Mechanism of hepatic fibrosis associated with Echinococcus: a review / 中国血吸虫病防治杂志

Echinococcosis is a zoonotic parasitic disease caused by Echinococcus infections, and this disorder may cause fibrosis of multiple vital organs, which may further progress into cirrhosis. Early-stage hepatic fibrosis is reversible, and unraveling the mechanisms underlying hepatic fibrosis induced by Echinococcus infections is of great significance for the prevention and treatment of early-stage hepatic fibrosis. Recently, the studies pertaining to hepatic fibrosis associated with Echinococcus infections focus on cytokines and immune cells. This review summarizes the advances in the mechanisms underlying host immune cells- and cytokines-mediated hepatic fibrosis in humans or mice following Echinococcus infections.

Capacity and training demand of the emergency staff from centers for disease control and prevention at county and municipal levels in Zhejiang Province / 预防医学

Objective To study the emergency staff's knowledge, skills and their training demand in centers for disease control and prevention (CDC) at county and municipal levels in Zhejiang Province. Methods Using multistage cluster sampling, 518 emergency staff from 34 CDCs in Zhejiang Province were involved in this study. A questionnaire survey was conducted among the emergency staff to evaluate their emergency knowledge and training demand. The differences between the staff from CDCs at county and municipal levels were evaluated. Results The average score of the emergency staff was 2.93 about all emergency knowledge. Some items' scores were lower, such as nuclear radiation control, first aid, risk management, ethics, laws and emergency system. The score of the survey items were similar at county and municipal level except education degree, positional title, and proportion of staff in emergency training, score of epidemiology, risk management and first aid. The highest degree of training demand was professional knowledge related to emergency response. The emergency staff inclined to the training mode (≥4) about short-term training, field guidance, drill and exercise and case study. Conclusion We should improve the health emergency training according to the demand and target of fostering inter-disciplinary talents for fieldwork. We should strengthen training of basic theories, basic knowledge and basic skills, to cover the shortage. The short-term training and practical training should be the main training model.

An analysis on the emergency personnel capability assessment and the influencing factors among CDCs of municipal and county levels / 预防医学

Objective To evaluate capacity among emergency staffs from center of disease control and prevention in Zhejiang Province at municipal and county levels, and to analyze the influencing factors. Methods Using multi-stage cluster sampling, 501 emergency staffs from 33 CDCs of the two levels in Zhejiang Province was involved in this study. Characteristics of the study population and their emergency acknowledge and capacities were collected by questionnaire. Rank test, correlation analysis and multiple logistic regression analysis were used to assess the level of capacities and analyze the influencing factors. Results At municipal and county levels, there were 165 (32.93%) and 336(67.07%) emergency staffs respectively, and the median scores of emergency acknowledge were 60 and 58.33, and the lowest scores of the knowledge both were Nuclear/Radiation. The median scores of emergency capacities were 61.82 and 55.76, and the lowest score of the capacities were both Sampling/Detection. Ordinal multivariate logistic regression analysis indicated that the scores of emergency knowledge (OR=1.19, 95%CI: 1.16-1.22), senior title (ORprimary title=0.22, 95%CI: 0.13-0.39; ORmiddle title=0.37, 95%CI: 0.23-0.60), male (OR=2.00, 95%CI: 1.39-2.89), experience of emergency tour (OR=1.63, 95%CI: 1.01-2.61) and the level of CDC (OR=1.57, 95%CI: 1.06-2.34) were the positive influencing factors of emergency capacity. Conclusion In Zhejiang Province, there were significant weaknesses in the Nuclear/Radiation knowledge and Sampling/Detection ability among emergency staffs of municipal-level and county-level CDCs. Level, gender, title, scores of emergency knowledge and experience of emergency tour were the influencing factors.

Using Delphi method to establish evaluation indicator system for the emergency response capability of Centers for Disease Control and Prevention / 预防医学

Objective To establish a evaluation indicator system for the emergency response capability of CDC by taking Zhejiang Province as an example.Method The manuscript of evaluation indicator system for Zhejiang province was established based on literature review and expert meeting.A 3 -rounds Delphi process was conducted and the specialist participating level,authority coefficient and Kendall's W were calculated to assess the indicator system.The weight of index was calculated by method of proportionate allocation.Results Three rounds of Delphi consultations was conducted by 1 7 consulters that from the administrative department of public health,scientific research institution or CDCs,and the response rate were 94.1 2%,87.50%,88.24% respectively.The specialist authority coefficient was 0.81 ±0.05.The final indicator system was consisted of 7 first -class indicators (Emergency response system,Emergency response team, Emergency response supply,Emergency coping capability,Surveillance and early warming,Scientific research and exchange,Communication and cooperation),22 second -class indicators and 77 third -class indicators.The W for each class of indicator were 0.701 ,0.531 ,0.547 and 0.697,0.629,0.548 respectively (P <0.01 ).The CV for each indicator ranges from 0.00 to 0.24.Conclusion The indicator system established in the study has good reliability and feasibility,and the specialists'opinions were consistent.The indicator system could be used in common assessment of CDC's emergency response capability in Zhejiang Province.

Sagittal Pelvic Radius in Low-Grade Isthmic Lumbar Spondylolisthesis of Chinese Population

OBJECTIVE: To investigate the variation of pelvic radius and related parameters in low-grade isthmic lumbar spondylolisthesis. METHODS: Seventy-four patients with isthmic lumbar spondylolisthesis and 47 controls were included in this study. There were 17 males and 57 females between 30 and 66 years of age, including 30 with grade I slippages and 44 grade II slippages; diseased levels included 34 cases on L4 and 40 cases on L5. Thoracic kyphosis (TK), the pelvic radius (PR), the pelvic angle (PA), pelvic morphology (PR-S1), and total lumbopelvic lordosis (PR-T12) were assessed from radiographs. RESULTS: Statistically significant differences were found for the PA, PR-T12, and PR-S1 (24.5±6.6°, 83.7±9.8°, and 25.4±11.2°, respectively) of the patients with spondylolisthesis and the healthy volunteers (13.7±7.8°, 92.9±9.2°, and 40.7±8.9°, respectively). The TK/PR-T12 ratios were between 0.15 and 0.75. However, there were no differences in all the parameters between the L4 and L5 spondylolysis subgroups (p>0.05). The TK and PR-S1 of grade II were less than grade I, but the PA was greater. The PR-T12 of female patients were less than male patients, but the PA was greater (p<0.05). CONCLUSION: Pelvic morphology differed in patients with low-grade isthmic lumbar spondylolisthesis compared to controls. Gender and the grade of slippage impacted the sagittal configuration of the pelvis, but the segment of the vertebral slip did not. Overall, the spine of those with spondylolisthesis remains able to maintain sagittal balance despite abnormal pelvic morphology.

An analysis on spatial and temporal distribution of highly pathogenic avian influenza H5 N1 / 预防医学

Objective To investigate the spatial and temporal distribution of highly pathogenic avian influenza H5N1 based on Geography Information System (GIS),and to learn the mechanism of the occurrence and spread of H5N1.Methods A total of 2 069 officially confirmed cases of H5N1 outbreak reported to WHO and World Organization for Animal Health (OIE)from 2003 to 2012 were analyzed using a GIS based approach.Hot spot analysis (Getis-Ord Gi*)was used in the spatial and temporal analysis.Results From 2003 to 2012,2 069 cases of H5N1 outbreak was reported in Vietnam (1 055),Bangladesh (528)and Indonesia (209).The most of the outbreaks were reported in Ganges Delta,Mekong Delta,areas around Dacca and West Java.The occurrence,spread and distribution pattern of the disease varied within different spatial scale,and the epidemic showed a bipolar distribution in Vietnam,aradial distribution in Bangladesh and a shrinking pattern in Indonesia.Conclusion Highly pathogenic avian influenza H5N1 was first emerged in city and then spread through poultry trading or transportation,and finally caused epidemic in regions with high density poultry and intensive agriculture.Hot spot analysis had a great application value in disease surveillance and early warning.

Study on the correlation between induced abortion and reproductive tract infections / 中华流行病学杂志

Objective To explore the correlation between induced abortion and reproductive tract infections (RTIs). Methods On the basis of keeping the representation of cities under study,53 652 fertile women aged 15-49 were surveyed by using a stratified-cluster-random sampling.Investigation and gynecological examination were conducted by two steps - firstly converging at the clinics, and then visiting those households for someone who did not show up at the clinics. Results Among all the 32.0% (n=16 800) women ever having experienced the history of induced abortion,21.1%(n= 11 090) of them had one, 7.6%(n=3976) women had two, and 4.1%(n=1734) women had at least three events. 59.0%(n=30 959) women among our studied samples had ever had RTI,with 30.9% ( n = 16 215 ) of them had only one 20.0% (n = 10 494 ) women had two and 8.1% (n =4250) had three or more RTIs. Data from x2 text and ordinal regression analysis revealed that the rural married women who underwent more induced abortions were more likely to suffer from RTIs,especially cervical infection and PID. Conclusion Our study showed that the rates of induced abortion and reproductive tract infections among married women in Anhui province were both high.Women who underwent induced abortions had a higher prevalence rate of reproductive tract infections.

Intervention trial on HIV/AIDS among men who have sex with men based on venues and peer network / 中华预防医学杂志

<p><b>OBJECTIVE</b>To determine feasibility and effectiveness of the intervention on HIV/AIDS among MSM based on venues and peer network.</p><p><b>METHODS</b>The intervention trial was conducted in Mianyang and Yibin in Sichuan province, where the cultural and social environment were similar. These two cities have no HIV/AIDS intervention conducted yet before this study. The intervention was conducted in Mianyang, while Yibin was regarded as control, in which education materials related HIV/AIDS and VCT service were available. Intervention in Mianyang included MSM venue intervention distributing the education materials, condom and promoting HIV-test and STIs clinic referral by 40 MSM as Popular Opinion Leaders who received the knowledge and intervention skill training.Meanwhile, Popular Opinion Leader intervention was implemented in MSM peer network to advocate safe sex. After 6-month intervention the survey was conducted to assess the effectiveness of intervention.</p><p><b>RESULTS</b>The scores of knowledge related HIV/STDs and self-efficacy of condom use was 1.293 (95%CI: 0.657 - 1.292, P < 0.05) and 1.556 (95%CI: 0.656 - 2.456, P < 0.05) higher in post-intervention than in pre-intervention which was (12.42 +/- 0.232) and (10.25 +/- 0.327) respectively in Mianyang, while no significant changing in Yibin during the time. Score of knowledge related HIV/STDs increase 0.577 (95%CI: -0.173 - 1.327, P > 0.05) in post-intervention compared with (10.40 +/- 0.412) in pre-intervention and score of self-efficacy of condom use decreased 0.362 from 9.86 +/- 0.547 in pre-intervention (95%CI: -1.458 - 0.534, P > 0.05). In the six months prior to survey, the rate of unprotected sexual intercourse with male casual sexual partners in last 3 times decreased to 11.0% (22/200) (OR(adjusted) = 0.472, 95%CI: 0.265 - 0.841, P < 0.05) from 19.5% (39/200) baseline in Manyang, while in Yibin that increased to 19.0% (38/200) from 17.5% (35/200) in baseline (OR(adjusted) = 1.153, 95%CI: 0.660 - 2.014, P > 0.05). The rate of HIV-test increased significantly from 9.0% (18/200) to 22.0% (44/200) (OR = 2.852, 95%CI: 1.583 - 5.138, P < 0.05) in intervention city and Accordingly in the control, that was 24.5% (29/200) in baseline and 24.0% (28/200) in post-intervention (OR = 0.960, 95%CI: 0.548 - 1.682, P > 0.05). No difference was found in number of male sexual partner pre- and post-intervention both in intervention and control city.</p><p><b>CONCLUSION</b>The intervention based on MSM venues and peer network among MSM is feasible and can increase knowledge related HIV/STDs and self-efficacy and as well as condom use and HIV testing.</p>