广西人体华支睾吸虫感染现状调查分析

目的了解广西人群华支睾吸虫病流行现状和态势。方法按流行程度和水系流域进行分层整群随机抽样。用改良加藤厚涂片法粪检虫卵并计数。结果调查了9个县(市)27个点13990人,华支睾吸虫平均感染率为9.76%,平均EPG为1083,有6个县(市)查出感染者,其中3个县感染率超过20%。男性平均感染率和EPG分别为13.09%和1320;女性分别为5.89%和658,差异均有显著性。各年龄组人群均有感染,以成人感染为重。蒙古族居民感染率最高,为16.67%;汉族感染率为11.56%,高于壮族的8.17%;壮族感染者EPG最高,为1470。职业分布以医生、教师、农民和行政干部感染为重。结论1989年以来广西华支睾吸虫感染率显著上升,疫情快速蔓延,已经成为一个严重的公共卫生问题,应积极开展综合性防治工作。     

应用两级催化模型分析广西两县居民华支睾吸虫病的感染状况

目的了解广西横县和上林县居民华支睾吸虫病的感染情况。方法应用改良加藤法确诊华支睾吸虫感染者,应用两级催化模型对居民华支睾吸虫感染情况进行分析。结果两县居民华支睾吸虫感染率为56.51%,其中40～年龄组感染率最高,为70.37%,各年龄组间感染率差异有统计学意义。居民华支睾吸虫感染率的两级催化模型曲线方程为y^=1.36（e-0.012t-e-0.045t）,感染力a值为0.045,失去感染力b值为0.012,每年分别有4.5%的新增感染者和1.2%的感染者转阴,感染率最高的理论年龄c值为40.05岁。结论经χ2检验认为两级催化模型拟合良好,华支睾吸虫传播速度较快且阴转慢,人群感染华支睾吸虫维持在一个比较高的水平。     

我国华支睾吸虫病流行区感染现状调查

目的 了解我国华支睾吸虫病流行区的感染现状。 方法 2002-2004年对全国27个省（市、区）按不同流行程度和水系流域进行分层整群随机抽样,对样本人群采用改良加藤厚涂片法检查华支睾吸虫虫卵（一粪三检）。 结果 调查217 829人,检出华支睾吸虫感染者5 230例,感染率为2.40%,推算全国华支睾吸虫感染者约为1 249万。平均每克粪便含虫卵2 208个,低、中、高度感染构成比分别为78.93%、17.40%和3.67%。19个省（市、区）查出感染者,感染率居前3位的是广东（16.42%,2 278/13 876）、广西（9.75%,1 365/13 990）和黑龙江（4.72%,636/13 458）。男性平均感染率（2.94%,3 267/111 262）高于女性（1.84%,1 963/106 567）。各年龄组均有感染,其中50～59岁年龄组感染率最高（9.16%）。华支睾吸虫感染存在职业差异,以商人感染率最高（13.42%,124/924）、其次为工人（7.9%,298/3 773）和离退休人员（5.28%,70/1 327）。在以食生鱼片为主要感染方式的地区,成人感染为主,其他地区则以儿童为主。不同地形间感染率亦有差异,水网地区感染率最高（5.23%,687/13 125）,其次为丘陵地区（2.34%,1 111/47 552）。采用二项分布拟合法分析,发现华支睾吸虫感染具家庭聚集性。 结论 华支睾吸虫病在我国流行范围广、感染率高,呈地方性分布,成年男性感染率高,具家庭聚集性。     

广西梧州市人群华支睾吸虫感染情况调查

目的 了解梧州市华支睾吸虫感染情况,探讨华支睾吸虫病感染方式、途径等流行病学特征,为开展华支睾吸虫病防控提供科学依据.方法 根据梧州市地理方位、居民生活习惯选择万秀、长洲和蝶山三个城区作为调查点,用改良加藤氏厚涂片法粪检华支睾吸虫虫卵,阳性者计算克粪虫卵数( eggs per garm of faces,EPG).结果 共调查3 078人,华支睾吸虫平均感染率为4.48％.其中万秀区感染率为6.45％;长洲区感染率为4.23％;蝶山区感染率为2.79％.男性和女性的感染率分别是6.13％和2.74％.所有年龄组均有感染,以20～岁组至60～岁组较高,EPG1～999占90.57％.结论 梧州市是华支睾吸虫病轻度流行区,食鱼生是感染华支睾吸虫主要途径,应积极开展综合性防治工作.     

广西华支睾吸虫病分布及流行趋势

目的了解广西华支睾吸虫病分布范围及流行趋势,为该病的防治提供科学依据。方法用Kato-Katz法或改良醛醚法粪检华支睾吸虫虫卵。收集既往资料与现场调查数据作统计分析。结果2004年广西华支睾吸虫病流行县市为59个,受威胁人口3852.6万。与1985年相比,流行县(市)增加了36个,受威胁的人口增加了2628.8万。2002年人群平均感染率为9.8%,为1987~1989年(1.2%)的8.1倍;轻、中、重、超重度感染分别占49.5%、36.2%、9.8%和4.5%。目前某些地区华支睾吸虫成为优势虫种,感染率达33.0%。结论广西华支睾吸虫病流行范围扩大,受威胁人口增多;有些地方华支睾吸虫已成为优势虫种,使当地人体寄生虫病谱发生了变化。     

吉林省西部地区华支睾吸虫病流行现状调查

目的掌握吉林省西部地区华支睾吸虫病流行现状,为后续防治策略的制定提供科学依据。方法 2017年按照整群抽样的方法,选择吉林省西部地区有食用生鱼片风俗习惯的县(市、区),每个县(市、区)按东、西、南、北、中5个方位各选取1个乡(镇)、每个乡(镇)各选取1个村作为调查点。采用问卷调查收集居民基本信息。采用Kato-Katz法(1粪2检)检查居民华支睾吸虫感染情况,对检测结果进行描述性分析。结果在吉林省5个县(市、区)、25个乡(镇)、25个村共调查居民4 980人,检出华支睾吸虫感染者1 220人,人群平均感染率为24.50%。各县(市、区)人群华支睾吸虫感染率差异有统计学意义(χ^2=793.63,P <0.01),其中大安市感染率最高(53.82%)。不同性别、民族、年龄、文化程度和职业人群华支睾吸虫感染率差异亦有统计学意义(P均<0.01),其中男性高于女性、汉族高于其他民族、高年龄组高于低年龄组、大专学历高于其他学历、干部职业高于其他职业,检查前服用驱虫药人群感染率低于未服药者。结论吉林省西部地区仍为华支睾吸虫病高发区;今后仍应针对重点人群开展服药驱虫和健康教育等综合性防控措施,以有效控制华支睾吸虫病的流行与传播。     

医院就诊患者华支睾吸虫感染及临床特征分析

目的了解医院就诊患者华支睾吸虫感染情况及临床特点,为采取相应的防治措施提供依据。方法对2010～2011年17 584例就诊患者进行粪检,并分析华支睾吸虫虫卵阳性者的感染情况及实验室检测结果。结果受检者中华支睾吸虫感染2 043例,感染率11.62%,其中男性感染率为18.74%,女性为2.99%,男性显著高于女性(χ2=1052.15,P<0.01),30～岁组感染率最高,为22.15%;民族分布以壮族感染率最高,为29.98%;职业分布以农民感染率最高,为20.06%;有明显症状者1 735例(84.92%);实验室辅助检查中,74.94%感染者(1531例)有嗜酸性粒细胞升高,83.95%(1 715例)感染者有谷氨酰转移酶升高。华支睾吸虫感染者中62.41%有明确的食鱼生史,29.86%食过半生鱼虾。结论医院就诊者华支睾吸虫感染率较高,感染人群分布有明显差异性,应针对易感人群加强宣教等防治工作;对有食鱼生史且伴有嗜酸性粒细胞和谷氨酰转移酶增高患者,应粪检虫卵,以免漏诊。     

广西146例华支睾吸虫疑似感染者粪样虫卵和血清IgG抗体的检测分析

检测广西华支睾吸虫疑似感染者粪样华支睾吸虫/扇棘单睾吸虫虫卵和血清华支睾吸虫IgG抗体,分析二者的相关性,为华支睾吸虫感染的监测和诊断提供参考。收集2017年3-9月于广西疾病预防控制中心预防性健康体检科就诊的疑似华支睾吸虫感染者粪样,采用改良加藤厚涂片法(一粪三检)检查华支睾吸虫/扇棘单睾吸虫虫卵并计算每克粪样虫卵数(EPG)。同步收集粪检阳性患者的血液标本,采用间接ELISA法检测血清华支睾吸虫IgG抗体。分析EPG值与IgG抗体A_(450)值的相关性,并根据华支睾吸虫感染度分类标准,分析轻度、中度和重度感染者EPG值与血清IgG抗体阳性率以及IgG抗体定性结果与EPG值的关系。在146份华支睾吸虫/扇棘单睾吸虫虫卵阳性粪样中,EPG最大值为21 502,最小值为8。血清华支睾吸虫IgG抗体阳性率为84.9%(124/146),男、女性IgG抗体阳性率分别为86.0%(111/129)和13/17,差异无统计学意义(P 0.05)。感染者EPG值和IgG抗体A_(450)值呈正相关性(r_s=0.436, P 0.01)。轻度、中度和重度感染者IgG抗体阳性率分别为78.4%(69/88)、 96.0%(48/50)和7/8,差异有统计学意义(P 0.05)。华支睾吸虫血清IgG抗体阳性组和阴性组粪样几何均数(GM EPG)值分别为736和204,差异有统计学意义(P 0.01)。提示在华支睾吸虫和扇棘单睾吸虫共感染的广西,粪样虫卵镜检和血清华支睾吸虫IgG抗体检测结果呈正相关;但单独粪便虫卵检查用于华支睾吸虫监测和诊断会存在误判,应辅助IgG抗体等血清学检测。     

2015年贵州省人体华支睾吸虫感染现状调查分析

为了解2015年贵州省人体华支睾吸虫感染情况,按照《全国人体重点寄生虫病现状调查方案》和实施细则相关要求,采用分层整群随机抽样的方法从全省16个县(市、区)抽取30个农村和5个城镇为调查点,每个调查点检测不少于250人。采用改良加藤厚涂片法(一粪二检)对被调查者粪样进行检测,镜检华支睾吸虫卵及其他人体重点寄生虫虫卵并计数,同时采集被调查者一般情况信息。结果显示,全省共调查8 838人,华支睾吸虫感染37例,感染率0.42%(37/8 838),均属轻度感染。男、女华支睾吸虫感染率分别为0.50%(22/4 375)和0.34%(15/4 463)。36例感染者集中于黔东南州,1例在六盘水市,地区间差异有统计学意义(P <0.01)。农村调查点7 572人,感染率为0.04%(3/7 572);城镇调查点1 266人,感染率为2.69%(34/1 266),差异有统计学意义(P <0.01)。黔东南州城镇调查点中,榕江县(镇区)感染率达11.90%(30/252),高于凯里市(城区)(1.60%, 4/250)(P <0.01)。37例华支睾吸虫感染者中,仅1例合并蛔虫感染。各年龄组中以11~20岁组感染率最高,为0.97%;文化程度以高中、中专学历人群感染率最高,为3.14%;职业以工人、干部等上班族最高,为2.36%,不同年龄、文化程度、职业人群差异均有统计学意义(P <0.01)。贵州省黔东南州仍是华支睾吸虫病的重点流行区,需扩大城镇调查点进一步摸清华支睾吸虫感染流行状况。     

广东省华支睾吸虫病流行现状调查和分析

目的了解广东省华支睾吸虫病流行现状和态势。方法在全省原63个流行县（市）按流行程度和水系流域进行分层随机整群抽样，用改良加藤厚涂片法粪检虫卵并计数。结果全省调查9个县（市）27个点13876人，华支睾吸虫平均感染率为16．42％，平均克粪虫卵数（EPG）为359。有8个县市查出感染者，其中3个县感染率超过20％。平均感染率男性18．92％，女性13．89％，差异有显著性（x^2=616．7，P〈0．01）。各年龄组均有感染，以成人感染为重（感染率19．38％～27．42％）。职业分布以渔民和商人感染最重（感染率32．69％）。结论广东省华支睾吸虫病流行范围广、感染率高，已经成为一个严重的公共卫生问题，应积极开展综合性防控工作。     

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.