河南省人体重要寄生虫病流行现状调查与分析

目的掌握河南省人体重要寄生虫病流行现状。方法按照《全国人体重要寄生虫病现状调查》实施细则制定的方法和要求,抽取17个县51个调查点进行肠道寄生虫调查,10个县20个点进行旋毛虫病调查,10个县30个点进行囊虫病调查,5个县进行弓形虫病调查,1个县进行包虫病调查,2个县进行黑热病媒介白蛉调查。结果肠道寄生虫感染调查25 894人,总感染率为14.96%(3 873/25 894),其中蠕虫感染率为9.80%(2 537/25 894),原虫感染率为6.61%(1 609/24 348)。查出肠道寄生虫29种,其中蠕虫18种,原虫11种。人群血清学调查,旋毛虫、囊虫、包虫和弓形虫抗体阳性率分别为2.97%(300/1 0103)、0.05%(1/2 200)、0.60%(6/1 007)和4.64%(216/4 660);黑热病媒介调查2个县,发现2种白蛉,共317只,中华白蛉占98.42%(312/317)。结论河南省人群肠道寄生虫感染率较10年前显著下降,但不同地区流行情况仍有较大差异,低年龄组仍是寄生虫感染的高危人群。人群旋毛虫和囊虫感染率较低,弓形虫感染率相对较高,包虫病仅有局部发病灶点。     

2015年河南省秦巴山地生态区人体肠道寄生虫感染现状调查

目的　了解河南省秦巴山地生态区人体肠道寄生虫病流行现状,为该地区寄生虫病防治提供科学依据。方法　2015年按照《全国人体重点寄生虫病现状调查实施细则》的要求进行抽样,选取河南省秦巴山地生态区8个县（市）的26个调查点进行土源性线虫、带绦虫和肠道原虫感染调查,采用改良加藤厚涂片法（Kato?Katz法）检测肠道蠕虫卵,采用试管滤纸培养法鉴别十二指肠钩虫与美洲钩虫,采用透明胶纸肛拭法检查3 ~ 6岁儿童蛲虫卵和带绦虫卵,采用碘液直接涂片法检测肠道原虫滋养体和包囊。分析不同人群肠道寄生虫感染情况及其相关影响因素。结果　共检查6 706人,检出8种寄生虫,其中蠕虫3种、原虫5种,肠道寄生虫总感染率为3.39%,蠕虫和原虫感染率分别为2.92%和0.49%,3 ~ 6岁儿童肛拭蛲虫感染率为3.93%。查出的3种蠕虫分别为蛔虫、蛲虫和枝双腔吸虫,其中蛲虫感染率最高,为2.68%（[χ2] = 306.362,P < 0.05）;5种原虫分别为哈门氏内阿米巴、结肠内阿米巴、微小内蜒阿米巴、蓝氏贾第鞭毛虫和人芽囊原虫,其中微小内蜒阿米巴感染率最高,为0.24%（[χ2] = 23.842,P < 0.05）。8个县（市）中蠕虫感染率最高的地区为汝阳县（13.47%）,主要为蛲虫感染;原虫感染率最高的地区为新安县（1.55%）,主要为微小内蜒阿米巴感染;各县（市）蠕虫（[χ2] = 357.525,P < 0.05）和原虫感染率（[χ2] = 38.795,P < 0.05）差异均有统计学意义。男、女性蠕虫感染率差异无统计学意义([χ2] = 0.034,P > 0.05),但男性肠道原虫感染率高于女性([χ2] = 12.946,P < 0.05)。0 ~ 9岁年龄组人群蠕虫感染率最高（6.60%）,以蛲虫感染为主([χ2] = 62.600,P < 0.05)。肠道寄生虫总感染率在各民族间差异无统计学意义（[χ2] = 0.212,P > 0.05）。蠕虫在学龄前儿童中感染率最高（8.43%）,主要为蛲虫感染;蛔虫感染主要发生于农民,感染率为0.31%;不同职业人群蠕虫感染率差异有统计学意义([χ2] = 84.333,P < 0.05)。文盲人群肠道寄生虫感染率最高（7.63%）,不同文化程度人群肠道寄生虫感染率差异有统计学意义([χ2] = 72.013,P < 0.05)。平原地区人群肠道蠕虫感染率高于丘陵和山区([χ2] = 11.690,P < 0.05)。低收入人群肠道蠕虫感染率最高,为10.32% ([χ2] = 244.999,P < 0.05);原虫感染率最高的人群为年人均收入6 000 ~ 7 999元的中等收入人群([χ2] = 24.749,P < 0.05)。饮用井水人群蠕虫感染率远高于饮用自来水人群([χ2] = 62.255,P < 0.05),未进行集体驱虫人群原虫感染率高于驱虫人群([χ2] = 5.235,P < 0.05)。结论　河南省秦巴山地生态区人体肠道寄生虫感染率呈明显下降趋势,儿童蛲虫感染应成为今后该地区寄生虫病防治的重点。     

河南省农村儿童肠道寄生虫病流行现状及影响因素分析

目的　了解河南省农村儿童肠道寄生虫病流行现状及影响因素。方法　2014–2015年按照《全国人体重点寄生虫病现状调查实施细则》的要求，根据河南省不同生态区划分及经济水平确定调查县（市），根据被调查县（市）地形和经济水平等因素分层，每层随机抽取1个乡（镇）、每个乡（镇）随机抽取1个自然村作为调查点，共选取35个县（市）的104个点开展儿童肠道寄生虫病现状调查。每个调查点至少收集250份被调查者的新鲜粪样，采用改良加藤厚涂片（Kato?Katz）法检查肠道蠕虫卵，采用试管滤纸培养法鉴别美洲钩虫与十二指肠钩虫，应用生理盐水和碘液直接涂片法查肠道原虫滋养体和包囊；同时对3 ~ 6岁儿童采用透明胶纸肛拭法检查蛲虫卵和带绦虫卵。结果　河南省农村儿童肠道寄生虫感染率为3.21%（214/6 671），肠道蠕虫感染率（2.62%，175/6 671）高于原虫（0.60%，40/6 671）。共检出12种肠道寄生虫，其中肠道线虫4种、吸虫1种、原虫7种；所有检出虫种中以蛲虫感染率最高，为2.47%（161/6 671）。全省4个生态区中，秦巴山地生态区儿童肠道寄生虫感染率最高，为5.85%（90/1 538）。男、女儿童肠道寄生虫感染率差异无统计学意义（P > 0.05），不同年龄组（[χ2] = 32.762，P < 0.05）和文化程度（[χ2] = 67.507，P < 0.05）儿童肠道寄生虫感染率差异均有统计学意义，且各年龄组均以蛲虫感染为主。多因素非条件logistic回归分析结果显示，文化程度高、无害化厕所覆盖率高、饮用自来水及集体驱虫是儿童感染肠道寄生虫的保护因素。本次调查河南省农村儿童肠道寄生虫总感染率明显低于首次全国人体寄生虫分布调查和全国人体重要寄生虫病现状调查中河南省的相关数据，呈逐渐下降趋势。结论　河南省农村儿童肠道寄生虫感染率呈明显下降趋势，蛲虫应成为今后河南省农村儿童肠道寄生虫病的防治重点。     

云南省人体肠道寄生原虫分布调查

于１９８７－１９９０年，我们应用分层整群随机抽样的方法，对云南省２８个县１０３个点进行了人体肠道寄生虫调查，每县查３－５个点，每点５００人，共检查５３０６１人。全省寄生虫总感染率为７６．３％，其中查见肠道原虫１０种，包括溶组织内阿米巴（２．５％）、贾第虫（２．５％）、结肠内阿米巴（６．２％）、哈氏内阿米巴（２．１％）、微小内蜒阿米巴（５．２％）、布氏嗜碘阿米巴（１．７％）、人芽囊原虫（７．０％）、隐孢子虫（２．３％，２／８７）、人毛滴虫和等孢球虫。并对溶组织内阿米巴、贾第虫和人芽囊原虫３种致病性原虫的人群的地理分布及其流行因素进行讨论。     

安徽省肠道原虫病流行病学研究进展

肠道原虫病是人体常见的肠道寄生虫病,安徽省肠道原虫病种类多样,流行范围广。 ２０１４ ～２０１５ 年的全省人体寄生虫感染调查显示,安徽省人体肠道原虫病的总体感染率约为 ０． ４６％ ,按全省人口总数推算感染者人数接近 ３０ 万。 目前安徽省人群肠道原虫感染率已经超过除钩虫以外的其它肠道蠕虫的感染率总和,成为我省仅次于钩虫病的主要肠道寄生虫病。 本文结合近年来有关文献资料对安徽省肠道原虫病的流行病学研究进展进行了综述。     

河南省农村儿童肠道寄生虫病流行现状及影响因素分析

目的　了解河南省农村儿童肠道寄生虫病流行现状及影响因素。方法　2014–2015年按照《全国人体重点寄生虫病现状调查实施细则》的要求,根据河南省不同生态区划分及经济水平确定调查县（市）,根据被调查县（市）地形和经济水平等因素分层,每层随机抽取1个乡（镇）、每个乡（镇）随机抽取1个自然村作为调查点,共选取35个县（市）的104个点开展儿童肠道寄生虫病现状调查。每个调查点至少收集250份被调查者的新鲜粪样,采用改良加藤厚涂片（Kato?Katz）法检查肠道蠕虫卵,采用试管滤纸培养法鉴别美洲钩虫与十二指肠钩虫,应用生理盐水和碘液直接涂片法查肠道原虫滋养体和包囊;同时对3 ~ 6岁儿童采用透明胶纸肛拭法检查蛲虫卵和带绦虫卵。结果　河南省农村儿童肠道寄生虫感染率为3.21%（214/6 671）,肠道蠕虫感染率（2.62%,175/6 671）高于原虫（0.60%,40/6 671）。共检出12种肠道寄生虫,其中肠道线虫4种、吸虫1种、原虫7种;所有检出虫种中以蛲虫感染率最高,为2.47%（161/6 671）。全省4个生态区中,秦巴山地生态区儿童肠道寄生虫感染率最高,为5.85%（90/1 538）。男、女儿童肠道寄生虫感染率差异无统计学意义（P > 0.05）,不同年龄组（[χ2] = 32.762,P < 0.05）和文化程度（[χ2] = 67.507,P < 0.05）儿童肠道寄生虫感染率差异均有统计学意义,且各年龄组均以蛲虫感染为主。多因素非条件logistic回归分析结果显示,文化程度高、无害化厕所覆盖率高、饮用自来水及集体驱虫是儿童感染肠道寄生虫的保护因素。本次调查河南省农村儿童肠道寄生虫总感染率明显低于首次全国人体寄生虫分布调查和全国人体重要寄生虫病现状调查中河南省的相关数据,呈逐渐下降趋势。结论　河南省农村儿童肠道寄生虫感染率呈明显下降趋势,蛲虫应成为今后河南省农村儿童肠道寄生虫病的防治重点。     

2014年江西省人体重点寄生虫感染现状

目的 了解和分析江西省重点寄生虫病的流行现状,并为制定全省“十三五”规划提供科学依据。方法 按照2014年全国第3次人体重点寄生虫感染现状调查方案,结合江西省具体情况开展调查。其中土源性线虫和肠道原虫调查以生态区为基础,按照经济条件和地理方位进行分层整群抽样;华支睾吸虫的调查在农村地区与土源性线虫调查一并进行,在城镇地区以随机整群抽样法进行调查。 结果 在全省32个县的92个调查点共计调查了23 606人,其中21 569人接受了肠道原虫检查,1 486名儿童接受了蛲虫卵检查。全省共查出肠道寄生虫20种,感染率为9.64%,推算全省肠道寄生虫感染者约429.6万人。儿童蛲虫感染率为13.73%,华支睾吸虫感染率为0.58%,肠道原虫感染率为1.42%,目标人群弓形虫阳性率为7.50%。 结论 江西省人群土源性线虫感染率呈下降趋势,华支睾吸虫感染率在局部地区明显上升,全省寄生虫病防治工作仍需加强。     

对人体寄生虫分布调查的几点看法

在防治危害人民健康最严重的血吸虫病、疟疾、丝虫病及黑热病取得令人鼓舞的成就之际,卫生部从全面关怀人民健康出发,于1987年秋由卫生防疫司组织开展全国人体寄生虫分布调查。两年来获得了预期的进展。调查内容以寄生肠道的原虫及蠕虫为主,在有地方性流行线索的地区,还包括了除前述几种寄生虫以外的虫种,如包虫、猪囊虫、旋毛虫、并殖吸虫等。这一大规模调查,体现了我国卫生领导的远见卓识。由于肠道寄生虫,特别是土源性蠕虫的高度感染总是和生活条件落后有关,因此人群中肠道寄生虫的     

河北省农村人群肠道蠕虫感染调查

目的 了解河北省农村人群肠道蠕虫的感染现状，为今后寄生虫病的防治提供科学依据。方法 选择6个县15个1990年全国人体寄生虫分布调查中签点，按照《全国人体重要寄生虫病现状调查方案和实施细则》的要求和方法，于2002年进行人体肠道蠕虫感染状况的调查。结果15个调查点粪检7316人，共检出5种肠道蠕虫虫卵，其中蛔虫感染117例，感染率1．60％；鞭虫感染7例，感染率0．10％；钩虫感染4例，感染率0．05％；东方毛圆线虫感染3例，感染率0．04％；粪便检出蛲虫卵4例。采用透明胶纸肛拭法检查683名12岁以下儿童，检出蛲虫感染134例，感染率19，62％。结论 本次调查结果与第一次人体寄生虫分布调查相比，蛔虫感染率下降幅度最大，下降了94．97％，鞭虫和钩虫也有较大幅度下降，但12岁以下儿童蛲虫感染率仍为19．62％，仅下降了26．43％，说明目前河北省12岁以下儿童蛲虫感染仍然比较严重，今后应加强儿童的蛲虫病防治工作。     

贵州省人体重要寄生虫病现状调查与分析

目的掌握贵州省重要寄生虫病流行分布现状。方法按照《全国重要人体寄生虫病现状调查实施细则》要求进行。结果土源性线虫病调查30个点15 958人,感染率为47.52%,其中蛔虫、钩虫、鞭虫、蛲虫感染率分别为42.41%、4.71%、10.77%和1.67%。绦/囊虫病调查16个点,其中问卷调查17 889人,无确诊绦虫病人;血清学检查6 669人,阳性16人,阳性率0.24%。华支睾吸虫病调查9个点5 195人,粪检虫卵阳性2人,感染率0.04%。包虫病调查2个点1041人,血清学阳性率8.26%;弓形虫病调查10个重点人群及3个点共4 933人,血清学阳性率16.81%。黑热病调查3个点1 442人,未发现患者或疑似患者,调查地亦未发现白蛉。结论与1991年全国首次人体寄生虫分布调查结果相比,贵州省人体土源性线虫感染率明显下降,但感染率水平仍较高,并存在食源性寄生虫及弓形虫等感染。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.