成人麻疹的临床特征及预防策略

目的：监测湖州市成人麻疹发病情况。方法：由市防疫站统计本市近三年成人麻疹发病例数；由医院统计室提供本科三年成人麻疹发病例数，结果：虽然麻疹疫苗预防接种工作开展广泛，我市麻疹发病率已控制在较低水平，但仍有散发流行。三年来成人麻疹发病呈逐年上升趋势，其临床特征不同于小儿麻疹，结论，成人麻疹的增多与幼年接种麻疹疫苗后至成人抗体水平下降有关，院内采取积极的预防措施，尤其强调对易感人群实施后续强化免疫是成人麻疹的最佳预防策略，同时保证情报告的及时 与准确性，可为今后消灭麻疹的远程规划作准备。     

2004年菏泽市麻疹流行特征分析及控制策略探讨

目的了解2004年菏泽市麻疹流行病学特征。方法根据菏泽市常规传染病报告系统和年度麻疹发病统计表,对2004年麻疹进行描述流行病学分析。结果2004年共报告麻疹疑似病例162例,确诊病例146例。麻疹发病呈散发和暴发并存的流行模式,个别高发县影响全市麻疹发病水平。麻疹发病以学龄前儿童和成人为主。确诊病例中有麻疹疫苗免疫史者占19.19%,无免疫史者占47.26%。免疫史不详者占33.55%。结论根据报告病例的年龄和免疫史状况表明,麻苗的常规免疫仍需加强,同时要考虑对大年龄组人群接种麻苗,继续加强麻疹监测。     

重庆市永川区2015年麻疹疫情分析

目的：分析麻疹疫情流行病学特征及主要影响因素，针对性开展麻疹疫情防控，加快消除麻疹工作进程。方法应用描述性流行病学方法，利用2015年麻疹监测信息报告管理系统流行病学调查资料，分析其特征及影响因素。结果疫情以散居儿童为主，主要发生在城区，8个月龄至8岁病例麻疹疫苗接种率低，仅11．69％（9／77），经常生病和对鸡蛋过敏是未接种的主要原因（占82．00％），发病前7～21天曾经到医疗机构就诊者占52．82％。结论麻疹疫苗首针及时接种率低（病例均未及时接种），散居儿童接种率低，是发病主要原因，易感人群院内暴露是重要因素，应加强目标人群预防接种，加强医院内感染控制，落实城区目标儿童摸底调查和预防接种措施。     

1957-2006年浙江省奉化市麻疹流行病学分析

目的 分析奉化市1957-2006年50年麻疹流行病学特征,为调整麻疹免疫策略提供依据.方法 将50年麻疹疫情分为麻疹疫苗接种前、麻疹疫苗推广应用、麻疹疫苗纳入计划免疫一年一次突击接种和麻疹疫苗冷链装备按月接种四个阶段.前三个阶段年均发病率用几何均数,第Ⅳ阶段用算术均数.结果 四个阶段麻疹年发病率和年龄构成有显著差异;发病年龄构成由幼儿和学龄儿童为主向8月龄小婴儿和15岁以上人群转移,2005-2006年奉化市本地人口8月龄小婴儿和15岁以上人群发病占总病例数的96.92%.结论 为降低大小两端年龄麻疹发病,达到消除麻疹的目标,建议对初中学生加强接种麻疹疫苗.     

深圳市福田区2001-2003年麻疹流行病学分析

麻疹是危害儿童健康的急性传染病之一,在未使用麻疹疫苗免疫前,由于易感人群的积累,每隔2—3年总是周期性地出现一次较大流行。为全面了解和客观评价深圳市福田区麻疹免疫情况,掌握麻疹发病的流行病学特点,为今后制定麻疹免疫对策,评价免疫效果,提高麻疹确诊率提供科学依据,现将2001—2003年麻疹监测情况总结分析如下。     

小儿麻疹40例临床特点分析

目的：分析2005年4月、5月、6月麻疹流行特点。方法：40例麻疹病例从发病年龄，确诊时间，发病季度，流行病学资料，临床特点综合分析，总结出临床特点。结论：发病年龄后移，流行高峰季节为春季以4月、5月、6月发病高峰。皮疹经过典型临床表现符合以往麻疹特点。确诊手段，麻疹粘膜斑（＋），血-麻疹抗体（＋）。对易感者接种麻疹疫苗，另外对以往接种过麻疹疫苗而体内抗体水平低的儿童及成年人进行预防接种再次提高免疫力。     

麻疹病的临床变异与护理

６０年代以来，麻疹研究工作取得了重大进展。由于广泛在儿童中接种麻疹疫苗．儿童麻疹发病率逐年下降，使麻疹流行得到了控制。近些年来．麻疹发病年龄向大年龄组推移。故麻疹的发病年龄、流行周期性、季节性、临床症状和发病规律发生了明显变异。提示人们重视观察成人麻疹变异动态。     

麻疹人群易感性评价方法探讨

麻疹人群易感性评价方法探讨河南省柘城县卫生防疫站（４７６２００）刘飙一般认为，麻疹易感人群如有７０％得到免疫，即可控制当年的麻疹流行。开展计划免疫工作以来，麻疹的发病得到了较好控制，发病率大幅度下降，流行的周期性被打破。但近几年来，麻疹局部暴发流行有...     

156例儿童的流行病学及护理特点

目的：探讨麻疹近年来流行病学情况年龄变化、地区分布及临床特点。采用2004-2005年确诊为麻疹患儿监测资料共156例，并对全部资料按年度、年龄组、居住地区进行分析。结果显示麻疹发病人数逐年增多，农村发病人数多于城市。年龄0-10个月组发病人数逐年增多，未预防接种者高于已做预防接种者。结论：应加强基层计划免疫工作，减少易感人群累积。加强疫苗管理，减少免疫失败率。     

8个月内婴儿麻疹93例临床分析

麻疹是儿童常见的急性呼吸道传染病之一，多见于8个月以上儿童，在广泛推行麻疹疫苗接种后已少见，但近年来麻疹发病率又有所上升，时有局部流行现象，同时有8个月内婴儿发病增多的特点。现将2005年3月至2005年5月本院收治的8个月内未接种疫苗的麻疹患儿93例，作一分析报告。     

Plasma catecholamines and resuscitation from prolonged cardiac arrest

Plasma catecholamine levels rise markedly with cardiac arrest and attempted resuscitation. We examined whether epinephrine (EPI) or norepinephrine (NE) plasma concentrations could predict resuscitation outcome. In nine mongrel dogs, EPI and NE levels were drawn before cardiac arrest and after 8 and 14 min of cardiac arrest and CPR. Intravenous EPI (1 mg) was given 1 min before the last plasma level was drawn. Catecholamines were quantitated by high-performance liquid chromatography with triple-electrode coulometric electrochemical detection. Plasma catecholamines increased significantly with cardiac arrest, EPI levels increased from a control level of 15.9 +/- 3.0 to 396.0 +/- 63.3 pmol/ml after 8 min of cardiac arrest (p less than .05), and NE levels similarly increased from 4.4 +/- 1.7 to 66.5 +/- 12.0 pmol/ml (p less than .01). Neither the absolute catecholamine plasma concentration nor the response to cardiac arrest of the endogenous catecholamine concentrations could predict outcome, but catecholamine responses to exogenous EPI did correlate with outcome. Animals which were subsequently resuscitated had a greater increase in the plasma EPI concentrations after exogenous EPI than animals that were not resuscitated, a 53-fold vs. a 23-fold increase (p less than .05). Successfully resuscitated animals also had increased NE levels after exogenous EPI, while unsuccessfully resuscitated animals had either no change or a decrease (p less than .02). Successfully resuscitated animals had an increase in coronary perfusion pressure (p less than .01) in response to exogenous EPI, in contrast to those that were not resuscitated. This suggests that the exogenous administration of EPI during prolonged CPR is beneficial despite markedly elevated endogenous catecholamine levels.     

Chronic Performance of Steroid-Eluting Epicardial Leads in a Growing Pediatric Population:

Patient size and congenital heart defects complicate pacemaker therapy in children favoring an initial epicardial approach. Steroid-eluting (SE) epicardial (EPI) leads maintain stable, low pacing thresholds in the short-term when compared to the nonsteroid (NSE) epicardial (EPI) leads. The purpose of this study was to evaluate chronic, 10-year performance of SE leads in growing children compared with NSE EPI leads implanted during the same time interval. From 1990 to 2000, 35 patients (age 1 month to 18 year, median 3 years), 28 with and 7 without congenital heart disease (CHD) received 51 SE leads: 27 ventricular and 24 atrial. NSE leads were implanted in 27 patients (age 1–28 years, median 8 years), 24 with and 3 without CHD: 27 ventricular and 1 atrial. Pacing lead threshold, impedance, and energy were measured at implant and during a 10-year follow-up. Unpaired t-test showed that impedance remained stable for all leads with lower mean values for the SE   (376 ± 55 vs 443 ± 109 Ω) (P = NS)   . The mean energy requirement for SE leads at 10 years   (1.2 ± 0.9 μJ)   was significantly lower than for NSE   (4.4 ± 5.5 μJ) (P < 0.05)   . At 2.5-V output, chronic thresholds for SE leads did not significantly differ from implant values for atrial (0.08 vs 0.09 ms) or ventricular (0.08 vs 0.08 ms) sites. There were no differences in SE lead performances among patients with or without CHD. Fracture or dislodgement occurred in two SE (4%) and four NSE (14%) leads. SE outperform NSE EPI leads and show stable, chronic low thresholds over time in all growing children. (PACE 2003; 26[Pt. I]:1467–1471)     

Results of a dose-intense phase 1 study of a combination chemotherapy regimen with cisplatin and epidoxorubicin including medroxyprogesterone acetate and recombinant interleukin-2 in patients with inoperable primary lung cancer

Based on the role of cytokines in the pathogenesis of cancer-related anorexia-cachexia and the ability of progestins, such as medroxyprogesterone acetate, to reduce cytokine production and relieve cancer-related anorexia-cachexia symptoms, the authors designed an open, dose-finding phase I study of a combined chemotherapy regimen (cisplatin [CDDP], epidoxorubicin [EPI]), including recombinant interleukin-2 (IL-2) and medroxyprogesterone acetate for patients with stage IIIB to IV inoperable primary lung cancer. The end points were clinical response and toxicity with definition of dose-limiting toxicity and maximal tolerable dose; relief of cancer-related anorexia-cachexia symptoms; the assessment of patient serum levels of IL-1beta, IL-6, tumor-necrosing factor-alpha (TNF-alpha), and soluble IL-2 receptor (sIL-2R). From March to October 1997, 16 patients (M:F ratio, 14:2; mean age, 60.5 years; age range, 41 to 74 years) were enrolled. All patients were evaluable for toxicity and 14 of them for response. The patients were assigned to increasing dose levels of drugs according to a dose-escalation schedule. The weekly schedule consisted of a combination of CDDP given intravenously on day 1, EPI given intravenously on day 1, 1 g/day medroxyprogesterone acetate given orally on days 1 to 7, and recombinant IL-2 1.8 MIU administered subcutaneously on days 2 to 7 plus 300 microg granulocyte-colony stimulating factor support given subcutaneously on days 2 to 5. Administration of medroxyprogesterone acetate began 1 week before the first cycle. Dose escalation of the drugs was as follows: 30 mg x m2 x week(-1) CDDP and 25 mg x m2 x week(-1) EPI (first level, two patients); 30 mg x m2 x week(-1) CDDP and 33 mg x m2 x week(-1) EPI (second level, 2 patients); 40 mg x m2 x week(-1) CDDP and 33 mg x m2 x week(-1) EPI (third level, 6 patients); and 40 mg x m2 x week(-1) CDDP and 40 mg x m2 x week(-1) EPI (fourth level, 6 patients). Six cycles were planned for each patient. The actual dose intensity delivered was more than 80% of the projected dose intensity of all drugs. After six cycles, clinical response (according to World Health Organization criteria), toxicity (according to World Health Organization criteria), Eastern Cooperative Oncology Group (ECOG) performance status, body weight, appetite, and serum levels of cytokines were evaluated. After six cycles, 9 of 14 patients (64.3%) had partial response, 3 of 14 (21.4%) had stable disease, and 2 of 14 (14.3%) had progressive disease, and the objective response rate was 64.3%. ECOG performance status and body weight did not change significantly after treatment, whereas appetite showed an increase that was of borderline statistical significance. Toxicity was acceptable and only hematologic. Dose-limiting toxicity was established at the fourth dose level; consequently, maximal tolerable dose was assessed at the third dose level. Before treatment, the serum levels of IL-1beta, IL-6, and TNF-alpha were significantly greater in the patients than in healthy persons. The comparison between pretreatment and posttreatment serum values of IL-1beta, IL-6, TNF-alpha, and sIL-2R did not reveal significant differences in the patients. Similar results were obtained when the patients were considered as responders (partial response) or non-responders (stable or progressive disease) to therapy. Only IL-6 serum levels were increased (p = 0.014) after treatment.     

广东省1999年177例发热出疹性疾病的实验室监测

对全省 1999年 177例RFIs病例进行麻疹IgM抗体测定 ,结果阳性率为 59.30 % ;对麻疹抗体阴性的样本补做风疹IgM抗体测定 ,结果风疹抗体阳性率达 45.80 %。结果分析表明 ,麻疹病例主要集中在 4～ 14岁儿童 ,占 89.20 % ,阳性病例中无免疫史或免疫史不详的占多数 (73.33% ) ;流动人口占病例的相当比例 (20.90% ) ,其中麻疹IgM抗体阳性病例 2 0例 ,大多为无免疫史或免疫史不详者 (17例 ,占 85.00 % )。以上结果表明 ,我省应加强麻疹疫苗的补种复种工作 ,并应加强对流动人口的免疫接种。另外 ,由于风疹的普遍流行 ,我们在做好麻疹监测的同时 ,应该注意风疹的监测工作。     

2006-2019年天津市河北区伤害发生趋势分析

目的 了解天津市河北区居民伤害发生的流行特征和变化趋势,评价伤害干预效果,为制定伤害防控策略提供依据.方法 选取天津市非传染病发病监测管理系统中伤害发生时间为2006年1月1日至2019年12月31日的天津市河北区户籍居民的伤害病例资料.采用SPSS 17.0计算粗发生率和标化率,用年度变化百分比分析伤害发生率的变化趋...     

运用集中度和圆形分布分析传染病的季节性分布

本文运用向量合成表示法—集中度对北京市东城区３８年间１０种法定传染病的季节性分布进行分析。按全面实施计划免疫前（１９５８～１９７８）和全面实施计划免疫后（１９７９～１９９６）两个阶段分别计算集中度Ｍ值和圆形分布Ｒ值。结果表明:除麻疹的发病高峰在第二阶段向后推移一月余和季节性更趋明显外，其余传染病的季节性分布均未改变，即乙脑发病仍有严格的季节性；流脑和痢疾有较强的季节性；百日咳和伤寒有一定的季节性；肝炎、脊灰和猩红热的季节性较差。这为我们调整传染病防治对策提供了科学依据。     

信阳市病毒性乙型肝炎疫苗接种效果调查

目的了解河南省信阳市浉河区病毒性乙型肝炎（乙肝）疫苗纳入规划免疫后出生的儿童血清学状况,评价乙肝疫苗（HepB）接种效果。方法按照抽样方案要求,随机调查267名1~14儿童,并采集其血清进行乙肝病毒（HBV）表面抗原（HBsAg）、乙肝病毒表面抗体（抗-HBs）和乙肝病毒核心抗体（抗-HBc） 检测,对HBsAg阳性者再进行乙肝病毒e抗原(HBeAg)和乙肝病毒e抗体(抗-Hbe)的检测。结果信阳市浉河区1~14岁儿童HBsAg阳性率为2.25%,抗-HBs阳性率为89.14%,HBV感染率为28.84%,不同年龄组和性别差异均无统计学意义。结论信阳市浉河区通过14年HepB的接种,农村地区近90%的儿童产生了乙肝保护性抗体,可以有效阻断乙肝在儿童间的传播,但应提高新生儿HepB首针及时接种率,阻断母婴传播,降低乙肝感染率和流行率。     

郑州市2000-2001年麻疹确诊病例流行病学分析

为了解郑州市麻疹发病状况 ,探索麻疹流行规律 ,以便更好地控制麻疹 ,对郑州市 2000年和 2001年经实验室确诊的麻疹病例进行流行病学分析。结果显示 :两年共报告确诊麻疹病例 601例 ,其中流动人口发病 222例 ,占总病例数的 36.94 % ,麻疹两年发病率分别为 4.75/10万和 4.83/10万。全市麻疹病例呈散发和暴发并存的状态 ,局部地区的暴发病例以及流动人口发病较多直接影响着全市的发病水平。2000年和 2001年病例主要集中在 7岁以下儿童 ,分别占 79.53%和 72.28% ,以 <1岁年龄组发病居多。如何降低 <1岁组麻疹发病 ,也是值得我们研究和探讨的问题。     

2002－2019年辽宁省锦州市甲型肝炎疫苗纳入免疫规划前后甲型肝炎的流行病学特征

目的分析2002 — 2019年辽宁省锦州市甲型肝炎（甲肝）的流行状况，了解甲肝疫苗纳入免疫规划前、后甲肝的流行特征，为制定有针对性的防控措施提供科学依据。方法采用描述性流行病学方法，对2002 — 2019年锦州市的甲肝疫情进行分析，比较甲肝疫苗纳入免疫规划前（2002 — 2007年）、后（2008 — 2019年）甲肝的流行病学特征变化。结果甲肝年平均发病率由纳入免疫规划前的6.24/10万下降至纳入免疫规划后的2.42/10万。 纳入免疫规划前，县城的甲肝发病率总体高于市区。 纳入免疫规划后，地区差异减小，除开发区、太和区外，各县（区）甲肝发病率呈下降趋势，差异均有统计学意义。 甲肝病例年龄呈单峰分布，纳入免疫规划前、后发病高峰分别为30～、45～岁年龄组，略有后移趋势。 0～和15～岁年龄组病例构成比显著下降，差异均有统计学意义。 30～和60～岁年龄组病例构成比小幅上升，45～和≥75岁组病例占比显著上升。 纳入免疫规划前、后男性发病数均高于女性。 纳入免疫规划前，春季流行高峰明显，夏季小高峰不明显，纳入免疫规划后发病季节性特征逐渐消失。 病例职业以农民、家务及待业人员、工人为主。 纳入免疫规划后，学生、工人占比显著下降，农民、离退人员、家务及待业人员占比显著上升。结论甲肝疫苗纳入免疫规划后，锦州市甲肝发病水平显著降低，在常规免疫的基础上，开展重点地区、高危人群应急接种工作，大规模接种甲肝疫苗，提高人群免疫水平，是预防甲肝的根本措施。     

膀胱灌注表阿霉素预防表浅性膀胱癌术后复发的系统评价

目的评价膀胱灌注表阿霉素预防表浅性膀胱癌术后复发的疗效和副作用.方法按文内所述纳入标准,参考Cochrane协作网工作手册,计算机检索Medline(1966～2002.9)、EMbase(1985～2002)、Cochrane Library(2002年第4期)和中国生物医学文献光盘数据库(CBMdisc,1970～2002);手工检索发表或未发表的文献,包括<中华泌尿外科杂志>等12种杂志、中华泌尿外科学会组织的学术会议论文集(1990～2002)、美国AUA(1995～2002)、欧洲ECCO会议论文集(1995～2002)和北京大学等3所大学学位论文汇编等.文献资料用统一的表格由两名评价者独立进行提取,采用Jadad质量计分法评价文献质量,并应用Rev-man 4.2软件进行数据处理与分析.结果共检索到文献213篇,经排查后,符合纳入标准并进入系统评价的文献共10篇,其中3篇属于高质量RCT,其余为低质量RCT.Meta分析结果显示:表阿霉素膀胱灌注加手术治疗与单纯手术比较,在1年未复发方面,RR合并=1.51,95%CI(1.32,1.72);在2年未复发方面,RR合并=1.49,95%CI(1.35,1.66);剂量＜50 mg/次的表阿霉素膀胱灌注,在术后复发预防方面,RR合并=1.34,95%CI(1.22,1.48);剂量＞50 mg/次的表阿霉素膀胱灌注,在术后复发预防方面,RR合并=1.63,95%CI(1.48,1.79);单次阿霉素膀胱灌注的术后1年未复发率,RR=1.49,95%CI(1.33,1.66),术后2年未复发率,RR=1.58,95%CI(1.36,1.84);表浅性膀胱癌术后疾病进展率:RR-0.79,95%CI(0.53,1.17);阿霉素膀胱灌注后的总副作用发生率:RR=4.34,95%CI(2.62,7.19).结论不同剂量的表阿霉素膀胱灌注均可降低表浅性膀胱癌术后复发率;单次表阿霉素膀胱灌注可以降低表浅性膀胱癌术后复发率,但应谨慎选择病例;表阿霉素膀胱灌注对表浅性膀胱癌病情进展没有影响;表阿霉素膀胱灌注可引起一些副作用,但可以耐受,不影响患者正常生活.