Objective By collecting and sorting the information of varicella cases reported in Liaoning Province from 2006 to 2021, the epidemiological characteristics were analyzed, and the monthly incidence data were predicted, so as toexplore the prevention and control strategy of varicella disease in Liaoning Province.Methods By collecting thecharacteristic information of varicella cases in Liaoning Province, epidemiological analysis was carried out on the regional,population, and temporal characteristics of varicella incidence. The monthly incidence data of varicella were fitted with Eviewssoftware, seasonal ARIMA model was used for modeling, and models were selected according to SC and AIC. After modeling,the model was used to predict the incidence data in 2022.Results The incidence rate of varicella in Liaoning Province hasincreased in recent years. The onset time was "bimodal distribution", with the main peak occurring from November to Januaryof the next year and the secondary peak occurring from May to June. Since 2019, the onset age has shifted backward. From theoriginal 0-＜10 age group with the highest incidence rate, it shifted to the 10-＜20 age group with the highest incidence rate.From 2006 to 2021, the incidence of varicella mainly concentrated in people aged 0 to ＜40 years old, and the incidence rate ofthe population over 40 years old showed a cliff-like decline. The incidence of chickenpox was higher in the central region ofLiaoning Province, such as Shenyang, Dalian, Anshan and Panjin, and relatively low in Huludao, Jinzhou, Fuxin and Liaoyang.The distribution of the population was mainly students, followed by kindergartens and scattered children. ARIMA model ofmonthly incidence data was established by software as ARIMA（1, 0, 1）（1, 1, 1） 12 .Conclusions The incidence rate ofvaricella in Liaoning Province has been rising in recent years. The incidence is obviously seasonal, and the age group of theaffected population has moved backward. It is predicted that the incidence will continue to increase in 2022. The preventionand control of varicella should still be the current key work. In order to reduce the population incidence rate, two-dosevaccination strategies should be vigorously promoted the implementation of the, and the inclusion of varicella vaccine in theimmunization program should be achieved as soon as possible.
目的 对一起感染奥密克戎变异株输入病例引起的新型冠状病毒肺炎(以下简称新冠肺炎)暴发疫情调查处置情况进行复盘分析,为新冠肺炎暴发疫情处置提供依据.方法 采用描述流行病学方法对三亚市2022年3月31日-4月15日暴发的新冠肺炎疫情进行描述,绘制传播链,并分析应急处置的经验及不足.结果 本次疫情报告本地新型冠状病毒感染者95例,潜伏期M(P25,P75)为4(3,5)d.95例感染者发现方式中密接筛查、集中隔离、社区筛查、封控区筛查、管控区筛查、主动就诊(检)、重点人群筛查所占比例分别为33.68％、22.11％、18.95％、12.63％、6.32％、4.21％和2.11％.疫情共传播6代,引起聚集性疫情5起,聚集性发病12起.疫情波及三亚市2个区的12个村/居委会、1个酒吧、1家医院、1个小型诊所、1家农贸市场、1家大型商场、1家餐厅.基因测序结果为奥密克戎变异株BA.1.1进化分支.通过第一时间启动应急预案、开展核酸与抗原检测、管控感染者及密切接触者与密接的密接、暂停室内经营场所、中心城区管控、暂时停课等措施,在16d内控制住新冠肺炎疫情.结论 本次疫情传播链条清晰,为输入病例引起的暴发疫情,通过加强关口管理,做好信息共享、对接,及时搜索病例,及时排查、推送、管控风险人群,落实综合控制措施,能有效防范疫情的蔓延,为相关场景疫情控制提供参考.
目的 调查内蒙古地区医疗机构梅毒病例报告质量和诊断准确性,了解报告和诊断中可能存在的问题及影响因素,为梅毒防控措施的制定提供依据.方法 在内蒙古12个盟市中,各随机抽取2个旗县,对其不同类别医疗机构于2019年7月-2020年6月期间报告的梅毒病例进行抽样核查;按照《梅毒诊断(WS 273-2018)》及《全国性病病例报告质量管理方案(2018年版)》中有关指标,对梅毒病例报告质量和准确性进行评价.另外调查医疗机构的基本信息及实验室开展梅毒检测情况,访谈首诊医生了解其对梅毒诊断和报告的掌握,综合分析影响报告准确性的主要因素.结果 内蒙古地区医疗机构梅毒的报告率为99.04％(311/314),漏报率0.96％(3/314);报告及时率98.05％(1 659/1 692),报卡填写完整率99.64％(1 686/1 692),报卡填写正确率99.35％(1 681/1 692),网络录入正确率84.63％(1 432/1 692);不同类型、级别的医疗机构报告及时率(x2=13.95,P＜0.05;x2=11.40,P＜0.05)及网络录入正确率(x2=30.06,P＜0.05;x2=44.93,P＜0.05)差异均有统计学意义.医疗机构梅毒报告准确率86.17％(1 458/1 692),分类正确率为87.06％(1 473/1 692),分期正确率90.25％(1 527/1 692).多因素logistic回归结果显示,临床首诊医生近3年是否参加过培训[OR=6.26,95％CI:(2.12～18.46)]、是否掌握梅毒分期要点[OR=2.79,95％CI(1.21～6.46)]影响报告准确性.结论 内蒙古医疗机构梅毒报告质量水平较高,但报告准确率及网络录入正确率尚未达到95％目标要求,报告和诊断能力仍需提升,建议进一步加大临床医生诊断和报告标准培训力度和覆盖面.
目的 探讨5-氨基酮戊酸(5-aminolevulinic acid,ALA)光动力学疗法(photodynamic therapy,PDT)联合抗真菌药物辅以综合护理干预治疗难治性脓癣的疗效和安全性.方法 针对2019-2022年就诊于海南省第五人民医院的6例难治性脓癣患者进行5-氨基酮戊酸光动力学疗法联合抗真菌药物治疗.将浓度20％的5-氨基酮戊酸溶液均匀滴在棉片上,避光封包3 h后,使用(633±10)nm LED红光照射20～30 min qw,3次为1个疗程.治疗前给予清创、火针预处理,在治疗期间给予及时、针对性的心理护理及健康宣教,缓解患者的负面心理.治疗后6个月内对患者进行随访复查,评估临床疗效、安全性及患者满意度情况.结果 6例患儿接受规范ALA-PDT联合抗真菌药物治疗,辅以综合护理干预,患儿治愈率达100％,均未见病情复发或萎缩性瘢痕.患者及家属满意度100％.结论 ALA-PDT联合抗真菌药物临床效果明显,辅以综合护理干预,有助于缓解患者紧张情绪,可提高脓癣的治疗效果及患者对治疗的依从性,进一步提高患者满意度.
目的 探讨在新冠病毒感染后出现儿童多系统炎症综合征(multisystem inflammatory syndrome in children,MIS-C)合并多器官功能损伤的临床表现、诊断、治疗和预后,并尝试分析MIS-C中类川崎表现与川崎病的区别.方法 报道 1 例确诊新型冠状病毒(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染患儿发生 MIS-C,合并多器官功能衰竭的病例.通过查阅文献对MIS-C的临床症状、诊断、治疗和预后进行探讨复习.结果 该患儿病情进展快,病情重,入院时存在急性肾功能衰竭,尿量8 h 0 mL,血肌酐675.1 μmol/L,尿素氮38.2 mmol/L,肌酸激酶4 932 U/L,同时血清淀粉酶持续升高,最高达5 809.7 U/L,丙氨酸氨基转氨酶995 U/L,天冬氨酸氨基转氨酶240U/L,伴频繁呕吐,为极危重症患者.确诊病例通过儿科重症监护室(pediatric intensive care units,PICU)监护,早期的血液净化,留置十二指肠营养管和静丙联合甲泼尼龙冲击的治疗,最终治愈出院.通过查阅文献分析MIS-C以细胞因子风暴损伤各脏器功能为特点的全身炎症反应,与同样由感染因素触发的急性全身血管炎为特点,最终导致心血管意外为主要死因的川崎病的区别.结论 当发现发热(≥38℃)持续至少24h,高炎症症状,伴有2个系统以上功能障碍,需要重症监护治疗,并且有感染SARS-CoV-2证据的患者时,应该尽早诊断MIS-C并干预治疗,可获得良好预后.
