2005—2015年全国肝癌发病趋势分析

目的 通过分析《中国肿瘤登记年报》中肝癌发病的变化趋势,为有效开展肝癌防治工作提供科学参考依据。 方法 整理2005—2015年肝癌发病数据,运用Joinpoint软件进行回归模型分析我国肝癌发病率变化趋势,利用R软件进行负二项回归模型分析肝癌在人群水平上发病的危险因素。 结果 2005—2015年我国肝癌标化发病率基本表现为农村高于城市,男性高于女性。肝癌标化发病率总体呈下降趋势(AAPC=-0.818,P<0.05);城乡男性肝癌年龄别发病率大多在30~岁年龄组呈快速上升趋势,农村和城市女性年龄别发病率分别在45~和50~岁年龄组,随时间增长呈快速上升趋势。城市人群的发病风险是农村人群的1.198倍(95%CI:1.041~1.379,P＜0.05),男性是女性的3.715倍(95%CI:3.228~4.275,P＜0.001),每增加5岁,肝癌的发病风险平均增大8.0%(OR=1.080,95%CI:1.077~1.083,P＜0.001)。 结论 2005—2015年我国肝癌发病情况总体呈下降趋势,但存在城乡、性别及年龄差异,需要制定更加有效完善的预防措施,从而达到预防肝癌的最优效果。     

中国职业卫生与职业病研究的进展

近年来中国职业卫生与职业病研究取得了长足的发展,以职业暴露人群为研究中心,针对职业病的病因、发病机制、人群易感性生物标志物以及风险评估等方面开展了大量的研究,填补了中国甚至世界范围内诸多职业卫生与职业病方面的空缺,具有重要的公共卫生意义。目前中国处于高速发展阶段,大批新兴的、创新的技术正应用于各个领域,推动着中国的产业结构、生产方式和生产技术发生巨大变革,新兴领域的高速发展对职业卫生提出了新的挑战,表现为传统的职业性有害因素带来的职业卫生问题逐渐减少,新的问题不断出现。职业卫生和职业医学也迫切需要将医学科学的新理念、新技术应用于本学科,建立新型健康风险评价体系,进而满足职业人群健康监护和职业病诊断治疗的需求。     

“家校卫融合”模式对深圳市光明区学生伤害结果的影响

  目的  了解“家校卫融合”模式对中小学生伤害发生和结果的影响,为制定中小学生伤害预防与干预政策提供科学依据。  方法  采用分层整群抽样方法,抽取深圳市光明区已采用“家校卫融合”模式运作的3所哨点学校2019学年(2019年9月1日-2020年8月31日)11 439名中小学生,与干预模式实施前的2014学年(2014年9月1日-2015年8月31日)3所学校8 056名中小学生的伤害数据作为对照进行比较,采用SPSS 21.0软件进行统计分析,定性资料采用频率描述,组间比较使用χ2检验,等级资料组间比较使用非参数检验。  结果  2019学年光明区学校报告年平均伤害发生率为19.86%,男生伤害发生率为24.54%,女生伤害发生率为13.89%;小学伤害发生率最高,为35.01%;伤害发生时最主要的状态是活动娱乐/玩耍/休闲,占比60.40%;伤害类型主要表现为跌倒/坠落伤、钝器伤,分别占比57.39%、30.85%;伤害部位以膝部、头部为主,分别占比19.76%、15.76%;挫伤、擦伤是最主要的伤害后果,占比64.13%;与2014学年相比,2019学年学生轻度伤害比例提升,中度和重度比例下降,差异具有统计学意义(Z=-51.88, P < 0.001)。  结论  “家校卫融合”模式促进了家庭、学校、医疗卫生机构的在学校卫生工作各方面的有效协同,提高了中小学生伤害监测的敏感度。     

First molecular detection of Anaplasma species in cattle from Kyrgyzstan; molecular identification of human pathogenic novel genotype Anaplasma capra and Anaplasma phagocytophilum related strain

Anaplasmosis is a rickettsial infection with significant effects on human and animal health, and the discovery of new species or genotypes with zoonotic potential in recent years has increased this importance. The aim of this study was to provide the first assessment of the molecular etiology and prevalence of bovine anaplasmosis in Kyrgyzstan (specifically in the Chuy, Talas, Djalal-Abad, Naryn, and Issyk-Kul regions). The prevalence of bovine anaplasmosis was determined as 1.7% (6/358). PCR and partial DNA sequencing results of the 16S ribosomal RNA (rRNA) gene revealed that Anaplasma centrale, A. phagocytophilum like-1, and the human pathogenic novel genotype A. capra are circulating in cattle herds in Kyrgyzstan. Six DNA nucleotide sequences obtained in this study were deposited in GenBank under the following accession numbers: A. centrale (MW672117, MW672118, MW672119, MW672120), A. phagocytophilum (MW672121), and A. capra (MW672115).     

Ehrlichia,Coxiella and Bartonella infections in rodents from Guizhou Province,Southwest China

Rodents are generally recognized to be the reservoir hosts of a great many zoonotic pathogens. In some areas of China, rodent-borne pathogens, as well as the role of rodents in the natural cycle of these pathogens, are still poorly investigated. To increase our knowledge on the distribution and epidemiology of rodent-borne bacterial pathogens, 81 rodent liver samples were collected in three locations of Guizhou province located in Southwest China, and screened for the presence of Ehrlichia, Coxiella, and Bartonella in them. A putative novel Ehrlichia species was identified in 5 Berylmys bowersi samples (100%, 5/5). Its 16S rRNA, gltA, and groEL genes have highest 99.84%, 89.11%, and 98.02% identities to those from known Ehrlichia species, and form distinct clades in the phylogenetic trees. Herein we name it “Candidatus Ehrlichia zunyiensis”. Bartonella was tested positive in 8 A. agrarius (striped field mouse), 2 A. chevrieri (Chevrier's field mouse), 1 R. norvegicus (Norway rat), 1 N. confucianus, and 1 N. lotipes, with a total positive rate of 16.05% (13/81). Sequence analysis indicated high genetic diversity in these Bartonella strains. Unexpectedly, two Coxiella strains were identified from the rodents (1 Niviventer confucianus and 1 Mus pahari). Genetic and phylogenetic analysis indicated that both of them are closely related to the Coxiella endosymbiont of ticks. This result supported previous conjectures that vertebrate hosts such as rodents may play a role in the preservation and transmission of Coxiella endosymbiont of ticks.     

Rickettsia spp. in Rhipicephalus sanguineus sensu lato ticks collected from stray dogs in Kerman city,Iran

Rickettsial diseases are recognized as one of the most important vector-borne infectious diseases for humans all over the world. Dogs and their ticks are considered the most important reservoirs for Rickettsia spp., especially in spotted fever group rickettsioses. The aim of the study was to investigate Rickettsia infections in ticks collected from stray dogs in southeastern Iran. In this study, 50 stray dogs in Kerman city were randomly selected, of 68% and 52% of which were above 8 months age and male, respectively. Ticks were collected from the dog skins. After identification of collected ticks, genomic DNA of all ticks was extracted. DNA samples were tested using real-time PCR for Rickettsia spp. infections. The species of Rickettsia in positive samples were determined using gltA gene amplification and sequencing. A total of 250 ticks were collected from 50 stray dogs and all of them belonged to Rhipicephalus sanguineus sensu lato. Totally, 10 pooled of 50 pooled ticks were positive for Rickettsia spp. in real-time PCR and the minimal Rickettsial infection rate was 4% in this study. The identified Rickettsia spp. included R. massiliae (n = 5), R. rhipicephali (n = 1), and R. sibirica (n = 1). In this study, molecular evidence of Rickettsia spp. infection was observed in collected ticks from stray dogs in southeast Iran. More sensitivity to human and animal health care systems in southeastern Iran is essential to the diagnosis of suspected clinical cases that are related to rickettsiosis.     

Analysis of the complete mitochondrial genomes of Dermacentor albipictus suggests a species complex

Dermacentor albipictus is a one-host tick broadly distributed across North America. There are two easily recognizable color variants – ornate and inornate/brown – that have been taxonomically synonymized. Based on mt-cox1 and mt-16S data, there is also evidence for two genetic lineages which do not match the color variants. We present for the first time the complete mitochondrial genomes of the two color variants of D. albipictus including representatives of each lineage. The AT-rich genomes are 14,822 bp – 14,865 bp in length and contain 13 protein coding genes, 2 ribosomal RNA genes and 22 transfer RNA genes, arranged in the conserved type 3 metastriate mitochondrial genome order. The overall differences were 10.66% between the mitochondrial genomes of D. albipictus ornate variant lineage 1 and lineage 2, 10.51% between lineage 1 and inornate/brown variant and 5.87% between lineage 2 and inornate/brown variant. The inornate/brown variant did not form a separate lineage and all inornate isolates were found to belong to lineage 2. Ornate variant isolates occurred in both lineage 1 and 2. The high divergence of the mitochondrial genome suggests that D. albipictus may represent a species complex. Other barcoding genes that may help capture the genetic differences between color and lineage variants include nad1, nad2, nad5, cox1 and atp8 loci. The mtDNA data generated in this study are available in GenBank (Accession numbers: OM678457 - OM678459 and ON032564 - ON032573) for future studies on tick taxonomy, phylogenetics and molecular epidemiology.     

Quantifying the incidence of clinically significant respiratory depression in women with and without obesity class III receiving neuraxial morphine for post-cesarean analgesia: a retrospective cohort study

BackgroundObesity is a suspected risk factor for respiratory depression following neuraxial morphine for post-cesarean analgesia, however monitoring guidelines for obese obstetric patients are based on small, limited studies. We tested the hypothesis that clinically significant respiratory depression following neuraxial morphine occurs more commonly in women with body mass index (BMI) ≥40 kg/m² compared with BMI <40 kg/m².MethodsWe conducted a single-center, retrospective chart review (2006–2017) of obstetric patients with clinically significant respiratory depression following neuraxial morphine, defined as: (1) opioid antagonist administration; (2) rapid response team activation (initiated in April 2010); or (3) tracheal intubation due to a respiratory event. The incidence of respiratory depression was compared between women with BMI ≥40 kg/m² and BMI <40 kg/m².ResultsIn total, 11 327 women received neuraxial morphine (n=1945 BMI ≥40 kg/m²; n=9382 BMI <40 kg/m²). Women with BMI ≥40 kg/m² had higher rates of sleep apnea, hypertensive disorders, and magnesium administration. Sixteen cases of clinically significant respiratory depression occurred within seven days postpartum. The incidence did not significantly differ between groups (odds ratio 2.2, 95% CI 0.6 to 6.9, P=0.174). Neuraxial morphine was not deemed causative in any case, however women with BMI ≥40 kg/m² had higher rates of tracheal intubation unrelated to neuraxial morphine (2/1945 vs. 0/9382, P=0.029).ConclusionsRespiratory depression in this population is rare. A larger sample (∼75 000) is required to determine whether the incidence is higher with BMI ≥40 kg/m². Tracheal intubation was higher among the BMI ≥40 kg/m² cohort, likely due to more comorbidities.