某市新型农村合作医疗病人、资金流向对乡村卫生服务的影响

目的了解乡村医疗服务状况和参合农民受益程度,为提高新农合医疗服务水平提供科学依据。方法通过报表和问卷收集昆明市实施新农合的14个县(市、区)的资金流向、患者流向、参合农民对医疗机构的评价以及党政干部和医疗人员对补偿比例的评价。结果大量的住院病人和资金流向县及县级以上医疗机构,参合农民对乡村医疗机构评价不高,党政干部和卫生人员大部分表示应该提高补偿比例。结论应通过适当提高新农合补偿比例、调整资金流向,提高基层医疗机构的服务水平,让参合农民得到更多实惠。

2008年四川省阿坝藏族羌族自治州人与家畜棘球蚴病流行病学调查研究

目的调查并分析棘球蚴病在四川省阿坝藏族羌族自治州人群和家畜中的流行与分布状况。方法调查分为人群调查和家畜调查两部分。人群调查按WHO公布的棘球蚴病诊断标准(WS257-2006)[1],应用B超对全州13县141个棘球蚴病流行乡镇常驻人口进行患病率调查;应用ELISA法检测12岁以下儿童血清抗棘球蚴IgG;家畜调查检测犬粪抗原阳性率;并在各县定点屠宰场检查宰杀的牛羊胸腹腔,确定牛羊感染情况。结果人群调查:B超筛查共计48288人,确诊患者470人,检出率为0.97%,其中泡型棘球蚴病患者19人,囊型棘球蚴病患者451人;检测儿童血清IgG人数5372人,其中阳性358人,阳性率6.67%。家畜调查:共检测犬粪抗原5814份,阳性数989份;阳性率17.01%,检查牦牛绵羊共3336头,发现113头感染,感染率为3.39%。结论四川省阿坝州人群与家畜中存在泡型和囊型棘球蚴病流行,以囊型为主。

Influencing factors analysis of spontaneous knee joint osteoarthritis among middle aged and old aged pople in Xi'an

Objective:To explore the prevalence rate of knee joint osteoarthritis and its pathogenetic fea- tures among the middle-aged and old aged people in the urban and rural area of Xi'an.Methods:From May to October 2005,1538 Han nationality above 40 years in Xi'an were investigated according to strati- fied and cluster random sampling.The same questionnaire was delivered to subjects who had been given normotopia and lateral position radiographic examination in both knees.Excluded from etiological arthri- tis,some subjects with clinical symptoms and a radiographic grade (beyond Kellgren & Lawrence gradeⅡ) were finally diagnosed as spontaneous knee joint osteoarthritis.All analyses were performed with SPSS 13.0 and t test,U test.Single factor analysis and multiple logistic regression analysis were used to analyze dates.Results:The total prevalence of spontaneous knee joint osteoarthritis was 12.1% with 2.5% and 2.1% for right and left knees,respectively.The prevalence of knee joint osteoarthritis in wom- en was 2.5 times of that in men (17.2% vs 6.8%,P=0.000).the osteophyte prevalence in women was 2.3 times of that in men (26.5% vs 11.4%,P=0.000).The prevalence of knee joint osteoarthritis and osteophyte increased with the growth of age.So did the symptomatic knee,except for the age group of 56- 60 years and 66-70 years.The prevalence of symptomatic knee joint for urban area was significantly higher than that for rural area (56.3% vs 45.3%,P=0.003).In women,the prevalence of knee joint os- teoarthritis increased significantly with the increasing of body mass index,which had not been observed in men.Female and obesity are the risk factors for osteoarthritis,but bean and its products and meat could prevent the osteoarthritis.Conclusion:Old age,female and obesity serve as risk factors for knee joint os- teoarthritis.

Epidemiology of Hepatitis B and Associated Liver Diseases in China

Hepatitis B virus (HBV) infection has long been a critical public health challenge in China. National surveys revealed a prevalence of approximate 10% for chronic HBV infection in general population. HBV has been the leading cause of chronic hepatitis, cirrhosis, and liver cancers in Chinese population and a common pathogen of acute viral hepatitis. Meanwhile, the epidemic provided important opportunities to research the natural history, public health impact, and therapeutic and preventive interventions for HBV in China. In this review, we summarized the selected key epidemiological studies since 1970s regarding HBV infection and its associated liver diseases in China, and provided considerations for future research, prevention and treatment of HBV.

Fusarium Vascular Infection of Oil Palm： Epidemiology, Molecular Diagnostic Tools and the Potential of Fusarium Suppressive Soil in Malaysia

Vascular wilt disease caused by Foe （Fusarium oxysporum f. sp. elaeidis） invades the host xylem and causes a devastating disease of oil palm in west and central Africa. This disease has not been reported in Southeast Asia, in spite of long term importation for breeding purposes of African seed and pollen, shown in this laboratory at the University of Bath to be contaminated with Foe disease epidemiology was recently studied in plantations in Ghana. Infection mainly occurred in clusters, implying root-root transmission rather than aerial spread by spores. Molecular diagnostic tools has being developed for： （1） rapid detection and quantification of Foe in plant tissue, soil, seed and pollen for quarantine purposes in order to prevent transcontinental spread of Foe; and （2） to test efficacy of putative disease resistant or tolerant palm genotypes. We have investigated the possibility of Foe-suppressive soils in Malaysia in order to explain the non-appearance of this vascular disease there and possibly to reveal other potential biocontrol agents. The explanation as to why Malaysia has not yet attained the disease is likely to revolve around the soil properties, in particular the microflora. This review reported that greater disease severity based on visual symptoms occurred in autoclaved soils and compost than in untreated soils when oil palm seedlings artificially infected with Foe.

SEXUALLY TRANSMITTED DISEASES:INCIDENCE AND DISTRIBUTION

The incidence of sexually transmitted diseases(STDs) increased from 26. 04 per 100 000 in 1987 to 104. 81 per 100 000 in 1993 in selected areas of the country. Gonorrhea is by far the most common STD but its constituent ratio declined because of a rapid increase of nongonococcal uretheritis and genital warts during most recent years. The incidence of syphilis is relatively low and cases of congenital infection are noted. The wide spread of resistant Neisseria gonorrhoeae infection gives a challenge to the therapeutical and control strategies of STDs. Sexually transmitted Chlamydia trachomatis infections, an important cause of urethritis. cervicitis and pelvic inflammatory disease. is becoming common in our country. Attention has been drawn on viral hepatitis in their means of transmission by sexually behaviors, and also, on the homosexuals, assumed to be the high risk group to catch STDs. Coordinated national efforts to control STDs in China have been taken.

Epidemiology of pulmonary hypertension in the elderly

1 Introduction Pulmonary hypertension （PH） is a haemodynamic and pathophysiological condition defined as increase in mean pulmonary arterial pressure≥ 25 mmHg at rest as assessed by right heart catheterization （RHC）.

Pond Water Quality and Cyclops Population in Dracunculiasis Endemic Areas of Ogun State, Nigeria

This study investigated the association between Cyclops population and physico-chemical properties of pond water in villages selected from Odeda and Obafemi-Owode areas of Ogun State, Nigeria. Epidemiological data on guinea worm were collected from Global 2000 South-West Zonal Office. Two villages were selected from each of Odeda and Obafemi-Owode LGAs while one village was sampled from Abeokuta North LGA as control. Physico-chemical analysis and microscopic examination of pond water utilized for domestic purpose in the selected villages were conducted. Mean values of 6.78±0.10, 33.00±0.14℃, 1.09＋0.80 mg/L and 1.30±0.25 mg/L were recorded for pH, temperature, DO and nitrate respectively while control had 7.30±0.14, 36.30±14℃2, 2.72±0.14 mg/L and 5.80±0.57 mg/L. These values with the exception of DO and nitrate were within WHO standard but vary significantly （P〈0.05） between the villages. The results further showed that BOD, COD and acidity were positively correlated with Cyclops population during the rainy and dry seasons while temperature, nitrate, pH, and alkalinity have negative correlation coefficients （r=-0.81, -0.91） with Cyclops population during the two seasons. Regression analysis showed that nitrate, BOD and acidity levels explained 67.7 percent, 50.4 percent and 44.5 percent of Cyclops population in the ponds. Guinea worm eradication in endemic rural areas should incorporate ecological strategy.

Analysis on the Trends of HIV/AIDS Epidemic in Shenzhen

Objective:To make a summary of the trends of HIV/AIDS epidemic and route of transmission in Shenzhen from 1992 to 2000 to provide scientific evidence for the policy-maker to formulate strategies of HIV/AIDS prevention and control in Shenzhen.Method:To analyze HIV/AIDS surveillance data in Shenzhen from 1992 to 2000 by software Epi-Info. Results: One hundred and two HIV positive cases including 18 AIDS cases (three cases deceased) were identified in Shenzhen from 1992 to 2000. Among the 102 cases, those infected via sex were 46.0%, intravenous drug use 42.9%.Blood donation 7.8%, blood transfusion recipient 3.9%, and indeterminate 2%. Conclusion: In Shenzhen, HIV/AIDS infection is spreading and increasing rapidly. Effective prevention measures must be taken to reduce the HIV prevalence as soon as possible.

Hospital ethical climate associated with the professional quality of life among nurses during the early stage of COVID-19 pandemic inWuhan,China:A cross-sectional study

Objectives:To describe the professional quality of life and explore its associated factors among nurses coming from other areas of China to assist with the anti-epidemic fight inWuhan and especially examine whether the hospital ethical climate was independently associated with nurses’professional quality of life.Methods:A cross-sectional online survey was conducted from March 2020 to April 2020.The nurses working in Wuhan from the other parts of China were the target population.The Professional Quality of Life Scale version 5,the Hospital Ethical Climate Survey,and a basic information sheet were used to collect data.Descriptive statistics,t-test,ANOVA,Pearson correlation,and multiple linear regression analysis were used to analyze the data.Results:In total,236 nurses participated in this study,and 219 valid questionnaires were analyzed.The average age of the participants was 31.2±5.0 years.Most nurses were female(176/219;80.4%)and married(145/219;66.2%).In term of professional quality of life,nurses reported moderate(129/219;58.9%)to high(90/219;41.1%)levels of compassion satisfaction,low(119/219;54.3%)to moderate(100/219;45.7%)levels of burnout,and low(67/219;36.0%)to high(10/219;4.6%)levels of secondary traumatic stress.Regarding hospital ethical climate,nurses reported moderately high hospital ethical climates with an average score of 4.46.After controlling for socio-demographic characteristics,the multiple linear regression models showed that the hospital ethical climate subscale of“relationship with physicians”was independently associated with the compassion satisfaction(b=0.533,P<0.01)and burnout(b=0.237,P<0.05);the hospital ethical climate subscale of“relationship with peers”(b=0.191,P<0.01)was independently associated with the secondary traumatic stress.Conclusions:During the early stage of the pandemic,nurses demonstrated moderate to high level of compassion satisfaction,low to moderate level of burnout,and all nurses experienced secondary traumatic stress.Nurses perceived a high level of hospital ethical climate,and the perceived hospital ethical climate played an important role in promoting nurses’professional quality of life during a lifethreatening infectious disease pandemic.

A scoping review of COVID-19-related stress coping resources among nurses

Objective:The entire mental health hazard among the nurses dealing with COVID-19 is just the tip of the iceberg.The goal of this study was to find acceptable and adaptive coping techniques for nurses in order to keep the healthcare system resilient during and after the COVID-19 pandemic.Method:The scoping review search took place from January 2020 to May 2021 published articles,and the results were saved in Endnote software.For data synthesis and review,the Joanna Briggs Institute manual and PRISMA-ScR principles were followed.Following backward and forward screening to exclude redundant,irrelevant,and ineligible studies,13 studies(3,613 nurses)were finally selected for this review.Results:The majorities of participants in these studies were female and had children,and worked in departments of critical care,emergency,and fever clinics.Safety concerns for family or colleagues,as well as a lack of safe working environment,were the primary causes of the mental illness.Professional re-sponsibility attitude,COVID-19 training,workplace safety,team spirit,and a few relaxation activities such as deep breathing,reading books,watching movies,and praying,on the other hand,were found to be beneficial for stress coping among nurses.Conclusion:Mentally fit nurses are more capable and flexible in the face of any life-threatening outbreak,even if it is very contagious.Several coping strategies were found to be effective for nurses during the COVID-19 pandemic,whereas problem-specific intervention trials might yield even better results.We should not delay specific mental health interventions to keep them viable and more efficient during a pandemic battlefield,whereas Post-Traumatic Stress Disorder and suicide rates can destroy the entire health care system.

On the Reproduction Number and a Presentation of Results for Infectious Diseases Models

The classical Kermack-McKendrick homogeneous SIR （susceptible, infected and removed） model is well known, Its general solution is a function of the unique parameter （the reproduction number） that is equal to a mean number of secondary cases produced by a typical infected individual in a completely susceptible population. If the reproduction number is more than one （the threshold value） its value describes an epidemic scope： larger values correspond to more severe epidemics. In the more complex compartment SIR models the population is divided into several non-overlapping groups. It allows us to partly remove assumptions of the classical model. It is well known that for this kind of models, just as for the classical model there is the threshold parameter R0. Usually it is called by the same name--the reproduction number--though the physical meaning of this parameter has changed. The main purpose of the paper is to show that this new parameter is a not unique measure of an epidemic severity for any compartment SIR model. In particular it means that for such models comparison of the severity of two epidemics by simple comparing values of their reproduction numbers is incorrect. For compartment models these statements were proved with the help of the corresponding ODEs analysis. Very popular now individual-based models （IBMs） are more complex in comparison with the compartment ones since they use overlapping groups （school children are members of families also, for example）. In such a case Diekmann＇s calculation method for the reproduction number used in many papers is inapplicable as well as a presentation the simulation results obtained as functions of this parameter.

A Molecular Epidemiology Analysis of HIV in Shenzhen and HIV Env Gene Variation Replication Analysis

Objective: To analyze molecular trends of the HIV epidemic in Shenzhen. Methods: Serum collected from Shenzhen AIDS patientsbetween 1992-1999 was analyzed using molecular techniques.DNA fragments of the HIV-1 Env gene were amplified bynested PCR from uncultured peripheral blood mononuclearcells (PBMCs) from these serum samples. The C2-C3 region ofthe Env gene was sequenced and analyzed. Specific high-riskbehaviors were also analyzed. Results: We found that the transmission of HIV in the citywas mainly through sexual behaviors (46.0%). There werefour HIV-1 subtypes: B', B, C and E with 6.31%, 7.95%,3.09% and 8.92% gene divergence inside each subtype inShenzhen. These results suggested that epidemic times were 6,8, 3 and 9 respectively. The main cpidemic subtypes were Eand B strains. AIDS patient's antigenic variation was slightlyhigher than that of HIV infected individuals. Conclusion: Surveillance data reflect trends and theepidemic time of HIV which will be useful for policy makersto formulate effeive strategies of HIV/AIDS prevention and control in Shenzhen.

A review of trachoma history in China: research, prevention, and control

Trachoma is one of the most widespread blinding eye diseases, which is harmful to human visual health. The efforts to prevent and control trachoma in China can be divided into three periods, i.e., highly epidemic period, research on pathogenesis and control of trachoma, and blinding trachoma elimination and epidemiological evaluation. In 1956, Prof. Feifan Tang and Xiaolou Zhang first discovered and isolated Chlamydia trachomatis, which clarified the cause of trachoma, and kick-started a fresh chapter in trachoma research, prevention, and control around the world. Although, the prevalence of trachoma differed in different areas, the average prevalence once exceeded 50% and was as high as 90% in some areas before and at early liberation of China. Therefore, the government-led efforts were made to comprehensively prevent and control trachoma, including development of National Plan for the Prevention and Control of Trachoma, nationwide screening and treatment of trachoma, implementation of National Patriotic Health Campaign and improvement of water supply and lavatories. After decades of effort, China reached the goal of eliminating blinding trachoma in 2015. China has gained remarkable achievements in the prevention and treatment of trachoma, making outstanding contributions toward the goal of eliminating trachoma worldwide. The research, prevention, and control of trachoma in China were reviewed in this paper.

Epidemiological characteristics of fatal pedestrian ac- cidents in Fars Province of Iran： a community-based survey

Objective： To determine the epidemio logical characteristics of fatal pedestrian accidents in Fats Province of Iran. Methods： This crosssectional study was conducted in Fats Province of Iran during a 29month period from March 2009 to July 2011. The data were from the Fats Forensic Medi cine Registry, In 4 923 recorded road traffic accident fatalities, 971 deaths were due to pedestrian accidents. The demographic and accidentrelated information were analyzed by SPSS ver sion 11.5. P value less than 0.05 was considered significant. Results： The mean age of decedents was （47.2±26.2） years, ranging from 6 months to 103 years old. Males ac counted for 69.8% of all deaths. Fatal accidents were mostcommon in September; 56.1% of the fatal injuries occurred on intracity roads and 33.1% on extracity roads. Fatal head injuries were present in 60.54% of cases. Evaluation of the injury site and the cause of death found that they were significantly associated with age, interval between injury and death. Besides, the type of roads played an important role in mortality. Conclusion： Although the clinical management of trauma patients has been improved in our country in the recent decade, decreasing the burden of injuries needs co ordination among trauma system organizations.

GLOBAL ATTRACTIVENESS OF DISCRETE-TIME EPIDEMIC OUTBREAK IN NETWORKS

Epidemic dynamics in networks have attracted a great deal of attention from researchers of many fields. In this paper, we mainly study the global behaviors of discrete-time epidemic model in heterogenous networks. By theoretical analysis, we show that the model can be characterized by the basic reproduction number R0. When R0 is smaller than unit, the disease-free equilibrium is globally stable, while R0 is larger than unit, the unique positive equilibrium is globally attractive.

Healthcare utilization and costs associated with cholangiocarcinoma

Background and aims.Cholangiocarcinoma is a rare but devastating malignancy associated with a poor prognosis and a high mortality rate.With the recent advances in detection and treatment,it is unclear if the incidence and outcomes of cholangiocarcinoma are improving in the United States.The aim of this study was to evaluate the trends in the incidence,costs and mortality rates of cholangiocarcinoma-related hospital admissions in the USA.Methods.We utilized the National Inpatient Sample Database(NIS)from 1997–2012 for all patients in whom cholangiocarcinoma(ICD-9 code 155.1,156)was the principal discharge diagnosis.The temporal trends in the number of hospital admissions,length of stay and,hospitalization costs along with mortality rates over the study period were determined by using regression analysis for trends.Results.There was a significant increase in the number of hospital admissions for cholangiocarcinoma as the principal diagnosis from 1997 to 2012(10357 vs 11970,P<0.001).The mean length of stay for cholangiocarcinoma decreased by 17%between 1997 and 2012 from 9.5 days to 7.9 days(P<0.001).However,during the same period,the mean hospital charges per patient(adjusted for inflation)increased 113.25% from $36460 in 1997 to$77753 in 2012.The in-hospital mortality rate decreased from 9.3% in 1997 to 6.4% in 2012(P<0.001).Conclusions.There was a significant increase in the number of hospital admissions and associated costs from cholangiocarcinoma in the USA between 1997 and 2012.However,this was accompanied by a decrease in the inpatient mortality rates from cholangiocarcinoma.