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ObjectiveTo study the relationship between the exposure to two kinds of phthalate esters （PAEs） ［Di-N-butyl phthalate，（DBP） and Di-（2-ethylhexyl）phthalate （DEHP）］ and estrogen homeostasis in pregnant women. MethodsIn 2021， we classified the Jiading District of Shanghai into five geographical areas， east， west， south， north and central. A total of 151 pregnant women from each area were selected for questionnaire survey， with random urine samples during first， second， and third trimesters collected. A DBP metabolite ［Mono-N-butyl phthalate （MBP）］ and two DEHP metabolites ［Mono（2-ethylhexyl） phthalate （MEHP）， Mono（2-ethyl5-oxohexyl） phthalate， （MEOHP）］ and three estrogens ［estrone （E1）， 17β -estradiol （E2）， and estriol （E3）］ in urine were determined by ultra-performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry. After a natural logarithmic transformation of PAEs metabolite levels and estrogen concentration， multivariable linear regression was used to control potential confounders and determine the relationship between PAEs metabolite levels and estrogen concentration. ResultsThe detection rates of three PAEs metabolites in urine of pregnant women were more than 98%. The median corrected concentrations of MBP， MEHP and MEOHP were 5.18， 0.59 and 4.23 mg·kg-1， respectively. During the whole pregnancy， MEOHP was positively correlated with E1 （β=0.450， 95%CI： 0.057‒0.844）， and MBP was positively correlated with E3 （β=0.250， 95%CI： 0.034‒0.465）. Stratified by trimesters， MBP was positively correlated with E3 in the first trimester （β=0.428， 95%CI： 0.103‒0.752）. MEOHP was positively correlated with E1 in the second trimester （β=0.734， 95%CI： 0.130‒0.752）， and had a possitive trend with E1 in the third trimester （β=0.744， 95%CI： -0.140‒1.629）. In addition， MEHP had a negative correlation with E1 in the second trimester （β=-0.498， 95%CI： -1.063‒0.066）. MEOHP had a positive correlation trend with E2 （β=0.628， 95%CI： -0.101‒1.356） in the third trimester. ConclusionPAEs exposure may interfere with estrogen homeostasis during pregnancy and differs by trimesters. Given the cross-sectional nature of this study， it warrants further study to validate the findings.
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Objective To understand the spatial epidemic characteristics of hand-foot-mouth disease in Pudong New Area of Shanghai from 2015 to 2018, and to provide reference for prevention and control. Methods SPSS 21.0 software was used for statistical analysis of the reported incidence of hand-foot-mouth disease, ArcGIS 10.2 software was used to make geographic distribution map, and OpenGeoDa software was used to make spatial autocorrelation analysis. Results The global Moran's I autocorrelation coefficient of the reported incidence rate of hand-foot-mouth disease in various streets and towns in Pudong New Area of Shanghai was 0.38, which was statistically significant (P=0.001). Local spatial autocorrelation analysis found that 5 streets were in high-high area. Conclusion The geographical distribution of reported incidence of hand-foot-mouth disease in various streets and towns of Pudong New Area in Shanghai was spatially aggregated, and the reported incidence decreased from north to south.
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Objective To understand the epidemiological characteristics of norovirus detection based on the diarrhea syndromic surveillance in Pudong ,Shanghai .Methods Diarrhea syndromic surveillance program was conducted in outpatient and emergency departments of 12 sentinel hospitals during 2012 -2016 .The clinical and epidemiological data of diarrheal patients were collected .The fecal specimens were also sampled . The detections for norovirus by polymerase chain reaction and gene sequencing were performed .Chi-square test or Fisher exact probability test was used to compare the detection rate .Binary logistic regression was used to explore the impact factors of norovirus infection among diarrheal patients . Results The detective rate of norovirus among diarrheal patients was 21 .59％ ,peaking from October to next March .Among all the age groups ,the detection rate was highest among patients with 25 - 64 years old .The patients with more severe diarrhea symptoms (> 5 times a day) were more likely to be infected with norovirus than those with diarrhea 3 - 5 times a day (χ2 = 21 .167 ,P< 0 .01) .Vomiting was also an indicator of norovirus infection .Patients presented with vomiting had a higher norovirus detection rate (χ2 = 198 .543 , P < 0 .01) . Norovirus G Ⅱ was the predominant genotype .Conclusions The recent epidemic of norovirus infection in diarrheal patients in Pudong new district has an apparent seasonality peaked from October to next March .Adult ,patients with vomiting and more severe diarrhea symptoms are at risk of norovirus infection .The long-term surveillance is critical for the norovirus infection control .
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Objective To establish emergency disposal procedures of healthcare-associated infection(HAI) in Pudong New Area, evaluate on-site investigation method, identify the key links and risk factors for infection, and timely control HAI outbreak.Methods From January 2012 to December 2014, epidemiological investigation on HAI outbreaks in 65 hospitals in Pudong New Area was performed, emergency plan for disposal procedures of HAI was initiated, the emergency disposal procedures of each event was evaluated by experts.Results There were 6 infection outbreaks occurred in Pudong New Area from January 2012 to December 2014, all were HAI, and no community-associated infection existed simultaneously;6 cases of HAI outbreaks involved 119 persons, the major were hospitalized patients (n=99,83.19%) and care workers (n=16,13.45%);5 outbreaks all detected Norovirus, the main transmission route wasclose contact of nurses with patients during care for patients;the evaluation of each incident revealed that the total score was >90.Conclusion The emergency disposal procedure of HAI suitable for Pudong New Area has been established, the effect is good and proved effective according to the expert evaluation on practical outbreaks.
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Objective To prepare vardenafil hydrochloride orally disintegrating tablets and evaluate their quality. Methods The tablets were prepared by direct power compression method, using crosslinking povidone ( PVPP ) as disintegrants. The preparation method was optimized by response surface test using amount of PVPP, menthol and taste-masking agents as factors with disintegrating time and distance of bitterness as index. The results of taste of orally disintegrating tablets were determined by electronic tongue, comparing to the results of taste tests. At the same time, the properties of the tablets were evaluated using appearance, content uniformity, disintegrating time, et al. as index. Results The optimal formula was as follows:PVPP 13. 26%, menthol 0. 43%, taste-masking agent SGxj 1. 26%. The results on evaluation of electronic tongue were consistent with the results of taste tests. The quality of the prepared tablets was in line with standard. The disintegrating time was (22. 34 ± 0. 34 ) s. Conclusion The preparation technology of orally disintegrating tablets is simple, and controllable in quality.
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Objective To investigate the situation of infectious diseases prevention and control and its possible influencing factors of primary and middle schools in Pudong New Area,in order to provide evidence for establishment of effective control system of primary and middle schools.Methods The situation of infectious diseases prevention and control of 368 primary and middle schools in Pudong New Area was investigated.Results Organization and relevant system for infectious diseases prevention and control were carried well,but the proportion of full-time health care personnel was low.There had been infectious diseases in 297 (80.71％) schools from 2013 to 2015,involving 4 326 cases.And 129 (35.05％) schools had 255 infectious diseases clusters.Whether the disinfection of sanitary ware and indoor air were qualified were the possible influencing factors of infectious diseases prevention and control.Conclusions The overall work of infectious diseases prevention and control is developed well,but some aspects need further improvement.
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Objective To investigate the prevalence of healthcare-associated infection(HAI)in medical institutions in Pudong New Area.Methods Ten medical institutions in Pudong New Area were selected as monitored hospitals, cross-sectional survey on HAI in each hospital at a given day of November 2013 and November 2014 were conduc-ted.Prevalence of HAI in different levels of hospitals were compared.Results The prevalence rates of HAI in 2013 and 2014 were 4.04% and 3.75% respectively,there was no significant difference between two years(χ2 =0.709,P=0.400).The prevalence rates of HAI in primary,secondary,and tertiary hospitals in 2013 were 0.66%,3.32%, and 4.60% respectively,in 2014 were 0,3.52%,and 4.01 % respectively,prevalence rates of HAI in different lev-els of hospitals of each year were significantly different (all P <0.05).Prevalence rates of HAI were high in depart-ments of neurosurgery,hematology,intensive care units(ICUs),and gerontology.The prevalence rate of infection in ICUs increased obviously,from 10.09% to 18.78% (χ2 =3.921 ,P =0.048),departments of gerontology de-creased obviously,from 10.07% to 5.02%(χ2 =5.698,P =0.017).The main HAI sites were lower respiratory tract (36.72%),upper respiratory tract (9.96%),and urinary tract (12.89%).172 pathogenic isolates were de-tected in 2013,and 177 were detected in 2014,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 60.74%,26.37%,and 12.89% respectively.Constituent ratios of pathogens causing HAI between two surveys were not significantly different (χ2 =5.819,P =0.830).Conclusion Among different levels of hospitals in Pudong New Area,tertiary hospitals have the highest prevalence rate,HAI in ICU increases obviously,the main HAI site is lower respiratory tract,the main pathogens are gram-negative bacteria.