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1.
Fudan University Journal of Medical Sciences ; (6): 596-601, 2017.
Article in Chinese | WPRIM | ID: wpr-662170

ABSTRACT

Objective To explore herpes simplex virus type 2 (HSV-2) infection and associated factors among people participating premarital physical examination in 2013-2014 in Minhang District of Shanghai.Methods During 2013 to 2014,people participating premarital physical examination in Minhang District were interviewed with questionnaire regarding HIV/AIDS related Knowledge,sexual behaviors,etc.Blood samples were collected to detect HIV,HSV-2 and syphilis.Results A total of 2 116 participants were investigated,among which 92 were infected with HSV-2,with a prevalence rate of 4.35%.The HSV-2 infection rates were 3.69% and 5.01% for male and female,respectively.Multivariate logistic regression analysis showed that for the males,education level of high school and below (OR=2.47,95%CI:1.195-5.108),fiancee infected with HSV-2 (OR=9.29,95%CI:4.279-20.164) were more susceptible to HSV-2.For the females,aged above 25 years (OR=9.29,95%CI:4.279-20.164),census register of other cities in China (OR =2.19,95%CI:1.091-4.378),education level of high school and below (OR =3.37,95%CI:1.721-6.596),never used condoms (OR =3.45,95%CI:1.265-9.392),fiance infected with HSV-2 (OR =8.46,95%CI:3.700-19.351) were more susceptible to HSV-2.Conclusions The prevalence of HSV-2 among premarital population is relatively low in Minhang District.However,low condom use rate leads to an increase in the risk of HSV-2 infection when either partner infected with HSV-2,suggesting increasing condom use between affianced couples.

2.
Fudan University Journal of Medical Sciences ; (6): 612-616, 2017.
Article in Chinese | WPRIM | ID: wpr-662167

ABSTRACT

Objective To analyze the epidemiological characteristics of aggregation outbreaks of pulmonary tuberculosis (TB) in a private middle school in Minhang District of Shanghai.Methods Symptom and radiographic screening were performed on the students of Grade 3 in this senior high school.Epidemiological survey,sputum smear,culture and molecular epidemiological examination were conducted on suspected patients.Whole genome sequencing was completed on positive strains.Results In the screening of 49 close contacts with one TB patient (index case) in the school,a total of 10 patients with pulmonary TB were diagnosed,of which 3 cases were positive for culture.Another case was diagnosed and positive for culture after expanding the scope of screening.The genotype of the isolated strains from index case and the 4 patients positive for culture was identical to that of the first case of the classoneyear before,suggesting the transmission within the grade of Senior Three.Conclusions This is an aggregation outbreak that may be attributable to the first patient with positive bacteria.Therefore,timely diagnosis and effective treatment of pulmonary TB patients,as well as timely screening of close contacts with pulmonary TB patients are significant to control potential outbreaks in schools.

3.
Fudan University Journal of Medical Sciences ; (6): 668-673, 2017.
Article in Chinese | WPRIM | ID: wpr-662152

ABSTRACT

Objective To investigte the direct medical expense for diagnosis and treatment of pulmonary tuberculosis (TB) patients and its financial burden on family in Minhang District,Shanghai,and to provide evidence for improving TB derating policy and reducing the economic burden.Methods A total of 347 pulmonary TB patients who had completed treatment were investigated by questionnaire.Their receipts on diagnosis and treatment of TB were collected.Ranksum test,linear regression and x2 test were used to analyze medical expenses,influencing factors and social economic burden.Results The median of TB patients' direct medical expenses was 5 657 yuan/person.Linear regression showed that direct medical expenses were related with census,main medical institutions and complications.The main medical institutions have a greater impact on direct medical expenses (β'=-0.217).In the patients,7.5 % had high medical expenditures after the deduction of medical reimbursement and derating.And they were mainly distributed among low-income people.Conclusions The diagnosis and treatment expenses of TB patients were relatively high,which resulted in a heavier financial burden to the patient's family.The elderly tuberculosis patients,patients with complications and poor groups should become the focus of medical reimbursement and derating policy.

4.
Fudan University Journal of Medical Sciences ; (6): 680-684,692, 2017.
Article in Chinese | WPRIM | ID: wpr-662146

ABSTRACT

Objective To investigate the effect of the third party evaluation on improving the quality of medical service as well as the degree of patient trust in hospital.Methods Discharge patients from a two-level hospital in Minhang District was enrolled to evaluate their trust for medical service.Telephone follow-up were implemented in group A by the third party evaluation team.Group B was evaluated by the in-patient department when they left the hospital.These two evaluation methods were compared for the effects.Results During the first evaluation,1 073 people in group A,the equipartition satisfaction was 3.83 ± 0.57,the satisfaction rate was 54.99%.While in group B of 1 480 people,the equalization satisfaction was 3.83 ± 0.49,the satisfaction rate was 57.03% (P>0.05).At the fourth evaluation,1 233 people in group A and 1 512 people in group B were evaluated.Regarding group A,the patient satisfaction scores was 4.18 ± 0.33,patients satisfaction rate was 84.43%,the equipartition of patients referral was 3.44 ± 0.83,the equipartition of patients recommends the physician was 3.52 ±0.88,the equipartition of the doctor and patient had a quarrel was 4.33 ± 0.60,the equipartition of patients will find another doctor for diagnosis was 3.31 ± 0.72,the equipartition of patients expressed fully in accordance with the doctor's order of medication was 3.45 ± 0.72,group A were better than groupB (P<0.05).Of the28 entries in the level of trust related to medical services,15 entries of group A were higher than group B (P<0.05).In group A,the equipartition of moderate intensity activity was 3.62 ± 0.81,the equipartition of emotional coordination refers to 3.71 ± 0.76,the equipartition of family coordination was 3.69 ± 0.58,the equipartition of friends coordination was 3.73 ± 0.74,the equipartition of overall health was 3.31 ± 0.77,all were superior to group B (P<0.05).Conclusions The third party evaluation is a supplementation for hospital management,which has positive effects on improving medical service quality of medical institutions,the hospital performance appraisal system,patients' experiences and trust degree.

5.
Fudan University Journal of Medical Sciences ; (6): 585-589, 2017.
Article in Chinese | WPRIM | ID: wpr-662078

ABSTRACT

Objective To understand the trends and epidemiological characteristics of syphilis in Minhang District of Shanghai,so as to provide scientific basis for making control strategies.Methods The data of reported cases of syphilis in Minhang District from 2005 to 2016 were analyzed with epidemiological methods.Results Overall 11 394 cases of syphilis were reported from 2005 to 2016,the incidence was 42.9 per 100 000 person-year.The incidences of Phase Ⅰ,Phase Ⅱ,Phase Ⅲ,genital and latent syphilis were 10.3,13.4,0.3,2.3 and 16.6 per 100 000 person-year,respectively.In 2009,the incidence reached 59.1 per 100 000 person-year and reach peak.The cases were constituted by local residents (62.4%) and residents from other provinces (37.6%),male patients predominated with male/female ratio of 1.1∶1.Most cases were aged from 25 to 54 years old(61.1 %),and those people older than 54 years were more and more likely to be found infected.Local residents predominated by those who aged 25-64 years (74.2%) and other province predominated by 15-44 years (79.1%),the ratios of male/female were 1.3 ∶ 1 and 0.8 ∶ 1.Female were much younger than male,there were 50.0% of female and 29.3% of male who were aged between 15-34 years old.Latent syphilis was mostly reported in local male residents who were older than 55 years,female who were 25-54 years and other provinces' female aged 15-44.Phase Ⅰ and Ⅱ syphilis were mostly reported in local male residents less than 55 years old and other provinces' male less than 65 years old.There were significant difference between residence,sex,age and different kinds of syphilis with P<0.001.Conclusions The trends of syphilis incidence was increasing before 2009 in Minhang District and then declining and slowing down in recent years.The measure of reinforcing monitor,propaganda and education,active screening syphilis in female and local old man should be taken to control and prevent the spread of syphilis.

6.
Fudan University Journal of Medical Sciences ; (6): 590-595, 2017.
Article in Chinese | WPRIM | ID: wpr-662077

ABSTRACT

Objective To investigate the quality of life (QOL) and mental health status of patients with HIV/AIDS in Minhang District of Shanghai,and to explore the factors that affect their quality of life.Methods A cross-sectional study was conducted in Minhang District among HIV/AIDS patients.All subjects finished general situation questionnaire,Beck depression inventory (BDI),self rating anxiety scale (SAS),social support scale (SSS) and generic quality of life inventory-74 (GQOLI-74) survey.Results A total of 294 patients were recruited in this study with mean age of (39.6 ± 12.6) years old.Among the subjects,mean score of SAS was 40.5 ± 8.8,higher than national normative score (t =20.8,P<0.001).The prevalence of anxiety was 13.9%.The mean score of BDI was 8.90 ± 8.59,and the prevalence of depression was 28.6%.The mean score of quality of life (QOL) was 66.6 ± 10.9.Multivariate logistic regression analysis showed that QOL of patients with high school or secondary school was lower than those with college and above education (OR =0.34,95 % CI:0.12-0.95).QOL scores of patients with moderate or severe depression were lower than those with less depressed patients,OR values were 0.14(95 % CI:0.06-0.34) and 0.07(95 CI:0.03-0.20)respectively.QOL of patients with anxiety was lower than the patients without anxiety (OR =0.10,95 %CI:0.04-0.27).QOL of patients with high scores of social support was higher than the patients with low scores of social support (OR =3.95,95 % CI:1.82-8.59).Conclusions We should pay more attention to the psychological state of patients with HIV/AIDS.The quality of life can be improved by improving social support and reducing the occurrence of anxiety and depression.

7.
Fudan University Journal of Medical Sciences ; (6): 596-601, 2017.
Article in Chinese | WPRIM | ID: wpr-659515

ABSTRACT

Objective To explore herpes simplex virus type 2 (HSV-2) infection and associated factors among people participating premarital physical examination in 2013-2014 in Minhang District of Shanghai.Methods During 2013 to 2014,people participating premarital physical examination in Minhang District were interviewed with questionnaire regarding HIV/AIDS related Knowledge,sexual behaviors,etc.Blood samples were collected to detect HIV,HSV-2 and syphilis.Results A total of 2 116 participants were investigated,among which 92 were infected with HSV-2,with a prevalence rate of 4.35%.The HSV-2 infection rates were 3.69% and 5.01% for male and female,respectively.Multivariate logistic regression analysis showed that for the males,education level of high school and below (OR=2.47,95%CI:1.195-5.108),fiancee infected with HSV-2 (OR=9.29,95%CI:4.279-20.164) were more susceptible to HSV-2.For the females,aged above 25 years (OR=9.29,95%CI:4.279-20.164),census register of other cities in China (OR =2.19,95%CI:1.091-4.378),education level of high school and below (OR =3.37,95%CI:1.721-6.596),never used condoms (OR =3.45,95%CI:1.265-9.392),fiance infected with HSV-2 (OR =8.46,95%CI:3.700-19.351) were more susceptible to HSV-2.Conclusions The prevalence of HSV-2 among premarital population is relatively low in Minhang District.However,low condom use rate leads to an increase in the risk of HSV-2 infection when either partner infected with HSV-2,suggesting increasing condom use between affianced couples.

8.
Fudan University Journal of Medical Sciences ; (6): 612-616, 2017.
Article in Chinese | WPRIM | ID: wpr-659509

ABSTRACT

Objective To analyze the epidemiological characteristics of aggregation outbreaks of pulmonary tuberculosis (TB) in a private middle school in Minhang District of Shanghai.Methods Symptom and radiographic screening were performed on the students of Grade 3 in this senior high school.Epidemiological survey,sputum smear,culture and molecular epidemiological examination were conducted on suspected patients.Whole genome sequencing was completed on positive strains.Results In the screening of 49 close contacts with one TB patient (index case) in the school,a total of 10 patients with pulmonary TB were diagnosed,of which 3 cases were positive for culture.Another case was diagnosed and positive for culture after expanding the scope of screening.The genotype of the isolated strains from index case and the 4 patients positive for culture was identical to that of the first case of the classoneyear before,suggesting the transmission within the grade of Senior Three.Conclusions This is an aggregation outbreak that may be attributable to the first patient with positive bacteria.Therefore,timely diagnosis and effective treatment of pulmonary TB patients,as well as timely screening of close contacts with pulmonary TB patients are significant to control potential outbreaks in schools.

9.
Fudan University Journal of Medical Sciences ; (6): 668-673, 2017.
Article in Chinese | WPRIM | ID: wpr-659486

ABSTRACT

Objective To investigte the direct medical expense for diagnosis and treatment of pulmonary tuberculosis (TB) patients and its financial burden on family in Minhang District,Shanghai,and to provide evidence for improving TB derating policy and reducing the economic burden.Methods A total of 347 pulmonary TB patients who had completed treatment were investigated by questionnaire.Their receipts on diagnosis and treatment of TB were collected.Ranksum test,linear regression and x2 test were used to analyze medical expenses,influencing factors and social economic burden.Results The median of TB patients' direct medical expenses was 5 657 yuan/person.Linear regression showed that direct medical expenses were related with census,main medical institutions and complications.The main medical institutions have a greater impact on direct medical expenses (β'=-0.217).In the patients,7.5 % had high medical expenditures after the deduction of medical reimbursement and derating.And they were mainly distributed among low-income people.Conclusions The diagnosis and treatment expenses of TB patients were relatively high,which resulted in a heavier financial burden to the patient's family.The elderly tuberculosis patients,patients with complications and poor groups should become the focus of medical reimbursement and derating policy.

10.
Fudan University Journal of Medical Sciences ; (6): 680-684,692, 2017.
Article in Chinese | WPRIM | ID: wpr-659478

ABSTRACT

Objective To investigate the effect of the third party evaluation on improving the quality of medical service as well as the degree of patient trust in hospital.Methods Discharge patients from a two-level hospital in Minhang District was enrolled to evaluate their trust for medical service.Telephone follow-up were implemented in group A by the third party evaluation team.Group B was evaluated by the in-patient department when they left the hospital.These two evaluation methods were compared for the effects.Results During the first evaluation,1 073 people in group A,the equipartition satisfaction was 3.83 ± 0.57,the satisfaction rate was 54.99%.While in group B of 1 480 people,the equalization satisfaction was 3.83 ± 0.49,the satisfaction rate was 57.03% (P>0.05).At the fourth evaluation,1 233 people in group A and 1 512 people in group B were evaluated.Regarding group A,the patient satisfaction scores was 4.18 ± 0.33,patients satisfaction rate was 84.43%,the equipartition of patients referral was 3.44 ± 0.83,the equipartition of patients recommends the physician was 3.52 ±0.88,the equipartition of the doctor and patient had a quarrel was 4.33 ± 0.60,the equipartition of patients will find another doctor for diagnosis was 3.31 ± 0.72,the equipartition of patients expressed fully in accordance with the doctor's order of medication was 3.45 ± 0.72,group A were better than groupB (P<0.05).Of the28 entries in the level of trust related to medical services,15 entries of group A were higher than group B (P<0.05).In group A,the equipartition of moderate intensity activity was 3.62 ± 0.81,the equipartition of emotional coordination refers to 3.71 ± 0.76,the equipartition of family coordination was 3.69 ± 0.58,the equipartition of friends coordination was 3.73 ± 0.74,the equipartition of overall health was 3.31 ± 0.77,all were superior to group B (P<0.05).Conclusions The third party evaluation is a supplementation for hospital management,which has positive effects on improving medical service quality of medical institutions,the hospital performance appraisal system,patients' experiences and trust degree.

11.
Fudan University Journal of Medical Sciences ; (6): 585-589, 2017.
Article in Chinese | WPRIM | ID: wpr-659337

ABSTRACT

Objective To understand the trends and epidemiological characteristics of syphilis in Minhang District of Shanghai,so as to provide scientific basis for making control strategies.Methods The data of reported cases of syphilis in Minhang District from 2005 to 2016 were analyzed with epidemiological methods.Results Overall 11 394 cases of syphilis were reported from 2005 to 2016,the incidence was 42.9 per 100 000 person-year.The incidences of Phase Ⅰ,Phase Ⅱ,Phase Ⅲ,genital and latent syphilis were 10.3,13.4,0.3,2.3 and 16.6 per 100 000 person-year,respectively.In 2009,the incidence reached 59.1 per 100 000 person-year and reach peak.The cases were constituted by local residents (62.4%) and residents from other provinces (37.6%),male patients predominated with male/female ratio of 1.1∶1.Most cases were aged from 25 to 54 years old(61.1 %),and those people older than 54 years were more and more likely to be found infected.Local residents predominated by those who aged 25-64 years (74.2%) and other province predominated by 15-44 years (79.1%),the ratios of male/female were 1.3 ∶ 1 and 0.8 ∶ 1.Female were much younger than male,there were 50.0% of female and 29.3% of male who were aged between 15-34 years old.Latent syphilis was mostly reported in local male residents who were older than 55 years,female who were 25-54 years and other provinces' female aged 15-44.Phase Ⅰ and Ⅱ syphilis were mostly reported in local male residents less than 55 years old and other provinces' male less than 65 years old.There were significant difference between residence,sex,age and different kinds of syphilis with P<0.001.Conclusions The trends of syphilis incidence was increasing before 2009 in Minhang District and then declining and slowing down in recent years.The measure of reinforcing monitor,propaganda and education,active screening syphilis in female and local old man should be taken to control and prevent the spread of syphilis.

12.
Fudan University Journal of Medical Sciences ; (6): 590-595, 2017.
Article in Chinese | WPRIM | ID: wpr-659335

ABSTRACT

Objective To investigate the quality of life (QOL) and mental health status of patients with HIV/AIDS in Minhang District of Shanghai,and to explore the factors that affect their quality of life.Methods A cross-sectional study was conducted in Minhang District among HIV/AIDS patients.All subjects finished general situation questionnaire,Beck depression inventory (BDI),self rating anxiety scale (SAS),social support scale (SSS) and generic quality of life inventory-74 (GQOLI-74) survey.Results A total of 294 patients were recruited in this study with mean age of (39.6 ± 12.6) years old.Among the subjects,mean score of SAS was 40.5 ± 8.8,higher than national normative score (t =20.8,P<0.001).The prevalence of anxiety was 13.9%.The mean score of BDI was 8.90 ± 8.59,and the prevalence of depression was 28.6%.The mean score of quality of life (QOL) was 66.6 ± 10.9.Multivariate logistic regression analysis showed that QOL of patients with high school or secondary school was lower than those with college and above education (OR =0.34,95 % CI:0.12-0.95).QOL scores of patients with moderate or severe depression were lower than those with less depressed patients,OR values were 0.14(95 % CI:0.06-0.34) and 0.07(95 CI:0.03-0.20)respectively.QOL of patients with anxiety was lower than the patients without anxiety (OR =0.10,95 %CI:0.04-0.27).QOL of patients with high scores of social support was higher than the patients with low scores of social support (OR =3.95,95 % CI:1.82-8.59).Conclusions We should pay more attention to the psychological state of patients with HIV/AIDS.The quality of life can be improved by improving social support and reducing the occurrence of anxiety and depression.

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