广西疟疾流行现状及消除疟疾可行性分析

目的 分析广西壮族自治区（广西）当前疟疾流行现况和趋势,探讨广西2018年实现消除疟疾目标的可行性。方法收集2001-2011年广西本地发热患者、疟疾病灶点居民和流动人口等疟疾监测资料,采用流行病学方法,对全区疟疾发病情况、病例的分布与分类等进行描述和统计分析。结果 2001-2011年,广西共血检本地发热患者491.63万人次、病灶点居民19.59万人次、外出回归人员28.25万人次、外来人群22.83万人次,共检出疟疾患者1 896例,4类人群平均血检阳性率分别为0.004 8%、0.007 7%、0.480％和0.127％。本地感染病例从2001年的51例下降到2009年的1例,2010-2011年未发现本地感染病例和输入性继发病例。全区疟疾发病率控制在1/10万以下,疟疾患者以输入性病例为主。结论 对照世界卫生组织消除疟疾的标准,广西已进入消除疟疾阶段巩固期。只要政府和相关部门继续加强对全区劳务输出等归国人员监测和管理,同时采取有效的防控措施,广西于2018年达到消除疟疾的目标是可以实现的。     

云南省2001-2005年疟疾疫情分析

目的 分析2001-2005年云南省疟疾流行态势, 为制定和实施“十一五”抗疟规划提供参考依据。方法 用Microsoft office excel 2003 及ArcView GIS 3.3等软件, 对2001-2005年疟疾疫情数据进行统计分析。 结果 2001-2005年云南省16州(市)129县(市)各县各月均有疟疾病例报告, 计63 562例, 发病高峰在5～8月和10～11月。5年平均发病率为3.049/万, 比前5年上升4.67％, 差异具有统计学意义( χ2＝63.15, P＜0.05), 各年发病率呈上升趋势。发病数和发病率处于前5位州(市)和排名前10位的县(市)除梁河县(二线边境县)外均为边境州(市)和一线边境县(市)。发病率为5/万以上的23县人口仅占全省总人口的12.74%, 发病占全省的80.31%。45岁以下年龄组发病占87.30％, 死亡占79.36％; 发病数和死亡数男女之比分别为3.44 ∶ 1和6 ∶ 1; 农民、 民工和学生的发病率在各职业中居前3位; 流动人口发病和死亡数分别占全省发病和死亡数的17.06％和23.42％,是感染疟疾的高风险人群。 结论 云南省疟疾流行态势依然严峻。“十一五”期间, 应全面抓好疟疾的病例管理、 态势监测并及时开展各种防控工作。     

盐城市疟疾流行态势及防控对策探讨

目的掌握盐城市疟疾发病特征和流行态势,为疟疾防治决策提供科学依据。方法采用回顾性调查方法,收集1993-2011年全市疟疾确诊病例流行病学资料,分析疟疾病例发病的流行病学特征和流行态势。结果1993-2011年盐城市9个县(市、区)疟疾发病总人数为134例,其中本地间日疟18例,输入性间日疟59例,输入性恶性疟56例,输入性三日疟1例,分别占总病例数的13.43%、44.03%、41.79%和0.75%。19年全市疟疾总发病率为0.03/10万～0.29/10万,本地疟疾发病率为0～0.06/10万,呈低度流行态势,2006年以后全市未发现本地感染疟疾病例。2007-2011年发现境外输入性恶性疟病例56例,并呈逐年上升趋势,同时发现境外输入性三日疟1例。病人发病至就诊时间的间隔中位数为1 d,当天就诊的占58.96%,村卫生室为主要首诊医院,占44.06%;病人发病至血检、确诊和治疗时间间隔中位数均为4 d。结论盐城市本地疟疾发病已趋于逐步消除态势,境外输入性恶性疟明显增加,加强输入病例监测和防控是当前工作的重点。     

1995～2004年广西疟疾监测措施与防治效果

目的分析广西壮族自治区1995~2004年疟疾监测结果,评价监测措施,为制定疟疾防治对策提供科学依据。方法收集1995~2004年广西区92个县(市)当地居民发热病人、病灶点居民和流动人口监测资料进行描述和分析。结果10年间全区92个县(市)共血检当地发热病人1092万人次,病灶点居民42.7万人次,外出回归人群24.6万人次,外来人群25.4万人次,4类人群血检阳性率分别为0.009%、0.079%、1.386%和0.324%,共检出疟疾病例5517例,本地感染病例占总病例的23.29%(1285/5517),输入性病例占76.71%(4232/5517)。结论广西区连续17年疟疾发病率控制在1/万以下,当地感染病例少,输入性疟疾病例多、分布面广、高度分散,但输入继发病例发生率较低,现行疟疾监测与防治措施能有效监控疟疾流行动态。     

上海市疟疾基本消灭后的流行特征分析

目的　分析上海市基本消灭疟疾后 ,1994～ 1999年疟疾流行的变化趋势。　方法　对全市 1994～ 1999年多项疟疾监测指标、调查结果资料进行回顾性研究。　结果　 6年共发现 74 7例疟疾病例 ,总发病率本地居民为 0 .31/10万 ,外来流动人口为 8.88/10万 ,差别有统计学意义 (χ2 =4 312 .31,P<0 .0 0 1) ;两者 1999年发病率较 1994年分别下降了6 7.4 4 %和 95 .2 5 %。输入病例占病例总数的 82 .4 6 % ;市区只有输入病例 ,5 7.94 %外省输入病例和 5 5 .73%本地感染病例相对集中在流动人口较为聚集的 4个区 (县 ) ,前者的发病高峰约较本地病例提前 1个月。本地居民未查见带虫者 ,纵向监测点青少年儿童 IFAT抗体阳性率为 0 .31%。82 .5 0 %为非活动性病灶点 ,99.4 0 %病灶点仅有 1个病例。　结论　上海市疟疾以输入病例为主 ,虽然市郊区 (县 )仍发生低水平的本地传播和感染 ,但未引起局部流行或暴发流行     

百色市疟疾流行现状和消除疟疾可行性探讨

目的 分析百色市2001-2010年疟疾流行现况和趋势,探讨百色市2018年消除疟疾的可行性.方法 收集2001-2010年百色市12个县(区)当地居民发热患者、病灶点居民和流动人口监测资料进行描述和分析.结果 10年间百色市共血检本地发热患者92.44万人次,病灶点居民1.90万人次,外出回归农民工2.69万人次,外来人群5.60万人次,检出疟疾病例297例,三类人群血检阳性率分别为0.005 9％、0、0.705 9％和0.092 6％.本地疟疾病例从2001年的10例下降到2007年的1例,2008-2010年连续3年无本地病例发生.结论 10年来百色市疟疾发病率控制在1/10万以下,按照世界卫生组织消除疟疾的标准,百色市疟疾疫情已进入消除疟疾阶段巩固期,但在黔桂交界、中越边境地区仍有个别本地病例发生,只要加大经费投入和技术措施执行力度,百色市2018年消除疟疾是可以实现的.     

2004-2013年江苏省沭阳县疟疾疫情流行病学分析

目的 目的 分析2004-2013年沭阳县疟疾疫情及流行特征, 为下一步制订有效的疟疾防治策略和措施提供科学依 据。 方法 方法 对2004-2013年沭阳县网络报告的疟疾疫情和流行病学调查资料进行分析。 结果 结果 沭阳县2004-2013年共 报告疟疾病例31例, 年平均报告发病率为0.18/10万。其中本地感染22例, 输入性病例9例; 本地感染病例发病高峰在 8～10月; 本地感染病例以男性为主, 男女性别比为2.87： 1, 年龄分布集中在10～39岁。 结论 结论 2004-2013年沭阳县疟 疾流行趋势由本地感染为主逐渐转变为以输入性病例为主。针对目前的流行特征, 应做好流动人口管理, 加大培训、 宣 传力度, 在巩固消除疟疾成果的基础上, 加强输入性疟疾的防控。     

2002～2003年广西流动人口疟疾监测情况报告

流动人口疟疾管理是控制疟疾的重要措施。通过监测及时发现、治疗输入性疟疾病例 ,防止其引起传播[1] 。现将 2 0 0 2～ 2 0 0 3年全区流动人口疟疾监测结果报告如下。1　内容和方法1.1　血检　由市、县、乡 (镇 )医疗卫生机构对就诊的流动人口发热病人进行疟原虫血检 ;乡 (镇 )卫生院防保人员和村医对流动人口造册登记 ,发现发热病人及时采血送检 ,查出疑似疟疾病例 ,将血片及采血送检单送县卫生机构核实诊断 (市、县查出本地感染恶性疟和输入性恶性疟继发病人时 ,将病人血片及个案调查表及时报自治区疾控中心复查 ) ;县、乡防保人员对病灶…     

1982～2001年福建省微小按蚊分布区疟疾流行态势及防治效果

目的 了解福建省微小按蚊分布区疟疾流行态势，评价防治效果。方法 采用回顾性调查的方法，收集1982～2001年闽南微小按蚊分布区13个县(市、区)的疟疾疫情及媒介监测资料进行统计分析。结果 1982～1994年25个疟疾暴发点均发生在流动人口聚居的采石场、砖瓦厂及邻近村庄。1992年疟疾以外地输入及外来民工聚居地感染为主，之后逐渐扩散到本地居民感染。1995年本地感染占病例总数的91．79％(917／999)，经采取治疗传染源和灭蚊并重的综合性防治措施，至2001年本地感染仅占16．67％(4／24)，而输入病例则由1996年的14．95％(48／321)上升为83．33％(20／24)。1985年以来在13个县36个村(点)捕到微小按蚊，微小按蚊数占按蚊总数的24．85％，1996年以后仅在2个县2个村(点)捕到微小按蚊。结论 福建省微小按蚊分布区疟疾流行趋于控制，所采取的综合性防治措施效果显著。     

2001-2014年韶关市消除疟疾监测

目的 目的 分析2001-2014年韶关市疟疾疫情监测情况, 评价疟疾防控效果, 为制定符合实际的消除疟疾措施提供 科学依据。方法 方法 2001-2014年韶关市各级医疗机构建立 “四热” 病人镜检监测点, 开展发热病人镜检和主动病例侦查 等监测。采用流行病学方法, 对全市疟疾发病情况、 疟疾病例的分类等进行描述和统计分析。结果 结果 2001-2014年韶关 市共监测检查 “四热” 病人91 381例, 发现疟疾病例22例, 平均阳性率为0.02%, 其中输入性病例占90.91% （20/22）, 本地 感染病例仅占9.09% （2/22）。本地感染病例均为间日疟, 输入性病例中有16例间日疟、 2例恶性疟及2例卵形疟。2006 年后未再发现本地感染病例。所有病例均未出现二代病例。2011-2014年在7个县 （市、 区） 开展主动病例侦查2 611人 次, 未发现疟原虫阳性者。结论 结论 韶关市疟疾防控工作已取得显著成效, 但仍有输入性病例, 今后应加强疟疾病例诊治 及疫情处置能力的建设、 完善监测系统、 开展有效监测, 以达到消除疟疾的目标。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.