代谢综合征成重要公卫问题

全国营养与健康调查技术工作组最近所做的专项统计表明．我国18岁以上人群中代谢综合征患病率高达6．6％．成为不容忽视的重要公共卫生问题．急需开展预防干预活动。

社区短信息

不安全注射已成严重公卫问题 日前在京召开的安全注射研讨会透露,在发展中国家,每年儿童接受55亿次注射,其中10%的免疫注射是不安全的。我国每年包括免疫接种在内的各种注射约为30亿次,有些地区存在不经消毒重复使用注射器和针头、一次性注射器使用后回流市场的现象。此外,医务人员工作中被针头刺伤现象也不少见。

Celiac disease in the developing countries: A new and challenging public health problem

In the past, celiac disease was believed to be a chronic enteropathy, almost exclusively affecting people of European origin. The availability of new, simple, very sensitive and specific serological tests （anti-gliadin, anti- endomysium and anti-transglutaminase antibody assays） have shown that celiac disease is common not only in Europe and in people of European ancestry but also in the developing countries where the major staple diet is wheat （Southern Asia, the Middle East, North West and East Africa, South America）, both in the general population and in the groups at risk. Gluten intolerance thus appears to be a widespread public health problem and an increased level of awareness and clinical suspicion are needed in the New World where physicians must learn to recognize the variable clinical presentations （classical, atypical and silent forms） of celiac disease. In the developing countries, both serological screening in the general population and serological testing in groups at risk are necessary for an early identification of celiac patients. The gluten-free diet poses a challenging public health problem in the developing countries, especially since commercial gluten-free products are not available.

Worldwide epidemiology of liver hydatidosis including the Mediterranean area

The worldwide incidence and prevalence of cystic echinococcosis have fallen dramatically over the past several decades.Nonetheless,infection with Echinococcus granulosus(E.granulosus)remains a major public health issue in several countries and regions,even in places where it was previously at low levels,as a result of a reduction of control programmes due to economic problems and lack of resources.Geographic distribution differs by country and region depending on the presence in that country of large numbers of nomadic or semi-nomadic sheep and goat flocks that represent the intermediate host of the parasite,and their close contact with the final host,the dog,which mostly provides the transmission of infection to humans.The greatest prevalence of cystic echinococcosis in human and animal hosts is found in countries of the temperate zones,including several parts of Eurasia(the Mediterranean regions,southern and central parts of Russia,central Asia,China),Australia,some parts of America(especially South America)and north and east Africa.Echinococcosis is currently considered an endemic zoonotic disease in the Mediterranean region.The most frequent strain associated with human cystic echinococcosis appears to be the common sheep strain(G1).This strain appears to be widely distributed in all continents.The purpose of this review is to examine the distribution of E.granulosus and the epidemiology of a re-emerging disease such as cystic echinococcosis.

Crimean-Congo Hemorrhagic Fever: An Overview

Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral infection that is a serious threat to humans. The disease is widely distributed in Africa, Asia, and Europe and has developed into a serious public health concern. Humans become infected through the bites of ticks, by contact with a patient with CCHF, or by contact with blood or tissues from viremic livestock. Microvascular instability and impaired hemostasis are the hallmarks of the infection. Infection in human begins with nonspecific febrile symptoms, but may progress to a serious hemorrhagic syndrome with high mortality rates. Enzyme-linked immunoassay (ELISA) and polymerase chain reaction (PCR) are the most used and specific tests for the diagnosis. The mainstay of treatment is supportive. Although definitive studies are not available, ribavirin is suggested to be effective especially at the earlier phase of the infection. Uses of universal protective measures are the best way to avoid the infection. In this review, all aspects of CCHF are overviewed in light of the current literature.

Animal models to study Mycobacterium tuberculosis and HIV co-infection

Mycobacterium tuberculosis(M.tb) and human immunodeficiency virus(HIV) co-infection has become a public health issue worldwide. Up to now, there have been many unresolved issues either in the clinical diagnosis and treatment of M.tb/HIV coinfection or in the basic understanding of the mechanisms for the impairments to the immune system by interactions of these two pathogens. One important reason for these unsolved issues is the lack of appropriate animal models for the study of M.tb/HIV coinfection. This paper reviews the recent development of research on the animal models of M.tb/HIV co-infection, with a focus on the non-human primate models.

Antihyperglycemic Effect of Zygophyllum Geslini Aqueous Extract in Streptozotocin-lnduced Diabetic Wistar Rats

Diabetes mellitus is a major public health concern. Finding a cure for the disease without its side-effects is the objective of modem medicine. The plant is a raw material for these studies. Zygophyllum gemini is a species widely used in Algeria to treat this disease. Our aim is to investigate the antidiabetic activity of aqueous extract and its fractions in induced diabetic Wistar rats by streptozotoein. The three drugs caused a decrease in blood sugar for 14 days. Butanolic fractions （BF） fraction gives significant results on blood glucose after seven days and significant regulating oral glucose tolerance. This preliminary study shows that Z. geslini is endowed with a remarkable antidiabetic activity and that further studies are needed.

Attitudes and Practices of Health Care Providers Regarding the Management of Uncomplicated Malaria in Abidjan, Cote d＇lvoire

Malaria is a major public health problem in the Cote d＇Ivoire where it is the leading cause of morbidity and mortality. The objective of this study was to assess the knowledge, attitudes and practices of health care providers on the diagnosis and therapeutic procedures used to ensure the management of uncomplicated malaria in the health district of Abidjan. A cross-sectional study was conducted from November 2008 to December 2008 among 169 caregivers who treated 1,691 cases of uncomplicated malaria. Results： The knowledge of the caregivers of the national guidelines regarding malaria was sufficient （89%）. A diagnosis of uncomplicated malaria was established only on clinical arguments （70%）. The percentage of patients who were prescribed artemisinin-based combination therapy （ACT） was 86%. However, 25% of the antimalarials drugs that were prescribed to patients （oral quinine, artemisinin derivatives monotherapy, and herbal medicine） did not meet the recommendations on first choice treatment as suggested by the national program against malaria. These results indicate sufficient knowledge of the national guidelines for the treatment of malaria by health care providers as evidenced by acceptable prescriptions for ACTs despite an incomplete knowledge of the guidelines.

Evaluation of Total and Faecal Coliforms and Salmonella spp. in Irradiated Mussels from Brazil

Ilha Grande Bay is one of the biggest producers of bivalves of Rio de Janeiro State. Statistics reports of foodborne diseases are quite low in Brazil, however, this fact is a matter of Public Health. In their majority concerning consumption of bivalves meat, the availability of safe products requires the use of technology as food irradiation. The objective of this paper was to evaluate the presence of bacteria resulting from the environmental contamination and epidemiological importance, Salmonella spp., total and faecal coliforms of mussel （Perna perna） from that region and the use of irradiation on the product in natura. Fifteen indicative samples of mussel were collected from five gr owing points in Ilha Grande Bay. A sample of each point was irradiated with doses of 1.0 and 1.5 kGy. The bacteriological analysis followed the instructions of the Brazilian legislation. The samples presented irregularities in relation to Salmonella spp. and faecal coliforms, the latter for the control group. The control group was noticed as not appropriate for consumption. The dose of 1.0 kGy was effective for the reduction of faecal coliforms, but ineffective for the extinction of Salmonella spp.

Time analysis of fatal traffic accidents in Fars Province of Iran

Objective： To analyze the time factor in road traffic accidents （RTAs） in Fats Province of Iran. Methods： This study was conducted in Fars Province, Iran from November 22, 2009 to November 21,2011. Victims＇ information consisted of age, sex, death toll involving dri- vers or passengers of cars, motorcycles and pedestrians, and site of injury etc. Accidents were analyzed in relation to hour of the day, season of the year, lighting condition in- cluding sunrise, sunset, daytime and nighttime. Results： Atotal of 3 642 deaths （78.3% were males, and the ratio of males to females was about 3.6：1） were studied regarding their autopsy records. There was a steady in- crease in fatal accidents occurring at midnight to 15：59. The risk of being involved in a fatal traffic accident was higherfor those injured between 4：00 to 7：59 than at other times （OR=2.13, 95% C11.85-2.44）. The greatest number of fatal RTAs took place in summer. Mortalities due to RTA during spring and summer were more pronounced at 20：00 to 23：59 and midnight to 3：59, whereas mortalities in fall and winter were more pronounced from 12：00 to 15：59. Conclusion： The high mortality rate ofRTAis a major public health problem in Fars Province. Our results indicate that the time is an important factor which contributes to road traffic deaths.

Contribution of epigenetics in diabetic retinopathy

Diabetes has become the epidemic of the 21 st century, and with over 90% patients with diabetes becoming at a risk of developing retinopathy, diabetic retinopathy has emerged as a major public health concern. In spite of cutting edge research in the field, how retina and its vasculature are damaged by the diabetic milieu remains ambiguous. The environmental factors, life style or disease process can also bring in modifications in the DNA, and these epigenetic modifications either silence or activate a gene without altering the DNA sequence. Diabetic environment up- or downregulates a number of genes in the retina, and emerging research has shown that it also facilitates epigenetic modifications. In the pathogenesis of diabetic retinopathy, the genes associated with important enzymes(e.g., mitochondrial superoxide dismutase, matrix metalloproteinase-9 and thioredoxin interacting protein) and transcriptional factors are epigenetically modified, the enzymes responsible for these epigenetic modifications are either activated or inhibited, and the levels of micro RNAs are altered. With epigenetic modifications taking an important place in diabetic retinopathy, it is now becoming critical to evaluate these modifications, and understand their impact on this slow progressing blinding disease.

Heart failure research in China： current status and future direction

Heart failure is a major public health problem worldwide. Despite advances in the therapy and care of heart failure, morbidity and mortality remain persistently high. Recent years have witnessed major breakthroughs in the investigations of pathogenesis, prevention, and treatment of heart failure in China. It is noteworthy that the continuing and growing support from funding agencies in China including the National Natural Science Foundation of China has yielded substantial effects on the basic and clinical research in heart failure in the last decade. In this review, we provide an update on the current status of heart failure research, both basic and translational/clinical, in China, including funding and publications. We also discuss the future challenges and possible strategies in improving our understanding and management of heart failure in China.

Discovery of ferrocene-carborane derivatives as novel chemical antimicrobial agents against multidrug-resistant bacteria

Antimicrobial resistance has now become a very serious global public health problem. New drug discovery and development are urgently needed to combat the growing threat of multidrug-resistant (MDR) bacteria. The aim of this study was to explore the potential application of three ferrocene-carborane derivatives as new promising agents to confront the problem of increasing antibiotic resistance. The results of agar diffusion bioassay, minimal inhibitory concentrations (MIC) testing and time-kill assay illustrate their broad-spectrum antimicrobial activities to both American Type Culture Collection (ATCC) control strains and MDR clinical isolates. It is evident that the relevant antimicrobial properties are all in a dose-dependent manner and gradually transform into a bactericidal effect from a bacteriostatic effect with the increasing of the drug concentration. Furthermore, these ferrocene-carborane derivatives have no/little toxic effect on normal cells like HELF cells and lead to little hemolysis at their MICs. This raises the possibility to develop novel antimicrobial drugs using these new ferrocene carborane derivants.

Asymptomatic stage of human immunodeficiency virus infection is the optimal timing for its management with Traditional Chinese Medicine

Acquired immune deficiency syndrome(AIDS) is a worldwide public health problem and an incurable disease.The roles of Traditional Chinese Medicine(TCM) on AIDS had been recognized and accepted by more and more people.Being a relatively long period,to initiate combination antiretroviral therapy(cART) for the asymptomatic human immunodeficiency virus(HIV) infection patient is not consensus.According to TCM theory,not only the imbalance of Yin and Yang but also the disharmony of internal body function and external natural environment had occurred in the body of the patient,the imbalance and the disharmony should be adjusted by the means of the treatment based on the patters identified among the symptoms in terms of TCM.We aimed to analyze the feature of patients with asymptomatic infection,and compare the advantages and disadvantages of the usage of cART for asymptomatic infection,explored the possible mechanism underlying TCM treatment of the asymptomatic infection,by reviewing the TCM treatment progress on asymptomatic HIV infection.

Epidemiology of patients admitted to a major trauma centre in northern India

Objective： Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northem India. Methods： An observational study of 748 patients chosen by random assortment was carried out over a peri- od of 1 year （August 2008 to July 2009）. Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted. Results： Injuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6：1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries （94.92%） were much more common than penetrating injuries. Among patients with head injury, two wheelers related accidents were the most common （40.3%）. Most spinal cord injuries were caused by falls from height （51.09%）. Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than up- per limb fractures. Conclusion： Strict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and plan- ning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends.

Development and evaluation of a Traditional Chinese Medicine syndrome questionnaire for measuring sub-optimal health status in China

OBJECTIVE:Sub-optimal health status(SHS),in which a person's mind and body exists in a low-quality state of being between disease and health,has become a public health problem that cannot be ignored in China.SHS measurement presents a challenge to the academic fields.We developed and evaluated a questionnaire from the perspective of traditional Chinese medicine(TCM) that embodies the features of TCM syndrome diagnosis for measuring SHS in China.METHODS:The construction of the theoretical framework of the questionnaire was based on a literature review,an expert questionnaire survey and group interviews.The subscales and questionnaire items were screened through a pilot study using statistical means and qualitative analysis.Reliability tests that were used included test-retest reliability,Cronbach's α coefficient,split-half reliability;validity tests included content validity,criterion validity,discrimination validity and construct validity.RESULTS:The final questionnaire,the SHSQ-50,included 50 five-class quantifiable items that encompassed nine subscales:liver stagnation syndrome,liver-Qi deficiency syndrome,spleen-Qi deficiency syndrome,liver-fire syndrome,heart-fire syndrome,stomach-fire syndrome,heart-Qi deficiency syndrome,lung-Qi deficiency syndrome and dampness syndrome.Questionnaires were completed by 268 of the 288 SHS subjects(93.0%) and by 86 of the 94 healthy subjects(91.5%).The Cronbach α coefficients,split-half coefficients and stability coefficients ranged from 0.70 to 0.95,0.67 to 0.87 and 0.88 to 0.98,respectively,for the overall scores and subscales.The Wilcoxon rank test showed statistically significant differences in the subscales and overall scores between the SHS group and the healthy group(P<0.01).Twelve factors with an eigenvalue greater than one were extracted by factor analysis and merged into nine factors,for which the cumulative contribution rate was 63.63%.The nine factors were corresponded to the overall structure of the questionnaire.CONCLUSION:The SHSQ-50 is a reliable and valid instrument for measuring TCM syndrome diagnosis of SHS in China.

Study of infectious conjunctivitis among children in rural areas of Qinghai province

Infectious conjunctivitis is no longer a common eye disease in cities and developed areas, but in remote mountainous regions of China where living conditions are relatively under-developed, the occurrence of infectious conjunctivitis remains a public health issue. Here, we evaluate the ratio of infectious conjunctivitis among primary school students in the rural areas of Xunhua, Huangyuan, and Huzhu Counties in the Qinghai province of China, and report the microorganisms involved in causing infection. Of the 765 eligible primary school students, 694 participated to this study(a response rateof 90.7%), 381 boys and 313 girls, with a mean age of 7.52 years(range 7–9 years). A clinical diagnosis of infectious conjunctivitis was returned for 238 of the 694 children examined. The ratio of infectious conjunctivitis in Xunhua County(46.64%) was higher compared to that in Huangyuan(26.67%; P=0.03) and Huzhu Counties(23.61%; P=0.02). The leading cause of conjunctivitis was bacterial, followed by chlamydial and viral. Our results show that there is a high ratio of infectious conjunctivitis among rural primary school students in Qinghai province.