安徽省农村地区风疹感染基线调查及风疹疫苗免疫效果观察

对安徽省农村地区115名≤2岁～≥23岁的健康人检测了风疹血凝抑制（HI）抗体,结果表明：风疹HI抗体平均阳性率为67．89％;≤5岁儿童为43.85％;育龄期妇女易感率为8．59％。对361名≤2岁～≥23对岁的健康人接种了BRDⅡ株风疹减毒活疫苗,免疫应答研究结果表明：各年龄组对风疹疫苗均有较好的免疫应答反应;免疫前HI抗体阳性者接种风疹疫苗后仍可获得良好的免疫应答．说明我国选育的BRDⅡ株风疹减毒活疫苗具有良好的免疫原性。作者建议：①在全省建立风疹的监测系统;②将风疹疫苗的接种纳入计划免疫管理,实行1岁儿童完成初种及对婚前育龄期妇女给予1剂风疹疫苗的接种方案;③在条件许可的情况下,对全省农村地区14岁以下儿童进行普种．     

2000年粤北山区健康人群风疹抗体水平的分析

目的　了解粤北山区人群风疹感染状况。方法　采用血凝抑制 (HI)试验 ,于 2 0 0 0年对粤北山区 6 15名不同年龄健康人进行风疹HI抗体检测。结果　粤北山区人群平均风疹抗体阳性率、GMRT分别为 30 2 4%、9 99± 5 11,随年龄增长 ,人群风疹抗体阳性率、GMRT均呈上升趋势 (P均 =0 0 0 0 ) ,15岁及以上人群风疹抗体处于较高水平 ,抗体阳性率、GMRT均为 0～ 14岁人群的 4倍 (P均=0 0 0 0 )。 16岁及以上育龄妇女风疹抗体阳性率、GMRT分别为 78 33%、2 6 2 9± 1 19。不同地区、性别人群风疹抗体阳性率、GMRT差异均无显著性 (P均 >0 0 5 )。结论　粤北山区人群风疹抗体处于低水平 ,建议实施 15岁以下人群普种风疹疫苗 ,育龄妇女婚前检查时接种风疹疫苗的免疫策略     

福州市2007年健康人群风疹抗体监测结果分析

目的了解正常人群风疹的免疫状况,探讨风疹免疫策略。方法采用酶联免疫吸附试验（ELISA）检测IgG抗体。结果0—44岁健康人群风疹抗体阳性率为79．71％,≤15岁人群抗体阳性率（69．93％）低于〉15岁人群（88．07％）（X^2=36．936,P〈0．01）,15岁以下农村人群风疹抗体阳性率（85．37％）高于城市（69．43％）（x^2=21．924,P〈0．01）。结论建立完善的风疹监测系统,在实行风疹疫苗免疫规划管理的基础上,对所有15岁以下流动人口进行风疹疫苗免疫,同时对婚前检查的妇女也要免疫接种1剂风疹疫苗。     

大连地区正常人群风疹免疫状况调查

为了解大连市正常人群风疹的免疫状况,我们于1987年6～12月收集了不同年龄正常人血清共555份,测定风疹抗体水平。结果;HI抗体≥1:8者431份,阳性率77.66%,GMT为21.57。其中5岁以下儿童风疹抗体的阳性率为11.8%～71.4%,GMT为5.42。<1岁时阳率为11.8%,11～15岁时为84.62%,16岁以上阳性率     

余杭市接种风疹疫苗前人群风疹抗体水平调查

本文调在接种风疹疫苗前人群风疹抗体水平,余杭市健康人群风疹HI抗体阳性率63.24％,GMT1:32.28.抗体阳性率<5岁儿童最低(8.05％),5岁以后急剧上升,15～19岁达高峰.男女抗体阳性率无差异.     

潍坊市坊子区风疹和流行性腮腺炎抗体水平检测

目的了解潍坊市坊子区健康人群风疹、流行性腮腺炎（腮腺炎）抗体水平和自然感染情况。方法采集潍坊市坊子区1～≥70岁健康人群血清标本843人份,采用血球凝集抑制（HI）试验检测风疹和腮腺炎抗体。结果风疹抗体共检测血清843份,抗体阳性率83．51％,几何平均滴度（GMT）1：93．96。腮腺炎抗体共检测血清834份,抗体阳性率71．46％,GMT1：4．76。结论由于〈5岁儿童风疹感染率为58．64％,腮腺炎感染率为38．58％,建议对≤5岁儿童进行风疹和腮腺炎疫苗查漏补种工作。     

2002年睢宁县正常人群麻疹血清抗体水平抽样调查

[目的]了解睢宁县正常人群麻疹免疫水平。[方法]2002年采用微量血常规法对2～4岁、6～8岁、13～15岁、25～49岁的756名正常人群检测麻疹血凝抑制抗体(HI)。[结果]检测756人，麻疹HI抗体阳性率为99．21％，几何平均滴度(GMT)为30．68。抗体阳性率4个年龄组为98．69％～99．54％；2～4岁组GMT较低，6～8岁、13～15岁较高。[结论]睢宁县正常人群中已经形成了可靠的麻疹免疫屏障。     

莱芜市1999-2001年麻疹实验室检测结果分析

[目的]了解人群麻疹免疫状况，评价麻疹实验室检测质量。[方法]采用ELISA法检测麻疹特异性IgG和麻疹、风疹IgM抗体。[结果]1999—2001年监测1—39岁易感人群542人，麻疹IgG抗体阳性率为83．8％，GMT为1：822．52；不同年龄组人群抗体GMT差异显著，以15—19岁最低。检测疑似麻疹病例发病早期血清标本379份，麻疹IgM检出率11．1％，而风疹IgM检出率72．8％；标本来集及时率等反映检测质量的指标均达到目标要求。[结论]本地区自然人群麻疹免疫水平较高，短期内仍以散发为主，开展实验室诊断，为及时控制疫情、降低麻疹发病率．起到了重要作用。     

宜宾市儿童麻疹病毒抗体水平调查

目的：了解宜宾市7岁以下儿童麻疹疫苗普种后的免疫现状。结果：7岁以下儿童HI抗体总阳性率为86％,GMRT为30．7,抗体水平随年龄增长而下降,1－3岁儿童HI抗体滴度≤1：16者占34．1％,4－7岁组儿童HI抗体滴度≤1：16者占53．1％,两年龄组间差异显著（P＜0．01）。结论：宜宾市儿童免疫状况总体良好,但仍有麻疹易感人群的存在。建议对4岁以上儿童进行复种,同时提高疫苗接种质量。     

志丹县健康人群麻疹、风疹及腮腺炎抗体水平监测分析

目的了解志丹县健康人群麻疹、风疹、流行性腮腺炎（腮腺炎）抗体水平,为制定预防控制策略提供科学依据。方法采用分层随机抽样抽取志丹县健康人群280人,分为〈1岁、1～2岁、3—4岁、5～6岁、7～14岁、15～19岁和≥20岁7个年龄组,每组随机抽取40人,采集血清;采用酶联免疫吸附试验法（enzyme—linkedimmu—nosorbentassay,ELISA）检测麻疹、风疹、腮腺炎IgG抗体,同时调查其患病史、免疫史及人口学特征。结果麻疹、风疹和腮腺炎抗体阳性率分别为94．64％、80．71％和57．50％;抗体几何平均浓度（geometricmeanconcentration,GMC）分别为2702．89IU／L、177．48IU／L和350．28U／L。结论麻疹抗体阳性率高于风疹、腮腺炎抗体阳性率,0～19岁腮腺炎抗体阳性率随着年龄的增加而逐渐升高,接种疫苗可以显著提高抗体水平,应继续加强儿童麻风疫苗和麻腮风疫苗接种。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。     

244株真菌鉴定结果分析

目的 了解某院2000～2001年各类真菌的检出率。方法 用酵母样真菌同化试验编码鉴定板TH-15进行编码鉴定。结果 真菌分离率为8．85％；244株真菌分为10种，其中以白色念珠菌和热带念珠菌较高，分别占真菌总数的75．41％和11．47％；检出真菌的主要标本是痰和阴道分泌物。结论 及时进行真菌培养，有利于合理使用抗菌药物和控制真菌感染。