河南省1963-2008年钩端螺旋体病流行病学特征分析

中国是受钩端螺旋体病（简称钩体病）危害十分严重的国家。河南是全国钩体病高发区之一,1957年武陟县首次发生钩体病流行,由于历史原因,自1963年起始有完整的钩体病疫情资料,近50年来,全省范围内暴发过8次大规模钩体病流行。     

四川省钩端螺旋体病高发县报告病例的准确性调查研究

目的 了解四川省钩端螺旋体病高发地区报告钩体病例准确性,为进一步控制钩体病流行提供科学依据。方法 采集2012年钩体病高发地区报告临床诊断病例血清进行钩体菌培养,血清学诊断,对钩体病检测结果为阴性的标本进行乙脑、出血热和立克次体检测。结果 共采集87例报告病例的血清标本,培养出4株钩体菌,钩体菌培养阳性率为4.6%。采集64份病例急性期和恢复期双份血清进行钩体病检测,其中54例阳性,阳性率为84.4%,采集23份病例单份血清,其中6份钩体菌检测阳性,阳性率为26.1%。对27份钩体检测阴性标本进行乙脑ELISA检测,阳性1例,出血热、立克次体检测结果均为阴性。结论 四川省钩体病高发地区临床诊断钩体病准确性较高,但依然需要加强病例双份血清采集和检测。     

四川省钩端螺旋体病高发县报告病例的准确性调查研究北大核心CSCD

目的了解四川省钩端螺旋体病高发地区报告钩体病例准确性,为进一步控制钩体病流行提供科学依据。方法采集2012年钩体病高发地区报告临床诊断病例血清进行钩体菌培养,血清学诊断,对钩体病检测结果为阴性的标本进行乙脑、出血热和立克次体检测。结果共采集87例报告病例的血清标本,培养出4株钩体菌,钩体菌培养阳性率为4.6%。采集64份病例急性期和恢复期双份血清进行钩体病检测,其中54例阳性,阳性率为84.4%,采集23份病例单份血清,其中6份钩体菌检测阳性,阳性率为26.1%。对27份钩体检测阴性标本进行乙脑ELISA检测,阳性1例,出血热、立克次体检测结果均为阴性。结论四川省钩体病高发地区临床诊断钩体病准确性较高,但依然需要加强病例双份血清采集和检测。     

湖北省90年代钩端螺旋体病流行病学监测与控制

钩端螺旋体 (下称钩体 )病是湖北省重点流行的传染病 ,从 1960年报告钩体病人以来 ,至 1999年累计发病 15万余例 ,病死 2 0 0 0余例 ,其发病率和病死率均居法定报告传染病前 10位。为了控制钩体病流行 ,掌握钩体病流行规律 ,我们从 1990年开始 ,按照全国钩体病监测方案要求 ,在长江流域一带选择了仙桃、宜都、新州等市钩体病流行较为严重的地区作为钩体病监测点 ,进行了传染源、血清学等监测 ,结果报告如下 :1　内容与方法1.1　基础资料收集与整理　各监测点收集当年人口、气象、牲畜饲养方式、钩体病人流行病资料等。1.2　人间钩体病疫情监…     

钩体病神经系统后发症者尿中分离出钩体两例报告

<正> 钩端螺旋体(钩体)病康复期带菌,近年来已陆续有报道,但钩体病神经系统后发症带菌未见报告。1990年,我们对15例钩体病神经系统后发症患者,分别取尿分离培养钩体,发现2例阳性。现报告如下。 一、材料及方法 观察对象为南宁市各医院临床疑似钩体病神经系统后发症,并取血清作显凝试验阳     

PCR技术在钩端螺旋体病传染源监测中的应用

钩端螺旋体（钩体）病在我国分布广泛、流行严重，自1955年被列入法定传染病以来，全国累计病例240多万我，列亡病例超过2万人。钩体病属自然疫源性疾病，为了有效控制钩体病流行，必须加强对钩体病传染带菌情况进行监测。野鼠是钩体最重要的传染源，其次是猪、犬、牛等。目前，监测传染源带菌率主要是靠钩体菌分离培养，但受各种因素影响，如杂菌污染、培养基质量不高、农药的使用等，致使钩体培养阳性率不高。因此，本文介绍多聚酶链式反应（PCR）技术用于钩体病传染源带菌率监测，提高钩体病的疫情监测质量。     

钩端螺旋体病的早期临床诊断标准探讨一附142例临床分析

钩端螺旋体病（Leptospirosis以下简称钩体病）是农村夏秋季节常见发热性急性传染病，其预后与能否早期诊断有着密切的关系，近年来钩体病的症状体征多不典型，现行的对钩体病的确诊仍有赖于对钩体的培养分离和血清学试验，但费时日，新的钩体DNA检测在一般医院特别是基层医院开展甚少。现就142例住院资料完整的病人作回顾性临床分析，从中找出钩体病的早期临床诊断要点，供参考。     

钩端螺旋体病中枢神经系统后发症的血清学调查

<正> 钩端螺旋体病(简称钩体病),我省近几年来每年都有不同程度的流行发生,由于钩体病带菌动物多,菌型复杂,临床表现多样化,尤其是轻型钩体病人和隐性感染者,由于误诊和漏诊,未能及时得到正确治疗。据文献报道,上述因素是引起钩体病中枢神经系统后发症的重要原因之一。现将我们自1991年9月～1992年1月收检的29份临床上诊断为钩体病中枢神经系     

螺旋体传染病

钩端螺旋体病的X线表现及分析——赖鸣晓(江西吉安县人民医院343100)；《井冈山医专学报》，2003，11(1)：45[目的：讨论钩体病病情和胸部X线改变之间的关系。方法：从15例钩体病胸片中对比观察钩体病治疗前后胸片改变。结果：钩体病皆可有胸部X线异常表现。     

螺旋体传染病

娄底市钩端螺旋体病流行特征及其变化研究——戴练平等（湖南娄底市疾病预防控制中心417000）；《疾病监测》，2005。20（4）：192-193【目的：了解娄底市钩端螺旋体病（简称钩体病）流行特征及其变化情况。方法：对娄底市1967-2003年钩体病的流行情况进行分析。结果：娄底市钩体病发病范围在扩大，但强度下降，病死率变化不明显。发病时间分布有聚集性，年龄分布呈分散趋势。结论：娄底市钩体病发病可能有周期性，流行特征的变化提示钩体病防制工作仍不能放松。】     

Serotonin Releases a Vasoconstrictor Prostanoid in the Kidney of the Aging Spontaneously Hypertensive Rat

The isolated and perfused kidney of the spontaneously hypertensive rat (SHR) exhibits an increased vascular reactivity to serotonin when compared to normotensive Wistar-Kyoto (WKY) rats. Experiments were designed to determine the involvement of a prostanoid constricting factor in the augmented response to serotonin in the SHR kidney. Kidneys taken from male (12 months) SHR and WKY rats were studied in parallel and perfused with Tyrode's solution at constant, optimal flow rates. Vasoconstrictor responses were recorded as increases in perfusion pressure. The dose-response curves to serotonin obtained in the SHR were shifted to the left compared to the WKY. Indomethacin decreased the responses to the smaller doses of serotonin in the SHR, but increased those to the higher doses of the monoamine in the WKY. The responsiveness to the monoamine was no longer significantly different in the two strains in the presence of the inhibitor of cyclooxygenase. Dazoxiben, an inhibitor of thromboxane synthetase, did not alter the responses to serotonin in either the WKY and SHR kidneys. These experiments suggest that a prostanoid, but not thromboxane A₂, may play a role in the augmented response to serotonin in the kidney of aged SHR.     

Pharmacogenomics in colorectal cancer： The first step for individualized-therapy

Interindividual differences in the toxicity and response to anticancer therapies are currently observed in practically all available treatment regimens. A goal of cancer therapy is to predict patient response and toxicity to drugs in order to facilitate the individualization of patient treatment. Identification of subgroups of patients that differ in their prognosis and response to treatment could help to identify the best available drug therapy according the genetic profile. Several mechanisms have been suggested to contribute to chemo-therapeutic drug resistance： amplification or overexpression of membrane transporters, changes in cellular proteins involved in detoxification or in DNA repair, apoptosis and activation of oncogenes or tumor suppressor genes. Colorectal cancer （CRC） is regarded as intrinsically resistant to chemotherapy. Several molecular markers predictive of CRC therapy have been included during the last decade but their results in different studies complicate their application in practical clinical. The simultaneous testing of multiple markers predictive of response could help to identify more accurately the true role of these polymorphisms in CRC therapy. This review analyzes the role of genetic variants in genes involved in the action mechanisms of the drugs used at present in colorectal cancer.     

Pain management in older adults: prevention and treatment

The release of guidelines in 1998 by the American Geriatrics Society on "The Management of Chronic Pain in Older Persons" was a breakthrough in helping to manage pain in this population. Already advances have fostered a need to update recommendations. This article focuses on the treatment strategies available for seniors that are likely to help to fulfill the obligation to relieve pain and suffering in patients. A review was done of the literature using Medline and other search techniques. New pain scales have been developed with seniors in mind and greater testing of older scales in elderly populations have helped to identify measures of pain more suited to frail seniors. Advances in cyclooxygenase inhibition selectivity, alternative medicine, and progress in the identification of nonopioid pain receptors and the development of products to target them are just a few of changes that have altered the way clinicians think about treating pain. The use of hospice in end-of-life palliative care is a valuable resource for clinicians managing pain at that phase in care as well. Tools are available to prevent and treat pain successfully in seniors. Educating clinicians about available assessment tools, techniques and interventions may be the biggest challenge to comforting the older adult in pain.     

Renal denervation beyond the bifurcation: The effect of distal ablation placement on safety and blood pressure

Renal denervation may be more effective if performed distal in the renal artery because of smaller distances between the lumen and perivascular nerves. The authors reviewed the angiographic results of 97 patients and compared blood pressure reduction in relation to the location of the denervation. No significant differences in blood pressure reduction or complications were found between patient groups divided according to their spatial distribution of the ablations (proximal to the bifurcation in both arteries, distal to the bifurcation in one artery and distal in the other artery, or distal to the bifurcation in both arteries), but systolic ambulatory blood pressure reduction was significantly related to the number of distal ablations. No differences in adverse events were observed. In conclusion, we found no reason to believe that renal denervation distal to the bifurcation poses additional risks over the currently advised approach of proximal denervation, but improved efficacy remains to be conclusively established.     

Long-term smoking and ethanol exposure accentuates oxidative stress in hearts of mice

The present study was undertaken to investigate the influence of ethanol on the cardiac antioxidant defense system of mice exposed to cigarette snoke. Cigarette smoke exposure for 10 wk led to an increase in the levels of lipid peroxidation in the heart. These levels increased further in animals co-exposeds to ethanol and cigarette, smoke. Concomitantly, the levels of glutathione were found to decrease after cigarette smoke exposure. In the animals co-exposed to ethanol and cigarette smoke, there was a further decrease in glutathione levels. Catalase activity increased in the animal sexposed to cigarette smoke; this activity increased further with combined exposed to cigarette smoke and ethanol. On the other hand, superoxide dismutase (SOD) activity was not affected by cigarette smoke exposure, while it increased in the ethanol-exposed group. SOD activity was higher in the hearts of animals co-exposed to cigarette smoke and ethanol as compared to animals that received ethanol alone. The actvity of heat-stable lactate dehydrogenase in serum was not affected when the animals were exposed to either cigarette smoke or ethanol, whereas this activity was observed to be, elevated in animals co-exposed to cigarette smke and ethanol. It appears from these results that ethanol potentates the cigarette-smoke-induced peroxidative damage to heart.     

Development of Tolerance to Inhibitory Effect of Ethanol on Endothelium-dependent Vascular Relaxation in Ethanol-fed Rats

Rats were maintained on liquid diets containing ethanol (35% of total calories) or an equicaloric volume of sucrose instead of ethanol for 10 wk. Vascular strips of isolated rat aortas were mounted in organ chambers to record isometric tension. Ethanol in vitro inhibited the endothelium-dependent relaxation responses to acetylcholine and ATP in both pair-fed control and ethanol-fed rats. The inhibitory effect of ethanol was greater in the pair-fed rats. In addition, the magnitudes of these relaxation responses in the absence of ethanol in vitro in pair-fed rats were similar to those in the presence of ethanol in ethanol-fed rats. In the absence of ethanol in vitro, the relaxations in response to acetylcholine and ATP in the ethanol-fed rats were greater than in the pair-fed rats. These results suggest that chronic ethanol consumption can induce tolerance to ethanol-induced inhibition of endothelium-dependent relaxation responses to acetylcholine and ATP, and that the relaxations can become adapted to the presence of plasma levels of ethanol, which may inhibit the relaxation in vivo. The augmented relaxation in the ethanol-fed rats may result from the mechanism causing tolerance to the inhibitory effect of ethanol.     

Emerging technologies and their applications in interactions between nutrition and immunity to gastrointestinal parasites in sheep

Despite the plethora of evidence on the consequences of host nutrition on their immune responses to gastrointestinal parasites, the identity of molecules and mechanisms that drive the manifestations of immunity under nutrient abundance are not yet known. This is partly due to limitations of the methodologies employed to date that have failed to give comprehensive answers. The great advancements in the technological front over the past few years have opened a window of opportunity to identify these effector molecules, to explore both the mechanisms and cellular pathways and to evaluate their importance in the immune response to parasites. The aim of this paper is to present some of the novel, high-throughput technologies that are currently available in immunology and to explore their use in advancing our knowledge in interactions between nutrition and immunity to nematode parasites, with special reference to sheep. In the first part, we introduce the technologies and we discuss advantages and pitfalls of their use. We bring in successful examples of how their employment advanced knowledge and improved our understanding of the mechanisms that regulate immune responses to pathogens (both micro- and macroparasites). In the second part, we focus on the impact of nutrition on the immune response to parasites, and explore how these technologies can be used to advance our knowledge of immunonutritional interactions. We use as our starting point well-established models that have been successfully used to investigate the consequences of nutrition on the manifestations of immunity to parasites, which we further consider in the context of the novel technologies. We conclude by emphasizing the great potential of the described methodologies in unravelling the complex interactions between nutrition and immunity, but we also recommend caution when interpreting the outcomes.     

Rapidly assessing changes in bone mineral balance using natural stable calcium isotopes

The ability to rapidly detect changes in bone mineral balance (BMB) would be of great value in the early diagnosis and evaluation of therapies for metabolic bone diseases such as osteoporosis and some cancers. However, measurements of BMB are hampered by difficulties with using biochemical markers to quantify the relative rates of bone resorption and formation and the need to wait months to years for altered BMB to produce changes in bone mineral density large enough to resolve by X-ray densitometry. We show here that, in humans, the natural abundances of Ca isotopes in urine change rapidly in response to changes in BMB. In a bed rest experiment, use of high-precision isotope ratio MS allowed the onset of bone loss to be detected in Ca isotope data after about 1 wk, long before bone mineral density has changed enough to be detectable with densitometry. The physiological basis of the relationship between Ca isotopes and BMB is sufficiently understood to allow quantitative translation of changes in Ca isotope abundances to changes in bone mineral density using a simple model. The rate of change of bone mineral density inferred from Ca isotopes is consistent with the rate observed by densitometry in long-term bed rest studies. Ca isotopic analysis provides a powerful way to monitor bone loss, potentially making it possible to diagnose metabolic bone disease and track the impact of treatments more effectively than is currently possible.     

Occupational respiratory cancers

Lung cancer and pleural mesothelioma are the most common occupational cancers. Recent epidemiological studies have estimated that the fraction attributable to occupational factors varies from 13 to 29% for lung cancer in men and is about 85% for pleural mesothelioma in men. Previous occupational exposure to asbestos is the most common occupational exposure in these cancers. Mesothelioma immediately leads the clinician to look for past asbestos exposure. In contrast, the search for an occupational exposure that should be routine in all cases of lung cancer, is generally more difficult because of the number of occupational aetiological factors and the absence of criteria that allow distinction of an occupational cancer from a tobacco related one. Therefore attention should be paid to the identification of occupational exposure in order to set up primary prevention programmes to prevent exposure still present in the working environment and, on the other hand, to identify the subjects entitled to the acknowledgement of occupational disease and/or to obtain the compensation available to asbestos victims.     

广州地区淋球菌对环丙沙星耐药的监测与分析

目的 为了解广州地区1998～2002年淋球菌对环丙沙星敏感性和耐药性的变迁。方法 采用琼脂稀释法测定环丙沙星对每年分离的淋球菌的最低抑菌浓度(MIC)。结果 对1998～2002年在广州市性病监测中心就诊的性病患者中分离到的603株淋球菌，进行耐药性分析，环丙沙星的敏感率由1998年的12％降至2002年的零敏感，而耐药率由1998年的56．5％上升至2002年的98％。结论 广州地区流行的淋球菌的耐药情况日趋严重，喹诺酮类药物的高耐药率表明已不再适宜被推荐为治疗淋病的一线药物。有必要持续监测淋球菌的耐药性，并减少抗菌药物的滥用，以保证药物的敏感性。