Etiology,clinical features,and epidemiological analysis of diarrhea patients visiting a gastrointestinal clinic in a comprehensive hospital in Beijing,China,in 2023

Objective:To investigate the clinical features and epidemiology of diarrhea patients and analyze the current distribution of enteropathogens causing diarrhea in a comprehensive hospital in Beijing,China,in 2023.Materials and Methods:From April to October 2023,we enrolled patients with diarrheal diseases who visited the gastrointestinal Clinic in our hospital.The patients'demographic,epidemiological,and clinical features were obtained via a questionnaire.Stool samples were examined for 20 enteropathogens by multiplex polymerase chain reaction testing.Results:We enrolled 260 patients;men and adults accounted for 55.77%and 95.77%of the patients,respectively.The median age was 37 years.Eighty-four enteropathogens,72 bacteria and 12 viruses,were identified in 74 patients.Enteroaggregative Escherichia coli was the predominant agent.Patients with and without pathogens detected in stool samples showed no significant differences in age,sex,gastrointestinal symptoms,and stool characteristics.Possible food-related events were recorded in 57.31%of the patients.Leukocyte counts in patients with bacterial infections were higher than those of patients with viral infections and those with no detected pathogens(p<0.05).Seasonality of bacterial distribution was observed(p<0.05).Conclusion:Bacteria were predominant pathogens among the diarrhea patients.The incidence of diarrhea was related to hot weather and foodborne illness.Bacterial diarrhea may cause systemic infection.The clinical symptoms of infectious diarrhea were usually non-specific and unrelated to the type of infection.Timely and comprehensive multi-pathogen surveillance might be helpful to detect suspected pathogens and promote epidemic prevention and control.

Surveillance, epidemiology, and pathogen spectrum of hand, foot, and mouth disease in mainland of China from 2008 to 2017

Hand,foot and mouth disease(HFMD)was reported in May 2,2008 to be the 38th legally notifiable disease in China's National Notifiable Disease Reporting and Surveillance System.In order to solve the infection,an extensive three-level HFMD surveillance laboratory network was established.In this study,the framework of that network is assessed and the incidence of HFMD in China from 2008 to 2017 is reported using a descriptive epidemiologic method.During these 10 years,a series of techniques have been widely applied in all the network laboratories.Using information and material obtained from the network,a virus bank and database containing 18,238 viruses were established.Nationally,18,184,834 HFMD cases,including 152,436 severe cases and 3633 fatal cases,were reported in mainland of China.The average annual incidence in the population was 133.99/100,000 people,with a maximum incidence of 205.06/100,000 people in 2014.The incidence and mortality rates of HFMD were the highest in children aged 1–2 years.The numbers of reported cases fluctuated,with a high incidence observed every 2 years.An overall increase in the number of reported cases was also observed throughout the study period.Despite this,the incidence of severe cases and the mortality rate have been decreasing.High-risk regions are located in southern,eastern,and central China.Two peaks of HFMD infection cases were observed annually except for Northeast China.Different proportions of enterovirus serotypes were observed during the studied years.The predominant enterovirus varies from year to year,but the disease severity is always closely related to the specific serotype.EV-A71 is the dominant serotype associated with severe and fatal cases,with constituent ratios of 70.03%and 92.23%,respectively.The studied highly sensitive and efficient surveillance network provides information that is critical for prevention and control of the disease.It is extremely necessary and important to continuously conduct extensive virological surveillance for HFMD.

Surveillance of Hand,Foot,and Mouth Disease in China's Mainland (2008-2009)

Objective Since HFMD was designated as a class C communicable disease in May 2008,18 months surveillance data have been accumulated to December 2009.This article was to describe the distribution of HFMD for age,sex,area,and time between 2008 and 2009,to reveal the characteristics of the epidemic.Methods We analyzed weekly reported cases of HFMD from May 2008 to December 2009,and presented data on the distribution of age,sex,area and time.A discrete Poisson model was used to detect spatial-temporal clusters of HFMD.Results More than 1 065 000 cases of HFMD were reported in China's Mainland from May 2008 to December 2009 （total incidence：12.47 per 10 000）.Male incidence was higher than female for all ages and 91.9% of patients were 5 years old.The incidence was highest in Beijing,Shanghai,Zhejiang and Hainan.The highest peak of HFMD cases was in April and the number of cases remained high from April to August.The spatial-temporal distribution detected four clusters.Conclusion Children 5 years old were susceptible to HFMD and we should be aware of their vulnerability.The incidence was higher in urban than rural areas,and an annual pandemic usually starts in April.

Cold weather and Kashin-Beck disease

Kashin-Beck disease(KBD)is an endemic osteoarthropathy.Its distribution region covers a long and narrow belt on the Pacific side and belongs to continental climate with short summer,long frost period,and large temperature differences between day and night.In particular,KBD patients are typically scattered in the rural areas with seasonal features such as cold winters and rainy autumns.Etiological studies have demonstrated that the carrier of pathogenic factors is the grains produced in endemic areas.Risk factors for KBD include fungal contamination of grains due to poor storage conditions associated with cold weather.The epidemiological characteristics of KBD include agricultural area,early age of onset,gender equality,family aggregation,regional differences,and annual fluctuations.A series of preventive measures have been successfully taken in the past decades.National surveillance data indicate that the annual incidence of KBD is gradually declining.

2017—2021年柳州市食源性疾病监测结果分析

目的了解2017—2021年柳州市食源性疾病监测情况,分析其流行病学特征,为进一步提高食源性疾病监测能力策略的制订提供科学依据。方法收集2017—2021年柳州市食源性疾病监测点报告系统中数据,并对采集的粪便/肛拭子标本进行病原体检测,采用描述性流行病学方法进行统计分析。结果2017—2021年柳州市共监测病例13721例,男性6569例,女性7152例;年龄以0~4岁组病例最多(3490例,25.44%),职业以散居儿童居多(3147例,22.94%);发病高峰期为每年的7—9月(3999例,29.15%);病例的主要暴露食品为水果及其制品(2854例,20.80%),可疑暴露食品的包装方式以散装为主(4309例,31.40%),暴露场所以家庭为主(10127例,73.81%)。共采集生物标本3517份,其中致病菌检出率为11.57%,主要为沙门菌(6.11%),集中在5—10月(80.84%),诺如病毒检出率为8.94%,主要集中在1—3月(3.57%),年龄、职业、季节组内病原体检出率差异有统计学意义(P<0.001)。结论柳州市食源性疾病发病高峰期为7—9月,高危人群为0~4岁儿童,主要暴露场所以家庭为主,相关部门应在高峰期加强对以上高危人群食源性疾病的监测和预防,加强对家庭食品加工安全的宣教;生物标本检测主要检出的病原体为沙门菌和诺如病毒,提示相关部门应加强此类微生物易污染食品的监督监测,做出及时预警和宣传。

2020—2022年日照市东港区食源性疾病监测结果分析

目的:了解日照市东港区食源性疾病的流行趋势及特点,为相关部门制定预防食源性疾病的措施提供依据。方法:在食源性疾病监测系统中收集2020—2022年日照市东港区二级以上医院报告的食源性疾病病例,并进行统计分析。结果:共收集食源性疾病病例8570例,东港区食源性疾病病例发病时间主要集中在6—9月份;病例年龄主要集中在14~34岁年龄段;职业为农民的病例最多;可疑暴露食品中,水产动物及其制品病例最多;可疑进食场所为家庭的病例最多。2020—2022年日照市东港区共采集到粪便标本644份,其中副溶血性弧菌阳性检出55份,阳性率为8.54%;诺如病毒检出53份,检出率为8.23%;沙门氏菌检出阳性13份,检出率为2.02%;致泻大肠埃希氏菌和志贺氏菌均未检出。结论:2020—2022年日照市东港区食源性疾病的发生主要集中在夏秋季,可疑食品以水产动物及其制品为主,致病微生物以副溶血性弧菌和诺如病毒最为常见,农民群体食源性疾病发生较高。

基于Join Point及时间序列的2018—2022年梧州市其他感染性腹泻流行特征及趋势分析

目的了解2018—2022年广西梧州市其他感染性腹泻的流行特征,探讨传播趋势变化,预测短期发病情况,为疾病防控工作提供依据。方法收集整理2018—2022年梧州市各级医疗卫生机构在“疾病监测信息报告管理系统”中报告的其他感染性腹泻的数据,使用描述性流行病学方法进行分析;采用JoinPoint回归分析对2018—2022年梧州市其他感染性腹泻发病率变化趋势进行分析。运用SPSS 19.0软件建立简单季节性指数模型预测2023年梧州市其他感染性腹泻发病趋势。结果2018—2022年梧州市其他感染性腹泻共报告发病41411例,死亡1例,年平均发病率为279.55/10万,男、女性别比为1.27∶1,男、女发病率差异有统计学意义(χ^(2)=19.499,P<0.001);其他感染性腹泻主要发病年龄为0~<1岁及1~<10岁年龄组,职业分布以散居儿童为主,占报告病例总数的51.94%,但散居儿童构成比逐年下降,学生构成比逐年上升。龙圩区、长洲区和万秀区是发病的热点地区。JoinPoint回归分析显示,2018—2022年梧州市其他感染性腹泻发病率呈现下降趋势,平均月度变化百分比下降2.11%(95%CI:-6.00%~1.95%,P=0.304),散居儿童的构成比呈现下降趋势,年度变化百分比下降8.30%(95%CI:-11.94%~-4.50%,P=0.006);学生的构成比呈现上升趋势,年度变化百分比上升17.43%(95%CI:7.27%-28.56%,P=0.011),长洲区的发病率呈下降趋势,年度变化百分比下降15.60%(95%CI:-24.18%~-0.82%,P=0.044)。利用简单季节性模型预测2023年1~12月梧州市其他感染性腹泻发病率分别为22.20/10万、19.06/10万、16.66/10万、9.17/10万、8.89/10万、6.82/10万、6.18/10万、7.26/10万、9.01/10万、9.44/10万、5.90/10万、10.58/10万;模型拟合效果好,可以进行相关预测。结论2018—2022年梧州市其他感染性腹泻疫情呈缓慢下降趋势,在儿童、农民及学生群体中发病风险较高,应继续开展有效的干预措施控制其他感染性腹泻的流行。

2019—2023年湖南省浏阳市牛羊布鲁氏菌病血清学监测

为掌握浏阳市牛羊布鲁氏菌病(以下简称布病)流行现状及防控净化效果,2019—2023年在全市开展了牛羊布病血清学监测工作。结果显示:共检出阳性场21个(其中羊场16个、牛场5个),平均场群阳性率为0.35%,阳性样品329份,平均个体阳性率为0.48%;除2019年外,每年均检测到布病阳性场,5—8月检出布病阳性场点数较多;有12个乡镇检出布病抗体阳性样品,4个区均有布病发生;21个阳性养殖场户中,17个为散养户,4个为商品代场,交易市场与种牛羊场均未检出阳性样品。结果表明:浏阳市牛羊群体中存在布病流行且流行范围较广,但处于低水平流行态势,发生区域性大流行的风险较小,但商品代场和散养户仍具有布病散发风险,还须继续加强布病防控并加大夏季的监测力度,同时严格落实检疫监督和调运监管,进一步加强从业人员的专业培训和行为干预,持续推进布病净化工作,全面提升布病综合防控能力。

规模化奶牛场常发高害疾病的流行病学调查与思考

2018年10月~2022年7月期间,为掌握新疆生产建设兵团第八师石河子市规模化牛场奶牛常发高害疾病的发生情况,课题组对某大型国有公司所属的6个规模化奶牛场临床发病病种及发病情况进行了不间断的流行病学调查。共调查各生长阶段的奶牛9541头,临床常发高害疾病主要有犊牛腹泻、犊牛支气管肺炎、蹄病、乳房炎、酮病、酸中毒、产科病(子宫内膜炎、胎衣不下、卵巢疾患)等,年总平均发病率为7.85%;其中:犊牛腹泻发病率最高,平均发病率为19.10%;其次是成母牛蹄病,平均发病率为15.05%;再次是酮病,平均发病率为5.76%;产科疾病发病率最低,平均发病率为2.11%。从营养平衡、气候环境和防治能力等方面探寻了致病的主要原因,以期为降低疾病造成的危害、助力石河子市奶牛业高质量发展提供技术支撑。

2013—2022年天津市西青区百日咳流行病学特征分析

目的:分析2013—2022年天津市西青区百日咳流行病学特征,以期为百日咳防控措施的制定和免疫规划策略的优化提供参考依据。方法:利用中国疾病预防控制信息系统,收集2013—2022年天津市西青区百日咳报告病例,描述性分析百日咳流行特征。结果:2013—2022年天津市西青区共报告百日咳病例413例,年均发病率为4.14/10万,2017年、2018年、2019年年均发病率较前4年有明显上升,年均发病率分别为10.07/10万(89例)、9.40/10万(82例)、6.60/10万(66例);全年均有百日咳病例报告,发病呈季节性双峰分布,发病高峰在7—8月和10—11月,高峰时间共报告百日咳病病例171例,占全部病例数的39.58%;发病人群中1岁以下儿童发病最多,占总发病数的49.39%;14岁以下未完成全程疫苗接种人群中鸡鸣音和发绀的发生率均高于已完成全程接种的人群。结论:2013—2019年天津市西青区百日咳发病率呈上升趋势,2020—2021年发病率明显下降,2022年有所上升,发病人群以婴幼儿为主,需加强百日咳主动监测,并且提高实验室检测能力,优化儿童及高危成年人百日咳免疫策略。

Non-alcoholic fatty liver disease and hepatocellular carcinoma:Clinical challenges of an intriguing link

Non-alcoholic fatty liver disease(NAFLD)has emerged as the most common liver disorder worldwide mainly attributed to the epidemic spread of obesity and type 2 diabetes mellitus.Although it is considered a benign disease,NAFLD can progress to non-alcoholic steatohepatitis,liver cirrhosis and hepatocellular carcinoma(HCC).Most data regarding the epidemiology of NAFLD-related HCC are derived from cohort and population studies and show that its incidence is increasing as well as it is likely to emerge as the leading indication for liver transplantation,especially in the Western World.Although cirrhosis constitutes the main risk factor for HCC development,in patients with NAFLD,HCC can arise in the absence of cirrhosis,indicating specific carcinogenic molecular pathways.Since NAFLD as an underlying liver disease for HCC is often underdiagnosed due to lack of sufficient surveillance in this population,NAFLDHCC patients are at advanced HCC stage at the time of diagnosis making the management of those patients clinically challenging and affecting their prognostic outcomes.In this current review,we summarize the latest literature on the epidemiology,other than liver cirrhosis-pathogenesis,risk factors and prognosis of NAFLD-HCC patients.Finally,we emphasize the prevention of the development of NAFLD-associated HCC and we provide some insight into the open questions and issues regarding the appropriate surveillance policies for those patients.

2017—2021年我国其他感染性腹泻突发公共卫生事件流行特征分析

目的 了解近年来我国其他感染性腹泻突发公共卫生事件(简称其他感染性腹泻事件)的发生规律及流行病学特征,为该类事件的预警和有效控制提供科学依据。方法 采用描述性流行病学方法,对2017—2021年全国通过突发公共卫生事件报告管理信息系统报告的其他感染性腹泻事件的流行病学特征进行分析。结果 2017—2021年全国有28个省(自治区、直辖市)共报告其他感染性腹泻事件2 360起,累计报告病例90 689例,死亡病例5例。其他感染性腹泻事件的高发期是冬、春两季,分别在11—12月和3月呈现两个高峰。浙江、广东、江苏、重庆、福建、山东、安徽、广西、湖南和湖北等10个省份报告事件数和病例数较多。明确病原体的其他感染性腹泻事件共2 269起,其中病毒感染导致的事件占95.7%(2 171/2 269),细菌感染导致的事件占3.7%(84/2 269),病毒/细菌混合感染导致的事件占0.6%(14/2 269)。在所有明确病原体的其他感染性腹泻事件中,诺如病毒感染导致的占93.5%(2 122/2 269)。生活接触传播、食品污染和饮用水污染是其他感染性腹泻事件发生的主要原因,生活接触传播所致事件占比最高(51.0%,1 204/2 360)。托幼机构和学校是其他感染性腹泻发生的主要场所,共发生2 163起。结论 近年来我国其他感染性腹泻事件发生数呈上升趋势,主要病原为诺如病毒,托幼机构和学校是其发生的主要场所。今后应做好学校等重点场所的卫生监管和重点人群的健康宣教,加强食品安全和饮用水卫生管理,同时提高其他感染性腹泻流行病学调查和病原学诊断能力,提升事件监测报告水平,有效预防和控制该类事件的发生。

2020-2021年洛阳市食源性疾病病例监测分析

目的分析2020—2021年洛阳市食源性疾病病例的流行病学特征,为食源性疾病的预防控制提供科学依据。方法从食源性疾病监测报告系统收集2020—2021年洛阳市医疗机构报告的食源性疾病监测病例信息,对37182例食源性疾病病例的基本信息及部分病例病原学检测结果进行分析。结果2020—2021年洛阳市共报告食源性疾病37182例,男女比0.84∶1,年龄主要集中在25~34岁,职业以农民居多,占43.69%。发病时间以6—9月为主,病例临床症状以消化系统疾病为主。可疑暴露食物以粮食类及其制品、水果及其制品和肉及肉制品为主,可疑暴露食品加工及包装方式以家庭自制为主。就餐模式以1~2人就餐为主,就餐地点主要集中在家庭。2020年散装(包括简易包装)食品、粮食类及其制品的阳性占比较高,而家庭自制食品、在家庭就餐的阳性占比低于2021年。采集标本558例,检出阳性87例,阳性率为15.59%,其中沙门菌检出最多,为75例,阳性率为13.44%,占86.21%。其中住院患者、第二三季度、家庭就餐、家庭自制食品以及3~4人就餐的沙门菌检出率较高。2020年与2021年洛阳市食源性疾病病例的可疑暴露食品分布和沙门菌检出率存在差异,相比之下2021年食源性疾病患者更倾向于在家庭就餐,沙门菌在多人同时就餐时检出率更高。结论洛阳市食源性疾病多发于夏秋季节,致病因素以沙门菌污染为主。应加强食源性疾病监测分析,积极开展健康教育,促进健康生活方式,预防食源性疾病的发生。

2018—2022年临沂市食源性疾病病原体分布及流行特征

目的:分析临沂市食源性疾病病原体分布及流行特征,为防控食源性疾病提供依据。方法:采用SPSS 29.0软件对临沂市2018—2022年上报的2340例食源性疾病病例进行流行病学分析。结果:2018-2022年临沂市食源性疾病病原体总检出率为19.49%,其中,细菌感染检出率为8.68%,以鼠伤寒沙门氏菌和肠产毒性大肠埃希氏菌(ETEC)为主;诺如病毒感染检出率为9.79%,以GⅡ型感染为主;多重感染检出率为1.03%。不同年份病原检出率比较,差异有统计学意义(χ^(2)=66.19,P<0.01)。食源性疾病发病以夏秋季为主。患者年龄以4~17岁为主,占23.11%。可疑暴露食品居前3位的分别为水果及其制品、粮食及其制品、肉与肉制品,分别占26.32%、15.79%和14.91%。结论:诺如病毒、沙门氏菌、致泻大肠埃希氏菌是临沂市食源性疾病的主要病原体,且存在以致泻大肠埃希氏菌—诺如病毒感染为主的多重感染,发病以夏秋季为主。

Epidemiological characteristics of seven notifable respiratory infectious diseases in the mainland of China:an analysis of national surveillance data from 2017 to 2021

Background Respiratory infectious diseases(RIDs)remain a pressing public health concern,posing a signifcant threat to the well-being and lives of individuals.This study delves into the incidence of seven primary RIDs dur‑ing the period 2017-2021,aiming to gain deeper insights into their epidemiological characteristics for the purpose of enhancing control and prevention strategies.Methods Data pertaining to seven notifable RIDs,namely,seasonal infuenza,pulmonary tuberculosis(PTB),mumps,scarlet fever,pertussis,rubella and measles,in the mainland of China between 2017 and 2021 were obtained from the National Notifable Disease Reporting System(NNDRS).Joinpoint regression software was utilized to analyze temporal trends,while SaTScan software with a Poisson probability model was used to assess seasonal and spatial patterns.Results A total of 11,963,886 cases of the seven RIDs were reported during 2017-2021,and yielding a fve-year aver‑age incidence rate of 170.73 per 100,000 individuals.Among these RIDs,seasonal infuenza exhibited the highest aver‑age incidence rate(94.14 per 100,000),followed by PTB(55.52 per 100,000),mumps(15.16 per 100,000),scarlet fever(4.02 per 100,000),pertussis(1.10 per 100,000),rubella(0.59 per 100,000),and measles(0.21 per 100,000).Males experi‑enced higher incidence rates across all seven RIDs.PTB incidence was notably elevated among farmers and individu‑als aged over 65,whereas the other RIDs primarily afected children and students under 15 years of age.The inci‑dences of PTB and measles exhibited a declining trend from 2017 to 2021(APC=−7.53%,P=0.009;APC=−40.87%,P=0.02),while the other fve RIDs peaked in 2019.Concerning seasonal and spatial distribution,the seven RIDs displayed distinct characteristics,with variations observed for the same RIDs across diferent regions.The proportion of laboratory-confrmed cases fuctuated among the seven RIDs from 2017 to 2021,with measles and rubella exhibit‑ing higher proportions and mumps and scarlet fever showing lower proportions.Conclusions The incidence of PTB and measles demonstrated a decrease in the mainland of China between 2017 and 2021,while the remaining fve RIDs reached a peak in 2019.Overall,RIDs continue to pose a signifcant public health challenge.Urgent action is required to bolster capacity-building eforts and enhance control and prevention strategies for RIDs,taking into account regional disparities and epidemiological nuances.With the rapid advancement of high-tech solutions,the development and efective implementation of a digital/intelligent RIDs control and pre‑vention system are imperative to facilitate precise surveillance,early warnings,and swift responses.

Update and latest advances in mechanisms and management of colitis-associated colorectal cancer

Colitis-associated colorectal cancer(CAC)is defined as a specific cluster of colorectal cancers that develop as a result of prolonged colitis in patients with inflammatory bowel disease(IBD).Patients with IBD,including ulcerative colitis and Crohn’s disease,are known to have an increased risk of developing CAC.Although the incidence of CAC has significantly decreased over the past few decades,individuals with CAC have increased mortality compared to individuals with sporadic colorectal cancer,and the incidence of CAC increases with duration.Chronic inflammation is generally recognized as a major contributor to the pathogenesis of CAC.CAC has been shown to progress from colitis to dysplasia and finally to carcinoma.Accumulating evidence suggests that multiple immune-mediated pathways,DNA damage pathways,and pathogens are involved in the pathogenesis of CAC.Over the past decade,there has been an increasing effort to develop clinical approaches that could help improve outcomes for CAC patients.Colonoscopic surveillance plays an important role in reducing the risk of advanced and interval cancers.It is generally recommended that CAC patients undergo endoscopic removal or colectomy.This review summarizes the current understanding of CAC,particularly its epidemiology,mechanisms,and management.It focuses on the mechanisms that contribute to the development of CAC,covering advances in genomics,immunology,and the microbiome;presents evidence for management strategies,including endoscopy and colectomy;and discusses new strategies to interfere with the process and development of CAC.These scientific findings will pave the way for the management of CAC in the near future.

Rabies in a postpandemic world:resilient reservoirs,redoubtable riposte,recurrent roadblocks,and resolute recidivism

Rabies is an ancient disease.Two centuries since Pasteur,fundamental progress occurred in virology,vaccinology,and diagnostics—and an understanding of pathobiology and epizootiology of rabies in testament to One Health—before common terminological coinage.Prevention,control,selective elimination,and even the unthinkable—occasional treatment—of this zoonosis dawned by the twenty-first century.However,in contrast to smallpox and rinderpest,eradication is a wishful misnomer applied to rabies,particularly post-COVID-19 pandemic.Reasons are minion.Polyhostality encompasses bats and mesocarnivores,but other mammals represent a diverse spectrum of potential hosts.While rabies virus is the classical member of the genus,other species of lyssaviruses also cause the disease.Some reservoirs remain cryptic.Although global,this viral encephalitis is untreatable and often ignored.As with other neglected diseases,laboratory-based surveillance falls short of the notifiable ideal,especially in lower-and middleincome countries.Calculation of actual burden defaults to a flux within broad health economic models.Competing priorities,lack of defined,long-term international donors,and shrinking local champions challenge human prophylaxis and mass dog vaccination toward targets of 2030 for even canine rabies impacts.For prevention,all licensed vaccines are delivered to the individual,whether parenteral or oral–essentially‘one and done’.Exploiting mammalian social behaviors,future‘spreadable vaccines’might increase the proportion of immunized hosts per unit effort.However,the release of replication-competent,genetically modified organisms selectively engineered to spread intentionally throughout a population raises significant biological,ethical,and regulatory issues in need of broader,transdisciplinary discourse.How this rather curious idea will evolve toward actual unconventional prevention,control,or elimination in the near term remains debatable.In the interim,more precise terminology and realistic expectations serve as the norm for diverse,collective constituents to maintain progress in the field.

2013—2022年重庆市南岸区细菌性痢疾流行病学特征分析

目的分析南岸区细菌性痢疾(菌痢)流行病学特征,为制订防控措施提供科学依据。方法从疾病监测报告管理系统获取2013—2022年细菌性痢疾相关数据,采用描述流行病学方法分析南岸区菌痢的流行特征、率的比较采用χ^(2)检验,不同年份发病率变化用χ^(2)趋势检验,以P<0.05为差异有统计学意义。运用圆形分布探索发病高峰期。结果2013—2022年南岸区累计报告细菌性痢疾3721例,发病率从103.92/10万下降到5.71/10万;发病高峰期在3—10月;20~岁、25~岁、30~岁、45~岁、50~岁、55~岁、60~岁年龄组女性发病率均高于男性(P<0.05),0~岁、5~岁、10~岁、85~岁年龄组男性发病率均高于女性(P<0.05),其余年龄组性别发病率差异无统计学意义(P>0.05);职业分布发病率居前3位的是散居儿童(18.51/10万)、家务及待业(4.54/10万)、和离退人员(4.22/10万);2013—2018年疫情高发地区主要分布在西南部部分街镇,2019年及之后集中在西部地区的部分街镇。结论2013—2022年南岸区菌痢发病率呈下降趋势,疫情防控效果显著,但需重点针对学生、低年龄儿童和60岁以上老年人群体加强宣传,保护“一老一小”,落实好学校、养老机构等集体场所食品安全和饮用水卫生的监管以及医疗机构菌痢诊断标准的培训。

基于监测和最终结果数据库的冠心病PCI术后冠脉微循环损伤预测模型的建立与验证

目的基于监测和最终结果(SEER)数据库构建冠心病经皮冠状动脉介入治疗(PCI)术后冠脉微循环损伤(CMI)预测模型,并进行临床验证。方法选取SEER数据库中2021年1月至2022年12月在南阳市中心医院接受PCI术治疗的106例冠心病患者作为建模样本,收集其临床资料,统计术后CMI发生情况,根据术后是否发生CMI分为损伤组47例和未损伤组59例。另选取2023年1~6月我院收治的62例冠心病患者作为外部验证样本,根据PCI术后是否发生CMI分为损伤患者25例与未损伤患者37例。比较建模样本中两组患者的临床资料,采用Logistic多因素回归分析冠心病PCI术后CMI的影响因素,构建预测模型,采用受试者工作特征曲线(ROC)及曲线下面积(AUC)评价模型预测价值。结果损伤组患者的周围血管病史、高血压史、糖尿病史、吸烟史和饮酒史的比例明显高于未损伤组,差异均有统计学意义(P<0.05);损伤组患者的冠脉病变长度、冠脉狭窄率、预扩张次数、预扩张时间、同型半胱氨酸(Hcy)、D-二聚体(D-D)水平明显长/高于未损伤组,差异均有统计学意义(P<0.05);经Logistic多因素回归分析结果显示,高血压史、糖尿病史、冠脉病变长度、冠脉狭窄率、预扩张次数、预扩张时间、Hcy、D-D均为CMI发生的独立预测因子(P<0.05);根据上述独立预测因子构建预测模型,该预测模型拟合度较好,校准度为0.892,一致性指数为0.917,预测冠心病PCI术后CMI的AUC为0.947(95%CI:0.910~0.985),敏感度为95.74%,特异度为81.36%。外部验证显示,该预测模型预测冠心病PCI术后CMI的AUC为0.969(95%CI:0.939~1.000),敏感度为96.00%,特异度为86.49%。结论根据高血压史、糖尿病史、冠脉病变长度、冠脉狭窄率、预扩张次数、预扩张时间、Hcy、D-D等资料构建冠心病PCI术后CMI的预测模型预测价值可靠,能为临床防治提供指导信息。

2019—2021年河南省安阳市食源性疾病流行病学分析

目的通过整理分析河南省安阳市2019—2021年食源性疾病报告和监测情况,为制定和调整食源性疾病防控策略提供参考。方法收集整理安阳市2019—2021年食源性疾病监测数据,采集患者粪便并检测相关病原体,对监测结果进行整体统计分析。结果2019—2021年安阳市共报告22867例食源性疾病监测病例,男10340例,女12527例。报告病例主要集中于6—8月,其中以30~<40岁组(16.01%,3661/22867)最多;报告罹患率最高为龙安区(680.32/100000)。可疑暴露食品中水果及其制品(26.64%,6364/23887)报告最多,加工或包装方式以家庭自制(34.96%,8350/23887)、散装(包括简易包装)(34.38%,8212/23887)为主,家庭是主要的进食场所(83.15%,19862/23887)。安阳市食源性疾病病原学监测总标本检出率为8.73%。结论应进一步完善该市食源性疾病监测系统,加大重点高危人群监测力度,针对家庭自制食品,尤其是在夏秋季节,加强食品安全教育。