大鼠脑出血灶周围星形胶质细胞内糖原含量的变化

目的：研究脑出血后局部超微结构的变化，探讨脑出血的病理生理过程，为临床治疗提供理论依据．方法：健康雄性SD大鼠4只，随机等分为实验组和对照组．实验组采用细菌胶原酶注射制作纹状体脑出血模型，对照组采用相同方法在相应部位注入等体积生理盐水，采用透射电镜观察脑出血后24h病变局部及其周围和对照组超微结构的变化和糖原的水平变化．结果：电镜观察到在脑出血动物出血灶周围区，不同类型的细胞内均可见到各种各样的超微结构改变．最为醒目的是在脑内血肿周围星形胶质细胞胞质和突起内有大量的糖原颗粒聚集，尤其在毛细血管周围的胶质细胞突起内非常明显；小胶质细胞和少突胶质细胞内均未发现明显糖原颗粒存在．在生理盐水对照组动物，相应部位的各种细胞的超微结构正常；而且神经元、各种胶质细胞和毛细血管内皮细胞内均无明显糖原颗粒聚集．结论：脑出血周围糖原含量增高，局部存在明显的糖代谢障碍．     

Malaria in children in Birmingham in the 1970s

Thirty-two children with malaria were admitted to Dudley Road Hospital, Birmingham, in the 1970s. None was admitted before 1974 and there was a rapid increase after that. All the infections were due to Plasmodium vivax and occurred in children of Asian immigrant families who had been born in or had visited India or Pakistan apart from one infant born in England who acquired the disease transplacentally. All presented within 12 months of entering or re-entering the United Kingdom. The clinical features of the 32 patients have been analysed and it is suggested that more effort should be made to educate travellers about the need for anti-malarial chemoprophylaxis and the necessity to continue it for one month after return.     

小儿耳鼻喉手术麻醉的新进展

因小儿耳鼻喉手术刺激强,时间短,且常与气道相关,故麻醉的控制有一定难度,现对国内外现阶段小儿耳鼻喉手术麻醉的改良方法及新观点进行评述,以期对临床工作有较好的指导意义。     

广东高州市2005年医疗机构消毒质量监测分析

目的评价辖区内医疗机构消毒灭菌质量，督促各医疗单位提高消毒灭菌效果，防止医源性感染的发生。方法对辖区内的医疗单位已消毒或灭菌的用品进行抽样检测，将检测结果进行统计学分析。结果这次采集使用中消毒液、无菌器械、物体表面、手术室空气和医务人员手共3556份，检测达卫生标准2955份，符合率为83、10％，不同样品检测达卫生标准百分率依次为97．37％、95．56％、86．25％、75．41％和62、49％。结论高州市医疗机构消毒灭菌质量用卫生指标评价，卫生站的符合卫生标准率低于医院，手术室空气和医务人员手的监测合格率低于使用中消毒液和无菌器械。     

2005年汕头市登革热定点监测结果分析

目的 通过定点监测为汕头市登革热流行趋势的预测、预警和制定防治对策、措施提供科学依据。方法收集监测点的登革热疫情、人群抗体水平和媒介伊蚊等监测资料，用EPI2002软件统计分析。结果2005年汕头市无登革热疫情，抗登革热病毒IgG、IgM阳性率低，伊蚊幼虫孳生密度高峰在6、8、9、10月份，低谷在4、7、11月份，孳生情况随着月平均降水量、平均气温变化而变化；孳生场所以农村、暂时性容器为主。结论汕头市有登革热流行的自然、社会环境条件，人群普遍对登革热易感，8～10月是发动爱国卫生运动，清除伊蚊孳生地，预防、控制登革热流行的适当时机。     

Divergences in antihypertensive therapy in special situations in nephrology.

CONTEXT AND OBJECTIVE: The choice of an antihypertensive drug is based on several criteria and specific situations give rise to doubt and controversy. The aim here was to evaluate physicians approaches towards treatment with antihypertensive agents in specific situations. DESIGN AND SETTING: Cross-sectional study, at Universidade Federal de S?o Paulo, S?o Paulo. METHODS: A questionnaire was applied during a nephrology meeting to evaluate individual approaches towards each hypothetical clinical situation. The questionnaire consisted of five multiple-choice questions (clinical cases) concerning controversial aspects of antihypertensive therapy. RESULTS: A total of 165 questionnaires were analyzed. Most participants were nephrologists (93.2%). There was a preference for angiotensin-converting enzyme (ACE) inhibitors in at least two of the cases. Only 57.2% of the physicians were correct in choosing beta-blockers as the first-line drugs for patients with ischemic coronary disease. Moreover, 66.2% chose ACE inhibitors as the first-line drugs for patients with chronic kidney disease and proteinuria. About 5% of the physicians did not follow the current recommendations for the use of ACE inhibitors in diabetic patients with microalbuminuria. The most controversial question concerned the first-line drug for advanced chronic kidney disease. Most physicians were correct in choosing calcium channel blockers and avoiding ACE inhibitors in renovascular hypertension in the case of a patient with a single functioning kidney. CONCLUSIONS: Most physicians adopted the correct approach, but some had an alternative strategy for the same situations that was not based on evidence.     

云南省2001年流动人口疟疾感染情况分析

目的：分析2001年云南省流动人口疟疾感染及管理状况。方法：按照边境地区及元江流域疟疾联防规划，实施对流动人口的疟疾管理。结果：流动人口共查出发热病人81496例，疟原虫阳性率为6．73％。另外，检查非发热病人4968例，症原虫阳性率为11．00％。由国外返回的当地流动人口原虫阳性率最高，蕨是由外县进入的流动人群。结论：国外和外地进入的流动人群是造成当地疟疾传染源扩散的主要原因。因此，加强流动人口的疟疾管理，是提高防治效果的必要措施。     

纤维连接蛋白在肾脏疾病中变化的意义

测２０例尿毒症患者血浆纤维连接蛋白含量，证实尿毒症者血浆Ｆｎ降低，并与患者中性粒细胞吞噬功能低下有关联。体外实验证实Ｆｎ有促进ＰＭＮ吞噬功能作用，且与其浓度正相关。表明血浆Ｆｎ与机体免疫防御功能关系密切，其水平可反映患者细胞吞噬功能状态。     

昆明市某高校957名学生失眠症情况调查评估

目的了解昆明市某高校大学生失眠情况及其分布特征.方法对昆明市某高校957名学生进行睡眠质量和失眠相关问题的问卷调查.结果 27.3%的同学有不同程度的失眠,女生失眠率高于男生（P〈0.01）;本科生的失眠检出率高于研究生（P〈0.05）;三年级学生失眠率高于一年级和二年级学生（P=0.01）.不同专业、不同年龄段学生失眠率差异无统计学意义.结论性别、年级、学历是影响高校学生睡眠的主要因素.     

Anaemia in Asians in London.

Many Asian subjects were seen in London in the early 1970s with megaloblastic anaemia; in a majority of cases, this was dietary in origin. Pernicious anaemia occurs in Asians, but the incidence is probably lower than in Caucasians. Megaloblastic anaemia is now less common in this group, but a population survey in Punjabi females in the late 1970''s showed anaemia in 32%, and one or more features of iron deficiency in 76%.     

云南省2006年登革热监测分析

目的了解云南省登革热的疫情动态、人群抗体水平、媒介伊蚊种群（包括成幼虫孳生和密度变化）的动态变化、为登革热流行趋势的预测、预警和制定防治对策、措施提供科学依据。方法各级医疗、卫生、检疫机构的医务人员对疑似、临床病例进行及时发现和诊断;在流行季节前随机抽取正常人群血清,-20℃保存,用ELISA方法进行血清学检测;在6～10月采用定时、定点调查法,对登革热的主要传播媒介白纹伊蚊、埃及伊蚊的种群、孳生环境、伊蚊幼虫指数和成蚊密度进行监测,每月1次。结果2006年云南省发生输入性登革热病例18例;健康人群登革热IgG抗体阳性率8．09％。伊蚊幼虫密度布雷图指数（BI）、容器指数（Cl）分别在14～98、4．7～73．68之间,白纹伊蚊成蚊密度在3．5～34只,人工小时之间。结论云南省输入性登革热疫情有不断上升的趋势;人群抗体水平登革热IgG抗体阳性率较高,提示当地人群中可能存在该病毒的既往感染或隐性感染;媒介伊蚊幼虫布雷图指数、容器指数和白纹伊蚊成蚊密度均较高。对登革热传播具有极高的危险性,应引起高度注意。     

重庆地区汉族CD14启动子区多态性分析

目的调查CD14(-260)多态性在重庆地区汉族中的分布特征,及检验该随机样本遗传学研究的可靠性.方法对110名重庆汉族个体,采用降落式PCR和限制性片段长度多态性法(RFLP)进行基因型分析.结果重庆地区汉族CD14(-260)多态性TT、TC、CC 3种基因型频率分别为43.6%、39.1%和17.3%; 样本分布符合Hardy-Weinberg平衡.结论重庆汉族CD14(-260)多态性基因型分布特征与白种人存在明显差异.样本为H-W平衡群体,可进一步用于重庆汉族全身性炎症反应的关联分析.     

Trypanosomes in cattle in southern Ontario

Trypanosomes were found in the blood of 155 out of 274 Holstein cows of various ages from southern Ontario. The incidence varied from about 8% in one herd to about 85% in another herd. Two species of trypanosomes were found in cattle in the Guelph area. One was Trypanosoma theileri. The other was a much smaller trypanosome which morphologically resembles T. uniforme of the Salivaria. This is the first report of such a trypanosome in cattle in North America. Epimastigotes from blood agar slants of both trypanosomes, when inoculated into chick embryos, produced blood forms morphologically identical to those found in the blood of the cows. T. theileri survived at least two weeks in blood kept at 4-5 degrees C.     

Progress in malaria control in China

Purpose To summarize the main achievements of the control of malaria in the People’s Republic of China. Data sources The data are from national case reporting system ( 1955-1998), and bibliographic reviews of textbooks and review articles. Study selection Successes in control and research of malaria were identified and selected to address the stated purpose. Data extraction In the past 50 years, large-scale malaria control activities were conducted in the country, relying on primary health care networks and community participation. The control of malaria was implemented according to the time- and locality- oriented approaches. As a result, remarkable success has been achieved. By the end of 1998, there were 31. 3 thousand malaria cases in China, with a morbidity of 0.25 per ten thousand, which dropped by 99% in comparison with that in the 1950s.Results Most of the original hyper- endemic areas became meso- or hypo- endemic and for most of the previously meso- or hypo- endemic areas, the disease became sporadic. Malaria distribution and epidemic pattern also demonstrated great changes. Conclusions Malaria control in China has been considerably successful in the past 50 years, which coincides with the target of the World Health Organization’s 'Health for all by the year 2000'.     

Time trends in autism and in MMR immunization coverage in California

CONTEXT: Considerable concern has been generated in the lay and medical communities by a theory that increased measles-mumps-rubella (MMR) immunization among young children may be the cause of an apparent marked increase in autism occurrence. OBJECTIVE: To determine if a correlation exists in secular trends of MMR immunization coverage among young children and autism occurrence. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analyses of MMR immunization coverage rates among children born in 1980-1994 who were enrolled in California kindergartens (survey samples of 600-1900 children each year) and whose school immunization records were reviewed to retrospectively determine the age at which they first received MMR immunization; and of autism caseloads among children born in these years who were diagnosed with autism and were enrolled in the California Department of Developmental Services regional service center system. MAIN OUTCOME MEASURES: Measles-mumps-rubella immunization coverage rates as of ages 17 months and 24 months and numbers of Department of Developmental Services system enrollees diagnosed with autism, grouped by year of birth. RESULTS: Essentially no correlation was observed between the secular trend of early childhood MMR immunization rates in California and the secular trend in numbers of children with autism enrolled in California's regional service center system. For the 1980-1994 birth cohorts, a marked, sustained increase in autism case numbers was noted, from 44 cases per 100 000 live births in the 1980 cohort to 208 cases per 100 000 live births in the 1994 cohort (a 373% relative increase), but changes in early childhood MMR immunization coverage over the same time period were much smaller and of shorter duration. Immunization coverage by the age of 24 months increased from 72% to 82%, a relative increase of only 14%, over the same time period. CONCLUSIONS: These data do not suggest an association between MMR immunization among young children and an increase in autism occurrence.     

Teaching ethics in a masters program in public health in Lithuania

This article aims to present 10 years of experience of teaching ethics in a Masters Program in Public Health in Lithuania, and to discuss the content, skills, teaching approach and tools of this programme. In addition, the article analyses the links between ethics and law, identifies the challenges of the teaching process and suggests future teaching strategies. The important role of teaching ethics in countries that are in transition owing to a radically changing value system is emphasised.     

氟马西尼用于小儿腹腔镜手术全麻催醒的临床探讨

目的：通过将氟马西尼应用于小儿腹腔镜手术全麻催醒过程的临床效果观察和危险性评价。方法整群选取自2014年4月20日—2015年4月20日来该院接受小儿腹腔镜手术的患儿52例作为研究对象,采用随机数字表法将研究对象随机分为氟马西尼组(以下简称,氟组）和生理盐水组(以下简称,生组）,对氟组患儿采用氟马西尼催醒,对生组患儿采用等量的生理盐水做安慰剂对照,比较两组患儿在给药3 min、6 min和10 min后的呼吸功能、心率、平均动脉压水平,同时观察苏醒时间和不良反应发生率。结果氟组和生组在给药后10 min潮气量、呼吸频率、心率和平均动脉压均改变明显(P<0.05）;氟组患儿的压眼会哭时间、呼唤睁眼时间和气管拔管时间均低于生组(P<0.05）,且不良反应率明显低于生组(P<0.05）。结论氟马西尼应用于小儿腔镜手术全麻催醒效果良好,能够有效减少不良反应发生,减轻患儿痛苦,缩短苏醒时间,值得在临床上进行大范围的推广。     

Oxidative protein damage parameters in plasma in chronic experimental diabetes in rats

An increase in oxidative stress may contribute to the development of oxidative protein damage (OPD) in the streptozotocin-diabetic rat. To show the effect of hyperglycemia in promoting OPD, we determined protein carbonyl (PCO), nitrotyrosine (NT), total thiol (T-SH) and advanced oxidation protein product (AOPP) levels as markers of OPD, and lipid hydroperoxide (LHP) levels as a marker of lipid peroxidation in plasma of acute and chronic diabetic male Sprague-Dawley rats and their controls. The levels of the studied markers, except NT, were determined by colorimetric methods. NT levels were measured by ELISA. Plasma PCO and AOPP levels of chronic diabetic rats were increased significantly compared with those of both acute diabetic rats and the controls. Plasma NT levels of the three groups were not different. Plasma T-SH levels of acute diabetics were increased significantly compared with those of the controls while T-SH increase in the chronic diabetics was not significant. Plasma LHP levels were increased significantly in the chronic diabetic rats compared with those of the controls. The increase in plasma PCO, AOPP, LHP levels in chronic but not in acute diabetic rats may be indicating that persistence of hyperglycemia is involved in the evolution of OPD while plasma NT levels do not seem to reflect OPD in diabetes.     

2011年上海市浦东新区社区卫生服务中心就诊伤害病例分析

目的:了解上海市浦东新区卫生服务中心门/急诊伤害就诊病历分布特征,为社区伤害干预提供科学依据。方法:以上海市浦东新区47家社区卫生服务中心为伤害监测点医院,对2011年1月1日~2011年12月31日到医院门/急诊就诊的被确诊为伤害的首诊患者作为分析对象。结果:共收到报告病例34046例,其中男、女性别比为1.61:1;以本区人口为主,有20448人(60.06%),其次外省市10882人(31.96%);本区人口伤害高发年龄为40~64岁,伤害发生地点以家为主;外省市伤害高发年龄为15~39岁,地点以工业和建筑区域占首位;伤害原因以跌倒/坠落为主,其次为刀/锐器伤、钝器伤和非机动车车祸。结论:跌倒/坠落、刀/锐器伤是伤害发生的主要原因,应作为防治的重点;还应重视老年人口及外来人口的伤害干预。     

Inequalities in health in Britain: specific explanations in three Lancashire towns

The reasons why mortality is higher in the poorer areas of Britain are largely unknown. Thus how to reduce inequalities in health is a matter of conjecture. In three neighbouring towns in northern England the rates of death from all causes differ greatly. Socioeconomic conditions in the towns are similar though below average for England and Wales. The pattern of disease specific rates was analysed and related to past differences in infant mortality. It is suggested that past differences in maternal health and physique and in the postnatal environment, particularly infant feeding, housing, and overcrowding, may be determinants of current differences in adult mortality.