深圳南山区广州管圆线虫主要螺类宿主感染状况调查

目的了解深圳市南山区广州管圆线虫中间宿主螺类的感染状况,为广州管圆线虫病防治策略的制订提供依据。方法根据地理位置随机选择深圳市南山区5个不同生态环境调查点,采集主要螺类中间宿主标本,以酶消化镜检法检测广州管圆线虫幼虫。结果在深圳市南山区共采集螺类标本392只,其中褐云玛瑙螺135只,小管福寿螺188只,铜锈环棱螺56只,中国圆田螺13只。广州管圆线虫总感染率为11.7%;褐云玛瑙螺和小管福寿螺感染率分别为30.4%和2.7%,前者的感染率高于后者,差异有统计学意义(χ2=49.40,P0.01);铜锈环棱螺和中国圆田螺标本未检出广州管圆线虫。结论深圳市南山区存在广州管圆线虫自然疫源地,褐云玛瑙螺和福寿螺是主要中间宿主。     

广东省阳春市褐云玛瑙螺和福寿螺广州管圆线虫感染的调查

目的 了解广东省阳春市褐云玛瑙螺和福寿螺广州管圆线虫的感染情况.方法 在阳春当地采集野生的褐云玛瑙螺和福寿螺,在实验室用人工胃液消化法检查其中的广州管圆线虫幼虫并记数.用检获的幼虫感染实验小鼠.结果 共检查褐云玛瑙螺350只,福寿螺465只,广州管圆线虫第3期幼虫的阳性率分别为7.71%和0.86%;感染度分别为1～312和1～4.从上述感染的实验小鼠中检获到广州管圆线虫第4期幼虫,且其血清特异性IgM均为阳性.结论 阳春是广州管圆线虫的自然疫源地,该虫中间宿主以褐云玛瑙螺感染较严重.     

输入性福寿螺传播广州管圆线虫的潜能研究

目的研究广州管圆线虫对福寿螺和褐云玛瑙螺感染性差异,阐述输入性福寿螺在中国作为广州管圆线虫中间宿主传播广州管圆线虫的潜能。方法生态学调查比较福寿螺和褐云玛瑙螺生存环境的差异及其在中国目前的地理分布,采集不同地理环境下福寿螺和褐云玛瑙螺分析自然环境下广州管圆线虫幼虫的感染率与感染度,同时观察自然环境下野生鼠感染广州管圆线虫的情况;在相同的条件下,用广州管圆线虫I期幼虫感染阴性的福寿螺和褐云玛瑙螺,观察福寿螺和褐云玛瑙螺在实验室的感染差异。结果对调查点发现的螺类检查发现,自然条件下福寿螺的感染率和感染度均低于褐云玛瑙螺,发现螺重与螺感染度呈正相关,大于20 g福寿螺平均感染度高于20 g以下的螺,差异有统计学意义(P0.01);阳性螺孳生地捕获三种鼠,解剖检查发现广州管圆线虫总感染率为9.24%(22/238),褐家鼠的感染率高于黄胸鼠(P0.05),并且雌鼠的感染率显著高于雄鼠(P0.05);两种螺类在实验室人工感染条件下感染率和感染度比较差异均无统计学差异。结论在自然和实验室条件下褐云玛瑙螺、福寿螺对广州管圆线虫均易感,褐云玛瑙螺和福寿螺在自然环境条件下其感染率表现不同。福寿螺在我国适生环境广泛,长江以南均有分布,具备将广州管圆线虫从华南地区扩散到长江以南的潜能,福寿螺的扩散可导致我国广州管圆线虫流行区域的扩大。     

东莞市广州管圆线虫病疫源地调查

目的掌握东莞市广州管圆线虫病疫源地分布情况,为制定东莞市广州管圆线虫病防治策略提供参考。方法采用随机整群抽样方法,抽取东莞市两个镇街作为调查点,通过匀浆法确定各调查点广州管圆线虫中间宿主感染情况。结果采用匀浆法共检测福寿螺标本128份,阳性34份,阳性率为26.56%;褐云玛瑙螺97份,阳性44份,阳性率为45.36%;环棱螺91份,阳性3份,阳性率为3.30%,三者之间差异有统计学意义（P〈0.05）;感染广州管圆线虫幼虫福寿螺最高的是110条/螺,最少是5条/螺,平均为36条/螺;大、中、小福寿螺阳性率为48.57%、18.60%、14.28%,三者之间差异有统计学意义（P〈0.05）;大、小褐云玛瑙螺阳性率为52.38%和32.35%,二者之间差异有统计学意义（P〈0.05）;阳性率与离居民区的远近有关,差异有统计学意义（P〈0.05）。结论东莞市为广州管圆线虫病疫源地,而且是广东省阳性率较高的调查点之一,虽然东莞市暂未发现广州管圆线虫病例,但仍然要加强宣教工作,不能掉以轻心。     

广州管圆线虫对不同宿主感染性的比较研究

目的比较广州管圆线虫在褐云玛瑙螺和福寿螺螺体内的发育情况及对BALB/c小鼠和昆明鼠的毒力,寻找适宜的实验室易感宿主。方法连续7d分别用感染大鼠的粪便喂食福寿螺和褐云玛瑙螺,1个月后解剖感染螺,观察螺体内广州管圆线虫幼虫的发育情况及虫数;从褐云玛瑙螺和福寿螺分离广州管圆线虫Ⅲ期幼虫(L3)分别感染昆明鼠;而感染BALB/c小鼠的Ⅲ期幼虫来自于褐云玛瑙螺。通过观察感染小鼠的死亡率、体重变化、mmp-9活性、脑组织的病理变化、脑内虫体数及脑脊液总蛋白含量等指标评价不同来源幼虫对不同小鼠的致病力。结果广州管圆线虫在褐云玛瑙螺及福寿螺中的发育无显著性差异,但褐云玛瑙螺感染的幼虫数量高于福寿螺。BALB/c小鼠感染广州管圆线虫后其死亡率、mmp-9活性、脑内虫体数及脑脊液总蛋白含量等明显高于昆明小鼠,其体重减轻、病理变化也更明显。用不同螺来源的Ⅲ期幼虫感染的小鼠其mmp-9活性、脑内虫体数、脑脊液总蛋白含量、体重减轻及脑组织病变程度均无显著差异。结论BALB/c小鼠、褐云玛瑙螺与福寿螺对广州管圆线虫易感,BALB/c小鼠是较好的实验室易感宿主,褐云玛瑙螺与福寿螺来源的广州管圆线虫Ⅲ期幼虫对小鼠的毒力无差异,从环保角度考...     

清远市广州管圆线虫宿主动物感染情况调查

目的 了解清远市广州管圆线虫宿主的感染情况,为防治工作提供依据.方法 按照不同地理位置,选佛冈、连州和清新3个县进行调查,调查当地鼠类及螺类广州管圆线虫的感染情况.结果 共检查鼠类387只,感染率9.56%,检出广州管圆线虫成虫总计139条,平均感染度为3.76条/只;共检查福寿螺223只,感染率为2.69%,平均感染度为241.17条/螺:检查褐云玛瑙螺102只,感染率为2.94%,平均感染度为1条/螺.结论 清远市鼠类和螺类中普遍存在广州管圆线虫感染,说明清远地区为广州管圆线虫的疫源地.     

福州市广州管圆线虫病流行状况的调查

目的调查福州市广州管圆线虫病流行状况,为今后开展防治工作提供科学依据。方法收集福州市各医院2000年以来临床诊断的广州管圆线虫病例;在市辖9个县(市、区)采集中间宿主和转续宿主,用人工捣碎消化法检查广州管圆线虫第Ⅲ期幼虫;以笼捕法捕捉终末宿主鼠类,定种后逐一解剖,查找寄生在鼠心、肺血管的广州管圆线虫。结果共发现广州管圆线虫病33例;共检查中间宿主6种,转续宿主3种,2105个样本,有4种中间宿主和1种转续宿主检及广州管圆线虫Ⅲ期幼虫。福寿螺的平均感染率为18.82%,褐云玛瑙螺为15.38%;沼水蛙为34.72%。捕获的4种鼠均感染有广州管圆线虫,平均感染率为13.7%(269/1964),以褐家鼠的感染率最高,为22.46%。平潭县未检出阳性中间宿主和终末宿主。结论福州市除平潭县外均为广州管圆线虫自然疫源地,其中长乐、闽侯和福州城郊为该病流行区。     

海南省广州管圆线虫病疫源地调查

目的了解海南省广州管圆线虫病疫源地的分布情况，为预防控制该病提供科学依据。方法按照卫生部《广州管圆线虫病疫源地调查方案》要求，采用研磨匀浆法对重要中间宿主进行检查。结果在3个调查点共解剖检查6种活体物种1160只。其中主要中间宿主福寿螺、褐云玛瑙螺、蛞蝓的感染率分别为10．80％、20．00％、21．75％。在距离民宅点近及周围有生活垃圾的环境的地方捕获的褐云玛瑙螺感染高。结论海南省广州管圆线虫病疫源地分布广泛，种类也较多，存在着广州管圆线虫病在人群中传播流行和局部地区的暴发疫情的潜在危险，应引起重视。     

湖南省抽样点广州管圆线虫宿主分布及其感染情况调查

目的了解湖南地区广州管圆线虫宿主及疫源地的分布。方法从野外、餐饮店、农贸市场等场所采集食用淡水螺、陆生螺、蛞蝓、虾、溪蟹、鱼和青蛙,用组织捣碎匀浆法及过筛沉淀法检查中间宿主、转续宿主体内的广州管圆线虫幼虫;解剖检查野鼠心肺广州管圆线虫成虫。结果7县(市、区)有5县(市、区)从野外捕获到福寿螺;3县从野外捕获中国圆田螺、中华圆田螺、方形环棱螺和蛞蝓,检查均未发现广州管圆线虫幼虫;7县(市、区)均未发现褐云玛瑙螺。6县(市)解剖褐家鼠、黄胸鼠、鼩鼱3种鼠,仅在1只褐家鼠的心脏和肺检获广州管圆线虫成虫8条。结论福寿螺在湖南南部地区分布广泛,首次证实湖南存在广州管圆线虫疫源地。     

佛山市褐云玛瑙螺、福寿螺、中华圆田螺和环棱螺广州管圆线虫感染情况调查

[摘要] 目的 了解佛山市五区（禅城区、南海区、顺德区、三水区、高明区）四种螺（褐云玛瑙螺、福寿螺、中华圆田螺、环棱螺）广州管圆线虫的感染情况。 方法 取螺体组织，用剪刀剪碎加入8ml的生理盐水，过滤沉淀，取上清液，离心，取渣镜检广州管圆线虫Ⅲ期线虫蚴虫为阳性。 结果 共检查褐云玛瑙螺589 只,福寿螺742 只, 中华圆田螺745只，环棱螺751只。广州管圆线虫Ⅲ期蚴虫的阳性率分别为40.75 %，31.54 %，16.51%，19.71%。与国内各地比较四种螺感染广州管圆线虫均处于较高水平。 结论 佛山市五区褐云玛瑙螺、福寿螺、中华圆田螺、环棱螺存在广州管圆线虫感染，其中褐云玛瑙螺在佛山地区广州管圆线虫传播中可能起主要作用，加强佛山市广州管圆虫病的预防和控制工作。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.