2004–2015年湖北省预防控制血吸虫病中长期 规划健康教育终期评估

目的　评估湖北省预防控制血吸虫病中长期规划健康教育效果。方法　结合问卷调查及资料回顾等方法,收集2004–2015 年湖北省血吸虫病健康教育相关资料,评价健康教育效果。结果　2004–2015年,湖北省13个市63个血吸虫病流行县（市、区）累计发放血防健康教育宣传材料16 662 499份,媒体宣传累计28 712次,树立血防警示性标志174 506个,张贴宣传标语185 985条,发放个人防护用品1 212 810份,举办村干部培训班9 248班·次、中小学师资培训班5 569班·次。2015年抽样调查3个（县）6个乡（镇）的4 815名居民,血防知识知晓率为91.62%,血防信念、态度正确率分别为89.54%和96.91%,人群总体血防行为正确率为91.91%;同期血吸虫感染率、急性感染病例等人群疫情相关指标逐年下降。结论　湖北省预防控制血吸虫病中长期规划期间实施的健康教育措施,对改善流行区人群血防知识、态度,促进居民血防正确行为形成等有明显效果,为推动全省血吸虫病防治工作进程发挥了积极作用。     

安庆市居民血吸虫病防治知信行调查分析

目的    了解安庆市居民对血吸虫病防治知识、态度、行为的现状,分析其影响因素,为血吸虫病防治健康教育工作提供参考依据。方法    采用简单随机抽样,抽取安庆市3个流行县（区）,通过Credamo调研平台发放问卷,调查当地居民对血吸虫病防治知识的认知、态度和行为并进行统计学分析。结果    安庆市居民血吸虫病防治知识总知晓率为84.33%,态度正确率为91.54%,行为正确率为76.25%。不同性别、职业人群血防知识知晓率差异有统计学意义（χ2=11.549、57.459,P均＜0.05）;不同流行区类型、年龄组、文化程度人群知晓率差异无统计学意义（P均＞0.05）;不同流行区类型、年龄组、性别、文化程度、职业等人群的血防态度正确率、行为正确率差异均无统计学意义（P均＞0.05）。结论    安庆市居民对血吸虫病防治知识的总知晓率较高,对血吸虫病防治态度总体较为积极,但行为正确率有待提高。在今后血防工作中需加强对居民行为上的引导,对经常接触疫水的居民进行针对性教育,同时提高在校学生特别是高校学生的健康教育力度。     

安徽和县沿江造船厂血防健康教育效果的调查

目的  了解血防健康教育对沿江血防区造船企业职工血防知识和行为的影响。 方法 选择和县3个重点流行村江滩的3座造船厂,开展连续3年的血防健康教育和相关调查,调查外来人员血防知识知晓率、正确的血防态度观、主动接触疫水情况以及血吸虫病查治病依从情况变化。 结果  经过连续3年的血防健康教育和行为干预,3座船厂职工血防知识知晓率、血防态度正确率和查治病依从率分别由干预前的11.2%、9.1%、38.8%和31.7%上升至93.8%、91.9%、93.2%和84.3%,主动疫水接触率由干预前的6.8%下降为0。无一人感染血吸虫。 结论  连续的血防健康教育可以增强血防区居民和外来人员的血防意识和自我保护意识,对控制血吸虫病流行和传播有着积极作用。     

江苏省居民血吸虫病知信行调查及行为影响因素分析

目的了解江苏省居民血吸虫病防治相关知识、态度和行为现状及其影响因素,为制定有效的健康教育与健康促进模式提供科学依据。方法采用与人口规模成比例的整群抽样方法和多阶段抽样方法,对血吸虫病流行区非集体居住的16~69岁常住居民进行问卷调查,统计分析居民血吸虫病知识、态度、行为现况。结果调查对象血吸虫病防治知识总知晓率为95.98%,信念态度正确率为89.06%,行为判断正确率为77.43%,知、信、行正确率逐步下降且有显著差异(χ2=1 282.96,P0.01);渔船民血吸虫病防治知识知晓率为90.98%,但行为判断正确率仅为53.81%(χ2=120.52,P0.01)。非条件Logistic回归分析,随着学历的逐步提高,行为判断正确合格率也随之上升,大专以上学历人员合格率是文盲的6.411倍(OR=6.411,95%CI:4.896~8.395)。渔船民行为判断正确合格率仅为农民的5.1%(OR=0.051,95%CI:0.029~0.091)。结论江苏省居民血防基本知识总知晓率达到了《全国预防控制血吸虫病中长期规划纲要(2004-2015年)》目标要求,但行为正确水平较低。文化程度、职业、居住区域等因素对居民血吸虫病防治健康行为形成均有不同程度影响。需要重点开展有针对性的健康促进活动,促进健康生活方式与行为的形成。     

湖北荆州区人群血防知识行为现况调查

目的评估荆州区居民血防健康教育达到湖北省预防控制血吸虫病中长期规划纲要目标要求。方法采用现场随机问卷方式调查荆州区疫区居民和中小学学生,计算问卷应答正确率,血防知识知晓率和血防行为正确率,采用SPSS17软件统计分析。结果 469名居民的血防知识知晓率和血防行为正确率分别为99.15%和93.60%,家庭主妇分别为98.45%和93.30%,性别、不同年龄组、职业间无差异。高中及以上文化程度者血防行为正确率最高。458名学生血防知识知晓率和血防行为正确率分别为97.38%和99.34%,二年级及以上年级间无差异。结论家庭主妇和学生血防知识知晓率和血防行为正确率均达到中长期规划纲要目标要求。     

湖沼型疫区血吸虫病健康教育现况调查

目的了解湖沼型疫区成年居民和中小学生血防健康教育现状。方法采用现场随机问卷方式调查荆州区疫区居民和中小学学生,计算问卷应答正确率,血防知识知晓率和血防行为正确率。结果 369名成年居民的血防知识知晓率和血防行为正确率分别为98.10%和95.12%,男女之间、不同年龄组间差异无统计学意义(P>0.05)。文盲知晓率和正确率分别为86.21%和82.76%,低于小学至高中文化程度者。262名学生血防知识和血防行为问卷应答正确率分别为93.98%和99.39%;学生血防知识知晓率和血防行为正确率分别为99.62%和97.33%。结论成年居民和学生血防知识知晓率和血防行为正确率均达到现行目标要求,成年居民血防知识知晓率和血防行为正确率与受教育程度有关。     

昆山市血防中长期规划健康教育评估报告

目的 评价昆山市血吸虫病健康教育效果,为制定血吸虫病传播阻断后期巩固策略提供依据。方法 随机抽查2个乡镇各1个社区、1所中学和1所小学的居民、中学生和小学生,采用访谈和问卷调查方式,调查昆山市中小学校和社区血吸虫病健康教育开展情况,统计分析学生、居民血防知识知晓情况。结果 调查了4所学校452名中小学生,学生血吸虫病知识知晓率为98.21%（基本知识知晓率98.42%,预防知识知晓率98.01%）。其中调查小学生220人,小学生血吸虫病知识知晓率为97.21%（基本知识知晓率97.60%,预防知识知晓率96.82%）;调查中学生232人,中学生血吸虫病知识知晓率为99.17%（基本知识知晓率99.20%,预防知识知晓率99.14%）。经检验,中、小学生血吸虫病知识知晓率差异均有统计学意义（[χ2]基本知识知晓率= 13.045,[χ2]预防知识知晓率= 21.796,[χ2]总体知识知晓率= 34.661,P均< 0.001）。4所学校均有血防健康教育教材或教案。调查了2个社区402名居民,居民血防知识知晓率为98.87%。结论 昆山市血防健康教育形式多样、效果良好,人群血防知识知晓率达到了预防和控制血吸虫病中长期规划中大于95%的目标要求。     

洪灾后皖江地区农村人群血防知识 态度 行为现状调查

目的了解皖江地区农村居民血防知识、态度和行为,为开展针对性血防健教工作提供参考。方法采用多阶段抽样方法,选取皖江地区农村居民为调查对象,用自行设计的问卷调查其血防知识、态度、行为现状。结果皖江地区农村居民血防知识总知晓率为47.92%;年龄、教育程度、家庭月收入、医疗机构工作的亲友和健康教育对居民知识知晓率均有显著影响(χ2=12.76、89.19、18.19、50.83、92.60,P均0.05);血防态度和行为正确率分别为62.89%和52.37%。结论皖江地区农村居民血防知识知晓率、态度正确率和价值观正确率均不高,应加强健康教育,降低当地血吸虫病传播风险。     

中小学生血吸虫病防治健康教育效果调查分析

目的 了解当前中小学生血吸虫病防治健康教育工作的实施效果,探讨存在的问题与挑战,为“十四五”期间血防健教工作提供参考。方法 采用三阶段分层整群抽样的方法,在3个省抽取流行区中小学生作为调查对象,通过问卷调查统计中小学生血防知识得分情况,计算血防知识知晓率及行为正确率。结果 共收集学生有效问卷586份,满分率为73.5%,不及格率为0.7%,平均分为96.4±8.0。学生血防知识知晓率为95.7%,血防行为正确率为98.2%;男、女生血防知识知晓率(95.2%vs. 96.3%)和行为正确率(97.5%vs. 98.9%)的差异均分别有统计学意义(χ²=6.973、8.101,P均<0.05);同时初中生、小学生血防知识知晓率(98.9%vs. 92.6%)和行为正确率(99.2%vs.97.1%)差异均分别有统计学意义(χ²=199.451、18.443,P均<0.05)。结论 中小学生血防健康教育效果明显,但不同性别和年级存在差距,今后应继续加强健康教育工作,不断提高流行区整体人群防护意识和行为。     

慈溪市流动人口血吸虫病健康教育效果

慈溪市开展流动人口血防健康教育后,流动人口血防知识知晓率和卫生行为正确率分别由健康教育前的33.5%、34.5%提高到90.1%、93.2%,流动人口血吸虫病主动受检率比干预前明显上升。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.