Medidas poblacionales para la seguridad vial: más allá de la responsabilidad individual

Las lesiones causadas por el tránsito (LCT) se encuentran dentro de las principales causas de mortalidad y discapacidad a nivel mundial, hecho reflejado en el puesto que ocupan dentro de las primeras diez causas de vida ajustados por discapacidad, con importantes costos e impacto económico y social para las sociedades que las padecen. En 2004, la Organización Mundial de la Salud (OMS) lanzó el primer informe sobre prevención de LCT. Sin embargo, en años posteriores esa situación no mejoró, por lo cual las Naciones Unidas lanzó la Década de Acción para la Seguridad Vial (2011-2020), donde se invitaba a los gobiernos a diseñar e implementar acciones para reducir la carga asociada a este problema; entre estas se encuentra diseño y mejoramiento de vías, atención oportuna pos siniestro, control de la velocidad, medidas de control administrativo, diseño y mejoramiento de estándares vehiculares, entre otras. Las medidas basadas en enfoque poblacional han demostrado ser más poderosas que las medidas que inducen cambios de comportamiento individual.

Injuries caused by traffic (ICT) are among the main causes of mortality and disability worldwide, reflected in the fact that they occupy the first ten causes of disability adjusted life years with economic and social cost impacts for the societies that suffer from them. In 2004, the World Health Organization (WHO) released the first Prevention Report about ICT. Nevertheless, in subsequent years this situation has not improved, motivating the United Nations to launch the Decade of Action for Road Safety (2011-2020), where governments were invited to design and implement actions to reduce the burden associated with this problem: designing and improving of roads, increasing timely post-crash care, speed control, administrative control measures, designing and improving vehicle safety standards, among others. Population-based measures have been shown to be more powerful than measures that induce individual behavior changes.

Uso inconsistente del preservativo masculino en hombres VIH negativos que tienen sexo con hombres / Inconsistent use of male condoms among HIV-negative men who have sex with other men / Uso inconsistente do preservativo masculino entre homens HIV negativos que fazem sexo com homens

Objetivo: analizar los factores asociados con el uso inconsistente del preservativo masculino en hombres VIH negativos que tienen sexo con hombres. Método: estudio transversal, analítico, nacional realizado de forma online en todas las regiones de Brasil, en 2020, a través de redes sociales y sitios de citas. El uso inconsistente del preservativo se definió como el uso ocasional o no usarlo nunca. Se realizaron análisis estadísticos descriptivos, pruebas de asociación y regresión logística binaria. Resultados: 1222 (85%) de los 1438 participantes informaron uso inconsistente del preservativo. Las variables "homosexuales" (ORA: 2,03; IC 95%: 1,14-3,59; p = 0,016), "tener pareja estable" (ORA: 2,19; IC 95%: 1,55-3,09; p<0,001), "sexo oral" (ORA: 2,41; IC 95%: 1,31-4,43; p = 0,005), "anal insertivo" (ORA: 1,98; IC 95%: 1,10-3,58; p = 0,023) y "diagnóstico de ITS" (ORA: 1,59; IC 95%: 1,13-2,24; p = 0,007) se asociaron de forma independiente con el uso inconsistente del preservativo masculino. Las variables "recibió consejo de un amigo sobre la prueba del VIH" (ORA: 0,71; IC 95%: 0,52-0,96; p = 0,028) y "trabajador sexual" (ORA: 0,26; IC 95%: 0,11-0,60; p = 0,002) fueron factores protectores. Conclusión: las variables estudiadas indicaron que hay una fuerte relación entre las parejas estables y el aumento de la confianza y la baja adherencia al uso del preservativo, lo que coincide con otros estudios.

Objective: to analyze the factors associated with inconsistent use of male condoms among HIV-negative men who have sex with other men. Method: a cross-sectional, analytical and nationwide study conducted online in all the Brazilian regions in 2020, via networks and in dating websites. Inconsistent condom use was defined as occasional use or as never using it. Descriptive statistical analyses were performed, as well as association and binary logistic regression tests. Results: inconsistent condom use was reported by 1,222 (85%) of all 1,438 participants. The "homosexuals" (ORAdj: 2.03; 95% CI: 1.14-3.59; p=0.016), "having a fixed partner" (ORAdj: 2.19; 95% CI: 1.55-3.09; p<0.001), "oral sex" (ORAdj: 2.41; 95% CI: 1.31-4.43; p=0.005), "insertive anal" (ORAdj: 1.98; 95% CI: 1.10-3.58; p=0.023) and "STI diagnosis" (ORAdj: 1.59; 95% CI: 1.13-2.24; p=0.007) variables were independently associated with inconsistent use of male condoms. The "receiving advice on HIV test from a friend" (ORAdj: 0.71; 95% CI: 0.52-0.96; p=0.028) and "sex worker" (ORAdj: 0.26; 95% CI: 0.11-0.60; p=0.002) variables were protective factors. Conclusion: the variables under study pointed to a strong relationship between steady partners and increased trust and low adherence to condom use, corroborating other studies.

Objetivo: analisar os fatores associados ao uso inconsistente do preservativo masculino entre homens HIV negativos que fazem sexo com homens. Método: estudo transversal, analítico, de abrangência nacional realizado on-line em todas as regiões do Brasil, em 2020, por meio de redes sociais e em sites de relacionamento. O uso inconsistente do preservativo foi definido como uso ocasional ou nunca ter usado. Foram realizadas análises estatísticas descritivas, testes de associação e regressão logística binária. Resultados: o uso inconsistente do preservativo foi relatado por 1222 (85%) dos 1438 participantes. As variáveis "homossexuais" (ORA: 2,03; IC 95%: 1,14- 3,59; p = 0,016), "ter parceiro fixo" (ORA: 2,19; IC 95%: 1,55-3,09; p<0,001), "sexo oral" (ORA: 2,41; IC 95%: 1,31-4,43; p = 0,005), "anal insertivo" (ORA: 1,98; IC 95%: 1,10-3,58; p = 0,023) e "diagnóstico de IST" (ORA: 1,59; IC 95%: 1,13-2,24; p = 0,007) foram independentemente associadas ao uso inconsistente do preservativo masculino. As variáveis "recebeu aconselhamento de amigo sobre teste de HIV" (ORA: 0,71; IC 95%: 0,52-0,96; p = 0,028) e "profissional do sexo" (ORA: 0,26; IC 95%: 0,11-0,60; p = 0,002) foram fatores de proteção. Conclusão: as variáveis estudadas apontaram uma forte relação das parcerias fixas com o aumento da confiança e uma baixa adesão ao uso do preservativo, o que corrobora com outros estudos.

Valoración de algunos indicadores del programa de atención a la conducta suicida en adolescentes / Evaluation of Some Indicators of the Program of Attention to Suicidal Behavior in Adolescents

Introducción: El suicidio está entre las tres primeras causas de muerte en el grupo de adolescentes y adultos jóvenes, su incidencia no ha descendido en el presente siglo. Objetivo: Valorar algunos indicadores relevantes del programa de atención a la conducta suicida en adolescentes. Métodos: Investigación en sistema y servicios de salud con diseño de estudio observacional descriptivo en tres áreas de salud del municipio Cienfuegos: áreas V, VII y VIII, de enero a septiembre del 2019. El universo fue de 46 profesionales de los Equipos de Salud Mental y Equipo Básicos de Salud. Se utilizaron como instrumentos dos encuestas, diseñadas y validadas por criterio de experto. Fueron seleccionados 6 indicadores en las dimensiones estructura y proceso y 4 en resultado. Se utilizó una media ponderada para procesar los datos. Resultados: Los indicadores valorados de regular fueron: en la estructura: capacitación de los recursos humanos y capacidad técnica del personal; en el proceso: confección de las historias clínicas, diseminación del programa en las unidades de salud y su verificación y las modalidades terapéuticas; y en resultado: la participación del equipo de salud mental en las investigaciones relacionadas con la conducta suicida. Conclusiones: Existe un grupo de deficiencias que conlleva a que el cumplimiento del programa de atención a la conducta suicida en adolescentes sea valorado como regular, en las tres áreas de salud del municipio Cienfuegos estudiadas(AU)

Introduction: Suicide is among the first three causes of death in the group of adolescents and young adults; its incidence has not decreased in the present century. Objective: To assess some relevant indicators of the adolescent suicidal behavior care program. Methods: Research in health system and services with descriptive observational study design in health areas V, VII and VIII of Cienfuegos municipality from January to September 2019. The universe was 46 professionals of the Mental Health Teams and Basic Health Team. Two surveys were used as instruments, designed and validated by expert criteria. Six indicators were selected in the structure and process dimensions and four in outcome. A weighted average was used to process the data. Results: The indicators rated as fair were: in the structure: training of human resources and technical aptitude of personnel; in the process: preparation of clinical histories, dissemination of the program in health units and its verification and therapeutic modalities; and in the outcome: participation of the mental health team in research related to suicidal behavior. Conclusions: There is a group of deficiencies that leads to the fact that compliance with the program of attention to suicidal behavior in adolescents is valued as regular in the three health areas of the Cienfuegos municipality studied(AU)

Interpretation of the International Myopia Institute's White Papers on Myopia Prevention and Control Ⅲ / 中华实验眼科杂志

The high prevalence of myopia is a global public health concern, and the risk of associated complications is becoming increasingly apprent.The International Myopia Institute (IMI) was established in 2015 to promote scientific research and clinical practice in myopia control, and IMI published the White Paper on Myopia Prevention and Control on the diagnosis, treatment, and management of myopia.In 2023, the IMI released the series three of the White Paper on Myopia Prevention and Control, which delves deeper into key issues in myopia research and management.The white paper focuses on non-pathological changes observed in axial myopia, and the role of the choroid in eye growth and myopia management.It also reviews the evidence for myopia incidence, progression and management in atypical populations, such as infants, pre-school children, and young adults.It provides recommendations and strategies for clinical practice in myopia management and summarizes important new findings in myopia research since 2019, which are summarized into the IMI 2023 Digest.This article aims to interpret the key contents of the series three of the White Paper on Myopia Prevention and Control, to help professionals involved in myopia control to stay informed about the latest evidence from international research, to optimize strategies for preventing and treating myopia-related diseases, and ultimately to promote the development of myopia research and management in China.

Meta-analysis of repeated low-level red light therapy for retarding myopia progression in children / 中华实验眼科杂志

Objective:To systematically evaluate the effect of repeated low-level red light (RLRL) therapy on controlling the progression of myopia in children.Methods:Medline, Embase, Cochrane Library, Web of Science, ClinicalTrial.gov and the CNKI, VIP, Wanfang database, and Chinese Clinical Trial Registry (www.chictr.org.cn) were searched from their establishment to September 2022 to obtain the randomized controlled trial (RCT) about RLRL controlling myopia progression in children.Grey literature was also searched.Inclusion and exclusion criteria were developed according to the PICOS principle.Two researchers screened the literature independently, extracted data, and assessed the risk of bias in the included studies using the Cochrane collaboration tool for assessing risk of bias.The data were imported into RevMan 5.4 software for meta-analysis.Mean and standard deviation of data were used to obtain mean differences and 95% confidence intervals of included studies.Changes in spherical equivalent (SE) and axial length (AL) were compared between before and after the intervention in RLRL and single-vision spectacle (experimental group) and single-vision spectacle (control group). The GRADE system was used to grade the quality of evidence for the outcome indicators.Results:A total of 157 studies were obtained.After the screening, 7 RCT studies including 1 038 study subjects met the inclusion criteria.Meta-analysis results showed that retarded SE progression was retarded and AL elongation was reduced significantly after different follow-up durations (1, 3, 6, 12 and 24 months) in experimental group compared with control group.As the follow-up duration extended from 1 month to 24 months, the retard of SE progression increased from 0.14 to 0.93 D, and the reduction of AL increased from 0.07 to 0.48 mm.Both 635 and 650 nm red light significantly retarded SE progression and reduced AL elongation.The two outcome indicators, SE change and AL change were moderate-strength evidence by GRADE.Conclusions:The current moderate-strength evidence shows that RLRL can better retard myopia progression in children than single-vision spectacle glasses.

Developing a development index system of Shanghai district-level disease prevention and control institutions using the Delphi method / 上海预防医学

ObjectiveTo construct an evaluation index system for the development of district-level disease prevention and control centers according to the requirements of the modernization of Shanghai’s disease control system and public health work practices， and to comprehensively assess the construction and development of district-level disease prevention and control institutions. MethodsAccording to the national and municipal requirements for the development of disease prevention and control institutions， an index framework was proposed through literature search and expert interviews. 39 representative experts in the field of public health at the national， provincial， and municipal （district） levels were selected to participate in the consultation and construction of the index system. The authority coefficient， the coefficient of variation， etc. were used to carry out quality control and determination of each index on the Delphi method. ResultsThe questionnaire response rate was 100%， the expert authority coefficient was 0.86，the degree of familiarity was 0.79， and the judgment basis was 0.92. The coefficients of variation of the necessary indicators in the index system were all <0.25 in the dimension of importance， and there were statistical differences in the statistical test of Kendall’s W coordination coefficients at all levels and dimensions （all P<0.001）. After multiple rounds of consultation， experts reached a consensus， forming a development evaluation index system of district-level CDCs with 6 first-level indicators， 24 second-level indicators， and 105 third-level indicators （including 63 necessary indicators and 42 recommended indicators）. ConclusionThe evaluation index system of Shanghai district-level CDCs based on the Delphi method has good authority， reliability， sensitivity and operability. This indicator system can effectively support the development of Shanghai district-level CDCs， and can be used for evaluation at multiple levels and in an all-round way in the future. The evaluation results can provide an evidence-based basis for the modernization of the disease prevention and control system and the continuous and dynamic updating of the development goals in the future.

Epidemiological characteristics of pesticide poisoning in Chengdu City from 2012 to 2021 / 中华劳动卫生职业病杂志

Objective: To explore the present situation and epidemiological characteristics of pesticide poisoning in Chengdu City from 2012 to 2021, and to provide scientific evidence for further prevention and control. Methods: In January 2022, the pesticide poisoning report cards of Chengdu City from 2012 to 2021 were collected from the China Disease Control and Prevention Information System. The data of the report card was reorganized and the distribution characteristics of pesticide poisoning such as time, region, gender, age and pesticide types were analyzed. Results: 14326 cases of pesticide poisoning were reported in Chengdu City from 2012 to 2021, 651 deaths, and the fatality rate was 4.54%. The cases of productive pesticide poisoning and unproductive pesticide poisoning were 504 and 13822, respectively. The fatality rates of productive and unproductive pesticide poisoning were 1.39% and 4.66%, which were significant different (χ(2)=11.99, P=0.001). The highest reported cases of pesticide poisoning was in 2013 (1779) and the lowest in 2021 (1047). The number of reported cases showed a downward trend year by year (t=-12.30, P<0.001), and the fatality rates also showed a downward trend year by year (χ(2)(trend)=25.48, P<0.001). The fluctuation range of unproductive pesticide poisoning cases in each month of the year was small, and the productive pesticide poisoning mainly occurred from May to August. The regions with the largest number of reported poisoning cases were Pengzhou (1620), Jianyang (1393), Jintang (1266) and Qionglai (1158). The high incidence of poisoning was among 25-54 years old (50.21%, 7193/14326). The fatality rate in the age group 75-96 years old was the highest (8.98%, 95/1058), and the fatality rates increased gradually with age (χ(2)(trend)=186.03, P<0.001). The pesticides causing poisoning were mainly insecticide (43.86%, 6284/14326) and herbicides (35.75%, 5121/14326). Herbicides paraquat had the highest fatality rate (9.54%, 286/2998) . Conclusion: Pesticide poisoning in Chengdu City is mainly unproductive poisoning. Health education should be carried out for key areas and people, and the control of highly toxic pesticides such as insecticide and herbicides should be strengthened.

Cross-sectional study on the use of masks among occupational groups with high-risk positions for overseas import and pollution transmission / 中华劳动卫生职业病杂志

Objective: To investigate the wearing of masks and the knowledge of masks among high-risk positions for overseas import and pollution transmission. Methods: From May 14 to 17, 2022, a convenient sampling method was used to conduct an online survey among 963 workers in high-risk positions for overseas import and pollution transmission in Beijing. The behaviors of individual use and wearing masks, the distribution and supervision of the unit, the knowledge of personal mask protection and the subjective feelings of wearing masks were analyzed. The χ(2) test and logistic regression model were used to analyze the influencing factors of the correct selection of masks. Results: The majority of the workers in high-risk positions for overseas import and pollution transmission were male (86.0%, 828/963), age concentration in 18-44 years old (68.2%, 657/963), and the majority of them had college or bachelor degrees (49.4%, 476/963). 79.4%(765/963) of the workers chose the right type of masks, female, 45-59 years old and high school education or above were the risk factors for correct selection of masks (P <0.05). Workers had good behaviors such as wearing/removing masks, but only 10.5% (101/963) could correctly rank the protective effect of different masks. 98.4% (948/963) of the workers believed that their work units had provided masks to their employees, and 99.1% (954/963) and 98.2%(946/963) of them had organized training and supervision on the use of masks, respectively. 47.4%(456/963) of the workers were uncomfortable while wearing masks. Conclusion: The overall selection and use of masks among occupational groups in high-risk positions for overseas import and pollution transmission in China need to be further standardized. It is necessary to strengthen supervision and inspection on the use of masks among occupational groups, and take improvement measures to improve the comfort of wearing masks.

Research progress on defocus technique of orthokeratology lens in the prevention and control of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

The incidence of myopia is gradually on the rise worldwide, which seriously affects the eye health of teenagers and children, causing enormous loss of socioeconomic benefits. As a result, the prevention and control of myopia is crucial and urgent. In recent years, orthokeratology lens have gradually demonstrated its superiority in the field of myopia prevention and control. At present, the principle of controlling the development of myopia by orthokeratology lens is mainly based on the theory of retinal hyperopia optical defocus, which promotes the shift of hyperopic defocus to myopic defocus in myopic patients to curb the growth of the axial length. The effect of controlling the development of myopia is related to various factors, including the total amount of defocusing, pupil diameter, optical zone design, and lens decentration. The widespread use of orthokeratology lenses will effectively reduce the incidence of myopia in teenagers and children. This paper discusses the principle of controlling the development of myopia by the defocus technique of orthokeratology lenses, and the relationship between the amount of defocusing and the position of the defocusing circle and the effect of myopia prevention and control. A specific review was conducted to clarify the research progress on defocus technique of orthokeratology lens in the prevention and control of myopia.

Relationship between reduction of urban PM2.5 and mental health of middle-aged and elderly people after China's Air Pollution Prevention and Control Action Plan / 环境与职业医学

Background Epidemiological evidence indicates an association of particulate matter with depression and cognitive performance. From 2013 to 2017, China implemented the Air Pollution Prevention and Control Action Plan to reduce particulate matter concentration. There are few studies on the relationship between the decrease of particulate matter concentration and the improvement of mental health in middle-aged and elderly people. Objective To analyze the relationship between the decrease of city-level particulate matter concentration and the improvement of depression and cognitive function in the middle-aged and elderly population after the implementation of the Air Pollution Prevention and Control Action Plan. Methods Using the China Health and Retirement Longitudinal Study (CHARLS) data in 2011 and 2018, this study applied longitudinal data clustering technology to group cities based on the actual response of each city to the policy (the dynamic change trajectory of PM2.5 in each city during the study period); the higher the degree of response, the greater the reduction of PM2.5 concentration in the city. We assigned participants to three groups with different degrees of response to the policy, including low-response group A as the control group, medium-response intervention group B, and high-response intervention group C. A difference-in-differences (DID) model was used to estimate the influence of PM2.5 decline on the depression and cognitive function among middle-aged and elderly people in China by considering potential individual and city-level time-varying confounders. Depression was measured using the 10-item Center for the Epidemiological Studies of Depression Scale (CES-D10) (10 questions, total score range 0-30) with higher score representing higher severity of depression. Cognitive function was evaluated with reference to the international cognitive function test questionnaire for the middle-aged and the elderly which was further categorized into two dimensions of memory and cognitive status and included 31 questions with a score range of 0-31; the higher the score, the better the cognitive function. Samples with relatively complete outcomes were selected for analysis, including 10729 people in depression analysis and 4510 people in cognitive analysis. Results The longitudinal clustering results indicated that the urban groups with the highest decline of PM2.5 concentrations (high-response group C) had the highest baseline PM2.5 concentrations, mainly in Beijing-Tianjin-Hebei region, Chengdu-Chongqing metropolitan area, and Wuhan metropolitan area. In 2011, no significant differences were observed in depression and cognitive function among the three groups of middle-aged and elderly populations (Kruskal Wallis test: Pdepression=0.864, Pcognition=0.239). Significant differences were found in depression and cognitive function in both low-response group A and medium-response group B in 2018 compared to 2011 (paired Wilcox test, all P<0.001). However, in the high-response group C, there was no significant difference in depression in 2018 compared to 2011 (P=0.195), while a significant difference was detected in cognitive function (P=0.006). As PM2.5 concentrations decreased, the DID model showed that the depression of the middle-aged and elderly people in the high-response group C decreased by 7.55% (95%CI: 2.83%-12.03%), and the cognitive function improved by 2.70% (95%CI: 0.25%-5.22%) compared with the low-response group A. However, no intervention effect was observed in group B with moderate response level compared with group A with low response level. Conclusion After the implementation of the Air Pollution Prevention and Control Action Plan policy, the decrease of PM2.5 concentration has an ameliorative effect on the depression and cognitive function of middle-aged and elderly people in China. Given the aging population and the increasing burden of mental-related diseases in China, the promotion of environmental air pollution control has important public health implications.

Prevalence and risk factors of dry eye in children aged 7-14 years in myopia prevention and control clinic / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyse the prevalence and risk factors of dry eye among children aged 7-14 years in myopia prevention and control clinic.METHODS:A total of 222 children aged 7-14 years in myopia prevention and control clinic from December 2021 to February 2022 were included. General data of included children were collected, assessing the prevalence of dry eye by the ocular surface disease index(OSDI)scale and Keratograph 5M, and analyzing risk factors for dry eye occurrence by Logistic regression model.RESULTS:The prevalence of dry eye in children in myopia prevention and control clinic was 27.9%. Logistic Regression analysis showed that, allergic conjunctivitis(OR=2.31, 95%CI=1.12-4.78, P=0.02), refractive error(OR=5.57, 95%CI=2.40-12.94, P&#x0026;#x003C;0.01), use time of electronic &#x0026;#x003E;2h per day(OR=2.74, 95%CI=1.11-6.78, P=0.03), time of playing games &#x0026;#x003E;2h per day(OR=2.33, 95%CI=1.12-4.84, P=0.02), outdoor activity time ≤2h per day(OR=4.28, 95%CI=2.02-9.07, P&#x0026;#x003C;0.01)and sleep duration &#x0026;#x003C;8h per day(OR=3.23, 95%CI=1.44-7.27, P=0.01)were risk factors for dry eye among the children.CONCLUSIONS:The prevalence of dry eye among children in myopia prevention and control clinic should be paid high attention. Therefore, improving behavior habits and controlling the use time of visual display terminal products to prevent and slow down the occurrence of dry eye in children.

Interpretation on Consensus on drug-induced liver injury by CIOMS Working Group:liver injury attributed to herbal and dietary supplements / 中国中药杂志

With the increase in the medical level, the improvement of adverse drug reaction(ADR) monitoring systems, and the enhancement of public awareness of safe medication, drug safety incidents have been frequently reported. Drug-induced liver injury(DILI), especially liver injury attributed to herbal and dietary supplements(HDS), has globally attracted high attention, bringing great threats and severe challenges to the people for drug safety management such as clinical medication and medical supervision. Consensus on drug-induced liver injury had been published by the Council for International Organizations of Medical Sciences(CIOMS) in 2020. In this consensus, liver injury attributed to HDS was included in a special chapter for the first time. The hot topics, including the definition of HDS-induced liver injury, epidemiological history, potential risk factors, collection of related risk signals, causality assessment, risk prevention, control and management were discussed from a global perspective. Based on the previous works, some experts from China were invited by CIOMS to undertake the compilation of this chapter. Meanwhile, a new causality assessment in DILI based on the integrated evidence chain(iEC) method was widely recognized by experts in China and abroad, and was recommended by this consensus. This paper briefly introduced the main contents, background, and characteristics of the Consensus on drug-induced liver injury. Significantly, a brief interpretation was illustrated to analyze the special highlights of Chapter 8, "Liver injury attributed to HDS", so as to provide practical references for the medical staff and the researchers who worked on either Chinese or Western medicine in China.

Main Infection Control Measures for Respiratory Infectious Diseases in Medical Institutions and Public Places in China / 中国医学科学院学报

Respiratory infectious diseases (RID) are the major public health problems threatening the people's lives and health.Infection control (IC) is one of the effective tools to contain the occurrence and spread of RID.We collected the articles and data on IC published since January 1,2018 and summarized the achievements,problems,and challenges of IC from administrative control,management control,environment and engineering control,and personal protection in the medical institutions and public places in China.The efforts for IC vary in different regions and medical institutions of different levels.There are still links to be improved for IC from administrative control,management control,environment and engineering control,and personal protection,especially in community-level medical institutions and public areas.It is urgent to strengthen the implementation of IC policies and conduct IC precisely according to local situations.We proposed the following suggestions.First,the existing IC products and tools should be applied to precisely implement the IC measures;second,modern high technology should be employed to develop efficient and convenient IC products and tools;finally,a digital or intelligent IC platform should be built for monitoring infections,so as to contain the occurrence and spread of RID.

Characteristics of Gram-positive cocci infection and the therapeutic effect after liver transplantation / 中南大学学报(医学版)

OBJECTIVES@#Gram-positive cocci is the main pathogen responsible for early infection after liver transplantation (LT), posing a huge threat to the prognosis of liver transplant recipients. This study aims to analyze the distribution and drug resistance of Gram-positive cocci, the risk factors for infections and efficacy of antibiotics within 2 months after LT, and to guide the prevention and treatment of these infections.@*METHODS@#In this study, data of pathogenic bacteria distribution, drug resistance and therapeutic efficacy were collected from 39 Gram-positive cocci infections among 256 patients who received liver transplantation from donation after citizens' death in the Third Xiangya Hospital of Central South University from January 2019 to July 2022, and risk factors for Gram-positive cocci infection were analyzed.@*RESULTS@#Enterococcus faecium was the dominant pathogenic bacteria (33/51, 64.7%), followed by Enterococcus faecalis (11/51, 21.6%). The most common sites of infection were abdominal cavity/biliary tract (13/256, 5.1%) and urinary tract (10/256, 3.9%). Fifty (98%) of the 51 Gram-positive cocci infections occurred within 1 month after LT. The most sensitive drugs to Gram-positive cocci were teicoplanin, tigecycline, linezolid and vancomycin. Vancomycin was not used in all patients, considering its nephrotoxicity. Vancomycin was not administered to all patients in view of its nephrotoxicity.There was no significant difference between the efficacy of daptomycin and teicoplanin in the prevention of cocci infection (P>0.05). Univariate analysis indicated that preoperative Model for End-Stage Liver Disease (MELD) score >25 (P=0.005), intraoperative red blood cell infusion ≥12 U (P=0.013) and exposure to more than 2 intravenous antibiotics post-LT (P=0.003) were related to Gram-positive cocci infections. Multivariate logistic regression analysis revealed that preoperative MELD score >25 (OR=2.378, 95% CI 1.124 to 5.032, P=0.024) and intraoperative red blood cell transfusion ≥ 12 U (OR=2.757, 95% CI 1.227 to 6.195, P=0.014) were independent risk factors for Gram-positive cocci infections after LT. Postoperative Gram-positive cocci infections were reduced in LT recipients exposing to more than two intravenous antibiotics post-LT (OR=0.269, 95% CI 0.121 to 0.598, P=0.001).@*CONCLUSIONS@#Gram-positive cocci infections occurring early after liver transplantation were dominated by Enterococcus faecalis infections at the abdominal/biliary tract and urinary tract. Teicoplanin, tigecycline and linezolid were anti-cocci sensitive drugs. Daptomycin and teicoplanin were equally effective in preventing cocci infections due to Gram-positive cocci. Patients with high preoperative MELD score and massive intraoperative red blood cell transfusion were more likely to suffer Gram-positive cocci infection after surgery. Postoperative Gram-positive cocci infections were reduced in recipients exposing to more than two intravenous antibiotics post-LT.

Population-based active screening strategy contributes to the prevention and control of tuberculosis / 浙江大学学报·医学版

Despite the achievements obtained worldwide in the control of tuberculosis in recent years, many countries and regions including China still face challenges such as low diagnosis rate, high missed diagnosis rate, and delayed diagnosis of the disease. The discovery strategy of tuberculosis in China has changed from "active discovery by X-ray examination" to "passive discovery by self-referral due to symptoms", and currently the approach is integrated involving self-referral due to symptoms, active screening, and physical examination. Active screening could help to identify early asymptomatic and untreated cases. With the development of molecular biology and artificial intelligence-assisted diagnosis technology, there are more options for active screening among the large-scale populations. Although the implementation cost of a population-based active screening strategy is high, it has great value in social benefits, and active screening in special populations can obtain better benefits. Active screening of tuberculosis is an important component of the disease control. It is suggested that active screening strategies should be optimized according to the specific conditions of the regions to ultimately ensure the benefit of the tuberculosis control.

Perinatal and neonatal management plan for prevention and control of SARS-CoV-2 infection (3rd Edition) / 中国当代儿科杂志

Since the global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2020, the virus has been evolving through mutations to acquire enhanced infectivity but reduced virulence. With a wide vaccination coverage among Chinese population, China is entering a new stage of SARS-CoV-2 infection control. The Working Group for the Prevention and Control of Neonatal SARS-CoV-2 Infection in the Perinatal Period of the Editorial Committee of Chinese Journal of Contemporary Pediatrics released the first and second editions of perinatal and neonatal management plan for prevention and control of SARS-CoV-2 infection in January and March 2020, respectively. In order to follow up new prevention and control needs, it is necessary to update the management plan to better guide clinical practice. Therefore, the Working Group formulated the 3rd-edition plan.