Role of Diabetes Mellitus on Treatment Effects in Drug-susceptible Initial Pulmonary Tuberculosis Patients in China

We assessed the role of diabetes mellitus(DM) on treatment effects in drug‐susceptible initial pulmonary tuberculosis(PTB) patients. A prospective study was conducted in eight provinces of China from October 2008 to December 2010. We enrolled 1,313 confirmed drug‐susceptible initial PTB patients, and all subjects received the treatment regimen(2 H3 R3 E3 Z3/4 H3 R3) as recommended by the national guidelines. Of the 1,313 PTB patients, 157(11.9%) had DM; these patients had more sputum smear‐positive rates at the end of the second month [adjusted odds ratios(aO R) 2.829, 95% confidence intervals(CI) 1.783‐4.490], and higher treatment failure(aO R 2.120, 95% CI 1.565‐3.477) and death rates(aO R 1.536, 95% CI 1.011‐2.628). DM was a contributing factor for culture‐positive rates at the end of the second month and treatment failure and death of PTB patients, thus playing an unfavorable role in treatment effects of PTB.     

How community-level social and economic developments have changed the patterns of substance use in a transition economy?

Most social changes take place at the community level before indirectly affecting individuals. Although the contextual effect is far-reaching, few studies have investigated the important questions of: how do community-level developments affect drinking and smoking, and how do they change the existing gender and income patterns of drinking and smoking, particularly in transition economies? In this study, I used a Chinese panel dataset between 1991 and 2011 to reveal the moderating effects of community developments. Through multilevel growth curve modeling that controls for age, period, and cohort effects, as well as individual- and community-level covariates, I found that community-level economic development and social development are negatively associated with drinking and smoking. Moreover, economic and social developments also moderate the important influences of income and gender: women start to drink more in communities with higher economic development; the traditionally positive association between income and smoking/drinking is also reversed, i.e. the rich start to smoke and drink less in communities with higher social development. This study concludes that the rapid changes in communal social and economic structures have created new health disparities based on the gender and socioeconomic hierarchy.     

不同可变数目串联重复序列组合对中国流行结核分枝杆菌分辨力的评价研究

目的 在规范化的结核分枝杆菌（Mycobacterium tuberculosis,MTB）可变数目串联重复序列（variable number of tandem repeats,VNTR）基因分型的基础上,构建我国31个省（自治区、直辖市）VNTR数据库,每个省优化一套VNTR位点组合,为我国结核病预防控制策略的制定提供科学依据。方法 对2007－2008年全国结核病耐药性基线调查的4 116株MTB15位点VNTR（15-VNTR）基因分型。汉高指数（Hunter-Gaston Index,HGI）分析每个位点的分辨率。依据谱系流行特征,以分辨率高和稳定性强为原则,为各省设计一套VNTR优化组合（12-VNTR、10-VNTR、8-VNTR和5-VNTR）,采用HGI和成簇率进行评价。结果 完成了涵盖率为96.36%（3 966/4 116）MTB完整15-VNTR图谱。发现QUB11b、MIRU26等7个高分辨率位点;QUB26、MIRU16、Mtub21、QUB11b在部分地区遗传稳定性差。内蒙古自治区、重庆市、黑龙江省的最优组合为10-VNTR,其他各省的最佳组合为8-VNTR。结论 VNTR数据库的建立将推动全国范围MTB传染源的追踪;各省优化VNTR组合的推出有助于当地结核病疫情的监测和群体遗传学的研究。     

920例儿童肺结核临床流行病学特征分析

目的分析儿童肺结核的临床流行病学特征。方法回顾分析2010年-2015年收治的920例肺结核患儿临床资料,并根据病情严重程度分为重症组及非重症组,分析引起重症结核的危险因素。结果 920例患儿的中位发病年龄为7.66岁(9天～17岁7个月)。单纯肺结核470例(51.1%),肺结核合并肺外结核450例(48.9%),其中以合并结核性脑膜炎最为多见(236/450,52.4%)。最常见症状为发热(80.4%)和咳嗽(71.3%)。T-SPOT.TB试验阳性率81.5%。胸部CT阳性率优于胸片。重症结核355例、非重症565例。与非重症相比,重症患儿中男性比例较低,农村患儿、PPD阴性以及年龄0～3岁的比例较高,差异均有统计学意义(P0.05)。多因素logistic回归分析显示,女孩(OR=1.58,95%CI:1.03～2.42)、年龄0～3岁(0～1岁:OR=6. 78,95%CI 3. 66～12. 56;1～3岁:OR=4. 90,95%CI 2. 68～8. 98)、农村患儿(OR=2. 49,95%CI:1. 54～4. 04)是重症结核的独立危险因素,PPD阳性为保护因素(OR=0. 31,95%CI:0. 19～0. 49)。结论儿童肺结核临床表现不典型,病原学阳性率低,需重视接触史、卡介苗接种情况,并强调综合分析,提高对重症结核危险因素的认识。     

2016年南阳市结核病耐药监测结果分析

目的了解南阳市区耐药情况,监测南阳市区结核患者的药敏结果,为本市结核病的防控提供科学依据。方法选取本市2016年结核病控制项目患者痰培养阳性的菌株,用比例法对异烟肼(H)、利福平(R)、乙胺丁醇(E)、链霉素(S)的耐药性进行耐药性监测。结果共有1613例结核患者纳入监测分析,总耐药率为18.9%,耐药率顺位由高到低依次为S(15.9%)、H(10.2%)、R(8.6%)、E(5.6%);耐多药率为7.9%,初始耐多药率为7.2%,获得性耐多药率为27.1%;初始耐多药构成比为87.5%。结论南阳市结核病总体耐药处于较高水平,应加强耐药水平的监测,尤其在初治涂阳患者中的监测,同时采取更全面的举措有效改善耐药结核病的现状。     

我国新型冠状病毒肺炎疫情早期围堵策略概述

2019年12月,湖北武汉市发生新型冠状病毒肺炎疫情,并迅速向全国蔓延。在疫情发生初期,我国采用围堵策略,并围绕此策略要点实施一系列核心措施,包括社会动员、加强病例隔离和密切接触者追踪管理、封锁疫区和交通管控以减少人员流动、增加人际距离、环境卫生措施以及个人防护等,以期尽快将疫情控制在武汉等有限地区。本文对围堵策略实施的背景、主要内容、以及核心措施进行了概述,分析了我国现阶段实施的围堵策略及核心措施的公共卫生意义,并基于措施效果的全面评价与疫情发展的态势评估提出下一步考虑建议。     

The Catalonian Expert Patient Programme for Chagas Disease: An Approach to Comprehensive Care Involving Affected Individuals

The Catalonian Expert Patient Programme on Chagas disease is a initiative, which is part of the Chronic Disease Programme. It aims to boost responsibility of patients for their own health and to promote self-care. The programme is based on nine sessions conducted by an expert patient. Evaluation was focusing in: habits and lifestyle/self-care, knowledge of disease, perception of health, self-esteem, participant satisfaction, and compliance with medical follow-up visits. Eighteen participants initiated the programme and 15 completed it. The participants were Bolivians. The 66.7 % of them had been diagnosed with chagas disease in Spain. The 100 % mentioned that they would participate in this activity again and would recommend it to family and friends. The knowledge about disease improve after sessions. The method used in the programme could serve as a key strategy in the field of comprehensive care for individuals with this disease.