社区“5+1”糖尿病分阶段达标管理对2型糖尿病患者生存质量干预效果分析

目的 分析社区"5+1"糖尿病分阶段达标管理对2型糖尿病患者生存质量的干预效果及其影响因素，为提高患者生存质量提供依据。方法 采用分层整群抽样的方法在山西省、江苏省和宁夏回族自治区选择12个社区卫生服务中心，分别作为干预组（管理方式：社区"5+1"糖尿病分阶段达标管理）、对照组[管理方式：依据《国家基本公共卫生服务规范（2011年版）》的相关要求]，进行为期2年的随访观察。采用面对面问卷调查的方式，收集患者的人口学信息等基本信息；采用健康调查简表（SF-36）对患者在干预前后测量生存质量。采用SAS 9.4软件进行双重差分法以及多重线性回归模型分析。结果 基线时共纳入2 467名研究对象，终末时共1 924人接受了为期2年完整的随访管理。干预后，干预组、对照组患者生理健康维度（PCS）、心理健康维度（MCS）评分变化净差值分别为13.6分、29.8分。多重线性回归分析结果显示，影响患者PCS得分的主要因素有年龄、医保类型、基线PCS得分以及所在地区，影响患者MCS得分的主要因素有年龄、医保类型、基线MCS得分、是否合并高血压以及所在地区。结论 社区"5+1"糖尿病分阶段达标管理对2型糖尿病患者生存质量的干预效果较好。     

Bio-accumulation and health risk assessment of heavy metals in different edible fish species from Hurghada City,Red Sea,Egypt

BackgroundHeavy metal contamination has become a serious issue in this century especially detected in fish organs. Due to the presence of radioactive compounds in agricultural and sewage effluent, which destroys aquatic ecosystems, threatening human livelihoods. Health hazards associated with low and high consumption consumers assessed in five commercial fish species collected from Hurghada City, Egypt, during winter and summer, 2020. Atomic absorption spectrophotometer technique used for determination heavy meals in different organs and expressed as μg/g wet weight.ResultsHeavy metal concentrations in muscle ranged between:(0.054–0.109), (0.260–1.043), (0.264–0.897), (5.895–11.898), (0.381–0.970), (13.582–29.133) and (0.332–0.589) µg/g for Cd, Pb, Mn, Zn, Cu, Fe and Ni respectively, which were lower than those of gills and liver. These concentrations were within WHO, FAO/WHO, and EU standards. Consumption of edible species was lower than the (TDIs) established by the (JECFA) and Egyptian Standards. Even though THQ and TTHQ values were < 1 while, in children with highly consumer were> 1.ConclusionThis study concluded that intake of Red Sea fish is safe for human health. It is critical for consumers to be aware of the consequences of excessive fish consumption, particularly children with highly consumer, which represent possible health risks.     

Inactivated influenza vaccine formulated with single-stranded RNA-based adjuvant confers mucosal immunity and cross-protection against influenza virus infection

Influenza vaccination is considered the most valuable means to prevent and control seasonal influenza infections, which causes various clinical symptoms, ranging from mild cough and fever to even death. Among various influenza vaccine types, the inactivated subunit type is known to provide improved safety with reduced reactogenicity. However, there are some drawbacks associated with inactivated subunit type vaccines, with the main ones being its low immunogenicity and the induction of Th2-biased immune responses. In this study, we investigated the role of a single-stranded RNA (ssRNA) derived from the intergenic region in the internal ribosome entry site of the Cricket paralysis virus as an adjuvant rather than the universal vaccine for a seasonal inactivated subunit influenza vaccine. The ssRNA adjuvant stimulated not only well-balanced cellular (indicated by IgG2a, IFN-γ, IL-2, and TNF-α) and humoral (indicated by IgG1 and IL-4) immune responses but also a mucosal immune response (indicated by IgA), a key protector against respiratory virus infections. It also increases the HI titer, the surrogate marker of influenza vaccine efficacy. Furthermore, ssRNA adjuvant confers cross-protective immune responses against heterologous influenza virus infection while promoting enhanced viral clearance. Moreover, ssRNA adjuvant increases the number of memory CD4⁺ and CD8⁺ T cells, which can be expected to induce long-term immune responses. Therefore, this ssRNA-adjuvanted seasonal inactivated subunit influenza vaccine might be the best influenza vaccine generating robust humoral and cellular immune responses and conferring cross-protective and long-term immunity.     

Weighted Markov chains for forecasting and analysis Incidence of infectious diseases in jiangsu Province,China

This paper first applies the sequential cluster method to set up the classification standard of infectious disease incidence state based on the fact that there are many uncertainty characteristics in the incidence course.Then the paper presents a weighted Markov chain,a method which is used to predict the future incidence state.This method assumes the standardized self-coefficients as weights based on the special characteristics of infectious disease incidence being a dependent stochastic variable.It also analyzes the characteristics of infectious diseases incidence via the Markov chain Monte Carlo method to make the long-term benefit of decision optimal.Our method is successfully validated using existing incidents data of infectious diseases in Jiangsu Province.In summation,this paper proposes ways to improve the accuracy of the weighted Markov chain,specifically in the field of infection epidemiology.     

泰州市居民慢性病防治健康素养水平及其影响因素

目的分析泰州市居民慢性病防治健康素养水平及其影响因素。方法在2018年6月—2019年5月间经多阶段分层整群随机抽样选取泰州市2022名常住居民开展慢性病防治健康素养相关问卷调查,分析调查结果。结果2022份问卷回收有效问卷2010份;以“儿童青少年也可能发生抑郁症”正确率89.0%、“超重或肥胖者易患的病”正确率80.3%占据前两名;慢性病防治健康素养水平相关因素包括地区,年龄,文化等,差异有统计学意义(P<0.05),性别方面差异无统计学意义(P>0.05);经Logistic回归分析显示,影响慢性病防治健康素养影响因素主要包括地区、年龄、学历、职业及家庭收入,差异有统计学意义(P<0.05)。结论泰州市居民慢性病防治健康素养在蔬菜水果、儿童抑郁症及肥胖者易患病等方面水平较高,而在骨质疏松相关知识了解程度则较低,影响因素包括地区、年龄、学历、职业及家庭收入。     

无锡市中小学校和幼儿园消毒质量现状

  目的  了解无锡市中学、小学和幼儿园的消毒质量现状,为查找存在的问题并提出改进建议提供参考。  方法  采用分层随机抽样的方法选取无锡市73所学校,对室内空气、物体表面、工作人员手、餐饮具、紫外线灯以及使用中消毒剂(染菌量和含氯消毒剂有效氯浓度)进行检测。  结果  共采集标本2 563份,合格率为88.02%,幼儿园、小学和中学的合格率分别为87.89%,90.67%,85.83%。锡山区和江阴市学校的合格率较低,分别为75.24%,75.89%。城区学校的合格率(89.51%)高于农村(83.44%)(χ2=16.57,P < 0.01),公办(87.99%)和民办学校(88.17%)的合格率差异无统计学意义(χ2=0.01,P=0.92)。不同对象的合格率依次为使用中消毒剂的染菌量(100.00%)、空气(93.13%)、餐饮具(91.87%)、物体表面(89.40%)、紫外线灯(84.00%)、含氯消毒剂有效氯浓度(73.68%)、工作人员手(73.53%)。中学空气和物体表面的合格率均低于幼儿园和小学(P值均 < 0.05)。  结论  无锡市中小学校和幼儿园的消毒质量情况总体较好。要重点关注工作人员手、含氯消毒剂有效氯浓度以及紫外线灯,加强中学环境中空气和物体表面的消毒质量。     

苏州市2011—2020年学生肺结核患者发现延迟状况

  目的  分析苏州市学生肺结核患者发现延迟情况,为学校结核病疫情防控工作提供参考依据。  方法  以2011—2020年苏州市登记管理的1 148例学生肺结核患者为研究对象,采用Kruskal-Wallis H检验、χ2检验和Cochran-Armitage趋势检验分析学生肺结核患者发现延迟的时间趋势,采用χ2检验和Logistic回归分析学生肺结核患者入院特征与发现延迟的关系。  结果  调查的学生肺结核患者中,共有569例发现延迟,发现延迟率为49.6%,发现时长中位数为26(11~49)d。2011—2020年学生肺结核患者发现时长差异有统计学意义(Hc=54.62,P < 0.05),发现延迟率(51.2%,44.2%,33.9%,26.2%,65.8%,51.0%,43.2%,61.5%,55.0%,53.5%)差异有统计学意义(χ2=53.69,P < 0.05)。发现延迟率随时间变化而波动,总体呈上升趋势(Z=-3.67,P < 0.05)。发现方式为因症就诊(OR=5.57,95%CI=1.91~16.27)、病原学检查结果为阳性(OR=1.46,95%CI=1.14~1.86)均与发现延迟呈正相关(P值均 < 0.05)。  结论  苏州市学生肺结核患者发现延迟情况不容乐观,因症就诊、病原学检查阳性是发现延迟的影响因素。针对日常学校结核病防控中的突出问题,多部门应联动合作落实相关防控措施,减少发现延迟的发生。     

建成环境对南京市儿童青少年体力活动影响

目的分析不同建成环境特征对江苏省南京地区儿童青少年体力活动水平的影响,为提高儿童青少年体力活动水平提供科学依据。方法于2018年5—6月采用现况研究设计,使用多阶段整群随机抽样方法,选择南京市12个行政区4~12年级学生(9~17岁儿童青少年)共4401人进行问卷调查,采用国际上通用体力活动居住环境量表(PANES)来评价建成环境的特征;采用多水平logistic回归方法分析不同建成环境特征对南京市儿童青少年体力活动水平的影响。结果调查的4401名儿童青少年体力活动水平充足比例为21.1%(930/4401)。以学校为随机因素,在调整了年龄、性别以及父母最高文化水平后,多水平logistic回归分析结果显示,社区道路具有人行道(OR=1.40,95%CI=1.10~1.78)、社区具有隔离的自行车车道(OR=1.37,95%CI=1.12~1.67)对儿童青少年体力活动水平具有促进作用。以小学、初中、高中进行分层,结果显示,初中组社区具有隔离的自行车车道(OR=1.59,95%CI=1.11~2.27)以及高中组看到社区居民积极锻炼身体(OR=1.88,95%CI=1.05~3.39)对儿童青少年体力活动水平具有促进作用。结论不同建成环境特征能够明显影响儿童青少年体力活动水平,建成环境作为影响儿童青少年体力活动水平的一个可控因素应引起更多关注。