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1.
Medicine (Baltimore) ; 98(38): e16973, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567932

RESUMO

BACKGROUND: As the most important component of cardiovascular disease, coronary heart disease (CHD) is closely related to psychological factors such as anxiety. Anxiety, whether present before or after the onset of illness, can lead to many serious consequences. The aim of this systematic review and meta-analysis was to assess the prevalence of and potential risk factors for anxiety after coronary heart disease (post-CHD anxiety). METHOD: Systematic searches were performed in electronic databases including China National Knowledge Infrastructure (CNKI), Wanfang, Technology Journal database (VIP), PubMed, Web of Science, Embase and Medline. RESULT: Thirteen studies were included. With regard to cross-sectional studies, the prevalence of post-CHD anxiety was P = .37, 95% CI (0.26-0.49). The overall analysis among cohort studies revealed that the prevalence of post-CHD anxiety was P = .50, 95% CI (0.05-0.95). Among the 11 potential risk factors, low education level [OR = 1.46, 95% CI (1.05-2.02)] and long duration of disease [OR = 2.05, 95% CI (1.05-4.00)] were statistically significant. CONCLUSION: There is high heterogeneity between studies and many defects; thus, further research is required to support these results. Attention should be paid to post-CHD anxiety, and clinical caring should include psychological counselling and imparting disease-related knowledge to patients with a long disease duration and low educational background.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infarto do Miocárdio/psicologia , Transtornos de Ansiedade/psicologia , China/epidemiologia , Humanos , Prevalência , Fatores de Risco
2.
Medicine (Baltimore) ; 98(38): e17123, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567950

RESUMO

To investigate the age, gender, time, and etiology differences of traumatic lower limb fractures (TLLFs) in a population of children (≤18 years old), we retrospectively reviewed 936 children who had TLLFs and who came to our university-affiliated hospitals from 2001 to 2010. This study enrolled 657 males (70.2%) and 279 females (29.8%) aged (11.6 ±â€Š4.9) years old. The most common etiologies and fracture sites were motor vehicle collisions (MVCs, 440, 47.0%) and tibias (376, 40.2%). A total of 126 (13.5%) patients suffered neurological deficits (NDs), 127 (13.6%) patients sustained associated injuries (ASOIs), and 78 (8.3%) patients sustained complications. During all periods the occurrence increased with increasing age group and a male preponderance was observed in all age groups. With increasing age, the proportion of injuries due to different etiologies increased and the proportion of femur fracture decreased from 65.2% to 34.5%. With increasing year of admission, the proportion of injuries due to MVCs decreased. The most common fracture sites were tibias in MVCs, femurs in low fall, high fall, and struck by object, feet in sprain. Male patients presented with significantly higher proportions of injuries due to struck by object and sprain, significantly lower proportions of pelvis fracture than the female patients. MVCs and tibias were the most common etiologies and fracture sites. Prevention and treatment should be taken according to the pattern of TLLFs which have specific annual, gender, and age characteristics.


Assuntos
Fraturas do Fêmur/epidemiologia , Fraturas da Tíbia/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Fatores Etários , Criança , Serviços de Saúde da Criança , Pré-Escolar , China/epidemiologia , Feminino , Fraturas do Fêmur/etiologia , Humanos , Lactente , Extremidade Inferior/lesões , Masculino , Fatores Sexuais , Fraturas da Tíbia/etiologia
3.
Medicine (Baltimore) ; 98(39): e17296, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574852

RESUMO

The angiotensin-receptor-neprilysin inhibitor (ARNI) reduced cardiovascular deaths and heart failure hospitalization in patients with heart failure of reduced ejection fraction (HFrEF). Its role in non-HFrEF patients was not clear. This study aims to answer this question.In this retrospective study, we enrolled 928 patients diagnosed with non-HFrEF, 492 of them received angiotensin converting enzyme inhibitor (ACEI) and the rest 436 received angiotensin-receptor-neprilysin inhibitor. Outcomes were compared by Kaplan-Meier survival analysis and various clinical parameters were investigated using Cox multivariable analysis, followed by interaction analysis. Minnesota living with heart failure Questionnaire (MLHFQ) was employed as one of the criteria to assess heart failure outcome.The cardiovascular (CV) death or HF hospitalization at 24 months occurred in 49 patients in ACEI group compared with 31 in ARNI group (Hazard Ratio (HR): 1.231, 95% confidence Interval (CI): 1.080-2.460, P = .031). And ARNI showed better prognosis of HF hospitalization (HR: 1.283, 95%CI: 1.065-1.360, P = .038). Cumulative Kaplan-Meier estimates of endpoints, ARNI could reduce the incidence of CV death or HF hospitalization (P = .042) and HF hospitalization (P = .035). The stratified analysis revealed that participants with age less than 70 years old had a lower incidence of CV death or HF hospitalization (HR: 1.194, 95%CI: 1.011-1992, P = .031) after treated with ARNI. Patients received diuretics could benefit from ARNI (HR: 1.383, 95%CI: 1.082-1.471, P = .019). Similar results were also observed in patients with heart rate lower than 90 bpm (HR: 1.556, 95%CI: 1.045-2.386, P = .003) and patients with atrial fibrillation history (HR: 1.873, 95%CI: 1.420-2.809, P = .011). ARNI could improve the quality of life both from the total, emotional and physical aspects.ARNI is an efficacy treatment strategy to improve the outcome and quality of life in patients with non-HFrEF.


Assuntos
Antagonistas de Receptores de Angiotensina , Insuficiência Cardíaca , Hospitalização/estatística & dados numéricos , Neprilisina/antagonistas & inibidores , Qualidade de Vida , Volume Sistólico , Idoso , Antagonistas de Receptores de Angiotensina/administração & dosagem , Antagonistas de Receptores de Angiotensina/efeitos adversos , China/epidemiologia , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/psicologia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento , Função Ventricular Esquerda
4.
Medicine (Baltimore) ; 98(39): e17300, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574855

RESUMO

We investigated associations between inflammatory marker levels and hepatitis C virus (HCV)-related compensated liver cirrhosis risk in patients with chronic hepatitis C (CHC) infection in China. We used a case-control design and data from the records of 110 Chinese patients with CHC and cirrhosis for the study; 458 CHC patients who did not have a diagnosis of cirrhosis were matched to the case group by age and sex characteristics. We also investigated fatty liver disease risk factors. The group of patients with CHC infection and cirrhosis had lower platelet-to-lymphocyte ratio (PLR) values (60.63 [44.09, 89.31]) compared with the control group patients (80.24 [57.85, 111.08]). The results indicated that the group of patients with cirrhosis had higher 4-factor fibrosis index and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) values compared with the group of patients with CHC-only (1.66 [0.98, 2.60] vs 0.71 [0.45, 1.17], respectively; P < .001 and 2.12 [0.97, 4.25] vs 0.99 [0.51, 2.01], respectively; P < .001). Compared with the control group, the AST/alanine aminotransferase ratio (AAR) values in the group of patients with cirrhosis were significantly higher (P < .001). Logistic regression analysis that included model adjustment for demographic characteristics and other factors that could affect cirrhosis risk revealed that greater 1/PLR values were associated with an increased odds of having cirrhosis (adjusted odds ratio [AOR], 95% confidence interval [CI] 0.991 [0.985-0.996]); APRI and AAR values were also independent predictors of the presence of compensated cirrhosis. We found that compared with the patients with CHC-only, the triglyceride, cholesterol, and low-density lipoprotein cholesterol levels in the patients with both CHC and fatty liver disease were significantly higher. The multivariate analysis of the risk of fatty liver development in patients with CHC infection found that cholesterol level was a statistically significant risk factor (AOR [95% CI] 1.380 [1.089-1.750], P = .008). Increased 1/PLR, APRI, and AAR values were associated with increased risks for development of cirrhosis in this population of Chinese patients with CHC infection. Higher cholesterol levels increased the risk of development of fatty liver disease in patients with CHC.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Hepatite C Crônica , Cirrose Hepática , Biomarcadores/sangue , Estudos de Casos e Controles , China/epidemiologia , Fígado Gorduroso/sangue , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/epidemiologia , Feminino , Hepacivirus/isolamento & purificação , Hepatite C Crônica/sangue , Hepatite C Crônica/complicações , Hepatite C Crônica/epidemiologia , Humanos , Lipoproteínas/sangue , Cirrose Hepática/sangue , Cirrose Hepática/diagnóstico , Cirrose Hepática/epidemiologia , Cirrose Hepática/etiologia , Contagem de Linfócitos/métodos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas/métodos , Fatores de Risco
5.
Medicine (Baltimore) ; 98(39): e17302, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574856

RESUMO

With the deepening population aging process in China, the medical expenses of older adults has become a widespread concerned. Medical insurance is a major source of Chinese medical financing and payment. The study aims to understand the current status of medical expenses for older adults and explore the effect of different types of health insurance on medical expenses in China.The data came from the Chinese Longitudinal Health Longevity Survey (CLHLS) in 2014. The Kruskal-Wallis test and general multivariate linear regression model were applied to analyze the current situation and to explore how medical insurance as the main payment impacts medical expenses.A total of 4376 older participants were included in this study. The median of medical expenses of a total was 1500 Yuan per year. The proportions of participants who had the urban employee-based basic medical insurance (UE-BMI), the urban residents basic medical insurance (UR-BMI), the new rural cooperative medical insurance scheme (NCMS), and the commercial medical insurance were 10.8%, 8.4%, 72.7%, and 0.9%, respectively. 34.8% of older adults paid the health care service via the NCMS and 11.9% paid via the UE-BMI. Participating in the NCMS and UR-BMI are significantly related to the level of the medical fees of older adults. UE-BMI, UR-BMI, and NCMS as main payment eased the pressure of medical expenses.The influence of different types of medical insurances as main payments on the medical expenses of older adults is varied. Implementation of medical insurance should be taken to further relieve the medical expenses of older adults.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , Idoso , China/epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Inquéritos Epidemiológicos , Transição Epidemiológica , Humanos , Longevidade , Estudos Longitudinais , Masculino , Inquéritos e Questionários
6.
Medicine (Baltimore) ; 98(39): e17305, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574858

RESUMO

Until now, the recognition of sodium taurocholate cotransporting polypeptide (NTCP) deficiency has been mainly based on sporadic case reports. It was previously believed to be mildly symptomatic and resulting in mild liver dysfunction. However, to our knowledge, there have been no reports about the histopathologic and ultrastructural pathologic characteristics of the disease. The aim of the study was to analyze the clinical, histopathologic and ultrastructural pathologic characteristics of NTCP deficiency in 13 pediatric patients.From August 2012 to October 2018, this retrospective study conducted in the Department of Pediatrics of Tongji Hospital, China analyzed the data of 13 NTCP deficient patients with an SLC10A1 gene mutation. Except for NTCP deficiency, no other liver diseases were present in the patients, which was determined by both a genetic testing panel for jaundice and by reviewing medical records. The laboratory results, imaging, histopathologic, and ultrastructural pathologic information were recorded for analysis.The serum level of total bile acid was high in all 13 patients. All patients had adequate growth and development. Eight of the patients (8/13) presented with visible jaundice and 12 (12/13) were found to have hyperbilirubinemia. A needle liver biopsy was performed in 11 cases, which revealed slightly chronic inflammation in all 11 patients. One of the patients (1/13) was found to be suffering from gallstones.The data showed that although NTCP deficiency was often asymptomatic, some of the patients showed obvious clinical expressions, such as jaundice. Among the 13 pediatric patients with NTCP deficiency, both the biochemical and histopathologic features were similar to those of mild hepatocellular jaundice. In addition, it was determined that the clinical features in the patient with gallstones may have been caused by NTCP deficiency.


Assuntos
Ácidos e Sais Biliares/sangue , Icterícia , Hepatopatias , Fígado , Transportadores de Ânions Orgânicos Dependentes de Sódio , Simportadores , Desenvolvimento Infantil , Pré-Escolar , China/epidemiologia , Testes Genéticos/métodos , Humanos , Biópsia Guiada por Imagem/métodos , Lactente , Icterícia/diagnóstico , Icterícia/etiologia , Fígado/metabolismo , Fígado/patologia , Hepatopatias/diagnóstico , Hepatopatias/genética , Hepatopatias/fisiopatologia , Hepatopatias/terapia , Testes de Função Hepática/métodos , Glicoproteínas de Membrana/metabolismo , Mutação , Transportadores de Ânions Orgânicos Dependentes de Sódio/deficiência , Transportadores de Ânions Orgânicos Dependentes de Sódio/genética , Pediatria/métodos , Estudos Retrospectivos , Simportadores/deficiência , Simportadores/genética
7.
Medicine (Baltimore) ; 98(39): e17307, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574859

RESUMO

To investigate the cognitive and psychological outcomes of pediatric allogeneic HSCT survivors in China.A total of 135 3 to 18 years old children and adolescents who underwent allo-HSCT and survived at least 3 months post-HSCT were recruited and completed the assessments. Cognitive and psychological functions were assessed via age-appropriate standardized measures. Clinical information was extracted from the medical records.Forty one 3 to 6 years old children completed Psychological Questionnaires for 3 to 6 years Children. The scores of 21(51.2%) children in cognitive development dimension, 18(43.9%) in motor development dimension, 16(39.0%) in language development and social development dimension, 15(36.6%) in emotion and will dimension and 14(34.1%) in living habits dimension were less than the standard. Fifty six 8 to 16 years old children and adolescents completed the Depression Self-rating Scale for Children and 9 (16.1%) of these met the criteria of depression. Sixty nine 7 to 16 years old children and adolescents completed the screening for Child Anxiety Related Disorders and 7 (10.1%) of these met the criteria of anxiety, especially social phobia and school phobia. Eighty nine 6 to 18 years old children and adolescents completed the Symptom Checklist-90 and 43.8% to 77.5% of these experienced mild symptoms like obsession-compulsion (77.5%), hostility (64%), and interpersonal sensitivity (60.7%). Children treated with total body irradiation (TBI) showed more cognitive impairments like motor deficits than those without TBI. Also older children and adolescents had more symptoms like psychoticism.These findings demonstrated cognitive and psychological late effects of pediatric allo-HSCT survivors in a single center in China and highlighted that the survivors conditioned with TBI had more cognitive impairments and older children and adolescents had more symptoms. Early intervention in these children and adolescents might minimize the cognitive losses and psychological effects.


Assuntos
Ansiedade , Disfunção Cognitiva , Depressão , Transplante de Células-Tronco Hematopoéticas , Complicações Pós-Operatórias , Qualidade de Vida , Adolescente , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/prevenção & controle , Criança , Pré-Escolar , China/epidemiologia , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Depressão/diagnóstico , Depressão/etiologia , Depressão/prevenção & controle , Intervenção Médica Precoce/métodos , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Destreza Motora , Avaliação de Processos e Resultados (Cuidados de Saúde) , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , Técnicas Psicológicas , Sobreviventes/psicologia
8.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 244-250, 2019 Jul 26.
Artigo em Chinês | MEDLINE | ID: mdl-31544401

RESUMO

OBJECTIVE: To explore the integrated schistosomiasis control model in mountainous and hilly endemic regions, so as to provide insights into the development of the schistosomiasis elimination strategy. METHODS: Five hilly and mountainous areas endemic for schistosomiasis were selected as the integrated control demonstration areas in Sichuan Province from 2011 to 2015. According to the epidemic characteristics, economic levels and overall development planning of the demonstration areas, the goals, strategies and measures were developed, and the effectiveness of schistosomiasis control was evaluated following implementation of the integrated control. RESULTS: The support system of the integrated schistosomiasis control model was built in the integrated control demonstration areas in Sichuan Province from 2011 to 2015, and five ecological, industrialized and sustainable development models of integrated schistosomiasis control were developed, including integration of balancing rural and urban development, systematic ecological improvement, intensified ecological agriculture, scientific management and health education of schistosomiasis control and ecological ethnic circular economy. Since the implementation of the integrated schistosomiasis control model, the snail habitats were completely changed. Until 2015, 92.0% of all historical areas with snails were managed, the coverage of safe drinking water was 100.0%, and more than 95.0% of the livestock were fenced. The coverage of sanitary toilets increased by 93.0%, 96.8%, 78.8%, 87.1% and 82.0% from 2011 to 2015, respectively, and the farmers'mean yearly income increased by 32.7% in the demonstration areas. From 2011 to 2015, the seroprevalence of human Schistosoma japonicum infections reduced from 3.1% in 2011 to 1.6% in 2015 in the demonstration areas, and no egg-positives were identified. In addition, the number of fenced bovines reduced year by year, and no egg-positives were detected. The areas of snail habitats were 398.7, 108.2 hm2 and 52.9 hm2 in the demonstration areas from 2011 to 2013, with no infected snails found, and no snails were detected since 2014. The awareness of schistosomiasis control knowledge and percentage of correct behavior formation increased year by year among residents in the demonstration areas from 2011 to 2015. CONCLUSIONS: The five integrated schistosomiasis control models meet the needs of the current schistosomiasis control activities in mountainous and hilly endemic areas of Sichuan Province, and achieve the goals of controlling the sources of S. japonicum infections, economic development, social progress and improving the ecological environment, which provides new insights into schistosomiasis elimination in the country.


Assuntos
Ecossistema , Esquistossomose , Criação de Animais Domésticos/normas , Criação de Animais Domésticos/tendências , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , China/epidemiologia , Humanos , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Esquistossomose Japônica , Estudos Soroepidemiológicos , Caramujos/fisiologia , Desenvolvimento Sustentável/tendências
9.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 251-257, 2019 Aug 13.
Artigo em Chinês | MEDLINE | ID: mdl-31544402

RESUMO

OBJECTIVE: To build a schistosomiasis transmission risk surveillance system in Sichuan Province, so as to provide technical support for facilitating the progress towards schistosomiasis elimination in the province. METHODS: The surveillance sites for schistosomiasis transmission risk were assigned in 63 endemic counties (districts) of 11 cities (prefectures) in Sichuan Province. During the period from 2015 through 2018, wild feces contamination, the sources of Schistosoma japonicum infections (fever patients, livestock and wild animals), water infectivity in key settings, snail distribution in key settings, and snail breeding risk (snail importation and spread, floating debris carrying snails and snail breeding in ecological wetlands) were monitored in the surveillance sites. RESULTS: From 2015 to 2018, a total of 1 636 wild faces were detected in Sichuan Province, and 3 faces were positive for S. japonicum, with a 0.18% positive rate; among 3 995 livestock and 59 wild mice monitored, no S. japonicum infection was detected. A total of 49 414 fever patients were monitored in 2018, and 493 were seropositive for S. japonicum infection; then, 445 seropositives were subjected to stool examinations, and no egg-positives were found. From 2010 to 2018, a total of 93 sentinel sites were assigned, and 3 994 sentinel mice were placed for monitoring the water infectivity, with one S. japonicum-infected mouse detected. Between 2015 and 2018, a total of 4 156 key settings were investigated covering an area of 1 998.46 hm2, and 668 settings were detected with snails (16.07%), covering an area of 193.26 hm2; 497 suspected settings with a likelihood of snail importation with plant introduction were monitored from 2017 to 2018, and 65 settings with snails were found with 2 673 snails captured; 593 sites were assigned to collect the floating debris from 2017 to 2018, and 9 191.39 kg floating debris were collected with 186 snails captured; 4 wetlands were monitored for the risk of schistosomiasis transmission from 2013 to 2015, and snail breeding was found in 2 wetlands. No S. japonicum infection was identified in snails captured from all surveillance sites. CONCLUSIONS: A sensitive and effective schistosomiasis transmission risk surveillance system has been successfully established in Sichuan Province. There is still a risk of schistosomiasis transmission risk in local areas of Sichuan Province. Therefore, the integrated schistosomiasis control measures with emphasis on the control of the source of S. japonicum infections should be further intensified, and snail monitoring and control and monitoring and control of schistosomiasis in wetlands should be also intensified.


Assuntos
Vigilância da População , Esquistossomose Japônica , Esquistossomose , Animais , Cruzamento , China/epidemiologia , Cidades , Fezes/parasitologia , Humanos , Gado , Camundongos , Vigilância da População/métodos , Prevalência , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Esquistossomose/transmissão
10.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 264-268, 2019 Aug 13.
Artigo em Chinês | MEDLINE | ID: mdl-31544404

RESUMO

OBJECTIVE: To understand the status of current schistosomiasis patients after the interruption of schistosomiasis transmission in Sichuan Province, so as to provide the reference for the development of specific rescue and treatment schemes and the implementation of dynamic management of the patients. METHODS: The information of registered schistosomiasis patients in disease control and prevention institutions and medical institutions were reviewed in all schistosomiasis-endemic counties (districts) across Sichuan Province in 2018, and the data of all newly discovered schistosomiasis patients were collected and analyzed. RESULTS: A total of 1 558 current schistosomiasis cases were diagnosed in 11 endemic cities (prefectures) across Sichuan Province, and all were advanced cases. Megalosplenia and ascites were the predominant types of advanced schistosomiasis cases, and no age- (χ2 = 16.723, P > 0.05) or gender-specific difference (χ2 = 2.493, P > 0.05) was seen in the clinical types of current schistosomiasis cases. There were 9.3% of current schistosomiasis patients from poor households. There was a tendency towards a decline in the number of advanced schistosomiasis cases since 2012, and the number of schistosomiasis cases in 2018 reduced by 17.8% as compared to that in 2012. CONCLUSIONS: Currently, all current schistosomiasis patients are advanced cases in Sichuan Province. In the future, multidisciplinary collaboration should be implemented to search for a feasible financial subsidy pattern and establish an effective care system for advanced schistosomiasis patients.


Assuntos
Esquistossomose , Animais , China/epidemiologia , Feminino , Humanos , Masculino , Fatores de Risco , Esquistossomose/epidemiologia , Esquistossomose/patologia , Fatores Socioeconômicos
11.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 275-279, 2019 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-31544406

RESUMO

OBJECTIVE: To assess the effectiveness of infectious source control at various stages of transmission control of schistosomiasis in Eryuan County of Yunnan Province, so as to provide insights into the further monitoring and management of infectious sources of schistosomiasis. METHODS: Wenbi Village, a plateau subtype region and Qiandian Village, a mountain subtype region in Eryuan County were selected as the study areas. The species, schistosome infection and transmission capability of infectious sources were investigated in Wenbi and Qiandian villages in 2011 and 2018 and were compared. RESULTS: Schistosome infections were detected in human, bovine, horse, dog and mouse in Qiandian Village in 2011, with positive rates of 1.19%, 0.91%, 1.25%, 3.13% and 0.95%, respectively, and human, bovine and dog were found to have schistosome infections, with positive rates of 0.76%, 1.66% and 9.30%, respectively. However, no infections were identified in human, bovine, horse, pig, dog, sheep or mouse in these two villages in 2018. A total of 731 wild feces were collected in both villages in 2011. In Qiandian Village, horse, bovine and dog feces accounted for 34.40%, 29.80% and 20.20% of all fecal samples, and dog and horse feces were found to have schistosome infections (11.94% and 6.90% positive rates, respectively). In Wenbi Village, dog, bovine and human feces accounted for 44.59%, 39.83% and 14.29% of all fecal samples, and dog, human and bovine feces were found to have schistosome infections (16.95%, 9.52% and 2.33% positive rates, respectively). In 2018, a total of 204 wild feces were collected in both villages, and no schistosome infections were identified. Sheep, dog and bovine feces accounted for 36.27%, 33.33% and 27.45% of all fecal samples in Qiandian Village, and dog, bovine and human feces accounted for 72.55%, 11.76% and 10.78% of all fecal samples in Wenbi Village. CONCLUSIONS: A remarkable achievement has been obtained in the control of infectious sources of schistosomiasis in Eryuan County, and the role of human and bovine as the major infectious sources of schistosomiasis has been effectively controlled. In the future, the integrated strategy with emphasis on the control of infectious sources should be intensified, and the management of reservoir hosts including dog and mouse should be strengthened.


Assuntos
Reservatórios de Doenças , Esquistossomose , Animais , Bovinos , China/epidemiologia , Reservatórios de Doenças/parasitologia , Cães , Fezes/parasitologia , Cavalos , Humanos , Camundongos , Prevalência , Schistosoma , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Esquistossomose/transmissão , Ovinos , Caramujos , Suínos
12.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 280-284, 2019 Jun 12.
Artigo em Chinês | MEDLINE | ID: mdl-31544407

RESUMO

OBJECTIVE: To compare the approaches used for the assessment of disability adjust life years (DALYs) for advanced schistosomiasis japonica, so as to provide scientific evidence for accurate assessment of the burden of advanced schistosomiasis japonica. METHODS: The patients with advanced schistosomiasis japonica receiving treatment and assistance programs in Hunan Province in 2017 were enrolled, and the years lived with disability (YLD) for the patients with advanced schistosomiasis japonica was calculated using the common global burden of disease (GBD) estimation method, the modified GBD method with addition of common syndromes of advanced schistosomiasis japonica, and the quality of life assessment method. RESULTS: The YLDs of patients with advanced schistosomiasis japonica, the mean YLDs per capita, and the percentages of YLD were 673.94, 728.77 person-years and 1 761.99 person-years; 0.181, 0.196 person-years and 0.474 person-years; and 10.61, 11.48 person-years per 100 thousand persons and 27.75 person-years per 100 thousand persons with the common GBD method, modified GBD method and the quality of life method, respectively. The YLDs of the patients with advanced schistosomiasis japonica in Hunan Province estimated with the modified GBD method and the quality of life method were 8.14% and 2.61 times higher than that with the common GBD method. Of the major symptoms included in the calculation, the 5 symptoms with the greatest contribution to the burden of advanced schistosomiasis japonica included ascites, moderate anemia, severe anemia, diarrhea and hematochezia. CONCLUSIONS: The quality of life method may more comprehensively assess the YLDs in patients with advanced schistosomiasis japonica than the common and modified GBD methods.


Assuntos
Pessoas com Deficiência , Anos de Vida Ajustados por Qualidade de Vida , Esquistossomose Japônica , China/epidemiologia , Carga Global da Doença , Humanos , Qualidade de Vida , Esquistossomose Japônica/epidemiologia , Esquistossomose Japônica/patologia
13.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 299-300, 2019 Jul 24.
Artigo em Chinês | MEDLINE | ID: mdl-31544411

RESUMO

OBJECTIVE: To understand Clonorchis sinensis infections in cats in Nanning City, so as to provide evidence for the control of the reservoir host of C. sinensis. METHODS: The cat livers were purchased from cat slaughterhouses in Nanning City. The cat gallbladder and liver were dissected, and liver flukes were collected and counted. Then, the worms were subjected to morphological observation, amplification of the ITS2 gene and sequencing. The species of the worms were identified using BLAST. RESULTS: A total of 105 cat livers were collected from two cat slaughterhouses, and 68 were detected with C. sinensis infections, with an infection rate of 64.76%. The highest burden was 980 worms in a single liver, and the mean burden was 72 worms in a liver. There were 3 types of liver flukes with various size and morphology, and all were identified as C. sinensis by means of morphological observation, ITS2 gene amplification, sequencing and sequence alignment. CONCLUSIONS: There is a high infection rate of C. sinensi in marketed cats in Nanning City, and it is therefore suggested that targeted interventions should be intensified for the management of C. sinensis infections in cats.


Assuntos
Doenças do Gato , Clonorquíase , Clonorchis sinensis , Reservatórios de Doenças , Animais , Doenças do Gato/epidemiologia , Doenças do Gato/parasitologia , Gatos , China/epidemiologia , Clonorquíase/epidemiologia , Clonorquíase/parasitologia , Clonorquíase/veterinária , Clonorchis sinensis/anatomia & histologia , Clonorchis sinensis/genética , Reservatórios de Doenças/parasitologia , Fígado/parasitologia , Carga Parasitária , Prevalência
14.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 307-310, 2019 Jul 26.
Artigo em Chinês | MEDLINE | ID: mdl-31544414

RESUMO

OBJECTIVE: To investigate the epidemic factors of schistosomiasis in wetlands in Sichuan Province, so as to provide scientific evidence for the prevention and control of schistosomiasis in wetlands. METHODS: The artificial and natural wetlands were selected from Sichuan Province, and the relevant data regarding wetlands were collected. Routine snail survey, investigation on human morbidity due to schistosomiasis, snail diffusion experiments, questionnaire survey, determination of water infectivity and retrospective survey were conducted. RESULTS: In Sichuan Province, the mean densities of living snails were 0.003 snails/0.1 m2 and 2.033 snails/0.1 m2 in the upper and lower reaches of the Meiwan Reservoir wetlands, 0.08 snails/0.1 m2 in the Jinyan Lake of Guanghan City, 0.21 snails/0.1 m2 in Muhe River of Guanghan City, and 0.02 snails/0.1 m2 prior to the construction of Qiong-hai wetland park in Xichang City in 2015. Artificial simulation experiments showed that the largest distance of snail diffusion in water was 2 000 m. There were 8.80% (41/466) of subjects that lived neighboring wetlands, worked in wetlands and visited wet-lands having infested water contact behaviors. A total of 690 sentinel mice were assigned, and no Schistosoma japonicum infection was detected in the 677 mice dissected. Retrospective survey showed that the construction of the Meiwan Reservoir caused the spread of schistosomiasis in Dailing County, and snails were found in the ditches entering the Jinyan Lake and in Jinyan Lake areas 5 years following the construction of the Jinyan Lake in Guanghan City, with S. japonicum -infected snails detected in the ditches entering the Jinyan Lake. CONCLUSIONS: O. hupensis snails are found in some wetlands in Sichuan Province. Protection of wetlands and snail control with environmental improvements are recommended for the prevention of snail importation in natural wetlands, while in artificial wetlands, thorough snail control is recommended during the construction of the wetlands because of the likelihood of snail importation via water systems. In addition, both natural and artificial wetlands require long-term systematic surveillance of schistosomiasis.


Assuntos
Esquistossomose , Áreas Alagadas , Distribuição Animal , Animais , China/epidemiologia , Conservação dos Recursos Naturais , Humanos , Camundongos , Densidade Demográfica , Estudos Retrospectivos , Fatores de Risco , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Espécies Sentinelas/parasitologia , Caramujos/parasitologia
15.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 311-314, 2019 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-31544415

RESUMO

OBJECTIVE: To understand the epidemiological features and changing patterns of intestinal parasitic diseases in Jiangxi Province from 1989 to 2014, so as to provide scientific evidence for formulating the preventive and control strategy for intestinal parasitic diseases. METHODS: The data regarding the status of intestinal parasitic diseases in Jiangxi Province were captured from the 1989 national survey on the distribution of human parasites in China and the 2014 national survey on major human parasitic diseases in China, and the status of human intestinal parasite infections was compared between the two surveys in Jiangxi Province. RESULTS: The prevalence rate of human intestinal parasite infections was 79.59% and 9.64% in Jiangxi Province in 1989 and 2014, with a decline rate of 87.89% during the 25-year period (χ2 = 30 870.5, P < 0.01). There were 24 and 20 species of human intestinal parasites detected in Jiangxi Province in 1989 and 2014, respectively, with totally 26 species detected during the two surveys. In Jiangxi Province, the 3 most highly prevalent human intestinal parasites included Ascaris lumbricoides (71.06%), hookworm (17.61%) and Enterobius vermicularis (17.59%) in 1989, and E. vermicularis (13.73%), hookworm (4.66%), whipworm (0.95%) in 2014. A higher rate of human intestinal parasite infections was found in females than in males in both surveys in Jiangxi Province (P < 0.01), and the prevalence of human intestinal parasite infections reduced by 82.50% to 95.31% in different age groups in Jiangsu Province during the 25-year period. CONCLUSIONS: The prevalence of human intestinal parasite infections shows a remarkable decline tendency in Jiangxi Province, and soil-transmitted nematodes remain the main species of human intestinal parasites in Jiangxi Province.


Assuntos
Enteropatias Parasitárias , Ancylostomatoidea , Animais , Ascaris lumbricoides , China/epidemiologia , Enterobius , Feminino , Humanos , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Prevalência , Inquéritos e Questionários
16.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 315-318, 2019 Jul 29.
Artigo em Chinês | MEDLINE | ID: mdl-31544416

RESUMO

OBJECTIVE: To analyze the epidemic situation of malaria and explore the targeted control strategy in Guangxi from 2011 to 2018. METHODS: The malaria surveillance data were collected in Guangxi Zhuang Autonomous Region from 2011 to 2018, and a descriptive method was employed to analyze the epidemiological features of the malaria cases. RESULTS: A total of 2 944 malaria cases were reported in Guangxi Zhuang Autonomous Region from 2011 to 2018, including a case with local infection (0.03%) and 2 943 imported cases (99.97%). There were 2 933 cases (99.63%) positive for Plasmodium confirmed by laboratory testing, including 2 166 cases (73.86%) with P. falciparum malaria, 388 cases (13.23%) with P. ovale malaria, 276 cases (9.41%) with P. vivax malaria, 40 cases (1.36%) with P. malariae malaria and 62 cases (2.11%) with mixed infections, and 11 clinically diagnosed cases (0.37%). The malaria cases were distributed in 91 counties (districts) of 14 cities in Guangxi, with the largest number of cases found in Nanning City (2 515 cases, 85.43%). The malaria cases were originated from 29 countries in Africa (94.67%), 7 countries in Southeast Asia (5.10%), one country in South America (0.07%), 2 countries in South Asia and China (0.10%). In African countries, most malaria cases were from Ghana (1 947 cases, 66.13%), and in Southeast Asian countries, most cases were from Myanmar (75 cases, 2.55%). Most malaria cases were young men, and 2 899 cases (98.13%) were male, while 2 583 cases (87.74%) were at ages of 20 to 49 years. Gold washing and mining was the predominant occupation (2 561 cases, 86.99%), and the malaria cases were reported in each month across the year, with the largest number of cases detected in June (665 cases, 22.59%), while no season-specific distribution was found. There were 1 431 cases (48.61%) reported by disease control and prevention institutions, 1 511 cases (51.30%) reported by medical institutions, and 2 cases (0.07%) reported by inspection and quarantine institutions. During the period from 2011 to 2018, there were 6 deaths of imported malaria cases in Guangxi, and no secondary cases were reported. CONCLUSIONS: The epidemic situation of local malaria has been effectively controlled in Guangxi; however, there is a great challenge for the management of overseas imported malaria. Strengthening the monitoring and management of migrant labors is the key to consolidate the achievements of malaria elimination.


Assuntos
Malária , Adulto , China/epidemiologia , Feminino , Humanos , Malária/tratamento farmacológico , Malária/epidemiologia , Malária/parasitologia , Malária/prevenção & controle , Masculino , Pessoa de Meia-Idade , Plasmodium , Adulto Jovem
17.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 323-325, 2019 Aug 27.
Artigo em Chinês | MEDLINE | ID: mdl-31544418

RESUMO

In China, the mountainous and hilly schistosomiasis-endemic areas are mainly distributed in 2 provinces of Sichuan and Yunnan. Although great success has been achieved in schistosomiasis control in mountainous and hilly areas, there is a risk of re-emerging schistosomiasis in local areas. Hereby, we described the emergency treatment of two schistosomiasis outbreaks that occurred in transmission-interrupted areas of Yunnan Province in 2011 and 2013, pointed out the risk of schistosomiasis rebounding in mountainous and hilly areas and proposed some suggestions.


Assuntos
Surtos de Doenças , Tratamento de Emergência , Esquistossomose , Animais , China/epidemiologia , Humanos , Esquistossomose/tratamento farmacológico , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Esquistossomose/transmissão , Caramujos
18.
Zhonghua Er Ke Za Zhi ; 57(9): 686-693, 2019 Sep 02.
Artigo em Chinês | MEDLINE | ID: mdl-31530354

RESUMO

Objective: To observe and compare the effects of two standards on the overweight trend in urban Shanghai infants and young children. Methods: A cluster randomized controlled trial was conducted in 19 communities in two districts of Shanghai, and the subjects (n=15 019) were divided into S-group and W-group by sealed envelope randomization. The subjects were newborns born between November 2013 and December 2014. The 2005 Shanghai growth standard was applied in the S-group and the 2006 WHO growth standard was used in the W-group. At each follow-up time point age of 1, 2, 4, 6, 9, 12 and 18 months, the outpatient physician assessed the length and weight of the infants according to the standard adopted by each group and provided feeding guidance. The weight-for-age Z scores (WAZ), length-for-age Z scores (LAZ) and weight-for-length Z scores (WLZ) were calculated according to the WHO standard. Weight, length, WAZ, LAZ, WLZ and overweight ratio (WLZ≥2) were compared between the two groups using t test, Wilcoxon test and χ(2) test. Results: A total of 6 509 infants (3 391 were boys, 3 118 were girls) were in the W-group, and 8 510 infants (4 374 were boys, 4 136 were girls) were in the S-group. Among the boys, the weight values at the age of 4, 6, 9, 12, 18 months in the W-group were all lower than those in the S-group ((7.5±0.8) vs. (7.7±0.8) kg, (8.6±0.8) vs. (8.7±0.8) kg, (9.6±0.9) vs. (9.7±0.9) kg, (10.4±1.0) vs. (10.5±1.0) kg, (11.5±1.1) vs.(11.7±1.1) kg; t=4.329, 2.422, 3.739, 2.451, 2.736; P<0.01, 0.015,<0.01, 0.014, 0.009). The length had no significant difference between two groups at all months of age(all P>0.05). The overweight ratio in the W-group was lower than that in the S-group at the age of 9, 12, 18 months(3.3% (71/2 170) vs. 4.9% (143/2 927), 2.5% (51/2 037) vs. 4.5% (126/2 818), 0.8% (7/832) vs. 3.1% (39/1 266); χ(2)=6.520, 14.209, 12.350; P=0.011,<0.01,<0.01).Among the girls, except at the age of 2 months (W-group (5.6±0.6) vs. S-group (5.7±0.6), t=2.935, P=0.003), weight values had no significant difference between the two groups at other age months (all P>0.05).The length in the W-group was higher than that in the S-group at 12 and 18 months of age ((75.6±2.4) vs.(75.5±2.3)cm, (82.4±2.9) vs.(82.2±2.7) cm; t=2.351, 2.197; P=0.019, 0.028). The ratio of overweight in the W-group was lower than that of S-group at the age of 12 and 18 months (1.8% (33/1 871) vs.3.0% (80/2 658), 0.6% (5/790) vs.1.7% (20/1 178); χ(2)=6.764,4.276; P=0.009, 0.039). Conclusions: The application of WHO growth standard can help to reduce the weight gain rate of boys, promote the linear growth of girls, and thus alleviate the overweight trend of infants within 18 months. It suggested that 2006 WHO growth standard should be applied to infants within 1 year of age in Shanghai.


Assuntos
Estatura , Peso Corporal , Sobrepeso/fisiopatologia , Estatura/fisiologia , Peso Corporal/fisiologia , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Sobrepeso/epidemiologia , Padrões de Referência , População Urbana , Ganho de Peso , Organização Mundial da Saúde
19.
Zhonghua Er Ke Za Zhi ; 57(9): 694-699, 2019 Sep 02.
Artigo em Chinês | MEDLINE | ID: mdl-31530355

RESUMO

Objective: To investigate the incidence and risk factors of extraintestinal manifestations (EIMs) in children with inflammatory bowel disease (IBD). Methods: The clinical data of 161 children with IBD was collected from the electronic medical records in the Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine from January 2012 to December 2017. These patients were divided into Crohn's disease (CD) group and ulcerative colitis (UC) group, accounting for 82.0% (132 cases) and 18.0%(29 cases), respectively. The incidence of EIMs in each group was analyzed. The potential risk factors of EIMs including the IBD phenotype, gender, age, location of the CD lesion, disease activity of CD, and the presence of perianal lesion were analyzed with logistic regression model. Results: Eighty-eight patients (54.7%) had EIMs. The main EIMs were immune-mediated EIMs and growth retardation, accounting for 41.0% (66/161) and 24.2% (39/161), respectively. Aphthous ulcer (39/161, 23.0%) was the most common symptom among immune-mediated EIMs, followed by arthropathy (20/161, 12.4%) and skin lesions (19/161, 11.8%). Forty-three patients (26.7%) had EIMs before being diagnosed as IBD. Fifty-eight (65.9%) patients had only one EIM during the whole course of IBD. By logistic regression analysis, CD (OR=5.536, 95%CI:1.825-16.788) and perianal disease (OR=1.969, 95%CI:1.035-3.746) were the risk factors of immune-mediated EIMs. Meanwhile, CD (OR=11.319, 95%CI: 1.487-86.179), younger than six-year-old at diagnosis (OR=8.556, 95%CI: 3.109-23.545), moderate to severe activity of CD (OR=3.447, 95%CI: 1.196-9.934) and perianal disease (OR=3.361, 95%CI: 1.720-7.793) increased the risk of growth retardation. Conclusions: The children with IBD have a high incidence of EIMs, which were more common in CD than in UC. The risk factors of developing EIMs include CD, perianal diseases, younger than six-year-old at diagnosis and moderate to severe activity of CD.


Assuntos
Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Doenças Inflamatórias Intestinais/epidemiologia , Criança , China/epidemiologia , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/patologia , Doença de Crohn/diagnóstico , Doença de Crohn/patologia , Humanos , Incidência , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/patologia , Fatores de Risco
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 880-882, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484247

RESUMO

The recent developed diarrhea and acute respiratory infections surveillance systems were a breakthrough of the infectious disease surveillance and monitoring in Shanghai. This series "Infectious Disease Surveillance in Shanghai" briefly introduced current experiences of the updated surveillance systems, in order to provide evidences for promotion in other disease surveillance and to enhance the connection between different surveillance systems.


Assuntos
Diarreia/epidemiologia , Controle de Infecções/métodos , Vigilância da População/métodos , Vigilância em Saúde Pública/métodos , Doença Aguda , China/epidemiologia , Doenças Transmissíveis/epidemiologia , Surtos de Doenças , Humanos , Infecções Respiratórias/epidemiologia , Vigilância de Evento Sentinela
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