开封市顺河区2004-2010年法定传染病疫情分析

目的了解开封市顺河区2004-2010年法定传染病发生水平、构成情况及流行特征,为制定防控对策提供科学的参考依据。方法采用描述流行病学方法对发病率、死亡率、构成比等指标进行分析。结果 7年通过大疫情网络报告法定传染病22种10 669例,总发病率为778.20/10万;其中报告死亡19例,总死亡率为1.39/10万。无甲类传染病报告。报告乙类传染病15种8 871例,发病率为647.05/10万;报告死亡19例,死亡率为1.39/10万。发病呈下降趋势,以乙肝、肺结核、丙肝、痢疾、梅毒为主。报告丙类传染病7种1 798例,发病率为131.15/10万;无死亡病例报告。发病呈上升趋势,以手足口病、流行性腮腺炎、其它感染性腹泻病为主。结论乙类传染病发病率、死亡率远高于丙类传染病,是影响该区法定传染病分布的重要因素;血源及性传播传染病、呼吸道传染病、肠道传染病是威胁当地居民身体健康与生命安全的主要传染病;应根据传染病发病情况,及时调整防控措施。     

2008年~2012年某县法定报告传染病流行特征的分析

目的了解南召县5年来法定报告传染病的流行特征,为制定传染病的预防控制措施提供科学依据。方法采用描述性流行病学方法对南召县2008年²012年法定报告传染病疫情资料进行分析。结果 2008年2012年法定报告传染病疫情资料进行分析。结果 2008年²012年南召县共报告法定传染病23种10608例,年发病率介于259.01/10万2012年南召县共报告法定传染病23种10608例,年发病率介于259.01/10万⁴44.31/10万,年平均发病率为369.90/10万。各类传染病发病以血源及性传播疾病为主(3941例),占报告传染病发病总数的37.16%;其次是呼吸道传染病(3145例),占传染病发病总数的29.65%;肠道传染病共报告2951例,占发病总数的27.82%;自然疫源及虫媒传染病共报告571例,占发病总数的5.39%。报告发病的主要疾病为病毒性肝炎(主要为乙型肝炎)、肺结核、手足口病、梅毒、布鲁氏菌病等。结论南召县法定报告传染病发病率呈上升趋势,要加大对乙型肝炎、梅毒等血源及性传播疾病的防控与监测力度,加强呼吸道和肠道传染病的防治,高度重视布鲁氏菌病的防治。同时要加强对医务人员乙型肝炎诊断报告工作的培训。     

白云区2011年法定传染病疫情报告分析

目的分析白云区2011年法定传染病的流行情况,为制定传染病防治对策提供科学依据。方法用描述性流行病学方法(现况研究)对白云区法定传染病疫情报告资料进行分析。结果 2011年白云区无甲类传染病报告;乙类传染病报告发病19种11047例,年报告发病率为497.02/10万;丙类传染病报告发病10种14703例,年报告发病率为661.51/10万。2011年白云区法定传染病发病居前3位的疾病依次为手足口病(434.52/10万)、病毒性肝炎(221.90/10万)、肺结核(168.63/10万)。按发病系统分,发病最高的是肠道传染病(占50.51%),第二是血源及性传播传染病(占26.40%),第三是呼吸道传染病(占21.88%)。传染病总体发病男性高于女性;高发年龄组在0～1岁;高发月份在5～7月。结论传染病防治工作重点是要加大肠道和血源及性传播疾病的防治与监测,加强呼吸道传染病的防治力度;加强对手足口病、病毒性肝炎、肺结核等发病率较高的传染病的预防控制工作;加强对重点人群的健康教育。     

揭西县2009-2013年法定报告传染病疫情分析

目的 探讨揭西县2009至2013年法定报告传染病的流行特征,为传染病防控提供科学依据.方法 采用描述性流行病学方法对相关数据进行分析.结果 5年共报告乙、丙类法定传染病29种13 037例,年平均发病率为318.69/10万,年平均死亡率0.73/10万.肠道传染病发病率最高,其次是呼吸道传染病、血液及性传播疾病;年报告发病率居前5位的依次为手足口病、肺结核、病毒性肝炎、其他感染性腹泻、梅毒.结论 5年间传染病发病总体呈上升趋势,应继续做好传染病防控工作.     

苏州市姑苏区2012—2013年儿童手足口病流行特征分析及其防治措施

目的：分析2012—2013年间苏州市姑苏区儿童手足口病流行特征,为进一步做好儿童手足口病防控工作提供科学依据。方法：采用描述性流行病学方法对儿童手足口病病例、重症手足口病的个案调查表以及肠道病毒核酸检测结果等相关资料进行分析。结果：2012年和2013年苏州市姑苏区疾病预防控制中心收到儿童手足口病患者2 088例,其中临床诊断病例为1 981例,实验室诊断病例为97例,疑似报告病例为10例;报告重症病例59例,无死亡病例;2012年其发病率为110.2/10万,2013年其发病率为93.47/10万;两年度儿童手足口病报告病例呈现2个高峰期（3~7月和11~12月）,≤3岁的儿童为主（分别占66.12%和73.65%）,其发病率（男∶女）性别比分别为1.57：1.00和1.63：1.00;在实验室诊断病例中,CoxA16阳性者为27例（27.83%）,EV71阳性者为43例（44.34%）,其他肠道病毒（EVG）阳性者为27例（27.83%）。结论：苏州市姑苏区儿童手足口病的流行具有明显的季节性和人群特征,对婴幼儿的身心健康影响较大,虽然姑苏区两年度的发病率均低于苏州市同期发病率,但儿童手足口病流行优势的毒株发生转变;在流行季节应针对高危人群采取积极防控措施,做好5岁及以下托幼机构和社区散居儿童手足口病防控工作,临床上应及时识别和诊疗手足口病,加强对重症病例的监测和救治,是当前对手足口病防控工作的主要措施。     

昌黎县2004至2013年法定传染病流行病学特征分析

目的：分析昌黎县2004至2013年10年法定传染病流行特征及规律,为有效预防和控制传染病提供科学依据。方法对传染病报告信息管理系统中报告的昌黎县10年法定传染病疫情数据进行整理,采取描述性流行病学方法分析。结果昌黎县10年共报告乙、丙类法定传染病22种8059例,其中乙类15种5684例,丙类7种2375例,年均发病率145唵．10／10万。死亡12例,年均病死率0．22／10万,病死率0．15℅,无甲类传染病报告。乙类传染病发病呈下降趋势,丙类传染病发病有上升趋势。报告的传染病病种主要为肺结核、乙肝、流行性出血热、手足口病、流行性腮腺炎。发病人群,农民以肺结核、乙肝、流行性出血热发病为主,散居儿童和学生以手足口病、流行性腮腺炎病种为主,男女性别比为2．03∶1。6～8月份为发病高峰,1～2月和10月份发病较低。结论昌黎县肺结核、乙肝、流行性出血热、手足口病是重点防控的传染病,农民、散居儿童和学生是重点防控人群,需进一步采取疾病监测、预防知识宣传、疫苗接种的综合预防控制措施。     

郑州市管城回族区2010年法定传染病疫情分析

目的分析该区传染病流行特征及防治效果。方法疫情资料来自该区2010年传染病疫情网络直报系统,用Excel软件进行统计分析。结果 2010年该区共报告法定传染病18种5086例,死亡16例,发病率为1539.50/10万,死亡率为4.84/10万,病死率为0.31%,与2009年相比发病率、死亡率、病死率分别上升5.48%、218.42%、201.82%。无甲类传染病报告;乙类传染病报告12种3455例,丙类传染病报告6种1631例,居前5位的病种为乙型肝炎、其他感染性腹泻、手足口病、丙型肝炎、梅毒,其中7月发病数相对较多,0～9岁组发病数最高。血源及性传播类传染病与2009年相比上升37.66%;肠道传染病下降20.43%;呼吸道传染病下降16.10%。结论病毒性肝炎仍为该区重点控制的传染病;获得性免疫缺陷综合征防控形势不容乐观,应进一步加大重点人群监测;继续开展肠道传染病、呼吸道传染病和发热患者的管理和监测,加强肺结核的归口管理工作。     

郑州市管城回族区2010年法定传染病疫情分析

目的 分析该区传染病流行特征及防治效果.方法 疫情资料来自该区2010年传染病疫情网络直报系统,用Excel软件进行统计分析.结果 2010年该区共报告法定传染病18种5086例,死亡16例,发病率为1539.50/10万,死亡率为4.84/10万,病死率为0.31%,与2009年相比发病率、死亡率、病死率分别上升5.48%、218.42%、201.82%.无甲类传染病报告;乙类传染病报告12种3455例,丙类传染病报告6种1631例,居前5位的病种为乙型肝炎、其他感染性腹泻、手足口病、丙型肝炎、梅毒,其中7月发病数相对较多,0～9岁组发病数最高.血源及性传播类传染病与2009年相比上升37.66%;肠道传染病下降20.43%;呼吸道传染病下降16.10%.结论 病毒性肝炎仍为该区重点控制的传染病;获得性免疫缺陷综合征防控形势不容乐观,应进一步加大重点人群监测;继续开展肠道传染病、呼吸道传染病和发热患者的管理和监测,加强肺结核的归口管理工作.     

2013～2015年广西宜州市手足口病流行特征分析

目的:了解宜州市手足口病的发病规律,为制定防控策略提供参考依据。方法:应用描述性流行病学方法对宜州市2013~2015年手足口病疫情资料进行统计分析。结果:宜州市2013~2015年共报告手足口病7637例,年均发病率为389.99/10万;男性年均发病率(468.32/10万)明显高于女性(306.61/10万);发病有明显的季节性,有两个流行高峰期,第一个流行高峰期出现在4~6月,第二个流行高峰出现在8~10月;以5岁以下儿童为高发年龄,以散居儿童和幼托儿童为主;重症和死亡病例以肠道病毒EV71感染为主,占77.27%。结论:该市手足口病疫情在性别、年龄、人群、季节分布有明显流行病学特征,可根据流行特点采取有针对性综合防控措施。     

广东省清新县2004-2008年法定传染病流行特征分析

目的分析清新县2004-2008年法定传染病流行特征,为制订传染病防控措施提供科学依据。方法采用描述性流行病方法对法定传染病报告资料进行分析。结果2004-2008年清新县共报告法定传染病23种11792例,年平均发病率330.57/10万。发病率最高是2007年为359.48/10万,最低是2005年为297.04/10万。5年间呼吸道传染病一直居高不下,占总病例数的50.53%;其次是肠道传染病,占总病例数的24.14%;再次是血源及性传播疾病,占总病例数的23.50%。结论肺结核、其它感染性腹泻、病毒性肝炎、梅毒和麻疹是当地近年的重点传染病,今后工作重点应加强对呼吸道传染病、肠道传染病、血源及性传播疾病的监测和防治。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.