河南省1983—1999年黑热病监测

目的 了解我省基本消灭黑热病后黑热病的发病及有关流行因素的变动情况。方法 血清学结合病在学检查确诊病人，在代表地区调查查媒介白蛉残存情况，抽样LDT检测了解人群黑热病感染情况。结果 1983-1999年全省发现3例病人，1例为当地感染，2例输入；京广铁路以西的丘陵，山区尚有媒介白蛉残存；对16-25岁人群LDT结合IFAT抽样检测未发现有黑热病感染者，结论 河南黑热病流行已经中止，基本消灭的成果是巩固的。     

河南省1983-1999年黑热病监测

目的了解我省基本消灭黑热病后黑热病的发病及有关流行因素的变动情况.方法血清学结合病原学检查确诊病人,在代表地区调查媒介白蛉残存情况,抽样LDT检测了解人群黑热病感染情况.结果1983-1999年全省发现3例病人,1例为当地感染,2例输入;京广铁路以西的丘陵、山区尚有媒介白蛉残存;对16～25岁人群LDT结合IFAT抽样检测未发现有黑热病感染者.结论河南黑热病流行已经中止,基本消灭的成果是巩固的.     

山东、江苏两省原黑热病流行区人群免疫学监测

1989～1992年用LDT和MAT对山东和江苏两省17个地区(市)、38个县(区)的134个乡(镇)人群进行免疫学监测。山东省30岁以下人群LDT无1例阳性,30岁以上的人群阳性率平均为4.4％,显示山东省黑热病的传播早已得到有效控制。江苏省LDT阳性者最小年龄为8岁,1～9岁年龄组LDT阳性率是各年龄组中最低的,其中1～7岁1 409人无1例阳性,30岁以下与30岁以上人群平均阳性率分别为2.2％和9.0％;非流行区各年龄组人群LDT均为阴性,显示江苏黑热病的传播亦已得到有效控制。两省受检人群IFAT均为阴性。     

LDT和IFAT用于黑热病防治效果考核的研究

本文用LDT方法于1989～1991年对山东、江苏两省15个地市、28个县区、89个村庄12835名农村居民进行了黑热病的免疫学研究。结果发现,在近30年无病人地区,30岁以下无一人呈LDT阳性反应;而近10年曾有病人地区,各年龄组均有阳性人群,且10岁组(1.81％)和30岁组(3.28％)阳性率差异不显著(x~2=2.18,P>0.05)。两地区LDT阳性率随年龄增加而增加。对泰安地区青少年进行LDT的动态观察,发现其阳性反应和黑热病患病率呈正比关系。不仅证实LDT对黑热病流行病学研究的作用,而且初步肯定了LDT用于黑热病防治效果考核的可行性。对IFAT在黑热病研究方面的应用亦给予肯定。     

江苏省黑热病防治效果的综合评价

江苏省的黑热病于1958年达到基本消灭后,坚持监测,积极防治,1973～1985年仅查见11例病人。为全面评价对该病的防治效果,于1991～1992年对苏北4个市、14个县(市、区)、56个乡镇进行了一次全面监测,所查地区无现患黑热病人,既往病人无复发,也未查见白蛉,人群免疫状况和黑热病基本消灭后的非流行区人群免疫状况基本一致。有理由认为:江苏省的黑热病防治效果巩固,已由原来的流行区转为非流行区。     

湖北省黑热病流行态势的评估

[目的 ]复查湖北省自 1989年起陆续报告的 14例“黑热病”,及评估我省黑热病的流行现况。 [方法 ]复查“黑热病”患者的骨髓片、免疫学检查 (L DT、IFAT)、接种动物及真菌培养、媒介 (白蛉 )和保虫宿主 (犬 )的调查。[结果 ]除 1例输入的和 1例残存的皮肤型黑热病外 ,其余 12例为播散型荚膜组织胞浆菌病。1997～ 1999年在 9个地市的 2 3个县 (市 )的 2 5个乡镇进行了免疫学监测 ,对 13 890人采用利什曼素皮内试验 (L DT) ,阳性率 0 .0 0 7% ,40岁以下的人群无阳性。其中 175 6人作间接荧光抗体试验 (IFAT) ,结果均为阴性。在调查区内未发现中华白蛉。查犬 30 2只 ,未发现病犬。 [结论 ]湖北省已消灭黑热病 ,且防治成果巩固     

江苏省基本消灭丝虫病后重点地区巩固措施的效果观察

目的 监测江苏省基本消灭丝虫病后，重点地区采取巩固措施的效果。方法 对以往未服用或未同步实施“海盐”和海盐”服用质量较差的边缘地区灌云与东海2个县，采取整群抽调查，重点搜索的方法，并对重点村阳性病人作正规治疗，其周围人群作预防性服药。结果 1996年，东海与灌云2个县人群血检微丝蚴阳性率分别为20％（2／995）和0．27％（3／1128），1997－1999年2个县累计血检6012人，均未发现微丝蚴阳性者。结论 江苏省基本消灭丝虫病后，重点地区采取的巩固性防治措施是有效的，可作为防治后期进一步净化的措施之一。     

山东省黑热病防治效果的免疫学评价与有关问题的探讨

山东省黑热病于1958年达到基本消灭后,坚持监测,继续防治,自1972年以来仅查见18例因长期误诊或治而未愈的残余病人,未再出现新感染的患者;白蛉显著减少,在85%的村庄已告绝迹。为了对防治效果作进一步的评价,1989年在13个地(市)、24个县(市区)的78个乡镇进行了免疫学监测,对10239名农村居民作利什曼素皮内试验(LDT),结果30岁以下人群无1例阳性反应(0/8020),30岁以上的居民阳性率平均为4.42%(98/2219),显示黑热病的传播早已得到有效的控制。在作LDT的人群中,对1232人同时采血作间接荧光抗体试验(IFAT),结果均为阴性。     

四川省北川县黑热病流行病学调查

目的 了解北川县黑热病的流行现状，为制定相应的仿治方案提供依据。方法在白草河流域曾有发病的乡及相邻的两个乡进行人群黑热病普查、家犬利什曼原虫感染调查；开展了病人线索调查和媒介白蛉的分布调查。结果共普查村民1847人，未查到黑热病现症病人。检查家犬56只，发现rk39试纸条阳性犬2只。病人线索调查共发现临床表现与黑热病相似的可疑病人11例，但有标本可查的仅4例，其中1例证实为黑热病。仅在白草河流域发现中华白蛉，最高密度17只／人工小时，从上游至下游白蛉密度依次降低。白蛉的生态习性为野生野栖。结论白草河流域存在黑热病的传播媒介中华白蛉与传染源病犬，显示该流域具备黑热病流行的环节和条件。受自然、环境条件的制约，该流域的媒介密度和家犬的感染率均较低，这可能是当地黑热病发病较低的主要原因。     

基本消灭班氏丝虫病后的远期监测

本文报道采用海群生对象治疗加流行村全民服药和对象治疗加食用海群生药盐基本消灭班氏丝虫病后的纵向和横向监测结果。两种不同措施基本消灭丝虫病后已监测9－11年，人群微丝蚴率均在逐年下降，前6年仍可检出残存微丝蚴血症者，以后连续5年未再发现微丝蚴阳性，蚊媒调查亦未发现幼丝虫自然感染，IFAT检测人群丝虫抗体阳性率为1．4－5．5％，降至非丝虫病流行区抗体水平，证明丝虫病的传播已被阻断。认为基本消灭班氏丝虫病后监测年限以10年左右为宜，并需连续3年以上未检出微丝蚴血症者和感染蚊，人群丝虫抗体阳性率降至当地非流行区水平，可以确认丝虫病已达到消除。     

Diphtheria in Estonia, 1991-1996

Clinical diphtheria reappeared in Estonia in 1991. Between 1991 and 1996, 61 cases and 5 deaths occurred; 19 cases were among children 5-9 years of age, and 11 were among persons 40-49 years of age. From 1993-1995, vaccine supplies donated by Finland were used in vaccination programs. In 1995, the International Federation of Red Cross and Red Crescent Societies and the Estonian Red Cross launched a mass vaccination campaign targeting the adult population. By the end of 1997, it was estimated that 46% of adults had received at least one dose of vaccine. Although the vaccination campaigns did not target the pediatric population, vaccination coverage in school-aged children remained high due to continuing routine vaccination programs. The reappearance and epidemic of clinical diphtheria cases and the mass vaccination campaign efforts demonstrated that preventive measures are important and must be maintained in order to keep diphtheria under control.     

同型半胱氨酸对Kkay小鼠糖尿病肾病作用机制的探讨

目的 探讨基质金属蛋白酶-9(MMP-9)在同型半胱氨酸(Hcy)加重糖尿病肾病(DN)过程中的可能作用。方法 22～24周龄Kkay糖尿病鼠16只随机分两组:糖尿病组(KA)和高蛋氨酸组(KB),每组8只;C57BL/6小鼠9只为对照组(C57),以相应饲料喂养4个月后取材。测定血糖和血Hcy水平,以PAS染色观察各组肾组织肾小球病理改变,比较肾小球硬化指数(GI)。对肾脏MMP-9表达进行免疫组化染色和半定量图像分析,并以逆转录PCR检测。肾脏MMP-9 mRNA的表达水平。结果 与C57对照组相比,Kkay两组均有不同程度糖尿病肾病病变,其中KB组病变更重,其GI值(283.33)高于KA组(240.00),P<0.05。免疫组化显示KB组肾小球MMP-9阳性着色面积(15.90％)高于KA组(11.14％),P<0.05,MMP-9 mRNA表达水平KB组高于KA组。结论 高Hcy血症具有加重Kkay小鼠糖尿病肾病程度的作用,此作用可能与上调MMP-9的表达水平有关。     

Establishment of reference values for standard dose short synacthen test (250 microgram), low dose short synacthen test (1 microgram) and insulin tolerance test for assessment of the hypothalamo-pituitary-adrenal axis in normal subjects

OBJECTIVE: To assess the integrity of the hypothalamo-pituitary-adrenal(HPA) axis, many authors have proposed the short synacthen test (ACTH1-24, Tetracosactrin) as a replacement for the insulin tolerance test (ITT). The aim of this study was to compare the plasma cortisol response obtained with both short synacthen tests (high dose (HDT, 250 microgram) and low dose (LDT, 1 microgram)) with the peak reached during the ITT in healthy volunteers, and to establish the plasma cortisol cut-off level in each test. SUBJECTS AND METHODS: Thirty healthy subjects (16 F, 14 M), mean age 34 years, underwent both short synacthen tests. Twenty healthy subjects, 15 of whom (11 F, nine M) belonged to the above group, mean age 30 years, underwent an ITT. Plasma cortisol was measured using a chemiluminiscence immunoassay. RESULTS: There were no differences between plasma cortisol 30 minutes after both short synacthen tests (HDT: 684 +/- 123, LDT: 669 +/- 119 nmol/l) and the peaks reached with the LDT (691 +/- 123 nmol/l) and the ITT (673 +/- 99 nmol/l).The only difference (P < 0.001) was found in the comparison of plasma cortisol peak reached with the HDT (802 +/- 142 nmol/l) with the other tests. Plasma cortisol levels obtained in the 5th percentile in each test were: at + 30 minutes: (HDT: 537, LDT: 489 nmol/l), peak: (HDT 649, LDT 498, ITT: 539 nmol/l). CONCLUSIONS: Comparison of the plasma cortisol response at + 30 minutes with both short ACTH tests and the peak in the insulin tolerance test did not reveal differences. Each test, for each time point and for each biochemical method, requires its own minimum threshold of normality to assess the hypothalamo-pituitary-adrenal axis.     

A comparison between low-dose (1 µg), standard-dose (250 µg) ACTH stimulation tests and insulin tolerance test in the evaluation of hypothalamo–pituitary–adrenal axis in primary fibromyalgia syndrome

OBJECTIVE: Primary fibromyalgia syndrome (PFS) is a nonarticular rheumatological syndrome characterized by disturbances in the hypothalamo-pituitary-adrenal (HPA) axis. The site of the defect in the HPA axis is a matter of debate. Our aim was to evaluate the HPA axis by the insulin-tolerance test (ITT), standard dose (250 microg) ACTH test (SDT) and low dose (1 microg) ACTH test (LDT) in patients with PFS. DESIGN AND PATIENTS: Sixteen patients (13 female, three male) with PFS were included in the study. Sixteen healthy subjects (12 female, four male) served as matched controls. ACTH stimulation tests were carried out by using 1 microg and 250 microg intravenous (i.v.) ACTH as a bolus injection after an overnight fast, and blood samples were drawn at 0, 30 and 60 min. The ITT was performed by using i.v. soluble insulin, and serum glucose and cortisol levels were measured before and after 30, 60, 90 and 120 min. The 1 microg and 250 microg ACTH stimulation tests and the ITT were performed consecutively. RESULTS: Peak cortisol responses to both the low dose test (LDT) and standard dose test (SDT) (589 +/- 100 nmol/l; 777 +/- 119 nmol/l, respectively) were lower in the PFS group than in the control group (1001 +/- 370 nmol/l; 1205 +/- 386 nmol/l, respectively) (P < 0.0001). Peak cortisol responses to ITT (730 +/- 81 nmol/l) in the PFS group were lower than in the control group (1219 +/- 412 nmol/l) (P < 0.0001). Six of the 16 patients with PFS had peak cortisol responses to LDT lower than the lowest peak cortisol response of 555 nmol/l obtained in healthy subjects after LDT. There was a significant difference between the peak cortisol responses to LDT (589 +/- 100 nmol/l) and peak cortisol responses to ITT (730 +/- 81 nmol/l) in the PFS group (P < 0.0001). Peak cortisol responses to SDT (777 +/- 119 nmol/l) were similar to peak cortisol responses to ITT (730 +/- 81 nmol/l) in the PFS group. CONCLUSION: We conclude that the perturbation of the HPA axis in PFS is characterized by underactivation of the HPA axis. Some patients with PFS may have subnormal adrenocortical function. LDT is more sensitive than SDT or ITT in the investigation of the HPA axis to determine the subnormal adrenocortical function in patients with PFS.     

1992-2009年广西壮族自治区北海市疟疾监测结果

目的 了解广西壮族自治区北海市1992-2009年消除疟疾后期疟疾流行现状.方法 用描述流行病学方法分析北海市疟疾监测资料.收集北海市疾病预防控制中心保存的疟疾监测资料和有关记录,包括该市1992-2009年疟疾病例的疫情报告、个案调查和血检相关资料,统计分析这些资料的血检数、病例数、血检率和阳性率等指标.结果 199...     

Dehydroepiandrosterone, 17alpha-hydroxyprogesterone and aldosterone responses to the low-dose (1 micro g) ACTH test in subjects with preclinical adrenal autoimmunity

OBJECTIVE: The appearance of 21-hydroxylase autoantibodies (21OHAbs) identifies subjects with preclinical adrenal insufficiency. In 21OHAb-positive subjects, the adrenocortical function is best evaluated by peak cortisol (F) levels after the low-dose (1 micro g) ACTH stimulation test (LDT). No information is currently available on the correlation between F and other adrenocortical hormone responses to the LDT in subjects with an ongoing autoimmune adrenal process. In this study, we tested the hypothesis that the dehydroepiandrosterone (DHEA), 17alpha-hydroxyprogesterone (17OHP) and aldosterone (A) responses to the LDT are consensual to that of F during the preclinical phase of autoimmune adrenal insufficiency. DESIGN AND PATIENTS: We studied 12 subjects positive for 21OHAb, in the absence of clinical signs of adrenal insufficiency. On the basis of peak F levels after the LDT, and according to the lower level of normal observed in 15 healthy volunteers (510.4 nmol/l), patients were subdivided into two groups: group A, n = 6 subjects with normal F response; and group B, n = 6 subjects with impaired F response. Results were expressed as absolute delta increase (Delta) between peak and basal levels. RESULTS: DeltaF was significantly higher in group A (314.5 +/- 115.8 nmol/l) than in group B (151.7 +/- 88.2 nmol/l) (P = 0.041). DeltaDHEA and Delta17OHP were also significantly higher in group A (17.0 +/- 13.5 nmol/l and 6.1 +/- 4.4 nmol/l, respectively) than in group B (0.69 +/- 2.25 nmol/l and 1.9 +/- 1.7 nmol/l, respectively) (P = 0.002 and P = 0.041). The difference in DeltaA between the two groups did not reach statistical significance (group A 321.8 +/- 272.0 pmol/l vs. group B 157.0 +/- 154.0 pmol/l). DeltaDHEA, Delta17OHP and DeltaA tended to correlate positively with DeltaF (P = 0.039, P = 0.039 and P = 0.044, respectively), but the correlations did not reach significance after correction of the P-value. CONCLUSIONS: Our study demonstrates a high concordance between F and DHEA, 17OHP and A responses to the LDT in subjects with preclinical adrenal autoimmunity, thus strengthening the concept that the LDT is an accurate test to identify early adrenal dysfunction.     

湖南省1990-1999年钉螺面积变化情况分析

目的对湖南省1990-1999年10年间的钉螺面积变化趋势进行分析.方法收集1990-1999年湖南省血吸虫病各疫区上报有关钉螺面积的报表资料,作统计分析.结果10年间除1992、1993和1994年3年未发现新的流行区外,其余每年均有新流行区被发现,其中新发现流行村以1996和1998年较多,分别为30个和52个,新发现的流行乡以1998年最多,为11个;10年间全省查出的有螺面积从1990年至1994年呈下降趋势,以后呈增长势头,以1996、1998年增幅较多,1996年比1995年增长了2.54%;1998年比1997年增长1.56%;10年中灭螺面积除1992年有上升之外,总的呈下降趋势,至1999年灭螺面积为1700万m2,比1990年下降了54.20%;垸外灭净钉螺面积除1991年超过垸内之外,其余各年均低于垸内,从1996年起垸外灭净钉螺面积为0.垸内灭净钉螺面积在10年中以1998年最多,为246.2万m2.结论我省钉螺面积近年来有增长的趋势,并且有向城市逼近的特点,引起钉螺面积增长的重要原因之一可能是特大的洪灾造成部分堤垸溃决和渍水,引起钉螺不同程度的扩散所致.垸内灭螺能对控制垸内钉螺面积的增长起到一定的作用.     

A study of total serum alkaline phosphatase activity in men following partial gastrectomy

Total serum alkaline phosphatase (SAP) activity has been measured in 463 men with partial gastrectomy (Polya type), and in a control group of 271 men with vagotomy with pyloroplasty or gastroenterostomy.

An analysis of variance of the values in the range of 3·0 to 11·5 KA units/100 ml showed that the enzyme serum activity is influenced by three independent factors: age, ABO blood group, and the type of operation. Marginally raised levels (12·0-17·0 KA units/100 ml) were found to be affected by the same factors, and it was concluded that these levels do not, usually, indicate either bone or liver disease. In 18 men the total serum alkaline phosphatase was over 17·0 KA units: 16 had Paget's disease of bone, and two had liver disease.