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[Insights from plague control from a "One Health" perspective: Wu Lien-teh and the centennial legacy of public health in China]. [从“同一个健康”的视角看鼠疫控制:吴连德与中国公共卫生的百年遗产]。
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20250401-00267
R F Yang

Taking Dr. Wu Lien-teh's contributions to the containment of the 1910 Northeastern Plague as a starting point, this article briefly examines a century of development in China's public health and explores the application of the "One Health" concept. It first outlines Dr. Wu's groundbreaking achievements and enduring institutional legacies, including his pioneering scientific methods, the establishment of a modern public health system, and mechanisms for talent cultivation. Subsequently, the article analyzes Dr. Wu's containment strategies through the lens of "One Health", demonstrating that his approaches-characterized by multi-sectoral collaboration, international cooperation, administrative support, and evidence-based practice-closely align with core principles of "One Health" idea. The discussion then traces the establishment and development of China's plague preventive and control system, highlighting its foundation on the principle of "prevention first, combined with treatment and prevention, " as well as achievements in integrated surveillance and control networks, legal frameworks, specialized institutions and professional teams, joint prevention and control mechanisms, and scientific and technological innovation. Finally, the article proposes future directions for China's public health development, calling for deeper implementation of the "One Health" approach, enhanced cross-border joint prevention and control, a transformation in health governance, and the building of a shared global health community.

本文以吴连德博士对1910年东北鼠疫防控的贡献为切入点,简要考察了中国公共卫生的百年发展历程,并探讨了“一个健康”理念的应用。它首先概述了吴博士的开创性成就和持久的制度遗产,包括他开创性的科学方法,现代公共卫生体系的建立和人才培养机制。随后,本文从“同一个健康”的视角分析了吴博士的防控策略,表明其多部门协作、国际合作、行政支持和循证实践的方法与“同一个健康”理念的核心原则紧密契合。讨论追溯了中国鼠疫预防控制体系的建立和发展,强调了“预防为主,防治相结合”的原则基础,以及在综合监测和控制网络,法律框架,专业机构和专业团队,联防联控机制和科技创新方面取得的成就。最后,文章提出了中国公共卫生发展的未来方向,呼吁深入实施“一个健康”,加强跨境联防联控,转变卫生治理方式,构建共享的全球卫生共同体。
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引用次数: 0
[Epidemiological characteristics analysis of monkey injury cases caused in Qianlingshan Park, Guiyang City, Guizhou Province]. 贵州省贵阳市千灵山公园猴伤病例流行病学特征分析
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20250225-00138
C Yang, Y Chen, Y Chang, L Li, Q Y Pan, T T Lu, D Chen, C X He, M Huang, L S Yang, T Q Rao, S Guo, C Luo, L H Zhou, X Mu, L Liu, Y Y Yang, Y D Hu

Objective: To analyze the epidemiological characteristics of cases involving monkey injuries at medical institutions surrounding Qianlingshan Park in Guiyang City, and to provide a reference basis for preventive measures to reduce monkey injuries and standardized post-exposure treatment. Methods: A retrospective cross-sectional study was conducted, collecting 1 900 cases of monkey-induced injuries in Qianlingshan Park treated at the outpatient clinic of Guizhou Provincial Center for Disease Control and Prevention and the Department of Surgery at Qianling Hospital, Guiyang City, from 2021 to 2024. Statistical analysis was performed using Pearson's chi-square test. Results: Total of 1 900 cases of monkey-related injuries in Qianlingshan Park were collected from 2021 to 2024. The exposure time distribution exhibited significant seasonality, with 48.58% of cases occurring during July and August, totaling 923 cases, indicating a peak in the summer. There were 774 male patients and 1 126 female patients, with a ratio of 1∶1.45.and significant differences were observed between different age groups and genders (χ²=195.00, P<0.001), with the highest number of cases occurring in the 0-9 and 20-29 age groups, accounting for 22.05%(419 cases) and 21.79%(414 cases), respectively. The upper limbs were the most common injury site, accounting for 50.84% of the total cases(966 cases in total), with significant differences between gender and injury location (χ²=22.00, P<0.001), Among females, the proportion of injuries to the upper and lower limbs (30.11% and 16.47%, respectively) was higher than that among males (20.74% and 8.63%, respectively). The majority of injuries were classified as Grade Ⅲ, making up 57.38% of cases(1 069 cases in total). Self-treatment after exposure was the most common approach(60.44%), with significant differences observed between wound severity and treatment method (χ²=6.90, P=0.032), Patients with Grade Ⅱ and Grade Ⅲ wounds were more likely to choose self-management (26.84% and 33.23%, respectively) than outpatient management (15.14% and 24.15%). Approximately 98.05% (1 863 cases) of monkey-injured patients had received rabies vaccinations. Conclusions: This study analyzes monkey-related injuries in Qianlingshan Park from 2021 to 2024, clarifying the temporal distribution of injuries, demographic characteristics, injury sites, and treatment methods. The findings provide references for optimizing human-monkey conflict management and the prevention and control of zoonotic diseases in urban ecological parks.

目的:分析贵阳市千灵山公园周边医疗机构猴伤病例的流行病学特征,为采取预防措施减少猴伤和规范暴露后治疗提供参考依据。方法:采用回顾性横断面研究方法,收集2021 - 2024年贵州省疾病预防控制中心门诊和贵阳市钱陵医院外科收治的钱陵山公园猴源性损伤病例1 900例。统计学分析采用Pearson卡方检验。结果:2021 - 2024年,在潜灵山公园共收集猴相关伤害病例1 900例。暴露时间分布具有明显的季节性,7月和8月共923例,占48.58%,夏季为高峰;男性774例,女性1126例,男女比例为1∶1.45。不同年龄组和性别间差异有统计学意义(χ 2 =195.00, PPP=0.032),Ⅱ级和Ⅲ级伤口患者选择自我管理的比例分别为26.84%和33.23%,高于门诊管理的比例(15.14%和24.15%)。约98.05%(1 863例)猴伤患者接种了狂犬病疫苗。结论:本研究对2021 - 2024年千灵山公园猴类伤害进行了分析,明确了损伤的时间分布、人口统计学特征、损伤部位和治疗方法。研究结果可为优化城市生态公园人猴冲突管理和人畜共患疾病防控提供参考。
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引用次数: 0
[Research progress on high-quality development of dietary nutrition and chronic disease big data]. 【膳食营养高质量发展与慢性病大数据研究进展】。
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20241113-00903
J Q Lai, Z Y Yang, Y Wang, H Y Guo

This article delves into the importance and urgency of improving the quality of big data on dietary nutrition and chronic diseases within the disease control system. With the continuous rise in the incidence of chronic diseases, enhancing the quality of relevant data has become crucial in addressing public health challenges. The article proposes a series of concrete measures to improve the accuracy, completeness, and usability of the data, drawing on theoretical and technical support. By strengthening data collection, management, analysis, and application, the goal is to establish a high-quality big data system for dietary nutrition and chronic diseases. This will provide solid data support and scientific evidence for formulating targeted prevention and control strategies, supporting policy development, promoting scientific research innovation, and improving public health standards.

本文探讨了在疾病控制系统中提高膳食营养和慢性病大数据质量的重要性和紧迫性。随着慢性病发病率的不断上升,提高相关数据的质量已成为应对公共卫生挑战的关键。本文从理论上和技术上提出了提高数据准确性、完整性和可用性的一系列具体措施。通过加强数据收集、管理、分析和应用,建立高质量的膳食营养与慢性病大数据系统。这将为制定精准防控战略、支持政策制定、促进科研创新、提高公共卫生水平提供坚实的数据支持和科学依据。
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引用次数: 0
[A retrospective cohort study on the risk of pulmonary tuberculosis incidence among individuals with latent tuberculosis infection in schools]. [学校潜伏性结核感染者肺结核发病风险的回顾性队列研究]。
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20241223-01030
X W Dong, J W Lai, S S Huang, L J Fang, J W Li, H Z Wu, Y H Chen, W P Wen

Objective: To evaluate the risk of developing pulmonary tuberculosis (PTB) among individuals with latent tuberculosis infection (LTBI) in schools and the protective effect of tuberculosis preventive treatment (TPT). Methods: A retrospective cohort study was conducted to collect data on 15 school outbreaks that occurred in Guangdong Province from 2017 to 2021. Baseline information on tuberculin skin test (TST) or interferon-gamma release test (IGRA) was obtained during contact surveys, as well as baseline information such as TPT. The incidence of PTB between 2017 and 2022 was queried using the Chinese Center for Disease Control and Prevention Information System. Poisson regression analysis was used to compare the incidence risk of PTB in the LTBI population under different TST states at baseline. Current cases, new cases and all cases (the sum of the two) were used as dependent variables. Cox regression models were used to analyze various risk factors affecting the risk of PTB in the LTBI population and evaluate the protective effect of TPT. Results: A total of 6 550 contacts were included in this study, of which 409 received TPT. Within 0-3 months after baseline survey, 119 cases were diagnosed as current cases [19.4‰, 119/(6 550-409)]. A total of 17 221.65 person-years of follow-up were conducted, during which 71 new cases were diagnosed (4.1/1 000 person-years, 71/17 221.65). The incidence density of PTB was 47.7/1 000 person-years, 6.6/1 000 person-years, 1.4/1 000 person-years, and 0.9/1 000 person-years, respectively, in TST strong/IGRA positive, TST moderate positive, TST generally positive, and TST and IGRA negative populations. The difference in PTB incidence density was statistically significant [likelihood ratio test LRT=153.16, P<0.001]. TPT was performed for individuals with strong TST or IGRA positivity, and the protection rate could reach 93% (HR=0.07, 95%CI: 0.02-0.23). Conclusion: After the outbreak of the school epidemic, individuals with strong TST/IGRA positivity have a higher risk of developing PTB in the future. Targeted implementation of TPT can achieve better protection effects. In addition, the risk of developing PTB in individuals with moderate TST positivity is also worth noting.

目的:评价学校潜伏性结核感染者(LTBI)发生肺结核(PTB)的风险及结核病预防治疗(TPT)的保护作用。方法:采用回顾性队列研究方法,收集2017 - 2021年广东省发生的15起学校疫情资料。在接触调查期间获得结核菌素皮肤试验(TST)或干扰素γ释放试验(IGRA)的基线信息,以及TPT等基线信息。使用中国疾病预防控制中心信息系统查询2017 - 2022年肺结核发病率。采用泊松回归分析比较不同TST状态下LTBI人群PTB的发病风险。当前病例、新病例和所有病例(两者之和)作为因变量。采用Cox回归模型分析影响LTBI人群患PTB风险的各种危险因素,评价TPT的保护作用。结果:本研究共纳入接触者6 550例,其中409例接受TPT治疗。基线调查后0 ~ 3个月内诊断为当前病例119例[19.4‰,119/(6 550 ~ 409)]。共随访17 221.65人-年,其中新增病例71例(4.1/ 1000人-年,71/17 221.65)。在TST强/IGRA阳性、TST中度阳性、TST一般阳性、TST和IGRA阴性人群中,PTB的发病密度分别为47.7/1 000人年、6.6/1 000人年、1.4/1 000人年和0.9/1 000人年。PTB发病密度差异有统计学意义[似然比检验LRT=153.16, PHR=0.07, 95%CI: 0.02 ~ 0.23]。结论:学校疫情爆发后,TST/IGRA阳性较强的个体未来发生PTB的风险较高。有针对性地实施TPT可以达到更好的保护效果。此外,中等TST阳性个体发生PTB的风险也值得注意。
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引用次数: 0
[Development and future prospects of the national human biomonitoring technology system of China]. [中国国家人体生物监测技术体系的发展与未来展望]。
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20250805-00761
X M Shi

In 2025, Chinese Medical Association commemorates its 110th anniversary. Over this century-spanning journey in medical advancement, human biomonitoring (HBM) has emerged as a pivotal tool in environmental medicine for assessing population exposure to environmental pollutants and associated health risks. Since the dawn of the 21st century, China has actively advanced its HBM technological framework, providing critical scientific support for chemical regulation policies and public health protection. Chinese Journal of Preventive Medicine has consistently chronicled progress in this field, publishing high-impact research and serving as a key platform for academic exchange and knowledge dissemination.Marking this milestone, this article systematically reviews the current state of global HBM development, elucidates its indispensable role in preventive medicine, and highlights advancements and technical innovations within China's National Human Biomonitoring Program. It further examines persistent challenges and outlines future directions, offering scientific support for precision interventions in environmental health risks under the "Healthy China 2030" strategy.

2025年,中华医学会将迎来110周年纪念。在长达一个世纪的医学进步历程中,人体生物监测(HBM)已成为环境医学中评估人群暴露于环境污染物和相关健康风险的关键工具。进入21世纪以来,中国积极推进HBM技术框架,为化学品监管政策和公众健康保护提供了重要的科学支持。《中华预防医学杂志》一直记录着这一领域的进展,发表了高影响力的研究成果,是学术交流和知识传播的重要平台。为了纪念这一里程碑,本文系统地回顾了全球HBM发展的现状,阐明了其在预防医学中不可或缺的作用,并强调了中国国家人体生物监测计划的进步和技术创新。该报告进一步探讨了持续存在的挑战,并概述了未来的发展方向,为“健康中国2030”战略下的环境健康风险精准干预提供了科学支持。
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引用次数: 0
[Effects of changes in disease and injury spectrum on the health-adjusted life expectancy of permanent residents aged 55 and above in Shenzhen City from 2016 to 2030]. [2016 - 2030年深圳市55岁及以上常住居民疾病和损伤谱变化对健康调整预期寿命的影响]。
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20241115-00913
J Y Xi, Y J Wang, Y B Fu, X H Li, J J Bai, Y N Xiang, X Lin, J Gu, Y T Hao, G Liu

Objective: To analyze the effects of the disease and injury spectrum on health-adjusted life expectancy (HALE) among permanent residents aged 55 and above in Shenzhen from 2016 to 2030. Methods: Based on the mortality surveillance data and the permanent resident population data in Shenzhen from 2016 to 2022, the Sullivan method was used to calculate the HALE during 2016-2022. The Bayesian age-period-cohort model and the grey system model were used to predict the HALE during 2023-2030. The HALE changes in the two periods were decomposed into the contributions of 20 categories of diseases and injuries, respectively. Results: From 2016 to 2022, the HALE increased from 31.41 years (95%CI: 30.50-32.32) to 33.57 years (95%CI: 32.47-34.67). During this period, the mortality effect of neurological disorders slowed the increase of HALE, with a reduction of 0.27 years. By 2030, it is anticipated that the HALE will reach 36.40 years (95%CI: 34.78-38.01). This is expected to be influenced by the mortality effects of nutritional deficiencies (-0.40 years) and mental disorders (-0.29 years), as well as the disability effects of musculoskeletal disorders (-0.66 years), skin and subcutaneous diseases (-0.21 years) and nutritional deficiencies (-0.13 years). Conclusion: The HALE of permanent residents aged 55 years and above in Shenzhen demonstrated an increasing trend over time. Greater attention should be paid to the adverse effects of neurological disorders, nutritional deficiencies, mental disorders, musculoskeletal disorders, and skin and subcutaneous diseases on the continuous increase of HALE in this population.

目的:分析2016 - 2030年深圳市55岁及以上常住居民疾病和损伤谱对健康调整预期寿命(HALE)的影响。方法:基于深圳市2016-2022年的死亡率监测数据和常住人口数据,采用Sullivan方法计算2016-2022年的HALE。采用贝叶斯年龄-时期-队列模型和灰色系统模型对2023-2030年的HALE进行预测。将两个时期的HALE变化分别分解为20类疾病和损伤的贡献。结果:2016 - 2022年,HALE由31.41年(95%CI: 30.50 ~ 32.32)上升至33.57年(95%CI: 32.47 ~ 34.67)。在此期间,神经系统疾病的死亡率效应减缓了HALE的增加,减少了0.27年。到2030年,预计HALE将达到36.40年(95%CI: 34.78-38.01)。预计这将受到营养缺乏(-0.40岁)和精神障碍(-0.29岁)的死亡率影响,以及肌肉骨骼疾病(-0.66岁)、皮肤和皮下疾病(-0.21岁)和营养缺乏(-0.13岁)的残疾影响的影响。结论:深圳市55岁及以上常住居民HALE随时间的推移呈上升趋势。神经系统疾病、营养缺乏、精神疾病、肌肉骨骼疾病以及皮肤和皮下疾病对这一人群中HALE持续增加的不利影响应给予更多关注。
{"title":"[Effects of changes in disease and injury spectrum on the health-adjusted life expectancy of permanent residents aged 55 and above in Shenzhen City from 2016 to 2030].","authors":"J Y Xi, Y J Wang, Y B Fu, X H Li, J J Bai, Y N Xiang, X Lin, J Gu, Y T Hao, G Liu","doi":"10.3760/cma.j.cn112150-20241115-00913","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20241115-00913","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the effects of the disease and injury spectrum on health-adjusted life expectancy (HALE) among permanent residents aged 55 and above in Shenzhen from 2016 to 2030. <b>Methods:</b> Based on the mortality surveillance data and the permanent resident population data in Shenzhen from 2016 to 2022, the Sullivan method was used to calculate the HALE during 2016-2022. The Bayesian age-period-cohort model and the grey system model were used to predict the HALE during 2023-2030. The HALE changes in the two periods were decomposed into the contributions of 20 categories of diseases and injuries, respectively. <b>Results:</b> From 2016 to 2022, the HALE increased from 31.41 years (95%<i>CI</i>: 30.50-32.32) to 33.57 years (95%<i>CI</i>: 32.47-34.67). During this period, the mortality effect of neurological disorders slowed the increase of HALE, with a reduction of 0.27 years. By 2030, it is anticipated that the HALE will reach 36.40 years (95%<i>CI</i>: 34.78-38.01). This is expected to be influenced by the mortality effects of nutritional deficiencies (-0.40 years) and mental disorders (-0.29 years), as well as the disability effects of musculoskeletal disorders (-0.66 years), skin and subcutaneous diseases (-0.21 years) and nutritional deficiencies (-0.13 years). <b>Conclusion:</b> The HALE of permanent residents aged 55 years and above in Shenzhen demonstrated an increasing trend over time. Greater attention should be paid to the adverse effects of neurological disorders, nutritional deficiencies, mental disorders, musculoskeletal disorders, and skin and subcutaneous diseases on the continuous increase of HALE in this population.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":"59 10","pages":"1640-1647"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356030","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
[Association of blood selenium exposure with sex hormones among men aged 18-79 years in China]. [中国18-79岁男性血硒暴露与性激素的关系]。
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20250420-00333
Z Li, Y L Qu, Y W Li, S S Ji, H C Song, Q Sun, M Zhang, W L Zhang, J Y Cai, L Ding, Y Zhu, F Zhao, Z J Cao, Y B Lyu, L Wang, X M Shi

Objective: To investigate the association between blood selenium levels and sex hormones in Chinese men aged 18-79 years. Methods: Data were derived from the China National Human Biomonitoring survey conducted in 2017-2018, with a final sample size of 5 414 men. General demographic characteristics, behavioral habits, and dietary frequency were collected through questionnaires and physical examinations. Fasting blood samples were collected to measure blood lead, serum testosterone, and estradiol levels. Complex sampling linear regression models were used to analyze the associations between blood selenium levels and testosterone, estradiol, and the testosterone/estradiol ratio, adjusting for confounding factors including age, education level, marital status, smoking status, alcohol consumption, seafood intake, soy product intake, protein supplement intake, BMI, and diabetes status. Results: The mean age of the 5 414 participants was (46.85±27.91) years; 4 774 (91.65%) were of Han ethnicity and 4 505 (86.68%) were married. The median (Q1, Q3) blood selenium concentration in men was 97.80 (80.64, 116.99) μg/L. After adjusting for confounding factors, the complex sampling linear regression model revealed negative associations between blood selenium levels and both testosterone levels and the testosterone/estradiol ratio, with a significant linear trend (Ptrend<0.05). Compared with the Q1 group, the β (95%CI) values for testosterone in the Q2, Q3, and Q4 groups were -0.02 (-0.06 to 0.02), -0.03 (-0.08 to 0.01), and -0.06 (-0.09 to -0.02), respectively. Similarly, the β (95%CI) values for the testosterone/estradiol ratio in the Q2, Q3, and Q4 groups were -0.01 (-0.03 to 0.02), -0.01 (-0.04 to 0.04), and -0.03 (-0.06 to -0.01), respectively. Subgroup analysis indicated stronger associations between blood selenium levels and testosterone/estradiol levels in non-smoking and obese men (BMI≥28 kg/m²). Conclusion: Blood selenium levels are negatively associated with testosterone levels and the testosterone/estradiol ratio in Chinese adult males.

目的:探讨中国18 ~ 79岁男性血硒水平与性激素的关系。方法:数据来源于2017-2018年中国全国人体生物监测调查,最终样本量为5414名男性。通过问卷调查和体格检查收集一般人口统计学特征、行为习惯和饮食频率。采集空腹血样,测定血铅、血清睾酮和雌二醇水平。采用复杂抽样线性回归模型分析血硒水平与睾酮、雌二醇和睾酮/雌二醇比值之间的关系,并对年龄、受教育程度、婚姻状况、吸烟状况、饮酒情况、海鲜摄入量、豆制品摄入量、蛋白质补充剂摄入量、BMI和糖尿病状况等混杂因素进行校正。结果:5414例患者平均年龄为(46.85±27.91)岁;汉族4774人(91.65%),已婚4505人(86.68%)。男性血硒浓度中位数(Q1, Q3)为97.80 (80.64,116.99)μg/L。在校正混杂因素后,复合抽样线性回归模型显示血硒水平与睾酮水平和睾酮/雌二醇比值均呈负相关,且呈显著线性趋势(PtrendQ1组,Q2、Q3和Q4组睾酮β (95%CI)值分别为-0.02(-0.06 ~ 0.02)、-0.03(-0.08 ~ 0.01)和-0.06(-0.09 ~ -0.02)。同样,Q2、Q3和Q4组睾酮/雌二醇比值的β (95%CI)值分别为-0.01(-0.03至0.02)、-0.01(-0.04至0.04)和-0.03(-0.06至-0.01)。亚组分析表明,在不吸烟和肥胖男性(BMI≥28 kg/m²)中,血硒水平与睾酮/雌二醇水平之间存在更强的相关性。结论:中国成年男性血硒水平与睾酮水平及睾酮/雌二醇比值呈负相关。
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引用次数: 0
[Clinical characteristics and carbapenem resistance gene of Klebsiella pneumonia isolates from children in Chongqing region from 2019 to 2024]. [2019 - 2024年重庆地区儿童肺炎克雷伯菌临床特征及碳青霉烯类耐药基因分析]。
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20250529-00497
M R Zhou, D P Chen, C M Jing, Z Z Xiong, Y P Xiang, F Liu, W Xie
<p><p><b>Objective:</b> To investigate the clinical distribution characteristics changes in antimicrobial resistance, and carbapenemase resistance genes of Klebsiella pneumoniae isolated from children in Chongqing region during the period of January 2019 to December 2024, providing a basis for the rational use of antibiotics and the prevention and control of nosocomial infections. <b>Methods:</b> An observational study was conducted to retrospectively analyze 5 020 <i>Klebsiella pneumoniae</i> (KP) isolates detected in four hospitals of the Southwest Pediatric Laboratory Specialty Alliance. Antimicrobial susceptibility testing was performed by the minimum inhibitory concentration method combined with the disk diffusion method. Results were interpreted according to the 2024 Clinical and Laboratory Standards Institute (CLSI) standards. Carbapenemase resistance genes were detected by polymerase chain reaction (PCR) combined with Sanger sequencing. WHONET 5.6 was used for resistance analysis and SPSS 19.0 for statistical analysis. The chi-square test was used to assess trends in resistance rates, ESBL detection rates, and resistance rates of different CRKP carbapenemase genotypes from 2019 to 2024. Statistical significance was confirmed if the two-tailed <i>P</i>-value was <0.05. <b>Results:</b> A total of 5 020 strains were isolated, with a detection rate of 5.1% (5 020/99 063). The majority were from sputum (59.2%, 2 970/5 020), followed by pus (17.1%, 857), urine (9.7%, 487), venous blood (6.5%, 326), secretions (2.6%, 130), and other specimens (5.0%, 250).The lowest resistance rate was to amikacin (3.8%), followed by levofloxacin (10.9%), imipenem (19.1%), and meropenem (19.9%). Resistance rates to cefoperazone/sulbactam (<i>χ</i>²=9.982 0, <i>P</i>=0.001 6), piperacillin/tazobactam (<i>χ</i>²=10.110 0, <i>P</i>=0.001 5), ceftazidime (<i>χ</i>²=3.849 0, <i>P</i>=0.049 8), cefotaxime (<i>χ</i>²=7.605 0, <i>P</i>=0.005 8), cefepime (<i>χ</i>²=13.510 0, <i>P</i>=0.000 2), aztreonam (<i>χ</i>²=6.457 0, <i>P</i>=0.011 1), imipenem (<i>χ</i>²=4.672 0, <i>P</i>=0.030 7), and levofloxacin (<i>χ</i>²=7.555 0, <i>P</i>=0.006 0) showed an annual increasing trend. The main carbapenemase genes were blaNDM-5 (42.2%, 127/301), blaNDM-1 (33.9%, 102/301), and blaKPC-2 (17.3%, 52/301). Patients with KPC-2-producing strains (median age, 240 days) were older than those with NDM-1/NDM-5-producing strains (median age, 40 days) (<i>χ</i>²=22.620 0, <i>P</i><0.000 1). In neonatal wards, the detection rate of NDM-KP was higher than that of KPC-KP (64.6%, 148/229 <i>vs.</i> 26.9%, 14/52, <i>χ</i>²=24.680 0, <i>P</i><0.000 1), whereas in ICUs, it was lower (6.1%, 14/229 <i>vs.</i> 26.9%, 14/52, <i>χ</i>²=20.450 0, <i>P</i><0.000 1). <b>Conclusion:</b> In Chongqing region, the isolation rate of K. pneumoniae from sputum was the highest with most cases from neonatal wards. Resistance to carbapenems showed an upward trend. BlaNDM-5 was the predominant genotype in pediatric CR
目的:了解重庆地区2019年1月至2024年12月儿童分离肺炎克雷伯菌抗微生物药物耐药性及碳青霉烯酶耐药基因的临床分布特征变化,为合理使用抗生素及预防和控制院内感染提供依据。方法:回顾性分析西南儿科实验室专科联盟所属4家医院检出的5 020株肺炎克雷伯菌(KP)。采用最小抑菌浓度法联合纸片扩散法进行药敏试验。结果按照2024年临床与实验室标准协会(CLSI)标准进行解释。采用聚合酶链反应(PCR)结合Sanger测序法检测碳青霉烯酶耐药基因。采用WHONET 5.6进行耐药分析,SPSS 19.0进行统计分析。采用卡方检验评估2019 - 2024年不同CRKP碳青霉烯酶基因型的耐药率、ESBL检出率和耐药率趋势。结果:共分离菌株5 020株,检出率为5.1%(5 020/99 063)。以痰标本最多(59.2%,2 970/5 020),其次为脓液标本(17.1%,857)、尿液标本(9.7%,487)、静脉血标本(6.5%,326)、分泌物标本(2.6%,130)和其他标本(5.0%,250)。耐药率最低的是阿米卡星(3.8%),其次是左氧氟沙星(10.9%)、亚胺培南(19.1%)、美罗培南(19.9%)。头孢哌酮/舒巴坦(χ²=9.982 0,P=0.001 6)、哌拉西林/他唑巴坦(χ²=10.110 0,P=0.001 5)、头孢他啶(χ²=3.849 0,P=0.049 8)、头孢噻肟(χ²=7.605 0,P=0.005 8)、头孢吡肟(χ²=13.510 0,P=0.000 2)、氨曲南(χ²=6.457 0,P=0.011 1)、亚胺培南(χ²=4.672 0,P=0.030 7)、左氧氟沙星(χ²=7.555 0,P=0.006 0)的耐药率呈逐年上升趋势。碳青霉烯酶基因主要为blaNDM-5(42.2%, 127/301)、blaNDM-1(33.9%, 102/301)和blaKPC-2(17.3%, 52/301)。产kpc -2菌株(中位年龄,240 d)患者比产NDM-1/ ndm -5菌株(中位年龄,40 d)患者年龄大(χ²=22.620 0,Pvs. 26.9%, 14/52, χ²=24.680 0,Pvs. 26.9%, 14/52, χ²=20.450 0,p)。结论:重庆地区肺炎克雷伯菌痰分离率最高,以新生儿病房病例最多。对碳青霉烯类的抗性呈上升趋势。BlaNDM-5是儿童CRKP的主要基因型。KPC-KP患者比NDM-KP患者年龄大。新生儿病房以NDM-KP为主,icu以KPC-KP为主,KPC-KP表现出更高的抗菌药物耐药性。
{"title":"[Clinical characteristics and carbapenem resistance gene of <i>Klebsiella pneumonia</i> isolates from children in Chongqing region from 2019 to 2024].","authors":"M R Zhou, D P Chen, C M Jing, Z Z Xiong, Y P Xiang, F Liu, W Xie","doi":"10.3760/cma.j.cn112150-20250529-00497","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20250529-00497","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the clinical distribution characteristics changes in antimicrobial resistance, and carbapenemase resistance genes of Klebsiella pneumoniae isolated from children in Chongqing region during the period of January 2019 to December 2024, providing a basis for the rational use of antibiotics and the prevention and control of nosocomial infections. &lt;b&gt;Methods:&lt;/b&gt; An observational study was conducted to retrospectively analyze 5 020 &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; (KP) isolates detected in four hospitals of the Southwest Pediatric Laboratory Specialty Alliance. Antimicrobial susceptibility testing was performed by the minimum inhibitory concentration method combined with the disk diffusion method. Results were interpreted according to the 2024 Clinical and Laboratory Standards Institute (CLSI) standards. Carbapenemase resistance genes were detected by polymerase chain reaction (PCR) combined with Sanger sequencing. WHONET 5.6 was used for resistance analysis and SPSS 19.0 for statistical analysis. The chi-square test was used to assess trends in resistance rates, ESBL detection rates, and resistance rates of different CRKP carbapenemase genotypes from 2019 to 2024. Statistical significance was confirmed if the two-tailed &lt;i&gt;P&lt;/i&gt;-value was &lt;0.05. &lt;b&gt;Results:&lt;/b&gt; A total of 5 020 strains were isolated, with a detection rate of 5.1% (5 020/99 063). The majority were from sputum (59.2%, 2 970/5 020), followed by pus (17.1%, 857), urine (9.7%, 487), venous blood (6.5%, 326), secretions (2.6%, 130), and other specimens (5.0%, 250).The lowest resistance rate was to amikacin (3.8%), followed by levofloxacin (10.9%), imipenem (19.1%), and meropenem (19.9%). Resistance rates to cefoperazone/sulbactam (&lt;i&gt;χ&lt;/i&gt;²=9.982 0, &lt;i&gt;P&lt;/i&gt;=0.001 6), piperacillin/tazobactam (&lt;i&gt;χ&lt;/i&gt;²=10.110 0, &lt;i&gt;P&lt;/i&gt;=0.001 5), ceftazidime (&lt;i&gt;χ&lt;/i&gt;²=3.849 0, &lt;i&gt;P&lt;/i&gt;=0.049 8), cefotaxime (&lt;i&gt;χ&lt;/i&gt;²=7.605 0, &lt;i&gt;P&lt;/i&gt;=0.005 8), cefepime (&lt;i&gt;χ&lt;/i&gt;²=13.510 0, &lt;i&gt;P&lt;/i&gt;=0.000 2), aztreonam (&lt;i&gt;χ&lt;/i&gt;²=6.457 0, &lt;i&gt;P&lt;/i&gt;=0.011 1), imipenem (&lt;i&gt;χ&lt;/i&gt;²=4.672 0, &lt;i&gt;P&lt;/i&gt;=0.030 7), and levofloxacin (&lt;i&gt;χ&lt;/i&gt;²=7.555 0, &lt;i&gt;P&lt;/i&gt;=0.006 0) showed an annual increasing trend. The main carbapenemase genes were blaNDM-5 (42.2%, 127/301), blaNDM-1 (33.9%, 102/301), and blaKPC-2 (17.3%, 52/301). Patients with KPC-2-producing strains (median age, 240 days) were older than those with NDM-1/NDM-5-producing strains (median age, 40 days) (&lt;i&gt;χ&lt;/i&gt;²=22.620 0, &lt;i&gt;P&lt;/i&gt;&lt;0.000 1). In neonatal wards, the detection rate of NDM-KP was higher than that of KPC-KP (64.6%, 148/229 &lt;i&gt;vs.&lt;/i&gt; 26.9%, 14/52, &lt;i&gt;χ&lt;/i&gt;²=24.680 0, &lt;i&gt;P&lt;/i&gt;&lt;0.000 1), whereas in ICUs, it was lower (6.1%, 14/229 &lt;i&gt;vs.&lt;/i&gt; 26.9%, 14/52, &lt;i&gt;χ&lt;/i&gt;²=20.450 0, &lt;i&gt;P&lt;/i&gt;&lt;0.000 1). &lt;b&gt;Conclusion:&lt;/b&gt; In Chongqing region, the isolation rate of K. pneumoniae from sputum was the highest with most cases from neonatal wards. Resistance to carbapenems showed an upward trend. BlaNDM-5 was the predominant genotype in pediatric CR","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":"59 10","pages":"1655-1664"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356255","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
[Prediction model and feature analysis of pneumonia hospitalization duration based on CT radiomics and clinical indicators]. [基于CT放射组学及临床指标的肺炎住院时间预测模型及特征分析]。
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20241223-01032
X F Sun, Z H Wu, Y N Zhang, J H Zhang, J Q Chen

Objective: To analyze clinical indicators and imaging data of hospitalized pneumonia patients and develop prediction models for length of hospital stay based on CT radiomics features and clinical indicators. Methods: Patients admitted to the First Clinical School of Hainan Medical University for pneumonia treatment between November 2020 and May 2024 were enrolled. Clinical data and CT imaging were collected, and radiomics features were extracted. Patients were divided into three groups based on the length of stay (<8 d, 8-28 d,>28 d, and poor prognosis). Three prediction models were constructed using logistic regression (LR): clinical features model, imaging features model and a combined clinical and imaging features model. The predictive performance of three models was evaluated using the area under the receiver operating characteristic (ROC) curve and DeLong test, followed by feature analysis. The Kappa test was used to compare the consistency of the overall classification. Results: A total of 343 subjects were included, with an average age of 61.46±20.98 years. The area under the curve (AUC) values of the combined model in different hospitalization duration classifications (<8 d, 8-28 d,>28 d, and poor prognosis) were 0.73, 0.65 and 0.78 in the training set, and 0.71, 0.65 and 0.76 in the validation set, respectively. The AUC values of the clinical feature model in different hospitalization duration classifications were 0.63, 0.64 and 0.73 in the training set, and 0.60, 0.52 and 0.63 in the validation set, respectively. The AUC values of the imaging feature model in different hospitalization duration classifications (<8 d, 8-28 d,>28 d, and poor prognosis) were 0.67, 0.66 and 0.73 in the training set, and 0.68, 0.54 and 0.66 in the validation set, respectively. The DeLong test results showed that the combined model outperformed other models in hospitalization duration classification (validation set AUC, all P<0.05, Bonferroni correction). Kappa test results showed that the combined model achieved the highest consistency between predicted classifications and actual hospitalization classifications (K=0.615). Shape features, texture features and clinical features all contributed proportionally to the combined model. Conclusion: The combined model integrating radiomics features with clinical indicators can significantly enhance the predictive efficacy for the length of hospitalization in pneumonia patients.

目的:分析肺炎住院患者的临床指标和影像学资料,建立基于CT放射组学特征和临床指标的住院时间预测模型。方法:选取2020年11月至2024年5月在海南医科大学第一临床学院住院治疗的肺炎患者。收集临床资料和CT影像,提取放射组学特征。根据住院时间(28 d,预后不良)将患者分为三组。采用logistic回归(LR)构建3种预测模型:临床特征模型、影像学特征模型和临床与影像学联合模型。采用受试者工作特征(ROC)曲线下面积和DeLong检验评价三种模型的预测性能,并进行特征分析。采用Kappa检验比较总体分类的一致性。结果:共纳入受试者343例,平均年龄61.46±20.98岁。联合模型在不同住院时间分类(28天、预后不良)下的曲线下面积(AUC)值在训练集中分别为0.73、0.65和0.78,在验证集中分别为0.71、0.65和0.76。临床特征模型在不同住院时间分类下的AUC值在训练集中分别为0.63、0.64和0.73,在验证集中分别为0.60、0.52和0.63。不同住院时间分类(28 d、预后不良)下的影像特征模型AUC值在训练集中分别为0.67、0.66、0.73,在验证集中分别为0.68、0.54、0.66。DeLong检验结果表明,联合模型在住院时间分类方面优于其他模型(验证集AUC,所有PK=0.615)。形状特征、纹理特征和临床特征对组合模型的贡献都是成比例的。结论:将放射组学特征与临床指标相结合的联合模型可显著提高对肺炎患者住院时间的预测效果。
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引用次数: 0
[Comparative study on the resistance of phage and bacteria indicative of the disinfection effect on object surfaces]. [噬菌体与细菌耐药性对比研究,指示物体表面消毒效果]。
Q3 Medicine Pub Date : 2025-10-06 DOI: 10.3760/cma.j.cn112150-20241230-01062
C C Ma, Q Zhang, Y Tong, L Yu, Q Q Fang, B Y Zhang, J Shen

Objective: To investigate the differences in resistance to chemical disinfectants between bacteriophage Phi-X174 and disinfection effect indicator microorganisms, Staphylococcus aureus and Escherichia coli. Methods: Three commonly used disinfectants, including chlorine-containing disinfectants, alcohol-based disinfectants and quaternary ammonium salt disinfectants, were selected to analyze the differences in resistance of phage Phi-X174, Staphylococcus aureus and Escherichia coli by using the quantitative sterilization test of suspension. Results: The 250 mg/L sodium dichloroisocyanurate solution treated for 10 minutes yielded log reduction values of 3.39, 7.25 and 7.37 against phage Phi-X174, Staphylococcus aureus and Escherichia coli respectively. The 40% ethanol for 1 minute yielded log reduction values of 0.03, 2.46 and 7.30 against phage Phi-X174, Staphylococcus aureus and Escherichia coli, respectively. The 100 mg/L benzalkonium chloride for 10 minutes yielded log reduction values of 1.41, 6.84 and 0.93 for phage Phi-X174, Staphylococcus aureus and Escherichia coli, respectively. Conclusion: Phage Phi-X174 has stronger resistance to chlorine-containing disinfectants and alcohol-based disinfectants than Escherichia coli and Staphylococcus aureus. Its resistance to quaternary ammonium salt disinfectants is between that of Staphylococcus aureus and Escherichia coli.

目的:探讨噬菌体Phi-X174与消毒效果指示微生物金黄色葡萄球菌和大肠杆菌对化学消毒剂的耐药性差异。方法:采用悬浮液定量杀菌试验,选取含氯消毒剂、醇基消毒剂和季铵盐消毒剂3种常用消毒剂,分析噬菌体Phi-X174、金黄色葡萄球菌和大肠杆菌的耐药性差异。结果:250 mg/L二氯异氰尿酸钠溶液作用10 min,对噬菌体Phi-X174、金黄色葡萄球菌和大肠杆菌的对数还原值分别为3.39、7.25和7.37。40%乙醇作用1分钟对噬菌体Phi-X174、金黄色葡萄球菌和大肠杆菌的对数还原值分别为0.03、2.46和7.30。100 mg/L苯扎氯铵作用10分钟,噬菌体Phi-X174、金黄色葡萄球菌和大肠杆菌的对数还原值分别为1.41、6.84和0.93。结论:噬菌体Phi-X174对含氯消毒剂和酒精类消毒剂的耐药性较大肠杆菌和金黄色葡萄球菌强。其对季铵盐消毒剂的耐药性介于金黄色葡萄球菌和大肠杆菌之间。
{"title":"[Comparative study on the resistance of phage and bacteria indicative of the disinfection effect on object surfaces].","authors":"C C Ma, Q Zhang, Y Tong, L Yu, Q Q Fang, B Y Zhang, J Shen","doi":"10.3760/cma.j.cn112150-20241230-01062","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20241230-01062","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the differences in resistance to chemical disinfectants between bacteriophage Phi-X174 and disinfection effect indicator microorganisms, <i>Staphylococcus aureus</i> and <i>Escherichia coli</i>. <b>Methods:</b> Three commonly used disinfectants, including chlorine-containing disinfectants, alcohol-based disinfectants and quaternary ammonium salt disinfectants, were selected to analyze the differences in resistance of phage Phi-X174, <i>Staphylococcus aureus</i> and <i>Escherichia coli</i> by using the quantitative sterilization test of suspension. <b>Results:</b> The 250 mg/L sodium dichloroisocyanurate solution treated for 10 minutes yielded log reduction values of 3.39, 7.25 and 7.37 against phage Phi-X174, <i>Staphylococcus aureus</i> and <i>Escherichia coli</i> respectively. The 40% ethanol for 1 minute yielded log reduction values of 0.03, 2.46 and 7.30 against phage Phi-X174, <i>Staphylococcus aureus</i> and <i>Escherichia coli</i>, respectively. The 100 mg/L benzalkonium chloride for 10 minutes yielded log reduction values of 1.41, 6.84 and 0.93 for phage Phi-X174, <i>Staphylococcus aureus</i> and <i>Escherichia coli</i>, respectively. <b>Conclusion:</b> Phage Phi-X174 has stronger resistance to chlorine-containing disinfectants and alcohol-based disinfectants than <i>Escherichia coli</i> and <i>Staphylococcus aureus</i>. Its resistance to quaternary ammonium salt disinfectants is between that of <i>Staphylococcus aureus</i> and <i>Escherichia coli</i>.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":"59 10","pages":"1703-1707"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355797","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
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中华预防医学杂志
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