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Objective To understand the epidemic status of alveolar echinococcosis in Tibetan children in south Qinghai Province. Methods The imageology and serology methods were applied to investigate the epidemic status of alveolar echinococ?cosis of elementary school students in Yushu and Guoluo prefectures. Results Totally 19 629 children were investigated by the portable B ultrasound and 221 children were diagnosed as alveolar echinococcosis with the morbidity of 1.13%. Totally 9 888 were investigated by the indirect ELISA,and the positive rate of serum tests was 12.59%(190/9 888). The total morbidity of al?veolar echinococcosis of children in Yushu Prefecture was 0.42%(31/7 454)and it was 1.57%(190/12 175)in Guoluo Prefec?ture and there was a significant difference between them(χ2=53.42,P0.05). The total morbidity of alveolar echinococcosis of children in different age groups was from 1.00%to 1.13%,and there was no significant difference among the age groups(χ2=2.73,P>0.05). The P1a type,P1b type and P2 type accounted for 67.76%(145/214),10.75%(23/214)and 16.36%(35/214)respectively among the alveolar echinococcosis patients. The diameters of nidus of 87.38%(187/214)patients were less than 5 cm,and 2.80%(6/214)were more than 10 cm. Conclusions The epidemic status of alveolar echinococcosis of Tibetan children in south Qinghai Province is serious,but most of the patients were at early stage of the disease. The screening work of al?veolar echinococcosis should be strengthened in Tibetan children,so as to perform the early diagnosis and treatment.
ABSTRACT
Objective To understand the situation of prevention and control knowledge of echinococcosis in people,and analyze the influencing factors of prevention and control knowledge of echinococcosis,so as to provide efficient and targeted evidence for taking intervention measures against echinococcosis.Methods All the districts (counties) in agricultural and pastoral area-based cities (zhous) in Qinghai Province were selected,3 townships were selected in each district (county),and 100 residents were randomly selected in each township via the stratified random sampling method.In each district (county),students of Grade Four or higher were randomly selected via the multi-stage stratified cluster sampling method,they were all investigated through a questionnaire survey about echinococcosis in Qinghai Province in 2012-2014.The influencing factors of prevention and control knowledge of echinococcosis were analyzed using Logistic regression analysis,including age,gender and district.Results Totally 11 959 residents and 23 600 students were selected and surveyed,and the qualified rate of residents and students in prevention and control knowledge of echinococcosis was 62.4％ (7 464 cases) and 66.0％(15 566 cases),respectively,and the difference was statistically significant (x2 =43.695,P ＜ 0.01).The aware rate of echinococcosis knowledge between residents and students was significantly different (x2 =113.680,60.712,1 204.943,273.296,P ＜ 0.01) except the question "washing hands before eating".Logisitic regression analysis showed that the main factors influencing the qualified rate of echinococcosis of residents were age (OR =0.989,95％CI:0.986-0.991) and district (compared with Huangnan Zhou,Haidong City OR =3.478,95％CI:2.978-4.063;Haixi Zhou OR =10.284,95％CI:8.578-12.330;Hainan Zhou OR =7.750,95％CI:6.468-9.286;Haibei Zhou OR =11.056,95％CI:9.089-13.448;Guoluo Zhou OR =7.309,95％CI:6.132-8.713;and Yushu Zhou OR =0.319,95％CI:0.258-0.393);and the main factors influencing the qualified rate of echinococcosis of students were age (OR =0.981,95％CI:0.964-0.998),gender (OR =1.103,95％CI:1.040-1.170) and district (compared with Huangnan Zhou,Xi'ning City OR =5.428,95％CI:4.823-6.109;Haidong City OR =3.860,95％CI:3.437-4.334;Haixi Zhou OR =6.557,95％CI:5.750-7.477;Hainan Zhou OR =2.757,95％CI:2.444-3.112;Haibei Zhou OR =9.968,95％CI:8.498-11.692;Guoluo Zhou OR =4.306,95％CI:3.653-5.075;and Yushu Zhou OR =0.616,95％CI:0.545-0.695).Conclusions The general aware rate of echinococcosis knowledge in people is not high in Qinghai Province.The main factors that have influenced the qualified rate of echinococcosis knowledge of residents are age and district,and of students are age,gender and district.It is necessary to implement the targeted intervention measures to improve mastering level of prevention and control knowledge of echinococcosis of people in Qinghai Province.
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Objective To understand the situation of prevention and control knowledge of echinococcosis in students in Qin?ghai Province,so as to provide an evidence for effective prevention and control of echinococcosis. Methods The students of Grade Four or above were randomly selected with the multi?stage stratified cluster sampling method and investigated with the questionnaire about echinococcosis in Qinghai Province. Results Totally 23 600 students were selected and surveyed,with the pass rate of 66.0%(15 566 cases). The pass rates of the male and female students were 65.1%(7 947 cases)and 66.9%(7 619 cases)respectively,and the difference was significant(χ2=8.454,P<0.01). The difference of pass rates among different dis?tricts of Qinghai Province was statistically significant(χ2=3 848.619,P<0.01). Conclusion The general aware rate of echino?coccosis knowledge in students is not high in Qinghai Province,and therefore,it is necessary to enhance the health education, especially for students in pasturing areas.
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Objective To observe the therapeutic effect and safety of dexmedetomidine for sedation in ICU. Methods We selected 40 patients who transferred to the ICU with retained endotracheal intubation after abdominal surgery under general anesthesia in this study. 40 patients were randomly divided into the dexmedetomidine group (D group,20 cases) and midazolam group (M group,20 cases) . Patients in group D were treated with loading dose 1 μg/kg from central vein pump injection 20 min, 1h according to Ramsay score for each adjustment of drug dose is pumped into 0.2 ~ 0.7 μg/(kg.h). Patients in M group were given a loading dose of midazolam 0.05mg/kg intravenous injection 1 min, depending on the degree of sedation maintenance dose of 0.02 ~ 0.1 mg/(kg.h). Pain scores every 2 h (NRS),when the NRS score>4 sharing,plus fentanyl 1μg/kg. When the patients achieved the offline condition, the endotracheal tube was pulled out. The sedation efficiency, dosage of fentanyl, after discontinuation wake-up time, extubation time, duration of mechanical ventilation, the incidence of cardiovascular events and delirium were compared between two groups.Results The sedation efficacy in Group D sedation was significantly higher than in group M ( <0.05) . Compared with group M, the dosage of fentanyl in patients in D group was significantly reduced ( <0.05), the wake time after stopping, extubation time were significantly shorter ( <0.05) . The incidence of cardiovascular events has no significant difference between two groups during the treatment. The incidence of postoperative delirium in D group was significantly lower than in that in group M ( <0.05) . Conclusions Dexmedetomidine has good sedative effect, and can shorten the time of extubation with hemodynamic stability and low incidence of delirium for patients in the ICU. It is an ideal ICU sedative.