简介:AbstractGlobally, rabies remains a serious threat to public health. In particular, large number of cases continue to be detected in Africa and Asia. China has experienced three major outbreaks with the current epizootic starting in 1990s, peaking in 2007 with 3,300 cases, and consistently decreasing since this point. A key factor of the success in keeping the rabies outbreak under control is the National Public Health Reporting Program that was introduced to coordinate surveillance at provincial and regional levels. Through this program, it is possible to obtain an integrated overview of how rabies was spreading and how various factors were contributing to the outbreak. At the same time, samples have been collected from suspected rabies cases and a subset of positive samples selected for sequencing. In this way, it is possible to investigate the outbreak from a phylogenetic perspective, providing the comprehensive description of a rabies outbreak to date. In this work, we review rabies control efforts over the last 20 years, and show how this integrated approach has led to a deeper characterization of the outbreak and a better understanding of the factors driving the spread of the disease.
简介:AbstractObjective:To determine the incidence of preeclampsia (PE) and preterm PE in Spain and to identify the risk factors for developing the disease.Methods:This is a multicenter prospective cohort study performed at six maternity units across Spain. Women with singleton pregnancies attending their first-trimester routine visit at the hospital were offered participation. Maternal and pregnancy characteristics, including mean arterial pressure, as well as ultrasound findings were recorded. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for subsequent development of PE.Results:A total of 5868 pregnancies were recruited for this study, including 174 (3.0%) cases of PE, 47 (0.8%) cases of preterm PE and 127 (2.2%) cases of term PE. Median maternal age was 33.9 years (interquartile range: 30.1 to 36.9) and median gestational age at the routine visit was 12.7 weeks (interquartile range: 12.3 to 13.0). However, 293 (5.0%) of the women were on aspirin treatment during pregnancy, likely reducing the true incidence of the disease. As expected, increasing body mass index (P < 0.001), uterine artery pulsatility index (P= 0.011) and mean arterial pressure (P < 0.001), assisted conception (P= 0.013), previous personal (P < 0.001) or family history of PE (P= 0.024) and chronic hypertension (P= 0.001) were identified as independent risk factors for developing subsequent PE during pregnancy. Screening for PE by maternal factors alone leads to a detection rate of 36.8% (64/174) at 10.0% (587/5868) screen positive rate.Conclusion:In Spain, 3.0% of singleton pregnancies are complicated by PE and 0.8% require delivery before term due to its severity. Screening of PE by risk factors alone is only able to detect about 40% of total PE at 10% screen-positive rate.
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简介:【摘要】目的:对全腹腔镜根治性全胃切除术患者使用改良Overy-lap吻合技术的效果进行探讨。方法:将2014年3月-2021年6月期间前来本院治疗的118例全腹腔镜根治性全胃切除术患者列为实验对象,根据食管空肠吻合方式把患者分成常规1组(43例)和常规2组(42例)以及研究组(33例)。常规1组患者使用π吻合法,常规2组使用管状器吻合法、研究组使用改良Overy-lap食道空肠吻合,观察患者治疗效果(临床指标、治疗有效率)。结果:研究组治疗效果明显优于常规1组、2组,组间差异有统计学价值,P