Evaluación de la gestión de recetas en un servicio farmacéutico de un hospital especializado

error de medicación es cualquier incidente prevenible que puede causar daño al paciente o dar lugar a una utilización inapropiada de los medicamentos, cuando estos están bajo el control de los profesionales sanitarios o del paciente, con potenciales consecuencias para estos últimos. En Paraguay las enfermedades respiratorias crónicas (EPOC, asma, etc.), junto con la diabetes, los problemas cardiovasculares y el cáncer son responsables de una alta morbi-mortalidad, registrando una prevalencia que va en aumento. Esta investigación tuvo el objetivo de evaluar las recetas prescriptas en el consultorio externo de un hospital especializado en enfermedades respiratorias y dispensadas en la farmacia, gracias a un estudio observacional de corte transversal, retrospectivo, y un muestreo no probabilístico que consistió en la revisión de recetas médicas de pacientes que acudieron al consultorio del Instituto Nacional de Enfermedades Respiratorias y del Ambiente durante los meses de septiembre de 2015 y 2016. Los datos se registraron en planillas. Se analizaron 4828 recetas, de las cuales 2421 corresponden al mes de septiembre del 2015, y 2407 recetas que corresponden al mes de septiembre del 2016. Los errores técnicos de prescripción más frecuentes fueron la ilegibilidad y la ausencia de dosis e indicación. Por ello, se plantea la importancia de establecer un programa de gestión de riesgos en los hospitales, para implementar nuevas tecnologías que faciliten la prescripción.

Medication error is any preventable incident that may cause harm to the patient or result in inappropriate use of medications when these are under the control of healthcare professionals or the patient, with potential consequences for patients. In Paraguay, chronic respiratory diseases (COPD, asthma, etc. ), together with diabetes, cardiovascular problems, and cancer, are responsible for a high morbi-mortality in the country, with an increasing prevalence; therefore, this research aimed to evaluate the prescriptions that were prescribed in the outpatient clinic of a hospital specialized in respiratory diseases and dispensed in the pharmacy through a cross-sectional, retrospective, observational study and a non-probabilistic sampling, by convenience, which consisted of the review of medical prescriptions issued to patients of both sexes who attended the adult outpatient clinic of the National Institute of Respiratory and Environmental Diseases, during the months of September 2015 and 2016. The data were recorded in spreadsheets designed for this purpose, and a total of 4828 prescriptions were analyzed, of which 2421 correspond to the month of September 2015, with a total of 5955 drugs prescribed, and 2407 prescriptions correspond to the month of September 2016, with 6195 drugs prescribed. The most frequent technical prescription errors found in the prescriptions were the illegibility of the prescriptions and the absence of dosage and indication, being the most frequent errors for September 2015, and the absence of dosage and therapeutic indication (79.76 %)and illegibility of the prescription in September 2016 (87.00 %). Considering the legal requirements, the absence of diagnosis was the prevalent error (Sep-15: 64.19 %; Sep-16:60.08 %). This is why it is important to establish a risk management program in hospitals to implement new technologies that facilitate prescribing.

erro de medicação é qualquer incidente evitável que pode causar danos ao paciente ou resultar no uso inadequado de medicamentos, quando estes estão sob o controle dos profissionais de saúde ou do paciente, com potenciais consequências para os pacientes. No Paraguai, as doenças respiratórias crônicas (doença pulmonar obstrutiva crônica, asma etc.), juntamente com o diabetes, os problemas cardiovasculares e o câncer são responsáveis por uma alta taxa de morbidade e mortalidade no país, com uma prevalência crescente. Portanto, esta pesquisa teve como objetivo avaliar as prescrições feitas no ambulatório de um hospital especializado em doenças respiratórias e dispensadas na farmácia por meio de um estudo observacional transversal, retrospectivo e de amostragem não probabilística por conveniência, que consistiu em uma revisão das prescrições emitidas para pacientes de ambos os sexos que frequentaram o ambulatório de adultos do Instituto Nacional de Doenças Respiratórias e Ambientais, em setembro de 2015 e 2016. Os dados foram registrados em planilhas elaboradas para esse fim, e foi analisado um total de 4.828 prescrições, das quais 2.421 correspondem ao mês de setembro de 2015, com um total de 5.955 medicamentos prescritos, e 2.407 prescrições correspondem ao mês de setembro de 2016, com 6.195 medicamentos prescritos. Os erros mais frequentes encontrados nas prescrições foram a ilegibilidade destas e a ausência de dosagem e indicação, sendo que os erros mais frequentes em setembro de 2015 foram a ausência de dosagem e indicação terapêutica (79,76%) e em setembro de 2016, a ilegibilidade da prescrição (87%). Levando em conta os requisitos legais, a ausência de diagnóstico foi o erro prevalente (set.-15: 64,19%; set.-16:60,08%). Por isso, é importante estabelecer um programa de gestão de riscos nos hospitais para implementar novas tecnologias que facilitem a prescrição.

Insecticide resistance tendency and prevention strategies of Aedes albopictus in Yangpu District， Shanghai， China / 上海预防医学

Objective To investigate the resistance development of Aedes albopictus to commonly used insecticides in Yangpu District of Shanghai， China， and to provide scientific bases for the control of A. albopictus and the emergency treatment of dengue fever. Methods The larva immersion method recommended by WHO was used to assay the median lethal concentration （LC50） of A. albopictus larva. SPSS 25.0 was used to calculate the toxicity baselines of insecticides. Results A. albopictus kept a medium resistance to beta-cypermethrin， and the resistance ratios were 14.44， 10.00， 17.78， respectively， in 2015， 2017， 2019. The mosquitos kept a high resistance to permethrin， and the resistance ratios were 54.00， 140.00， 52.00 respectively， in 2015， 2017， 2019. Besides， A. albopictus also kept a medium resistance to propoxur， and the resistance ratios were 15.34， 13.06， 10.83 respectively， in 2015， 2017， 2019. To deltamethrin， A. albopictus showed high resistance in 2015 and medium resistance in 2017， the resistance ratios were 40.00 and 35.00. To temephos， A. albopictus showed low resistance in 2015， with the resistance ratio of 9.38. Conclusion A. albopictus has developed high resistance to permethrin in Yangpu District of Shanghai， and cautious and reduced use of permethrin is suggested. It is necessary to implement and adopt the strategy of comprehensive management， in order to establish the long-term mechanism for mosquito control and prevention.

Causes of perinatal mortality and risk factors in a district of Shanghai after the implementation of universal two-child policy / 上海预防医学

Objective To determine the changing trend and causes of perinatal mortality in Changning District after the implementation of the universal two-child policy， and then explore effective interventions for preventing perinatal mortality. Methods Data of perinatal mortality in Changning District from 2011 to 2020 were retrospectively collected. Change of perinatal mortality， causes of death and related factors were compared in consecutive 5 years before and after the universal two-child policy. Results In total， there were 153 099 perinatal births from 2011 to 2020 in Changning District， in which 352 deaths were documented. The perinatal mortality was 2.30 per 1 000 births， showing an overall downward trend from 2011 to 2020 （ P <0.05）. Residents with local household registration had lower perinatal mortality， compared to those with non-local household registration， which was observed both before and after the universal two-child policy （ P <0.05）. Furthermore， the perinatal mortality showed an upward trend after the universal two-child policy （ χ 2trend=5.481， P <0.05）. The major causes of perinatal death were fetus and its accessories， fetal malformation， and maternal diseases during pregnancy before the universal two-child policy； in contrast， the causes changed to maternal diseases during pregnancy， fetus and its accessories， and neonatal diseases after the policy. The proportion of pregnant women of advanced maternal age， menstrual delivery， and pregnancy complications or comorbidities were significantly higher after the policy than that before the policy （ P <0.05）. The most common pregnancy complication was gestational diabetes mellitus， gestational hypertension， and hypothyroidism during pregnancy after the universal two-child policy. Of them， the proportion of gestational hypertension increased from 6.56% （4/61） to 25.88% （22/85）. Conclusion Before and after the universal two-child policy， the perinatal mortality in non-local residents remains high and further shows an upward trend. Moreover， pregnant women advanced maternal age and those with complications or comorbidities may increasingly contribute to perinatal deaths after the policy. Therefore， health education should be strengthened to improve the awareness of self-health care， especially for non-local women. Hierarchical perinatal health service， primary prevention and treatment of pregnancy complications or comorbidities should be improved to further reduce perinatal mortality.

Causes of perinatal mortality and risk factors in a district of Shanghai after the implementation of universal two-child policy / 上海预防医学

Objective To determine the changing trend and causes of perinatal mortality in Changning District after the implementation of the universal two-child policy， and then explore effective interventions for preventing perinatal mortality. Methods Data of perinatal mortality in Changning District from 2011 to 2020 were retrospectively collected. Change of perinatal mortality， causes of death and related factors were compared in consecutive 5 years before and after the universal two-child policy. Results In total， there were 153 099 perinatal births from 2011 to 2020 in Changning District， in which 352 deaths were documented. The perinatal mortality was 2.30 per 1 000 births， showing an overall downward trend from 2011 to 2020 （ P <0.05）. Residents with local household registration had lower perinatal mortality， compared to those with non-local household registration， which was observed both before and after the universal two-child policy （ P <0.05）. Furthermore， the perinatal mortality showed an upward trend after the universal two-child policy （ χ 2trend=5.481， P <0.05）. The major causes of perinatal death were fetus and its accessories， fetal malformation， and maternal diseases during pregnancy before the universal two-child policy； in contrast， the causes changed to maternal diseases during pregnancy， fetus and its accessories， and neonatal diseases after the policy. The proportion of pregnant women of advanced maternal age， menstrual delivery， and pregnancy complications or comorbidities were significantly higher after the policy than that before the policy （ P <0.05）. The most common pregnancy complication was gestational diabetes mellitus， gestational hypertension， and hypothyroidism during pregnancy after the universal two-child policy. Of them， the proportion of gestational hypertension increased from 6.56% （4/61） to 25.88% （22/85）. Conclusion Before and after the universal two-child policy， the perinatal mortality in non-local residents remains high and further shows an upward trend. Moreover， pregnant women advanced maternal age and those with complications or comorbidities may increasingly contribute to perinatal deaths after the policy. Therefore， health education should be strengthened to improve the awareness of self-health care， especially for non-local women. Hierarchical perinatal health service， primary prevention and treatment of pregnancy complications or comorbidities should be improved to further reduce perinatal mortality.

COVID-19 y determinantes sociales desde una perspectiva comunitaria

RESUMEN Introducción: La estrategia cubana de prevención de la COVID-19 se distingue por el trabajo intersectorial y la integración entre gestión gubernamental y científica; sin embargo, cada territorio posee particularidades que pueden constituir determinantes del estado de salud de la población con implicaciones para la respuesta y deben ser tenidos en cuenta por los gobiernos locales para enfrentar la enfermedad. Objetivo: Describir el comportamiento de determinantes sociales de la salud en la comunidad "Ho Chi Min" de la ciudad de Guantánamo en el contexto de la estrategia de prevención de la COVID-19 en el periodo abril-junio de 2020. Método: Se realizó una investigación cualitativa con uso del método fenomenológico. Se organizaron dos grupos focales de 15 personas cada uno, con líderes formales, adolescentes y jóvenes seleccionados por criterios de inclusión y exclusión. Según el principio de la saturación de la información fueron realizadas cuatro sesiones en dos encuentros por grupo. Los datos se procesaron a partir del análisis de contenido. Resultados: La ocupación, nivel de ingresos, condiciones de vida y los comportamientos fueron determinantes sociales intermedios afectados por las medidas preventivas ante la pandemia por COVID-19. Conclusiones: En la comunidad estudiada resulta importante la contribución positiva del contexto socioeconómico y político como determinante estructural que evidencia una voluntad política dirigida a mitigar los daños sufridos en indicadores de la posición socioeconómica como la ocupación y los ingresos. El sistema sanitario como determinante intermedio se constata como una fortaleza en la respuesta ante la COVID-19.

ABSTRACT Introduction: Cuba's COVID-19 prevention strategy is distinguished by an intersectoral work and integration between governmental and scientific management; however, each territory has particularities that may constitute determinants of the health status of the population with implications on the reply and should be taken into account by local governments to address the disease. Objective: To describe the behavior of social determinants of health at the "Ho Chi Min" community in Guantánamo city, all in the context of the COVID-19 prevention strategy from April to June 2020. Method: A qualitative research using the phenomenological method was carried out. Two focus groups of 15 people each were organized, with formal leaders, adolescents and young people selected via inclusion and exclusion criteria. Method: A qualitative research using the phenomenological method was carried out. Two focus groups of 15 people each were organized, with formal leaders, adolescents and young people selected via inclusion and exclusion criteria. According to the principle of saturation in information, four sessions were conducted (two meetings per group). The data were processed on the basis of the analysis of content. Results: Occupation, income level, living conditions and behaviors were intermediate social determinants affected by preventive measures against the COVID-19 pandemic. Conclusions: The positive contribution of the socioeconomic and political context in the community studied, it is important as a structural determinant that evidences a political will aimed for mitigating the damage suffered in indicators of socioeconomic position such as employment and revenue. The health system as an intermediate determinant is seen as a strength to confront COVID-19.

RESUMO Introdução: A estratégia cubana para a prevenção da COVID-19 se distingue pelo trabalho intersetorial e pela integração entre a gestão governamental e científica; Porém, cada território possui particularidades que podem se constituir em determinantes do estado de saúde da população com implicações para a resposta e devem ser levadas em consideração pelos governos locais para o enfrentamento da doença. Objetivo: Descrever o comportamento dos determinantes sociais da saúde na comunidade "Ho Chi Min" da cidade de Guantánamo no contexto da estratégia de prevenção COVID-19 no período abril-junho de 2020. Método: Pesquisa qualitativa com uso do método fenomenológico. Foram organizados dois grupos focais de 15 pessoas cada, com lideranças formais, adolescentes e jovens selecionados por critérios de inclusão e exclusão. De acordo com o princípio da saturação de informações, foram realizadas quatro sessões em dois encontros por grupo. Os dados foram processados a partir da análise de conteúdo. Resultados: Ocupação, nível de renda, condições de vida e comportamentos foram determinantes sociais intermediários afetados pelas medidas preventivas frente à pandemia COVID-19. Conclusões: Na comunidade estudada, a contribuição positiva do contexto socioeconômico e político é importante como determinante estrutural que evidencia uma vontade política voltada para a mitigação dos danos sofridos em indicadores de posição socioeconômica como ocupação e renda. O sistema de saúde como um determinante intermediário é visto como um ponto forte na resposta ao COVID-19.

Distribution drug resistance and prevention strategy of infection pathogens in lung cancer patients / 公共卫生与预防医学

Objective To study the distribution and drug resistance of pathogens in patients with lung cancer,and analyze the prevention strategies. Methods A total of 312 cases of lung cancer patients with infection treated in our hospital from January 2017 to January 2021 were selected as the research objects.The lower respiratory tract secretions,urine and feces were collected for pathogen culture and drug sensitivity test;the distribution and drug resistance of pathogens were analyzed,and the corresponding prevention strategies were formulated. Results Of the 312 patients, 165 (52.88%) had respiratory tract infection, 79 (25.32%) had oropharyngeal infection, and 68 (21.80%) had urinary tract infection.The highest proportion was respiratory infection.Among the 312 patients,398 pathogens were detected of which 212 Gram-positive bacterias (53.27%)were found of which Staphylococcus epidermidis(15.58%)and Staphylococcus aureus(13.07%)accounted for a relatively high proportion. Among 175 Gram-negative strains,Klebsiella pneumoniae(15.94%)and E.coli (10.05% ) accounted for a large proportion.The resistance rate of Gram-positive bacteria,such as Staphylococcus epidermidis and Staphylococcus aureus,to amikacin,gentamicin and penicillin,was more than 50%,which was sensitive to vancomycin. Gram negative bacteria such as Klebsiella pneumoniae and E.coli have high resistance to common antibiotics,and the drug resistance rate to cefepime and cefazolin is more than 50%,and sensitive to imipenem/cilastatin and imipenem/cilastatin.Among 11 fungi,4 cases were resistant to fluconazole , 36.36%,3 to itraconazole,27.27%,0 to ketoconazole and voriconazole,0.00%. Conclusion The distribution and drug resistance of pathogenic bacteria in patients with lung cancer infection in our hospital have certain characteristics,in which Gram-positive bacteria are mainly Staphylococcus epidermidis and Staphylococcus aureus,Gram-negative bacteria are mainly Klebsiella pneumoniae and Escherichia coli,and there are also a small number of fungal infections.Therefore,we should strengthen the monitoring of etiology and drug resistance,and strengthen the management of hospital disinfection Drug sensitivity results of patients,rational use of antibiotics,so as to improve the treatment effect and reduce the risk of infection.

Efficacy of Doppler ultrasound-assisted facial filler injection / 中华医学美学美容杂志

Objective:To explore the safety and efficacy of ultrasound-assisted facial filler injection, based on the anatomy of facial vessels to prevent intravascular embolization.Methods:From Jan. 2019 to Sep. 2020, 142 patients were treated with facial soft-tissue filler injection (mean age, 39.7 years; 131 female and 11 male). According to the patients＇ own will, autologous fat or hyaluronic acid was applied respectively. When injecting, the assistant could press over the periorbital artery to temporarily occlude the artery, confirmed with Doppler ultrasound, thus reduced the risk of intravascular embolization, and carefully injected with minimal pressure and tiny amount.Results:A total of 142 patients were enrolled in the study, and 54 patients were treated with autologous fat grafting, while 88 patients were injected with hyaluronic acid. The injection sites included forehead, temple, glabella, nasal root, tear trough, nasolabial fold, cheek, chin, and lips. Facial rejuvenation improvement was satisfied with a smooth contour and proper augmentation. No vascular embolization occurred. 9 patients received a second or third round fat grafting to achieve better outcome. Follow-up duration ranged from 1 month to 6 months.Conclusions:With ultrasound assistant, digital pressure over the orbital artery could temporarily occlude the artery and may reduce the risk of intravascular embolization. The simple technique may add a significant benefit with no additional cost or risk to the patients.

Advances in the prevention of mother-to-child transmission of hepatitis B virus / 中华围产医学杂志

Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) represents the most common mode by which children acquire HBV infection. For pregnant women with high viral load and positive hepatitis B e antigen (HBeAg), antiviral therapy during late pregnancy combined with timely and standardized inoculation of neonatal hepatitis B immunoglobulin and hepatitis B vaccine can minimize the possibility of MTCT of HBV. This review focuses on using and withdrawing antiviral drugs during pregnancy, managing postpartum hepatitis, and breastfeeding issues to further optimize the combined immunization and antiviral treatment strategies and seek the optimal solution to preventing MTCT of HBV.

Instance analysis on medical disputes in a provincial hospital of traditional Chinese medicine and related questionnaire survey / 中国中西医结合急救杂志

At present medical disputes still happen sometimes though governments at all levels, health departments and hospitals pay more and more attention to correctly guide patient's behavior, regulate doctor's behavior in diagnosis and treatment, purify therapeutic environment, strengthen legislation and protect the legitimate rights and interests of doctors and patients. The causes of medical disputes are great many, and the fundamental reason is that the medical behavior from the beginning to the end is related to the life and health, naturally accompanying medical risk and hiding dispute, therefore what we ought to do is not to absolutely eliminate the risk, but to reduce the risks and disputes. In this report, to explore the causes of medical disputes and risks and look for ways to reduce them, the survey of questionnaires was carried out and practical cases of medical disputes were analyzed in hospitals. Seventy-seven cases of medical disputes from 2013 to 2015 had been completed by arbitration or court decisions, and the final arbitral ideas were as follows: invalid doctor-patient communication, low technology and insufficient management were the main causes of medical disputes; the survey of 483 questionnaires on doctors and nurses in the hospital showed that in addition to the above 3 reasons, there were other deep reasons, namely heavy working intensity, low quality of patients or their family members, and the insufficient management runs through all the links in the way. Therefore, to reduce medical disputes, the following aspects should be commenced: effective communication between doctors and patients; improving doctors' clinical diagnosis and treatment ability; optimizing medical management; correcting medical work attitude;timely medical consultation; attaching importance to medical records; doctor's order leaving some leeway or allowing for unpredictable circumstances; constructing healthy hospital culture; paying attention to the physical and mental health of medical staff; actively improving the medical dispute settlement mechanism and related legal system construction.

Analysis of calculus composition of upper urinary tract: A single-center study / 第二军医大学学报

Objective To analyze the calculus composition of upper urinary tract and to explore its distribution and variation trend in patients of different genders and ages, so as to provide a basis for the prevention and treatment of urinary stone. MethodsStone specimens from 1 832 patients with upper urinary tract stone were collected in our hospital from Jan. 2012 to Jan. 2016. The stone composition was detected and analyzed by infrared spectrum automatic analysis system. The proportion and gender difference of stone composition, and the related risk factors and concomitant diseases of major types of stones were analyzed. Results Among the 1 832 cases of stone specimens, there were 478 (26.1%) cases of single component stones, of which the calcium oxalate monohydrate stone accounted for 10.6% (193 cases), followed by anhydrous uric acid stone (7.9%, 144 cases). Mixed stone accounted for 73.6% (1 349 cases), and the most common mixed stone consisted of calcium oxalate monohydrate, calcium oxalate dihydrate and carbonate apatite, accounting for 39.6% (725 cases). For the main composition of stones, calcium oxalate stone accounted for 1 545 cases (84.3%), followed by carbonate apatite stone (1 048 cases, 57.2%), anhydrous uric acid stone (208 cases, 11.4%), magnesium ammonium phosphate stone (111 cases, 6.1%) and cystine stone (29 cases, 1.6%). There were also 5 cases of other types of stones. The overall incidence was significantly higher in men than that in women (70.1% [1 285/1 832] vs 29.9% [547/1 832], P<0.01). The overall high-incidence age of stone ranged from 31 to 60 years old, with 41-50 years for men and 51-60 years for women. Body mass index and incidences of diabetes and gout were obviously higher in anhydrous uric acid stone patients than those in the other stone patients. Conclusion This variation trend of upper urinary tract stone composition has great significance for the prevention and treatment of urinary stones.

Efficacy of epiphytic bacteria to prevent northern leaf blight caused by Exserohilum turcicum in maize / Eficacia de bacterias epifíticas en la prevención del tizón foliar del maíz causado por Exserohilum turcicum

Eight potential biological control agents (BCAs) were evaluated in planta in order to assess their effectiveness in reducing disease severity of northern leaf blight caused by Exserohilum turcicum. The assay was carried out in greenhouse. Twenty-six-day-old plants, V4 phenological stage, were inoculated with antagonists by foliar spray. Only one biocontrol agent was used per treatment. Ten days after this procedure, all treatments were inoculated with E. turcicum by foliar application. Treatments performed were: C-Et: control of E. turcicum; T1: isolate 1 (Enterococcus genus) + E. turcicum; T2: isolate 2 (Corynebacterium genus) + E. turcicum; T3: isolate 3 (Pantoea genus) + E. turcicum; T4: isolate 4 (Corynebacterium genus) + E. turcicum; T5: isolate 5 (Pantoea genus) + E. turcicum; T6: isolate 6 (Bacillus genus) + E. turcicum; T7: isolate 7 (Bacillus genus) + E. turcicum; T8: isolate 8 (Bacillus genus) + E. turcicum. Monitoring of antagonists on the phyllosphere was performed at different times. Furthermore, the percentage of infected leaves and, plant and leaf incidence were determined. Foliar application of different bacteria significantly reduced the leaf blight between 30-78% and 39-56% at 20 and 39 days respectively. It was observed that in the V10 stage of maize plants, isolate 8 (Bacillus spp.) caused the greatest effect on reducing the severity of northern leaf blight. Moreover, isolate 8 was the potential BCA that showed more stability in the phyllosphere. At 39 days, all potential biocontrol agents had a significant effect on controlling the disease caused by E. turcicum.

Se evaluó a 8 potenciales agentes de control biológico (ACB) en un ensayo in planta, con el objetivo de probar su efectividad en la reducción del daño provocado por Exserohilum turcicum, agente causal del tizón foliar del maíz. El ensayo se llevó a cabo en invernadero. Plantas de maíz de 26 días, en estadio fenológico V4, se inocularon con los potenciales antagonistas por aplicación foliar como espray. Solo un agente de biocontrol fue usado por tratamiento y todos los tratamientos se inocularon con E. turcicum 10 días después, también por aplicación foliar. Los tratamientos desarrollados fueron los siguientes: C-Et: control de E. turcicum; T1: aislamiento 1 (género Enterococcus) + E. turcicum; T2: aislamiento 2 (género Corynebacterium) + E. turcicum; T3: aislamiento 3 (género Pantoea) + E. turcicum; T4: aislamiento 4 (género Corynebacterium) + E. turcicum; T5: aislamiento 5 (género Pantoea) + E. turcicum; T6: aislamiento 6 (género Bacillus) + E. turcicum; T7: aislamiento 7 (género Bacillus) + E. turcicum; T8: aislamiento 8 (género Bacillus) + E. turcicum. La monitorización en la filosfera de los antagonistas se llevó a cabo a diferentes tiempos. Además, se determinó el porcentaje de hojas infectadas y la incidencia en plantas y hojas. La aplicación foliar de diferentes bacterias redujo significativamente la gravedad del tizón del maíz: entre el 30 y el 78% a los 20 días y entre el 39 y el 56% a los 39 días. En el estadio V10 de las plantas de maíz se observó que el aislamiento 8 (Bacillus spp.) causó el mayor efecto de reducción del tizón foliar. Además, dicho aislamiento fue el potencial agente de biocontrol que mostró mayor estabilidad en la filosfera. A los 39 días, todos los potenciales agentes de biocontrol demostraban un efecto significativo sobre el control de la enfermedad causada por E. turcicum.

A cross-sectional study on HIV/AIDS “90-90-90” treatment target in Shandong province, 2015 / 中华流行病学杂志

Objective To analyze the status and its factors associated with HIV/AIDS“90-90-90”-treatment-target in Shandong province,China.Methods Data regarding testing,treatment on HIV/AIDS in Shandong province by December 31,2015 was collected.Chi-square test and logistic regression model were used to analyze related factors associated with the “90-90-90”-treatment-target.Results Of the 11 700 estimated HIV/AIDS,61.2％ were diagnosed,of whom 74.4％ had received Highly active antiretroviral therapy (HAART).More than 80％ of the HIV/AIDS on HAART reached the criteria on viral suppression.HIV/AIDS infected by homosexual contacts were less likely to seek for diagnosis (P＜0.05).HIV/AIDS lived in Qingdao city (OR=1.30,95％CI:1.05-1.60),Yantai city (OR=1.53,95％CI:1.02-2.31) and Weihai city (OR=1.96,95％CI:1.07-3.58) were more likely to receive HAART.HIV/AIDS patients that infected through homosexual or (OR=O.12,95％CI:0.06-0.24) or heterosexual contacts (OR =0.13,95 ％CI:0.07-0.26),through injecting drug use (OR =0.08,95％CI:0.03-0.17) or being diagnosed at the custodial institutions (OR=0.29,95％CI:0.21-0.41)were less likely to receive HAART.HIV/AIDS patients who received HAART at medical institutions (OR=1.81,95％ CI:1.05-3.47) were more likely to meet the level of Viral load (VL) suppression.However,those who were infected through homosexual (OR=0.43,95％ CI:0.25-0.75) or heterosexual contacts (OR =0.49,95％CI:0.28-0.81) or diagnosed at the custodial institutions (OR =0.48,95％CI:0.28-0.80) were less likely to meet the criteria set for VL suppression.Conclusions There was a gap between the status of testing/treatment and the target on HIV/AID “90-90-90”-treatment,especially on the target set for testing,in Shandong Province.Both HIV testing and comprehensive care services need to be strengthened.

Grading prevention strategy for airway burn during CO2 laser surgery of larynx / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore t he significance of reducing the incidence rate of airway burn of CO2 laser laryngeal surgery by spreading the idea of grading prevention st rateg y. M ETHODS We retrospectively reviewed the data of laryngeal lesions treated by the endoscopic CO2 laser surgery from Feburary 1992 to December 2016. The period was divided into two stages, the first one is from Feburary 1992 to December 2008, and the second one is from January 2009 to December 2016. We will distinguish the difference of airway burn between the two stages. RESULTS Four cases of airway burn were found in the first stage including 3 cases of glottic cancer and 1 case of vocal cord polyp with Reink's edema. But no airway burn happened in the second stage. Two cases of endotracheal intubation cuff broken by laser were found promptly, but with FiO2 decreasing from 70% to 30%, wet gauze filling subglottic region and the endotracheal tube reserved, the laser surgery proceeded till airway burn happened. The endotracheal intubation cuffs of the remaining two cases kept intact intraoperatively, the FiO2 was 70% when airway burn happened. One case had the cervical tracheal stenosis with long-term tracheotomy, The other 3 cases had no postoperative complications. CONCLUSION The grading prevention strategy is helpful for reducing airway burn during the CO2 laser surgery of larynx.

The Application of Disease Prevention Strategy of TCM on Psychosomatic Recovery of Students Suffering Accidental Damage / 浙江中医药大学学报

[Objective]To propose new strategies on enhancing effectiveness of accidental damage and pioneer new realms for disease prevention strategy, this paper emphasized on analyzing the way and function of disease prevention strategy in therapeutic process of accidental damage.[Method]Literature review was applied to summarize and discuss the effect of some approaches guided by disease prevention strategy, including relieving the emotional tension and none-drug treatment.[Result]Three psychological defense lines were constructed during the therapeutic process which were under the guidance of disease prevention strategy, resulting in contribution to improve cognitive evaluation of patients, improve mood and relieve stress disorder. [Conclusion]Disease prevention strategy plays an important role in the psychosomatic recovery of injured students.

Epidemiological characteristics of malaria in Yizheng City from 2000 to 2016 / 中国血吸虫病防治杂志

Objective To explore the epidemiological characteristics of malaria in Yizheng City,so as to provide a reference for formulating the control strategy in the future. Methods The data of malaria case reports and prevention and control work in Yizheng City were collected and retrospectively analyzed. Results Totally 55 malaria cases were found in Yizheng City from 2000 to 2016 with an average incidence of 0.56/105. The malaria cases were local cases from 2000 to 2010 and since 2011 they were all imported cases. Conclusion The endemic situation of malarial in Yizheng City is stable and no local infection cases oc-cur in this place for six consecutive years. The imported cases should be paid more attention to in the future control work.

A cross-sectional study on HIV/AIDS “90-90-90” treatment target in Shandong province, 2015 / 中华流行病学杂志

Objective To analyze the status and its factors associated with HIV/AIDS“90-90-90”-treatment-target in Shandong province,China.Methods Data regarding testing,treatment on HIV/AIDS in Shandong province by December 31,2015 was collected.Chi-square test and logistic regression model were used to analyze related factors associated with the “90-90-90”-treatment-target.Results Of the 11 700 estimated HIV/AIDS,61.2％ were diagnosed,of whom 74.4％ had received Highly active antiretroviral therapy (HAART).More than 80％ of the HIV/AIDS on HAART reached the criteria on viral suppression.HIV/AIDS infected by homosexual contacts were less likely to seek for diagnosis (P＜0.05).HIV/AIDS lived in Qingdao city (OR=1.30,95％CI:1.05-1.60),Yantai city (OR=1.53,95％CI:1.02-2.31) and Weihai city (OR=1.96,95％CI:1.07-3.58) were more likely to receive HAART.HIV/AIDS patients that infected through homosexual or (OR=O.12,95％CI:0.06-0.24) or heterosexual contacts (OR =0.13,95 ％CI:0.07-0.26),through injecting drug use (OR =0.08,95％CI:0.03-0.17) or being diagnosed at the custodial institutions (OR=0.29,95％CI:0.21-0.41)were less likely to receive HAART.HIV/AIDS patients who received HAART at medical institutions (OR=1.81,95％ CI:1.05-3.47) were more likely to meet the level of Viral load (VL) suppression.However,those who were infected through homosexual (OR=0.43,95％ CI:0.25-0.75) or heterosexual contacts (OR =0.49,95％CI:0.28-0.81) or diagnosed at the custodial institutions (OR =0.48,95％CI:0.28-0.80) were less likely to meet the criteria set for VL suppression.Conclusions There was a gap between the status of testing/treatment and the target on HIV/AID “90-90-90”-treatment,especially on the target set for testing,in Shandong Province.Both HIV testing and comprehensive care services need to be strengthened.

Risk factors and prevention strategies of traumatic dental injury in children / 口腔疾病防治

@#Traumatic dental injury (TDI) in children and adolescents has become one of the most serious problems in public health. TDI has relatively high prevalence, broad etiology, which may influence esthetic and function of involved teeth, resulting in economic loss and affecting life quality. The prevalence of TDI increases with children’s age. Males suffer from TDI more easily than females. Maxillary central incisors are most commonly affected. Luxation and enamel fracture are common types of TDI. The main causes of TDI include fall, collision, sport, violence and accident. Overjet, lip incompetency and caries may be risk factors of TDI. According to risk factors of TDI, appropriate prevention measures need to be taken, which is the key of preventing TDI.

Characteristics of bloodborne occupational exposure among health care workers in a tertiary infectious diseases hospital for five consecutive years / 中国感染控制杂志

Objective To evaluate the correlation between occupational exposure and work intensity of health care workers(HCWs)in an infectious diseases hospital for 5 consecutive years,and provide reference for occupational precaution.Methods Occupational exposures cases reported between January 2010 and December 2014 were ana-lyzed retrospectively,occupation types,exposure routes,and exposure sources were analyzed.Results A total of 228 cases of occupational exposure were reported,nurses and doctors were the major exposure population(75.44%and 19.30% respectively);occupational exposure mainly occurred during the infusion process(52.19%);hepatitis B was the main exposure source (71 .05%),followed by human immunodeficiency virus (10.09%).The Pearson correlation coefficient between the occupational exposure rate of doctors and the ratio of doctors to patients was-0.849 (P <0.05),and for nurses,the correlation coefficient was -0.823 (P <0.05 ).Conclusion Nurses are high risk population of occupational exposures,occupational exposure is most likely to occur during transfusion process,occupational exposure of doctors and nurses has a strong correlation with the work intensity.

Review of Suicide Prevention Programs: Massachusetts, United States, in Comparison with Seoul

Suicide is a tragedy that has massive impact on society. In order to prevent suicide, active government intervention is necessary. The suicide rate in Seoul is rapidly increasing and is more than five times higher than that in the state of Massachusetts (MA) during the last decade, especially in the elderly. The suicide prevention program of MA is one of the most effective suicide prevention programs in the United States. The program views suicide as a preventable public health problem, and emphasizes treatment of depression and de-stigmatization of mental health illnesses to prevent suicide. Also, through active collaboration with mental health professionals, they try to identify at-risk populations and help them to get medical interventions. The program also actively collaborates with the regional coalition program and the Samaritans in taking care of the elderly, and supports the elderly in feeling worthwhile after retirement by helping them to work for communities as volunteers. For its part, the Seoul suicide prevention program puts more emphasis on "life respect culture" and "emotional support to high risk individuals by regular visiting". The annual budget of the Seoul suicide prevention program is one-quarter and that for mental health is about one-twentieth that of MA. Considering the high suicide rate and lower mental health service usage in Seoul, it is crucial to raise awareness of depression and decrease the stigma on mental illnesses. Furthermore, educational efforts with long-term investment in research on suicide are necessary.

Epidemiological characteristics and prevention strategy of Japanese encephalitis from 2003 to 2012 in Shaoguan / 国际检验医学杂志

Objective Through the 2003 -2012 epidemic encephalitis B cases analysis ,to study the prevalence of epidemic en-cephalitis B in Shaoguan ,and to provide the scientific basis for the prevention and control epidemic encephalitis B .Methods Active surveillance of suspected cases ,retrospective analysis of laboratory confirmed cases related materials were done .Results There were 47 cases who suffered from epidemic encephalitis B in Shaoguan from 2003 to 2012 ,and 2 death cases occurred .Epidemic en-cephalitis B incidence in years was (0 -0 .531) /10 million .There was a morbidity peak in June and July ,which accounted for 87 .23% of the total incidence ,20 cases occurred in June(42 .55% )and 21 cases occurred in July(44 .68% ) .Men suspected cases in 130 cases ,31 laboratory confirmed cases .Women suspected cases in 86 cases ,16 laboratory confirmed cases .The positive cases of male was more than female .In 47 epidemic encephalitis B cases ,0- <4 years old 6 cases ,4- <7 years old 22 cases ,7- <20 years old 17 cases ,≥ 20 years old 2 cases .Most of the patients were preschool children and students ,accounting for 82 .97% .There were 32 cases with no or uncertain history of vaccination ,accounting for 68 .08% of the total cases .15 cases had history of immunity ,ac-counting for 31 .92% of the total cases .Conclusion Prevention of epidemic encephalitis B should pay more attention to epidemic en-cephalitis B vaccination .Mosquito control work of rural and peri-urban areas should be strengthened .