目的 分析海宁市1950-2018年疟疾的流行特征,为海宁市今后疟疾防控策略提供科学依据.方法 收集海宁市疟疾疫情数据、报表等资料,采用描述流行病学的方法进行分析.结果 1950-2018年海宁市共报告疟疾病例95 361例,年平均发病率为254.3/10万,死亡病例27例.2007年为最后1例本地病例,2008年起海宁市无本地疟疾感染病例报告,均为输入性病例.海宁市流行高峰分别在1954年和1960年出现,发病率分别为2 481.02/10万和7 219.20/10万,1977年第2个流行周期结束,发病率为17.91/10万.除在1963-1964年2年间发现过50例恶性疟病人和2014年后报告的6例病例为输入性恶性疟病例外,其余均为间日疟,恶性疟病例占全部病例的0.06％.中华按蚊是我市疟疾传播媒介.结论 海宁市近年来疟疾的流行特征以输入性疟疾为主,在今后的疟疾防控工作中要抓好以输入性传染源监测为主的疟疾防治工作,加强疟疾病情的动态监测,持续开展疟疾健康教育和对医务人员的培训工作,巩固消除疟疾防治成果.

Objective To determine the density of primary vector species and their seasonal fluctuation in Haining county for improvement of prevention and control strategies. Methods Light traps, cage traps,roach pastes and night traps were used to capture mosquitoes, flies, cockroaches and rodents,respectively, for density calculations. Results From 2009 to 2012,the average density of mosquitoes in Haining county was 2.31 per lamp?hour, with the prominent species being Culex pipiens pallens/Cx. pipiens quinquefasciatas accounting for 80.23%. The average density of flies was 5.21 per cage with Chrysomya megacephala and Musca domestica as the predominant species,which accounted for 55.40% and 27.46%, respectively. The density of cockroaches was 0.53 per paste, with Blattella germanica as the predominant species (90.35%). The rodent density was 0.69%with Rattus norvegicus and Mus musculus as the predominant species, which accounted for 35.88%and 44.27%, respectively. Most mosquitoes and flies appeared in May;the former became most active in August and the latter in June through August. Cockroaches and rats were observed throughout the year with relatively high roach density from March to October and generally peak rodent density in September. Conclusion By the surveillance, the population composition and seasonal fluctuation of primary vectors in Haining county are clarified, and provide the basic information for vector?borne disease control and prevention.

目的:了解海宁市农村居民结核病防治核心知识知晓率,为结核病防治工作提供科学依据.方法:采用分层随机抽样的方法,使用统一的结核病防治相关知识调查问卷对600名12岁以上农村居民进行调查.结果:结核病防治核心信息的总知晓率为56.50％,男女性的知晓率差异无统计学意义,“12岁～”年龄组的知晓率最高,而且随着年龄的增加知晓率随之下降,“小学及以下”文化程度组的知晓率最低,随着文化程度的增高知晓率而提高,不同的职业人群中教师、医师等“技术人员”的知晓率最高,而农民的知晓率最低.结论:需加强对农村居民的结核病健康教育,在今后的健康教育工作中应考虑受众的各种人口学差异,明确各类目标受众,开展不同类型的健康教育活动.

Objective To examine the risk factors of type II diabetes in rural area of Haining city in order to provide basis for disease control and prevention. Methods Residents aged over 18 in four towns were selected through multi- stage stratified cluster random sampling method,and a questionnaire investigation,physical examination and blood biochemical indicator testing were conducted. Results The adjusted prevalence of type II diabetes in Haining city was 5. 17% overall with 5. 81% in men and 4. 56% in women. The results of multivariate logistic regression analysis showed that age( OR =1. 78),overweight( OR = 1. 71),family history of diabetes( OR = 16. 05) were risk factors( all P 0. 05). Conclusion The prevalence of type II diabetes is considerably high in rural area of Haining city. Risk factor monitoring and comprehensive intervention should strongly be advocated.

目的:研究社区麻风病受累者心理健康状况.方法:采用症状自评量表(SCL-90)对浙江3个地区的336例社区麻风病受累者(研究组)和按照性别年龄配对的336例社区居民组(配对)进行调查.结果:麻风受累者心理障碍筛查阳性率为21.13％(71/336)与配对组19.05％(64/336)比较差异无统计学意义,显示在总体心理障碍严重程度上研究组与配对组没有差异；除强迫因子和焦虑因子外,研究组SCL-90总分及其余因子分与配对组差异均有统计学意义,尤其躯体化、抑郁以及恐怖因子分高于全国常模.显示研究组与配对组在心理健康水平及内部各心理症状群构成上不够平衡.结论:社区麻风病受累者躯体化、抑郁以及恐怖症状突出,应作为今后心理干预重点内容.

随着麻风防治与综合性卫生服务的逐渐结合,基层社区医生越来越多地参与麻风服务,因此,基层社区医生的麻风服务能力和实际承担的服务职能情况就成为评价麻风防治一体化效果和程度的重要指征.1,2为了解当前浙江省基层社区医生相关情况,更好地为今后我省麻风防治能力建设和医务人员培训规划的制定以及麻风防治的管理督导提供指导,在荷兰麻风救济会的支持下,我们在浙江海宁和绍兴地区开展了专题的调查研究,现将有关结果报道如下.

目的:了解海宁市企业外来务工人员人口社会学情况及其对麻风病的相关认知,为制定针对性麻风防治策略服务.方法:采用整群随机抽样方法,调查海宁市5个乡镇的359名企业外来务工人员,问卷当场填写,核对后资料输入计算机处理.结果:海宁市企业外来务工人员大多数为青壮年,文化程度较低,57.66％对象来自麻风病高流行省份,曾听说过或见到过麻风病的占总人数82.73％,对麻风病基本知识知晓率在2.51％～51.81％之间,对于麻风病持比较正面的态度与行为者占14.76％～28.13％.结论:外来务工人员是麻风病防治工作重点人群,应该对该市外来流动人口开展麻风病筛查体检及麻风病健康教育工作,并采取针对性措施,消除此类人群的麻风病歧视现象.

随着麻风病防治与综合性卫生服务一体化进程的逐渐启动,如何使广大社区及群众有效认识和充分利用麻风病防治一体化服务体系成了必须面对的一个课题,也是最终成功实现麻风病一体化服务转型的关键所在[1].开展对社区群众麻风病及一体化服务的健康教育是一个有效的措施,更是麻风病防治一体化服务成效的标志[2].浙江省海宁市从2001年开始启动麻风病防治一体化服务转型以来,社区和综合型卫生服务机构对于麻风病服务的参与力度逐渐增强.

目的:了解海宁市农村地区代谢综合征患病率及流行病学特征.方法:采用分层整群随机抽样的方法,对1475名18岁以上农村居民进行问卷调查、体格检查和实验室检查,代谢综合征的诊断按照IDF( 2005)的进行.结果:海宁市农村18岁以上人群MS的粗患病率为17.36％,标化患病率为16.00％；中心性肥胖+低HDL-C血症高血压组合最常见;女性患病率高于男性(分别为23.62％、10.66,P＜0.001)；患病率随年龄增加而升高,随文化程度增高而降低.结论:海宁市农村人群具有较高的MS患病率,应针对重点人群开展采取综合防治策略.

Objective:To analysis of serotype distribution and biological properties and virulence gene and to develop strategies for the prevention and control of Cholerae.Methods:Samples were collected and tested from external environment water,food,delicatessen,sea food products and diarrhea patients from 2005 to 2008.Bacterial strains were isolated and tested.The positive water were tested temperature,pH,oxygen consumption and chloride.Results:Totally 2680 samples were collected and 104 strains of Vibrio cholerae were idendified,the positive rate was 4.03%.Identified by serological typing: EVC Rice leaves had 38 strains,accounted for 36.54%,EVC Ogawa had 16 strains,accounted for 15.38%,O139 had 50 strains,accounted for 48.08%.Type of 23 strains Vibrio cholerae phage to O1 EVC rice leaf-1 f majority,accounting for 86.96%(20/23).14 strains Vibrio cholerae virulence gene test results were positive with ctx,ace,zot virulence genes.Sensitivity test of O1 and O139 Vibrio cholerae′s antibacterial drugs have different resistance levels,the resistance rate of SD up to100%.The sensitive rate of CF,FRA,AKN are as high as100%.Type of bacteria in river is complex,O139,Ogawa,rice leaf coexist.O139 and Ogawa could be tested where the water tempeture lower 6℃ and pH value was about 6.6 and chloride was 49.7 mg/L and oxygen consumption was 16.4 mg/L.Conclusion:Type of bacteria in river was complex in Haining,O139,Ogawa,rice leaf coexist.Virulence gene detection were producing strains and senstiving to CF,FRA,AKN.O139 and Ogawa could live in the lower water tempeture and lower chloride and higher oxygen consumption.

目的:计量认证现场试验方案合理化和正确评价试验结果。方法:通过2008年2月浙江省计量认证专家组对海宁市疾病预防控制中心实验室进行计量认证复评审的理化现场试验方案和检测结果进行分析和探讨。结果:现场试验方案对新扩项目的覆盖率为92%、对产品类别的覆盖率为90%、对检验技术或方法类别的覆盖率为100%,盲样测试结果合格,但有2个参数结果有偏离倾向。结论:现场试验方案合理;用不确定度范围评价试验结果欠妥;相对误差较大的结果需查找原因。

[Objective]To explore the shifts of tuberculosis clinical treatment function from CDC to comprehensive medical unit,and through strengthening tuberculosis project measure,make sure each kind of responsibility and duty of the project,carry out the direction inspection and incentive system,maintain the tuberculosis control project work to continue developing.[Methods]Transformed tuberculosis clinical treatment pattern from original CDC which undertook the tuberculosis clinical diagnosis work to the comprehensive medical unit for the tuberculosis patients' clinical treatment,and established the patients' social management undertaken by the CDC,completed the tuberculosis patient's treatment by the municipal peoples' hospital,implemented effective work strategy on the tuberculosis patients' transfer treatment and the management by other medical units.[Results]The new smear positive tuberculosis case registration rate in whole city was 34.53 per 100 thousand in 2005,was 29.69 per 100 thousand in 2006. The cure rate of smear positive tuberculosis patients was 88.10% in 2005,was 89.38% in 2006,and the achievement rate of transfer treatment was 95.50% in 2005,was 95.10% in 2006.[Conclusion]Through the transformation of tuberculosis clinical treatment pattern,the results of tuberculosis control project in the whole city continue to maintain,the tuberculosis's each performance measure does not obviously change and continues to maintain the high discovery rate,high cure rate,and high management rate. And the fully utilizing tuberculosis network management system working platform creates the condition for promoting tuberculosis control project work development in the whole city.

<正>2006年5月,浙江省海宁市某村庄发生一起腹泻病暴发,共有19例患者。该村共有村民52户208人,发病时间为5月1日至5月21日。发病时间较分散,无明显高峰。年龄最小3岁,最大73岁,40岁以上占63.2%。男9例,

OBJECTIVE The number of measles in 2005 was quantity 8.67 times as great as average of last five years.Search the reasons of the increasing incidence of measles and providing the evidence for making the controlling measure.METHODS Analyse the epidemic situation of measles in 2005 and the epidemic direction from 1985 throuhg descriptive study.RESULTS The population of measles was mostly native which related with that the low immunity quality and low incidence of measles reduce the antibody level of population.The measles cases included children who was less than 8 month because their antibody coming from mother were the low level and disappeared quickly.The cases from one age to seven age were mostly floating population who haven't received the immunity because the managers to the planned immunity for the floating children were weakness.CONCLUSION It's necessary that strengthening the planned immunity and the immunity manager for the floating children,increasing the immunity rate of measles in time,inoculating measles bacterin fortified.

海宁市自1984年起实行麻疹疫苗按月接种模式,之后麻疹发病一直维持在较低的水平.但在2005年,海宁市的麻疹发病显著增高,发病数是前5年平均水平的8.67倍.为探讨2005年海宁市麻疹高发的原因,为制定控制措施提供依据,对2005年的麻疹疫情进行了分析.

2006 年 5 月,浙江省海宁市农村某村庄发生一起腹泻病暴发,共有病例 19 例.经流行病学调查分析和实验检测,证实这是一起经水传播的由类志贺邻单胞菌所致的腹泻病流行.

OBJECTIVE Through the investigation in Haining external labourers health situation,grasps present situation of the intestinal infectious disease knowledge and personal hygiene behavior. METHOD Applies the random sampling the method determination investigation object. Through knowledge questionnaire survey and scene investigation. RESULT Haining city external labourer's knowledge of preventing the acute intestinal infectious disease were deficient and the knowing rate were only 35.25%. Majority of people's living conditions and the housing conditions were worse.Their health behavior and consciousness need promoted. The main way were TV and circular and broadcast. CONCLUSION External labourer were key of preventing the acute intestinal infectious disease.Through health education and environmental sanitation comprehensive program of public order.

目的:了解国产(上海)水痘疫苗的免疫原性、反应原性,为制定本地区科学有效的免疫策略提供依据.方法:采用ELISA法测定2～6岁人群和水痘疫苗接种者的酶标抗体GMT水平,并观察疫苗接种的安全性.结果:2～6岁人群水痘抗体阳性率为12.02%,水痘感染率随年龄升高.水痘疫苗接种后血清抗体阳转率为91.43%,GMT平均滴度为1 : 969.92,全身和局部反应轻微.结论:该疫苗有良好的免疫性和安全性,可用于预防水痘-带状疱疹病毒,接种年龄以2周岁前为宜.

水痘减毒活疫苗是一种新的疫苗,其免疫效果尚不十分清楚.为了进一步了解其效果,我们于2002年6月19～29日对水痘减毒活疫苗进行了免疫效果的观察,现将结果报告如下.