目的 分析初治病原学阳性且利福平敏感肺结核患者不同阶段T细胞斑点试验(T-SPOT.TB)、结核抗体与痰涂片+培养检测动态变化及临床意义.方法 收集2020年8月至2021年5月北京结核病控制研究所门诊收治的肺结核患者34例,分别于治疗前、治疗2月和6月行以上方法检测.结果 34例患者,疗前痰涂片+培养、T-SPOT.TB、结核抗体阳性检出率分别为85.29％、100％、76.47％;治疗2月阴转率分别为89.66％、5.88％、11.54％;治疗6月阴转率分别为100％、23.53％、26.92％.治疗前、治疗2月和6月之间T-SPOT.TB试验结核特异性抗原与植物血凝素(TBAg/PHA)比值差异均有统计学意义(P值均<0.05),治疗前与治疗2月或6月痰涂片+培养差异有统计学意义(P值均<0.05),结核抗体差异均无统计学意义(P值均>0.05).结论 在有效抗结核治疗6月后,肺结核患者的T-SPOT.TB试验TBAg/PHA比值显著降低;结核抗体不能很好地反映疗效情况;痰涂片+培养亦能够很好地反映疗效.

Objective: To evaluate the application value of the fluorescent PCR probe melting curve （MeltPro） technique in the detection of rifampicin-resistance of Mycobacterium tuberculosis （MTB） in sputum samples. Methods: Sputum samples of primary treated pulmonary tuberculosis （PTB） with positive GeneXpert MTB/RIF from Beijing Center for Disease Control and Prevention between May 2021 and May 2022 were collected. These sputum samples were tested using smear， mycobacterium isolation， and rifampicin-resistance by MeltPro technique. Drug sensitivity test （DST） of rifampicin was used for culturing positive strains， the differences in the detection rate of rifampicin resistance using DST， GeneXpert MTB/RIF， and MeltPro technique were compared. The proportional DST results of rifampicin were used as a standard to evaluate the drug-resistance detection efficiency of MeltPro technique. Results: A total of 158 qualified positive MTB sputum samples were collected， after mycobacterium culture， 130 strains were got. The success rate of the detection by MeltPro technique for rifampicin in sputum samples was 79.1% （125/158）. As the grade of sputum smear results increased， the success rate of MeltPro technique increased from 59.3% （32/54， negative） to 100.0% （18/18， positive， grade +++）; the success rate also increased with the increase of MTB grade detected by GeneXpert MTB/RIF， from 64.5% （20/31， extremely low） to 92.9% （26/28， high）， the differences between each grade were statistically significant （Z=22.271， P=0.001; Z=15.637， P=0.001）. The detection rates of rifampicin resistance using MeltPro technique， GeneXpert MTB/RIF method and proportional DST were 17.5% （22/126）， 12.7% （20/158） and 13.1% （17/130）， respectively. There was no statistically significant difference between the three methods (χ 2 =1.537， P=0.464). Based on the results of proportional DST， the sensitivity， specificity， positive predictive value， negative predictive value， Kappa of MeltPro technique in the detection of rifampicin were 100.0% （17/17）， 94.6% （88/93）， 77.3% （17/22）， 100.0% （88/88）， 0.845， respectively， and were 100.0% （17/17）， 97.3% （110/113）， 85.0% （17/20）， 100.0% （110/110）， 0.906， respectively of GeneXpert MTB/RIF in the detection of rifampicin. Conclusion: The MeltPro technique has high sensitivity and specificity in detecting rifampicin resistance of MTB in sputum samples of PTB， and can quickly and accurately screen the rifampicin resistance; attention should be paid to the quality of sputum samples when promoting the application in grassroots laboratories.

目的:评价二代测序(NGS)技术对临床痰标本中结核分枝杆菌的检测效能.方法:采用前瞻性研究方法,选取北京市疾病预防控制中心(北京结核病控制研究与防治所)2021年8-10月接诊的49例疑似肺结核患者痰标本,同时进行抗酸杆菌涂片镜检(简称"涂片")、分枝杆菌培养(包含罗氏培养和MGIT 960液体培养;简称"培养")、GeneXpert MTB/RIF(简称"Xpert")和NGS技术检测结核分枝杆菌,比较4种方法检测不同分类患者阳性率差异,并以最终临床诊断为参照标准,评价4种检测方法的检测效能.结果:49例疑似肺结核患者中,最终肺结核诊断者40例(包括病原学确诊患者25例、病原学阴性临床诊断患者15例),非肺结核患者9例(包括肺炎6例,非结核分枝杆菌感染、慢性阻塞性肺疾病和哮喘各1例).NGS技术检测49例疑似肺结核患者的阳性率[69.4％(34/49)]明显高于涂片[44.9％(22/49)]、培养[51.0％(25/49)]和 Xpert[49.0％(24/49)],差异均有统计学意义(x2=17.614、17.018、20.753,P值均=0.000);检测病原学阴性肺结核患者的阳性检出率为46.7％(7/15).以临床诊断结果为参照标准,涂片、培养、Xpert、NGS技术对49例疑似患者痰标本的检测敏感度分别为55.0％(22/40)、60.0％(24/40)、60.0％(24/40)、80.0％(32/40),特异度分别为 9/9、8/9、9/9、7/9,一致率分别为63.3％(31/49)、65.3％(32/49)、67.3％(33/49)、79.6％(39/49),Kappa 值分别为 0.310、0.297、0.355、0.459.结论:以临床诊断为参考标准,NGS技术检测的敏感度最高,与临床诊断的一致性也最高,能够快速、高效检测痰标本中的结核分枝杆菌,可早期辅助诊断疑似肺结核患者.

目的 了解北京市复治结核病患者非北京基因型菌株谱系及耐药情况,为复治非北京基因型结核病患者有效防治提供科学依据.方法 采用RD105基因缺失法对复治患者所分离的结核分枝杆菌(Mycobacteriumi tuberculosis,MTB)进行检测,筛查出非北京基因型菌株,使用可变数目串联重复序列基因分型实验分析非北京基因型菌株的遗传特征,再使用比例法药敏实验及全基因组测序分析其耐药情况.结果 134例复治结核病患者所分离的MTB中,北京基因型为125例(93.3％),非北京基因型为9例(6.7％).9例非北京基因型MTB呈现9种不同的基因型,均不成簇,为独特型.9例非北京基因型MTB均为谱系4,其中,亚谱系L4.4有4株,亚谱系L4.5有5株.耐药预测结果显示,9例非北京基因型中,6例为全敏感菌株(66.7％),1例单耐异烟肼,耐药突变位点为ahpC_c.-48G＞A,1例同时耐异烟肼与乙硫异烟胺,耐药突变位点为fabG1_c.-15C＞T,1例单耐氟喹诺酮,耐药突变位点为gyrA_p.Asp94Asn与gyrA_p.Ala90Val.全基因组测序预测耐药结果与比例法药敏结果完全一致.结论 复治结核病患者非北京基因型菌株主要为谱系4,呈明显的多态性.耐药突变位点均为常见突变位点.

了解2013—2019年北京市境外输入性疟疾病例特征,为进一步做好疟疾防控工作提供科学依据.2013—2019年北京市共报告境外输入性疟疾病例614例,死亡10例,非洲输入的病例占95.11％(584/614).所有病例为实验室确诊病例,包括恶性疟504例(82.08％,504/614)、间日疟46例(7.49％,46/614)、卵形疟34(5.54％,34/614)、三日疟20例(3.26％,20/614)、混合感染10例(1.63％,10/614).病例报告无明显季节分布,男女性别比为13.62:1,80.65％的病例集中在20～49岁年龄段,排名前两位的职业是干部职员(35.12％,216/614)和务工人员(25.41％,156/614).614名病例中包括中国籍534例,外籍80例,现居住地分布广,其中现住址在北京的病例占57.00％(350/614),分布于全市15个区.病例的发病—确诊时间间隔中位数是3 d,3 d内确诊比例57.98％(356/614),其中恶性疟3 d内确诊比例为61.71％(311/504).结果表明,北京市输入性疟疾病例较多,且近两年三日疟、卵形疟、混合感染病例有所增加,须继续加强疟疾健康教育宣传和提升实验室检测能力.

采用描述流行病学的方法,分析了近5年北京市输入性伊蚊传播疾病病例的流行病学特征,以评估伊蚊传播疾病本地化风险.近5年来,北京市共输入伊蚊传播疾病病例107例,其中,寨卡病毒病病例3例,黄热病例5例、基孔肯雅热病例2例、裂谷热病例1例、登革热病例96例.寨卡病例均来自委内瑞拉,3例尿液核酸检测阳性,2例唾液核酸检测阳性、1例血标本阳性.5例黄热病病例均来自安哥拉,1例肾衰无尿,其余4例尿液核酸均阳性;1例血液标本阳性(1/5)、2例唾液标本阳性(2/4).1例基孔肯雅热病例2017年来自孟加拉,另1例2019年来自缅甸,分别在入境检疫、入境后体检中发现.登革热病例96例,每月均有病例输入,夏秋季输入病例居多.北京市伊蚊传播疾病输入风险高且本地伊蚊构成比日益增加,存在本地续发感染风险,应加强检疫,提高接诊医生发现、报告意识和高危人群健康教育.

裂谷热是以急性高热为特征的烈性、 病毒性人畜共患病,对畜牧业生产以及人类健康造成严重威胁.本文分析国际疫情形势,结合我国蚊媒种类和季节消长情况,对我国进行输入和传播风险分析.

目的 描述北京市2013-2018年肾综合征出血热(hemorrhagic fever with rental syndrome,HFRS)的时空聚集特征.方法 研究对象是发病日期在2013年1月1日-2018年12月31日现住址为北京市的肾综合征出血热病例,病例信息来源于国家疾病监测信息报告管理系统.乡(镇、街道)人口数据来源于国家统计局.使用SPSS 22.0软件进行统计描述,使用SaTScan 9.5软件进行时空扫描分析.结果 2013-2018年,北京市共报告肾综合征出血热病例74例,年病例数在7～23之间,月发病数在0～6之间,月平均病例数为1.03,单纯时间分析显示发病高峰月份是5月,5月理论病例数应为6.37,实际病例数为15.单纯空间扫描的主要聚集区域为朝阳区与顺义区交界处的6个乡镇街道,次要聚集区域包括延庆区与怀柔区的15个乡(镇).结论 北京市近6年肾综合征出血热存在朝阳区和顺义区交界处的6个乡(镇、街道)和延庆区与怀柔区的15个乡(镇)的聚集发病区域,聚集区域的发现有利于进一步明确并消除危险因素,从而降低肾综合征出血热发病率.

目的 根据2006-2018年北京市登革热病例诊疗信息,分析北京市登革热病例流行病学特征,提出防控措施关键点.方法 采用描述流行病学方法,总结北京市登革热病例输入地来源和人口学特征,并分析登革热潜伏期末至痊愈过程中传播的风险点.结果 2006-2018年北京市累计报告登革热病例233例,病例职业主要为干部职员(35.6％,83/233)、家务及待业(14.6％,34/233)、商业服务(10.7％,25/233)和学生(10.7％,25/233).病例年龄主要为20～ 50岁.病例输入地来源主要为东南亚和南亚(74.7％,174/233).非洲感染的病例占全部病例的11.6％ (27/233).7-10月为病例主要发病时间.54.1％ (126/233)的病例在发病≥7d时才被明确诊断.病例多居住在城区.本市户籍病例仅占47.2％(110/233).结论 登革热疫区的返京病例、疫区共同返京人员和病例在京密切接触人员为北京市登革热防控高危人群.病例防蚊隔离和社区居民广泛参与灭蚊行动能有效降低疫情本地化风险.

Objective To investigate the community composition,species diversity and density of rodents and to explore the infection of Yersinia pestis in Beijing during 2011 to 2018. Methods The surveillance was conducted in the districts of Mentougou,Yanqing,Huairou,Miyun and Shunyi. The species were identified and the density was calculated using the trap -at-night method . The blood samples were collected from the heart of the rodents captured alive by cage-trap method and the anti-Yersinia pestis F1 antibodies were tested using serological method referred to Diagnostic Criteria for plague (WS- 279) . Results There were 1 454 rodents captured during 2011 to 2018. These rodents were classified into eight species. Among them,Niviventer confucianus (43. 5％) ,Apodemus peninsulae (33. 6％) and Apodemus agrarius (11. 6％) could be infected with and spread Yersina pestis. The density of rodents by year changed from 2. 52％ to 6. 02％ (P＞0. 05) ,and the density by district changed from 4. 01％ to 6. 22％ (P＞0. 05) . The highest density (17. 25％) was found in October. The serological F1 antibodies were all negative in 827 blood samples. Conclusion The three rodents with highest density could be infected by Yersinia pestis which are Niviventer confucianus,Apodemus peninsulae and Apodemus agrarius. But no infection of Yersinia pestis are founded by serological test method .

Objective To analyze the spatial distribution characteristics of hemorrhagic fever with renal syndrome (HFRS) cases in Beijing, so as to provide evidences for prevention and control of HFRS. Methods The information of local HFRS cases from 2010 to 2018 were collected and the regional distribution of the current addresses of the cases were visualized by geographic information system at township and subdistrict levels. Spatial autocorrelation method was used to analyze the spatial clustering features of the reported cases, and the hot spot analysis was used to explore the hot spots of HFRS in Beijing. Results From January 1, 2010 to December 31, 2018, 132 HFRS cases were reported in Beijing, including one case reported in 2011 whose current address was missing. The 131 cases distributed accumulatively in 96 townships and subdistricts. The clustering features of reported cases was found in 2011, 2012, 2013 and 2015, with more cases reported in the districts on the north and the south of central city (Xicheng district and Dongcheng district). Spatial autocorrelation analysis indicated that the statistically significant clustering features of the regional distribution were found in year 2012 (Moran's I=0.05, P=0.03), 2013 (Moran's I=0.08, P<0.01), 2015 (Moran's I=0.09,P<0.01) and for the accumulative number of annual reported cases (Moran's I =0.12, P<0.01). Hot spot analysis showed that the hot spots of reported cases were distributed in the northern and southern urban areas and in city-country fringe areas. Conclusions Certain townships and subdistricts in the northern and southern urban areas and in city-country fringe areas were hot spots of reported HFRS cases in Beijing. Surveillance of the cases as well as deratization measures should be used in these areas.

医学科研论文的英文摘要是展示研究成果的重要组成部分,也是论文质量的参考指标之一,体现着作者的科研素养、研究的可信度、以及期刊的水平.而目前许多中文论文的英文摘要质量欠佳.作者从审稿论文中摘录了部分典型错误,涉及词汇、句法、表达等多个层面.词汇层面包括名词、动词、形容词、介词、代词等,句法层面包括冗余和过度简略以及表达习惯上的错误.对于例子中的各类错误,作者都提出了相应的修改建议.由于这些错误均来自真实语料,所以修改和分析具有现实性和针对性.希望通过对于这些错误的整理和归纳,能够对医学科研人员的英文摘要写作提供指导和帮助.

目的 调查昌平区恙虫病的感染现状及危险因素,为制定全区恙虫病的防控策略提供依据.方法 2017年10-12月,在昌平区8个镇随机抽取常住人口开展恙虫病血清流行病学调查并进行危险因素分析.分别采用独立x2检验、分层x2检验及趋势性x2检验进行组间感染率分析.结果 本次调查共检测480份血清样本,其中55份恙虫病IgG抗体阳性,阳性率为11.45％;不同年龄(x2=57.712,P＜0.001)、教育程度(x2=35.257,P＜0.001)、职业(x2=17.222,P＜0.001)和地区(x2=69.469,P＜0.001)人群阳性率的差异有统计学意义.田间劳作(OR=3.03,95％CI:1.31～6.98)和草地行走(坐卧)(OR=3.18,95％CI:1.07～9.46)分别是农民和在职人员感染的危险因素.涂抹防虫剂(OR=0.45,95％CI:0.21～0.98)和外出后洗澡换衣(OR=0.48,95％CI:0.25～0.93)是保护因素.结论 北京市昌平区存在恙虫病隐性感染病例且具有显著的人群和地区差异,提示应加强监测与防控并开展进一步的调查研究.

在恙虫病疫区农村社区医院开展恙虫病早期感染病例筛查研究,选择北京市平谷区发病率较高的王辛庄镇、 峪口镇、 黄松峪乡、 金海湖镇的乡镇卫生院作为筛查医院(筛查组),选择法定传染病疫情报告网(中国疾病预防控制信息系统)疫情上报医院平谷区医院和中医院作为对照组医院,比较同一地区社区筛查和临床诊断恙虫病病例特征的差异,为临床诊疗提供依据.在筛查组和对照组医院选择有流行病学史,具有发热、 淋巴结肿大或皮疹的患者作为研究对象,采集患者的血液标本,采用ELISA和PCR法开展检测.2016年平谷区通过疫情网(对照组)报告恙虫病病例156例,同年9—11月份通过社区筛查发现恙虫病实验室检测阳性病例58例,社区监测病例总体阳性检出率为49.57％,其中9—11月病例阳性检出率分别为38.46％、65.22％和42.11％.两种发现途径的病例性别构成无统计学差异,社区筛查病例中农民构成比高于疫情网报病例(χ2=11.042,P=0.026),监测病例诊断时间早于疫情网报病例.恙虫病早期感染病例临床症状不典型,应在接诊医生和高危人群中开展宣教,密切关注疾病进展,有助于早期诊疗.

[Objective] To analyze the distribution and trend of lung cancer deaths in Shunyi District of Beijing from 2005-2016.[Methods] The death data were collected from the Chinese population death information registration management system and the Death cause monitoring information system in Beijing.Trend x2 test was used to analyze the crude mortality of lung cancer,standardized mortality,proportionate mortality ratio of malignant tumor and proportions of death age.[Results] The crude mortality rate of lung cancer in Shunyi District of Beijing from 2005-2016 was 30.05/lakh (38.77/lakh in males and 21.09/lakh in females).The mortality rate was fluctuating upward,while the crude mortality rate increased from 16.98/lakh in 2005 to 37.75/lakh in 2016,with a significant rising trend (x2=100.87,P＜0.01).The standardized mortality rate increased from 13.48/lakh in 2005 to 27.20/lakh in 2016,with a significant rising trend (x2=-107.73,P＜0.05).In 12 years,the age distribution of lung cancer male deaths showed an aging trend.The proportion of ≥60 year-old age group increased (x2=4.41,P＜0.05),and that of 35-59year-old age group decreased (x2=4.50,P＜0.05),while that of 0-34 year-old age group has not changed significantly.[Conclusion] The mortality of lung cancer shows increase trend but the death age of lung cancer in males shows an aging trend between 2005 and 2016 in Shunyi District of Beijing,which decreases the average potential life lost of lung cancer to some extent.

目的 描述北京市鼠疫媒介蚤的分布特征和种群结构.方法 在北京市西、北的5个区设立监测点,每年4-10月使用笼捕法捕捉活鼠,乙醚麻醉后梳检蚤,鉴定种属后计算染蚤率和蚤指数.结果 调查中,共检鼠666只,捕获蚤类5种100组305只,包括屈褶副角蚤、窄板额蚤、二齿新蚤、印鼠客蚤和多齿细蚤.鼠染蚤率为15.08％,总蚤指数为0.46.野外环境中,岩松鼠有较高的染蚤率(47.93％)和蚤指数(1.84),家栖鼠中褐家鼠体表检出有印鼠客蚤,蚤指数为0.10.结论 北京市优势蚤种为鼠疫媒介效能低的屈褶副角蚤,鼠疫本地传播的可能性较小.

Yellow fever virus (YFV), as the first proven human-pathogenic virus, is still a major public health problem with a dramatic upsurge in recent years. This is a report on four imported cases of yellow fever virus into China identified by whole genome sequencing. Phylogenetic analysis was performed and the results showed that these four viruses were highly homologous with Angola 71 strains (AY968064). In addition, effective mutations of amino acids were not observed in the E protein domain of four viruses, thus confirming the effectiveness of the YFV-17D vaccine (X03700). Although there is low risk of local transmission in most part of China, the increasing public health risk of YF caused by international exchange should not be ignored.

Descriptive epidemiological method, circular distribution methods and SaT Scan 9.4 software were used to analyze the temporal and spatial distribution,and other epidemiological characteristics of dengue fever in Beijing from 2006 to 2016. Arcgis software was used to analyze the spatial distribution of the cases. There were 131 cases of dengue fever enrolling in the present study in Beijing. Circular distribution analysis showed that the peak of dengue fever was on August 25 and the epidemic period of dengue fever was from April 28 to December 23. Dengue cases clustered as a circular region, with radius 10.20 km, centered geographic coordinates 39.98 N, 116.41 E. These dengue fever cases were mainly imported from Southeast Asia and South Asia. The onset date of illness, infection site and address showed temporal and spatial aggregation. The main occupations included staffs, students, housekeeping personnel, unemployed and business servants. The results obtained in the present paper provide scientific basis for the prevention and control of dengue fever.

Objective To describe the epidemiological characteristics,the management and control measures of three confirmed imported patients of Zika virus disease in Beijing.Methods The patients were interviewed,and the information on epidemiological history and clinical manifestation was acquired.The RT-PCR method was employed to test the blood,urine and saliva samples of the patients.The control measure included the quarantine of the patients,disinfection,and health education.Results Morbilliform rash was a common main clinical symptom of the three patients,accompanied by low-grade fevers and conjunctival congestion.All three patients got infected and suffered an onset in Caracas,the capital of Venezuela.They arrived in Beijing in 1,3,7 days after onset and were quarantined from mosquito and hospitalized after self-declare to a quarantine officer.The urine samples of the three patients were positive for Zika virus detected by real-time PCR.Conclusions This report summarized related information of the three imported cases of Zika virus disease in Beijing and discussed the related issues in control measures.And it will be helpful to the management of imported Zika virus disease and other mosquito-borne diseases in the future.

From March to April 2016,5 yellow fever cases imported from Angola were documented by Beijing Center for Diseases Control and Prevention.All the 5 cases were male,with age ranged from 29 to 50 and their occupation including businessman,employee and engineers.One patient died on the 6th day after administration in hospital,other 4 patients survive after proper treatments.Among the cases,only one patient was immunized with yellow fever vaccine two years ago,and clinically,more significant liver and kidney damages were recorded.Therefore,mandatory immunization with yellow fever vaccine should be carried out among those exited for Yellow fever epidemic areas and those with hepatotropism and fever symptoms entranced from these areas should be focused to surveillance and vigilant by doctors.