Distribution and change of poor vision among school students aged 6-19 in Hainan Province, 2013-2020 / 中国热带医学

@#Abstract: Objective　To explore the regional, age and annual characteristics of distribution and variation trend of children and adolescents with poor vision in Hainan Province, and to provide a theoretical basis for the formulation of targeted and effective prevention and treatment strategies. Methods　The eyesight monitoring data of 5 657 231 children and adolescents aged 6 to 19 from 17 cities and counties in Hainan Province from 2013 to 2020 were analyzed. Using the "Standard Logarithmic Vision Chart" (GB11533-2011) that complies with national standards for testing. Results　The rate of poor vision among children and adolescents in Hainan Province increased significantly from 2013 to 2020, and the difference between the years was statistically significant (P<0.001). The total poor vision rate in the left eye increased 10.09% (32.79% to 42.88%), and that of severe poor vision rate increased 6.68%, while that of the right eye increased 9.80% (33.11% to 42.91%) and 6.49%. The poor vision rate was significantly higher in females than in males of same year (P<0.001), but the increase pattern was the same. In 2020, there were significant differences between the same age groups in different cities and counties and between different age groups in the same city and county (P<0.001), and they all tended to increase with age. The result of analyzing the distribution characteristics of the total poor vision rate of different age groups children in the eastern (Qionghai), southern (Sanya), western (Changjiang), northern (Haikou) and central (Dingan) cities showed that the regional rate difference was small at 6-7 years old, and then increased with the increase of age. The poor vision rate of Haikou City ranked the first in all age groups, and reached the highest at 17 years old, with 76.32% and 80.89% of total poor vision rate of left and right eyes respectively. Sanya City ranked second, Qionghai ranked third. The poor vision rate of Changjiang County was lower and the growth rate was slower according to age. Conclusions　From 2013 to 2020, the total and severe poor vision rates in left and right eyes of children aged 6-19 in Hainan Province increased year by year, with the ascension range of female higher than that of male, and right eye higher than that of left eye. In the same year, the poor vision rate increase rapidly with age. It is recommended to further strengthen the daily intervention and management of key populations and special age groups to reduce the rate of low vision in children and adolescents.

Diagnostic value of cross-primer isothermal amplification technology in tuberculosis and its related influencing factors / 中国热带医学

@#Abstract： Objective　To analyze the value and influencing factors of cross-primer isothermal amplification technology(CPA) in clinical screening and diagnosis of tuberculosis (TB). Methods　We collected 543 inpatients in the Second Affiliated Hospital of Hainan Medical College from January 1, 2018 to December 31, 2021, including 179 patients with tuberculosis, 187 patients with pneumonia and 177 patients with other diseases. The patients' sputum, alveolar lavage fluid, pleural effusion and midstream urine were detected by CPA, smear microscopy, culture method and gene detection. The value of CPA detection in the diagnosis of tuberculosis and its influencing factors were evaluated. Statistical analysis was performed using SPSS 26.0. Results　The total positive rate of CPA was 14.4% (78/543), and the positive rate of sputum samples accounted for 29.1% (39/134). Among the 78 cases of CPA positive patients, the tuberculosis group accounted for 69.2% (54/78), followed by pneumonia group 21.8% (17/78), and other diseases group accounted for 9.0% (7/78). Taking CPA test as the reference method, the "sensitivity" of smear microscopy was lower than that of genetic testing and culture, while the "specificity" was higher than that of culture and gene testing, and the "missed diagnosis rate" of smear microscopy was higher than that of genetic testing and culture. CPA test positive was related to gender, ESR and pneumonia. There is a good agreement between CPA test and culture method and gene test (Kappa>0.9), and a moderate agreement between CPA test and smear microscopy (Kappa=0.616). Conclusions　Sputum specimen is the best choice for CPA detection, while the value of pleural effusion detection is relatively limited. Sputum, alveolar lavage fluid and midcourse urine can be used as clinical specimens for screening and diagnosis of "tuberculosis group and other disease group", while sputum can be used for screening and diagnosis of "tuberculosis group and pneumonia group". Gender, ESR and pneumonia are the influencing factors of CPA positive patients. Therefore, CPA testing is worthy of clinical promotion, but more clinical research data are needed.

[Seven kinds of new SCCmec type in Methicillin-resistant Staphyloccus aureus and their susceptibility to the antibiotics].

In order to explore the resistance and the staphylococcal chromosome cassette mec (SCCmec) types of Methicillin-resistant S. aureus (MRSA) in the area of Haikou, 686 strains of MRSA had been distinguished from 1174 strains of S. aureus using PBP2a testing. The resistance to the seven deputies of seven kinds antibiotics which in common use in clinic, including Oxacillin, Vancomycin, Doxycyclin, Amikacin, Erythromycin, Chloramphenicol, Ciprofloxacin, and SCCmec type of 58 strains had been tested using the K-B Agar diffuse, E-test and multiplex PCR strategy, and seven kinds of new SCCmec types were found in 17 strains. Their specialties of structure are: type-new3 possess four loci of A, F, H, M; New4 possess three loci of F, H, M; New5 possess three loci of D, B, M; New6 possess three loci of A, B, M; New7 possess four loci of H, E, C, M; New8 possess two loci of A, M; New9 possess three loci of A, C, M. All of them are different from the types reported. The strains carrying new SCC mec types are different from that carrying old SCC mec types in the epidemical distribution and resistance to the antibiotics: they were mostly isolated from the out-patients and have high level and wider range of resistance to antibiotics and deserve to pay more attention.

[Two kinds of new Sccmec type in Methicillin-resistant Staphylococcus aureus and their susceptibility to the antibiotics].

In order to explore the resistance, epidemical distribution and the staphylococcal chromosome cassette mec (SCCmec) types of Methicillin-resistant S. aureus (MRSA) in the area of Haikou, the resistance and SCCmec type of MRSA isolated from clinical sample has been tested using the K-B Agar diffuse, E-test and multiplex PCR strategy, resulting that two kinds of new SCC mec types were found in them. Type-newl possess three loci of B, M, F. Locus M, which locate in mecA, is the indicator of mecA, and also used as the positive control. Locus B, which locate in upstream of mec A, is specific for type- II and F, which locate in downstream of mec A, is specific for type- iU ; and so, type-newl was combined from the type- II and - I . Type-new2 possess five loci of A, B, M, F, H. Locus A, which is locate in upstream of mecA, is specific for type- I and H, which is locate in downstream of mecA, is also specific for type- 1 ; and so, type-new2 was combined from the type- I , - II and - I . The strains carrying new SCC mec types are different from that carrying old SCC mec types in the epidemical distribution and resistance to the antibiotics. They can be usually isolated from the out-patients and have high level and wider range of resistance to antibiotics. It must be paid more attention to them.