老年慢性乙型肝炎住院患者生活质量及其影响因素

<正>2006年全国血清流行病学调查结果显示,我国1⁵9岁人群乙肝表面抗原(HBsAg)阳性率为7.18%,乙肝感染流行率为34.28%,据此推算,我国仍有HBsAg携带者9 300万人,全国有近5亿人感染过乙肝病毒。研究显示,乙肝携带者中约有近10%的人会发展为慢性乙肝〔159岁人群乙肝表面抗原(HBsAg)阳性率为7.18%,乙肝感染流行率为34.28%,据此推算,我国仍有HBsAg携带者9 300万人,全国有近5亿人感染过乙肝病毒。研究显示,乙肝携带者中约有近10%的人会发展为慢性乙肝〔1³〕。老年人在机体生理和免疫功能等多方面都逐渐减退。本研究探讨老年慢性乙肝住院患者生活质量现状及其影响因素。     

乙肝病毒感染对血吸虫病肝纤维化影响的超声图分析

我国南方血吸虫病流行严重，同时又是乙肝病毒的高感染区。血吸虫和乙肝病毒均可引起肝脏不同程度的损害，血吸虫和乙肝病毒感染关系的调查较多，但结果不一，有报道乙肝病毒感染是加速慢性血吸虫病发展成肝癌的重要原因之一［‘］。有关乙肝病毒感染对血吸虫病肝纤维化，特别是肝超声日改变的报道甚少。为此，我们对四川一血吸虫病重流行区的一千余人进行了血吸虫、乙肝两对半和肝脏B超等三项检查，并分析了乙肝病毒感染对血吸虫病肝纤维化的影响。1对欧和方法1．且对我选自眉山县正山口乡白塔、与管两个村6－60岁村民。1．2血吸由田诊所…     

塔城市居民就诊人群中检测乙肝病毒感染模式分析

我国是乙型肝炎病毒感染的高发区,乙肝病毒表面抗原阳性者高达9.8%,乙肝传播途径复杂,流行面广,发病率高。为了解乙肝病毒在就诊人群中的感染情况,我们自2005年6月～2009年5月,4年间收集了大量血清学资料,旨在分析新疆塔城市居民就诊人群中乙肝病毒感染情况,给乙肝的防治工作提供帮助,现将分析结果报告如下。     

新疆生产建设兵团人群乙肝血清学流行状况及影响因素分析

目的 了解新疆生产建设兵团（简称兵团）人群乙型病毒性肝炎（简称乙肝）的感染及疫苗接种情况,并分析影响因素,为控制当地乙肝流行提供依据。方法 采用多阶段分层随机抽样方法,于2018年抽取新疆兵团6个师的常住人口入户调查并抽取静脉血,采用酶联免疫吸附试验（ELISA）进行血清学检测,以单因素和多因素Logistic回归分析影响因素。结果 共调查2 420人,乙肝病毒表面抗原（HBsAg）阳性率、抗乙肝病毒表面抗原抗体（抗-HBs）阳性率和抗乙肝病毒核心抗原抗体（抗-HBc）阳性率分别为1.98%,67.31%,32.93%。HBsAg阳性率随年龄增加呈升高趋势（趋势χ2=16.730,P<0.05）,南疆、北疆和东疆分别为2.82%,1.36%,1.21%,差异有统计学意义（χ2=6.891,P<0.05）;抗-HBc阳性率随年龄增加呈升高趋势（趋势χ2=207.118,P<0.05）。乙肝疫苗接种率随年龄增加呈下降趋势（趋势χ2=349.918,P<0.05）,1岁～组儿童最高（99.60%）,29岁及以上组最低（57.01%）。共用牙刷、有输血史是HBsAg阳性...     

1例由输入性疟疾感染者引起输血疟疾的调查

目的　对泰州市1例因输血感染恶性疟的病例进行分析,为疟疾防控提供科学依据。方法　对1例恶性疟患者开展流行病学追踪调查,通过实验室方法对供血者血样进行检测,以明确感染来源。结果　1名64岁肾病住院患者的血液标本镜检查见疟原虫,确诊为恶性疟。经流行病学调查,患者除接受过输血外,无非洲和东南亚等恶性疟流行区旅行史;住院期间曾接受14次输血治疗,对23份供血者血样进行检测,发现1名印度尼西亚籍留学生留存血样PCR检测呈恶性疟原虫阳性,流行病学调查发现该供血者曾有疟疾感染史。结论　该患者为输血感染恶性疟病例,应加强对献血者的疟疾筛查,以预防输血传播疟疾的发生。     

1例由输入性疟疾感染者引起输血疟疾的调查

目的　对泰州市1例因输血感染恶性疟的病例进行分析，为疟疾防控提供科学依据。方法　对1例恶性疟患者开展流行病学追踪调查，通过实验室方法对供血者血样进行检测，以明确感染来源。结果　1名64岁肾病住院患者的血液标本镜检查见疟原虫，确诊为恶性疟。经流行病学调查，患者除接受过输血外，无非洲和东南亚等恶性疟流行区旅行史；住院期间曾接受14次输血治疗，对23份供血者血样进行检测，发现1名印度尼西亚籍留学生留存血样PCR检测呈恶性疟原虫阳性，流行病学调查发现该供血者曾有疟疾感染史。结论　该患者为输血感染恶性疟病例，应加强对献血者的疟疾筛查，以预防输血传播疟疾的发生。     

河南省不同人群HCV感染相关因素分析北大核心

目的了解影响河南省不同人群丙型肝炎病毒（HCV）感染的相关因素。方法采取多阶段抽样的方法,在全省抽取1~75周岁的常住居民开展问卷调查和静脉血采集,并对不同人群的感染相关因素进行分析。结果共调查河南省普通人群32 203人,标化后HCV抗体阳性率是0.64%。HCV感染水平在年龄组和城乡人群的差异有统计学意义。经年龄分层分析,有偿采供血史[比值比（OR）=15.16]、输血史（OR=7.44）、文身（OR=2.53）、使用血液制品史（OR=2.42）、手术史（OR=2.32）和非一人一针一管注射行为（OR=1.93）,是18岁及以上成年人感染HCV的危险因素,但对18岁以下儿童则无统计学意义。经城乡分层分析,穿耳洞、内窥镜检查和针灸、刮痧仅对城镇居民感染HCV有统计学意义,而使用血制品史仅对农村居民有统计学意义。结论 18岁以下儿童HCV感染水平低,与加强血液安全管理、实施安全医疗注射等措施有关。建议加强城镇居民远离不健康的生活方式,到正规医疗机构就医的教育,增加丙型肝炎防治知识的学习。     

河南省不同人群HCV感染相关因素分析

目的了解影响河南省不同人群丙型肝炎病毒(HCV)感染的相关因素。方法采取多阶段抽样的方法,在全省抽取1~75周岁的常住居民开展问卷调查和静脉血采集,并对不同人群的感染相关因素进行分析。结果共调查河南省普通人群32 203人,标化后HCV抗体阳性率是0.64%。HCV感染水平在年龄组和城乡人群的差异有统计学意义。经年龄分层分析,有偿采供血史[比值比(OR)=15.16]、输血史(OR=7.44)、文身(OR=2.53)、使用血液制品史(OR=2.42)、手术史(OR=2.32)和非一人一针一管注射行为(OR=1.93),是18岁及以上成年人感染HCV的危险因素,但对18岁以下儿童则无统计学意义。经城乡分层分析,穿耳洞、内窥镜检查和针灸、刮痧仅对城镇居民感染HCV有统计学意义,而使用血制品史仅对农村居民有统计学意义。结论 18岁以下儿童HCV感染水平低,与加强血液安全管理、实施安全医疗注射等措施有关。建议加强城镇居民远离不健康的生活方式,到正规医疗机构就医的教育,增加丙型肝炎防治知识的学习。     

有受血史的肿瘤患者HBV、HCV感染状况分析

为了调查有受血史的肿瘤患者HBV、HCV感染状况 ,将 4 93例有受血史的肿瘤患者和 5 0 0例无受血史的肿瘤患者HBV、HCV感染情况进行调查分析。结果显示 ,有受血史的肿瘤患者HBV、HCV单纯感染率及HBV/HCV重叠感染率分别为 30 4 %、14 0 %、9 5 % ,显著高于对照组 (17 8%、3 8%、2 8% ) (均P <0 0 1) ,而且三种不同的感染类型均与输血量存在着关联 (均P <0 0 1)。由此可见 ,输血是引起HBV、HCV感染的高危因素 ,严格控制输血指征 ,大力提倡义务献血 ,同时对献血员采用高敏感性的筛选手段 ,是控制HBV、HCV血源性感染的有效措施     

重庆万州区HBsAg阳性携带率普查与医学干预的效果

目的普查重庆万州城区乙肝感染现状和HBsAg阳性携带率,并给予主动医学干预包括注射乙肝疫苗,观察干预前后对乙肝感染的影响。方法以单位集体和集中分散城区居民46175人进行健康体检,检查肝功、二对半、B超、胸部X光透视等,普查所检人员健康状况包括乙肝感染现状和HBsAg阳性携带率,同时进行主动医学干预。对肝炎的干预方法有健康讲座、病情随访、采取防治措施和注射乙肝疫苗等。结果万州区HBsAg阳性携带率分别为1999年7.65%,2000年为5.64%,2001年为4.74%,2002年为5.1%,2003年为4.5%。结论研究提示乙肝病毒有可能从消化道炎症病灶处感染机体;采取有效的医学干预对区域性控制乙肝传染有明显的效果。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.