丹阳市中小学生结核菌感染情况

学生是一个特殊群体，多为群居，且来自不同地方，易感染结核菌，加上在校期间学习紧张，居住较为拥挤，一旦发病，极易造成爆发流行。丹阳市某中学2003年5月曾发生一起结核病爆发流行，引起了社会各界的广泛关注。为了解丹阳市学生结核菌感染情况，以便为防治工作提供依据，2003年秋季学生体检中我们对该市中小学生进行PPD试验，筛查结核病人。现将结果报道如下。     

泰安市大中专院校新生结核菌感染状况分析

目的调查泰安市大中专院校入学新生结核感染状况,为高校结核病防治提供科学依据。方法对2006年-2011年泰安市驻泰大中专院校入学新生开展的PPD试验资料进行汇总、分析。结果 2006年至2011年,共为泰安市驻泰大中专院校入学新生95850人进行了PPD试验,总体阳性率41.57%,强阳性率3.82%。大中专学生的结核菌感染率逐年升高,同时随着年龄的增长而升高。结论通过开展PPD试验专项结核病筛查,摸清了大中专院校新生结核菌感染状况,为学校针对性的采取防控措施提供了依据,有效避免了高校结核病的发生和流行,值得在更大范围内推广。     

2006年太原市某高校入学新生结核菌感染调查

[目的]了解太原市某高校新生结核菌感染情况。[方法]对某高校1 503名大学新生进行结核菌素（PPD）试验调查。[结果]总阳性率38.41%,PPD硬结平均直径5 mm~、10 mm~1、5 mm~、≥20 mm分别占15.22%、12.92%、5.17%、5.10%。男生阳性率为39.53%,女生阳性率为35.08%,差异无统计学意义（P〉0.05）;城市生源大学生PPD试验阳性率为42.13%,乡村生源大学生为32.29%,差异有统计学意义（P〈0.01）。[结论]太原市高校新生是结核病控制的重点人群,应采取有力的相应预防措施。     

淮安市高校学生肺结核密切接触者筛查结果分析

了解淮安市高校学生肺结核密切接触者筛查情况,为高校结核病防控工作提供依据.方法 对2013-2015年淮安市高校学生肺结核密切接触者进行肺结核可疑症状调查、结核菌素(PPD)试验、X线胸片和结核分枝杆菌检查.结果 2013-2015年淮安市登记高校学生肺结核密切接触者682例,密切接触者肺结核可疑症状筛查率为100%,PPD筛查率为97.21% (663/682),X线胸片筛查率为70.23% (479/682);涂阳肺结核密切接触者PPD强阳性率及X线胸片异常率(30.1%,3.5%)均高于涂阴肺结核密切接触者(16.6%,0.6%)(x2值分别为14.570,4.087,P值均<0.05);筛查发现的6例涂阴肺结核患者均由定点医院收治,但其他符合预防性服药条件的密切接触者无人接受预防性治疗.结论 学校出现结核病疫情时,应及时规范开展密切接触者筛查工作,减少疫情的播散,同时应有效落实预防性服药,减少感染者发病风险.     

北京市朝阳区2013—2015年高校新生结核菌潜伏感染现状及发病情况

了解北京市朝阳区2013—2015年高校新生结核菌潜伏感染(latent tuberculosis infection,LTBI)及随访发病情况,为学校结核病防控工作提供依据.方法 采用结核菌素纯蛋白衍生物(TB-PPD)皮肤试验进行结核菌潜伏感染的检测,收集整理2013—2015年朝阳区65233例高校新生的入学结核病筛查及感染者后期发病的相关资料,并对资料进行描述性统计分析.结果 65233例新生中,有效PPD试验结果63135例,PPD阳性11754例(18.62%),PPD强阳性2720例(4.31%).男生PPD阳性率及强阳性率(19.56%,4.76%)均高于女生(17.87%,3.95%)(χ2值分别为29.37,24.29,P值均<0.01),藏族(29.45%,8.69%)高于汉族(18.25%,4.16%)(χ2值分别为102.01,70.04,P值均<0.01),西部生源(21.88%,5.11%)最高、本市生源(16.25%,3.46%)较低(χ2值分别为220.63,99.03,P值均<0.01),有卡痕者(18.94%,4.34%)略高于无卡痕者(16.96%,4.08%)(χ2值分别为48.46,10.43,P值均<0.01).筛查发现结核病患者19例,患病率为29.13/10万,其中PPD强阳性而发现者占68.42%(13/19).单纯PPD强阳性预防性服药率为52.94%(1433/2707).随访单纯强阳性学生2年共发现结核病患者7例,年均发病率为129.29/10万(7/2707).结论 朝阳区高校新生LTBI处于相对较低水平,但对于来自结核病疫情高发地区或藏族等少数民族的学生应重点关注,继续开展新生PPD筛查.LTBI者是结核病发病高风险人群,应对其在校期间密切定期观察.     

某高校对大学生结核菌感染者干预及4年跟踪的结果分析

目的了解对大学生结核菌感染者进行相关干预及连续4年跟踪在控制结核病发病及传播方面取得的结果,为高校结核病防控工作提供参考。方法对河北科技大学2007级学生中结核菌感染者进行预防性医学干预和连续4年跟踪观察,并观察干预效果;对疑似肺结核病例进一步明确诊断并治疗;确诊病例及时隔离治疗,并登记管理及跟踪。结果 2007级学生在校4年来结核菌感染总人数逐年明显增加(χ2值分别为184.51和76.49,P0.01);而新增感染者人数逐年明显下降(χ2值分别为166.62和37.95,P0.01),两者差异均有统计学意义,每年新增结核病发病人数稳定,年发病率4年差异无统计学意义(χ2=0.71,P0.05),平均年发病率为232.0/10万,发病者中痰涂阳性占8.93%;在预防用药方面,肌肉注射"母牛分枝杆菌"(微卡)和口服传统药物预防效果相比差异无统计学意义(χ2=0.59,P0.05)。结论大学生每年进行一次结核病筛查,对结核菌感染者采取相关干预和跟踪管理,可有效控制结核病发病及传播,避免结核病在高校暴发流行。     

大学生结核菌感染情况分析

为掌握我校大学生群体中结核菌感染情况,搞好预防工作,保证在校学生正常学习生活,我们于2003年1月～3月分别对校本部和江宁校区本科生进行了结核菌感染情况的检查。     

石家庄某高校学生结核病发病情况及随访观察

了解大学生的结核病发病情况及相关因素,为制定学校结核病防控措施提供依据.方法 选取河北经济管理学院2006级至2009级4届新生,按入学时的TB-PPD试验结果分为阴性组、一般阳性组和强阳性组,每届学生均观察3年,采用回顾性队列研究的方法对在校期间的结核病发病情况进行分析.结果 2006级至2009级共8 414人,有PPD结果8 394人,阳性率、强阳性率分别为2006级39.0%,12.1%;2007级33.6%,7.6%;2008级46.4%,11.2%;2009级50.4%,13.0%,各年级之间差异均有统计学意义(P值均<0.05).阳性率、强阳性率女生均高于男生,差异均有统计学意义(x2值分别为6.003,39.938,P值均<0.05).城市学生的阳性率(47.2%)高于农村学生(39.6%),强阳性率均为10.9%.累计观察25 242人年,共发现结核病人37例,年发病率为146.6/10万.PPD结果阴性组、一般阳性组、强阳性组的发病率差异有统计学意义(x2=132.720,P<0.01),发病率与强阳性率呈正相关(r=1.00,P<0.01).强阳性组中农村学生发病率高于城市(x2 =5.319,P=0.021).结论 青年学生是结核病的高危人群.应做为重点关注对象,给予适当的干预措施.     

柳州市区2010-2012年中小学新生结核菌感染及发病情况分析

分析柳州市区2010-2012年中小学生结核菌素试验结果及结核病流行状况,为学校结核病防治工作提供依据.方法 对柳州市区2010-2012年16 326名中小学入学新生进行结核菌素试验(PPD试验),同时对中小学生肺结核发病情况进行分析.结果 2010-2012年16 326名中小学新生PPD试验强阳性率为1.00%,初中一年级新生PPD强阳性率(1.10%)高于小学一年级新生(0.67%);3 a间通过PPD试验筛查仅发现1例初中生活动性肺结核病例,未发现小学生活动性肺结核病例;2010-2012年柳州市区小学生和初中生活动性肺结核发病率分别为3.80/10万和30.23/10万,且初中生肺结核发病率呈逐年下降趋势.结论 PPD试验筛查不是发现学生(尤其是小学生)肺结核最有效的方法.加强晨检工作和结核病防治知识健康教育才是及早发现学生肺结核的关键.     

某高校新生结核菌素试验及肺结核检出结果分析

目的为掌握新生入校时肺结核患病情况,检出PPD强阳性者,筛检结核病患者,从而早期规范治疗,减少结核病在大学生中的传播;动员PPD强阳性者预防性服药,降低学生结核病发病率。方法对入校新生进行免费实施结核菌素纯蛋白衍化物(PPD)实验,强阳性者进行胸透,疑似者进一步检查确诊。胸透无异常者进行预防性治疗。结果3届新生中,总强阳性率7.80%之间,肺结核患病率128/10万,低于2000年第4次全国结核病流调同年龄段患病率233/10万。结论为了控制肺结核在大学生中传播流行,必须从新生入校进行相关的专项检测,检出传染源及易感者,针对性的进行治疗预防及相关措施,控制结核病在校园内传播。     

Follow-up study of cancer incidence after chlorophenol exposure in a community in southern Finland

OBJECTIVES: In the 1970s and 1980s, people in a village in southern Finland had been exposed to high concentrations of chlorophenols in the drinking water and in fish from a nearby lake. An ecological analysis and a case-control study conducted around 1990 indicated significant excess in the incidence of non-Hodgkin's lymphoma and soft-tissue cancer in the municipality and a relationship between the chlorophenol exposure and the incidence of these cancers. The present article reports a follow-up of cancer risk in the same study area during a 20-year period after the closing of the old water intake plant, which was contaminated by chlorophenols. METHODS: The observed and expected numbers of cancer were obtained for three periods, 1953-1971 (before exposure), 1972-1986 (during exposure) and 1987-2006 (after exposure), for all cancers combined and separately for cancers potentially related to chlorophenols. RESULTS: The present study demonstrates that all of the cancer risks returned to the average population level during the 20-year period after the old water intake plant was closed and chlorophenol exposure stopped. CONCLUSIONS: The rapid changes in cancer risk after changes in chlorophenol exposure suggest that chlorophenols may have a promotion effect in the carcinogenic process.     

某医科大学学生认知特征及其对抑郁的影响

目的 探讨大学生归因风格、应对方式及功能失调性态度等认知特征与抑郁症状发生之间的关系,为在大学生中开展抑郁高危人群筛查和抑郁的预防干预提供依据.方法 以安徽省合肥市某医科大学为研究现场,以该校临床医学专业一年级298名无抑郁症状的在校大学生为研究对象,分别于0.5a和1 a后进行2次随访调查.结果 参加第1次和第2次随访的学生分别为254人和278人,随访率分别为85.2％和93.3％.Cox回归分析表明,男生抑郁症状发生的危险是女生的2.52倍(95％ CI:1.45 ～4.39),采取消极应对和功能失调性态度异常者均为抑郁症状发生的危险因素(RR=1.65,95％ CI:0.93～2.94;RR =2.11,95％CI:1.22～3.63).结论 悲观归因、消极应对方式和功能失调性态度异常是导致抑郁症状发生的高危因素,三者对抑郁症状的产生可能存在联合作用.消极应对方式和功能失调性态度异常对抑郁的发生具有预测作用.     

Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students

Incidence data on human papillomavirus (HPV) infection are limited, and risk factors for transmission are largely unknown. The authors followed 603 female university students in Washington State at 4-month intervals between 1990 and 2000. At each visit, a sexual and health questionnaire was completed and cervical and vulvovaginal samples were collected to detect HPV DNA. At 24 months, the cumulative incidence of first-time infection was 32.3% (95% confidence interval: 28.0, 37.1). Incidences calculated from time of new-partner acquisition were comparable for enrolled virgins and nonvirgins. Smoking, oral contraceptive use, and report of a new male sex partner--in particular, one known for less than 8 months before sex occurred or one reporting other partners--were predictive of incident infection. Always using male condoms with a new partner was not protective. Infection in virgins was rare, but any type of nonpenetrative sexual contact was associated with an increased risk. Detection of oral HPV was rare and was not associated with oral-penile contact. The data show that the incidence of HPV associated with acquisition of a new sex partner is high and that nonpenetrative sexual contact is a plausible route of transmission in virgins.     

医科大学新生心理社会适应干预效果分析

目的探讨改善医科大学新生心理社会适应能力干预实验的方法、内容和效果,为制定干预措施提供依据。方法采用心理测验量表评价被试的心理社会适应能力。在对560名新生进行基线问卷测查的基础上,通过分层整群随机抽样对223名学生进行了"学校生活技能"干预,对照组为其余337人。干预实验以班为单位进行,每周2学时,共进行5次。干预实验结束后,采用基线测查时所用相同心理测验问卷进行复测。结果干预后干预组的社会适应和人际关系测验总得分均显著高于干预前(P值均<0.05),且干预组均显著高于对照组(P<0.05)。但干预前、后2组学生的应对方式总得分差异无统计学意义(P>0.05)。结论学校生活技能干预对改善医科大学新生的社会适应能力和人际关系状况有一定的效果,但对应对方式的改善效果不明显。     

脑卒中病人鼻饲管直径与肺部感染的相关性研究

目的:研究鼻饲管直径大小与脑卒中吞咽困难病人肺部感染发生率的相关性.方法:将90例脑卒中吞咽困难病人随机分为大口径鼻饲管组、小口径鼻饲管组和静脉营养组,每组30例.观察各组肺部感染发生率,并进行比较.结果:大、小口径鼻饲管组及静脉营养组肺部感染发生率分别为40%,13.33%和36.67%.总鼻饲组肺部感染发生率与静脉营养组相似(P＞0.05).小口径鼻饲管组肺部感染发生率显著低于大口径鼻饲管组及静脉营养组(P＜0.05).结论:鼻饲不会增加脑卒中病人肺部感染发生率,应用小口径鼻饲管可降低脑卒中病人肺部感染的发生率.     

Prevalence of nosocomial infection and antibiotic use at a university medical center in Malaysia.

BACKGROUND AND OBJECTIVE: Most reports of nosocomial infection (NI) prevalence have come from developed countries with established infection control programs. In developing countries, infection control is often not as well established due to lack of staff and resources. We examined the rate of NI in our institution. METHODS: A point-prevalence study of NI and antibiotic prescribing was conducted. On July 16 and 17, 2001, all inpatients were surveyed for NI, risk factors, pathogens isolated, and antibiotics prescribed and their indication. NIs were diagnosed according to CDC criteria. Cost of antibiotic acquisition was calculated by treatment indication. SETTING: Tertiary-care referral center in Malaysia. PATIENTS: All inpatients during the time of the study. RESULTS: Five hundred thirty-eight patients were surveyed. Seventy-five had 103 NIs for a prevalence of 13.9%. The most common NIs were urinary tract infections (12.2%), pneumonia (21.4%), laboratory-confirmed bloodstream infections (12.2%), deep surgical wound infections (11.2%), and clinical sepsis (22.4%). Pseudomonas aeruginosa, MRSA, and MSSA were the most common pathogens. Two hundred thirty-seven patients were taking 347 courses of antibiotics, for an overall prevalence of antibiotic use of 44%. NI treatment accounted for 36% of antibiotic courses prescribed but 47% of antibiotic cost. Cost of antibiotic acquisition for NI treatment was estimated to be approximately 2 million per year (Malaysian dollars). CONCLUSION: Whereas the rate of NI is relatively high at our center compared with rates from previous reports, antibiotic use is among the highest reported in any study of this kind. Further research into this high rate of antibiotic use is urgently required.     

Prevalence of hospital infection and antibiotic use at a university medical center in Hong Kong

Hospital infection prevalence surveys were performed in our 1400-bed University medical centre in Hong Kong from 1985 to 1988. We investigated the rates of four major hospital-acquired infections (HAIs) (pneumonia, symptomatic urinary tract infection, surgical site infection and laboratory-confirmed bloodstream infection) in order to identify current distribution and any changes after 15 years. A one-day point prevalence study was performed on 7 September 2005. All inpatients were surveyed for HAIs, community-acquired infections (CAIs), risk factors, pathogenic isolates and antibiotics prescribed. Infections were diagnosed according to Centers for Disease Control and Prevention (CDC) criteria. In total, 1021 patients were surveyed; of these, 41 had 42 HAIs (4% prevalence) and 389 (38%) were receiving antibiotics. The commonest HAI was pneumonia (1.4%) followed by bloodstream infection (0.9%) and symptomatic urinary tract infection (0.8%). The prevalence of postoperative surgical site infection was 5.6%. The nosocomial prevalence rate was highest in the Intensive Care Unit, followed by the Pediatric and Neonatal Intensive Care Units, Children's Cancer Centre/Bone Marrow Transplant Unit and Orthopaedics with Traumatology. Meticillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa were the commonest pathogens. The rates are significantly lower than previously and reflect the increased resources for infection control made available following the outbreak of severe acute respiratory syndrome (SARS).