云南省伤寒副伤寒空间分布特征及其气候影响因素研究

Objective To characterize the spatial distribution of typhoid and paratyphoid fever(TPF)in Yunnan province, China and to determine the effectiveness of meteorological factors on the epidemics of TPE Methods Data of reported TPF cases in Yunnan province(2001 -2007)from the China Information System for Diseases Control and Prevention was applied to GIS-based spatial analyses to detect their spatial distribution and clustering of TPF incidence at the county level.Panel data analysis was used to identify the relationships between the TPF incidence and meteorological factors including monthly average temperature, monthly cumulative precipitation and monthly average relative humidity. Results During the study period, the average incidence of TPF in Yunnan province was 23.11/100 000, with majority of the TPF cases emerged in summer and autumn. Although widely distributed, two TPF clusters were detected in Yunnan province based on the spatial analysis:one area around Yuxi city with the average annual incidence as 207.45/100 000 and another at the junctions of Yunnan province with Burma and Laos. Based on results from panel data analysis, the incidence of TFP was shown to be associated with meteorological factors such as temperature,precipitation, relative humidity and one month lag of temperature increase [10 ℃ increase in the monthly average temperature:IRR=1.30(95%CI: 1.24-1.36);10% increase in monthly average relative humidity:IRR= 1.07(95%CI: 1.05-1.09); 100 mm rise in monthly cumulative precipitation:IRR=1.02(95%CI: 1.00-1.03); and 10 ℃ average temperature increase, the last month: IRR=1.73(95%CI: 1.64-1.82)]. Conclusion Areas with high TPF incidence were detected in this study,which indicated the key areas for TPF control in Yunnan province. Meteorological factors such as temperature, precipitation and humidity played a role in the incidence of TPF.     

云南省伤寒副伤寒空间分布特征及其气候影响因素研究

目的 分析云南省2001-2007年伤寒副伤寒发病的空间分布特征以及气象因素与伤寒副伤寒流行的关联性.方法 收集2001-2007年云南省以县为单位的伤寒副伤寒发病数据,应用空间聚类、面板数据模型等方法分析伤寒副伤寒的分布特征,以及伤寒副伤寒流行与气温、降水、相对湿度等气象因素的关系.结果 2001-2007年云南省伤寒副伤寒的年均发病率为23.11/10万,病例主要分布于夏秋季.空间聚类分析发现两个伤寒副伤寒的高发聚集区:玉溪地区(7年平均发病率207.45/10万)及该省与缅甸、老挝交界地区.多因素面板数据分析显示,云南省伤寒副伤寒发病增加与气温升高、降水量增多和湿度增加等气候因素相关:月平均气温升高10℃,IRR=1.30(95%CI:1.24～1136);湿度增加10%,IRR=1.07(95%CI:1.05～1.09);月降水量增多100 mm,IRR=1.02(95%CI:1.00～1.03);前1个月的气温升高10℃,IRR=1.73(95%CI:1.64～1.82);P＜0.05.结论 云南省伤寒副伤寒发病存在聚集区,相对湿度等气候因素在流行中发挥了一定的作用.

Abstract：

Objective To characterize the spatial distribution of typhoid and paratyphoid fever(TPF)in Yunnan province, China and to determine the effectiveness of meteorological factors on the epidemics of TPE Methods Data of reported TPF cases in Yunnan province(2001 -2007)from the China Information System for Diseases Control and Prevention was applied to GIS-based spatial analyses to detect their spatial distribution and clustering of TPF incidence at the county level.Panel data analysis was used to identify the relationships between the TPF incidence and meteorological factors including monthly average temperature, monthly cumulative precipitation and monthly average relative humidity. Results During the study period, the average incidence of TPF in Yunnan province was 23.11/100 000, with majority of the TPF cases emerged in summer and autumn. Although widely distributed, two TPF clusters were detected in Yunnan province based on the spatial analysis:one area around Yuxi city with the average annual incidence as 207.45/100 000 and another at the junctions of Yunnan province with Burma and Laos. Based on results from panel data analysis, the incidence of TFP was shown to be associated with meteorological factors such as temperature,precipitation, relative humidity and one month lag of temperature increase [10 ℃ increase in the monthly average temperature:IRR=1.30(95%CI: 1.24-1.36);10% increase in monthly average relative humidity:IRR= 1.07(95%CI: 1.05-1.09); 100 mm rise in monthly cumulative precipitation:IRR=1.02(95%CI: 1.00-1.03); and 10 ℃ average temperature increase, the last month: IRR=1.73(95%CI: 1.64-1.82)]. Conclusion Areas with high TPF incidence were detected in this study,which indicated the key areas for TPF control in Yunnan province. Meteorological factors such as temperature, precipitation and humidity played a role in the incidence of TPF.     

2004-2006年北京夏季最低气温对心脑血管疾病急诊数的影响

目的 探讨北京市夏季最低气温对心脑血管疾病(ICD10:100～199)急诊的影响.方法 收集2004-2006年北京大学某医院急诊科心脑血管疾病急诊资料、北京市环境监测中心大气污染物数据和中国气象科学数据共享服务网的气象资料,应用时间分层的病例交叉设计研究方法进行数据分析.结果 在控制大气污染物SO_2、NO_2、可吸入颗粒物(PM10)影响的情况下,无滞后夏季最低气温对心脑血管疾病总急诊、冠心病急诊、心律失常急诊、心衰急诊和脑血管疾病急诊的影响最大,气温每升高1℃,OR值分别为1.039(95%CI:1.008～1.071),1.077(95%CI:0.987～1.174),1.037(95%CI:0.963～1.116).1.103(95%CI:0.909～1.339)和 1.030(95%CI:0.985～1.077),其中最低气温与总心脑血管疾病急诊的关联有统计学意义(P<0.05).在多因素模型中,考虑到相对湿度因素时,气温每升高1℃对冠心病急诊和脑血管病急诊的OR值分别为1.095(95%CI:1.001～1.075)和1.050(95%CI:1.002～1.100),关联具有统计学意义(P<0.05).结论 夏季最低气温升高可以导致心脑血管疾病总急诊增加,同时相对湿度可能与气温有协同作用,可导致冠心病急诊,脑血管病急诊增加.

Abstract：

Objective To explore the association between the minimum temperature in different seasons and the hospital emergency room visits for cardiocerebrovascular diseases(International Classification of Diseases,tenth vision ICD-10：100-199)in Beijing.China.Methods The data of the daily hospital emergency room visits for cardiocerebrevascular diseases(ICD-10：100-199)from one of Peking university hospitals,the data of relevant ambient air pollution from the Beijing Municipal Environmental Monitoring Center and the data of meteorological index from China meteorological data sharing service system between 2004—2006 were collected The time-stratified case-crossover design was used to analyze the data.Results After adjusting SO_2,NO_2,and PM10.The results showed that each 1℃ increase in the daily minimum temperature in summer was associated with the intraday hospital emergency room visits(OR=1.039,P<0.05)for the total cardiocerebrovascular diseases.In multi-factor model,considering relative humidity,1℃ increase in the daily minimum temperature was associated with the coronary heart disease(OR=1.095,95％CI:1.001—1.075)and the cerebrovascular diseases(OR=1.050,95％CI：1.002—1.100)(P<0.05).Conclusion These outcomes suggest that elevated level of minimum temperature in summer will increase the hospital emergency room visits for the total circulatory diseases,and the relative humidity may enhance the effects of minimum temperature on the hospital emergency room visits of coronary heart disease and cerebrovaseular diseases.     

广州市2006-2009年气温与居民每日死亡人数的时间序列研究

目的 研究2006-2009年广州市气温与居民死亡人数的关系.方法 应用泊松分布的广义相加模型分析时间序列资料,控制时间的长期趋势(季节)、星期几效应、空气污染、其他气象因素等的混杂后,分析广州市日平均气温与每日死亡人数之间的关系.结果 广州市日平均气温与每日总死亡人数呈"U"形.广州市最适宜日平均气温为19.7℃,高于19.7 ℃时,平均气温每升高1 ℃,每日总死亡的风险增加3.0%(RR=1.030,95%CI:1.011～1.050);当日平均气温不超过19.7 ℃时,平均气温每升高1 ℃,每日总死亡的风险减少3.3%(RR=0.967,95%CI:0.936～0.997),循环系统疾病死亡风险减少3.6%(RR=0.964,95%CI:0.935～0.994).结论 广州市日平均气温与居民每日死亡人数有关系,应该采取有效的预防措施减少气温相关死亡的发生.

Abstract：

Objective To study the association between temperature and daily mortality from June 1, 2006 to December 31, 2009 in Guangzhou. Methods Time series approach was used to estimate the impact of temperature on the rates of total and cause-specific daily mortality. We fitted generalized additive Poisson regression using non-parametric smooth functions to control for the long-term time trend, day of week, air pollution and other weather variables. Results A slight sloping U-like relationship between the total mortality and temperature was found, with an optimum average temperature (temperature with lowest mortality risk) value of 19.7 ℃ in Guangzhou. For temperature above the optimum value, the relative risk of total mortality increased by 3.0% (RR=1.030,95%CI: 1.011-1.050) for each increase of degree in Celsius. For average temperature below the optimum value, the relative risk of total mortality and diseases of circulatory system had a 3.3%(RR=0.967,95%CI: 0.936-0.997 ) decrease and a 3.6% ( RR= 0.964,95%CI:0.935-0.994 ) increase,for each degree of Celsius increase, respectively. Conclusion Our findings showed that the temperature had an impact on the daily mortality in Guangzhou. Countermeasures needed to be taken to reduce the temperature related mortality.     

艾滋病患者马尔尼菲青霉菌优势株酵母相全长cDNA文库的构建和初步分析

Objective To construct a full length cDNA library of the dominant strain of Penicillium marneffei (PM) in yeast phase isolated from AIDS patients in Guangdong province and screen UniGenes as well as full-length genes, so as to establish the foundation for the study of PM's functional genes and pathogenic mechanisms. Methods CloneMiner cDNA construction kit was utilized to extract mRNA of the dominant PM strain isolated from AIDS patients in Guangdong province. The mRNA was reversed into cDNA, then cloned into a pDONR222 vector by BP recombination to obtain an Uncut cDNA library, which was homogenized later to construct a normalized cDNA library with the principal of saturation hybridization for DNA genome. 2000 clones were chosen randomly to make a bi-directional sequencing and analyzed with bioinformatics for screening UniGenes and full-length genes. Results The total clone number of the Uncut cDNA library was 1.16 × 107 cfu/mL, with a recombination rate of 95% and an average insertion element being over 1 kb. The total clone number of the normalized cDNA library was 1.18 × 106 cfu/mL, with a recombination rate of 95% and an average insertion element being over 1 kb as well. 1945 genes which DNA length were longer than 1 kb were obtained by sequencing and merged into 1360 UniG enes, of which 632 genes were full-length ones. Conclusions The full-length cDNA library of the dominant strain of PM from AIDS patients in Guangdong province possesses good quality.Meanwhile, the technical routine presents high efficiency in obtaining full-length genes and establishing a gene expression spectrum, which can contentedly meet the needs of future experiments.     

餐饮业引发食源性疾病的主要危险因素

Objective To study main risk factors that cause foodborn diseases in food catering business.Methods Data from references and investigations conducted in food catering units were used to establish models which based on @ Risk 4.5 with Monte Carlo method referring to food handling practice model(FHPM)to make risk assessment on factors of food contamination in food catering units.The Beta-Poisson models on dose-response relationship to Salmonella(developed by WHO/FAO and United States Department of Agriculture)and Vibrio parahaemolyticus(developed by US FDA)were used in this article to analyze the dose-response relationship of pathogens.Results The average probability of food poisoning by consuming Salmonella contaminated cooked meat under refrigeration was 1.96×10-4 which was 1/2800 of the food under non-refrigeration(the average probability of food poisoning was 0.35 at room temperature 25℃).The average probability by consuming 6 hours stored meat under room temperature was 0.11 which was 16 times of 2 hours storage(6.79×10-3).The average probability by consuming contaminated meat without fully cooking was 1.71 X 10-4 which was 100 times of consuming fully cooked meat(1.88×10-6).The probability growth of food poisoning by consuming Vibrio parahaemolyticus contaminated fresh seafood was proportional with contamination level and prevalence.Condusion The primary contamination level,storage temperature and time,cooking process and cross contamination are important factors of catering food safety.     

餐饮业引发食源性疾病的主要危险因素

Objective To study main risk factors that cause foodborn diseases in food catering business.Methods Data from references and investigations conducted in food catering units were used to establish models which based on @ Risk 4.5 with Monte Carlo method referring to food handling practice model(FHPM)to make risk assessment on factors of food contamination in food catering units.The Beta-Poisson models on dose-response relationship to Salmonella(developed by WHO/FAO and United States Department of Agriculture)and Vibrio parahaemolyticus(developed by US FDA)were used in this article to analyze the dose-response relationship of pathogens.Results The average probability of food poisoning by consuming Salmonella contaminated cooked meat under refrigeration was 1.96×10-4 which was 1/2800 of the food under non-refrigeration(the average probability of food poisoning was 0.35 at room temperature 25℃).The average probability by consuming 6 hours stored meat under room temperature was 0.11 which was 16 times of 2 hours storage(6.79×10-3).The average probability by consuming contaminated meat without fully cooking was 1.71 X 10-4 which was 100 times of consuming fully cooked meat(1.88×10-6).The probability growth of food poisoning by consuming Vibrio parahaemolyticus contaminated fresh seafood was proportional with contamination level and prevalence.Condusion The primary contamination level,storage temperature and time,cooking process and cross contamination are important factors of catering food safety.     

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.     

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.     

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.     

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.