长江经济带建设战略下血吸虫病防治工作思考

长江经济带建设已纳入国家战略，其目的不仅仅是提高全民经济水平，更是以经济性、均衡性、生态性和公平性共同发展，建设一个绿色生态廊道。长江经济带作为血吸虫病流行的主要地区，在进行经济建设时更应严格做好血吸虫病防治工作，促进血吸虫病消除目标顺利实现。本文对长江经济带区域血吸虫病流行现况，以及长江经济带建设对血吸虫病防治工作可能造成的影响进行剖析，并对今后该区域内的血吸虫病防治工作提出一些建议。     

Living in an urban environment and non-communicable disease risk in Thailand: Does timing matter?

BackgroundThis paper uses a life-course approach to explore whether the timing and/or duration of urban (vs rural) exposure was associated with risk factors for NCDs.MethodsA cross-sectional survey was conducted among health care workers in two hospitals in Thailand. Two measures of urbanicity were considered: early-life urban exposure and the proportion of urban life years. We explored four behavioral NCD risk factors, two physiological risk factors and four biological risk factors.ResultsBoth measures of urbanicity were each independently associated with increases in all behavioral and physiological risk factors. For some biological risk factors, people spending their early life in an urban area may be more susceptible to the effect of increasing proportion of urban life years than those growing up in rural areas.ConclusionUrbanicity was associated with increases in behavioral and physiological risk factors. However, these associations may not translate directly into increases in biological risk factors. It is likely that these biological risk factors were results of a complex interaction between both long term accumulation of exposure and early life exposures.     

Lutzomyia longipalpis spatial distribution and association with environmental variables in an urban focus of visceral leishmaniasis, Misiones, Argentina

This study describes the spatial distribution pattern of Lu. longipalpis abundance in Posadas-Garupá, Argentina, where four cases of human Visceral Leishmaniasis had been recorded. A total of 2428 Lu. longipalpis were captured in 42% of the 305 sites sampled with CDC light traps, its abundance shows spatial autocorrelation ranging up to 590 m (semivariogram model), with six downtown ‘islands’ of vector highest abundance (≥60 individuals). A significant association between Lu. longipalpis and the presence of chickens was observed (odds ratio 3.26). The best stepwise multiple regression using Generalized Linear Models explained 31% of the deviance for Lu. longipalpis abundance, including as explanatory variables: (a) negatively: households with ‘lack of building material and with economic deprivation’, (b) positively: surface covered by trees and bushes at 50 meters of the house, and households without electrical lighting. In conclusion, Lu. longipalpis in a recent settled focus of visceral leishmaniasis was urbanized with a highly heterogeneous spatial distribution within the cities, with the vectors concentrated in limited ‘islands’ of high abundance, in the downtown relatively more affluent and dense populated areas, but also more heterogeneous with patches that had higher tree coverage and poor urban services. These results once validated will contribute to the control strategy design through risk maps, in order to prioritize areas for prevention and control, and setting the appropriate scale for intervention.     

城镇非户籍人口的医疗保障总结与评价

通过对各城市已有的外来人口医疗保险模式现况总结,从管理模式、保险覆盖服务范畴、筹资模式和费用控制模式四方面对其进行评价,提出相应的政策建议。     

中国城镇化与健康相关行为关系分析:一项基于CHARLS数据的实证研究

目的: 探讨中国城镇化与居民健康相关行为的关系,理清城镇化对健康行为的影响。方法: 基于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)在2011、2013和2015年均被追踪到的数据构建个体面板,采用面板数据固定效应模型分析城镇化水平对戒烟、饮酒、睡眠质量和锻炼行为的影响,利用人口密度、人均国内生产总值(gross domestic product, GDP)、第二三产业产值占比代表城镇化水平。结果: 2011—2015年中国城镇化水平呈增加趋势,表现为人口密度、人均GDP和第二三产业产值占比的逐年增长。戒烟率随人均GDP水平、第二三产业产值占比水平的增加均有所提高。饮酒率以低水平为对照,人均GDP水平在45 000元以上的地区饮酒率提高2.49%,第二三产业产值占比为80%~85%的地区饮酒率降低2.48%,人口密度的差异无统计学意义。睡眠质量随人均GDP水平的增加而降低,人均GDP在93%以上的地区睡眠质量好的比低水平降低3.71%,人口密度水平和第二三产业产值占比的差异无统计学意义。锻炼率以低水平为对照,人口密度在400~600人/平方公里和800人/平方公里以上的地区锻炼率分别降低5.2%和7.7%,人均GDP在25 000~35 000元和45 000元以上的地区锻炼率分别降低3.26%和3.73%,第二三产业产值占比在93%以上的地区锻炼率降低10.68%。结论: 城镇化不同维度对不同健康行为的影响不同,戒烟率随城镇化水平增加而上升,与人均GDP和第二三产业产值占比有关;锻炼率随城镇化的增加而降低,与三个维度均有关系;睡眠质量好的概率随城镇化水平的增加而降低,与人均GDP关系更为密切;饮酒率与城镇化水平无明显相关趋势,还需要进一步研究。     

城市对海口市南渡江的微生物群落及其毒力因子与抗生素耐药基因组的影响

目的探讨河流流经海口市前后河水中细菌菌群结构、抗生素耐药基因组和病原菌毒力基因组的变化, 及其传播扩散模式。方法从流经海口市前的南渡江上游至南渡江入海口划分前、中、后段3个研究区域, 每个区域选择3个采样点, 每个采样点平行采集6份样本并混合为1份, 每份3 L。通过宏基因组测序和16S rRNA基因全长测序获得相关生物信息数据, 分析前、中、后3段水体中微生物群落结构以及耐药基因、毒力因子和可移动遗传元件信息。运用主坐标分析、普氏分析和曼特尔检测等方法分析样本间菌群分布差异以及传播模式相关性。结果随着河水流经海口市, 微生物的α多样性呈现逐渐降低趋势。其中变形菌门在前、中、后段的细菌群落中均占据主导地位, 中、后段变形菌门相对丰度高于前段。抗生素耐药基因、毒力因子及可移动遗传元件的多样性和丰度在前段均处于较低水平, 流经海口市后, 均明显升高。同时, 可移动遗传元件介导的水平传播在抗生素耐药基因和毒力因子扩散中发挥较大作用。结论城市化对河流中的微生物及其携带的耐药基因、毒力因子和可移动遗传元件产生显著影响。在海口市南渡江, 河流流经城市受纳了人群排出的抗生素耐药菌和病原相关细菌, 同...     

Gene-Environment Interaction in Adults’ IQ Scores: Measures of Past and Present Environment

Gene-environment interaction was studied in a sample of young (mean age 26 years, N = 385) and older (mean age 49 years, N = 370) adult males and females. Full scale IQ scores (FSIQ) were analyzed using biometric models in which additive genetic (A), common environmental (C), and unique environmental (E) effects were allowed to depend on environmental measures. Moderators under study were parental and partner educational level, as well as urbanization level and mean real estate price of the participants' residential area. Mean effects were observed for parental education, partner education and urbanization level. On average, FSIQ scores were roughly 5 points higher in participants with highly educated parents, compared to participants whose parents were less well educated. In older participants, IQ scores were about 2 points higher when their partners were highly educated. In younger males, higher urbanization levels were associated with slightly higher FSIQ scores. Our analyses also showed increased common environmental variation in older males whose parents were more highly educated, and increased unique environmental effects in older males living in more affluent areas. Contrary to studies in children, however, the variance attributable to additive genetic effects was stable across all levels of the moderators under study. Most results were replicated for VIQ and PIQ.     

Cardiovascular disease: A global problem extending into the developing world

This article reviews the current status of cardiovascular disease (CVD) on the international scale. Presently viewed as an epidemic that has migrated from westernized societies to developing countries, several important issues are elaborated upon. They include the basis for the increasing prevalence of CVD and the associated societal implications. The challenges related to lack of resources and infrastructure support may also impede successful implementation of proven strategies to reduce CVD. In addition to traditional risk factors such as cigarette smoking, hypertension, obesity, hyperlipidemia, diabetes mellitus and insulin resistance, many developing countries must also contend with other risk biomarkers. Included in this grouping are human immunodeficiency virus/acquired immunodeficiency syndrome and other infectious/inflammatory processes as well as nutritional and vitamin deficiencies that make preventive measures more difficult to prioritize. Taken together, greater partnering between local governments, affiliated hospitals and international societies is needed to enhance and facilitate efforts aimed at optimizing standard of care measures in developing countries in order to reduce cardiovascular risk.     

Malaria vectors and urbanization in the equatorial forest region of south Cameroon

Entomological surveys were carried out in the town of Mbalmayo and in the nearby rural village of Olama, within the equatorial forest zone of Cameroon. Mosquitoes were captured when landing on human volunteers and by pyrethrum spray catches. Malaria vectors captured were Anopheles gambiae Giles (M and S forms) and A. moucheti Evans in both areas, together with A. funestus Giles in Mbalmayo. One A. marshallii (Theobald) specimen infected by Plasmodium falciparum was found in Olama. Anopheles moucheti was the most abundant anopheline species caught in Olama, while A. gambiae was the most abundant in Mbalmayo. All these vectors were highly anthropophilic as indicated by the fact that only 5 of 201 blood meals analysed had been taken from non-human hosts. Plasmodium falciparum was the only malaria parasite species found in Mbalmayo, while P. malariae was also found in Olama. The annual entomological inoculation rate was estimated at 129 infective bites/person/year in Mbalmayo and 322 in Olama. Comparison with data published in 1955 from Mbalmayo, before expansion of the town, showed the impact of urbanization on the composition of the vector system and malaria transmission dynamics. Such changes should be considered when implementing sustainable control measures.     

The Relationship between Population Density and Cancer Mortality in Taiwan

Many investigators have examined urbanization gradients in cancer rates. The purpose of this report was to identify urban-rural trends in cancer mortality rates (1982–1991) for municipalities in Taiwan. For this purpose, Taiwan's municipalities were classified as rural, suburban, urban, or metropolitan, using population density as an ordinal indicator of the degree of urbanization. Average annual age-adjusted, site-specific cancer mortality rates were calculated for both sexes within each population density group. Significant increasing trends with more urbanization were observed in mortality rates for cancers of the lung, pancreas, and kidney among both males and females, as well as male prostate cancer, and female breast and ovary cancer. In addition, this study revealed a significant rural excess for nonmelanoma skin cancer among both males and females, as well as male non-Hodgkin's lymphoma, and cancers of the female bone, and female connective tissue. Analytic studies for sites with consistent urban-rural trends may be fruitful in identifying the aspect of population density, or other unmeasured factors, that contribute to these trends.