[Epidemiological characteristics and spatiotemporal clustering of hepatitis A in Zhejiang Province from 2010 to 2019].

Objective: To analyze the epidemiological characteristics and spatiotemporal clustering of hepatitis A in Zhejiang Province from 2010 to 2019. Methods: The data of hepatitis A incidence in Zhejiang Province from 2010 to 2019 were collected from the infectious disease surveillance system of China Information System for Disease Control and Prevention. ArcGIS 10.7 software was used for spatial autocorrelation analysis. SaTScan 9.6 software was used for spatiotemporal scanning analysis. SPSS 25.0 software was used for additional analysis. Results: Zhejiang Province has reported 5 465 cases of hepatitis A in 2010-2019 years, with an average annual incidence rate of 1.00/100 000, and periodicity and seasonality are not obvious. The incidence of male was higher than that of female (P=0.023), and the highest incidence rate was 50-59 years old. Spatial autocorrelation analysis showed that there was a positive spatial correlation between the incidence of hepatitis A in Zhejiang Province from 2010 to 2017, with the weakest correlation in 2010 (Moran's I =0.103, Z=1.769, P=0.049), and the strongest correlation in 2016 (Moran's I=0.328, Z=4.979, P=0.001). Spatiotemporal scanning analysis showed that there was spatial aggregation of hepatitis A in Zhejiang Province from 2010 to 2019, with a total of three aggregation areas identified. Among them, the mostly aggregation area was concentrated in Xiangshan county of Ningbo city, which covered 10 counties (cities and districts), including Ninghai county and Yinzhou district, and appeared from January 1 to June 30, 2012. Conclusion: The incidence level of hepatitis A in Zhejiang Province shows a stable fluctuation trend from 2010 to 2019, and the seasonal regularity is not obvious. The population group aged 50-59 years old is the key population. There is spatial aggregation in the epidemic situation of hepatitis A. Targeted prevention and control measures of hepatitis A should be done based on the law of spatiotemporal aggregation and local incidence.

Analysis of risk factors and prognosis of post-stroke pulmonary infection in integrated ICU.

OBJECTIVE: The incidence of SAP (stroke-associated pneumonia) is high in integrated ICU (Intensive Care Unit), and it might result in sepsis, which exacerbates the clinical outcome and increases mortality. It is necessary to investigate the epidemiological features of post-stroke infection and sepsis, identify the risk factors and analyze the prognosis. PATIENTS AND METHODS: We retrospectively analyzed the data of 329 patients with cerebral infarction or cerebral hemorrhage, from seven tertiary university hospitals in Suzhou, Jiangsu Province, between January 1, 2016, and December 31, 2016. Basic demographic and clinical data including common health evaluation, stroke severity, microbiological parameters, surgical interventions and treatments were recorded for the analysis. SAP was diagnosed according to the criteria and recommendation from American Heart Association (AHA). RESULTS: 188 (66.4%) patients suffered pneumonia, 124 patients were diagnosed as SAP. Compared with SAP, patients with non-SAP pulmonary infection had prolonged mechanical ventilation time, prolonged central venous catheter indwelling time, and higher incidence of sepsis (17.7% vs. 48.4%). 53 patients (18.7%) developed sepsis during hospitalization, whose mortality rate during hospitalization and the occurrence of neurologic dysfunction at 3 months were significantly increased (p<0.05). 130 positive results of sputum cultures were found. The detected pathogens were mainly gram-negative bacteria. The pathogenic detection rate of non-SAP patients with pulmonary infection was higher (78.1%). The in-hospital mortality was 16.3% and the related risk factors were higher NIHSS score at admission, lower GCS score at admission, pulmonary infection (especially non-SAP pulmonary infection) and sepsis during hospitalization. CONCLUSIONS: The incidence of pulmonary infection after stroke in the integrated ICU is high, and it is easy to be complicated with sepsis, prolonging the mechanical ventilation time, central venous catheter indwelling time and hospitalization time, and the prognosis of long-term neurological function is relatively poor. The definition of stroke-associated pneumonia has implications for the classification of clinical infections, the prediction of possible pathogenic pathogens, and the guidance of anti-infective treatment.

[Analysis on the incidence of occupational pneumoconiosis of migrant workers in Shiyan city from 2013 to 2017].

Objective: To explore the incidence regularity and characteristics of pneumoconiosis among migrant workers in Shiyan city, and to provide a basis for making policies about pneumoconiosis prevention and treatment among migrant workers. Methods: In September 2018, 338 cases of pneumoconiosis among migrant workers and 354 cases of pneumoconiosis among non-migrant workers were collected between 2013 and 2017. The proportions of pneumoconiosis types, the age and seniority of onset workers, the severity grade of pneumoconiosis, the type of pneumoconiosis, the type of work and regional distribution, etc. were analyzed. Results: The age at onset of pneumoconiosisand the length of service of migrant workers and non-migrant workers in Shiyan city were significantly different (t=2.237, 3.208, P<0.05) . The proportion of pneumoconiosis stage was significantly different from that of non-migrant workers (χ(2)=47.897, P<0.05) , among migrant workers, the types of pneumoconiosis were mainly silicosis (308 cases, 91.1%) , coal worker's pneumoconiosis (29 cases, 8.6%) . The leading work types are rock drilling (115 cases, 34.0%) and blasting (105 cases, 31.1%) . The industry was mainly engaged in non-ferrous metal mining (205 cases, 60.7%) and coal (105 cases, 31.1%) . The area distribution involved each counties of Shiyan city, with Zhushan county (175 cases, 51.8%) and Yunxi county (125 cases, 37.0%) as the top two districts in number of cases. Of the cases of migrant workers, 89 cases (26.3%) had blood relationship with any others. There was no work-related injury insurance for migrant workers with pneumoconiosis. Conclusion: There is a high incidence of pneumoconiosis among migrant workers in Shiyan city, featured with the phenomenon of "late occurrence" and "family clustering", so it is urgent to strengthen the prevention and treatment of pneumoconiosis of migrant workers.

[Investigation on the cold-chain temperature of vaccine in some areas of Zhejiang Province].

Objective: To investigation the situation of cold chain on vaccine in parts of Zhejiang Province and to provide recommendations for the management. Methods: From October to December, 2016, we each selected an immunization clinic in Cangnan County of Wenzhou, Yongkang City of Jinhua, Jianggan District of Hangzhou. Temperature recorder and vaccine viral monitor (VVM) labels were used to monitor the cold chain during all the storage and transportation process. In Jianggan District, we use optical density sensor to detected 20 VVM labels every time when the vaccine was stock in and out. Results: In total, 54 958 records were collected by temperature recording devices in all the three immunization clinic. 275 records exceeded the temperature limit required for store and transportation, of which 270 (98.2%) were above 8 ℃ and 5 (1.9%) were under 2 ℃. Excessive temperature exposure mainly occurred during the transportation (38.2%, n=105), followed by storage process in CDCs at different levels (26.2%, n=72), stock in and out (20.7%, n=50) and storage in the refrigerators in immunization clinics (14.9%, n=41). The average optical density difference between VVM labels and the reference circular decreased from 0.404 to 0.344 when the vaccines were delivered from the Zhejiang provincial CDC to immunization clinics. The color of VVMs did not significantly changed before use. Conclusions: The potential risk of vaccine cold chain in the monitoring sites is over-temperature. The weak links of cold chain management include the transportation, storage process, and stock in and out.

Adolescence et pathologies psychiatriques: a propos de 100 cas colliges a l'hopital psychiatrique de Bingerville

L'hopital psychiatrique de Bingerville est le centre de reference des troubles psychiatriques en Cote d'Ivoire . Population et methode : Il s'agissait d'une etude retrospective des pathologies psychiatriques de dossiers de 100 adolescents hospitalises a l'hopital psychiatrique de Bingerville. Resultats : Ils indiquaient que; la majorite des patients (64) etait en fin d'adolescence (19-21ans). Les pathologies psychiatriques selon les criteres de l'OMS (CIM10) sont dominees par les troubles psychotiques aigus polymorphes sans symptomes schizophreniques (45); les troubles psychotiques chroniques (24) et les troubles bipolaires (20) ; tous declenches par des facteurs organiques (47); des facteurs psychologiques (37) et medicamenteux (16). Commentaires : Les facteurs qui ont declenche ou favorise ces decompensations etaient d'ordre organique; psychologique et medicamenteux (non observance d'un traitement psychotrope)

[Descriptive study of suicidal adolescents conducted in Abidjan]. / Etude descriptive des conduites suicidaires des adolescents à Abidjan.

INTRODUCTION: The answer to the various problems encountered during adolescence is experienced in the form of behavioural thoughts and/or action expressed in conduct. The failure to act could lead to suicidal ideation and its completion. Are there any risk factors? The general aim of this study was to describe the motives and methods of suicide among adolescents observed in Abidjan, in order to contribute to their care. MATERIALS AND METHODS: The prospective study, referred to as descriptive, was initiated in the Mental Health Service of the National Public Health Institute in Abidjan from the 1(st) of June to the 31(st) of October 2005, within the setting of the resuscitation service of the University Hospital centers of Cocody, Treichville and the emergency department of the university hospital of Yopougon. The sociodemographic, clinical, therapeutic and evolutive data of suicidal behaviour was analysed in 42 subjects. RESULTS: The study shows the following observations: a predominance of emotional problems (52.38%) versus 38.10% of family conflicts and 7.14% of failure at school; the subjects had resorted to chemical means dominated by chloroquin (45.62%) followed by psychotropics 14.40%; suicide was completed impulsively in 85.71% of cases; except in one case, suicidal behaviour took place at home and 66.67% in the evening; only three suicidal adolescents were oriented towards a psychiatric unit. CONCLUSION: Our study underlined the difficulties. Once the vital emergency has been managed, the solution would be the immediate orientation of suicidal adolescents towards psychiatric structures. This situation calls for a wider integration of psychiatry in health facilities in the Ivory Coast.

[First therapeutic recourse of the teenagers received to the service of Mental Hygiene of the INSP of Abidjan]. / Premier recours therapeutique des adolescents reçus au Service d'Hygiene Mentale de l'INSP d'Abidjan.

INTRODUCTION: The care of health in Africa is characterized more and more by an increasing offer, as well by its volume as by the diversity of its forms ("traditional" care, practise therapeutic related to the religion, medicine of the Western type). The request for psychiatric care is high at the teenager (25.34%) and causes the description of the therapeutic route of the teenagers to the Dispensary of Mental Hygiene. MATERIAL AND METHODS: The exploratory study with descriptive aiming proceeded with the Service of Mental Hygiene of the INSP of Abidjan of July 1 at November 31, 2005. The data socio epidemiologic, clinical, paraclinic and therapeutic were analyzed at 27 teenagers received in ambulatory consultation in 2004. RESULTS: It arises from the structured interviews, the following observations: a male prevalence (66.7%); the majority of the teenagers (63%) was pupils and students, of Christian religion (55.6%); 63% of the teenagers were referred by their families frequently for are delirious (22.2%) and insomnia (22.2%); a prevalence of the schizophrenic subjects (40.7%) followed disorders of mood 25.9%; No patient had had resort as a first intention with the DHM; the first recourse being dominated by the tradithérapie (33.3%) followed centers of conventional care (25.5%) and churches and camps of prayers (18.5%). CONCLUSION: He comes out from this study that the profile of the teenagers was of male sex, for the majority of the pupils and the students. Also, the majority of the patients were referred by their family and schizophrenia represents principal pathology. The tendency to choose in first resort the healers should challenge the authorities on the need into practice for putting recommendations of consensus to improve the mental health of the teenagers.

[Epidemiologic study on patrons of traditional drink establishments (Bandjidromes) in Abidjan, Ivory Coast and surrounding areas]. / Enquête epidémiologique a propos des usagers des débits de boissons traditionnelles (Bandjidromes d'Abidjan et de sa banlieue).

This transverse descriptive study was conducted over a three-month period from January 10 to April 10, 2003. Findings demonstrated a clear profile of 120 patrons of traditional drinking establishments called n the city of Abidjan and surrounding areas in the Ivory Coast. All subjects interrogated were male. Mean age was 31.1 years. Almost all subjects interrogated (99.2%) were of Ivory Coast nationality. The main ethnic group was Akan (86.7%) from Baoulé (60%). More than a third (35.9%) of subjects interviewed were unemployed. Most (62.5%) were single. All subjects interrogated stated that they attended "bandjidromes" to drink palm wine although other alcoholic beverages were served. However only 9.2% of subjects drank only palm wine. The euphoric effect of alcohol and friendly atmosphere of the drinking establishment were the main reasons for attendance (53.3%). Most persons interrogated (63.3%) had been consuming alcohol for more than 10 years. More than half (55%) spent less than three hours a day drinking alcoholic beverages. Daily consumption of palm wine ranged from two to four liters for most atrons (76.7%). Only 2.5% (3/120) presented neuropsychiatric disturbances. These results could be useful in the fight against alcoholism.

[Effect of pulse current iontophoretic transdermal delivery of insulin on blood glucose in diabetic rats].

Iontophoresis of pulse current with various current intensity, frequency, on/off ratio and duration of treatment was used to facilitate the transdermal delivery of insulin in order to control blood glucose levels in diabetic rats. Male Sprague-Dawley rats were made diabetic by i.p. injection of streptozotocin (65 mg . kg-1 body weight). After two days, diabetic rats were anaesthetized with urethane (as 25% aqueous solution, 1.5 mg . g-1). Both the reservoir electrodes and the receptor electrodes were applied on the abdominal site of the diabetic rats. Iontophoresis was carried out using a prototype transdermal periodic iontophoretic system in order to provide the required direct current with desired pulse modes. The extent of reduction of blood glucose levels was found to be positively correlated with the current intensity, frequency and duration of treatment to some extent. But when the current intensity was over 0.8 mA/cm2 and the frequency was over 3000 Hz, the reduction of blood glucose levels did not continuously increase. Blood glucose levels were found to be better controlled when the on/off ratio of 1 : 1 was used.

[Facilitated transdermal delivery of insulin by pulse current iontophoresis].

Facilitated transdermal delivery of insulin by pulse current iontophoresis was investigated. It was found that pulse current iontophoresis can increase the transdermal permeation rate, and there was a positive correlation between reservoir insulin concentration and skin permeation rate of insulin. Moreover, when the reservoir solution pH (3.6) was below the isoelectric point of insulin (pI 5.2), the transdermal permeation rate of insulin was the highest, 324.3 +/- 33.4 microU/(cm2.h). When the pH of the reservoir solution was brought up to 7.4, the transdermal permeation rate of insulin declined markedly to 143.7 +/- 27.3 microU/(cm2.h). When the reservoir solution pH was close to the isoelectric point of insulin, the transdermal permeation rate of insulin was the lowest, 78.4 +/- 21.9 microU/(cm2.h).