目的旨在探讨全国手足口病"三间分布"(人群、时间、空间)的流行规律,为手足口病防控提供科学依据。方法利用描述性研究方法和基于地理信息系统(geographic information systems,GIS)的可视化展示技术,对2008-2011年全国手足...目的旨在探讨全国手足口病"三间分布"(人群、时间、空间)的流行规律,为手足口病防控提供科学依据。方法利用描述性研究方法和基于地理信息系统(geographic information systems,GIS)的可视化展示技术,对2008-2011年全国手足口病监测数据进行系统分析。结果人群研究表明,病例绝大多数发生于5岁以下年龄段,占所有患者的89.5%;2008-2011年男性人群的手足口病发病率均高于女性人群(均有P<0.001);发病人群主要以散居儿童为主。基于时间研究表明,手足口病发病率前3年呈现逐年升高的趋势,2011年开始下降,发病时间呈现明显的季节性特征。基于空间分布研究表明,不同地区发病强度不同,呈现明显的地区差异,发病高发大多数集中在发达地区,总体态势是从北方向南部(特别是沿海地区)、东部向西部扩散的趋势,而西南地区仍处于较低的发病水平。结论中国大陆手足口病发病有明显的季节、地区、年龄、性别和人群分布特征,因此,做好重点地区、重点时段、重点人群的防控工作尤为重要。展开更多
This study evaluated the value of high-frequency ultrasonograpy for early detection of dorsal artery of foot in patients with type 2 diabetes mellitus （MD）. Eighty subjects including 40 patients with type 2 MD （T2D...This study evaluated the value of high-frequency ultrasonograpy for early detection of dorsal artery of foot in patients with type 2 diabetes mellitus （MD）. Eighty subjects including 40 patients with type 2 MD （T2DM group） and 40 healthy volunteers （NC group） were recruited. The intima-media thickness （IMT）, the inner diameter and the perfusion of dorsal artery of foot were measured by using high-frequency ultrasonograpy. Meanwhile, the parameters of vascular elasticity, including stiffness parameter （]3）, pressure-strain elastic modulus （Ep）, arterial compliance （AC）, augment index （AI）, and pulse wave conducting velocity （PWV]3） were detected by means of echo-tracking technique. The results showed that no significant difference was found in the IMT, systolic diameter （Ds）, diastolic diameter （Dd） and peak systolic velocity （PSV） between T2DM and NC groups. Ep and PWVβ were increased, and AC was decreased in T2DM group as compared with those in NC group with the differences being significant （P〈0.05 for all）. There was no significant difference in β and AI between T2DM and NC groups. It was concluded that high-frequency ultra- sonography in combination with echo-tracking technique is sensitive and non-invasive, and can be used for early detection of sclerosis of the lower extremity artery in patients with type 2 MD.展开更多
手足口病(Hand,foot and mouth disease,HFMD)是一种全球性的病毒性传染病,目前已成为重要的公共卫生问题,引起世界各国的广泛关注。自20世纪90年代开始,该病在亚太地区频繁暴发,中国自2008年出现全国范围的HFMD大暴发,重症和死亡病例...手足口病(Hand,foot and mouth disease,HFMD)是一种全球性的病毒性传染病,目前已成为重要的公共卫生问题,引起世界各国的广泛关注。自20世纪90年代开始,该病在亚太地区频繁暴发,中国自2008年出现全国范围的HFMD大暴发,重症和死亡病例居高不下。虽然多年来中国大陆HFMD主要病原多为肠道病毒A组71型(Enterovirus A71,EV-A71)和柯萨奇病毒A组16型(Coxsackievirus A16,CVA16),但病原谱在不断变化,病原在逐步进化,情况日趋复杂。本文就中国HFMD的流行状况、病原谱变化进行综述和初步分析。展开更多
Objective Since HFMD was designated as a class C communicable disease in May 2008,18 months surveillance data have been accumulated to December 2009.This article was to describe the distribution of HFMD for age,sex,ar...Objective Since HFMD was designated as a class C communicable disease in May 2008,18 months surveillance data have been accumulated to December 2009.This article was to describe the distribution of HFMD for age,sex,area,and time between 2008 and 2009,to reveal the characteristics of the epidemic.Methods We analyzed weekly reported cases of HFMD from May 2008 to December 2009,and presented data on the distribution of age,sex,area and time.A discrete Poisson model was used to detect spatial-temporal clusters of HFMD.Results More than 1 065 000 cases of HFMD were reported in China's Mainland from May 2008 to December 2009 （total incidence：12.47 per 10 000）.Male incidence was higher than female for all ages and 91.9% of patients were 5 years old.The incidence was highest in Beijing,Shanghai,Zhejiang and Hainan.The highest peak of HFMD cases was in April and the number of cases remained high from April to August.The spatial-temporal distribution detected four clusters.Conclusion Children 5 years old were susceptible to HFMD and we should be aware of their vulnerability.The incidence was higher in urban than rural areas,and an annual pandemic usually starts in April.展开更多
Objective To investigate the epidemiological and cl （HFMD） since several outbreaks of HFMD caused between 2007 and 2008. inical features of hand, foot and mouth disease by enteroviruses were documented in China Meth...Objective To investigate the epidemiological and cl （HFMD） since several outbreaks of HFMD caused between 2007 and 2008. inical features of hand, foot and mouth disease by enteroviruses were documented in China Methods HFMD cases reported to the National Infectious Disease Information Management System database between May 2008 and April 2009 were assessed. Clinical features in some of the severe and fatal cases were analyzed the etiology of the outbreaks was investigated. Results 89.1% of reported HFMD cases were found in children〈5 year-old with an age-specific incidence rate of 834.1/100 000 in the first year as the notifiable disease in China from May 2008 to April 2009. The incidence, mortality and percentage of severe cases were studied for three regions of China and found to be highest in the central region. The incidence of severe cases and mortality in rural population were significantly higher than those in urban population. Among the laboratory confirmed EV17 positive cases there were 52.6% mild, 83.5% severe, and 96.1% fatal cases. More myoclonic jerks were found in the severe case group than in group that died. Tachypnea, lip purpling, pink foaming and low limb temperature occurred more frequently in the fatal cases than in the severe cases. Conclusion The epidemic of HFMD in China was characterized predominantly by EV71 infections, had relatively high mortality rates especially in the central region, and was most prevalent in young, rural populations.展开更多
Hand foot and mouth disease is a febrile sickness complex characterized by cutaneous eruption (exanthem) on the palms and soles with simultaneous occurrence of muco-cutanous vesiculo-ulcerative lesions (enanthem) affe...Hand foot and mouth disease is a febrile sickness complex characterized by cutaneous eruption (exanthem) on the palms and soles with simultaneous occurrence of muco-cutanous vesiculo-ulcerative lesions (enanthem) affecting the mouth. The illness is caused by a number of enteroviruses with coxsackievirus A16 and enterovirus 71 as the main causative agents. Human enterovirus 71 (EV71) belongs to the species Human enterovirus A under the genus Enterovirus within the family Picornaviridae. EV71 has been associated with an array of clinical diseases including hand foot and mouth disease (HFMD), aseptic meningitis, encephalitis and poliomyelitis-like acute flaccid paralysis. A large outbreak of HFMD due to highly neurovirulent EV71 emerged in Malaysia in 1997, and caused 41 deaths amongst young children. In late 2000, a recurrence of an outbreak of HFMD occurred in Malaysia with 8 fatalities in peninsular Malaysia. Outbreak of HFMD due to EV71 recurred in 2003 with an unknown number of cases and mortalities. A similar outbreak of HFMD with 2 recorded deaths in young children occurred in peninsular Malaysia in late 2005 and this was followed by a larger outbreak in Sarawak (Malaysian Borneo) with 6 reported fatalities in the early part of 2006. The current on-going outbreak of HFMD started in peninsular Malaysia in epidemiological week 12 of 2010. As with other HFMD outbreaks in Malaysia, both EV71 and CA16 were the main aetiological viruses isolated. In similarity with the HFMD outbreak in 2005, the isolation of CA16 preceded the appearance of EV71. Based on the VP1 gene nucleotide sequences, 4 sub-genogroups of EV71 (C1, C2, B3 and B4) co-circulated and caused the outbreak of hand, foot and mouth disease in peninsular Malaysia in 1997. Two sub-genogroups (C1 and B4) were noted to cause the outbreak in 2000 in both peninsular Malaysia and Sarawak. EV71 of sub-genogroup B5 with smaller contribution from sub-genogroup C1 caused the outbreak in 2003. In the 2005 outbreak, besides the EV71 strains of sub-genogroup C1, EV71展开更多
Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence...Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it's suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications.展开更多
文摘目的旨在探讨全国手足口病"三间分布"(人群、时间、空间)的流行规律,为手足口病防控提供科学依据。方法利用描述性研究方法和基于地理信息系统(geographic information systems,GIS)的可视化展示技术,对2008-2011年全国手足口病监测数据进行系统分析。结果人群研究表明,病例绝大多数发生于5岁以下年龄段,占所有患者的89.5%;2008-2011年男性人群的手足口病发病率均高于女性人群(均有P<0.001);发病人群主要以散居儿童为主。基于时间研究表明,手足口病发病率前3年呈现逐年升高的趋势,2011年开始下降,发病时间呈现明显的季节性特征。基于空间分布研究表明,不同地区发病强度不同,呈现明显的地区差异,发病高发大多数集中在发达地区,总体态势是从北方向南部(特别是沿海地区)、东部向西部扩散的趋势,而西南地区仍处于较低的发病水平。结论中国大陆手足口病发病有明显的季节、地区、年龄、性别和人群分布特征,因此,做好重点地区、重点时段、重点人群的防控工作尤为重要。
文摘This study evaluated the value of high-frequency ultrasonograpy for early detection of dorsal artery of foot in patients with type 2 diabetes mellitus （MD）. Eighty subjects including 40 patients with type 2 MD （T2DM group） and 40 healthy volunteers （NC group） were recruited. The intima-media thickness （IMT）, the inner diameter and the perfusion of dorsal artery of foot were measured by using high-frequency ultrasonograpy. Meanwhile, the parameters of vascular elasticity, including stiffness parameter （]3）, pressure-strain elastic modulus （Ep）, arterial compliance （AC）, augment index （AI）, and pulse wave conducting velocity （PWV]3） were detected by means of echo-tracking technique. The results showed that no significant difference was found in the IMT, systolic diameter （Ds）, diastolic diameter （Dd） and peak systolic velocity （PSV） between T2DM and NC groups. Ep and PWVβ were increased, and AC was decreased in T2DM group as compared with those in NC group with the differences being significant （P〈0.05 for all）. There was no significant difference in β and AI between T2DM and NC groups. It was concluded that high-frequency ultra- sonography in combination with echo-tracking technique is sensitive and non-invasive, and can be used for early detection of sclerosis of the lower extremity artery in patients with type 2 MD.
文摘Objective Since HFMD was designated as a class C communicable disease in May 2008,18 months surveillance data have been accumulated to December 2009.This article was to describe the distribution of HFMD for age,sex,area,and time between 2008 and 2009,to reveal the characteristics of the epidemic.Methods We analyzed weekly reported cases of HFMD from May 2008 to December 2009,and presented data on the distribution of age,sex,area and time.A discrete Poisson model was used to detect spatial-temporal clusters of HFMD.Results More than 1 065 000 cases of HFMD were reported in China's Mainland from May 2008 to December 2009 （total incidence：12.47 per 10 000）.Male incidence was higher than female for all ages and 91.9% of patients were 5 years old.The incidence was highest in Beijing,Shanghai,Zhejiang and Hainan.The highest peak of HFMD cases was in April and the number of cases remained high from April to August.The spatial-temporal distribution detected four clusters.Conclusion Children 5 years old were susceptible to HFMD and we should be aware of their vulnerability.The incidence was higher in urban than rural areas,and an annual pandemic usually starts in April.
文摘Objective To investigate the epidemiological and cl （HFMD） since several outbreaks of HFMD caused between 2007 and 2008. inical features of hand, foot and mouth disease by enteroviruses were documented in China Methods HFMD cases reported to the National Infectious Disease Information Management System database between May 2008 and April 2009 were assessed. Clinical features in some of the severe and fatal cases were analyzed the etiology of the outbreaks was investigated. Results 89.1% of reported HFMD cases were found in children〈5 year-old with an age-specific incidence rate of 834.1/100 000 in the first year as the notifiable disease in China from May 2008 to April 2009. The incidence, mortality and percentage of severe cases were studied for three regions of China and found to be highest in the central region. The incidence of severe cases and mortality in rural population were significantly higher than those in urban population. Among the laboratory confirmed EV17 positive cases there were 52.6% mild, 83.5% severe, and 96.1% fatal cases. More myoclonic jerks were found in the severe case group than in group that died. Tachypnea, lip purpling, pink foaming and low limb temperature occurred more frequently in the fatal cases than in the severe cases. Conclusion The epidemic of HFMD in China was characterized predominantly by EV71 infections, had relatively high mortality rates especially in the central region, and was most prevalent in young, rural populations.
文摘Hand foot and mouth disease is a febrile sickness complex characterized by cutaneous eruption (exanthem) on the palms and soles with simultaneous occurrence of muco-cutanous vesiculo-ulcerative lesions (enanthem) affecting the mouth. The illness is caused by a number of enteroviruses with coxsackievirus A16 and enterovirus 71 as the main causative agents. Human enterovirus 71 (EV71) belongs to the species Human enterovirus A under the genus Enterovirus within the family Picornaviridae. EV71 has been associated with an array of clinical diseases including hand foot and mouth disease (HFMD), aseptic meningitis, encephalitis and poliomyelitis-like acute flaccid paralysis. A large outbreak of HFMD due to highly neurovirulent EV71 emerged in Malaysia in 1997, and caused 41 deaths amongst young children. In late 2000, a recurrence of an outbreak of HFMD occurred in Malaysia with 8 fatalities in peninsular Malaysia. Outbreak of HFMD due to EV71 recurred in 2003 with an unknown number of cases and mortalities. A similar outbreak of HFMD with 2 recorded deaths in young children occurred in peninsular Malaysia in late 2005 and this was followed by a larger outbreak in Sarawak (Malaysian Borneo) with 6 reported fatalities in the early part of 2006. The current on-going outbreak of HFMD started in peninsular Malaysia in epidemiological week 12 of 2010. As with other HFMD outbreaks in Malaysia, both EV71 and CA16 were the main aetiological viruses isolated. In similarity with the HFMD outbreak in 2005, the isolation of CA16 preceded the appearance of EV71. Based on the VP1 gene nucleotide sequences, 4 sub-genogroups of EV71 (C1, C2, B3 and B4) co-circulated and caused the outbreak of hand, foot and mouth disease in peninsular Malaysia in 1997. Two sub-genogroups (C1 and B4) were noted to cause the outbreak in 2000 in both peninsular Malaysia and Sarawak. EV71 of sub-genogroup B5 with smaller contribution from sub-genogroup C1 caused the outbreak in 2003. In the 2005 outbreak, besides the EV71 strains of sub-genogroup C1, EV71
基金Supported by Health Research Institute,Diabetes Research Center,Ahvaz Jundishapur University of Medical Sciences,Ahvaz,Iran
文摘Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it's suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications.
