吡喹酮隔年普治控制血吸虫病效果研究

１９９４－１９９７年在感染率〉１５％的流行村进行为期４年的吡喹酮隔年普治（Ａ组）和每年普治（Ｂ组）对照试验显示，Ａ组人群感染率下降７８．２３％，耕牛感染率下降６３．６１％，人群ＥＰＧ下降７９．９０％；Ｂ组分别下降７７．６９％，４６．４０％和９２．８４％。两组粪是性者的Ｂ型超声波图像干预前后无显著性差异。两组效果相当，但是Ａ组费用仅Ｂ组的１／２。对于经济欠发达的高度流行区，用吡喹酮隔呈次是一种既能有     

血吸虫病中度流行区不同感染率人群化疗方案的选择

目的 评价在中度流行区较高感染率人群（≥10％而＜15％）采用“询诊”法筛检的化疗方案和在中度流行区较低感染率人群（10％而＞3％）采用IHA法隔年筛检1次的化疗方案的防治效果和费用－效果。方法 在血吸虫病流行区选择人群感染率为10％左右的5具行政村的沿湖20个村民组作为试区，其中10个村民组实行“询诊”法筛检的化疗方案，另10个村民组实行IHA法筛检的化疗方案。方案实施2年后评价两种化疗方案的防治效果和费用－效果。当人群感染率下降到较低水平后，两组均采取IHA法隔年筛检1次的化疗方案，观察其防治效果和费用－效果。结果 通过2年现场实施，“询诊”组人群感染率下降66．4％，每百人感染率下降1％的费用为4．86元，“询诊”组的防治效果是IHA法筛检组的1．8倍，费用－效果是IHA组的0．75倍。当感染率下降到较低水平后，IHA法筛检方案的防治效果是较高感染率时的2倍以上，每百人感染率下降1％的费用是较高感染率时的0．6倍以下。结论 在中度流行区较高感染率人群宜采用“询诊”法筛检的化疗方案；在中度流行区较低感染率人群可采用免疫学方法筛检的化疗方案。     

湖区消灭传染源阻断血吸虫病传播的研究

选择湖沼型洲垸亚型、河滩水位不能控制的现场作为实验区。实验区2900人,居民感染率21.33％～32.81％,牛感染率35.90％～40.79％,人群肝肿大率35.89％,属重流行区。1987～1990年,A、B两村同时实施吡喹酮“2、4、4”化疗方案,但B村第1年对易感地带加1农药物灭螺。居民感染率分别由21.33％及32.81％下降到1.11％及0.26％,下降94.80％及99.21％;钉螺感染率下降89.62％及83.54％,B村已无新感染,取得明显的防制效果。表明A与B村所实施的两种方案都是可行的,“2、4、4”化疗方案具有效显、价廉、适用的优点。对照村（C）虽有一定防制效果,但4年急感5人。比较A村与B村、B村与C村、A村与C村4年间人群总阳性率,均有显著差异。     

比较群体化疗和目标化疗在较高感染率水平的成本─效果研究

在枞阳县凤仪乡选择感染率在12％左右的2组人群，分别实施群体化疗方案（A组）和目标化疗方案（B组），对其防治效果及实施成本进行了对比观察和分析。结果：连续实施2年，2组人群感染率分别下降69．37％和56．75％（P＞0．05）；实施成本分别为14．26元／人均和9．70元／人均；而单位效果成本，第1年B组是A组的1．4倍，第2年A组则是B组的1．8倍。提示在较高感染率水平（12％以上）的人群中宜采用群体化疗方案，而当其感染率水平降低到一定程度（8％以下）时，则应改用目标化疗方案。     

肠道线虫病现场防治研究

经对肠道线虫病现场防治研究，结果为单纯普治试点乡（淮阳）经１９９１～１９９３年连续３年冬季普治抽检人群防治后，钩虫，鞭虫感染率下降显著，分别由１９９１年的１４．６％和８．０％下降为１９９５年的１．２％和０．７（Ｐ〈０．０１），鞭虫，蛲虫感染率下降幅度较小，分别由１９９１年的２９．６％和２７．８％下降为１９９５年的２６．２％和１３．０％，土壤和水样中虫卵和钩蚴污染率亦明显下降，综合防治试点乡（项城）     

肠道线虫病现场防治研究

经对肠道线虫病现场防治研究，结果为单纯普治试点乡（淮阳）经１９９１～１９９３年连续３年冬季普治抽检人群防治后，钩虫、鞭虫感染率下降显著，分别由１９９１年的１４．６％和８．０％下降为１９９５年的１．２％和０．７％（Ｐ＜０．０１）。蛔虫、蛲虫感染率下降幅度较小，分别由１９９１年的２９．６％和２７．８％下降为１９９５年的２６．２％和１３．０％。土壤和水样中虫卵和钩蚴污染率亦明显下降。综合防治试点乡（项城）防治后蛔虫、钩虫、鞭虫感染率呈逐年下降态势，防治前与防治后（至１９９５年）各年间同种虫感染率有显著性差异（Ｐ＜０．０１）。防治前蛔虫、钩虫和鞭虫感染率分别为３５．２％、７．２％和２．９％，至１９９５年分别降至７．１％、０．２％和０．５％。土壤和水样中虫卵和钩蚴污染率亦明显下降。但蛲虫感染率无明显下降。结果表明，冬季全民普治对钩虫、鞭虫感染有良好的防治效果，对蛔虫、蛲虫感染防治效果较差；而综合防治可弥补前者的不足，对感染率较高的蛔虫感染亦有良好的防治效果     

云南省血吸虫病重度流行区化疗后两种维持巩固方案的研究

目的 探索云南省血吸虫病重度流行区化疗后维持巩固方案。方法 在原血吸虫病重度流行的坝区,经连续人、畜同步化疗后,选择居民感染率降至8％左右的中和行政村。随机分为A、B两组,各组约1000人。A组3 －60岁人群每年用IHA筛检约600人,阳性者化疗,扩大化疗至400人左右。B组每年用询检法筛检3－60岁人群,确定化疗对象400人左右。每年春秋两季各组在村庄周围及交叉路口周围环境查灭螺1次,化疗25％的牛群,干预措施连续2年。结果 A组居民感染率下降78．00％,儿童感染率下降64．40％,钉螺自然感染率下降16．66％,感染螺平均密度下降60．03％。B组居民感染率下降84．12％,儿童感染率下降78．77％,并且于第2年秋季及效果考核时未发现阳性钉螺。结论 用IHA筛检及询检法筛检各化疗50％人群。辅以桂冠周围易感环境灭螺方案匀可作为云南省重疫区连续化疗后的维持巩固措施,而且B方案防治效果较好。     

消化性溃疡与幽门螺杆菌的关系研究

目的探讨消化性溃疡与幽门螺杆菌的关系。方法研究对象为2007-2008年来我院消化科就诊并且经过胃镜确诊的患者人群。分为A、B两组,A组31例,均为消化性溃疡（胃、十二指肠溃疡）患者,B组28例,均为浅表性胃炎或正常人群,均经胃镜检查确诊。A、B两组人群在给予胃镜检查的同时取胃、十二指肠黏膜组织,置于Hp指示剂中以诊断是否感染Hp。结果A组Hp阳性25例,感染率80．6％,B组Hp阳性9例,感染率为32．1％,A、B两组Hp感染率比较,差异有显著性（P〈0．05）。结论消化性溃疡患者感染Hp明显高于正常人群,从而提出Hp感染是消化性溃疡产生的重要致病因素。     

吡喹酮顿服疗法伍用护肝药护肝效果观察

目的探讨吡喹酮40mg／kg顿服治疗慢性血吸虫病是否必须口服护肝药。方法在疫区现场随机抽取266例慢性血吸虫病人，分为两组：一组为吡喹酮加护肝药（护肝组），另一组为吡喹酮加安慰剂（对照组）。治前与治毕7～10d，检查肝功能，并辅以询诊和重点体检。结果两组治疗前后总胆红素、直接胆红素、总蛋白、A／G比值均正常。ALT〉40U（40-55U），治前护肝组14例（10．77％），对照组11例（8．090／0），两组比较差异无统计学意义（X^2=0．56，P〉0．05）；治后复查，护肝组4例（3．74％），对照组8例（6．890／0），两组差异亦无统计学意义（X^2=1．09，P〉0．05）。治后随访期间，两组均无厌油、食欲减退、肝区疼痛不适等肝损害表现。结论吡喹酮40mg／kg顿服治疗慢性血吸虫病可以不伍用护肝药物。     

健康教育提高重度流行区白族人群化疗依从性的研究

在洱源县重度流行疫区选择传播资源基本相同的4个白族自然村，共2000人，以村为单位随机分为A、B2组。进行基线调查，结果表明：A组血防知识及格率为48．20％、化疗覆盖率61．60％、人群感染率16．00％。B组血防知识及格率为54．20％、化疗覆盖率65．40％、人群感染率15．48％。在A组中对不同的目标人群用不同的传播途径进行健康教育和培训，B组采取一般防治措施。2年后进行效果评估结果为：A组血防知识及格率93．37％、化疗覆盖率93．35％、人群感染率5．18％。B组血防知识及格率55．83％，化疗覆盖率66．23％，人群感染率10．84％。A组人群感染率较B组下降52．21％，达到预期目标。     

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.