2007－2016年内蒙古自治区鄂尔多斯市手足口病流行病学及病原学特征分析

目的 分析2007－2016年鄂尔多斯市手足口病流行病学特征,为制定防控策略和措施提供依据。方法 用描述流行病学方法对2007－2016年鄂尔多斯市手足口病发病资料和病原学检测结果进行统计分析。结果 2007－2016年鄂尔多斯市共报告手足口病18 436例。年均发病率为10.30/10万,年发病率总体呈上升趋势。每年的5－7月为发病的第1个高峰,9－11月为第2个高峰;发病人群以1～3岁儿童为主,男女性别比为1.42∶1,职业以散居儿童和幼托儿童为主。全市9个旗（区）均有病例报告,其中准格尔旗、东胜区、达拉特旗及伊金霍洛旗发病率较高。引起手足口病流行的病原为肠道病毒71型（EV71）、柯萨奇病毒A组16型（Cox A16）以及其他肠道病毒（EV）。2012年及2016年以Cox A16感染为主,2010年Cox A16和其他EV感染比例相近,2011年EV71和其他EV感染比例相近;2015年以其他EV感染为主,其余年份均以EV71感染为主。结论 鄂尔多斯市近10年手足口病发病率有逐年增长趋势,病原学特征复杂多变,应加强疫情和病原学监测、强化传染源管理、健康教育以及重点人群的综合防控。     

Long-term observation of the trends in morbidity, lethality and mortality from myocardial infarct in the population aged 25 to 64

The data are provided on long-term observation (for 10 years) of the myocardial infarction (MI) death rate, and incidence among the community using the standard WHO program. The Register of Acute Myocardial Infarction. It is shown that over the first two years of observation, the death rate and mortality tended towards decrease and then got stabilized. The diseases incidence tended towards growth and then got stabilized as well. It is noted that the prehospital death rate and lethality because of MI considerably exceeded the hospital ones and underwent almost no changes over 10 years. It is emphasized that perfection of the assistance rendering to MI patients does not solve the problem of the high death rate because of MI. It is probable that only primary care may solve the problem of reducing the cardiovascular disease incidence and death rate.     

Diabetic nephropathy in the Arab Gulf countries

While the prevalence of diabetes mellitus is increasing worldwide, one third of the diabetic patients will eventually develop chronic kidney disease. The aim of this review is to present the available data on diabetic nephropathy and its complications in the Arab Gulf countries. This will eventually help to raise the awareness of both government and healthcare systems towards the substantial value of prevention, early detection as well as proper management of both diabetes mellitus and chronic kidney disease. This could be achieved by funding large-scale longitudinal studies, improving training programs (both research and clinical) and increasing the role of media in fighting this epidemic.     

网络直报模式对传染病报告发病率的影响分析

目的分析椒江区实行网络直报后,对传染病报告发病率的影响。方法运用SPSS10.0统计软件、EXCEL分析软件,作字2检验和时间序列分析t检验。结果2004年甲乙类传染病报告发病率比2003年上升了8.42%(字2=1136.90,P0.05),与近5年平均报告发病趋势也完全一致(t=0.14,P>0.05)。结论网络直报模式下椒江区2004年甲乙类传染病报告发病率上升,且对总体发病趋势没有影响,表明网络直报模式对于传染病疫情信息报告是完全成功的。     

2008-2014年上海市浦东新区居民肺结核发病情况及其趋势分析

目的 分析上海市浦东新区居民2008-2014年肺结核发病情况并预测其发展趋势, 为肺结核防治策略提供参考。方法 以2008-2014年上海市浦东新区常住户籍居民为研究对象, 按1985年世界标准人口和1982年中国标准人口计算TB及涂阳TB标化发病率、死亡率(age-standardized rate, ASR), 并应用Join-point regression program分析率值的年均变化百分比(annual percent change, APC)并进行趋势分析。结果 浦东新区2008-2014年肺结核新发5548例, 世界标化发病率为20.34/10万, 中国标化发病率为18.92/10万, 趋势平稳(APC=0.84%, Z=1.68,P=0.15), 年龄组发病率呈双高峰, 分别在20~24岁(36.72/10万)和80~84岁 (68.55/10万);共报告涂阳肺结核2285例, 世界标化发病率为7.32/10万, 中国标化发病率为6.45/10万, 呈明显下降趋势(APC=-4.22%, Z=3.41,P=0.01), 其中男性下降明显(APC=-4.51%, Z=6.77, P0.01), 女性趋势平稳(APC=-2.20%, Z=1.16,P=0.29)。结论 肺结核防控应分年龄段关注重点人群, 并采取有效措施积极探索发病相关危险因素, 从而降低肺结核的发病率。     

Danesbury — changing patterns in the care of the younger disabled over three decades

The pattern of care in a subregional Younger Disabled Unit (YDU) over three decades is described. The trend is now towards planned short-stay admissions, but the need for some long-stay beds remains. A survey of one district with a total population of 287 600 found 165 patients aged 18–65 with significant disability. It is suggested that there are four main categories within the younger disabled group whose requirements range from independent living to special units run by psychiatrists. The YDU is an important focal point for information on all aspects of disability.     

绍兴市1999～2004年新生儿破伤风病例流行病学分析

目的了解绍兴市新生儿破伤风(NT)的流行病学特征,为控制和消除该病提供科学依据。方法用描述流行病学方法,对绍兴市1999～2004年NT专报系统的监测资料和个案调查材料进行统计分析。结果NT发病率波动在0.15‰～0.65‰之间,总体呈上升趋势,其中2004年有2个县(区)发病率≥1‰。NT病死率波动在11.11%～37.50%之间。病例主要集中在经济相对发达的越城区和绍兴县,发病无明显季节性。78例确诊病例中流动人口占89.74%,男性多于女性,男女性别比为2.12∶1,发病日龄集中在5～8d。在家分娩的占83.33%,接生员均未受过培训,所有母亲均无明确的破伤风类毒素(TT)接种史。结论旧法接生和产前未注射破伤风类毒素及人口流动是NT发病的主要因素。提高孕妇自我保健意识,推广住院分娩,对高危人群接种TT,加强新法接生培训,是消除NT的基本措施。     

乌鲁木齐市天山区358例猩红热患者的流行状况分析

了解乌鲁木齐市天山区猩红热流行病学特点。收集乌鲁木齐市天山区猩红热疫情资料,进行统计分析。2008年收治或报告猩红热病例358例,比2007年的111例增加了247例,明显超过了历年发病水平。应严密监测发病情况,防止疫情扩散,将猩红热发病率控制到最低水平。     

2008年北京市昌平区手足口病流行病学分析

目的探讨北京市昌平区手足口病(HFMD)的流行规律。方法用描述流行病学方法对昌平区2008年报告的HFMD疫情资料进行分析。结果昌平区2008年报告HFMD 1786例,发病率为247.08/10万,居北京市第3位。5月病例最多,自8月病例明显减少。2岁组儿童发病率最高,为5835.04/10万,4岁以下儿童病例占82.31%,散居和幼托儿童各占49.94%和44.57%,男童发病率明显高于女童。城乡结合部及人口密度大、流动人口较多的镇街发病率高。EV71型和CoxA16型为昌平区HFMD的主要病原体。结论4岁以内婴幼儿是昌平区HFMD防控工作的重点,开展长期性的疫情监测、做好人口密度大、流动人员多的地区婴幼儿和看护人群的健康教育与健康促进工作,对控制HFMD疫情起着至关重要的作用。     

The mechanisms of disorders in the hemostatic system of patients with chronic diffuse liver diseases

A total of 70 patients with chronic hepatitis and 60 with liver cirrhosis (LC) were examined. The hemorrhagic syndrome (HS) was identified in 16% of patients with chronic active hepatitis, in 26% with compensated and in 76% with decompensated LC. Intravital study of intravascular blood coagulation and liver microcirculation with the aid of fibrin determination according to D. D. Zerbino made it possible to establish local intravascular coagulation (LIC-syndrome). Study into the hemostatic and fibrinolytic systems, analysis of liver function, hemocoagulation and the intensity of the LIC-syndrome permitted one to arrive at conclusions about complex impairments of the hemostatic system in patients with chronic diffuse liver diseases characterized by a tendency towards blood hypocoagulation in the systemic blood flow with the risk of the development of the HS and a tendency towards hypercoagulation (with the risk of thrombosis development) in the vascular bed of the liver. It has been shown that the main cause of the HS occurring in chronic diffuse liver diseases lies in derangements of the thrombocytic component of the hemostatic system: thrombocytopenia as a consequence of hypersplenism and consumption of the most active thrombocytes in the process of the LIC. Activated fibrinolysis starts to exert an inhibitory action on hemocoagulation in patients with chronic diffuse liver diseases in the stage of decompensated LC. In compensated hepatopathies, the influence of fibrinolysis on coagulation and the development of the HS was immaterial.     

An evaluation of elementary school nutrition practices and policies in a southern Illinois county

The purpose of this study is to assess elementary school nutrition programs in a rural county in southern Illinois. The researcher interviewed the food service managers of eight schools and completed the School Health Index (SHI) based on their responses. Eighty-seven percent of the schools did not have venues such as vending machines outside the cafeteria. Three food service managers stated that from 75% to 80% of the students in the district ate lunch in the cafeteria. The SHI corresponds to the eight components of a coordinated school health program; nutrition services are just one of the eight components. The SHI is a tool that can be used to identify strengths and weaknesses in the nutrition program. It covers items from healthy, low-fat choices to food preparation and cafeteria practices. School nurses can work with teachers and food service personnel to create nutrition programs and a curriculum related to healthy nutrition practices.     

Electronic nursing documentation in primary health care

The aim of this study was to describe and analyse nursing documentation based on an electronic patient record (EPR) system in primary health care (PHC) with emphasis on the nurses' opinions and what, according to the nursing process and the use of the keywords, the nurses documented. The study was performed in one county council in the south of Sweden and included 42 Primary Health Care Centres (PHCC). It consisted of a survey, an audit of nursing records with the Cat-ch-Ing instrument and calculation of frequencies of keywords used during a 1-year period. For the survey, district nurses received a postal questionnaire. The results from the survey indicated an overall positive tendency concerning the district nurses' opinions on documentation. Lack of in-service training in nursing documentation was noted and requested from the district nurses. All three parts of the study showed that the keywords nursing interventions and status were frequently used while nursing diagnosis and goal were infrequent. From the audit, it was noted that medical status and interventions appeared more often than nursing status. The study demonstrated limitations in the nursing documentation that inhibited the possibility of using it to evaluate the care given. In order to develop the nursing documentation, there is a need for support and education to strengthen the district nurses' professional identity. Involvement from the heads of the PHCC and the manufactures of the EPR system is necessary, in cooperation with the district nurses, to render the nursing documentation suitable for future use in the evaluation and development of care.     

南京市鼓楼区病毒性肝炎流行现状与分析

目的分析南京市鼓楼区病毒性肝炎流行现状,为制定防治对策提供科学依据。方法采用描述流行病学方法对1990～2004年病毒性肝炎发病情况进行统计与分析。结果近15年来鼓楼区病毒性肝炎年平均发病率为81.09/10万,发病率最高为1993年(194.78/10万),最低为2003年(19.58/10万)。分型监测显示甲型肝炎所占比重下降,乙型肝炎所占比重上升,戊肝所占比重超过甲肝。结论病毒性肝炎发病总体呈下降趋势,乙型肝炎是病毒性肝炎的主要构成。应采取综合防治措施,加强疫情监测和分析,在做好常规免疫工作的同时,开展成人接种工作。     

Single-incision laparoscopic surgery: hernia repair

In most countries, inguinal hernia repair is the most frequent procedure performed in a surgical practice. Different approaches have been developed during the last decades, with a strong tendency towards tension-free techniques. The laparoscopic approach offers advantages in terms of less postoperative pain and faster recovery with a low incidence in recurrence. In the last few years, single-incision laparoscopic surgery (SILS) has been introduced to further improve surgical outcome and cosmetic results. For SILS inguinal hernia repair, there is little data available so far, but both totally extraperitoneal hernia repair and transabdominal preperitoneal hernia repair have been succesfully performed without complications in a limited number of patients. In our experience, totally extraperitoneal hernia repair seems to be an ideal indication for the application of SILS.     

2006-2014年浙江省衢州市水痘疫情流行特征及水痘疫苗免疫效果分析

目的 分析2006-2014年浙江省衢州市水痘疫情流行特征及疫苗使用效果, 为制定水痘防控策略提供依据。方法 采用描述性流行病学方法, 对所有报告病例疫情资料进行分析。分析2005年之后出生儿童的水痘发病及水痘疫苗接种情况, 计算水痘疫苗保护效果。结果 衢州市2006-2014年水痘年报告发病率为24.12/10万, 其中, 柯城区发病率最高, 为87.25/10万, 江山市发病率最低, 为2.17/10万。每年5-6月以及11月至次年1月发病数较多, 5~9岁儿童发病率最高, 为183.56/10万, 10~14岁发病率呈逐年上升趋势。2005年之后出生儿童水痘突破病例的构成比为30.46%, 2岁内水痘疫苗接种率逐年提高, 平均接种率为69.93%, 水痘疫苗的接种有效延迟了水痘发病。水痘疫苗1年保护效果为100%, 然后逐年下降, 6年后保护效果明显下降。结论 小学校是水痘疫情的高发场所。现有免疫策略使发病年龄高峰后移, 但不能阻止集体单位疫情暴发, 调整水痘疫苗免疫程序为2剂次非常必要。     

Palliative sedation in Latin America: survey on practices and attitudes

Introduction Palliative sedation (PS) is the subject of ethical and legal debates worldwide. Statistics of its utilization are available in developed countries; however, in Latin America, these data are scarcely known. The purpose of this research was to determine the practices and attitudes of palliativists in Latin America towards PS. Materials and methods Data was collected during the Latin American Congress on Palliative Care in Isla Margarita, Venezuela. A total of 89 professionals participated in this survey. Results It was found that the use of PS was positively associated with being a physician and being members of a palliative care (PC) group. On the other hand, it was found that being a psychologist and identifying barriers toward PS limited its utilization. Discussion The findings of this study support the need to establish clinical guidelines for its utilization and to educate other specialists on end-of-life care approaches, and the need to develop PC programs in acute care hospitals in Latin America.     

Comparison of incidence of IDDM in childhood between Estonia and Finland, 1980-1988.

OBJECTIVE: To compare nationwide incidence of childhood insulin-dependent diabetes mellitus (IDDM) in children aged 0-14 yr between Estonia and Finland during 1980-1988. For Estonia, which has a population genetically and linguistically related to Finland, only limited information was available. Finland has the highest incidence of IDDM in the world. RESEARCH DESIGN AND METHODS: The registration of all new cases of IDDM in Estonia was conducted by the local district pediatricians who reported every newly diagnosed diabetic patient to the Republic Endocrinology Centre. Registration of all new cases of IDDM in Finland was based on the statistics of the Social Insurance Institution, which approves free-of-charge insulin treatment for diabetes. These data were validated with one or more additional data sources. The case ascertainment rate approached 100% in both countries. RESULTS: The average yearly incidence of IDDM standardized for age for the years 1980-1988 in Estonia was approximately 33% of that in Finland. Among males it was 11.3 (95% confidence interval [CI] 10.3-12.3) per 100,000 in Estonia and 35.1 (95% CI 33.4-36.9) per 100,000 in Finland, and among females 10.1 (95% CI 9.2-11.1) per 100,000 in Estonia and 30.4 (95% CI 28.8-32.1) per 100,000 in Finland. When the two periods 1980-1982 and 1986-1988 were compared, the age-standardized incidence in Estonia remained unchanged, whereas in Finland it increased approximately 20%. CONCLUSIONS: The data between two populations who are ethnically and linguistically similar and live geographically close but in a different environment, provides further evidence that both genetic and environmental factors are contributing to the risk of IDDM.