狂犬咬伤致狂犬病死亡1例

近年来被狂犬咬伤致狂犬病死亡者有所增加。我院于2002年收治狂犬病患者1例，抢救无效死亡。现报告如下。     

狂犬病26例临床分析

目的通过对狂犬病的流行病学、临床表现、病死率等方面的分析引起人们对动物咬伤及狂犬病的足够重视。方法选择近年来收治的26例狂犬病患者，对其动物咬伤史、清创、疫苗注射、治疗及疾病转归进行统计。结果狂犬病的发病率与犬咬伤史、是否彻底清创、疫苗注射与否有密切关系，且发病后病死率高达100％。结论狂犬病发病后病死率极高，做好暴露后的彻底清创及主、被动免疫，防止狂犬病的发病是惟一合理的手段。     

浅析狂犬病的流行病调查及预防处理

目的通过加强对狂犬病的认识,一旦咬伤,伤口正规处理,可阻断狂犬病的感染。方法对于狗猫动物咬伤的病人,未出血的皮肤咬伤、抓伤、破损的皮肤被舔,可规范全程注射狂犬病疫苗,只要出血,就立即进行伤口局部处理,并联合应用抗狂犬病的血清或免疫球蛋白及疫苗,在伤口周围进行等倍量浸润注射,抗狂犬病的免疫血清按40IU/kg,免疫球蛋白按20IU/kg。结果3000余例受伤病人,有12例发病,发病率为0.4%,全部死亡,符合流行病规律[1]。结论狂犬病是可防可控不可治的疾病,只要加强预防和认识,发病率是可以降低的。     

狂犬病的临床表现与防治

狂犬病在我国95％以上是因为被狗咬伤所致。狂犬病的潜伏期较长，一般咬伤头面部者40d左右，咬伤手指60d左右，咬伤足部187d左右，有的潜伏期可长达几年甚至十几年之久，狂犬病的病死率很高，就目前的医疗水平其病死率几乎是100％，所以狂犬病的防治尤为重要。     

狂犬病小析

狂犬病是由狂犬病病毒引起的,狂犬病病毒是一种嗜神经性病毒。该病毒可以引起多种野生动物和家畜等的自然感染及其在动物间的传播,并且可以通过咬伤,抓伤或亲密接触等形式传播给人类而引起狂犬病,狂犬病是人畜共患的自然疫源性疾病。     

关于防制狂犬病问题的若干建议（附狂犬病10例报告）

1989年以来，我县共有10人被犬或猫咬伤后发生狂犬病死亡，现将有关情况报告如下，并就有关狂犬病防制问题提出几点意见。     

鼬獾咬伤引起狂犬病死亡1例

近年来,浙江省多地报道鼬獾咬伤而引发狂犬病。笔者所在的缙云县也发生了1例鼬獾咬伤引起的狂犬病死亡病例。     

人狂犬病的研究进展

狂犬病是一种古老的疾病。最早引用“狂犬病”一词是在4000多年前的巴比伦。在疫苗问世之前，一旦被狂犬咬伤必死无疑，人们谈病色变，以致不少被狗咬伤的人自杀。1885年，刘易斯．巴斯德首次利用兔脑脊髓制备的减毒狂犬病疫苗应用于人体获得成功，自此，被狂犬咬伤者的生存史发生了明显的改变。然而120年过去了，尽管现在已拥有有效的疫苗，但据WHO最新公布，全球每年死于狂犬病的患者仍有约30000-70000人，99％的死亡人数发生在热带发展中国家，如非洲、亚洲和南美洲。美国近20年，每年死于狂犬病的患者1-3例，而接受暴露后治疗的有25000-40000人，每人注射全程的狂犬病免疫球蛋白和接种5剂疫苗需花费约1000美元。     

高州市1990～2003年狂犬病流行病学分析

目的分析高州市1990～2003年狂犬病发病情况及影响因素,为制定防制措施提供科学依据。方法对高州市1990～2003年的狂犬病疫情报表及个案调查表,采用描述性流行病学的方法进行分析。结果1990～2003年高州市共报告狂犬病病例29例,死亡29例,病死率为100%。在这十四年中,有九年无病例发生。发病率最高的是2002年,发病12例,发病率为0.75/10万,占总病例的41.38%。近年来高州市狂犬病疫情呈上升趋势。病例全部发生于农村,主要分布于春夏两季,15岁以下儿童为高发人群。结论加强犬类管理,尤其是对犬进行免疫接种,是切断狂犬病传播的关键措施;被犬、猫等动物咬伤后及时规范处理伤口,及时全程接种狂犬疫苗是防止狂犬病发作的主要措施;加强宣传教育,普及狂犬病防治知识,提高人群防病意识和能力,是预防感染狂犬病的关键途径。     

狂犬病33例的临床治疗及流行病学分析

狂犬病是一种病死率接近100%的急性传染病,人被带狂犬病病毒的犬、猫等动物咬伤而得病。上世纪80年代初期,贵阳地区人狂犬病发病率较高,经过十几年的低发病期后,近二年人狂犬病发病率呈明显升高的趋势,而且全部病例都因犬、猫咬伤后发病。现将2004年1月至2006年1月两年中我院收     

Serum IgG subclass antibody responses in children vaccinated with influenza virus antigens by live attenuated or inactivated vaccines

To ascertain whether live attenuated or inactivated vaccines can be considered equivalent, we examined the primary antibody response of children following vaccination with influenza virus antigens in three different formulations. Nine children received cold recombinant vaccine (CRV) containing A/Korea/82 (H3N2) and A/Dunedin/83 (H1N1) variants. Eight of these children responded to HA of the H3N2 subtype and the major portion of the elicited antibody was in the IgG1 subclass. Antibody of low titer in the IgG2 and IgG3 subclasses was detected in two and six serum specimens, respectively. Six of the nine children administered with CRV responded to the H1 antigen and only IgG1 antibody was detected. Serum specimens from eight children less than one year of age (5 less than 6 months of age) who had developed an antibody response to trivalent inactivated vaccine (TIV) vaccination were examined. High levels of IgG1 antibody to purified H3 were detected in all eight children. Low titers of antibody in IgG2 and IgG3 subclasses were detected in two and five children, respectively. Antibody responses to purified H1 showed a similar subclass distribution. In order to examine secondary response, eight children primed by immunization with TIV vaccine were subsequently given a single booster dose of purified hemagglutinin (HA) conjugated to diphtheria toxoid (HA-D). In 6/8 specimens antibody rises were detected to purified H3 and H1 antigens. Prior to the HA-D immunization, low levels of HA specific IgG1 antibody were detected in all serum specimens and vaccine induced responses were primarily of the IgG1 subclass.(ABSTRACT TRUNCATED AT 250 WORDS)     

除草剂百草枯对大鼠胎儿动脉管的毒性作用

目的研究除草剂百草枯对胎儿动脉管的毒性影响。方法(1)取妊娠21 d大鼠100只,随机分成每组20只。皮下注射25 mg/kg百草枯,于不同时间测定母体和胎儿血液中百草枯浓度;(2)取妊娠21 d大鼠随机分成4组,实验组分别皮下注射2、7和25 mg/kg百草枯后,于不同时间观察胎儿动脉管收缩情况;(3)取妊娠19 d(上午)1、9 d(下午)、20和21 d的大鼠各8只,随机分成2组。实验组于不同时间皮下注射25 mg/kg百草枯,3 h后观察动脉管收缩情况。结果百草枯在母体及胎儿血液中呈不同迁移。百草枯可引起胎儿动脉管收缩,且存在剂量-效应关系。百草枯引起胎儿动脉管收缩的临界期在胎龄19.5和19.7 d之间。结论百草枯对胎儿动脉管具有毒性作用。     

Phase I, randomized, controlled trial to study the reactogenicity and immunogenicity of a nasal, inactivated trivalent influenza virus vaccine in healthy adults

We performed a randomized, placebo-controlled, dose-escalating clinical trial to evaluate the safety and immunogenicity of an inactivated, split virion, trivalent, nasal influenza vaccine using lipid/polysaccharide molecules as carriers. A total of 64 adults (mean age 29; range 19-69 years) were randomly allocated to receive a mixture of lipid/polysaccharide carrier molecules and 7.5, 15, or 30 microg hemagglutinin antigen of each of the three influenza strains (A/Johannesburg/82/96 [H1N1], A/Nanchang/933/95 [H3N2], B/Harbin/07/94) or placebo via nasal spray on two occasions separated by 28 days. Adverse events were assessed immediately after immunization and for 14 days after each dose. Nasal and serum antibodies were measured before and two weeks after each dose. All but three participants completed the study; no withdrawals were because of adverse events. Adverse events were similar immediately after immunization except for anterior nasal dripping after the first dose which was more common in the combined vaccine groups (64.4%) than in the placebo group (31.3%; p < 0.05). A similar trend was observed after the second dose. Nasal dripping was also more common in the first two days after immunization in the vaccine groups than the placebo group (31.3%-50% vs. 0%) with no difference with increasing vaccine dose. The vaccine elicited a modest serum antibody response against all three viruses, with the highest dose eliciting the highest serum antibody levels. In contrast, significant nasal antibody rises were observed for all three viruses; again, the 30 microg group achieved the highest mucosal antibody levels at the earliest time points. We conclude that this trivalent, split virion, inactivated nasal influenza vaccine formulated with lipid/polysaccharide molecule carriers is well tolerated and modestly immunogenic in healthy adults.     

Effects of various drugs on insulin antibodies

1. Insulin antibodies were induced in young guinea-pigs of both sexes weighing 300-400 g and housed in a room maintained at 28 degrees C+/-2 degrees C, by subcutaneous injection of 2 ml of freshly prepared insulin antigen emulsion between the shoulders once every month.2. To estimate the titre of serum antibody the serum was incubated with a known concentration of insulin for 90 min at 37 degrees C and the insulin not bound to antibody was estimated by the rat hemidiaphragm method.3. No significant (P>0.5) development of insulin antibody could be detected in the serum samples collected 1 month after the first and 15 days after the second monthly injections in groups of ten male guinea-pigs and six female guinea-pigs. However, the titre of insulin antibody in the serum of these groups of guinea-pigs 15 days after the third monthly injection of insulin antigen emulsion was significantly (P<0.01) raised. There was no further increase in the titre of insulin antibody in the sera 15 days after the fourth and fifth monthly injections of insulin antigen emulsion. Thus the peak titre was reached 15 days after the third monthly injection of the antigen.4. Two groups of ten male guinea-pigs each received testosterone propionate or diethylstilboestrol daily for 1 week after each monthly injection of insulin antigen emulsion. Two other groups of six female guinea-pigs each received testosterone propionate or diethylstilboestrol in a similar manner. One more group of ten female guinea-pigs received both sex hormones for 1 week after each monthly injection of insulin antigen emulsion. Testosterone facilitated the induction of insulin antibody in the serum of males but did not affect the antibody titre in the female guinea-pigs. Diethylstilboestrol facilitated the induction of insulin antibody in the serum of groups of either sex, the peak titre being attained after the second monthly injection of insulin antigen emulsion. The response of the females which received both sex hormones was similar to that of females which received diethylstilboestrol alone.5. Fifteen days after the third monthly injection of insulin antigen emulsion a group of ten guinea-pigs received hydrocortisone subcutaneously each day for 1 month. The serum antibody titre was estimated at the end of the drug treatment, and was significantly (P<0.01) reduced.6. Fifteen days after the third monthly injection of insulin antigen emulsion three different groups of five-six guinea-pigs each received tolbutamide, chlorpropamide or phenformin orally every day for a month. Antibody titres of the serum were estimated at the end of this period; there was no significant (P>0.05) reduction in groups receiving chlorpropamide or phenformin, but the serum antibody titre of the group receiving tolbutamide was significantly (P<0.01) raised.7. Fifteen days after the third monthly injection of insulin antigen emulsion different groups of five-six guinea-pigs received one of the following: 5-bromouracil, 5-fluorouracil, 6-mercaptopurine, methotrexate, 6-azauridine, busulphan, chlorambucil, cyclophosphamide, actinomycin-D or mytomycin-C intraperitoneally each day for 5 days. The serum antibody titre of all the groups of guinea-pigs was significantly (P<0.01) reduced. On the other hand the serum antibody titre of a control group of six guinea-pigs receiving normal saline intraperitoneally each day for 5 days was not significantly (P>0.5) affected.     

The immune response and protective efficacy of vaccination with oral microparticle Aeromonas sobria vaccine in mice

The effect of an oral alginate microparticle Aeromonas sobria vaccine on immune response and protection of mice was investigated. The formalin-killed cultures (FKC) of A. sobria strain Z-1 treated with three methods were incorporated into alginate microparticles, and the encapsulated vaccines were orally used for immunizing mice. Four weeks after immunization, the serum agglutinating antibody titers, bactericidal activity of leucocytes and relative percent survival (RPS) of mice immunized orally with three microparticle vaccines were significantly higher than those of control mice. Among the immune efficacy of 3 microparticle vaccines, vaccine prepared directly from FKC (MVC) was the most, vaccine from FKC treated with freeze-melt method (MVCF) secondly, and vaccine from FKC treated with ultrasonic wave (MVCU) the worst. The serum agglutinating antibody titers and phagocytic activity of the blood monocytes in mice immunized orally with MVC reached a level equivalent to those of injection with FKC, and were significantly higher than those of control group. Moreover, from the 7th to 12th weeks, the serum agglutinating antibody titers in the MVC-immunized mice was significantly higher than those of injection with FKC. The RPS of mice immunized orally with MVC was 87.5%, while 100% of mice immunized orally with FKC and also the control mice died. These results demonstrated that oral alginate microparticle of A. sobria strain Z-1 was immunogenic and conferred protective immunity in mice, and could be used as a candidate vector system of oral vaccine of Aeromonas.     

氯磷定持续静脉泵入治疗急性有机磷农药中毒51例分析

目的探讨持续静脉泵入氯磷定治疗急性有机磷中毒（AOPP）的疗效。方法将符合重症有机磷中毒患者分为三组：一组：静脉注射氯磷定2．0g,后以0．25g／h静脉泵人;二组：静脉注射氯磷定2．0g,后以0．5g／h静脉泵人;三组：氯磷定每次2．0g,每天3次静脉滴入。观察各组疗效与并发症。结果一组与二组比较,在加快阿托品化,减少阿托品用量,恢复胆碱酯酶活力,缩短住院天数,减少反跳数和中间综合征的发生,提高治愈率方面差异无统计学意义,但两组与第三组比较有明显差异。结论氯磷定首剂足量,继以小剂量静脉维持泵人对治疗AOPP效果更好。     

Antiidiotypic antibodies carrying the "internal image" of peptide YIGSR inhibit spontaneous metastasis of Lewis lung carcinoma in mice

BACKGROUND: It has been reported that the laminin derivative synthetic peptide YIGSR can bind to a metastasis-associated laminin receptor and inhibit experimental metastasis. Several antiidiotypic antibody (anti-Id) vaccines have been used in clinical trials with promising results. We used an anti-Id vaccine based on peptide YIGSR for the inhibition of spontaneous metastasis in Lewis Lung carcinoma-bearing mice. MATERIALS AND METHODS: High titer anti-YIGSR serum from immunized rabbits was used to immunize sixteen Lewis Lung Carcinoma (LLC)-bearing mice. Another group of sixteen mice (controls) inoculated with LLC was immunized with control rabbit serum. After 24 days of tumor growth, the volume of the tumor was estimated, a blood sample was collected and the lungs were examined macroscopically and microscopically for metastasis. The presence of anti-Id antibodies was detected by Western blotting, ELISA and inhibition of cell attachment assays. RESULTS: Tumor growth was limited and metastasis was inhibited in the mice that received the anti-Id YIGSR vaccine as compared to controls. Both groups of mice developed anti-rabbit antibodies as indicated by Western blotting. However only the serum of mice immunized with high titer anti-YIGSR rabbit serum (anti-Id YIGSR vaccine) could inhibit the binding of the anti-YIGSR rabbit serum to the peptide YIGSR in ELISA assays. In addition the serum of mice that received the anti-Id YIGSR vaccine but not the controls inhibited cell attachment to the peptide on solid face assays. CONCLUSION: An anti-Id antimetastatic vaccine may be developed based on YIGSR.     

应急条件下接种甲、乙型肝炎疫苗免疫效果分析

目的通过在较短时间内接种甲、乙型肝炎(甲、乙肝)疫苗,提高部队官兵应急条件下机体免疫水平,预防疾病的发生。方法Ⅰ组先接种甲肝疫苗,33 d后接种乙肝疫苗第一针;Ⅱ组先接种乙肝疫苗第一针,45 d后,接种甲肝疫苗。收集血清,用酶联免疫方法检测疫苗接种前、后不同时期血清IgG抗体水平的变化。结果Ⅰ、Ⅱ组官兵疫苗接种前甲肝抗体阳性率分别为81.19%、81.25%,接种疫苗后4个月,抗体阳性率Ⅰ、Ⅱ组分别为99.01%、98.75%,18个月后仍保持高的抗体水平。Ⅰ、Ⅱ组维和官兵在接种乙肝疫苗前抗体阳性率为60.40%,56.25%,接种疫苗后4个月后,血清抗体阳性率分别为91.09%、93.75%,比接种疫苗前血清抗体水平有显著提高(P<0.01)。第三次血清抗体阳性率Ⅰ组阳性率89.11%,Ⅱ组阳性率为87.50%。结论间隔适合的时间,接种甲肝、乙肝疫苗,疫苗的预防效果没有影响。     

风疹病毒减毒活疫苗猴体神经毒力试验

目的 评价风疹病毒减毒活疫苗的潜在神经毒力。方法 普通级恒河猴随机分为2组,风疹病毒减毒活疫苗组10只,对照组2只,采用猴脑定位的方法将风疹病毒减毒活疫苗接种于猴两侧丘脑,对照组接种等体积生理盐水;检测血清抗体效价;并观察动物是否产生抽搐、癫痫、共济失调、震颤等神经毒力症状,以及风疹病毒减毒活疫苗对一般体征、饮食、体温的影响;风疹病毒减毒活疫苗组疫苗接种后20 d、对照组接种后31 d进行脑部及脊髓大体解剖和组织病理学检查,以评价该疫苗的神经毒力。结果 猴丘脑注射疫苗后,风疹病毒减毒活疫苗组动物血清抗体效价呈阳性,免疫应答较好,对照组均呈阴性;动物未出现情绪激怒、呕吐、颈强直、抽风惊厥等神经毒力症状;动物外观、行为活动、饮食情况、体温等各方面均未见明显异常;组织病理学检查未见药物引起脑及脊髓的明显病理学改变。结论 风疹病毒减毒活疫苗在猴体中不具有神经毒力。