上海市一起输入性皮肤炭疽疫情的流行病学调查

目的 探讨上海市作为特大城市对急性传染病防控的挑战和问题。方法 2019年5月30日上海市发生一起输入性皮肤炭疽疫情,上海市CDC对患者进行流行病学调查及处置,在疫情发生后,上海市CDC收集皮肤炭疽患者相关资料,并对其进行流行病学调查,同时采集患者伤口创面标本和血标本,进行实验室检测。结果 该患者的7份伤口创面标本中,6份炭疽芽胞杆菌核酸检测阳性;双份血清学检测结果显示,炭疽芽胞杆菌抗体滴度增长4倍,上海市CDC对该确诊病例进行流行病学调查并对其接触者进行了观察。经治疗,病例康复,19例接触者无续发病例出现。结论 上海市有必要加强临床医生对新发传染病的培训,对输入性传染病做到早发现、早诊断、早治疗,减少疾病的发病、传播和死亡。同时需要多部门联防联控,预防和控制继发病例的发生。     

上海市徐汇区伏案工作人群颈椎健康状况调查

目的 了解上海市徐汇区伏案工作人群颈椎健康现状.方法 采用随机整群抽样的方法,在徐汇区随机抽取2个街道(镇),对该辖区的三家健康促进示范基地(企业、学校、机关)内所有符合标准的人员进行调查.研究对象为伏案工作人群,进入单位满一年以上的正式员工.采用Epi Data 3.1录入数据并建立数据库,应用SPSS 22.0统计软件完成统计分析.结果 780名伏案工作人群中,颈椎病患病率为13.8%,高于一般人群.主要表现为颈型颈椎病,三个最常见症状为颈部酸痛、肩部酸痛和头晕.颈部酸痛和肩部酸痛与性别(P<0.01)、年龄(P<0.01)、文化程度(P<0.01)、职业(P<0.05)等因素都有关,头晕症状则只与性别(P<0.05)、年龄(P<0.01)相关.结论 伏案工作人群为颈椎病的高危人群,且越来越趋向年轻化.应尽早开展相应的干预措施,有助于此人群的颈椎病预防.     

无机三氧化物聚合物根尖段根管充填与倒充填治疗慢性根尖周炎的疗效比较

目的:比较应用无机三氧化物聚合物(mineral trioxide aggregate,MTA)在显微镜下进行根尖段根管充填与倒充填治疗慢性根尖周炎的疗效。方法:对慢性根尖周炎患者107例共130颗患牙进行治疗,根据MTA在根尖段充填方式的不同将其分为2组:根尖段根管充填MTA组(n=58)和根尖倒充填MTA组(n=72)。随访2年,通过临床症状和X线片检查评价疗效。结果:根尖段根管充填MTA组成功率为82.76%,根尖倒充填MTA组成功率为90.28%,2组成功率无显著差异(P>0.05)。结论:采用MTA根尖段根管充填与倒充填的方法治疗慢性根尖周炎均能获得较好的疗效。     

上海市徐汇区艾滋病防治人员艾滋病歧视状况调查

[目的]了解徐汇区艾滋病防治医务人员对艾滋病毒感染者/患者(PLWHA)的歧视状况,分析影响医务人员歧视态度和行为意愿的因素。[方法]自行设计调查问卷,对徐汇区31家医疗机构133名艾滋病防治医务人员开展问卷调查。[结果]在对待PLWHA态度方面,歧视得分最高项和最低项分别为"艾滋病感染者应该到传染病医院就诊"、"应该尊重艾滋病感染者的隐私",分值分别为1.59分、0.03分;在对待PLWHA行为意愿方面,歧视得分最高项和最低项分别为"不会去艾滋病感染者处买东西"、"愿意继续和感染了艾滋病的熟人交往",分值分别为1.05分、0.48分。歧视得分女性>男性,临床岗位>检验岗位>防保岗位。[结论]性别、从事岗位类别为影响歧视得分的主要因素;对待PLWHA存在态度与行为意愿不一致的现象。应切实贯彻实施《艾滋病防治条例》、加强医务人员职业道德培训、强化职业防护政策保障和培训,减少对PLWHA的歧视。     

上海市肺结核病防治示范区I—PPM模式的实施现状与效果研究

目的：了解上海市肺结核病防治示范区I-PPM模式的实施情况,总结上海大城市结核病防治的效果、经验与挑战,提出进一步完善的建议。方法：以上海市7个结核病防治示范区为研究现场,采用现有资料收集、补充问卷的定量调查方法和深入访谈、小组讨论的定性调查方法。结果：各示范区运用结防PPM模式于病例发现、转诊追踪、确诊治疗、督导化疗和健康教育等各个过程。2009年示范区新涂阳肺结核患者的治愈率达到88．3％,自付费用占家庭年收入的比例约为5％。患者总体满意超过90％,结防人员满意度3．55分。结论：该模式有效整合资源,加强了疾病预防控制中心（CDC）的监督管理职能,实现了患者在医疗机构的“非中心化”发现、提高了地区结核病诊疗水平,充分发挥了社区督导管理的便利可及性。但在提高人力可持续性和控制医疗费用方面仍需研究有效的机制来提高I-PPM的效果。     

城市人口老龄化及危险因素改变对近20年糖尿病死亡率的影响

[目的]定量评价因城市人口老龄化及危险因素改变对糖尿病死亡率的影响,为促进健康老龄化和制定糖尿病社区防治策略提供依据。[方法]分析上海市徐汇区1986～2005年糖尿病死亡率的变化,计算人口老龄化及危险因素改变对糖尿病死亡率变化的作用,并对危险因素归因构成比的时间趋势进行分析,拟合指数曲线。[结果]徐汇区1986～2005年65岁以上老龄人口构成增加了近1倍,糖尿病标准化死亡率女性高于男性,男女性别比1：1．65。20年间男性和女性标化死亡率均随时间呈上升趋势,男性r=0．9180,F=32．17,P=0．0013;女性r=0．8458,F=15．08,P=0．0081。20年间糖尿病粗死亡率上升了414．54％,归因于人口老龄化因素占68．49％,男性高于女性;归因于危险因素改变占31．51％。归因于老龄化效应的比例无论男性还是女性均有逐年上升趋势,相关系数男性r=0．9202,F=27．64,P=0．0033;女性r=0．9523,F=48．67,P=0．0009。[结论]人口老龄化对糖尿病死亡率影响作用大于危险因素改变的作用,男性尤其明显;与之相应的,归因于危险因素改变的影响所占构成比随时间变化有下降趋势。     

Acceptance of Chemo-prophylaxis for Latent Tuberculosis Infection among High School/College Student Contacts of Tuberculosis Patients in Shanghai,China

正Student contacts of tuberculosis(TB)cases are susceptible to latent tuberculosis infection(LTBI),and chemo-prophylaxis can reduce the risk of active TB among them.This study aimed to assess the     

Effect of light pressure stroking massage with sesame (Sesamum indicum L.) oil on alleviating acute traumatic limbs pain: A triple-blind controlled trial in emergency department

ObjectivesDue to adverse effects of common medications used for traumatic pain management, it is crucial to use complementary methods to alleviate this pain. Present study aimed to assess the effect of light pressure stroking massage with topical sesame oil on pain severity of patients with limbs trauma.MethodsThis triple-blinded randomized trial was conducted on 40 patients with upper or lower extremities trauma in emergency department of Busheher Amir Al-Momenian Hospital, Busheher, Iran, in 2015–2016. Patients received a 5 min massage with either liquid paraffin (placebo) or sesame oil on trauma site twice a day for 9 days duration. Pain severity was assessed by visual analogue scale in first day (baseline), 3th, 6th and 9th days of intervention in the both groups.ResultsMean changes of pain severity between two groups was significant in the 6th (−0.20 ± 1.36; P = 0.036) and 9th (−0.36 ± 1.12; P < 0.001) days of intervention. Regarding to intake of diclofenac, no significant difference was seen between sesame oil and placebo groups during 9 days of intervention (575.23 ± 3.11 and 625.13 ± 4.23 respectively, P = 0.601). There were no adverse effects during the study in the both groups.ConclusionMassage with topical sesame oil was associated with significant reduction in pain severity of patients with limbs trauma. Therefore, it is suggested to use this oil on complementary medicine for pain relief due to low cost, easy usage and lack of adverse effects.     

Efficacy and safety of traditional Chinese medicine on thromboembolic events in patients with atrial fibrillation: A systematic review and meta-analysis

ObjectivesTraditional Chinese medicine (TCM) in combination with Western medicine (WM) has been widely used worldwide. This systematic review aimed to evaluate the efficacy and safety of TCM in prevention of thromboembolic events in patients with atrial fibrillation (AF).MethodsPotential studies were searched through the Cochrane Library, PubMed, EMBASE, CBM, VIP, CNKI, and Wanfang databases up to February 2016. Randomized controlled trials (RCTs) investigating the thromboembolic events and/or safety outcome of TCM in patients with AF were included.ResultsA total of 905 AF patients from 9 RCTs were identified. Meta-analysis showed that TCM in combination with warfarin was better than warfarin alone for preventing total thromboembolic events with a 68% reduction of risk (risk ratio [RR] 0.32; 95% confidence interval [CI] 0.13–0.78) without increasing the risk of total bleeding (RR 0.71; 95% CI 0.29–1.72). Compared with warfarin, TCM therapy was associated with lower risk of total bleeding (RR 0.13; 95% CI 0.04–0.47), but increased the risk of total thromboembolic events (RR 1.84; 95% CI 1.03–3.27).ConclusionsThis meta-analysis suggests that TCM combined with warfarin is superior to warfarin alone for the prevention of total thromboembolic events in patients with AF, with equal risk of bleeding as warfarin alone.     

水中二溴乙烯的静态顶空-气相色谱分析方法研究

目的:应用静态顶空气相色谱检测方法测定生活饮用水中的二溴乙烯。方法:水样用静态顶空平衡及自动进样,经DB-35毛细柱分离、μ-ECD测定,外标法定量。结果:在0.015μg/L～1.5μg/L范围内质量浓度与峰面积有良好的线性关系,平均加标回收率为101%,相对标准偏差(RSD)在1.7%～2.6%之间,方法检出限为0.0050μg/L。结论:该方法充分利用顶空技术的操作简单,低毒,及μ-ECD的高灵敏性,检测结果准确、可靠,达到方法学和国家标准限值的要求,适用生活饮用水和其他环境水样的分析。