2008—2012年中国流行性出血热流行病学分析

目的分析2008～2012年中国流行性出血热流行病学特征,为部队预防和控制该病提供参考依据。方法收集2008～2012年中国流行性出血热监测资料,采用描述性流行病学方法,对其进行分析。结果2008～2012年中国有29个省（区、市）报告流行性出血热病例,共报告发病52455例,年平均报告发病率0．7854／10万;共报告死亡553例,年平均报告死亡率0．0083／10万。各年龄段均有病例,中年人居多;发病者以农民为主,占67．77％。结论2008—2012年中国流行性出血热发病总体呈上升趋势,发病呈现春季和秋冬季两个高峰;年龄、性别、职业存在差异;有明显的区域性,疫情主要集中在陕西、东北和华东地区。     

驻高原某部一起乙型流感暴发疫情的处置与分析

 目的 分析驻高原某部乙型流感暴发疫情的流行特征,探讨其有效防控措施。方法 采用标准流感现场调查方法对此次疫情进行现场调查,并采集咽拭子标本进行快速抗原检测,描述性统计分析流行病学特征。结果 首例病例发病于2019年3月19日,末例病例发病于2019年4月6日,共发病69例,总发病率13.01％。首发分队发病率最高,为23.01%,显著高于其他分队(P<0.01)。临床症状以急性发热、咳嗽、咽痛为主,并发肺炎23例(33.33%),预后良好,100%治愈,无死亡病例。实验室检测190份咽拭子标本,乙型流感病毒抗原检测阳性14例,阳性率7.36%,检测腺病毒IgM抗体96份,均为阴性。结论 基层部队人群聚居,是流感疫情暴发的高危环境,驻高原部队冬春季节易出现流感暴发流行,必须加强疫情监测,严格落实防控措施。     

营口市2015年流行性出血热疫情分析及2016年预测

目的：分析2015年营口地区流行性出血热的流行病学特征,并对2016年流行性出血热发病趋势进行预测,为制定防控措施提供科学依据。方法采用描述性流行病学分析方法对2015年营口市流行性出血热疫情以及鼠密度和鼠带毒率进行分析。结果营口市2015年流行性出血热发病64例,发病率为2.74／10万,发病高峰为3月份和5月份,均占发病总数的42.31％;春季鼠密度为2.11％,鼠带毒率为5.88％;秋季鼠密度2.02％,鼠带毒率为3.77％。发病率与鼠密度间的相关系数0.989,P值为0.000,提示发病率与鼠密度呈正相关关系。而发病率与鼠带毒率间的相关系数0.047,P值为0.449（＞0.05）,鼠密度与鼠带毒率间的相关系数0.071,P值为0.423（＞0.05）,尚不能认为发病率与鼠带毒、鼠密度与鼠带毒存在线性关系。结论营口地区流行性出血热发病率与鼠密度密切相关,由于近年来鼠密度监测无太大差异,预测2016年流行性出血热发病仍将维持2012－2015年平均水平。     

部队呼吸道腺病毒疫情流行病学调查分析

 目的 分析我国部队呼吸道腺病毒暴发疫情的流行特点、暴发原因及临床表现,为有效控制疾病的发生与蔓延提供依据。方法 从PubMed、万方数据库搜集2009-2017年国内公开报道的部队呼吸道腺病毒暴发疫情文献,对疫情暴发的流行病学特征和临床表现进行统计分析。结果 病原分型:7型、55型暴发病例最多,分别占暴发疫情的47.11%(1782/3783)和30.11%(1139/3783)。7型10起,检测数551例,阳性率为54.02%(551/1020);55型5起,检测数1035例,阳性率为90.10%(437/485);时间分布以2013年最多,共发生7起;发病时间主要集中在每年12月至次年3月;河南地区报告最多,共发生4起;主要以新兵为高发人群,共18起是新兵为主的聚集性暴发疫情。呼吸道腺病毒临床表现主要为发热(50.83%~100.00%)、咽部充血(37.91%~100.00%)、咳嗽(48.17%~95.45%)、咽痛(57.14%~87.00%)、咳痰(15.66~85.23%)等症状。结论 呼吸道腺病毒是引起部队暴发疫情的主要病原体之一,提示应加强疫情监测和防控工作,防止疫情的扩大蔓延。     

一起肾综合征出血热流行的调查

目的 查明7例流行性出血热病人的发病原因、流行因素,以便控制疫情,防止进一步蔓延。方法 采用个案调查、查阅病例、现场卫生流行病学调查。结果 患者驻地属出血热高发区;患者在发病高峰均曾外出活动及食用鼠污染的食品和接触鼠排泄物历史,且无出血热疫苗接种史。结论 落实流行性出血热防制措施;加强鼠情、疫情的监测及上报的准确性和及时性;切实抓好健康教育,强化个人防护意识;提高疫苗的全程免疫接种率。     

对部队传染病疫情漏报原因及对策的思考

<正>据对某师、旅、团各五个医疗卫生单位1993年1～12月间的传染病疫情调查统计发现:传染病发病数为489例,报告病例数288例,漏报201例,漏报率为41.1%;传染病报告卡489张,上报227张, 漏报262张,漏报率为53.7%;暴发疫情3起(甲肝、食物中毒,菌痢)发病53例、上报2起(甲肝、食物中毒)44例,漏报1起,(菌痢)9例,漏报率分别为33.3%和17%.目前,传染病疫情漏报现象在基层部队医疗卫生单位中比较普遍.调查的15个单位中存在疫情漏报有12个单位,占70%.造成疫情漏报的原因很多.     

1996～2005年军队传染病发病的描述性分析

目的 研究1996～2005年全军传染病发病构成变动趋势,为军队制定符合当前形势的传染病预防控制措施提供依据.方法 从军队疫情监测管理信息系统数据库获取1996～2005年全军上报传染病疫情数据,计算构成比,进行描述性分析.结果 全军10年间共上报各类传染病42种78 500余例,其中病毒性肝炎、痢疾、肺结核发病数居前三位,占发病总数的81.49%.1996～2000年全军传染病报告发病数持续下降,2000年后则大体维持在稳定状态,并且呼吸道传染病逐渐超过肠道传染病成为军队最主要的传染病.结论 军队传染病防控工作不容懈怠,尤其是呼吸道传染病应该成为防控工作的重点.     

某部2000～2003年肺结核疫情分析

结核病是我国主要传染病之一,是部队肝炎、感染性腹泻之后排名第三的传染病。近年来全球肺结核发病明显回升。为了掌握部队肺结核病流行状况,有效地指导部队做好肺结核防控,现对某部2 0 0 0～2 0 0 3年的肺结核疫情分析报告如下:1　流行病资料1 1　流行概况　4年共上报肺结核病     

控制军队呼吸道传染病疫情的做法和体会

呼吸道传染病传播迅速、流行性强,短期内疫情容易迅速播散,给传染病防控带来严峻挑战[1]。近60年来,军队传染病的构成发生了明显变化,肠道、虫媒传染病发病率呈下降趋势,而呼吸道传染病所占比例显著上升,目前已达50%以上。特别是2006-2008年,呼吸道传染病疫情呈多发态势,所以部队呼吸道传染病的防控仍是刻不容缓的课题[2]。作为全军传染病专     

驻陕空军部队出血热防治工作面临的形势和任务

出血热防治是我区卫生防疫工作的重点和难点。现就驻陕空军部队出血热防治工作面临的形势和任务探讨如下:(1)出血热防治工作面临的形势:①人员思想麻痹。近年出血热疫情平稳,部队行政领导、卫生部门及官兵不同程度存在麻痹松懈思想。②防治力量薄弱。目前部队防疫人员少,业务素质较低。③防病措施不到位。表现在思想麻痹,经费投入少,驻疫区高危人群的出血热疫苗注射及加强注射落实不够,流行高峰季节人员外出控制不严等。(2)出血热防治工作面临的任务:①强化健康教育,增强官兵防病意识;②培训防治骨干人员,健全防治技术人员队伍;③防治工作要把推广疫苗接种、严格人员管理和实施科学灭鼠等方面作为重点工作突出抓;④驻疫区部队应建立和完善出血热防治预案,明确应急处     

左旋卡尼汀治疗老年流行性出血热心脏损害的疗效观察

目的　观察左旋卡尼汀对老年流行性出血热患者心脏损害的治疗效果。方法　 3 5例患者随机分为观察组 (左旋卡尼汀组 )及对照组 ,观察两组心肌酶谱恢复正常所需天数及心电图恢复正常的比率。结果　观察组心肌酶谱恢复正常所需时间明显短于对照组 (P <0 .0 0 1或 0 .0 5 ) ,7d后心电图恢复正常的例数观察组显著高于对照组 (P <0 .0 5 )。结论　左旋卡尼汀能够增进和保护心脏功能 ,使升高的心肌酶及异常心电图迅速恢复正常。     

一起人炭疽疫情的疫源调查报告

2010年7月新疆某县报告了一起人感染炭疽疫情,通过对此次疫情进行流行病学调查,并采集相关样品进行实验室检测,经综合分析判定此次人炭疽疫情为家畜源性的.随后严格按照农业部颁布的<炭疽疫情防治技术规范>对此次疑似家畜炭疽疫情进行了及时处置,控制了疫情进一步的扩散.     

肿瘤坏死因子致伤无菌大鼠对脑组织β受体及磷脂酶A_2活性的影响

用放射配基结合分析法测定了经腹腔注射重组人肿瘤坏死因子α型(TNFα)致伤的无菌大鼠脑细胞膜肾上腺素能β受体,同时用ELISA法测定了血中TNFα水平,用生化法测定脑细胞组织膜磷脂酶A_2(PLA_2)活性。结果表明,外原性重组人的TNFα在整体状况下能增加脑组织β受体数量,激活膜PLA_2,同时血中TNFα水平亦高于对照组。     

Practical management: community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA): the latest sports epidemic.

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has gained international recognition as a superbug that causes serious infectious outbreaks in high-risk populations such as athletes. Clusters of cases in various athletic teams, particularly contact sports, have been reported since 1993 in the United States and more recently in Canada. CA-MRSA infections are not limited to North America, and all athletes are considered high risk. Skin-to-skin contact appears to be the primary mode of transmission. While typical infections are local skin and soft-tissue abscesses, CA-MRSA infections can spread systemically and lead to significant morbidity and mortality if not promptly identified and treated. The gold standard of treatment for all abscesses is incision and drainage with wound culture for bacterial identification and antibiotic sensitivity testing. A limited number of antibiotics are currently useful in the treatment of CA-MRSA and are reviewed. Geographical variation in patterns of antibiotic resistance further complicates the treatment. Meticulous, consistent use of infection prevention strategies is critical to control outbreaks in the athletic population. Good hygiene, prompt identification of infection, limited exposure to infected persons and contaminated objects, and proper treatment combined with close follow-up of infected athletes will help contain CA-MRSA outbreaks. Future research is needed to explore person-to-person and fomite transmission risks, to define the significance of nasal carriage and skin colonization in relation to CA-MRSA infections, and to further investigate antibiotic resistance patterns. Universal education is needed for all athletes and personnel who provide care in the athletic setting to help control this widespread epidemic.     

新兵入伍训练阶段军事训练伤的流行病学特点

为调查分析步兵按照新的陆军军事训练与考核大纲进行训练过程中军训伤发生的流行病学特点，明确其致伤原因，选取陆军及武装警察部队（仍采用旧大纲）某部参加2002年度入伍训练的3428名新兵，统一进行流行病学调查。结果发现，陆军和武装警察部队军训伤发生率分别为27．21％和33．72％，陆军显著低高于武装警察部队（P＜0．01），两组军训伤发生的时间高峰相近；训练伤以下肢为多；急性创伤性损伤与过劳性损伤的发生与受训部位明显相关。说明采用新的《军事训练与考核大纲》后，新兵入伍训练阶段军训伤的发生率明显下降。     

Immunoendocrine response to cycling following ingestion of caffeine and carbohydrate

PURPOSE: This study investigated the effect of caffeine consumed with and without carbohydrate (CHO) on immunoendocrine responses after exercise. METHODS: On four occasions, 12 recreational male cyclists cycled for 2 h at 65% V O2max. Sixty minutes before exercise, participants ingested 6 mg.kg(-1) body mass of caffeine (CAF) or placebo (PLA), then during exercise they consumed a 6% CHO or placebo (PLA) drink, providing CAF/CHO, PLA/CHO, CAF/PLA, and PLA/PLA conditions. RESULTS: f-MLP-stimulated neutrophil oxidative burst responses were significantly higher after exercise on CAF/CHO and PLA/CHO (both P<0.05) than PLA/PLA when expressed as a percentage of baseline value. The response on CAF/PLA tended to be higher than PLA/PLA at this point (P=0.056). No significant differences between CAF/CHO, PLA/CHO, and CAF/PLA were observed after exercise; however, only PLA/CHO showed no significant postexercise decline. Coingestion of CAF/CHO significantly attenuated epinephrine (P<0.05) and IL-6 (P<0.05) responses that occurred after ingestion of CAF alone (CAF/PLA) and significantly attenuated the transient alterations in circulating leukocyte (P<0.05) and neutrophil (P<0.01) counts. Plasma cortisol concentration was significantly lower on PLA/CHO than CAF/PLA and PLA/PLA after exercise (P<0.05). Perceived exertion during exercise was significantly lower on CAF/CHO than the other three trials (P<0.05). CONCLUSION: Taken together, this suggests that coingestion of caffeine and CHO has greater influence on immunoendocrine responses than neutrophil functional responses to prolonged exercise.     

ω-3鱼油脂肪乳对肝移植术后炎症、免疫及预后影响的前瞻性研究

目的探讨ω-3鱼油脂肪乳对肝移植术后炎症、免疫及预后的影响。方法 2009年1月-2010年12月在解放军81医院肝移植中心行同种异体原位肝移植的患者36例,前瞻性随机分为鱼油组(18例)和对照组(18例)。术后第2天开始予等氮等热量的营养支持,共6d。分别于术前及术后第2、5、8天抽取外周静脉血,检测细胞因子(IL-1β、IL-2、IL-6、IL-10、TNF-α)、C反应蛋白(CRP)、淋巴细胞亚群(CD4+、CD8+、HLA-DR+);观察和记录术后重症监护时间、术后住院时间以及急性排斥反应发生率、感染发生率和死亡率等。结果两组肝移植术后细胞因子水平均高于术前。鱼油组术后IL-1β、IL-2、IL-6、TNF-α水平显著低对照组(P<0.05或P<0.01);术后第5天CRP显著低于对照组(P<0.01),CD4/CD8显著高于对照组(P<0.01);术后第8天IL-10及TNF-α显著高于对照组(P<0.01),HLA-DR+淋巴细胞计数显著低于对照组(P<0.05)。术后感染发生率鱼油组(16.7%)显著低于对照组(55.6%,P=0.035)。两组围术期死亡率和急性排斥反应发生率无显著性差异,但鱼油组术后重症监护时间和术后住院时间(分别为3.9±1.9、28.6±7.2d)显著短于对照组(分别为5.8±3.1、35.7±10.6d,P=0.034,P=0.024)。结论ω-3鱼油脂肪乳可纠正肝移植术后过度的炎症反应,恢复促炎/抗炎因子平衡,调整细胞免疫状态,降低感染发生率,改善预后。     

Infectious disease outbreaks in competitive sports: a review of the literature

Recent outbreaks of infectious diseases in athletes in competitive sports have stimulated considerable interest. The environments in which these athletes compete, practice, receive therapy for injuries, and travel, both domestically and internationally, provide varied opportunities for the transmission of infectious organisms. The purpose of this medical literature review is to identify the agents most commonly reported in the medical literature as responsible for infectious disease outbreaks in specific sports and their modes of transmission and to guide targeted prevention efforts. A literature review of English-language articles in medical publications that reported outbreaks of infectious diseases in competitive athletes was conducted in PubMed MEDLINE from 1966 through May 2005. Outbreaks that were solely food borne were excluded. Fifty-nine reports of infectious disease outbreaks in competitive sports were identified in the published medical literature. Herpes simplex virus infections appear to be common among wrestlers and rugby players, with no single strain responsible for the outbreaks. Methicillin-resistant Staphylococcus aureus was responsible for several recent outbreaks of soft tissue and skin infections among collegiate and professional athletes. The most common mode of transmission in outbreaks was direct, person-to-person (primarily skin-to-skin) contact. Blood-borne exposure was implicated in 2 confirmed outbreaks of hepatitis. Airborne and vector transmissions were rarely reported. This review provides an overview of infectious disease outbreaks thought to be either serious enough or unusual enough to report. Appropriate surveillance of the frequency of infections will allow sports medicine staff to identify outbreaks quickly and take necessary measures to contain further transmission and prevent future outbreaks.