目的 分析2008-2017年湖北省乙型脑炎减毒活疫苗(Japanese Encephalitis Attenuated Live Vaccine,JEV-L)接种后疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)的发生特征,评价JEV-L疫苗安全性.方法 采用描述流行病学方法对湖北省2008-2017年AEFI信息管理系统JEV-L接种后AEFI个案数据进行分析.结果 湖北省2008-2017年共报告JEV-L接种后AEFI个案5 738例,报告发生率51.54/10万剂.一般反应占95.09％,异常反应占4.43％;男女性别比为1.23:1,1岁以下和2岁组儿童分别占59.41％和24.82％,夏、秋2季报告病例分别占34.47％和33.13％;83.17％的AEFI病例接种至反应发生时间间隔＜1d;所有AEFI中仅有1例(脑炎和脑膜炎病例)有后遗症.一般反应以发热、红肿、硬结为主;异常反应以过敏性皮疹为主,严重异常反应以热性惊厥为主,其他严重异常反应报告发生率均较低;近年来热性惊厥报告发生率有逐年升高趋势.结论 AEFI以一般反应为主,异常反应占比较低,严重异常反应较少见,湖北省JEV-L疫苗安全性良好,但仍需关注热性惊厥、神经系统脑病等严重异常反应的发生.

目的 了解以乡(镇、街道)为单位儿童免疫规划疫苗(National Immunization Program Vaccines,NIPV)接种率.方法 采用批质量保证抽样方法确定调查样本量,入户调查2岁组和7岁组儿童,定性评价以乡为单位NIPV接种率≥90％的情况.结果 共抽查35个乡,共计2940名适龄儿童.2岁组,百白破疫苗、乙脑疫苗接种率≥90％的乡比例均为97.14％,乙肝疫苗、卡介苗、脊灰疫苗、A群流脑疫苗、含麻疹成分疫苗、甲肝疫苗接种率≥90％的乡比例为100.00％;7岁组,脊灰疫苗、乙脑疫苗、白破疫苗、A群C群流脑疫苗接种率≥90％的乡比例分别为97.14％、94.29％、88.57％、80.00％,乙肝疫苗、卡介苗、百白破疫苗、A群流脑疫苗、含麻疹成分疫苗、甲肝疫苗≥90％乡比例为100.00％.2岁组有97.14％乡NIPV接种率≥90％;7岁组有77.14％NIPV接种率≥90％.结论 湖北省以乡为单位NIPV接种率保持在较高水平,但少数乡疫苗接种率<90％.

目的 分析湖北省2010-2016年疑似预防接种异常反应(Adverse events following immunization,AEFI)的发生特征,评价疫苗的安全性.方法 采用描述流行病学方法对湖北省2010-2016年通过AEFI信息管理系统报告的AEFI个案数据进行描述性分析.结果 湖北省2010-2016年共报告AEFI个案30 599例,年均报告发生率为24.79/10万剂.在所有AEFI中,一般反应、异常反应分别占91.05％、7.59％;男女性别比为1.41∶1;≤1岁儿童占71.43％;夏、秋季发生分别占35.58％、33.89％;99.39％的AEFI痊愈或好转;91.22％的不良反应病例接种至反应发生时间间隔≤1d.AEFI报告发生率较高的疫苗为麻疹风疹联合减毒活疫苗(76.73/10万剂)、无细胞百白破联合疫苗(48.61/10万剂)和乙型脑炎减毒活疫苗(45.28/10万剂);报告发生率最高的异常反应为过敏性皮疹(1.50/10万剂),严重过敏反应和神经系统反应报告发生率分别为0.07/10万剂、0.06/10万剂.结论 湖北省2010-2016年AEFI监测敏感性逐年提高,所有疫苗安全性良好.

Objective To build a large data base and distributed cloud computing platform for the Hubei Immunization Program Information Management System (HIPIMS).Methods We used the basic structure of a cloud computing platform and its virtual applications,combined with the application server configuration of HIPIMS,to build a distributed platform,and we evaluated its impact.Results We built a large data base and virtualized cloud computing platform for HIPIMS.Sharing online resources was achieved by data interactions between immunization clients and prefectural/provincial application servers through a specific link line.The system was able to optimize and use immunization data.The platform significantly improved the performance of HIPIMS,and achieved that each key point (server) became a redundant structure (≥ 1 servers) for running and maintenance of the system.The previous bottleneck of single points was eliminated,with a 60％ decrease of failures and 99.5％ use of immunization data.Conclusions The large data base and distributed cloud computing platform for HIPIMS is practical and effective,and is of great significance.

目的 评估湖北省免疫规划信息管理系统(HIIMS)建设的工作质量和管理水平.方法 在全省各选择30家县(市、区,下同)级疾病预防控制中心(CDC)、医院产科接种单位和乡(镇、街道,下同)级接种单位,按照HIIMS规定的CDC、接种单位、儿童预防接种信息管理系统客户端(CIIMCS)基本操作流程规范和考核指标,对2014年HIIMS实施效果进行评估,对全省1 884个CIIMCS上传到HIIMS平台的相关数据进行分析.结果 在全省2008 ～ 2014年出生的在册管理儿童中,第一类疫苗累计应种53 635 062剂次,实际接种48 342 942剂次,总接种率90.13％.2014年1 884个接种单位纳入HIIMS管理,1 857个接种单位异地接种2 534 204剂次,占98.57％;异地迁入接种1 152 984剂次,异地临时接种1 381 220剂次,分别占总异地接种的45.50％、54.50％.在30家产科接种单位中,个案录入率＞98％、基本信息录入完整率＞95％者分别占93.33％、96.67％,接种证机打率为92.05％.在30家乡级接种单位中,每月开展主动搜索和及时补种等工作占46.67％;CIIMCS儿童111 672名中,未分类占0.33％,姓名未更新占3.10％,重卡占0.01％;5日内个案信息及时上传率和备份率均为100％;5日内新生儿个案信息及时审核率为98.68％;5日内及时审核率＞99％的县占70.87％.结论 HIIMS的实施全面实现了全省“一地建卡、异地接种”和所有预防接种信息的共享;开展评估工作可及时发现并解决存在的问题,有效地促进各级CDC和接种单位正确规范的使用信息系统,提高数据质量.

高层次人才对地方产业转型升级、企业创新发展有着至关重要作用.然而有的地方在引进人才的具体操作中,却存在片面追求“光鲜数字”,搞“拉郎配”现象.这样的引才方式,从源头上注定项目很难实施,也违背了人才对接引进的初衷.

目的 分析2016年3月18日发生的非法经营疫苗系列案对湖北省预防接种工作的影响,探讨应对疫苗突发事件的有效策略.方法 从湖北省免疫规划信息管理系统中选取非法经营疫苗系列案发生前后的儿童第一类疫苗和第二类疫苗接种数据,采用描述流行病学方法分析事件发生前后疫苗接种剂次变化.结果 事件发生后与发生前相比,第一类疫苗总接种剂次下降33.08％;第二类疫苗总接种剂次下降50.38％.事件发生前后第一类疫苗总平均接种率分别为98.7％和73.4％(x2=94 715.70,P＜0.01).结论 非法经营疫苗系列案对儿童疫苗接种造成了显著的不利影响;应加强疫苗安全性的宣传,制定应对疫苗突发事件的有效策略.

创新作为"五大发展理念"重要一项,在新常态下被赋予了新的意义.要实现"你我中国梦、全面建小康",亦或中国制造2025,重点是企业创新发展,关键在企业家创新意识.在创新驱动中,应充分发挥企业家的主体地位,建立有利于企业家参与创新决策、凝聚创新人才、整合创新资源的新机制,让企业家想创新、能创新、创成新.

Objective Evaluation of obstetric neonatal immunization information management system implementation and evaluate effect,strengthen and standardize child vaccination information management system reports,improve immunization information collection timely rates and accuracy and coverage.Method By using the Browser /Server( B /S) structure,to establish obstetric neonatal vaccination information management platform and to achieve the systematic management to Hubei province's 1457maternity units inoculated users and more than 500 units of health administrative departments and disease prevention and control,and obstetric neonatal vaccination case information management system. Based on the selected units,children's immunization information automatically sent to the 1844 vaccination units in the whole province. The client download the vaccination information,complete platform and customer end of data between dynamic updates. Result After implementation the information system for two years,there were total 1,457 units of obstetric inoculation in the province,the user system coverage was 100%.There were 1,392 obstetrics which being in charge of neonatal delivery,and the coverage of establishingfile of neonatal in obstetric was 95. 54%.1,271,781 neonatal completed the immunization information. Completeness of case immunization information was 94. 02%. Timely filing rate within5 days was 87. 19%,the timely audit rate within 5days was 95. 64%. Bacilli Calmette-Guerinvaccine vaccination rate was 86. 27%,HepB1coverage was 95. 58%,timely HepB1coverage was90. 26%,mothers' hepatitis B surface antigen positive rate was 4. 12%,all neonatal hepatitis B immuno globulin coverage rate was 5. 45%. Conclusion Implementation and application of neonatal vaccination information management system in obstetric enhanced information collection timeliness,accuracy and completeness. It resolved problems,such as getting correct targeted population,repeat vaccination cards,sharing immunization information of migrant children,and inaccuracy vaccination coverage.

目的 探索通过预防接种信息系统直接评价儿童接种率的可行性.方法 在调查县通过儿童预防接种信息管理系统(Children Immunization Information Management System,CIIMS)统计其扩大国家免疫规划疫苗接种率,并与按容量比例概率抽样法(Probability Proportional to Size,PPS)接种率调查结果和常规免疫报告接种率进行对比分析.结果 CIIMS共统计到调查县1岁儿童3 264人,2岁儿童3 205人.PPS法共入户调查420名儿童,其中1岁和2岁各210人.2010年调查县常规免疫报告接种率各疫苗各剂次均＞99.00％.CIIMS和PPS两种方法得到的接种率经x2检验,1岁儿童乙型肝炎疫苗(Hepatitis B Vaccine,HepB)第2剂、百日咳-白喉-破伤风联合疫苗(Diphtheria,Pertussis and Tetanus Combined Vaccine,DPT))第1剂和含麻疹成分疫苗(Measles-containing Vaccine,MCV)第1剂接种率的差异有统计学意义(P＜0.05);2岁儿童HepB第3剂、DTP第3剂、MCV第2剂、乙脑疫苗(Japanese Encephalitis Vaccine,JEV)第1剂和第2剂接种率的差异有统计学意义(P＜0.05),其余疫苗及剂次接种率的差异均无统计学意义(P＞0.05).1岁和2岁CIIMS统计接种率和2010年常规免疫监测报告接种率经x2检验,分别有7剂次和13剂次的疫苗接种率的差异有统计学意义(P＜0.05),占58.33％和72.22％.结论 通过CIIMS统计接种率迅速、准确,是评价免疫规划工作的有力工具.

党的十八届三中全会提出要深化经济体制改革,发挥市场“决定性”作用,这对人才工作提出了新要求.政府部门在做人才工作时应进一步树立市场意识,遵循市场规律,发挥企业主体作用,做到简政放权,有所为有所不为. 要厘清职能.在人才引进、培育、使用过程中充分发挥企业主体作用,做到少干扰、多扶持,做好政策制定、执行、维护市场公平等基础工作.对人才引进、申报项目等工作可广发“招贤榜”“纳贤书”,通过猎头、专业机构等专业人员来操作,提高服务企业效能.

目的探讨免疫规划信息管理系统建设的功能结构。方法采用模块化设计思想,利用系统分析方法,综合运用计算机技术,网络技术、通讯技术对湖北省免疫规划信息管理系统的功能结构和功能组成进行设计,通过应用支撑组件+业务功能构件的方式实现系统各项功能。结果湖北省免疫规划信息管理系统由湖北省免疫规划之窗、预防接种信息管理系统、免疫规划办公自动化系统、免疫规划GIS系统、免疫规划信息服务中心五个功能子系统构成;经过近一年的试用和改进,系统功能日趋完善,运行稳定,使用方便。结论系统功能设计合理、先进,实施效果理想,能满足当前免疫规划工作信息化需求。

Objective To understand the sero-epidemiology of hepatitis B among healthy population in some districts of Hubei province,and provide evidence for establishing the immunization strategy.Methods Cluster random sampling method was conducted,HBsAg and anti-HBs level were detected in healthy population from three counties belonging to two cities.Results Atotal of 700 healthy people were monitored,the total positive rate of HBsAg was 2.1%,and the positive rate of HBsAg for the two cities were 1.7% and 2.6%,respectively,the difference was not-significant(χ2=2.409,P=0.270).The positive rate of HBsAg of 0~4,15~ age group were 0.67%,and 5% respectively,while 15~19 age group being the highest(7.0%).There was significant difference among different age groups(χ2=18.530,P=0.005).There was no significant difference between the people living in urban and rural area(χ2=0.613,P=0.434).The total positive rate of anti-HBs was 56.3%,and the positive rate of anti-HBs for the two cities swere 51.4% and 61.1%,respectively,the difference was significant(χ2=8.989,P=0.011).The positive rate of anti-HBs were significantly different among the age groups(χ2=35.661,P=0.000),the 0~1,0~4,5~14 and 15~ age groups were 77%,63.67%,42.5% and 59%,respectively.There was no significant difference between the people lived in countryside and urban area(χ2=2.322,P=0.128).Conclusions The positive rate of HBsAg among the young was low,especially those ≤5 year old children(1%).But the level of anti-HBs among healthy people was not high enough in some districts of Hubei province,especially among the 5-14 age group.Therefore,routine immunization should be reinforced,and Hepatitis B revaccination should be implemented for some parts of the people.This is to enhance the immunity level against hepatitis B among healthy population,and for the further control of hepatitis B.

Objective To evaluate the safety and effect of vaccines, collect and administrate the information of immunization, then adjust the strategy of influenza A H1N1 vaccine immunization. Methods We upgraded the report client software and information management platform with client/server and browser/server, and exchanged the data between clients and national information platform with XML Web service principle to manage and use the information. Results By Dec. 2010, 70 104 429 of influenza A H1N1 vaccine immunization cases from clients have been reported to the national information platform. We got the information of immunization cases by area, age groups, occupations and lot numbers. Conclusion We could dynamic monitor the immunization information with the directly reporting of clients and manage the vaccination activity.

目的了解2004年以来湖北省儿童免疫规划疫苗接种率,分析影响因素,评价工作成效,为进一步改进免疫规划工作措施提供决策依据。方法 用分层容量比随机抽取县级调查单位共10个,用整群随机抽取乡镇级调查单位共50个,用容量比整群抽取村级调查单位共461个,入户调查2004-01-01/2010-06-31出生的适龄儿童。结果全省调查适龄儿童37 944人,平均建证率为91.75%,平均建卡率为89.84%;五苗单苗基础免疫平均接种率维持在90%以上,五苗全程平均接种率为87.29%,卡痕率为73.45%,乙肝疫苗首针及时接种率88.74%。但加强疫苗和扩大国家免疫规划新增疫苗平均接种率均低于85%。结论 全省平均接种率基本维持较高水平,但建证率、建卡率、加强疫苗及扩大国家免疫规划新增疫苗接种率均离目标要求有不同程序的差距,今后应重点强化相关工作措施,提高免疫规划工作质量。

Objective To know the immunization coverage rate of EPI vaccines since 2004 in Hubei and find the factors associated with children who were not inoculated.Methods Stratified random sampling was conducted by selecting 10 counties in the investigation of immunization of children born from January 1,2004 to December 31,2009.Descriptive epidemiology method was conducted to analyse the rate of inoculation and unvaccinated reasons.Results The routine immunization coverage rate of BCG,OPV,DPT,MV/MR/MMR and HepB was all more than 95%,and the five vaccines coverage rate was all more than 89.64%,and the timely rate of immunization of HepB1 was 91.13%.The immunization coverage rate of JE,MenA1,MenA2 and HepA,which were included in EPI recently,was 71.82%、80.27%、73.74% and 57.42% respectively.The reinforced immunization coverage rate of DPT,OPV,MV/MR/MMR,MenAC1 and JE was 80.10%、76.29%、82.35%、58.48% and 59.93% respectively.Sickness accounted for 52% factors involved in failure of immunization BCG.Lack of positivity of immunization of OPV、DPT、MV、HepB、JE、MenA、MenAC、HepA accounted for 57.9%、47.7%、40.3%、45.9%、38.8%、44.6%、46.2%、39.0% respectively.Conclusions The routine immunization rate of the five Immunization program vaccines were still high.The reinforced immunization coverage rates decreased with the increase of age.Lack of positivity of immunization of parents for their children led to the lower rate of inoculation of all vaccines.

目的 提高湖北省项目地区新生儿乙肝疫苗接种率和首针及时接种率,特别是首针及时接种率,全面推行自毁型注射器,实施安全注射,降低乙肝发病率.方法 加强领导、规范实施；保障项目经费；加强乙肝疫苗、注射器材管理；采取综合措施,提高接种率；推行自毁型注射器,确保安全注射；加强人员培训,提高项目管理和业务水平；开展多种形式的健康教育,普及乙肝防治知识；加强督导,不断改进工作质量.结果 项目实施前的2002年,湖北省项目地区乙肝疫苗首针及时接种率为32.06％,全程接种率为81.27％,项目实施后的2009年,乙肝疫苗首针及时接种率为94.97％,比2002年提高了196.23％；全程接种率为99.31％,比2002年提高了22.20％.结论 项目采取的策略和各项措施的实施,实现了项目目标,显著提高了乙肝疫苗首针及时接种率和全程接种率,全省实现了安全注射,15岁以下人群乙肝发病率显著下降.

Objective To Evaluate the surveillance system through analyzing the reported cases of hepatitis B by surveillance System of Hubei province,National Immunization Programme and National Notifiable Disease Reporting System.Methods To compare and analyze the reported cases of Hepatitis B.Results Reported cases in Surveillance System of China National Immunization Programme in Hubei province were incomplete,and much less than that reported in National Notifiable Disease Reporting System.The reported proportion shows a increasing trend.The first three with high reported proportion are Jingmen,Jingzhou and Xianning.The personnel in charge of report work don't know the definition of for sure.Conclusion It is necessary to strengthen the National Immunization Programme system for hepatitis B to reporting the acute cases among the children under 15 years old.

Objective To investigate the epidemic characteristics of hepatitis A during 1997-2010 in Hubei province,in order to provide evidence for formulating control strategy.Methods The reported epidemic data of 1997-2010 and the reported viral hepatitis A from public emergency events during 2004-2010 in Hubei province were statistically analyzed with descriptive epidemiological method.Results The reported cases and incidence rate of viral hepatitis A were declining during 1997-2010 in Hubei province.There were viral hepatitis A cases reported in every month of the year,with more cases in spring and summer.The majority were sporadic,outbreak occurred occasionally.Most cases were farmers,students,workers,cadre or staff members,and children,aged 5-49 years old(70.39%),and the proportion of farmers was ascending.Male cases were more than female.All outbreaks occurred in schools.conclusions Epidemic of viral hepatitis A is still a serious public health problem. Conclusion Strategy should be adopted and focused on children,adolescents and farmers,particularly young and middle-aged.

Objective To explore the outcome of the model for immunization information management system.Methods On the basis of modular design,system analysis method,computer technology,network technology and communication technology,the system architecture,server systems and network architecture for immunization information management system were designed.Results Hubei immunization information management system architecture was consisted of five platforms and three systems,they worked together to support the task;Server system design was on the ground of the three-level logical architecture: WEB server-Application server-database server.The network architecture system,after nearly a year of trial and improvement,showed that the system was stable,easy to use and fully functional.Conclusions The system design was reasonable,advanced,and the results were satisfactory,it could meet the need of immunization information management system in Hubei.