江西省肺吸虫和肺吸虫病近况

江西四境山区的肺吸虫疫源地或流行区分布广泛,流行区人群常有不同方式的空吃溪蟹习惯,成虫抗原皮试阳性率18.1％—50.4％不等,患者多属肺外型。已发现的肺吸虫有卫民肺吸虫、斯氏肺吸虫、扁囊肺吸虫和三平正肺吸虫,以卫民肺吸虫为优势种。螺类病主有放逸短沟蜷、敏捷短沟蜷、褶拟钉螺和小豆螺。第二中间宿主有锯齿华溪蟹、福建华溪螺、凹胶华溪蟹和浙江华溪蟹等种类,肺吸虫囊蚴感染普遍。     

三平正并殖为主要病原的福建省漳平市肺吸虫病调查--纪念陈心陶教授百年诞辰暨三平正并殖命名40周年

目的 调查漳平市肺吸虫虫种的第一、二中间宿主及人群的感染率。方法按水系或地理分布采集全市乡镇村的淡水蟹类检查肺吸虫囊蚴：对山羊隔、城口和香寮村人群作肺吸虫成虫抗原皮内试验,阳性者的血清以ELISA法检测肺吸虫抗体。结果发现的病原虫种为三平正并殖吸虫和卫氏并殖吸虫,以前者为主。第一中间宿主为放逸沟短沟蜷和福建拟钉螺,发现的溪蟹有4种,即福建华溪蟹、永安马来溪蟹、平和华溪蟹和华南溪蟹属一新种,但只在福建华溪蟹中检及阳性,阳性率为9．01％(10／110),人群皮内试验阳性率为6．90％(106／1536),山羊隔、城口、香寮村的人群皮试验分别为7．87％(40／508)、5．04％(26／516)和781％(40／512),而这3个村皮内试验阳性者血清抗体阳性率分别为15．00％(6／40)、7．69％(2／26)和7．50％(3／40)。结论漳平市为闽西肺吸虫轻度流行区。     

肺吸虫病金标渗滤试剂盒现场应用价值及流行病学调查

目的 评价肺吸虫病金标渗滤法抗体快速检测试剂盒(DIGFA-kit)现场应用效果及调查肺吸虫病流行情况. 方法 应用DIGFA-kit检测流行区人群血清抗体,并与常规ELISA相比较;同时调查流行区中间宿主、动物宿主感染情况. 结果 共采集人群血清样本1 062份,阳性54份,阳性率为5.08%,ELISA平行对照试验阳性符合率为100%.第一中间宿主螺的感染率为0.64%,第二中间宿主淡水蟹感染为2.95个囊蚴/只,动物宿主猫的自然感染率为44.68%. 结论 DIGFA-kit具有较好的灵敏度和特异性,适合于流行区临床检验和大规模流行病学调查.调查区域有第一、第二中间宿主和保虫宿主的存在,为斯氏肺吸虫病流行地区.     

福建省松溪县肺吸虫病病原学的调查研究

目的　调查福建省松溪县肺吸虫虫种，第一、二中间宿主及其感染率。方法与结果　有两种肺吸虫，即斯氏狸殖吸虫和泡囊狸殖吸虫(经实验动物感染证实)，分布于东部和西部乡村。全县发现福建拟钉螺和放逸短沟蜷两种螺蛳，只有前者为斯氏狸殖吸虫和泡囊狸殖吸虫的第一中间宿主，其感染率为0．7％(4／569)。全县有3种溪蟹，即福建华溪蟹、南海角肢溪蟹、福建马来溪蟹，其充当第二中间宿主，携带斯氏狸殖和泡囊狸殖囊蚴，感染率为56．06(37／66)，平均每只蟹和每g蟹组织携带囊蚴分别为14、22和1．28个。结论　松溪县为福建省北部肺吸虫病高度流行区。斯氏狸殖吸虫为重要致病虫种，主要第一、二中间宿主分别为福建拟钉螺和福建华溪蟹。     

肺吸虫病22例临床分析

肺吸虫病是由于寄生在人体内脏器的肺吸虫所致的一种人畜共患慢性寄生虫病。人吞食含有肺吸虫活囊虫幼的溪蟹或蜊蛄而感染。我区属肺吸虫流行区，每年都有一些患者住院。为了加强对肺吸虫病的认识，现将我院1974年以来收治的22例肺吸虫病患者的临床资料进行回顾性分析。现总结如下。     

金标免疫渗滤法（DIGFA）快速检测血吸虫循环抗原的研究

目的建立一种简便、快速的血吸虫病诊断方法。方法在已建立的检测血吸虫抗体的DIGPA基础上，以抗血吸虫重组蛋白SVLBP多抗为捕捉抗体，金标抗SEA多抗为覆盖抗体，建立快速检测病人血清中血吸虫循环抗原的双夹心DIGFA。结果用该法检测了急性血吸虫病病人血清30人份和慢性血吸虫病病人血清38人份，其阳性检出率分别为100％和52．6％；120人份流行区健康人血清全为阴性；100人份非流行区健康人群血清的阴性符合率为100％，与10例华支睾吸虫病病人血清无交叉反应；15例肺吸虫病病人血清有1例阳性，交叉反应率为6．7％；与双夹心ELISA的符合率为97.4％，经x^2检验表明两法检测效果无显著性差异。结论用DIGFA检测血吸虫循环抗原具有较高的敏感性和特异性，并且方法简便、快速、不需特殊仪器设备，有广阔的应用前景。     

丹江口库区肺吸虫病流行现状调查

目的了解丹江口库区肺吸虫病的流行现状。方法调查库区丹江口市自然环境变化和移民情况,并对溪蟹的肺吸虫囊蚴携带率进行流行病学调查,应用肺吸虫抗原IDT和ELISA检测易感人群。结果丹江口库区的环境有利于中间宿主溪蟹的繁殖、扩散,而淹没区的移民将使人口分布更趋集中。人群的肺吸虫抗原皮试（IDT）和ELISA的阳性率分别为8.09%和7.96%,当地溪蟹的肺吸虫囊蚴携带率为5.35%。结论丹江口库区环境、人口的变化及居民有生食和半生食溪蟹的习惯,将可能导致肺吸虫病的流行和扩散,应加强肺吸虫病防治知识的宣传和教育,制定相应的防治措施,防止肺吸虫病在库区的流行。     

景洪市肺吸虫病流行区20年后的变化

目的 了解景洪市肺吸虫病流行区20年后疫区疫情变化和溪蟹的自然感染情况.方法 从原流行区采集溪蟹,鉴定种类,用研磨水洗沉淀法、生物体视显微镜检查囊蚴或脱囊蚴并计数.将本次检查结果与周本江等1989年报告的结果进行比较,获得该流行区的纵向变化结果,分析引起变化的主要原因.结果 从原流行区共采集溪蟹474只,经鉴定全为景洪溪蟹:从溪蟹体内共检获95个囊蚴.经分类鉴定全部为小睾并殖吸虫囊蚴,并通过感染实验动物家猫获得成虫加以证实.溪蟹的自然感染率为10.8%,感染度平均为1.86.结论 景洪市同一流行区20年后发生了明显的变化,无论是溪蟹的种类、肺吸虫的虫种、溪蟹的自然感染率、感染度均出现了明显的下降.引起这些变化的主要原因是居民的健康意识增强和环境因素的改变所致.     

肺吸虫病亚临床型诊断问题探讨(附249例分析)

作者对卫氏肺吸虫病流行区自然人群中有食石蟹史、抗原皮试阳性而无临床症状的所谓亚临床型249例进行3～20年的长期观察,发现铁锈痰者154例(61.8％),其中1年内咯出锈痰者90例(36.1％),痰中虫卵阳性45例(18.1％),24.9％患者确无症状呈隐性经过,提示肺吸虫病流行区亚临床型比例不高,大部分属感染早期及愈合阶段的既患病例。因此,临床诊断肺吸虫病亚临床型时应审慎。     

三峡库区重庆段移民区肺吸虫病的血清流行病学研究

目的：了解三峡库区重庆段移民区移民人群肺吸虫病的隐性感染状况。方法：现场流行病学调查和血清流行病学研究。采用ELISA检测移民人群血清肺吸虫IgG抗体。结果：在3个移民区发现肺吸虫IgG抗体阳性，即奉节县万胜乡、康乐镇和巫山县培石镇，阳性率分别为21.43%、16.67%和25.85%。结论：在三峡库区重庆段移民区移民人群的肺吸虫病的隐性感染是存在的，且感染率较高，为21.96%，采取措施预防肺吸虫病的流行是必要的。     

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.