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[Analysis of the epidemic characteristics and treatment outcomes of rifampicin-resistant pulmonary tuberculosis in Yangzhou City from 2012 to 2020]. [2012-2020年扬州市耐利福平肺结核疫情特点及治疗效果分析]。
Q3 Medicine Pub Date : 2024-11-06 DOI: 10.3760/cma.j.cn112150-20240102-00003
H Wang, J C Li, C G Bo, L Wang, Q Y Zhao, L M Zhu

Information on patients with rifampicin-resistant pulmonary tuberculosis (RR-PTB) in Yangzhou City from 2012 to 2020 was obtained from the Information System of the Chinese Center for Disease Control and Prevention. The epidemic characteristics of RR-PTB patients were analyzed by using χ2 test. The average annual registered incidence rate of RR-PTB patients in Yangzhou City from 2012 to 2020 was 0.57/100 000, and the difference between the registered incidence rates in each year was statistically significant (χ2=29.326, P<0.001). The proportion of re-treated patients (64.8%) was higher than that of newly treated patients (35.2%, χ2=50.593, P<0.001). The registered incidence rate in males (0.91/100 000) was higher than that in females (0.24/100 000, χ2=80.566, P<0.001). The age distribution showed that the highest incidence rate was in the age group≥60 years (0.96/100 000) and the lowest was in the age group 0-<45 years (0.31/100 000, χ2=55.853, P<0.001). From 2012 to 2020, Baoying County had the largest number of registered RR-PTB patients (44 cases), and its registered incidence rate (0.64/100 000) was only lower than that of Guangling District (0.98/100 000). The registered incidence rate of RR-PTB patients in Baoying County during 2016-2020 also increased significantly compared to 2012-2015 (P=0.001). Logistic regression was used to analyze the factors related to the treatment outcome of RR-PTB patients. The results showed that patients aged≥60 years and those classified as the re-treatment were risk factors for successful treatment of RR-PTB patients (P<0.05). In summary, males, people aged≥60 years, patients classified as the re-treatment, and residents of Baoying County should be the key populations for RR-PTB epidemic prevention and control in Yangzhou City.

2012-2020年扬州市耐利福平肺结核(RR-PTB)患者信息来自中国疾病预防控制中心信息系统。采用χ2检验分析耐药肺结核患者的流行特征。2012-2020年扬州市RR-PTB患者年均登记发病率为0.57/10万,各年登记发病率之间差异有统计学意义(χ2=29.326,Pχ2=50.593,Pχ2=80.566,Pχ2=55.853,PP=0.001)。采用 Logistic 回归分析 RR-PTB 患者治疗效果的相关因素。结果显示,年龄≥60 岁和属于再治疗者是 RR-PTB 患者治疗成功的危险因素(P
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引用次数: 0
[Analysis of clinical characteristics and risk factors for recurrence of combined EB virus infection in patients with inflammatory bowel disease treated with biological agents]. [接受生物制剂治疗的炎症性肠病患者合并 EB 病毒感染的临床特征和复发风险因素分析]。
Q3 Medicine Pub Date : 2024-11-06 DOI: 10.3760/cma.j.cn112150-20240620-00486
T T Hu, X Y Jiang, M Guan
<p><p>To investigate the degrees of EB virus reactivation in patients with inflammatory bowel disease (IBD) treated with different biologics and the levels of important cytokines associated with relapse under the influence of this virus, and to assess its diagnostic efficacy as a risk factor for identifying disease relapse. A case-control retrospective study based on patients' hospitalization history data was conducted to select a total of 105 patients who were hospitalized in the Department of Gastroenterology, Huashan Hospital, Fudan University, with a confirmed diagnosis of IBD from 2021 to 2023. Based on the quantitative copy level of whole blood EBV DNA to determine the status of EB virus infection in patients, integrated cytokine 8 (IL-2, IL-4, IL-6, IL-10, IL-12p70, IL-17, TNF-α, IFN-γ), C-reactive protein, and fecal calreticulin, to find the risk variable associated with treatment relapse. Logistic regression was used to analyze the relative risk between this variable and treatment relapse, and ROC curves were used to predict the diagnostic efficacy of cytokine multifactorial thresholds for treatment relapse. Results showed that the median age of the study was 37(26, 54)years, with a minimum of 18 years and a maximum of 70 years, with a median age of 34(24, 51) years for Crohn's Disease (CD) patients and 46(35, 60) years for Ulcerative colitis (UC) patients, with a statistically difference between the ages of the two groups (<i>t</i>=2.675, <i>P</i>=0.009). The median age at 50 years of patients treated with Vedolizumab (VDZ) in the UC group was higher than in the treatment groups other than VDZ. The highest rate of EB virusreactivation was found in the group treated with immunosuppressants Azathioprine (AZA) combined with anti-tumor necrosis factor-α (anti-TNF-α) and VDZ (62.5% in both groups), and the lowest in the group treated with Ustekinumab (UST) (0%). IL-2 levels were elevated in the AZA+anti-TNF-α and anti-TNF-α groups after EB virus entryreactivation. Three treatment groups, AZA+anti-TNF-α, anti-TNF-α, and VDZ, had elevated levels of IL-6 expression after EB virus entry reactivation.In the anti-TNF-α treatment-related group IL-2was associated with treatment relapse in IBD (<i>OR</i>=1.127, 95%<i>CI:</i> 1.044-1.256, <i>P</i>=0.007). ROC analysis showed that the AUC for IL-2 combined with EB virus in a replicative state was 0.8282 (<i>P</i>=0.006), with a negative predictive value and a positive value of 90% and 75%, respectively. As well as IL-6 was associated with treatment relapse of IBD in the anti-TNF-αtreatment-related group as well as in the VDZ-treated group (<i>OR</i>=1.049, 95%<i>CI:</i> 1.017-1.095, <i>P</i>=0.008). ROC analysis showed that the diagnostic sensitivity and specificity for post-treatment relapse at a critical value of 6.10 pg/ml for IL-6 was 83.33% and 82.93%, respectively. The AUC for IL-6 combined with EB virus in a replicative state was 0.900 (<i>P</i><0.000 1), with negative and positive predictive va
目的:研究接受不同生物制剂治疗的炎症性肠病(IBD)患者的EB病毒再激活程度以及在该病毒影响下与复发相关的重要细胞因子水平,并评估其作为识别疾病复发风险因素的诊断功效。一项基于患者住院史资料的病例对照回顾性研究选取了2021年至2023年期间在复旦大学附属华山医院消化内科住院并确诊为IBD的患者共105例。根据全血EB病毒DNA的定量拷贝水平判断患者的EB病毒感染状况,综合细胞因子8(IL-2、IL-4、IL-6、IL-10、IL-12p70、IL-17、TNF-α、IFN-γ)、C反应蛋白、粪便钙粘蛋白等指标,寻找与治疗复发相关的风险变量。利用逻辑回归分析该变量与治疗复发之间的相对风险,并利用ROC曲线预测细胞因子多因素阈值对治疗复发的诊断效果。结果显示,研究对象的中位年龄为37(26,54)岁,最小18岁,最大70岁,其中克罗恩病(CD)患者的中位年龄为34(24,51)岁,溃疡性结肠炎(UC)患者的中位年龄为46(35,60)岁,两组患者的年龄差异有统计学意义(t=2.675,P=0.009)。溃疡性结肠炎组接受维多珠单抗(VDZ)治疗的患者 50 岁时的中位年龄高于 VDZ 以外的其他治疗组。使用免疫抑制剂硫唑嘌呤(AZA)联合抗肿瘤坏死因子-α(anti-TNF-α)和 VDZ 治疗组的 EB 病毒复活率最高(两组均为 62.5%),而使用乌司他单抗(UST)治疗组的 EB 病毒复活率最低(0%)。EB病毒进入再激活后,AZA+抗-TNF-α组和抗-TNF-α组的IL-2水平升高。在抗TNF-α治疗相关组中,IL-2与IBD治疗复发相关(OR=1.127,95%CI:1.044-1.256,P=0.007)。ROC分析显示,IL-2与处于复制状态的EB病毒的AUC为0.8282(P=0.006),阴性预测值和阳性预测值分别为90%和75%。此外,IL-6与抗TNF-α治疗相关组以及VDZ治疗组的IBD治疗复发相关(OR=1.049,95%CI:1.017-1.095,P=0.008)。ROC分析显示,当IL-6的临界值为6.10 pg/ml时,治疗后复发的诊断敏感性和特异性分别为83.33%和82.93%。IL-6 与处于复制状态的 EB 病毒结合的 AUC 为 0.900(P
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引用次数: 0
[Progress in prevention and treatment of cytomegalovirus infection in patients with allogeneic hematopoietic stem cell transplantation]. [同种异体造血干细胞移植患者巨细胞病毒感染的预防和治疗进展]。
Q3 Medicine Pub Date : 2024-11-06 DOI: 10.3760/cma.j.cn112150-20240503-00358
S Q Zhong, N N Li, M H Wang

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains an effective treatment for hematological malignancies. Cytomegalovirus (CMV) infection is one of the common Infection complications after hematopoietic stem cell transplantation, and also the main cause of death of transplant recipients, which has a significant impact on the prognosis and survival of transplant recipients. It is particularly important to take timely and effective prevention and treatment for CMV infected transplant patients. This article discusses the latest prevention and treatment of CMV infection after transplantation,and reviews the recent progress in the prevention and drug treatment of CMV infection in allo-HSCT patients by searching the relevant literature through Pubmed.

异基因造血干细胞移植(allo-HSCT)仍然是治疗血液恶性肿瘤的有效方法。巨细胞病毒(CMV)感染是造血干细胞移植后常见的感染并发症之一,也是导致移植受者死亡的主要原因,对移植受者的预后和生存有重要影响。对CMV感染的移植患者采取及时有效的预防和治疗尤为重要。本文通过Pubmed检索相关文献,探讨了移植后CMV感染的最新预防和治疗方法,并综述了异体HSCT患者CMV感染预防和药物治疗的最新进展。
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引用次数: 0
[Expert consensus on the diagnosis and management of IgE mediated food allergy in children]. [关于儿童 IgE 介导的食物过敏的诊断和管理的专家共识]。
Q3 Medicine Pub Date : 2024-10-31 DOI: 10.3760/cma.j.cn112150-20240802-00622

The prevalence of food allergy in children is increasing, which seriously affects the quality of life of children and their families. Among children and adolescents, IgE-mediated food allergy is the most common type. In recent years, allergen specific IgE (sIgE) and skin prick testing (SPT) have been widely used in clinical practice, with component resolved diagnosis (CRD) also gaining traction for precise diagnosis of IgE-mediated food allergy. However, a challenge persists in clinical practice due to the tendency to over-interpret food allergen test results without considering the patient's clinical history. While food avoidance remains the most effective treatment for IgE-mediated food allergy, there are varying approaches to clinical management. Strict food avoidance for non-severe food allergies may increase the patient's burden and impact their quality of life. To address these challenges, a consensus on the diagnosis and management of IgE-mediated food allergy in children has been developed based on the latest guidelines and research evidence. This consensus aims to guide physicians in standardizing the management of IgE-mediated food allergy in children.

儿童食物过敏的发病率越来越高,严重影响了儿童及其家庭的生活质量。在儿童和青少年中,IgE介导的食物过敏是最常见的类型。近年来,过敏原特异性 IgE(sIgE)和皮肤点刺试验(SPT)已广泛应用于临床实践,成分解析诊断(CRD)也逐渐被用于 IgE 介导的食物过敏的精确诊断。然而,临床实践中仍然存在一个难题,那就是人们倾向于过度解读食物过敏原检测结果,而不考虑患者的临床病史。虽然避免进食仍然是治疗 IgE 介导的食物过敏症最有效的方法,但临床治疗的方法多种多样。对于非严重的食物过敏,严格的食物回避可能会增加患者的负担,影响他们的生活质量。为了应对这些挑战,我们根据最新指南和研究证据,就儿童 IgE 媒介型食物过敏的诊断和管理达成了共识。该共识旨在指导医生对 IgE 介导的儿童食物过敏进行标准化管理。
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引用次数: 0
[Focus on and response to climate-sensitive diseases]. [关注和应对气候敏感性疾病]。
Q3 Medicine Pub Date : 2024-10-12 DOI: 10.3760/cma.j.cn112150-20240910-00723
E M Ding, W Z Yang

With the current climate change characterized by global warming becoming more severe, the increasing frequency of extreme weather events such as heatwaves, cold waves, sandstorms, floods, and droughts caused by climate change has posed serious threats to human health. Climate change is not only a major public health challenge in China, but also a focus problem in global. This article focuses on climate-sensitive diseases and summarizes and reviews the latest scientific facts and progress on how climate change impacts infectious diseases and chronic non-communicable diseases. It further proposes measures and strategies for addressing climate-sensitive diseases with public health in center, providing ideas and suggestions for scientifically addressing climate-sensitive diseases in the future.

当前,以全球变暖为特征的气候变化日趋严重,气候变化导致的热浪、寒潮、沙尘暴、洪水、干旱等极端天气事件日益频繁,对人类健康构成严重威胁。气候变化不仅是中国面临的重大公共卫生挑战,也是全球关注的焦点问题。本文以气候敏感性疾病为重点,总结和回顾了气候变化对传染病和慢性非传染性疾病影响的最新科学事实和进展。文章进一步提出了以公众健康为中心应对气候敏感性疾病的措施和策略,为今后科学应对气候敏感性疾病提供了思路和建议。
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引用次数: 0
[Expert consensus on the passive immunization prevention of infant respiratory syncytial virus infection in China]. [中国婴儿呼吸道合胞病毒感染被动免疫预防专家共识]。
Q3 Medicine Pub Date : 2024-10-08 DOI: 10.3760/cma.j.cn112150-20240826-00684

Respiratory syncytial virus (RSV) infection, which has the very heavy disease burdens, is the most common viral pathogen that seriously threatens the health of infants and young children. In order to better guide and standardize the clinical diagnosis, treatment, monitoring and immunization prevention and control of RSV infection in China, the Chinese Preventive Medicine Association jointly organized multidisciplinary experts to form a special working group, drawing on the implementation experience of foreign passive immunization prevention of RSV, integrating the existing evidence and the latest progress as a problem oriented, and putting forward the expert consensus on the passive immunization prevention of infant RSV infection in China in the future. The aim is to answer some professional questions about RSV infection and its immunoprophylaxis, especially passive immunoprophylaxis, in order to provide reference for the practice of immunoprophylaxis for professionals in medical institutions, disease prevention and control institutions and community health service centers at all levels.

呼吸道合胞病毒(RSV)感染疾病负担极重,是严重威胁婴幼儿健康的最常见病毒性病原体。为了更好地指导和规范我国RSV感染的临床诊断、治疗、监测和免疫防控工作,中华预防医学会联合多学科专家组成专项工作组,借鉴国外RSV被动免疫预防的实施经验,以问题为导向,整合现有证据和最新进展,提出了未来我国婴幼儿RSV感染被动免疫预防的专家共识。旨在解答有关RSV感染及其免疫预防,尤其是被动免疫预防的一些专业问题,为各级医疗机构、疾病预防控制机构和社区卫生服务中心的专业人员提供免疫预防的实践参考。
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引用次数: 0
[Establishment and application of infectious disease monitoring, early warning and disposal system]. [传染病监测、预警和处置系统的建立与应用]。
Q3 Medicine Pub Date : 2024-10-06 DOI: 10.3760/cma.j.cn112150-20231206-00407
H X Jia, L F Jiang, C L Wang, J N Zhang, Y N Wei, J F Lu, Y M Qiu, J J Zhao, B J Ma

Using big data and artificial intelligence to establish a multi-point monitoring, early warning, and disposal system to achieve early warning and intervention of infectious disease outbreaks is an important means of controlling the spread of the epidemic. Taking Xiaoshan district as an example, this study analyzes the monitoring contents, warning methods, and application effectiveness of the infectious disease monitoring, early warning and disposal system. Based on Xiaoshan's health big data resources, the system starts with syndrome, disease diagnosis and etiology. Through advanced technologies such as artificial intelligence and block chain, it realizes early identification of infectious disease outbreaks, data fusion, multi-cross collaboration, and closed-loop management. It has improved the sensitivity of clustered outbreaks monitoring and the effectiveness of epidemic disposal and provided a reference for grassroots disease prevention and control departments to establish an infectious disease monitoring and early warning system.

利用大数据和人工智能建立多点监测、预警、处置体系,实现传染病疫情的预警和干预,是控制疫情蔓延的重要手段。本研究以萧山区为例,分析了传染病监测预警与处置系统的监测内容、预警方式和应用效果。该系统基于萧山健康大数据资源,从综合征、疾病诊断和病原学入手,通过人工智能、大数据等先进技术,实现对传染病疫情的监测、预警和处置。通过人工智能、区块链等先进技术,实现传染病疫情的早期识别、数据融合、多方协同、闭环管理。提高了聚集性疫情监测的灵敏度和疫情处置的有效性,为基层疾病预防控制部门建立传染病监测预警系统提供了参考。
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引用次数: 0
[Analysis of the changes of bacterial spectrum and drug resistance in sputum culture of ICU children in a hospital of pediatric in Jiangsu Province from 2017 to 2022]. [2017-2022年江苏省某医院儿科ICU患儿痰培养细菌谱及耐药性变化分析]。
Q3 Medicine Pub Date : 2024-10-06 DOI: 10.3760/cma.j.cn112150-20240514-00386
H Huang, J Wei, H J Shen, Q X Tan, J Xue, C Wang
<p><p><b>Objective:</b> To investigate the changes of the distribution and drug resistance profile of bacteria from ICU children with lower respiratory tract infection (LRTI) in Suzhou City, Jiangsu Province from 2017 to 2022. <b>Methods:</b> From January 2017 to December 2022, a cross-sectional observational study on the bacterial spectrum analysis among intensive care unit (ICU) children with LRTI was conducted in Children's Hospital of Soochow University. The bacteria was cultivated by culture methods from sputum samples, and identified by MALDI-TOF mass spectrometry. Drug sensitivity tests were performed by the VITEK2 Compact fully automated analysis system and the paper slide method. The <i>χ</i><sup>2</sup> test or Fisher's exact probability was used to analyze the changes of the distribution of sputum culture-positive bacteria and drug resistance in ICU children. <b>Results:</b> The overall detection rate of sputum culture was 42.06% (1 182/2 810). <i>Staphylococcus aureus</i> (25.63%,303/1 182), <i>Acinetobacter baumannii</i> (13.62%,161/1 182) and <i>Haemaphilus influenzae</i> (13.28%,157/1 182) were the top three. Proportions of <i>Acinetobacter baumannii</i> (17.90% <i>vs.</i> 11.02%,<i>χ</i>²=11.17, <i>P</i>=0.001), especially carbapenem-resistant <i>Acinetobacter baumannii</i> (43.70% <i>vs.</i> 23.50%, <i>χ²</i>=15.21, <i>P</i><0.001) increased significantly from 2020 to 2022. However, the proportions of <i>Haemophilus influenzae</i> (8.50% <i>vs.</i> 16.19%, <i>χ</i>²=14.27, <i>P</i><0.001), <i>Streptococcus pneumoniae</i> (8.50% <i>vs.</i> 15.92%, <i>χ</i>²=13.42, <i>P</i><0.001) and extended-spectrum-lactamase producing <i>Escherichia coli</i> (8.89% <i>vs.</i> 18.00%, <i>χ</i>²=5.45, <i>P</i>=0.025) decreased. Drug resistant results showed that <i>Acinetobacter baumannii</i> was obviously more resistant to imipenem (<i>χ²</i>=4.43, <i>P</i>=0.035) and levofloxacin (<i>χ</i>²=12.53, <i>P</i><0.001), while more sensitive to minocycline (<i>χ</i>²=8.34, <i>P</i>=0.004). Escherichia coli showed a significant increase in resistance to piperacillin tazobactam (<i>χ</i>²=8.29, <i>P</i>=0.008) and cefoperazone sulbactam (<i>χ</i>²=5.07, <i>P</i>=0.024) from 2020 to 2022; Klebsiella pneumoniae consistently maintained a resistance rate of more than 60% to first and second-generation cephalosporins, and remain susceptible to quinolones and carbapenems. Staphylococcus aureus remained highly susceptible to levofloxacin (drug resistance rate: 2.31%,7/303) and sulfamethoxazole/trimethoprim (drug resistance rate: 4.95%,15/303) from 2020 to 2022. <b>Conclusion:</b> Higher detection and resistance rates of <i>Acinetobacter baumannii</i> from sputum culture in ICU children from 2020 to 2022 were explored. Resistance of <i>Escherichia coli</i> to β-lactamase inhibitor combinations was more serious. Regular monitoring the changes of the etiology of respiratory tract infections in ICU Children is particularly important for the prevention and treatmen
目的研究2017-2022年江苏省苏州市ICU患儿下呼吸道感染(LRTI)细菌分布及耐药谱的变化。方法:从 2017 年 1 月至 2022 年 12 月,对江苏省苏州市 ICU 下呼吸道感染患儿的细菌分布和耐药性情况进行调查:2017年1月至2022年12月,在苏州大学附属儿童医院开展了一项关于重症监护病房(ICU)下呼吸道感染患儿细菌谱分析的横断面观察研究。通过培养方法从痰液样本中培养细菌,并通过 MALDI-TOF 质谱法进行鉴定。药敏试验采用 VITEK2 Compact 全自动分析系统和纸片法进行。采用χ2检验或费雪精确概率分析ICU患儿痰培养阳性菌分布和耐药性的变化。结果痰培养总检出率为 42.06%(1 182/2 810)。金黄色葡萄球菌(25.63%,303/1 182)、鲍曼不动杆菌(13.62%,161/1 182)和流感嗜血杆菌(13.28%,157/1 182)位居前三位。鲍曼不动杆菌(17.90% vs. 11.02%,χ²=11.17,P=0.001),尤其是耐碳青霉烯鲍曼不动杆菌(43.70% vs. 23.50%,χ²=15.21, PHaemophilus influenzae (8.50% vs. 16.19%, χ²=14.27, PStreptococcus pneumoniae (8.50% vs. 15.92%, χ²=13.42, PEscherichia coli (8.89% vs. 18.00%, χ²=5.45, P=0.025)下降。耐药性结果显示,鲍曼不动杆菌对亚胺培南(χ²=4.43,P=0.035)和左氧氟沙星(χ²=12.53,Pχ²=8.34,P=0.004)的耐药性明显更强。从 2020 年到 2022 年,大肠埃希菌对哌拉西林他唑巴坦(χ²=8.29,P=0.008)和头孢哌酮舒巴坦(χ²=5.07,P=0.024)的耐药性显著增加;肺炎克雷伯菌对第一代和第二代头孢菌素的耐药率始终保持在 60% 以上,对喹诺酮类和碳青霉烯类仍然易感。从 2020 年到 2022 年,金黄色葡萄球菌对左氧氟沙星(耐药率:2.31%,7/303)和磺胺甲恶唑/三甲氧苄啶(耐药率:4.95%,15/303)仍然高度敏感。结论探讨了 2020 年至 2022 年 ICU 儿童痰培养中鲍曼不动杆菌更高的检出率和耐药率。大肠埃希菌对β-内酰胺酶抑制剂复方制剂的耐药性更为严重。定期监测重症监护室儿童呼吸道感染病因的变化对于预防和治疗耐多药细菌感染尤为重要。
{"title":"[Analysis of the changes of bacterial spectrum and drug resistance in sputum culture of ICU children in a hospital of pediatric in Jiangsu Province from 2017 to 2022].","authors":"H Huang, J Wei, H J Shen, Q X Tan, J Xue, C Wang","doi":"10.3760/cma.j.cn112150-20240514-00386","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20240514-00386","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the changes of the distribution and drug resistance profile of bacteria from ICU children with lower respiratory tract infection (LRTI) in Suzhou City, Jiangsu Province from 2017 to 2022. &lt;b&gt;Methods:&lt;/b&gt; From January 2017 to December 2022, a cross-sectional observational study on the bacterial spectrum analysis among intensive care unit (ICU) children with LRTI was conducted in Children's Hospital of Soochow University. The bacteria was cultivated by culture methods from sputum samples, and identified by MALDI-TOF mass spectrometry. Drug sensitivity tests were performed by the VITEK2 Compact fully automated analysis system and the paper slide method. The &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test or Fisher's exact probability was used to analyze the changes of the distribution of sputum culture-positive bacteria and drug resistance in ICU children. &lt;b&gt;Results:&lt;/b&gt; The overall detection rate of sputum culture was 42.06% (1 182/2 810). &lt;i&gt;Staphylococcus aureus&lt;/i&gt; (25.63%,303/1 182), &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; (13.62%,161/1 182) and &lt;i&gt;Haemaphilus influenzae&lt;/i&gt; (13.28%,157/1 182) were the top three. Proportions of &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; (17.90% &lt;i&gt;vs.&lt;/i&gt; 11.02%,&lt;i&gt;χ&lt;/i&gt;²=11.17, &lt;i&gt;P&lt;/i&gt;=0.001), especially carbapenem-resistant &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; (43.70% &lt;i&gt;vs.&lt;/i&gt; 23.50%, &lt;i&gt;χ²&lt;/i&gt;=15.21, &lt;i&gt;P&lt;/i&gt;&lt;0.001) increased significantly from 2020 to 2022. However, the proportions of &lt;i&gt;Haemophilus influenzae&lt;/i&gt; (8.50% &lt;i&gt;vs.&lt;/i&gt; 16.19%, &lt;i&gt;χ&lt;/i&gt;²=14.27, &lt;i&gt;P&lt;/i&gt;&lt;0.001), &lt;i&gt;Streptococcus pneumoniae&lt;/i&gt; (8.50% &lt;i&gt;vs.&lt;/i&gt; 15.92%, &lt;i&gt;χ&lt;/i&gt;²=13.42, &lt;i&gt;P&lt;/i&gt;&lt;0.001) and extended-spectrum-lactamase producing &lt;i&gt;Escherichia coli&lt;/i&gt; (8.89% &lt;i&gt;vs.&lt;/i&gt; 18.00%, &lt;i&gt;χ&lt;/i&gt;²=5.45, &lt;i&gt;P&lt;/i&gt;=0.025) decreased. Drug resistant results showed that &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; was obviously more resistant to imipenem (&lt;i&gt;χ²&lt;/i&gt;=4.43, &lt;i&gt;P&lt;/i&gt;=0.035) and levofloxacin (&lt;i&gt;χ&lt;/i&gt;²=12.53, &lt;i&gt;P&lt;/i&gt;&lt;0.001), while more sensitive to minocycline (&lt;i&gt;χ&lt;/i&gt;²=8.34, &lt;i&gt;P&lt;/i&gt;=0.004). Escherichia coli showed a significant increase in resistance to piperacillin tazobactam (&lt;i&gt;χ&lt;/i&gt;²=8.29, &lt;i&gt;P&lt;/i&gt;=0.008) and cefoperazone sulbactam (&lt;i&gt;χ&lt;/i&gt;²=5.07, &lt;i&gt;P&lt;/i&gt;=0.024) from 2020 to 2022; Klebsiella pneumoniae consistently maintained a resistance rate of more than 60% to first and second-generation cephalosporins, and remain susceptible to quinolones and carbapenems. Staphylococcus aureus remained highly susceptible to levofloxacin (drug resistance rate: 2.31%,7/303) and sulfamethoxazole/trimethoprim (drug resistance rate: 4.95%,15/303) from 2020 to 2022. &lt;b&gt;Conclusion:&lt;/b&gt; Higher detection and resistance rates of &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; from sputum culture in ICU children from 2020 to 2022 were explored. Resistance of &lt;i&gt;Escherichia coli&lt;/i&gt; to β-lactamase inhibitor combinations was more serious. Regular monitoring the changes of the etiology of respiratory tract infections in ICU Children is particularly important for the prevention and treatmen","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":"58 10","pages":"1534-1540"},"PeriodicalIF":0.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Reflections on the positioning and implementation pathways of adult vaccine prescriptions]. [对成人疫苗处方的定位和实施途径的思考]。
Q3 Medicine Pub Date : 2024-10-06 DOI: 10.3760/cma.j.cn112150-20240527-00430
M M Jia, Y L Cao, Y X Liu, L Zhang, J X Ma, L Z Feng

The innovation of integrating medical treatment and prevention mechanisms is a key task deployed by the government, aiming to promote the construction of a Healthy China and address the prevalent "treatment over prevention" mindset in healthcare services and society. Vaccination is an effective strategy for preventing and controlling infectious diseases; however, adult vaccination rates in China remain low due to insufficient awareness and enthusiasm among the public and healthcare professionals. In recent years, various regions have begun to explore the model of physicians in medical institutions prescribing vaccines to improve vaccination rates. This article analyzes the positioning, current implementation status, and challenges of vaccine prescriptions, and proposes recommendations advocating policy formulation, improving service models and supporting measures, improving funding mechanisms, and strengthening publicity and education to promote the widespread implementation and effectiveness of vaccine prescriptions.

创新医防结合机制是政府部署的一项重点工作,旨在推进健康中国建设,解决医疗卫生服务和社会中普遍存在的 "重治疗、轻预防 "的思想。疫苗接种是预防和控制传染病的有效策略,但由于公众和医务人员对疫苗接种的认识和积极性不足,我国成人疫苗接种率仍然较低。近年来,各地开始探索医疗机构医师开具疫苗处方的模式,以提高疫苗接种率。本文分析了疫苗处方的定位、实施现状和面临的挑战,提出了倡导制定政策、完善服务模式和配套措施、健全经费保障机制、加强宣传教育等建议,以促进疫苗处方的广泛实施和有效性。
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引用次数: 0
[The effect and mechanism of exposure to polystyrene nanoplastics on lipid metabolism in mice liver]. [暴露于聚苯乙烯纳米塑料对小鼠肝脏脂质代谢的影响和机制]。
Q3 Medicine Pub Date : 2024-10-06 DOI: 10.3760/cma.j.cn112150-20240708-00546
X N Zhang, Q T Meng, H W Zhang, C Wang, S Y Zhang, H Q Chen, X B Li, R Chen
<p><p><b>Objective:</b> To investigate the effect and potential mechanism of exposure to 20 nm polystyrene nanoplastics (PS-NPs) on lipid metabolism in mice liver. <b>Methods:</b> An animal experimental model was designed, which was completed from September 2022 to July 2023 on the exposure omics platform of the School of Public Health at Capital Medical University and the Key Laboratory of Environment and Population Health at the Chinese Center for Disease Control and Prevention.1 mg/kg and 10 mg/kg PS-NPs tail vein mice exposure models were constructed. After exposure 7 d, serum was collected to measure the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and air flow assisted desorption electrospray ionization-mass spectrometry imaging (AFADESI-MSI) analysis were used to analyze the mRNA levels of fatty acid esterification related genes (<i>Dgat1</i> and <i>Dgat2</i>) and lipid transport related genes (<i>ApoB</i>, <i>Cd36</i>, <i>ApoE</i> and <i>Mttp</i>) and metabolites' spatial changes in liver tissue. <i>In vivo</i> imaging system (IVIS) and tissue shake sections were employed to observe the fluorescence biological distribution of PS-NPs. <i>t</i>-test or one-way ANOVA was used to explore the difference between groups. <b>Results:</b> The serum ALT levels were (83.97±4.58), (91.17±13.69) and (142.43±6.09) U/L in the control group, 1 mg/kg PS-NPs exposure group and 10 mg/kg PS-NPs exposure group respectively (<i>F</i>=37.281, <i>P</i><0.05). The relative mRNA levels of <i>Dgat1</i>, <i>Dgat2</i>, <i>ApoB</i>, <i>Cd36</i> and <i>ApoE</i> were (1.49±0.63, 2.53±0.32, 2.45±0.54), (1.07±0.38, 1.86±0.83, 2.23±0.73), (1.01±0.13, 1.58±0.43, 2.03±0.52), (1.01±0.14, 1.55±0.37, 1.52±0.51), (1.01±0.17, 2.11±0.27, 2.39±0.93) in these three groups respectively. The differences were statistically significant (<i>F</i>=11.54, 6.95, 14.90, 5.98 and 14.68, <i>P</i><0.05). AFADESI-MSI analysis found that PS-NPs exposure led to a significant decrease in the levels of glutarylcarnitine and O-Linoleoylcarnitine (<i>t</i>=4.12 and 3.35, <i>P</i><0.05), which were associated with lipid beta oxidation. The content of triglycerides (TG) (m/z 921.726 4, <i>t</i>=8.69, <i>P</i><0.05; m/z 919.711 4, <i>t</i>=3.20, <i>P</i><0.05), phosphatidylic acid (PA) (m/z 895.712 3, <i>t</i>=3.60, <i>P</i><0.05; m/z 821.526 6, <i>t</i>=3.36, <i>P</i><0.05), lysophosphatidylcholine (LysoPC) (m/z 560.310 6, <i>t</i>=3.35, <i>P</i><0.05; m/z 582.295 3, <i>t</i>=6.28, <i>P</i><0.05), phosphatidylcholine (PC) (m/z 778.533 9, <i>t</i>=3.53, <i>P</i><0.05; m/z 804.549 6, <i>t</i>=3.60, <i>P</i><0.05; m/z 820.523 1, <i>t</i>=3.37, <i>P</i><0.05), phosphatidylethanolamine (PE) (m/z 772.523 3, <i>t</i>=3.08, <i>P</i><0.05) showed a significant increase in the PS-NPs exposure group. <i>In vivo</i> and <i>in vitro</i> imaging and in situ cell localization revealed that PS-NPs were mai
目的研究暴露于 20 纳米聚苯乙烯纳米塑料(PS-NPs)对小鼠肝脏脂质代谢的影响和潜在机制。方法:设计了一个动物实验模型,并于 2010 年 7 月至 2010 年 12 月期间在小鼠肝脏中暴露 20 纳米聚苯乙烯纳米塑料:设计动物实验模型,于2022年9月至2023年7月在首都医科大学公共卫生学院和中国疾病预防控制中心环境与人群健康重点实验室暴露omics平台上完成。暴露 7 d 后,采集血清测定丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)的水平。采用实时定量反转录聚合酶链反应(qRT-PCR)和气流辅助解吸电喷雾电离质谱成像(AFADESI-MSI)分析方法,分析肝组织中脂肪酸酯化相关基因(Dgat1 和 Dgat2)和脂质转运相关基因(ApoB、Cd36、ApoE 和 Mttp)的 mRNA 水平以及代谢物的空间变化。采用活体成像系统(IVIS)和组织切片观察PS-NPs的荧光生物分布。结果对照组、1 mg/kg PS-NPs暴露组和10 mg/kg PS-NPs暴露组血清ALT水平分别为(83.97±4.58)、(91.17±13.69)和(142.43±6.09)U/L(F=37.281),PDgat1、Dgat2、载脂蛋白B、Cd36和载脂蛋白E分别为(1.49±0.63, 2.53±0.32, 2.45±0.54), (1.07±0.38, 1.86±0.83, 2.23±0.73), (1.01±0.13, 1.58±0.43, 2.03±0.52)、(1.01±0.14,1.55±0.37,1.52±0.51)、(1.01±0.17,2.11±0.27,2.39±0.93)。差异有统计学意义(F=11.54,6.95,14.90,5.98 和 14.68,Pt=4.12 和 3.35,Pt=8.69,Pt=3.20,Pt=3.60,Pt=3.36,Pt=3.35,Pt=6.28,Pt=3.53,Pt=3.60,Pt=3.37, Pt=3.08, P 体内和体外成像及原位细胞定位显示,PS-NPs 主要富集于肝组织中的肝星状细胞和肝 Kupffer 细胞。结论暴露于 PS-NPs 会导致肝脏脂质代谢紊乱,这可能与 PS-NPs 在肝星状细胞和肝 Kupffer 细胞中的富集有关,为寻找 PS-NPs 暴露的早期生物标志物和进一步的机制研究提供了依据。
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中华预防医学杂志
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