宁德市2018—2020年食源性疾病监测结果分析

目的：分析宁德市食源性疾病的流行病学特征,为制定宁德市的食源性疾病防控政策提供科学有效的依据。方法：收集整理2018—2020年宁德市食源性疾病监测结果数据,利用描述流行病学的方法进行分析和讨论。结果：宁德市2018—2020年共上报食源性疾病患者9 706例,男、女比例为0.94∶1.00,25～34岁年龄组患者数最多（占18.39%）,发病高峰期为12月份（占20.10%）,患者以农民为主（占34.30%）,临床症状以消化系统症状为主（占98.19%）,暴露食品种类以水产动物及其制品为主（占31.08%）,宁德市2018—2020年食源性疾病暴露场所最多的是家庭（占63.48%）。结论：根据宁德市食源性疾病的流行特点,充分利用多种信息化渠道,并结合现场宣传工作,开展线上线下健康宣传,进一步加强对食源性疾病知识的宣传和健康教育工作,提升居民食品安全意识,预防和减少食源性疾病的发生。     

2020年菏泽市食源性疾病流行病学分析

目的 了解菏泽市食源性疾病的流行病学特征，为制定食源性疾病防治策略提供科学依据。方法选取2020年山东省菏泽市的食源性疾病报告资料，分析相关食源性疾病发生率以及流行病学特征。结果 2020年菏泽市共报道食源性疾病50 520例，其中细菌性食源性疾病49 759例，动、植物毒素中毒596例，误食亚硝酸盐中毒165例。该病发病有明显的季节性，以5～10月份较为多见，7～8月份达到高峰；患者以55～64岁年龄段为主，4～6岁次之；男性患者多于女性患者；相较于城市，农村人口的发病率更高；可疑暴露食品场所主要以家庭为主，其次是街头食品和餐饮服务业；进食食品的种类，肉与肉制品最多，其次是水果类及其制品；无死亡病例。结论 食源性疾病危害性大，发病率高，全年均有发病。切实做好疫情监测，进一步完善食源性疾病监测网络报告体系，开展健康教育和诊疗技术培训是食源性疾病预防控制的有效措施。     

长沙市2015—2017年食源性疾病暴发事件流行病学特征

目的 分析2015—2017年长沙市食源性疾病暴发事件的流行特征,从而采取有针对性的防控策略,预防食源性疾病暴发事件的发生。方法 对2015—2017年通过国家“食源性疾病暴发监测系统”上报的长沙市食源性疾病暴发事件信息进行整理,分析事件发生时间、地点、发生场所、事件原因和致病因子等因素,描述食源性疾病暴发事件的流行病学特征。结果 2015—2017年,长沙市共报告食源性疾病暴发事件173起,发病174人,死亡20人。6—9月是食源性疾病暴发事件发生的高峰,事件发生起数和发病人数分别占总数的75.14%和65.67%;事件发生较多的地区是浏阳市和宁乡市,事件报告数占总数的27.17%和17.34%;事件发生场所以家庭为主,占事件总数的67.05%,其次是农村聚餐;导致食源性疾病暴发的原因食品主要是毒蘑菇,占事件总数的58.96%。食源性疾病暴发事件的死亡病例90%由毒蘑菇中毒所致。结论 毒蘑菇中毒是长沙市危害严重的食源性疾病暴发事件,应针对高发季节、高发地区采取有效措施进行重点管理。做好毒蘑菇相关科普宣传,加强对基层医疗机构有关毒蘑菇中毒知识和救治措施的培训,是预防和控制毒蘑菇中毒事件的有效措施。     

郑州市城市居民食源性疾病认知水平调查分析

目的 了解郑州市城市居民食源性疾病认知状况及影响因素，为合理开展食源性疾病宣教提供参考。方法 2020年8—10月采用多阶段整群随机抽样方法抽取中心城区2个调查点居民，采用自制问卷对其进行食源性疾病知识和来源、行为态度的掌握情况进行现场调查。结果 有效调查545人，食源性疾病总知晓率为40.9%。其中19～≤40岁年龄组知晓率最高(59.6%);文化程度越高食源性疾病知晓率越高；年家庭人均收入水平5 000元以下居民食源性疾病的知晓率较低；职业以国家机关党群组织企事业单位负责人和专业技术人员知晓率较高，分别为71.4%和70.8%。24.7%的居民非常关注食源性疾病的相关安全问题；66.8%的居民错误认为“食源性疾病”就是食物中毒；35.9%的居民认为“夏季食用家庭自制的腌渍食品”会导致食源性疾病的发生；58.3%的居民错误认为“控制食品污染”不能预防食源性疾病的发生。结论 郑州市城市居民对食源性疾病认识不够，知识掌握程度不足，今后要结合不同人群的特点有针对性开展薄弱环节的食源性疾病知识培训，有效提高居民的防范意识。     

浅议食品安全和食源性疾病控制

进入21世纪，食源性疾病日益成为影响人类健康的巨大威胁，而食品安全已成为世界性的公共卫生问题。我国加入WTO后，在面临重大机遇和挑战的同时，应顺应全球化的趋势，进一步加强食品安全和食源性疾病监控工作，控制食源性疾病的发生，减轻社会经济负担。本文通过分析我国食源性疾病的现状，探讨食源性疾病的原因及其预防控制和监测，从而为食源性疾病的防制工作提供理论参考。     

深圳市2012—2018年食源性疾病流行特征

目的 分析2012—2018年深圳市10个区食源性疾病的流行病学特征,揭示深圳市食源性疾病的流行趋势,为食源性疾病的预防控制提供依据。方法 采用描述性流行病学方法,对2012—2018年深圳市627个社区健康服务中心食源性疾病监测系统上报的食源性疾病数据进行统计分析,包括年龄、性别、地区、初步诊断、食源性疾病种类等。结果 2012—2018年期间,共上报病例254 223例次。其中,2012年发病率最低,为7.26/万,至2017年达最高,为61.86/万,2018年发病率又降至2014年的水平;男女发病人数比为1.20∶1,男性患者的总数量多于女性患者,2015—2018年中,2016、2017年男性发病率高于女性;8月份的就诊病例数最多,占9.77%,4月份的就诊病例数最少,占6.58%;平均发病率最高的行政单位（区）为南山区,年均发病率为36.70/万,最低为盐田区,年均发病率3.30/万;各年龄组中,31~40岁的病例数最多,占29.01%,发病人数最少的年龄组为71岁以上组,占1.40%;食源性疾病的主要类型中,细菌性食源性疾病占比最高,为88.66%,有毒动物性食源性疾病占比最低,为0.03%。不同行政单位内的食源性疾病各种类型发生率基本一致,细菌性食源性疾病发生率均最高。结论 深圳市食源性疾病病例具有时间性、地区性及人群流行特征,应当有针对性地加强健康宣教及监督管理,并提高食源性疾病的监测能力,控制食源性疾病的发生。     

1例食用羊蹄发生腹泻的报道

目的：探讨食源性疾病（食物中毒）的诊断、治疗方法及流行病学调查的研究分析,对突发食品卫生事件处理的快速反应能力,制订有效方法减少食源性疾病的发生。方法：采用流行病学等方法分析18名均有共同进食同一商贩的熟食羊蹄的患者资料。结果：从2份患者吃剩的羊蹄中检出沙门菌属B群鼠伤寒沙门菌,该菌株生化特性和血清学检测完全一致。结论：根据流行病学调查结果和实验室检验结果及我所食品卫生监督员集体讨论,认定18人食用羊蹄后发生的疾病是食源性疾病（食品中毒）。     

浅析部队预防食源性疾病的措施

目的探讨部队预防食源性疾病的措施，提高部队食品卫生安全。方法通过分析部队饮食卫生特点及食源性疾病发生常见的原因，提出部队预防食源性疾病的措施。结果（1）从机制上对食堂进行改革：（2）对食堂的布局进行改造；（3）常规管理中加强卫生监督；（4）尽快实现GMF认证和建立HACCP管理模式。结论部队预防食源性疾病从措施上还应该加强，针对军队固有的特点结合食品加工过程的关键控制点分析。得到重要得预防措施。     

慢性肺源性心脏病患者的健康教育

目的：探讨新的护理模式，研究健康教育对慢性肺源性心脏病患者的作用，从而提高护理质量。方法：在临床护理实践中对慢性肺源性心脏病患者实施健康教育。结果：对2006年10月～2007年10月入住我科的58例慢性肺源性心脏病患者进行健康教育后，提高了慢性肺源性心脏病患者的自我保健意识。改变了不良的心理和不良的生活方式、不合理的膳食，同时密切了护患关系。结论：健康教育对提高治疗效果、减少并发症的发生和提高患者的生活质量有很大的促进作用。     

韶关市食品安全与食源性疾病基线调查

目的 了解韶关市食品安全与食源性疾病的现况，为研究与制订食品安全保障和食源性疾病控制的策略与措施提供科学依据。方法 收集1998～2002年韶关市粮油类、肉制品类、酒类、糕点类等9类食品的卫生监测资料，对15项卫生指标比较分析。参照WHO食源性疾病监测规划，收集韶关市1990～2002年传染病疫情报告、寄生虫调查报告、食物中毒报告、传染病漏报调查等资料进行现况分析。结果1998～2002年韶关市各类食品监测合格率为82．36％。15项卫生指标95％上限值与国家卫生标准比较：2项大于国标，占13．33％；1990～1999年和2000～2002年韶关市食源性传染病发病分别占传染病的41．55％和20．97％，累积发病率分别为113．0／10万和57．16／10万，病因构成以感染性腹泻和痢疾为主；食源性寄生虫感染率1992～1999年和2000～2002年分别为18．98％和7．22％，病因构成以蛔虫病为主；食物中毒共发生44起，1992。1999年和2000～2002年累积发病率分别为1．65／10万和2．81／10万，中毒类型以农药为主。结论 该市食品安全仍存在一定的隐患而且食源性疾病已对居民健康构成危害。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.