ABSTRACT
Objective@#To understand epidemiological characteristics of human rabies in China in 2017 and provide evidence for the development of strategy of human rabies control and prevention.@*Methods@#The descriptive epidemiological analysis was conducted based on the epidemic data from Chinese Infectious Disease Surveillance Reporting System, sentinel surveillance system in 6 provinces (Hunan, Guangxi, Anhui, Guizhou, Jiangsu and Shandong) and National Bureau of Statistics in 2017.@*Results@#A total of 516 human rabies cases, including 502 deaths, were reported by 27 provinces in 2017 with the morbidity rate and mortality rate of 0.037/100 000 and 0.036/100 000, respectively. The case number and death number decreased by 19.88% (128/644) and 15.20% (90/592) respectively compared with 2016. Rabies epidemics were mainly found in southern and central areas. The first 5 provinces reporting high case numbers were Hunan (71 cases), Henan (52 cases), Guangxi (41 cases), Anhui (39 cases) and Hubei (39 cases), their cases accounted for 46.90% (242/516) of the total reported cases in China. Rabies mainly occurred in summer and autumn, and the majority of patients were farmers, students and children outside child care settings. The male to female ratio of the cases was 2.46 ∶ 1 (367 ∶ 149). Cases was reported in all age groups, and more cases occurred in middle aged and old adults than in adolescents. Questionnaires survey was conducted for 186 cases, the results indicated that 94.89% (167/176) of exposures were caused by dog bites. The exposure degree was mainly category Ⅲ, accounting for 68.86% (115/167), and only 6.02% (10/166) of cases were immunized after exposure. The median of latent period of these cases was 72 days.@*Conclusions@#By 2017, the human rabies incidence in China had declined consecutively for ten years, more cases were reported in southern area than in northern area. The case number showed downward trends in provinces with high incidences and fluctuant increase in provinces with low incidence. Rabies cases mainly occurred in rural areas, and most cases were men and farmers. Low rate of post exposure prophylaxis, low rates of vaccination and passive immunization product injection were main causes for the onset of human rabies. It is necessary to strengthen the surveillance for human rabies, especially in rural areas, health education about treatment after rabies exposure and expend the coverage of canine immunization.
ABSTRACT
The aim of this study was to establish whether the use of an extramedullary or intramedullary tibial cutting guide leads to superior mechanical leg axis and implant positioning. A meta-analysis of six randomized controlled trials including 350 knees was performed. For the mechanical axis, frontal tibial component angle and tibial slope, there were no significant differences in the mean values or the number of outliers (±3°) between the extramedullary and intramedullary groups. A reduced tourniquet time was associated with the intramedullary guide. No significant difference in the complication rate was noted between the two groups. Neither extramedullary nor intramedullary tibial alignment was more accurate in facilitating the tibial cut. Use of an intramedullary guide results in a shorter tourniquet time and exhibits a similar complication rate as the extramedullary guide.
Subject(s)
Humans , Arthroplasty, Replacement, Knee/methods , Tibia/surgery , Bias , Randomized Controlled Trials as Topic , Time Factors , Tourniquets , TibiaABSTRACT
<p><b>UNLABELLED</b>></p><p><b>OBJECTIVE</b>To understand the prevalence of high risk sex behaviors and HIV infection status among the female sex workers (FSWs) from Vietnam in Yunnan province during a 5 year intervention project and provide evidence for the improvement of the behavior intervention among this population.</p><p><b>METHODS</b>The survey was conducted annually among Vietnamese FSWs sampled in a county near China-Vietnam border to collect the information about their demographic characteristics, high risk sex behaviors and HIV test results through questionnaire and in-depth interview by bilingual outreach team. The behavior intervention included peer advise, training, lectures, interactive games, free condom distribution. The database was set up with Excel 2003 and the results were analyzed with SPSS 16.0.</p><p><b>RESULTS</b>The condom use rates among the Vietnamese FSWs at commercial sex in last month were 1.5%, 36.0%, 67.7%, 86.5% and 90.3% (P<0.05) respectively; and the condom use rates at the latest sex were 89.5%,44.8%, 86.6%,92.5% and 99.0% respectively (P<0.05) . The HIV antibody positive rates were 7.5%, 3.6%, 5.9%, 4.0% and 3.1% respectively (P>0.05).</p><p><b>CONCLUSION</b>The condom use rate of Vietnamese FSWs at commercial sex increased by more than 90% after the 5 year intervention project. However, the HIV-infection rate was still high. It is necessary to promote condom use among FSWs from Vietnam and their regular sex partners and strengthen the health education among clients.</p>