Monitoring Plasmodium falciparum chloroquine resistance in Yunnan Province, China, 1981-2006

The emergence and spread of drug resistant malaria parasites are an important factor contributing to the global resurgence of malaria, demonstrating the essence of drug resistance surveillance in endemic areas. In the malarious border regions of Yunnan Province, China, we have selected three study sites to monitor in vitro and in vivo resistance of Plasmodium falciparum parasites to chloroquine (CQ) from 1981 to 2006. In vitro studies using the microtest clearly showed high degree of CQ resistance in the early 1980s, when CQ was replaced by artemether monotherapy for falciparum malaria. In subsequent in vitro surveys performed in the early 1990s and 2003-2004, we found reductions in both the concentrations inhibiting 50% parasite growth (IC₅₀s) and the percentage of resistant parasites at all study sites, although the degrees of the reduction varied among sites. Even though amodiaquine has never been used in this area, there were consistently high levels of resistance to this drug, confirming crossresistance between CQ and amodiaquine. In vivo clinical studies were consistent with the results of the in vitro assays. The overall rate of resistant clinical cases decreased from 97% in 1981-1983 to 40% in 2005-2006. Collectively, whereas a general trend of reduction in CQ resistance was observed in Yunnan, variations among sites existed in this relatively small area, probably as the result of both geographical heterogeneity of malaria epidemiology in Yunnan and different levels of CQ resistance in neighboring countries.     

Immunogenicity and Protective Efficacy Conferred by a Novel Recombinant Mycobacterium bovis Bacillus Calmette‐Guérin Strain Expressing Interleukin‐12p70 of Human Cytokine and Ag85A of Mycobacterium tuberculosis Fusion Protein

Mycobacterium bovis bacillus Calmette‐Guérin (BCG) immunization provides protection against tuberculosis (TB) in infants, but the antituberculosis protective immunity wanes gradually after initial immunization and lasts less than 15 years. Therefore, more efficacious vaccines are urgently needed. In this study, we constructed a new tuberculosis vaccine of recombinant BCG strain (rBCG‐IA), which could express IL‐12p70 of human cytokine and Ag85A of M. tuberculosis fusion protein, and investigated its immunogenicity in BALB/c mice by measuring antibody titres, proliferation rate of splenocytes, ratios of CD4⁺ T and CD8⁺ T cells stimulated by specific antigens and levels of IFN‐γ production in antigen‐stimulated splenocyte cultures. Meanwhile, we evaluated its protective efficacy against M. tuberculosis H37Rv infection through detecting lung histopathology, organ bacterial loads and lung acid‐fast stain. Immunogenicity experiments illustrated that from 2nd to 8th week after immunization, the rBCG‐IA vaccine was able to induce the highest level of antibody titres, proliferation rate of splenocytes and IFN‐γ production among groups and gained improved ratio of CD4⁺ T and CD8⁺ T cells from 6th to 8th week after vaccination. And from 2nd to 8th week after M. tuberculosis H37Rv infection, the score of pathology and bacterial loads in the rBCG‐IA group were obviously lower than that in rBCG‐I group, rBCG‐A group or control group (PBST group), but similar to that in BCG group. This study suggested that rBCG‐IA was able to elicit stronger humoral and cellular immune responses, but could only confer similar protective efficacy compared with its parental BCG vaccine.     

云南香格里拉山地自然风景区蚤类多样性的研究

蚤类是传播多种自然疫源性疾病的重要媒介昆虫,人类在自然风景区户外活动时存在被其叮咬而感染虫媒传染病的风险。为了解云南香格里拉县主要山地自然风景区蚤类的多样性状况,2005年秋,我们选择了虎跳峡、哈巴雪山、白水台、千湖山和红山5个不同海拔高度的自然风景区为调查研究的空间范围,应用夹线法捕小型兽类并收集其体表寄生蚤类进行调查取样,对蚤类多样性、群落相似性和蚤类与宿主关系进行了测度和比较研究。结果显示：（1）共捕获蚤类633只,隶属4科19属34种,其中发现云南省1新纪录属及种（喜马狭蚤Stenoponiahimalayana）,当地新纪录蚤类10种（亚种）,显示当地山地自然风景区内蚤种丰富;（2）红山和千湖山景区蚤种丰富度较高（各18种）和物种多样性也较高（分别为2．50和2．18）,而虎跳峡景区捕获的蚤类丰富度（8种）和物种多样性指数（1．79）最低,蚤类物种丰富度和Shannon—Wienor指数均随着景区海拔的升高呈递增趋势;（3）综合分析Jaccard指数和聚类分析的结果,5个风景区被划为虎跳峡-哈巴雪山-白水台、千湖山-红山两个类型,相对植被和水湿条件而言,人为干扰或是导致这一结果更重要的原因;（4）5个自然风景区蚤类群落与宿主群落丰富度的Spearman秩相关系数为0．24,Shannon—Wiener指数的Spearman秩相关系数为0．60,显示5个景区的蚤类多样性与宿主多样性无相关。     

人体生命科学馆作为“三生教育”基地模式的探讨

目的探讨以人体生命科学馆作为实践教育基地的“三生教育”模式,为更好的开展大学生“三生教育”探索新的思路和方法。方法在我校公共卫生学院2010-2012级新生入学教育中,把人体生命科学馆作为实践教育基地开展“三生教育”活动,并进行问卷调查。结果85．7％的人觉得“三生教育”的开展应该理论与实践结合;87．6％的人认为把人体生命科学馆作为“三生教育”实践基地,是一种新的“三生教育”模式,具有较好的效果。结论以人体生命科学馆作为实践教育基地的“三生教育”模式加深学生个人对生命价值和意义的理解,为“三生教育”活动的开展提供较好的思路和方法。     

基层医疗机构多学科主题药学查房模式的探索与实践

目的：探索适合基层医疗机构的新药学查房工作模式,为临床药师开展药事服务提供参考。方法：于2019年建立以主题为导向的多学科联合药学查房模式,建立健全药学查房的内容和流程,对药学查房用药干预类别及临床接受率进行统计分析。结果：主题药学查房共涉及10个主题,干预用药问题247例,临床接受干预231例,接受率为93.52%。开展多学科主题药学查房后,本院抗菌药物使用率、住院抗菌药物使用强度、抗菌药物使用金额比例及一类切口围手术期预防用药率均低于未开展前;基本药物使用率和处方合格率均高于未开展前（P<0.05）。结论：医院开展多学科主题药学查房模式,可有效提升临床合理用药水平,优化药学服务质量。     

Life saving carotid artery stenting in Takayasu arteritis

We present two patients who had high grade unilateral carotid artery stenosis and controlateral carotid artery occlusion secondary to active stage of Takayasu arteritis. The patients were presented with hemiplegia and history of transient ischemic attacks and visual disturbances. Despite the administration of high dose systemic corticosteroids, both patients deteriorated clinically and surgery was not preferred. Angiogram of the first patient revealed the occlusion of the right common carotid, right subclavian and left subclavian artery and high grade stenosis (>95%) of the left common carotid and right vertebral artery. These two stenotic arteries were stented. Angiogram of the second patient revealed the occlusion of the left common carotid and subclavian artery and high grade stenosis (>90%) of the right common carotid artery. PTA + stenting of the right carotid artery was performed. There were no complications during a follow-up period of 10.5±7 months and control angiograms revealed that all stented vessels were free of restenosis. In conclusion, stent-supported PTA to carotid arteries provides immediate symptomatic relief for patients in the active phase of the disease. Its efficacy in the long term should be investigated.     

重庆市2006-2012年艾滋病高危人群HIV/AIDS流行情况分析

目的 分析重庆市2006-2012年艾滋病高危人群HIV/AIDS流行情况,为艾滋病高危人群的干预提供科学依据.方法 从重庆市传染病上报系统和艾滋病监测哨点收集时间序列数据,评价指标为HIV新发病例数、HIV感染率和安全套使用率,利用泊松分布估计总体率的95％可信区间,采用时间序列相关性分析方法进行时间序列趋势性检验.结果 2006-2012年艾滋病感染的主要途径为异性性途径、同性性途径和静脉注射吸毒.暗娼(female sex worker,FSW)、静脉注射吸毒者(injecting drug use,IDU)、男男性行为人群(men who have sex with men,MSM)和性病门诊患者(people withsexually transmitted diseases,STDs)的HIV年平均感染率分别为0.18％ (95％ CI:0.10％ ～0.25％)、8.42％ (95％CI:7.82％ ～9.03％)、15.62％ (95％ CI:14.41％ ～ 16.86％)和1.58％ (95％ CI:1.25％ ～1.91％).FSW和MSM平均安全套使用比例分别为74.01％(95％ CI:73.21％ ～74.82％)和62.30％(95％ CI:60.67％ ～63.92％).结论 重庆市必须加强针对男男性行为人群、暗娼和性病门诊患者的干预工作,并在男男性行为人群和暗娼人群中加强安全套使用重要性的宣传力度.     

2009-2013年大理市细菌性痢疾流行病学分析

目的了解2009-2013年大理市细菌性痢疾的流行特征,为制定细菌性痢疾的科学防控措施和策略提供参考依据。方法收集《中国疾病预防控制信息系统》中报告的大理市细菌性痢疾数据资料,采用描述性流行病学方法对大理市2009-2013年细菌性痢疾流行病学特征进行分析。结果 2009-2013年大理市共报告细菌性痢疾病例1 348例,年平均发病率44.11/10万,无死亡病例报告。每年的5~9月为发病高峰;全市11个乡镇及1个开发区均有病例报告,发病率位居前3位的分别是下关镇、太邑乡、开发区;病例集中在3岁以下儿童,占42.06%;男性发病高于女性;发病居前3位的职业分别是散居儿童(44.96%)、农民(13.20%)、学生(9.05%);5年中无菌痢引起的暴发疫情。结论大理市细菌性痢疾发病率仍然较高,有明显的季节、地区和人群分布特征。提示在流行季节来临之前应加强疫情监测报告,针对散居儿童、农民、学生等高发人群在社区、农村、学校等重点场所加强细菌性痢疾等肠道传染病防治知识的宣传工作,以有效控制大理市细菌性痢疾疫情的蔓延和避免暴发疫情的发生。     

音乐疗法缓解手外伤患者疼痛的临床应用及研究进展

归纳音乐疗法缓解疼痛的原理及疼痛可能给手外伤患者带来的后果,介绍音乐疗法在缓解手外伤患者疼痛中的临床应用及研究现状,阐述音乐疗法在缓解手外伤患者疼痛应用中的注意事项,以期为音乐疗法的临床护理实践提供信息。