国内外公共卫生领域标准化工作管理体制比较与思考

目的:为了更好地促进我国的卫生健康标准化工作,为建立完善我国卫生健康领域标准化的发展战略、管理体制提供依据。方法:本文收集了公共卫生领域标准化相关国际组织标准管理机制方面的资料,并将收集到的信息进行汇总分析。结果:公共卫生领域的各种标准在各国际组织的管理体制不同,在组织性质、标准种类、应用、发布、组织结构、标准制定原则...     

吴忠市2007～2009年医疗单位消毒效果监测

[目的]了解吴忠市医疗单位消毒情况,为制定有效的消毒管理对策提供科学依据。[方法]2007～2009年按《消毒管理办法》和《消毒技术规范》-2002版对吴忠市各医疗单位进行消毒效果监测。[结果]2007～2009年共抽样5 056份,合格3 673份,平均合格率为72.65%。2007、2008、2009年的合格率分别为65.40%(1 115/1 705)、74.53%(1 229/1 649)、78.08%(1 329/1 702);3年间合格率比较差异有统计学意义(P﹤0.01);3个年份不同级别医院的合格率比较差异有统计学意义(P﹤0.01)。[结论]吴忠市医疗单位消毒效果不断改善,但须进一步加强,行政干预是提高消毒管理工作效率的重要手段。     

苏州市吴中区实施全球基金流动人口结核病项目的效果

目的评价苏州市吴中区全球基金流动人口结核病控制项目的实施效果,为控制结核病提供科学依据。方法收集整理2007—2010年吴中区当地患者及流动人口结核病患者的发现和治疗管理信息。结果项目实施4年共投入流动人口专项经费140万元人民币。流动人口新登记活动性肺结核患者1 104例,新登记涂阳患者598例。2006—2009年4年间本地人口涂阳治愈率为89.91%,而流动人口涂阳治愈率也达到了84.78%。结论加强流动人口结核患者的管理,和当地患者同样进行规范化的治疗,可以基本达到国家结核病防治规划的要求。     

Moderate doses of dietary nitrate elicit greater effects on blood pressure and endothelial function than a high dose: A 13-week pilot study

Background & aimsFew studies have explored the prolonged effects of dietary nitrate on vascular health. This pilot study tested the effects of prolonged consumption (13 weeks) of a range of doses of dietary nitrate (NO₃⁻), provided as beetroot juice (BJ), on blood pressure (BP) and endothelial function in overweight and obese older participants.Methods and resultsSixty-two overweight or obese older participants (60–75 years) were randomized to the following interventions: (1) high NO₃⁻ (2) medium NO₃⁻, (3) low NO₃⁻, or (4) placebo. Resting clinic and home BP were measured pre- and post-intervention. Laser Doppler iontophoresis was used to quantify changes in endothelial-dependent and independent microvascular blood flow.ResultsThis pilot study showed that medium and low doses of NO₃⁻ were more effective in lowering resting-clinic SBP (P = 0.04 and, P = 0.03, respectively) than was PL. The lower doses of NO₃⁻ also resulted in significant increases in microvascular perfusion (medium, P = 0.02; low, P = 0.002) relative to baseline values.ConclusionThese findings indicate that supplementation with medium and low, but not high, doses of NO₃⁻ for 13 weeks had positive effects on BP and endothelial function in older overweight and obese adults. These findings require confirmation in larger studies.     

Maximizing cardiovascular benefits of fish consumption within the One Health approach: Should current recommendations be revised?

AimsCurrent dietary recommendations on fish consumption for cardiovascular disease (CVD) prevention put somewhat vague emphasis on fatty fish, mainly driven by evidence on the cardioprotective effects of n–3 PUFAs. Recent data on the consumption of different types of fish in relation to hard cardiovascular endpoints suggests that fatty but not lean fish can contribute to CVD prevention. This considered, we aimed at evaluating, by an environmental perspective, fish consumption limited to the fatty type – in appropriate amounts for optimizing CVD prevention – within the European context.Data synthesisStarting from the current average intake of total fish by the European population (i.e., 2 servings/week of fatty plus lean fish), we show that the shift towards the consumption of 2 servings/week of solely fatty fish – appropriate for optimizing CVD prevention – would allow a 32% saving of greenhouse gas (GHG) emissions related to fish consumption. This is due to the lower environmental impact of fatty fish globally considered, compared to lean fish. However, since the carbon footprint of different fatty fish species can vary significantly – with small blue fish (e.g., anchovies, sardines, herrings) in the lowest range, we estimated that GHG emissions due to fish consumption in Europe could be reduced by 82% by focusing on small blue fish consumption.ConclusionsConsumption of 2 servings/week of small blue fish could represent a feasible and effective choice among the functional dietary strategies available to achieve the maximal benefits for human and environmental health.     

Mild and asymptomatic influenza B virus infection among unvaccinated pregnant persons: Implication for effectiveness of non-pharmaceutical intervention and vaccination to prevent influenza

BackgroundWe estimated symptomatic and asymptomatic influenza infection frequency in community-dwelling unvaccinated pregnant persons to inform risk communication.MethodsWe collected residue sera from multiple antenatal-care blood draws during October 2016–April 2017. We determined influenza infection as seroconversion with ≥ 4-fold rise in antibody titers between any two serum samples by improved hemagglutinin-inhibition assay including ether-treated B antigens. The serology data were linked to the results of nuclei acid testing (rRT-PCR) based on acute respiratory illness (ARI) surveillance.ResultsAmong all participants, 43 %(602/1384) demonstrated serology and/or rRT-PCR evidenced infection, and 44 %(265/602) of all infections were asymptomatic. ARI-associated rRT-PCR testing identified only 10 %(61/602) of total infections. Only 1 %(5/420) of the B Victoria cases reported ARI and had a rRT-PCR positive result, compared with 33 %(54/165) of the H3N2 cases. Among influenza ARI cases with multiple serum samples, 19 %(11/58) had seroconversion to a different subtype prior to the illness.ConclusionsThe incidence of influenza B infection in unvaccinated pregnant persons is under-estimated substantially. Non-pharmaceutical intervention may have suboptimal effectiveness in preventing influenza B transmission due to the less clinical manifestation compared to influenza A. The findings support maternal influenza vaccination to protect pregnant persons and reduce consequent household transmission.     

HPLC-RID法测定吸附无细胞百白破联合疫苗中甘油的残留量

通过对婴儿接种吸附无细胞百白破联合疫苗（diphtheria, tetanus and acellular pertussis combined vaccine, DTaP）后局部不良反应的主动监测,评价婴儿接种DTaP的安全性。

于2020 年 7 月— 2021 年 3 月,对在江苏省滨海县东坎镇、陈涛镇、界牌镇、滨海现代农业产业园4个乡镇卫生院接种DTaP的3～5月龄婴儿局部不良反应进行主动监测,并按照《预防用疫苗临床试验研究不良事件分级标准指导原则》（2019 年第102号）对发生的局部不良反应进行分级,用描述流行病学方法进行局部不良反应分析。

共有2 490人次纳入至本次DTaP接种后局部不良反应主动监测分析中。DTaP 接种后,局部不良反应1 009例次,总发生率为40.52%,其中局部硬结和红晕发生率最高,分别为14.4%和17.0%。1 级局部不良反应发生率为35.9%（893/2 490）,其中硬结和红晕占比最高,分别占38.18%（341/893）和42.89%（383/893）;2 级局部不良反应发生率为4.66%（116/2 490）,其中红晕和触痛占比最高,分别占34.48%（40/116）和26.72%（31/116）;未见 3 级及以上局部不良反应。局部不良反应多发生在 DTaP接种后 3d 内,占总发生率的 98.0%（988/1 009）。硬结和红晕的发生率在 3 个不同厂家（A、B、C厂家）DTaP 受种儿间差异有统计学意义（P < 0.05）。不同剂次 DTaP 接种后,硬结、肿胀、红晕和皮疹发生率差异有统计学意义（P < 0.05）,其中第 2 剂、第 3 剂 DTaP 接种后硬结、肿胀、红晕发生率明显高于第 1 剂（P < 0.01）,第 3 剂 DTaP 接种后皮疹发生率明显高于第1 剂（P < 0.05）。男、女婴儿接种DTaP后局部不良反应发生率分别为 40.71%（517/1270）和40.33%（492/1220）,差异无统计学意义（P > 0.05）。

硬结、红晕和肿胀为3～5月龄婴儿DTaP 接种后发生的主要局部不良反应。

     

江苏省苏州市吴中区光福镇一起食源性伤寒暴发调查报告

2009年6-7月,苏州市吴中区光福镇发生了一起伤寒暴发流行,共发生病例98例,为同源暴发;病例主要集中在迂里、太湖和镇区;性别无差异,各年龄组均有发病,农民发病占多数。通过对病例分布与自来水管网走向的分析、环境水样的检测、病例对照研究等,排除水源污染引起暴发。暴发原因为食用无证流动摊贩生产的受到污染的卤菜,在采取了相应的防控措施后疫情得到了控制。     

成年人睡眠状况与糖尿病患病关系的研究

目的 探讨成年人睡眠状况与糖尿病患病关系。方法 利用“中国慢性病前瞻性研究”苏州市项目点53 260名30~79岁常住居民基线调查数据,通过多因素logistic回归模型分析睡眠状况与糖尿病患病关系。结果 调查人群糖尿病患病率为5.3%,入睡困难、容易早醒和经常打鼾的比例分别为7.2%、10.0%和29.5%,22.6%的调查对象报告睡眠时间≤6 h。经多因素模型调整后,入睡困难（男性：OR=1.63,95%CI：1.30~2.05;女性：OR=1.48,95%CI：1.27~1.73）、容易早醒（男性：OR=1.37,95%CI：1.12~1.68;女性：OR=1.31,95%CI：1.14~1.51）和经常打鼾（男性：OR=1.16,95%CI：1.00~1.34;女性：OR=1.39,95%CI：1.23~1.57）均与糖尿病罹患风险存在关联。女性服用助眠药物与糖尿病的患病相关（OR=1.42,95%CI：1.06~1.92）。与睡眠时间8 h相比,睡眠时间不足（≤6 h）与男女性糖尿病患病均存在统计学关联,OR值分别为1.37（95%CI：1.17~1.60）和1.24（95%CI：1.08~1.41）,睡眠时间过长（≥9 h）与糖尿病未见统计学关联。结论 睡眠问题（入睡困难、容易早醒、药物助眠、经常打鼾和睡眠时间不足）与糖尿病患病风险密切相关,睡眠时间过长与糖尿病患病未见统计学关联。     

西藏0~5岁藏族儿童心理行为发育与生长迟缓的关系

  目的  了解西藏0~5岁藏族儿童心理行为发育现状, 为分析生长迟缓与儿童心理行为发育的关系提供基础数据。  方法  采用分层、与规模成比例的概率比例抽样方法和整群抽样方法, 于2020年9—11月间在西藏7个区县随机抽取2 788名0~71月龄藏族儿童进行问卷调查和体格检查。采用多因素Logistic回归模型分析生长迟缓对儿童心理行为发育的影响。  结果  西藏0~5岁藏族儿童心理行为发育偏异的检出率为24.68%, 其中言语、大运动、精细动作和社交4个能区发育偏异检出率分别为8.07%, 9.15%, 12.02%和12.73%。调整潜在混杂因素后, 生长迟缓儿童心理行为发育偏异风险的OR值(95%CI)为1.34(1.05~1.70), 其中与言语、精细动作和社交3个维度呈正关联。亚组分析显示, 生长迟缓与儿童心理行为发育的关联存在年龄(0~35月龄: OR=1.16, 95%CI=0.88~1.53;36~71月龄: OR=2.28, 95%CI=1.44~3.62)和性别差异(男童: OR=1.69, 95%CI=1.23~2.32;女童: OR=0.98, 95%CI=0.67~1.42)。  结论  西藏0~5岁藏族儿童心理行为发育偏异检出率较高, 生长迟缓与儿童心理行为发育偏异的风险相关。应以高年龄段男童为重点人群, 做好儿童营养和心理行为发育问题的早期筛查和综合干预工作。