某市公共场所公共用品用具达标的影响因素分析

目的了解2018—2019年甘肃省某市公共场所公共用品用具卫生达标的影响因素,为加强公共场所卫生管理、提高传染病防控技术以及公共场所卫生水平提供科学依据。方法分析2018—2019年1256份公共场所样品的微生物检测结果,按照《公共场所卫生指标及限值要求》GB 37488-2019评价,采用单因素分析方法发现场所类型、量化分级和卫生知晓对公共用品用具的达标情况有显著影响的因素,利用二元Logistic回归分析进一步探究影响公共用品达标情况的因素。结果公共用品用具在宾馆/酒店占62.8%,量化分级A级占18.0%,卫生知晓占68.4%;回归分析显示,量化分级从C到A每变化一级,公共用品用具达标率增长56.2%(β=0.562);与不知晓的对象相比,卫生知晓每变化一个单位,公共用品用具达标率提升73.4%(β=0.734);以沐浴场所为参照,场所类型为宾馆或酒店时、公共用品用具达标的概率增加65.8%(β=0.658),场所类型为理发店时、公共用品用具达标的概率增加119.8%(β=1.198),场所类型为美容店时、公共用品用具达标的概率增加59.4%(β=0.594)。结论公共用品用具达标率主要受量化分级、卫生知晓情况以及场所类型影响;为提高公共场所卫生水平,应增强卫生监督监管力度并加强场所服务人员的卫生知识宣传教育。     

分子生物学和液体培养方法提高综合医院结核病病原学诊断能力的价值

目的 分析应用分子生物学检测及液体培养法对提升综合医院结核病病原学诊断能力的价值。方法 提取中日友好医院病案系统中2014年3月至2018年12月全院各科室诊断为肺结核且上报传染病卡的1438例住院患者的诊断依据、病原学检测方法及结果、病原学送检时间及结果返回时间、入院时间及出院时间等信息。分析该院2014—2016年仅开展抗酸染色和分枝杆菌固体培养法(罗氏培养法)时与2017—2018年开展分子生物学检测[GeneXpert MTB/RIF检测(简称“GeneXpert检测”)]和液体培养法(BACTEC MGIT 960分枝杆菌快速液体培养)后肺结核患者病原学诊断能力和确诊时间的变化情况。结果 2014年该院肺结核患者病原学检测阳性率仅为19.83%(24/121),2018年升至53.89%(256/475)。分子生物学检测及液体培养法开展前后,肺结核患者病原学检测阳性率分别为22.68%(132/582)和49.65%(425/856),差异有统计学意义(χ²=106.184,P=0.000)。开展GeneXpert检测后(2017—2018年),该院经检测确诊的肺结核患者中利福平耐药比例为7.45%(28/376),而在开展前无耐药结核病诊断能力。开展分子生物学和液体培养法检测后(2017—2018年),肺结核患者确诊时间为7.00(3.00,12.00)d 明显短于开展之前(2014—2016年)的10.00(6.00,14.00)d,差异有统计学意义(Z=-7.815,P=0.000 )。结论 分子生物学和液体培养方法的应用可提高综合医院结核病病原学诊断能力,缩短患者确诊时间。     

2009—2013年云南省边境地区传染病类突发公共卫生事件流行特征分析

目的通过了解云南省边境地区传染病类突发公共卫生事件流行特征,以指导边境地区传染病防控工作。方法对2009—2013年间云南省边境地区的传染病类突发公共卫生事件资料进行整理和描述分析,资料来源于《中国疾病预防控制信息系统》。结果云南省25个边境县(市)共报告传染病类突发公共卫生事件110起,占全省疫情的16.72%。主要为一般事件(Ⅳ级),占74.55%;发病7 086例,死亡15人;疫情波及446 213人,罹患率为1.59%。甲类传染病事件4起,占3.64%;乙类46起,占41.82%;丙类33起,占30.00%;其他27起,占24.54%。事件主要发生于每年3—5和9—12月份,以水痘等呼吸道传染病为主,主要发生在学校。境外输入传染病事件6起,均为缅甸输入。结论传染病跨境输入,特别是甲类传染病跨境输入引起的突发公共卫生事件,是云南省边境地区疾病预防控制工作的一个难点和重点。     

Quality of primary health care in China: an analysis of data from a nationwide longitudinal survey

Background

China has made remarkable efforts and achievements since its health reform in 2009, yet there are substantial knowledge gaps in the quality of primary health care (PHC) in China. We aimed to assess the quality of PHC in China by analysing hospital admission rates among diabetics, a frequently used quality indicator for PHC.

Challenges and prospects in the public health research system in the occupied Palestinian territory: a qualitative study

Background

A public health research system is the bedrock of health systems to improve population health, system responsiveness, and equity. An international concern, referred to as the 10/90 gap, is that less than 10% of global funds are devoted to diseases or conditions that account for 90% of the global disease burden, particularly in developing countries. Palestinian health research is progressing, but it is not sufficiently investigated, with a remarkable knowledge gap on its conceptualisation, stewardship, stakeholders, and capacity and resources. The aim of this study was to understand the Palestinian public health research system by investigating challenges related to the system components that need to be strengthened.

Arthropathy,hypouricemia and normal serum iron studies in hereditary hemochromatosis

A patient manifesting the arthropathy of hemochromatosis without abnormal serum iron studies is described. Hemochromatosis was confirmed by liver biopsy. This case serves to emphasize the diagnostic value of the characteristic arthropathy of hemochromatosis. Our observations in this patient support the hypothesis that the pathogenesis of hereditary hemochromatosis differs from that of acquired iron overload states. The concurrent presence of hypouricemia is explored in this patient and in 18 other patients with hereditary hemochromatosis. Men with hereditary hemochromatosis were found to have lower serum uric acid levels than expected. In our patient, a renal defect in tubular reabsorption of uric acid appears responsible for hypouricemia.The apparent association of hemochromatosis and hypouricemia deserves further investigation.     

Total and regional myocardial blood flow in aortic regurgitation.

Total, phasic, and regional flow were studied in 12 open-chest dogs with aortic regurgitation. An adjustable catheter device was used to produce aortic regurgitation. Four differently labeled 7 to 9μ microspheres were injected into the left atrium during control, mild (5 to 25 per cent), moderate (25 to 50 per cent), and severe (50 to 80 per cent) regurgitation. Aortic regurgitation (AR) and the ratio of diastolic coronary blood flow to systolic coronary blood flow ($\text{DIAS}\text{SYS}$ RATIO) were measured from the electromagnetic flow tracings. The simultaneous left ventricular and aortic pressures were used to calculate $\text{DPTI}\text{SPTI}$ (diastolic pressure time index to systolic time index). Myocardial flow, flow to major subgroups, and endocardial/epicardial ratios were determined from radioisotope analysis of the left ventricle.Mean absolute control values and mean changes of key variables from control were:

3.

	Control	Mild AR	Mod AR	Severe AR
Heart rate (beats/min.)	163.42	?5.00	?4.831	?8.56
$\text{DPTI}\text{SPTI}$	1.18	?0.121	?0.241	?0.561
Dias/Sys ratio	4.23	?0.28	?1.641	?3.311
Myo. flow (ml./100g./min.)	99.90	?5.63	11.18	21.63
Endocardium (ml./100 g./min.)	97.27	?5.28	10.26	7.39
Epicardium (ml./100 g./min.)	100.15	?7.38	7.88	21.58
$\text{ENDO}\text{EPI}$ ratio	0.99	0.01	0.01	?0.11

1

Denotes significant change from control state (P = 0.05).

The phasic coronary blood flow results in this study are similar to those reported in chronic, intact anesthetized dogs; when the degree of aortic regurgitation increased, there was a significant decrease in diastolic coronary blood flow with an increase in systolic coronary blood flow. Not previously reported are the changes in the distribution of myocardial perfusion. Total myocardial flow increased slightly. There were minimal changes in blood flow to the endocardium which resulted in a slight decrease in the $\text{ENDO}\text{EPI}$ ratio and a decrease in the per cent of flow to the endocardium. These results indicate that, although acute aortic regurgitation produces significant changes in phasic coronary flow, there are much smaller effects on total and regional myocardial blood flow.     

北京市外来务工人员AIDS防治宣传教育前后相关知识调查分析

目的了解北京市外来务工人员艾滋病(AIDS)防治宣传教育前后相关知识和行为现状,并评价宣传教育效果。方法采用教育前后自填式问卷,调查北京市1200名外来务工人员对AIDS传播途径、安全套可以预防性传播疾病(STD)／AIDS的相关知识、对待AIDS患者的态度、在性生活中使用安全套行为等内容。结果教育后。调查对象对“AIDS目前可以治愈”的答对率提高了23．0个百分点,“知道AIDS、性病的咨询热线电话”提高了49．9个百分点,在对待AIDS患者采取“避免接触”、“同情,但避而远之”两种态度者,比教育前分别下降了13．0和7．1个百分点;而采取“与从前一样”态度者比教育前上升了20．3个百分点;对安全套相关知识的了解,比教育前分别增加了6．1～24．0个百分点。结论通过AIDS防治知识的宣传教育和培训,对于提高外来务工人员防治AIDS的相关知识是行之有效的。