迎接双重挑战 再创新的辉煌

回顾建国以来我国以传染病控制为重点的疾病的控制事业所取得的巨大成就,指出当前疾病控制面临的双重挑战,提出必须一方面继续抓紧抓好传染病的控制工作,另一方面应尽快抓起慢性非传染性疾病的预防控制。     

疾病编码主体的探讨

ICD是一门科学性、技术性、专业性很强的疾病分类方法,具有自身的系统性、复杂性及标准化的操作规程。疾病编码主体必须是专业的编码员,临床医师的责任是准确、完整、规范地书写诊断。保证高质量的编码,应让编码员与临床医师各司其职,各有侧重,并建立有效的沟通机制。     

江门市郊区妇女常见病普查结果分析

目的:了解江门市郊区已婚育龄妇女常见病普查情况,为制定干预措施提供依据。方法:对江门市郊区11 672例已婚妇女进行妇科、白带、宫颈刮片脱落细胞及乳腺(包括触诊和乳腺B超)检查,并对普查结果进行统计分析。结果:11 672例妇女中患病7 104例,患病率为60.86%。其中妇科疾病的患病率为48.67%,根据其患病率顺位排名前3位为宫颈炎、阴道炎、子宫肌瘤;乳腺疾病的患病率为35.23%,主要疾病为乳腺增生及乳腺肿块。结论:江门市郊区妇女常见病患病率高,应定期开展妇女常见病的普查工作,同时应与多部门合作,采取相应干预措施降低妇女病的患病率。     

石油企业中老年职工健康状况调查

为了解石油企业中老年职工的健康现状，我们对承德石油机械厂的３７５名中老年职工进行了体检。结果如下：共检出疾病３３种。慢性病占９１％；有７７．６％的人患有各种疾病，患病总例数为４４９例；老年人的患病率高于中年人（Ｐ＜０．０１）；生活方式疾病患病率和心身疾病患病率分别为５２．５３％、２４．９３％。提示慢性病，尤其是生活方式疾病和心身疾病是威胁企业中老年职工健康的主要疾病。因此，提高职工自我保健意识、改变不良生活习惯和行为是企业中老年职工促进自身健康的必由之路     

深圳市松岗街道职业病危害因素分析

目的 分析深圳市松岗街道10年来的职业病危害因素,为进一步做好职业病预防工作提供科学依据.方法 分析最近10年来诊断的职业病资料、危害因素构成以及日常的监测与健康检查结果.结果 本地区发生职业病52例,粉尘引起的矽肺在2000-2002年是本地区的主要职业病病种,三氯乙烯、正己烷等有机溶剂引起的职业中毒增长速度最快,是最近三年本地区的主要职业病病种,噪声危害也不容忽视.结论 有机溶剂、粉尘是本地区危害最严重的职业病危害因素,应加强综合管理措施,加强健康教育,做好职业健康监护,减少职业病的发生.     

非酒精性脂肪肝与冠心病和脑血管病关系的研究

目的非酒精性脂肪肝与冠心病和脑血管病关系的研究。方法基于非酒精性脂肪肝患者冠心病和脑血管病的发病风险增高这一假设，我们对我院6年间的住院病历进行了回顾性研究，对年龄和性别匹配的550例非酒精性脂肪肝患者和550例正常肝脏患者的临床资料加以对比分析。结果非酒精性脂肪肝患者的收缩压、舒张压以及体重指数均显著高于正常肝脏者，非酒精性脂肪肝患者的ALT水平较之于正常肝脏者明显增高。非酒精性脂肪肝患者中冠心病发病率为36．5％，脑血管病发病率为25．6％；正常肝脏中冠心病发病率为12．2％，脑血管病发病率为7．1％。结论非酒精性脂肪肝患者的冠心病发病率和脑血管病发病率均显著增高。     

黄石地区2000～2005年出入境人员健康体检传染性疾病和非传染性疾病结果分析

目的掌握黄石地区出入境人员中传染性疾病和非传染性疾病的发病情况,有针对性的开展出入境人员的传染病监督监测工作,探讨非传染性疾病的检出在出入境人员健康体检工作中的重要性。方法2000-2005年在黄石出入境检验检疫局进行健康体检的3 365例出入境人员,胸部x光片,心电图,B超,内科,外科,五官科检查,血清样本HIV,HBsAg,梅毒抗体,ALT检测。结果黄石地区出入境人员中乙肝病毒的携带率为5．53％,肺结核的感染率为1．34％,梅毒的感染率为0．15％,非传染性疾病中高血压的患病率为12．69％,心电图异常为10．25％,肝胆B超检查异常为5．73％,色觉异常为1．99％。结论加强对出入境人员的传染病的监督和监测工作,是防止传染病传入、传出国境的重要措施,梅毒等性传播疾病(STD)在出入境人员中的检出率已大大高于中国平均水平,由于这部份人群活动量大,活动区域广而成为感染、携带和传播性传播疾病的重要环节。同时做好非传染性疾病的检查工作。     

陕西传染病发病及死亡分析

目的了解陕西省传染病流行规律及特点.方法利用陕西卫生统计资料,分析传染病的发病率和病死率.结果全年共报告传染病19种85 289例、死亡141例,发病和病死率分别为236.21/10万和0.17%,发病和死亡列入前3位的依次是肝炎、细菌性痢疾、肺结核,占总发病和死亡数的86.53%和60.53%.结论陕西传染病发病和死亡与往年相比有升有降基本平稳,但一些可用计划免疫预防的传染病仍有发生,提示防治工作有所放松.     

高台县2012年31729例患病儿童疾病报告分析

目的分析2012年我县儿童疾病病例报告情况,为制定儿童疾病防治策略和措施提供科学依据。方法根据我县3所县级医疗机构和11个乡镇卫生院上报的2012年0-通讯作者14周岁全年发病儿童疾病排列汇总数据,并对门诊和住院病例分别进行了分析和排序后进行统计处理。结果 2012年全县县、乡医疗机构儿童报告疾病病种达35种之多,呼吸道疾病和胃肠道疾病为儿童所患主要的报告病种。结论通过对全县县、乡医疗保健机构儿童疾病谱排序,做到对儿童常见多发疾病的掌握,采取切实可行的防范和治疗措施,制定综合有效的防治策略,切实保障儿童身体健康。     

某市娱乐服务行业女性血液传播及性传播疾病检测结果分析

目的：调查某市娱乐服务行业女性血液传播及性传播疾病的流行情况，为相关疾病的预防和控制提供依据。方法：乙肝、丙肝、梅毒、单纯胞疹病毒和艾滋病检测均采用ELISA法，乙肝、丙肝、梅毒初检阳性者用金标试纸条法复检。艾滋病抗体初复检均为阳性者，送市疾控中心做确证试验。结果：各项检测指标中HBsAg阳性率为7．69％，说明乙型肝炎病毒携带者为本地区的主要感染源，HBsAg和抗HCV阳性率有逐年下降的趋势，而梅毒感染者尽管比例较低但有逐年增加的迹象。结论：对娱乐服务行业从业人群应加强疫情监测，尤其应动员社会力量开展针对血液传播及性传播疾病感染者的行为干预活动。     

Socioeconomic determinants of continuing functional disablement from chronic disease episodes

Functional disablement of persons with chronic disease is a complex outcome shaped by a variety of medical and socioeconomic factors, including those influencing the competing risk of death from the disease. The increasingly important task of explaining trends in the functional health status of various populations requires more detailed knowledge about the respective roles of these disability determinants. This paper reports the results of an analysis of the determinants of continuing functional incapacity after an episode of heart disease. A proportional hazards regression model is used to estimate the relative effects of socioeconomic and disease factors on the duration of work disablement and functional incapacitation of 976 surviving and nonsurviving patients hospitalized for presumptive myocardial infarction. The analysis shows that socioeconomic variables play a prominent role in disability outcomes, especially in work resumption. Evidence of aging effects on disability prevalence is also found.     

Bacterial communities in Haemaphysalis,Dermacentor and Amblyomma ticks collected from wild boar of an Orang Asli Community in Malaysia

Ticks are hematophagous vectors of arthropod-borne disease agents globally. In Malaysia, despite seroprevalence studies indicating the presence of tick-borne diseases among the indigenous people, the etiological agents of these diseases are still unclear. These indigenous people, also known as the Orang Asli, still live in forested areas with frequent contact with wildlife. Wild boar are ubiquitously found in the forested areas where the Orang Asli communities are located and are commonly hunted as a food supplement. In this study, we aim to determine the tick species parasitizing wild boar from an Orang Asli community, and explore the tick-associated bacterial communities using 16 s rRNA amplicon sequencing on the Ion Torrent PGM™ platform.A total of 72 ticks were collected from three wild boar and were morphologically identified as Haemaphysalis hystricis (n = 32), Dermacentor compactus (n = 15), Amblyomma testudinarium (n = 13), Dermacentor steini (n = 10) and Dermacentor atrosignatus (n = 2). Across all tick samples, 910 bacterial taxa were identified. Although the bacterial communities were not significantly distinct between tick species in beta-diversity analyses, Coxiella, Rickettsia and Francisella were detected at high relative abundance in H. hystricis, D. compactus and D. steini respectively. Many other bacterial genera, including those that have been described in many different tick species, were also identified, including Pseudomonas, Acinetobacter, Staphylococcus and Corynebacterium. Beta-diversity analyses also showed that the bacterial communities were separated based on the animal host from which the ticks were collected from, suggesting that the bacterial communities here may be influenced by the animal skin microflora, host blood or the environment. PCR screening confirmed the presence of Rickettsia sp. related to spotted fever group Rickettsia in some of the ticks.This study provides baseline knowledge of the microbiome of H. hystricis, D. atrosignatus, D. compactus, D. steini and A. testudinarium parasitizing wild boar in this region. The information gained in this study provides the basis to target our efforts in H. hystricis, D. compactus and D. steini for the future investigation of vector competence and the zoonotic potential for the Coxiella, Rickettsia and Francisella detected here, as well as their implications for the risks of tick-borne diseases among the Orang Asli communities.     

150例心脑血管病患者血液流变学观察

目的 监测血液流变学指标变化与心脑血管疾病之间的联系。方法 检测150例心脑血管疾病患者及30例健康对照者血液流变学。结果 心脑血管疾病组血液流变学参数显著高于健康组。疾病组的红细胞变形系数、红细胞聚集系数明显高于健康组。疾病组使用改善血液黏滞状态药物后，红细胞变形系数升高，血液黏稠度下降。结论 高黏滞血症与心脑血管疾病有密切联系。使用改善血液黏滞状态的药物，对老年心脑血管疾病有明显帮助。     

Work-related accidents and occupational diseases in veterinarians and their staff

Objectives: We assessed the occupational hazards in veterinary practice by analysing accident insurance data in order to stimulate strategies to prevent occupational accidents and diseases in veterinarians and their staff. Methods: Approximately 10,000 veterinary practices comprising about 27,500 veterinarians and their staff are covered by the Institution of Statutory Accident Insurance of the Health and Welfare Service (BGW). Each year about 2,000 accident and occupational disease claims are filed by these veterinarians and their staff. The claims for the 5-year period from 1998 to 2002 are analysed in this paper. Results: For 2002, the incidence rate for accidents in the workplace was 105.4 per 1,000 full-time workers, a rate 2.9-times higher than for general practitioners of human medicine. When only severe accidents resulting in a loss of work time of more than 3 days were analysed, the relative risk increased to 9.2. Approximately 66% of the reported accidents are due to scratches, bites, or kicks from animals. Claims of occupational disease are filed 2.7-times more often by veterinarians and their staff than by general practitioners and their staff. The occupational diseases filed most often concern the skin (39%), followed by allergic respiratory diseases (30.5%), and infectious diseases (19.1%). Conclusions: Prevention strategies for veterinarians should focus on accidents caused by animals. The prevention of occupational diseases should focus on skin diseases, respiratory disease, and infections.Dedicated to Prof. Jürgen Berger, Department of Biostatistics, University Hospital Eppendorf, emeritus in 2004     

哺乳动物雷帕霉素靶蛋白与神经退行性疾病

哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)作为细胞代谢和生存的关键调节剂,调节细胞的增殖,存活和代谢。越来越多的研究表明,mTOR是神经退行性疾病的新型治疗靶点,mTOR对于神经元的存活、发育和分化至关重要。 然而,基于mTOR介导的神经退行性疾病影响的分子机制尚未完全了解。本文综述了mTOR信号通路与神经退行性疾病之间关系的研究进展,并进一步讨论了mTOR在神经退行性疾病中的潜在作用。     

Scrub typhus, Republic of Palau

Scrub typhus, caused by Orientia tsutsugamushi, is a severe febrile illness transmitted to humans by trombiculid mites, which normally feed on rodents. The first known outbreak of scrub typhus in Palau occurred in 2001 to 2003 among residents of the remote southwest islands. To determine the extent of scrub typhus distribution in Palau, we tested serum samples from humans and rodents for antibodies to O. tsutsugamushi. Of 212 Palau residents surveyed in 2003, 101 (47.6%) had immunoglobulin G (IgG) antibody titers >1:64, and 56 (26.4%) had concurrent IgG and IgM antibody titers >1:512 and 1:64, respectively. Of 635 banked serum samples collected from Palau residents in 1995, 34 (5.4%) had IgG antibody titers >1:64. Sera collected from rodents (Rattus norvegicus and R. rattus) in 2003 and 2005 were tested, and 18 (28.6%) of 63 had IgG antibody titers >1:64. These findings suggest that scrub typhus is endemic in Palau.     

Economic Burden of Cardiovascular Disease in Type 2 Diabetes: A Systematic Review

Background

Cardiovascular diseases (CVDs) constitute major comorbidities in type 2 diabetes mellitus (T2DM), contributing substantially to treatment costs for T2DM. An updated overview of the economic burden of CVD in T2DM has not been presented to date.

疾病管理对帕金森病患者的影响

目的 探讨疾病管理对帕金森病患者非运动症状、生活自理能力的影响,为疾病管理系统的建立和完善提供参考.方法 选取收治的帕金森病患者90例,按照住院顺序分为观察组和对照组各45例,观察组较对照组患者增加疾病管理模式.出院随访6个月后,比较两组患者非运动症状的发生及生活自理能力.结果 两组患者非运动症状发生及生活自理能力比较,差异具有统计学意义（均P＜0.05）,观察组患者优于对照组.结论 疾病管理模式能明显降低帕金森病患者非运动症状的发生,提高患者的生活自理能力,从而改善患者生活质量,减轻家庭及社会的负担.     

全沟硬蜱为内蒙大兴安岭莱姆病螺旋体的主要生物媒介

我们于1990年5～8月在内蒙大兴安岭,对莱姆病螺旋体的生物媒介和人群感染进行了调查,全沟硬蜱(Ixodes persulcatus)是当地蜱类的优势种,用直接荧光抗体法检查全沟硬蜱的中肠涂片,发现其带菌率为40%;从46组(380只)全沟硬蜱中分离出19株莱姆病螺旋体。分离出的菌株在单克隆反应上与美国菌株不同。用间接荧光抗体法检测308名居民血清,阳性率为13.3%。以上研究证明,大兴安岭是莱姆病疫区,全沟硬蜱是将莱姆病螺旋体传播到人和动物的主要生物媒介。