云南省孟连县疟疾漏报程度分析

目的了解云南省孟连县疟疾发病实情和漏报程度。方法采用回顾性调查方法,统计2002年疟疾报告疫情、血检情况、疟疾治疗及村民疟史等。以捕获-再捕获方法估计疟疾实际发病和漏报率。结果孟连县疟疾发病率为21.5/万。7个乡均有病例分布,被调查3个乡的疟疾发病率分别为47/万、15/万和5/万。所调查的25个自然村在2002年共报告5例疟疾,采用发热病人血检、查阅医生疟疾治疗处方、调查疟史3种再捕获方法核实疫情,估算得孟连县3种疟疾疫情漏报率分别为0、70.59%和97.80%。结论孟连县疟疾漏报现象比较普遍。     

云南省澜沧县疟疾流行及其防治现状

目的了解澜沧县疟疾流行现状及其控制能力。方法采用回顾性调查方法,统计2000~2002年疟疾发病情况,分层随机抽样调查乡、村级卫生机构的疟疾疫情报告、血检能力和疟防资源分布,问卷调查人群疟疾常识知晓、村民疟史及蚊帐使用情况。结果2000~2002年,澜沧县的疟疾发病率为0.253‰,22个乡均有病例分布,发病率为0.06‰~0.8‰;2002年接受入户调查的21个自然村共有11例疟疾疫情报告病例,据此估算全县血检、处方和走访漏报率分别为35.30%、0和96.79%。卫生部门占有较多的卫生资源,承担50%以上的发热病人血检任务和疟疾病人治疗。当地居民的疟疾常识知晓程度不高,村民的经验积累型疟防知识水平与中小学生接近,间接传授型疟防知识水平低于中小学生,村民蚊帐拥有和使用率各为26.2%和30.7%。结论澜沧县的疟疾控制对策应体现多样性,应加强乡村一级疟防资源的投入及不同人群疟防知识的宣教,3种估算疟疾漏报率对该县疟疾控制的导向作用和参考价值有待进一步确定。     

云南省福贡县2002年疟疾漏报调查结果分析

目的了解福贡县目前疟疾流行状况,为今后制定疟疾防治规划和措施提供科学依据。方法采用分层整群随机抽样,选取3个乡、9个行政村、27个自然村为调查点,逐人逐户问卷调查,抽查诊所处方和血检登记;学生疟防知识问卷调查等。结果共调查15909人,疟疾发病率6·34/万,走访村民2788人,发现有疟史293人。3个乡镇共问卷调查中小学生542人,知晓疟防知识156人,知晓率28·78%;村民走访2788人,知晓疟防知识80人,知晓率2·87%。对发热患者血检、治疗处方、疟史调查进行核查,估算血检、处方、走访漏报率分别为17·20%、98·40%和98·62%。结论福贡县疟防工作仍然存在许多困难和问题,需进一步加强和完善。在规范疟疾处方管理的基础上,使用处方漏报率估算疟疾发病率可能比较合适。     

云南省澜沧县疟疾流行及其防治现状

目的了解澜沧县疟疾流行现状及其控制能力. 方法采用回顾性调查方法,统计2000～2002年疟疾发病情况,分层随机抽样调查乡、村级卫生机构的疟疾疫情报告、血检能力和疟防资源分布,问卷调查人群疟疾常识知晓、村民疟史及蚊帐使用情况. 结果 2000～2002年,澜沧县的疟疾发病率为0.253‰,22个乡均有病例分布,发病率为0.06‰～0.8‰;2002年接受入户调查的21个自然村共有11例疟疾疫情报告病例,据此估算全县血检、处方和走访漏报率分别为35.30%、0和96.79%.卫生部门占有较多的卫生资源,承担50%以上的发热病人血检任务和疟疾病人治疗.当地居民的疟疾常识知晓程度不高,村民的经验积累型疟防知识水平与中小学生接近,间接传授型疟防知识水平低于中小学生,村民蚊帐拥有和使用率各为26.2%和30.7%. 结论澜沧县的疟疾控制对策应体现多样性,应加强乡村一级疟防资源的投入及不同人群疟防知识的宣教,3种估算疟疾漏报率对该县疟疾控制的导向作用和参考价值有待进一步确定.     

用捕获-再捕获方法对江城县疟疾漏报程度的评价

目的了解江城县的疟疾发病实际和漏报程度。方法采用回顾性调查方法，统计江城县2002年疟疾报告疫情、血检情况、疟疾治疗及村民疟史等，以捕获-再捕获方法估计疟疾实际发病和漏报率。结果2002年，江城县疟疾发病率为0.51‰，被调查3个乡的疟疾发病率分别为1.46‰、0.29‰和0，所调查的27个自然村全年共报告30例疟疾。根据发热病人血检、医生疟疾治疗处方及疟史数估算江城县的疟疾疫情漏报率分别是58.33%、16.67%和84.13%，估计疟疾病例数分别为130、65和340例。结论江城县的疟疾漏报程度比较严重。     

捕获-再捕获法分析云南澜沧县疟疾漏报程度

目的了解澜沧县的疟疾发病实情和漏报程度。方法采用回顾性调查方法,统计2002年疟疾疫情报告、血检情况、疟疾治疗及村民疟史等。用捕获-再捕获方法估计疟疾实际发病和漏报率。结果澜沧县疟疾发病率为0·297‰,22个乡均有病例分布,被调查3个乡的疟疾发病率分别为0·62‰、0·42‰和0·08‰,被调查的21个自然村在2002年共报告9例疟疾,采用发热患者血检、医生疟疾治疗处方、疟史3种再捕获方法核实疫情,估算澜沧县的疟疾漏报率分别是35·71%、0·00%和95·89%。结论澜沧县的疟疾漏报现象比较普遍。     

普洱市疟疾防治资源现状调查

目的了解普洱市疟疾流行程度和疟防资源现状。方法采用分层整群不等比例抽样调查方法，回顾性调查乡、村卫生单位疟疾病例管理，问卷收集居民家庭财产、个人一般情况、疟防常识知晓、疟防态度、行为习惯等资料，数据用SPSS13．0分析处理。结果普洱市10县／区2002-2006年疟疾发病在波动中有下降，居民带虫率0．6‰，疟疾疫情3d内报告率21．6％、非边境县达88．6％，疟病病例1d治疗率19．5％、非边境县为31．8％，边境县居民、少数民族、男性具有疟防常识知晓优势，但前两者知晓疟防常识、持正确态度与行为间呈反向增长。结论医疗机构管理疟疾病例的规范性、居民疟防常识知晓率和疟防态度及行为正确率在边境与非边境县存在明显差异，普洱市应注重对成功疟防经验的借鉴与推广。     

云南省孟连县溪络渡电站移民疟疾流行情况调查

目的 了解移民和移民区的疟疾流行情况，为防治提供依据。方法 调查移民和当地居民的疟疾发病情况、居住房屋及防蚊情况、小学生和当地居民疟疾带虫情况，收集全县疟疾疫情和移民点周围发热患者血检资料，媒介情况和防治措施。结果 近6年全县的疟疾发病率波动在15．25／万～31．19／万之间，2002～2003年42．48％的疟疾病例为境外感染，2004年勐马地区恶性疟占17．39％，小学生和当地村民的带虫率为O；移民的住房和防蚊条件好于村民，移民疟史率为0，当地居民为21．28％；查获微小按蚊等9种按蚊，微小按蚊占总数的3．350／0。结论 移民具有良好的居住及生活环境，免受疟疾感染。鉴于当地是疟疾高发区，又受境外疟疾高度流行的影响，要继续做好移民的疟疾防范工作。     

云南省勐腊县勋伴镇疟疾流行病学调查

目的　调查勐腊县勐伴镇上回落、下回落、盘山、象朵牙4个村寨发生的疟疾流行情况。方法对4个村居民的疟史、蚊帐覆盖及蚊媒进行调查，对发热病人及疑似疟疾病人血检。结果4个村近2年的疟史率平均为62．76％，4个村平均蚊帐覆盖率为42．86％。现场血检发热病人及疑似疟疾者318人，阳性130人，血检阳性率为41．40％，其中恶性疟102人，恶性疟比例达78．46％，共有30例查见配子体，配子体携带率为23．08％。4村总发病率为20．12％，瑶族村发病率较高。传疟媒介调查，微小按蚊占55．76％。结论4村发生了以恶性疟为主的点状暴发流行，微小按蚊为主要传疟媒介，发生原因是当地防疫网络不完善，传疟媒介大量存在及村民疟防知识匮乏等。     

广西宾阳县1954—2001年疟疾防治简况

宾阳县疟疾曾广泛流行，1954年发病率达157．58／万。1956—1957年，共血检居民2171人，疟原虫阳性121人，平均阳性率5．57％，其中间日疟占66．12％，恶性疟占3．26％，三日疟占25．62％。1957年学生脾脏检查1057人，脾脏肿大232人，脾肿率21．95％(10．91％－33．68％)；1958年全县进行疟疾调查420000人，有疟史19099人，疟史率为4．55％。主要传播媒介为微小按蚊和中华按蚊。4—11月为疟疾流行李节。1954年、1957年、1964年曾发生3次疟疾暴发流行，发病率分别为157．58／万、48．28／万、30．52／万，其余年份在一些地区也有局部性或灶性流行。     

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.     

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.     

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.     

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.