益阳地区无偿献血人群梅毒、艾滋病、丙型肝炎及乙型肝炎感染状况分析

目的回顾性分析益阳市地区无偿献血人群梅毒、艾滋病、丙型肝炎及乙型肝炎感染状况,为提高临床用血安全性提供可参考依据。方法收集从2010年1月～2012年12月益阳市无偿献血人群的资料,进行回顾性总结,分析3年间益阳市地区梅毒、艾滋病、丙型肝炎及乙型肝炎感染情况及变化。结果益阳地区无偿献血人群中梅毒、艾滋病、丙型肝炎及乙型肝炎均有一定感染率,有高危接触者感染风险更高。丙型肝炎感染率呈降低趋势,梅毒、艾滋病及乙型肝炎感染率均呈上升趋势,以梅毒感染率增加最明显,其逐年感染率比较差异具有统计学意义（P〈0．05）。结论无偿献血人群中仍然存在较高梅毒、艾滋病、丙型肝炎及乙型肝炎感染率,且梅毒等部分疾病感染率增加,应加强对献血人群血样的检测,警惕高危接触人群．以保证临床用血安全性,避免医源性感染及疾病传播。     

高危人群梅毒检测结果分析

目的：了解陕西省汉中市略阳县高危人群梅毒感染情况,为制定相应的干预措施和实验室检测策略提供依据。方法：对2010年组织到我院体检的高危人群采用梅毒螺旋体ELISA试验（TP-ELISA）方法进行检测,阳性结果用梅毒螺旋体明胶凝集试验（TPPA）进行确认。结果：2010年共129份血清样本（上半年61份,下半年68份）,ELISA法共检出阳性16例,阳性率为12.40%,有2例经TPPA法确诊为阴性,特异性为89.15%。结论：本地区高危人群梅毒感染率高,实验室应该尽快制定相应的预防、检验和治疗策略,控制梅毒的性传播途径,降低梅毒感染带来的危害性;同时证明ELISA检测法特异性好,可作为高危人群梅毒感染的一种理想检测方法,但对ELISA阳性标本应做TPPA确认。     

感染科护理人员发生HIV针刺伤的原因及安全防护措施

针刺伤是护理人员最常见的职业性伤害,尤其感染科护士是发生针刺伤及感染和经血液传播疾病的高危职业群体.有关专家评估中国艾滋病感染者约65万人,近年来以30%的速度递增.而根据"艾滋病综合倡导与分析项目"中"亚洲流行模型"对云南艾滋病流行的预测,在现有艾滋病防治干预水平下,初步估计2006年至2010年,云南全省将新增感染人数73291例,累计艾滋病感染者总数将达161863例,为全国感染人数最多的省份.     

南华县2004～2009年HIV/AIDS监测结果分析与对策

目的：通过对南华县2004～2009年艾滋病疫情资料进行分析,发现流行特点及影响因素,并提出相应的防治对策。方法：对南华县2004～2009年艾滋病病毒血清学监测检测资料进行分析。结果：2004年发现第1例输入性艾滋病病毒感染者,截至2009-12,全县累计报告HIV感染者68例,其中艾滋病病人25例。以青壮年为主,农民占72.06%;男女比例1：1.2。性传播占91.18﹪,血液传播占4.41﹪,母婴传播占4.41﹪,其中有9例分布在3个家庭,占13.24﹪。结论：南华县艾滋病呈低流行状态。3种传播途径并存,呈现由高危人群向一般人群扩散趋势。主要集中在青壮年农民,始终以性传播为主。加强农村居民、流动人口健康教育、行为干预,增强艾滋病的预防意识,是南华县防制艾滋病流行、蔓延的有效措施。     

1991～2010年某部空勤人员与普通人群幽门螺旋杆菌感染率对比分析

目的:通过对比1991～2010年20年间某部空勤人员幽门螺杆菌(Hp)感染率及普通就医人群HP感染率,总结对空勤人员HP感染的干预效果.方法:收集1991～2010年间因上腹不适症状行胃镜检查的门诊及住院空勤人员359例,在相同年龄段内随机抽取同期门诊及住院普通人群637例,对HP感染率进行对照分析.以五年为一个时间段进行比较.结果:20年间空勤人员HP感染率为52.09％,普通人群HP感染率为57.77％,两者无明显差异性.但近5年中空勤人员幽门螺杆菌感染率呈明显下降趋势,与普通人群感染率有明显差异性.结论:空勤人员幽门螺杆菌感染率呈显著下降趋势,干预措施有效.     

ARMA模型在胆结石病发病率预测中的应用

目的探讨应用时间序列自回归移动平均模型（ARMA）预测胆结石病发病率的可行性。方法应用EV iews3.1软件对青海海西自治州2001~2006年逐月发病率进行ARMA建模拟合;按照残差不相关和简洁的原则确定模型结构,依据赤池信息准则（AIC）与施瓦茨准则（SC）、拟合优度确定模型的阶数。对所得模型的残差进行统计验证,依据残差序列图中实际值与拟合值的拟合效果确定最终模型。利用最终模型预测2007年的胆结石病月发病率,比较预测值和实际值,检验预测效果。结果AR IMA（1,1,1）模型能够较好地拟合及预测胆结石病月发病率值,除个别观测数据与模型预测数据相差较大外,模型所得结果与实际值非常接近。结论ARMA模型可以较好地模拟胆结石病发病率在时间序列上的变动趋势,可用于预测未来的胆结石病发病率趋势,是一种短期预测精度较高的预测模型。     

MSM人群HIV感染状况及高危行为影响因素分析

目的了解自贡市男男性行为者（MSM）的HIV感染情况及影响因素,为制定MSM人群干预策略提供依据。方法采用问卷调查法对参与自愿咨询检测的366例MSM人员进行调查并采集静脉血液样本进行HIV抗体、梅毒抗体检测。结果自贡市MSM人群的HIV阳性检出率为24．32％,梅毒阳性检出率4．64％,年龄、文化程度、艾滋病知识知晓率、是否接受过艾滋病干预、首次性行为年龄、最近6个月男性性伴侣数、安全套的使用率、寻找性伴侣的场所是高危行为影响因素。结论自贡市MSM人群知识知晓情况较好,但高危行为较为普遍,安全套使用率较低,存在知行分离。MSM人群艾滋病防治形势严峻,需要根据男男性行为特征制定切实可行的干预措施,以遏制艾滋病的传播。     

11239例海洛因依赖者HIV感染的临床检测

目的 了解海洛因依赖HIV感染的原因,为控制HIV蔓延提供依据。方法 对11239例海洛因依赖进行HIV血清抗体检测,并对阳性的吸毒方式进行调查。结果 HIV血清学检测抗体阳性反应36例,全部为静脉注射毒品滥用,有共用注射器具史和性乱史。结论 静脉注射毒品已成为我国目前艾滋病传播的最主要的途径,海洛因依赖为艾滋病高发人群。建议(1)加强对高危人群预防艾滋病的宣传教育;(2)对高危行为进行干预;(3)加强对海洛因依赖的血清学检测。以控制HIV流行。     

季节分解法和ARIMA法预测乌鲁木齐市肺结核发病趋势效果分析

目的 比较时间序列季节分解法和差分自回归滑动平均(ARIMA)法预测肺结核发病趋势的效果,为肺结核预测预警提供科学依据.方法 对新疆乌鲁木齐市2005年1月至2014年12月肺结核月发病率时间序列分别构建季节分解拟合模型和ARIMA拟合模型,对2015年各月发病率分别进行预测并与实际发病率进行比较.结果 乌鲁木齐市肺结核流行表现出春季高发的年度周期性.应用季节分解法构建的拟合模型中,线性模型和三次曲线模型对2015年各月发病率预测结果的平均绝对百分误差(MAPE)分别为18.75%和92.25%,线性模型预测值整体上低于实际值,三次曲线模型预测值整体上高于实际值;应用ARIMA方法构建的拟合模型为ARIMA(2,1,1)(1,1,0)12,对2015年各月发病率预测结果的MAPE为9.46%,整体上预测值和实际值无明显差异.结论ARIMA法较季节分解法对乌鲁木齐市肺结核发病率的预测效果更佳.     

我国艾滋病神经功能影像学研究现状与临床应用

艾滋病即获得性免疫缺陷综合征（acquiredimmunodeficiencysyndrome,AIDS）在全球广泛流行,已成为严重威胁人类健康重大传染病之一,被称为21世纪的新瘟疫。中国艾滋病形势总体处于低流行,但特定人群和局部地区呈高流行态势,防治形势依然严峻。中华人民共和国卫生部、联合国艾滋病规划署和世界卫生组织联合对2007年中国艾滋病疫情进行估计显示截至2007年底,中国现有艾滋病毒感染者约70万（55～85万人）,全人群感染率为0．05％。到2010年,中国艾滋病感染人数将力争控制在150万人以内。可见,中国艾滋病防治的严峻形势早已受到政府和全社会的广泛关注和高度重视。     

抗病毒治疗的HIV感染/AIDS病人社会支持状况

目的了解抗病毒治疗的HIV感染/AIDS病人所面对的社会支持系统的状况。方法采用统一设计的调查问卷,对泸州市某区疾控中心2011年建档的62例HIV感染病人进行逐个面对面的调查。结果 64.0%的病人有良好的家庭支持。85.48%的病人努力过好每一天。80.65%的病人建议政府向公众加大力宣传HIV感染途径和预防措施,并尊重病人。全部病人对国家的免费治疗表示很满意。30.61%病人选择将来拒绝性活动,64.50%的病人在性活动中选择使用安全套,4.84%病人不使用任何防护措施。结论 HIV感染/AIDS所面对的支持系统状况,来自医务人员的支持很好,其中从事感染病工作的医务人员做得最好,其他科有歧视病人现象。社会支持功能还不是很好,社会的歧视现象普遍存在。暴露与非暴露病人的生活态度之间统计学表明没有显著差异。     

Prevalence of HIV risk factors for individuals examined in clinical forensic medicine

Objective: to identify the prevalence of high-risk factors for infection with Human Immunodeficiency Virus (HIV) in individuals examined in clinical forensic medical practice and to determine opinions and attitudes about HIV in this patient group. Design: Anonymised questionnaire completed by consecutive individuals seen in clinical forensic medical practice. Setting: Police stations in London attended by Group IV forensic medical examiners. Subjects: 518 individuals examined in police stations (including prisoners and suspects, those detained in police custody, police officers and victims of crime). Results: 164 (31.7%) individuals did not respond to the questionnaire because of: 1) refusal (12.6%) 2) inability because of drugs and/or alcohol (11.4%) 3) mental illness/disorder (4.2%) or 4) language difficulties (3.5%). 28.4% of the respondents were in at least one of the 'high-risk' categories for HIV infection. 26.5% were intravenous drug misusers; 15% were prostitutes; 9.8% (or their sexual partners) had lived in Central or East Africa since 1977; 5.9% were male homosexuals and 0.5% were haemophiliacs. 5.1% were infected with HIV or had Acquired Immunodeficiency Syndrome (AIDS). Only 28.8% of individuals always used condoms in short-term sexual relationships. 44.4% of respondents believed that everyone should be tested for HIV. Conclusion: Over one-quarter of the respondents were in higher-risk groups for infection with HIV. Almost one-third could or would not respond. It is concluded that it is not possible to identify by questionnaire, individuals at higher risk of HIV infection in forensic medical practice. This reinforces the necessity of observing good clinical practice to reduce contamination risks in this work environment. It is clear that education about risks for HIV infection is still much needed.     

A pilot trial of high-dose-rate intraoperative radiation therapy for malignant pleural mesothelioma

PURPOSE: To report results of a phase II trial of high-dose-rate intra-operative radiation therapy (HDR-IORT) for malignant pleural mesothelioma (MPM). METHODS AND MATERIALS: Seven patients had extrapleural pneumonectomy with IORT (EPP/IORT) and 6 patients had pleurectomy/decortication with IORT (PD/IORT) between 1994 and 1996. IORT was delivered with 192Ir using a customized applicator with a remote afterloader. A median of 3 sites were treated to a median area of 143 cm2. A dose of 1500 cGy was prescribed at each site, with 1000 cGy delivered to the mediastinum. Postoperative external beam radiation therapy (EBRT) was given 3-5 weeks later. Median follow-up was 8 months (range, 1-84 months). RESULTS: Five patients developed local failure. Two-year local control and survival rates were 35% and 23%, respectively. Mortality was 2/13 (15%), 1 from each surgical group. Serious complications requiring further intervention occurred in 3/6 (50%) of the EPP/IORT group and 1/5 (20%) of the PD/IORT group. CONCLUSIONS: HDR-IORT after EPP for MPM is prohibitively toxic and has been abandoned, while its use with PD remains in question.     

Female genital mutilation: medico-legal issues

The rising prevalence and severe impact of HIV/AIDS in relation to women still persists in South Africa. Both economically and socially the HIV/AIDS pandemic strikes women the hardest, with disadvantaged black women mainly at risk of higher infection. The theoretical framework of this paper focuses on the connection between HIV/AIDS, sexual inequalities and sexual violence, and more precisely, female genital mutilation, a cultural practice and custom which amplifies women's exposure to HIV. Pertinent to this focus is inescapably an analysis of apparent threats to precise essential human rights as a result of the continued use of the practice of female genital mutilation in South Africa.     

HIV/AIDS, psychiatric disorder and sexual assault in Transkei: a case report

HIV infection and psychiatric disorders have a complex relationship. HIV infection could lead to psychiatric disorders, and psychiatric patients are more vulnerable to HIV infection. HIV is not only an illness which is associated with stigmatization and discrimination, but also has several risks attached including physical and sexual abuse. There is a scarcity of literature on HIV, mental illness and sexual assault although they are a common trio. The author describes an HIV-positive woman with a psychiatric disorder. She suffered from AIDS and periodic psychotic epidsodes. On a day when she had such an episode she became a rape victim. The history, and physical and genital examination has been described. The need for further research in the area of HIV/AIDS and mental health has been discussed. Preventive strategies have been recommended for HIV-infected individuals in poor health resource settings.     

北京市房山区2008-2010年水痘暴发疫情流行病学分析

目的 了解北京市房山区2008-01至2010-12水痘暴发疫情情况,为制订托幼园所、学校水痘疫情防制措施提供科学依据.方法 对房山区2008-01至2010-12水痘暴发疫情进行流行病学分析研究.结果 共发生水痘暴发疫情21起,总病例数为193例,罹患率为1.72%.2008年发生15起,2009年发生2起,2010年发生4起.其中5起发生在托幼园所,16起发生在小学.结论 水痘传染性强,病毒一旦引入托幼园所、学校,传播迅速;加强监测,落实传染源隔离、对易感人群应急接种、消毒等措施是预防水痘暴发的重要措施.     

The effect of pre-season dance training on physical indices and back pain in elite cross-country skiers: a prospective controlled intervention study

OBJECTIVE: To evaluate the effect of pre-season dance training on back pain, joint mobility, and muscle flexibility, and on speed and agility in elite cross-country skiers. METHODS: 26 skiers participated (mean (SD) age, 19 (3.9) years). An intervention group (n = 16) had 12 weeks of dance training; a control group (n = 10) did not dance; otherwise both groups followed a similar pre-season physical training programme. Joint mobility and muscle flexibility of the spine, hip, and ankle were measured. Two sports related functional tests (slalom and hurdle) were also done. All measurements/tests were carried out before and after the dancing period. RESULTS: Four (of six) subjects from the intervention group who initially complained of ski related back pain did not report back pain after the dance training; the three subjects with back pain from the control group were unchanged. At study onset the intervention group had a slightly impaired range of motion in the spine compared with the control group. After dance training, there was a better relation between kyphosis of the thoracic spine and lordosis of the lumbar spine, and a 7.1 degrees increase in hip flexion with the knee extended (p = 0.02). In the control group hip extension decreased by 0.08 m on average (p = 0.01). No positive effects of dance training on sports related functional tests were observed. CONCLUSIONS: Preseason dance training improved the range of hip motion and joint mobility and the flexibility of the spine. These improvements might explain the reduction in ski related back pain in the intervention group.     

Risk of transmission of blood borne infections in climbing--consensus statement of UIAA Medcom

Blood borne infections such as hepatitis B, C (HBV, HBC) and human immunodeficiency disease (HIV) are major health problems globally. As the number of blood borne infections is postulated to increase among athletes, the question to the UIAA Medical Commission arises as to whether there is a risk of transmission in climbing. Using a nominal group consensus model approach a working group was formed during the UIAA Medical Commission's meeting in Adr?pach-Zdoóov, in the Czech Republic, 2008. A working document was prepared and circulated via email. After several revisions the following final form was approved by written consent in lieu of a live meeting of the UIAA MedCom on 31st May, 2010: The main pathways of transmission of blood borne infections in athletes are similar to those experienced in the general population. The greatest risk to the athlete for contracting any blood borne pathogen infection is through sexual activity and parenteral drug use, and not in the sporting arena. The transmission risk in climbing is even smaller compared to contact sports. Mandatory HIV, HBV or HCV testing or widespread screening is not recommended, voluntary testing is recommended for all high risk athletes in the same way as for non-athletes. HIV and HBV positive climbers should not be banned from climbing or climbing competitions. The risk of transmission from infected athletes to other athletes is very low, the focus should be on preventive activities and education.     

电针、推拿结合牵引治疗慢性腰痛疗效观察

目的:回顾性分析比较电针、推拿结合牵引与单纯电针、推拿治疗慢性腰痛的疗效。方法:以本院2010年1月之后应用电针、推拿结合牵引治疗的100例慢性腰痛患者为A组,之前采用电针、推拿治疗的100例患者为B组。两组治疗前后均采用改良JOA腰痛问卷评分、疼痛视觉评分(VAS)以及指地距离(FFD)评定疗效。同时以治愈率、好转率和未愈率三个等级计算两组临床治疗总有效率,并对比二组疗效。结果:治疗后两组JOA问卷评分较治疗前均显著提高(P<0.05),且A组显著高于B组(P<0.05);治疗后两组VAS及FFD指标较治疗前均显著降低(P<0.05),且A组显著低于B组(P<0.05);A组临床治疗总有效率显著高于B组(P<0.05)。结论:两种治疗方法均可有效改善慢性腰痛患者功能障碍,缓解症状,电针、推拿结合牵引治疗法效果优于单纯电针、推拿治疗。