国产与进口头孢他啶治疗小儿细菌性下呼吸道感染的成本-效果分析

目的对国产与进口头孢他啶治疗小儿细菌性下呼吸道感染进行成本—效果分析。方法对我院2008年10月-2009年10月间患小儿细菌性下呼吸道感染且单用头孢他啶治疗的住院患者136例进行回顾性分析,根据药品不同产地将其分为A、B两组,A组给与头孢他啶（国产）60mg/（kg·d）,分2次静脉滴注;B组给与头孢他啶（进口）60mg/（kg·d）,分2次静脉滴注,两组疗程均为7d,分别计算两组病人治疗后的细菌清除率、不良反应发生率,两组的治疗有效率和总成本,计算成本-效果比。结果疗程结束后A、B两组的药物治疗成本分别为：A组236.4元、B组982.5元,组间比较存在显著性差异（P〈0.05）;治疗有效率分别为：91.30%、94.03%;A、B两组的细菌清除率分别为：86.36%、90.70%;两组不良反应发生率分别为：5.80%、2.99%,组间比较差异均无显著性（P〈0.05）;两组成本-效果比分别为：2.59、10.45。结论国产头孢他啶的成本-效果比优于进口头孢他啶,为较佳的治疗方案。     

Emerging diseases, zoonoses and vaccines to control them

Vaccination, when available, is undoubtedly the most cost-effective means of preventing and controlling, and even eradicating, infectious diseases. In recent years vaccination has also been used for other purposes in animal health, production and welfare, e.g. immunocastration.Vaccination of animals serves many different purposes, such as controlling animal infections and infestations, thus improving animal health and welfare; controlling anthropozoonoses and food poisoning in humans, thereby protecting public health; solving problems associated with antibiotic and anthelmintic resistance; helping to leave food-producing animals free of chemical residues; protecting the environment and biodiversity and ensuring animal farming sustainability. The problem is nevertheless more complex when facing emerging or re-emerging infections particularly zoonotic ones.     

Hepatitis B and Delta virus infection among heterosexuals,homosexuals and bisexual men

The hepatitis B virus (HBV) and hepatitis Delta virus (HDV) infection rates were estimated in patients attending a venereal disease outpatient clinic: 759 heterosexuals and 154 homosexual-bisexual men. The anti-HBC prevalence was higher in homo-bisexual men (68.8 per 100) than in heterosexuals (41.8 per 100), whereas HBsAg was roughly the same in the two groups (about 6 per 100). The anti-HBc prevalence rate among heterosexuals was higher than that estimated in hospital personnel from the same geographical area. A positive association between anti-HBc prevalence and present or past sexually transmitted diseases (STD) was found among homo-bisexual men. Anti-HBc was also positively associated with herpes simplex type 2 antibodies in both heterosexuals and homo-bisexual men. These data are consistent with the hypothesis that sexual behavior also plays a role in the spread of infection among heterosexuals. Ten of the 46 HBsAg-positive subjects were anti-HDV positive: 6 of the 36 heterosexuals and 4 of the 10 homosexuals. All HDV-positive subjects had present or past STDs. These findings suggest sexual transmission of HDV infection.     

Interleukin 1 receptor antagonist (IL1RA) in acute leukaemia: IL1RA is both secreted spontaneously by myelogenous leukaemia blasts and is a part of the acute phase reaction in patients with chemotherapy- induced leucopenia

Abstract: Blast cells derived from peripheral blood of patients with acute myelogenous leukaemia (AML) were cultured in vitro and interleukin 1 receptor antagonist (IL1RA) concentrations determined in culture supernatants. AML blasts derived from patients classified as AML-M4 and AML-M5 subtype showed an increased release of IL1RA. IL1α and IL1β caused a similar increase in AML blast release of IL1RA, and addition of anti-ILl antibodies decreased IL1RA release. IL1RA release from AML blasts was also increased by stem cell factor, tumour necrosis factor α (TNFα), granulocyte-macrophage colony-stimulating factor and macrophage colony-stimulating factor, whereas interleukin 3, interleukin 6, leukaemia inhibitory factor and granulocyte colony- stimulating factor did not significantly alter IL1RA release. When investigating IL1RA serum levels, serum concentrations were decreased in acute leukaemia patients with chemotherapy-induced cytopenia compared with healthy controls. Serum levels of both IL1RA as well as IL1β and soluble TNFα receptors increased when the leucopenic patients developed complicating bacterial infections.     

Candidaemia: a 10-year study in an Indian teaching hospital

Retrospective evaluation of candidaemia patients was performed in an Indian teaching hospital over a 10-year period. The incidence of patients with candidaemia increased eleven-fold in the second half of the study period (55 patients) compared with the first half (5 patients). Haematological malignancies (11 patients), neonatal septicaemia (9), cardiac abnormalities and cardiac surgery (9) were the commonest underlying diseases in these patients. Candida albicans (50%), C. guilliermondii (17%), C. tropicalis (15%) and C. parapsilosis (8%) were the most common fungal pathogens isolated from blood culture. Therapy with two or more antibiotics (92%), corticosteroid administration (25%), intravascular catheter use for over 24 h (78%) and neutropenia (48%) were the accountable predisposing factors. Prolonged hospitalization (mean average 22.2 days as compared with 11.2 days in other patients) was an added risk factor in these patients.     

Hypocomplementaemia caused by C3 nephritic factors (C3 NeF): clinical findings and the coincidence of C3 NeF type II with anti-C1q autoantibodies

Abstract. Skattum L, MBrtensson U, Sjoholm AG (Lund University, Lund, Sweden). Hypocomple-mentaemia caused by C3 nephritic factors (C3 NeF): clinical findings and the coincidence of C3 NeF type I1 with anti-Clq autoantibodies. 1 Intern Med 1997; 242: 455-64.
Objectives: The main purposes were to document manifestations associated with prolonged or clinical ly unexplained C3 deficiency and to approximate how often hypocomplementaemia of this kind is caused by C3 nephritic factors (C3 NeF), i.e. autoantibodies to alternative pathway C3 convertases. We also wished to distinguish between C3 NeF types I and I1 and to assess coincident autoantibody responses to the collagen-like region of Clq (ClqCLR).
Setting: The investigation was based on serum Samples referred to a specialized laboratory for complement analysis in the course of several years.
Subjects: Twenty-five persons with C3 concentrations lower than 0.43 g L', a third of the normal, were included in the study.
Results: Analysis using three methods provided evidence of C3 NeF in 20 persons with equal frequencies of C3 NeF types I and 11. We also gave evidence of antibody specificity differences for the two types of C3 NeF. Six patients with C3 NeF type I1 showed antibodies to C1 qCLR. Membranoproliferative glomerulonephritis was the predominant diagnosis and two patients had partial lipodystrophy reflecting the wellknown association between these diseases and C3 NeF. Anaphylactoid purpura, systemic lupus erythematosus, and severe infection, mainly meningococcal disease, were also observed.
Conclusions: The study group was probably fairly representative of C3 deficiency syndromes as encountered in clinical practice. The findings emphasize the heterogeneity of C3 NeF, and that acquired C3 deficiency syndromes caused by C3 NeF should perhaps be considered more often in diagnostic work.     

不同人群生殖道解脲支原体感染症流行病学研究

本文报告了对２８１名女性性乱者和３００名正常对照妇女生殖道解脲支原体（Ｕｕ）感染状况的流行病学研究。性乱妇女生殖道Ｕｕ感染率为５４．４５％，其他性病患病率为２４．５６％，而正常对照妇女分别为２８．６７％和０．６７％，差异有极显著性意义（Ｐ〈０．０１）。分析结果表明：生殖道Ｕｕ感染的主要流行因素为性生活混乱、性伴数多、性活动初始年龄较小、社会经济地位低、文化程度差等；性接触是主要传播途径；选用避孕套     

医院感染及漏报率统计分析

目的　了解我院医院感染发生及漏报率。方法　将我院 2 0 0 3年 1～ 12月出院的所有病例进行回顾性调查。结果　医院感染率 7.3 2 %、漏报率 14 .93 %,均符合国家卫生部要求。结论　做好医院感染监测工作 ,严格执行各项工作制度 ,掌握医院感染与手术并发症的鉴别诊断 ,提高医院感染诊断的准确率     

性罪错人群阴道毛滴虫寄生情况的连续观察

目的:为了解阴道毛滴虫在性罪错人群寄生的情况,探讨和分析阴道毛滴虫寄生与性罪错人群间可能存在的联系。方法:对南通市公安局收容教育所性罪错人群以及本市某国营纺织厂健康纺织女工阴道毛滴虫的寄生情况进行了6个月～1年的连续性观察。对1998～2001年间南通市公安局收容教育所性罪错人群3490人和随机抽样国营纺织厂纺织女工284人分别采用生理盐水涂片法镜检阴道毛滴虫滋养体。结果:性罪错人群中淋病双球菌、解脲文原体、沙眼衣原体和梅毒螺旋体感染者阴道毛滴虫滋养体的平均阳性检出率为31.54％,明显高于正常对照组(2.46％,7/284),差异非常显著(x~2=29.97,P<0.005),并且淋病双球菌、解脲支原体、沙眼衣原体和梅毒螺旋体混合感染者,阴道毛滴虫滋养体的阳性检出率高于单纯淋病、解脲支原体感染、沙眼衣原体感染和梅毒螺旋体感染者。结论:建议性罪错人群在接受淋病双球菌、解脲支原体、沙眼衣原体、梅毒螺旋体时,甚至包括艾滋病毒等特异性检测的同时,必须常规检查阴道毛滴虫滋养体,尤其应当高度重视性传播疾病混合感染,务必选用抗性病和抗滴虫相结合的治疗方法,有利于患者迅速痊愈。     

湘西自治州1995～2002年男性劳教人员法定性病监测报告

目的 了解湘西自治州重点人群性病患消长趋势，为性病防治工作提供科学依据。方法 从1995年起，采用统一的表格，每年对湘西州劳教所新入教人员进行一次法定性病监测。结果 三种法定性病平均患病率为14．64％(4．96～26．7％)，以1995年最低，1997年最高，8年未发现HIV／AIDS，患病率以20～39岁的性跃期人群为最高，汉族患病率高于其它民族；化程度越高，患病率越低。结论 男性劳教人员作为性病患病的高危人群，是哨点监测理想的目标人群。