2014—2018年黄山市淋病疫情流行特征分析

目的分析2014-2018年黄山市淋病的流行特征,为全市的淋病防控工作提供科学依据。方法通过中国疾病预防控制信息系统收集黄山市2014—2018年的淋病数据、人口数据,进行统计分析。结果2014—2018年黄山市累计报告淋病病例761例,年均发病率为11.09/10万,年均增长率为29.14%,发病率呈逐年上升趋势(χ^2趋势=112.29,P<0.05)。淋病的人群分布中,男女报告病例数之比为13.63:1,男女发病率有统计学差异(χ^2=113.18,P<0.05);15~49岁年龄组病例数最多,占85.94%,职业以农民最多,占44.81%;以屯溪区、歙县报告病例数较多,分别占37.45%、23.26%。结论2014—2018年黄山市淋病发病率呈上升趋势,淋病防控形势严峻,需进一步完善各项防控措施。     

Is There a Weekly Pattern for Health Searches on Wikipedia and Is the Pattern Unique to Health Topics?

Background

Online health information–seeking behaviors have been reported to be more common at the beginning of the workweek. This behavior pattern has been interpreted as a kind of “healthy new start” or “fresh start” due to regrets or attempts to compensate for unhealthy behavior or poor choices made during the weekend. However, the observations regarding the most common health information–seeking day were based only on the analyses of users’ behaviors with websites on health or on online health-related searches. We wanted to confirm if this pattern could be found in searches of Wikipedia on health-related topics and also if this search pattern was unique to health-related topics or if it could represent a more general pattern of online information searching—which could be of relevance even beyond the health sector.

Objective

The aim was to examine the degree to which the search pattern described previously was specific to health-related information seeking or whether similar patterns could be found in other types of information-seeking behavior.

Methods

We extracted the number of searches performed on Wikipedia in the Norwegian language for 911 days for the most common sexually transmitted diseases (chlamydia, gonorrhea, herpes, human immunodeficiency virus [HIV], and acquired immune deficiency syndrome [AIDS]), other health-related topics (influenza, diabetes, and menopause), and 2 nonhealth-related topics (footballer Lionel Messi and pop singer Justin Bieber). The search dates were classified according to the day of the week and ANOVA tests were used to compare the average number of hits per day of the week.

Results

The ANOVA tests showed that the sexually transmitted disease queries had their highest peaks on Tuesdays (P<.001) and the fewest searches on Saturdays. The other health topics also showed a weekly pattern, with the highest peaks early in the week and lower numbers on Saturdays (P<.001). Footballer Lionel Messi had the highest mean number of hits on Tuesdays and Wednesdays, whereas pop singer Justin Bieber had the most hits on Tuesdays. Both these tracked search queries also showed significantly lower numbers on Saturdays (P<.001).

Conclusions

Our study supports prior studies finding an increase in health information searching at the beginning of the workweek. However, we also found a similar pattern for 2 randomly chosen nonhealth-related terms, which may suggest that the search pattern is not unique to health-related searches. The results are potentially relevant beyond the field of health and our preliminary findings need to be further explored in future studies involving a broader range of nonhealth-related searches.     

Antimicrobial resistance in Neisseria gonorrhoeae in the UK: surveillance and management

Successful antimicrobial therapy is fundamental to the public health control of gonorrhea, in the absence of a protective immune response. Neisseria gonorrhoeae, the causative agent, has presented a constant challenge for the provision of such therapy as it has demonstrated the ability to become resistant to successive highly active agents chosen for first-line treatment. Acquisition of plasmids from other bacteria and long-term use of a single agent has selected both single step high-level and low-level resistance due to multiple mutations. While therapeutic failure of the current recommended agents cefixime and ceftriaxone begins to emerge, choice of alternative therapies is limited. Guidelines for therapy will be dependent on surveillance programs but individual patient management will require a viable organism to detect emerging resistance. Advances in molecular detection, while advantageous for the diagnosis of gonorrhea, fail to provide a viable organism, posing even greater challenges for the definition of treatment failure, and appropriate end points for test of cure. Innovative and collaborative approaches will be essential to maintain gonorrhea as a treatable infection.     

男性泌尿生殖道非淋球菌奈瑟菌感染的诊断与治疗研究

目的:探讨非淋球菌奈瑟菌感染对男性泌尿生殖道感染诊断与治疗的影响。方法:采集8例急性尿道炎或慢性前列腺炎患者的尿道分泌物、前列腺按摩液或/和精液标本,分别接种淋球菌培养基、血琼脂培养基、沙保氏琼脂培养基和支原体培养基分离淋病奈瑟菌与其他细菌、真菌、支原体以及Gemenez染色检查衣原体。对分离的革兰阴性双球菌分别进行氧化酶、生化反应、药物敏感试验及淋病奈瑟菌核酸荧光聚合酶链反应(PCR)检测与鉴定。根据药物敏感试验结果选择和使用抗菌药物,对患者以静脉注射或/和口服治疗。结果:从8例患者前列腺按摩液或精液内分离的8株革兰阴性双球菌分别鉴定为粘液奈瑟菌3株、灰色奈瑟菌4株、嗜乳糖奈瑟菌1株,各菌株的隐蔽质粒pJD1基因PCR检测均表现与淋病奈瑟菌相似的阳性反应。男性生殖道分离的非淋球菌奈瑟菌具有多重耐药性,对喹诺酮类药物和磷霉素具有显著高的耐药性。静脉或/和口服给予病原菌敏感的头孢菌素或/和米诺环素治疗7d后,病原学复查无菌和患者症状消失。结论:寄生人体上呼吸道的某些正常菌群奈瑟菌也可以感染男性泌尿生殖器官,引起淋病样尿道炎与慢性前列腺炎。仅仅通过形态、氧化酶试验或/和检测隐蔽质粒基因以及其他淋病奈瑟菌非特异性核苷酸序列的PCR方法,可导致淋病的临床和病原学诊断错误。根据病原学检查结果选择药物静脉注射或/和口服,能够有效治愈非淋病奈瑟菌引起的急性尿道炎与慢性前列腺炎等男性生殖器官感染疾病,病原菌耐药性是影响治疗效果的主要因素。     

基于Delphi法的《石淋病中医临床诊疗指南》问卷调查与结果分析

目的：运用德尔菲法,为制修订石淋病中医临床诊疗指南进行专家调研。方法：在文献研究的基础上,采用德尔菲法编制《石淋病中医临床诊疗指南专家调查问卷》,共两轮问卷调查,通过“浙江省中医院临床研究信息平台”向全国30位专家进行调查,从病名、诊断、证候分型、治疗、预防和调摄等方面进行调查和统计分析。结果：两轮专家调查问卷的专家积极系数均为100%,各指标的不重要性百分比均<50%,专家对石淋病各指标意见的集中程度和协调程度均较高,初步形成了《石淋病中医临床诊疗指南(修订)》草稿。结论：基于德尔菲法的专家问卷调查能较好地总结石淋病的中医诊疗方案,对促进石淋病辨证规范,提高诊疗水平具有积极的意义。     

Causes and Treatment of Urticaria

Urticaria is a symptom which can be brought about in a variety of ways. Not all cases of urticaria are on an allergic basis; some of the causes include contactants, ingestants, inhalants, injectants, physical stimuli, microorganisms, metazoan parasites, endocrines, altered tissue products and psychogenic stimuli.     

2000-2007年浙江省金华市淋病流行特征分析

目的　了解2000－2007年浙江省金华市淋病的流行病学特征。方法　对金华市2000－2007年淋病疫情资料进行回顾性分析。结果　8年中，金华市淋病年均发病率为60.47/10万；男性发病高于女性，男女性别比为3.96∶1。结论　20～39岁为主要发病年龄组，农民、商业服务、工人和民工为主要发病人群。针对重点人群加强健康宣教工作，对遏制淋病的流行十分重要。     

2003—2007年上海市淋病、梅毒流行特征分析

目的：了解上海市淋病和梅毒发病的流行特征。方法：对2003—2007年上海市淋病和梅毒疫情报告资料进行分析。结果：2003—2007年,上海市报告的淋病疫情呈下降态势,而梅毒发病率逐年上升,梅毒病例年均增长14．0％。报告梅毒病例以二期梅毒、一期梅毒和潜伏梅毒为主,二期梅毒的年均增长幅度高达12．0％。男性淋病发病显著多于女性,本市户籍淋病和梅毒病例居多,本市和外地户籍的淋病和梅毒发病呈现相似的增减态势。结论：上海市梅毒流行形势严峻,应当采取有效的检测、治疗和干预措施,遏制梅毒的进一步流行。     

中山地区淋球菌头孢菌素敏感性及NG-MAST研究

目的：研究中山辖区淋球菌对头孢曲松与头孢克肟的敏感性,及淋球菌多抗原测序分型(NG-MAST)的基因型别。方法：收集2017-2018年中山市辖区医疗机构淋球菌菌株,经分离、鉴定和纯化后,采用琼脂稀释法检测其对头孢曲松与头孢克肟的最小抑菌浓度(MIC);应用NG-MAST进行淋球菌porB和tbpB外膜蛋白基因分型。结果：共检测193株淋球菌,对头孢曲松、头孢克肟的低敏率分别为5.2％和13.5％;NG-MAST分型显示193株菌共有125个型别,其中65种为已知型别,60种为新型别;所检菌株以ST5308、ST5061、ST2268、NEW1、ST10091、NEW2和NEW3为优势型别,并且同型别菌株对同一抗生素的MIC值相同或相近。结论：头孢曲松和头孢克肟作为淋病治疗的一线药物,已出现低敏;本地区淋球菌porB和tbpB外膜蛋白出现新的基因型别。     

2005-2017年烟台市淋病流行特征分析

目的：总结烟台市淋病流行特征及趋势，为淋病防治工作提供科学依据。方法：收集烟台市2005-2017年报告的淋病病例资料进行流行病学统计分析。结果：烟台市淋病报告发病率由2005年的8.69/10万下降到2017年3.78/10万，淋病疫情呈下降趋势。淋病性别比差异明显，男女比为10.20∶1。淋病病例主要集中在芝罘区、莱州市和莱阳市。发病年龄集中在20~39岁年龄组。结论：烟台市淋病疫情呈下降趋势，但对发病率高的市区应加强干预宣传。