江西省九江地区血吸虫病与肝癌的相关分析

本文用流行病学方法分析了江西省九江地区血吸虫病与肝癌的关系。结果为５６５例肝癌病例－对照研究发现血吸虫病史、疫区居住史的相对危险性分别为３．１和２．８；血吸虫病发病率、死亡率与肝癌死亡率的地理分布一致，血吸虫病疫区３５－７４岁人群肝癌死亡率明显高于非疫区，提示该地区的血吸虫病可能是肝癌的诱因之一。     

马鞍山市血吸虫病非流行区和传播阻断地区疫情调查

目的 了解马鞍山市非流行区和已消灭地区血吸虫病的疫情以针对性地做好监测工作。方法 采用系统抽样结合环境抽查方法在疫点查螺。对血吸虫感染者和接触疫水者作个案调查。结果 1998—2001年马鞍山市非疫区和消灭地区共发生血吸虫病疫情4起，其中发现螺、病情2起，未发现钉螺但发生病情2起。发现钉螺面积28．6hm^2。IHA≥1：10的194人，感染率为10．6％。结论 与血吸虫病流行区吡邻的非疫区和血吸虫病传播阻断地区极易受到钉螺输入和传染源输入的威胁并可造成血吸虫病的流行。应加强这些地区的螺、病情监测，并积极开展血防健康教育。     

血吸虫病对人群生长、体能和劳动力的影响

血吸虫病分布非常广泛，对热带及亚热带地区的社会经济及人群健康影响仅次于疟疾。据ＷＨＯ１９８９年统计，血吸虫病流行于７５个国家和地区，全球约３１亿人生活在有血吸虫病流行的国家和地区，疫区５．６亿人口中有１．５亿人受到感染。我国是日本血吸虫病流行最严重及...     

60例晚期血吸虫病肝组织病理学观察──晚期血吸虫病与肝癌关系的探讨

九江地区是江西省血吸虫病流行严重的地区,发病率及死亡率均居本省首位,肝癌年均死亡率亦略高于全国平均水平[1]。针对防治工作中这一实际情况,我们从流行病学、血清学、动物实验、病理学4个方面与有关单位协作,开展了系列研究,以探讨本地区血吸虫病与肝癌的关系。流行病学研究,提示血吸虫病可能是肝癌的诱因之一[1];动物实验结果更直接提示感染血吸虫可促进肝癌的发生[2];在383例晚血病人的AFP检测中,阳性＞1：1000的13人,其中有7例系单纯性血吸虫性肝纤维化患者,提示血吸虫病与肝癌的发生可能有内在联系[3]。现就病理学观察…     

应城市血吸虫病流行区改水改厕的做法与体会

为了加快消灭血吸虫病的步伐，自1991年以来，应城市在全市血吸虫病流行区大力开展了改水改厕工作。现在，疫区改水改厕覆盖率分别达到97．4％和90．3％，明显改变了疫区环境卫生面貌，有力地阻断了血吸虫病的传播。方法1筹资1．l孝感市综合防治试点经费的30％，列入疫区改水改     

晚期血吸虫病患者乙型肝炎病毒DNA的检测及其意义

３１例晚期血吸虫病患者血清及肝组织乙型肝炎病毒ＤＮＡ（ＨＢＶ－ＤＮＡ）阳性率分别为９．７％及１９．４％低于血清及肝组织乙型肝炎病毒表面抗原（ＨＢｓＡｇ）检出率（分别为２９％及４８．４％），ＨＢＶ－ＤＮＡ阳性者病死率高（６６．６％），且死亡与肝病直接相关（肝衰竭及原发性肝癌）。ＨＢＶ－ＤＮＡ阴性患者病死率较低（１２％），其死亡与肝病无直接关系。结果提示，检测晚期血吸虫病患者ＨＢＶ－ＤＮＡ有重要意义。抗乙型肝炎病毒治疗对改善存在ＨＢＶ复制的晚期血吸虫病患者预后可能有重要作用，在血吸虫病疫区普及乙肝疫苗接种将对血吸虫病防治工作产生重大效益。     

全民化疗结合健康教育控制湖区血吸虫病效果的纵向研究

本文报道了鄱阳湖区血吸虫病重疫区实施全民化疗结合健康教育策略控制血吸虫病效果的纵向观察结果。结果表明，居民血吸虫病粪检阳性率从1992年的26.0％降到1994年的10．7％；感染度（EPG）从1992年的1．92降到1994年的0．55，居民的患病状况，如肝脾肿大、肝纤维化等在化疗后有较大的改善。根据湖区血吸虫病传播规律和不同人群血吸虫病防制效果，本文并提出此类疫区今后血吸虫病防治的优化策略。     

彭山县29例急性血吸虫病病例分析

彭山县是血吸虫病流行重疫区，分布于18个乡镇167个流行村，全县32万人，疫区人口23．4万人。2003年发生急性血吸虫病感染15例，2004年发生急性血吸虫病感染14例，两年共发生29例。     

东至县稠林村江滩血吸虫病流行现状的调查与分析

江滩地区是安徽省血吸虫病流行的重点地区。为了进一步摸清该地区血吸虫病流行的各种因素，为制定防治对策提供依据，我们于1994年对东至县江滩型重疫区稠林村进行了血吸虫病流行状况的调查与分析。1调查村概况稠林村位于东至县长江江外滩与七里湖垦区交汇处。该村总人口1789人     

金标免疫渗滤法诊断试剂盒诊断血吸虫病的价值研究

目的：评价金标免疫渗滤法诊断试剂盒（DIGFA－kit)用于血吸虫病血清流行病学调查的价值。方法：采用DIGFA与ELISA单盲平行检测各期血吸虫病病人血清，非流行区人群血清，疫区人群血清和血吸虫病已控制地区人群血清共2304份。结果：DIGFA检测血吸虫抗体的敏感性为96．8％，对非流行区健康人群的特异性为100％，该法检测疫区居民血清508份，抗体阳性检出率为35．6％，在Kato法粪检阳性的81人中，其中抗体阳性79人，阳性符合率为97．5％；检测血吸虫病已控制地区人群血清，抗体阳性率为4．6％，根据DIGFA的敏感性和对非流行区人群的特异性，计算其Youden's指数为0．926，上述各项结果与ELISA比较，差异无显著性（P＞0．05），结论：DIGFA与ELISA有相似的敏感性和特异性，且方法简便，快速，胶体金标记物制备容易，试剂稳定，运送方便，在现场和临床诊断更具有优越性。     

Coccidioidomycosis in Liver Transplant Recipients Relocating to an Endemic Area

Coccidioidomycosis is an endemic fungal infection of the desert southwestern United States. This infection occurs at a rate of 1% to 8% in solid organ transplant recipients residing in the endemic area, and it has a high rate of disseminated infection and mortality. The risk of infection among transplant recipients from nonendemic areas visiting or moving to an endemic region is not known. We reviewed the clinical course of 41 liver transplant recipients who originally resided in and underwent liver transplantation in an area of low coccidioidal endemicity and who later relocated their follow-up care to our program, which is located in an endemic area. No patients received antifungal prophylaxis to prevent primary coccidioidomycosis. Among 37 patients with at least 1 year of follow-up care, the incidence of new coccidioidal infection was 2.7%. Coccidioidomycosis was identified in one patient and was manifested by fatigue, anemia, and pulmonary nodules. This patient survived with oral antifungal therapy. Coccidioidomycosis was not a frequent event in liver transplant recipients from areas of low endemicity who relocated to our highly endemic area.     

望江县江滩型地区洪灾与血吸虫病流行关系的研究

目的探讨望江县江滩地区洪灾与血吸虫病流行的关系。方法通过螺情、病情和人群暴露调查,疫水测定及气象水文资料收集进行综合分析。结果试区1998年和1999年遭受洪灾,年降雨量分别为1756.9mm和2263.1mm。江滩新增钉螺面积16.50万m~2;汛后人群血吸虫感染率和感染度显著增高。结论洪灾造成钉螺扩散,增加人群暴露与感染,在血吸虫病传播动力学的主要环节上起促进作用。     

Balkan nephropathy and malignant tumors

The question of whether the cancer death risk is higher in Balkan nephropathy (BN) foci has been approached by a comparison of 25 BN endemic municipalities with the same number of the group matched ones. It came out that the total cancer mortality was considerably higher, and mortality of nonurinary cancer slightly higher in BN endemic municipalities. The absence of a significant difference for the non-urinary cancer sites the authors explain by the fact that in municipalities designated as endemic only a part of the population lived in actual BN foci. They re-evaluated data published for Bulgarian BN endemic foci and concluded that, apart of a higher total cancer mortality, there was a significantly higher (although unrecognized) risk of nonurinary deaths in BN endemic settlements.     

The high incidence of esophageal cancer in parts of China may result primarily from genetic rather than environmental factors

About 40 000 inhabitants migrated from a high‐risk area of esophageal squamous cell carcinoma (ESCC) to a low‐risk area of esophageal cancer 40 years ago. Little is known about the change in the mortality in esophageal cancer among these immigrants. This study examined the impact of changing environments on esophageal cancer by comparing age‐standardized mortality rates of immigrant group to the rates of native population (natives who live in high cancer location and have never moved) and host populations (hosts who live in low cancer location and have never moved people). All ESCC deaths taking place during 1999–2004 among the migrant, native, and host populations were identified by retrospective population‐based screening. Direct age‐adjusted mortality rates were calculated by using the China population of year 2000 as standard population. From 1999–2004, the average annual age‐adjusted mortality of ESCC for the migrant, native, and host population was 61.6/100 000, 59.7/100 000, and 6.7/100 000, respectively. No decreasing tendency was found in mortality rate of ESCC in the population of young immigrants. The mortality rate of ESCC of migrants remained high even they had been living in the low endemic region for 40 years. This study strongly suggested that genetic susceptibility, rather than environment exposure, is responsible for the high risk of ESCC in the migrants.     

黄山市山丘型血吸虫病传播阻断地区残存钉螺复现规律的探讨

目的探讨山丘型务血吸虫病传播阻断地区残存钉螺复现规律,指导监测工作。方法对全市1994～2002年螺情、气象等资料进行综合分析。结果 9年监测表明,残存钉螺主要分布在原疫情严重区县,有螺环境分布与历史螺情相一致,二者相关分析有非常显著性意义(r=0.9923,P<0.01)。有螺面积和有螺环境数于1997和2001年出现两次高峰。残存钉螺复现与降雨量等气象因素关系不密切。结论山丘型地区残存钉螺复现与历史疫情有关。     

APACHE II score and primary liver cancer history had risk of hospital mortality in patients with pyogenic liver abscess

BACKGROUND: The Acute Physiology and Chronic Health Evaluation II classification system has been extensively used for predicting the patient mortality in various diseases. However, its utilisation on the pyogenic liver abscess has not yet been well studied. AIMS: The purpose of this study was to validate this system on this high death rate disease. PATIENTS: A retrospective study was conducted to assess 314 patients with pyogenic liver abscesses admitted to tertiary medical centre in past 12 years. METHODS: The outcome measurement was the in-hospital mortality. A multiple logistic regression model was used to assess the association between mortality and Acute Physiology and Chronic Health Evaluation II score while controlling for the potential confounding factors. RESULTS: The overall in-hospital mortality was 8.3%. The mean Acute Physiology and Chronic Health Evaluation II score of the expired patients was higher (P<0.0001). The mortality rate increased rapidly when Acute Physiology and Chronic Health Evaluation II score >or=15. After controlling for the potential confounding factors, patient with high admission Acute Physiology and Chronic Health Evaluation II score >or=15 had a higher chance of in-hospital mortality (P<0.01). In addition, the primary liver cancer history is also a risk factor (P=0.03). CONCLUSIONS: The Acute Physiology and Chronic Health Evaluation II score and the primary liver cancer history predict the in-hospital mortality of the pyogenic liver abscess patient.     

Gastric adenocarcinoma after renal transplantation

BACKGROUND/AIMS: Little is known of the characteristics of gastric adenocarcinoma after renal transplantation. This study was performed to find out the incidence and clinicopathological features of gastric adenocarcinoma after renal transplantation in an endemic area for gastric cancer. METHODOLOGY: Between April 1979 and March 2001, fourteen gastric adenocarcinoma patients (0.7%) out of 2000 renal transplant recipients in a single institute were retrospectively reviewed. RESULTS: Gastric adenocarcinoma was identified in 14 recipients (8 males and 6 females; mean age 47.6 years) about 60 months after renal transplantation. Four patients had early gastric cancer; ten patients had cancer in an advanced stage. Eleven patients underwent surgical resection, while three with distant metastasis were treated symptomatically. There was no postoperative mortality. Seven patients survived without evidence of recurrence, whereas four died of recurrence and three of gastric cancer progression. CONCLUSIONS: Renal transplant recipients are at increased risk of gastric adenocarcinoma, the most common malignancy in Korea. With curative surgery, favorable prognosis can be anticipated when the diagnosis is made at an early stage. Regular endoscopic examination for early diagnosis is recommended during the follow-up period after renal transplantation in a gastric cancer endemic area.     

Early results of targeted prophylaxis for coccidioidomycosis in patients undergoing orthotopic liver transplantation within an endemic area

Abstract: Coccidioidomycosis (CM) is an endemic fungal infection of the desert southwestern United States. In immunocompromised hosts, such as transplant recipients, this infection is often a severe, disseminated disease with high mortality. A history of coccidioidal infection or positive serologic results increases the risk of CM after transplantation. At our institution, all liver transplant candidates with either positive history or serologic results for coccidioidal infection receive fluconazole in order to prevent recurrent infection after transplantation. Patients with neither a history of coccidioidal infection nor positive serologic results do not receive prophylaxis but are followed serologically every 3 months. From June 1999 to October 2001, 81 liver transplantations were performed at our institution in 76 patients with end-stage liver disease. Four of these 76 patients received prophylactic fluconazole in order to prevent CM. None of these 4 patients had reactivation of CM. A new coccidioidal infection developed after orthotopic liver transplantation in 1 of 72 patients (1.4%). Close surveillance and targeted prophylaxis are safe and effective alternatives to universal prophylaxis for CM in patients undergoing liver transplantation in an endemic area.     

Risk of cancer incidence and mortality associated with diabetes: A systematic review with trend analysis of 203 cohorts

AimWhether the relative risk of cancer incidence and mortality associated with diabetes has changed over time is unknown.Data synthesisOn August 12th, 2020, we electronically searched for observational studies reporting on the association between diabetes and cancer. We estimated temporal trends in the relative risk of cancer incidence or mortality associated with diabetes and calculated the ratio of relative risk (RRR) comparing different periods. As many as 193 eligible articles, reporting data on 203 cohorts (56,852,381 participants; 3,735,564 incident cancer cases; 185,404 cancer deaths) and covering the period 1951–2013, were included. The relative risk of all–site cancer incidence increased between 1980 and 2000 [RRR 1990 vs.1980: (1.24; 95% CI: 1.16, 1.34); 2000 vs.1990: (1.23; 1.15, 1.31)] and stabilised thereafter at a relative risk of 1.2; the relative risk of all–site cancer mortality was constant at about 1.2 from 1980 to 2010. Both magnitudes and trends in relative risk varied across cancer sites: the relative risk of colorectal, female breast, and endometrial cancer incidence and pancreatic cancer mortality was constant during the observed years; it increased for bladder, stomach, kidney, and pancreatic cancer incidence until 2000; and decreased for liver while increased for prostate, colon and gallbladder cancer incidence after 2000.ConclusionsAlongside the increasing prevalence of diabetes, the temporal patterns of the relative risk of cancer associated with diabetes may have contributed to the current burden of cancer in people with diabetes.     

Risk-stratified approach by aMAP score for community population infected with hepatitis B and C to guide subsequent liver cancer screening practice: A cohort study with 10-year follow-up

The aim of this study was to determine whether the age-Male-ALBI-Platelet (aMAP) score is applicable in community settings and how to maximise its role in risk stratification. A total of thousand five hundred and three participants had an aMAP score calculated at baseline and were followed up for about 10 years to obtain information on liver cancer incidence and death. After assessing the ability of aMAP to predict liver cancer incidence and death in terms of differentiation and calibration, the optimal risk stratification threshold of the aMAP score was explored, based on absolute and relative risks. The aMAP score achieved higher area under curves (AUCs) (almost all above 0.8) within 10 years and exhibited a better calibration within 5 years. Regarding absolute risk, the risk of incidence of and death from liver cancer showed a rapid increase after an aMAP score of 55. The cumulative incidence (5-year: 8.3% vs. 1.3% and 10-year: 20.9% vs. 3.6%) and mortality (5-year: 6.7% vs. 1.1% and 10-year: 17.5% vs. 3.1%) of liver cancer in individuals with an aMAP score of ≥55 were significantly higher than in those with a score of <55 (Grey's test p < .001). In terms of relative risk, the risk of death from liver cancer surpassed that from other causes after an aMAP score of ≥55 [HR = 1.38(1.02–1.87)]. Notably, the two types of death risk had opposite trends between the subpopulation with an aMAP score of ≥55 and < 55. To conclude, this study showed the value of the aMAP score in community settings and recommends using 55 as a new risk stratification threshold to guide subsequent liver cancer screening.