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Objective:To analyze the status of hepatitis B virus (HBV) infection in pregnant women in Taizhou City in recent years and the effect of immunization management of hepatitis B vaccine project on the status.Methods:The pregnant women hospitalized in Taizhou People′s Hospital, Taizhou Second People′s Hospital, Taizhou Traditional Chinese Medicine Hospital and Taixing People′s Hospital from 2014 to 2017 were enrolled. According to the HBV serological results, the pregnant women were divided into non-immune population, successful immunization population, previous HBV infection population, HBV infection population and atypical manifestation population. The year of immunization management for the implementation of the hepatitis B vaccine plan was 1992. The HBV infection status of the pregnant women was analyzed based on the year of delivery and vaccination status, respectively. Chi-square test and trend chi-square test were used for statistical analysis.Results:A total of 31 449 cases were included in this study, of which 13 203 (41.98%) were non-immunized, 10 123 (32.19%) were successfully immunized, 6 409 (20.38%) were previous HBV infected, 1 566(4.98%) were HBV infected, and 148(0.47%) cases were atypical manifestation. The negative rate of all HBV serological markers of pregnant women born before 1992 and after 1992 (including 1992) were 42.07%(10 794/25 657) and 41.59%(2 409/5 792), respectively, with no statistically significant difference ( χ2=0.44, P=0.51). The hepatitis B surface antibody (anti-HBs) positive rate of pregnant women born before 1992 was 28.95%(7 428/25 657), which was lower than 46.53%(2 695/5 792) of pregnant women born after 1992 (including 1992). The difference was statistically significant ( χ2=668.94, P<0.01), and showed an upward trend year by year ( χ2=602.11, P<0.01). The hepatitis B core antibody (anti-HBc) positive rate of pregnant women born after 1992 (including 1992) was 8.81%(510/5 792), which was lower than 22.99%(5 899/25 657) of pregnant women born before 1992, the difference was statistically significant ( χ2=589.10, P<0.01), and the overall trend was declining year by year ( χ2=478.72, P<0.01). The hepatitis B surface antigen (HBsAg) positive rate of pregnant women born before 1992 was 5.46%(1 402/25 657), which was higher than 2.83%(164/5 792) of pregnant women born after 1992 (including 1992), the difference was statistically significant ( χ2 =69.23, P <0.01), and the overall trend was decreasing ( χ2=49.25, P<0.01). Among pregnant women infected with HBV, the negative rate of hepatitis B e antigen (HBeAg) was 78.16%(1 224/1 566). Conclusions:Pregnant women with HBV infection in Taizhou City are mainly HBeAg negative. Hepatitis B vaccine immunization management significantly reduces the HBsAg positive rate and anti-HBc positive rate of pregnant women, and increases the positive rate of anti-HBs, while the rate of all HBV serum marker negative is not significantly decreased. Horizontal transmission may still be a risk factor for HBV present and previous infections.
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Objective To determine the predictive factors for antiviral therapy in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection [HBeAg(-) CHBI] patients with HBV DNA＜4.3 lg IU/mL.Methods A total of 179 HBeAg (-) CHBI patients were retrospective analyzed.Histology activity index (HAI) and fibrosis (S) were scored according to the Knodell HAI scoring system,and HAI＞3 and/or S≥3 was adopted as indications for treatment.Univariate and multiple regression analysis were used to assess factors associated with treatment indications.Receiver operating curves (ROC) and area under curve (AUC) were used to determine the predictive value of relevant factors.Results There were 81 cases with HAI＞3 (45.3％) and 72 with S≥3 (40.22％),and the proportion of patients with indications for treatment was 54.7 ％.Multiple regression analysis showed that age,γ-glutamyl transpeptadase (γ-GT),platelet (PLT) and albumin (Alb) were the predictive factors for the severity of liver damage and indication for treatment (all P＜0.05).The AUC for age,PLT,γ-GT and Alb were 0.655,0.657,0.726 and 0.65,respectively,and the corresponding Yoden index for age,PLT,γ-GT,and Alb were 0.297,0.426,0.03 and 0.012,respectively,the sensitivities of predicting HBeAg (-CHBI for treatment indications were 0.643,0.842,0.705 and 0.653,respectively.Conclusions This study shows that 54.7％ of HBeAg(-)CHBI patients with HBV DNA＜4.3 lg IU/ml have significant liver histological changes and require antiviral treatment.Older age,higher γ-GT,lower PLT and lower Alb levels are the predictive factors for treatment.
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Objective To analyze functioning and disability, unmet needs and the service for people with disabilities in Shenzhen, Guangdong, China. Methods Based on International Classification of Functioning, Disability and Health (ICF) and World Report on Disabil-ity, the theoretical framework had been constructed, and the unmet needs and service status for people with disabilities in Shenzhen in 2015 had been statistically analyzed. Results For the statistics of disability by categories, physical disability composed of 42.5%, speech disability composed of 1.5%;people with severe and extremely severe disabilities composed of 52.8%;Futian District composed of 19.7%, Yantian District composed of 2.2%;people aged 0 to 18 years composed of 17.4%, and people aged over 60 years (27.0%) were the larger group. For the unmet needs of people with disabilities, 25%needed rehabilitation therapy, 18.8%needed functional training, 23.2%needed assis-tive devices, and 32.9%had no need. For rehabilitation sevice in Shenzhen, 24.4%received rehabilitation therapy, 17.4%received function-al training, 20.4%received assistive devices, and 37.6%did not receive any service. For the barrier-free reconstruction, 4.6%needed bath-room reconstruction, and 0.7%needed internet access screen software. Conclusion The status of functioning and disability, unmet needs and service development of rehabilitation in Shenzhen had been analyzed. There was still a gap between unmet needs and services of rehabilita-tion. It recommended to construct precise services delivery based on unmet needs, improve the full coverage and quality of service of reha-bilitation.
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Objective@#To study the epidemiological characteristics of tsutsugamushi disease, and to confirm the existence of the disease's epidemic foci in Taizhou.@*Methods@#From 2013 to 2014, Dongxing town hospital and Xingqiao town hospital were selected as specimen collection sites in Jingjiang city. Blood samples (5 ml) were collected from 40 patients with acute tsutsugamushi disease. A total of 59 rodents were captured with cage night method in the survey sites at 5, 7, 9, 10, and 11 months in 2013, from which, the spleen, liver, and kidney specimens were selected. Chigger mites were captured by small blackboard method and from the ears of the captured rodents. A total of 226 small blackboards were laid, 27 mites were captured, and the samples were grounded into suspension. Nested-polymerase chain reaction and cell and tissue culture techniques were used to test the specimen from the probable patients, host animals and chigger mites.@*Results@#Among the 40 acute tsutsugamushi disease blood samples, 29 were found to meet the test requirements, 17 were positive for orientia tsutsugamushi nucleic acid with 59% of the positive rate, and 1 stran orientia tsutsugamushi was isolated. 59 rats were captured and the density of mice was 5.5%. Among them, there were 26 Mus musculus (2.4%), 18 Rattus flavipectus (1.7%) and 15 Smelly shrew (density 1.4%). 1 Smelly shrew was tested positive for orientia tsutsugamushi nucleic acid, and the negative results were found in the other rodent specimens. 27 Chigge mites were collected by small blackboard method and the density of mites was 0.12 for each blackboard, among which 3 larvae and 24 nymphs were found. 33 Chigger mites were collected from the ears of 3 Smelly shrew, and the density of the mite was 11 per mouse. All the captured Chigger mites were identified as Leptotrombidium scutellare and 1 group of specimens of Chigger mites from the external environment were positive for orientia tsutsugamushi nucleic acid.@*Conclusion@#There was a high density of mice in the epidemic area from May to November and the species of the chigger mites were Chigger mites in Taizhou. The nucleic acid of the oriental tsutsugamushi was detected in the patients with acute scrub typhus, rodents and vectors. According to the above-mentioned results, it was considered that the scrub typhus epidemic area of Taizhou city has the natural foci of scrub typhus.
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Based on international framework of rehabilitation, this paper summarized the theories and practice of rehabilitation in Shen-zhen. An inclusive rehabilitation model had been established in Shenzhen in light of international concepts of rehabilitation, in which the functions of medical rehabilitation, education, employment, assistive technology, care, right protection, accessible environment and culture had been integrated. The comprehensive services had been provided through this model and the target of inclusive development had been re-alized.
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Objective To explore the epidemiological characteristics of acute sporadic hepatitis E.Methods 109 cases of hepatitis E were investigated to collect the information on epidemic history and other health behaviors and the rate was used to describe the data.Results Of 67.3%(109/162) cases of hepatitis E in 2008 of Taizhou,the male to female ratio was 1∶0.31.Among the 109 cases,illiterates and semi-illiterates accounted for 47.7% and the proportion of rural workers was 78.0%.87.2% cases had an average monthly incomes below 1 000 Yuan and 45.9% cases occurred from February to April.47.7% cases had meals in small restaurants,and the rates of unhealthy foods and business travelling were 36.7% and 16.5% within 15 to 75 days before onset of the disease.64.2% cases had poor habits of washing hands before meals.Conclusions The occurring of hepatitis E were reported from February to April in Taizhou and most cases came from rural residents between 30 to 60 with low income and lower educational levels.The top three exposure risk factors were the history of eating outside,unhealthy foods and business travelling.