2007-2015年北京市密云区手足口病流行特征分析

目的 分析2007-2015年密云区手足口病流行病学特征,为调整防控措施提供科学依据.方法 采用描述性流行病学方法,对密云区2007-2015年手足口病监测数据进行分析.结果 2007-2015年密云区手足口病报告发病数及发病率每2-3年有一发病高峰,发病时间以4-9月份为主;手足口病高发地区主要为城区及城乡结合部的平原地区;患者以5岁以下儿童为主;男童病例数高于女童;EV71和CVA16为手足口病的主要致病病原体.结论 密云区手足口病报告发病数及发病率呈周期性波动趋势,幼托儿童和散居儿童为手足口病高发人群,城区及城乡结合部的平原地区是手足口病防控的重点区域.     

北京市2007-2010年手足口病流行特征分析

目的 通过对2007-2010年北京市手足口病流行病学和病原学特征进行分析,为手足口病防控工作提供依据.方法采用描述性流行病学方法,对北京市2007-2010年手足口病监测数据进行分析,率的比较采用x2检验.结果北京市2007-2010年报告病例数分别为11012例、18445例、24483例和45409例,报告死亡例数分别为0例、2例、4例和18例,报告发病率分别为69.65/10万、112.90/10万、144.44/10万、258.74/10万.流动人口聚集区报告发病例数较多;四季均有病例报告,但以夏秋季为主,5-7月份为发病高峰;发病年龄以5岁及以下儿童为主;男性儿童发病高于女性儿童;散居儿童死亡例数高于幼托儿童.EV71和CoxA16为手足口病的主要致病病原体,EV71病毒均为C4基因型.结论北京市报告手足口病病例数早逐年增加趋势.每年夏秋季节,应加强对5岁以下儿童手足口病的防控工作,流动人口聚居区散居儿童是防控的重中之重.     

湖南省祁阳县2012-2015年手足口病流行病学特征及防制策略研究

目的 分析湖南省祁阳县2012-2015年手足口病的流行病学特征,探索影响手足口病的影响因素,为调整控制策略提供依据.方法 运用SPSS 13.0软件对2012-2015年手足口病数据进行统计分析.结果 祁阳县2012-2015年共报告手足口病病例3 430例,年均发病率80.90/10万.病例发病时间集中分布在5-6月,占病例总数的44.99％.病例年龄最小的为3个月,最大的为17岁,0～5岁年龄组占发病数的94.08％,男女性别比为1.9:1.散居儿童占发病总数的91.05％.乡村高于城镇,其差异有统计学意义.致病病原体EV71、CoxA 16和其他肠道病毒同时存在,以EV71为主,占总数的50.49％.死亡病例2例均为EV71感染.结论 2012-2015年祁阳县手足口病发病水平呈逐年增高趋势,应重点加强对散居儿童的防控力度.     

2011-2013年北京市平谷区手足口病流行特征分析

目的 对平谷区2011-2013年手足口病病例流行病学特征进行分析,为科学防控手足口病提供依据.方法 采用描述流行病学方法分析平谷区2011-2013年手足口病监测数据,利用率和构成比对资料进行统计学描述.结果 平谷区2011-2013年累计报告手足口病例2012例,以5岁以下散居儿童及托幼儿童为主,男性高于女性,发病时间以5-10月为主,发病高峰集中在6-7月,年均发病率为161.18/105.EV71和CoxA 16为手足口主要病原体.结论 平谷区手足口病存在明显的年龄、性别、季节、地区和职业差异,应加强监测,有针对性的进行手足口病防控工作.     

2012年河北省邢台市手足口病流行病学特征分析

目的 了解2012年河北省邢台市手足口病病例流行病学特征,为有效控制手足口病疫情提供科学依据.方法 采用描述性流行病学分析方法对2012年邢台市手足口病病例资料进行分析.结果 2012年河北省邢台市累计报告手足口病病例593例,发病率为8.35/10万.城镇人口发病率(0.99/10万)高于农村人口发病率(7.37/10万),差异具有统计学意义(P＜0.05).重症患者73例(12.31％).死亡病例1例,病死率为0.17％.4-5月发病人数占全年患者总数的52.95％.5岁以下患者占97.47％.593份标本中检出肠道病毒阳性 436例,阳性率为73.52％,其中CoxA16阳性137例,EV71阳性228例,其他肠道病毒71例,分别占标本总数的23.10％、38.45％和11.97％.结论 邢台市手足口病发病率农村高于城市,患者主要为5岁以下儿童,4-5月为发病高峰.手足口病在短时期内可造成较大范围的流行,应加强疫情监测和对高危人群的健康教育.     

深圳市61例手足口病重症病例流行病学特征

目的了解深圳市手足口病重症病例的流行病学特点和临床特征。方法对深圳市2010年61例手足口病重症病例进行个案调查,收集信息,建立数据库并进行统计分析。结果 5月是手足口病重症高发季节,男女比例为1.77：1,3岁以下患儿占80.33%,散居儿童占83.61%,临床表现以发热和皮疹为主,出现呕吐、嗜睡占67.21%,病原体为EV71占88.10%,从发病到首诊的时间间隔为1.98d。结论深圳市手足口病重症发病有季节性,以3岁以下散居儿童多发,应在流行季节针对重点人群开展综合防控措施。     

东莞市2009-2010年手足口病疫情分析及防治对策探讨

目的了解东莞市2009-2010年手足口病疫情的流行病学特点,为今后的防控工作提出对策。方法对东莞市2009-2010年手足口病疫情资料采用描述流行病学方法进行分析,对患者的咽拭子或粪便标本采用RT-PCR法进行肠道病毒核酸检测和病毒分型。结果东莞市2009年和2010年分别报告手足口病9263例和22721例,发病率分别为127.34/10万和373.28/10万。5岁以下婴幼儿分别占当年报告病例的91.68%和92.15%;散居儿童分别占当年报告病例的78.26%和73.58%;男性分别占当年报告病例的65.29%和65.27%;每年的4月份和10月份有2个发病高峰,前者为全年的发病高峰;暴发疫情均发生在托幼机构;分别有49.30%和53.65%的病例由EV71引起,所有死亡病例均由EV71引起。健康人群肠道病毒隐性感染率为11.67%,感染的主要病原体为其他肠道病毒（95.24%）。结论东莞市2010年手足口病流行强度大于2009年;应重点做好手足口病的病原学监测及5岁以下散居儿童和托幼机构的手足口病防治工作。     

北京市手足口病重症病例影响因素研究

目的 了解北京市手足口病(hand-foot-mouth disease,HFMD)重症病例的流行特征,探讨手足口病重症病例发病的影响因素,为早期发现手足口病重症病例、降低死亡病例发生风险提供依据.方法 以北京市2012年报告的手足口病重症病例作为病例组,手足口病普通病例作为对照组,使用Logistic回归分析对手足口病重症病例发病危险因素进行分析.结果 单因素Logistic回归分析结果显示年龄、职业、初诊医院类型、初诊是否正确诊断为手足口病、发病前一个月是否接种疫苗、发病前是否接触患病儿童、病原学类型这7个因素有统计学意义;多因素Logistic回归分析结果显示:散居儿童、初诊未正确诊断为手足口病、发病前接触过患病儿童和感染EV71病毒是手足口病重症病例的影响因素,OR值(95％ CI)分别为1.52(1.02 ～2.45)、11.49(5.05 ～ 26.32)、1.75(1.07 ～2.84)和2.87(1.42～5.85).结论 加强对散居儿童疾病监测,对发病儿童及时进行隔离,对儿童家长进行健康宣教,通过培训等途径提高医师的诊治水平,提高病原学检测、监测水平是防制手足口病重症病例的有效措施.     

新疆第八师石河子市2015~2018年手足口病原学特征及病流行病学分析

目的 探讨石河子市2015~2018年手足口病流行病学以及病原学特征,为石河子市手足口病的预防控制提供一定的科学依据和理论基础。方法 对2015年1月~2018年7月石河子市手足口病疫情资料进行描述性流行病学分析,并利用RT-PCR技术检测主要人肠道病毒病原体,包括EV71型、CoxA16型、CoxA6型、CoxA4型和CoxA10型,分析其分布特征。结果 2015~2018年石河子市实验室确诊手足口病373例,其中男性多于女性,男女性别比为1.94:1;发病呈典型的单峰分布,4~8月份为全年发病高峰期,占4年总发病人数的97.78%;城区和团场均有发病,其发病比例为0.97:1。2018年手足口病患者中CoxA6阳性率高于2016年和2017年;相较于2015~2017年,2018年石河子市手足口病患者EV71和CoxA16阳性率降低（P＜0.05）。结论 石河子市手足口病发病有明显的季节性,存在年龄、性别差异,并且CoxA6型感染者逐渐增多,今后应持续开展手足口病病原学监测,并加强手足口病疫苗的预防接种工作。     

深圳市重症手足口病临床与实验特征变化趋势及随访1年报告

目的比较2012与2008年深圳市重症手足口病临床和实验特征,探讨其变化趋势。方法深圳市第三人民医院2008年及2012年共收治778例手足口病住院患儿,重点分析其中260例手足口病重症患者（2008年64例,2012年196例）。通过RT—PCR检测CoxsackieA16（CoxA16,A16）及Enterovirus71（EV71）病毒核酸,出现神经系统症状或体征者检查脑脊液常规及生化,部分患儿行头颅MRI检查,同时比较临床表现、血液生化等变化趋势。所有患者随访12个月评估再发情况。结果与2008年相比,2012年手足口病重症患者发病高峰年龄下降,〈12月龄儿童分别占2008年和2012年重症的15％和40％。两个年度重症患者均以EV71感染为主;与2008年相比,2012年EV71感染所占比率有下降趋势;重症患者手、足皮疹出疹率下降,而口腔疱疹出疹率明显增高,疱疹性咽峡炎引起的重症病例数上升;外周血白细胞计数、中性粒细胞比值及CRP水平均明显增高;但并发脑干脑炎或神经源性肺水肿的病例数略有下降。随访1年结果显示,无论EV71或CoxA16型手足口病临床治愈后均可多次再发,轻症再发率高于重症。结论深圳市手足口病从2008年暴发至2012年,发病呈上升趋势,重症手足口病病例临床表现具有一些新的特征,应引起广大医护人员重视。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.