ACUTE ENCEPHALITIS IN CHILDREN A CLINICAL AND SEROLOGICAL STUDY OF TEN EPIDEMIC CASES

The incidence of acute encephalitis in epidemics was not known in the Chinese medical literature until 1936, when Su (1) reported from Amoy one series of five patients seen in July, 1935, and another of four patients seen from January to February, 1936. . One of them recovered and the rest all died. In the summer of 1938 ten cases of acute encephalitis were seen in the Pediatric Service of this hospital within a short period of 24 days. In six cases opportunities were available for the collection of convalescent sera and the determination of their neutralizing power against two strains of encephalitis virus. It is the purpose of this paper to report the clinical and serological find- ings in these cases.     

HPV感染在高发区与低发区宫颈癌中的检测

收集宫颈癌高发区湖北省五峰县宫颈癌活检组织２５例、宫颈炎２２例，低发区的宫颈癌活检组织４０例、宫颈炎１５例由湖北医科大学附二医院妇瘤科提供。应用ＧＰ－ＰＣＲ（ｇｅｎｅｒａｌｐｒｉｍｅｒｓ－ＰＣＲ）技术检测多型ＨＰＶ感染，发现宫颈癌高发区阳性率为８８．０％（２２／２５），低发区为８７．５％（３５／４０），宫颈炎高发区为３６．４％（８／２２），低发区为６．７％（１／１５）。同时同一份样品进行ＨＰＶ１６型Ｅ７基因的检测，在宫颈癌高发区中检出率为６０．０％（１５／２５），低发区为５２．５％（２１／４０），宫颈炎中为２２．７％（５／２２），而在低发区宫颈炎中没有检测到ＨＰＶ１６Ｅ７基因。结果表明：ＨＰＶ感染在高发区宫颈炎组织中明显高于低发区，两者差异具有显著性。     

Th17/Treg细胞失衡与乙肝病毒感染相关性肝病的关系

HBV感染相关性肝病是我国乃至全世界的一种常见性传染性疾病、发病率高、病程长、预后差,目前乙肝相关性肝病发病机制并不完全明确,HBV持续感染与机体免疫应答紧密相关,同时HBV的持续感染是引起宿主免疫调节紊乱,导致不能有效清除病毒、病情迁延不愈的原因之一,加之Th17/Treg细胞失衡可能参与了乙肝相关性肝病异常免疫反应,从而导致乙肝相关性肝病炎症慢性化、肝组织纤维化、肝硬化和癌变的形成。本文就Th17/Treg细胞失衡与乙肝相关性肝病的相互关系进行了综述和展望。     

银川地区几种气象因子对儿童呼吸道感染发生影响的探讨

目的：探讨银川地区几种气象因子对儿童呼吸道感染发生的影响，为预防这类疾病提供依据。方法：将四种气象因子气温，相对湿度，扬沙，浮尘分别同呼吸道感染发病率做单项回归分析和相关检验。结果：扬沙，浮尘对呼吸道感染发生的呈正相关（Ｐ〈０．０５）。气温，相对湿度对呼吸道感染发生的影响呈负相关（Ｐ〈０．０１），结论：证明呼吸系统疾病与气象因子有关，不同地区同一种气象因子对呼吸道感染的影响也不同。     

滹沱河献县泛区肾综合征出血热宿主动物监测研究

目的了解滹沱河献县泛区肾综合征出血热(hemorrhagic fever with renal syndrome,HFRS)宿主动物的构成、分布及携带汉坦病毒状况,为HFRS的防制提供科学依据。方法在泛区的3个监测点,分别于春季、秋季开展宿主动物调查,采用夹夜法调查鼠密度,免疫荧光法检测鼠肺病毒抗原。结果 2007-2011年监测点居民区鼠密度范围在0.67%～3.33%之间,野外鼠密度范围在0.22%～0.77%之间,居民区鼠密度高于野外(χ2=49.11,P<0.01);鼠带病毒率居民区为4.08%,野外为0.00%;鼠种构成以褐家鼠为优势鼠种(41.86%),其次是大仓鼠(33.72%)和小家鼠(17.44%);2份阳性鼠肺标本均为褐家鼠。结论滹沱河献县泛区是以褐家鼠为主要宿主动物的混合型疫源地,应采取以消灭住宅区褐家鼠为主的综合性防治措施。     

Incidence of Community-associated Methicillin-resistant Staphylococcus aureus Infections in a Regional Hospital

Background and Objective: Since the early 2000s, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections among the community of people lacking known healthcare risk factors has increased. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection and is distinct from hospital-associated MRSA (HA-MRSA) infection, which occurs among people with known healthcare risk factors. Understanding the epidemiology of CA-MRSA infections is critical; however, this has not been investigated in detail in Japan. Our objective was to investigate the incidence of CA-MRSA infections in a regional hospital.Patients and Methods: We investigated CA-MRSA isolates and infections in a rural regional hospital by reviewing medical records of one year. Infections were classified as CA-MRSA if no established risk factors were identified.Results: During 2008, 31 Staphylococcus aureus (S. aureus) isolates were detected in 29 unique patients, with 1 methicillin-sensitive S. aureus (MSSA) isolates obtained from 19 patients (66%) and MRSA obtained from 10 patients (34%). In the 10 patients with MRSA, the number of HA-MRSA and CA-MRSA cases were nine (32% of patients with S. aureus isolates) and one (3%), respectively. The patient with CA-MRSA was diagnosed with cellulitis due to CA-MRSA. All nine patients with HA-MRSA exhibited colonization.Conclusion: We observed a CA-MRSA case in a regional hospital in Japan, suggesting that incidence trends of CA-MRSA should be considered in future research and treatment.     

IIYGIENE AND PUBLIC IIEALTH GONOCOCCAL OPHTHALMIA AN EPIDEMIOLOGICAL STUDY

Infection of eyes with gonococcus is. a very serious condition and is regarded as one of the major causes of blindness in various parts of the world. In infants it goes by the name of ophthalmia neonatorum, and the infection is transmitted through the genital tract of mothers dur- ing delivery. In the pre-Crede days this formed one of the chief obstetrical complications. This disease is now rare where good obste- trics is practised. In the adult this condition is generally known as gonococcal ophthalmia. As a rule it occurs as chance infection through personal uncleanliness. The infrequent incidence of this disease in the adult in view of such widespread presence of gonauhea is remarkable. For it to occur as an epidemic is even still rarer. Therefore the report of such art epidemic as embodied in the present study should be of interest to the medical profession, particularly those interested in public health work of the country.     

西盟县1991～2009年疟疾疫情监测结果分析

目的分析1991～2009年西盟县疟疾发病及流行情况,评价发热病人疟疾血检措施的落实情况。方法将历年收集的疟疾疫情资料,现症病人、发热病人血检监测结果、居民带虫结果及相关流行病学资料进行回顾性统计分析。结果1991～2009年共报告疟疾疫情病例7 760例,其中间日疟7 271例,占93.70%,1991年发病率为39.02%;2009年发病率为1.80%;2009年与1991年发病率比较,下降95.39%。发热病人疟疾血检阳性8 216例,阳性率5.43%,其中间日疟7 670例,占93.35%;西盟县以间日疟流行为主。阳性病例中当地居民当地感染占88.49%;以当地感染为主。疟疾病例数,居民带虫率、疟疾病灶点数均以1998、1999年为最高;当地居民外出人员的疟疾感染率为6.02%,外来人口血检阳性率为20.81%,其中外地和境外感染输入阳性率为24.76%。病灶点2009年与1991年相比下降93.33%。结论近年来西盟县的疟疾发病率呈大幅下降,疟疾流行严重的态势得到了有效控制,但鉴于西盟县存在适宜传疟媒介繁殖的自然条件和以内源性疟疾感染为主的实际情况,疟疾疫情长期存在和出现反复的可能性不容忽视     

Improving mental health care for people with an intellectual disability in Singapore: bridging the health-social care divide

Intellectual disability is known to be associated with a high incidence of psychiatric co-morbidity and problem behaviours. However, there are many challenges in trying to meet the mental health needs of people with an intellectual disability, and these are often not adequately addressed in Singapore's current healthcare system. This article outlines the present service provisions for this area in the country and details the importance of, as well as difficulties in the integration of health and social care measures in service development and delivery.     

A rare case of community acquired Burkholderia cepacia infection presenting as pyopneumothorax in an immunocompetent individual

Burkholderia cepacia (B. cepacia) infection is rarely reported in an immunocompetent host. It is a well known occurence in patients with cystic fibrosis and chronic granulomatous disease where it increases both morbidity and mortality. It has also been included in the list of organisms causing nosocomial infections in an immunocompetent host, most of them transmitted from the immunocompromised patient in which this organism harbors. We report a rare case of isolation of B. cepacia from the bronchoalveolar lavage fluid of an immunocompetent agriculturist who presented with productive cough and fever associated with a pyopneumothorax. This is the first case of community acquired infection reported in an immunocompetent person in India.     

Prevalence and incidence of Entamoeba histolytica infection in South Africa and Egypt

There are little data on the true prevalence and incidence of Entamoeba histolytica infection in Africa. This is due to the inability, historically, to differentiate Entamoeba histolytica from the more common, but non-pathogenic, Entamoeba dispar. In addition, newer studies have demonstrated that the previous gold standard, culture with zymodeme analysis, is insensitive in detecting the presence of infection, especially when compared to PCR. Recent published articles as well as data from the authors' previous work are reviewed and summarized to elucidate what is known about prevalence and incidence of Entamoeba histolytica in Africa. The majority of data on asymptomatic infection are published from South Africa, Egypt and Cote d'Ivoire. Egypt has high rates of asymptomatic infection detected in the stool (>21%), whereas South Africa and Cote d'Ivoire rates range between 0 and 2%. Seroprevalence estimates the rate of recent infection, because anti-amebic antibodies generally persist for <5 years. Seropositivity rates (IgG, IgA) range from approximately 10 to 20%, indicating recent infection in this proportion of the population. Entamoeba histolytica infects a significant proportion of many populations of Africa; however, little data are currently available to indicate true prevalence and incidence. Further studies are needed to determine the burden of infection and disease in Africa.     

Natural foci of tsutsugamushi disease in the Nan Peng Lie Islands in China

目的：近年我国南潮列遍恙虫病率明显增高,而国内并无该地区恙虫病疫源地的记载,为当地人民的健康,本研究对该地区作为恙虫病疫源地进行全面调查与研究。方法：疫源地流行病学调查,病原分离,当地预防措施的制定。结果：该地区为南亚热带岛屿疫源地,主要宿主为褐家鼠,其季节消长与发病一致。主要媒介为地里纤恙螨,褐家鼠带螨率、地里纤恙螨的季节消长与发病均一致。从宿主与媒介分离35株恙虫病立克次体,鉴定7株大部分为Karp株。血清流行病学调查表明该岛居民恙虫病抗体阳性率极高。预防措施应用以后发病率降低。结论：这是第一次成功地证明我国南澎列岛是恙虫病疫源地。     

中国双胎及双胎合并出生缺陷的流行病学调查

目的：调查我国围产儿双胎与双胎合并出生缺陷尤其是合并神经管缺陷的发生率及其流行病学情况。方法：于1986年10月1日－1987年9月30日,对全国原29个省,市、自治区共945所城乡医院 住院分娩围产儿,进行了双胎出生率的调查及统一标准的出生缺陷前瞻性的监测,结果：全年共生围产儿1243284名,其中双胎12715对,双胎发生率为10．23％,双胎中出生缺陷发生率为36．81‰,其中神经管缺陷最为高发,为5．27‰,双胎的发生无南北地域及城乡的差异,多发生在生育期高峰年龄（20－29）岁,初产多见,1年中10,11月份出生的发生率高,双胎合并出生缺陷亦无明显南北地域及城乡差异,多发生在20－39岁,无产次及季节的差异;双胎合并神经管缺陷多见于北方诸省及农村人口,其发生与年龄及产次无明显关系;但与季节密切相关,11月份高发。结论：双胎合并出生缺陷,尤其是合并神经管缺陷的发生率均明显高于全国总围产儿合并出生缺陷及神经管缺陷的发生率,因此对双胎妊娠应注意作产前监测。     

FILARIASIS'IN CHINA WITH SPECIAL REFERENCE TO ITS DISTRIBUTION AND TRANSMISSION

Filariasis in China, so far as it is known at present,is confined to one variety, filariasis bancrofti, of which Wuchereria bancrofti is the cause. This infection runs a chronic course, often so mild as to cause no inconvenience to the host. Therefore some individuals, though harbouring a fairly large number of microfilariae in their blood, do not show any symptoms. Nevertheless sooncr or later infection may ter- minate in one or several sequelae or complications, notably the well known troublesome manifestation: elephantiasis.     

SEXUALLY TRANSMITTED DISEASE CONTROL IN CHINA(1949—1994)

ＳＥＸＵＡＬＬＹＴＲＡＮＳＭＩＴＴＥＤＤＩＳＥＡＳＥＣＯＮＴＲＯＬＩＮＣＨＩＮＡ（１９４９─１９９４）ＳｈａｏＣｈａｎｇｇｅｎｇ（邵长庚）；ＸｕＷｅｎｙａｎ（徐文严）ａｎｄＹｅＧａｎｙｕｎ（叶干运）（ＩｎｓｔｉｔｕｔｅｏｆＤｅｒｍａｔｏｌｏｇｙ，ＣＡ...     

论陈实功在中医外科史上的贡献

陈实功是我国明代著名外科医生,自幼精研外科医术,积40年的治疗经验写成了重要的外科学专著——《外科正宗》,该书对许多外科疾病的病因、诊断、治疗技术、医案记录、护理以及有关科学依据和学理等方面的记述,都明显超过了前人。陈氏致力创新,强调内外结合以治疗外科疾患,改变了过去外科只重技巧而不深研医理的落后状况,在发展外科医学方面起到了重要作用。陈氏还在书中告诫后学要端正言行,既要医德高尚,又要医术精湛,《外科正宗》又是一本很好的医德方面的教材。     

Is Routine Human Papillomavirus Vaccination an Option for Ghana?

Cervical cancer remains an important public health problem in developing countries where over 80% of the global burden occurs annually but screening has been ineffective. In a polygamous country like Ghana with a high incidence of cervical cancer but no national screening program, the Human Papilloma Virus (HPV) vaccine presents a unique opportunity to reduce the burden of HPV infection and cervical cancer in Ghanaian women. The evidence so far indicates that the vaccines are safe and efficacious. Although routine HPV vaccination of girls raises several religious, political, socioeconomic and ethical challenges, the emphasis of this paper will be on addressing the ethical challenges using the principles of autonomy, beneficence, non-maleficence and justice as a framework. Parental autonomy can be preserved with judicious exemptions for those who decline the vaccine on religious and philosophical grounds. This promotes public health without trampling parental authority. Routine HPV vaccination confers several benefits to individuals and society by preventing HPV infection. Instead of causing harm; it reduces harm by preventing the development of about 70% of cervical cancers and removing the negative physical and psychological impact of a cervical cancer diagnosis. It also has the potential to reduce the disparities in cervical cancer rates and its cost effectiveness will ensure considerable cost savings in terms of the money spent on diagnosis and treatment. Consequently, the HPV vaccine is an important public health landmark and achievement in women's health that must be heralded, especially in developing countries where the bulk of the disease and death occur.     

广西肝癌高发区成年居民乙型肝炎病毒感染的现况研究

目的探讨广西肝癌高发区防癌筛查对象的HBV感染现况。方法共采集筛查对象早上空腹静脉血15701人份,分离血清并检测其HBsAg和ALT等生化指标。结果防癌筛查对象的HBsAg阳性率为17．83％,ALT异常率为1．80％,HBsAg阳性且ALT异常的百分率为1．08％;男性筛查对象的HBsAg阳性率和／或ALT异常率均明显高于女性;随着年龄增长．防癌筛查对象的Ⅻ3sAg阳性率和／或ALT异常率逐渐降低。结论该地区不但是肝癌高发区,也是乙型肝炎高发地区。     

Usefulness of molecular techniques to identify ongoing tuberculosis transmission in Saudi Arabia

This study represents the first time that molecular tracing techniques have been used to identify patterns of tuberculosis TB infection in Saudi Arabia. The 2 strains were isolated from a socio-economically advantage family who share a number of common facilities including a car and a driver. There are several factors that may play vital roles in on-going transmission of TB in Saudi Arabia including a high number of expatriates, the Hajj pilgrimage, and the social habits of Saudi citizens. Our sibling case series is believed to be a frequent pattern of disease transmission in this country. Control measures such as health education, active case finding, and prompt and supervised medical treatment are needed. More studies using molecular techniques are recommended to find the incidence of cross infection in Saudi Arabia. In addition, molecular techniques have to be established in all reference laboratories to help the detection of ongoing active transmission, molecular epidemiology and detect sources of infection.