2016—2020年安徽省人群华支睾吸虫感染情况调查分析

目的 了解安徽省人群华支睾吸虫感染情况,为制定防治措施提供依据.方法 2016—2020年在全省56个县(市、区)设立华支睾吸虫病监测点,各监测点按地理方位划分为东、西、南、北、中5个片区,每片区抽取1个乡镇的1个行政村开展调查.在每个行政村整群抽取3周岁以上常住居民作为调查对象,调查人数不少于200人.收集调查对象的...     

2016—2020年北京市人体重点寄生虫感染监测分析

了解2016—2020年北京市土源性线虫病和华支睾吸虫病人群感染状况,为制定防控措施提供科学依据。2016—2020年,北京市每年设立3个监测点,包括土源性线虫病固定监测点和流动监测点各1个,华支睾吸虫病流动监测点1个,开展人群土源性线虫和华支睾吸虫感染状况监测,各监测点按照地理方位划分为东、西、南、北、中5个片区,每片区抽取1个乡(镇)的1个行政村,每个行政村整群抽取3周岁以上常住居民200人,采用改良加藤厚涂片法(一粪两检)检测虫卵,土源性线虫病监测点对3～9岁儿童加做透明胶纸肛拭法检测蛲虫卵。计算感染率,感染率间差异采用卡方检验。从传染病监测报告系统和流行病学调查资料收集华支睾吸虫病病例信息,对感染地和感染来源进行回顾性调查分析。2016—2020年,共调查15 200人,发现感染者10人,总感染率为0.07%(10/15 200),蛔虫和蛲虫感染率分别为0.06%(9/15 200)和0.01%(2/15 200),未检出华支睾吸虫感染者。山区感染率为0.13%(6/4 697),平原、丘陵和盆地等的感染率为0.04%(4/10 503),两者差异无统计学意义(P 0.05)。男性感染率为0.04%(3/7 148),女性感染率为0.09%(7/8 052),差异无统计学意义(P 0.05)。感染者年龄在33～65岁,感染者职业主要为农民(6人),其次为家务及待业人员(2人)。2016—2020年,北京市共报告华支睾吸虫病16例,14例有食用生鱼片史,2例有食用未熟透的鱼肉史。北京市土源性线虫病感染率已较低,近郊和远郊少数农村是防控重点地区;华支睾吸虫病例时有报告,应加强监测和健康教育。     

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。     

广西人体华支睾吸虫病流行现状分析与防制对策

目的了解广西华支睾吸虫病流行现状,提出适合其流行特点的对策。方法采用改良醛醚法或Kato-Katz法调查人群感染率;收集广西两次全国人体寄生虫调查数据及其他既往资料作回顾性分析。结果广西华支睾吸虫病流行区在扩大,人群感染率在升高,感染度在加重。目前全部89个县市中59个有本病,比1994年增加了14个县市;全省14个地级市中13个市的城区有本病流行;与首次全国调查时比较,2002年人群感染率上升7.1倍,中重度感染所占比例由26.3%上升到52.2%。7县18个调查点中,本虫已成为优势寄生虫虫种。提出了“成瘾型”流行区华支睾吸虫病的防制对策。结论广西华支睾吸虫病流行有蔓延、加重的趋势,应采取相应对策加以控制。     

超声检查华支睾吸虫病与胆石病的关系研究

目的分析研究华支睾吸虫病与胆石病发病的相互关系。方法分析华支睾吸虫病流行区1326名健康体检人员华支睾吸虫病和胆石病的超声表现及相关临床情况。结果 1326名受检者中检出华支睾吸虫病682例,占51.4%,检出胆石病398例,占30.0%。男性均明显高于女性(P0.01)。华支睾吸虫病组胆石病检出率51.6%,非华支睾吸虫病组胆石病检出率12.1%,两组比较差异有统计学意义(P0.01)。结论华支睾吸虫病是流行区内胆石病形成的危险因素。     

《华支睾吸虫病诊断标准》解读

华支睾吸虫是被世界卫生组织确认的胆管癌Ⅰ类致癌物。2005年调查显示,我国华支睾吸虫病流行区的标化感染率为0.58%,估算感染人数为1 249万人,且全球华支睾吸虫感染者中有80%分布在中国大陆。原国家卫生部卫生政策法规司于2009年3月13日颁布实施了《华支睪吸虫病诊断标准》(WS309-2009)。该标准由6章组成,包括适用范围、术语和定义、诊断依据、诊断原则、诊断标准和鉴别诊断。另附有3个资料性附录(病原学、流行病学和临床表现、酶联免疫吸附试验及鉴别诊断)和1个规范性附录(病原学检查)。该标准的颁布施行,为全国各级医疗机构和疾病预防控制机构诊断华支睾吸虫病提供了技术规范。本文结合我国华支睪吸虫病的流行情况,对《华支睪吸虫病诊断标准》(WS309-2009)的主要内容进行了解读,以促进该标准的宣传贯彻和实施。     

淮南地区华支睾吸虫病临床资料分析

华支睾吸虫病(clonorchiasis)是由华支睾吸虫成虫寄生于人肝胆管引起的一种严重危害人类健康的人兽共患病。淮河流域是重要流行区之一,其中淮南地区的发病率较高。该病易于继发肝胆系统其他疾病。作者对淮南地区华支睾吸虫病临床特征作了分析,以便为防治本病提供参考。     

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。     

判别分析法在华支睾吸虫病筛查中的应用

目的采用逐步判别分析法建立华支睾吸虫病判别函数,探讨其在华支睾吸虫病筛查中应用的可行性。方法在黑龙江省哈尔滨市木兰县采取整群随机抽样法,抽取10个沿江村屯常住人口作为调查对象,采用改良加藤厚涂片法检测受检者粪便中的华支睾吸虫虫卵。设计华支睾吸虫病调查表,用EpiData 3.1软件建立数据库并录入数据,用SPSS 15.0软件对数据进行判别分析。采用逐步判别分析法筛选变量,然后采用Fisher判别法建立判别函数,通过与改良加藤厚涂片法结果进行对比,评价判别函数的判别能力。结果判别函数中慢性胆囊炎、胆管炎、性别、吃生鱼、腹胀、民族、腹痛、年龄等8个变量有统计学意义,华支睾吸虫病判别正确率为88.75%。结论利用SPSS软件的强大数据处理和分析能力,可以快速简便地建立华支睾吸虫病判别分析函数。该函数具有较高判别分析能力,能够快速筛检本地区华支睾吸虫病患者,同时为其他华支睾吸虫病流行区建立快速筛检模式提供借鉴。     

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.     

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.     

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.     

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.