云南省景洪市虫媒病毒调查分析

近１０多年来，先后从云南省景洪市各乡镇的当地病人、猪、蝙蝠和蚊虫体内分离出乙型脑炎病毒２２株，从白纹伊蚊中分离到登革４型病毒１株，从蝙蝠和蚊体内分离到基孔肯雅病毒５株，从患急性期血液中分离到辛德毕斯病毒１株，从发热病人血液、脑炎病人脑脊液、猪血清和牛血清中分离到新环状病毒４７株，从黄胸鼠肺脏中检查出流行性出血热病毒抗原阳性６份；人群、猪恒河猴或鼠类血清中亦检出上述６种病毒的抗体，表明景洪市存在乙     

用昆虫生长调节剂Hexaflumuron对白纹伊蚊的孽生进行控制

白纹伊蚊是亚洲一些国家和地区登革热的重要媒介,在印度的Kanpur区,很多病例中都可分离到登革4型病毒,一些地区的血清流行病学调查中,登革病毒的中和抗体也常能测出。白纹伊蚊在印度城乡地区广泛分     

福建省首次从病人血清及蚊体分离出登革病毒的研究

目的　１９９９ 年入夏以来, 我省某地发生不明原因发热、头痛、肌痛、乏力、皮疹等症状的病人, 拟诊为登革热。为了从病原学上证实, 我们进行了病毒分离, 为防治工作提供科学依据。方法　应用早期病人血清７ 份, 白纹伊蚊１ 份经处理后接种Ｃ６／３６ 细胞, 并应用恢复期病人血清、双相血清、免疫血清及单克隆抗体进行免疫荧光法鉴定及分型。结果　在７份早期病人血清中经２ ～３ 代分离出５ 株登革病毒, 并从白纹伊蚊体内分离出１ 株登革病毒。结论　此分离的毒株经鉴定均为登革ＩＩ型病毒。此系福建省首次从病人血清及蚊媒体内分离出病毒的报告。不仅为防制工作提供科学依据, 而且为今后的研究奠定了基础。     

云南省西双版纳州蚊虫分布特点及与虫媒病毒的关系

１９８１、１９８２、１９８３、１９８６、１９８７和１９８８年在西双版纳州景洪、勐海和勐腊县（市）捕获成年雌性蚊虫８属３４种３４５０８只。夜晚在农村畜圈及其周围采获蚊虫２１种,优势蚊种为棕头库蚊和三带喙库蚊;白天在野外竹林采获蚊虫２５种,优势蚊种为贺斑伊蚊和白蚊伊蚊。从三带喙库蚊（８株）、霜背库蚊（４株）、伪杂鳞库蚊（３株）、环带库蚊（１株）、棕头库蚊（１株）、中华按蚊（３株）、刺扰伊蚊（２株）、白     

云南省德宏州蚊虫分布特点及乙型脑炎病毒分离

１９８３年５月以及１９８４年和１９８９年７￣８月，在云南省德宠州路西，瑞丽和盈江三县，市捕获成年雌性蚊虫９属４４种１９０８３只。三带喙库蚊，霜背库蚊，棕头库蚊和中华按蚊是农村畜圈的主要蚊种。伪白纹伊蚊和白纹伊蚊是野外竹林区的优势蚊种。对所获蚊虫用Ｃ６／３６细胞和乳鼠方法分离病毒，结果从三带喙库蚊中分离到乙型脑炎病毒２株，从霜背库蚊，白纹伊蚊和窄翅伊蚊中各分离出１株乙型脑炎病毒。分析认为，三带喙库蚊     

白纹伊蚊中肠组织和C6/36细胞与登革病毒相互作用蛋白的筛选

目的 筛选登革Ⅱ型病毒与白纹伊蚊中肠组织和C6/36细胞中的连接分子。方法 富集纯化登革Ⅱ型病毒,用12%SDS-PAGE分析提取的C6/36细胞膜蛋白和白纹伊蚊中肠组织总蛋白,将分离胶上的蛋白转于硝酸纤维素膜(PVDF)上,应用病毒覆盖蛋白结合试验(VOPBA)方法筛选白纹伊蚊中肠组织和C6/36细胞中表达连接登革Ⅱ型病毒的分子。结果 白纹伊蚊中肠组织总蛋白经12% SDS-PAGE分离后转膜,分别与纯化的病毒液和阴性对照液孵育,用抗登革病毒单克隆抗体检测,结果显示病毒孵育组在分子量30 kDa的位置有特异性的条带出现, 而阴性对照组无此条带;用同样的方法筛选C6/36细胞上表达蛋白,病毒孵育组在分子量30 kDa和40 kDa的位置出现特异条带,而阴性对照组无。结论 VOPBA结果显示分子量为30 kDa的分子在中肠组织与C6/36细胞中都能表达,具有连接登革Ⅱ型病毒的作用,对其氨基酸序列的鉴定和功能分析工作正在进行中。     

胃粘膜中增殖细胞核抗原及p53、K-ras、bc1-2基因蛋白的表达

为了解胃粘膜癌变过程中多基因蛋白的表达及意义，应用免疫组化技术检测１０７例内镜活检胃粘膜组织中增殖细胞核抗原（ＰＣＮＡ）及ｐ５３、Ｋ－ｒａｓ、ｂｃ１－２基因蛋白。结果各基因蛋白阳性率随病变程度加重而增加。Ⅲ型肠化生者增殖细胞核抗原标记指数（ＰＣＮＡＬＩ）及Ｋ－ｒａｓ、ｂｃ１－２基因蛋白阳性率较之Ⅰ、Ⅱ型肠化亦有增高趋势但未见统计学差异（Ｐ≥０．０５）。１２例Ⅲ型肠化中有９例出现Ｋ－ｒａｓ或ｂｃ１－２蛋白异常表达（７５．０％），显著高于Ⅰ、Ⅱ型肠化（２３．８％）（Ｐ＜０．０５）。在肠型及胃型胃癌ｐ５３表达率为５３．３％、３７．０％（Ｐ＞０．０５）；Ｋ－ｒａｓ为４０．０％、７．４％（Ｐ＜０．０５）；ｂｃ１－２为９３．３％、５９．３％（Ｐ＜０．０５）。１５例肠型胃癌中有９例同时存在２种或２种以上蛋白异常表达（３例ｐ５３与ｂｃ１－２表达异常，２例ｂｃ１－２与Ｋ－ｒａｓ表达异常，４例ｐ５３与ｂｃ１－２、Ｋ－ｒａｓ异常表达），高于胃型胃癌（Ｐ＜０．０５）。结果提示以上基因产物的表达异常与胃粘膜癌变相关，Ⅲ型肠化属于胃癌癌前病变范畴，肠型胃癌发生发展的分子机制与胃型胃癌显著不同。     

输入性登革热七例

登革热是由伊蚊传播登革病毒所致的急性传染病。临床特征为发热，头痛，全身肌肉、骨骼和关节痛，乏力，皮疹，淋巴结肿大及WBC减少。登革热在全球热带和亚热带100多个国家和地区广泛流行。张海林等对云南登革热作了研究，云南省未发现埃及伊蚊分布，但白纹伊蚊分布广泛。1975年及1981年至1983年的7～9月，在云南河口、西双版纳采集的白纹伊蚊标本中分离出登革4型和登革3型病毒。从当地发热患者血清中查到登革抗体，说明有散在患者存在。云南过去曾发生输入性登革热。     

上海地区丙型肝炎病毒基因分型的研究

目的 研究上海地区不同人群中丙型肝炎病毒基因型的分布和频率。方法 应用新改进的第二代谱线探针分析（Ｌｉｎｅ Ｐｒｏｂｅ Ａｓｓａｙ,ＬｉＰＡ）试验盒,对１０９份血清的ＨＣＶ ＲＮＡ逆转录－巢式ＰＣＲ阳性分离物进行了基因分型。结果 ８１份丙型肝炎患者ＨＣＶ分离物中７１份（８６．７％）为１ｂ型,４份（４．９％）为２ｃ型,２份（２．５％）为３ｂ份,１份（１．２％）为６ａ型,２份（２．５％）为混合型９２／     

云南白纹伊蚊登革热Ⅲ型病毒的分离和鉴定

<正> 为了搞好登革热的监测,我们于1983年8月在西双版纳地区捕捉蚊虫进行病毒分离,从白纹伊蚊体内分离出1株登革Ⅲ型病毒,现将结果报告如下。 材料与方法 一、病毒分离 在畜圈、野外竹林及山地树林捕蚊,将蚊虫低温冻死,分类编号后,液氮冻存。检验时将蚊虫无菌研磨,用0.5％乳蛋白Hanks液制成1∶10悬液,离心取上清液接种白纹伊蚊C6/36细胞,37℃培养观察7天,盲传3代,如连续出现病变者转种1～3日龄小白鼠,乳鼠规律发病即行鉴定。     

A single injection of adrenergic agonists enhances pineal melatonin production in Turkish hamsters

Abstract: The purpose of this study was to determine whether the pineal gland of Turkish hamsters (Mesocricetus brandti) responds to adrenergic agonists with an increase in melatonin production, and, if it does, whether the sensitivity of the pineal gland to agonists would differ throughout the dark phase. Adult Turkish hamsters weighing 110–210 g received a subcutaneous injection of isoproterenol (ISO, 1 mg/kg B.W.) or norepinephrine (NE, 1 mg/kg B.W.) at different times of night. Animals exposed to LD 16:8 responded to ISO or NE with increased pineal melatonin content only when injected at dawn, when endogenous melatonin is at basal or near-basal levels. When the 8 hr scotophase was entirely replaced with light, the responsiveness to ISO injections at dawn disappeared. In animals exposed to light from 30 min prior to injection to the time of sacrifice, ISO injections increased pineal melatonin content (P < 0.005, three-way ANOVA), which varied, depending on the specific time of injection (effect of time of night, P < 0.05, three-way ANOVA). These results demonstrate that (1) adrenergic agonists enhance the production of pineal melatonin in Turkish hamsters, (2) this stimulatory effect takes place late, but not early in the 8 hr scotophase, and (3) the adrenergic induction of pineal melatonin production in Turkish hamsters requires priming by darkness during the appropriate circadian phase.     

MUTATION FREQUENCY IN NURSES AND PHARMACISTS WORKING WITH CYTOTOXIC DRUGS

Individuals occupationally exposed to cytotoxic drugs may be at risk owing to the effects of these agents on DNA. As an index of DNA damage, in vivo mutations were measured in lymphocytes from 24 oncology nurses or pharmacists and 24 matched controls. Mutation frequency was significantly increased in exposed individuals and appeared to be related to duration of exposure. However, the overall magnitude of the increase was small and its biological significance remains to be determined.     

Immune effector mechanisms in malaria: An update focusing on human immunity

The past decade has witnessed dramatic decreases in malaria‐associated mortality and morbidity around the world. This progress has largely been due to intensified malaria control measures, implementation of rapid diagnostics and establishing a network to anticipate and mitigate antimalarial drug resistance. However, the ultimate tool for malaria prevention is the development and implementation of an effective vaccine. To date, malaria vaccine efforts have focused on determining which of the thousands of antigens expressed by Plasmodium falciparum are instrumental targets of protective immunity. The antigenic variation and antigenic polymorphisms arising in parasite genes under immune selection present a daunting challenge for target antigen selection and prioritization, and is a given caveat when interpreting immune recall responses or results from monovalent vaccine trials. Other immune evasion strategies executed by the parasite highlight the myriad of ways in which it can become a recurrent infection. This review provides an update on immune effector mechanisms in malaria and focuses on our improved ability to interrogate the complexity of human immune system, accelerated by recent methodological advances. Appreciating how the human immune landscape influences the effectiveness and longevity of antimalarial immunity will help explain which conditions are necessary for immune effector mechanisms to prevail.     

Secondary aortoduodenal fistula

Aorto-duodenal fistulae （ADF） are the most frequent aorto-enteric fistulae （80%）, presenting with upper gastrointestinal bleeding. We report the first case of a man with a secondary aorto-duodenal fistula presenting with a history of persistent occlusive syndrome. A 59-year old man who underwent an aortic-bi-femoral bypass 5 years ago, presented with dyspepsia and biliary vomiting. Computed tomography scan showed in the third duodenal segment the presence of inflammatory tissue with air bubbles between the duodenum and prosthesis, adherent to the duodenum. The patient was submitted to surgery, during which the prosthesis was detached from the duodenum, the intestine failed to close and a gastro-jejunal anastomosis was performed. The post-operative course was simple, secondary ADF was a complication （0.3%-2%） of aortic surgery. Mechanical erosion of the prosthetic material into the bowel was due to the lack of interposed retroperitoneal tissue or the excessive pulsation of redundantly placed grafts or septic procedures. The third or fourth duodenal segment was most frequently involved. Diagnosis of ADF was difficult. Surgical treatment is always recommended by explorative laparotomy. ADF must be suspected whenever a patient with aortic prosthesis has digestive bleeding or unexplained obstructive syndrome. Rarely the clinical picture of ADF is subtle presenting as an obstructive syndrome and in these cases the principal goal is to effectively relieve the mechanical bowel obstruction.     

Married to M. tuberculosis: risk of infection and disease in spouses of smear-positive tuberculosis patients

Objectives To quantify the risk of infection and disease in spouses of tuberculosis patients and the extent to which intervention could reduce the risk in this highly exposed group. Methods We compared HIV prevalence, TB prevalence and incidence and tuberculin skin test (TST) results in spouses of TB patients and community controls. HIV‐positive spouses were offered isoniazid preventive therapy (IPT), and TST was repeated at 6, 12 and 24 months. Results We recruited 148 spouses of smear‐positive patients ascertained prospectively and 3% had active TB. We identified 203 spouses of previously diagnosed smear‐positive patients, 11 had already had TB, and the rate of TB was 2.4 per 100 person years(py) over 2 years (95% CI 1.15–5.09). 116 were found alive and recruited. HIV prevalence was 37% and 39% in the prospective and retrospective spouse groups and 17% in controls. TST was ≥10 mm in 80% of HIV negative and in 57% of HIV‐positive spouses ascertained retrospectively; 74% HIV negative and 62% HIV‐positive spouses ascertained prospectively, and 48% HIV negative and 26% HIV‐positive community controls. Of 54 HIV‐positive spouses, 18 completed 6‐month IPT. At 2 year follow‐up, 87% of surviving spouses had TST ≥10 mm and the rate of TB was 1.1 per 100 py (95% CI 0.34–3.29). Conclusions Spouses are a high‐risk group who should be screened for HIV and active TB. TST prevalence was already high by the time the spouses were approached but further infections were seen to occur. Uptake and adherence to IPT was disappointing, lessening the impact of short‐duration therapy.     

Dénervation rénale pour HTA réfractaire sans anesthésie générale : intérêt d’un protocole MEOPA Morphine. Expérience préliminaire

Renal denervation using the technique of radiofrequency is used only recently for the treatment of resistant hypertension. Normally, it is done under general anesthesia because the ablation point technique is painful. We suggest an alternative to general anesthesia comprising an association of morphin 0.1 mg/kg IV to MEOPA (gas combining oxygen and azot protoxyd) delivered through an oxygen mask. Our series includes 12 consecutive patients treated between October 2011 and June 2013, the first five patients (group 1) have received only an hydroxizin and morphin sedation. Every five have felt the ablation painful, in two cases bearable pain (EVA < 5), in three cases intense (EVA > 5) pain leading to increasing doses of morphin, (total dose of 0.25 mg/kg in two cases, 0.17 mg in one case). For the seven following patients, a protocol including hydroxyzin, morphin and MEOPA given through a mask has been set up. Only one patient has felt a mild pain (EVA 5) leading to an increasing dose of morphin (total dose 0.17 mg/kg). None of the six other patients has felt any pain during the procedure. The average dose of morphin is 0.17 mg/kg in group 1, 0.11 mg/kg in group 2. This is a preliminary study; if confirmed, it will allow a lot of hospitals without on-site possibilities of general anesthesia, to realize such procedures. Conclusion: regarding pain, the procedure of renal ablation was well tolerated for six among seven patients receiving the association MEOPA and IV morphin. In contrast, in the five patients treated only with IV morphin, we observed a less good tolerance to pain and the need to increase the doses of IV morphin.     

Scale‐up of TB and HIV programme collaborative activities in Zambia – a 10‐year review

Objective To review the activities, progress, achievements and challenges of the Zambia Ministry of Health tuberculosis (TB)/HIV collaborative activities over the past decade. Methods Analysis of Zambia Ministry of Health National TB and HIV programme documents and external independent programme review reports pertaining to 2000–2010. Results The number of people testing for HIV increased from 37 557 persons in 2003 to 1 327 995 persons in 2010 nationally. Those receiving anti‐retroviral therapy (ART) increased from 143 in 2003 to 344 304 in 2010. The national HIV prevalence estimates declined from 14.3% in 2001 to 13.5% in 2009. The proportion of TB patients being tested for HIV increased from 22.6% in 2006 to 84% in 2010 and approximately 70% were HIV positive. The proportion of the HIV‐infected TB patients who: (i) started on ART increased from 38% in 2006 to 50% in 2010; (ii) commenced co‐trimoxazole preventive therapy (CPT) increased from 31% in 2006 to 70% in 2010; and (iii) were successfully treated increased to an average of 80% resulting in decline of deaths from 13% in 2006 to 9% in 2010. Conclusions The scale‐up of TB/HIV collaborative programme activities in Zambia has steadily increased over the past decade resulting in increased testing for TB and HIV, and anti‐retroviral (ARV) rollout with improved treatment outcomes among TB patients co‐infected with HIV. Getting service delivery points to adhere to WHO guidelines for collaborative TB/HIV activities remains problematic, especially those meant to reduce the burden of TB in people living with HIV/AIDS (PLWHA).     

C-MET在非小细胞肺癌对表皮生长因子受体酪氨酸激酶抑制剂耐药中的作用研究进展

以表皮生长因子受体(EGFR)为靶点的酪氨酸酶抑制剂(TKI)是近年来非小细胞肺癌(NSCLC)治疗的重大突破.但是随着临床的广泛应用,耐药成为新的难点.新近研究已发现对EGFRTKI的耐药产生主要涉及原癌基因C-MET的扩增突变.C-MET是原癌基因,是蛋白产物肝细胞生长因子/离散离子(HGF/SF)的受体,具有酪氨酸酶活性,C-MET基因扩增激活ErbB3-PI3K信号途径导致NSCLC对EGFR-TKI产生耐药,大量研究证实NSCLC患者对EGFR-TKI耐药约20％归因于C-MET基因扩增.     

Artificial intelligence in pancreaticobiliary endoscopy

Artificial intelligence (AI) applications in health care have exponentially increased in recent years, and a few of these are related to pancreatobiliary disorders. AI‐based methods were applied to extract information, in prognostication, to guide clinical treatment decisions and in pancreatobiliary endoscopy to characterize lesions. AI applications in endoscopy are expected to reduce inter‐operator variability, improve the accuracy of diagnosis, and assist in therapeutic decision‐making in real time. AI‐based literature must however be interpreted with caution given the limited external validation. A multidisciplinary approach combining clinical and imaging or endoscopy data will better utilize AI‐based technologies to further improve patient care.