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991.
Ailing Wang Yaping Qiao Lixia Dou Qian Wang Xiaoyan Wang Min Su Zhen Li Xiaona Huang Yuning Yang Xi Jin Li Song 《Lancet》2018
Background
China's Integrated Prevention of Mother-to-Child Transmission of HIV, Syphilis and Hepatitis B Virus programme (iPMTCT Programme) was launched in 2010 and has been extended nationwide since 2015. China also set up the Elimination of Mother-to-Child Transmission (EMTCT) of HIV, Syphilis, and Hepatitis B virus in 2016. This study aimed to assess the progress that has been made in eliminating mother-to-child transmission of HIV, syphilis and hepatitis B, and to identify the challenges that remain.Methods
Data on testing coverage among 17·58 million pregnant women who attended antenatal care services, and services received by pregnant women with HIV, syphilis or hepatitis B infection and by children exposed to infection were extracted from the Management Information System of China's iPMTCT Programme. Document review, group discussions and field observations were conducted to assess the iPMTCT in line with the four evaluation components set out in the WHO EMTCT validation guidelines: program assessment, data quality, laboratory quality assurance, and human rights, gender equality, and community engagement. Informed consent was obtained from pregnant women when they received services in the health facilities.Findings
The mother-to-child transmission rate of HIV was 4·9% (the reported number of children with HIV was 55 of 2172 children exposed to HIV, and the adjusted mother-to-child transmission rate was 4·9% [114·6 of 2333]) in 2017, which decreased from 12·8% in 2005. Between 2011 and 2017, the number of reported congenital syphilis cases declined from 13 294 to 3 846, and the reported number of children with HIV through mother-to-child transmission reduced from 79 to 55. In 2017, the coverage of HIV, syphilis and hepatitis B screening tests among pregnant women was over 99·5%. Of the pregnant women who were screened and diagnosed with HIV or syphilis, 89·6% and 80·0% received treatment, respectively. The rate of early infant diagnosis in children exposed to HIV reached 84·3% in 2017. Nearly all (99·7%) of infants exposed to hepatitis B virus received hepatitis B immune globulin vaccine at birth in 2017. The following factors were identified as the main gaps to be bridged to achieve the goals of eliminating mother-to-child transmission of HIV, syphilis and hepatitis B: inconsistency in the definitions of progress indicators; lack of a system to collect follow-up data on outcomes in children exposed to hepatitis B virus; a relatively weak laboratory network at grass-roots level (inadequate number and quality of laboratories); limited capacity of health facilities at grass-roots level; inadequate quality of reported data; and insufficient involvement of community-based organizations (CBOs).Interpretation
The mother-to-child transmission rate of HIV and reported congenital syphilis cases has decreased since the program launched, and comprehensive PMTCT services are available for all pregnant women across the country. Universal coverage of screening in pregnant women and HBIG vaccination in infants exposed to infection has been achieved. To achieve elimination of mother-to-child transmission of all three viruses, efforts are needed to strengthen multisectoral collaboration, increase treatment rates among women with infection, develop a standardised indicator system in accordance with WHO EMTCT validation tools, improve reporting and quality control mechanisms, strengthen laboratory networks, improve the capacity of the private sector, and extend the involvement of CBOs.Funding
The Chinese government and UNICEF China. 相似文献992.
Weidong Xiao Jisheng Zhu Long Peng Le Hong Gen Sun Yong Li 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2018,20(10):896-904
Background
The aim of this systematic review and meta-analysis was to compare the clinical outcomes of central pancreatectomy (CP) with distal pancreatectomy (DP) and pancreaticoduodenectomy (PD).Methods
A systematic literature research in PubMed/Medline, Embase and Cochrane Library was performed to identify articles reporting CP from January 1983 to November 2017.Results
Fifty studies with 1305 patients undergoing CP were identified. The overall morbidity, mortality, pancreatic fistula (PF) rate and reoperation rate was 51%, 0.5%, 35% and 4% respectively. Endocrine and exocrine insufficiency were occurred in 4% and 5% of patients after CP. Meta-analysis of CP versus DP favored CP with regard to less blood loss (WMD = ?143.4, P = 0.001), lower rates of endocrine (OR = 0.13, P < 0.001) and exocrine insufficiency (OR = 0.38, P < 0.001). CP was associated with higher morbidity and PF rate. In comparison with PD, CP had a lower risk of endocrine (OR = 0.14, P < 0.001) and exocrine insufficiency (OR = 0.14, P < 0.001), but a higher PF rate (OR = 1.6, P = 0.015).Conclusions
CP maintains pancreatic endocrine and exocrine function better than DP and PD, but is associated with a higher PF rate. 相似文献993.
Background
Depression is an important mental health disorder, which is facing a serious problem of inequality. However, compared with the field of physical health, there is not as much research into the fairness of mental health. Moreover, the research mainly focuses on cross-sectional studies. Vertical comparison is missing. Therefore, we aimed to measure the income-related inequality of depressive symptoms and its trends among elderly people in China.Methods
We extracted data from the 2011 baseline and 2015 follow-up of the China Health and Retirement Longitudinal Study (CHARLS), which is a nationally representative survey for elderly people aged 45 years and more in China. Depressive symptoms were evaluated with the Chinese version of the ten-item Center for Epidemiologic Studies-Depression Scale (CES-D). Participants were considered to have depressive symptoms once the CES-D score was 10 or more. We used five relative income levels derived from ratios between the participants' annual per capita household expenditure (PCE), excluding medical expenditure, and the median PCE of their cities. The concentration curve and index were used to measure and compare the magnitude of income-related inequality of depressive symptoms between 2011 and 2015. A logistic regression model was used to explore the crux of the inequality issue. Several confounding factors were controlled for in this model, including age, sex, marital status, and educational level.Findings
The prevalence of depression among the elderly in China decreased from 37·0% (5540 of 14?956 participants) in 2011 to 32·7% (5606 of 17?165) in 2015. However, the absolute value of the standardised concentration index increased from 0·005 in 2011 to 0·028 in 2015. The prevalence of depression in the lowest-income group had the weakest improvement of 2·4% points compared with the other four groups. In the logistic regression model, being a part of the population with the lowest income level in 2015 was a significant risk factor for depression compared with the other income groups.Interpretation
The prevalence of depression in people aged 45 years and more in China is declining, but the issue of income-related inequality has been exacerbated. The lowest-income group is the main factor contributing to the inequality. Policy analysis pointed out that China's current policy on equalisation of public health services has not specifically mentioned the issue of mental health. However, under the requirement of the Healthy China strategy, the fairness of mental health deserves attention.Funding
None. 相似文献994.
Risk of Cardiovascular Mortality Associated With Serum Sodium and Chloride in the General Population
Xin He Chen Liu Yili Chen Jiangui He Yugang Dong 《The Canadian journal of cardiology》2018,34(8):999-1003
Background
The prognostic value of serum chloride among patients with heart failure was demonstrated by previous studies. However, the association of serum chloride and risk of cardiovascular mortality among the general population remains unclear.Methods
We included 16,483 participants in National Health and Nutrition Examination Survey III. Cox proportional hazards models were used to assess the association of serum sodium and chloride and cardiovascular mortality. Potential confounders were included in the models. Levels of serum sodium and chloride were also modeled with restrictive cubic splines for potential nonlinear associations. Subgroup analyses were based on baseline diseases and use of diuretics.Results
The mean age was 43.5 years, and 47.8% of the participants were men. During 277,059 person-years of follow-up, there were 1714 cardiovascular deaths. In the multivariate model, low-level serum sodium was associated with an increased risk of cardiovascular mortality (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.02-1.18 per standard deviation [SD]; P = 0.009), whereas a lower level of serum chloride was not (HR, 1.04; 95% CI, 0.97-1.12 per standard deviation; P = 0.278). Analyses with restrictive cubic splines yielded similar results.Conclusions
Low serum sodium, rather than chloride, was independently associated with an increased risk of cardiovascular mortality. 相似文献995.
We review, for the first time, a 20-year Chinese story of research and development pertaining to tribendimidine, a promising anthelmintic agent that is safe and exhibits a broad spectrum of activity. Tribendimidine was first synthesized at the National Institute of Parasitic Diseases in Shanghai in the mid 1980s. In laboratory studies, tribendimidine showed high efficacy against Nippostrongylus braziliensis in rats, Necator americanus in hamsters, Ancylostoma caninum and Toxocara canis in dogs, and Syphacia mesocriceti in mice. Activity was also found against several species of cestodes in chicken. In clinical trials, a single oral dose of 400 mg tribendimidine, administered to patients infected only with N. americanus, or with N. americanus and Ancylostoma duodenalis, resulted in cure rates of 85.7% (132/154) and 89.8% (53/59), respectively. In comparison, a single oral dose of 400 mg albendazole resulted in significantly lower cure rates, namely 65.5% (91/139; chi(2) = 16.47, P < 0.001) and 71.7% (43/60; chi(2) = 6.29, P = 0.012), respectively. Single oral doses of tribendimidine (300 mg) and albendazole (400mg) were equally effective against Ascaris lumbricoides infections; cure rates were 96.0% (97/101) and 98.1% (101/103), respectively. In 5-14-year-old children with an Enterobius vermicularis infection, treated with a single oral dose of 200 mg tribendimidine, a cure rate of 81.6% (93/114) was observed. Tribendimidine was well-tolerated as only mild and transient side effects were observed. It would be of great public health significance if these findings are confirmed in other epidemiological settings, as more than one-quarter of the world population is currently affected by intestinal nematodes, with only very few drugs currently available on the market. 相似文献
996.
Wenming Shi Cong Liu Dan Norback Qihong Deng Chen Huang Hua Qian Xin Zhang Jan Sundell Yinping Zhang Baizhan Li Haidong Kan Zhuohui Zhao 《Lancet》2018
Background
Evidence of the effects of fine particulate matter (PM2·5) and its chemical constituents on childhood pneumonia is scarce. We aimed to investigate the effects of PM2·5 and its chemical constituents on doctor-diagnosed pneumonia in preschool children in China.Methods
A cross-sectional study was done in six Chinese cities (ie, Shanghai, Nanjing, Chongqing, Changsha, Urumqi, and Taiyuan), based on the China, Children, Homes and Health project (2011–12), and included 30?759 preschool children across 205 preschools. Information on the prevalence of life-ever pneumonia, demographic characteristics, and home environmental factors were collected by validated questionnaires. Questionnaires were answered by parents or guardians of the children, and completed questionnaires were returned within 1 week, under the guidance of trained project investigators. The annual levels of ambient air pollutants (PM2·5, ozone, and dust) and five major PM2·5 chemical constituents (ie, black carbon, organic carbon, and three water-soluble ions [ammonium, NH4+; sulphate, SO42?; and nitrite, NO3?]) were obtained from a combination of satellite remote sensing, chemical transport modelling, and ground-based monitors (spatial resolution of 0·01° × 0·01° [ie, 1 km?×?1 km]). The ambient air pollutants and chemical constituents were allocated to children according to geocoded preschool addresses. A hierarchical multiple regression model was done to evaluate the associations between PM2·5 and chemical components and childhood pneumonia at the preschool level and at the individual level, after adjusting for covariates. The study was approved by the ethics committee of the School of Public Health, Fudan University, Shanghai, China.Findings
The prevalence of life-ever doctor-diagnosed pneumonia was significantly different between the six cities (p=0·004). Apart from family history of allergy, parental smoking, indoor dampness, and interior decoration, we found the prevalence of diagnosed pneumonia was significantly associated with the ambient PM2·5 (per 10 μg/m3) by an adjusted odds ratio (OR) of 1·10 (95% CI 1·00–1·21). The secondary chemical components, NH4+, SO42?, and NO3? (per 1 μg/m3), were significantly associated with childhood pneumonia, as shown by adjusted ORs of 1·08 (1·02–1·14), 1·04 (1·00–1·08), and 1·05 (1·01–1·09), respectively. Stratified analyses showed children who lived in urban areas or who were breastfed for less than 6 months had increased risk of pneumonia by ambient NH4+, SO42?, or NO3? exposure.Interpretation
The chemical constituents of PM2·5, especially the water-soluble parts of NH4+, SO42?, and NO3?, were significantly associated with childhood pneumonia in China. This association indicates that these constituents might be important environmental triggers of childhood pneumonia.Funding
National Key R&D Program of China, National Natural Science Foundation of China, the State Key Basic Research Program (973) Project. 相似文献997.
本文报道了１９９３－１９９５年新疆四个单位实验动物室４种普通实验动物体内寄生虫 初步调查研究结果。在被调查的实验动物物体内，共获得寄生蠕虫及原虫１１种，四家实验动物室实验动物体内寄生虫的杂率为６６．２％。 相似文献
998.
新疆克拉玛依皮肤利什曼病病原生物学的研究 总被引：3，自引：0，他引：3
从新疆克拉玛依地区皮肤利 曼病患者皮损内分离的３株婴儿利什曼原虫，接种至草原名词行鼠或背纹仓鼠的腹腔／睾丸内后，引起内脏感染。习的病理变化与内脏利什曼病人体内分离出来的婴儿利什曼原虫／杜氏利什曼原虫引起的一致。 相似文献
999.
中国登革热的流行现状 总被引：1，自引：0，他引：1
登革热是由登革病毒4个血清型引起的急性传染病。广泛流行于全球热带和亚热带地区,是分布最广,发病最多,危害较大的一种虫媒病毒性疾病。本文就登革热在我国的流行历史、流行现状进行了回顾和总结,对该病流行的各个基本环节、预防控制、预警等方面的研究情况进行了综述,并对数据收集、分析和整理方面存在的问题提出了建议。 相似文献
1000.