疫苗衍生脊髓灰质炎病毒分子生物学研究进展

脊髓灰质炎（脊灰）是由脊灰病毒引起的以肢体麻痹为主要临床表现的急性肠道传染病。自1988年世界卫生组织（WHO）提出在全球范围内消灭脊灰的目标后,世界各国大力开展口服脊灰减毒活疫苗（OPV）的免疫,脊灰的发病率明显下降。目前本病的流行国家已由1988年的125个降至2008年的4个。     

梧州地区急性弛缓性麻痹病例流行病学分析及监测系统评价

梧州地区急性弛缓性麻痹病例流行病学分析及监测系统评价曾宪彪（广西梧州地区卫生局贺州市５４３００１）关键词弛缓性麻痹；流行病学；梧州地区；监测梧州地区与全国各地一样，已进入消灭脊髓灰质炎（脊灰）的后期关键阶段［１］。为实现消灭脊灰目标，梧州地区在抓好常...     

浙江省消灭脊髓灰质炎策略的应用

脊髓灰质炎 (以下简称脊灰 )是长期以来严重危害儿童健康的传染病 ,1988年ＷＨＯ提出全球消灭脊灰目标以来 ,国家和浙江省采取了疫苗免疫和监测的策略 ,并加以实施 ,已达到无脊灰省的目标。现将我省消灭脊灰策略的应用及进展效果进行评价。一、对象与方法1.资料来源 :脊灰疫情资料来自全省法定传染病报告系统和急性弛缓性麻痹 (以下简称ＡＦＰ)病例监测系统 ;脊髓灰质炎疫苗免疫接种资料来自全省常规免疫接种率报告系统 ;脊灰病毒学监测资料来自浙江省脊灰确认实验室。2 .防制措施和消灭脊灰策略 :(1)普及儿童脊灰疫苗免疫 ,提高常规免疫接…     

银川市消灭脊髓灰质炎的前景

银川市消灭脊髓灰质炎的前景谭玉臻，曹俊隰脊髓灰质炎（以下简称脊灰）是一种严重危害儿童健康的疾病。病死率虽不高，但患病之后可留有终身残疾，不仅影响儿童的身心健康，也会给社会增加很大的负担。脊灰属于用疫苗可以预防的疾病，自以脊灰疫苗问世，特别是开展计划免...     

全球消灭脊髓灰质炎进展及面临的挑战

脊髓灰质炎 (脊灰 )是一种由脊灰病毒引起的致残率很高的疾病。历史上曾造成无数儿童的残疾或死亡。脊灰病毒（ＰＶ）分Ⅰ、Ⅱ、Ⅲ三个型别 ,经口进入人体 ,并在肠道淋巴组织中增殖 ,主要损害人的神经系统造成躯体瘫痪。在所有瘫痪者中 ,约有５%～１０%的患者因呼吸肌麻痹而死亡。消灭脊灰即是消灭脊灰野病毒 ,阻断其在人群中及自然界的循环 ,从而实现无脊灰野病毒引起的病例。在１９８８年世界卫生大会提出全球消灭脊灰目标后的十余年间 ,由于各国家和地区的共同努力以及各项消灭脊灰策略的实施 ,全世界脊灰病例减少了９５ %以上 ,全球消灭…     

青海省AFP病例实验室监测结果分析

青海省ＡＦＰ病例实验室监测结果分析青海省卫生防疫站赵生仓，巴卓玛ＷＨＯ确定２０００年在全球消灭脊髓灰质炎（脊灰），消灭工作的证实主要靠实验室来完成，为此我们对１９９２～１９９５年全省报告的急性弛缓性麻痹（ＡＦＰ）病例进行了实验室监测。材料与方法１标本...     

美洲地区率先限制脊髓灰质炎流行的策略与经验

全球消灭脊髓灰质炎具有严格的标准并需在基本策略指导下完成。美洲地区率先限制脊髓灰质炎（脊灰）野病毒流行，其主要策略是高免疫覆盖率、敏感的临床与实验室监测系统和补充免疫的实施。我国是西太平洋地区消灭脊灰中的重点国家，在消灭脊灰中还存在急需解决的若干问题。借鉴美洲的策略与经验是有所裨益的。     

强化免疫-消灭脊髓灰质炎对策浅析

儿童计划免疫实现了三个85%目标,推行了计划免疫信息的电脑化管理,实现了计划免疫工作的科学化,规范化管理.同时达到了世界卫生组织(WHO)提出的2000年消灭脊髓灰质炎的战略目标.回顾这十年来消灭脊灰(无脊灰状态)的历程,一方面通过采取以均衡有效提高脊灰疫苗(TOPV)接种率(95%).加强急性弛缓性麻痹(AFP)病例监测等为主的免疫策略,使本地区达到"无脊灰区".另一方面,由于本地区为农村山区,居住比较分散,强化免疫成了消灭脊灰的关键所在.本文拟就本地区进行"无脊灰区"的基本对策作一简要论析.     

甘肃省天祝县1995-2009年急性弛缓性麻痹病例监测分析

天祝藏族自治县（天祝县）曾是脊髓灰质炎（简称脊灰）的高发地区之一,1972年发病率高达13．38／10万。随着消灭脊灰各项措施的进一步实施,该县已连续16年未发现脊灰病毒引起的病例,急性弛缓性麻痹（AFP）病例的监测成为消灭脊灰最重要的工作之一。现将天祝县1995—2009年AFP病例监测分析如下。     

青海省1995年急性弛缓性麻痹（AFP）监测系统评价

青海省１９９５年急性弛缓性麻痹（ＡＦＰ）监测系统评价青海省卫生防疫站赵建海，段万瑞为如期实现消灭脊髓灰质炎（以下简称脊灰），为消灭脊灰提供科学依据，进一步提高ＡＦＰ监测系统工作质量，现将我省１９９５年监测系统情况进行分析。资料来源与方法１资料来源：各...     

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.