cases

案例
  • 文章类型: Journal Article
    人类朊病毒病(PrD),一组致命和可传播的神经退行性疾病,包括克雅氏病(CJD),库鲁,致命的家族性失眠(FFI),Gerstmann-Sträussler-Scheinker病(GSS),和可变蛋白酶敏感的prionopathy(VPSPr)。牛海绵状脑病(BSE)和变异型CJD(vCJD)的出现极大地威胁了公众健康,无论是人类还是动物。自1990年代以来,数十个国家和地区开展了PrD监视计划。
    在这项研究中,从1993年到2020年,全球和不同国家或地区不同类型的PRD的病例数量和替代趋势是根据国际和国家PRD监测计划网站的数据进行收集和分析的,以及相关出版物。
    在34个国家/地区报告的PrD和零星CJD(sCJD)病例总数分别为27,872和24,623。PrD病例最多的7个国家是美国(n=5,156),法国(n=3,276),德国(n=3,212),意大利(n=2,995),中国(n=2,662),英国(n=2,521),西班牙(n=1,657),加拿大(n=1,311)。每年的PrD病例数和死亡率,无论是在全球还是在各国,在过去的27年中显示出增长趋势。遗传性PrD病例占所有报告的PrD病例的10.83%;然而,不同国家和地区之间的趋势差异很大。全球报告有485例医源性CJD(iCJD)病例和232例vCJD病例。
    拥有PrD监测项目的国家大多是高收入和中高收入国家。然而,世界上大多数低收入和中低收入国家没有进行PRD监测,甚至没有报告PRD病例,这表明全球人类PrD病例的数量明显被低估。从公共卫生的角度来看,对人类和动物进行积极的国际PrD监测对于消除pr病毒疾病的威胁仍然至关重要。
    UNASSIGNED: Human prion disease (PrD), a group of fatal and transmissible neurodegenerative diseases, consists of Creutzfeldt-Jakob disease (CJD), kuru, fatal familial insomnia (FFI), Gerstmann-Sträussler-Scheinker disease (GSS), and variably protease-sensitive prionopathy (VPSPr). The emergence of bovine spongiform encephalopathy (BSE) in cattle and variant CJD (vCJD) has greatly threatened public health, both in humans and animals. Since the 1990\'s, dozens of countries and territories have conducted PrD surveillance programs.
    UNASSIGNED: In this study, the case numbers and alternative trends of different types of PrD globally and in various countries or territories from 1993 to 2020 were collected and analyzed based on the data from the websites of the international and national PrD surveillance programs, as well as from relevant publications.
    UNASSIGNED: The total numbers of the reported PrD and sporadic CJD (sCJD) cases in 34 countries with accessible annual case numbers were 27,872 and 24,623, respectively. The top seven countries in PrD cases were the USA (n = 5,156), France (n = 3,276), Germany (n = 3,212), Italy (n = 2,995), China (n = 2,662), the UK (n = 2,521), Spain (n = 1,657), and Canada (n = 1,311). The annual PrD case numbers and mortalities, either globally or in the countries, showed an increased trend in the past 27 years. Genetic PrD cases accounted for 10.83% of all reported PrD cases; however, the trend varied largely among the different countries and territories. There have been 485 iatrogenic CJD (iCJD) cases and 232 vCJD cases reported worldwide.
    UNASSIGNED: The majority of the countries with PrD surveillance programs were high- and upper-middle-income countries. However, most low- and lower-middle-income countries in the world did not conduct PrD surveillance or even report PrD cases, indicating that the number of human PrD cases worldwide is markedly undervalued. Active international PrD surveillance for both humans and animals is still vital to eliminate the threat of prion disease from a public health perspective.
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  • 文章类型: Journal Article
    H10禽流感病毒在野生鸟类中传播,并可以与其他亚型重新分类。H10N8和H10N3以前曾在中国引起零星的人类感染。
    本报告记录了首例人类同时感染禽源H10N5和季节性H3N2流感病毒的病例。流行病学调查在与患者相关的环境样本中确定了H10N5,但是没有传输给密切接触者。
    加强对活禽市场和家禽种群中禽流感的监测对于彻底确定流行病学特征至关重要,传输,和H10N5病毒的发病机理。加强对疫情控制措施的评估对于指导有效管理至关重要。
    UNASSIGNED: H10 avian influenza viruses circulate in wild birds and can reassort with other subtypes. H10N8 and H10N3 have previously caused sporadic human infections in China.
    UNASSIGNED: This report documents the first human case of co-infection with avian-origin H10N5 and seasonal H3N2 influenza viruses. Epidemiological investigations identified H10N5 in environmental samples linked to the patient, but no transmission to close contacts occurred.
    UNASSIGNED: Enhanced surveillance of avian influenza in live poultry markets and poultry populations is crucial for thoroughly characterizing the epidemiology, transmission, and pathogenesis of H10N5 viruses. Strengthening assessments of outbreak control measures is essential to guide effective management.
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  • 文章类型: Journal Article
    背景:棘球蚴病流行于中国西部和北部的9个省。2012年和2016年云南省包虫病流行病学调查显示包虫病病例。
    目的:了解云南省包虫病的空间分布和流行病学特征,为云南省包虫病的预防和控制提供依据。
    方法:基于中国疾病预防控制信息系统(CISDCP),从2021年到2022年,对36家医院和34个疾病控制中心报告的包虫病病例进行了调查和流行病学分析。排除标准包括疑似病例,同样的病例只统计了一次,而不是云南的病例。共调查了705例,其中397例适用于统计学分析。在这397个案例中,对187例病例进行流行病学追踪调查。所有数据均使用Excel数据库中的双重条目输入,通过双输入比较进行纠错。利用ArcGIS10.1软件对云南省包虫病病例资料进行分析,生成包虫病分布密度图。所有统计分析均使用SPSS17.0进行,包括卡方检验,线性回归检验和Logistic单变量和多元回归分析。
    结果:云南省89个县共发现397例。病例数前三的州为大理(38.1%),迪庆(10.1%),和昆明(8.3%),排名前五位的县是剑川(9.1%),香格里拉(8.3%),洱源(7。6%),鹤庆(6.9%),和大理地区(5.0%)。不同地区之间存在显著差异。CISDCP的病例报告率(33.8%)较低;2002年CISDCP报告了第一例病例,最高病例数为50例(2017年)。确诊和临床病例分别占62.5%和37.5%,分别。然而,90.9%的包虫病病例由医院系统报告,社区中只有9.1%的包虫病病例是通过积极筛查发现的。两种病例检测方法差异有统计学意义。包虫病的大多数病例发生在农牧民(75.1%)和学生(9.1%)中。此外,汉族(43.6%)和白族(26.2%)的感染率高于其他民族,肝(87.7%)和肺(6.8%)是最常见的囊肿形成部位。在分析的案例中,对187例进行流行病学分析,47.1%的病例早期临床症状不明显。Logistic回归分析结果显示,教育水平,狗在家庭中的存在(以前或现在),洗手(偶尔或不洗手)是与包虫病感染有关的因素。55.6%的病例发生在流行地区,44.4%的病例在非流行地区。在非流行地区的83例病例中,只有4个病例去过流行区,有生活史,工作,旅行,或者在包虫病流行地区狩猎。
    结论:在整个云南省报告了包虫病病例,大部分分布在云南西部,建议在该地区加强包虫病的控制。我们建议今后开展流行病学调查,根据医院或CISDCP新发现病例的线索。医院新发现的病例提供了线索,全面确定了病例发生的地点和应该在哪里进行疫点调查。
    BACKGROUND: Echinococcosis is prevalent in 9 provinces in Western and Northern China. An epidemiological survey of echinococcosis in 2012 and 2016 showed cases of echinococcosis in Yunnan Province.
    OBJECTIVE: To understand the spatial distribution and epidemiological characteristics of echinococcosis in Yunnan for the prevention and control of echinococcosis and to reduce the risk of infection in Yunnan Province.
    METHODS: Based on the China Information System for Disease Control and Prevention (CISDCP), echinococcosis cases reported from 36 hospitals and 34 Centers for Disease Control were investigated and epidemiologically analyzed from 2021 to 2022. The exclusion criteria included suspected cases, same case only counted once and cases not from Yunnan. A total of 705 cases were investigated, of which 397 cases were suitable for statistical analysis. In these 397 cases, epidemiological investigation was tracked in 187 cases. All data were inputted using double entry in the Excel database, with error correction by double-entry comparison. The data on echinococcosis cases in Yunnan Province were analyzed by ArcGIS 10.1 software to generate a density map of echinococcosis distribution. All statistical analyses were conducted using SPSS 17.0, including the chi-square test, linear regression test and logistic univariate and multivariate regression analyses.
    RESULTS: A total of 397 cases were found in 89 counties in Yunnan Province. The number of cases in the top three prefectures were Dali (38.1%), Diqing (10.1%), and Kunming (8.3%), and the top five counties were Jianchuan (9.1%), Shangri La (8.3%), Eryuan (7. 6%), Heqing (6.9%), and Dali Districts (5.0%). There were significant differences between the different areas. The case reporting rate by CISDCP (33.8%) was low; the first case was reported by CISDCP in 2002, and the highest number of cases was 50 (2017). Confirmed and clinical cases accounted for 62.5% and 37.5%, respectively. However, 90.9% of the cases of hydatid disease were reported by the hospital system, and only 9.1% of the cases of hydatid disease were found in the community through active screening. The difference between the two methods of case detection was statistically significant. Most of the cases of echinococcosis were found in farmers/herdsmen (75.1%) and students (9.1%). In addition, Han (43.6%) and Bai (26.2%) had a higher incidence of infection than other nationalities, and the liver (87.7%) and lung (6.8%) were the most common sites of cyst formation. Among the analyzed cases, 187 were epidemiologically analyzed and the clinical symptoms were not obvious in the early stage in 47.1% of cases. The results of logistic regression analysis showed that the age group, education level, presence of dogs in the family (either previously or currently), and handwashing (occasionally or not) were factors related to echinococcosis infection. 55.6% of cases were in endemic areas, and 44.4% of cases were in non-endemic areas. Among 83 cases in non-endemic areas, only 4 cases had been to endemic areas and had a history of living, working, travelling, or hunting in echinococcosis epidemic areas.
    CONCLUSIONS: Cases of echinococcosis were reported throughout the entire Yunnan province, with the majority distributed in Western Yunnan, suggesting that echinococcosis control should be strengthened in this area. We suggest that an epidemiological investigation should be carried out in the future, based on the clues from newly discovered cases in hospitals or from the CISDCP. The newly discovered cases in the hospital provided clues to comprehensively determine the location of cases and where epidemic spot investigation should be conducted.
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  • 文章类型: Journal Article
    布鲁氏菌病是一种通常被忽视的人畜共患病,但仍然是全球严重的公共卫生问题。在过去的几十年中,人类布鲁氏菌病的流行病学演变发生了很大变化,疫情地理不断扩大。人类布鲁氏菌病越来越多地出现和重新出现,从因旅行而流行的地区进口,移民,和国际贸易。这种疾病在亚洲和非洲继续猖獗,包括西亚,中亚,北非,东非,在叙利亚发生率最高,吉尔吉斯斯坦,蒙古,伊朗,阿尔及利亚,肯尼亚。在布鲁氏菌病已得到控制的地方,经常记录重新出现的病例,比如波斯尼亚和黑塞哥维那,阿塞拜疆,和美国。在疾病负担较高的国家,由于畜牧业是唯一的生计来源,控制和根除这种疾病极其困难,关于动物的独特宗教信仰,游牧的生活方式,低社会经济水平。需要采取以保护牲畜饲养者为重点的干预措施,特别是那些帮助山羊和绵羊出生和食用生乳制品的人。令人震惊的是,在大多数疾病负担较高的国家,发病率低的每几年都伴随着病例的增加,强调持续的投资和监督是必要的。此外,倡导将布鲁氏菌病列为全球强制报告的疾病,严格限制动物活动,强制食用巴氏杀菌牛奶,需要健康教育。本研究将有助于为国际组织制定基于证据的策略,以遏制布鲁氏菌病的未来传播。
    Brucellosis is a commonly neglected zoonosis that remains a serious global public health concern. The epidemiological evolution of human brucellosis has considerably changed over the past few decades, and epidemic geography is continuously expanding. Human brucellosis is emerging and re-emerging, and is imported from areas where it is endemic due to travel, immigration, and international trade. The disease continues to be prevalent in Asia and Africa, including West Asia, Central Asia, North Africa, and East Africa, with the highest incidence in Syria, Kyrgyzstan, Mongolia, Iran, Algeria, and Kenya. Re-emerging cases are frequently recorded in places where brucellosis has been controlled, such as Bosnia, Herzegovina, Azerbaijan, and the USA. In countries with a high disease burden, disease control and eradication have been extremely difficult because of livestock farming being the only source of livelihood, unique religious beliefs regarding animals, nomadic lifestyle, and low socioeconomic levels. Interventions focused on protecting livestock keepers are needed, particularly for those assisting with goat and sheep births and the consumption of raw dairy products. Notably, in most countries with a high disease burden, each period of several years with a low incidence rate was followed by a subsequent increase in cases, highlighting the necessity of continuous investment and surveillance. In addition, advocacy for the inclusion of brucellosis as a globally mandated reported disease, strict restrictions on animal movement, mandated consumption of pasteurized milk, and health education are needed. This study will help form an evidence-based strategy for international organizations to curb the future spread of brucellosis.
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  • 文章类型: Journal Article
    背景:中国已经在全国范围内实施了封锁,以从早期阶段遏制COVID-19。先前关于COVID-19对中国性传播疾病(STD)和血液传播病毒(BBV)引起的疾病的影响的研究得出了截然不同的结果,关于性病和BBV导致的死亡的研究很少。
    目的:我们旨在阐明COVID-19封锁对病例的影响,死亡,性病和BBV的病死率。
    方法:我们提取了每月艾滋病病例和死亡数据,淋病,梅毒,乙型肝炎,2015年1月至2021年12月,来自中国国家卫生健康委员会官方网站上的法定报告疾病报告数据库。我们使用描述性统计数据来总结病例数和死亡人数,并计算了实施全国封锁前后(2020年1月)的发病率和病死率。我们使用负二项分段回归模型来估计封锁对病例的直接和长期影响,死亡,和病例死亡率分别为2020年1月和2021年12月。
    结果:艾滋病共14,800,330例,127,030例死亡,淋病,梅毒,乙型肝炎,丙型肝炎从2015年1月到2021年12月报告,封锁前发病率为149.11/100,000,封锁后发病率为151.41/100,000,锁定前的病死率为8.21/1000,锁定后的病死率为9.50/1000。在负二项模型中,艾滋病病例(-23.4%;0.766,0.626-0.939)和死亡(-23.9%;0.761,0.647-0.896),淋病病例(-34.3%;0.657,0.524-0.823),梅毒病例(-15.4%;0.846,0.763-0.937),乙型肝炎病例(-17.5%;0.825,0.726-0.937)和丙型肝炎病例(-19.6%;0.804,0.693-0.933)在2020年1月显示显着下降。淋病,梅毒和丙型肝炎在2020年1月的死亡人数或病死率上略有增加.到2021年12月,案件死亡,每种疾病的病死率均达到或保持低于预期水平.
    结论:COVID-19封锁可能导致报告的艾滋病病例减少,淋病,梅毒,乙型肝炎,和丙型肝炎,更多报告的淋病死亡或病死率,梅毒和丙型肝炎在中国。
    China implemented a nationwide lockdown to contain COVID-19 from an early stage. Previous studies of the impact of COVID-19 on sexually transmitted diseases (STDs) and diseases caused by blood-borne viruses (BBVs) in China have yielded widely disparate results, and studies on deaths attributable to STDs and BBVs are scarce.
    We aimed to elucidate the impact of COVID-19 lockdown on cases, deaths, and case-fatality ratios of STDs and BBVs.
    We extracted monthly data on cases and deaths for AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C between January 2015 and December 2021 from the notifiable disease reporting database on the official website of the National Health Commission of China. We used descriptive statistics to summarize the number of cases and deaths and calculated incidence and case-fatality ratios before and after the implementation of a nationwide lockdown (in January 2020). We used negative binominal segmented regression models to estimate the immediate and long-term impacts of lockdown on cases, deaths, and case-fatality ratios in January 2020 and December 2021, respectively.
    A total of 14,800,330 cases of and 127,030 deaths from AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C were reported from January 2015 to December 2021, with an incidence of 149.11/100,000 before lockdown and 151.41/100,000 after lockdown and a case-fatality ratio of 8.21/1000 before lockdown and 9.50/1000 after lockdown. The negative binominal model showed significant decreases in January 2020 in AIDS cases (-23.4%; incidence rate ratio [IRR] 0.766, 95% CI 0.626-0.939) and deaths (-23.9%; IRR 0.761, 95% CI 0.647-0.896), gonorrhea cases (-34.3%; IRR 0.657, 95% CI 0.524-0.823), syphilis cases (-15.4%; IRR 0.846, 95% CI 0.763-0.937), hepatitis B cases (-17.5%; IRR 0.825, 95% CI 0.726-0.937), and hepatitis C cases (-19.6%; IRR 0.804, 95% CI 0.693-0.933). Gonorrhea, syphilis, and hepatitis C showed small increases in the number of deaths and case-fatality ratios in January 2020. By December 2021, the cases, deaths, and case-fatality ratios for each disease had either reached or remained below expected levels.
    COVID-19 lockdown may have contributed to fewer reported cases of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C and more reported deaths and case-fatality ratios of gonorrhea, syphilis, and hepatitis C in China.
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  • 文章类型: Journal Article
    中国是世界上结核病负担最高的国家之一。然而,结核病风险在良好水平上的不平衡的时空趋势仍不清楚.
    我们的目的是调查不同水平的肺结核(PTB)的不平衡风险,以及它们如何从时间和空间方面演变,使用来自中国2851个县的PTB通知数据超过十年。
    收集2009年至2018年中国大陆县级通报的PTB病例数据。构建了贝叶斯分层模型,以分析这一时期在国家以下尺度上PTB通知率的不平衡时空模式。计算基尼系数以评估各县之间PTB相对风险(RR)的不平等。
    从2009年到2018年,中国大陆通报的PTB病例从946,086例下降到747,700例。县的平均PTB病例数为301(SD26),总体平均通知率为每100,000人中60例(SD6)。PTB的RRs存在明显的区域差异(基尼系数0.32,95%CI0.31-0.33)。新疆的PTB通知率最高,多年平均值为155/100,000(RR2.3,95%CI1.6-2.8;P<.001),其次是贵州(117/100,000;RR1.8,95%CI1.3-1.9;P<.001)和西藏(108/100,000;RR1.7,95%CI1.3-2.1;P<.001)。PTB的RR呈稳定下降趋势。甘肃(局部趋势[LT]0.95,95%CI0.93-0.96;P<.001)和山西(LT0.94,95%CI0.92-0.96;P<.001)下降最快。然而,西部地区PTB的RR(如新疆的县,贵州,和西藏)显著高于东部和中部地区(P<.001),PTB的RR下降率低于整体水平(P<.001)。
    PTB风险在中国各县之间表现出显著的区域不平等,西部地区呈现高高原疾病负担。需要提高经济和医疗服务水平,以促进PTB病例的发现并最终降低整个国家的PTB风险。
    China has one of the highest tuberculosis (TB) burdens in the world. However, the unbalanced spatial and temporal trends of TB risk at a fine level remain unclear.
    We aimed to investigate the unbalanced risks of pulmonary tuberculosis (PTB) at different levels and how they evolved from both temporal and spatial aspects using PTB notification data from 2851 counties over a decade in China.
    County-level notified PTB case data were collected from 2009 to 2018 in mainland China. A Bayesian hierarchical model was constructed to analyze the unbalanced spatiotemporal patterns of PTB notification rates during this period at subnational scales. The Gini coefficient was calculated to assess the inequality of the relative risk (RR) of PTB across counties.
    From 2009 to 2018, the number of notified PTB cases in mainland China decreased from 946,086 to 747,700. The average number of PTB cases in counties was 301 (SD 26) and the overall average notification rate was 60 (SD 6) per 100,000 people. There were obvious regional differences in the RRs for PTB (Gini coefficient 0.32, 95% CI 0.31-0.33). Xinjiang had the highest PTB notification rate, with a multiyear average of 155/100,000 (RR 2.3, 95% CI 1.6-2.8; P<.001), followed by Guizhou (117/100,000; RR 1.8, 95% CI 1.3-1.9; P<.001) and Tibet (108/100,000; RR 1.7, 95% CI 1.3-2.1; P<.001). The RR for PTB showed a steady downward trend. Gansu (local trend [LT] 0.95, 95% CI 0.93-0.96; P<.001) and Shanxi (LT 0.94, 95% CI 0.92-0.96; P<.001) experienced the fastest declines. However, the RRs for PTB in the western region (such as counties in Xinjiang, Guizhou, and Tibet) were significantly higher than those in the eastern and central regions (P<.001), and the decline rate of the RR for PTB was lower than the overall level (P<.001).
    PTB risk showed significant regional inequality among counties in China, and western China presented a high plateau of disease burden. Improvements in economic and medical service levels are required to boost PTB case detection and eventually reduce PTB risk in the whole country.
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  • 文章类型: Case Reports
    Hepatic portal pneumatosis has a high mortality rate, and whether surgical intervention is necessary remains controversial. This experiment retrospectively analyzed the etiology, treatment methods and prognosis of adult patients with hepatoportal pneumocele to provide a theoretical basis for the treatment of this disease.
    We analyzed the clinical symptoms and post-treatment of a 43-year-old male patient with HPVG admitted to hospital. We retrieved adult non-iatrogenic HPVG cases with complete clinical data in PUBMED,  and MEDLINE and other databases were retrieved for analysis, and summarized the pathogenesis, clinical symptoms, pathogenesis, pathogenesis and prognosis of different treatment schemes were summarized.
    The main etiology of HPVG are intestinal ischemia (27%), severe enteritis/intestinal perforation/intestinal fistula (16%), intestinal obstruction (7%), abdominal infection (7%), gastric diseases (11%), appendicitis and its complications (5%), acute hemorrhage or necrotizing pancreatitis (5%), Crohn\'s disease and its complications (4%), trauma (traffic accidents, falls) (2%), diverticulitis and perforation (6%), nephrogenic diseases (4%), spontaneous pneumohepatic portal vein (2%), other reasons (4%). And after analysis, we found that the survival rate of patients treated by surgery was 40.5% and the mortality rate was 19.1%, the difference between the two was significant.
    Etiology should be actively explored and surgical treatment is necessary.
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