北京城、郊区儿童哮喘及相关过敏疾患的室内环境因素比较

Objective To study the indoor environmental factors associated with the prevalence of asthma and related allergies among school children.Methods A cluster sampling method was used and the ISAAC questionnaire was conducted.A total of 4612 elementary students under Grade Five of 7 schools were enrolled in the survey for the impact of indoor environmental factors on the prevalence of asthma and related allergies in several urban and suburban schools of Beijing.Results A total of 4060 sample were finally analyzed including 1992 urban and 2068 suburban.The prevalence of wheeze, allergic rhinoconjunctivitis and atopic eczema in the past 12 months was 3.1% (61/1992) ,5.3% (106/1992) ,1.1% (22/1992) among urban children while 1.3% (27/2068) ,3.1% (65/2068), 1.0% (22/2068) among suburban children respectively.The prevalence of wheeze and allergic rhinoconjunctivitis of the past 12 months in urban were both significantly higher than that in suburban ( χ2 = 14.77, 11.93, P ＜ 0.01 ).The incidences of having asthma and eczema ever among urban children (5.3% (105/1992) ,29.4% (586/1992))were significantly ( χ2 = 39.03, 147.22, P ＜ 0.01 ) higher than that among suburban ( 1.7% ( 35/2068 ), 13.8%(285/2068)).Atlthough the distributions of indoor environmental factors were similar in both areas, passivesmoking and interior decoration had different influence on the prevalence of asthma and related allergies among school children in the two areas.The significant impact of passive smoking on having asthma ever among suburban children was observed ( OR = 2.70,95% CI = 1.17 - 6.23 ) while no significant result in urban ( OR = 1.06,95% CI = 0.71 - 1.58 ); the percentage of interior decoration was 84.0% ( 1673/1992 )among urban children and 80.0% (1655/2068)among suburban children, there was significant impact of interior decoration on the prevalence of having eczema ever among urban children ( OR = 1.57,95% CI =1.17-2.10) but no significant results were found in suburban sample (OR= 1.06,95% CI =0.76-1.48).Conclusion The prevalence of asthma and related allergies among school children is much higher in urban areas than that in suburban areas and the indoor environmental factors such as passive smoking and interior decoration may differently explain the prevalence of asthma and related allergies in the two areas.     

福建省沿海地区鼠形动物巴尔通体感染状况调查及基因类型研究

Objective To investigate Bartonella infection in rodent hosts from different environments and types of climate in Fujian coastal regions. Genetypes of the Bartonella strains was also studied to provide scientific basis for prevention and control of the correlated diseases. Methods By random sampling method, we selected six study sites in Fujian southeastern coastal regions. Rodents were captured by cages to Isolate Bartonella strains. Bartonella-like isolates were confirmed by polymerase chain reaction (PCR). The 379 bp fragment of gltA gene was sequenced and the growth and development tree was constructed to determine Bartonella species. Distribution of Bartonella species in the different area and related hosts was also analysed. Results Bartonella species were isolated from 188 of 1161 small animals including five rodent species. The infected animals were grouped into 2 genera and 2 orders. They were Suncus murinus, Rattas norvegicus, Rnttus flavipectus, Mus masculus and Rattus rattus. The overall prevalence of Bartonella bacteremia was 16.19% in the most prevalent species of rodents in Fujian southeastern coastal regions including 21.43% in Suncus murinus, 13.54% in Rattas norvegicus and 18.27% in Rattus flavipectus. Rodents in every investigated areas were infected by Bartonella species (9.25% in Ningde, 9.52% in Fuzhou, 9.38% in Putian, 28.18% in Quanzhou, 17.42% in Xiamen and 13.33% in Zhangzhou). There were significant differences among infected rates in different annual accumulated temperature districts (χ2=12.93, P<0.001). Isolates from rodents were clustered in three genotypes (B.elizabethae, B.qeenslandensis and B.tribocorum A, B). Conclusion The local rodents in Fujian southeastern coastal regions were widely infected by Bartonella spp. Differences among the prevalent species of Bartonella in Fujian southeastern coastal region, Yunan and Beijing were noticed. Our findings suggested there was a need to study the prevalence, related vectors and the molecular organism of Bartonella spp.     

Serostatus disclosure and associated factors among people living with HIV/AIDS （PLWHA） in Liuzhou City,China

Introduction HIV serostatus disclosure has become an entry criterion for prevention of sexual partners spread, so we aimed to examine the prevalence of disclosure and associated factors among people living with HIV/ AIDS （PLWHA） in Liuzhou City, Guangxi Zhuang Autonomous Region, southern China. Methods The PLWHA with marital or regular sexual relationship were eligible for our study, and a self-de- signed questionnaire was assigned to all the convenient- ly sampled participants. Determinants of disclosure were analyzed using chi-square test and binary Logistic regression. Results A total of 425 PLWHA were included in the present study. Two hundred and forty-five （57.6%） disclosed their HIV-positive status to their spouses/reg- ular sexual partners, while 180（42.4% ） did not. A- mong the 245 informed spouses/regular sexual part- ners, 236 （96. 3 % ） had received the HIV testing and the positive rate was 50.4%. While among the non-informed spouses/regular sexual partners, 63 （35.0%） had received the HIV testing and the positive rate was 3.2%. Binary Logistic regression analysis indicated that age, area, monthly income, HIV/AIDS related knowledge and antiretroviral therapy （ART） were in- dependently associated with HIV serostatus disclosure. Conclusions The disclosure rate was low in this study. As to its influencing factors, it is necessary to provide comprehensive disclosure consulting among PLWHA living in urban, the elderly or high monthly income and emphasize the propaganda on HIV/AIDS related knowledge, expand coverage for antiretroviral therapy, so as to provide scientific reference for promoting HIV disclosure and reducing the HIV incidence of spouses/ regular sexual partners among PLWHA.     

中国农村地区儿童血铅水平分析

目的 描述中国农村儿童血铅总体水平及分布特征,为改善农村铅污染状况提供依据.方法 通过计算机检索中国期刊全文数据库及相关文献追溯等途径,依照严格的入选标准收集并筛选国内1994-2008年10月公开发表的关于农村儿童血铅水平研究的文献进行分析.结果 我国农村儿童血铅均值为74.93μg/L(范围:41.14～193.54μg/L),铅中毒率为19.32%(范围:2.2%～43%).禁止含铅汽油使用后儿童血铅从87.53μg/L降至71.16μg/L(u=7.13,P<0.01),禁止含铅汽油使用前后农村儿童血铅水平均低于同时期全国儿童血铅水平.调整无铅汽油使用的影响后,北京、山东农村儿童血铅均值较高.分别为99.16和92.13μg/L;吉林、河北较低,分别为41.14和56.14μg/L;18篇文献的综合分析显示,农村儿童和城市儿童的血铅均值分别为77.90和87.24 μg/L(u=3.73,P<0.01);8篇文献的综合分析显示,农村儿童和工业区儿童血铅均值分别为70.25和80.86μg/L(u=10.00.P<0.01).结论 农村地区儿童血铅水平低于全国总体水平,低于城市和工业区儿童血铅水平,推广无铅汽油后农村儿童血铅水平有了明显改善.

Abstract：

Objective To evaluate Chinese rural children's blood lead levels (BLLs) and identify its distribution features and to provide data for policy development to the prevention of rural environmental lead pollution. Methods The papers on rural children's BLLs published from 1994 to Oct. 2008 were collected by using CNKI's (China National Knowledge Infrastructure) Chinese Journal Full-test Database and other ways. The papers which were eligible for the following criteria were reviewed:(l) BLLs measured by atomic absorption spectroscopy (graphite or others) or inductively coupled plasma-mass spectrometry; (2) strict quality control; (3) no local lead pollution sources in the areas where the screened subjects live in; (4) children aged from 0 to 14 years old; (5)sample size more than 40. Results Analysis on the included 32 papers indicated that, the mean BLLs of Chinese rural children between 1994 and 2008 was 74.93μg/L (range:41.14-193.54 μg/L)and 19.32%(range:2.2%-43%) of the subjects had BLLs higher than 100 μg/L. The rural children's BLLs changed from 87.53 μg/Lto 71.16 μg/L after the use of lead free gasoline in 2000 in China, which were both lower than the general children's BBLs before 2000 and after 2001. The children in Beijing city and Shandong province showed the highest mean BLLs , with 99.16 μg/L and 92.13 μg/L respectively; while the children in Jilin province and Hebei province showed the lowest levels, with 41.14 μg/L and 56.14 μg/L respectively. The comprehensive analysis of 18 papers indicated that the mean BLLs in rural areas and urban areas were 77.90 μg/L and 87.24μg/L respectively (u=3.73, P<0.01 ). The comprehensive analysis of 8 papers indicated that the mean BLLs in rural areas and industrial areas were 70.25 μg/Land 80.86 μg/L respectively(u=10.00,P<0.01). Conclusion The BLLs of rural children in China are lower than the general levels of children in China, and also lower than urban areas and industrial areas. Promoting lead free gasoline can make a considerable decrease in the blood lead levels of rural children.     

学龄期儿童膳食钙与骨密度的关系

Objective To investigate the prevalence of overweight and obesity and the nutritional status of dietary calcium intake in school-age children in Shanghai and to analyze the relationship between dietary calcium and bone mineral density (BMD).Methods A cross-sectional study was conducted in the second and third grade students of 10 primary schools in Yangpu District and Baoshan District in Shanghai. Food frequency questionnaire was used tu estimate the relative intake of dietary calcium of students in 6 primary schools in Baoshnn District. Quantitative ultrasound bone density examination was used to estimate the calcaneal BMD.The relation-ship between calcium intake and BMD was analyzed.Results The average calcium intake was 647 mg/d among ested students.BMD was not significantly different among different age groups (F=1.595,P=0.173),while Z-score was significantly different among different age groups (F=16.02,P=0.000).The total calcium intake was not correlated with BMD or Z-score.The percentage of dairy calcium intake was positively correlated with BMD (r=0.097,P=0.015)and Z-score (r=O.117,P=0.003),the percentage of non-dairy calcium intake and the non-dairy calcium intake were negatively correlated with BMD (r=-0.097,P=0.015) and Z-score(r=-0.110,P=0.006).When the total dietary calcium intake was ≥600 mg/d,BMD and Z-score significantly higherin students with high dairy calcium intake than those with low dairy calcium intake (P<0.05).When the total dietary calcium intake was <600mg/d,BMD and Z-score were higher in students with high dairy calcium in-take than in those with low dairy calcium intake,although no statistical significance was noted (P>0.05).Conclusions BMD and Z-score increase along with the increase of dairy calcium intake.Such effect becomes even more obvious when the total dietary calcium intake is ≥600 mg/d.     

新疆哈萨克族人群代谢综合征患病率调查

Objective To analyze the prevalence of metabolic syndrome (MS) in Kazakh population, using the NCEP-ATP Ⅲ, CDS, IDF MS standards. Methods Questionnaire-based survey,physical examination and blood testing were conducted according to cluster random samplings in Kazakh residents in Xinjiang. 2745 samples were collected and diagnosed by NCEP-ATP Ⅲ, CDS,IDF standards to analyze the prevalence, with the distribution of its main components of MS, among the Kazakhs population. Results The prevalence rates of MS diagnosed by NCEP-ATP Ⅲ, CDS,IDF standards were 18.5%, 14.2% and 26.6%, while they became 14.2%, 10.9% and 20.1% after standardized by age. The prevalence of MS diagnosed by NCEP-ATP Ⅲ and IDF standard in males were higher than in females, while CDS was in the opposite situtation. The prevalence of MS by these three standards increased with age. Among all the main components of MS diagnosed after these three standardization process, the prevalence of obesity, blood pressure rising and the abnormity of HDL-C were rather high. The prevalence of MS main components ≥1, ≥2, ≥3, ≥4, 5 ranked the highest compared to the lowest as to the IDF, ATP Ⅲ ' and CDS diagnostic. standards Conclusion The prevalence rates and gender distribution of MS diagnosed by different standards among Kazakhs were different. The prevalence of IDF standard was the highest, with the IDF standard better than the others in early identifying the risk factors of cardiovascular disease.     

Analysis on the trend of smoking prevalence and main causes of death of dead residents in Tianjin from 2010 to 2019CSCD

Objective To evaluate the change trend of smoking prevalence and the composition of main causes of death in Tianjin from 2010 to 2019. Methods The study was based on the data collected in the Tianjin All Cause of Death Surveillance System from 2010 to 2019. A total of 699 372 cases were included in the study. The smoking prevalence, ex‑smoking and never smoking prevalence were calculated according to different death years and gender. The proportion of smoking status was calculated according to the year of birth and gender. The distribution of smokers dying of smoking related diseases were calculated by different age‑group. The change trend of smoking rate was analyzed by Joinpoint regression 4.9.0.0 statistical software. The diseases that smokers died of were expressed by proportion. Results From 2010 to 2019, the smoking rate of dead residents decreased from 28.7% to 21.4%, and the average annual change percentage (AAPC) was -3.0% (95%CI: -3.9%, -2.2%). The same trend was shown in dead residents of different genders. The proportion of ex‑smokers showed an upward trend, from 10.5% in 2010 to 14.7% in 2019; The proportion of light smokers increased with the postponement of birth year. The proportion of light smokers born at and before year 1950 was 14.7%, while the proportion of light smokers born at and after year 1981 was as high as 85.9%; the proportion of heavy smokers decreased with the year of birth. Lung cancer and cardiovascular and cerebrovascular diseases were the main causes of death of smokers and quitters. 13.86% of quitters died of lung cancer, which was slightly lower than that of smokers (16.39%) and significantly higher than that of non‑smokers (5.55%). With the increase of smoking degree, the proportion of smokers who died of lung cancer also increased gradually, from 9.19% to 19.11%. Conclusions From 2010 to 2019, the smoking prevalence of dead residents in Tianjin shows a downward trend, which is consistent with the change trend of the overall smoking prevalence of residents in Tianjin. Lung cancer, acute myocardial infarction and ischemic heart disease rank among the top three causes of death among smokers. © 2021 Journal of Clinical Otorhinolaryngology Head and Neck Surgery. All rights reserved.     

新疆哈萨克族人群代谢综合征患病率调查

Objective To analyze the prevalence of metabolic syndrome (MS) in Kazakh population, using the NCEP-ATP Ⅲ, CDS, IDF MS standards. Methods Questionnaire-based survey,physical examination and blood testing were conducted according to cluster random samplings in Kazakh residents in Xinjiang. 2745 samples were collected and diagnosed by NCEP-ATP Ⅲ, CDS,IDF standards to analyze the prevalence, with the distribution of its main components of MS, among the Kazakhs population. Results The prevalence rates of MS diagnosed by NCEP-ATP Ⅲ, CDS,IDF standards were 18.5%, 14.2% and 26.6%, while they became 14.2%, 10.9% and 20.1% after standardized by age. The prevalence of MS diagnosed by NCEP-ATP Ⅲ and IDF standard in males were higher than in females, while CDS was in the opposite situtation. The prevalence of MS by these three standards increased with age. Among all the main components of MS diagnosed after these three standardization process, the prevalence of obesity, blood pressure rising and the abnormity of HDL-C were rather high. The prevalence of MS main components ≥1, ≥2, ≥3, ≥4, 5 ranked the highest compared to the lowest as to the IDF, ATP Ⅲ ' and CDS diagnostic. standards Conclusion The prevalence rates and gender distribution of MS diagnosed by different standards among Kazakhs were different. The prevalence of IDF standard was the highest, with the IDF standard better than the others in early identifying the risk factors of cardiovascular disease.     

新疆吐鲁番地区维吾尔族和汉族成人支气管哮喘相关因素调查分析

Objective To analyze possible difference in bronchial asthma between ethnic and geographic groups and explore its correlates among Uygur and Han adults in Turpan Prefecture,Xinjiang. Methods One hundred and sixty-six clinically diagnosed asthmatic patients at Turpan Prefecture Hospital,Xinjiang,86 of Uygnr and 80 of Han ethnic,and 166 1:1 matched controls from ophthalmological outpatient department at the same hospital were recruited into the study. Interview with questionnaire was conducted and serum levels of eosinophilie cation protein (S-ECP),total IgE (T-IgE) and specific IgE (S-IgE) were measured for all of the participants to study related factors for asthma with univariate and multivariate conditional logistic regression analyses. Results Bronchial infection (ORU=5.111,95% CI: 1. 203-21.710; ORH=2. 498,95 % CI: 1.471-5. 069), family history of asthma (ORU=3. 078,95% CI: 1. 812-5.188; ORH=2. 711,95% CI: 1. 010-6. 176), personal allergy history (ORU=2.083,95% CI: 1. 043-4. 162;ORH=3. 998,95% CI: 1. 739-9. 198), weather change (Oru=2.218,95% CI: 1. 199-3. 778;OR,=1. 733,95% CI: 1. 004-2. 994) and positive S-IgE (Oru=1. 592,95% CI: 1. 018-2. 491;OR,=3. 858, 95% CI: 2. 246-8. 507) correlated with asthma in patients of both Uygur and Han ethnic. Percentage of asthma attack induced by respiratory infection [59. 30% (51/86)]and weather change [36. 05% (31/86)]in Uygur patients was significantly higher than that in Han ethnic [42. 50% (34/80) and 21.25% (17/80), respectively], but percentage of those with personal allergy history [48.75% (39/ 80)]and positive S-IgE [52.50% (42/80)]in Han ethnic was significantly higher than that in Uygur [32. 56% (28/86) and 30.23% (26/86), respectively]. Levels of S-ECP and T-IgE in patients with moderate and severe asthma of both Uygnr and Han ethnic [(S-ECPU=7. 95±3.98) μg/L, S-ECPH=(11.21±4.74)μg/L,T-IgEU=(72. 23±45.92) kU/L,T-IgEH=(108. 81±64.07) kU/L,respectively]were significantly higher than those in controls of the same ethnic [S-ECPU=(1.94±1.16) μg/L, S-ECPH=(2. 07±1.63)μ/L,T-IgEU=(46.19±32.47) kU/L,T-IgEH=(50. 97±38.51) kU/L;t values were 8.96,10.52,2.81,4.97, P<0.01], higher in Han ethnic than those in Uygur (t values were 3.01, 2. 68, P < 0. 01). Conclusion Bronchial infection,family asthma history, personal allergy history, weather change and positive S-IgE all were important correlates of asthma in Turpan Prefecture, Xinjiang. Levels of S-ECP and T-IgE in patients with moderate and severe asthma increased during its attacks, higher in Han ethnic than those in Uygur. Genetic and environmental factors may be involved in occurrence and development of asthma.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

Europe and hospitals--strengths and requirements

Hospitals all over Europe must get ready to face the important challenge of 1993 at all levels: micro-economic, macro-economic, local, regional and European. Despite the liberalization trends which will inevitably appear with the increased freedom of exchange and movement, hospitals must strive to remain havens of peace to patients.     

护士职业礼仪与整体护理研究

整体护理强调的是以病人为中心，以护理程序为核心，有系统的对病人进行身心整体护理。整体护理是否见效，在很大程度上取决于护士的职业素质。从我院开展的整体护理模式病房工作成效分析，在学习新模式，转变传统护理观念的同时，同样要重视护士职业礼仪的教育，这样既提高整体护理的理论知识，     

Overweight and obesity in children and adolescents and preventative measures

The prevalence of overweight and obesity in children is increasing rapidly. This is alarming because obesity is associated with severe chronic diseases, such as type 2 diabetes mellitus. Obesity at young age is related to obesity at adult age. Consequently, the prevention of overweight from childhood onwards is an important issue. Apart from diabetes mellitus type 2 there is an increased risk of orthopaedic complications, respiratory problems, fertility problems, cardiovascular diseases and psychosocial consequences in the form of a negative self-image, emotional and behavioural problems and depression. Environmental and behavioural factors are regarded as the most important causes of the rapid increase in the prevalence of overweight and as the most important starting points for prevention. Most prevention programmes are still in the initial stages. Prevention programmes aimed at stimulating breast feeding and daily physical activity (playing outside) and the restriction of sweetened drinks and watching TV are very promising. With such preventive measures the involvement of both the school and the parents is important.