江苏省农村散发性戊型肝炎流行病学特征分析

目的了解江苏省农村散发性戊型肝炎的流行病学特征。方法通过建立覆盖市、镇、村三级医疗卫生服务机构的疑似肝炎主动监测网络,系统全面地监测戊型肝炎病例的发病情况。结果主动监测网络的敏感性明显高于网络报告系统,能更加准确、全面地掌握戊肝的发病规律。结果显示戊型肝炎病例占疑似急性肝炎病例的26.7%,男性戊肝发病率高于女性(P<0.01);发病随着年龄增长而上升,多见35岁以上人群;全年均有发病,冬春季节较高;戊型肝炎病毒株HEV1、4型并存,但以HEV4型为主(92.5%)。结论疑似肝炎主动监测系统数据显示目前戊肝发病率有被低估的风险。     

急性戊型肝炎诊治6例

戊型肝炎（戊肝）为戊型肝炎病毒（HEV）引起的急性自限性病毒性肝炎,在临床上远较乙型肝炎、丙型肝炎少见,多表现为散发病例,但其发病率在我国多数地区成人急性病毒性肝炎中仍占首位。由于在临床工作中相对少见、与药物性肝病等疾病临床表现类似以及对戊型肝炎的认识不够等原因导致其误诊、误治情况多见,为此我们对4年来我院诊治的戊型肝炎患者的临床特征、实验室检查及转归进行分析,以促进我们更好地认识、诊治急性戊型病毒性肝炎。     

急性病毒性肝炎1711例病原学分析

目的:研究福州地区急性病毒性肝炎病原学的特征.方法:对2002年1月～2007年12月份福州市传染病医院收治的急性散发性肝炎患者1 711例,进行血清病原学分型及流行病学研究.结果:1 711例中,男性患者1 175例,女性患者536例,男女性患者之比为2.2:1.甲、戊型病毒性肝炎分别占12.16%、54.88%,未分型占32.96%.年龄分布主要集中在2～87岁,甲型肝炎病例中15～39岁者占83.65%,14岁以下者占14.9%,戊型肝炎病例中30～69岁者占89.00%,每年第一、二季度为高发季节,分别占34.02%、29.46%;2003-2004年间发病数高于其他年份.结论:戊型病毒性肝炎是福州地区常见的急性肝炎类型;接种甲肝疫苗是有效的预防措施,注意个人卫生有助于预防甲肝病毒和戊肝病毒的传播.     

2008—2014年武威市病毒性肝炎流行病学特征分析

目的了解2008—2014年甘肃省武威市病毒性肝炎流行病学特征,为病毒性肝炎的预防控制提供参考。方法采用描述流行病学方法分析2008—2014年武威市法定传染病监测系统中报告的病毒性肝炎发病情况及流行病学特征。结果 2008—2014年武威市共报告病毒性肝炎69 600例,年均报告发病率530.57/10万,报告发病率呈逐年下降趋势;病毒性肝炎患者中乙型肝炎最多占82.23%,甲型肝炎和乙型肝炎报告发病率总体上呈现逐年下降趋势,丙型肝炎和戊型肝炎报告发病率基本呈现先升高后降低趋势;甲型肝炎夏秋季高发,乙型肝炎、丙型肝炎冬春季高发,戊型肝炎发病无明显季节性;病毒性肝炎各县(区)年均报告发病率由高到低依次为凉州区689.52/10万、古浪县451.67/10万、天祝县384.20/10万和民勤县212.85/10万,不同地区差异有统计学意义(χ2=6 813.14,P0.05);甲型肝炎40~49岁年龄组高发,乙型肝炎20~49岁年龄组高发,丙型肝炎40~69岁年龄组高发,各年龄组不同型别构成差异有统计学意义(χ2=6 182.68,P0.05);报告病毒性肝炎病例比例农民最高64.64%,其次为学生11.60%、工人4.66%、家务及待业4.58%。结论武威市病毒性肝炎报告发病率呈现明显的下降趋势,应继续加强相关肝炎疫苗的接种以及病毒性肝炎的监测和控制。     

戊型肝炎疫苗研究进展

戊型肝炎(戊肝,HE)是由戊型肝炎病毒(HEV)引起的一种非甲非乙型病毒性肝炎。HE属典型的自限性疾病,急性肝炎期持续1～4周,一般不会发展成慢性肝炎。主要经粪-口途径传播,既有散发,也有流行,在卫生条件差的地区常引起大规模     

散发性急性戊型肝炎与乙型肝炎的临床特征比较

散发性急性戊型肝炎是一种由戊型肝炎病毒所引起的病毒性肝炎,其在世界范围内流行比较广泛,在发展中国家更是一种多发性疾病。与其他肝炎病毒相比,散发性急性戊型肝炎死亡率较高,约为0.5%～3%。在我国,散发性急性戊型肝炎的发病率约为12.3%～43.2%。研究探讨散发性急性戊型肝炎与乙型肝炎的临床特征,分析其共性与特性并进行比较。为了进一步分析二者之间的特征,我院以2008年12月—2011年12月共收治的100例散发性戊型肝炎以及乙型肝炎患者为研     

戊型肝炎人畜共患性的研究进展

戊型肝炎(Hepatitis E,以下简称戊肝)是由戊型肝炎病毒(Hepatitis E virus,HEV)引起的肠道传播为主的传染性疾病。戊肝的爆发流行主要累及发展中国家,常因饮用水源被污染所致,散发病例呈全球分布。HEV 主要侵犯青壮年,重型肝炎多,易感染孕妇并且病死率可高达15%～25%,严重     

戊型肝炎

老年人戊型病毒性肝炎26例临床分析——袁霞等（广西桂林广西区南溪山医院541002）；《华夏医学》，2005，18（4）：547．548【目的：探讨老年人戊型病毒性肝炎的临床特点。方法：对26例老年人戊型病毒性肝炎患进行临床及生化指标分析。结果：老年人戊肝发病率为24．3％，全年均可发病，乏力、尿黄及消化道症状典型，发热少见。黄疸深，淤疸型较常见。重叠乙肝病毒感染6例，2例为重型肝炎。结论：老年人戊肝不少见，呈散发，以黄疸型为主，易发生淤疸。重叠乙肝后，使病情加重，病程延长。老年人戊肝重型发病率较高，但预后良好。】     

慢性HBV感染重叠HEV感染的临床研究

目的进一步了解慢性乙型肝炎病毒(HBV)感染重叠戊型肝炎病毒(HEV)感染的临床特点及转归。方法对慢性HBV感染重叠HEV感染与单纯戊型肝炎进行临床对照研究。结果167例戊型肝炎均为散发型,发病无明显季节性,以40岁以上成人发病为主,平均年龄为42.12±14.06岁,男女比例为2.71∶1。其中,慢性HBV感染重叠HEV感染(简称乙戊肝)79例(47.31%),单纯戊型肝炎88例(52.69%)。乙戊肝组重度黄疸(TB>280μmol/L)、严重凝血功能异常(PTA<40%)和低蛋白血症的发生率明显高于单纯戊型肝炎组(P<0.01)。结论重叠戊型肝炎病毒感染是导致慢性HBV感染者病情急性加重和重症化,甚至发展成致死性重型肝炎的重要原因之一。     

戊型肝炎

戊型肝炎(戊肝)是一种自限性、肠道传播的急性病毒性肝炎,多以流行暴发出现,病因为新认定的戊型肝炎病毒(HEV)。其常由于粪便污染饮用水而传播,也称为肠道传染性非甲非乙型肝炎(NANB)。 流行病学、临床及病理学特点 流行病学 戊肝可以在短期内暴发或持久流行形式发生。病源通常是污染水,且流行常发生在雨季之后。平均潜伏期为6周(2～9周)。患者家庭成员中两代发病率(0.77％)不高,但     

Clinical trials update: highlights of the scientific sessions of The American College of Cardiology 2002: LIFE,DANAMI 2, MADIT-2, MIRACLE-ICD,OVERTURE, OCTAVE,ENABLE 1 & 2, CHRISTMAS,AFFIRM, RACE,WIZARD, AZACS,REMATCH, BNP trial and HARDBALL

This article continues a series of reports updating recent research developments of particular interest to personnel involved in the treatment and management of patients with heart failure. This is a summary of selected presentations made at the American College of Cardiology 51st Annual Scientific Session held in Atlanta on 17-20 March 2002. Reports of the following clinical studies are included: LIFE, DANAMI 2, MADIT-2, MIRACLE-ICD, OVERTURE, OCTAVE, ENABLE 1 & 2, CHRISTMAS, AFFIRM, RACE, WIZARD, AZACS, REMATCH, BNP trial and HARDBALL.     

Electrochemical Recovery and Behaviors of Rare Earth (La,Ce, Pr,Nd, Sm,Eu, Gd,Tb, Dy,Ho, Er,Tm, and Yb) Ions on Ni Sheets

The electrochemical behaviors of rare earth (RE) ions have extensively been studied because of their high potential applications to the reprocessing of used nuclear fuels and RE-containing materials. In the present study, we fully investigated the electrochemical behaviors of RE(III) (La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, and Yb) ions over a Ni sheet electrode in 0.1 M NaClO₄ electrolyte solution by cyclic voltammetry between +0.5 and −1.5 V (vs. Ag/AgCl). Amperometry electrodeposition experiments were performed between −1.2 and −0.9 V to recover RE elements over the Ni sheet. The successfully RE-recovered Ni sheets were fully characterized by scanning electron microscopy, energy dispersive X-ray spectroscopy, Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and photoluminescence spectroscopy. The newly reported recovery data for RE(III) ions over a metal electrode provide valuable information on the development of the treatment methods of RE elements.     

Prevalence,Self-Awareness,Treatment, and Control of Hypertension in Lhasa,Tibet

To investigate the prevalence, self-awareness, and treatment of hypertension in Lhasa, Tibet, a total of 1370 native Tibetan aged ≥18 years were selected, using stratified proportional sampling. The study showed that the prevalence of hypertension was 51.2%, significantly higher in men (56.0%) than in women (48.0%) (P = .004). The hypertension prevalence increased with increasing age (77.8% in 60–74 y and 82.5% in ≥75 y groups) and was higher in urban, suburban, or agricultural area than in pastoral area (P < .001). The self-awareness, treatment, and control rate of hypertension were 63.5%, 24.3% and 7.7%, respectively. In multivariable regression analysis, age, urban residence, amount of daily intake of fat and oil, and body mass index <18.5 kg/m² were independently associated with hypertension. In conclusion, hypertension was highly prevalent among native Tibetan people in Lhasa, and the rates of self-awareness, treatment, and control of hypertension were low.     

Lack of effect of colesevelam HCl on the single-dose pharmacokinetics of aspirin,atenolol, enalapril,phenytoin, rosiglitazone,and sitagliptin

Aims

Drug interactions with bile acid sequestrants are primarily due to the potential of these agents to bind to concomitant drugs. Six clinical studies were performed to determine the effects of colesevelam on the pharmacokinetics of aspirin, atenolol, enalapril, phenytoin, rosiglitazone, and sitagliptin.

Methods

All six studies enrolled healthy subjects aged 18–45 years. The phenytoin study used a single-dose, three-period crossover design (phenytoin alone, phenytoin simultaneously with colesevelam, and phenytoin 4 h before colesevelam). The other studies used a two-period crossover design (test drug alone and test drug simultaneously with colesevelam). Colesevelam (3750 mg once daily) was dosed throughout the pharmacokinetic sampling period. After each single dose of the test drug, serial blood samples were collected for determination of plasma drug concentrations and calculation of pharmacokinetic parameters.

Results

For all six test drugs, 90% CIs for geometric least-squares mean ratios of AUC and C_max for the measured analytes were within specified limits, indicating no interaction between the test drug and colesevelam.

Conclusions

Aspirin, atenolol, enalapril, rosiglitazone, and sitagliptin may be taken with colesevelam. Although the phenytoin study indicated no pharmacokinetic interaction, phenytoin should continue to be taken ≥4 h before colesevelam in accordance with current prescribing information.     

Clinical trials update from the American College of Cardiology 2008: CARISMA, TRENDS, meta-analysis of Cox-2 studies, HAT, ON-TARGET, HYVET, ACCOMPLISH, MOMENTUM, PROTECT, HORIZON-HF and REVERSE

This article provides information and a commentary on trials relevant to the pathophysiology, prevention and treatment of heart failure, presented at the American College of Cardiology. Unpublished reports should be considered as preliminary data, as analyses may change in the final publication. CARISMA investigated the use of implantable loop recorders for detecting life-threatening arrhythmias in patients with LVSD after MI and found that brady- and ventricular tachy-arrhythmias predicted an adverse prognosis. The TRENDS study showed that the burden of atrial fibrillation detected by pacemakers or defibrillators predicted the risk of embolic events but not with sufficient precision to justify changes in anti-thrombotic management. A meta-analysis of six trials reported an increased cardiovascular risk associated with celecoxib, particularly for heart failure, which was related to dose and baseline cardiovascular risk. The HAT study failed to show a benefit of providing post-MI patients with a home defibrillator. MOMENTUM, a study of a device designed to augment aortic blood flow, was stopped early due to increased bleeding risk. Results from PROTECT support the use of rolofylline 30 mg/day in acute heart failure, a definitive study is now underway. Istaroxime, an agent that appears to have both inotropic and lusitropic effects, improved haemodynamics when added to standard therapy in patients stabilised after admission with heart failure in HORIZON-HF. The REVERSE study suggested that CRT improves ventricular function and reduces morbidity even in patients with few or no symptoms of heart failure and may delay or prevent worsening heart failure.     

Clinical trials update from the American College of Cardiology 2007: ALPHA, EVEREST, FUSION II, VALIDD, PARR-2, REMODEL, SPICE, COURAGE, COACH, REMADHE, pro-BNP for the evaluation of dyspnoea and THIS-diet

This article provides information and a commentary on trials relevant to the pathophysiology, prevention and treatment of heart failure, presented at the American College of Cardiology meeting in March 2007. Unpublished reports should be considered as preliminary data, as analyses may change in the final publication. The ALPHA study suggested that patients with heart failure (HF) due to idiopathic dilated cardiomyopathy who have a negative T-wave alternans test have a good prognosis and are unlikely to benefit from ICD therapy. EVEREST provides some evidence of short-term symptom benefit of tolvaptan in patients with acute decompensated HF but no clinically important long-term benefit. FUSION II failed to show a benefit of nesiritide in patients with chronic decompensated HF. Reducing blood pressure in hypertensive patients improved diastolic dysfunction in VALIDD. Eplerenone did not improve left ventricular remodelling in mild to moderate chronic HF. Selecting HF patients for revascularisation using FDG-PET imaging did not significantly improve outcome. Crataegus extract added to standard HF therapy did not reduce morbidity or mortality in SPICE. The COURAGE study, conducted in patients without HF or major cardiac dysfunction, showed that PCI did not reduce cardiac morbidity or mortality and can be safely deferred in patients with stable coronary disease on optimal medical therapy. The COACH study failed to show that HF nurse-intervention could reduce hospitalisations but did show trends to lower mortality, especially amongst patients with reduced ejection fraction; however, the smaller REMADHE study suggested striking benefits on morbidity and mortality. A large study of BNP provided additional information on its ability to distinguish cardiac and pulmonary breathlessness. The importance of dietary intervention in post-MI patients was highlighted by the findings of THIS-diet study.