霍乱弧菌04-5a糖发酵激活蛋白编码基因分析

目的 比较霍乱弧菌04-5a株糖发酵激活蛋白编码基因与霍乱流行株与非流行株相关序列的差异,明确其基因型.方法 采用基因克隆测序方法,对霍乱弧菌04-5a株糖发酵激活蛋白编码基因进行序列分析,并与相关序列进行比较.结果 霍乱弧菌04-5a株糖发酵激活蛋白编码基因由771个碱基对组成,编码258个氨基酸的多肽,流行株和非流行株相关序列比较发现,04-5a株与流行株两者基因完全相同,与非流行株在334、622和666位核苷酸碱基的具有差异,第666位碱基的差异导致了氨基酸的不同,在非流行株与流行株分别为丙氨酸与苏氨酸.结论 霍乱弧菌04-5a株糖发酵激活蛋白编码基因序列符合流行株基因特征,在非流行株与流行株第666位碱基差异可能与其致病性及流行有关,值得深入研究.     

Association between hepatic iron overload assessed by magnetic resonance imaging and glucose intolerance states in the general population

Background and aimWhile there is evidence that iron overload disorders are associated with type 2 diabetes, the relationship between hepatic iron overload and prediabetes remains unclear. We aimed to investigate the association between hepatic iron overload, as assessed by magnetic resonance imaging (MRI), and different glucose intolerance states in the population-based Study.Methods and resultsWe included data from 1622 individuals with MRI data, who did not have known type 2 diabetes (T2DM). Using an oral glucose tolerance testing, participants were classified as having isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), combined IFG and IGT (IFG + IGT) or previously unknown T2DM. Hepatic iron and fat contents were assessed through quantitative MRI. We undertook linear and multinomial logistic regression models adjusted for potential confounders and MRI-assessed hepatic fat content to examine the association of hepatic iron overload with different glucose intolerance states or continuous markers of glucose metabolism.MRI-assessed hepatic iron overload was positively associated only with both 2-h plasma glucose (β = 0.32; 95%CI 0.04–0.60) and the combined IFG + IGT category (relative risk ratio = 1.87; 95%CI 1.15–3.06). No significant associations were found between hepatic iron overload and other glucose intolerance states or biomarkers of glucose metabolism, independently of potential confounders.ConclusionsMRI-assessed hepatic iron overload was associated with higher 2-h glucose concentrations and the combined IFG + IGT category, but not with other glucose intolerance states. Our findings suggest a weak adverse impact of hepatic iron overload on glucose metabolism, but further studies are needed to confirm these findings.     

Joint effect of physical activity and blood lipid levels on all-cause and cardiovascular disease mortality: The Rural Chinese Cohort Study

Background and aimsWe aimed to evaluate the joint effect of physical activity (PA) and blood lipid levels on all-cause and cardiovascular disease (CVD) mortality.Methods and resultsWe analyzed 17,236 participants from the Rural Chinese Cohort Study. Cox's proportional-hazards regression models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) between the joint effect of PA and blood lipid levels and risk of all-cause and CVD mortality. Restricted cubic splines were used to estimate the dose–response relationship of PA with risk of all-cause and CVD mortality. During a median follow-up of 6.01 years there were 1106 deaths (484 from CVD) among participants. For all-cause mortality, compared with the group with dyslipidemia and extremely light PA (ELPA), the HRs with dyslipidemia and light PA (LPA), moderate PA (MPA), and heavy PA (HPA) were 0.56 (95% CI 0.45–0.70), 0.59 (0.46–0.75), and 0.59 (0.45–0.78), respectively, while the HRs of groups with normal lipid levels and ELPA, LPA, MPA, and HPA were 0.88 (0.72–1.04), 0.59 (0.48–0.73), 0.53 (0.41–0.67), and 0.38 (0.29–0.50), respectively. We observed similar effects on CVD mortality. Restricted cubic splines showed a curvilinear relationship between PA and risk of all-cause and CVD mortality with normal lipid levels and with dyslipidemia.ConclusionHigher PA reduces the risk of all-cause and CVD mortality. Higher levels of PA are needed in the population.     

2006年江苏省血吸虫病监测点疫情分析Ⅱ钉螺和感染性钉螺分布情况

目的了解江苏省钉螺和感染性钉螺分布情况,为制定防治规划提供科学依据。方法根据全国和江苏省血吸虫病疫情监测方案的要求,在全省血吸虫病流行区选择有代表性的82个流行村作为监测点,开展钉螺和感染性钉螺分布情况的监测调查。结果全省监测村中有42个监测村发现了钉螺,占监测村的51.22%;有10个监测村发现了感染性钉螺,占监测村的12.20%。监测村发现的钉螺面积占调查总面积的27.86%,发现的感染性钉螺面积占总有螺面积的17.35%。监测村总的钉螺密度为0.16只/0.1m2,总的感染性钉螺平均密度为0.00044只/0.1m2。结论全省螺情仍不容乐观,有可能成为2010年实现江苏省达到"血吸虫病传播控制"目标的主要制约因素。全省在今后的防治策略上,仍应加强钉螺,尤其是感染性钉螺的控制工作,以从根本上消除和降低血吸虫病的危害。     

残存钉螺观察及控制措施

目的了解变电所墙外残存钉螺复燃情况，探索长期有效的控制措施。方法采用机械抽样法调查螺点钉螺，确定活螺密度和有螺面积，灭螺方法分别为五氯酚钠药物浸杀、氯硝柳胺药物浸杀以及氯硝柳胺药物喷洒和沟渠硬化工程灭螺。结果第1次复燃距1974年为26年，第2次复燃距2000年为1年，第3次复燃距2001年为6年，今后是否复燃有待于进一步观察。结论不同的灭螺措施对钉螺的控制效果有所不同，大规模的筑圩药浸灭螺可快速有效压缩钉螺面积；但对特殊环境下的残存钉螺还需因地制宜，采用不同常规的方法。     

14株医院感染病原菌对对氯间二甲苯酚抗力的观察

目的了解常见医院感染病原菌对对氯间二甲苯酚的抗力。方法肉汤稀释法对14株医院感染病原菌进行最低抑菌浓度和最小杀菌浓度测定。结果对氯间二甲苯酚对7株临床分离的铜绿假单胞菌的最小抑菌浓度范围为78 mg/L~625 mg/L,WX11株最高,WX44株与WX12株最低;另外4株与标准株的M IC均为312 mg/L。对氯间二甲苯酚对7株临床分离的铜绿假单胞菌的最小杀菌浓度范围为156~1250 mg/L,WX45株与NJ90株MBC最高,WX12与WX44最低;其余3株与标准株的MBC均为625 mg/L。对氯间二甲苯酚对7株临床分离的大肠杆菌的M IC和MBC均与标准菌株一致。结论铜绿假单胞菌对对氯间二甲苯酚抗力有差异,存在抗力株和敏感株;大肠杆菌对对氯间二甲苯酚抗力与标准株相同。     

南水北调东线江都泵站钉螺扩散情况现场观察

目的了解南水北调东线取水口抽调江水时钉螺能否进入输水河道孳生扩散。方法对泵站前水源河道、泵站拦污栅、泵站消力池滩地和渠首输水河道进行钉螺分布调查,采用打捞的方法检测水源河道漂浮物携带钉螺情况,结合水工建筑功能、调水量及有关河道水位资料,对钉螺通过泵站扩散可能性进行分析研究。结果江都泵站前水源河道查出钉螺面积185.28hm2,水源河道漂浮物调查发现钉螺主要在汛期吸附于漂浮物漂流扩散;泵站前拦污栅及泵站出水口消力池滩地及泵站后渠首输水河道均未发现钉螺。结论南水北调东线调水泵站水闸、拦污栅、水泵、消力池等水工建筑物具有阻挡、沉淀钉螺的作用,泵站消力池及输水河道因水体大,常年保持高水位运行,不适宜钉螺孳生。     

江苏省血吸虫病监测预警系统的研究 Ⅴ长江水域血吸虫毛蚴感染性的监测

目的建立长江水体血吸虫毛蚴监测方法,监测水体受血吸虫虫卵污染情况,为追踪与控制传染源、切断传播途径及灭螺提供参考依据。方法在长江江苏段选择45个监测点,采用浮瓶-尼龙袋哨螺测定法,每个点投放500只阴性钉螺,于2009年5-9月每月投放1次,每次投放28 h,钉螺收回后置于25℃恒温箱内饲养。首次回收2个月后每月采用群体逸蚴法检测1次钉螺感染性,在末次投放3个月后,采用压碎法解剖全部钉螺,观察钉螺血吸虫感染情况,并调查出现感染螺环境的人畜活动情况。建立江苏省长江水域哨螺监测数据库,绘制哨螺阳性点地理分布图,计算江水中钉螺单位时间被血吸虫毛蚴感染的阳性率。结果 45个点5个月共投放哨螺44 717只,回收43 477只,回收率为97.23%;钉螺逸蚴81 410只次,未发现感染性钉螺;解剖钉螺13 033只,发现5只感染血吸虫,钉螺感染率为0.038%,水体中钉螺感染血吸虫的阳性率为4.11/100万。在45个监测点中检出阳性点5个,阳性点出现率为11.11%;其中哨螺阳性点分布在长江南岸3个、北岸1个、江心洲1个,其阳性点出现率分别为21.43%、5.56%和7.69%,南岸哨螺阳性点出现率是北岸的3.8倍。5个阳性点中有3个为渔船民集散地。结论江苏省长江南岸水域受血吸虫虫卵污染程度高于北岸,渔船民集散地是重要的污染地之一。浮瓶-尼龙螺袋哨螺测定法是监测水体受血吸虫虫卵污染的有效方法。     

南水北调东线一期工程血吸虫病监测预警研究Ⅲ监测预警指标和风险评估研究

目的 建立南水北调东线工程血吸虫病监测预警指标体系,为东线工程血吸虫病传播风险评估和制订应急预案提供科学依据.方法 采用专家咨询法和流行病学多维综合评价等方法对东线工程血吸虫病监测预警指标进行评估,以确定预警指标.结果 评估研究了53个监测预警指标,其中一级指标3个,二级指标10个,三级指标40个.结果 表明钉螺是南水北调东线工程血吸虫病监测预警的主要指标,其中又以钉螺孳生位置最为重要.据此建立了东线工程4个血吸虫病监测预警等级,分别为I级:钉螺扩散进入输水河道渠首(一级泵站上);Ⅱ级:里运河钉螺扩散越过N 32°54';Ⅲ级:里运河钉螺扩散越过N 33°03'或越过金湖站;Ⅳ级:钉螺扩散越过N 33°15'或越过洪泽站.同时确定了4个人畜感染指标为重要的指示性指标.根据各项指标间关系,确定了东线工程血吸虫病传播风险评估方法.结论 初步确定了钉螺为主、人畜感染为辅的监测预警指标体系和东线工程血吸虫病传播风险评估方法.     

序贯疗法根治幽门螺杆菌感染的疗效观察

目的 观察序贯疗法对幽门螺杆菌(Helicobacter pylori,Hp)感染的治疗和根治效果.方法 选择无锡市第四人民医院经胃镜检查确诊为慢性胃炎、消化性溃疡且Hp感染阳性患者92例,随机分为序贯疗法组(治疗组)和标准三联疗法组(对照组)2组.治疗组45例,给药方案:前5d,埃索美拉唑20 mg+阿莫西林1000mg,日2次;后5d,埃索美拉唑20 mg+克拉霉素500 mg+替硝唑500 mg,日2次;对照组47例,采用标准三联疗法:埃索美拉唑20 mg+克拉霉素500 mg+阿莫西林1 000mg,日2次,疗程7d.所有患者停药4周后复查,观察2组患者治疗的总有效率;采用13C-尿素呼气试验判断Hp感染根治效果,观察Hp根除率.结果 2组患者治疗的总有效率,治疗组为95.56％,对照组为91.48％,两组差异无统计学意义(x2=0.528,P＞ 0.05).Hp根除率治疗组为93.33％,对照组为78.72％,差异有统计学意义(x2=4.040,P＜ 0.05).不良反应治疗组出现7例,发生率为15.56％,对照组8例,发生率为17.02％,差异无统计学意义(x2=0.008,P＞0.05).治疗组平均每例患者治疗费用为165.90元/人,对照组为171.78元/人,费用基本相同.结论 序贯疗法治疗Hp感染疗效明显,是一种有效、安全、经济的Hp感染根除疗法.