广西急性脑炎脑膜炎症候群的监测与研究

Objective To estimate disease burden and epidemiological characteristics of acute meningitis/encephalitis,and provide the basis for the disease control strategy development.Methods A syndrome surveillance system was established in Guigang city with a population of 5 020 000.For the suspected cases, serum and CSF were collected,and bacterial culture,latex agglutination test,real-time PCR and ELISA tests were carried out. All involved cases were identified to 6 categories according to WHO case definition. Results 1424 suspected cases were evaluated in a surveillance of 30 months,yielding the incidence,mortality and mortality of 11.35/100 000(1424/12 546 500 person years),0.43/100 000(54/12 546 500 person years),3.79%(54/1424)respectively.A total of 103 and 51 cases were confirmed for JE,bacterial meningitis,with a incidence of 0.82/100 000(103/12 546 500 person years),0.41/100 000(51/12 546 500 person years).96.10%(99/103)of JE sases and 37.30%(19/51)bacterial meningitis cages occurred in＜10 years old children and＜5 years old children.A clinical misdiagnosis rate of 19.42%(20/103)and 15.69%(8/51)were obserred for JE and bacterial meningitis.Conclusion Acute encephalitis,meningitis syndrome can cause a higher burden of disease.of which the main components of viral encephalitis.Most of syndrome is occurred in summer and autumn,mainly reported in children of younger than 10 years old.A quite misdiagnosis would be made among meningitis and encephalitis syndrome cases.     

广西急性脑炎脑膜炎症候群的监测与研究

目的 系统监测急性脑炎脑膜炎症候群患者,分析其流行病学特征、病原谱构成,为科学防治脑炎脑膜炎症候群提供依据.方法 在人口约502万的广西贵港市建立急性中枢神经系统感染的症候群监测系统,开展血液和脑脊液标本的细菌学培养、乳胶凝集试验、实时荧光PCR、ELISA 等多种实验室检测,完成患者入院、出院2次流行病调查,按照WHO监测手册的患者定义将疑似患者分为流行性乙型脑炎(简称乙脑)、细菌性脑炎、可能的病毒性脑炎等6个分类,分析其流行病学特征.通过对比临床诊断与实验室检测结果评估症候群监测系统的收益.结果 在30个月的监测期内,共评估急性脑炎脑膜炎症候群患者1424例,报告年均临床发病率、死亡率、病死率分别为11.35/10万(1424/12 546 500人年)、0.43/10万(54/12 546 500人年)、3.79%(54/1424);病原学确诊154例,其中乙脑103例、细菌性脑炎51例,估算年发病率分别为0.82/10万(103/12 546 500人年)、0.41/10万(51/12 546 500人年);96.10%(99/103)的乙脑患者为10岁以下儿童,37.30%(19/51)的细菌性脑膜炎发生在5岁以下儿童中.乙脑、细菌性脑膜炎的临床误诊率分别为19.42%(20/103)和15.69%(8/51).结论 急性脑炎脑膜炎症候群病原以病毒性为主,急性脑炎脑膜炎症候群主要危害10岁以下散居儿童,当前脑炎、脑膜炎的临床诊断存在一定比例的误诊.

Abstract：

Objective To estimate disease burden and epidemiological characteristics of acute meningitis/encephalitis,and provide the basis for the disease control strategy development.Methods A syndrome surveillance system was established in Guigang city with a population of 5 020 000.For the suspected cases, serum and CSF were collected,and bacterial culture,latex agglutination test,real-time PCR and ELISA tests were carried out. All involved cases were identified to 6 categories according to WHO case definition. Results 1424 suspected cases were evaluated in a surveillance of 30 months,yielding the incidence,mortality and mortality of 11.35/100 000(1424/12 546 500 person years),0.43/100 000(54/12 546 500 person years),3.79%(54/1424)respectively.A total of 103 and 51 cases were confirmed for JE,bacterial meningitis,with a incidence of 0.82/100 000(103/12 546 500 person years),0.41/100 000(51/12 546 500 person years).96.10%(99/103)of JE sases and 37.30%(19/51)bacterial meningitis cages occurred in＜10 years old children and＜5 years old children.A clinical misdiagnosis rate of 19.42%(20/103)and 15.69%(8/51)were obserred for JE and bacterial meningitis.Conclusion Acute encephalitis,meningitis syndrome can cause a higher burden of disease.of which the main components of viral encephalitis.Most of syndrome is occurred in summer and autumn,mainly reported in children of younger than 10 years old.A quite misdiagnosis would be made among meningitis and encephalitis syndrome cases.     

An Investigation on the Incidence of Type 1 Diabetes in Hainan Children

ObjectiveTo investigate the incidence of type 1 diabe tes in Hainan children.MethodsAccording to the demands of WHO DiaMo nd Project,all the newly diagnosed cases of type 1 diabetes under 15 years old d uring 1989～1996 were retrospectively registered by the capture-recapture method .ResultsThe population under 15 years old was about two million,and 53 cases of type 1 diabetes (male 25,female 28) were found.50 of them were Han nationality(94.3%) and 3 cases were the other nationalities(5.6%).There was no significant difference between the two incidences according to their population ratios.The total ascertainment corrected incidence was 0.40/100 000/yr(95% CI0 .37～0.42).ConclusionThe Hainan children incidence of type 1 diabete s is lower than the average level of the whole country,which suggested that the incidence in south China is lower than that in north region.     

日本脑炎流行病学和疫苗研制

Japanese encephalitis (JE) caused by Japanese encephalitis virus (JEV) is widely spread in the east and southeast part of Asia and number of human cases are estimated approximately 20000 annually in the world. The epidemic area is expanding recently as a newly emerging disease in the Oceanic countries.     

年轻子宫内膜癌的临床特点及预后分析

目的 探讨年轻子宫内膜癌的临床特点及预后.方法 对82例确诊的子宫内膜癌患者进行回顾性分析,其中≤45岁31例(年轻组),＞45岁51例(年老组),分析两组患者的临床特点、诊治情况及预后.结果 年轻组原发性不孕率和妊娠＜3次率[38.7%(12/31)和74.2%(23/31)]明显高于年老组[3.9%(2/51)和29.4%(15/51)](P＜0.05).两组患者肌层浸润程度比较,差异有统计学意义(P＜0.05);而病理类型、组织学分级、手术病理分期、5年生存率及复发时间比较,差异均无统计学意义(P＞0.05).结论 不孕或少孕为年轻子宫内膜癌的发病因素;年轻子宫内膜癌肌层浸润程度较年老患者轻,病理类型、组织学分级、手术病理分期与年老患者相似,但并没有获得比年老者更好的预后.

Abstract：

Objective To investigate the clinical characteristics and prognosis of young patients with endometrial cancer. Methods Eighty-two cases with endometrial cancer were analyzed retrospectively,31 cases in the young group were ≤ 45 years old, and 51 cases in the old group were ＞ 45 years old. The clinical characteristics, diagnosis, treatment and prognosis between the two groups were compared. Results Twelve cases with primary infertility took up 38.7% in the young group,23 cases with less than 3 times of pregnancy occupied 74.2%, and there was no statistical difference,compared with the old group [3.9%(2/51)and 29.4% (15/51)] (P＜0.05). There was statistically significant between the two groups in myometrial invasion (P ＜ 0.05 ); while there was no significance between the two groups in pathological type, histological grade,clinical stage, 5-year survival rate and recurrence period (P＞0.05). Conclusion Infertility or less pregnancy are risk factors for endometrial cancer in the young; the degree of endometrial invasion in the young is more shallow than that in the old; there is no significant difference between the young and the old in pathological type, histological grade and clinical stage; but the prognosis is similar between the young and the old patients.     

70例手足口病病原检测和临床分析

Objective To analyze the etiology and clinical manifestations of 70 patients with hand-foot-mouth disease (HFMD). Methods The viral RNA from the pharynx swab samples were extracted and collected from 70 HFMD patients (of which,60 cases were under 5 years old) to detect the 5'-UTR gene of EV,the Vp3-Vp1 genes of EV71 and Cox-A16 by utilizing the technique of RT-PCR. Results Of 70 HFMD patients,30 cases (42.8%, 30/70) were positive in enterovirus nucleic acid, including EV71 and Cox-A16,pharynx swab sample testing. While, of the enteroviral pathogen RNA-positive 30 cases, EV71 accounted for 66. 7% (20/30). The proportion of etiological positive of 39 samples collected within 4 days after onset was 66.7% (26/39), but the probability of 31 samples collected after more than 5 days after onset was 12.9%(4/31),the difference was significantly(χ2=20.4,P<0. 01). Conclusion HFMD patients were mainly infants and young children between 0-5 years old, but adults could also be attacked. The enterovirus detected was mainly EV71,and the pharynx swab samples should be collected within 4 days after onset to increase the related viral nucleic acid positive detection probability.     

散装熟肉制品中单核细胞增生李斯特菌的定量风险评估

Objective To conduct a quantitative risk assessment for Listeria monocytogenes in bulk cooked meat products in China.Methods The data on the contamination level of Listeria monocytogenes in cooked meat products was from national foodborne disease surveillance network.involving a total of 841samples.All the samples were detected by a qualitative method and 97 samples among them were detected using a quantitative method.The intake data of cooked meats was from Chinese National Nutrition and Health Survey in 2002 and population data in the monitoring sites was collected from National Bureau of Statistics in 2008 to estimate the composition of the population of different ages.which would be the base ofassessing the probability of listeriosis in the different subpopulations.Using @ Risk software to estimate the risk of listeriosis caused by consuming deli meats for different subpopulation(0-4 years old,5-64 years old and 65 years and older)by quantitative risk assessments which involved hazard identification,hazard characterization,exposure assessment and risk characterization and conduct sensitivity analysis.Results The contamination level of Listeria monocytogenes in the most of samples(96.08%.808/841)was less than 3 MPN/g(0.5 1g MPN/g),and the average concentration of Listeria monocytogenes was -0.61 1g CFU/g(90%CI:-1.22-0.46 1g CFU/g).Estimated servings of cooked meat consumption for 0-4,5-64 and 65 years and older were 5.52 × 109,8.99×1010.1.01×1010,respectively.Estimated number of cases(median)of listeriosis each year per million people caused by consuming cooked meats in young(0-4 years old),intermediate age(5-64 years old)and elderly(65 years and older)population were 5.53×10-2,1.72×10-4,7.57×10-3,respectively.Results of sensitivity analysis showed that contamination level at retail,serving size of cooked meats,storage time at home,storage temperature and ERG at 5 ℃ were positive factors for the risk of listeriosis(r value was 0.607,0.408,0.339,0.259,0.183 respectively,P＜0.05).Conclusion Cooked meat products in bulk is a risk food,which could cause listeriosis.Contamination level of Listeria monocytogenes in cooked meat products in bulk is the top risk factor for the listeriosis.     

散装熟肉制品中单核细胞增生李斯特菌的定量风险评估

Objective To conduct a quantitative risk assessment for Listeria monocytogenes in bulk cooked meat products in China.Methods The data on the contamination level of Listeria monocytogenes in cooked meat products was from national foodborne disease surveillance network.involving a total of 841samples.All the samples were detected by a qualitative method and 97 samples among them were detected using a quantitative method.The intake data of cooked meats was from Chinese National Nutrition and Health Survey in 2002 and population data in the monitoring sites was collected from National Bureau of Statistics in 2008 to estimate the composition of the population of different ages.which would be the base ofassessing the probability of listeriosis in the different subpopulations.Using @ Risk software to estimate the risk of listeriosis caused by consuming deli meats for different subpopulation(0-4 years old,5-64 years old and 65 years and older)by quantitative risk assessments which involved hazard identification,hazard characterization,exposure assessment and risk characterization and conduct sensitivity analysis.Results The contamination level of Listeria monocytogenes in the most of samples(96.08%.808/841)was less than 3 MPN/g(0.5 1g MPN/g),and the average concentration of Listeria monocytogenes was -0.61 1g CFU/g(90%CI:-1.22-0.46 1g CFU/g).Estimated servings of cooked meat consumption for 0-4,5-64 and 65 years and older were 5.52 × 109,8.99×1010.1.01×1010,respectively.Estimated number of cases(median)of listeriosis each year per million people caused by consuming cooked meats in young(0-4 years old),intermediate age(5-64 years old)and elderly(65 years and older)population were 5.53×10-2,1.72×10-4,7.57×10-3,respectively.Results of sensitivity analysis showed that contamination level at retail,serving size of cooked meats,storage time at home,storage temperature and ERG at 5 ℃ were positive factors for the risk of listeriosis(r value was 0.607,0.408,0.339,0.259,0.183 respectively,P＜0.05).Conclusion Cooked meat products in bulk is a risk food,which could cause listeriosis.Contamination level of Listeria monocytogenes in cooked meat products in bulk is the top risk factor for the listeriosis.     

粤东地区四种性传播疾病病原感染的流行状况

Objective To investigate the infection situation of Ureaplasma urealyticum, Nersseria gonorrhoeae, Chlamydia trachomatis and HSV- Ⅱ among the people in east Guangdong. Methods 4404 cases of out-patients with self-clinical symptoms or suspicious reproductive tract infection were selected as study subject and were examined for UU, NG, CT and HSV- Ⅱ . Results Among the 4404 cases, 864 cases were UU positive(41.90%), 72 were NG positive (10.70%), 192 were CT positive(12.90%) and 24 were HSV-Ⅱ positive(12.90%). Of the 1152 cases of above positive patients, the highest infection rate was in the patients of 20 to 40 years old(86.55%), and the females were ob-viously higher than the males. Conclusions In the people of east Guangdong, the situation of UU, NG, CT and HSV- Ⅱ infection was severe, especially in 20 to40 ages.It is very important to detect the sex transmitted disease agents in high risk people and is also the key link to control UU, NG, CT and HSV- Ⅱ infection.     

粤东地区四种性传播疾病病原感染的流行状况

Objective To investigate the infection situation of Ureaplasma urealyticum, Nersseria gonorrhoeae, Chlamydia trachomatis and HSV- Ⅱ among the people in east Guangdong. Methods 4404 cases of out-patients with self-clinical symptoms or suspicious reproductive tract infection were selected as study subject and were examined for UU, NG, CT and HSV- Ⅱ . Results Among the 4404 cases, 864 cases were UU positive(41.90%), 72 were NG positive (10.70%), 192 were CT positive(12.90%) and 24 were HSV-Ⅱ positive(12.90%). Of the 1152 cases of above positive patients, the highest infection rate was in the patients of 20 to 40 years old(86.55%), and the females were ob-viously higher than the males. Conclusions In the people of east Guangdong, the situation of UU, NG, CT and HSV- Ⅱ infection was severe, especially in 20 to40 ages.It is very important to detect the sex transmitted disease agents in high risk people and is also the key link to control UU, NG, CT and HSV- Ⅱ infection.     

1996 outlook: systems, for-profit chains, medical groups, religious healthcare, managed care, post-acute care, finance, purchasing, info systems, labor, legal, construction

It's put-up-or-shut-up time for healthcare providers in 1996. Two years ago, everyone talked about fixing the healthcare system. Not much happened. Last year, providers and politicians concentrated on squeezing medical costs. According to some of Modern Healthcare's key beat reports, this year it's back to the basics of running a business.