不同干预措施在煤矿农民工预防艾滋病中的效果

目的探讨在煤矿农民工艾滋病预防中不同干预措施的效果。方法 2009年7-12月,选取开滦矿业集团某煤矿农民工459人,在基线调查基础上分成3组,分别施加发放宣传品、专业讲座、同伴教育三种干预措施,连续干预6次,干预周期5个月。收集干预前后艾滋病相关知识、态度及危险性行为情况,比较三种干预措施的效果。结果专家讲座组的知识知晓率干预后提高到61.33%,明显高于宣传教育组的45.83%和同伴教育组的50.30%,后两组之间差异无统计学意义。艾滋病相关态度及意识比较,干预后专业讲座组有1个问题正答率较宣传品发放组有所提高,有2个问题正答率较同伴教育组有所提高;而同伴教育组与宣传品发放组差异无统计学意义。艾滋病相关危险行为比较发现,三组在干预前后寻找CSW(女性性工作者)的人数差异无统计学意义,但从安全套使用率比较来看,专业讲座组及同伴教育组干预后有所提高,差异有统计学意义;宣传品发放组干预前后差异无统计学意义。结论三种干预措施从干预效果角度来看,专家讲座组最好、同伴教育次之、发放宣传品组最差。     

2010～2011年张家口市宣化区游泳池水水质检测结果分析

[目的]了解张家口市宣化区游泳池水质卫生状况,找出存在的问题及原因,为加强游泳池的卫生管理提供科学依据,保障游泳者的身体健康。[方法]按GB/T 18204.9.10.29-2000《公共场所卫生标准检验方法》进行菌落总数、大肠菌群、尿素的检测;按GB/T 5750.4.11-2006进行pH值、浑浊度、余氯的检测对宣化区游泳池水质进行检测,并对2010～2011年检测结果情况进行统计分析。[结果]共检测水样152份,合格的105份,合格率为69.08%。2010年合格率为59.72%,2011年合格率为77.50%,差异有统计学意义(P<0.05)。不合格项目主要为菌落总数、游离性余氯、尿素。两年水样总体合格率差异有统计学意义(P<0.05)。学校泳池合格率最高,其次为住宅小区内泳池,公共泳池合格率最低。[结论]宣化区泳池水质卫生状况有了一定的改善,但仍需强化游泳池水的消毒工作,同时需注意定期换水。监督监测的重点是公共泳池和住宅小区内泳池。     

金栀洁龈含漱液在中重度牙周炎治疗中的作用

目的观察金栀洁龈含漱液配合常规牙周基础治疗对中重度牙周炎的治疗效果。方法选取中重度牙周炎患者120例,随机分为治疗组与对照组,各60例,在牙周基础治疗过程中,治疗组采用金栀洁龈含漱液进行牙周袋冲洗,对照组采用3%双氧水进行牙周袋冲洗。观察2组治疗后5周复诊时菌斑指数（plaqueindex,PLI）、龈沟出血指数（Sulcus bleeding index,SBI）、牙周探诊深度（probing depth,PD）、附着丧失（attachmentloss,AL）等牙周指数改善情况,并检测患牙龈沟液中白介素-6（IL-6）含量变化。结果治疗5周后,2组牙周各项指标均较治疗前显著改善（P〈0.05）;观察组SBI、PD、AL改善程度较对照组更为显著,且龈沟液中IL-6含量较对照组显著降低,组间比较差异有统计学意义（P〈0.05）。结论栀洁龈含漱冲洗配合牙周基础治疗,可有效改善中重度牙周炎患者临床症状及牙周指标,并能降低患者龈沟液中IL-6含量。     

2019年冬季青岛市手足口病患者感染柯萨奇病毒A组16型基因特征分析

  目的  调查2019年冬季青岛市妇幼医院和中心医院手足口病（HFMD）住院患儿病原感染情况,分析柯萨奇病毒A组16型（Cox A16）基因进化特征。  方法  收集2019年冬季青岛地区HFMD住院患儿104份咽拭子,采用实时荧光定量PCR进行肠道病毒核酸检测。 使用肠道病毒通用分型引物扩增阳性样本,扩增序列测序后进行Blast比对。 设计Cox A16 VP1全长引物,通过半巢式PCR扩增测序,使用DNAStar进行核苷酸和氨基酸的基因分析,使用MEGA软件构建进化树。  结果   HFMD住院患儿的咽拭子样本肠道病毒总体阳性率为57.7%（60/104）。 其中Cox A16阳性率为30.8%（32/104）,Cox A6阳性率为26.9%（28/104）。 对32份Cox A16阳性的样本进行VP1区全长扩增、测序并进行比对和同源性分析,其核苷酸同源性为87.0%～100%,氨基酸同源性为98.3%～100%。 系统进化分析表明,32株Cox A16中有17株为Cox A16 B1a基因型,另外15株为Cox A16 B1b基因型。  结论  引起2019年冬季青岛地区住院HFMD的病原体之一是Cox A16,且同时流行Cox A16的B1a和B1b型。     

Suicide prevention program for at-risk groups: Pointers from an epidemiological study

ObjectivesThe aim of this paper is to identify at-risk groups for a focused suicide prevention program for Malaysia.MethodsData from 20,552 persons aged 16 years and above (males 45.9%), was obtained using stratified, random sampling in a national survey of psychiatric morbidity using locally validated General Health Questionnaire (GHQ-28) which included questions on suicidal ideation.ResultsThe overall prevalence of suicidal ideation (SI) was 6.3%, CI 6.1–6.8 (n = 1288). Logistic regression analysis was performed with age, ethnicity, gender, urban/rural residence, age group, marital status, household income, type of household, presence of chronic pain, social dysfunction, somatic, anxiety or depressive symptoms, obesity, and chronic medical illnesses as independent variables. Only Insomnia, Religion, Marital Status, Depression, Social Dysfunction and Anxiety were seen to be significant predictors. Prevalence of SI was significantly higher among Indians (11.0%, CI 9.5–12.5), especially those of the Hindu faith (12.2%, CI 10.5–14.0), Chinese (9.7%, CI 8.8–10.7) and those having depressive symptoms.ConclusionIn a developing country with competing priorities, prudent allocation of resources requires focusing suicide prevention efforts on treating depression in vulnerable groups.     

河北省首例B群脑膜炎奈瑟菌感染死亡病例报告

本文报告了河北省首例B群脑膜炎奈瑟菌致流脑死亡病例。患者为3月龄婴儿,始发症状为发热,恶心,呕吐,皮肤瘀点、瘀斑。因在血液和脑脊液中均分离培养得到B群脑膜炎奈瑟菌从而确诊。     

医院与CDC信息交换的安全域设计

全国卫生信息系统正在加速统一整合,医院信息系统从封闭走向开放,安全问题日益突出.介绍安全域划分的目的、依据、原则及等级防护,具体探讨医院信息系统与CDC进行信息交换时医院信息系统的安全域模型的设计,并强调安全域管理保障的重要性.     

Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based,multicenter,cross-sectional survey

Background:The increasing prevalence of colorectal cancer (CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment.We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.Methods:We conducted a multicenter,cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014.Each enrolled patient was interviewed using a structured questionnaire.All expenditure data were inflated to the 2014 Chinese Yuan (CNY;1 CNY =0.163 USD).We quantified the overall expenditure and financial burden and by subgroup (hospital type,age at diagnosis,sex,education,occupation,insurance type,household income,clinical stage,pathologic type,and therapeutic regimen).We then performed generalized linear modeling to determine the factors associated with overall expenditure.Results:A total of 2356 patients with a mean age of 57.4 years were included,57.1％ of whom were men;13.9％ of patients had stage Ⅰ cancer;and the average previous-year household income was 54,525 CNY.The overall average direct expenditure per patient was estimated to be 67,408 CNY,and the expenditures for stage Ⅰ,Ⅱ,Ⅲll,and Ⅳ disease were 56,099 CNY,59,952 CNY,67,292 CNY,and 82,729 CNY,respectively.Non-medical expenditure accounted for 8.3％ of the overall expenditure.The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY,which accounted for 59.9％ of their previous-year household income and caused 75.0％ of families to suffer an unmanageable financial burden.Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups (P ＜ 0.05),except for sex.Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more,whereas those with a lower household income and those who underwent surgery spent less (all P ＜ 0.05).Conclusions:For patients in China,direct expenditure for the diagnosis and treatment of CRC seemed catastrophic,and non-medical expenditure was non-ignorable.The financial burden varied among subgroups,especially among patients with different clinical stages of disease,which suggests that,in China,CRC screening might be cost-effective.     

Management of common respiratory problems

This article reviews the clinical management of common respiratory illnesses that primary care providers encounter in an out-patient setting. The latest recommendations from the American Thoracic Society, the National Heart, Lung, and Blood Institute, and the Centers for Disease Control and Prevention are summarized. The article discusses the causative organisms and antibiotics of choice for community-acquired pneumonia, and how to determine which patients require hospitalization. The appropriate use of asthma medications is described in detail, along with strategies for reducing aeroallergen exposure and for educating patients. An extensive section covers the interpretation of tuberculin skin tests and use of prophylactic isoniazid for preventive therapy of latent tuberculosis infection, as well as the treatment of active tuberculosis. Controversies regarding antibiotics for both acute and chronic bronchitis are discussed, along with other treatment options including over-the-counter medications, bronchodilators, and non-pharmacologic interventions. Finally, a strategy for dealing with the compliant of chronic cough is outlined. Although many of these conditions require active comanagement by collaborating physicians, the nurse-midwife will be better able to communicate with and advocate for her clients if she possesses expanded and current knowledge of treatment strategies.