发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)是由发热伴血小板减少综合征病毒(severe fever with thrombocytopenia syndrome virus,SFTSV)引起的急性自然疫源性传染病,以发热、胃肠道症状、血小板及白...发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)是由发热伴血小板减少综合征病毒(severe fever with thrombocytopenia syndrome virus,SFTSV)引起的急性自然疫源性传染病,以发热、胃肠道症状、血小板及白细胞减少为主要临床表现。本文报道1例由安徽省输入深圳市的C基因型重型SFTS病例。患者为老年男性,发病前常住安徽省安庆市太湖县农村(当地为SFTS自然疫源地且蜱媒监测密度较高),发病前两周有频繁田间劳作史,推测因蜱虫叮咬感染。患者急性起病,临床表现为持续发热、白细胞减少、进行性血小板减少(最低26×10^(9)/L)及多器官功能损伤(肝酶、心肌酶显著升高),确诊为重型SFTS病例。实验室检测显示血液及咽拭子SFTSV核酸阳性(Ct值分别为27、33),血清SFTSV IgM抗体阳性、IgG抗体阴性。全基因组测序结果表明该病例感染毒株属于C基因型,与湖北省分离株亲缘关系较近。经输注血小板、免疫球蛋白及白蛋白等对症支持治疗13d后好转出院。本研究通过系统回顾病例流行病学史、临床特征及病毒分子特征,发现SFTSV存在跨区域传播风险,提示非疫区需加强输入病例的早期识别与防控,为SFTS的临床诊疗和跨区域传播预警提供参考。展开更多
BACKGROUND Rabies is a zoonotic viral disease affecting the central nervous system,caused by the rabies virus,with a case-fatality rate of 100%once symptoms appear.AIM To analyze high-risk factors associated with ment...BACKGROUND Rabies is a zoonotic viral disease affecting the central nervous system,caused by the rabies virus,with a case-fatality rate of 100%once symptoms appear.AIM To analyze high-risk factors associated with mental disorders induced by rabies vaccination and to construct a risk prediction model to inform strategies for improving patients’mental health.METHODS Patients who received rabies vaccinations at the Department of Infusion Yiwu Central Hospital between August 2024 and July 2025 were included,totaling 384 cases.Data were collected from medical records and included demographic characteristics(age,gender,occupation),lifestyle habits,and details regarding vaccine type,dosage,and injection site.The incidence of psychiatric disorders following vaccination was assessed using standardized anxiety and depression rating scales.Patients were categorized into two groups based on the presence or absence of anxiety and depression symptoms:The psychiatric disorder group and the non-psychiatric disorder group.Differences between the two groups were compared,and high-risk factors were identified using multivariate logistic regression analysis.A predictive model was then developed based on these factors to evaluate its predictive performance.RESULTS Among the 384 patients who received rabies vaccinations,36 cases(9.38%)were diagnosed with anxiety,52 cases(13.54%)with depression,and 88 cases(22.92%)with either condition.Logistic regression analysis identified the following signi ficant risk factors for psychiatric disorders:Education level of primary school or below,exposure site at the head and neck,exposure classified as grade III,family status of divorced/widowed/unmarried/living alone,number of wounds greater than one,and low awareness of rabies prevention and control(P<0.05).The risk prediction model demonstrated good performance,with an area under the receiver operating characteristic curve of 0.859,a specificity of 74.42%,and a sensitivity of 93.02%.CONCLUSION In real-world settings,psychiatric disorders following rabies vaccination are relatively common and are associated with factors such as lower education level,higher exposure severity,vulnerable family status,and limited awareness of rabies prevention and control.The developed risk prediction model may aid in early identification of high-risk individuals and support timely clinical intervention.展开更多
目的分析1990—2021年中国青少年和20~24岁成年人艾滋病疾病负担的变化趋势,为该病的防治工作提供参考。方法基于2021年全球疾病负担研究(global burden of disease study 2021,GBD 2021)数据,选择死亡人数、死亡率、伤残调整寿命年(dis...目的分析1990—2021年中国青少年和20~24岁成年人艾滋病疾病负担的变化趋势,为该病的防治工作提供参考。方法基于2021年全球疾病负担研究(global burden of disease study 2021,GBD 2021)数据,选择死亡人数、死亡率、伤残调整寿命年(disability adjusted life year,DALY)和DALY率作为分析指标,分析1990—2021年中国青少年和20~24岁成年人艾滋病疾病负担,利用Joinpoint软件分析不同年龄组死亡率与DALY率的变化情况,并计算平均年度变化百分比(average annual percent change,AAPC)。结果1990—2021年中国青少年和20~24岁成年人艾滋病死亡人数、死亡率均呈上升趋势,死亡人数(死亡率)分别从1990年的71例(0.02/10万)上升至2021年的693例(0.30/10万),与1990年相比,2021年分别上升870%、1396%;DALY和DALY率分别从1990年的5777人年(1.60/10万)上升至2021年的51877人年(22.16/10万),与1990年相比,2021年分别上升789%、1285%。男性死亡人数、死亡率、DALY和DALY率始终高于女性。1990—2021年中国青少年和20~24岁成年人不同年龄组艾滋病死亡人数、死亡率在10~14岁年龄组上升最高(26.44%、28.46%),DALY和DALY率在10~14岁年龄组上升最高(22.78%、27.46%)。1990、2000、2010和2021年中国青少年和20~24岁成年人艾滋病主要危险因素中,危险性行为导致的DALY率始终排名第一位,DALY率分别为1.38/10万、4.75/10万、13.80/10万、18.06/10万。结论1990—2021年中国青少年和20~24岁成年人艾滋病疾病负担呈上升趋势,防控形势仍严峻,要重点关注男性和青少年,从而减轻我国艾滋病疾病负担。展开更多
基金Supported by the 2024 Yiwu City Research Plan Project,No.24-3-102.
文摘BACKGROUND Rabies is a zoonotic viral disease affecting the central nervous system,caused by the rabies virus,with a case-fatality rate of 100%once symptoms appear.AIM To analyze high-risk factors associated with mental disorders induced by rabies vaccination and to construct a risk prediction model to inform strategies for improving patients’mental health.METHODS Patients who received rabies vaccinations at the Department of Infusion Yiwu Central Hospital between August 2024 and July 2025 were included,totaling 384 cases.Data were collected from medical records and included demographic characteristics(age,gender,occupation),lifestyle habits,and details regarding vaccine type,dosage,and injection site.The incidence of psychiatric disorders following vaccination was assessed using standardized anxiety and depression rating scales.Patients were categorized into two groups based on the presence or absence of anxiety and depression symptoms:The psychiatric disorder group and the non-psychiatric disorder group.Differences between the two groups were compared,and high-risk factors were identified using multivariate logistic regression analysis.A predictive model was then developed based on these factors to evaluate its predictive performance.RESULTS Among the 384 patients who received rabies vaccinations,36 cases(9.38%)were diagnosed with anxiety,52 cases(13.54%)with depression,and 88 cases(22.92%)with either condition.Logistic regression analysis identified the following signi ficant risk factors for psychiatric disorders:Education level of primary school or below,exposure site at the head and neck,exposure classified as grade III,family status of divorced/widowed/unmarried/living alone,number of wounds greater than one,and low awareness of rabies prevention and control(P<0.05).The risk prediction model demonstrated good performance,with an area under the receiver operating characteristic curve of 0.859,a specificity of 74.42%,and a sensitivity of 93.02%.CONCLUSION In real-world settings,psychiatric disorders following rabies vaccination are relatively common and are associated with factors such as lower education level,higher exposure severity,vulnerable family status,and limited awareness of rabies prevention and control.The developed risk prediction model may aid in early identification of high-risk individuals and support timely clinical intervention.
文摘目的分析1990—2021年中国青少年和20~24岁成年人艾滋病疾病负担的变化趋势,为该病的防治工作提供参考。方法基于2021年全球疾病负担研究(global burden of disease study 2021,GBD 2021)数据,选择死亡人数、死亡率、伤残调整寿命年(disability adjusted life year,DALY)和DALY率作为分析指标,分析1990—2021年中国青少年和20~24岁成年人艾滋病疾病负担,利用Joinpoint软件分析不同年龄组死亡率与DALY率的变化情况,并计算平均年度变化百分比(average annual percent change,AAPC)。结果1990—2021年中国青少年和20~24岁成年人艾滋病死亡人数、死亡率均呈上升趋势,死亡人数(死亡率)分别从1990年的71例(0.02/10万)上升至2021年的693例(0.30/10万),与1990年相比,2021年分别上升870%、1396%;DALY和DALY率分别从1990年的5777人年(1.60/10万)上升至2021年的51877人年(22.16/10万),与1990年相比,2021年分别上升789%、1285%。男性死亡人数、死亡率、DALY和DALY率始终高于女性。1990—2021年中国青少年和20~24岁成年人不同年龄组艾滋病死亡人数、死亡率在10~14岁年龄组上升最高(26.44%、28.46%),DALY和DALY率在10~14岁年龄组上升最高(22.78%、27.46%)。1990、2000、2010和2021年中国青少年和20~24岁成年人艾滋病主要危险因素中,危险性行为导致的DALY率始终排名第一位,DALY率分别为1.38/10万、4.75/10万、13.80/10万、18.06/10万。结论1990—2021年中国青少年和20~24岁成年人艾滋病疾病负担呈上升趋势,防控形势仍严峻,要重点关注男性和青少年,从而减轻我国艾滋病疾病负担。
