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A patient with fever, chills, and pancytopenia as major clinical manifestations was presented. To investigate the cause, the patient’s peripheral blood was collected for pathogen screening using metagenomic next - generation sequencing (mNGS). The DNA sequence of Leishmania donovani was detected, and Leishmania amastigotes were found in bone marrow smears using microscopy. The case was therefore definitively diagnosed as visceral leishmaniasis, and was cured and discharged from hospital following treatment with liposomal amphotericin B for 14 days. This is the first imported case of visceral leishmaniasis since the founding of Shenzhen City in 1979.
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【Objective】 To determine the reference range of thromboelastogram(TEG) and establish a TEG feature for local population by measuring TEG parameters in healthy adults in Shenzhen comparing the difference between gender and age, and analyzing the reference data provided by reagent manufacturer. 【Methods】 A total of 916 healthy adults, aged between 19 to 59, who did their regular health checks in our hospital from September 2020 to August 2021 were selected. The TEG(from Lepu Medical Technology Co., Ltd.) was performed, and the clot reaction time(R), clot formation time(K), coagulation angle(α-Angle), maximum amplitude(MA), coagulation index(CI), fibrinolysis index LY30 and the estimated percent lysis (EPL) were analyzed. 【Results】 The reference ranges of TEG parameters, including R, K, α-Angle, MA, CI, LY30 and EPL, of 916 healthy adults from Shenzhen were 3.25~8.19 min, 0.66~3.18min, 47.70~76.56deg, 50.05~72.91mm, -4.3~3.4, 0~2.2% and 0~3%, respectively. The value of α-Angle, CI, K, LY30, MA and R didn’t all meet the given range provided by the manufacturer; some were exceeding and some inferior to. A total of 227 out of 916 individuals presented abnormal results, relative to the references, in at least one parameter, and 78 were diagnosed of abnormal coagulation based on the given reference range, with a specificity of 75.2%. 【Conclusion】 The reference range of TEG parameters of Shenzhen locals is significantly different from that provided by manufacturers. And it is imperative for local TEG laboratories to establish their own reference ranges according to age and gender groups based on local population characteristics.
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BACKGROUND@#China is the most populated country and the second economic entity worldwide. Hong Kong and Shenzhen are two adjacent cities in southern China, with similar environmental, cultural, ethnic groups, and economic development. They both have a very interesting turning point in their destiny, leading to a miraculous economic development. However, their government structure and health care system are totally different.[1] This is a vivid example of Deng Xiaoping's formulation of the principle of "one country, two systems".
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Objective To summarize and analyze the prevention and control model of colorectal cancer in Nanshan District, Shenzhen, and to provide references for other regions. Methods Based on the three-level prevention and control network in Nanshan District, top specialists from across the country and abroad were brought in serving as a technical support team to explore scientific and feasible early screening techniques and management models for colorectal cancer. Results Through a series of measures, such as government leadership, departmental cooperation, closed-loop management of the prevention and control services, health education and so on, the residents' participation increased and health literacy was also improved. More than 20,000 residents participated in the risk assessment of colorectal cancer, and the positive detection rate was nearly 50% in people at a high risk. Conclusion The public health institution-community-hospital three-level prevention and control network was conducive to improving the compliance of residents with cancer screening, early detection and early intervention to reduce cancer morbidity and mortality.
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OBJECTIVE：To investigate th e cognition ，attitude and behavior of part of drug practitioners in Shenzhen on compensation of adverse drug reaction （ADR）injury，and to provide relevant reference for the establishment of ADR injury compensation system. METHODS ：Taking marketing authorization holder （MAH），staff of medical institutions at the second level or above and drug regulatory authorities in the relevant meeting held in Shenzhen in 2018 as objects ，on-the-spot anonymous investigation of “questionnaire star ”was used to collect and analyze the cognition ，attitude（including attitude towards ADR compensation and ADR compensation system ）and behavior of the above-mentioned personnel to ADR compensation. The relevant suggestion was put forward. RESULTS & CONCLUSIONS ：A total of 172 questionnaires were collected （all being valid ）. In term of cognition ，the respondents generally had high awareness of ADR （response rate of ADR concept was 82.0％）. In term of attitude to ADR injury compensation ，100 respondents（58.1％）believed that ADR after medication should be compensated ，and 147 respondents（85.5％）believed that compensation should be made for serious and fatal adverse reactions. In term of attitude to ADR injury compensation system ，respondents thought that ADR damage compensation funds be undertaken by MAH for 131 case times （76.2％）. As for the difficulties in the implementation of ADR compensation ，it was considered that the evaluation of the correlation between adverse reactions and drugs led to the difficulties in the implementation of ADR compensation （143 case times ， 83.1％）；most respondents thought that the first thing to do in the implementation of ADR compensation system was to implement laws and regulations （145 case times ，84.3％）. In term of behavior ，104 respondents（60.5％）had processed costs due to ADR ， most of whom chose self-resolved （85 cases，81.7％）；112 respondents （65.1％） chose to inform medical personnels or pharmacies directly. It is suggested that the relevant departments in Shenzhen should explore and establish ADR injury compensation mechanism in Shenzhen by establishing a public oriented platform and mechanism for ADR science popularization （setting up relevant departments ，supervising the public propaganda of news media ，expanding the public propaganda to the commu nity），exploring and establishing ADR injury compensation mechanism （setting up a special legislative pilot of ADR injury regulations ，setting up ADR injury appraisal committee ），and increasing the investment in ADR testing （fully using of “Internet+”Big Data ，allocating special funds ）.
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Objective To evaluate the effect of family doctor contracted service system in Shenzhen and explore the influencing factors for families to contract their family doctors. Methods A total of 480 residents were selected from 12 first-class community medical rehabilitation centers in Luohu, Futian and Nanshan districts of Shenzhen. The contents of the survey included the contracting status between the contracted and non-contracted residents, the utilization of four basic public health services, and the difference of satisfaction with community medical rehabilitation centers.Meanwhile, logistic regression was used to explore the important influencing factors of the contracted family doctors. Results The overall contracting rate of residents was 51.9% (248/478), and the lowest contracting rate was 23.1% (27/117) (P<0.05), found among patients under 40 years old.The utilization rate of contracted residents for growth and development examination, maternal health care as well as guidance of chronic disease prevention and treatment was higher than that of non-contracted residents ( P <0.05 ). fees and medical environment, service attitude,medical fees was higher than that of non-contracted residents(P<0.05).The satisfaction for convenience in medical environment, service attitude,medical fees and access to medical service was higher than that of non-contracted residents(P<0.05).The results of binary logistic regression analysis showed that age, education level, occupation ( retirement ) and chronic diseases were important factors affecting the signing of contracts.Conclusions The family doctors tend to be embraced by residents better than before. Family doctors contracted service system is conducive to improving the utilization rate of basic health services, acceptance rate of health services and satisfaction of residents. At the same time, the young population at large requires greater efforts before they can embrace the family doctor system.
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Objective Data from the surveillance program was collected,to analyze the situation of hospitalization and cases of death with recorded causes,in Shenzhen,from 1995 to 2014.Situation of hospitalization and causes of deaths were studied in Shenzhen which had been a fast-developing city with growing number of immigrants so as to provide reference for decision-making on related prevention and control strategies.Methods Data on hospitalizations and deaths collected from the surveillance program,were classified by both International Classification of Diseases (ICD)-9 and ICD-10.A database was constructed with methods on related descriptive and trend analysis.Results Around 6.3 million inpatients were seen in the past two decades in Shenzhen.The top five diseases for hospitalization were pregnancy childbirth and puerperium complications,respiratory diseases,injury and poisoning,digestive system diseases and circulatory system diseases,that accounting for 68.4％ of all the hospitalization burden.The number of inpatients increased annually,with an 11 times increase during the past two decades.Proportions for pregnancy childbirth and puerperium complications,circulatory system diseases and urinary system diseases all showed increasing (x2=53 806.94,6 893.95 and 15 383.14,P＜0.01),while proportions for injuries and poisoning,respiratory diseases,digestive system diseases showed a declining trend (x2=131 480.09,1 711.84 and 11 367.66,P＜ 0.01).Number of cumulative inpatient deaths exceeded 60 000,with the top five causes as malignant tumor,circulatory system diseases,injury and poisoning,respiratory system diseases and digestive system diseases,that accounting for 82.28％ of all the inpatient deaths.Deaths due to circulatory system diseases,injury and poisoning increased and then decreased.Malignant tumor and respiratory diseases-induced deaths showed an increasing trend (x2=1 546.48,309.55,P＜0.01),while induced deaths from disease of the other systems showed slight changes.The overall case fatality rate showed an annual decline (x2=4 378.63,P＜0.01),from 2.23％ in 1995 to 0.74％ in 2014,with mortality attribute to tumor,circulatory system disease decreased significantly.Conclusions Shenzhen had been under an ageing transition,with relatively young population living in the city.Chronic diseases such as tumor gradually had become the major causes for heavy hospitalization burden on the population of Shenzhen.
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Objective Data from the surveillance program was collected,to analyze the situation of hospitalization and cases of death with recorded causes,in Shenzhen,from 1995 to 2014.Situation of hospitalization and causes of deaths were studied in Shenzhen which had been a fast-developing city with growing number of immigrants so as to provide reference for decision-making on related prevention and control strategies.Methods Data on hospitalizations and deaths collected from the surveillance program,were classified by both International Classification of Diseases (ICD)-9 and ICD-10.A database was constructed with methods on related descriptive and trend analysis.Results Around 6.3 million inpatients were seen in the past two decades in Shenzhen.The top five diseases for hospitalization were pregnancy childbirth and puerperium complications,respiratory diseases,injury and poisoning,digestive system diseases and circulatory system diseases,that accounting for 68.4％ of all the hospitalization burden.The number of inpatients increased annually,with an 11 times increase during the past two decades.Proportions for pregnancy childbirth and puerperium complications,circulatory system diseases and urinary system diseases all showed increasing (x2=53 806.94,6 893.95 and 15 383.14,P＜0.01),while proportions for injuries and poisoning,respiratory diseases,digestive system diseases showed a declining trend (x2=131 480.09,1 711.84 and 11 367.66,P＜ 0.01).Number of cumulative inpatient deaths exceeded 60 000,with the top five causes as malignant tumor,circulatory system diseases,injury and poisoning,respiratory system diseases and digestive system diseases,that accounting for 82.28％ of all the inpatient deaths.Deaths due to circulatory system diseases,injury and poisoning increased and then decreased.Malignant tumor and respiratory diseases-induced deaths showed an increasing trend (x2=1 546.48,309.55,P＜0.01),while induced deaths from disease of the other systems showed slight changes.The overall case fatality rate showed an annual decline (x2=4 378.63,P＜0.01),from 2.23％ in 1995 to 0.74％ in 2014,with mortality attribute to tumor,circulatory system disease decreased significantly.Conclusions Shenzhen had been under an ageing transition,with relatively young population living in the city.Chronic diseases such as tumor gradually had become the major causes for heavy hospitalization burden on the population of Shenzhen.
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Objective:To research and evaluate community health service management,analyze the influencing factors,seek for related enlightenment and provide references for health decision making.Methods:In 2016,it organized the municipal community health service's management as a whole,reported by the research units.Results:Health center,65 held a total of 590 units,took part in the comprehensive assessment,60 held health centers were stratified randomly sampled and 42 units participated in the municipal review assessment.Conclusion:It needed to make better the construction and development of community health services,keep the maintain and upgrade for the policy environment and financial support,including community primary public health services and primary medical service fund support,personnel allocation standard and fund support,medical insurance policy support.Under the current community health management system,it needed to set up efficient community health operation mechanism,provide fast primary health care and primary public health service projects to solve the residents' primary health demands.
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Objective To study the efficiency changes of private hospitals in Shenzhen and explore influencing factors for the utilization efficiency of health resources. Methods DEA-Tobit two-stage model was used to analyze the operating efficiency and influencing factors of Shenzhen′s private hospitals. Results The range of technical efficiency varied between 0.690 to 0.742 in six years, and the index of total factor production was consistent with the technical change index. The input and output indicators showed non-linear growth. The internal and external factors of sample hospitals jointly influence the efficiency of operation. Conclusions The two-stage method effectively reveals the dynamic efficiency change and the influencing factors of these hospitals in Shenzhen. The technical efficiency of sample hospitals fluctuates in waves in six years,with investment redundancy and insufficient output found. Sample hospitals need to strengthen their innovative application of diagnostic and therapeutic technology,and to strengthen their internal management and improve operating efficiency.
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Objective To investigate the levels and distribution of radon in dwellings in Shenzhen cities of China.Methods A total of 108 low-,multi-,middle-and high-rise buildings were selected.Indoor radon concentrations were measured by using solid track detector.Results The arithmetic mean of indoor radon concentrations in Shenzhen was 64 Bq/m3,and geometric mean was 58 Bq/m3,in range of 15 to 155 Bq/m3.The average indoor radon concentration in Bao'an district was 50 Bq/m3 with the lowest value,and that in Pingshan new district was 87 Bq/m3 with the highest value.There were 12 measuring points where indoor radon concentrations were higher than 100 Bq/m3 in Shenzhen,accounting for 11.1％ of the total number.Shapiro-Wilk test showed that the frequency distribution of indoor radon concentration in Shenzhen follows lognormal distribution (P ＞ 0.05).The indoor radon concentrations showed a downward trend from 1990 to 2015.The indoor radon concentration decreases with the elevated floors except 10th and above floors.Conclusions The indoor radon concentrations in Shenzhen increased by 35％,compared to the previous investigations.It is recommended that efforts continue to improve radioactive materials standards about building material and to enhance the natural ventilation in high-rise buildings in order to lower the radiation hazards from radon.
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The system of first contact in community health institutions, as the core element of hierarchical di-agnosis and treatment system, is of great importance for reforming successfully China’ health service system. The sys-tem of first contact in community health institutions implemented among labor workers in Shenzhen City plays an im-portant role in patients ’ distribution and the interested parties can accept this mandatory system. Campared with Shenzhen City, the level of services is enough to meet patients’ primary health demands in some cities which the com-munity health service develops well, and it should be thought highly of the mandatory in the process of policy imple-mentation in order to ensure the implementation effect.
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An investigation and analysis of the current hierarchical medical system in Shenzhen,probed into its existing problems and shortcomings.The findings of the study can help recommend on proposals for the local government to enhance the hierarchical system,accelerate the construction of a rational order of medical visits,improve the utilization efficiency of health care resource and the quality of care.
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Objective To explore the growing development and community succession of main sarcos-aphagous insects on pig carcasses in summer indoor and outdoor environment in Shenzhen area and to estimate the postmortem interval (PMI). Methods From early May to August in 2013, in Forensic Med-ical Examination Center of Shenzhen Public Security Bureau, the main insect species and the decomposi-tion process were observed in two adult pig carcasses of simulative indoor and outdoor environment. The different decomposition stages and the community succession of insects were recorded. Results The indoor and outdoor pig carcasses showed skeleton 412.5 and 325 hours after death, respectively. The main species of flies on pig carcasses were Chrysomya megacephala, Chrysomya rufifacies and Chrysomya chani. The main species of beetles were Crecphilus maxillosus, Necrobia ruficollis, Saprinus splendens and Dermestes maculatu. The dominant species of flies in the outdoor pig carcasses obviously produced the second generations due to the effect of mass rainfall, nor in the indoor pig carcasses. Conclusion There are regular patterns on the community succession of insects on pig carcasses in summer indoor and out-door environment in Shenzhen area. The activity patterns of seven typical insects and their larva show important value for estimating PMI.
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The information construction and information sharing in Shenzhen public hospitals were investigated with their achievements and problems summarized .Suggestions were put forward for perfecting their information construction, improving their information sharing level, and realizing their regional medical information sharing for the reference in working out their information development program and making health information policies.
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Objectives To investigate the clinical features of Guillain-Barré syndrome (GBS) in children from Shen-zhen. Methods The clinical manifestations, results of electrophysiological tests and prognosis of 28 GBS patients from July 2002 to July 2012 were retrospectively analysed. Results Of 28 children, 16(57.1%) had preceding acute upper respiratory infection for 3-14 days but no patient had acute gastroenteritis. One had received HBV vaccination in 2 weeks before the onset of GBS. The peak season for GBS is spring. According to the clinical presentations and the neurophysiological results 17 patients had demyelinating neuropathy, 5 acute motor axonal neuropathy, 2 acute motor sensory axonal neuropathy, 3 Miller-fisher syndrome, and 1 polyneuritis cranialis. 14 (50.0%) patients suffered from pain in limbs which is the most nota-ble symptom in the early stage. Intravenous immune globulin (IVIG) and steroids were given during the acute phases in the majority of the patients, and assisted ventilation was performed in 2 patients due to respiratory muscle paralysis. No diffe-rence was found in Hughes scores, average hospitalization durations, and the prognosis between patients with GBS variants patients and patients with classic GBS. Conclusions Children with GBS in Shenzhen area have different clinical features.
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BACKGROUND: In Shenzhen, the Emergency Medical Service (EMS) system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS. METHODS: In this retrospective quantitative descriptive study, the data from the Shenzhen 120 EMS registry in 2011 were analyzed. RESULTS: Shenzhen 120 EMS center is a communication command center. When the number of 120 are dialed, it is forwarded to the closest appropriate hospital for ambulance dispatch. In 2011, the Shenzhen 120 EMS center received 153160 ambulance calls, with an average of 420 calls per day. Calling emergency services was mainly due to traffic accidents. Trauma and other acute diseases constituted a majority of ambulance transports. The adult patients aged 15–60 years are the principal users of EMS. There are no recognized 'paramedic' doctors and nurses. The pre-hospital emergency service is under the operation of emergency departments of hospitals. Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in post-trauma management. Moreover, specialized pre-hospital training, financial support, and public health education on proper use of EMS should be emphasized. CONCLUSION: The Shenzhen 120 EMS center has its own epidemiology characteristics. Traumatic injury and traffic accident are the main reasons for calling ambulance service. In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS.
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This article described the basics of the University of Hong Kong-Shenzhen Hospital and the practices of Shenzhen government to promote the comprehensive reform of public hospitals.The article also introduced the reform,on such aspects as hospital management structure,corporate governance,hospital operating mechanism,compensation mechanisms,service mode,staff training mechanism,and supervision mechanisms.In addition,it analyzed the benefits of these reforms and proposed policy changes.
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We investigated the distribution of vibrios in Shenzhen coastal waters in order to obtain valuable information for the aquaculture industry and a health warning system. Quantities of vibrios from surface waters ranged from 0 to 4.40×10(4) CFUs mL-1 in April (spring), while from 0 to 2.57×10³ CFUs mL-1 in September (autumn); the abundance of V. alginolyticus-like species from surface water ranged from 0 to 6.72×10³ CFUs mL-1 in April (spring) and from 0 to 1.28×10³ CFUs mL-1 in September (autumn); higher counts were observed in spring. The V. alginolyticus-like species was dominant in Shenzhen coastal waters, with the highest abundance in the clean region (stations YMK001 and GDN064) in April, suggesting that Vibrio spp. were naturally occurring bacteria in marine environments. The correlation between the abundance of vibrios (including V. alginolyticus-like species) and environmental factors varied in different regions and different seasons. There were no vibrios detected when the salinity was less than 11.15ë in the Zhujiang River estuary, which indicated that salinity played a key role in the distribution of vibrios and V. alginolyticus-like species.
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Humans , Aquatic Fauna , Coastal Water , Environmental Microbiology , Gram-Negative Bacterial Infections , Surface Waters , Vibrio Infections , Vibrio alginolyticus/isolation & purification , Vibrio alginolyticus/pathogenicity , Water Distribution , Methods , Methods , Virulence , Water SamplesABSTRACT
Objective To understand the situation of drug resistance( DR) and multi-drug resistance( MDRTB) tuberculosis in Shenzhen and provide scientific evidence for TB control in Shenzhen. Methods According to drug resistance TB guidelines issued by WHO/IUALD, all new smear positive cases and.new registered retreatment smear positive cases in 2005 and 2009 were included in the surveillance. A total of 1856 strains of mycobacterium tuberculosis were isolated and drug susceptibility test were performed with the proportional method. Results In 2005, the overall DR rate was 18. 3% , 17. 2% and 31. 3% for initial and acquired DR respectively, overall MDR rate was 4. 74% ,3.25% and 21.9% respectively for initial and acquired MDR. In 2009, the overall DR rate was 17.4% , 16% and 39. 3%for initial and acquired DR respectively,overall MDR rate was 3.8% ,3.02% and 16.4% respectively for initial and acquired MDR. In 2005,2009, the rates of acquired DR and acquired MDR were significantly higher than the rates of initial DR and initial MDR. Conclusion The incidence of TB drug resistance in Shenzhen was high and merits attention.