某大型水面舰艇部队肾结石和肾结晶流行病学调查分析

【摘要】目的 分析某大型水面舰艇官兵尿石症流行病学特点及其危险因素。 方法 收集2021年某大型水面舰艇部队官兵体检报告原始数据,包括一般信息、内外科体检结果、超声、血尿检验结果等,并行作训环境及生活习惯调查,分析官兵肾结石和肾结晶患病情况及影响因素。 结果 1315名官兵中,肾结石/结晶总患病率6.92%。肾结石和肾结晶患病率均随着年龄、军龄和上舰龄的增长而增加。肾结石/结晶患者中合并超重者占32.97%,显著高于无肾结石/结晶者（17.04%）。肾结石/结晶患者饮水量大于2000ml/d的比例（20.45% vs. 30.24%）及饮用牛奶的比例（82.95% vs. 90.64%）显著低于无肾结石/结晶者。与不伴有肾结石/结晶的官兵相比,患有肾结石/结晶官兵的作训环境、水源、饮料摄入、血尿酸水平、尿渗透压均无显著差异。Logistic多因素回归分析显示年龄增加和超重是舰艇官兵肾结石/结晶患病的独立危险因素,而多饮水和牛奶是保护性因素。 结论 舰艇官兵肾结石和肾结晶患病率较高,其发生与年龄增加、超重、少饮水和少饮牛奶等因素相关。     

HIV prevalence among IDUs in Australia: a methodological review

A review was carried out of Australian studies which have measured the prevalence of HIV infection among injecting drug users (IDUs). The review considered published studies which had reported on serologically-determined HIV prevalence. There were five studies reported from specialized sexually-transmissible disease of HIV clinics, five studies reported from health services aimed at IDUs, three studies reported from other health services and one multi-centre behavioural study. The main findings from the studies were that HIV prevalence in IDUs has been low in Australia, apart from in male IDUs who also had homosexual contact. HIV prevalence ranged from 20 to 24% in male IDUs reporting homosexual contact and from 0 to 5% in other IDUs.

The studies, while reflecting a range of research methodologies, are subject to a number of limitations. Most of the studies did not provide detailed analyses of HIV prevalence by age and sex or behavioural factors, and several studies used sampling frames which were not clearly defined. There is little available information on temporal trends in seroprevalence and geographical comparisons are rendered difficult by differences in the study methodology. Adoption of standardized, continuing seroprevalence surveys on IDUs would provide a better means of monitoring the occurrence of HIV infection in this group, which has been a key determinant of the course of the HIV epidemic in a number of Western countries.     

Antimicrobial susceptibility and serotype replacement of Streptococcus pneumoniae in children before and after PCV13 introduction in Taiwan

BackgroundSince 2015, 13-valent pneumococcal conjugate vaccine (PCV13) was included in the national immunization program in Taiwan. Subsequently, the serotypes of the main circulating Streptococcus pneumoniae strains have changed. PCV administration is also associated with changes in the antimicrobial susceptibility of S. pneumoniae strains. Therefore, in this study, we analyzed the serotype distribution and antimicrobial susceptibility of S. pneumoniae in pediatric infections.MethodsChildren with S. pneumoniae infections, including invasive pneumococcal disease (IPD) and non-IPD, were enrolled from January 2010 to December 2020. The samples were collected from Mackay Memorial Hospital, MacKay Children's Hospital, and Hsinchu Mackay Hospital in Taiwan. We analyzed the epidemiology of sample collection site, infection diagnosis, and the serotype and antimicrobial susceptibility of S. pneumoniae strains. The study period was divided into time points before and after PCV13 administration.ResultsIn total, 322 isolates were collected during the study period. The incidence of IPD declined annually, from 29.7% before 2015 to 7.3% after 2015 (p < 0.001). The prevalence of serotype 19 A had increased gradually since 2010 but declined rapidly after 2013. Serotypes 15 A and 23 A were the most common serotypes after 2015. The non-susceptibility of the S. pneumoniae isolates to penicillin, cefotaxime, and ceftriaxone decreased. Based on meningitis breakpoints, the non-susceptibility to cefotaxime and ceftriaxone gradually decreased, but increased in 2020.ConclusionPCV13 was considerably effective in reducing the incidence of IPD in children; however, the prevalence of serotypes 15 A and 23 A increased. The increase in antimicrobial non-susceptibility caused by non-vaccine serotypes must be continuously monitored.     

The incidence of alcohol-related problems and the risk of alcohol withdrawal in a general hospital population

A survey was carried out using the Canterbury Alcohol Screening Test (CAST) and clinical criteria for risk of alcohol withdrawal of 2000 randomly selected hospital in-patients in order to determine the prevalence of alcohol-related problems, the work-load for a specialist alcohol withdrawal service and the target group for early intervention. Patients at risk of alcohol withdrawal were followed prospectively.

The major findings were: 14.3% of patients had a positive CAST and 8% were at risk of alcohol withdrawal; the prevalence of positive clinical criteria was greatest in men under the age of 30 years (OR 3.6) and very low (OR 0.34) in women over 60 years. In addition, patients who were too sick or refused to complete the questionnaire had high rates of being at risk for alcohol withdrawal. The prevalence of CAST positivity was greatest in men under the age of 40 years (OR 3.7) and lowest in women over 70 years (OR 0.2).

It is concluded that 15-20% of in-patients have alcohol problems and 8% are at risk of withdrawal; questionnaires will produce underestimates of the order of 25%; and female in-patients over the age of 60 years are extremely unlikely to have problems with alcohol.     

蒙城县疟疾防治对策与效果评价

本文报告了蒙城县非稳定性单纯间日疟流行区,从６０年代初到７０年代初曾发生过两次大面积暴发流行,７０年代中和８０年代初又发生三次较大流行。通过２４年来的积极防治,在采取“两根治、一预防、消灭传染源”为主的综合性防治和现症病人管理三个阶段不同对策后,使流行范围逐年缩小,疟疾发病大幅度下降,全县疟疾发病率从１９７０年的１６８３．８８／万,降至１９９７年的０．００９／万,并实现了连续１２年在１／万以下,１９９８年全县无疟疾疫情,达到了部颁基本消灭疟疾标准。     

深圳市糖尿病流行特征研究

采用分层整群抽样方法,对深圳市５个行政区在深圳居住５年及以上,年龄在２０岁及以上的８２００名社区人群进行了糖尿病流行病学调查。结果表明,深圳居民糖尿病（ＤＭ）标化患病率为４３１％,糖耐量低减（ＩＧＴ）标化患病率为１１９３％,两者之比为１∶２７８;其中女性糖尿病（ＤＭ）和耐糖量低减（ＩＧＴ）标化患病率分别为４３１％和１１９３％,明显高于男性,后者分别为３７１％和１０２８％。研究结果还表明糖尿病和糖耐量低减率随年龄的升高而升高,离退休人员和家庭妇女明显高于其他职业人群,末发现来自不同地区人群糖尿病和ＩＧＴ患病率间差异。     

The prospects of a harm reduction approach among indigenous people in Canada

A harm reduction approach to alcohol and substance abuse is becoming increasingly popular as an alternative to prohibitionist and abstentionist policies. It is seen as particularly valuable for some high-risk populations, such as injection drug users and street youth. A strong argument can be made that Aboriginal communities in Ontario, Canada, and probably across the country, are appropriate environments for a harm reduction approach. Aboriginal people are at extremely elevated risk for accident, illness and death. At the same time, alcohol use is a predominant factor in many of these outcomes, and elevates many of the risks associated with Aboriginal life. Isolated, remote reserve communities in northern Ontario present additional risks of extremely poor living conditions and extreme weather conditions. Prohibition and abstinence are currently the main approaches to alcohol and substance abuse in many of these communities, while the role of alcohol in morbidity, mortality and other social problems remains high. There are positive indications that the feasibility of harm reduction strategies could be broached in some communities. It is concluded that the obstacles are significant but a community-by-community approach is a strong feature of harm reduction, and may increase its prospects for piloting strategies in individual communities.     

One-year prevalence and incidence of depression among first-year university students in Japan: a preliminary study

A structured interview was used to examine the 1-year incidence and prevalence of depression among 116 first-year university students. While 24 of the subjects (20.7%) met the Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM-IV) criteria for Major Depressive Episode (MDE), 62 (53.4%) met the Diagnostic and Statistical Manual of Mental Disorders 3rd ed. Revised (DSM-III-R) criteria for MDE, and 27 (23.3%) also met the Research Diagnostic Criteria (RDC) for Major Depressive Disorder (MDD) for the 12 months prior to the interview. Moreover, 23 of the subjects (19.8%) had onset of the DSM-IV criteria for MDE, 54 (46.6%) had onset of the DSM-III-R criteria for MDE, 24 (20.7%) had onset of the RDC for MDD, during the same time period. These high rates of depression may be explained by the students' difficulties in and by their readjustment after entering university.