南宁市2014年登革热流行特征及防控效果

目的 分析南宁市2014年登革热流行概况,评价综合防控效果,为今后登革热防控提供参考依据.方法 收集南宁市2014年登革热疫情资料和蚊媒监测资料,采用描述性流行病学方法分析其流行因素和特征,用发病率、疫情持续时间、新发病例、布雷图指数评价综合防控效果.结果 2014年南宁市共发生登革热病例719例,年发病率10.62/10万;疫情涉及全市12个县区,发病高峰在9月和10月,占94.02％;女性感染率高于男性,临床症状均为轻型,有81.08％的病例呈现典型的登革热症状.经采取综合防控措施后,一周内平均布雷图指数和外环境平均标准间指数降低到安全值范围.结论 2014年南宁市登革热为一起输入性、局部多点暴发疫情,总体呈低流行态势,经政府主导、多部门联动,动员全社会共同参与,采取综合防控措施后,疫情得到有效控制,防控效果显著.     

手足口病的流行病学特征及临床预防情况分析

目的：分析手足口病的流行病学特征及临床预防情况。方法选择2012年1月与至2013年12月在我院接受治疗的手足口病患儿254例作为研究对象。以2012年12月31日为临界点，此时间之前的患者纳入2012年组，共158例，此时间之后(实施严格的预防措施)的患者纳入2013年组，共96例。对比不同时间组各季度的预防效果、手足口病的发病年龄分布情况以及手足口病的临床表现。结果采取预防措施后，2013年组的手足口病在各季度的发病例数均少于2012年组，差异有统计学意义(P<0.05)；两组各年龄段均有手足口患儿，但均主要分布在1~4岁，其中2013年组的1岁、2岁等年龄段的患儿手足口病发病率明显低于2012年组，差异均有统计学意义(P<0.05)；不同时间组手足口病患儿在症状和程度等方面比较差异均无统计学意义(P>0.05)；2012年组的致病病毒主要为CoxA，而2013年组的致病病毒主要为EV71，占比81.3%，显著高于2012年组的31.0%，差异有统计学意义(P<0.05)。结论手足口病主要在1~5岁婴幼儿群体中发病，近年来致病病毒已趋向为EV71，做好手足口病的预防措施，可以较好地降低发病率，效果明显，值得重视。     

深圳市南山区2014年登革热疫情流行病学特征分析

目的分析深圳市南山区2014年登革热疫情的流行病学特征。方法通过中国疾病预防控制信息系统获得本地登革热疫情信息,采用描述性流行病学方法对登记调查的病例进行流行病学特征分析。结果深圳市南山区2014年报告登革热患者104例,其中实验室诊断登革热103例,临床诊断登革热1例。输入性登革热患者46例,本地登革热患者57例,不明感染原因的登革热患者1例,发病率为9.29/10万,无死亡病例。流行季节在7月下旬至12月下旬,高峰在10月。全区各个街道均出现登革热患者,以蛇口街道居多。输入性登革热的输入来源地主要以东南亚国家为主。结论 2014年深圳市南山区登革热发病范围广,持续时间长,输入性登革热和本地感染登革热并存。 更多还原     

长治市2013-2017年流感流行病学分析

目的:分析长治市2013-2017年流感疫情现状及发病趋势,并提出有效防控措施.方法:选择长治市13个县市区各级各类医疗机构通过《中国疾病预防控制信息系统》报告的流感个案信息为研究对象,采用描述流行病学方法,按时间、职业、年龄性别进行分析.结果:全市2013-2017年共报告流感病例3 066例,发病率稳中略降,年平均发病率为18.12/10万,当年12月至次年1月为发病高峰,男性略高于女性,发病年龄主要集中在0～5岁、40～60岁,分别占13.76％、36.11％.结论:流感发病高峰为冬季,＜5岁和40～60岁年龄组是高发人群,强化监测,加大防控知识的宣传和普及,提高防控意识,提高流感疫苗接种率是控制流感传播的关键.     

岑溪市2020年登革热疫情流行特征及时空分析

目的 研究岑溪市2020年登革热疫情流行特征和时空分布特征,为该地区制定防控登革热疫情的公共卫生措施提供指导和参考依据。方法 运用描述性流行病学方法和空间分析方法对岑溪市登革热疫情的流行特征和时空聚集特征进行分析描述。结果 该研究共收集岑溪市2020年报告登革热367例,其中男性病例180例,女性病例187例,男女病例比为0.96∶1,性别患病情况差别不大;病例全部为当地轻症病例,无重症和死亡病例;9月16日—10月1日为发病高峰期,发病人群涉及各年龄组,30～49岁人群发病最集中,发病率最高的地区是岑城镇,其中岑城镇城厢社区和甘冲社区为高高相邻发病区域及一类聚集区。结论 岑溪市2020年登革热疫情在地区、年龄、职业之间的分布均有集中趋势,其中岑城镇作为具有发病高风险的地区,应该针对性制定防控措施。     

论广州市2012年登革热确诊病例流行病学特征及核酸检测分析

目的了解广州市2012年登革热的流行情况。方法收集广州市2012年登革热确诊病例的流行病学资料和血清标本,用荧光定量PCR检测并确定血清型。结果广州市2012年登革热发病率较2011年上升,发病高峰在9～10月间。输入地以东南亚为主,马来西亚和柬埔寨是主要的输入国家。流行地区以老城区为主,越秀区发病数居首位。4种登革热血清型均有检出,以4型为主。结论广州市登革热疫情形势不容乐观,存在登革热暴发的潜在风险,疫情防控形势较为严峻。     

新疆维吾尔自治区2007～2009年流行性腮腺炎流行病学分析

目的：了解新疆维吾尔自治区流行性腮腺炎流行情况,分析流行因素,为今后有效防控流行性腮腺炎提供依据。方法：对新疆维吾尔自治区2007～2009年疫情网络上报的流行性腮腺炎病例,采用描述流行病学方法作疫情分析。结果：2007～2009年发病率逐年下降,发病时间集中在春末夏初和秋末冬初,以学生和托幼机构儿童为主,年龄集中在3～15岁,男女比例为1：0.7.结论：流行性腮腺炎最有效的预防措施是接种含腮腺炎病毒成分的疫苗：防控关键在中、小学校和托幼机构。     

兴业县2013年—2015年手足口病流行病学特征分析

目的 分析手足口病(HFMD)流行病学特征,以做好预防工作.方法 采用描述性流行病学方法 分析兴业县2013年—2015年手足口病流行病学特征.结果 兴业县2013年—2015年共报告HFMD病例9839例,重症病例为16例,年均发病率为433.01/10万.每年各个月份均有发病,以4月~10月发病较为集中,共8762例,占总数的89.05%;发病人数最少的在1月~3月和次年的11月~12月,共1077例,占10.95%.男性多于女性,男女比例为1.63:1.发病人群集中在<5岁,共8922例(占90.68%).致病毒菌以肠道病毒71型(EV71)和柯萨奇病毒A组为主.结论 兴业县2013年—2015年手足口病的发病存在明显的年龄、季节、性别差异,需加强措施进行针对性防控.     

深圳市福田区2014年登革热疫情流行病学特征分析

目的 分析2014年深圳市福田区登革热疫情流行病学特征,探讨预防控制措施.方法 对各医院报告的福田区病例进行流行病学个案调查,采集病例血液样本开展血清学或病原学检测,并划定疫点进行蚊媒调查和病例搜索.结果 深圳市福田区2014年报告登革热病例87例,发病率6.52/10万,无死亡病例;发病高峰出现在10月份,当月气温徘徊在25～30℃,适宜白纹伊蚊生长;男女性别比为1:0.47;发病年龄最小13岁,最大67岁,以青壮年为主.全区有2个暴发点,病毒型别主要为登革热Ⅰ型.疫情发生时布雷图指数最高达140.结论 深圳市福田区存在登革热流行的基本条件,疫情存在着明显的季节性、人群对登革热普遍易感等特征.有效控制疾病传播媒介白纹伊蚊是控制疫情的根本措施,疫情的早发现早报告也是有效控制措施之一.     

2014-2019年深圳市南山区本地登革热时空分析

目的了解2014-2019年深圳市南山区本地登革热流行病学特点,明确南山区登革热本地病例高发区域及高发时间。方法采用描述性分析方法分析2014-2019年南山区登革热本地病例流行病学概况,探索高发时间,采用地理信息系统(GIS)技术探索登革热高发区域。结果 2014-2019年南山区共报告167例本地登革热病例,累计发病率11.18/10万;病例男女性别比为1.74∶1,年龄以20~50岁为主(115例,占68.87%),职业以民工最多(39例,占23.35%)。南部的蛇口街道累计发病率最高(24.08/10万),中部的粤海街道最低(1.40/10万)。南山区本地登革热疫情具有明显的季节性,发病时间分布在8-12月,以10月最多(102例,占61.07%)。空间自相关分析(Moran's I=0.14,Z=2.72,P=0.003)显示南山区本地登革热分布具有明显地域聚集性,核密度估计显示本地登革热发病有4个聚集区域,分别为福光、渔一、阳光棕榈和西丽社区,空间扫描分析结果显示南山区本地登革热分布主要有3个聚集区,均涉及工地,其中一级聚集区为桃源街道的塘朗和福光社区(RR=11.16),二级聚集区位于西丽街道(RR=4.68),三级聚集区位于蛇口街道(RR=2.49)。结论南山区登革热本地病例分布具有明显的时空特征,工地是高危地区,本地登革热防控应早于8月,并将有限卫生资源向高危区域合理倾斜。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.