The China Infectious Disease Automated-alert and Response System (CIDARS) was successfully implemented and became operational nationwide in 2008.The CIDARS plays an important role in and has been integrated into the routine outbreak monitoring efforts of the Center for Disease Control (CDC) at all levels in China.In the CIDARS,thresholds are determined using the'Mean+2SD'in the early stage which have limitations.This study compared the performance of optimized thresholds defined using the'Mean +2SD'method to the performance of 5 novel algorithms to select optimal 'Outbreak Gold Standard (OGS)'and corresponding thresholds for outbreak detection.Data for infectious disease were organized by calendar week and year.The'Mean+2SD',C1,C2,moving average (MA),seasonal model (SM),and cumulative sum (CUSUM) algorithms were applied.Outbreak signals for the predicted value (Px) were calculated using a percentile-based moving window.When the outbreak signals generated by an algorithm were in line with a Px generated outbreak signal for each week,this Px was then defined as the optimized threshold for that algorithm.In this study,six infectious diseases were selected and classified into TYPE A (chickenpox and mumps),TYPE B (influenza and rubella) and TYPE C [hand foot and mouth disease (HFMD) and scarlet fever].Optimized thresholds for chickenpox (P55),mumps (P50),influenza (P40,P55,and P75),rubella (P45 and P75),HFMD (P65 and P70),and scarlet fever (P75 and Ps0) were identified.The C1,C2,CUSUM,SM,and MA algorithms were appropriate for TYPE A.All 6 algorithms were appropriate for TYPE B.C1 and CUSUM algorithms were appropriate for TYPE C.It is critical to incorporate more flexible algorithms as OGS into the CIDRAS and to identify the proper OGS and corresponding recommended optimized threshold by different infectious disease types.

Objective To investigate the relationships between hyperuricaenia,serum uric acid (SUA) level and the chronic kidney disease (CKD) in adult residents of Pudong New Area,Shanghai.Methods 3326 residents aged 20-80 years were randomly selected from Pudong New Area,Shanghai through multistage sampling and interviewed between April and July of 2008.Fasting blood sample and morning ovid urine sample were collected for each participant for testing of SUA,serum creatinine,urinary albumin and creatinine.Both urine albumin to creatinine ratio (ACR)and glomerular filtration rate (GFR) were calculated to estimate the renal function.Results The overall prevalence of CKD was 16.0％ (age standardized 13.2％ ).The mean values of estimated GFR in participants with CKD and without CKD were (89.19 ± 27.25) and ( 105.88 ± 98.37) ml· min-1 ·(1.73 m2) -1,respectively.The prevalence rates of CKD in serum uric acid quartiles:first quartile,less than 4.2 mg/dl; second quartile,4.2-5.0 mg/dl; third quartile,5.0-6.0 mg/dl; and fourth quartile,6.0 mg/dl or more were 13.9％,15.0％,15.8％and 19.4％ (P＜0.05) respectively,increasing along with the increase of SUA among both sexes.Compared to the serum uric acid first quartile,the multivariate-adjusted odds for CKD of the second,third and fourth quartiles were 1.19 [95％ confidence interval (CI):0.90-1.58],1.27 (95％ CI:1.02-1.70),1.28 (95％ CI:1.10-1.68),respectively. Conclusion Hyperuricaemia was independently associated with the increased prevalence of CKD among population living in the Pudong New Area,Shanghai.

OBJECTIVETo evaluate the clinical effects of iliolumbar fixation for the sacrum fractures of Denis type II.

METHODSThe clinical data of 86 patients with sacrum fracture of Denis type II treated by iliolumbar fixation from January 2008 to January 2012 were retrospectively analyzed. There were 55 males and 31 females, aged from 17 to 55 years old with an average of 39.1 years. Among them, 73 cases complicated with pelvis fracture and 13 cases with acetabular fracture; 37 cases with sacral neurological symptoms and 49 cases without sacral neurological symptoms. Fracture healing time, nerve function, clinical function and complications were observed in the patients.

RESULTSIn 86 cases, 6 cases were out of followed-up and 80 cases were followed up from 24 to 71 months with an average of 36 months. The mean fracture healing time was 13 weeks (ranged, 10 to 38 weeks). According to Gibbons scoring to evaluate the neurological function, preoperative nerve rehabilitation, lower limbs feeling, lower limbs activity,bladder and rectum function,total score respectively were 0.62 +/- 0.04, 1.54 +/- 0.35, 1.12 +/- 0.18, 0.23 +/- 0.01, 3.46 +/- 0.47 and postoperative respectively were 0.82 +/- 0.12, 0.36 +/- 0.04, 0.05 +/- 0.01, 0.03 +/- 0.01, 1.25 +/- 0.22, there were statistically significant differences between preoperative and postoperative (P < 0.05). According to Majeed scoring to evaluate the clinical function, postoperative pain, standing, sitting, sexual life, work ability, total score respectively were 22.54 +/- 4.02, 27.93 +/- 5.46, 8.47 +/- 3.61, 2.54 +/- 1.33, 16.46 +/- 4.34, 81.32 +/- 8.73, 60 cases got excellent results, 17 good, 3 fair. The main complications including fracture nonunion of 5 cases,deep incision infection of 1 case, and screw prominence resulting uncomfortable of 8 cases.

CONCLUSIONIliolumbar fixation has the advantages of stable fixation, satisfactory functional rehabilitation, less complications, and is a good method in treating sacrum fracture of Denis type II.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sacrum ; injuries ; surgery ; Spinal Fractures ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the methods of estimating measurement reliability and their limitations.

METHODSAccording to the given examples, reliabilities of measurement were calculated and limitations of the methods of estimating reliability were analyzed.

RESULTSThe Kappa value of interobserver reliability was 0.793 between two pathologists. Between the two populations with different prevalence rates, the values of Kappa were 0.800 and 0.137 respectively, and with big difference. Cronbach's alpha coefficient of compositive index for A type behavior was 0.55.

CONCLUSIONThe Kappa index and alpha coefficient were both inherently population-specific. Before generalizing to different populations, the reliability needs to be measured.

Algorithms ; Data Collection ; methods ; statistics & numerical data ; Epidemiologic Measurements ; Observer Variation ; Reproducibility of Results ; Time Factors

Objective To analyze the sequence of microsatellite and the flanking sequence from four populations of Oncomelania hupensis. Methods We cloned 159 SSR-PCR amplification products of a commonly used primer, (CA)8RY, using O. hupensis genomie DNA as template, and sequenced 82 products Results The sequences obtained were novel O. hupensis genomic sequences but not repeat simple sequence. It was observed that 36 out of 82 clones contained microsatellites between priming sites.The flanking sequences of certain microsatellite were invariant. Both (GA/CT). and (TTAGGG/CCCAA)n were found in four populations of O. hupensis. However, (CAA)n were found only in O. hupensis from Fuqing,Fujian province and (TCTCTG), were found only in O. hupensis from Guichi,Anhui province and (GAA/TTC)n, (CAA/TTG)n, (CAT), were found only in O.hupensis from Puge,Sichuan province. Conclusion The results obtained by SSR-PCR should not be interpreted as the amplification of microsatellite loci, and analytical rules similar to those for Random Amplified Polymorphic DNA should be used. SSR-PCR could not make the most of the priority of microsatellite. It seems better to amplify the microsatellites with the primers designed on the basis of the flanking sequence.

Benchmarking ; China ; Humans ; Public Health Administration ; standards

The impact of key physical properties on granulated products by the high-speed mixing wet method was studied. Andrographis extracts were utilized as the model drug. Four processing methods were adopted to prepare mixed powder of microcrystalline cellulose (MCC) and starch with the mass ratio 1:0.5, 1:1 and 1:2 by the high-speed mixing wet method. The properties of the prepared granules were evaluated with such indexes as granule yield, the ratio of lumps and fine powder, granule-AOR and granule-HR. The impact of key physical properties on granulated products was analyzed through stepwise regression analysis. The results showed that angle of repose, moisture content, pore volume, density and contact angle with water were key physical properties of the powder. The key physical properties of Chinese medical extracts powder are the important factor impacting granulated products made by the high-speed mixing wet method. In this study, the impact of key physical properties on granulated products of Chinese medical extracts was analyzed from the physical angle.
Andrographis ; chemistry ; Drug Compounding ; instrumentation ; methods ; Drugs, Chinese Herbal ; chemistry ; Particle Size ; Powders ; chemistry

So far the etiology of chronic prostatitis (PC) and particularly chronic pelvic pain syndrome (CPPS) remains to be elucidated. According to recent epidemiologic data, CP is the most common urological disease in men below 50 years and occurs in 2.5%-16.0% of the world population. Since the 1990s, researchers of many countries have carried out deeper, more extensive and larger scaled studies than ever before on the etiology, diagnosis and treatment of the disease, with the sponsorship and coordination of such international institutions as the International Prostatitis Collaborative Network (IPCN), the Chronic Prostatitis Collaborative Research Network of the National Institute of Health (NIH-CPCRN) and so on. As prevalent as multiple sclerosis, CPPS is the most common yet most poorly understood "prostatitis syndrome". This article reviews the progress in the studies of the treatment of CPPS, explores the main problems and ventures the prospects for the development in this field.
Chronic Disease ; Humans ; Male ; Pelvic Pain ; therapy ; Prostatitis ; therapy ; Syndrome

OBJECTIVETo explore the biases and confoundings in Spatial Epidemiological studies.

METHODSPossible bias and confounding and their impact on study results in Spatial Epidemiology were analyzed in given examples.

RESULTSIn Spatial Epidemiology, biases related to ascertainment/numerator/denominator induced by the choice of the disease induction/latency period and mis-specification of exposure-disease model, exposure inaccuracy, spatial dependency, significance tests etc. were involved, as well as to ecological, socio-economic confoundings factors.

CONCLUSIONThe sources of bias in 'Spatial Epidemiology' were both numerous and complex, that might be overestimated or underestimated on the study results. Hence, careful interpretation of such studies was needed.

Bias ; Confounding Factors (Epidemiology) ; Ecology ; Epidemiology ; Geographic Information Systems ; Geography ; Humans ; Socioeconomic Factors ; Space-Time Clustering

OBJECTIVETo study the effect of infection control on schistosomasis Japonicum based on selective chemotherapy.

METHODSData were derived from national surveillance of schistosomiasis from 2000 to 2002, and random effect model of Meta-analysis was used to analyze the effect of chemotherapy on controlling schistosomiasis infection.

RESULTSOne year after chemotherapy was started in the pilot villages where infection rate of schistosomiasis was more than 10%, the infection rates among residents and eggs per gram (EPG) of patients as well as population (geometric mean, GM) significantly reduced by 20.15%, 22.91% and 33.93% with 95% confidence interval (CI) 6.95 - 31.48, 14.69 - 30.34 and 11.69 - 50.68 respectively. In the pilot villages where infection rates were between 6% and 10%, the control measures largely base on chemotherapy significantly reduced the infection rate, by 24.50 (95% CI: 5.35 - 39.83). However the infection rates were no longer reduced in the pilot villages where the infection rate was less than 6%; EPG of patients and residents were maintained at the original level in the pilot villages where infection rate was 10% or less.

CONCLUSIONIn China, the rates of schistosomiasis Japonicum infection could be effectively reduced through the control measures largely based on chemotherapy, and they were kept at a relatively low level. However, it was very difficult to interrupt the transmission of schistosomiasis.

Adolescent ; Adult ; Aged ; Anthelmintics ; therapeutic use ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Parasite Egg Count ; Praziquantel ; therapeutic use ; Schistosomiasis japonica ; drug therapy ; epidemiology ; prevention & control