郭巧芝,马文军.溺水流行特征与预防控制研究进展[J].Chinese journal of Epidemiology,2009,30(12):1311-1314 |
溺水流行特征与预防控制研究进展 |
Drowning and its prevention |
Received:February 18, 2009 |
DOI: |
KeyWord: 溺水 流行病学特征 预防控制 |
English Key Word: Drowning Epidemiological characteristics Prevention |
FundProject:国家“八五”科技攻关课题 (859150102) ;国家自然科学基金(39370612);上海市科委科技发展基金 (934113060,944912014,984419014,004119006) |
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Abstract: |
溺水是一个非常重要但被忽视的公共卫生问题.据WHO估计,2002年全球约38万人死于非故意溺水(除洪水、运输事故和水上运输事故引起外),溺水成为全球意外伤害中继交通伤害和跌落之后的第三位死亡原因~([1]).中国也是溺水高发国家之一,但相关研究和预防控制仍处于起步阶段.为此本文对国内外溺水研究与预防控制进行了综述,希望为相关专业人员提供参考. |
English Abstract: |
Objective To investigate human papillomavirus (HPV) prevalence in the high incidence areas of cervical cancer in Shanxi and to study the association between HPV infection and cervical cancer. Methods Cells exfoliated from cervix (collected by clinician) and from vagina (collected by subject herself) of 1997 women aged 35 45 from Xiangyuan county, Shanxi province were analyzed blindly by Hybrid Capture Assay (HC Ⅱ), which could detect 13 HPV types of high risk. Unconditional logistic regression model was used to analyze the relation between HPV and cervical cancer/cervical intraepithelial neoplasia (CIN). Kappa coefficient was used to compare the agreement of the two tests. Results HPV DNA detection rate in the population was 20.8 % while HPV infection rates increased with the seriousness of cervical lesions (χ 2= 444.04, P = 0.000 ). Rates of the two groups (35 39 and 40 45) had no significant difference ( 20.9 %∶ 20.6 %,χ 2= 0.03, P = 0.86 ). Unconditional logistic regression analysis showed, when comparing with the normal subjects, the risk odds ratio of HPV infection with cervical cancer/high grade CIN and low grade CIN were 254.2 and 26.4 respectively, with attributable risk proportions ( ARP ) 98.1 % and 83.6 % respectively. The sensitivity of self collected vaginal swabs assayed for HPV DNA was lower than that of clinician collected cervical samples assayed for HPV DNA (84%∶98%,χ 2= 5.92, P = 0.015 ). No significant difference in specificity was seen between them (86%∶85%,χ 2= 0.00, P = 0.997 ) and there was fair agreement between the two tests (kappa= 0.74 ). Conclusion High risk HPV infection in female genital tract was the major risk factor of cervical cancer and CIN in the areas. Prevention and control of cervical cancer should be focused on avoiding HPV infection, screening women for HPV infection and monitoring population infected by high risk HPV. Self collected vaginal swabs assayed for HPV DNA seemed a more practical method in primary screening for cervical cancer. |
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