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影響增生性糖尿病視網膜病變診治的因素調查

The Effect of Improving Drinking Water and Lavatories in Potential Endemic Areas of Schistosomiasis in the Three Gorges Reservoir Area

Objective　To learn the status and compare the effect of improving drinking water and lavatories in potential endemic areas of schistosomiasis in the Three Gorges Reservoir Area. Methods　A cluster random sampling method was adopted and a questionnaire survey was conducted to four selected villages and towns before and after organized and large scale drinking water and lavatories improvement in the potential endemic areas of schistosomiasis in the Three Gorges Reservoir Area. Results　A total of 807 households in four demonstrate villages and towns were investigated for the baseline survey, while 856 households in the same four villages and towns were investigated for the terminal survey. The popularity rate of using tap water from waterworks went up from 33.58% to 66.12% (P=0.000); the summation of popularity rate of using tap water from both waterworks and water tower made by local residents went up from 76.33% to 96.38% (P=0.000); and the popularity rate of using decontaminated lavatories went up from 53.68% to 78.85% (P=0.000). According to Chi-square test, there were significant differences compared with the popularity rate before improvement (Plt;0.05). Conclusion　The condition of intervention villages and towns gets greatly improved through the organized and large scale project of improving water quality and lavatories decontamination, and the potential danger of schistosomiasis is obviously reduced in the Three Gorges Reservoir Area.

Epidemiological characteristics of sleep disorders in the Chinese elderly: a meta-analysis

Objectives To systematically review the prevalence of sleep disorders in Chinese elderly population. Methods CNKI, Wanfang, VIP, PubMed and Web of Science were searched to collect studies on the prevalence of sleep disorders the Chinese elderly from January 2000 to November 2017. Two reviewers independently screened literatures, extracted data and evaluated risk of bias of the included studies, then meta-analysis was performed by Stata 14.0 software. Results A total of 19 cross-sectional studies were included. The results of the meta-analysis showed that, the overall prevalence of sleep disorders was 41.2% (95% CI 36.2% to 46.2%). Male and female prevalence rates were 35.7% and 45.0%, respectively. For individuals aged between 60 to 70, 70 to 80 and above 80, the prevalence rates were 29.9%, 42.0%, 44.2%, respectively. For individuals with primary school education and below, junior/high school education, college degree or above, the prevalence rates were 29.0%, 23.1%, 22.4%, respectively. The prevalence rate of individuals with normal marital status was 31.5%, and those with abnormal marital status (widowed, divorced, single, etc.) was 41.0%. The prevalence rate in individuals with in people with physical illness was 45.7%, and those without physical illness was 32.4%. For the urban population, the prevalence rate was 36.4%, while for the rural population, the prevalence rate was 42%. Conclusions The overall prevalence of sleep disorders in the Chinese elderly is high. The prevalence rate of sleep disorders among gender, age, educational level, marital status, physical illness, and living space is different.

Research progress in nonalcoholic fatty liver disease: disease burden and medical expenses control

ObjectiveTo summarize the epidemiology of nonalcoholic fatty liver disease (NAFLD) and the epidemiological and economic burdens of NAFLD, so as to provide a reference for hospital management decision-making. MethodThe domestic and foreign guidelines relevant to NAFLD and the literatures relevant to epidemiological investigation and disease burden researches were summarized and its research progress was reviewed. ResultsThe global prevalence of NAFLD was increasing over years. The incidence, mortality, and disability adjusted life years of liver cirrhosis and liver cancer caused by NAFLD had increased year by year. The patients relevant to NAFLD of inpatients and outpatients had increased obviously, and the overall medical expenses had also shown a rising trend. The possible reasons were health care awareness, new drug research, population aging, and excessive medical consumption. In addition, children and adolescents with NAFLD had a obviously increased risk of liver or extrahepatic diseases. ConclusionsBy understanding the epidemiological trend of NAFLD, it is a certain understanding of the disease burden of NAFLD and the related factors affecting the increase of its treatment cost. It is believed that it is necessary to further pay attention to and strengthen the genetic characteristics, pathogenesis, drug research and development, and early diagnosis of cirrhosis and liver cancer relevant to NAFLD in the future. At the same time, the NAFLD group of children and adolescents should not be ignored.

Investigation and improvement of prevention and control strategies for gastric cancer: epidemiology, pathogens, and risk factors

ObjectiveTo summary the study results of the Sichuan Gastric Cancer Early Detection and Screening Research Program (SIGES). MethodsIn the past 10 years, SIGES program conducted a series of clinical and clinical epidemiological studies on the current situation and strategies of gastric cancer prevention and control in China, which provided evidence for supply-side structural reform to improve the gastric cancer prevention and control. We collected related studies and made a review. ResultsSIGES program systematically and specifically studied carcinogenic pathogens, risk factors, screening strategies, as well as critical technique and system construction of tertiary prevention for gastric cancer. The main results supported that Helicobacter pylori was highly correlated with precancerous atrophic gastritis and gastric cancer. Oncoviruses, such as Epstein-Barr virus, hepatitis B virus, human cytomegalovirus, human papillomavirus, John Cunningham virus were correlated with the risk of gastric cancer, and should be paid further attention in the prevention and screening strategy of gastric cancer. Ethnicity, domicile, and family history of gastric cancer were also correlated with gastric cancer and gastric cancer-related risk factors, so it was suggested to include in the personalized evaluation criteria system of high-risk groups for gastric cancer. ConclusionsAt present, the prevention and control of gastric cancer in China has achieved substantial achievements, but the burden of gastric cancer keeps heavy. It is still necessary to conduct further scientific research on critical technique or issues in designing prevention and control strategies.

Effects of Mass Immunization Campaign on the Epidemiological Characteristics of Measles

Objective　To evaluate the effects of mass immunization campaign on the epidemiological characteristics of measles. Methods　Comparison was made between the incidences of measles before and after the mass immunization campaign in 2007 in Shunqing prefecture of Nanchong city. Results　The total number of the reported measles cases reached 460 during 2004 to 2007 in Shunqing prefecture of Nanchong city, and the respective annual rates of incidence were 4.04, 23.53, 11.84, and 33.57, respectively per 100 000 heads. Cases reported from April to July accounted to 73.91% of the total (340/460). Children under 15 were reported to have the highest incidence rate and accounted to 83.70% of the total (385/460), of which incidences of children under 1 accounted to 0%, 10.81%, 13.51% and 25.82%, respectively. Only 20.00% of the subjects (92/460) in this study had a definite history of measles vaccination. After the mass immunization campaign in September, 2007, only 10 cases were reported in 2008 and the incidence rate was 1.58 per 100 000 heads, a 95.29% decrease in incidence rate in comparison with that of the last year. Conclusion　The mass immunization campaign has achieved substantial results.

流行性腮腺炎的觀察及護理

【摘要】　目的　總結對流行性腮腺炎患者實施人性化護理的臨床效果。　方法　將2009年1-9月收治的43例流行性腮腺炎患者隨機分為觀察組和對照組，對照組采用常規護理，觀察組在常規護理的基礎上加強人性化護理。　結果　觀察組患者的顯效率為82.6%，明顯高于對照組的55.0%，兩組比較有統計學意義（χ2=3.8659，Plt;0.05）；觀察組的總有效率為95.7%，對照組為85.0%，兩組比較無統計學意義（χ2=0.4532，Pgt;0.05）；觀察組的恢復時間為（6.5±2.0） d，明顯短于對照組（9.0±2.5） d，兩組比較有統計學意義（t=3.6413，Plt;0.05）。　結論　人性化護理臨床效果滿意，能夠促進流行性腮腺炎患者的早日康復。

褪黑素對子宮內膜癌的影響

子宮內膜癌是女性生殖道三大惡性腫瘤之一，病因迄今尚不明確，可能的危險因素有：肥胖、高血壓、糖尿病、外源性雌激素的增加、高雌激素導致的初潮提前和絕經推后、卵巢腫瘤等。褪黑素作為一種主要由松果體分泌的神經內分泌激素，有調節睡眠/覺醒周期、免疫調節、細胞凋亡調節及抗氧化等多種生理功能。由于其抗氧化、免疫刺激、誘導凋亡等特性，在許多腫瘤的抑制和治療上有一定效果。同時還具有調節血脂、血壓、血糖，調節卵巢功能，抑制子宮內膜增生和子宮內膜癌細胞增殖，恢復子宮內膜等作用。因此，褪黑素水平的降低會增加子宮內膜癌的發病風險，且對其治療有一定作用。現就褪黑素對子宮內膜癌的影響作一綜述。

Acute renal injury: new progress in epidemiology

Acute kidney injury (AKI) is characterized by a rapid decrease in renal function caused by different etiologies and can involve multiple organs and systems. AKI is a potentially reversible disease. However, it can also progress to chronic kidney disease (CKD) without proper treatment. The concept of acute kidney disease (AKD) is recently recommended as a derivative between AKI and CKD. At present, AKI still lacks specific drug treatment; therefore prevention and early diagnosis are crucial in AKI management. Due to the heterogeneity of the pathogenesis, the epidemiological features of AKI vary across nations and regions, so the strategies for prevention and control are different. This papers reports new progress of epidemiological features of AKI in different countries, so as to provide reference for assessing the disease burden and formulating public health policies.

癲癇的一級預防：一項來自國際抗癲癇聯盟預防工作組的報告

目前導致癲癇的病因中，有些是可以預防的。該綜述總結了由此類可預防病因所造成的癲癇的公共衛生負擔，并提出了癲癇一級預防的重要性。系統性回顧針對癲癇的 4 種可預防病因的流行病學研究，這些可預防病因分別是圍產期損傷、腦外傷、中樞神經系統感染和卒中。通過使用統一的標準，對每項研究進行質量評估，并從滿足質量評級標準的研究中提取了相關風險度量的數據，并將這些結果以中位數和四分位數的方式匯總。高質量的基于人群的研究結果顯示，在中低收入國家中，所有年齡段的癲癇患病率約為 1.11%，而在高收入國家中約為 0.7%。圍產期腦損傷是兒童癲癇中最常見的可預防病因，在中低收入國家中占 17%，在高收入國家中占 15%。在中低收入和高收入國家中，卒中均是老年癲癇患者中最常見的可預防病因，占所有新發癲癇病例的半數及以上，在高收入和中低收入國家中約 5%癲癇是由卒中造成的。在中低收入國家，中樞神經系統感染是較常見的癲癇病因，約占所有癲癇病例的 5%。在一些低收入農村地區和中等收入國家社區中，地方性神經囊蟲病所致癲癇占所有癲癇病例的 34%。可預防的病因所致癲癇占癲癇的總體公共衛生負擔的很大一部分。在中低收入和高收入國家中，圍產期損傷、感染、腦外傷和卒中所致癲癇占所有癲癇的 25%。母嬰保健、免疫接種、公共衛生、預防腦損傷和卒中這些公共衛生干預措施有可能會顯著減少癲癇負擔。