2008年三峡库区流动人口血吸虫感染分析

目的探讨三峡库区流动人口血吸虫感染特征,为制定三峡库区血吸虫病防治对策和措施提供科学依据。方法采用流行病学调查和酶联免疫吸附试验（ELISA）在三峡库区调查流动人口的血吸虫感染情况。结果调查流动人口1416人,其中返乡人员792人,疫区来渝人员624人。返乡人员流动原因以外出务工为主,疫区来渝人员以经商为主;流动人口血清学阳性率为3．04％,其中返乡人员、疫区来渝人员分别为4．04％、1．76％;来自流行省、传播阻断省分别为3．60％、1．33％,来自非流行省未发现阳性。流动人员主要来自湖北、湖南、四川,分别占33．40％、17．44％、10．52％;血清阳性率以江西、江苏、湖北最高,均超过4％。多因素Logistic回归分析显示。流动人口来源、可疑感染地区与血清学感染差异有统计学意义（P〈0．01）;返乡人员血清学阳性率显著高于疫区来渝人员（x^2=9．00,P〈0．01）,来自血吸虫病流行区的阳性率高于其它地区（x^2=6．99,P〈0．01）。结论三峡库区流动人口存在血吸虫感染情况,主要来自血吸虫病流行省份,重点监测来自库区周边省份的流动人员。特别是返乡人员。     

2008年三峡库区流动人口血吸虫感染分析

目的探讨三峡库区流动人口血吸虫感染特征,为制定三峡库区血吸虫病防治对策和措施提供科学依据。方法采用流行病学调查和酶联免疫吸附试验(ELISA)在三峡库区调查流动人口的血吸虫感染情况。结果调查流动人口1416人,其中返乡人员792人,疫区来渝人员624人。返乡人员流动原因以外出务工为主,疫区来渝人员以经商为主;流动人口血清学阳性率为3.04%,其中返乡人员、疫区来渝人员分别为4.04%、1.76%;来自流行省、传播阻断省分别为3.60%、1.33%,来自非流行省未发现阳性。流动人员主要来自湖北、湖南、四川,分别占33.40%、17.44%、10.52%;血清阳性率以江西、江苏、湖北最高,均超过4%。多因素Logistic回归分析显示,流动人口来源、可疑感染地区与血清学感染差异有统计学意义(P<0.01);返乡人员血清学阳性率显著高于疫区来渝人员(χ2=9.00,P<0.01),来自血吸虫病流行区的阳性率高于其它地区(χ2=6.99,P<0.01)。结论三峡库区流动人口存在血吸虫感染情况,主要来自血吸虫病流行省份,重点监测来自库区周边省份的流动人员,特别是返乡人员。     

重庆市农村留守儿童预防接种现状分析

目的了解重庆市农村留守儿童预防接种现状,分析影响农村留守儿童预防接种的因素,探索改进措施。方法采用分层抽样的方法,对0~6岁农村留守儿童监护人的预防接种知识、态度、行为进行调查,并查阅儿童预防接种证。结果农村留守儿童基础免疫(初种)情况较好,加强免疫(复种)漏种普遍;乙型肝炎疫苗首剂及时接种率为91.67%,含麻疹成分疫苗(Measles-containing Vaccine,MCV)首剂及时接种率58.99%,MCV超期接种10%;86.33%的留守儿童多为隔代抚养,监护人年龄大、文化程度低,对预防接种信息及相关知识把握有误;农村留守儿童监护人在预防接种时间上主要依靠村医的上门通知。结论留守是适龄儿童接受预防接种服务的一个危险因素。建议引入同伴教育的宣传方式,深入农村留守儿童家中开展宣传教育;加强基层预防保健人员的队伍建设,以满足农村留守儿童不断增加的预防接种需求;加强教育部门与卫生部门的合作,及时做好新生入学儿童的预防接种证查验和补种。     

重庆市2014年成年人吸烟、戒烟行为及认知现状调查

目的 了解2014年重庆市成年人吸烟、戒烟状况的流行水平及对烟草知识的认知水平,为制定有效的控烟措施提供科学依据。方法 利用中国慢性病及其危险因素监测(2014)调查数据,采取多阶段分层随机抽样方法,对重庆市9个监测点5 400名≥18岁居民进行问卷调查,采用现在吸烟率、被动吸烟率、戒烟率、成功戒烟率等指标,根据2010年第六次普查人口进行加权,使用复杂抽样设计方法进行统计学分析。结果 重庆市≥18岁居民的现在吸烟率为27.4%,其中男性为53.5%,女性为1.1%,40～50岁组男性最高(58.4%);农村高于城市,渝东南翼高于其他地区;现在每日吸烟率分别为27.5%,被动吸烟率为52.4%。现在吸烟者的人均每日吸烟量为17.5支,男女性分别为17.6和13.5支。男性以40～50岁组和初中文化组每日吸烟量最多,分别为20.1、18.9支。现在吸烟者人均每日吸烟量≥20支(重度吸烟)的比例男性高于女性,农村高于城市。男性重度吸烟比例为59.3%,其中以40～50岁组和初中文化组的男性最高,分别为66.8%和65.2%。每日吸烟者中,开始吸烟的平均年龄为(20.8±7.2)岁,女性晚于男性,农村晚于城市。开始吸烟的年龄< 25岁的占80.2%,15～25岁占70.3%。吸烟者的戒烟率为20.1%,成功戒烟率为13.7%,打算戒烟率为25.1%。戒烟率和成功戒烟率均呈随吸烟者年龄增长而上升的趋势,男性18～40岁组的成功戒烟率最低(4.8%)。人群对吸烟、被动吸烟引起其他疾病的认知普遍偏低,对主动吸烟引起3种疾病的知晓率为19.6%,对被动吸烟引起3种疾病的知晓率为21.9%。结论 重庆市≥18岁居民吸烟和被动吸烟状态仍处于高水平,吸烟率呈现明显上升趋势,对烟草知识的认知不足,烟草控制面临巨大挑战。     

Understanding the reasons for using methamphetamine by sexual minority people in Dhaka,Bangladesh

BackgroundInternationally, methamphetamine use is prevalent among males who have sex with males (MSM) and transgender women (hijra), with studies showing its association with risky sexual behaviours leading to HIV transmission. This study aimed to explore the underlying reasons for methamphetamine use among MSM and hijra in Bangladesh.MethodsWe conducted 30 in-depth interviews with MSM and hijra and six focus groups with MSM, hijra and service providers. Data were thematically analysed using manual data analysis procedures.FindingReasons cited for using methamphetamine varied across feminized MSM (i.e. kothis), masculine MSM (i.e. panthis), male sex workers and hijra. For sex workers, increased sexual pleasure and consequent ability to take more clients increased their income. For panthis, methamphetamine enhanced feelings of masculinity and sexual prowess. Kothis were able to feel more feminine due to their ability to receive multiple partners each night. For all participants, methamphetamine restored self-esteem and relieved the stress resulting from stigma.ConclusionsFindings indicate that reasons for using methamphetamine are not only rooted in the individual’s psyche but also grounded in the socio-cultural expectations about masculinities and femininities in Bangladeshi society. Limited knowledge about the complexities concerning methamphetamine use mean that appropriate counselling and treatment services are non-existent in Bangladesh. The study findings can be used to refine national and international harm reduction policies so as to incorporate and address methamphetamine use.     

2008～2012年重庆市克山病患者临床特征与地区分布情况

目的分析2008~2012年重庆市克山病患者临床特征与地区分布,为克山病的预防和控制提供数据。方法调查2008~2012年重庆市梁平、石柱、丰都、垫江、万州5个区、县的克山病患者情况,包括病历、体格检查和实验室检查,分析其临床特征和地区分布。结果共纳入58例克山病患者,分布在梁平(21例)、石柱(25例)、丰都(11例)、垫江(1例)4个区县。58例患者中,16例为潜在型,42例为慢型。患者平均年龄为54.91±15.53岁,以60岁组(32.76%)为主。患者主要特征表现为心界增大(36.76%)、第一心音减弱(22.41%)、收缩期杂音(10.34%)和心律不齐(8.62%)等,98.28%出现心电图异常,包括窦性心律(37.93%)、完全性右束支传导阻滞(25.86%)、ST-T改变(24.14%)、左心室肥大(15.52%)、心房颤动(13.79%)、偶发室性早搏(10.34%)、T波改变(10.34%)、窦性心动过缓(8.62%)和不完全性右束支传导阻滞(6.90%)。X线片结果显示,心脏扩大比例为82.76%,轻度扩大、中度扩大和重度扩大者分别占46.55%、27.59%和8.62%。结论近来年重庆市克山病患者以慢型克山病为主,年龄较大,临床症状以心脏扩大为主,心电图异常检出率较高。     

Sexual Partnerships with Men and Women Among Men Who Have Sex with Men in Beijing and Chongqing, China, 2010

HIV is spreading among Chinese MSM and may possibly lead to infection of female partners. Pressure to marry may drive a greater proportion of Chinese MSM to have female partners than MSM elsewhere in the world. Measurement of the size of the potential risk to female partners of Chinese MSM is inconsistent in the literature. From samples of MSM in two Chinese cities, we documented numbers of sexual partners and sexual activity with those partners. About 500 MSM were sampled in each city. 11.0 and 12.6 % of men reported having any female partners in the past 6 months in Chongqing and Beijing, respectively. Men also reported that only 7.3 and 6.7 % of their entire partnerships were with women in Chongqing and Beijing, respectively. Defining transmission risk accounting for receptive anal sex among men and condom non-use with both male and female partners, 3.4 % of MSM in both Chongqing and Beijing would have the potential to transmit HIV to female partners. Only 9 (1.8 %) men in Chongqing and 2 (0.4 %) in Beijing were HIV-positive and also had unprotected intercourse with females. The majority of HIV transmission risk among MSM in China is not from MSM to females.     

全民食盐加碘后重庆市学龄儿童甲状腺容积变化趋势

目的了解全民食盐加碘后重庆市学龄儿童甲状腺容积变化状况,为评价碘缺乏病病情提供科学依据。方法1997、1999、2002、2005、2011年采用人口比例概率抽样法（PPS）,在重庆市40个区县抽取30个监测点：2009年以所有40个区县为监测点;每个监测点抽取1所小学,每所学校随机抽取8～10岁40名以上儿童,采用B超法检查甲状腺容积情况。结果1997—2011年重庆市儿童甲状腺容积数据均不服从正态分布,呈右偏态分布。儿童甲状腺容积中位数分别为4．00、3．93、3．69、3．46、3．53、3．53ml。各年份甲状腺容积频数构成比（X^2=874．46,P〈0．01）和容积中位数（H=207．72,P〈0．01）比较,差异均有统计学意义;甲状腺容积的中位数（F中位数=13．65,P〈0．05）、90％分位数（FP90=32．12,P〈0．01）、95％分位数（F~6=61．83,P〈0．01）、99％分位数（Fp99=74．36,P〈0．01）均呈逐年下降的趋势。结论全民食盐加碘后重庆市儿童甲状腺容积呈逐年下降的趋势。     

Autonomic function may mediate the neuroprotection of remote ischemic postconditioning in stroke: A randomized controlled trial

ObjectivesTo evaluate the effect of remote ischemic postconditioning (RIPostC) on the prognosis of acute ischemic stroke(AIS) patients and investigate the mediating role of autonomic function in the neuroprotection of RIPostC.Materials and Methods132 AIS patients were randomized into two groups. Patients received four cycles of 5-min inflation to a pressure of 200 mmHg(i.e., RIPostC) or patients’ diastolic BP(i.e., shame), followed by 5 min of deflation on healthy upper limbs once a day for 30 days. The main outcome was neurological outcome including the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Barthel index(BI). The second outcome measure was autonomic function measured by heart rate variability(HRV).ResultsCompared with the baseline, the post-intervention NIHSS score was significantly reduced in both groups (P<0.001). NIHSS score was significantly lower in the control group than intervention group at day 7.[RIPostC:3(1,5) versus shame:2(1,4); P=0.030]. mRS scored lower in the intervention group compared with the control group at day 90 follow-up(RIPostC:0.5±2.0 versus shame:1.0±2.0;P=0.016). The goodness-of-fit test revealed a significant difference between the generalized estimating equation model of mRS and BI scores of uncontrolled-HRV and controlled-HRV(P<0.05, both). The results of bootstrap revealed a complete mediation effect of HRV between group on mRS[indirect effect: −0.267 (LLCI = −0.549, ULCI = −0.048), the direct effect: −0.443 (LLCI = −0.831, ULCI = 0.118)].ConclusionThis is the first human-based study providing evidence for a mediation role of autonomic function between RIpostC and prognosis in AIS patients. It indicated that RIPostC could improve the neurological outcome of AIS patients. Autonomic function may play a mediating role in this association.Trial registrationThe clinical trials registration number for this study is NCT02777099 (ClinicalTrials.gov Identifier)     

2011年重庆市不同人群碘营养现况评价

目的了解重庆市消除碘缺乏病阶段目标后不同人群碘营养状况,为进一步调整食盐加碘浓度提供科学依据。方法2011年在重庆市采用人口比例概率抽样法抽取30个监测点,每点抽取1所小学8～10岁儿童40名。调查儿童盐碘、尿碘、13均摄食盐量以及孕妇和哺乳期妇女尿碘。尿碘采用砷铈催化分光光度方法（WS／T107．2006）测定,盐碘采用直接滴定法（GB／T13025．7．1999）,摄入食盐量采用313称量法进行测算。结果共调查食用盐1322份,碘含量中位数为29．90mg／kg,碘盐覆盖率、碘盐合格率、合格碘盐食用率分别为99．62％、96．67％、97．04％。调查367户,居民每天摄入食盐量为8．4g。共调查8～10岁儿童、孕妇、哺乳妇女分别为1322名、462名、451名,尿碘中位数分别为254．1p,g／L、223．9斗g／L、219．6txg／L,〈100txg／L比例分别占9．68％、12．86％、14．07％,300la,g／L以上比例分别占36．38％、32．59％、31．82％：儿童、孕妇、哺乳妇女尿碘中位数比较差异有统计学意义（H=15．78,P〈0．01）。结论总体上重庆市不同人群碘营养充足,但同时存在碘不足和碘过量现象。