北京市人群甲型H1N1流感血清流行病学调查

目的 了解和掌握北京市人群对甲型H1N1流感的免疫水平.方法 在2009年11月27日至12月23日从医院患者(排除感染科和呼吸科)、血液中心志愿者和体检中心健康体检者中随机选取调查对象进行问卷调查,并采集血清标本进行甲型H1N1流感病毒血凝抑制(HI)抗体检测.结果 共选取调查对象856名,其中127名(14.8%)调查对象体内甲型H1N1流感病毒HI抗体为阳性.0～5岁、6～17岁、18～55岁、≥56岁年龄组HI抗体阳性率分别为14.5%、19.4%、17.4℅和8.0%(P=0.009).不同性别HI抗体阳性率差异无统计学意义(P=0.693).人群血清HI抗体年龄加权阳性率为15.8%.多因素logistic回归分析显示,年龄、出现过急性呼吸道症状以及接种甲型H1N1流感疫苗与HI抗体阳性呈显著性相关.结论 北京市已经有超过15%的人群具有甲型H1N1流感保护性抗体,普通人群中已经建立一定的免疫屏障.     

西安市甲型H1N1流感病毒感染状况调查

[目的]调查西安市区不同人群中甲型H1N1流感抗体水平,及时了解甲型H1N1流感病毒的感染状况.[方法]选取市内两个区,选定5个年龄组的1500人为调查对象,采用国家统一的调查表进行调查并采血.国家疾控中心统一用血凝抑制方法对血清标本进行甲型H1N1流感病毒抗体检测,抗体效价1:40判为阳性.[结果]实际共调查1508人,其中甲型H1N1流感抗体阳性率为29.38%,抗体几何平均滴度(GMT)为25.29,6～15与16～24岁组抗体阳性率最高.男性人群抗体阳性率高于女性(χ2=6.90,P<0.05).接种甲流疫苗后人群抗体阳性率为62.90%,明显高于未接种疫苗人群的22.78%(χ2=168.01,P<0.001).[结论]我市人群甲型H1N1流感病毒抗体水平不到30%,接种甲型H1N1流感疫苗可显著提高人群的保护率.接种疫苗对于防控可能造成新的暴发流行的甲型H1N1流感仍然有效.     

西安市2010年健康人群甲型H1N1流感病毒感染状况分析

目的调查西安市区健康人群的甲型H1N1流感病毒感染状况以及甲型H1N1流感病毒抗体水平,为预防和控制疫情提供依据。方法选取西安市内两个区,划分5个年龄组,每次至少选1500人为调查对象,采用国家统一的调查表进行调查并采血。国家疾控中心统一用血凝抑制方法对血清标本进行甲型H1N1流感病毒抗体检测,抗体效价1︰40判断为阳性。结果 3次共调查4495人,合计甲型H1N1流感抗体阳性率为29.28%,抗体几何平均滴度(GMT)为13.70。6～15与16～24岁组抗体阳性率最高。男性人群抗体阳性率高于女性(χ2=4.78,P﹤0.05)。接种甲流疫苗后人群抗体阳性率为58.84%,明显高于未接种疫苗人群的26.99%(χ2=286.11,P﹤0.001)。结论该市健康人群的甲型H1N1流感病毒抗体水平不到30%,接种甲型H1N1流感疫苗可提高人群的保护率。     

珠海市斗门区人群甲型H1N1流感病毒抗体影响因素分析

目的了解珠海市斗门区人群甲型H1N1流感病毒感染状况及抗体水平,探讨影响普通人群血清甲型H1N1流感病毒抗体阳性的因素。方法采用多阶段随机抽样方法,从斗门区2个镇选取480人进行问卷调查,并采集血液标本进行甲型H1N1流感病毒血凝抑制（HI）检测。结果甲型H1N1流感抗体阳性人数为110人,阳性率为22.92%（110/480）。单因素和多因素二项Logistic分析均显示职业、接种甲型H1N1流感疫苗、调查前曾患过感冒与血清甲型H1N1流感病毒抗体阳性有关。结论珠海市斗门区人群甲型H1N1流感病毒抗体水平不高。接种甲型H1N1流感疫苗是预防甲型H1N1流感的重要手段。     

武汉地区普通人群甲型H1N1流感病毒抗体水平分析

目的了解武汉地区2009年第四季度至2010年第一季度普通人群中甲型H1N1流感病毒抗体水平变化,及时掌握武汉市普通人群甲型H1N1流感病毒感染状况,为评估、研判疫情发展趋势提供信息支持。方法按照时间间隔(1个月)分次采集4个年龄组普通人群的血清共2106份,采用血凝抑制实验检测人群抗体水平。结果共调查2106人,甲流抗体总阳性率为18.14%,其中男性阳性率为17.00%,女性为19.48%。经过卡方检验,不同采集时间、不同年龄组、是否接种甲流疫苗人群间的甲流抗体阳性率差异有统计学意义(P﹤0.05)。结论武汉市2009年第四季度至2010年第一季度普通人群中甲型H1N1流感病毒抗体水平平均在18%以上,但是抗体水平仍然较低;接种甲流疫苗后人群抗体水平显著高于未接种疫苗人群,说明甲流疫苗的接种对人群具有明显的保护性意义。     

北京市顺义区健康人群甲型H1N1流感抗体水平及其疫苗免疫效果

目的了解北京市顺义区健康人群甲型H1N1流感抗体水平,评价甲型H1N1流感疫苗免疫效果,为卫生部门制定预防控制措施和策略提供依据。方法随机选取顺义区12个乡街的5岁以上健康人群(202名)采集免疫前静脉血检测抗体,评估健康人群抗体水平;接种甲型H1N1流感疫苗后,各年龄组随机选取部分人群做免疫后抗体水平检测,评估疫苗免疫效果。结果 202份血清标本中甲型H1N1流感抗体水平阳性率46.53%(94/202),与北京市人群甲型H1N1流感抗体水平检测结果差异有统计学意义。抗体几何平均滴度倒数(GMRT)为32.78。不同性别人群之间甲型H1N1流感抗体阳性率差异无统计学意义,不同年龄组之间抗体水平阳性率差异有统计学意义,25~29岁、10~14岁组抗体水平阳性率高。50名评估对象免疫前抗体阳性率50%(25/50),免疫后抗体阳性率94%(47/50),甲型H1N1流感抗体阳转率80%(30/50)。免疫前阴性和阳性评估对象之间抗体阳转率差异有统计学意义。评估对象总体抗体滴度呈6倍增高,各年龄组免疫前、后抗体GMRT的变化之间差异有统计学意义,25~29岁、60岁以上组滴度升高倍数最低。结论顺义区甲型H1N1流感实际感染数高于北京市甲型H1N1流感平均感染水平。疫苗接种使目标人群达到了形成该样本人群免疫屏障的要求,提示在甲型H1N1流感大流行之际接种疫苗是控制疫情的必要手段。免疫前抗体水平、年龄是甲型H1N1流感抗体阳转率的影响因素。     

广元市甲型H1N1流感抗体水平调查

目的了解广元市人群甲型H1N1流感病毒感染水平,为评估疫情发展趋势提供信息支持。方法采集不同年龄段的城市和农村人口的血清用血凝抑制实验（HI）方法进行抗体检测,用统计学方法对抗体水平进行分析。结果 2010年共采集754份血清标本,其中甲型H1N1抗体阳性140份,阳性率18.6%,GMT1∶11。不同时间点、不同地区调查对象甲型H1N1抗体水平差异有统计学意义（P〈0.05）,不同性别、不同年龄组之间抗体水平差异无统计学意义（P〉0.05）。多因素logistic回归分析显示,甲型H1N1疫苗接种、调查时间和地区差异与HI抗体阳性呈显著性相关。结论广元市人群中18%以上具有甲型H1N1流感保护抗体,但抗体水平仍然较低,应进一步加强甲型H1N1流感疫苗的宣传和接种。     

包河区健康人群甲型H1N1流感抗体水平监测及疫苗免疫效果分析

目的研究包河区健康人群中甲型H1N1流感病毒抗体水平和居民甲型H1N1流感感染情况。方法采用多阶段抽样方法,随机抽取638名调查对象进行个案调查并采集血液标本分离血清,用血凝抑制(HI)方法对标本进行检测。结果健康人群中,接种疫苗人群产生的保护性抗体与未接种人群产生的保护性抗体差异有显著性。结论接种甲型H1N1流感疫苗是最有效控制甲型H1N1流感发生大流行的手段之一。     

2010年四川省甲型H1N1流感血清学调查

目的了解四川省人群甲型H1N1流感病毒抗体水平,为及时科学评估疫情发展趋势和完善防控策略与措施提供依据。方法按照国家方案采集不同年龄组人群血清标本,用血凝抑制(HI)试验方法进行抗体检测,HI抗体滴度≥1∶40判为阳性。结果四川省甲型H1N1流感阳性率17.39%(663/3 812);不同地区阳性率差异无统计学意义;6～17岁组阳性率最高(20.52%);男女性阳性率差异无统计学意义;就诊人群阳性率高于献血人群和体检人群,差异有统计学意义。结论四川省人群甲型H1N1流感阳性率较低,,甲型H1N1流感在人群中的自然感染未形成有效免疫屏障,甲型H1N1流感疫苗接种仍有必要。     

广州市甲型H1N1流感血清学流行病学调查

目的了解2010—2011年广州市不同时段人群甲型H1N1流感(甲流)的感染水平,为完善防控措施提供依据。方法采用多阶段随机抽样方法,以广州市未接种甲流疫苗人群为对象,开展3次个案调查,并采集血液样本,采用血凝抑制试验(HI)进行抗体检测,抗体滴度≥1∶40判为阳性。结果共调查3 865人,检测甲流抗体阳性804人,阳性率20.8%;2010年1月、3月和2011年8月抗体阳性率分别为22.7%、14.2%、25.5%;3次调查抗体阳性率最高为16～24岁组;学生的阳性率较高。结论广州健康人群H1N1免疫屏障尚未建立,需加强流感防控宣传和疫苗接种。     

上海市甲型H1N1流感患者经济负担估计

目的:了解上海市甲型H1N1流感(甲流)大流行期间流感患者的经济负担情况.方法:2009-2010年上海市甲流大流行期间,随机选择流感轻症病例进行问卷调查,所有的甲流重症和死亡病例采用住院病历回顾和流行病学调查相结合的方法,收集流感患者就医相关费用和间接导致的误工旷学等,估计流感病例的经济负担.结果:研究共调查甲流轻症病例132人,重症病例119人,死亡病例9人.甲流轻症病例人均门诊花费265.5元,此外,多数患者还产生了交通、转诊和营养费等,人均直接花费达356.5元,间接经济损失约96314元.甲流重症病例住院治疗之前,平均就诊3.4次,转诊1.5次,住院费用约为20 712.2元,直接经济支出高达23 832.9元.间接经济损失至少1 962.9元.死亡病例的直接费用则更高,达49 320.2元,所有死亡病例因早死所致间接经济损失合计达1 427.6万元.结论:甲流大流行期间上海市流感患者,尤其是重症患者的经济负担较重,有必要在高危人群中开展疫苗接种工作.     

Student USMLE Step 1 preparation and performance

OBJECTIVES: Many medical students take commercial preparation courses to prepare for the USMLE Step 1. This investigation examined the relationships among Step 1 performance, preparation method, and academic achievement in medical school. METHOD: A survey was conducted on 148 junior students at a medical school in July 2000 regarding their preparation methods for Step 1. Additional data was collected on student Step 1 scores, attendance record on preparation courses, and course grades in medical school. RESULTS: One hundred students (68%) responded to the survey including 32 preparation course participants. Course participants had significantly lower Step 1 scores and second-year GPAs than those of the non-participants (p < 0.05). However, the effect of preparation method was not significant by using ANCOVA when the second-year GPA was used as a covariate (p = 0.71). CONCLUSION: Performance on Step 1 is related to academic performance in medical school and not the type of preparation methods.     

Serologic survey of pandemic influenza A (H1N1 2009) in Beijing, China

Objective

To examine the frequency and distribution of antibodies against pandemic influenza A (H1N1 2009) [H1N1] in populations in Beijing and elucidate influencing factors.

Methods

In January 2010, a randomized serologic survey of pandemic influenza A (H1N1 2009) was carried out. Six districts that were randomly selected with a total of 4601 participants involved in the survey have their antibody level tested by hemagglutination inhibition assay.

Results

Among the 4601 participants, the overall seropositive rate for pandemic influenza A (H1N1 2009) antibodies was 31.7%. The seropositivity prevalence in participants who received the pandemic H1N1 vaccination was 60.9%. Only 53.1% of the pandemic influenza A (H1N1 2009) seropositive individuals who had not received the vaccination experienced respiratory tract infection symptoms. Multivariate logistic regression revealed that factors such as age, occupation, dwelling type, whether the participant's family included students in school, and the vaccination history with pandemic influenza A (H1N1 2009) were associated with antibody titers (p < 0.05).

Conclusions

Our data indicated that almost 30.0% of the residents had appropriate antibody titers against pandemic influenza A (H1N1 2009) in Beijing, and these titers may provide an immune barrier.     

Student USMLE Step 1 Preparation and Performance

Objectives: Many medical students take commercial preparation courses to prepare for the USMLE Step 1. This investigation examined the relationships among Step 1 performance, preparation method, and academic achievement in medical school. Method: A survey was conducted on 148 junior students at a medical school in July 2000 regarding their preparation methods for Step 1. Additional data was collected on student Step 1 scores, attendance record on preparation courses, and course grades in medical school. Results: One hundred students (68%) responded to the survey including 32 preparation course participants. Course participants had significantly lower Step 1 scores and second-year GPAs than those of the non-participants (p < 0.05). However, the effect of preparation method was not significant by using ANCOVA when the second-year GPA was used as a covariate (p = 0.71). Conclusion: Performance on Step 1 is related to academic performance in medical school and not the type of preparation methods.     

Polymorphisms in CYP1A1, GSTM1, GSTT1 and lung cancer below the age of 45 years

BACKGROUND: A genetic component of early-onset lung cancer has been suggested. The role of metabolic gene polymorphisms has never been studied in young lung cancer cases. Phase 1 and Phase 2 gene polymorphisms are involved in tobacco carcinogens' metabolism and therefore in lung cancer risk. METHODS: The effect of metabolic gene polymorphisms on lung cancer at young ages was studied by pooling data from the Genetic Susceptibility to Environmental Carcinogens (GSEC) database. All primary lung cancer cases of both sexes who were Caucasian and 相似文献   

1266例妇女对月经周期的态度调查

目的:调查受试者理想的月经周期。方法:采用自设问卷,对1 266例在四川省人民医院妇科门诊就诊的有月经妇女进行月经认识态度调查。结果:1 266例妇女中,70.46%的妇女希望的月经周期为每月1次;其中61.69%的妇女不想改变月经周期的原因是认为每月1次是一种自然周期;59.48%的妇女想改变月经周期的原因是月经会带来不适。结论:被调查妇女普遍偏爱一月一次的月经周期并不愿改变这种规律,多数人认为月经是一种自然周期节律。     

一起学校甲型H1N1流感暴发疫情调查

目的分析甲型H1N1流感暴发疫情的流行病学特征及控制效果,为制定预防控制策略提供依据。方法采用面对面个案调查和现场流行病学调查,分析甲型H1N1流感暴发疫情的流行病学特征。结果南充某职业技术学院2009-09-12/10-09共发生甲型H1N1流感病例177例(采样确诊7例),病例波及全院3个年级,8个系,男女之比为1.49:1,临床特征以中度发热为主,体温38.1℃～39℃占病例总数(135/177)的76.27%,咳嗽占58.19%。结论该起暴发疫情为甲型H1N1流感。     

SULT1A1基因多态性与子宫肌瘤关系

目的了解硫酸基转移酶(SULT)1A1基因Arg 213His多态性与子宫肌瘤的关系,为预防子宫肌瘤的发病提供参考依据。方法采用以医院为基础的1:1病例对照研究方法对2009年8-10月在山东省滨州医学院附属医院妇产科就诊的123例子宫肌瘤患者和123名同期进行体检的健康女性进行流行病学调查和分子生物学检测。结果病例组和对照组SULT1A1基因Arg213His位点野生型(G/G)、突变型杂合子(G/A)、突变型纯合子(A/A)3种多态基因型频率分别为58.5%3、9.0%、2.5%和76.4%、22.0%、1.6%,2组多态基因型频率间差异有统计学意义(χ2=9.085,P=0.011);与G/G基因型比较,G/A、A/A和突变型(G/A+A/A)基因型个体发生子宫肌瘤的相对危险度OR值分别为2.321(95%CI=1.322～4.074)、1.958(95%CI=0.319～12.03)和2.296(95%CI=1.325～3.978);多因素Logistic回归分析结果表明,高血压病史、负性生活事件、既往阴道炎、既往盆腔炎、既往宫颈炎、一级亲属患子宫肌瘤、口服避孕药、人工流产史和SULT1A1基因Arg213His位点突变基因型是子宫肌瘤发生的危险因素,初潮年龄>12岁是子宫肌瘤发生的保护因素。结论 SULT1A1基因Arg213His位点突变基因型个体子宫肌瘤发病风险明显增加;有效防治慢性妇科炎症、高血压病、减少负性生活事件刺激等可以减少子宫肌瘤的发生。     

Pandemic influenza A (H1N1) 2009 in a critical care and theatre setting: beliefs and attitudes towards staff vaccination

West Midlands was particularly affected by the 2009 H1N1 influenza A (pH1N1) pandemic. Vaccination of frontline healthcare professionals (HCPs) aimed to prevent spread to vulnerable patients, minimise service disruption and protect staff. HCPs involved in upper airway management are particularly at risk of aerosol exposure. We assessed the attitudes of these HCPs towards pandemic influenza A (H1N1) 2009 vaccination uptake: primary reasons for acceptance, barriers to vaccination, and knowledge surrounding pH1N1 influenza. We performed a voluntary, anonymous questionnaire survey based in two West Midlands National Health Service Trusts, one month after introduction of the vaccine. In all, 187 useable responses were received (60.5% response rate); 43.8% (N=82) had/intended to receive vaccination. Concern over long term side-effects was the main deterrent (37.4%, N=70). Primary reasons for potentially accepting vaccination were: to protect themselves (36.9%, N=69), to protect family (35.3%, N=66), and to protect patients (10.2%, N=19). Of responders, 76.5% were unsure that the vaccines had undergone suitably rigorous clinical trials to ensure safety; 20.9% correctly identified reported vaccine efficacy. We conclude that pH1N1 vaccination uptake among high risk HCPs remained low, although twice that of peak seasonal influenza vaccination rates. HCPs' knowledge of vaccine efficacy is poor. Barriers to vaccination include concerns over safety profile given the short chronological time-span between the pandemic being declared and vaccine introduction. Side-effects, both acute and chronic, are a significant barrier to vaccination. Further reassurance/education surrounding vaccine safety/efficacy at the time of any future pandemic may improve uptake rates.     

Epidemiology of BHV 1 virus infections in dairy herds

The epidemiology of bovine herpesvirus 1 (BHV 1) infections was studied in 20 dairy herds. Periodic serological surveillance of these herds during three consecutive years (1980-82) was combined with clinical studies. In 19 herds seropositive cows were found indicating previous exposure to BHV 1. One herd had its first experience with BHV 1 during the study. No indication of virus circulation for at least three years was found in eight herds. In five herds an interval of 2 years without an indication of virus circulation was followed by infections in yearlings, first- and second-calf cows during the third year. One or two cycles of virus circulation in calves and/or yearlings during the 3 year survey were detected in six herds. Most BHV 1 infections passed unnoticed. Signs of respiratory disease in association with BHV 1 infection were observed in three herds: young animals were most seriously affected. Clinical manifestations of BHV 1 infections were less pronounced than a few years ago when infections in cows caused frank signs and diagnosis was frequently possible on the basis of a typical clinical picture. BHV 1 was the cause of abortions in the herd that experienced its first infections during this survey. A survey of the age-specific BHV 1 neutralizing antibody pattern may be helpful for tracing animals and herds at risk of an outbreak of infectious bovine rhinotracheitis.