广州花都地区华支睾吸虫病流行现状及防治对策

[目的]了解广州市花都区华支睾吸虫病的人群感染现状及流行特征,研究当地华支睾吸虫病的感染因素,为当地华支睾吸虫病的防治工作提供科学依据.[方法] 2011年8月～10月对花都区各乡镇常住居民进行华支睾吸虫病流行病学调查.采用酶联免疫吸附法检测血清中华支睾吸虫特异性抗体;改良加藤厚涂片法检测粪便虫卵;同时通过问卷调查了解与华支睾吸虫感染相关的内容.[结果]共调查1 800人,粪检检获华支睾吸虫卵者705人,平均感染率为39.17％,平均每克粪便虫卵数(EPG)为367.男性感染率为43.06％,女性感染率34.51％,差异有统计学意义(P＜0.01).各年龄组均有感染,成年人感染率较高,各年龄组华支睾吸虫的感染率差异有统计学意义(P＜0.01).不同职业人群华支睾吸虫感染存在显著差异,以渔民、饮食服务人员和商人感染率最高.问卷调查结果显示,69.2％的被调查者吃过淡水鱼生,48.5％的家庭生熟食物所使用的刀具、砧板没有分开,80％以上的居民对华支睾吸虫病防治知识知之甚少.[结论]广州市花都区仍然是华支睾吸虫重点流行区之一,居民的不良饮食及生活习惯是华支睾吸虫流行的重要因素,应加强宣传教育,积极开展综合性防控工作.     

江门市新会区华支睾吸虫病流行现状调查与分析

目的 了解江门市新会区华支睾吸虫病的流行现状,确定华支睾吸虫病的高危人群,提供当地华支睾吸虫病感染因素的线索.方法 采用免疫酶联吸附法检测血清中华支睾吸虫特异性抗体;采用改良加藤氏法检测粪便虫卵;采用消化法检测淡水鱼中华支睾吸虫囊蚴;进行问卷调查华支睾吸虫感染相关的生活和行为方式;同时采用病例对照方法分析影响华支睾吸虫感染的相关流行因素.结果 共调查1 720人,华支睾吸虫平均感染率为18.14%,男性感染率高于女性(P<0.001).各年龄组均有感染,感染率差异有统计学意义(P<0.001).共调查常见淡水鱼6种共273尾,6种淡水鱼体内均查到华支睾吸虫囊蚴.病例对照研究显示,吃半熟鱼习惯及外出饮食等行为是最重要的危险因子.结论 新会区华支睾吸虫病流行范围广,感染率高,已经成为一个严重的公共卫生问题,应积极开展综合性防控工作.     

佛山市南海区人群华支睾吸虫感染现况分析

目的了解南海区华支睾吸虫病感染状况及流行特点,为制定防治策略提供依据。方法采用分层随机整群抽样方法,以改良加藤氏厚涂片法粪检华支睾吸虫卵。结果共调查1137人,其中感染华支睾吸虫为263人,感染率为23.13%。男性感染率27.05%高于女性感染率19.15%（χ2=9.98,P〈0.05）;未成年组（0-15岁组）感染率3.98%低于成年组（20-岁组）感染率32.63%（χ2=16.82,P〈0.05）,沙头镇人群华支睾吸虫感染率高于里水镇（χ2=143.36,P〈0.05）。结论南海区人群华支睾吸虫感染仍属高度流行区。人群华支睾吸虫感染与生产方式、生活习惯、卫生条件等密切相关,应加大宣传力度,提高卫生意识,改变生活、饮食习惯,从而有效人群控制华支睾吸虫感染。     

广州市部分职业人群华支睾吸虫感染现状调查

目的了解广州市东山、荔湾、越秀、海珠区公务员、医务人员及银行等职业人群的华支睾吸虫病分布状况及流行特点,为今后制定防治策略提供依据。方法用改良加藤氏厚涂片法粪检华支睾吸虫虫卵。结果4个区共粪检1204人,华支睾吸虫感染150人,感染率为12.46%。远高于全国感染率(0.40%)和1998～2003广州市平均感染率(6.59%)。结论这4个区部分职业人群华支睾吸虫感染率较高,应加强宣教工作,改变人们的不良饮食习惯,提高个人防护意识;采取综合防制措施,阻断华支睾吸虫传播流行。     

佛山市南海区人群华支睾吸虫感染现况分析

目的了解南海区华支睾吸虫病感染状况及流行特点，为制定防治策略提供依据。方法用分层随机整群抽样方法抽取样本．用改良加藤氏厚涂片法粪检华支睾吸虫卵。结果共调查1137人，发现感染华支睾吸虫为263人，感染率为23．13％。男性感染率27，05％高于女性感染率19．15％（x^2=9，98，P〈0．05）；未成年组（0～15岁组）感染率3、98％低于成年组（20～岁组）感染率32．63％（X^2=16．82，P〈0．05），沙头镇人群华支睾吸虫感染率高于里水镇（X^2=143．36，P〈0．05）。结论南海区人群华支睾吸虫感染仍属高度流行区。人群华支睾吸虫感染与生产方式、生活习惯、卫生条件等密切相关，应加大宣传力度，提高人们卫生意识，改变生活、饮食习惯，以有效人群控制华支睾吸虫感染。     

珠海市农村地区2010年华支睾吸虫感染情况调查及其危险因素分析

目的了解珠海市农村地区华支睾吸虫感染和流行现状,为制定防治规划提供科学依据。方法采用改良加藤厚涂片法(kato-katz法)检查华支睾吸虫虫卵,并进行华支睾吸虫知晓和防治状况调查。结果本次抽样调查斗门区5个乡镇共1000人,检出华支睾吸虫感染者63人,以中年男性为主,总感染率为6.3%(63/1000)。被调查者对于肝吸虫防治知识的知晓率为87.8%,生熟食品砧板分开成为感染华支睾吸虫病的保护性因素(OR=0.11,OR95%C.I.(0.02-0.62)。结论珠海市农村地区华支睾吸虫感染率低于全省平均水平,肝吸虫防治知识知晓率较高,生熟食品砧板分开是感染华支睾吸虫病的保护因素。     

肇庆市华支睾吸虫病中间宿主感染情况及流行因素调查

目的了解肇庆市华支睾吸虫（肝吸虫）中间宿主感染的情况及流行因素,阻断和控制肝吸虫病在我市的传播流行。方法流行因素现场调查;淡水螺类采用解剖压片法;淡水鱼采用人工消化法;猫、狗、猪采用动物肝脏胆囊解剖法。结果肇庆市家常淡水鱼中的鲩鱼、鳙鱼、鲤鱼等3种鱼检出华支睾吸虫囊蚴,其中感染率最高的是鲩鱼为20.0%,各种鱼类总感染率为6.67%。阳性鱼主要集中在端州、高要和鼎湖等地。第一中间宿主淡水螺及保虫宿主均没检出阳性。结论鼎湖区、高要市是肇庆市肝吸虫病传播流行的源头,也是我市肝吸虫病防控的重点所在。     

台山市华支睾吸虫病基线调查

目的调查台山市华支睾吸虫病流行现况，为大规模开展华支睾吸虫病防治工作和评价防治效果提供科学依据。方法以随机抽样方法抽取台山市台城镇、大江镇作为调查点，采用改良加藤氏厚片法粪便检查人群华支睾吸虫卵。并开展中间宿主和保虫宿主调查；对华支睾吸虫住院慢性病人进行危害性调查。结果华支睾吸虫总感染率为6．8％；男性感染率为7．0％，女性感染率为6．5％，以20～49岁年龄组最高。解剖淡水鱼、猫、狗、老鼠没发现华支睾吸虫囊幼和成虫，但9份猫肝中均发现华支睾吸虫卵。结论华支睾吸虫已对当地居民的健康造成较严重的危害，应采取综合措施减少华支睾吸虫感染。     

深圳市公务员华支睾吸虫感染情况调查

目的调查深圳市公务员华支睾吸虫感染情况。方法采用系统抽样方法抽取1918份公务员血清样本,以酶联免疫吸附试验（ELISA）检测其华支睾吸虫IgG抗体。结果共调查1918人,血清华支睾吸虫IgG抗体阳性者为126人,感染率6.6%。其中男性感染率为6.8%,女性感染率为5.2%。在各年龄组中以50～59岁年龄组感染率最高。结论公务员华支睾吸虫感染率高于居民总体感染水平,应将公务员作为华支睾吸虫病防治的重点人群。     

华支睾吸虫病流行区流行病学研究

目的 为了解广州市番禺区华支睾吸虫流行情况，于2000年6月～2002年10月在番禺沙湾镇的紫坭村和石基镇的前锋村开展了华支睾吸虫病流行病学调查。方法 采用改良加藤氏厚涂片法粪便检查人群华支睾吸虫卵；华支睾吸虫感染静脉采血作转氨酶、乙肝表面抗原、核心抗体检测和腹部B超检查；开展中间宿主和保虫宿主调查。结果 华支睾吸虫总感染率13．7％。其中紫坭村感染率18．2％；前锋村感染率8．O％；男性感染率为22．3％，女性感染率为6．6％，以20～50岁年龄组最高。华支睾吸虫感染HBsAg阳性率为20．9％，HBeAb阳性率为40．3％；42．4％感染出现不同的肝胆道病变；在当地鱼塘的鱼苗中找到华支睾吸虫囊蚴；解剖当地犬、猫中，均发现华支睾吸虫成虫。结论 番禺区是华支睾吸虫重点流行区之一，且华支睾吸虫已对当地群众的身体健康造成了严重危害。     

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.