新肝炎病毒TTV在各类高危人群中分子流行病学研究

为观察新肝炎病毒TTV在各类高危人群中的感染状况和基因分型 ,在日本株TTVORF1保守区合成了特异性引物 ,采用巢式聚合酶链反应 (nPCR)两次扩增血清TTVDNA ,对各类人群中TTVDNA分别进行了分子克隆和部分基因测序 ,并与日本报道的TTVDNA基因序列比较。结果显示 :从非甲 戊型和非庚型肝炎病人、血清HBsAg阳性的肝炎病人、正常献血员、静脉内吸毒者和女性性乱者中 ,分别获得的 6份TTVDNA克隆 ,其基因序列与日本株TTVORF1部分基因核苷酸序列同源性为 97%～ 99% ,均属于TTVla型。提示 :我国各类高危人群感染TTV以la型为主 ;TTV基因型与疾病发生和传播方式关系不大。     

新肝炎病毒TTV在各类高危人群中分子流行病学研究

为观察新肝炎病毒TTV在各类高危人群中的感染状况和基因分型,在日本株TTV ORF,保守区合成了特异性引物,采用巢式聚合酶链反应(nPCR)两次扩增血清TTV DNA,对各类人群中TTV DNA分别进行了分子克隆和部分基因测序,并与日本报道的TTV DNA基因序列比较。结果显示：从非甲．戊型和非庚型肝炎病人、血清HBsAg阳性的肝炎病人、正常献血员、静脉内吸毒者和女性性乱者中,分别获得的6份TTV DNA克隆,其基因序列与日本株TTV ORF,部分基因核苷酸序列同源性为97％～99％,均属于TTV la型。提示：我国各类高危人群感染TTV 以la型为主;TTV基因型与疾病发生和传播方式关系不大。     

Clinical and radiographic correlates of primary and reactivation tuberculosis: a molecular epidemiology study

Context  The traditional teaching that pulmonary tuberculosis characterized by lymphadenopathy, effusions, and lower or mid lung zone infiltrates on chest radiography represents "primary" disease from recently acquired infection, whereas upper lobe infiltrates and cavities represent secondary or reactivation disease acquired in the more distant past, is not based on well-established clinical evidence. Furthermore, it is not known whether the atypical radiograph common in human immunodeficiency virus (HIV)–associated tuberculosis is due to a preponderance of primary progressive disease or altered immunity. Objective  To analyze the relationship between recently acquired and remotely acquired pulmonary tuberculosis, clinical and demographic variables, and radiographic features by using molecular fingerprinting and conventional epidemiology. Design, Setting, and Population  A retrospective, hospital-based series of 456 patients treated at a New York City medical center between 1990 and 1999. Eligible patients had to have had at least 1 positive respiratory culture for Mycobacterium tuberculosis and available radiographic data. Main Outcome Measures  Radiographic appearance as measured by the presence or absence of 6 features: upper lobe infiltrate, cavitary lesion, adenopathy, effusions, lower or mid lung zone infiltrate, and miliary pattern. Radiographs were considered typical if they had an upper lobe infiltrate or cavity whether or not other features were present. Atypical radiographs were those that had adenopathy, effusion, or mid lower lung zone infiltrates or had none of the above features. Results  Human immunodeficiency virus infection was most commonly associated with an atypical radiographic appearance on chest radiograph with an odds ratio of 0.20 (95% confidence interval, 0.13-0.31). Although a clustered fingerprint, representing recently acquired disease, was associated with typical radiograph in univariate analysis (odds ratio, 0.68; 95% confidence interval, 0.47-0.99), the association was lost when adjusted for HIV status. Conclusions  Time from acquisition of infection to development of clinical disease does not reliably predict the radiographic appearance of tuberculosis. Human immunodeficiency virus status, a probable surrogate for the integrity of the host immune response, is the only independent predictor of radiographic appearance. The altered radiographic appearance of pulmonary tuberculosis in HIV is due to altered immunity rather than recent acquisition of infection and progression to active disease.      

Extrapulmonary tuberculosis: clinical and epidemiologic spectrum of 636 cases

BACKGROUND: The aim of this study was to evaluate the percentage and characteristics of extrapulmonary tuberculosis (EPTB) cases in a Turkish industrial city, Kocaeli (population: 1,203,335) and to illustrate its extent as a serious health problem for this city and country. METHODS: We investigated the results of microbiologic, radiologic, and histopathologic findings of patients with extrapulmonary tuberculosis, retrospectively, who were admitted to four Tuberculous Dispensaries between 1996 and 2000. RESULTS: Six hundred thirty six cases were diagnosed with EPTB. Three hundred forty five were males (54.2%) and 291, females (45.8%). Mean age of patient cases was 22.5+/-17.1 years (range, 1-86 years); 41.4% of cases were <15 years of age and 30.9%, between 20 and 39 years of age. Contact history with tuberculosis cases was determined in 242 cases (38%); of these, 194 were <15 years of age (80.2%). The most common form of EPTB was observed to be lymph node tuberculosis (56.3%); of these cases, 256 (71.5%) had involvement in intrathoracic, 92 (25.7%) in cervical, and 10 (2.8%) in axillary lymph nodes. The second most frequent extrapulmonary form was pleural tuberculosis (31.1%). EPTB was diagnosed by histopathologic methods in 229 patients (36.0%) and by microbiologic methods in 27 (4.2%); tuberculin skin test was significantly positive (>10 mm) in 95.5% of patients. When cases were classified according to severity, 87 cases (13.7%) were found severe and 549 (86.3%) as less severe EPTB. Five hundred sixty one cases (88.2%) lived in urban areas and 75 (11.8%), in rural areas. CONCLUSIONS: EPTB is very common in early adulthood in the Kocaeli region, with lymph nodes the most common localization.     

一起肺结核病聚集性疫情的流行病学调查

目的探讨某院校学员队一起肺结核病聚集流行的影响因素,为控制肺结核病疫情提供科学依据。方法对该院校发病学员队进行流行病学调查、X线检查、结核菌素试验,X线检查异常者进行痰结核分枝杆菌检查,确诊结核患者,追踪传染源。结果 2011年10月初~2011年12月15日2个月多内,该院校某学员队80名学员中,共确诊肺结核病例9例,罹患率为11.25%。80例密切接触者中PPD检测,阳性人数62人,阳性率为77.50%;强阳性人数14人,强阳性率17.50%,高于对照的未发病学员队(P0.01)。结论首发病例的误诊与延误诊断,密切接触者预防措施不及时是本次肺结核聚集流行的源头。加强基层部队与卫生防疫部门之间的协作,采取综合性的肺结核病防控措施,预防肺结核病的聚集流行。     

基于时空重排扫描统计量的结核病聚集性研究

目的探讨青岛市结核病发病的时空聚集性。方法应用时空重排扫描统计量（采用SaTScan v8.0软件）对青岛市2006年1月1日至2007年12月31日的结核病登记资料进行分析。结果回顾性时空聚集分析确定了5个可能的结核病发病聚集区域：莱西市日庄镇东庞周围区域的结核病发病在2006年10月1日至2006年12月31日期间具有聚集性（P=0.001）,李沧区永安路办事处文安路周围区域的结核病发病在2007年1月1日至2007年6月30日期间具有聚集性（P=0.006）,平度市崔家集镇王家庄周围区域的结核病发病在2006年3月1日至2006年3月31日期间具有聚集性（P=0.016）,即墨市普东镇后家屯周围区域的结核病发病在2007年7月1日至2007年8月31日期间具有聚集性（P=0.041）,胶南市大村镇大石岭周围区域的结核病发病在2006年4月1日至2006年4月30日期间具有聚集性（P=0.066）。结论时空重排扫描统计量是空间流行病学中用于评价疾病时空聚集性的一种有效的方法,可为结核病时空聚集性特征的阐明以及结核病的有效防控提供统计学依据。     

Predictors of surgical wound infection in Australia: a national study

In July 1984, the first national Australian Nosocomial Prevalence Survey collected data on 12,742 surgical patients from 265 hospitals. This sample represented 59% of public and private hospitals with 50 or more acute-care beds in Australia. The infection control officers at each hospital provided data on patients in a random sample of beds. The over-all surgical wound infection rate was 4.6%. The surgical wound infection rate was twice (5.4%) as high in public than in private (2.8%) hospitals. The infection rates were greater in larger hospitals in both the public and private sector. However, after adjusting for the other predictor factors that are noted below the infection rate did not show any particular pattern for the size of hospital. Clean surgery had a higher (4.8%) infection rate than did clean-contaminated surgery (2.9%). The infection rate for contaminated surgery was 15.0%. Men were found to have nearly twice (6.5%) the infection rate of women (3.4%). Infection rates were lowest in the 15-to-34 years' age-group and highest in those of over 55 years of age. These trends remained even after adjusting for the other risk factors for infection. The cost of surgical wound infections for all hospitals during the year of 1984 was estimated at approximately $60 million. We suggest that a concerted effort should be made to attempt to reduce the infection rate for clean surgery to 1% or less.     

Carcinoma of the cervix: an epidemiologic study

122 patients with histologically confirmed squamous cell carcinoma of the cervix admitted to the gynecological wards of Charity Hospital in New Orleans from July 1, 1959, through March 31, 1960, were studied; suitable controls were selected from the same wards. All interviews were conducted by the same interviewer nurse who was unaware of the diagnoses. Hospital charts were later examined. Educational level of patients, occupation of husband and father, residence, original diagnosis, and religion were similar to those of controls. Less than 1/3 had more than grammar school education. Most husbands and fathers were farmers of unskilled laborers. In only 1/5 of the patients had the original cancer diagnosis been made by private physicians or at noncharity hospitals. About 45% were Catholics, 45% Baptists, and the remaining 10% other Protestant denominations. 49% of the patients and 43% of the controls reported 6 or more pregnancies. Douching practices were similar to controls; few had ever used other contraceptive measures. 13 patients and 6 controls had positive serological tests for syphilis. Only 6, 1 patient and 5 controls, had never been married. Of cancer patients, 47% had been married more than once vs. 16% of controls. 34% of the patients with cancer were married before the age of 17 vs. 14% of controls. 54% of patients with cancer and 26% of controls reported extramarital partners. 53% of patients had 1st coitus before age 17 vs. 26% of the controls. There was a considerably higher frequency of coitus in patients than in controls. It is concluded that no relation between number of pregnancies and cancer was shown. Douching with coal tar derivatives was not a factor. The association of carcinoma and syphilis was not certain as many had never had a serological test. The effect of circumcision of partners was not determined as it was often unknown. A significant association was shown with early marriage, extramarital relations, coitus at an early age, and frequent coitus at all ages.     

绥宁县肺结核分布的聚集性分析

目的 分析绥宁县肺结核分布的聚集性，为今后的防治工作提供对策。方法对2003～2005年新登记的肺结核病例进行泊松分布及x^2检验，对随机抽取的新登记肺结核病例采用二项分布及x^2检验进行家庭聚集性分析。结果不符合泊松分布和二项分布。结论绥宁县肺结核病例按村分布及家庭分布均呈现非随机分布，具有聚集性。     

结核分枝杆菌的分子生物学检测研究进展

该文对用于结核分枝杆菌菌种及菌株鉴定的基因标记和序列作一综述。这些基因标记和序列包括插入序列、串联重复序列、存在于质粒pTBNl2中的多态性GC丰富的重复序列、36bp顺向重复序列、间隔子寡核苷酸等。     

Predictors of mortality in childhood neurotuberculosis: a retrospective study of 84 cases

In our institute neurotuberculosis now forms (0.6%) of an average of 2000 total admission per year. Our mortality rate was 38%. Young age patients who present themselves late and delay in the initiation of anti-tuberculous therapy correlated significantly with poor outcome.     

An epidemiologic study of hypertension in Newfoundland

The distribution of arterial blood pressure (BP) values of 1499 adult inhabitants of four Newfoundland communities was surveyed. Mean age- and sex-adjusted BP scores were found to be higher in each of three fishing villages than in the logging and mining community, Badger, in the central part of the province. It is postulated that the observed differences may be caused by environmental factors. The prevalence of individuals with probable essential hypertension (diastolic BP > 100 mm. Hg) in individuals over 50 years of age was found to be three times higher in the island community, Fogo, than in Badger. In both communities less than one third of those with probable hypertensive disease had received treatment.     

2016年-2018年萍乡市结核病流行特征调查分析

目的 调查萍乡市结核病疫情现状及流行病学特征,为制定全市结核病防治策略提供参考依据。方法 由于我院为我市唯一结核病治疗医院,因此利用电子病历系统收集我院2016～2018 年结核病数据信息,使用SPSS软件进行统计学处理分析。结果 2016～2018 年我院总共收治结核病患者1693 例,其中2016、2017、2018 年分别报道结核患者为491、527、675 例。其中初治1405 例,占83.0%,痰菌阳性628 例,占37.1%;男女比例为3.15:1,男性发病率远高于女性（P＜0.05）;2018 年较2016 年各个县区大部分均有所增长,开发区与莲花县的发病递增率远高于其他地区（P＜0.05）。结论 萍乡市结核病患者数有逐年增长趋势,但仍明显低于全国流行水平,以中老年、农村患者为主,因此仍需进一步加强中老年及农村方面结核病宣教及防控工作。     

Tobacco smoking and pulmonary tuberculosis: a case-control study

A case-control study was carried out to assess if the tobacco smoking is associated with development of active pulmonary tuberculosis in 153 cases with active pulmonary tuberculosis and 160 control subjects. Detailed information on smoking habits was collected from cases and controls using questionnaire. It was seen that tobacco smoking was associated with pulmonary tuberculosis. The estimated crude odd's ratio (OR) of the association was 1.66 (95% confidence interval: 1.01-2.73) . The age adjusted OR was 1.70 (95% CI: 1.01-2.88), p < 0.05. The increased risk for pulmonary tuberculosis was significant in men who had smoked for over 20 years (OR 3.07; 95% CI: 1.37-6.86). The adjusted OR for heavy smokers (more than 20 bidis per day) was 2.72 (95% CI: 1.19-6.20). There was a dose-response relationship between the number of bidis smoked daily and the risk of development of pulmonary tuberculosis. The study showed that tobacco smoking is associated with pulmonary tuberculosis, with a dose-response relationship with the number of bidis consumed daily.