健康青年感染柯萨奇病毒血清流行病学调查

目的了解健康青年人群柯萨奇病毒(CA)IgG抗体的流行分布情况,为今后预防CA感染提供科学依据。方法采用血清流行病学调查方法,利用酶联免疫吸附试验(ELISA)技术,对本部近8年来自16个省市的364名入伍新兵血清进行了CA-IgG抗体检测并进行统计分析。结果入伍自16个省市,2001年至2008年期间的364名新兵,显示陕西省(13.04%)、河北省(9.09%)、湖南省(9.09%)和山东省(8.70%)各检测出2～3例抗体阳性者,其余12个省检测阳性率较低或为阴性,阳性率0～13.04%,平均阳性率为4.12%,入伍前工作与否,其抗体阳性检出率差异无统计学意义。结论目前,健康青年人群对CA高度易感,应重视CA预防工作。     

入伍新兵呼吸道合胞病毒血清学调查结果分析

目的了解入伍新兵呼吸道合胞病毒(RSV)IgG抗体水平,为预防RSV感染提供科学依据。方法采用血清流行病学调查方法,利用酶联免疫吸附试验(ELISA),对随机抽取的2001～2008年364名入伍新兵血清进行RSVIgG抗体检测,并进行统计分析。结果 364名新兵血清RSV抗体阳性57人,阳性率15.66%;2001～2008年各年度阳性率6.52%～28.89%,差异有统计学意义(χ2=21.006,P<0.05);被调查新兵来自16个省市,其中天津(47.83%)、广西(39.13%)、山东(34.78%)和甘肃(21.74%)来源新兵RSV抗体阳性率较高,其余省市相对较低,差异有统计学意义(χ2=72.323,P<0.05);入伍前工作与否者抗体阳性率差异无统计学意义(χ2=0.170,P>0.05)。结论入伍新兵RSV抗体水平较低,且存在显著的地区和年度差异,应引起高度重视。     

新兵流行性腮腺炎病毒抗体水平回顾性调查

目的了解入伍新兵人群腮腺炎病毒(MuV)抗体阳性分布情况。方法采用酶联免疫吸附试验(ELISA)方法,对随机抽取的2001~2008年364份入伍新兵血清样品进行MuV IgG抗体检测分析。结果 364份血清样品中,MuV抗体阳性249份,阳性率68.41%,各年度抗体阳性率为53.33%~80.44%;新兵MuV抗体阳性地区以黑龙江省(95.65%)、天津市(86.96%)、广东省(86.96%)和云南省(86.36%)较高,内蒙古自治区(34.78%)、四川省(39.13%)和山西省(47.83%)较低;新兵入伍前工作与否抗体阳性率差异无统计学意义。结论入伍新兵MuV抗体阳性率较低,并呈地区性差异,建议在入伍检疫期间对新兵进行免疫接种。     

2009年邯郸市手足口病血清流行病学调查

目的掌握2009年邯郸市0～15岁儿童EV71IgG和CoxA16IgG携带状况,探讨发病率与抗体的关系。方法采用酶联免疫吸附试验(ELISA)检测0～15岁儿童血清EV71IgG和CoxA16IgG,分析EV71IgG、CoxA16IgG阳性率随年龄的变化趋势及其与手足口病发病率间的关系。结果 2009年邯郸市报告HFMD病例19 457例,567例HFMD病例标本中450份肠道病毒核酸阳性,其中EV71 302份(占67.11%),CoxA16 75份(占16.67%)。采集856名儿童血清,EV71IgG阳性546例,阳性率63.79%;CoxA16IgG阳性579例,阳性率67.64%,差异无统计学意义(χ2=1.309,P>0.05)。儿童血清EV71IgG和CoxA16IgG阳性率呈负相关(r=-0.900),5岁以下儿童血清EV71IgG阳性率与2009年HFMD发病率呈正相关关系(r=0.852),CoxA16IgG阳性率与发病率呈负相关关系(r=-0.816)。结论 2009年邯郸市CoxA16和EV71均有流行,病例以EV71型为主。     

深圳市龙岗区肠道病毒71型抗体水平调查

目的了解深圳市龙岗区儿童肠道病毒71型(EV71)抗体水平及自然感染状况,为预防控制儿童手足口病传播与流行提供依据。方法 2012年6月采集528名0～5岁儿童血清标本,采用酶联免疫法检测血清中的EV71IgG。结果 2008～2011年深圳市龙岗区共报告手足口病28 847例,年龄11d～50岁,5岁以下幼儿占总病例数的89.40%(25789/例)。528名儿童中EV71IgG抗体阳性241例,阳性率为45.64%;<1岁龄的婴儿IgG抗体阳性率最低;男童IgG抗体阳性率为46.18%,女童为44.93%,差异无统计学意义(χ2=0.37,P>0.05)。结论 5岁以下幼儿特别<1岁龄的婴儿是应手足口病防控的重点人群。     

河南省肠道病毒71型(EV71)血清流行病学调查

目的通过检测河南省0～12岁健康儿童、手足口病痊愈病人、手足口病现症病人血清肠道病毒71型(EV71)抗体水平,了解手足口病优势病毒株EV71人群感染情况,为预防控制手足口病等提供科学依据。方法在河南省不同地区采集0～12岁健康儿童、手足口病痊愈病人和手足口病现症病人血清共226份,采用微量中和滴定法检测抗EV71抗体。结果健康儿童、手足口病痊愈病人和手足口病现症病人血清EV71中和抗体阳性率分别为51.46%、92.96%和55.77%,差异有统计学意义(P0.05),EV71几何平均滴度(GMT)分别为11.13(8.83～13.99)、66.51(52.09～84.97)和21.93(14.32～33.57),差异有统计学意义(P0.05)。结论手足口病流行地区健康儿童血清EV71中和抗体阳性率较高,EV71阴性感染较普遍。手足口病康复病人能够产生较高滴度的免疫保护性抗体,对EV71病毒再次感染具有一定的保护作用。     

2010年福建省肠道病毒71型血清流行病学调查

目的 了解经过2008及2009年手足口病流行之后,福建省普通人群血清肠道病毒71型的抗体水平。方法 采集2010年福建省390名普通人群的血清标本,采用中和试验检测血清EV71中和抗体。结果 390名普通人群中和抗体阳性186人,阳性率47.69%。男女性别之间中和抗体阳性率及抗体滴度均没有统计学差异(χ²=0.42,P=0.52>0.05;U=-0.24,P=0.81>0.05)。各个年龄组之间的抗体阳性率及抗体滴度均有统计学差异(χ²=55.69,P=0.00<0.05;H_C=50.36, P=0.00<0.05),抗体阳性率最低的为0~岁年龄组,为16.67%,抗体阳性率随年龄增大而增高。0~4岁年龄组的抗体阳性率为25.33%,5~年龄组的抗体阳性率为61.67%,两者之间的抗体阳性率及抗体滴度均有统计学差异(χ²=48.85, P=0.00<0.05;U=-6.39,P=0.00<0.05)。结论 经过2008及2009年手足口病流行之后,福建省普通人群血清肠道病毒71型的抗体水平仍较低,特别是0~4岁年龄组的儿童。今后福建省仍会出现EV71作为主要病原体之一引起的手足口病疫情,易感人群仍为5岁组以下儿童,应继续加强监测和防控。     

入伍新兵包虫感染血清流行病学调查

采用酶联免疫吸附试验（ELISA）：方法检测360份入伍新兵血清包虫IgG抗体,阳性10份,阳性率2．78％;江西、甘肃和四川籍新兵包虫抗体阳性率分别为7．50％、4．65％和4．48％,湖北、河南和广西籍新兵未检出包虫IgG抗体阳性者。     

2015年宿州市324例手足口病病原检测结果分析

【摘要】 目的  了解2015年宿州市手足口病病原学流行特征,为制订手足口病防控方案提供依据。 方法  采用Real-time RT-PCR方法检测肠道病毒71型（EV71）、柯萨奇病毒A组16型(CoxA16)的特异性核酸及其它肠道病毒核酸（非EV71和非CoxA16）。 结果  324份手足口病临床诊断病例标本,肠道病毒核酸总阳性137份,阳性率42.3%。EV71阳性35份,阳性率10.8%（35/324）,阳性构成比为25.5%（35/137）;CoxA16阳性26例,阳性率8.0%（26/324）,阳性构成比为19.0%（26/137）;其他肠道病毒（非EV71和非CoxA16）76份,阳性率23.5%（76/324）,阳性构成比为55.5%（76/137）。男女比为1.6︰1,男性和女性阳性率分别为43.4%(86/198)和39.7%（50/126）,男女阳性检出率差异无统计学意义(χ2=0.445,P>0.05);发病年龄组以0~3岁为主;1月及4~7月为发病高峰,阳性检出率均超过50%。 结论  2015年宿州市手足口病发病高峰在春夏季,3岁以下儿童为高发病人群,其流行型别以其他肠道病毒（非EV71和非CoxA16）为主,同时伴有EV71和CoxA16。     

玉溪市肠道病毒EV71型感染流行病学调查

目的了解玉溪市人群EV71病毒感染状况,为防制手足口病提供科学依据。方法采用容量比例概率抽样法(PPS法)对玉溪市峨山、新平县6个乡镇18个行政村人群按年龄分配随机调查。并对调查人群采集静脉血液标本进行EV71抗体检测。结果共调查788人,EV71病毒抗体(EV71-IgG)阳性率为41.37%,不同年龄组EV71-IgG抗体阳性率差异有统计学意义(χ2=42.24,P0.05),其中5~6岁人群阳性率最高为64.00%,1岁婴儿阳性率最低为20.65%;不同民族EV71-IgG抗体阳性率有显著差异(χ2=13.89,P0.05),彝族相对较高为46.67%,哈尼族最低为21.11%;性别间阳性率差异有统计学意义(χ2=5.63,P0.05),女性高于男性。结论玉溪市人群对手足口(EV71)病原普遍易感,做好人群手足口病防制仍然是今后的工作重点。     

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。     

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。     

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。     

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.