阜阳市颍东区农村生活饮用水水质调查分析

目的了解和掌握颍东区农村生活饮用水卫生状况,为改善水质提供科学依据。方法按分层随机原则选择集中式、分散式监测点,进行现场调查和水质检验分析。结果颍东区农村饮用水水源以地下水为主,供水方式以分散式供水为主,占70.99%。农村生活饮用水合格率为44.00%,丰水期合格率低于枯水期合格率。结论颍东区集中式供水覆盖率较低,微生物指标和氟化物是影响农村饮用水水质的主要因素。     

2008年安徽省阜阳市恙虫病流行因素调查

目的探讨造成此次恙虫病流行的危险因素,为疫情控制提供科学依据。方法利用病例对照研究,探索造成此次恙虫病流行的危险因素。以搜索到的临床诊断病例和确诊病例作为病例组,按1∶2个体匹配的方式,随机选择与病例所在行政村的同村、年龄相差5岁以内的同性别且无任何临床症状的村民为对照。统计分析方法用1∶M的条件logistic回归,数据录入用EpiData3.1软件,用SPSS17.0软件进行数据的统计分析。结果此次调查共发现恙虫病病例78例,其中实验室确诊病例16例,临床诊断病例34例,疑似病例28例。1∶M的多因素条件logistic回归分析结果表明,收种庄稼是造成此次恙虫病流行的危险因素（OR=6.33,95%CI：1.12～37.25）。进一步分析得知,51.6%的病例和22.8%的对照人群参加了收黄豆,是恙虫病发病的危险因素（OR=3.62,95%CI：1.36～9.59）,尚不能认为收玉米和种麦与本次恙虫病流行有关（P〉0.05）。结论此次事件是由于农民收黄豆时未采取保护措施而被恙螨幼虫叮咬引起的恙虫病流行。     

阜阳市1958—2007年肾综合征出血热流行特征及相关因素分析

目的了解阜阳市肾综合症出血热（hemorrhagic fever with renal syndrome,HFRS）流行特征及流行因素,为制定防制措施提供科学依据。方法对1958年以来的人间及1984年以来的鼠间疫情监测资料进行描述性分析,利用圆形分布,计算发病高峰日期;同时对发病率与带毒指数进行相关性分析。结果1958—2007年全市共报告HFRS病例40002例,死亡2381例,年平均发病率为11．99／10万,病死率为5．95％。各县市区均有病例,颍上县最多（占40．30％）,病死率以界首市最高（33．24％）。50年来共呈现4次发病高峰,20世纪80、90年代维持在较高的流行强度。各月均有发病,主要集中在11月至次年1月份,发病高峰日为12月13日。室内和野外鼠密度分别为9．84％和7．91％,带毒率分别为9．21％和6．99％。1984—2007年的鼠带毒指数和人群发病率的相关系数为r=0．58。室内的优势鼠种在2000年前为褐家鼠,2000年后为小家鼠;野外的优势鼠种一直为黑线姬鼠。结论阜阳市HFRS疫源地普遍存在,鼠密度及带毒率的高低直接影响到人群发病,应加强鼠间疫情监测。     

我国县级医疗机构人员人/禽流感相关知识知晓情况调查

目的了解我国县级医疗机构人员对人/禽流感防控知识的知晓情况,为各级相关部门组织开展有成效的培训提供依据。方法采用整群抽样方法,对安徽和辽宁2省6个项目县的县级医疗机构所有现职医务人员进行问卷调查。结果县级医疗机构人员平均得分是（56.98±24.68）分;不同科室和职称人员得分差异均有统计学意义（P〈0.05）;重点科室人员（呼吸内科）对人/禽流感核心信息的平均知晓率为43.8%。结论我国县级医疗机构人员已经掌握了一定的人/禽流感基本知识,但对知识的掌握还存在一些盲点和弱点,仍需进一步加大培训力度。     

Chinese guidelines for the diagnosis and treatment of hand,foot and mouth disease (2018 edition)

Background

Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treatments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed.

Methods

National Health Commission of China assembled an expert committee for a revision of the guidelines. The committee included 33 members who are specialized in diagnosis and treatment of HFMD.

Results

Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. Clinicians should particularly pay attention to those EV-A71 cases in children aged less than 3 years, and those with disease duration less than 3 days. The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia; (2) involvement of nervous system; (3) worsening respiratory rate and rhythm; (4) circulatory dysfunction; (5) elevated peripheral WBC count; (6) elevated blood glucose and (7) elevated blood lactic acid. For treatment, most mild cases can be treated as outpatients. Patients should be isolated to avoid cross-infection. Intense treatment modalities should be given for those severe cases.

Conclusion

The guidelines can provide systematic guidance on the diagnosis and management of HFMD.

     

气相色谱法在测定小麦中烯唑醇的应用

目的建立气相色谱ECD检测器测定粮食中烯唑醇农药残留的方法。方法样品中烯唑醇经乙腈提取浓缩后,石墨化碳固相萃取柱净化,DB-1701毛细管柱分离,气相色谱-电子捕获检测器(ECD)检测,外标法定量。结果烯唑醇在浓度0.05～1.00μg/mL范围内线性关系良好,相关系数r=0.9997,最低检出限0.02mg/kg。添加浓度为0.05mg/kg、0.10 mg/kg、0.20mg/kg、0.50mg/kg、1.00mg/kg时,回收率为76.0%～105.0%,相对标准偏差6.0%～10.0%。结论该方法准确灵敏,具有实际应用价值。     

阜阳市1061例艾滋病患者抗病毒治疗效果分析

目的分析阜阳市艾滋病抗病毒治疗的效果,为抗病毒治疗方案提供依据。方法应用国家免费提供的抗病毒治疗药物,对符合治疗条件的1061例艾滋病患者提供规范抗病毒治疗,定期随访病人体重、检测CD4^＋T淋巴细胞计数。结果59．51％的病例体重增加;治疗随访12个月,采用不同治疗方案,随治疗时间的延长,不同基线CD4^＋T淋巴细胞水平的患者CD4^＋T淋巴细胞平均计数增加均超过136个／μl,随访24个月,平均计数增加均超过150个／μl;治疗满36个月存活率为87．28％。结论高效抗逆转录病毒治疗（highlyactiveantiretroviraltherapy,HAART）方案效果肯定,患者的免疫功能得到重建,达到控制死亡率的目标。     

Combined peptides of human enterovirus 71 protect against virus infection in mice

Human enterovirus 71 (EV71) is a cause of hand, foot and mouth disease (HMFD) in children under 6 years old, and could cause serious neurological complications in some patients. Numerous large outbreaks of EV71 caused HMFD have occurred recently in Asia, especially in China. The cross-reactivity of EV71 with human brain tissue was observed and the cross-reactivity inducing regions were identified in previously study, which suggested that there were two regions in structural proteins of virus should be avoided in the vaccine. Six peptides without cross-reactivity were selected and combined into three vaccine candidates and applied in further evaluation in neonatal mice. The Vac6 comprising the peptides of P_70–159, P_140–249, P_324–443 and P_746–876 of the structural proteins could provide effective protection on pups against virus infection, as shown in viral copies detection and histopathology examination. Immunohistochemical staining results indicated that Vac6 had no cross-reactivity with human brain tissues. Our results suggested that Vac6 could have potential clinical value against EV71 epidemics caused mainly by C4 strains in the mainland of China.     

农村HIV感染者和病人个人卫生及相关行为习惯干预效果评价

目的了解农村HIV感染者和病人（PLwHA）个人卫生及相关行为习惯，制定相应的干预措施予以改善，以提高PLWHA预防疾病的能力。方法采用一对一匿名询问和现场实际察看PLWHA个人卫生及相关行为习惯进行基线调查，根据基线调查结果，制定相应的干预措施实施干预，并调查和评价干预效果。结果通过对安徽省皖北某县4个行政村共95位PLwHA进行调查，发现该地区农村居民经济收入较差（每人每年不足1000元），文化水平较低（小学及以下占83．2％），个人卫生及相关行为习惯较差。对于调查中发现部分因主观因素引起的个人卫生及相关行为习惯，实施干预措施后均有不同程度的改善。结论农村PLWHA个人卫生状况相对较差，实施干预措施后只能使部分因主观因素引起的个人卫生及相关行为习惯有所改善。     

阜阳市人群HBV感染的血清流行病学调查

目的了解某地自然人群乙型肝炎病毒(HBV)感染情况。方法调查2005年3-12月在某疾病预防控制中心进行健康体检人群的HBV血清标志物检测结果。HBV血清标志物检测采用酶联免疫吸附试验。结果单纯检测乙型肝炎表面抗原(HBsAg)的2 802人中,阳性255人,阳性率9.10%;各年龄组人群以31~40岁组HBsAg阳性率最高,占12.16%(71/584)。1 907例检测HBV5项血清标志物者中,HBsAg阳性者238例(12.48%),以HBsAg阳性合并抗HBe、抗HBc阳性为主(44.96%),HBsAg阳性合并HBeAg、抗HBc阳性次之(38.24%);5项全阴性者占总人群的46.88%。结论该地区自然人群HBV感染水平较高,近一半人没有保护性抗体,应加强健康宣教,推广普及乙肝疫苗的接种,改善环境卫生。