目的 探索在医院-家庭-社会体系下改善乳腺癌术后患者生活质量的有效的心理干预模式.方法 利用癌症生命质量核心问卷(EORTC QLQ-C30)对人选对象进行评估,并对数据资料进行t检验和方差分析,P＜0.05为差异有统计学意义.结果 乳腺癌患者在手术期生活质量较差(49.12±10.39),与乳腺良性肿瘤患者相比,差异有统计学意义(P＜0.05).心理干预可有效改善乳腺癌根治术后患者的生活质量(54.98±13.37),较干预前差异有统计学意义(P＜0.05),与良性患者比较,差异无统计学意义.结论 在医院-家庭-社会体系下建立综合性干预模式,开展针对性的心理干预,能有效改善乳腺癌根治术后患者的生活质量.
Objective To investigate the status of alcohol drinking and the family-related factors among hypertension patients in Fujian,and to provide scientific reference for carrying out family health education.Methods A total of 863 hypertension patients were investigated with family APGAR index(APGAR) and self-designed questionnaire.Results 24.0% of the hypertension patients were alcohol drinkers.Logistic regression analysis revealed that female(OR=0.557),low level of education(OR=1.846),abnormal marriage(OR=2.467),family disharmony(OR=1.494),poor family care(OR=2.460) and family dysfunction(OR=1.719)were associated with alcohol drinking.Conclusion The rate of alcohol drinking is high in the patients suffered from hypertension.The behavior is related to family structure,family function and family relationships.It is important to strengthen intervention of alcohol drinking in hypertension patients.
Objective To investigate the AIDS-related knowledge and behaviors among sexually transmitted disease(STD) clinic patients in Anhui province,and to provide basis for developing effective behavior intervention plans.Methods Patients attending the STD clinics in Huaibei,Chuzhou and Anqing city of Anhui province were enrolled in this study.A standard questionnaire was used to investigate the AIDS-related knowledge and behaviors of the participants.Results The participants had a lower prevalence rate of HIV(0.53%) and a higher level of awareness of AIDS-related knowledge(67.5%) expect the knowledge of non-transmission routs of having dinner with the patients(12.78%) and mosquito bite(23.07%).The rate of condom use was low in the participants.Only 19.84% of the participants had reported having used condoms during every commercial sex in the past three months.Conclusion Patients attending STD clinics are at risk for infection with HIV.Intervention skills should be promoted and voluntary counseling and testing for HIV/AIDS should be widely introduced to the STD clinic patients.
目的 了解南平市市售食品中食源性致病菌污染状况及分布和高危食品种类.方法 在全国食品污染物监测网与食源性疾病监测网控制体系下,2007-2009年采集4个监测点内的7大类市售食品共计208份,对沙门菌、单核细胞增生性李斯特菌、O157:H7出血性大肠埃希菌、金黄色葡萄球菌以及副溶血性弧菌5种食源性致病菌进行监测分析.结果 208份食品样品中,分离出目标菌38株.总检出率18.27%.其中生肉类、水产品检出率最高,分别为38.46%(15/39)和73.08%(19/26),其次为速冻米面,检出率20.00%(4/20).监测的5种食源性致病菌均有检出,各类食品中沙门菌和副溶血性弧菌的检出率最高,分别为33.33%和50.00%;O157:H7检出率为0.68%;金黄色葡萄球菌及单核细胞增生性李斯特菌检出率为4.22%和1.79%.O157:H7经毒力检测存在产志贺毒素.结论 通过连续3年对南平市市售食品中食源性致病菌的主动监测,掌握了食源性致病菌的污染状况、高危食品以及5种食源性致病菌在不同食品中的分布情况.
Objective To explore the clinical effects and safety of Narcotrend monitor(NT) in total intravenous anesthesia.Methods Two hundred and eight patients(ASA grade Ⅰ-Ⅱ) undergoing selective general anesthesia were randomly divided into observation group and control group(n=104 for each group).The NT was used in observation group but not in the control group to monitor the anesthesia depth of patients.The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),pulse oxygen saturation(SpO2),NT stages(NTS) and NT index(NTI) were determined on the time points of entering the operation room,anesthetic induction,intubation,skin incision,entering the abdomen,abdominal exploration,closing the abdomen,sewing skin,awareness recovery,post-anesthesia tracheal extubation,and going out the operation room.The total doses of sedatives and muscle relaxant,the recovery time,the extubation time and the incidence rate of intraoperative awareness were recorded.Results The vital signs were stable in patients of both groups.The MAP and HR were more stable in observation group than those in control group(P0.05).The doses of midazolam,propofol,remifentanil and doxapram used in patients of observation group were significantly fewer than those in control group.Compared with those of control group,the recovery time,the extubation time and the incidence rate of intraoperative awareness were significantly decreased in the observation group(P0.05).Conclusion With NT,the doctor can use fewer sedatives and get the best anesthesia effects,shorter recovery time and reduce the incidence of intraoperative awareness.
Objective To explore the major causes of death among AIDS patients underwent highly active anti-retrovirus therapy(HAART) and to provide basis for reducing mortality and improving therapeutic effects . Methods The data of 1 346 patients enrolled in this study were from the national comprehensive prevention and treatment database.The data were analyzed by SPSS 13.0.The mortality rate was calculated by cases per 100 person-year,and the relevant factors,which might affect mortality,induding clinical conditions and baseline CD4 count were analyzed. Results From 2003 to 2008,there were 1 346 AIDS patients received HAART and 221 death cases occurred since initation.Of the 221 death cases,198 died from AIDS-related diseases and 23 non-AIDS related diseases.The crude death rate was 13.6 per 100 person-year.The survival rate at 12 months was 14.0% and 19.8/100 person-year.Before entering treatment,94.9%(188/198) of the death cases had clinical symptoms,and 77.3%(153/198)of them ever suffered with more than two symptoms at the same time.Baseline CD4 counts of the 198 death cases had statistical differences among group 50,50-200,200(cell/mm 3).Baseline CD4 counts also had statistical difference between patients who survived within one year and over one year. Conclusion Survival rate of patients in HAART varies much in first 12 months.Death rate is strongly relevant with baseline CD4 count and general conditions of the patients.Early finding,timely treatment,and comprehensive social supporting system can contribute a lot to lower mortality and better therapeutic effect.
Objective To explore the preventive effect of resveratrol on gastric carcinogenesis induced by MNNG associated with other risk factors in wistar rats.MethodsNinety-five male wistar rats were randomly divided into the normal control group(10 rats),the model group(25 rats) and the low-does resveratrol group(50 mg/kg),middle-does resveratrol group(100 mg/kg),and high-does resveratrol group(150 mg/kg)(20 rats in each group).All rats except those in the normal control group were administered with MNNG etc to induce gastric cancer,at the same time,resveratrol was administered to the low-,middle-and high-does resveratrol groups.The weight change and the occurrence of gastric cancer in the rats were observed.ResultsThe mean weights of rats in all groups exposed to MNNG was lower than that of normal control group,and the mean weight in the model group was lower than that of the groups administered with the middle or high does resveratrol(P0.05).The rat mortality in the model group(68.0%,17/25) was higher than that in the middle-deos(35.0%,7/20) and the high-deos resveratrol group(30.0%,6/20)(P0.05).Eight rats developed the gastric cancer in the model group,which were more than that of the low-does(5 rats),middle-does(5 rats) and high-does resveratrol group(4 rats),but the statistic significance was not observed(P0.05).ConclusionResveratrol has benefit to prevention of MNNG-induced gastric cancer in the wistar rats.
Objective To investigate the malaria infection status among returned laborers from malaria-endemic countries,and to formulate a proper measures for malaria prevention and control.Methods The basic information of imported malaria cases reported by different levels of clinical institutes was filled in case-questionnaire.The earlobe blood samples of the cases were collected for microscopic examination and PCR detection.Results Of 238 returned laborers from malaria-endemic contries,38 were diagnosed with malaria,among whom 65.79% were infected with falciparum malaria,and 34.21% untyped malaria.94.74% of the cases worked in Angola,and 78.95% of the cases were diagnosed as malaria in Africa due to fever,with average 3.2 times of recurrence for each case.The prevalence of malaria among the returned laborers was 63.86% during their working in Africa.The positive rates were 23.56% and 11.72% respectively for microscopic examination and PCR detection,81.93% of the laborers received a course of malaria complementary therapy after return to China.Conclusion Returned laborers from malaria-endemic countries have a high malaria infection rate.It is necessary to take standard treatment as early as possible if the results of blood smears are positive.And it is essential to strengthen malaria surveillance,enhance the skill training of medical workers,and popularize the knowledge of malaria prevention and control.
Objective To investigate the epidemiological characteristics of hepatitis A in Gansu province,2008.Methods The data of patients with hepatitis A were collected from the Disease Surveillance and Reporting System.The population data were obtained from the Gansu Yearbook 2008.The epidemiological characteristics of hepatitis A was described and the two-step clustering method was used to analyze the data.Results The incidence rate of hepatitis A was 16.82/100 000 in Gansu province,20008.Children and adolescents aged below 20 years accounted for 49.92% of the total patients.52.01% of the patients suffered from the disease during July and November,and the incidence peak was in October.Significant differences in incidence rate of hepatitis A were found among different areas of Gansu province,and the western and southern areas had higher incidence rates of hepatitis A.The cluster analysis classified the patients into 2 categories(farmers and non-farmers).Most farmer patients were elderly,and mainly suffered from the disease during the first half of the year.The majority of the non-farmer patients were younger,and usually suffered from the disease in the second half of the year.Conclusion The prevalence of hepatitis A is high in Gansu province.The regional,occupation-related and age-related differences in hepatitis A prevalence are found in Gansu.Viral hepatitis A immunization should be promoted in the high-risk population and prevention and control measures should be adopted.
Objective To analyze the characteristics of evolution and mutation of 2009 H1N1 influenza viruses from China.Methods The sequences of HA、NA、M of the viruses were download from NCBI Genbank.Multiple sequences analysis were done by the software of ClustaX,and sequence homology analysis by Bioedit,then phylogenetic trees were constructed by Mega 4.0.Results 2009 H1N1 influenza viruses from china were homologous with the strain of A/California/04/2009(H1N1) which was isolated from USA.The sequences of HA、NA、M proteins isolated from different provinces of China were reciprocal chiasmata in the phylogenetic trees,but the HA proteins were formed groups by each provinces.The phylogenetic and homology analysis suggested that the strain isolated fom Hong Kong[A/Hong Kong/2369/2009(H1N1)]and Shanghai[A/Shanghai/LWS1/2009(H1N1)]had devoloped a drug tolerance of Oseltamivir,and only the strain from Shanghai[A/Shanghai/LWS1/2009(H1N1)]was sensitive to adamantanamine,the others were drug resistance.Conclusion 2009 H1N1 influenza viruses from China are not only conserved but also regiospecific.The 2009 H1N1 viruses maintain stability,and no significant mutation is found.
Objective To find out the regional distribution of the high-risk human papillomavirus(HPV)subtypes and the incidence of cervical diseases.Methods A total of 7 199 cases of cervical diseases visited the People′s Hospital of Yuyao during October 2006 and December 2008 were subjected to HPV genotyping test and the three-step diagnosis of cervical diseases.Results Out of 7 199 cases,2 443 cases were infected with HPV.The infection rate was 33.94%(2 443/7 199).The regional distribution of high-risk HPV subtypes ranked as follows:HPV-16,58,18,33 and 31.The peak age of infection was 21-30 years.Farmers,freelancers and low-educated persons were high-risk populations.There were 6 944 cases(96.46%)diagnosed with cervical mucous membrane inflammation,206 cases(2.86%)with cervical intraepithelial neoplasia(CIN),49 cases(0.68%)with cervical cancer.There were significant differences in distributions of HPV subtypes and HPV infection rate between patients with cervical mucous inflammation and patients with CIN(P0.001).There were signifcant differences in infection rates of HPV and HPV-16 subtype among patients with CIN of different degrees(P0.001).The patients with CIN were mainly aged 31-50 years,and 31-40 years were the peak ages of incidences.The incidence of CIN Ⅲ was higher than those of CIN Ⅰ and CIN Ⅱ in patients having more than 16 years of sexual life(P0.005).Conclusion The regional distribution of high-risk HPV subtypes is ranked as follows:HPV-16,58,18,33,31.The HPV infection rate increases with the increasing severity of cervical diseases.HPV-16 subtype shows the strongest pathogenicity.The latency from HPV infection to the occurrence of CIN lesions is about 10 years.
Objective To investigate the epidemic characteristics of varicella in Guandu district,Kunming city,and to provide scientific basis for control of varicella epidemic. Methods Data of 2 153 cases with varicella were collected and analyzed to reveal the epidemiological characteristics of varicella during 2005 and 2008. Results A toatl of 2 153 cases of varicella were confirmed in Guandu district during 2005 to 2008,with no death reported.The average annual incidence was 55.45/100 000 person-years.The cases occurred each month of the year,with two peaks in May to June(21.83%),November to December and January(36.04%).The disease was seen in all age groups.There were 1 932 cases aged below 14 years old,accounting for 89.74% of all the patients.The cases with varicella were mainly students,which accounted for 46.45% of the patients. Conclusion Comprehensive measures including epidemic surveillance,case investigation,health education,disinfection and isolation,as well as varicella vaccination should be adopted.
Objective To evaluate the quality of direct network report,and to analyze the distribution and causes of death.MethodsThe death data reported by the direct network reports in Pingyin County during 2007 and 2009 were analyzed.ResultsThere were total 1 201 death cases reported by the direct network reports during 2007-2009(348 reported in 2007,379 in 2008 and 474 in 2009),accounting for 15.66%(1 201/7 671)of the death cases reported by the public security bureau.Among the 1 201 death cases,50.88% were located in Pinyin Town;1.52% aged 0～years;62.37% were males and 58.62% were peasants.40.80% of the cases died of circulatory system diseases,25.32% died of cancers,and 16.53% accidents.ConclusionThe quality of direct network reports should be improved to provide complete death data.
目的 探讨重症、轻症手足口病临床表现及就诊过程中的影响因素,为手足口病防控、管理提供科学依据.方法 单纯随机抽取开封市102例手足口病病例开展病案和电话调查,对病人的临床表现及就诊情况进行分析.结果 手足口病临床表现以发热(78.43%)、出疹(99.02%)多见;57.84%可见精神差、惊颤、呕吐、咳嗽等其他症状;37.25%出现病毒性脑炎、支气管炎等并发症和合并症.重症与轻症病例相比最高体温较高(t=3.86.P<0.05)、先发热后出疹的较多(Y2=4.96.P(0.05)、可见嗜睡、肢体肌阵挛等特有症状且出现较晚,首诊不易确诊(X2=12.77,P<0.05).首诊医院中,县及县以下医院就诊率重症高于轻症(X2=16.32.P<0.05).但确诊率重症低于轻症(X2-5.27,P<0.05).结论 本研究结果表明,重症手足口病病例早期症状不典型,县及县以下基层医院易误诊.建议开展基层医务人员手足口病诊治技术培训,提高对手足口病的诊断鉴别能力.
Objective To investigate the expression and clinical significance of Caspase-3 in colorectal carcinoma(CRC),and to evaluate its role in tumorigenesis and progression in human CRC.Methods Sixty-six CRC,twenty-three adenomatous polypi and ten normal colorectal mucosal tissue specimens were detected for the expression of Caspase-3 by immunohistochemistry method.The association between the expression of Caspase-3 and the clinicopathological features was analyzed.Results The expression rate of Caspase-3 was significantly higher in CRC tissue(75.8%) than that in adenomatous polypi tissue(56.5%),while no significant differences in Caspase-3 expression rate were found between CRC tissue and normal tissues(70.0%) as well as between adenomatous polypi tissue and normal tissues.The expression of Caspase-3 in CRC tissues was associated with gender,and was not associated with ages,tumor size,tumor site,differentiation degree,lymph node metastasis,distant metastasis and TNM stages.Conclusion The Caspase-3 expression level is lower in polypi tissue than those in normal tissues and human CRC,which suggests that low expression of Caspase-3 may play some roles in early tumorigenesis of human CRC.
Objective To investigate the epidemiological characteristics of rabies in Yunnan province,and to provide basis for rabies prevention and control.Methods The epidemic data and case report data in Yunnan in 2008 were collected.Descriptive epidemiological analysis was used to analyze the data.Results One hundred and eight cases of rabies were reported in Yunnan province in 2008.The cases were reported from 20 counties/districts of 6 prefectures/cities.The incidence rate was 0.25/100 000.The ratio of males to females was 2.6∶1.Farmers were the dominant victims as a result of dog bites.The elders and the children were the most common patients.The incubation period ranged from 5 days to 12 years(mostly,1-3 months).The course of disease ranged from 1 day to 13 days(mostly,2-4 days).Forty-four of 108 cases did not effectively clean the wound after animal bites.Ninety-one cases did not inoculated against rabies.Conclusion Rabies cases are widely distributed in North-east and South-east parts of Yunnan province.Low immunity rate in dogs and the lack of preventive knowledge among people contribute to the prevalence of rabies.Dog management should be strengthened to ensure all dogs be vaccinated against rabies.Rabies education including post-exposure treatment of wound should be adopted.
Objective To confirm the infection source of the first human case of avian influenza A(H5N1) in North Fujian for the disease control and prevention.Methods The field epidemiological study and the laboratory tests were performed.Results Avian influenza virus-specific nucleic acids were detected in throat swab,gargle specimens and lower respiratory tract secretions of the patient,and the H5N1 virus was isolated from the samples.Conclusion This case is comfirmed to be infected with avain influenza.The infection source may be dead poultry.
了解具有硕士学位公共卫生人员的培训需求.采用问卷调查方法,对195名曾就读中国疾病预防控制中心公共卫生专业硕士研究生、现已返回单位的公共卫生人员的培训需求进行调查.有98.5%的调查对象表示需要接受培训.期望每次培训天数平均为8.6 d,单位级别和职称越低者所需要的培训时限越长.期望每年接受培训次数平均为3.9次,83.8%的调查对象需要每年参加2～5次培训.选择案例分析培训方法者最多(86.7%),选择理论讲授者最少(46.7%).选择进修学习者最多(56.9%),选择课堂培训者最少(17.0%).具有硕士学位的公共卫生人员偏重选择实践型技能培训,如进修学习、案例分析和实践操作等.
目的 寻找科学合理地预防和控制手足口病引起的医院内感染暴发流行的方案.方法 收集阜阳市人民医院就诊的1970例手足口病患者的资料,分析各组平均年龄以及各年龄组发病的分布情况.根据患者病情制定合理的治疗方案.采用"分层分区"的治疗方法,并采取消毒隔离措施以预防和控制医院内感染.结果 共诊治手足口病患者1970例,死亡18例(其中16例死亡病例是在手足口病流行初期,由于诊治经验不足所致).余均痊愈出院,未发生医院内感染.手足口病患者平均年龄为(2.85±2.72)岁,而病重的手足口病患者平均年龄为(1.93±1.07)岁.病重组与总患病组的平均年龄比较,差异有统计学意义(t=3.10.P<0.01),但两组病人的年龄分布特点一致·均以1～3岁感染率最高.结论 本研究结果表明,合理的诊治方案,严格的消毒、隔离措施,可有效地预防控制手足口病的传播.
为了解永登县农村集中式供水现状,为该县进行农村改水工作,制定农村饮水安全工程规划,保障农民身体健康提供科学依据,2008年1～12月我们对永登县部分农村集中式供水现状进行调查. 1对象与方法 1.1 对象 随机抽取永登县11个农村集中式供水点为调查对象,以一个集中式供水点为一个检测点,检测点能反应我县农村集中式供水现状.
