青岛市2018年1例疟疾死亡病例分析

目的 分析青岛市2018年1例输入性恶性疟的死亡原因,为预防疟疾死亡病例发生提供参考。方法 访谈接诊医生及患者家属,对患者病历和流行病学调查资料进行分析。结果 患者刘某,男,35岁,青岛市城阳区人,2018年3月19日到科特迪瓦务工,7月17日回国。25日患者到韩国办事,26日下午出现发冷、发热、出汗、头痛、浑身酸痛等症状,26—27日自服退烧药无好转,28日上午到韩国某医院就诊,未明确诊断,下午出现腹泻、呕吐症状,29日下午回国,14∶59到城阳区人民医院就诊,精神萎靡,经询问患者有非洲出国史可能患疟疾,16∶30将患者转诊至疟疾治疗定点医院,17∶50到达青岛市传染病医院时患者呈深昏迷状态,医生考虑患者病情危重且该院正在改建无ICU病房,建议转至有抢救条件的综合医院抢救。19:40患者转入海慈医疗集团ICU病房,21∶00被确诊为恶性疟,因病情危重,患者于30日14∶15死于多脏器功能衰竭。结论 对于输入性疟疾,根据流行病学史、临床症状和实验室检测结果尽早明确诊断,尽早使用抗疟药治疗,是避免出现死亡病例的关键。     

河南省疟疾防治研究回顾

本文从病原学、流行病学、诊断学、传播媒介和现场控制等方面回顾了河南省疟疾防治研究所取得的成果，并根据疟疾流行的现状，提出了将来的研究方向。     

121例重症恶性疟疾的临床抢救

目的重症恶性疟疾病情重，变化快，并发症多，患者若抢救不及时常可导致死亡，为观察疗效，总结121例重症恶性疟患者的临床抢救情况。方法用国产青蒿琥酯、蒿甲醚和法国产Quinimax配合一系列综合治疗。结果抢救121例重症恶性疟疾患者，共治愈103例（85．1％），死亡18例（14．9％）。结论早期诊断，积极预防并发症是降低死亡率的主要环节。     

对一宗入境二级放射货包的监测结果分析

汕头卫生检疫局空港处对汕头航空口岸—宗入境二级货包的监测过程及对有关运输工作人员作了放射知识问卷调查。从中发现。运输单位货物存放设施落后。有关工作人员放射卫生知识欠缺，对放射污染可能造成的危害缺乏正确的认识。为此，笔者提出了自己的看法，以期对放射监测工作的进一步完善提供参考。     

Aspects of imported malaria at a district general hospital in non-endemic Kuwait,Arabian Gulf

There is no indigenous mosquito-borne transmission of malaria in Kuwait. However, in a five year period at a district general hospital, the number of laboratory-diagnosed cases of malaria increased annually from 25 to 84, a rise of 336%. Except for two induced infections, all were imported, mainly from the Indian subcontinent. Plasmodium vivax was responsible for 87.29% of the cases; P. falciparum (12.05%), a mixed infection of P. vivax and P. falciparum (0.33%) and a case of P. ovale (0.33%) were also identified. Rapid preparation of acetone-fixed, Giemsa-stained thick blood films, a heightened awareness of the infection, examination of multiple samples of blood from patients and the general resurgence of malaria in endemic areas were some of the factors responsible for the high number of cases diagnosed. Most patients were young males and presented with clinical malaria due to P. vivax between May and October each year, an apparent seasonal peak. However, many were already resident in the country for a variable period. Patients with P. falciparum though, presented clinically within two weeks of arrival in the country. Parasite densities were calculated to monitor the progress of treatment and identify quickly any possible chloroquine-resistant P. falciparum strains. A policy of active prophylaxis is suggested to stem the tide of imported malaria.Corresponding author.     

Placental malaria. I. Pathological classification

Pregnant women are more likely to contract malaria than their non-pregnant counterparts. The aim of this study was to develop a simple classification system for the histopathological diagnosis of placental malaria infection applicable to placentas collected in field conditions. The placentas were classified into four groups depending on the presence and disribution of parasites and malaria pigment: active infection, active-chronic infection, past-chronic infection, not infected. The frequency of parasitized placentas (26.4%) was in keeping with the prevalence of placental parasitaemia documented in epidemiological studies. An additional 29.8% placentas showed pigment in fibrin only, indicating pastchronic infection. Chronic placental malaria infection was most common in primigravidae, possibly reflecting ineffective clearance of parasites from the placenta. Seasonal fluctuations between infection categories support progression of placental infection with delayed clearance of pigment from fibrin. The proposed classification system has allowed diagnosis of different categories of placental malaria infection by two independent observers. A stadardized method of diagnosis may enhance understanding of placental pathology and reduced birth weight in malaria infection during pregnancy.     

Protective immunity to malaria: studies with cloned lines of Plasmodium chabaudi chabaudi in CBA/Ca mice. III. Protective and suppressive responses induced by immunization with purified antigens

The protective effect of affinity purified antigen has been investigated in an experimental model for malaria which shows a well marked recrudescence of parasitaemia, a feature of the disease in man. A monoclonal antibody (MoAb) recognizing an epitope common to two genetically distinct cloned lines of Plasmodium chabaudi (AS and CB), was used to purify a Mr250,000 polymorphic schizont antigen (PSA) from these parasites. The purified preparations were then examined for the presence of specific and cross-reactive epitopes by immunoprecipitation with a panel of MoAb raised against P. chabaudi AS. When tested previously on smears of parasitized blood by immunofluorescence, or against lysates of parasitized erythrocytes by immunoprecipitation, most of these MoAb had been found to be AS specific. When either AS or CB affinity purified Mr250,000 PSA was used as the target, these same MoAb immunoprecipitated both antigens, and in some cases, a number of associated polypeptides (AP) which copurify with the Mr250,000 PSA. Subsequently, mice were immunized with either the purified AS or CB antigens in Freund's complete adjuvant (FCA). Prechallenge sera were compared by indirect immunofluorescence and immunoprecipitation. Sera from mice immunized with AS antigen reacted strongly with AS and cross-reacted with CB parasite preparations. Pre-challenge serum from CB antigen immunized mice reacted well with CB, but only faintly with AS preparations. In mice immunized with the AS antigen and then challenged with either AS or CB parasites, the initial parasitaemias were delayed in appearance and the height of the peak parasitaemia reduced, an effect which was most pronounced after challenge with homologous parasites. Only homologous challenge of the mice immunized with CB antigen produced statistically significant modification of the initial parasitaemia. In the immunized mice challenged with homologous parasites, the delayed appearance and slightly reduced peak of the primary parasitaemia was associated with delayed resolution of the patent parasitaemia and significant enhancement of the recrudescence.     

A Comparative Study of Dihydroartemisin in Compounds in Treatment of Uncomplicated Falciparum Malaria in Kampong of Cambodia

Objective: To compare the safety and efficacy of two compounds of dihydroartemisinin(DHA) -Artekin and Artekin (T) in the treatment of uncomplicated falciparum malaria. Methods:The regimen of 8-tablet for 2 days of Artekin and Artekin (T) were applied to 100 patients with uncomplicated falciparum malaria, who were randomly divided into two groups. Each group contained 50 cases. The cure rate, the mean parasites clearance time, the mean fever clearance and side-effects were observed to assess the safety and efficacy of the compounds used. Results: The mean parasites clearance time was 31. 7±9.0 hours in the Artekin group and 32. 8±8. 8 hours in Artekin (T) group respectively; the mean fever clearance time was 12. 7±7. 2 hours in Artekin group and 16. 5±7. 9 hours in Artekin (T) group; there were no recrudescence case in both groups within the 28 days of follow-up, the cure rates in Artekin group and Artekin (T) groups were 100%. It indicated that the tolerability of both compounds were very good, the     

青蒿琥酯和巴利捷克治疗塞内加尔恶性疟病儿的比较

目的：比较青蒿琥酯和巴利捷克治疗西非塞内加尔恶性疟的疗效。方法：西非恶性疟病儿１９０例，随机分为青蒿琥酯组７６例（男性４７例，女性２９例，年龄６±ｓ３ａ），用青蒿琥酯每次１５ｍｇ／ｋｇ，ｉｖ或１ｍ，于入院后即刻，ｈ４，ｈ２４，ｈ４８给药，２ｄ为一个疗程；巴利捷克组１１４例（男性６８例，女性４６例；年龄６±３ａ），用巴利捷克剂量２５ｍｇ奎宁基质／（ｋｇ·ｄ），ｉｖ或ｉｍ，ｂｉｄ，３ｄ为一个疗程。结果２组血检疟原虫转阴率，退热时间和住院时间各为９４．７％，７８．９％；１．３±０．５ｄ，２．７±１．１ｄ和３．２±１．１ｄ，４．５±１．５ｄ；差别皆有非常显著意义（Ｐ均＜０．０１）。结论：青蒿琥酯疗效优于巴利捷克。