目的 对泰州地区40岁及以上人群进行慢阻肺(COPD)筛查,探讨泰州居民COPD患病情况及其相关危险因素,为本地区COPD的防治和政策制定提供科学依据.方法 选取泰州市40岁及以上常住居民作为研究对象,通过分层整群随机抽样的方法 抽取样本进行问卷调查和肺功能检测.结果 本次共调查8816人,COPD患病率为7.20％,男性患病率(10.88％)高于女性(4.25％)(χ2=142.89,P<0.05).多因素logistic回归分析结果 显示,男性、≥70岁、吸烟、BMI<18.5kg/m2、小学及以下文化程度、儿童期患过呼吸系统疾病、不进行规律运动是泰州市40岁及以上人群COPD的危险因素.结论 应加强对重点人群的健康教育和干预,对各类危险因素加以控制.

目的 了解家长对儿童伤害的认知以及态度,为今后开展儿童伤害预防工作提供依据.方法 采取整群抽样的方法,抽取泰州市高新区9所幼儿园以及0～2岁散居儿童的家长为研究对象,利用网络平台进行问卷调查.结果 泰州市高新区家长对儿童预防伤害的态度以及相关知识认知的合格率(>60％)分别为95.64％、87.76％,均处于较高水平,但对相对专业的安全知识的掌握情况较差.多因素回归分析显示,儿童年龄大以及未入幼儿园、本地户籍、作为主要照料者、文化程度高、与儿童交流时间长的家长其预防儿童伤害知识知的晓率较高;家长对待伤害的态度正确率与是否有入有园儿童、是否作为照料者、文化程度,以及与儿童交流时间长短有一定的关系(P<0.05).结论 有必要开展预防儿童伤害的专项教育活动,以提高监护人相关专业知识水平;针对低文化程度家长的宣传教育尤为重要.另外,儿童入园后,家长对儿童伤害安全态度得分有一定程度的下降,仍需不断加强安全教育的干预,端正看护态度.

ObjectiveTo examine the relationship between intestinal flora and bone mineral density among rural Han residents aged 55 – 65 years in Taizhou city, Jiangsu province for exploring novel approaches to osteoporosis prevention. MethodsUsing cluster random sampling, we recruited 537 rural Han long term (≥ 20 years) residents aged 55 – 65 years in 3 villages with more compliant followees and high response rate in a cohort for multidisciplinary and multiple diseases research – the Taizhou Longitudinal Study. Questionnaire interview, physical examination, bone density measurement and stool specimen detection were carried out among the selected residents from March 2013 through October 2018. The residents were then assigned into one of the 3 groups with normal bone density, osteopenia and osteoporosis based on bone density measurement according to the diagnostic criteria of World Health Organization. Differences in intestinal flora among the 3 groups and the correlation between intestinal flora and bone density were analyzed. ResultsOf all the participants, 38.55% (207), 44.51% (239), and 16.94% (91) were assessed with normal bone density, osteopenia, and osteoporosis, respectively. After adjusting for variables such as gender, age, body mass index (BMI), smoking and alcohol drinking, the results of partial correlation analysis showed that intake frequency of fresh vegetables (β = – 0.125), fresh fruits (β = – 0.101), meat (β = – 0.098) ) and yogurt (β = – 0.033) were reversely correlated significantly with bone mineral density grouping (all P < 0.05). Compared with those in the normal bone density group, the intestinal abundances of Clostridium, Blautia, Campylobacter, Escherichia, Streptococcus, Actinomyces, Shigella, Anaerostipes, Streptomyces and Atopobium were significantly decreased in both osteopenia and osteoporosis group; but the intestinal abundances of Corynebacterium, Veillonella and Brevundimonas increased in osteopenia and osteoporosis group (all P < 0.05). After adjusting for confound-ing factors such as gender, age, BMI, smoking, alcohol drinking, and intake frequency of fresh vegetable/fresh fruit/ meat/yogurt, the results of unconditional multivariate logistic regression analysis showed that the increased intestinal relative abundance of Escherichia (odds ratio [OR] = 0.992, 95% confidence interval [95% CI]: 0.985 – 0.999), Shigella (OR = 0.984, 95% CI: 0.970 – 0.998), Blautia (OR = 0.959, 95% CI: 0.924 – 0.996) and Fusicatenibacter (OR = 0.980, 95% CI: 0.962 – 0.998) are protective factors for the occurrence of osteopenia in the residents; the intestinal relative abundance of Faecalibacterium (OR = 1.060, 95% CI: 1.006 – 1.118) is a risk factor for osteoporosis incidence, while that of Mogibacterium (OR = 0.865, 95% CI: 0.763 – 0.981) is a protective factor for osteoporosis incidence. ConclusionIn 55 – 65 years old rural Han residents, intestinal flora may associate with bone density; increased intestinal abundance of Escherichia , Shigella, Blautia, Fusicatenibacter, Faecalibacterium, and Mogibacterium could affect bone mineral density of the population.

目的 了解靖江市居民慢性病核心知识的掌握情况,为指导慢性病预防提供科学依据.方法 采用整群随机抽样的方法 ,在各乡镇卫生院和市人民医院服务范围内随机抽取1个村,对所抽取村15岁及以上的常住居民进行问卷调查.结果 5,548名居民的慢性病核心知识的平均知晓率为71.73％;男性平均知晓率(72.65％)高于女性平均知晓率(70.81％),差异具有统计学意义(P<0.01);随着居民文化程度的提高,核心知识的知晓率相应提高,不同文化程度核心知识知晓率差异具有统计学意义(χ2=995.45,P<0.01);不同职业人群的知晓率差异具有统计学意义(χ2=355.39,P<0.01).结论 在慢性病预防方面,应在了解当地人群核心知识知晓情况的基础上,对居民进行有针对性的干预.

Objectives: Loss of bone mass may affect the progression of atherosclerosis. We investigated the relationship between low bone mineral density (BMD) and subclinical atherosclerosis in rural China. Methods: In total, 333 men and 421 postmenopausal women aged 55–65 years were enrolled. BMD was measured in the lumbar spine, femoral neck, and total hip using dual-energy X-ray absorptiometry. Subclinical atherosclerosis was defined as increased carotid artery intima-media thickness (CIMT ≥0.9 mm), the presence of carotid plaques, high brachial-ankle pulse wave velocity (baPWV ≥1,400 cm/s), and low ankle-brachial index (ABI ≤1). Binary logistic regression analyses were used to estimate the association between low BMD and subclinical atherosclerosis. Results: There was no significant difference in BMD between the normal group and the subclinical atherosclerosis group. After full adjustment for the relevant covariates, a boundary significant association was found between low BMD in the femoral neck and baPWV in postmenopausal women (odds ratio = 1.77, p = 0.049). After full adjustment, neither BMD nor low BMD were significantly associated with subclinical atherosclerosis in men or postmenopausal women. Conclusions: Low BMD is not associated with subclinical atherosclerosis in Chinese individuals aged 55–65 years resident in rural China.

目的 评价线性探针(HAIN)技术快速检测耐药结核病及耐多药结核病(MDR-TB)的临床应用效果.方法 应用HAIN技术和传统比例法药敏试验(简称“药敏法”)检测300株结核分枝杆菌临床分离株的耐药性,以药敏法结果为金标准,分析HAIN技术对诊断耐药结核病及耐多药结核病的特异性、敏感性和符合率.结果 HAIN技术检测与药敏法检测临床毒株耐药率和耐多药率结果差异均无统计学意义(P值均＞0.05).HAIN技术检测菌株对利福平耐药性的敏感性、特异性和符合率分别为96.30％、99.20％和99.33％;对异烟肼耐药性的敏感性、特异性和符合率分别为97.47％、99.09％和99.33％;对MDR-TB耐药性的敏感性、特异性和符合率分别为92.86％、99.27％和99.33％.HAIN技术检测时间一般为≤6h,药敏法为4～6w.结论 HAIN技术能够快速检测耐药、耐多药结核病,可在有条件的实验室进行推广.

目的 了解高港区＞65岁老年人意外伤害死亡情况、构成特点.方法 下载2011-2015年高港区网络报告的死亡数据,对＞65岁老年人意外伤害死亡资料进行分析.结果 2011-2015年高港区＞65岁老年人意外伤害平均死亡率为177.01/10万,占全人群意外伤害死亡的37.82％;＞65岁老年人意外伤害死亡率男性大于女性,差异有统计学意义(P＜0.05);跌落居老年人意外伤害死亡首位(占26.14％),其次分别为交通事故、自杀、溺水和意外中毒,前5位伤害占总意外死亡数的71.73％.结论 高港区老年人意外伤害死亡率较高,应有针对进行安全知识的宣传教育等健康干预.

目的 掌握初治涂阳肺结核并发2型糖尿病患者的患病及治疗情况,进一步提高发现及诊治水平.方法 收集2012年1月1日至2014年12月31日泰州市人民医院收治的初治涂阳肺结核患者248例,对其中并发2型糖尿病的52例患者的主要临床特征、治疗方案、疗效及转归等相关信息进行分类,再将各项目录入Excel2007,用Epi Info 6.04对分类资料进行x2检验,以P＜0.05为差异有统计学意义.结果 初治涂阳肺结核患者中20.97％(52/248)并发2型糖尿病.4个年龄组(15～岁、30～岁、45～岁和60～岁)初治涂阳肺结核并发2型糖尿病的并发率分别为0.00％(0/47)、19.35％ (6/31)、28.36％(19/67)和26.21％(27/103),4个年龄组间比较差异有统计学意义(x2=16.44,P＜0.01).经过降糖及6～18个月的规范抗结核治疗,治愈42例,治愈率为80.77％(42/52).结论 糖尿病已成为肺结核常见并发疾病之一,应将45岁以上2型糖尿病患者列为肺结核筛查重点人群,尽可能早期发现并发肺结核者;肺结核并发糖尿病患者经过积极规范的治疗,其预后与疗效较好.

目的 了解泰州市交通事故死亡流行病学特征,为道路交通事故防控工作提供科学依据.方法 采取ICD-10分类法,收集整理2009-2015年泰州市居民交通事故死亡资料,计算死亡率,分析道路交通事故死亡人群分布及不同交通方式死亡人数构成比.结果 2009-2015年共报告交通事故死亡7 155例,平均死亡率21.66/10万,标化死亡率为15.54/10万,占全部伤害死亡的47.19％,2009年以后呈下降趋势.男性交通事故标化死亡率22.36/10万,女性为8.80/10万,男性标化死亡率是女性的2.54倍.随着年龄的增加,交通事故死亡率有先下降后升高的趋势,其中5～岁年龄组最低,之后缓慢上升,65岁以上老年人交通事故死亡率处于较高水平,85岁以上年龄组死亡率最高.公路上行人与骑自行车和摩托车(包括电动助力车)死亡5 475人,占交通事故死亡总数的76.52％,机动车驾驶员死亡1 026人,占14.34％.机动车辆交通事故死亡数占68.74％,高于机动车以外的运输事故死亡数.结论 居民意外伤害是泰州市居民死亡的主要死因之一,交通事故居意外伤害之首,应引起重视,采取相应的预防干预措施,对减少居民死亡率有十分重要的意义.

目的 了解泰州市肺结核病耐药情况,为提高耐药结核病防治工作质量提供依据.方法 收集本地区2012年结核病患者209株临床分离株,按WHO推荐的比例法进行药物敏感性试验和菌型鉴定.结果 209株临床分离株中检出结核分枝杆菌200株、非结核分枝杆菌9株.200株结核分枝杆菌总耐药率28.00％、耐多药率9.50％、广泛耐药率2.00％;9株非结核分枝杆菌全部为广泛耐药.200株结核分枝杆菌中,分离自初治患者的154株菌株总耐药率19.48％,耐多药率4.55％,无广泛耐药;复治患者46株菌株中总耐药率56.52％,耐多药率26.09％,广泛耐药率8.70％.初治患者总耐药率、耐多药率均低于复治患者,差异均有统计学意义(P值均＜0.01).200株结核分枝杆菌耐药率以耐异烟肼(H)最高(19.00％),耐卷曲霉素(Cpm)最低(6.50％),其他药物为7.50％～ 15.00％,差异有统计学意义(P＜0.01).结论 泰州市结核病初治患者的耐药情况明显好于全国,但复治患者耐药情况不容乐观,且结核分枝杆菌总耐多药率和广泛耐药率均较高,应引起高度重视.结核病患者以结核分枝杆菌感染为主,耐药水平与近年来相关报道数据基本一致.应采取多种措施,进一步降低结核病耐药水平.

目的 了解泰州市当前肺结核耐药水平和流行趋势,为提高耐药结核病防治质量提供科学依据.方法 对2012-2014年结核病信息管理系统中登记的全市痰培养阳性肺结核患者,采用比例法进行异烟肼(H)、利福平(R)、链霉素(S)、乙胺丁醇(E)、氧氟沙星(OFX)和卡那霉素(Km)的药敏试验结果进行分析.结果 1 239例痰培养阳性肺结核患者,总耐药率为9.20％,其中初治患者耐药率5.10％,复治患者耐药率20.18％;总耐多药率为5.65％,其中初治患者耐多药率2.33％,复治患者耐多药率14.54％;广泛耐药率为0.81％.6种抗结核药物的单耐药率顺位由高到低依次为:H(7.51％)、R(6.30％)、S(3.79％)、OFX(2.66％)、E(1.78％)、Km(1.61％).复治患者耐药率、耐多药率、不同耐药种类数的耐药率均显著高于初治组,差异有统计学意义(P＜0.001).结论 泰州市肺结核患者的耐药率较实施全球基金耐多药项目之前下降明显,基本与近年来国家调查结果及其他城市报道的数据一致,要针对本地区耐药状况,多措并举,进一步降低结核病耐药水平.

目的 了解实施基本公共卫生服务对高血压和糖尿病控制的影响.方法 实施项目前后的2010年和2013年,分别对泰州市≥18岁居民开展调查,包括2010年慢性病及其危险因素调查,及2013年高血压、糖尿病患者知晓率、治疗率和控制率(“三率”)现状专题调查,比较分析已知高血压、糖尿病患者“三率”情况,评估基本公共卫生服务项目实施效果.结果 知晓率、治疗率和控制率:2010年高血压患者分别为37.4％、31.7％、6.8％,2013年分别上升为71.3％、43.5％、24.3％;糖尿病患者分别为42.2％、32.6％、13.3％,2013年分别上升为58.6％、52.7％、26.1％;前后两病“三率”差异均有统计学意义(P值均＜0.05).结论 实施基本公共卫生服务项目后,高血压、糖尿病患者的知晓率、治疗率和控制率均有明显提高.

目的:了解实施基本公共卫生服务项目以来泰州市高血压和糖尿病患者知晓率、治疗率和控制率水平,为慢性病防治相关策略和措施提供必要的参考.方法:对泰州市高港区10个社区卫生服务中心服务范围内的乡村采用随机抽取的方法,每个社区卫生服务中心抽取一个村,对村里18周岁及以上的常住人口进行问卷调查.结果:调查发现高血压患者2 340人,主诉有高血压患者1 669人,高血压患者知晓率71.32％、治疗率60.99％、血压控制率34.09％;发现糖尿病患者505人,主诉有糖尿病患者296人,糖尿病患者知晓率58.61％、治疗率67.91％、血糖控制率19.59％.结论:基本公共卫生服务项目实施以来,通过宣传服务免费政策,开展慢性病人随访管理,提高公众知晓度,进而提高慢性病人管理依从性、规范性,高血压糖尿病的知晓率、治疗率和控制率均有一定程度的提高.

Objective to understand the past cure pulmonary tuberculosis patients with chronic non communicable diseases, the prevalence of physical condition and lifestyle related issues, as the guidance of pulmonary tuberculosis patients after healing, provide a reasonable way of life and provide the basis to improve the quality of life;Methods by Taizhou city“basic public health service information system”extraction over the age of 18 previous cure pulmonary tuberculosis personnel related data analysis;Results a total of 2014 residents information system management of tuberculosis in 923 residents, many residents over 55 years old, which combined with diabetes patients was 93, the prevalence rate of 10.08%diabetes combined with hypertension, are 329, the prevalence rate of hypertension was 35.64%, population of BMI index was 22.03 ± 2.63kg/m2, weight of 89 patients people, lean rate 9.64%, overweight rate is 18.85%, obesity rate was 2.06%, the smoking rate was 22.64%, the drinking rate 26.32%, never to participate in physical exercise rate 77.25%;Conclusion among tuberculosis patients in body mass index was significantly lower than that of ordinary people, should pay attention to poor nutritional status, TB patients more promptly corrected;at the same time TB patients excessive focus on diet, nutrient intake imbalance caused by excessive, will cause some nutrition related chronic diseases, should pay more attention to the prevention of nutrition related chronic diseases, improve their life style.

Objective To investigate the curative effect of amikacin or capreomycin in the treatment of multi-drug resistant pulmonary tuberculosis for 6-12 months. Methods We monitored and analyzed the treatment, adverse reactions, short and long term curative effect of multi-drug resistant pulmonary tuberculosis from January 2009 to June 2014. Results In all 51 patients with multi-drug resistant pulmonary tuberculosis, 44 cases completed 6-12 months′ injection, and the sputum negative conversion rate was 58. 82%, 52. 17% and 48. 48% respectively at the end of 6, 12 and 24 months. The amikacin group had less adverse reactions and better curative effect than the capreo-mycin group did. Conclusion Amikacin or capreomycin injection for 6-12 months is effective for multi-drug resistant tuberculosis, and the occurrence of serious adverse reactions can be avoided by monitoring of adverse reactions and timely disposal.

Objective To investigate clinical types,age structure,case classification and treatment outcome of tuberculosis patients in Taizhou urban area;to provide basis for tuberculosis prevention and control.Methods For patients diagnosed in 2011,all information and data of registration,diagnosis,treatment and management was input into worksheet(Excel 2003), which was subjected to epidemiological analysis using SPSS 18.0.Results In 2011,tuberculosis registration rate was 62.73/ 100 000,patients were mainly from 45to 64years old,accounted for 42.59%,with male to female ratio of 1.75∶1.Farmers accounted for 70.03%,followed by workers,which accounted for 19.19%.Annual cure rate of smear-positive TB patients was 88.24%;for smear-negative patients and patients whose sputum results were not available,the treatment rate was 95. 38%.Conclusion Current TB epidemic situation in Taizhou urban area is still serious.In order to reduce incidence of TB,advocacy should be enhanced to improve the intensity of prevention and control on key TB groups such as students and farmers.

目的:了解泰州市医药高新区2013年居民主要死亡原因及顺位,为疾病防控工作的决策、制定干预措施及评价干预效果提供依据.方法:数据来源于2013年1月1日-2013年12月31日录入中国疾病预防控制信息死因登记报告系统中的人口死亡数据,死因分类依据国际疾病分类ICD-10进行疾病分类,各死因构成从大到小进行顺位,将监测数据转换成DeathReg系统数据,用死因统计软件DeathReg2005进行统计分析.结果:2013年泰州市医药高新区居民死亡率为664.61/10万,其中男性死亡率为766.54/10万,女性死亡率为563.46/10万,男女死亡性别比为1.35∶1.慢性非传染性疾病占据主要死因位置,其中,循环系统疾病占慢性病死亡构成比最高,为43.82％,肿瘤为38.07％、呼吸系统疾病为4.87％,三者合计占慢性病死亡的86.76％.结论:慢性病防治工作的重点应加强对恶性肿瘤及循环系统疾病的干预,以减少慢性病对人群健康的危害.

Objective To assess the nutrition and health status of residents in Gaogang district of Taizhou.Methods The survey was conducted according to the handbook of Chinese National Nutrition and Health Survey in 2010 which included questionnaire,interview,physical examination,laboratory testing and dietary investigation.Results The meat and cereal consumption of local residents basically reached the requirement of Chinese dietary guideline,which were 318.6 and 75.5gram per person each day.However,the daily intake of milk and fruits were only 15.1 and 15.9 gram per person,which were obviously inadequate,while the consumption of oil and salt were both excessive(55.2 g and 10.9 g).45.9% of total energy came from grain product and 38.5% from lipid.The survey also found that the overall prevalence of anemia was 15.7 % with 10.7% of males and 19.3% of females(χ2 =14.18,P0.05);33.2% and 5.6% of population was overweight and obesity,respectively.The prevalence of hypertension was 31.7 % among residents aged 15 years and over with 38.7% of males and 25.9% of females(χ2 =18.62,P0.05).The incidence of diabetes,hypercholesteremia,hypertriglyceridemia,or low serum high density lipoprotein cholesterol were 10.8 %,13.1%,23.4 % and 7.4 % respectively among adults.Conclusions Eventhough the dietary structure of local residents has been improved,and it is still not very much reasonable.The average daily intake of basic nutrients per reference person was adequate,but some nutrients were still deficient.The increase of the incidence of nutrition-related noncommunicable diseases(NCD) is an important public health problem.

Objective To study the main death causes and ranks among the inhabitants in Taizhou in 2011,so as to provide a basis for developing intervention and evaluation of disease prevention and control decisions.Methods Data of death cases was download from China Disease Prevention and Control Information System Database of 2012,which are classified according to the International Classification of Diseases ICD-10.Various causes of death ranked from the large to small,and the monitoring data were converting to the system of Death Reg and analyzed by the death statistics software Death Reg 2005.Results The mortality of Taizhou residents was 657.15/105 in 2011.The mortality for male and female was 760.46/105 and 553.86/105 respectively.The total mortality rate of city was 752.11/105 ,and that of rural was 639.53/105 .The leading cause of death was chronic diseases in both urban and rural areas in Taizhou for both genders,accounting for 92.42% of the chronic diseases deaths,among which the circulatory system diseases accounted for the highest proportion (47.58%),followed by tumors (39.54%),and respiratory diseases (5.81%).Conclusions The prevention and control of chronic diseases should focus on strengthening the intervention of malignant tumors and diseases of the circulatory system,and reduce the harm of chronic diseases on human health.

目的：了解泰州市居民意外伤害死亡率及构成比及年龄间变化趋势，为制定预防措施提供科学依据。方法：采取ICD-10分类法，对该市2011年意外死亡资料进行分析。结果：意外伤害死亡率为45.55/10万（标化死亡率为37.51/10万），占全死因构成比的6.93%，仅次于脑血管疾病、恶性肿瘤，居全死因构成比的第三位。其中交通事故死亡占全部伤害死亡的构成比最高，为51.47%，其次是溺水、意外跌落、自杀、意外中毒；意外伤害死亡率男性高于女性（P<0.01）。结论：交通意外、溺水是泰州市居民伤害的主要死因，应引起重视，采取相应的预防干预措施，对减少意外伤害死亡率有十分重要的意义。