2018 年安徽省血吸虫病疫情分析

目的 报告并分析 2018 年全省血吸虫病疫情状况与近年的变化趋势。 方法 对 2004 年以来,特别是 2018 年的全省血吸虫病疫情资料进行统计与分析。 结果 截至 2018 年底,全省共有 9 个市的 50 个县(市、区)流行 血吸虫病,其中 27 个达到传播控制标准、13 个达到传播阻断标准、10 个达到消除标准。 2018 年,全省共询检 214. 7 万人,发现阳性 470 689 人;血检 98. 9 万人,发现阳性 11 759 人;粪检 12. 7 万人,未发现阳性病人;全省现有病人数 为 5 890 人,其中推算慢性病人 538 例、晚期血吸虫病 5 352 例,无急性血吸虫病病例,人群平均感染率为 0. 08%;全 省流行村牛存栏 26 470 头,共血检 528 头,粪检 12 992 头,未发现病牛。 全省共调查钉螺 84 365. 2 hm² ,查出钉螺面 积 20 269. 3 hm² ,其中新发现钉螺 15. 0 hm² 、复现钉螺 45. 9 hm² ,未发现感染性钉螺;累计药物灭螺面积 10 763. 8 hm² ,消灭钉螺面积 137. 4 hm² ,年底尚有钉螺面积 26 434. 0 hm² 。 2018 年,全省 50 个国家级血吸虫病监测点病情监 测未发现病人、病畜,钉螺监测显示有螺框出现率 11. 2%,活螺平均密度 0. 38 只/ 0. 11m² ,未发现感染性钉螺。 2004 ~ 2018 年,全省人群和牛的平均感染率均呈现明显的下降趋势,分别下降了 90.4%和 100%,有螺面积在 2. 64 亿 m² ~ 3. 10 亿 m² 间徘徊波动并有小幅下降,已连续 6 年未发现急性血吸虫病例和感染性钉螺。 结论 全省血吸虫病疫 情进一步下降,局部地区仍然存在血吸虫病传播风险。 为达到血吸虫病传播阻断乃至消除血吸虫病的目标,仍需要 加大防治及监测工作的力度。     

乙型肝炎病毒X基因转染人肝癌细胞株双向凝胶电泳图谱分析

目的 研究转染HBV X基因的人肝癌细胞株中蛋白质表达谱的改变,为筛查在HBV相关性肝细胞癌发生中发挥重要作用的关键蛋白质分子奠定基础.方法 利用分子生物学方法建立稳定表达HBV X蛋白(HBx)的肝癌细胞株HepG2+HBx,同时设空载体peDNA3转染细胞HepG2-pcDNA3及HBV全基因转染的人肝癌细胞株HepG2.2.15为对照.PCR法扩增Neo基因检测质粒DNA片段的插入,免疫印迹法检测HBx蛋白的表达.利用固相pH梯度双向凝胶电泳分离3种肝癌细胞株HepG2-pcDNA3、HepG2-HBx和HepG2.2.15的总蛋白,用图像分析软件比较、分析、识别细胞间的差异表达蛋白质.统计学分析采用t检验.结果 获得分辨率高、重复性好的3种细胞的双向电泳(2-DE)图谱.软件分析表明,HepG2-pcDNA3、HepG2-HBx和HepG2.2.15细胞的2-DE凝胶可识别蛋白点分别为(2 095±137)、(2 188±105)和(2 109±20)个.比较HepG2-pcDNA3与HepG2-HBx细胞的2-DE图谱发现37个差异显著的蛋白点,其中21个在HepG2-HBx表达上调,16个下调.6个表达量差异在5倍以上(t=0.027,P＜0.05);HepG2.2.15与HepG2-HBx细胞相比,有38个差异显著的蛋白点,其中35个在HepG2-HBx细胞中上调,3个下调,14个表达量差异在5倍以上(t=0.031,P＜0.05).结论 HBx基因转染引起人肝癌细胞株蛋白质表达谱的变化,可能与感染的肝细胞发生恶性转化的分子生物学机制有关.     

人工肝支持系统对慢性重型乙型肝炎Th1/Th2、Tc1/Tc2亚群的影响

目的 研究人工肝支持系统治疗慢性重型乙型肝炎对机体Th1/Th2、Tc1/Tc2亚群的影响.方法 采用流式细胞仪检测人工肝支持系统治疗慢性重型乙型肝炎前、后患者Th1/Th2、Tc1/Tc2亚群的变化.结果 患者Th1/Th2、Tc1/Tc2亚群明显高于对照组,经治疗后有所下降,但仍高于对照组.结论 慢性重型乙型肝炎患...     

Silencing of Bcl-2 gene expression by siRNA transfection in- hibits the protective effect of fluvastatin against cell apoptosis in human aortic endothelial cells

Objective To study the protective effect of fluvastatin,one of the HMG-CoA reductase inhibitors (statins),against oxygen radical-induced oxidative damages in human aortic endothelial cell,and the role of Bcl-2 in this protection.Methods Human aortic endothelial cells with or without Bcl-2 siRNA transfection were subjected to 1-100 nM of fluvastatin and 100 la hydrogen peroxide for 24 hours.Bcl-2 mRNA and protein expression were measured by Taqman quantitative PCR and Western blotting.Cell apoptosis was measured by normal and fluorescent microscopy and Cell Death Detection ELISA.Results In the Bcl-2-expressed cells,fluvastatin significantly reversed hydrogen peroxide-induced microscopic apoptosis and apoptotic DNA fragmentation,which were accompanied by a markedly upregulation of Bcl-2 expression by fluvastatin.However,the endothelial protection by fluvastatin was completely lost in Bcl-2 siRNA transfected cells.Conclusion Fluvastatin protects human endothelial cells against oxygen radical-induced cell apoptosis in vitro,and this protection seemed to be mediated in a Bcl-2 dependent pathway.(J Geriatr Cardil 12008;5:33-38)     

大灭微粒胶囊杀虫剂浸泡蚊帐杀灭中华按蚊的效果观察

目的观察微粒胶囊杀虫剂在浸泡尼龙蚊帐上的残效。方法用10、15、20mg/m^2的大灭悬浮剂（2.5%高效氯氟氰菊酯）和15mg/m^2拜虫杀悬浮剂（12.5%高效氟氯氰菊酯）浸泡尼龙蚊帐;采用WHO推荐的接触筒强迫接触法,观察中华按蚊接触药帐后每分钟的蚊虫击倒数和24h后死亡率。结果大灭悬浮剂10、15、20mg/m^2浸泡尼龙蚊帐180d后对中华按蚊的击倒中时（Kt50）分别为21.40、16.20、15.70min,24h后死亡率均为100%;拜虫杀15mg/m^2浸泡尼龙蚊帐120d后对中华按蚊的Kt50为16.06min,24h后死亡率为100%。结论2种杀虫剂浸泡的蚊帐均能够有效杀灭疟疾媒介按蚊,但微粒胶囊悬浮剂在尼龙蚊帐上的持效时间较长,效果更好。     

系统性红斑狼疮自身免疫性溶血性贫血的临床分析

目的 探讨系统性红斑狼疮(SLE)合并自身免疫性溶血性贫血(AIHA)患者的临床及血清学特点.方法 收集SLE患者222例,其中发生AIHA的患者17例,应用简单随机抽样法抽取未发生AIHA的34例SLE患者作为对照.回顾性分析患者的一般情况、临床表现、实验室及辅助检查等.计最资料采用t检验,计数资料采用x2检验.结果 SLE合并AIHA的发生率为7.6％.AIHA组抗心磷脂抗体IgG的阳性率(71％)与对照组(15％)相比明显升高(x2=15.366,P＜0.01),但2组抗磷脂抗体综合征的发生率差异无统计学意义(x2=0.000,P=1.000).AIHA组关节炎(12％,x2=4.554,P=0.033)、面部红斑(6％,x2=4.443,P=0.033)、白细胞减低(12％,x2=8.061,P=0.005)及淋巴细胞减低(41％,x2=5.075,P=0.024)的发生率较对照组低,差异有统计学意义.AIHA组有3例在病程中出现了肺泡出血,而对照组患者均未出现肺泡出血(x2=3.586,P=0.058).结论 SLE合并AIHA患者的抗心磷脂抗体IgG阳性率高,但抗磷脂抗体综合征的发生率无显著增加.SLE合并AIHA患者关节炎、面部红斑、白细胞减低及淋巴细胞减低的发生率低,但有发生肺泡出血的倾向.     

不同年龄段慢性乙型肝炎病毒携带者肝活体组织的病理分析

目的 分析各年龄段慢性HBV携带者肝活组织检查病理炎症分级≥G2级或纤维化分期≥S2者所占比例,探讨肝活组织检查最佳时机,指导抗病毒治疗. 方法 收集292例慢性HBV携带者肝活组织检查病理结果,按年龄分为3组,计算各年龄段炎症分级≥G2或纤维化分期≥S2者各占比例,比较组间差异.计数资料统计学描述用构成比,统计分析采用x2检验.P＜ 0.01为差异具有统计学意义. 结果 3个年龄段慢性HBV携带者炎症分级≥G2级或纤维化分期≥S2者,在11 ～ 29岁组占26.5％ (36/136),30～39岁组占39.4％ (37/94),40～60岁组占58.1％ (36/62),总体差异有统计学意义(P＜ 0.01).30 ～ 39岁组炎症分级≥G2级或纤维化分期≥S2者的比例为39.4％ (37/94),与40～60岁组58.1％ (36/62)比较,差异无统计学意义(P＞0.01).且30岁以前的慢性HBV携带者炎症分级≥G2级或纤维化分期≥S2者占26.5％(36/136),30岁以后的慢性HBV携带者炎症分级≥G2级或纤维化分期≥S2者占46.8％(73/156),差异有统计学意义(P＜0.01). 结论 年龄≥30岁为慢性HBV携带者肝活组织检查最佳时机,因此,对≥30岁慢性HBV携带者应尽早做肝穿刺活组织检查,对预防疾病发展,指导抗病毒治疗有重要意义.     

肝组织cccDNA水平与血清病毒学应答后治疗时间的关系

目的 探讨慢性乙型肝炎(CHB)患者肝组织cccDNA水平与外周血HBV DNA<1000 拷贝/ml后继续治疗时间的关系.方法 分别采用荧光定量PCR、酶联免疫吸附分析法检测58例CHB患者肝组织HBV cccDNA水平、肝组织和血清HBV DNA载量、HBV标志物,分析肝组织HBV cccDNA水平、肝组织总HBV DNA水平、HBeAg血清学转换与血清病毒学应答后继续治疗时间的关系.组间比较采用Nemenyi法,相关分析采用Spearman法.结果 肝组织HBVcccDNA水平在血清HBV DNA两阳性组间尢明显差异,而阴性组明显低于阳性组(χ2=9.6948,P<0.01;χ2=9.2824,P<0.01).35例达到血清病毒学应答后行肝活组织检查的患者,肝组织cccDNA水平随继续治疗时间的延长而降低(χ2≥6.4674,P<0.05),肝组织cccDNA水平在抗-Hbe(+)组明显低于HBeAg(+)组、HBeAg(-)/抗-Hbe(-)组(χ2=10.7482,P<0.01;χ2=11.7549,P<0.01).14例肝组织cccDNA水平低十检测限的患者,有12例已经发生HBeAg血清学转换,占抗-Hbe(+)组的2/3,其在血清病毒学应答后继续治疗时间平均为35个月,发生HBeAg血清学转换后继续治疗时间平均为30个月.结论 当患者发生血清病毒学应答后,肝组织cccDNA水平随继续治疗时间延长而降低;继续治疗35个月以上且血清抗-Hbe持续(+)30个月以上时,有2/3的患者肝组织cccDNA定量低于检测限水平.     

HBeAg血清转换延迟患者的临床病理特征

目的探讨HBV感染者延迟HBeAg血清转换与肝脏病理变化的相关性。方法分析148例慢性HBV感染者的血清HBeAg表达与肝脏病理改变和HBcAg的关系。结果本组病例中HBeAg阳性78例,肝脏病理炎症分级G≥2者,53例（67.9%）,肝脏病理纤维化分期S≥2者,29例（37.2%）,HBeAg阴性70例,G≥2者,36例（51.4%）,S≥2者,25例（35.7%）,HBeAg阳性与阴性组肝脏炎症损害差异有统计学意义,χ2=4.20,P〈0.05,纤维化程度差异无统计学意义,χ2=0.532,P〉0.05。HBeAg阳性组肝脏HBcAg阳性者有60例（76.9%）明显高于HBeAg阴性组26例（37.1%）,χ2=23.98,P〈0.01。两组均以胞浆型为主分别为58.3%,65.4%。结论免疫活动期,HBV感染者延迟HBeAg血清转换组与HBeAg阴性组比较有更明显的炎症程度,血清HBeAg表达与肝脏HBcAg表达有明显相关性。     

乙型肝炎病毒携带者的肝脏病理学与临床特征

目的 研究HBV携带者的肝脏病理学与临床特征.方法 回顾性分析和比较58例慢性HBV携带者和32例非活动性HBsAg携带者年龄、性别、肝脏炎症及纤维化程度,并将患者按ALT水平分为低酶组(ALT≤20 U/L)34例和高酶组(20 U/L40岁)28例;并将58例慢性HBV携带者根据HBeAg阳性与否,分为HBeAg阳性组23例和HBeAg阴性组35例;分别对肝脏炎症及纤维化程度进行比较,两组连续变量间比较采用t检验,计数资料采用χ2检验. 结果 慢性HBV携带组与非活动性HBsAg携带组患者年龄分别为(24.7±4.8)岁和(35.2±7.6)岁,两组比较,t=2.576,P=0.017,差异有统计学意义,两组性别构成比比较,差异无统计学意义.肝纤维化程度非活动性HBsAg携带组SO期2例(6.2%),S1期7例(21.9%),≥S2期23例(71.9%),慢性HBV携带组S0期23例(39.6%),S1期20例(34.5%),≥S2期15例(25.9%),非活动性HBsAg携带组重于慢性HBV携带组,两组比较,χ2=23.231,P<0.01,差异有统计学意义.肝脏炎症程度比较,慢性HBV携带组与非活动性HBsAg携带组间差异无统计学意义.肝组织炎症程度:高酶组G1期26例(46.4%),≥G2期30例(53.6%),低酶组G1期26例(76.5%),≥G2组8例(23.5%),高酶组重于低酶组,两组比较,χ2=7.827,P=0.008,差异有统计学意义.肝纤维化程度:高酶组S0期10例(17.9%),S1期14例(25%),≥S2期32例(57.1%),低酶组S0期15例(44.1%),S1期13例(38.3%),≥S2期6例(17.6%),高酶组重于低酶组,两组比较,χ2=14.303,P=0.001,差异有统计学意义.肝组织炎症程度:高龄组G1期9例(32.1%),≥G2组19例(67.90),低龄组G1期43例(69.6%),≥G2组19例(30.4%),高龄组重于低龄组,两组比较,χ2=10.949,P=0.001,差异有统计学意义.肝纤维化程度:高龄组S0期1例(3.6%),S1期6例(21.40%),≥S2期21例(75%),低龄组S0期24例(38.8%),S1期21例(33.8%),≥S2期17例(27.4%),高龄组重于低龄组,两组比较,χ2=21.271,P<0.01,差异有统计学意义.慢性HBV携带者肝组织炎症程度:HBeAg阴性组Gl期14例(40%),≥G2组21例(60%),HBeAg阳性组G1期19例(82.6%),≥G2期4例(17.4%),HBeAg阴性组重于HBeAg阳性组,两组比较,χ2=10.275,P=0.002,差异有统计学意义,HBeAg阴性组肝纤维化程度与HBeAg阳性组比较,差异无统计学意义. 结论 对年龄较大、ALT接近正常及HBeAg阴性的慢性HBV携带者应推荐行肝活体组织学检查来指导临床诊断和治疗.     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.     

Interplay between interferon-mediated innate immunity and porcine reproductive and respiratory syndrome virus

Innate immunity is the first line of defense against viral infection, and in turn, viruses have evolved to evade host immune surveillance. As a result, viruses may persist in host and develop chronic infections. Type I interferons (IFN-α/β) are among the most potent antiviral cytokines triggered by viral infections. Porcine reproductive and respiratory syndrome (PRRS) is a disease of pigs that is characterized by negligible induction of type I IFNs and viral persistence for an extended period. For IFN production, RIG-I/MDA5 and JAK-STAT pathways are two major signaling pathways, and recent studies indicate that PRRS virus is armed to modulate type I IFN responses during infection. This review describes the viral strategies for modulation of type I IFN responses. At least three non-structural proteins (Nsp1, Nsp2, and Nsp11) and a structural protein (N nucleocapsid protein) have been identified and characterized to play roles in the IFN suppression and NF-κB pathways. Nsp's are early proteins while N is a late protein, suggesting that additional signaling pathways may be involved in addition to the IFN pathway. The understanding of molecular bases for virus-mediated modulation of host innate immune signaling will help us design new generation vaccines and control PRRS.     

Disease Pandemics and Major Epidemics Arising From New Encounters between Indigenous Viruses and Introduced Crops

Virus disease pandemics and epidemics that occur in the world’s staple food crops pose a major threat to global food security, especially in developing countries with tropical or subtropical climates. Moreover, this threat is escalating rapidly due to increasing difficulties in controlling virus diseases as climate change accelerates and the need to feed the burgeoning global population escalates. One of the main causes of these pandemics and epidemics is the introduction to a new continent of food crops domesticated elsewhere, and their subsequent invasion by damaging virus diseases they never encountered before. This review focusses on providing historical and up-to-date information about pandemics and major epidemics initiated by spillover of indigenous viruses from infected alternative hosts into introduced crops. This spillover requires new encounters at the managed and natural vegetation interface. The principal virus disease pandemic examples described are two (cassava mosaic, cassava brown streak) that threaten food security in sub-Saharan Africa (SSA), and one (tomato yellow leaf curl) doing so globally. A further example describes a virus disease pandemic threatening a major plantation crop producing a vital food export for West Africa (cacao swollen shoot). Also described are two examples of major virus disease epidemics that threaten SSA’s food security (rice yellow mottle, groundnut rosette). In addition, brief accounts are provided of two major maize virus disease epidemics (maize streak in SSA, maize rough dwarf in Mediterranean and Middle Eastern regions), a major rice disease epidemic (rice hoja blanca in the Americas), and damaging tomato tospovirus and begomovirus disease epidemics of tomato that impair food security in different world regions. For each pandemic or major epidemic, the factors involved in driving its initial emergence, and its subsequent increase in importance and geographical distribution, are explained. Finally, clarification is provided over what needs to be done globally to achieve effective management of severe virus disease pandemics and epidemics initiated by spillover events.     

Barrett's Esophagus: Where Do We Stand?

Barrett''s esophagus (BE) is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.     

The Technology Transfer from Europe to China in the 17th–18th Centuries: Non-Invasive On-Site XRF and Raman Analyses of Chinese Qing Dynasty Enameled Masterpieces Made Using European Ingredients/Recipes

Two masterpieces of the Qing Dynasty (1644–1912 CE), one in gilded brass (incense burner) decorated with cloisonné enamels stylistically attributed to the end of the Kangxi Emperor’s reign, the other in gold (ewer offered by Napoleon III to the Empress as a birthday present), decorated with both cloisonné and painted enamels bearing the mark of the Qianlong Emperor, were non-invasively studied by optical microscopy, Raman microspectroscopy and X-ray microfluorescence spectroscopy (point measurements and mapping) implemented on-site with mobile instruments. The elemental compositions of the metal substrates and enamels are compared. XRF point measurements and mappings support the identification of the coloring phases and elements obtained by Raman microspectroscopy. Attention was paid to the white (opacifier), blue, yellow, green, and red areas. The demonstration of arsenic-based phases (e.g., lead arsenate apatite) in the blue areas of the ewer, free of manganese, proves the use of cobalt imported from Europe. The high level of potassium confirms the use of smalt as the cobalt source. On the other hand, the significant manganese level indicates the use of Asian cobalt ores for the enamels of the incense burner. The very limited use of the lead pyrochlore pigment (European Naples yellow recipes) in the yellow and soft green cloisonné enamels of the Kangxi incense burner, as well as the use of traditional Chinese recipes for other colors (white, turquoise, dark green, red), reinforces the pioneering character of this object in technical terms at the 17th–18th century turn. The low level of lead in the cloisonné enamels of the incense burner may also be related to the use of European recipes. On the contrary, the Qianlong ewer displays all the enameling techniques imported from Europe to obtain a painted decoration of exceptional quality with the use of complex lead pyrochlore pigments, with or without addition of zinc, as well as cassiterite opacifier.