What clinicians should know to fight against the novel avian-origin influenza A （H7N9） virus？

China has markedly increased infectious disease surveillance efforts after the outbreak of severe acute respiratory syndrome (SARS) in 2003.1 When the first pneumonia cases with unknown etiology from Shanghai were reported to the National Health and Family Planning Commission and the China Center of Disease Control and Prevention (CDC) in March 2013,our Chinese doctors and scientists show more confident to face the emerging infectious disease than 10 years ago.The marker is that we independently made the discovery that the pneumonia occurring in Shanghai,Jiangsu,Anhui and Zhejiang was caused by a novel reassortant avian-origin influenza A (H7N9)     

Infectivity of Severe Acute Respiratory Syndrome during Its Incubation Period

Objective To evaluate the infectivity of severe acute respiratory syndrome （SARS） during its incubation period by investigating chains of transmission and individuals isolated for medical observation with a view to providing scientific evidence for updating protocols of medical isolation. Methods Individuals related with the two SARS chains of transmission in Beijing in 2003 and a group of individuals isolated for medical observation in Haidian district of Beijing during the SARS outbreak were selected as subjects of study. Contactors with SARS patients and those with symptom development following the contacts were investigated via questionnaire. Serum samples were collected from super transmitters and tested for SARS-CoV antibody by neutralization test and enzyme linked immunosorbent assay （ELISA）. Results A total of 1 112 contactors were investigated in three surveys. Of them, 669 had a history of close contact with symptomatic SARS patients, 101 developed symptoms with a rate of 15.1%, 363 had a history of close contact with patients in their incubation period, none of whom developed symptoms （0%）. Serum samples were collected fi＇om 32 highly-exposed individuals, of whom 13 developing SARS symptoms atter contact had serum samples positive for SARS-CoV antibody. Samples collected from the asymptomatic contactors were all negative for SARS-CoV antibody. Conclusion SARS cases are infectious only during their symptomatic period and are non-infectious during the incubation period. Isolation for medical observation should be placed for individuals who are in close contact with symptomatic SARS patients. The results of our study are of decisive significance for the Ministry of Health to the definition of SARS close contactor.     

Case fatality rate of severe acute respiratory syndromes in Beijing

To describe the case fatality rate of SARS in Beijing. Methods Data of SARS cases notified from Beijing Center for Disease Control and Prevention （BCDC） and supplemented by other channels were collected. The data were analyzed by rate calculation. Results The case fatality rate of SARS in Beijing was 7.66%, and had an ascending trend while the age of cases was getting older, and a descending trend while the epidemic developmem. The case fatality rate in Beijing was lower than that in other main epidemic countries or regions. Conclusions The risk of death increases with the increment of age of SARS patients. Beijing is successful in controlling and treating SARS.     

某综合医院SARS暴发与控制

Objective: To investigate the SARS epidemic and the control effectiveness in a general hospital, Methods: Clinical and suspected cases of SARS were queried in the hospital, the emerging of the disease was described and the effectiveness of control measures were analyzed according to the rules and protective materials used during the epidemic. Resuits: The outbreak started with a patient from Beijing on 15 April. The disease spread quickly among the healthcare workers and the cohabit patients in the hospital which the first cases were admitted. By 17 May, 112 probable (clinical cases) and suspected cases had been reported with 14 deaths. 89 cases in the hospital were surely sourced from the index SARS patient whose admission for the sake of coronary heart disease caused the SARS outbreak. With the stringent control measures and the endeavors of the hospital staff, the epidemic was controlled successfully in a short period. From May 17 to now, no new cases occurred. Conclusion: Though with high infectivity, SARS can also be controlled with proper strategy and methods.     

Epidemiological features of severe acute respiratory syndrome in Beijing urban and suburb areas in 2003

To describe the epidemiologic features of an outbreak of severe acute respiratory syndrome （SARS） in urban and suburb areas in Beijing and to explore their differences between these two areas. Methods Data of SARS cases were collected from daily notification of China Ministry of Health and a database of infectious diseases was established by the Beijing Municipal Center for Disease Prevention and Control （BCDC）. All the data were put into dataset files by Microsoft Exeel-2000 and analyzed with SPSS version 10.0 software. Results The respective urban incidence and mortality rate were 29.06 and 2.21 per 100 000, while the case fatality rate was 7.62%. In contrast, the respective suburb incidence and mortality rate were 10.61 and 0.78 per 100 000, and the case fatality rate was 7.32%. No significant differences were found in demographic characteristics between the urban and suburb areas. Conclusion Beijing urban area suffered a more serious SARS epidemic than the suburb area in 2003.     

Risk factors for SARS-related deaths in 2003, Beijing

Objective To study the potential risk factors for severe acute respiratory syndromes （SARS）-related deaths in Beijing. Methods Epidemiological data were collected among the confirmed SARS patients officially reported by Beijing Centers for Disease Control and Prevention （BCDC）, and information was also supplemented by a follow-up case survey, Chi-square test and multivariate stepwise logistic regression analysis were performed. Results Old age （over 60 years） was found to be significantly associated with SARS-related deaths in the univariate analysis. Also, history of contacting SARS patients within 2 weeks prior to the onset of illness, health occupation, and inferior hospital ranking as well as longer interval of clinic consulting （longer than 1 day） were the risk factors for SARS-related deaths. Multivariate stepwise logistic regression analysis found four risk factors for SARS-related deaths. Conclusion Old age （over 60 years） is the major risk factor for SARS-related deaths. Moreover, hospital health workers, the designated hospitals for SARS clinical services and the interval of consulting doctors （less than 1 day） are protective factors for surviving from SARS.     

Trends in Suicide by Poisoning in China 2000-2006： Age, Gender, Method, and Geography

Objective This study analyzed patterns of suicide and suicide attempts by poisoning as reported through a national poison control system for the purpose of improving intervention and prevention. Methods During the period of 2000 to 2006, 6440 cases of poisoning suicide were reported to the telephone consultation service system of The National Center for Poisoning Control （Chinese Center for Disease Control and Prevention）. Among these records, 4728 cases had completed data for this analysis in terms of age, sex, trend of time and location, and type of poisons. Results There were 60.6% female cases with the age from 10 to 90 years old. The age of cases from 20 to 39 years accounted for 54.5% of all age groups. Both the numbers and percentage in record related to poisoning consultation of oral poisoning suicide showed an increasing tendency during the 7 years. In particular, there was a drastic increase from 2004 to 2006. In addition, the high frequency of cases occurred from May to October. Hebei, Shandong, Henan, and Anhui Provinces had the highest number of cases. Pesticide poisonings were the most common method in these cases of consultation for suicide and suicide attempts. Conclusion This study describes epidemiological characteristics in the oral poisoning suicide cases and provides scientific basis for suicide prevention interventions.     

Glomerular Disease Associated with Takayasu Arteritis： 6 Cases Analysis and Review of the Literature

Objective To evaluate the clinical features, renal histopathology and therapeutic response to glucocorticoid and immunosuppressive agents in patients with glomerular disease associated with Takayasu arteritis （TA）. Methods Patients with TA and renal biopsy-confirmed glomerular disease were investigated retrospectively. None of them had renal artery stenosis or occlusive changes.Results Six patients with glomerulopathy, accounting for 3.75% of the 160 TA patients admitted to our hospital at the same period, were analyzed. All of them were females with a mean age of 35.5 ± 10.0 years. Four cases presented with lower extremity edema. Laboratory tests showed that one was nephrotic syndrome, three were nephrotic range proteinuria, and two of them had mild renal dysfunction. The other two patients were asymptomatic microscopic hematuria and proteinuria. Renal pathology revealed mild immunoglobulin A nephropathy in two cases, mild mesangial proliferative glomerulonephritis （GN）, membranoproliferative GN, minimal change disease, and fibrillary GN in one case respectively. Five cases received glucocorticoids and cyclophosphamide therapy. Proteinuria and microscopic hematuria disappeared in 2 to 4 weeks after the initiation of therapy in three cases. The patient with membranoproliferative GN also reached complete remission of proteinuria and recovered renal function 6 months after the treatment. Conclusions TA may induce glomerular disease as a part of its histological spectrum. Apart from ischemic glomerular disease, glomerular disease should be suspected when TA patients have microscopic hematuria or proteinuria, that may be therapeutically responsive to glucocorticoids and immunosuppressive agent in relative early phase.     

Perioperative treatment for the central type carcinoma of lung by lung resection with bronchus-first cutting off through pericardium

Objective To investigate the perioperative treatment,the cause of death,and complications of the lung resection for therapy of central type carcinoma of lung.Methods we retrospectively analyzed the treatment and prognosis of 136 patients with central type carcinoma of lung using the bronchus-first lung resection through pericardium during May 1993 to December 2006.Results Total amount of complications in this group was 40 cases,among them,5 cases with pulmonary arterial bleeding,4 cases with respiratory dysfunction,3 cases with contralateral lung pneumonia,6 cases with heart dysfunction,15 cases with arrhythmia,2 cases with injury of recurrent laryngeal nerve,3 cases with chylopleura,and 2 cases with leaking of the bronchus nub.The total complication rate was 27.9%.3 cases died during perioperation,and the mortality was 2.2%.The older the patients were,the higher rate of complications occurred.Conclusion In this group of 136 cases of lung carcinoma,the frequent postoperative complications were the complications of respiratory system and cardiovascular system.The leading causes of death were respiratory dysfunction and heart dysfunction.According to our data,we concluded that the prevention and treatment should be performed during perioperation as follows:Airway should be intensively cared and prepared before operation.The ventilation should be kept unblocked after operation.Assistant ventilation should be performed if necessitated.For those with coronary heart disease or pulmonary heart disease active treatment should be given carefully.Efficient acesodyne and sedation and strictly monitoring of cardiograph should be given postoperatively,finding out the cause of arrhythmia for the correct therapy to protect the heart function.In addition,the indication of operation should be strictly predominated and the principle of operation should be kept on.     

中国疾病预防控制行业网站评估研究

为了掌握中国疾病预防控制行业网站的建设及服务情况,中国疾病预防控制中心信息中心制定了较为客观、全面和科学的评估指标体系,并与第三方专业测评机构于2008年对各省、计划单列市疾病预防控制中心及中国疾病预防控制中心直属单位的网站进行了评估。结果显示,国内疾病预防控制行业的网站建设已初具规模,但仍须从实际应用和信息保障机制方面加强建设,提升本行业网站的绩效。     

2003年北京市东城区SARS爆发流行特征

目的 分析2003年3月～5月间北京市东城区严重急性呼吸综合征(severe acute respiratory syndrome,SARS)爆发流行特征。方法 根据东城区疾病预防控制中心的疫情日报表,以及从其他渠道收集补充的信息进行分析。病例的诊断按照卫生部颁布的标准。用Excel软件建立数据库,用SPSS软件统计分析。结果 东城区首例发生于3月14日(3月16日人院),至4月中、下旬发病达高峰,5月5日开始下降,5月22日后未再发生新的临床诊断病例,5月24日、6月10日曾发生3例疑似SARS,后均被排除。共报告572例住院,99例在住院治疗过程中因被确诊为上感、普通肺炎、出疹性疾病等排除了SARS的诊断,实有473例SARS及疑似SARS。各年龄组人群普遍易感,以20～50岁最多,占总病例数的68．7％,平均发病年龄为40．7岁。病例的男女比例差异无显著性。SARS病例呈现明显的家庭聚集现象。医务人员病例占总数的18．0％,离退休人员占15．4％。全区10个街道均有病例发生。按常住人口计算,罹患率为28．3／10万。报告病例中,先后在区属二级医院住院的230例,占40．2％。85例医务人员SARS及疑似SARS病例中,18例发生在四所区属二级医院,占其在SARS病房或发热门诊工作的医务人员总数的4．5％。34．7％的SARS病例在病前无任何接触史。4l例SARS病例死亡,病死率8．7％。SARS病例的密切接触者罹患率为7．4％。结论 2003年3月～5月间东城区爆发流行SARS,人群普遍易感,主要威胁青壮年、医务人员、离退休人员。与患者直接接触是主要的传播方式。民工集中的建筑工地、医院是SARS防控的重点。现行的防治策略和措施对控制SARS流行是有效的。     

基于用户体验的中国疾病预防控制中心网站信息构建问题探讨

目的:通过用户体验测试探讨中国疾病预防控制中心网站信息构建问题。方法:采用模拟测试、问卷调查、访谈方式、现场测试4种方法开展了研究工作。结果:通过15个任务的测试,从参与者的反映及具体操作过程中发现了网站存在的诸多问题,体现在网站的导航设计、信息检索功能、栏目建设、信息呈现形式、可用性与人性化、排版布局6个方面。结论:对基于用户体验的网站信息构建模型中的战略层、范围层、结构层、框架层、表面层上发现的问题进行了研究。建议中国疾控中心网站管理者将以人为本的原则渗透到网站设计的每个环节,以保证网站的有效运行和可持续性发展,通过灵活的技术手段和人性化设计,使用户能够在浏览网站过程中获得积极的用户体验。     

Epidemiological characteristics of an outbreak of severe acute respiratory syndrome in Dongcheng District of Beijing from March to May 2003

Objective To describe epidemiologic features of an outbreak of severe acute respiratorysyndrome (SARS) in Dongcheng District, Beijing occurred in a period between March and May 2003.Methods Data of SARS cases notified from Dongcheng District Center for Disease Control and     

我国大骨节病文献作者研究能力和团队特征现状分析

目的：对我国大骨节病文献作者的研究能力和合作关系进行分析,为我国大骨节病的研究合作提供依据。方法：检索4个常用中文期刊数据库,纳入大骨节病的中文期刊文献。采用BICOMS抽取和整理关键词信息生成共现矩阵,采用NetDraw绘制图谱,采用SPSS 17.0对数据进行描述性分析。结果：有3 454位作者在1957-2012年8月从事大骨节病研究,其中81位作者发表15篇及以上文献。聚类分析将81个作者分为西安交通大学医学院地方病研究所、中国地方病防治研究中心大骨节病研究所、吉林省地方病第二防治研究所,以及由中国科学院、河南省疾病预防控制中心、甘肃省疾病预防控制中心组成的第四研究团队。结论：大骨节病研究人员众多,各团队研究方向明确,特点突出,但机构间合作较弱,有待加强。     

中国传染病监测报告信息系统简介

中国疾病预防控制中心(CDC)已经建成了对37种法定传染性疾病的实时网络监测系统,这是中国疾病预防控制以及公共卫生信息系统国家网络的重要组成部分。该系统包含了从乡镇到国家的5级网络传染病监测报告体系以及从地市到国家的3级网络平台。根据规定,在医院检测到传染病个案要实时通过Internet/VPN上报到国家CDC的中心数据库。全国范围内的所有卫生/医疗机构都可以随时访问中心数据库方便地获得信息。由于对传染病采取了实时的个案报告以及对于危险因素及症状的监测,使得对于可能的疫情暴发的及时预警成为可能。目前,每天有10000-20000例法定传染病上报至国家CDC。所产生的日报,周报,月报提交至各级卫生管理部门。最近已经逐步将该系统进一步扩展到对各种专病如结核、HIV感染者艾滋病等的监测。与此同时,各地也正在建设能够沟通区域内各类机构,实现区域信息共享的区域性公共卫生信息系统。