认真实施“一法一例” 抓好母婴保健工作

沈阳市人大、市政府高度重视《中华人民共和国母婴保健法》和《辽宁省母婴保健条例》的贯彻实施，认真抓好宣传工作，建立起一支高素质的执法队伍，加强监督执法的力度，清理整顿了母婴保健技术服务市场，使该市的妇幼卫生工作向法制化管理迈出了一大步     

辽宁省艾滋病抗病毒治疗死亡患者生存时间及相关因素分析

目的 探讨艾滋病（AIDS）患者生存时间及其影响因素。方法 采用回顾性队列研究方法,收集辽宁省接受高效抗反转录病毒治疗（HAART）且已死亡人免疫缺陷病毒感染者（HIV）/AIDS发病、死亡等信息并统计分析。结果 自2003年12月-2014年12月底,310例AIDS HAART死亡患者,AIDS相关死亡187例（60.32%）,意外死亡和自杀等非AIDS相关死亡123例（39.68%）;接受治疗前中位生存时间为3.00（95%CI=2.00~4.00）个月,接受治疗后的前6、6~12、12~18个月的累积生存率分别为（57±3）%、（44±3）%、（36±3）%。不同世界卫生组织（WHO）临床分期、基线CD4⁺T淋巴细胞水平组间生存时间差异明显（P<0.05）。WHO临床分期Ⅲ期或Ⅳ期患者死亡风险是Ⅰ期或Ⅱ期患者1.973倍,基线CD4⁺T淋巴细胞为50~199、≥200个/μL组患者死亡风险分别是<50个/μL组0.442倍和0.512倍。结论 死亡集中发生于开始治疗后的前6个月,随着时间延长,死亡速度减缓。基线CD4⁺T淋巴细胞水平低、WHO临床分期Ⅲ期或Ⅳ期是抗病毒治疗患者死亡危险因素。     

基于疫情数据分析的传染病模拟仿真平台构建

为提升突发公共卫生事件的应急处置能力,本研究借助政务云信息系统算力性能强、数据交换安全可靠、服务器部署灵活、数据采集高效等优势,利用大数据,云计算,图像识别、语音识别,5G、GIS等技术,设计基于政务云的辽宁省区域流行病学调查管理信息系统,以流行病学调查为源头,构建空间、时间和人物关系的多维疫情传播模型及大数据分析,实现省、市、区三级联动、跨省协查实时协同,联防联控信息全流程闭环管理。     

贯彻实施“一法一条例”促进妇幼保健法制化建设

辽宁省卫生厅与省人大等各有关部门密切配合，广泛深入宣传《母婴保健法》和《辽宁省母婴保健条例》，积极争取各级政府的重视，将母婴保健事业纳入本地区的国民经济和社会发展计划；从实际出发，采取多种措施，加强与有关部门的协调配合，逐步建立健全母婴保健法律法规体系，严格进行执法检查，保证了执法工作的顺利进行。     

辽宁省肺结核患者耐药状况及相关因素分析

目的调查辽宁省结核分枝杆菌耐药现状,为制定有效的防控对策和策略提供科学依据。方法在2012年1月1日—2012年6月30日全省耐药监测点连续纳入的998例涂阳患者作为研究对象。对其痰标本进行培养分离菌株,菌型鉴定,获得912例结核分枝杆菌完整病例资料,采用比例法对利福平(R)、异烟肼(H)、链霉素(S)、乙胺丁醇(E)4种药物进行药物敏感性试验。采用χ~2检验进行率的比较及多因素logistic回归分析耐药特点及影响耐药和耐多药的相关因素。结果 912株结核分枝杆菌总耐药率为38.16%(348/912),初治患者耐药率33.63%(228/678),复治患者耐药率51.28%(120/234);总耐多药率、多耐药率分别为11.84%(108/912)、10.09%(92/912),复治患者的总耐药率、耐多药率和多耐药率均明显高于初治患者,差异有统计学意义(P0.001)。耐药顺位链霉素的耐药率最高,异烟肼列第二位,耐多药、多耐药中包含二者的耐药谱耐药率较高,而单耐药中利福平(3.07%)耐药排在第二位。经多因素logistic回归分析,复治患者更易产生耐药(OR=2.08,95%CI=1.53~2.82,P0.05);20~39岁(OR=2.63,95%CI=1.04~6.66,P0.05)和40~59岁(OR=2.55,95%CI=1.02~6.34,P0.05)年龄组患者与耐药有关。结论辽宁省耐药水平仍然较高,耐药结核病防治形势依然严峻,需采取更全面的防控措施降低耐药结核病的流行。     

缺血性脑卒中患者糖尿病患病现状及影响因素研究

背景 糖尿病是缺血性脑卒中发病、复发、致残、致死的重要危险因素,评估缺血性脑卒中患者的糖尿病患病现状,开展综合防控,可有效改善患者预后。目的 了解辽宁省缺血性脑卒中患者合并糖尿病现状,为有针对性的干预提供理论依据。方法 2017—2018年,通过分层抽样、整群抽样、随机抽样相结合的方法,对辽宁省6个县区28个行政村/社区≥40岁的980例缺血性脑卒中患者进行横断面调查。采用多因素Logistic回归分析缺血性脑卒中患者糖尿病患病、知晓、治疗和控制情况的影响因素。结果 辽宁省缺血性脑卒中患者糖尿病患病、知晓、治疗和控制率分别为29.5%(289/980)、63.3%(183/289)、56.4%(163/289)和47.2%(77/163)。多因素Logistic回归结果提示,居住地为城市〔OR=1.818,95%CI(1.317,2.508),P<0.001〕、有糖尿病家族史〔OR=2.790,95%CI(1.922,4.050),P<0.001〕、高血压〔OR=1.813,95%CI(1.160,2.834),P=0.009〕、高三酰甘油〔OR=2.312,95%CI(1...     

WNT10A rs147680216 G>A mutation indicates a higher risk for non-syndromic oral cleft in a northeastern Chinese population

Non-syndromic oral cleft lip and palate is a heterogeneous group of congenital malformations that consist of cleft palate, and cleft lip with or without cleft palate. The members of the wingless type mouse mammary tumour virus (MMTV) integration site family (Wnts) regulate various developmental processes including craniofacial development, and have a role in that of cleft lip and palate. We aimed to identify the potential polymorphisms in the Wnt10a gene, and to explore the association between the variations in the gene and the risk of development of cleft palate. A total of 198 affected patients (cleft lip, n = 67; cleft palate, n = 48; and both, n = 83) together with 187 healthy controls were enrolled (all from the Chinese Han population in NE China). A fragment of 316 bp was amplified from the blood genome of each participant by polymerase chain reaction (PCR) using specific primers that targeted the Homo sapiens Wnt10a gene. By using the restriction enzyme AluI, the population analysed were classified into three genotypes, GG (316 bp), GA (316 bp, 117bp, 199bp) and AA (117bp, 199bp) based on the rs147680216 G/A polymorphism (Gly>Ser mutation at position 213 of Wnt10a protein) of theWnt10a gene. The frequency of allele A in the affected group was significantly higher (14.1% compared with 3.2% in the control group). The allele G with an odds ratio (OR) of 0.201 and 95% CI of 0.445 to 0.091 was not a risk factor for the condition in the affected group. However, the distribution of the genotype did affect its occurrence in the affected group (p < 0.001), but not the classification of types (p = 0.901). In conclusion we found an rs147680216 G>A mutation that was associated with non-syndromic cleft lip and palate in the Wnt10a gene.     

辽宁评分与多种无创评分系统预测肝硬化患者高危食管静脉曲张及出血或再出血的价值比较

目的　比较辽宁评分与终末期肝病模型（model for end?stage liver disease, MELD）、终末期肝病血清钠模型（model for end?stage liver disease?Na,MELD?Na）及Blatchford评分在预测肝硬化患者高危食管静脉曲张（esophageal varices, EVs）、1年内出血或再出血及输血治疗方面的价值。方法　收集2018年1月—2019年9月间因肝硬化于广西医科大学第一附属医院就诊,首次行内镜检查证实有EVs的170例患者的临床资料,计算首次内镜检查时的辽宁评分、MELD、MELD?Na及Blatchford评分,并随访1年记录出血或再出血情况。绘制受试者工作特征（receiver operating characteristic, ROC）曲线并应用曲线下面积（area under curve, AUC）评价4种评分系统预测肝硬化患者高危EVs、1年内出血或再出血及输血治疗的准确性,获取最佳诊断界值,并以最佳诊断界值分组,比较高危EVs占比、首次内镜检查后1年内出血或再出血的比例。结果　辽宁评分预测肝硬化患者内镜下高危EVs的最佳诊断界值为0.45,AUC为0.702（95%CI：0.612~0.781,P<0.01）,明显优于MELD、MELD?Na及Blatchford评分（AUC分别为0.593、0.648、0.610）。辽宁评分≥0.45组及<0.45组的高危EVs患者比例分别为71.8%（89/124）及34.8%（16/46）,两组差异有统计学意义（χ2=19.442,P<0.01）。辽宁评分预测患者首次内镜检查后1年内出血或再出血的AUC为0.680（95%CI： 0.595~0.765,P<0.01）,高于MELD、MELD?Na及Blatchford评分（AUC分别为0.605、0.615、0.598）。Blatchford评分预测患者住院期间输血治疗的AUC为0.775（95%CI：0.687~0.863,P<0.01）,明显优于MELD、MELD?Na、辽宁评分（AUC分别为0.653、0.719、0.631）。结论　辽宁评分在预测肝硬化患者高危EVs及首次内镜检查后1年内出血或再出血方面,优于MELD、MELD?Na、Blatchford评分系统。Blatchford评分能有效预测肝硬化合并EVs患者住院期间是否需输血治疗。     

Hepatitis C virus genotype and subtype distribution among ethnic minorities in Liaoning Province of China

To provide information and a basis for improved hepatitis C prevention and treatment, we aimed to determine the distribution of hepatitis C virus (HCV) genotypes among patients with hepatitis C from 4 ethnic minorities in Liaoning Province of China over the past 8 years and analyze and explore the virus’ genotype evolution and possible clinical significance.For gene-sequencing, we collected peripheral blood samples of HCV-infected patients belonging to the Korean, Hui, Mongol, and Manchu ethnic minorities in Liaoning Province who were diagnosed at the Second Hospital of Dalian Medical University, Anshan Central Hospital, and the Second People''s Hospital of Fuxin City between November 2011 and November 2019. To analyze genotype evolution and possible influencing factors, we determined the ratio of various genotypes. Among the 102 HCV-infected patients from 4 ethnic minorities in Liaoning Province, 46 had gene typing (GT)1b (45.10%), 15 had GT2a (14.71%), 14 had GT3a (13.73%), 13 had GT6a (12.75%), 3 had GT1a (2.94%), and 11 had an unclassified genotype (10.78%). The distribution of various genotypes in the Korean, Mongol, and Manchu ethnic minorities was significantly different (χ² = 10.788, P = .029; χ² = 7.846, P = .049; and χ² = 22.400, P = .000, respectively). All ethnic minorities exhibited >40% of GT1b. In the Korean (14/33) and Manchu (14/30) ethnic minorities, the proportion of GT1b was significantly higher than those of other genotypes (P < .05). The ethnic Koreans had a high proportion of GT3a (18.18%, 6/33), whereas the ethnic Mongolians had a high proportion of GT6a (23.08%, 6/26). GT1a was only found in the Korean (6.06%, 2/33) and Manchu (3.33%, 1/30) ethnic minorities; in the Hui ethnic minority, only 3 genotypes were prevalent: GT1b, GT2, and GT3a. The ethnic minorities in Liaoning Province currently have diverse HCV genotypes; the most prevalent genotype is GT1b, followed by GT2a and GT3a, and the prevalence of GT3 and GT6 has increased. The distribution of HCV genotypes varies across different ethnic minorities. The Korean and Manchu ethnic minorities have the most prevalent genotypes, whereas the Hui ethnic minority has a relatively single distribution of the HCV genotype.