1991～1998年新疆鼠疫流行趋势及其防治对策

已查明新疆范围内的鼠疫自然疫源地有１５个县（市）,疫源面积为１１１１５ｋｍ＾２,根据主要宿主的生态地理特征及菌型,将其分为四个类型。在分析１９９１－１９９８年以来监测数据的基础上,对疫源地内动物间鼠疫的流行动态及趋势做出初步判断,提出了控制新疆鼠疫的防治对策,并指出新疆动物鼠疫流行并非真正呈现减弱趋势,鼠疫防治形势不容乐观。     

新疆鼠疫自然疫源地

１９５５～１９９２年期间，以综合调查方法在新疆共１５个县、市的山地发现了相对分隔的１６小片鼠疫疫源地。疫源地面积共达１１ １１５ｋｍ＾２；发现自然染疫的脊椎动物９种，节肢动物１１处；分离出鼠疫菌１ ２８４株。根据生态地理特征，将１６小片疫源地划归为北天山灰旱獭一长尾黄鼠独立疫源地、南天山灰旱獭疫源地、帕米尔高原－阿赖山红旱獭疫源地、昆仑山喜马拉雅旱獭疫源地。平原荒漠中没有发现疫源地。本文另就各疫源     

甘宁阿拉善黄鼠疫源地动物鼠疫流行与控制

阿拉善黄鼠鼠疫疫源地，分布于甘肃会宁、平川及宁夏西吉，海源、固原五县（区）。面积２８２６．６ｋｍ＾２，动物间鼠疫每十年左右有一次大流行。流行范围具有空间移动性，最大幅度半径３２公里。流行时鼠密度１．０只／公顷以上，坚持综合灭鼠和联防监测，能控制动物病流行。     

庆元县历史疫源地的鼠疫自然疫源性探讨

目的 研究浙南庆元历史疫源地的鼠疫自然疫源性存在情况，为有效地预防和控制鼠疫提供科学依据。方法 采用现场监测、流行病学调查与血清学病原学实验研究，结合疫史调查资料对比分析判别确认鼠疫历史疫源地的现况。结果 历史疫源地内主要宿主黄胸鼠、褐家鼠在鼠疫间歇期的不同年代，其地位发生了改变，褐家鼠由50年代的次要位置上升为优势种群，黄胸鼠数量回升已达到50年代初期人、动物鼠疫流行时期水平，并均有外迁野外生活的习性；主要媒介印鼠客蚤指数回升、比例增加、并大量游离于室内地面；鼠疫病原学、血清学检测发现动物鼠疫静息35年后又于1989年首次在该县屏都历史疫点检出鼠疫RIP阳性抗体12份，总阳性率0．208％，阳性动物为黄胸鼠、褐家鼠、黄毛鼠与黄鼬；其余项目检验均为阴性。结论 浙南庆元县历史鼠疫疫源地内，存在鼠疫自然疫源性的迹象已日趋明显；鼠疫复燃的危险性日益严峻；家鼠鼠疫自然疫源地的多元性，应引以重视。     

甘肃省鼠疫疫源不明地区的调查与防控对策研究

目的明确甘肃鼠疫疫源不明地区是否存在鼠疫自然疫源地,研究提出防控对策。方法以自然地理景观和宿主动物为指标,分别开展鼠疫自然疫源地构成条件调查;针对不同地区的特点,研究相应的防控对策。结果甘南高原疫源不明区应是青藏高原喜马拉雅旱獭鼠疫自然疫源地的一部分;中部黄土高原疫源不明区没有发现鼠疫动物病的流行迹象;东部黄土高原疫源不明区不存在长爪沙鼠鼠疫自然疫源地,很可能也不存在阿拉善黄鼠鼠疫自然疫源地。结论甘南高原鼠疫疫源不明区建议采取喜马拉雅旱獭鼠疫自然疫源地控制策略;中部黄土高原鼠疫疫源不明区防控对策主要以防止历史疫区的死灰复燃,以及周边旱獭疫情的传入和波及为主;东部黄土高原疫源不明区鼠疫防控的主要任务是防止周边长爪沙鼠疫情的传入和波及。     

乌鲁木齐地区的鼠疫防治

乌鲁木齐地区的鼠疫防治马俊杰，刘玉栋（乌鲁木齐市地办室，乌鲁木齐市８３００００）乌鲁木齐南山鼠疫自然疫源地位天山山脉的天格尔山东端，东至阿拉沟，西与昌吉鼠疫疫源地接壤，南坡与和静县巴伦台相连。山体东西长１２０ｋｍ，南北宽５０ｋｍ，面积约６０００ｋｍ２...     

会宁县鼠疫与防治策略

会宁鼠疫自然疫源地是甘宁黄土高原阿拉善黄鼠疫自然疫源地的一部分，为该疫源地的西部边缘区，疫源面积３７０００ｈａ，占整个疫源面积的１２．９１％，疫史可追溯到１７３８年，１９６２年人间鼠疫为最后一次流行，共发病２６人，死亡１１人，并从人尸和沙狐体内分离出鼠疫杆菌。１９６３年从主要宿主阿拉善黄鼠及其主要媒介方形黄鼠蚤蒙古亚种体内分离到鼠疫杆菌。动物间鼠疫的流行在时间分布上仅限于阿拉善黄鼠地面活动的４￣８     

植树造林对鼠疫自然疫源地的影响

通过植树造林改变鼠疫赖以生存的生态环境来控制动物鼠疫，进而消除鼠疫疫源性，越来越为众多专业工作者推崇，普遍认为这是一条根本途径。而植树造林又是改造生态环境中的重要一环，这已为实践所证实。但是，建设什么样的林地可以消除疫源？哪些疫源地区可以推行，如何建设林地等等一些问题目前仍然处于探索阶段，对于有些地区还仅是一种愿望。本文是在对内蒙古自治区鼠疫自然疫源地内植树造林情况与动物鼠疫变化情况相关性调查的基础上，讨论植树造林对疫源地的影响。１ 鼠疫疫源地与森林地带 在我国已发现的１０个类型鼠疫自然疫源地中，…     

玉门市喜马拉雅旱獭鼠疫疫源地动物流行病学分析

目的对甘肃省玉门市喜马拉雅旱獭鼠疫疫源地旱獭鼠疫动物病某些特点进行分析和探讨。方法系统收集该疫源地70年代以来在鼠疫疫源监测中有关旱獭鼠疫动物病的流行强度、媒介昆虫、鼠疫菌毒力等流行特点,对旱獭鼠疫动物病进行流行病学分析。结果西部祁连山地的旱獭鼠疫自然疫源地疫情在自然条件下周期起伏不断循环,大面积内流行和宿主的栖息类型与生态习性紧密联系,不同月份分离的鼠疫菌菌株数量有差异,喜马拉雅旱獭为单一宿主。结论西部喜马拉雅旱獭鼠疫自然疫源地处于活动状态,2000年以后持续流行;旱獭是疫源地主要的疫源动物;旱獭体蚤是旱獭鼠疫流行的传播媒介,斧形盖蚤起主要传播媒介的作用,腹窦纤蚤主要侧重于保持巢内的疫源性,谢氏山蚤则两者兼有但后者的意义更大,不同区域的旱獭主要寄生蚤的种群组成不尽相同,寄生蚤的检菌数量也以季节消长为转移。     

新疆乌苏市巴音沟鼠疫监测报告

乌苏市南山巴音沟１９７８年被判定为鼠疫疫源地。１９８９年又确定了其后山亚马特鼠疫疫源地。疫源面积约２万化顷。１９７８－１９９８年共分离出鼠疫苗１５株；旱獭４株，长尾黄鼠１０株，蚤１株；检菌率分别为０．０６％，３．０１％和０．２８％。检出动物阳性血清旱獭３９份，长尾黄鼠４３份，牧犬３９份，阳性率分别为１．１６％，２０．９８５和４．９２％；血清阳性点集中在安集河以东地区，河西示查出阳性血清。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

CagA-Hp抗体IgG与胃炎的组织学分析

研究幽门螺杆菌(Hp)感染与胃炎的关系。方法对204例慢性胃炎患者胃粘膜进行观察分析,并测定其中137例Hp阳性患者血清CagA-Hp抗体IgG水平,与组织学对照。结果慢性萎缩性胃炎伴肠上皮化生患者血清CagA抗体IgG明显高于对照组(P＜0.01);其他类型胃炎患者血清CagA抗体IgG水平无明显增高(P＞0.05)。结论CagA-Hp可能是导致慢性萎缩性胃炎伴肠上皮化生的因素之一,对这类患者应密切随访观察。     

慢阻肺急性加重期患者预后的影响因素分析

目的探讨慢性阻塞性肺病急性加重期(AECOPD)患者预后的相关危险因素。方法回顾性调查、收集58例AECOPD患者可能影响其预后的相关因素,并对其分别进行单因素分析。并进行Logistic多元逐步回归进行多因素分析,筛选影响AECOPD患者预后的独立危险因素。结果单因素分析后将结果 P0.1的因素纳入多因素Logistic回归,分析发现是否合并呼吸衰竭、气促程度、白细胞计数、APACHEⅡ、应用抗氧化剂、慢阻肺治疗依从性为影响AECOPD患者预后不佳的独立因素(P0.05)。结论根据AECOPD患者预后的独立危险因素,及早判断,选择合适的后续治疗方案,对提高其生存率及生存质量具有重要意义。