南昌市狂犬病流行现状及防控措施分析

目的分析南昌市近年来狂犬病流行特征及影响因素,探讨有效的防控措施。方法收集2004-2010年南昌市狂犬病疫情资料及个案调查表,采用描述性流行病学方法进行统计分析。结果南昌市2004-2010年共报告狂犬病32例,狂犬病发病率波动在0.0 635/10万～0.1 511/10万之间,年均发病率为0.099/10万,在全省排位前移。南昌市狂犬病流行特征与国内其他省市相似,为典型的"三多"表现:即农村地区病例较多、男性病例较多、<15岁儿童和>40岁人群发病较多。职业以农民为主。有明显的季节高峰。传染源犬占90.63%,其次是猫,伤人动物均为散养,无免疫史或免疫史不详。病例暴露后处置率低,78.13%的病例暴露后未处理伤口也未注射疫苗及被动免疫制剂,18.75%的病例处理不规范。结论南昌市狂犬病疫情上升的主要原因是犬只管理滞后、犬只免疫率低和人群暴露后规范处置率低。今后狂犬病防控工作应采取加强犬类管理,提高犬免疫覆盖率;加强健康教育;开展人狂犬病预防处置门诊规范化建设,加强门诊业务人员培训,提高规范处置率;提倡开展暴露前免疫;制订相关政策,减轻群众负担等一系列有效措施。     

宝鸡市2010年犬伤暴露人员监测分析

目的分析宝鸡市犬伤暴露人群流行病学特征。方法采用分层抽样方法对宝鸡市755例犬伤暴露人员个案信息表进行分析。结果犬伤暴露人员主要分布在农村地区(72.98%,551/755),城市占27.02%(204/755);男女比例约为1.69∶1;15岁以下(38.81%,293/755)、40～岁(16.95%,128/755)犬伤暴露人员较多,犬伤暴露人员以农民(39.60%,299/755)和学生(31.66%,239/755)为主。暴露程度Ⅰ度为22.65%(171/755),Ⅱ度为45.69%(345/755),Ⅲ度为31.66%(239/755);犬伤暴露人员暴露前多数无狂犬疫苗免疫史(97.75%,738/755)。伤人犬只主要来源于邻居喂养犬只(50.99%,385/755),其次是自家喂养犬只(34.97%,264/755);犬只伤人原因主要是主动袭击(63.71%,481/755)。结论宝鸡市需加强养犬管理,加强狂犬病疫情监测工作,开展群众狂犬病防治知识健康教育。     

邵阳市2005～2010年狂犬病流行特征分析

目的:分析邵阳市近几年来狂犬病流行特征,初步探讨当前防控对策.方法:分析邵阳市2005～2010年狂犬病疫情资料、邵阳市狂犬病监测点资料与狂犬病病例个案调查资料,采用EXCEL2003绘制图表,病例个案调查表用Epidata3.1录入,相关统计值用SPSS 17.0计算.结果:邵阳市2005～2010年12个县(市、区)共报告狂犬病病例228例,以邵阳县发病人数最多,占全市病例数的28.07%;12个月都有病例报告,每年的7～11月发病人数相对较多;发病人群主要是10岁以下儿童及60～70岁老年人.对109例病例个案调查资料进行分析,主要是Ⅲ级暴露(59.62%);暴露部位大部分在四肢(89/104),伤人动物为犬和猫分别占89.42%、10.58%,有12例到医疗机构处理并注射了狂苗.2010年我市犬和猫密度为3.70只/100人,邵阳县健康犬狂犬病毒检出率为2.50%.结论:犬只数量大,狂犬病毒在犬、猫等宿主动物间传播是造成邵阳市狂犬病流行的根本原因,而部分人群无防病意识或因经济原因导致在暴露后没有到医疗机构进行处置、以及门诊处置不规范或疫苗原因导致免疫失败等也可能是重要原因.     

2004～2008年平果县狂犬病疫情分析

目的分析2004～2008年平果县狂犬病患者,探讨其流行因素,为防控工作提供科学依据。方法对31例狂犬疫患者进行个案调查。结果2004～2008年各年度发病例数分别为:2、7、12、5和5例,全县12个乡镇中有10个出现病例。结论犬只密度高,犬只免疫率低,受犬伤后未及时处理伤口、注射狂犬疫苗和抗狂犬病免疫球蛋白是导致疫情流行的主要原因。     

广东省1990-2005年狂犬病流行病学特征分析

[目的]描述并分析广东省1990～2005年狂犬病流行特征,为狂犬病的预防与控制提供科学依据。[方法]分析广东省1990～2005年狂犬病监测资料和犬用狂犬病疫苗销售资料,对2003-2004年资料完整的244例病例的个案资料进行分析,用EXCEL12.0软件对相关资料进行分析。[结果]狂犬病发病率波动于0.02/10万～0.38/10万;1990～1996年共报告狂犬病病例364例,以清远市(54例)和佛山市(48例)最多,2001～2004年共报告661例,以茂名市(117例)和梅州市(84例)最多:8月份发病人数最多。个案调查结果表明:87.71%病例暴露后伤口未经及时正确处理,97.55%病例未及时规范接种人用狂犬病疫苗,97.13%病例未及时局部注射抗狂犬病免疫球蛋白。[结论]进入上世纪90年代以来,广东省狂犬病发病率曾逐年下降,但1996年以后,狂犬病疫情呈逐年上升趋势。犬只免疫率低;暴露后伤口处理不规范及未及时全程免疫接种是造成狂犬病疫情反弹的重要原因     

2003-2007年灵山县人间狂犬病的流行因素分析

目的分析灵山县人间狂犬病流行及其流行因素,为政府制定防制对策提供科学依据。方法收集2003-2007年该县法定报告的狂犬病疫情流行病学个案资料及监测资料,用Excel软件分析其流行的关系。结果 2003-2007年5年共报告狂犬病85例,发病以农村为主,呈常年散发,夏、秋季较多,占71.76%（61/85）;农民和学生占80.00%（68/85）,为主要发病人群;男性多于女性,男女性别比为4.3∶1;6～15岁和32～60岁两个年龄组发病较多,占病例总数的68.24%（58/85）。报告病例的平均潜伏期为51 d,头面部咬伤的潜伏期较短（23 d）,下肢咬伤的潜伏期较长（83 d）;致伤动物主要是犬（占76.47%）,咬人犬只免疫接种率为7.06%（6/85）;农村犬只密度94.5只/100户;暴露治疗人群中,有74.12%（63/85）进行了伤口处理,27.06%（23/85）接种了疫苗,其中10.53%（4/38）已完成全程接种;5.88%（5/85）注射了抗病毒血清。结论犬只数量增加和防制工作力度不足,伤口处理不规范和疫苗全程接种率偏低是狂犬病发病流行的主要因素。规范犬只动物管理,提高其免疫率,提高暴露后人群伤口处理和免疫接种率,是狂犬病预防控制的重要措施。     

1981～2010年昆明市狂犬病流行因素分析

目的分析昆明市1981～2010年狂犬病流行特点,探讨昆明市狂犬病发病相关因素。方法收集1981～2010年昆明市狂犬病疫情资料进行总结和分析。结果 1981～2010年共报告狂犬病89例,49.44%的病例伤后未进行处理,仅3例病例注射了狂犬病疫苗,但均未完成免疫程序。潜伏期最短7d,最长12年,潜伏期中位数为46d。96.63%病例致伤动物为犬,犬密度最高为42条/100人,目前为7条/100人,但农村地区远远不止于此;犬免疫率不足10%。结论犬密度高而犬免疫率低,疾病危害认识不足、暴露后治疗率低,犬伤门诊设置不合理、处置不规范,是造成昆明市狂犬病流行的主要原因。     

河池市2000～2011年狂犬病流行特征分析

目的分析河池市人间狂犬病流行特征及影响因素,为狂犬病防治提供科学依据。方法采用描述性流行病学方法对河池市2000～2011年狂犬病疫情监测资料进行分析。结果2000～2011年河池市共报告狂犬病318例,年均发病（死亡）率为0.70/10万,2003年后疫情出现回升。各县（市、区）均有病例报告,最少13例,最多48例。农村男性农民和学生是狂犬病高危人群,男女性别比为2.28：1;8月、11月和12月发病较多;伤人动物以犬为主,占92.97%,犬只疫苗接种率较低（25.03%）,健康犬脑组织标本狂犬病毒抗原平均阳性率为4.79%;Ⅲ度伤口占52.86%,被动物伤后未接种疫苗的患者占90.75%。结论目前河池市狂犬病疫情形势仍严峻,应加强农村狂犬病的综合防制工作。     

来宾市2008～2013年狂犬病流行特征分析

目的了解来宾市2008~2013年狂犬病流行特征及其流行因素,为狂犬病防控提供依据。方法收集来宾市2008~2013年狂犬病疫情和监测资料进行流行病学描述和统计学分析。采集市场上销售狗脑组织,用DFA和RT-PCR方法检测狂犬病病毒感染情况。结果来宾市2008~2013年共报告狂犬病例139例,年平均发病率为1.05/10万。病例分布主要在兴宾区和武宣县,占总例数的79.86%。一年四季均有发病,7~12月份占58.99%。50~74岁人群发病最多占47.48%,其次为15岁以下儿童占17.98%。男女性别比为3.21:1。农民占总发病数的66.91%。被家犬咬(抓)伤占77.70%、被猫咬(抓)伤占14.38%。狂犬病例中有73.38%的患者暴露后未进行伤口处理,85.61%患者未进行疫苗接种,97.03%患者未注射抗狂犬病毒血清或免疫球蛋白。2008年犬只密度最高为13.31只/100人,最低2013年为10.01只/100人;犬只免疫率最高2013年为43.45%,最低2008年为34.35%。犬狂犬病毒核酸阳性率为1.43%。结论来宾市2008~2013年狂犬病发病率虽然呈逐年下降趋势,但疫情形势依然严峻。犬只密度高、免疫率低和带毒率高、暴露后预防处置率低和未按要求进行预防处置、犬只管理不到位和相关部门缺乏沟通协作等是狂犬病发生和扩散的主要原因。应进一步加强对狂犬病监测。     

1997-2005年广州市狂犬病疫情分析

目的对广州市近几年狂犬病发病态势进行分析,从而制定切实有效的预防控制狂犬病的措施。方法对广州市1997-2005年发生的狂犬病病例发病情况、分布、潜伏期等因素进行分析,找出疫情上升的原因。结果1997-2005年共发生狂犬病18例,1997-2000年,疫情局限在花都区,2002-2004年疫情集中在增城市,但2005年疫情迅速上升,共发生9例,并波及多个地区。结论犬只密度升高,犬伤人数增多,疫点处理不彻底及群众防病意识不高是疫情上升的原因,加强宣传教育、犬只管理,提高犬只免疫率是今后工作的重点。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.