目的 为了解河南省部分地区新近发现并报告的经异性性传播感染的HIV感染者/艾滋病患者(HIV/AIDS)在确诊前后的高危性行为变化情况,评估其二代传播HIV风险。方法 2015年1－5月使用自制的调查问卷,对随访到的经异性性传播的HIV/AIDS病例进行面对面的问卷调查。结果 361名调查对象中,有商业异性性行为和临时性伴性行为的比例分别由确诊前的77.3%(279/361)和28.5%(103/361)下降至确诊后的13.6%(49/361)和2.5%(9/361),差异均具有统计学意义(χ²=16.66,P<0.001; χ²=4.80,P=0.03);确诊感染前后,调查对象商业异性性行为发生地较多的省份均是河南、广东和浙江,寻找商业性伴的途径均以场所内等待为主;确诊感染后,与商业性伴、固定性伴和临时性伴使用安全套的比例分别是51.0%(25/49)、88.5%(184/208)和88.9%(8/9);多因素非条件logistic回归分析显示,商业异性性行为史、既往接受过HIV检测、35岁以上人群是发生二代传播高危性行为的危险因素。结论 非婚异性性传播成为艾滋病防制的重点和难点,强化HIV检测结果告知及干预技巧,加强对既往商业异性接触人群和35岁以上人群的行为干预和安全套使用等综合措施。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.