ABSTRACT
The implementation of the "Healthy China" policy is inseparable from public health. The improvement of the national health level, the control of health risk factors and the improvement of health service ability and other aspects need to rely on the talent training and discipline construction of public health and preventive medicine in medical colleges, which highlights that the public health discipline construction and development of our country has a certain lag and limitations: unprofessional public health academic team and disciplines; separation of teaching research and practice in public health; lack of public health expertise and insufficient personnel scale; health emergency and legal system that do not match economic development, etc. Therefore, in order to promote the construction of healthy China, we should promote the integration of public health disciplines, strengthen the teaching and practice of health emergency response, improve the health emergency response and dynamic monitoring system focusing on prevention so that we can make public health disciplines both scientific and contemporary.
ABSTRACT
Objective:To understand the characteristics of brucellosis in key population in rural areas of Hulunbuir City, Inner Mongolia Autonomous Region, and clarify the influencing factors of brucellosis infection, such as knowledge, belief and behavior, so as to provide scientific basis for the formulation of brucellosis prevention strategies and measures.Methods:A case-control study was used to study the confirmed cases of brucellosis among the key population of brucellosis in Hulunbuir rural areas in 2018. The patients without brucellosis were selected as control group. A questionnaire survey was used to investigated brucellosis related knowledge. The health-related behaviors (including raising livestock, cleaning houses, wells shared by human and livestock, immunizing livestock) were analyzed by single factor variation analysis and logistic regression analysis.Results:This study investigated 892 cases of population, 881 people responded effectively to the questionnaire, including 445 males, accounting for 50.51%, 436 females, accounting for 49.49%; the age range of 5-83 years old, the average age of (51.34 ± 11.87) years old; 153 cases of brucellosis antibody positive. The infection rate of brucellosis in this area was 17.37%, in which the male infection rate was 22.47%(100/445), and the female infection rate was 12.16% (53/436). There was a significant difference between male and female(χ 2=16.331, P < 0.05). Logistic regression analysis showed that raising cattle, cleaning houses, wells shared by human and livestock, using manure from cattle and sheep to fertilize, immunizing livestock were risk factors of brucellosis infection ( OR=1.905, 1.568, 1.320, 1.428, 1.488, P < 0.05). Conclusions:The incidence rate of brucellosis in Hulunbuir is higher than that in females. Close contact with infectious livestock and their excreta is a risk factor for brucellosis infection. According to the results of this survey. It is necessary to strengthen health education and behavior intervention of key population in order to effectively prevent and control brucellosis.
ABSTRACT
Objective To investigate significance in changes in level of platelet monocyte aggregates (PMA) associated with acute respiratory distress syndrome (ARDS) in patients with sepsis and discuss the role of PMA in the genesis of ARDS in order to evaluate the its diagnostic value and the significance in the severity of damage of lung in patients with sepsis. Methods This study was carried out in the Guizhou Provincial People's Hospital and 123 sepsis patients admitted from July 2014 to December 2015 were enrolled according the 2012 ARDS Berlin diagnostic criteria. The patients were divided into ARDS group (n=62) and non-ARDS group (n=61). The ARDS group were further divided into 3 subgroups according to Berlin criteria, namely mild group (n=22), moderate group (n=21), and severe group (n=19). Of all patients, blood samples were collected to determine the level of PMA using fl ow cytometry (FCM) and the level of IL-6 using enzyme linked immunosorbent assay (ELISA) method. Acute physiology and chronic health status (APACHEⅡ)score in each group were recorded at admission. Comparisons of PMA, IL-6 and APACHE Ⅱ score were carried out among groups. Receiver operating characteristic (ROC) curve were used to evaluate the signifi cance and value of PMA in predicting ARDS. Results Compared with non-ARDS group, APACHE Ⅱ score, IL-6 level, PMA level in ARDS group were signifi cantly higher with statistically signifi cant differences (P<0.01). When the severity of ARDS increased, the level of each biomarker increased with statistically significant differences (P<0.01). Correlation analysis showed that peripheral blood PMA positively correlated with IL-6 (r=0.791, P<0.01) and APACHE Ⅱ score (r=0.641, P<0.01), while it negatively correlated with PaO2/FiO2(r=-0.857, P<0.01).Area under the ROC curve of PMA was 0.833 for predicting ARDS, and when the optimal cutoff value was 8.8%, the specifi city was 82%, and sensitivity was 71%, which were higher than those of APACHE Ⅱ score and IL-6. Conclusions The increase of PMA in patients with sepsis is closely associated with the severity of ARDS. The PMA has correlation with IL-6 and APACHE II, and it is superior to IL-6 and APACH II score for predicting ARDS. PMA can be used as an adjuvant indicator to judge the sepsis severity and to predict the occurrence of ARDS.