京津冀平均达标天数比例为43.5%

近日媒体发布了2014年5月份京津冀、长三角、珠三角区域及直辖市、省会城市和计划单列市等74个城市空气质量状况。5月份,74个城市空气质量平均达标天数比例为66.3%,平均超标天数比例为33.7%,其中轻度污染占24.7%,中度污染占7.5%,重度污染占1.4%,严重污染占0.1%。海口、深圳、南宁等8个城市的达标天数比例为100%,重庆、厦门、广州等18个城市的达标天数比例在80%以上,台州、张家口、温州等28个城市达标天数比例范围为50%～80%,南京、邢台、邯郸等20个城市达标天数比例不足50％。     

10种病原菌药敏试验结果分析

[目的]探讨10种常见病原菌(包括副溶血性弧菌、霍乱弧菌、小肠结肠炎耶尔森菌、大肠杆菌0157、变形杆菌、沙门菌、志贺菌、金黄色葡萄球菌、单核细胞增生李斯特菌、溶血性链球菌)对抗菌药物的敏感性,为临床应用抗生素提供科学依据。[方法]按GB/T4789.5.6.8.11.10.30-2003、GB/T4789.7.4-2008、WS/T9-1996、GB15984对十种病原菌进行分离培养,采用纸片扩散法进行药敏试验,参照WS/T125-1999读取结果。[结果]副溶血性弧菌对丁胺卡那霉素、氯霉素等6种抗生素的敏感性为100.00%。大肠杆菌0157对丁胺卡那霉素、头孢唑啉等7种抗生素的敏感性为100.00%。霍乱弧菌感对丁胺卡那霉素、红霉素等4种抗生素的敏感性为100.00%。沙门菌对庆大霉素、氧氟沙星的敏感性为100.00%。小肠结肠炎耶尔森菌对环丙沙星、庆大霉素等6种抗生素的敏感性为100.00%。金黄色葡萄球菌对氯霉素、万古霉素的敏感性为95.00%以上。单核细胞增生李斯特菌对利福平、特利霉素等10种抗生素的敏感性为100.00%。溶血性链球菌对氧氟沙星、利福平等8种抗生素的敏感性为100.00%。志贺菌对丁胺卡那霉素、庆大霉素等3种抗生素的敏感性为100.00%。变形杆菌对羧卞西林的敏感性为100.00%。[结论]10种常见病原菌对某些抗生素仍保持较高的敏感性,可作为感染的首选药物。     

2014年度鹤壁市食品安全快速检测结果分析

目的了解鹤壁市食品安全现状,掌握影响食品安全的主要因素。方法采用分层随机抽样方法抽取全市辖区市售的糕点、熟肉制品及食用油等食品进行随机采样,按照国家食品卫生相关标准进行快速检测。结果糕点的合格率为15.00%,不合格项目为溴酸钾;水发食品的合格率为16.00%,不合格项目为甲醛;米面制品的合格率为27.08%,不合格项目为硼砂(14.17%)和吊白块(40.00%);肉丸的合格率为35.83%,不合格项目为硼砂;木耳的合格率为44.00%,不合格项目为硫酸镁;茶叶的合格率为71.67%,不合格项目为重金属铅;熟肉制品的合格率为80.83%,不合格项目为亚硝酸盐;饮料制品的合格率为82.50%,不合格项目为山梨酸;食用油的合格率为93.75%,不合格项目为酸价(10.45%)和过氧化值(25.36%)。结论鹤壁市市场中流通的糕点、水发食品、米面制品、肉丸和木耳等食品卫生状况不佳,应加强市场监督管理,糕点等卫生状况最差,存在一定的安全隐患,有待进一步强化食品卫生监督管理。     

广州市白云区三元里街社区慢性病现状调查及防治措施探讨

目的通过分析白云区三元里街社区居民高血压和糖尿病等慢性病发病情况、危险因素、健康知识知晓率和社区卫生服务满意度等现状,探讨慢性病综合防治措施。方法采取现场集中和入户调查方式对抽中的家庭所有成员进行询问式调查、体格检查和实验室检查。结果被调查的≥15岁居民慢性病总患病率为56.60%,男女性患病率分别为19.25%和37.36%,60岁及以上年龄组居民慢性病患病率为68.82%,慢性病位居前5位依次是高血压(17.55%)、高血脂(6.79%)、糖尿病(6.60%)、骨质增生(5.66%)和冠心病(2.83%);两周患病率为38.30%,病种位居前5位是高血压、上呼吸道感染、糖尿病、骨质增生和脊柱关节疾病。48.17%的居民主动参加体育锻炼和运动,以退休后的女性老年人为主,15岁及以上人群BMI平均为23.95 kg/m2,超重率为35.16%,肥胖率为11.18%;对自己生活满意度为58.33%。结论白云区三元里街社区人口老龄化问题比较突出,食盐、食油等健康知晓率低,女性重度肥胖率及慢性病总患病率高。社区工作重点是高血压、高血脂、糖尿病、骨质增生和冠心病等慢性病的健康教育促进和及早干预。     

重庆市2016年中小学生肥胖现况及其对常见疾病的影响

掌握重庆市中小学生肥胖基本情况及其对高血压、近视及龋齿等常见疾病的影响,为慢病在学龄期的预防与控制寻找方法.方法 通过2016年重庆市中小学生体质健康监测数据,以体质量指数(BMI)为标准分析学生肥胖情况;通过对比肥胖组与非肥胖组间视力不良、龋齿、高血压等常见疾病检出率的差异,分析肥胖对学生其他常见疾病的影响.结果 2016年重庆市中小学生肥胖率为6.86%,其中男生为8.99%,女生为4.77%;小学生为9.31%,初中生为5.63%,高中生为4.09%,性别、学段间差异均有统计学意义(P值均<0.01).肥胖组轻度视力不良率左眼为19.60%,右眼为20.64%;中度左眼为9.42%,右眼为9.34%;重度左眼为24.97%,右眼为25.10%;乳龋检出率为17.71%,恒龋为3.21%,高血压检出率为8.65%.非肥胖组轻度视力不良率左眼为15.86%,右眼为16.02%;中度左眼为9.21%,右眼为9.30%;重度左眼为31.64%,右眼为32.32%;乳龋检出率为24.55%,恒龋为5.53%,高血压检出率为1.45%.轻度视力不良、重度视力不良、乳牙龋、恒牙龋、高血压检出率在肥胖组与非肥胖组间差异均有统计学意义(P值均<0.01);中度视力不良检出率在肥胖组与非肥胖组间差异无统计学意义(P>0.05).结论 肥胖率越高,轻度视力不良、高血压等的检出率越高,重度视力不良、乳牙龋、恒牙龋的检出率越低,对中度视力不良检出率影响不大.     

陕西省宝鸡市某高校大学生意外伤害情况调查

目的了解陕西省宝鸡市宝鸡文理学院大学生意外伤害情况,为开展干预措施提供依据。方法采用整群随机抽样法,随机抽取4个年级2129名学生进行问卷调查。结果总的意外伤害发生率为22.5%,男生为26.4%,女生为19.9%;一年级为48.1%,二年级为15.0%,三年级为11.9%,四年级为14.7%;理科为15.7%,文科为18.1%,音体美为33.1%,工科为24.4%,上述差异均具有统计学意义。前5位的意外伤害依次是跌倒(11.7%),其次是交通伤(11.3%)、打架(5.3%)、物体砸伤(4.7%)、自我伤害(3.0%),结论意外伤害在性别、年级、专业等方面具有显著关系。加大宣传,建立一体化的预防体系,开设安全教育课等提高学生自我保护意识。     

柳州市某社区居民慢性病危险因素调查分析

目的了解柳州市社区居民慢性病危险因素流行水平,为控制慢性病提供依据。方法随机抽取一个街道办的某社区作为调查点用KISH表确定每户一名年满15周岁以上居民共862人作为调查对象。结果人群吸烟率为22.6%,其中男性吸烟率47.9%,女性吸烟率1.23%,差异有统计学意义。饮酒率为30.04%,饮食口味嗜咸的人占33.4%,居民每天吃肉的人占49.07%、吃腌熏食品的占11.25%、喝牛奶的占28.77%、吃豆制品的人占11.02%、吃蔬菜的人占63.34%、吃水果的人占39.09%。有38.56%的人平时不参加体育锻练,人群总超重率为31.55%,肥胖率为2.43%,腰围超标率26.68%,冠心病等慢性病的患病率为28.65%。结论柳州市居民普遍存在吸烟、饮酒、膳食不平衡、体育锻练不足以及超重、肥胖等慢性病发生的危险因素,提示今后应针对慢性病危险因素开展干预,才能有效预防慢性病的发生。     

新生隐球菌肺部感染的临床特征和4种检测方法性能评价

目的分析新生隐球菌肺部感染的临床特征和微生物学检测方法,探讨其早期诊断方法。方法收集2017年1月至2019年12月真菌培养确诊新生隐球菌肺部感染患者47例、非隐球菌感染患者56例,收集病历资料和临床样本(肺穿刺物、痰液和支气管灌洗液等),样本用革兰染色、墨汁染色和隐球菌荚膜多糖检测试剂盒(LFA)等方法检测。结果 47例新生隐球菌肺部感染患者均是非AIDS/HIV患者,其中8例为隐球菌脑膜炎患者。主要临床表现为咳嗽(59.6%),最常见的影像学表现为肺部结节(85.1%)、合并症为脂肪肝(27.7%);肺穿刺物样本检出率(真菌培养法78.7%、LFA法59.6%、墨汁染色法31.9%、革兰染色法19.1%)高于其他样本的检出率;以真菌培养为金标准,LFA、墨汁染色和革兰染色的敏感性为95.7%、44.7%和31.9%,特异性为98.2%、100.0%和96.4%,阳性预测值为97.8%、100.0%和88.2%,阴性预测值为96.5%、68.3%和62.8%。结论非AIDS/HIV的新生隐球菌肺部感染患者临床症状较轻;肺穿刺样本在4种检测方法中检出率最高;与传统检测方法比较,LFA具有早期、快速、敏感性和特异性较高等优势。     

辽宁省中学生健康危险行为调查

目的了解辽宁省中学生健康危险行为发生情况,为制定相关伤害的控制措施提供依据。方法采用《中国青少年健康相关行为调查问卷》,对省内18所初中3 960名中学生进行问卷调查。结果中学生各类健康危险行为发生率较高的依次为长时间上网（62.0%）、饮酒（50.7%）、运动不足（49.8%）、偏食（40.3%）、郁闷（26.8%）、打架（26.5%）和出走意念（25.9%）等。中学生意外伤害发生率为30.35%,与伤害相关的健康危险行为主要有打架、骑车违章等不良行为和经常感到郁闷、出走意念等不良心理因素。结论中学生健康危险行为发生率高且与意外伤害密切相关。     

消化性溃疡患者幽门螺杆菌感染治疗的临床研究

目的探讨治疗幽门螺杆菌感染对消化性溃疡的影响,以便提高临床治疗消化性溃疡水平。方法回顾性分析2010年1月-2013年1月70例消化性溃疡患者的临床资料,根据胃镜等检查分成两组,每组35例;对照组予以护胃等对症治疗,观察组予以根治幽门螺杆菌治疗,观察两组治疗后的效果。结果治疗后6、12、18、24个月复发率对照组分别为5.7%、11.4%、22.9%、34.3%,观察组分别为0、2.9%、8.6%、14.3%,两组比较差异有统计学意义(P<0.05);对照组的显效率为45.7%、总有效率为82.9%、Hp清除率为65.7%;观察组显效率为71.4%、总有效率为97.1%、Hp清除率为91.4%,两组比较差异有统计学意义(P<0.05);不良反应发生率对照组为8.6%、观察组为14.3%,两组不良反应发生率比较差异无统计学意义。结论根治幽门螺杆菌感染可提高治疗消化性溃疡的效果,减少复发率,且不良反应发生率较低。     

How much would closing schools reduce transmission during an influenza pandemic?

BACKGROUND: When deciding whether to close schools during an influenza pandemic, authorities must weigh the likely benefits against the expected social disruption. Although schools have been closed to slow the spread of influenza, there is limited evidence as to the impact on transmission of disease. METHODS: To assess the benefits of closing schools for various pandemic scenarios, we used a stochastic mathematical model of disease transmission fitted to attack rates from past influenza pandemics. We compared these benefits with those achieved by other interventions targeted at children. RESULTS: Closing schools can reduce transmission among children considerably, but has only a moderate impact on average transmission rates among all individuals (both adults and children) under most scenarios. Much of the benefit of closing schools can be achieved if schools are closed by the time that 2% of children are infected; if the intervention is delayed until 20% of children are infected, there is little benefit. Immunization of all school children provides only a slight improvement over closing schools, indicating that schools are an important venue for transmission between children. Relative attack rates in adults and children provide a good indication of the likely benefit of closing schools, with the greatest impact seen for infections with high attack rates in children. CONCLUSIONS: Closing schools is effective at reducing transmission between children but has only a moderate effect on average transmission rates in the wider population unless children are disproportionately affected.     

Distribution of otitis media among four Indian populations in Arizona.

More than 75 percent of the cases of acute suppurative otitis media (ASOM) among Indian children observed from May 1974 through March 1979 were experienced by preschool children. About 60 percent of the children observed during the first year of life had one or more attacks of ASOM, and 34 percent had two or more. Among those who had ASOM before their first birthday, 75 percent of the attacks occurred between 3 and 9 months of age. About 73 percent of the initial attacks were recorded during the first year of life among children observed from 3 to 5 years; almost 90 percent occurred before the second birthday. Approximately 75 percent of the second attacks occurred within 4 months of the first. More than 70 percent of the initial attacks before age 1 were followed by 1 or more subsequent attacks during the next 12 months. When the initial attack occurred during the second year of life, subsequent attacks were experienced by less than half as many children. Children at high risk of serious ear disease, including hearing loss, are characterized by having an attack of ASOM before their first birthday followed by a second attack within 4 months of the first. Efforts to control and prevent ASOM should selectively be directed toward this group.     

Role of schools in the transmission of measles in rural Senegal: implications for measles control in developing countries

Patterns of measles transmission at school and at home were studied in 1995 in a rural area of Senegal with a high level of vaccination coverage. Among 209 case children with a median age of 8 years, there were no deaths, although the case fatality ratio has previously been 6-7% in this area. Forty percent of the case children had been vaccinated against measles; the proportion of vaccinated children was higher among secondary cases (47%) than among index cases (33%) (prevalence ratio = 1.36, 95% confidence interval (CI) 1.04-1.76). Vaccinated index cases may have been less infectious than unvaccinated index cases, since they produced fewer clinical cases among exposed children (relative risk = 0.55, 95% CI 0.29-1.04). The secondary attack rate was lower in the schools than in the homes (relative risk = 0.31, 95% CI 0.20-0.49). The school outbreaks were protracted, with 4-5 generations of cases being seen in the two larger schools. Vaccine efficacy was found to be 57% (95% CI -23 to 85) in the schools and 74% (95% CI 62-82) in the residential compounds. Measles infection resulted in a mean of 3.8 days of absenteeism per case, though this did not appear to have an impact on the children's grades. Among the index cases, 56% of children were probably infected by neighbors in the community, and 7% were probably infected at health centers, 13% outside the community, and 24% in one of the three schools which had outbreaks during the epidemic. However, most of the school-related cases occurred at the beginning and therefore contributed to the general propagation of the epidemic. To prevent school outbreaks, it may be necessary to require vaccination prior to school entry and to revaccinate children in individual schools upon detection of cases of measles. Multidose measles vaccination schedules will be necessary to control measles in developing countries.     

2005-2009年广东省水痘流行病学分析

目的 分析2005-2009年广东省水痘报告发病资料,为开展预防控制工作提供参考依据.方法 对2005-2009年广东省报告的水痘病例及水痘暴发报告数据,采用描述性流行病学方法进行分析.结果 2005-2009年广东省共报告水痘病例106 894例,死亡1例,5年的病例数分别为10 854、16 287、24 747、...     

2005—2009年广东省水痘流行病学分析

目的分析2005—2009年广东省水痘报告发病资料,为开展预防控制工作提供参考依据。方法对2005—2009年广东省报告的水痘病例及水痘暴发报告数据,采用描述性流行病学方法进行分析。结果 2005—2009年广东省共报告水痘病例106 894例,死亡1例,5年的病例数分别为10 8541、6 287、24 747、27 931和27 075例,发病率在12.15/10万～29.90/10万之间,2005年报告发病率最低,2008年最高。1～5月病例为60 206例（占56.32%）,12月病例为13 306例（占12.45%）;广州、深圳、佛山、中山、韶关等5市病例数占全省总病例数的90.72%;〈15岁病例占报告病例总数的78.37%;5年报告病例中,学生占48.89%,幼托儿童占19.90%,散居儿童占18.88%。5年间共报告水痘暴发疫情279起（其中2005年无报告水痘暴发疫情）,病例7 853例,98.22%的暴发发生在学校（274起）,其中乡小学发生129起,占学校暴发数的47.08%。暴发疫情集中在3—5月和11—12月,分别占总数的49.82%、32.26%,暴发疫情规模最少的为10例,最多的为146例,病例数〈50例的疫情254起,占91.04%。结论广东省水痘发病高峰在冬春季,病例主要集中在珠江三角洲地区,发病人群以〈15岁青少年为主,乡村小学是水痘暴发发生的重要场所,大部分水痘暴发疫情规模〈50例病例。在儿童中开展含水痘疫苗的常规预防接种是控制水痘疫情最有效的手段。     

Cost-benefit of a streptococcal surveillance program among Navajo Indians.

A school-based streptococcal surveillance program has been in effect among Navajo Indians for more than 4 years. Throat cultures of symptomatic children are obtained when indicated, and routine throat cultures are performed monthly. Children whose cultures are positive for group A beta-hemolytic streptococci are treated. During 4 academic years, between 48 percent and 56 percent of elementary school children attended the schools that had 4 or more monthly surveys in each year, but only 24 percent (7 of 29) of the acute rheumatic fever (ARF) cases occurred in children at those schools. Six of seven children attending covered schools were not cultured before their ARF episodes. Five cases occurred in children attending previously covered schools, during years in which participation lapse. Three or four ARF cases per year appeared to have been prevented, but the program''s costs were five times the estimated costs of the prevented cases, even excluding risks of allergic reactions to penicillin. There is little evidence that most asymptomatic carriers are at risk to develop ARF. The authors recommend that streptococcal surveillance efforts be confined largely to culturing throat swabs of children with pharyngitis.     

Control of a measles outbreak in an elementary school. Baltimore County,Md. 1975.

Between April 18 and May 20, 1975, 16 cases of measles occurred in pupils in an elementary school in Baltimore County, Md., and 1 case occurred in a sibling at a junior high school. Measles was serologically confirmed in 16 of these pupils. Attack rates were determined by grade and by vaccine status. The measles attack rate was 2.1 percent for the 377 children who had been given measles vaccine at 1 year of age or later. The rates were 27.8 percent (13 times higher) for those vaccinated at less than 10 months of age and 20.0 percent (10 times higher) for those with no definite history of vaccine. The higher attack rates for children who were vaccinated only before 10 months of age supports the 1972 recommendation of the Public Health Service Advisory Committee on Immunization Practices that children vaccinated before this age need to be revaccinated with live measles virus vaccine to assure full protection. The finding that 2 of 10 children with a history of measles became ill during the outbreak suggests that such histories are not a totally reliable indicator of immunity. Containment of the outbreak was attributed to the high level of immunity in the community and prompt initiation of control measures.     

Acute rheumatic fever and rheumatic heart disease on the Navajo reservation, 1962-77.

The occurrence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) among Navajos was ascertained for the period from 1962 through 1977 by means of hospital discharge diagnoses and patients'' charts. The annualized attack rate for ARF was 12.4 per 100,000 population, with no clear evidence of an overall secular trend. The proportion of recurrences (19.6 percent) and clinical features were similar to those reported elsewhere, but no seasonal variation in attack rates was noted. Between 1962-71 and 1972-77, the age of RHD patients increased, suggesting few newly diagnosed cases and the aging of known patients. A streptococcal disease control program was instituted in many Navajo elementary schools before 1975. In the program, throat cultures were performed routinely for some asymptomatic children and for all symptomatic children. During the subsequent 3 years, ARF rates declined from 13.5 to 8.2 per 100,000 in areas covered by the program, while in the noncovered areas the rates showed little change-9.5 to 10.1 per 100,000.     

A study of children with special needs in mainstream schools and the role of nursing teachers

OBJECTIVE: Principals of elementary schools and classroom teachers of classes for children with special needs were surveyed by questionnaire to identify the features of children with special needs in mainstream schools and the role of nursing teachers. METHODS: Subjects in Y prefecture were asked to consider several items including the following: 1) presence in class of children with special needs; 2) presence of a child with special needs who was a target of a class or a school for children with special needs; 3) presence of education for special needs experience; 4) obstacles that such children face; 5) the relation with a nursing teacher from June to August in 1998. RESULTS: 1. There was no class for children with special needs in 87 among 135 schools. Children with special needs were present in 27 out of 87 schools, and the frequency of children with special needs was about 0.3% in mainsteam classes. 2. The total number of children in classes for special needs was 177 including 142 (79.8%) with intellectual disabilities, 77 (43.3%) with complex disabilities and 61 (34.3%) requiring medical care. 3. Ninety percent of teachers of special needs classes asked a school nurse about health care for special needs and how to cope with matters relating to disabilities. 4. Ninety percent of teachers of special needs classes were concerned about matters such as the method of teaching and coping with matters relating to disabilities. CONCLUSION: The survey found that there are children with special needs in mainstream classes. The situation with the disabilities is an appreciable number of complex, so teachers of special needs classes had many concerns. Those teachers are inclined to be isolated in school. To achieve good educational outcomes for children with special needs it is important to develop a systematic network between school and experts such as medical doctors and educational professionals. Nursing teachers could play an important role in their relation, with medical specialists.     

School-based measles outbreaks: correlation of age at immunization with risk of disease.

During the Spring of 1978, students with a history of previous measles vaccination accounted for over three-forths of 203 cases of measles in a metropolitan county. Seventy cases occurred in two schools where 99% of the students were vaccinated. We analyzed countywide data to determine past patterns of measles vaccination, including outbreak control and vaccination update clinics. We also examined records of children from the two schools to assess the relationship between disease incidence and age at vaccination. When susceptibility was determined by trained health workers rather than by parents, fewer doses of measles vaccine were estimated to be needed. The majority of cases occurred among children 5 to 9 years old. Attack rates were higher for children vaccinated at 12 months of age or younger than for those vaccinated at 13 months of age or older. There were no significant differences in attack rates among children vaccinated at 13 months of age or older. These findings support recommendations for delaying routine measles vaccination until after 12 months of age and suggest that, during outbreaks, all children vaccinated prior to 13 months of age be revaccinated.