北海市某社区流动学龄儿童免疫情况调查及影响因素分析

目的了解北海市某社区流动儿童计划免疫接种现状及影响因素。方法对本社区所辖的三所民营小学的新入学流动儿童286人的免疫状况进行调查。结果居住时间超过3年者卡介苗、乙型肝炎、脊髓灰质炎、百白破(百日咳、白喉、破伤风)、麻风、麻腮风(麻疹、腮腺炎、风疹)、流行性乙型脑炎、A群流脑(流行性脑脊髓膜炎)、A+C群流脑、甲型肝炎疫苗等首针及加强接种率远高于居住时间少于1年者,父母是小商贩的儿童接种率高于农民工或其他行业,省内流动儿童略高于省外。结论影响流动学龄儿童接种的因素主要有儿童在辖区居住时间长短及父母从事职业等。     

结核患者用药依从性及影响因素调查

目的:了解结核患者用药依从性及影响因素,探讨提高用药依从性的对策。方法:对已确诊结核的患者进行问卷调查,了解用药依从性及影响因素。结果:138例结核患者中,依从者占65.4%,不依从者占34.6%。患者用药依从性与是否曾住院,是否定期复诊、是否出现过药物不良反应,用药知识的知晓率有关(P<0.01)。结论:在护理中提供给患者更多的疾病及用药知识、并进行有效的监督、望提高结核患者的用药依从性。     

惠州市惠阳区公务员高血压流行病学特征和影响因素分析

目的了解本地区公务员高血压的流行病学特征和主要相关因素,方法利用2004年本地区年龄阶段在20～60岁的1386名公务员体检资料,获取血压值和相关数据,描述性分析高血压流行病学特征,以Logistic回归分析方法筛选高血压影响因素。结果在体检的1386名公务员中,高血压患者296人,患病率为21．4％,年龄阶段在20～39岁者96人,患病率为6．9％;血压在正常高值者557人,占40．2％,年龄阶段在20～39岁者436人,占31．5％。Logistic回归分析结果显示,高血压主要影响因素为体重指数、腰围、年龄、饮酒、职业和婚姻状况,OR值分别为2．74、2．18、2．16、1．80、1．65、1．32。结论本地区特定人群（公务员）的患病率明显加快,患病年龄阶段出现低龄化趋势;青壮年血压值大多数处于正常高值,随着患病趋势的继续维持,若干年后青壮年高血压患病率将进一步升高;控制高血压的重点应向一级预防倾斜。     

南通市开发区流动人口艾滋病知识知晓率及影响因素分析

目的：了解南通市开发区流动人口艾滋病知识知晓情况及其影响因素,为在流动人口中开展艾滋病宣传教育提供依据。方法2013年2-6月,对南通市开发区流动人口进行匿名自填式问卷调查。所有资料经Epidata3.1软件录入后用SPSS18.0软件进行统计学分析。结果共调查812人,艾滋病知识知晓率为61.1％（496/812）,多因素Logistic回归分析结果显示,性别、年龄、婚姻状况、职业和文化程度是流动人口艾滋病知识知晓情况的影响因素。结论南通市开发区作为流动人口聚集地,其流动人口艾滋病知识知晓率低,应加强对该人群的艾滋病相关知识健康教育。     

某区流动人口肺结核患者治疗依从性的现状调查及影响因素分析

目的为了研究和探讨惠城区流动人口肺结核患者的治疗依从性现状以及相关的影响因素,从而为相关临床研究提供借鉴和参考。方法本文选取了惠城区676例流动人口肺结核患者为研究对象,针对患者的治疗依从性现状进行了调查研究,针对影响因素进行探讨分析。结果 1本次调查的676例流动人口肺结核患者中,可以能够按照相关医护人员的要求进行规则治疗的患者592例,所占比例为87.57%,不能按照相关医护人员的要求进行规则治疗的患者84例,所占比例为12.43%;2在文化程度、是否有医疗保险、服药方式以及是否有医师上门随访等4个方面进行分组比较研究,这4个方面分组比较研究差异具有统计学意义(P均<0.05)。结论治疗依从性是影响惠城区流动人口肺结核患者治疗效果的关键因素,我们应针对影响因素采取有针对性的预防和干预措施,有效提高临床治愈率。     

女性尿失禁流行病学调查及影响因素

尿失禁是一种常见疾病，影响了世界上数以亿计的人口。尤其是老年女性。因此，了解尿失禁的一些宏观特征，例如患病率、发病率、可能的危险因素、人们对该病的认识情况，尿失禁对经济、社会、娱乐生活等的影响就具有极其重要的意义，而这些就是流行病学调查的主要内容。到目前为止国际上许多国家已经进行了多次调查，其结果千差万别。有几种因素可以影响尿失禁流行病学的调查。比如尿失禁的定义、调查方法、调查人群等，以下将分条综述。     

惠州市手足口病的流行病学调查

目的探讨手足口病的流行病学特征,重症手足口病的特点,以防治手足口病。方法回顾性调查本院收治的手足口病,重症病例由本院手足口病专家组根据诊断标准进行定义。结果2008年本院共收治手足口病499例,1～2岁患儿最多见,8月为发病高峰。重症病例66例,死亡4例。46例手足口病进行EV71病毒核酸检测,30例阳性。结论加强手足口病流行病学监测,提高基层医务人员的诊治水平,是降低手足口病发病率、死亡率的主要因素。     

镇结核病疫情分析及其风险与吸烟的相关性研究

目的统计镇结核病疫情概况,探讨吸烟与结核病发病风险的相关性。方法收集2012年镇各地卫生院结核病病案,选取其中600例可电话随访的病例和1200例对照的正常人。结核病风险与吸烟的关系用相关统计学方法研究。结果共发现19342例活动性肺结核患者,活动性肺结核登记率73.87/10万;烟龄和总计吸烟数都可导致结核病发病风险增加。吸烟年龄越小,患结核病的危险性越高。高龄、受教育低、喝酒的吸烟患结核病危险性更高。结论应加大结核传染病防治知识宣传力度。并将控烟干预指导纳入现行的DOTS策略中去。     

三年制和五年制护理专业学生对结核病认知现状的调查及影响因素分析

结核病是由结核杆菌引起的一种慢性传染性疾病,机体各个器官均可受累,尤以肺脏受累最为常见。世界卫生组织将结核病称为全球传染性疾病的“首位杀手”。其中15～35岁是结核病的主要感染人群。学校是一个特殊的结核病易感者的聚集场所,一旦出现传染性结核患者,可形成局部爆发流行趋势。护理学生从业后不仅在医院担负着对患者进行知识宣教的重要职责,而且随着卫生事业改革的深化、人们健康需求的日益增长,我国的社区卫生服务已经全面开展,     

六安市某县结核病细菌学检测及耐药相关因素分析

目的 了解六安市某县结核病耐药状况及相关因素,为制订全市耐药结核病控制策略提供参考依据。 方法 随机抽取我市辖区1县(区),将2013年1月至12月所有登记肺结核病例作为研究对象,进行痰涂片镜检、细菌培养、药敏实验及菌种鉴定,并分析相关影响因素。 结果 结核分枝杆菌总耐药率(单耐药率)为25%(37/148),耐多药率为8.1%(12/148),广泛耐药率为2.03%(3/148);非结核分枝杆菌总耐药率(单耐药率)为100%(5/5) 耐多药率为80%(4/5),广泛耐药率为80%(4/5);单因素及多因素分析显示,复治是单耐药及耐多药结核病的危险因素,20～50岁年龄是耐多药结核病的独立危险因素。涂片阳性率为16.27%(95/584),痰培养阳性率为26.20%(153/584)。 结论 六安市某县结核病耐药疫情形势严峻,需加强对初治病例及青壮年病例的管理,提高其治疗依从性和治疗成功率,减少耐药结核发生。同时需加强结核病的细菌学检测工作,提高菌阳肺结核和耐药结核分枝杆菌的发现率。     

弋阳县流动人口结核病防治情况的调查分析

目的调查本县流动人口的结核病防治情况,为本县制订结核病防治措施提供一定的理论依据。方法统计分析江西省弋阳县2010年6月～2012年6月的结核病防治管理资料。结果流动人口肺结核病新涂阳患者的概率为10．8／10万,高于户籍人口的7．29／10万;流动人口患者的治愈率为63．77％,低于户籍人口的77．59％（P〈0．05）;流动人口患者完成全程督导的概率为85．5％,低于户籍人口的99．1％（P〈0．01）。结论注重提高流动人口肺结核患者的治愈率及全程督导率,以期有效提高本地区结核病的防治管理水平．     

流动人口肺结核患者68例临床分析

目的 分析流动人口肺结核患者的临床特征及治疗效果.方法 回顾性分析流动人口中确诊的活动性肺结核68例（观察组）患者的临床资料,并与该市常住人口中活动性肺结核患者123例（对照组）相比较,观察两组性别构成、年龄分布、结核分型、痰菌阳性及治疗情况.结果 观察组男41例,女27例,男女比为1.52∶1;对照组男90例,女33例,男女比为2.73∶1,两组性别构成差异有统计学意义（x2=3.37,P＜0.05）.观察组年龄平均（30.23±18.52）岁;对照组年龄平均（46.46±31.50）岁,两组年龄差异有统计学意义（t=25.14,P＜0.05）.21～30岁年龄段中,观察组发病率为44.11%（30/68）,对照组则为24.39%（30/123）,两组差异有统计学意义（x2=9.91,P＜0.05）.观察组痰涂片68例,阳性47例（69.11%）;对照组痰涂片123例,阳性者70例（56.91%）.两组痰检阳性率差异有统计学意义（x2=3.210,P＜0.05）.观察组自行中断治疗22例（34.92%）,对照组自行中断治疗23例（18.67%）,两组在治疗依从性方面差异有统计学意义（x2=6.890,P＜0.05）.治疗6个月后,观察组完成治疗41例,痰菌阴转37例（90.24%）;对照组完成治疗100例,阴转92例（92.00%）,两组痰菌阴转率差异无统计学意义（x2=0.110,P＞0.05）.结论 流动人口肺结核痰菌阳性者高、但经过督导治疗均能达到与本市人口同样的治疗效果.     

个性化护理干预对提高流动人口肺结核患者服药依从性的影响

目的探讨个性化护理干预对提高流动人口肺结核患者服药依从性的影响。方法选取2012年1月至2012年12月在我院门诊就诊登记的流动人口肺结核病患者100例,随机分为实验组与对照组各50例。对照组患者给予常规护理干预,实验组患者在给予常规护理基础上采取个性化护理干预,比较两组患者服药依从性。结果治疗3个月后跟踪随访得知,实验组患者服药依从率为94％,对照组患者服药依从率为72％,实验组患者服药依从性有效率显著高于对照组（P〈0．05）;实验组患者在情绪稳定、定期检查以及饮食控制方面的反馈效果均显著优于对照组,差异有统计学意义（P〈0．05）。结论对肺结核患者采取个性化护理干预,可以有效提高患者服药的依从性。     

上海市虹口区流动人口艾滋病知信行状况调查

目的了解上海市虹口区流动人口艾滋病相关知识、态度、行为现况,为探索流动人口艾滋病防治模式提供参考。方法采用多阶段整群抽样的方法,对虹口区3个街道内的集贸市场、建筑工地和流动人口聚居的小区共1942名流动人员进行现场问卷调查。结果被调查对象以20—49岁中青年为主,占82．9％,艾滋病相关知识评分平均为（34．77±3．52）分（满分44）、态度评分平均为（12．11±2．32）分（满分19分）、行为评分平均为（5．50±0．95）分（满分7分）。文化程度越高,艾滋病相关知识、态度、行为等评分得分越高,其中知识得分为（小学及以下33．26±3．54分,初中34．63±3．23分,高中及以上36．56±3．39分）,态度得分为（小学及以下13．77±2．27分,初中14．79±2．39分,高中及以上15．62±2．38分）,行为得分为（小学及以下5．40±0．90分,初中5．51±0．93分,高中及以上5．58±1．03分）。结论上海市虹口区流动人口艾滋病相关知识、态度、行为水平仍较低,应采取相应的干预措施。     

对社区流动人口结核病管理的循证评价

Objective To investigate management and treatment to tuberculosis(TB)of floating population in the community,and evaluate systematically,study the effect of TB control management,in order to provide reliable basis for developing the scientific and practical intervention programs specifically for the floating population,and also to further explore and update the governance strategy of the floating population of TB.Hethods The databases of CHKD,WANFANG MED ONLING and CNKI Etc,were searched and analyzed by computer,and related medical journals and monographs were studied by manual searching,getting the issued literature on the treatment,management,nursing intervention of floating population tuberculosis from 1998 to 2010.At the same time we used non-probability purposive sampling method and had on-site interviews after obtaining the interviewee informed of consent.Besults We retrieyed 137 documents that have been published meeting the inclusion criteria,by viewing the full text,9 docunents had been evaluated for the 1 evidence and 15 documents had been evaluated for the 2～3 finally.From the literature with the evaluation and interviews.it showed that:to use a variety ofeffective management measures include health promotion,providing incentives,cross-regional referral tracking,DOTS nanagemerit of patient,had achieved certain effects.But the floating population understood limitedly TB-related knowledge and free treatment policy and had mixed views,that the awareness of TB control is poor,residential instability,lack of effective contact,resulted in difficuhing in supervision and tracking of the floating population.The TB management to floating population patients should be strengthened.Condusion It is necessary to expand the free flow of patient treatment and the corresponding cost of subsidies,to carry out comprehensive and multi-fornKq of community knowledge on TB and the publicity on national TB control policy,to make efforts to improve community supervision OfTB,and carry out individual recycling interactive health education for improving the compliance of TB patient.     

对社区流动人口结核病管理的循证评价

目的调查分析社区流动人口结核病管理和治疗措施,并对其进行系统评价,考察结核病控制管理的效果,为专门针对流动人口制定科学可行的干预方案,亦为进一步探索和更新流动人口结核病管治策略提供可靠依据。方法计算机检索中同医院数字图书馆、万方医学网及中国知网等数据库和手工检索有关医学期刊、专著;纳入1998—2010年发表的关于流动人门结核病治疗、管理、护理干预的文献;同时采用非慨率目的性抽样方法,在获得访谈对象知情同意后进行现场访谈。结果共检索到符合纳入标准的已发表文献137篇,通过查看全文,最后评价为1级证据9篇,2,3级15篇。从纳入评价的文献及访谈结果显示：运用各种有效的管理措施包括健康促进、提供激励机制、跨区域转诊追踪、对病人实行DOTS管理等,均取得一定的效果;但流动人口对结核病相关知识和免费治疗政策了解有限,看法不一,结核病防治的意识较差,居住不稳定,缺乏有效的联系方式,致使对流动人口的追踪督导刚难,流动结核病人的管理亟待加强。结论有必要对流动病人扩大免费治疗及相应的费用补贴,丌展全方化、多形式的社区防痨知识及旧家对结核病控制政策的宣传,加强社区结核病督导的力度．开展个体化循环且动式的健康教育,提高结核病人遵医的依从性。     

对社区流动人口结核病管理的循证评价

Objective To investigate management and treatment to tuberculosis(TB)of floating population in the community,and evaluate systematically,study the effect of TB control management,in order to provide reliable basis for developing the scientific and practical intervention programs specifically for the floating population,and also to further explore and update the governance strategy of the floating population of TB.Hethods The databases of CHKD,WANFANG MED ONLING and CNKI Etc,were searched and analyzed by computer,and related medical journals and monographs were studied by manual searching,getting the issued literature on the treatment,management,nursing intervention of floating population tuberculosis from 1998 to 2010.At the same time we used non-probability purposive sampling method and had on-site interviews after obtaining the interviewee informed of consent.Besults We retrieyed 137 documents that have been published meeting the inclusion criteria,by viewing the full text,9 docunents had been evaluated for the 1 evidence and 15 documents had been evaluated for the 2～3 finally.From the literature with the evaluation and interviews.it showed that:to use a variety ofeffective management measures include health promotion,providing incentives,cross-regional referral tracking,DOTS nanagemerit of patient,had achieved certain effects.But the floating population understood limitedly TB-related knowledge and free treatment policy and had mixed views,that the awareness of TB control is poor,residential instability,lack of effective contact,resulted in difficuhing in supervision and tracking of the floating population.The TB management to floating population patients should be strengthened.Condusion It is necessary to expand the free flow of patient treatment and the corresponding cost of subsidies,to carry out comprehensive and multi-fornKq of community knowledge on TB and the publicity on national TB control policy,to make efforts to improve community supervision OfTB,and carry out individual recycling interactive health education for improving the compliance of TB patient.     

对社区流动人口结核病管理的循证评价

Objective To investigate management and treatment to tuberculosis(TB)of floating population in the community,and evaluate systematically,study the effect of TB control management,in order to provide reliable basis for developing the scientific and practical intervention programs specifically for the floating population,and also to further explore and update the governance strategy of the floating population of TB.Hethods The databases of CHKD,WANFANG MED ONLING and CNKI Etc,were searched and analyzed by computer,and related medical journals and monographs were studied by manual searching,getting the issued literature on the treatment,management,nursing intervention of floating population tuberculosis from 1998 to 2010.At the same time we used non-probability purposive sampling method and had on-site interviews after obtaining the interviewee informed of consent.Besults We retrieyed 137 documents that have been published meeting the inclusion criteria,by viewing the full text,9 docunents had been evaluated for the 1 evidence and 15 documents had been evaluated for the 2～3 finally.From the literature with the evaluation and interviews.it showed that:to use a variety ofeffective management measures include health promotion,providing incentives,cross-regional referral tracking,DOTS nanagemerit of patient,had achieved certain effects.But the floating population understood limitedly TB-related knowledge and free treatment policy and had mixed views,that the awareness of TB control is poor,residential instability,lack of effective contact,resulted in difficuhing in supervision and tracking of the floating population.The TB management to floating population patients should be strengthened.Condusion It is necessary to expand the free flow of patient treatment and the corresponding cost of subsidies,to carry out comprehensive and multi-fornKq of community knowledge on TB and the publicity on national TB control policy,to make efforts to improve community supervision OfTB,and carry out individual recycling interactive health education for improving the compliance of TB patient.     

家庭医生服务团队在社区流动人口健康服务中的应用价值

目的：探讨家庭医生服务团队在社区流动人口健康服务中的应用价值。方法以我镇8个社区接受调查的4000名流动人员作为研究对象,将其随机分成两组,两组均给予常规的疾病对症治疗,其中对照组4个社区(2000名)未采取家庭医生团队服务,观察组4个社区(2000名)采取家庭医生团队服务,比较两组流动人员的健康知识、慢性病控制、传染病防治、孕前筛查率和年人均医药费,自行设计问卷调查两组的满意度。结果观察组健康知识知晓率、传染病发生率、慢性病控制率、孕前筛查率和年人均医药费分别为91.2%、0.15%、90.1%、98.5%和(48±12)元,均明显好于对照组[64.3%、0.75%、79.8%、79.1%、(126±24)元],差异有统计学意义(P<0.01);观察组对社区医疗健康服务的满意度为98.4%,对照组满意度为82.6%,组间比较差异有统计学意义(P<0.01)。结论家庭医生服务团队提高了社区流动人员的健康保护意识,值得进一步推广应用。     

Variability in the population pharmacokinetics of pyrazinamide in South African tuberculosis patients

Objective This study was designed to characterize the population pharmacokinetics of pyrazinamide in South African pulmonary tuberculosis patients, with special reference to interindividual and interoccasional variability (IIV and IOV, respectively).Methods Concentration-time measurements obtained from 227 patients receiving oral doses of pyrazinamide were pooled to create a dataset containing 3,092 data points spanning multiple dosing occasions. The software program NONMEM was used to analyze the data.Results A one-compartment model with first-order absorption, including a zero-order component describing release from formulation, and first-order elimination best described the data. The absorption rate constant was estimated to be bimodally distributed between two distinct subgroups, fast and slow, in approximately even proportion. Absorption rate was threefold greater in fast absorbers (3.56 h⁻¹) in comparison to slow absorbers (1.25 h⁻¹). Typical values of oral clearance and apparent volume of distribution were estimated as 3.42 L h⁻¹ and 29.2 l, respectively. IOV was supported in oral clearance (0.0238, variance) and absorption rate (0.623, variance). The duration of zero-order absorption was estimated as 0.290 h, and was quite variable between patients (0.957, variance).Conclusion The absorption of pyrazinamide in the studied population was highly variable and two separate subpopulations were identified. IOV accounted for a proportion of the variability in clearance and the absorption rate constant.An erratum to this article can be found at