保定市儿童社区获得性肺炎非典型病原学趋势

【目的】分析儿童社区获得性肺炎(community acquired pneumonia,CAP)的病原学特点及其与临床的关系,为经验性治疗提供依据。【方法】对558例符合CAP诊断的患儿应用ELISA技术检测呼吸道合胞病毒(RSV)、流感病毒(IA)、副流感病毒(PIV)、柯萨奇病毒(COX)IgM抗体,肺炎支原体(MP)、肺炎衣原体(CP)IgM抗体。同时设立健康对照组。【结果】558例CAP患儿中病原体IgM抗体检测阳性267例,占47.8%。特异性IgM抗体按检出率由高到低排列依次为MP 19.9%(111例),RSV16.3%(91例),ADV5.6%(31例),PIV3.6%(20例),IA2.5%(14例),COX1.6%(9例),CP0.4%(2例)。病原分布有年龄、季节差别。【结论】保定市儿童CAP非典型病原体主要是MP、RSV、ADV,尤其是MP感染在儿童CAP中占重要地位。不同的年龄段和不同季节病原不同。     

331例儿童重症肺炎病原学分析

目的研究儿童重症肺炎病原体分布情况,为临床诊治提供参考。方法回顾性分析2016年因重症肺炎入住福建省妇幼保健院PICU的病例331例。入院当日采集血液标本,用酶联免疫法检测呼吸道病原抗体,包括呼吸道合胞病毒(RSV)、副流感病毒1~3型(PIV)、流感病毒甲型及乙型(IFA、IFB)、腺病毒(AdV)、肺炎支原体(MP)、肺炎衣原体(CP),同时进行巨细胞病毒(CMV)DNA、EB病毒(EBV)DNA及痰培养检测。结果 331例患儿中182例检出至少1种病原,总检出率55.0%。MP感染主要在冬末春初(1~4月),占53.5%;RSV感染也多在冬末春初(12月至次年3月),占55.2%。年龄别MP检出率:1岁组最低(7.0%),≥5岁组达41.7%,随年龄增加检出率升高;年龄别RSV检出率:1岁组高于≥1岁组。结论儿童重症肺炎的MP感染和RSV感染均好发于冬末春初;MP多见于≥5岁儿童,而RSV以1岁婴儿多发。     

肺炎婴幼儿鼻咽分泌物呼吸道病毒、肺炎衣原体的检测分析

【目的】分析温州地区肺炎婴幼儿鼻咽分泌物7种呼吸道病毒、肺炎衣原体的感染及混合感染情况。【方法】选择2004年11月~2006年11月因肺炎而在温州医学院附属育英儿童医院住院治疗的婴幼儿,取其鼻咽分泌物做直接免疫荧光检测筛查7种呼吸道病毒与肺炎衣原体抗原,分析其结果。【结果】460例患儿送检标本,阳性260例(56.5%),其中合胞病毒(RSV)182例(39.6%)、腺病毒(ADV)2例(0.4%)、流感病毒A型(IVA)4例(0.9%)、流感病毒B型(IVB)2例(0.4%)、副流感病毒I型(PIVI)7例(1.5%)、副流感病毒III(PIVIII)16例(3.5%)、肺炎衣原体(CPn)42例(9.1%)。混合感染5例(1.1%),其中RSV IVA 2例(0.4%),RSV CPn 3例(0.7%)。RSV冬春两季高发,PIVI以秋季为主,PIVIII与CPn则无明显季节性。【结论】RSV是目前引起婴幼儿肺炎的主要病毒,CPn次之。RSV在温州地区的流行见于冬春季。CPn感染四季散发,存与RSV混和感染情况,在临床诊治中应给予关注。     

2776例儿童急性呼吸道感染病原学检测

目的探讨2014年儿童急性呼吸道感染(ARI)的病原学特点。方法选取本院2014年3月-2015年2月急性呼吸道感染2 776例患儿的血清,采用间接免疫荧光法检测9项病原体Ig M抗体,包括副流感病毒(PIV)、甲型流感病毒(IVA)、乙型流感病毒(IVB)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、嗜肺军团菌(LP)、肺炎衣原体(CP)、肺炎支原体(MP)及Q热立克次体(CB)。结果 2 776份标本中,共检出病原体抗体阳性1 237份,占44.6%,阳性率最高的是肺炎支原体(12.7%)。RSV、ADV夏季病毒感染率最低,春季最高;0.5岁~6岁组检出率较高,0.5岁组检出率较低。509例患儿呈现混合感染。结论商丘地区儿童急性呼吸道感染主要病原体是流感病毒,其次是肺炎支原体。腺病毒、呼吸道合胞病毒感染与季节相关。儿童急性呼吸道感染中病原体的协同感染较为普遍。     

2013年湖南省儿童医院住院患儿急性下呼吸道感染病原体分析

目的 了解湖南省儿童医院急性下呼吸道感染患儿常见非典型呼吸道病原的感染和流行情况,为临床诊断急性下呼吸道感染患儿提供病原学依据。 方法 采集该院2013年1-12月诊断为急性下呼吸道感染的1 726例住院患儿的血清标本,用间接免疫荧光法(IFA)快速检测和鉴定肺炎支原体、乙型流感病毒、呼吸道合胞病毒、副流感病毒(1.2.3)、腺病毒、嗜肺军团菌、甲型流感病毒、肺炎衣原体、Q热立克次体九种非典型呼吸道病原体。采用χ²检验分析检出率的人群、季节、时间分布差异。 结果 1 726例患儿肺炎支原体检出率为56.78%,其次为乙型流感病毒19.99%、呼吸道合胞病毒12.40%、副流感病毒9.21%、腺病毒5.16%、嗜肺军团菌5.16%,甲型流感病毒2.43%,肺炎衣原体1.10%,Q热立克次体0.9%;其中肺炎支原体检出率存在性别差异(χ²=6.04, P<0.05);副流感病毒、乙型流感病毒、呼吸道合胞病毒、肺炎衣原体、肺炎支原体、腺病毒检出率存在年龄差异(P<0.05);肺炎衣原体检出率不存在季节差异,其它病原体在检出率存在季节差异(P<0.05)。副流感病毒、甲型流感病毒检出率5月达最高峰;Q热立克次体秋冬季未检出;肺炎支原体、乙型流感病毒1月是检出高峰。重复感染率22.25%,其中肺炎支原体合并其他病原体感染率高达16.3%。 结论 导致该院儿童急性下呼吸道感染的主要病原体是肺炎支原体、乙型流感病毒、呼吸道合胞病毒;肺炎支原体与其它病原体混合感染普遍。     

2019年济南市某医院518例儿童呼吸道感染病原学特征分析

目的 了解本地区儿童呼吸道感染的病原学流行特征,为儿童呼吸道感染的早期诊治提供流行病学依据.方法 2019年10～12月选择济南市某医院呼吸道感染儿童患者518例,采集外周血样本,用酶联免疫吸附法联合检测呼吸道合胞病毒(RSV)、腺病毒(ADV)、肺炎支原体(MP)、衣原体(CP)、副流感病毒(PIV)、肺炎军团菌(L...     

新生儿肺炎的病原及临床研究

目的研究新生儿肺炎的病原和临床特点.方法呼吸道分泌物细菌培养;肺炎支原体(MP)及沙眼衣原体(CT)荧光核酸检测;直接免疫荧光法检测呼吸道合胞病毒(RSV),流感病毒A、B型,副流感病毒1、2、3型,腺病毒.结果474例新生儿肺炎中病原检测阳性148例(31.2%);其中细菌性病原93例(62.8%),RSV肺炎40例(27.0%),副流感病毒3型3例(2.0%),CT肺炎11例(7.4%),MP 1例(0.7%).阴性326例(68.8%).G-杆菌占细菌总数的80.6%,G 球菌占19.4%.早产儿(胎龄＜37W)、足月儿(胎龄≥37W)、早期新生儿(≤7d)、晚期新生儿(＞7d),G-杆菌的检出率显著高于G 球菌(P＜0.05).不同胎龄、日龄儿G-杆菌与G 球菌的检出率无显著性差异(P＞0.05).RSV肺炎发病季节在12月～5月底.临床表现为喘憋及肺部喘鸣音.CT肺炎阴道分娩占90.9%,剖宫产仅9.1%.结论新生儿肺炎临床症状不典型,难以依靠临床表现作出病原诊断.RSV肺炎是新生儿病毒性肺炎最常见的病原.     

吉林省小儿呼吸道感染病原简析

目的:简析小儿呼吸道感染的病原学特点及其与临床的关系。方法:采用酶联免疫法(ELISA)对239例呼吸道感染病儿进行多病原学(检测肺炎支原体、肺炎衣原体、呼吸道合胞病毒、EB病毒、结核杆菌、轮状病毒、腺病毒抗体)研究。结果:肺炎支原体抗体阳性者63例,占26.4%,肺炎衣原体抗体阳性者34例,占14.2%,两者均阳性者8例,占3.3%,呼吸道合胞病毒感染4例,占1.7%,肺炎支原体合并呼吸道合胞病毒感染1例,未检测到上述病原者136例,占56.9%。肺炎支原体感染在大于7岁年龄组感染率略高(55.2%)。结论:肺炎支原体已成为小儿呼吸道感染的重要病原,各年龄组儿童均易感染,以大于3岁的儿童为多见。     

中山市社区儿童获得性肺炎病原学分布特点及与气象因素相关性研究

目的了解中山市儿童社区获得性肺炎(community-acquired pneumonia,CAP)病原学分布特点及与气象因素的关系,为儿童CAP的预防、诊断及合理用药提供指导和依据。方法选取2014年9月至2016年8月在中山市博爱医院住院的13 705例CAP患儿病例,采用间接免疫荧光法(IFA)、酶联免疫吸附试验(ELISA)法、胶体金法和细菌培养法联合检测患儿痰、咽拭子、血样本、肺泡灌洗液中的呼吸道病原微生物,对各种病原微生物在不同性别、年龄、季节、气象的分布及特点进行分析。结果 13 705例患儿中,病原学检测阳性数为8 412例,阳性率为61.38%,检出率排在前3位的是呼吸道合胞病毒2 660例(19.41%)、肺炎支原体2 195例(16.02%)和流感嗜血杆菌1 798例(13.12%);混合感染率为34.27%。男女患儿的肺炎支原体感染率不同(χ~2=103.900,P0.01);肺炎支原体检出率夏秋季高于春冬季(χ~2=101.188,P0.01),流感病毒检出率春季最高(χ~2=123.415,P0.01),呼吸道合胞病毒检出率则是冬春季高于夏秋季(χ~2=317.574,P0.01);肺炎支原体和副流感病毒检出率与月平均日照、月平均温度呈正相关;流感病毒检出率与月平均湿度呈正相关。结论 CAP患儿病原微生物检出率在不同年龄段及季节有不同,呼吸道合胞病毒在儿童CAP病原微生物中占据着重要的地位,好发于冬春季;流感嗜血杆菌占儿童CAP细菌感染病原的首位;警惕夏秋季节儿童肺炎支原体感染率升高,尤其是月平均日照和温度增加时的流行。     

金华地区9种呼吸道病原体IgM抗体检测结果分析

目的分析金华地区9种呼吸道病原体的IgM抗体检测结果及流行情况。方法收集2016年1月-12月门诊与住院的呼吸道感染患者3 224例,应用间接免疫荧光法检测9种病原体IgM抗体:嗜肺军团菌(LP)、肺炎支原体(MP)、立克次体(COX)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(INFA)和乙型流感病毒(INFB)、副流感病毒(PIV)。结果检测血清IgM阳性610例,总阳性率为18.92%。MP阳性率最高,为12.38%;其次为INFB,阳性率为4.09%;单一感染536例(87.87%),混合感染74例(12.13%)。单一感染以MP为主,混合感染以MP+INFB模式最多。女性IgM阳性检出率高于男性,差异有统计学意义(P0.05);4岁~17岁为高发人群,50岁的感染率低于其他人群;IgM总阳性率、MP阳性率在春季最高,而INFB阳性率在秋季最低。结论 MP和INFB是引起本院呼吸道感染的最重要的病原体;应针对不同人群不同季节病原体的流行情况,做好防范工作。     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

芜湖地区儿童隐孢子虫病调查

1989年5月~9月,对安徽省芜湖市五所医院儿科就诊的腹泻患儿进行隐孢子虫病调查。粪检腹泻患儿3 498人,卵囊检出率1.9%。男女检出率无差异;6个月内的患儿中未检出卵囊阳性者;86.2%的卵囊阳性者分布于7个月~4岁年龄段;乡村患儿的卵囊检出率2倍于城市患儿;病例呈高度散发状态;卵囊检出率从6月下旬开始上升,在本调查中,92.5%的病例分布于6月下旬~9月。所见病例,从临床表现到大便性状均无特殊,且均呈自限性,病程似较文献报道者为短。     

Correlation among cadmium levels in river sediment, in rice, in daily foods and in urine of residents in 11 prefectures in Japan

Objective: The objective of this study is to examine if overall correlation exists among cadmium levels (Cd) in the general environment, dietary Cd intake, and Cd body burden of local residents. Methods: Eleven prefectures in Japan were selected as the areas where large-scale data on Cd levels in urine of adult women (40–49 and 50–59 years of age, respectively) were available to calculate geometric mean (GM) values for each of the prefecture. Other data were cited from published or previously established databases on Cd in the sediments of river bottoms (as a representative of Cd in the environment), Cd in rice for local consumption, and Cd in daily food duplicate samples collected from local women populations, and calculated for GM values for the prefectures. The GM values were subjected to correlation matrix and regression analysis. Results: Marginally significant (P<0.10) correlation was detected between Cd in sediment and Cd in rice. Furthermore, correlation of Cd in sediment was significant with Cd in total foods (P<0.05) and possibly with Cd in urine (P<0.05–0.10). Importance of data on Cd in rice paddy soil as a missing link is discussed. Conclusions: Correlation was demonstrated in the flow of Cd transport from the environment (expressed as Cd contents in river sediments) to humans (in terms of Cd in urine) among general populations in Japan.     

谈神经内科医院感染危险因素及护理对策

目的：了解引起神经内科住院患者医院感染的危险因素，采取有效的护理措施，以降低医院感染的发生率和死亡率。方法：结合多年临床经验，对医院感染不同的危险因素进行分析及提出护理对策。结论：神经内科医院感染发病率较高，获得途径以外源为主，针对主要危险因素的发生原因，我们应加强病房管理，严格执行消毒隔离制度，合理应用抗生素，加强基础护理和健康教育，缩短住院天数，以降低神经内科医院感染的发病率。     

2003年汕头市住院婴儿住院情况分析

目的调查住院婴儿疾病分布情况。方法利用SAS8．0对汕头市2003年住院婴儿2923例病例进行统计分析。结果婴儿住院的病因包括：早产、新生儿窒息、呼吸道及消化道感染、新生儿黄疸以及先天性疾病等；造成婴儿死亡的前5位病因主要是出生窒息、窘迫、先天性肺炎、新生儿吸人性肺炎以及先天性心脏畸形；婴儿的住院时间越长，入院情况越危急，受到医院感染的机会越大；入院婴儿平均住院日为7．089天，平均住院费用3717．834元。结论婴儿发病入院主要由于先天性疾病以及后天感染，这是家庭及社会进行婴儿健康干预与促进的重点。     

Musculoskeletal pain in ragpickers in a southern city in Brazil

BACKGROUND: Ragpickers are informal workers who collect recyclable materials to earn a small wage. Their life and working conditions are extremely precarious. The ergonomic hazards and musculoskeletal pain in a sample of ragpickers in Pelotas, a city in southern Brazil are examined. METHODS: Two comparison groups were available: a matched sample of non-ragpickers from the same poor neighborhoods, and a random sample of the general population of the city. The cross-sectional study gathered data by interview on 990 individuals in 2004. Musculoskeletal pain was assessed using the Standardized Nordic Questionnaire. RESULTS: Ragpickers reported higher prevalences for most awkward postures and ergonomic exposures compared to neighbors with other demanding manual jobs. The prevalence within the last 12 months of low back pain (LBP), lower extremity pain (LEP), and upper extremity pain (UEP) among ragpickers were 49.2%, 45.1%, and 34.9%, respectively; levels similar to those reported by neighborhood controls. Both ragpickers and non-ragpickers reported considerably higher ergonomic exposures, and more prevalent LBP, than the general population. CONCLUSIONS: Ragpickers experience many occupational hazards and ergonomic stressors. Their overall prevalence of musculoskeletal pain was similar to a comparison group with other physically demanding manual jobs. For LBP, this prevalence was substantially higher (49% vs. 35%) than in the general population.     

Changes in social inequalities in health in the Basque Country

STUDY OBJECTIVE: To determine the extent of the inequalities in self reported health between socioeconomic groups and its changes over time in the Basque Country (Spain). DESIGN: Cross sectional data on the association between occupation, education and income and three health indicators was obtained from the Basque Health Surveys of 1986 and 1992. Representative population samples were analysed. In 1986 the number of respondents was 24 657 and in 1992, 13 277. SETTING: Basque Country, Spain. MAIN OUTCOME MEASURES: The effect of socioeconomic position on health and the magnitude of social inequalities in health were quantified using the odds ratios based on logistic regression analysis, and the Relative Index of Inequality. RESULTS: As was expected, social inequalities in self reported health existed in both surveys, but the social gradient was greater in 1992. Social differences varied according to gender and health indicator. According to education an increase in social inequalities was observed consistently in all the health indicators except long term conditions in women. A consistent increase in inequalities in limiting longstanding illness was also observed according to all socioeconomic indicators. CONCLUSIONS: These results agree to a large extent with those of previous studies in other countries. In this context the unequal distribution of material circumstances and working conditions between socioeconomic groups seem to play a major part in health inequalities. The worsening of the labour market during this period and the onset of a new economic recession may explain the increase in social inequalities over time.