2003～2012年广西钦州市流行性乙型脑炎疫情分析

目的了解钦州市流行性乙型脑炎（简称乙脑）的流行情况,为有效预防控制乙脑提供科学依据。方法对钦州市2003-01~2012-12的乙脑疫情资料用描述流行病学方法进行整理分析。结果 2003~2012年该市共报告乙脑病例91例,年均发病率为0.29/10万;散居儿童发病69例,占75.82%;男性、女性分别占69.23%、30.77%;2~10岁儿童发病77例,占发病总数为84.62%;5~7月份发病90例,占病例总数的98.90%,呈明显的夏秋季发病高峰;病例主要集中在农村边远地区,共65例,占病例总数的71.43%。结论预防控制乙脑要重点抓好农村边远地区2~10岁散居儿童的乙脑疫苗常规接种和查漏补种工作,在乙脑高发的夏秋季节加强监测力度和宣传教育力度,落实防蚊措施,减少乙脑发病。     

2008—2018年天水市流行性乙型脑炎流行病学特征分析

目的了解甘肃省天水市流行性乙型脑炎(简称乙脑)发病情况及流行特征,为乙脑下一步防控工作提供依据。方法收集并整理乙脑监测信息报告管理系统中2008—2018年天水市报告的乙脑病例数据,采用描述流行病学分析乙脑发病及流行特征。结果 2008—2018年天水市乙脑发病317例,年均发病率为0.87/10万;死亡16例,年均死亡率0.044/10万;发病率2018年(5.30/10万)最高、2009年(0.03/10万)和2012年(0.03/10万)最低,各年发病率差异有统计学意义(χ~2=289.013,P<0.05);发病主要集中在7—9月(98.42%,312/317),8月发病人数最多(75.08%,238/317),其次是7月(14.82%,47/317)和9月(8.52%,27/317);7个县(区)均有发病,秦安县发病率最高(1.49/10万)、武山县最低(0.35/10万);发病年龄最大93岁、最小1岁,主要集中在40～79岁(76.66%,243/317);以农民为主、占88.01%;男女病例性别比为1∶1.22,年均发病率男性(0.39/10万)和女性(0.48/10万)差异无统计学意义(χ~2=0.111,P>0.05);无免疫史病例最多(233例,73.50%),免疫史不详77例、占24.29%,有免疫史仅7例、占2.21%。结论天水市儿童乙脑发病控制效果明显,农村地区防蚊灭蚊工作无法得到有效落实的情况下,在做好儿童乙脑疫苗常规接种的基础上,应制定成人乙脑免疫策略,结合监测、健康教育及防蚊灭蚊等综合措施防控乙脑疫情。     

2008-2018年天水市流行性乙型脑炎流行病学特征分析

目的了解甘肃省天水市流行性乙型脑炎(简称乙脑)发病情况及流行特征,为乙脑下一步防控工作提供依据。方法收集并整理乙脑监测信息报告管理系统中2008—2018年天水市报告的乙脑病例数据,采用描述流行病学分析乙脑发病及流行特征。结果2008—2018年天水市乙脑发病317例,年均发病率为0.87/10万;死亡16例,年均死亡率0.044/10万;发病率2018年(5.30/10万)最高、2009年(0.03/10万)和2012年(0.03/10万)最低,各年发病率差异有统计学意义(χ²=289.013,P<0.05);发病主要集中在7—9月(98.42%,312/317),8月发病人数最多(75.08%,238/317),其次是7月(14.82%,47/317)和9月(8.52%,27/317);7个县(区)均有发病,秦安县发病率最高(1.49/10万)、武山县最低(0.35/10万);发病年龄最大93岁、最小1岁,主要集中在40~79岁(76.66%,243/317);以农民为主、占88.01%;男女病例性别比为1∶1.22,年均发病率男性(0.39/10万)和女性(0.48/10万)差异无统计学意义(χ²=0.111,P>0.05);无免疫史病例最多(233例,73.50%),免疫史不详77例、占24.29%,有免疫史仅7例、占2.21%。结论天水市儿童乙脑发病控制效果明显,农村地区防蚊灭蚊工作无法得到有效落实的情况下,在做好儿童乙脑疫苗常规接种的基础上,应制定成人乙脑免疫策略,结合监测、健康教育及防蚊灭蚊等综合措施防控乙脑疫情。     

2005~2013 年成都市流行性乙型脑炎流行病学分析

目的 分析2005~2013 年成都市乙脑报告发病情况,探讨乙脑防治措施。方法 采用Excel软件对2005~2013 年成都市乙脑病例资料进行分析。结果 2005~2013 年成都市共报告乙脑病例124 例,死亡3 例,病例主要分布在金堂、金牛、郫县和双流。男女比例为1.70∶1,年龄最小6 个月,最大61 岁,以3~5 岁为主,占41.94%。无免疫史或免疫史不详占69.44%。蚊密度监测三带喙库蚊占4.27%。结论 成都市近年乙脑呈低水平散发态势,应做好乙脑疫苗查验补种,尤其要加强农村、偏远地区和流动人口密集地区的免疫接种,提高乙脑疫苗覆盖率,减少免疫空白,同时做好宣传教育、防蚊灭蚊等防控措施,减少乙脑发病。     

云南省乙型脑炎流行与防治现状调查

目的了解云南省乙型脑炎流行变化和趋势，为制定防治方案和策略提供科学依据。方法收集2002～2005年云南省乙脑疫情资料，采用乙型脑炎病例个案凋查表进行现场既往流行病学个案调查，应用诱蚊灯和吸蚊管人工捕蚊方法进行现场传播媒介调查，同时进行防治现状调查。结果2002～2004年全省报告乙脑病例1272例，发病率在1‰～1．84‰的县市有8个，每年平均有69个县（市）有病例报告，多集中在6～9月发病。2005年全省报告乙脑病例426例，比2004年397例上升12．40％；死亡22例，上升69．23％，病死率5．16％，上升50．44％。全省16个州（市）中有15个州（市）有乙脑病例报告。既往流行病学个案调查6个县（市）17例，其中儿童发病12例（占70．59％），治疗后有严重后遗症4例（致残率23．53％），死亡4例（病死率23．53％）；媒介调查12个县（市），乙脑主要传播媒介三带喙库蚊为当地的主要优势蚊种（58．10％）；防治现状调查了15个州（市）26个县，主要采取的防治措施为：疫情监测、健康教育、疫点灭蚊喷洒、乙脑疫苗接种。其中疫苗预防接种调查8个州（市）26个县，年接种率在0．10％～9．58％之间。结论1）云南省乙型脑炎发病多、分布较广，儿童发病、致残、病死率较高；2）乙脑的主要传播媒介三带喙库蚊在云南省广泛分布；3）人群乙脑疫苗预防接种率较低，特别是农村儿童接种覆盖率非常低。     

广东省乙型脑炎流行特征及其防制策略

目的分析广东省乙型脑炎流行特征,探讨防制策略。方法采用SPSS12.0软件建立数据库,进行描述性流行病学分析和多重线性回归分析。结果1990年以来,广东省于1995年和2003年出现2次乙脑发病的小高峰,其余各年度乙脑报告发病率均较低,疫情比较稳定。疫情主要分布在粤西和粤东地区;发病时间集中在每年5～7月,6月份为发病高峰;乙脑报告病例以1～14岁儿童为主,多为无免疫史和免疫史不详者。多重线性回归分析结果显示稻田种植面积、年平均降雨量与乙脑发病率存在统计学关联。结论广东省乙脑流行呈现明显的周期性、季节性和一定的地域性,1～14岁儿童为乙脑易感人群。接种乙脑疫苗和灭蚊是预防控制乙脑流行的重要措施。     

云南省大理州1992～2001年流行性乙型脑炎流行现状分析(摘要)

目的本文对云南省大理州12个县(市)1992～2001年流行性乙型脑炎(简称乙脑)的流行现状进行了分析.方法乙脑病例和疫苗接种率资料从大理州疾病预防控制中心收集,气象和稻田种植面积资料分别从大理州气象局和大理州土地局获得.统计学分析用STADA 6.0 软件进行.结果在这10年间,大理州共报道839例乙脑病例,其中死亡101例,发病率为0.91/10万～ 6.45/10万,死亡率为0.09/10万～ 0.52/10万, 病死率为7.92% ～16.47%.每年乙脑病例从4月出现,12月止,主要流行季节8至10月(占病例数的90.46%),9月为流行高峰 (占病例数的41.72%).大理州12县(市)都有乙脑病例分布,各县市发病率由高到低分别为宾川(7.3/10万)、祥云 (5.2/10万) 、漾濞 (5.2/10万) 、剑川(4.4/10万) 、巍山 (4.2/10万) 、洱源 (2.8/10万) 、大理市 (2.7/10万) 、弥渡(2.7/10万) 、南涧(2.7/10万) 、鹤庆 (1.8/10万) 、永平 (1.6/10万)和云龙(0.7/10万).从1997～2001年所报道的297例乙脑病例分析,1997年5～9岁为发病率最高年龄组,但是,随后几年,这种流行模式发生了变化,发病率的最高年龄组从5～9岁组逐渐迁移到大于15岁组.对于成人,发病率最高的人群为农民.乙脑病例中,男∶女比率为1.4∶ 1;死亡病例中,男∶女比率为4∶ 1.统计学分析发现各县市乙脑年发病率与年平均温度,年平均降雨量和水稻面积无明显相关,而乙脑疫苗接种是一种有效的预防控制方法.结论鉴于流行模式的改变,为防止乙脑的流行, 不仅要重视1～14岁年龄组乙脑疫苗的接种,而且要加强对15岁年龄组疫苗的预防接种.     

遂宁市麻疹179例临床分析

目的 分析遂宁市麻疹患者临床特点.方法 收集2006-01/2006-12住院麻疹患者179例临床资料,从患者性别、年龄分布、发病季节、发病地区、是否接种疫苗、临床特征、并发症等方面进行回顾性分析.结果 ①发病季节不仅限于冬春季,夏季患者增多,占33.52%(60/179);②低龄未接种疫苗儿童(4～8月38例)和成年女性(18例)发病率明显上升;③农村患者(106例)多于市区(73例).结论 低龄未接种疫苗儿童和成年女性麻疹有增多趋势.加强农村儿童的免疫覆盖率;高危地区的成年女性,尤其是孕前育龄妇女可以复种麻疹减毒活疫苗.     

2004-2008年绵竹市腮腺炎流行病学特征分析

目的 了解绵竹市流行性腮腺炎的流行特征,为有效控制该病提供科学依据.方法 采用描述流行病学分析方法,对该市2004-2008年流行性腮腺炎发病情况进行统计分析.结果 2004-2008年共发生流行性腮腺炎病例606例,年均发病率23.86/10万;城区发病213例,农村发病393例,农村发病高于城区(χ2=11.50,P<0.01);男性发病356例、女性发病250例,男女比为1.42:1;发病时间以4-7月较多,占发病总数的48.18%,经园形分布法分析,发病高峰时点为5月5日;发病年龄以4～15岁为主,占发病总数的78.22%;职业以15岁以下的散居儿童、托幼儿童、学生为主,占发病总数的88.12%.结论 腮腺炎已成为危害儿童健康的主要传染病之一,应规范的开展腮腺炎疫苗的免疫接种(以儿童、学生为主要接种对象),提高人群免疫水平,是减缓流行性腮腺炎的发病趋势的关键.     

上海地区2005年儿童麻疹临床流行病学特征分析

目的对上海地区2005年1月至6月儿童麻疹流行和临床特征进行分析。方法对567例麻疹初诊病例及其中333例住院病例进行临床流行病学分析。结果567例初诊患儿中有64例为外地发病至上海就医者,在上海发病的503例患儿中:外来儿童305例,占60.6%,本市儿童198例,占39.4%;<9月龄为301例,占59.8%,≥9月龄为202例(其中81.7%为外来儿童)。发病高峰为4～5月份。333例住院患儿中仅20例可以确定接种过麻疹疫苗,临床上仍以典型麻疹为主要表现,麻疹合并肺炎181例,占54.4%,其中129例为<1岁婴儿,占71.3%。529例送检麻疹特异性IgM抗体,502例为阳性,占94.9%。结论本次麻疹发病数明显高于往年,发病者绝大部分未接种过麻疹疫苗,高发年龄为<9月龄婴儿。肺炎仍是婴儿麻疹的常见并发症。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.