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1.
目的 分析2013-2015年河南省监测哨点5岁以下腹泻儿童轮状病毒(HRV)、人感染杯状病毒(HuCV)、人感染星状病毒(HAtV)及肠道腺病毒(EAdV)的感染状况。方法 采集4个哨点医院腹泻儿童住院病例粪便样本880份,ELISA法检测A组HRV并进行G/P基因分型;二步法多重RT-PCR检测B/C组HRV、HuCV和HAtV,单重PCR检测EAdV;对阳性病例进行流行病学统计分析。结果 共检出阳性样本594份(含混合感染样本24份):HRV 370份,阳性率42.0%,男性感染率高于女性,农村高于城市,小年龄组高于大年龄组;HuCV 162份,阳性率18.4%;HAtV 69份,阳性率7.8%;EAdV 17份,阳性率1.9%,3种病毒的城市总阳性率高于农村。A组HRV存在以G9P[8]为主的多种型别,秋季和春季有两个显著高峰;HuCV以诺如Ⅱ型为主,存在春季感染高峰。阳性病例以0~12月龄(HRV)和3~5岁(HuCV)为主;临床存在不同程度的发热、腹泻、呕吐等症状,性别及地区分布存在病原学差异。结论 河南省监测哨点5岁以下患儿中存在较高的腹泻病毒感染率,不同感染类别呈现不同的流行病学及临床特点。  相似文献   

2.
摘要:目的 分析2011-2014年河南地区5岁以下婴幼儿病毒性腹泻感染状况、季节流行特征及轮状病毒(HRV)血清型基因分型。方法 收集2011年12月-2014年12月单中心郑州市儿童医院住院腹泻患儿粪便共506份。由中国疾病预防控制中心检测轮状病毒(HRV),人星状病毒(HAstV)、人杯状病毒(HuCV)、肠道腺病毒(EAdV)及轮状病毒阳性标本血清型基因分型检测。结果 检测的506份标本中HRV(224)44.26%、HAstV(83)16.40%、HuCV(诺如病毒II型为主)(58)11.46%、EAdV(32)6.32%、未定型(109)21.54%,HRV是导致河南地区婴幼儿病毒性腹泻的主要病原;每年秋冬季节患儿病毒阳性率检出明显升高;病毒性腹泻各组间所占比例在男女性别上无显著差异;腹泻患儿发病的高峰年龄为6~24月龄,占51.54%(183/355);224份RV检测阳性标本G血清型和P基因型分布特征,G血清型流行优势毒株为G3型90份(40.17%),未发现G8型。P基因型分型结果显示,最常见的毒株是P8型99份(44.19%)。基因型组合:以G3P[8]为主;506份检测标本中混合感染共24份(4.74%),以轮状病毒混合其他病毒感染为主,占50%(12/24),轮状病毒和人星状病毒混合感染最多,占29.16%(7/24);其次,轮状病毒和人杯状病毒混合感染占20.83%(5/24)。混合感染的患儿中<2岁的占83.33%(20/24)。结论 河南地区5岁以下儿童病毒性腹泻的病原分型复杂,以轮状病毒检出率高,发病高峰在每年秋冬季节,以6~24月龄婴幼儿为主,HRV主要亚型G3[P8],同时存在不同病原混合感染的现象,具有明显的季节差异和人群分布。  相似文献   

3.
目的 分析河北省哨点监测<5岁儿童病毒性腹泻病原学特征,为儿童病毒性腹泻科学防控提供参考依据。方法 收集2010-2020年河北省卢龙县哨点监测医院<5岁腹泻住院病例粪便标本。采用ELISA法检测轮状病毒抗原,轮状病毒分型采用半巢式两轮RT-PCR方法。杯状病毒检测及分型、星状病毒和肠道腺病毒检测均采用实时荧光定量PCR方法。采用SPSS 20.0软件对数据进行统计学分析。结果 共检测2 925例粪便标本,病原总体阳性率为65.61%(1 919/2 925)。轮状病毒、杯状病毒、肠道腺病毒和星状病毒阳性率分别为42.80%(1 252/2 925)、22.12%(647/2 925)、6.19%(181/2 925)、3.56%(104/2 925)。2010-2017年病毒性腹泻主要以轮状病毒感染为主(59.30%,1 017/1 715),2018-2020年以杯状病毒感染为主(53.43%,109/204)。轮状病毒阳性率峰值出现在冬季,以12~17月龄婴幼儿最高(52.96%,483/912)。轮状病毒阳性标本,G/P分型以G9P[8]型为主(58.31%,730/1 252),其次为G3P[8]型(8.15%,102/1 252)。杯状病毒以诺如病毒Ⅱ组为主,2011-2016年和2018年优势基因型分别为GⅡ.4[P31]型和GⅡ.3[P12]型。结论 轮状病毒和杯状病毒是2010-2020年河北省卢龙县<5岁儿童病毒性腹泻的优势病原体,冬季为主要流行季节。  相似文献   

4.
目的 分析2013-2017年广东省115起由GⅡ.2、GⅡ.17和GⅡ.4/Sydney 3种基因型引起的诺如病毒感染暴发的流行特征,为诺如病毒感染疫情的防控提供科学依据。方法 通过“突发公共卫生事件报告管理信息系统”收集2013年1月1日至2017年11月30日广东省报告的诺如病毒感染暴发疫情,采用RT-PCR方法对每起疫情的病例标本进行诺如病毒核酸检测,经基因测序后确定病毒基因型,对GⅡ.2、GⅡ.17和GⅡ.4/Sydney 3种基因型暴发疫情特点进行分析,采用直接标准化法计算病例呕吐和腹泻的比例。结果 广东省2013年1月1日至2017年11月30日共报告诺如病毒感染暴发疫情167起,GⅡ.2、GⅡ.17和GⅡ.4/Sydney 3种基因型引起115起。暴发场所中,GⅡ.2型为小学占39.68%(25/63)、托幼机构占28.57%(18/63)、中学占25.40%(16/63)、大学占6.35%(4/63);GⅡ.17型为中学占41.03%(16/39)、其他社会单位占20.51%(8/39)、小学占15.38%(6/39)、大学占12.82%(5/39)、社区和托幼机构各占5.13%(2/39);GⅡ.4/Sydney型为大学占53.85%(7/13)、托幼机构和其他社会单位各占15.38%(2/13)、小学和中学各占7.69%(1/13)。传播途径中,GⅡ.2型为接触传播占77.78%(49/63)、食源性传播占17.46%(11/63);GⅡ.17型为食源性传播占53.85%(21/39)、接触传播占15.38%(6/39)、水源性传播占12.82%(5/39);GⅡ.4/Sydney型为食源性传播占53.85%(7/13)、接触传播占38.46%(5/13)。临床表现中,GⅡ.2型的标准化呕吐比例为73.76%、腹泻比例为42.85%;GⅡ.17型的标准化呕吐比例为76.37%、腹泻比例为51.40%;GⅡ.4/Sydney型的标准化呕吐比例为54.10%、腹泻比例为55.95%。结论 GⅡ.2型主要涉及小学、托幼机构和中学,以接触传播为主;GⅡ.17型主要涉及中学和其他社会单位,以食源性传播为主;GⅡ.4/Sydney型主要涉及大学,食源性传播比例最高,接触传播也有较高比例。  相似文献   

5.
目的 了解北京市肠道门诊散发腹泻病例中札如病毒的基因型别及特征。方法 收集2019年北京市肠道门诊散发腹泻病例的粪便样本,应用实时荧光RT-PCR对样本进行札如病毒核酸检测,对阳性样本应用不同种RT-PCR方法进行札如病毒衣壳蛋白VP1区和聚合酶RdRp区部分基因片段扩增,对扩增阳性产物进行测序,应用BioEdit 7.0.9.0软件对序列进行比对,应用Mega 6.06软件构建进化树进行分析。结果 札如病毒总检出率为2.89%(44/1 522),<5岁病例的检出率为3.34%(18/539),≥5岁病例的检出率为2.64%(26/983)。衣壳蛋白VP1区基因测序成功23株,包括8个基因型(GⅠ.2型6株、GⅠ.1型和GⅡ.3型各5株,GⅠ.3型和GⅡ.5型各2株,GⅠ.5型、GⅡ.1型和GⅣ.1型各1株);≥5岁病例占16株,GⅠ.2型构成比最高(37.50%,6/16),<5岁病例占7株,GⅠ.1型和GⅡ.3型构成比最高(均为42.86%,3/7);每个基因型内部相似性为95.5%~100.0%,与不同年份、不同国家的人源或污水源的51株参考株相似性为92.2%~100.0%。聚合酶RdRp区测序成功25株8个基因型(9株GⅡ.P3型,4株GⅠ.P3型,GⅠ.P1型、GⅠ.P2型和GⅡ.P1型各为3株,GⅠ.P5型、GⅡ.P5型和GⅣ.P1型各为1株);≥5岁病例占15株,GⅡ.P3型构成比最高(40.00%,6/15),<5岁病例占10株,GⅠ.P1型、GⅡ.P1型和GⅡ.P3型构成比最高(均为30.00%,3/10);每个基因型内部相似性为94.0%~100.0%,与不同年份、不同国家的人源或污水源的39株参考株相似性为90.2%~99.1%。结论 札如病毒是北京市散发腹泻病例的病原之一,主要基因组为GⅠ和GⅡ,基因型多样且分散;≥5岁和<5岁人群腹泻病例主要基因型不同。  相似文献   

6.
目的 了解我国门诊腹泻患者中诺如病毒的流行特征。方法 在国内27个省(市、自治区)173家医院的门/急诊中开展腹泻监测,收集腹泻病例临床和流行病学资料,同时采集病例粪便标本,送58家网络实验室采用RT-PCR检测诺如病毒,并分析2009-2013年不同地区、人群以及时间的诺如病毒检出率。结果 在34 031名腹泻监测病例中,有11.6%的病例检出诺如病毒。其中6~23月龄儿童和>45岁人群的检出率最高,分别为13.7%和12.4%。一年中以秋、冬季检出率较高;中温带和暖温带地区,诺如病毒在冬季检出率最高,分别为10.7%和11.6%;而亚热带地区,以秋季检出率最高(14.3%)。诺如病毒检出的主要型别为GⅡ组(89.9%)。结论 诺如病毒对我国各年龄组人群均有不同程度的影响,尤其在儿童和中老年门诊腹泻病例中较为常见,并呈现明显的季节性流行特征,且不同气候带地区的流行高峰存在差异。  相似文献   

7.
目的 了解我国不同城乡类型地区细菌性腹泻病原谱流行特征。方法 基于2010-2014年我国17省份腹泻症候群感染性腹泻病原学监测。收集门/急诊因急性腹泻就诊病例,采集粪便标本,并进行包括基本人口学信息、临床症状特征等个案调查。对粪便标本进行17种常见致泻细菌病原体的病原学检测。按就诊医院类别将病例分为传统农村、中小城镇/城乡过渡带、大型城市3种类型,比较其病原体阳性率及病原谱构成差异。应用非条件logistic回归分析,比较3种类型病例感染的风险。结果 共纳入传统农村病例5 138例、中小城镇/城乡过渡带病例13 683例、大型城市病例9 253例,3种类型地区病例病原体阳性率城乡差异最大的为福氏志贺菌(阳性率依次为5.81%、2.78%、0.46%)和嗜水气单胞菌(阳性率依次为2.14%、0.96%、0.48%)。中小城镇/城乡过渡带、传统农村相对于大型城市病例感染各种细菌风险差异最大的为福氏志贺菌[OR值及其95% CI分别为6.481(4.666~9.002)、11.304(8.018~15.938)]和嗜水气单胞菌[OR值及其95% CI分别为1.992(1.401~2.832)、4.083(2.833~5.884)]。细菌病原谱中致泻性大肠埃希菌、沙门菌的构成比随城市化程度的提高而增加,志贺菌、嗜水气单胞菌则随城市化程度的提高而降低。志贺菌属血清群构成中大型城市以宋内志贺菌为主(60.00%),传统农村以福氏志贺菌为主(77.37%)。结论 我国不同城镇化水平地区细菌性腹泻病原谱流行特征存在明显差异,其中以福氏志贺菌和嗜水气单胞菌的差异最为显著。  相似文献   

8.
我国2014-2015年其他感染性腹泻监测现状分析   总被引:12,自引:3,他引:9       下载免费PDF全文
目的 分析2014-2015年全国其他感染性腹泻(除霍乱、痢疾、伤寒/副伤寒)监测现状,为制订防控策略、改进监测工作提供依据。方法 收集2014-2015年中国疾病控制信息系统的其他感染性腹泻报告病例和突发公共卫生事件资料,对其流行病学及病原学信息进行描述性流行病学分析。结果 2014年和2015年分别报告病例867 545例、937 616例,发病率分别为64.0/10万、68.8/10万。全国各省均有病例报告,发病率范围为3.8/10万~506.7/10万。各年龄组人群均有发病,< 5岁儿童占53.7%(968 984/1 805 161);每年均有两个发病高峰,分别为6-8月和11月至次年1月。两年间实验室确诊病例分别占当年报告病例的9.5%(82 285/867 545)和9.3%(86 975/937 616),其中,病毒性腹泻分别占92.4%(76 045/82 285)和91.0%(79 176/86 975),细菌性腹泻分别占7.4% (6 062/82 285)和8.8%(7 614/86 975)。死亡病例仅有3例实验室确诊,2例为轮状病毒感染。结论 全国其他感染性腹泻报告病例以< 5岁儿童和散居儿童为主;确诊病例以病毒性腹泻为主,病原谱存在地区差异;全国各省市的病例报告和实验室检测能力不均衡,应进一步提高全国其他感染性腹泻的报告率及病原学诊断率。  相似文献   

9.
不同病原体导致感染性腹泻的症状特征与差异研究   总被引:1,自引:0,他引:1       下载免费PDF全文
目的 了解不同病原体导致感染性腹泻相关症状的特征与区别。方法 基于2010-2016年我国20个省份的腹泻症候群感染性腹泻病原学监测,收集因急性腹泻就诊的门急诊病例,调查病例基本信息、采集粪便标本,进行共22种常见致泻病原体的病原学检测,分析不同病原体导致患者腹泻的临床症状模式特征。结果 共收集腹泻就诊病例38 950例。分别对5种致泻病毒核酸检测,轮状病毒阳性率最高(18.29%),其次为诺如病毒(13.06%);对17种致泻细菌分离培养,致泻性大肠埃希菌分离率最高(6.25%)。细菌性与病毒性腹泻的临床特征差异主要体现在粪便性状与便常规检验结果,但致病性弧菌感染与病毒性腹泻较为相似。结论 不同病原体导致感染性腹泻的症状存在不同的特征,可为临床诊断提供依据。  相似文献   

10.
长沙地区秋冬季婴幼儿病毒性腹泻病原监测分析   总被引:1,自引:0,他引:1  
目的了解本地区秋冬季婴幼儿病毒性腹泻标本中轮状病毒、诺如病毒、星状病毒和肠道腺病毒流行现况,为病毒性腹泻的诊治提供依据。方法收集某医院2009年9月-2010年3月间就诊入院的急性腹泻患儿粪便252份,采用ELISA法检测轮状病毒(Human Rotavirus,HRV)、人杯状病毒(Human Caliciviruses,HuCV)、肠道腺病毒(Enteric Adenovirus,EAdV)和星状病毒(Astrovirus,AstV)四种病毒抗原,并进行统计分析。结果 252例标本总的病毒检出率为73.02%(184/252)。单纯HRV阳性率为53.97%(136/252);单纯NV阳性率为10.32%(26/252),其中合并HRV感染3例;单纯AstV阳性率为4.76%(12/252),其中合并HRV感染2例;单纯EAdV阳性率为3.97%(10/252)。结论轮状病毒仍然是本地区引起婴幼儿秋冬季腹泻的主要病原,人杯状病毒、肠道腺病毒和星状病毒被认为是引起腹泻的常见病原,有病毒混合感染现象。  相似文献   

11.
人力资源管理引论   总被引:44,自引:23,他引:21  
作者就人力资源和人才的概念与内涵以及其差异进行了探讨,同时就人力资源管理与人事管理的历史条件和职能的不同进行了阐述,最后就人事管理的特殊性与向人力资源管理过渡的迫切性作了论述。  相似文献   

12.
急性呼吸道感染(ARTI)是人类最常见的传染性疾病之一,90%以上的ARTI是由病毒引起,目前仍有大约30%的ARTI病原不能确定.近年来,一系列新出现的病原体被发现,如人偏肺病毒、人博卡病毒、人冠状病毒NL-63和HKU1、WU和KI多瘤病毒及Saffold心病毒等.此文就呼吸道感染新发病毒的流行病学研究进展进行综述.  相似文献   

13.
Forster AS  Marlow LA  Wardle J  Stephenson J  Waller J 《Vaccine》2012,30(30):4505-4510

Background and purpose

The United States’ Centers for Disease Control and Prevention recommends that boys aged 11–12 be vaccinated against HPV to reduce the risk of genital warts and HPV-related cancers. No recommendation has been made in England although there have been calls to widen access to the vaccine. This study aimed to assess boys’ willingness to have HPV vaccination, eliciting reasons for their decisions.

Methods

528 boys aged 16–18 years completed a questionnaire in school. Measures included demographic characteristics, HPV awareness, willingness to have the vaccine, and reasons for the vaccine decision. Coding of open responses was informed by social cognition model constructs.

Results

A large proportion of the sample (41%) intended to have the vaccine, however, slightly more were unsure (49%) and a small number (10%) would not get vaccinated. Uncertainty was associated with lack of previous awareness of HPV and perceived lack of adequate information. Boys who would not have the vaccine did not feel at risk or did not see the need for it.

Conclusion

These preliminary data suggest that HPV vaccination may be acceptable to boys, and confirm previous findings that information is vital in the decision-making process.  相似文献   

14.
目的建立表达人Kv1.5通道的细胞模型。方法采用Lipofactamine 2000脂质体将人Kv1.5通道基因转染人胚胎肾细胞(HEK293),通过荧光显微镜和全细胞膜片钳技术观测人Kv1.5通道基因的表达。结果pcDNAHKv1.5真核表达载体转染HEK293细胞2d后,荧光显微镜可观察到人Kv1.5通道表达;3d后全细胞膜片钳技术记录到人Kv1.5通道基因编码的通道电流。结论pcDNAHKv1.5真核表达载体转染HEK293细胞为人Kv1.5通道的研究提供了良好的真核细胞表达系统和细胞模型。  相似文献   

15.
Little is known of men's knowledge of cervical cancer and its links with human papillomavirus (HPV), or of their attitudes and beliefs about HPV vaccination. This is despite men's sexual behaviour contributing to HPV transmission and their potential role in deciding whether their children are vaccinated against HPV. To address this, a comprehensive survey was conducted in Singapore where plans are underway for an HPV vaccination program. A representative sample of 930 Singaporean men was found to have moderate knowledge of cervical cancer but poor knowledge and awareness of HPV. Although these men showed strong support for HPV vaccination, overall findings highlight the importance of including men in education campaigns that aim to decrease the incidence of cervical and other HPV-related cancers and to increase the uptake of HPV vaccination.  相似文献   

16.
三年建设前后卫生监督机构人力规模的比较研究   总被引:2,自引:0,他引:2  
通过全国系统抽样,获取卫生监督机构2001~2006年在岗人员数量及编制情况的基本资料,进行人力数量不同级别和地区间的比较。结果显示,我国卫生监督机构仍以事业单位编制人员为主,但已有部分实施或参照公务员编制管理,主要是在省级机构。卫生监督机构人员数量在机构改革后得到及时补充,达到机构改革前的91.9;2001~2005年人员数量高速增长的年份。  相似文献   

17.
Summary Concentrations of p,p'-DDE, p,p-DDD, and p,p-DDT were determined in 34 samples of human milk obtained 3–5 days after delivery and in 37 samples obtained at later times of lactation (up to 55 weeks). All samples contained p,p-DDE, but only several contained p,p-DDD and p,p-DDT. The concentrations of p,p-DDE were 31 g/l in the beginning of lactation and 53 g/l at later time intervals. The concentration ranges in both groups overlap almost completely and the difference in the mean values is not significant.Serum samples from 35 mothers and cord blood were also analyzed. All samples contained p,p-DDE, the concentrations being 18 g/l and 6.8 g/l in the mothers' and cord blood serum, respectively. Serum samples of 24 nonpregnant women contained the same amount of p,p-DDE (20 pg/1) as mothers' sera.All samples were collected in a continental town of Croatia (Yugoslavia) between 1977 and 1979. The concentrations of DDT residues were determined by gas chromatography, and two methods for extraction from milk were used and compared.This work was supported in part by the Environmental Protection Agency (USA) and the World Health Organization (Geneva)  相似文献   

18.
《Vaccine》2015,33(50):7075-7082
Dengue viruses (DENV) currently infect approximately 400 million people each year causing millions to seek care and overwhelming the health care infrastructure in endemic areas. Vaccines to prevent dengue and therapeutics to treat dengue are not currently available. The efficacy of the most advanced candidate vaccine against symptomatic dengue in general and DENV-2 in particular was much lower than expected, despite the ability of the vaccine to induce neutralizing antibody against all four DENV serotypes. Because seroconversion to the DENV serotypes following vaccination was thought to be indicative of induced protection, these results have made it more difficult to assess which candidate vaccines should or should not be evaluated in large studies in endemic areas. A dengue human infection model (DHIM) could be extremely valuable to down-select candidate vaccines or therapeutics prior to engaging in efficacy trials in endemic areas. Two DHIM have been developed to assess the efficacy of live attenuated tetravalent (LATV) dengue vaccines. The first model, developed by the Laboratory of Infectious Diseases at the U. S. National Institutes of Health, utilizes a modified DENV-2 strain DEN2Δ30. This virus was derived from the DENV-2 Tonga/74 that caused only very mild clinical infection during the outbreak from which it was recovered. DEN2Δ30 induced viremia in 100%, rash in 80%, and neutropenia in 27% of the 30 subjects to whom it was given. The Walter Reed Army Institute of Research (WRAIR) is developing a DHIM the goal of which is to identify DENV that cause symptomatic dengue fever. WRAIR has evaluated seven viruses and has identified two that meet dengue fever criteria. Both of these models may be very useful in the evaluation and down-selection of candidate dengue vaccines and therapeutics.  相似文献   

19.
《Vaccine》2023,41(11):1826-1833
BackgroundThe potential for vaccines to induce autoimmunity has been the subject of considerable investigation and autoimmune induction remains a common focus for vaccine safety research. This study assessed the risk of new onset autoimmune conditions among males receiving the 4-valent human papillomavirus (HPV) vaccine (4vHPV).MethodsWithin a US health insurance claims database, we formed a cohort of male 4vHPV vaccine recipients between 2009 and 2016, along with a propensity score matched cohort of males who did not receive the 4vHPV vaccine. The study outcome was new onset autoimmune conditions (20 separate conditions) within four categories (rheumatologic/hematologic, gastroenterologic, endocrinologic and neurologic/ophthalmalogic). Outcomes identified using diagnosis codes were adjudicated through medical record review. Incidence rates (per 1,000 person-years) were estimated for the vaccinated and unvaccinated groups along with rate ratios (RRs).ResultsThere were 65,606 males receiving at least one dose of 4vHPV vaccine, and 55,670 were matched to a comparator. The matched 4vHPV vaccine cohort provided 35 confirmed cases among 39,735 person-years, for an incidence rate of 0.88 (95% CI: 0.61–1.23), while the comparator cohort provided 47 confirmed cases among 58,215 person-years, an incidence rate of 0.81 (0.59–1.07), a RR of 1.09 (0.70–1.69). The RR within categories was 0.49 (0.10–2.42) for rheumatologic/hematologic, 1.26 (0.58–2.71) for gastroenterologic, 1.11 (0.61–2.02) for endocrinologic and 1.46 (0.21–10.40) for neurologic.ConclusionsThe incidence of autoimmune conditions among males receiving the 4vHPV vaccine was similar to that among unvaccinated males. These results are consistent with other studies that have assessed autoimmunity with the 4vHPV vaccine.  相似文献   

20.
Medeiros R  Ramada D 《Vaccine》2010,29(2):153-160
Knowledge about HPV and cervical cancer (CC) depends on several factors such as gender and education, which brings implications for health strategies and vaccination. A survey was conducted in Portugal with a representative sample of 1706 university students. Only 55.4% (n = 945) had already heard of HPV, although 88.3% (n = 834) from that know that is a risk factor for CC. 89% students (n = 841) wants to be vaccinated against it, but only 13.8% stated as main reason to be vaccinated “prevention of the disease”. Mean scores of knowledge were calculated. Statistical differences were found, regarding “CC knowledge”, in gender (p < 0.001) and between health sciences schools and non-health sciences schools (p < 0.001). Differences regarding the study area in “knowledge and beliefs of HPV” (p < 0.001) and in “relation between HPV and CC” (p < 0.001) were found. Therefore, these differences may help to develop effective strategies that lead to decline CC incidence and mortality.  相似文献   

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