2006—2020年北京市东城区美沙酮维持治疗患者依从性及影响因素分析

目的 为了解北京市东城区美沙酮维持治疗患者的依从性及其影响因素,为临床建立合理的治疗模式以及干预措施提供科学依据。方法 采用动态队列研究设计,研究起点为首次入组治疗的患者在美沙酮维持治疗门诊首次接受治疗的时间,终点为2021年4月30日。使用寿命表法分析维持治疗情况;利用COX比例风险模型分析患者依从性的影响因素。结果 共有331名患者进入本次研究。截至随访终点,累积发生脱失210例,脱失比例为63.44%。维持治疗时间中位数为5.33年。患者1、2、5年的累积维持治疗比例和维持治疗人年数分别为77.05%、67.67%、52.41%和279.00、234.50、170.00人年。COX比例风险模型分析结果显示:入组时年龄<50岁(HR=1.825,95%CI:1.087~3.062)、有职业(HR=1.515,95%CI:1.037~2.213)、日服药剂量<60 mg/d(HR=2.025,95%CI:1.380~2.972)、接受过强制隔离戒毒(HR=2.617,95%CI:1.345~5.092)是降低患者依从性的危险因素。结论 日服药剂量、职业、入组时年龄、是否接受过强制隔离戒毒是北京市东城区美沙酮维持治疗门诊患者依从性的影响因素。日服药剂量的减少有可能导致患者的依从性下降,最终影响治疗效果,因此门诊医生在降低患者的服药剂量时应慎重。     

北京市东城区预防呼吸道传染病宣传月效果评价

目的对东城区预防呼吸道传染病宣传月的效果进行评价。方法在宣传月开始和结束时对社区居民流感、禽流感预防知识、态度、行为进行调查。结果宣传月后,居民对流感、禽流感传播途径、预防方法和消毒方法及对政府处置流感、禽流感流行的能力的认识等有显著提高。结论东城区预防呼吸道传染病宣传月取得了显著的成果。     

Effects of trophic 2,2′, 4,4′-tetrabromodiphenyl ether (BDE-47) exposure in Oreochromis niloticus: A multiple biomarkers analysis

Polybrominated diphenyl esters are emerging environmental contaminants with few toxicological data, being a concern for the scientific community. This study evaluated the effects of BDE-47 on the health of Oreochromis niloticus fish. The animals were exposed to three doses of BDE-47 (0, 0.253, 2.53, 25.3 ng g⁻¹) every 10 days, for 80 days. The BDE-47 affected the hepatosomatic and gonadosomatic index in female and the condition factor by intermediate dose in both sexes. The levels of estradiol decreased and the T4 are increased, but the vitellogenin production was not modulated in male individuals. Changes in AChE, GST, LPO and histopathology were observed while the integrated biomarker response index suggests that the lowest dose of BDE-47 compromised the activity of antioxidant enzymes. The oral exposure to BDE-47 in environmental concentrations is toxic to O. niloticus and the use of multiple biomarkers is an attribution in ecotoxicology studies and biomonitoring programs.     

Invasive pneumococcal disease in children under 16 years of age: Incomplete rebound in incidence after the maximum effect of PCV13 in 2012/13 in Germany

ObjectiveTo identify a potential nadir of the impact of pneumococcal conjugate vaccination (PCV) in infancy on invasive pneumococcal diseases (IPD) in children under 16 in Germany.MethodsActive surveillance on IPD based on two independent data sources with capture-recapture correction for underreporting. Annual incidence rates by age group, serotypes, site of infection, and relative incidence reduction compared to pre-vaccination period (1997–2001) at nadir and for the most recent season are reported. We calculated vaccine coverage at the age of 24 months using health insurance claims data.Results96–97% of children had received at least two doses of PCV since 2009. The maximum impact on overall IPD incidence was achieved in 2012/13 (−48% [95% CI: −55%; −39%]) with a rebound to −26% [95% CI: −36%; −16%] in 2015/16. Non-PCV13 serotypes accounted for 84.1% of the IPD cases in 2015/16. The most frequent non-PCV serotypes in IPD in 2014/15 and 2015/16 were 10A, 24F, 15C, 12F, 38, 22F, 23B, and 15B. The impact at nadir was highest in children 0–1 years of age both in meningitis and non-meningitis cases, whereas the impact for other age groups was higher for meningitis cases. The rebound mainly pertained to non-meningitis cases.ConclusionThe maximum impact of pneumococcal conjugate vaccination has been attained and signs of a rebound are apparent. Sustained surveillance for IPD in children is warranted to assess whether these trends will continue. There may be a need for vaccines using antigens common to all serotypes.     

Willingness to accept a future influenza A(H7N9) vaccine in Beijing,China

BackgroundThe present study aimed to estimate residents’ willingness to accept a future H7N9 vaccine and its determinants in the general adult population in Beijing, China.MethodsWe conducted a multi-stage sampling, cross-sectional survey using self-administered anonymous questionnaires from May to June, in 2014. The main outcome variable was residents’ willingness to accept a future H7N9 vaccine. Logistic regression was used to identify the predictors of vaccination willingness.ResultsOf the 7264 eligible participants, 14.5% of Beijing residents reported that they had not heard of H7N9. Among those who had heard of H7N9, 59.5% of the general adult population would be willing to accept a future H7N9 vaccine, and approximately half of them reported ‘I am afraid of being infected by H7N9’ and ‘H7N9 vaccine can prevent infections’, and 28.1% reported ‘my daily life is affected by H7N9’. The variables that were significantly associated with a higher likelihood of reporting willingness were being younger adults (aged 18–29 years: OR = 1.52, 95% CI: 1.17–1.97; aged 30–39 years: OR = 1.39, 95% CI: 1.08–1.78), being farmers (OR = 1.61; 95% CI: 1.32–1.96), being unemployed people (OR = 1.36; 95% CI: 1.04–1.78), living in suburban areas (OR = 2.18; 95% CI: 1.89–2.51), having ≥2 children in the family (OR = 1.41; 95% CI: 1.03–1.92), perceived risk in China (OR = 1.30; 95% CI: 1.15–1.48), perceived susceptibility to disease (OR = 3.13; 95% CI: 2.73–3.58), perceived negative effect on daily life (OR = 1.32; 95% CI: 1.13–1.55), perceived effectiveness of vaccination (OR = 2.34; 95% CI: 2.07–2.64), and recent uptake of influenza vaccine (OR = 2.26; 95% CI: 1.92–2.66).ConclusionsA great number of Beijing residents had doubts about the vaccine’s effectiveness and were not concerned about disease risk, which were the factors affecting willingness to be vaccinated. Targeted education programs on disease risk as well as vaccine’s effectiveness are needed to improve the willingness of vaccination for potential H7N9 pandemic preparedness.     

Urinary arsenic metabolism in a Western Chinese population exposed to high-dose inorganic arsenic in drinking water: Influence of ethnicity and genetic polymorphisms

To investigate the differences in urinary arsenic metabolism patterns of individuals exposed to a high concentration of inorganic arsenic (iAs) in drinking water, an epidemiological investigation was conducted with 155 individuals living in a village where the arsenic concentration in the drinking water was 969 μg/L. Blood and urine samples were collected from 66 individuals including 51 cases with skin lesions and 15 controls without skin lesions. The results showed that monomethylated arsenic (MMA), the percentage of MMA (%MMA) and the ratio of MMA to iAs (MMA/iAs) were significantly increased in patients with skin lesions as compared to controls, while dimethylated arsenic (DMA), the percentage of DMA (%DMA) and the ratio of DMA to MMA (DMA/MMA) were significantly reduced. The percent DMA of individuals with the Ala/Asp genotype of glutathione S-transferase omega 1 (GSTO1) was significantly lower than those with Ala/Ala. The percent MMA of individuals with the A2B/A2B genotype of arsenic (+ 3 oxidation state) methyltransferase (AS3MT) was significantly lower than those with AB/A2B. The iAs and total arsenic (tAs) content in the urine of a Tibetan population were significantly higher than that of Han and Hui ethnicities, whereas MMA/iAs was significantly lower than that of Han and Hui ethnicities. Our results showed that when exposed to the same arsenic environment, different individuals exhibited different urinary arsenic metabolism patterns. Gender and ethnicity affect these differences and above polymorphisms may be effectors too.     

基于基因组序列的3种沙门菌分子血清分型方法比较研究

目的 比较3种沙门菌分子血清分型方法,获得一种准确度较高的方法用来替代传统的血清凝集技术用于沙门菌血清型判定.方法 对覆盖50个血清型的509株沙门菌提取核酸进行全基因组测序,根据全基因组序列分别利用多位点序列分型(MLST)、SalmonSeroPredicition 以及 SISTR(Salmonella in s...     

利用实时荧光定量聚合酶链式反应快速检测人及动物粪便中的沙门菌

目的为了快速检测、鉴定沙门菌属细菌,提高食源性疾病暴发应对能力,本研究建立了针对沙门菌属的实时荧光定量聚合酶链式反应(qPCR)检测方法,并对其特异性、敏感性和检测下限进行评价。方法筛选针对沙门菌的属特异基因,并建立该基因的qPCR检测体系,利用肠道不同种属细菌、不同亚种及血清型沙门菌属细菌、动物及人粪便样本评价该体系的特异度、灵敏度及检测下限。结果获得沙门菌的属特异基因ttrA,建立基于该基因的qPCR检测方法。发现该方法对纯DNA的最低检测下限为2拷贝/反应。对沙门菌属以外的肠道致病菌无扩增,对1 100株不同亚种及血清型的沙门菌的扩增结果均为阳性,对150份沙门菌致腹泻患者的粪便增菌液和210份动物带菌粪便增菌液均检测阳性。结论本研究建立的基于单一基因的沙门菌属快速分子检测方法具有特异度高、灵敏度高的特点,可用于快速筛查、鉴定沙门菌及由其引起的感染性腹泻。     

两种空气消毒方法对接台手术室空气消毒效果的比较

目的比较紫外线灯照射和独立单元空气净化系统两种方法对接台手术室空气的消毒效果,探讨无层流装置手术间的接台手术室空气消毒方法. 方法用平板自然沉降法于手术室空气开始消毒前及消毒后不同时段采样检测,观察两种方法对接台手术室空气中自然菌的杀灭效果. 结果在保证接台手术合理时间间隔的前提下,两种方法均能使术前空气中自然菌的消除率达到80%;利用紫外线消毒,在人员进入手术室后空气中菌落数明显上升;空气净化可以在人在条件下对手术室空气进行持续消毒杀菌,使手术全过程空气中平均菌落数达到国家标准. 结论独立单元空气净化系统可以缩短手术间隔时间,并且是解决接台手术人在条件下持续空气消毒的较好方法.