BACKGROUND:The objective of this retrospective hospital-based study was to describe the epidemiological features of traumatic spinal cord injury(TSCI)in the intensive care unit(ICU)and assess the incidence and possibl...BACKGROUND:The objective of this retrospective hospital-based study was to describe the epidemiological features of traumatic spinal cord injury(TSCI)in the intensive care unit(ICU)and assess the incidence and possible risk factors for venous thromboembolism(VTE)following TSCI.METHODS:We retrospectively reviewed the medical records of 370 patients with TSCI who were admitted between January 2018 and March 2023.The following parameters were collected:age,sex,body mass index,occupation,underlying diseases,smoking history,education level,etiology of injury,injury segments,American Spinal Injury Association(ASIA)Impairment Scale score,severity of injury,injury severity score(ISS),VTE risk score(Caprini score),treatment,VTE prophylaxis,ICU length of stay,length of hospital stay,concomitant injuries,and complications.Descriptive statistics were used to summarize the demographic and clinical characteristics of the study participants.Logistic regression analysis was used to determine the risk factors for VTE.RESULTS:The mean age of patients with TSCI was 55.5±13.4 years,with a male-to-female ratio of 6.5:1.The leading cause of TSCI was falls from height(46.5%),followed by traffic accidents(36.5%).The cervical spinal cord was the most affected segment,followed by the thoracolumbar region.Among all the patients,362(97.8%)had concomitant injuries.Complications were observed in 255 patients(68.9%)during hospitalization.The incidence rate of VTE was 25.1%.Logistic regression analysis revealed that age(OR=1.721,95%CI:1.207-2.454,P=0.003),mechanical ventilation(OR=3.427,95%CI:1.873-6.271,P<0.001),and non-use of chemical prophylaxis(OR=2.986,95%CI:1.749-5.099,P<0.001)were risk factors for VTE.CONCLUSION:Falls from height and traffic accidents were the main causes of TSCIs in the ICU,especially for male patients with cervical spinal cord injuries.VTE is a frequent complication in patients with TSCI in the ICU.Age,mechanical ventilation,and non-use of chemical prophylaxis were found to be independent risk factors for VTE following TSCI.展开更多
Objective:To expound geographical information system (GIS) technology is a very important tool when it was employed to assist to present the distribution by time and place and the model of transmission of infectious d...Objective:To expound geographical information system (GIS) technology is a very important tool when it was employed to assist to present the distribution by time and place and the model of transmission of infectious disease. Methods: We illustrated the assistant decision-making support function of GIS with an example of the spatial decision support system for SARS controlling in Shaanxi province of China which was developed by us. Results: The spatial decision support system established by applying GIS technology fulfilled the needs of real-time collection and management and dissemination SARS information and of surveillance and analysis the epidemic situation of SARS. Conclusion: Occurrence and epidemic of diseases, implement prevention and intervention measures and collocation hygienic resources are all with the characteristic of the variation of time and space, therefore, GIS technology has become a powerful tool for identifying risk factors of diseases, providing clues of causation of diseases , evaluating the effects of intervention measures and drawing a health management plan.展开更多
Objective:To study the epidemiological features of pancreatic cystadenoma and cystadenocarcinoma in China during the last 10 years and to analyze the diagnosis and treatment.Methods:Reports on pancreatic cystadenoma a...Objective:To study the epidemiological features of pancreatic cystadenoma and cystadenocarcinoma in China during the last 10 years and to analyze the diagnosis and treatment.Methods:Reports on pancreatic cystadenoma and cystadenocarcinoma published from 2000 to 2009 were retrieved from various databases,such as WANFANG data,VIP web and China National Knowledge Infrastructure(CNKI).The epidemiological features of pancreatic cystadenoma and cystadenocarcinoma and its diagnosis and treatment were analyzed.Results:Totally 1 865 patients with pancreatic cystadenoma and cystadenocarcinoma were reported in China during the last 10 years.The male to female ratio was approximately 1:2.1.The accurate ages were reported in 1 536 cases,the average age of them was 50.8 years,whose average age from 40 to 60 years old accounted 75.9% of the patients.65.3% of the cases were located in East China and Central China.Abdominal pain was the main clinical manifestation and was found in 54.9% of the patients.Pancreatoduodenectomy and resection of body and tail of the pancreas were the main procedure for the treatment of pancreatic cystadenoma and cystadenocarcinoma.Conclusion:Pancreatic cystadenoma and cystadenocarcinoma were mainly found in older women in East and Central China.Preoperative diagnosis is difficult.Pancreatoduodenectomy and resection of pancreatic body and tail were the main procedure for the treatment of pancreatic cystadenoma and cystadenocarcinoma.展开更多
Objective: To study epidemiological characteristics of the military training injuries (MTI) during parachuting training of the air force and sea training of the navy. Methods:The subjects of this study were 1382, incl...Objective: To study epidemiological characteristics of the military training injuries (MTI) during parachuting training of the air force and sea training of the navy. Methods:The subjects of this study were 1382, including 971 navy soldiers (300 recruits and 671 soldiers) and 411 for force recruits. Navy: Each of injured soldiers was investigated by the trained battalion surgeon; Air force: When the parachuting training finished , two doctors in specific field screened and investigated them one by one. Results: The incidence of injury in for force recruits was 16.3% and in navy recruits was 18. 7%. The incidence of navy soldiers was 5.5%, which was significantly lower than that of navy recruits. There was a peak of incidence in the 2nd training month of navy recruits. The peak of incidence of navy soldiers was in 1st training month. The incidence of air force maintained at a high level except 2nd training month. The incidences of lower legs and ankles were higher than those of other sites in navy with percentage of 42.9% and 17.9% respectively. The incidences of ankles and lumbar region were higher than those of other sites in air force with percentage of 26.9% and 23.9% respectively. Incidence of acute traumatic injuries was highest during special course. Conclusion: The result showed the incidence of injury in sea and parachuting training varied. Different preventive measures should be adopted during special training.展开更多
The European MOTTLES project set-up a newgeneration network for ozone(O 3)monitoring in 17 plots in France,Italy and Romania.These monitoring stations allowed:(1)estimating the accumulated exposure AOT40 and stomatal ...The European MOTTLES project set-up a newgeneration network for ozone(O 3)monitoring in 17 plots in France,Italy and Romania.These monitoring stations allowed:(1)estimating the accumulated exposure AOT40 and stomatal O 3 fl uxes(PODY)with an hourly threshold of uptake(Y)to represent the detoxifi cation capacity of trees(POD1,with Y=1 nmol O 3 m^−2 s^−1 per leaf area);and(2)collecting data of forest-response indicators,i.e.crown defoliation and visible foliar O 3-like injury over the time period 2017–2019.The soil water content was the most important parameter aff ecting crown defoliation and was a key factor aff ecting the severity of visible foliar O 3-like injury on the dominant tree species in a plot.The soil water content is thus an essential parameter in the PODY estimation,particularly for water-limited environments.An assessment based on stomatal fl ux-based standard and on real plant symptoms is more appropriated than the exposure-based method for protecting vegetation.From fl ux-eff ect relationships,we derived fl ux-based critical levels(CLef)for forest protection against visible foliar O 3-like injury.We recommend CLef of 5 and 12 mmol m^−2 POD1 for broadleaved species and conifers,respectively.Before using PODY as legislative standard in Europe,we recommend using the CLec for≥25%of crown defoliation in a plot:17,000 and 19,000 nmol mol^−1 h AOT40 for conifers and broadleaved species,respectively.展开更多
Since 2015,stroke has become the leading cause of death and disability in China,posing a significant threat to the health of its citizens as a major chronic non-communicable disease.According to the China Stroke High-...Since 2015,stroke has become the leading cause of death and disability in China,posing a significant threat to the health of its citizens as a major chronic non-communicable disease.According to the China Stroke High-risk Population Screening and Intervention Program,an estimated 17.8 million[95%confidence interval(CI)17.6–18.0million]adults in China had experienced a stroke in 2020,with 3.4 million(95%CI 3.3–3.5 million)experiencing their first-ever stroke and another 2.3 million(95%CI 2.2–2.4 million)dying as a result.Additionally,approximately 12.5%(95%CI 12.4%–12.5%)of stroke survivors were left disabled,as defined by a modified Rankin Scale score greater than 1,equating to 2.2 million(95%CI 2.1–2.2 million)stroke-related disabilities in 2020.As the population ages and the prevalence of risk factors like diabetes,hypertension,and hyperlipidemia continues to rise and remains poorly controlled,the burden of stroke in China is also increasing.A large national epidemiological survey initiated by the China Hypertension League in 2017 showed that the prevalence of hypertension was 24.7%;the awareness,treatment,and control rates in hypertensive patients were:60.1%,42.5%,and 25.4%,respectively.A nationally representative sample of the Chinese mainland population showed that the weighted prevalence of total diabetes diagnosed by the American Diabetes Association criteria was 12.8%,suggesting there are 120 million adults with diabetes in China,and the awareness,treatment,and control rates in diabetic patients were:43.3%,49.0%,and 49.4%,respectively.The“Sixth National Health Service Statistical Survey Report in 2018”showed that the proportion of the obese population in China was 37.4%,an increase of 7.2 points from 2013.Data from 1599 hospitals in the Hospital Quality Monitoring System and Bigdata Observatory Platform for Stroke of China(BOSC)showed that a total of 3,418,432 stroke cases[mean age±standard error(SE)was(65.700±0.006)years,and 59.1%were male]were admitted during 2020.Of those,over 80.0%(81.9%)were ischemic stroke(IS),14.9%were intracerebral hemorrhage(ICH)strokes,and 3.1%were subarachnoid hemorrhage(SAH)strokes.The mean±SE of hospitalization expenditures was Chinese Yuan(CNY)(16,975.6±16.3),ranging from(13,310.1±12.8)in IS to(81,369.8±260.7)in SAH,and out-of-pocket expenses were(5788.9±8.6),ranging from(4449.0±6.6)in IS to(30,778.2±156.8)in SAH.It was estimated that the medical cost of hospitalization for stroke in 2020 was CNY 58.0 billion,of which the patient pays approximately CNY 19.8 billion.In-hospital death/discharge against medical advice rate was 9.2%(95%CI 9.2%–9.2%),ranging from 6.4%(95%CI 6.4%–6.5%)for IS to 21.8%(95%CI 21.8%–21.9%)for ICH.From 2019 to 2020,the information about 188,648 patients with acute IS receiving intravenous thrombolytic therapy(IVT),49,845 patients receiving mechanical thrombectomy(MT),and 14,087 patients receiving bridging(IVT+MT)were collected through BOSC.The incidence of intracranial hemorrhage during treatment was 3.2%(95%CI 3.2%–3.3%),7.7%(95%CI 7.5%–8.0%),and 12.9%(95%CI 12.3%–13.4%),respectively.And in-hospital death/discharge against medical advice rate was 8.9%(95%CI 8.8%–9.0%),16.5%(95%CI 16.2%–16.9%),and 16.8%(95%CI 16.2%–17.4%),respectively.A prospective nationwide hospital-based study was conducted at 231 stroke base hospitals(Level III)from 31 provinces in China through BOSC from January 2019to December 2020 and 136,282 stroke patients were included and finished 12-month follow-up.Of those,over 86.9%were IS,10.8%were ICH strokes,and 2.3%were SAH strokes.The disability rate[%(95%CI)]in survivors of stroke at 3-month and 12-month was 14.8%(95%CI 14.6%–15.0%)and 14.0%(95%CI 13.8%–14.2%),respectively.The mortality rate[%(95%CI)]of stroke at 3-month and 12-month was 4.2%(95%CI 4.1%–4.3%)and 8.5%(95%CI 8.4%–8.6%),respectively.The recurrence rate[%(95%CI)]of stroke at 3-month and 12-month was 3.6%(95%CI 3.5%–3.7%)and 5.6%(95%CI 5.4%–5.7%),respectively.The Healthy China 2030 Stroke Action Plan was launched as part of this review,and the above data provide valuable guidelines for future stroke prevention and treatment efforts in China.展开更多
The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.In connection with the previous section,this fifth section of the report continues the dissec...The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.In connection with the previous section,this fifth section of the report continues the dissection on the manage-ment of cardiovascular diseases(CVD).Cerebrovascular disease is the leading cause of death and loss of healthy life among Chinese residents.Based on the results of GBD 2019,from 1990 to 2019,the years of life lost due to premature death caused by stroke showed a decreasing trend,while the years lived with disability still increased continuously.At present,national mortal-ity surveillance system can provide national and provincial representative annual death data on cerebrovascular disease,but the national representative data on some other important epidemiological indicators(such as incidence,prevalence,disability rate,and case fatality rate)are scarce in China.With the construction of large cohort population and extension of follow-up time,re-search on stroke-related risk factors is increasing,providing a basis for the prevention and control of risk factors.Due to limited large-scale population-based intervention studies,there is a lack of epidemiological evidence to transform into feasible interven-tion strategies and measures.In recent years,great progress in endovascular treatment for basilar-artery occlusion has been achieved in China,but there is still much room for improvement of guideline-based anticoagulant treatment and lipid-lowering treatment,as well as standardized diagnosis and treatment among patients with ischemic stroke.展开更多
The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China.In connection with the previous section,this eighth section of the report offers a comprehen...The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China.In connection with the previous section,this eighth section of the report offers a comprehensive analysis of pulmonary embolism and deep venous thrombosis.In recent years,research in the field of pulmonary vessel in China has made great progress.A number of nationwide multi-center registry research results have filled the gaps in the epidemiology,diagnosis and treatment of pulmonary hypertension and venous thromboembolism.Different types of pulmonary hypertension still need attention to the identification of risk factors and/or risk stratification,and venous thromboembolism needs attention in the prevention and the overall management inside and outside hospital.In the future,we look forward to the publication of more high-quality research in China,which could be able to improve relevant guidelines for pulmonary vascular diseases both domestically and inter-nationally.展开更多
The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.In connection with the previous section,this ninth section of the report offers a comprehensi...The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.In connection with the previous section,this ninth section of the report offers a comprehensive analysis of valvular heart disease and cardiomyopathy.Although rheumatic valve disease is still the main cause of valvular heart disease in China,with the aging of the population and the improvement of living standards,the prevalence of degenerative valvular heart disease is on the rise.Because many patients with valvular heart disease have only mild to moderate valve stenosis or insufficiency,and no symptoms,the detection rate in the population is low and late,resulting in many patients been in the severe late stage of disease at visit,increasing the difficulty of treatment and affecting effectiveness and prognosis.Therefore,we should strengthen the examination and screening of valvular heart disease in order to find and prevent it as early as possible.In addition,compared with other diseases,the treatment of valvular heart disease needs more and higher technical support(surgery,intervention,etc).However,not all hospitals can provide relevant technologies.At present,the treatment of valvular heart disease is still mainly concentrated in the provincial hospitals.It is necessary to carry out more professional training so that more doctors and hospitals can participate in the treatment of valvular heart disease.Cardiomyopathy is a group of myocardial diseases with abnormal myocardial structure and/or function,but couldn't be explained by hypertension,coronary atherosclerosis,valvular heart disease and congenital heart disease.It includes hypertrophic cardiomyopathy(HCM),dilated cardiomyopathy(DCM),arrhythmogenic cardiomyopathy(also known as arrhythmogenic right ventricular cardiomyopathy),restrictive cardiomyopathy(RCM)and undifferentiated cardiomyopathy.展开更多
In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient s...In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data.This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field.Currently,the SEER program covers approximately half of the total cancer patients in the US.A growing number of clinical studies have applied the SEER database in various aspects.However,the intrinsic features of the SEER database,such as the huge data volume and complexity of data types,have hindered its application.In this review,we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database.Therefore,the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.展开更多
The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascularhealth in China.In connection with the previous section,this sixth section of the report offers a comprehensiv...The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascularhealth in China.In connection with the previous section,this sixth section of the report offers a comprehensive analysis of heart failure(HF)in China.HF is one of the most important cardiovascular disease in the 21st century.Its mortality is equivalent to that of cancer.It is an important public health problem that seriously affects the health of Chinese residents.In recent years,with the deepeningof understanding,the change of treatment principles,the innovation of treatment methods and the update of treatment guidelines,the in-hospital mortality of HF patients has declined,and the long-term prognosis is also improving.However,there are stilldifferences in the management level of HF among different hospitals in China.How to improve the standardized diagnosis andtreatment level of HF in China remains an important challenge.展开更多
The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China. This is the fourth section of the report with a specific focus on epidemiology and current ...The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China. This is the fourth section of the report with a specific focus on epidemiology and current management of cardiovascular disease(CVD) in China. This section of the report highlights the epidemiological trends of CVD in China. It reveal a concerning rise in prevalence, with approximately 330 million affected individuals, including significant numbers with stroke, coronary artery disease(CAD), heart failure, and other conditions. CVD stands as the primary cause of mortality among both urban and rural populations, accounting for nearly half of all deaths in 2020. Mortality rates are notably higher in rural areas compared to urban centers since 2009. While age-standardized mortality rates have decreased, the absolute number of CVD deaths has increased, primarily due to population aging. Ischemic heart disease, hemorrhagic and ischemic strokes are the leading causes of CVD-related deaths. Notably, the burden of atherosclerotic cardiovascular disease has risen substantially, with atherosclerotic cardiovascular disease-related deaths increasing from 1990 to 2016. The incidence of ischemic stroke and ischemic heart disease has shown similar increasing trends over the past three decades. CAD mortality, particularly acute myocardial infarction, has been on the rise, with higher mortality rates observed in rural areas since 2016. The prevalence of CAD has increased significantly, with over 11 million patients identified in 2013. Studies assessing hospital performance in managing acute coronary syndrome reveal gaps in adherence to guideline-recommended strategies, with disparities in care quality across hospitals. However, initiatives like the China Patient-centered Evaluative Assessment of Cardiac Events(PEACE)-Retrospective AMI Study and the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS) project aim to improve patient outcomes through enhanced care protocols. Moreover, advancements in medical technology, such as quantitative flow ratio-guided lesion selection during percutaneous coronary intervention, show promise in improving clinical outcomes for patients undergoing intervention.展开更多
The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of car-diovascular health in China.In connection with the previous section,this 10th section of the report offers a comprehensi...The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of car-diovascular health in China.In connection with the previous section,this 10th section of the report offers a comprehensive analysis of aortic di-sease and peripheral artery disease.Aortic dissection is a critical disease,with a higher incidence in men than in women.The main risk factors include hypertension,gene mutations,and so on.Recent studies suggest that young patients with aortic dissection have a higher body mass index,and there is a significant correlation between low ambient temperature and sudden temperature drop and the onset of dissection.The main hazards are aortic rupture or poor branch perfusion,which is life threatening.According to the lesion location,it is divided into Stanford A type(involving the ascending aorta)and Stanford B type(not involving the ascen-ding aorta).The treatment of type A dissection is mainly open surgery,while the treatment of type B dissection is preferably endo-vascular treatment.In recent years,with the continuous development of endovascular technique,the treatment of aortic arch le-sions has transformed gradually from open to hybrid,and then to total endovascular treatment.The prevalence of abdominal aor-tic aneurysm is relatively low(<1%),and its risk factors mainly include smoking,hypertension,dyslipidemia,etc.The main haz-ard is the rupture of the aneurysm leading to death.Currently,treatment methods include endovascular repair and open surgery.According to data from Hospital Quality Monitoring System(HQMS),in the past five years,the number of open and endovascu-lar operations for aortic disease in China has shown an upward trend,which may be due to the popularization of diagnostic and th-erapeutic techniques and increased attention to aortic disease.The in-hospital mortality rates of thoracic endovascular aortic repa-ir,endovascular aortic repair,and Bentall operations are relatively low(all<2%).Due to the complexity and difficulty of the op-eration,the in-hospital mortality of total arch replacement is 5.9%-7.4%.Overall,the in-hospital mortality decreased while the number of surgeries increased.This section also elaborates on the five peripheral artery diseases(PADs):lower extremity artery disease(LEAD),carotid atherosclerotic disease,subclavian artery stenosis,mesenteric artery disease and renal artery stenosis,from the perspectives of epidemiology,risk factors,evaluation methods,diagnosis,and treatment.PAD is common among middle-aged and elderly people,and is significantly related to the risk factors of cardiovascular disease.Diagnosis and treatment methods are constantly being improved and updated.Besides traditional evaluation methods,artificial intelligence,molecular biology and other methods have been continuously developed,improving diagnostic sensitivity and specificity.Treatment meth-ods include risk factor control,medication,revascularization(percutaneous endovascular intervention and surgical treatment),and exercise etc.New treatment methods such as cell engineering and xenogeneic vascular graft have also shown promise in the treatment of LEAD.展开更多
美国SEER （surveillance epidemiology and end results） 2010年流行病学最新调查数据显示：老年急性髓系白血病（AML）在美国的发病中位年龄为67岁,且发病率随年龄的增长而递增.我国尚缺乏此类相关统计数据,但由于环境恶化和人口老...美国SEER （surveillance epidemiology and end results） 2010年流行病学最新调查数据显示：老年急性髓系白血病（AML）在美国的发病中位年龄为67岁,且发病率随年龄的增长而递增.我国尚缺乏此类相关统计数据,但由于环境恶化和人口老龄化日趋严重,估计我国老年AML的发病率将高于上述数值,且老年AML患者的完全缓解（CR）率不足50％～60％,3年总生存（OS）率低于10％.老年急性髓系白血病（AML）发病率高,目前治疗疗效不满意,传统化疗、姑息治疗、造血干细胞移植、新药应用等,在过去的20 a间均未取得大的进展.展开更多
In 2019, an outbreak of Mycoplasma pneumoniae(M. pneumoniae) occurred at a military academy in China. The attack rate(10.08%, 60/595) was significantly different among the units. High-intensity training and crowded en...In 2019, an outbreak of Mycoplasma pneumoniae(M. pneumoniae) occurred at a military academy in China. The attack rate(10.08%, 60/595) was significantly different among the units. High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M. pneumoniae. In-time prevention and control measures effectively controlled the spread of the epidemic.展开更多
Hepatitis B virus (HBV) infection has long been a critical public health challenge in China. National surveys revealed a prevalence of approximate 10% for chronic HBV infection in general population. HBV has been the ...Hepatitis B virus (HBV) infection has long been a critical public health challenge in China. National surveys revealed a prevalence of approximate 10% for chronic HBV infection in general population. HBV has been the leading cause of chronic hepatitis, cirrhosis, and liver cancers in Chinese population and a common pathogen of acute viral hepatitis. Meanwhile, the epidemic provided important opportunities to research the natural history, public health impact, and therapeutic and preventive interventions for HBV in China. In this review, we summarized the selected key epidemiological studies since 1970s regarding HBV infection and its associated liver diseases in China, and provided considerations for future research, prevention and treatment of HBV.展开更多
Bacterial vaginosis(BV) is a common vaginal disorder in women of reproductive age. Since the initial work of Leopoldo in 1953 and Gardner and Dukes in 1955, researchers have not been able to identify the causative eti...Bacterial vaginosis(BV) is a common vaginal disorder in women of reproductive age. Since the initial work of Leopoldo in 1953 and Gardner and Dukes in 1955, researchers have not been able to identify the causative etiologic agent of BV. There is increasing evidence, however, that BV occurs when Lactobacillus spp., the predominant species in healthy vaginal flora, are replaced by anaerobic bacteria, such as Gardenella vaginalis, Mobiluncus curtisii, M. mulieris, other anaerobic bacteria and/or Mycoplasma hominis. Worldwide, it estimated that 20%–30% of women of reproductive age attending sexually transmitted infection(STI) clinics suffer from BV, and that its prevalence can be as high as 50%–60% in high-risk populations(e.g., those who practice commercial sex work(CSW). Epidemiological data show that women are more likely to report BV if they: 1) have had a higher number of lifetime sexual partners; 2) are unmarried; 3) have engaged in their first intercourse at a younger age; 4) have engaged in CSW, and 5) practice regular douching. In the past decade, several studies have provided evidence on the contribution of sexual activity to BV. However, it is difficult to state that BV is a STI without being able to identify the etiologic agent. BV has also emerged as a public health problem due to its association with other STIs, including: human immunodeficiency virus(HIV), herpes simplex virus type 2(HSV-2), Chlamydia trachomatis(CT) and Neisseria gonorrhoeae(NG). The most recent evidence on the association between BV and CT/NG infection comes from two secondary analyses of cohort data conducted among women attending STI clinics. Based on these studies, women with BV had a 1.8 and 1.9-fold increased risk for NG and CT infection, respectively. Taken together, BV is likely a risk factor or at least an important contributor to subsequent NG or CT infection in high-risk women. Additional research is required to determine whether this association is also present in other low-risk sexually active populations, such as among women in the US military. It is essential to conduct large scale cross-sectional or population-based case-control studies to investigate the role of BV as a risk factor for CT/NG infections. These studies could lead to the development of interventions aimed at reducing the burden associated with bacterial STIs worldwide.展开更多
An upsurge of terrorist activity has occurred in the past two decades. As part of this, explosive devices continue to be extensively deployed against civilians in wide-ranging environments. Bombings remain the leading...An upsurge of terrorist activity has occurred in the past two decades. As part of this, explosive devices continue to be extensively deployed against civilians in wide-ranging environments. Bombings remain the leading worldwide cause of civilian fatalities due to terrorism. This demands an understanding of modern terrorist bombing trends to inform mitigation strategy. The objective of this study was to identify the occurrence and severity of bombings against civilian targets in diverse attack settings, and to establish corresponding blast injury profiles. Data was obtained from analysis of the Global Terrorism Database(GTD) and a meta-analysis of blast injury data derived from the PubMed database. Closed environment explosions were associated with significantly greater(p<0.05) mortality than in open spaces. The injury profiles were found to be influenced by attack setting, with higher rates of primary injury on trains and buses, and secondary injury in open space.展开更多
基金supported in part by grants from the Science and Technology Plan Project of Linhai(2023YW05)Medical Health Science and Technology Project of Zhejiang(2024KY555).
文摘BACKGROUND:The objective of this retrospective hospital-based study was to describe the epidemiological features of traumatic spinal cord injury(TSCI)in the intensive care unit(ICU)and assess the incidence and possible risk factors for venous thromboembolism(VTE)following TSCI.METHODS:We retrospectively reviewed the medical records of 370 patients with TSCI who were admitted between January 2018 and March 2023.The following parameters were collected:age,sex,body mass index,occupation,underlying diseases,smoking history,education level,etiology of injury,injury segments,American Spinal Injury Association(ASIA)Impairment Scale score,severity of injury,injury severity score(ISS),VTE risk score(Caprini score),treatment,VTE prophylaxis,ICU length of stay,length of hospital stay,concomitant injuries,and complications.Descriptive statistics were used to summarize the demographic and clinical characteristics of the study participants.Logistic regression analysis was used to determine the risk factors for VTE.RESULTS:The mean age of patients with TSCI was 55.5±13.4 years,with a male-to-female ratio of 6.5:1.The leading cause of TSCI was falls from height(46.5%),followed by traffic accidents(36.5%).The cervical spinal cord was the most affected segment,followed by the thoracolumbar region.Among all the patients,362(97.8%)had concomitant injuries.Complications were observed in 255 patients(68.9%)during hospitalization.The incidence rate of VTE was 25.1%.Logistic regression analysis revealed that age(OR=1.721,95%CI:1.207-2.454,P=0.003),mechanical ventilation(OR=3.427,95%CI:1.873-6.271,P<0.001),and non-use of chemical prophylaxis(OR=2.986,95%CI:1.749-5.099,P<0.001)were risk factors for VTE.CONCLUSION:Falls from height and traffic accidents were the main causes of TSCIs in the ICU,especially for male patients with cervical spinal cord injuries.VTE is a frequent complication in patients with TSCI in the ICU.Age,mechanical ventilation,and non-use of chemical prophylaxis were found to be independent risk factors for VTE following TSCI.
基金Supported by the Sci & Tech Development Foundation of Shaanxi province(2003K10G61)
文摘Objective:To expound geographical information system (GIS) technology is a very important tool when it was employed to assist to present the distribution by time and place and the model of transmission of infectious disease. Methods: We illustrated the assistant decision-making support function of GIS with an example of the spatial decision support system for SARS controlling in Shaanxi province of China which was developed by us. Results: The spatial decision support system established by applying GIS technology fulfilled the needs of real-time collection and management and dissemination SARS information and of surveillance and analysis the epidemic situation of SARS. Conclusion: Occurrence and epidemic of diseases, implement prevention and intervention measures and collocation hygienic resources are all with the characteristic of the variation of time and space, therefore, GIS technology has become a powerful tool for identifying risk factors of diseases, providing clues of causation of diseases , evaluating the effects of intervention measures and drawing a health management plan.
文摘Objective:To study the epidemiological features of pancreatic cystadenoma and cystadenocarcinoma in China during the last 10 years and to analyze the diagnosis and treatment.Methods:Reports on pancreatic cystadenoma and cystadenocarcinoma published from 2000 to 2009 were retrieved from various databases,such as WANFANG data,VIP web and China National Knowledge Infrastructure(CNKI).The epidemiological features of pancreatic cystadenoma and cystadenocarcinoma and its diagnosis and treatment were analyzed.Results:Totally 1 865 patients with pancreatic cystadenoma and cystadenocarcinoma were reported in China during the last 10 years.The male to female ratio was approximately 1:2.1.The accurate ages were reported in 1 536 cases,the average age of them was 50.8 years,whose average age from 40 to 60 years old accounted 75.9% of the patients.65.3% of the cases were located in East China and Central China.Abdominal pain was the main clinical manifestation and was found in 54.9% of the patients.Pancreatoduodenectomy and resection of body and tail of the pancreas were the main procedure for the treatment of pancreatic cystadenoma and cystadenocarcinoma.Conclusion:Pancreatic cystadenoma and cystadenocarcinoma were mainly found in older women in East and Central China.Preoperative diagnosis is difficult.Pancreatoduodenectomy and resection of pancreatic body and tail were the main procedure for the treatment of pancreatic cystadenoma and cystadenocarcinoma.
文摘Objective: To study epidemiological characteristics of the military training injuries (MTI) during parachuting training of the air force and sea training of the navy. Methods:The subjects of this study were 1382, including 971 navy soldiers (300 recruits and 671 soldiers) and 411 for force recruits. Navy: Each of injured soldiers was investigated by the trained battalion surgeon; Air force: When the parachuting training finished , two doctors in specific field screened and investigated them one by one. Results: The incidence of injury in for force recruits was 16.3% and in navy recruits was 18. 7%. The incidence of navy soldiers was 5.5%, which was significantly lower than that of navy recruits. There was a peak of incidence in the 2nd training month of navy recruits. The peak of incidence of navy soldiers was in 1st training month. The incidence of air force maintained at a high level except 2nd training month. The incidences of lower legs and ankles were higher than those of other sites in navy with percentage of 42.9% and 17.9% respectively. The incidences of ankles and lumbar region were higher than those of other sites in air force with percentage of 26.9% and 23.9% respectively. Incidence of acute traumatic injuries was highest during special course. Conclusion: The result showed the incidence of injury in sea and parachuting training varied. Different preventive measures should be adopted during special training.
基金This work was supported by the LIFE fi nancial instrument of the European Union in the framework of the MOTTLES project“Monitoring ozone injury for setting new critical levels”(LIFE15 ENV/IT/000183).
文摘The European MOTTLES project set-up a newgeneration network for ozone(O 3)monitoring in 17 plots in France,Italy and Romania.These monitoring stations allowed:(1)estimating the accumulated exposure AOT40 and stomatal O 3 fl uxes(PODY)with an hourly threshold of uptake(Y)to represent the detoxifi cation capacity of trees(POD1,with Y=1 nmol O 3 m^−2 s^−1 per leaf area);and(2)collecting data of forest-response indicators,i.e.crown defoliation and visible foliar O 3-like injury over the time period 2017–2019.The soil water content was the most important parameter aff ecting crown defoliation and was a key factor aff ecting the severity of visible foliar O 3-like injury on the dominant tree species in a plot.The soil water content is thus an essential parameter in the PODY estimation,particularly for water-limited environments.An assessment based on stomatal fl ux-based standard and on real plant symptoms is more appropriated than the exposure-based method for protecting vegetation.From fl ux-eff ect relationships,we derived fl ux-based critical levels(CLef)for forest protection against visible foliar O 3-like injury.We recommend CLef of 5 and 12 mmol m^−2 POD1 for broadleaved species and conifers,respectively.Before using PODY as legislative standard in Europe,we recommend using the CLec for≥25%of crown defoliation in a plot:17,000 and 19,000 nmol mol^−1 h AOT40 for conifers and broadleaved species,respectively.
基金supported by the National Major Public Health Service Projects(Z135080000022)。
文摘Since 2015,stroke has become the leading cause of death and disability in China,posing a significant threat to the health of its citizens as a major chronic non-communicable disease.According to the China Stroke High-risk Population Screening and Intervention Program,an estimated 17.8 million[95%confidence interval(CI)17.6–18.0million]adults in China had experienced a stroke in 2020,with 3.4 million(95%CI 3.3–3.5 million)experiencing their first-ever stroke and another 2.3 million(95%CI 2.2–2.4 million)dying as a result.Additionally,approximately 12.5%(95%CI 12.4%–12.5%)of stroke survivors were left disabled,as defined by a modified Rankin Scale score greater than 1,equating to 2.2 million(95%CI 2.1–2.2 million)stroke-related disabilities in 2020.As the population ages and the prevalence of risk factors like diabetes,hypertension,and hyperlipidemia continues to rise and remains poorly controlled,the burden of stroke in China is also increasing.A large national epidemiological survey initiated by the China Hypertension League in 2017 showed that the prevalence of hypertension was 24.7%;the awareness,treatment,and control rates in hypertensive patients were:60.1%,42.5%,and 25.4%,respectively.A nationally representative sample of the Chinese mainland population showed that the weighted prevalence of total diabetes diagnosed by the American Diabetes Association criteria was 12.8%,suggesting there are 120 million adults with diabetes in China,and the awareness,treatment,and control rates in diabetic patients were:43.3%,49.0%,and 49.4%,respectively.The“Sixth National Health Service Statistical Survey Report in 2018”showed that the proportion of the obese population in China was 37.4%,an increase of 7.2 points from 2013.Data from 1599 hospitals in the Hospital Quality Monitoring System and Bigdata Observatory Platform for Stroke of China(BOSC)showed that a total of 3,418,432 stroke cases[mean age±standard error(SE)was(65.700±0.006)years,and 59.1%were male]were admitted during 2020.Of those,over 80.0%(81.9%)were ischemic stroke(IS),14.9%were intracerebral hemorrhage(ICH)strokes,and 3.1%were subarachnoid hemorrhage(SAH)strokes.The mean±SE of hospitalization expenditures was Chinese Yuan(CNY)(16,975.6±16.3),ranging from(13,310.1±12.8)in IS to(81,369.8±260.7)in SAH,and out-of-pocket expenses were(5788.9±8.6),ranging from(4449.0±6.6)in IS to(30,778.2±156.8)in SAH.It was estimated that the medical cost of hospitalization for stroke in 2020 was CNY 58.0 billion,of which the patient pays approximately CNY 19.8 billion.In-hospital death/discharge against medical advice rate was 9.2%(95%CI 9.2%–9.2%),ranging from 6.4%(95%CI 6.4%–6.5%)for IS to 21.8%(95%CI 21.8%–21.9%)for ICH.From 2019 to 2020,the information about 188,648 patients with acute IS receiving intravenous thrombolytic therapy(IVT),49,845 patients receiving mechanical thrombectomy(MT),and 14,087 patients receiving bridging(IVT+MT)were collected through BOSC.The incidence of intracranial hemorrhage during treatment was 3.2%(95%CI 3.2%–3.3%),7.7%(95%CI 7.5%–8.0%),and 12.9%(95%CI 12.3%–13.4%),respectively.And in-hospital death/discharge against medical advice rate was 8.9%(95%CI 8.8%–9.0%),16.5%(95%CI 16.2%–16.9%),and 16.8%(95%CI 16.2%–17.4%),respectively.A prospective nationwide hospital-based study was conducted at 231 stroke base hospitals(Level III)from 31 provinces in China through BOSC from January 2019to December 2020 and 136,282 stroke patients were included and finished 12-month follow-up.Of those,over 86.9%were IS,10.8%were ICH strokes,and 2.3%were SAH strokes.The disability rate[%(95%CI)]in survivors of stroke at 3-month and 12-month was 14.8%(95%CI 14.6%–15.0%)and 14.0%(95%CI 13.8%–14.2%),respectively.The mortality rate[%(95%CI)]of stroke at 3-month and 12-month was 4.2%(95%CI 4.1%–4.3%)and 8.5%(95%CI 8.4%–8.6%),respectively.The recurrence rate[%(95%CI)]of stroke at 3-month and 12-month was 3.6%(95%CI 3.5%–3.7%)and 5.6%(95%CI 5.4%–5.7%),respectively.The Healthy China 2030 Stroke Action Plan was launched as part of this review,and the above data provide valuable guidelines for future stroke prevention and treatment efforts in China.
文摘The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.In connection with the previous section,this fifth section of the report continues the dissection on the manage-ment of cardiovascular diseases(CVD).Cerebrovascular disease is the leading cause of death and loss of healthy life among Chinese residents.Based on the results of GBD 2019,from 1990 to 2019,the years of life lost due to premature death caused by stroke showed a decreasing trend,while the years lived with disability still increased continuously.At present,national mortal-ity surveillance system can provide national and provincial representative annual death data on cerebrovascular disease,but the national representative data on some other important epidemiological indicators(such as incidence,prevalence,disability rate,and case fatality rate)are scarce in China.With the construction of large cohort population and extension of follow-up time,re-search on stroke-related risk factors is increasing,providing a basis for the prevention and control of risk factors.Due to limited large-scale population-based intervention studies,there is a lack of epidemiological evidence to transform into feasible interven-tion strategies and measures.In recent years,great progress in endovascular treatment for basilar-artery occlusion has been achieved in China,but there is still much room for improvement of guideline-based anticoagulant treatment and lipid-lowering treatment,as well as standardized diagnosis and treatment among patients with ischemic stroke.
文摘The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China.In connection with the previous section,this eighth section of the report offers a comprehensive analysis of pulmonary embolism and deep venous thrombosis.In recent years,research in the field of pulmonary vessel in China has made great progress.A number of nationwide multi-center registry research results have filled the gaps in the epidemiology,diagnosis and treatment of pulmonary hypertension and venous thromboembolism.Different types of pulmonary hypertension still need attention to the identification of risk factors and/or risk stratification,and venous thromboembolism needs attention in the prevention and the overall management inside and outside hospital.In the future,we look forward to the publication of more high-quality research in China,which could be able to improve relevant guidelines for pulmonary vascular diseases both domestically and inter-nationally.
文摘The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.In connection with the previous section,this ninth section of the report offers a comprehensive analysis of valvular heart disease and cardiomyopathy.Although rheumatic valve disease is still the main cause of valvular heart disease in China,with the aging of the population and the improvement of living standards,the prevalence of degenerative valvular heart disease is on the rise.Because many patients with valvular heart disease have only mild to moderate valve stenosis or insufficiency,and no symptoms,the detection rate in the population is low and late,resulting in many patients been in the severe late stage of disease at visit,increasing the difficulty of treatment and affecting effectiveness and prognosis.Therefore,we should strengthen the examination and screening of valvular heart disease in order to find and prevent it as early as possible.In addition,compared with other diseases,the treatment of valvular heart disease needs more and higher technical support(surgery,intervention,etc).However,not all hospitals can provide relevant technologies.At present,the treatment of valvular heart disease is still mainly concentrated in the provincial hospitals.It is necessary to carry out more professional training so that more doctors and hospitals can participate in the treatment of valvular heart disease.Cardiomyopathy is a group of myocardial diseases with abnormal myocardial structure and/or function,but couldn't be explained by hypertension,coronary atherosclerosis,valvular heart disease and congenital heart disease.It includes hypertrophic cardiomyopathy(HCM),dilated cardiomyopathy(DCM),arrhythmogenic cardiomyopathy(also known as arrhythmogenic right ventricular cardiomyopathy),restrictive cardiomyopathy(RCM)and undifferentiated cardiomyopathy.
基金Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization(2021B1212040007)Clinical Frontier Technology Program of the First Affiliated Hospital of Jinan University,China(JNU1AF-CFTP-2022-a01235)Science and Technology Projects in Guangzhou,China(202201020054,2023A03J1032).
文摘In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data.This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field.Currently,the SEER program covers approximately half of the total cancer patients in the US.A growing number of clinical studies have applied the SEER database in various aspects.However,the intrinsic features of the SEER database,such as the huge data volume and complexity of data types,have hindered its application.In this review,we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database.Therefore,the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.
文摘The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascularhealth in China.In connection with the previous section,this sixth section of the report offers a comprehensive analysis of heart failure(HF)in China.HF is one of the most important cardiovascular disease in the 21st century.Its mortality is equivalent to that of cancer.It is an important public health problem that seriously affects the health of Chinese residents.In recent years,with the deepeningof understanding,the change of treatment principles,the innovation of treatment methods and the update of treatment guidelines,the in-hospital mortality of HF patients has declined,and the long-term prognosis is also improving.However,there are stilldifferences in the management level of HF among different hospitals in China.How to improve the standardized diagnosis andtreatment level of HF in China remains an important challenge.
文摘The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China. This is the fourth section of the report with a specific focus on epidemiology and current management of cardiovascular disease(CVD) in China. This section of the report highlights the epidemiological trends of CVD in China. It reveal a concerning rise in prevalence, with approximately 330 million affected individuals, including significant numbers with stroke, coronary artery disease(CAD), heart failure, and other conditions. CVD stands as the primary cause of mortality among both urban and rural populations, accounting for nearly half of all deaths in 2020. Mortality rates are notably higher in rural areas compared to urban centers since 2009. While age-standardized mortality rates have decreased, the absolute number of CVD deaths has increased, primarily due to population aging. Ischemic heart disease, hemorrhagic and ischemic strokes are the leading causes of CVD-related deaths. Notably, the burden of atherosclerotic cardiovascular disease has risen substantially, with atherosclerotic cardiovascular disease-related deaths increasing from 1990 to 2016. The incidence of ischemic stroke and ischemic heart disease has shown similar increasing trends over the past three decades. CAD mortality, particularly acute myocardial infarction, has been on the rise, with higher mortality rates observed in rural areas since 2016. The prevalence of CAD has increased significantly, with over 11 million patients identified in 2013. Studies assessing hospital performance in managing acute coronary syndrome reveal gaps in adherence to guideline-recommended strategies, with disparities in care quality across hospitals. However, initiatives like the China Patient-centered Evaluative Assessment of Cardiac Events(PEACE)-Retrospective AMI Study and the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS) project aim to improve patient outcomes through enhanced care protocols. Moreover, advancements in medical technology, such as quantitative flow ratio-guided lesion selection during percutaneous coronary intervention, show promise in improving clinical outcomes for patients undergoing intervention.
文摘The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of car-diovascular health in China.In connection with the previous section,this 10th section of the report offers a comprehensive analysis of aortic di-sease and peripheral artery disease.Aortic dissection is a critical disease,with a higher incidence in men than in women.The main risk factors include hypertension,gene mutations,and so on.Recent studies suggest that young patients with aortic dissection have a higher body mass index,and there is a significant correlation between low ambient temperature and sudden temperature drop and the onset of dissection.The main hazards are aortic rupture or poor branch perfusion,which is life threatening.According to the lesion location,it is divided into Stanford A type(involving the ascending aorta)and Stanford B type(not involving the ascen-ding aorta).The treatment of type A dissection is mainly open surgery,while the treatment of type B dissection is preferably endo-vascular treatment.In recent years,with the continuous development of endovascular technique,the treatment of aortic arch le-sions has transformed gradually from open to hybrid,and then to total endovascular treatment.The prevalence of abdominal aor-tic aneurysm is relatively low(<1%),and its risk factors mainly include smoking,hypertension,dyslipidemia,etc.The main haz-ard is the rupture of the aneurysm leading to death.Currently,treatment methods include endovascular repair and open surgery.According to data from Hospital Quality Monitoring System(HQMS),in the past five years,the number of open and endovascu-lar operations for aortic disease in China has shown an upward trend,which may be due to the popularization of diagnostic and th-erapeutic techniques and increased attention to aortic disease.The in-hospital mortality rates of thoracic endovascular aortic repa-ir,endovascular aortic repair,and Bentall operations are relatively low(all<2%).Due to the complexity and difficulty of the op-eration,the in-hospital mortality of total arch replacement is 5.9%-7.4%.Overall,the in-hospital mortality decreased while the number of surgeries increased.This section also elaborates on the five peripheral artery diseases(PADs):lower extremity artery disease(LEAD),carotid atherosclerotic disease,subclavian artery stenosis,mesenteric artery disease and renal artery stenosis,from the perspectives of epidemiology,risk factors,evaluation methods,diagnosis,and treatment.PAD is common among middle-aged and elderly people,and is significantly related to the risk factors of cardiovascular disease.Diagnosis and treatment methods are constantly being improved and updated.Besides traditional evaluation methods,artificial intelligence,molecular biology and other methods have been continuously developed,improving diagnostic sensitivity and specificity.Treatment meth-ods include risk factor control,medication,revascularization(percutaneous endovascular intervention and surgical treatment),and exercise etc.New treatment methods such as cell engineering and xenogeneic vascular graft have also shown promise in the treatment of LEAD.
文摘美国SEER （surveillance epidemiology and end results） 2010年流行病学最新调查数据显示：老年急性髓系白血病（AML）在美国的发病中位年龄为67岁,且发病率随年龄的增长而递增.我国尚缺乏此类相关统计数据,但由于环境恶化和人口老龄化日趋严重,估计我国老年AML的发病率将高于上述数值,且老年AML患者的完全缓解（CR）率不足50％～60％,3年总生存（OS）率低于10％.老年急性髓系白血病（AML）发病率高,目前治疗疗效不满意,传统化疗、姑息治疗、造血干细胞移植、新药应用等,在过去的20 a间均未取得大的进展.
基金supported by the military medical innovation research project of PLAGH (CX19015)program for military medical innovation (18CXZ038)。
文摘In 2019, an outbreak of Mycoplasma pneumoniae(M. pneumoniae) occurred at a military academy in China. The attack rate(10.08%, 60/595) was significantly different among the units. High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M. pneumoniae. In-time prevention and control measures effectively controlled the spread of the epidemic.
文摘Hepatitis B virus (HBV) infection has long been a critical public health challenge in China. National surveys revealed a prevalence of approximate 10% for chronic HBV infection in general population. HBV has been the leading cause of chronic hepatitis, cirrhosis, and liver cancers in Chinese population and a common pathogen of acute viral hepatitis. Meanwhile, the epidemic provided important opportunities to research the natural history, public health impact, and therapeutic and preventive interventions for HBV in China. In this review, we summarized the selected key epidemiological studies since 1970s regarding HBV infection and its associated liver diseases in China, and provided considerations for future research, prevention and treatment of HBV.
基金funded by the US Armed Forces Health Surveillance Center and its Division of Global Emerging Infectious Surveillance and Response(AFHSC-GEIS)
文摘Bacterial vaginosis(BV) is a common vaginal disorder in women of reproductive age. Since the initial work of Leopoldo in 1953 and Gardner and Dukes in 1955, researchers have not been able to identify the causative etiologic agent of BV. There is increasing evidence, however, that BV occurs when Lactobacillus spp., the predominant species in healthy vaginal flora, are replaced by anaerobic bacteria, such as Gardenella vaginalis, Mobiluncus curtisii, M. mulieris, other anaerobic bacteria and/or Mycoplasma hominis. Worldwide, it estimated that 20%–30% of women of reproductive age attending sexually transmitted infection(STI) clinics suffer from BV, and that its prevalence can be as high as 50%–60% in high-risk populations(e.g., those who practice commercial sex work(CSW). Epidemiological data show that women are more likely to report BV if they: 1) have had a higher number of lifetime sexual partners; 2) are unmarried; 3) have engaged in their first intercourse at a younger age; 4) have engaged in CSW, and 5) practice regular douching. In the past decade, several studies have provided evidence on the contribution of sexual activity to BV. However, it is difficult to state that BV is a STI without being able to identify the etiologic agent. BV has also emerged as a public health problem due to its association with other STIs, including: human immunodeficiency virus(HIV), herpes simplex virus type 2(HSV-2), Chlamydia trachomatis(CT) and Neisseria gonorrhoeae(NG). The most recent evidence on the association between BV and CT/NG infection comes from two secondary analyses of cohort data conducted among women attending STI clinics. Based on these studies, women with BV had a 1.8 and 1.9-fold increased risk for NG and CT infection, respectively. Taken together, BV is likely a risk factor or at least an important contributor to subsequent NG or CT infection in high-risk women. Additional research is required to determine whether this association is also present in other low-risk sexually active populations, such as among women in the US military. It is essential to conduct large scale cross-sectional or population-based case-control studies to investigate the role of BV as a risk factor for CT/NG infections. These studies could lead to the development of interventions aimed at reducing the burden associated with bacterial STIs worldwide.
基金support of the Institute for Security Science and TechnologyThe Royal British Legion Centre for Blast Injury Studies at Imperial College LondonThe Institute of Shock Physics also acknowledges the support of Imperial College London
文摘An upsurge of terrorist activity has occurred in the past two decades. As part of this, explosive devices continue to be extensively deployed against civilians in wide-ranging environments. Bombings remain the leading worldwide cause of civilian fatalities due to terrorism. This demands an understanding of modern terrorist bombing trends to inform mitigation strategy. The objective of this study was to identify the occurrence and severity of bombings against civilian targets in diverse attack settings, and to establish corresponding blast injury profiles. Data was obtained from analysis of the Global Terrorism Database(GTD) and a meta-analysis of blast injury data derived from the PubMed database. Closed environment explosions were associated with significantly greater(p<0.05) mortality than in open spaces. The injury profiles were found to be influenced by attack setting, with higher rates of primary injury on trains and buses, and secondary injury in open space.
