膳食模式对社区管理2型糖尿病患者血糖控制影响的研究

目的 了解膳食对社区管理2型糖尿病（T2DM）患者血糖控制的影响，为实施针对糖尿病患者的防治策略和措施提供依据。方法 于2015年在常熟市和武汉市随机抽取8个社区，对进行社区管理的T2DM患者进行问卷调查、身体测量和血糖检测。研究采用因子分析获得膳食模式。并分别以FPG、餐后2 h血糖控制是否达标为因变量，进行非条件多因素logistic回归分析影响因素。结果 最终共纳入1 818名T2DM患者，患者FPG控制率为57.59%（95%CI：55.30%~59.86%），餐后2 h血糖控制率为24.90%（95%CI：22.93%~26.91%）；因子分析得到5种膳食模式：动物性食物模式、水果-水产-薯类模式、蔬菜-谷物模式、蛋-奶-豆模式和油盐模式。非条件多因素logistic回归分析显示，调整其他因素后，FPG达标概率降低与动物性食物模式（OR=0.71，95%CI：0.52~0.98）、水果-水产-薯类模式（OR=0.71，95%CI：0.51~0.97）相关，餐后2 h血糖达标概率降低与水果-水产-薯类模式（OR=0.60，95%CI：0.40~0.90）相关，FPG和餐后2 h血糖达标概率增加均与蔬菜-谷物模式（OR=1.41，95%CI：1.03~1.94；OR=1.68，95%CI：1.13~2.51）、蛋-奶-豆模式（OR=1.75，95%CI：1.25~2.46；OR=1.56，95%CI：1.00~2.42）有关。与蛋-奶-豆模式Q₄组相比，膳食模式组合（水果-水产-薯类模式Q₄组、蔬菜-谷物模式Q₂组、蛋-奶-豆模式Q₃组）FPG控制达标可能性更高（OR=6.79，95%CI：1.15~40.23，P=0.035）；与蔬菜-谷物模式Q₄组相比，膳食模式组合（水果-水产-薯类模式Q₄组、蔬菜-谷物模式Q₃组、蛋-奶-豆模式Q₂组、油盐模式Q₂组）餐后2 h血糖控制达标可能性更高（OR=12.78，95%CI：1.26~130.05，P=0.031）。结论 搭配得当的膳食模式及膳食模式组合更有利于武汉市和常熟市社区管理T2DM患者的FPG和餐后2 h血糖控制，应加强患者营养教育，提高患者食物搭配能力。     

北京市乙型肝炎病毒感染相关疾病疾病个人负担研究

目的 评价北京市乙型肝炎病毒(HBV)感染相关疾病所致疾病个人负担。方法 根据北京市传染病监测资料及死亡统计资料，以失能调整生命年(DALY)为指标，测量北京市HBV感染相关疾病的疾病个人负担。结果 北京市HBV感染相关疾病所致个人负担按DALY(年／千人)值由大到小排序依次为：HBV感染所致原发性肝癌(1．812820年／千人)、乙肝后肝硬化(1．125545年／千人)、慢性乙型肝炎(0．217946年／千人)、急性乙型肝炎(0．077745／千人)。结论 慢性乙型肝炎、乙肝后肝硬化和HBV感染引起的原发性肝癌所致疾病个人负担比较严重；HBV感染所致疾病负担是不可忽视的。     

青海省久治县人群棘球蚴病流行病学调查

目的掌握果洛藏族自治州久治县人群棘球蚴病流行现状,为科学制定青藏高原本病控制策略提供依据。方法应用ELISA检测及B超探查综合确定人群棘球蚴病的感染与患病情况。结果人群棘球蚴病ELISA检测阳性率为29.26%(287/981)、患病率为8.01%(124/1549)。其中细粒和多房棘球蚴病患病率分别为5.42%(84/1549)和2.52%(39/1549)、两型混合患病1例,多房棘球蚴病所占构成比为31.45%(39/124)。结论进一步证实果洛藏族自治州久治县为棘球蚴病混合存在流行县,县内棘球蚴病危害极为严重。     

Inactivated influenza vaccine effectiveness and an analysis of repeated vaccination for children during the 2016/17 season

ObjectivesWe assessed the vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) in children 6 months to 15 years of age during the 2016/17 season. In addition, we estimated the impact of repeated vaccination in children on VE.MethodsOur study for VEs in preventing influenza and admission due to influenza were conducted according to a test-negative case-control design (TNCC) based on influenza rapid diagnostic test results. We also analyzed the VE by vaccine status in the current and previous seasons for the impact of repeated vaccination.ResultsDuring the 2016/17 season, the quadrivalent IIV was used in Japan. The adjusted VE in preventing influenza illness was 38% (95% CI, 29–46) against influenza A and 39% (95% CI, 18–54) against influenza B. Infants showed no significant VE. The VE in preventing hospitalization was not demonstrated. For the analysis of repeated vaccination, the vaccine was effective only when immunization occurred in the current season. The children who were immunized in two consecutive seasons were more likely to develop influenza compared to those immunized in the current season only (odds ratio, 1.58 [95% CI, 1.05–2.38], adjusted odds ratio, 1.53 [95% CI, 0.99–2.35]). However, the odds ratio of repeated vaccination was not significant when the analysis excluded those who developed influenza in the previous season.ConclusionsVE in children in the 2016/17 season was similar to values previously reported. Repeated vaccination interfered with the VE against any influenza infection in the 2016/17 season. The results of our study suggest that decreased VE by repeat vaccination phenomenon was associated with immunity by influenza infection in the previous season. However, the influenza vaccine should be recommended every season for children.     

Chemotherapy induced small bowel obstruction in small cell lung cancer

Lung cancer is the leading cause of cancer related death in men and the second cause in women worldwide. We describe a case of a 51- year old lady with small cell lung cancer who developed small bowel obstruction following chemotherapy with cisplatin and etoposide. Abdominal CT scan showed changes confined to the jejunum and proximal ileum with diffuse mural thickening and hyper-attenuation of the mucosa with sparing of the terminal ileum, caecum and colon. Her condition improved with conservative management and intravenous antibiotics.     

Influenza vaccination in preventing outbreaks in schools: A long-term ecological overview

Influenza vaccination is the most effective way to reduce the incidence of influenza infections. However, the role of influenza vaccination, such as school-based influenza vaccination, in preventing the influenza outbreaks in schools remains unclear now. In this study, a total of 286 school febrile outbreaks involving 6863 cases in the Beijing area from September 1, 2006 to March 31, 2017 were analyzed. We also tested 294 circulating strains isolated in Beijing during the same period and compared with that of vaccine strains identified every influenza season. The virological match/mismatch between vaccine strains and circulating strains, and the coverage of vaccination in schools were analyzed against outbreaks during the 11 years. It showed that over 80% school febrile outbreaks were caused by influenza A/B virus, the most frequent being A(H3N2) virus (53.25%), followed by A(H1N1)pdm09 virus (25.11%) and B virus (21.64%). More importantly, low vaccine coverage (in 2006–2007 influenza season) and vaccine mismatch (in 2014–2015 and 2015–2016 influenza season) were associated with an increased number of influenza school outbreaks. High vaccination coverage with a matched vaccine can significantly reduce influenza outbreaks in schools (OR: 0.111, p < .001). We have shown the effectiveness of school-based influenza vaccination in preventing outbreaks using trivalent inactivated influenza vaccine in schools. Thus the school-based vaccine policy should be paid more attention in China and other countries worldwide.     

2008-2009年北京市沙门菌流行特征和分子分型

目的 分析2008-2009年北京市沙门菌流行特征及脉冲场凝胶电泳(PFGE)分子分型. 方法 对2008-2009年通过WHO全球沙门菌监测系统及北京市肠道门诊监测系统分离到的137株沙门菌进行生化鉴定、血清分型和相关流行病学分析;利用PFGE进行分子分型. 结果 北京市2008-2009年沙门菌的流行具有明显季节性,6-9月份高发,共分离菌株84株,占64.1%(84/131);患者年龄多为18～40岁,占46.1%(58/128);男性80例,女性51例,男女比例为1.57:1.137株沙门菌分属于20种血清型,其中肠炎沙门菌和鼠伤寒沙门菌为优势菌型,分别占46.7%(64/137)和17.5%(24/137).共分71种PFGE带型,其中肠炎沙门菌和鼠伤寒沙门菌都有16种PFGE型别.肠炎沙门菌的4种PFGE型别(JEGX01.CN0001、JEGX01.CN0003、JFGX01.CN0002、JEGX01.CN0019)和鼠伤寒沙门菌的JPXX01.CN0001为优势分子型别. 结论 2008-2009年北京市沙门菌的流行具有性别、年龄和季节性分布特征;PFGE分子型别较多,且存在差异明显的多个克隆系.

Abstract：

Objective To study the epidemiological characteristics and molecular phenotypes of Salmonella by pulsed-field gel electrophoresis (PFGE) in Beijing from 2008 to 2009. Methods A total of one hundred thirty-seven isolates recovered from the WHO Global Samonella Surveillance system and entero clinic surveillance system were identified by biochemical tests and serotyping.The related epidemiological informations were also analyzed.The isolates were further typed by PFGE. Results The prevalence of Salmonella from 2008 to 2009 showed obvious seasonal character.High incidence occurred from June to September,and 64.1% (84/131) isolates were recovered in this period.Patients of 18-40 year-old were 46.1% (58/128) and 80 patients were male and 40 patients were female with the ratio of 1.57:1.These 137 Salmonella isolates belonged to 20 serotypes,including Enteritidis (46.7%,64/137) and Typhimurium (17.5%,24/137) as the dominant serotype.In total,71 PFGE profiles were identified.Four PFGE patterns of S.Enteritidis isolates (JEGX01.CN0001,JEGX01.CN0003,JEGXO1.CN0002,JEGX01.CN0019) and S.Typhimurium pattern of JPXX01.CN0001 were dominant patterns. Conclusion The prevalence of Salmonella from 2008 to 2009 showed distribution characteristics of sex,age and seasons.The numerous PFGE patterns of Salmonella showed diversity of these isolates and different clones existed in Beijing.     

The role of mosapride and levosulpiride in gut function and glycemic control in diabetic rats

Background and study aimsGastroparesis is a well-known consequence of long-standing diabetes that presents with gastric dysmotility in the absence of gastric outlet obstruction. This study aimed to evaluate the therapeutic effects of mosapride and levosulpiride on improving gastric emptying in type 2 diabetes mellitus (T2DM) while regulating glycemic levels.Material and methodsRats were divided into the normal control, untreated diabetic, metformin-treated (100 mg/kg/day), mosapride-treated (3 mg/kg/day), levosulpiride-treated (5 mg/kg/day), metformin (100 mg/kg/day) + mosapride (3 mg/kg/day)-treated, and metformin (100 mg/kg/day) + levosulpiride (5 mg/kg/day)-treated diabetic groups. T2DM was induced by a streptozotocin–nicotinamide model. Four weeks from diabetes onset, the treatment was started orally daily for 2 weeks. Serum glucose, insulin, and glucagon-like peptide 1 (GLP-1) levels were measured. Gastric motility study was performed using isolated rat fundus and pylorus strip preparations. Moreover, the intestinal transit rate was measured.ResultsMosapride and levosulpiride administration showed a significant decrease in serum glucose levels with improvement of gastric motility and intestinal transit rate. Mosapride showed a significant increase in serum insulin and GLP-1 levels. Metformin with mosapride and levosulpiride co-administration showed better glycemic control and gastric emptying than either drug administered alone.ConclusionMosapride and levosulpiride showed comparable prokinetic effects. Metformin administration with mosapride and levosulpiride showed better glycemic control and prokinetic effects. Mosapride provided better glycemic control than levosulpiride. Metformin + mosapride combination provided superior glycemic control and prokinetic effects.     

A systematic review of outcomes and quality of life after ileorectal anastomosis for ulcerative colitis

Background and study aimsIleorectal anastomosis (IRA) is one option for restoring bowel continuity in patients who have undergone subtotal colectomy for ulcerative colitis (UC). This systematic review aims to assess short- and long-term outcomes after IRA for UC, including anastomotic leak rates, IRA failure (as defined by conversion to pouch or end stoma), cancer risk in the rectal remnant, and quality of life (QoL) post-IRA surgery.Materials & methodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist was used to demonstrate the search strategy. A systematic review of PubMed, Embase, Cochrane library, and Google Scholar from 1946 to August 2022 was undertaken.ResultsThis systematic review included 20 studies, representing 2538 patients who underwent IRA for UC. The mean age ranged from 25 to 36 years and the mean postoperative follow-up ranged between 7 and 22 years. The overall leak rate reported across 15 studies was 3.9 % (n = 35/907) ranging from 0 % to 16.7 %. The failure of IRA (requiring conversion to pouch or end stoma) as reported across 18 of the studies was 20.4 % (n = 498/2447). The risk of developing cancer in the remaining rectal stump following IRA was reported by 14 studies and was accumulatively 2.4 % (n = 30/1245). Five studies reported on patient QoL using a variety of different instruments and 66.0 % of patients (n = 235/356) reported a “high” QoL score.ConclusionIRA was associated with a relatively low leak rate and a low risk of colorectal cancer in the rectal remnant. However, it does carry a significant failure rate which invariably requires conversion to an end stoma or the formation of an ileoanal pouch. IRA provided a QoL to most of the patients.