2011～2012年乌苏市流行性腮腺炎发病分析

目的分析新疆乌苏地区流行性腮腺炎流行规律,探讨预防和控制流行性腮腺炎疫情的措施。方法对2011~2012年乌苏市流行性腮腺炎的发病情况进行流行病学分析。结果 2011~2012年乌苏地区共报告腮腺炎病例886例,发病率分别为203.30/10万、143.86/10万,其中市区内发病297例,占全市病例总数的33.52%,发病率高于其他乡(场);发病年龄集中在0~15岁,占发病总数的70.09%,患病人群以学生为主,占发病总数的66.51%。结论校内传染源未及时隔离是造成乌苏市流行性腮腺炎流行的主要原因,加强校内晨检、教室通风、及时隔离患者、提高免疫接种率是预防和控制流行性腮腺炎流行的主要措施。     

酒泉市流行性腮腺炎流行病学特征分析及防治策略探讨

目的分析2006—2014年甘肃省酒泉市流行性腮腺炎流行病学特征,探索预防控制措施和策略。方法对酒泉市法定传染病信息报告系统和突发公共卫生事件信息报告管理系统报告的流行性腮腺炎资料进行描述流行病学分析。结果 2006—2014年共报告流行性腮腺炎10 186例,年均发病率99.11/10万;4—7月为全年发病最高峰、占40.71%,11月至次年1月为次高峰、占34.04%;男性发病高于女性,性别比为1.44∶1;发病主要集中在5~15岁年龄组,占90.01%;发病以学生为主,占79.23%,其次为幼托儿童,占6.56%;流行性腮腺炎突发公共卫生事件共计17起,占总事件数的29.83%,发病813例,占总发病数的35.36%。结论酒泉市流行性腮腺炎发病率高,学生和幼托儿童是防治重点人群,中小学校是暴发流行的重点场所;建议调整免疫策略,加强中小学校和托幼机构腮腺炎暴发疫情的控制力度,切实控制流行性腮腺炎的流行。     

2004-2012年内江市流行性腮腺炎流行特征分析

目的了解四川省内江市流行性腮腺炎流行现状,探讨其有效控制对策。方法通过中国疾病预防控制信息系统收集2004-2012年内江市报告的流行性腮腺炎病例,采用EXCEL2003和SPSS17.0进行统计学分析。结果 2004-2012年全市共报告流行性腮腺炎病例5 828例,其中男性3 602例,女性2 226例,男女性别比1.62∶1,性别之间差异有统计学意义(χ2=177.87,P0.05);发病年龄以3~14岁年龄组为主,占88.44%;职业以学生、幼托儿童、散居儿童为主,分别占发病总数的55.71%、23.16%、15.00%;各年度发病率在4.82/10万~29.11/10万之间,各年发病率之间差异有统计学意义(χ2=1184.26,P0.05)。结论 2004-2012年内江市流行性腮腺炎发病人群为学校及托幼机构的少年儿童,应重点防控,有效提高疫苗接种率是降低流行性腮腺炎的发病率,预防流行性腮腺炎暴发和流行的有效措施。     

吐鲁番市流行性腮腺炎的流行病学分析

目的了解新疆吐鲁番市流行性腮腺炎的流行特征,为制定综合防控措施提供参考依据。方法运用描述流行病学方法,分析2008─2013年吐鲁番市流行性腮腺炎疫情资料。结果 6年间吐鲁番市共报告流行性腮腺炎病例870例,年均发病率51.223/10万;发病地区前三名分别是亚尔乡、高昌路街道、葡萄乡;男女发病性别比1.32∶1;全年均有发病,2011年底至2012年初有一次暴发流行,造成病例数急剧增多;发病主要以15岁以下青少年为主,学生、散居儿童、幼托儿童分别占病例报告总数的60.23%、16.44%和15.52%。结论加强对吐鲁番市重点地区、重点人群流行性腮腺炎的疫情监测及疫苗接种,做好疫情应急处理,积极开展健康教育,有效降低流行性腮腺炎的发病率。     

帕米尔高原一起流行性腮腺炎暴发的流行特征分析

目的了解2007年帕米尔高原腹地的塔什库尔干塔吉克自治县流行性腮腺炎的流行特征。方法对2007年报告和发现的流行性腮腺炎病例进行现场流行病学个案调查,采用描述性研究方法,利用全国法定传染病报告系统和公共卫生突发事件报告系统的流行性腮腺炎疫情资料进行综合分析。结果 2007年6月～2008年1月塔什库尔干塔吉克自治县共报告流行性腮腺炎临床诊断病例876例,罹患率为25.37‰,发病特点为春季无病例发生,其余3个季节均有发病,主要集中在秋末冬初,发病年龄集中在5～15岁,占发病的92.47%,城区罹患率高于农牧区,分别为35.64‰和7.65‰,男女性别比为1.15：1,有明显的职业特征,学生和托幼儿童为高发人群,占94.41%,并发症发生率为1.83%。结论流行性腮腺炎已成为危害学生和托幼儿童健康的主要传染病之一,发病明显高于计划免疫针对疾病,建议开展流行性腮腺炎免疫策略研究,制定合理、规范、科学的接种方案,并加以实施,以提高易感人群免疫水平,从根本上减少流行性腮腺炎发病。     

2012─2016年新疆墨玉县结核病疫情监测分析

目的分析新疆墨玉县结核病疫情的流行特点和发病趋势,为制定有效的防控措施提供依据。方法收集结核病管理信息系统中2012─2016年新疆墨玉县结核病相关基础资料,用EXCEL 2010汇总数据,以SPSS 22.0软件对疾病的三间分布进行描述性分析。结果 2012─2016年墨玉县报告结核病病例6 475例,年均发病率254.70/10万,其中涂阳病例1 557例,年均发病率61.05/10万、占报告病例总数的24.05%,涂阴4 918例,年均发病率193.45/10万、占75.95%,发病率涂阳病例明显低于涂阴病例;男性(224.12/10万)低于女性(286.43/10万),差异有统计学意义(χ2=178.29,P<0.05);以50岁以上中老年人为主(5 376例、占83.03%),农民最多(5 921例、占91.44%),冬春季高发(4 031例、占62.25%);芒来乡发病率最高(320.97/10万)、其乃巴格街道最低(45.90/10万),差异有统计学意义(χ2=349.87,P<0.05);报告发病数(6 475例)比登记发病数(5 346例)多出了1 129例。结论墨玉县各年度结核病发病率总体呈平稳趋势,发病形势依然严峻;因部分病人经济困难、缺乏肺结核病防治知识、自我保健意识淡薄和难以完成规范治疗均造成发病率居高,因此控制农村肺结核病疫情是今后防治工作的重点。     

新疆精河县流行性腮腺炎疫情调查

目的分析2010—2014年新疆精河县流行性腮腺炎疫情,了解并掌握其发病水平和流行特征,为制定防控措施提供科学依据。方法运用中国疾病预防控制信息系统统计数据,采用描述流行病学方法分析2010—2014年精河县流行性腮腺炎的流行特征及其时间、性别、年龄、职业和地区的分布情况。结果 2010—2014年精河县共报告流行性腮腺炎病例619例,无死亡病例,年均报告发病率84.65/10万,不同年份发病率差异有统计学意义(χ2=547.45,P0.001);男女发病比1.44∶1,不同性别发病率差异有统计学意义(χ2=14.50,P0.001);5月为发病高峰,占发病总数的18.90%;发病主要年龄组为0~14岁儿童,占发病总数的92.89%;以学生、托幼儿童居多,分别占病例总数的58.97%和25.36%;精河县7个乡(镇)均有病例报告,发病居前三位的地区依次为精河镇、大河沿子镇、茫丁乡,分别占报告病例总数的32.79%、23.91%和19.71%。结论精河县应提高疫苗免疫覆盖率,进一步做好常规疫苗查漏补种及入学查验预防接种证工作;在重要地区针对重点人群加强流行性腮腺炎疫情的监测和预警分析;加大健康教育力度,对学校和托幼机构暴发的疫情及时发现、及早处置。     

2006－2012年新疆昌吉州流行性腮腺炎流行趋势和特征分析

目的了解新疆昌吉回族自治州流行性腮腺炎的流行特征,为制定预防策略提供依据。方法利用Excel2003软件进行统计处理,采用描述流行病学方法分析流行性腮腺炎的流行病学特征。结果2006。2012年共报告流行性腮腺炎10124例,年均发病率98．95／10万;本病一年四季均有发病,4～7月和11月至次年1月两个发病高峰,占73．87％;发病年龄以5～14岁人群为主,15岁以下7920例,占病例总数的78．23％,男性多于女性,男女之比为1．39：1。职业以学生发病为主,占64．44％,幼托儿童次之,占16．58％。结论应针对高危人群、重点地区以及疾病的发病高峰期进一步加强流行性腮腺炎监测及防治工作。     

2004-2008年绵竹市腮腺炎流行病学特征分析

目的 了解绵竹市流行性腮腺炎的流行特征,为有效控制该病提供科学依据.方法 采用描述流行病学分析方法,对该市2004-2008年流行性腮腺炎发病情况进行统计分析.结果 2004-2008年共发生流行性腮腺炎病例606例,年均发病率23.86/10万;城区发病213例,农村发病393例,农村发病高于城区(χ2=11.50,P<0.01);男性发病356例、女性发病250例,男女比为1.42:1;发病时间以4-7月较多,占发病总数的48.18%,经园形分布法分析,发病高峰时点为5月5日;发病年龄以4～15岁为主,占发病总数的78.22%;职业以15岁以下的散居儿童、托幼儿童、学生为主,占发病总数的88.12%.结论 腮腺炎已成为危害儿童健康的主要传染病之一,应规范的开展腮腺炎疫苗的免疫接种(以儿童、学生为主要接种对象),提高人群免疫水平,是减缓流行性腮腺炎的发病趋势的关键.     

新疆策勒县流行性腮腺炎流行病学分析

目的分析流行性腮腺炎疫情的流行病学特征及发病原因,指导今后的流行性腮腺炎防治工作。方法运用描述流行病学方法,分析2009—2014年新疆策勒县流行性腮腺炎疫情资料。结果 6年间策勒县共报告流行性腮腺炎272例,年均发病率29.597/10万,其中2009年发病率最高,发病145例、发病率92.397/10万;2011年发病率最低,发病3例、发病率1.881/10万,各年发病率差异有统计学意义(χ2=457.421,P0.05);发病季节特征明显,每年春季4—5月为发病高峰期,发病174例、占总发病的63.97%,9—10月发病最少,仅发病5例、占总发病的1.84%;2014年全年均有发病,2009年、2014年出现过暴发流行;报告发病数前三位的是努尔乡、策勒镇、策勒乡;男女发病数性别比1.16∶1,差异无统计学意义(χ2=3.258,P0.05);病例年龄分布以小年龄组为主,5岁~组发病102例、占病例总数的37.50%;10岁~组发病92例、占病例总数的33.82%;报告病例数最多为学生,发病190例、占总病例数的69.85%。结论疫苗接种率低、易感人群积累是造成流行性腮腺炎疫情发生的主要原因;提高人群免疫接种率是防止疫情发生的主要措施,积极开展健康教育、做好疫情监测和应急处理,能有效降低流行性腮腺炎的发病率。     

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.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.