成都地区组织胞浆菌感染的流行病学调查

作者用组织胞浆菌素在成都市郊区的绵竹县对２７１例健康成人进行了组织胞浆菌病的流行病学调查，发现感染率为２１．７７％，健康人群组的ＰＰＤ阳性率为２６．２０％，两种皮试均为阳性者占８．１２％，其中ＰＰＤ强阳性又伴组织胞浆菌素阳性者占２．２１％。调查成都市某结核病院３３例住院结核病人，组织胞浆菌素阳性率为５４．５５％，ＰＰＤ阳性率为３６．３６％，合并感染率为２１．２１％。     

卡介苗对医务人员免疫效果观察

近年来结核病发病率有所回升，从而增加了蓖务人员因职业暴露而感染的机会，为评价卡介苗对蓖人员的免疫效果，１９９４年对２４名结核菌素（ＰＰＤ）试验阴性的医务人员拉处了卡介苗，接种后２个月复查ＰＰＤ试验阳性率为１００％，硬结平均直径为１２．２９±４．４５ｍｍ；接种后一年复查２０人，ＰＰＤ试验阳性维持率达１００％，硬结平均直径为９．５±３．７６ｍｍ，接种部位多数形式卡痕，提示卡介苗对成年易感者仍具有良好的     

医院感染患者血粘附分子的变化意义

目的研究粘附分子在医院感染患者发病过程中的变化意义。方法用流式细胞术测定６４例医院感染患者血粘附分子ＣＤ４４, ＣＤ５４,ＣＤ６２Ｐ的变化,并与２０例正常人比较。结果医院感染患者血粘附分子ＣＤ４４（ ２１．２％９．１％）,ＣＤ５４（５．４％±２．７％）,ＣＤ６２Ｐ（１８．９％±７．６％）较正常人（８．６％ ±４．４％,２．０％ ±０．９３％,６．３％±３．５％）明显升高（Ｐ＜０．０１）;轻症医院感染患者上述指标（１５．２％ ±５．９％,４．０％±２．１％,１３．８％ ±５．６％）较重症医院感染患者（２７．２％± ８．１％,７．２％± ３．８％,２６．３％± ５．２％）显著降低（Ｐ＜０．０５）,但仍高于正常人（Ｐ＜０．０５）。结论粘附分子升高在医院感染的发病机制中起重要作用,对判断或监测病情有一定意义。     

加硒食盐对疾病的干预效果观察

报告添加１５×ｌ０￣（－６）亚硒酸钠的富硒食盐对扬中居民主要疾病的５年干预效果（１９８９～１９９３年）。吃硒盐的５个乡镇１２．６万人，吃普通盐的５个乡镇１０．４万人，试验开始前成人血硒值０．０７２±０．０２μｇ／ｍｌ，观察结束时普盐区血硒０．０８５６±０．０１７μｇ／ｍｌ，硒盐区为０．０９２±０．０１３５μｇ／ｍｌ。普盐区１９８７～１９８８年总死亡率为８２５．３９×１０￣（－５），１９９０～１９９３年为８２０．５０×１０￣（－５），硒盐区则从７４９．８５×１０￣（－５）降为７０６．１５×１０￣（－５）下降了４３．７×１０￣（－５）或５．８３％。其中恶性肿瘤后４年比前２年下降３×１０￣（－５）或１２％，有统计意义，而对照区前后变化不大。主要呼吸系病（肺炎、支气管炎、肺气肿、哮喘）和３种心脏病（高血压性心脏病、急性心肌梗塞、冠心病）死亡率，硒盐区皆有下降而对照区均呈上升但未达显著性水平，未观察到硒盐对脑血管病及肝炎有何作用     

^99mTc—DTPA测定肠道通透性的方法及应用

目的：建立９９ｍ锝┐乙三胺五乙酸（９９ｍＴｃ┐ＤＴＰＡ）测定肠道通透性的方法并观察其在临床和动物实验研究中的应用效果。方法：口服９９ｍＴｃ┐ＤＴＰＡ３７～７４ＭＢｑ，收集２４ｈ尿液，γ计数器测定尿液中ＤＴＰＡ排泄量。采用此方法观察了９例健康人和２５例胃肠道手术病人手术前及术后７天肠道通透性，３组病人术后７天分别给予谷氨酰胺０ｇ／（ｋｇ·ｄ）（Ａ组，ｎ＝８），０．３ｇ／（ｋｇ·ｄ）（Ｂ组，ｎ＝８）和０．６ｇ／（ｋｇ·ｄ）（Ｃ组，ｎ＝９）；１０头杂交猪自体小肠移植后分别给予标准全肠外营养（ＳＴＰＮ组，ｎ＝５）和强化３％甘氨酰谷氨酰胺的全肠外营养（ＧＴＰＮ组，ｎ＝５）２８天观察移植小肠的通透性。结果：９例健康人２４ｈ尿液ＤＴＰＡ排泄率为４．８６±１．８６％，术后７天Ａ、Ｂ二组病人ＤＴＰＡ排泄率较术前明显增加（６．６４±３．９５％ｖｓ１３．７１±４．８５％；８．８８±３．９５％ｖｓ１０．７６±２．８８％，Ｐ＜０．０５），Ｃ组手术前后肠道通透性无变化（６．８０±２．１２％ｖｓ３．５５±１．２９％，Ｐ＞０．０５）。术后２８天ＳＴＰＮ组ＤＴＰＡ排泄率明显高于ＧＴＰＮ组（２４．０１±７．４４％ｖｓ７．７７±３．０４％，Ｐ＜     

大理州1 044名儿童7种疫苗免疫水平现状监测

１９９１年分层随机抽取１２个县（市）的４、８、１２岁组儿童１０４４名，按卫生部《计划免疫技术管理规程》对７种疫苗疫现状进行了监测。结果：抗体阳性率、ＧＭＴ分别为，麻疹８７．１６％±３．１４％，５．８３±０．４１（＜１：８者５６．９０％）；百日咳７８．１３％±９．１９％、２１８．１０±２３．３９（≥１：３２０者４１．６２％）；ＤＡＴ７４．４７％±１１．０４％、０．０９８±０．０２５；ＴＡＴ７５．８６     

维思多复治疗苯丙酮尿症的临床研究

维思多复为我国第二代氨基酸混合法苯丙酮尿症治疗专用奶粉。本文对２１例苯丙酮尿症患儿长期随访结果显示：疗效满意，患儿发育良好，目前ＤＱ或ＩＱ为９３．６±１５．２，较来院时明显提高（Ｐ〈０．００１）。其中４例新生儿筛查发现的患儿疗效最佳，目前，ＤＱ平均为１１７．７±５．９。成分分析结果：蛋白质、脂肪、碳水化合物含量分别为１６．１±０．８，１５．０±０．５，６０．４±３．１ｇ／１００ｇ，苯丙氨酸为０，１     

受人体铁含量高度影响的CDT(糖缺陷转铁蛋白)水平,作为长期酒精滥用指标的灵敏指标

ＣＤＴ是血清转铁蛋白（Ｔｆ）的变异体。酒精滥用者在有铁超载时ＣＤＴ水平明显低于无铁超载时（２４６±１６５ｕ／ｌｖｓ３３３±１１７ｕ／Ｌ;Ｐ＜００１）。同样在遗传性血色病者（ＧＨ）,ＣＤＴ低于正常对照者（９６±２２ｕ／Ｌｖｓ１５７±３３ｕ／Ｌ;Ｐ＜００００１）,然而缺铁性贫血病人则高于对照者（２８１±５８ｕ／Ｌｖｓ１５７±３３ｕ／Ｌ,Ｐ＜００００１）,将铁耗竭处理后ＣＤＴ水平明显低于ＧＨ病人（９７±２０ｕ／Ｌｖｓ１４７±４０ｕ／Ｌ;Ｐ＝０００１）。酒精滥用者…     

左旋肉碱对肥胖青少年体重综合性控制的影响

１８名１３～１７岁的肥胖中学生（肥胖度大于１２０％），随机分为实验组和对照组进行为期三个月的体重综合性控制实验，两组都接受营养教育、膳食控制和体育锻炼，但实验组补充左旋肉碱２ｇ／ｄ，对照组服用安慰剂，每月体检一次，测定身高、体重及三处皮褶厚度。三个月后，实验组的平均体重下降５．１１±２．０６ｋｇ，对照组下降０．５２±０．７９ｋｇ（Ｐ＜０．０１），实验组的肥胖度、体块指数（ＢＭＩ）分别下降了１３．４０％±０．３８％，２．６０±０．７０，三头肌皮褶厚度（ＴＳＦ）、肩胛下皮褶厚度（ＳＢＳ）、髂前上嵴皮褶厚度（ＩＣ）分别下降（ｍｍ）６．８０±５．６７，５．７０±４．４２，１０．９０±５．１７，而对照组肥胖度、体块指数（ＢＭＩ）仅分别下降（％）６．５０±０．３６，０．８８±０．６４，三头肌皮褶厚度、肩胛下皮褶厚度、髂前上嵴皮褶厚度分别下降（ｍｍ）１．７５±０．１３，０．１２±０．０８，６．６３±２．５６，两组差异显著，具有统计学意义（Ｐ＜０．０５）。     

镍作业工人细胞免疫功能、血清硒和过氧化脂质含量的变化

９６名镍作业工人测定结果：非特异酯酶阳性细胞百分率（ＡＮＡＥ＋％）为７６．８％±８．０％，Ｔ细胞亚群ＣＤ２、ＣＤ４、ＣＤ８阳性细胞百分率（ＣＤ＋２％、ＣＤ＋４％、ＣＤ＋８％）及ＣＤ＋４／ＣＤ＋８比值分别为６５．６％±１０．５％、５６．３％±１２．１％、３４．３％±８．２％和１．７６±０．６；酵母多糖刺激的外周血多形核白细胞化学发光（ＰＭＮ－ＣＬ）本底和峰值分别为４８±２３和３０７３±６８４ＣＰＳ／１０６ＰＭＮ；血清硒和丙二醛含量分别为１．２２±０．２３和４．７６±０．８８μｍｏｌ／Ｌ。与非镍作业的地区对照组比较，Ｔ细胞ＣＤ＋８％增高，ＣＤ＋４／ＣＤ＋８比值下降，化学发光的本底值降低，峰值增加，血清Ｓｅ含量下降，丙二醛含量升高。分析镍作业工人工龄与后三项指标变化的关系，工龄大于２０年与小于１０年有统计学上明显差别。这些观察指标为镍作业人员医学观察增加新的监护指标提供依据。     

Investigation of the delayed type hypersensitivity reaction in atopic patients

INTRODUCTION: In the last decades the prevalence of atopic diseases has increased highly in developed countries. Although the reasons for this increase are not clear, it has been hypothesized that a reduction in infections and immunization programs may contribute to the increased prevalence of atopic diseases. AIM: In the present study the relationship between tuberculin response and atopic disease was investigated. METHODS: A total of 1012 children vaccinated with BCG were included in the study. All the children were given five tuberculin units PPD, and PPD indurations were recorded after 72 h. The test result was considered to be positive if the induration size was greater than 9 mm. The atopic anamnesis (atopic dermatitis, rhinitis, conjunctivitis, asthma, urticaria) in the children and their families were investigated using a questionnaire. RESULTS: 608 individual (60.1%) had positive and 404 (39.9%) had negative tuberculin test. Positive atopic personal anamnesis was found in 31.74% in children with positive tuberculin skin test, whereas 39.85% was found in children with negative tuberculin test (p < 0.009, Fischer-test). Similarly more positive family anamnesis for atopic diseases was found among children with negative tuberculin test. In children with negative tuberculin test the prevalence of allergic conjunctivitis and rhinitis was significantly higher as compared to the group with positive tuberculin test. CONCLUSIONS: The authors found an inverse correlation between tuberculin response and atopy status. The observed decreased tuberculin sensitivity in atopic individuals is, however, probably not the cause, but rather the consequence of the disturbed immune regulation in atopic diseases.     

唐山地区原发性高血压与Y染色体非重组区HindⅢ酶切位点多态性的研究

目的探讨Y染色体非重组区HindⅢ酶切位点多态性与唐山地区汉族人群原发性高血压的关系.方法入选男性研究对象412名,原发性高血压患者225例、正常对照人群187名.所有研究对象用常规方法提取白细胞DNA.采用多聚酶链反应结合限制性内切酶（HindⅢ）方法检测Y染色体非重组区HindⅢ酶切位点多态性.结果对照组和原发性高血压组Y染色体HindⅢ酶切位点多态性各基因型的差异有统计学意义（P=0.007）.HindⅢ（＋）基因型较HindⅢ（）基因型收缩压、舒张压、脉压和平均动脉压均明显降低（P＜0.05）.结论Y染色体HindⅢ酶切位点多态性与唐山地区汉族人群原发性高血压有关,可能是唐山地区汉族人群原发性高血压的一个遗传标志.     

Utility of dual skin tests to evaluate tuberculin skin test reactions of 10 to 14 mm in healthcare workers.

OBJECTIVE: To define the utility of 10- to 14-mm reactions to a Mycobacterium tuberculosis purified protein derivative (PPD) skin test for healthcare workers (HCWs). DESIGN: Blinded dual skin testing, using PPD and M. avium sensitin, of HCWs at a single medical center who had a 10- to 14-mm reaction to PPD when tested by personnel from the Occupational Health Department as part of routine annual screening. SETTING: A single tertiary-care academic medical center. PARTICIPANTS: Employees of the medical center who underwent routine annual PPD screening and were identified by the Occupational Health Department as having a reaction of 10 to 14 mm to PPD. RESULTS: Nineteen employees were identified as candidates and 11 underwent dual skin testing. Only 4 (36%) had repeat results for PPD in the 10- to 14-mm range, whether read by Occupational Health Department personnel or study investigators. For only 5 (45%) of the subjects did the Occupational Health Department personnel and study investigators concur (+/- 3 mm) on the size of the PPD reaction. Two of the 4 subjects with reactions of 10 to 14 mm as measured by the study investigators were M. avium sensitin dominant, 1 was PPD dominant, and 1 was nondominant. CONCLUSION: A reaction of 10 to 14 mm to PPD should not be used as an indication for the treatment of latent tuberculosis (TB) infection in healthy HCWs born in the United States with no known exposure to TB.     

Screening for tuberculosis among 2381 household contacts of sputum-smear-positive cases in The Gambia

Contact investigation is a key component of tuberculosis (TB) control in developed, but not developing, countries. We aimed to measure the prevalence of TB among household contacts of sputum-smear-positive TB cases in The Gambia and to assess the sensitivity of an enzyme-linked immunospot (ELISPOT) assay in this regard. Household contacts of adult smear-positive TB patients were assessed by questionnaire, purified protein derivative (PPD) skin test, ELISPOT assay, physical examination, chest X-ray and sputum/gastric aspirate. Thirty-three TB cases were identified from 2174 of 2381 contacts of 317 adult smear-positive pulmonary TB patients, giving a prevalence of 1518/100000. The cases identified tended to have milder disease than those passively detected. The sensitivity of ESAT-6/CFP-10 ELISPOT test as a screening test for TB disease was estimated as 71%. Fifty-six per cent of contacts with a PPD skin test result >or=10mm induration had detectable responses to ESAT-6/CFP-10 by ELISPOT; 11% with a negative PPD skin test (<10mm) had a positive ESAT-6/CFP-10 response. Active screening for TB among contacts of TB patients may have a role in TB control in The Gambia. These individuals are a high-risk group, and the disease identified is less advanced than that found through passive case detection. An ELISPOT assay was relatively insensitive as a screening test for TB.     

The effect of bacille Calmette-Guérin vaccination at birth on immune response in China

Bacille Calmette-Guérin (BCG) vaccine is still the most effective approach to prevent tuberculosis in childhood. In order to provide protection against severe forms of childhood tuberculosis, it is customary to give BCG vaccination at birth in China. Tuberculin skin testing after vaccination is usually used to evaluate the immunogenic activity and protective efficacy of the BCG. We report the results of a multi-site prospective cohort study to evaluate the immunological reactivity against BCG in four prefectural cities in China. A total of 59,022 newborn infants were vaccinated between January 2011 and March 2012, and follow-up data on 27,517 vaccinated infants were available for this study. Of these, 679 (2.5%) had PPD readings of 0–5 mm, 17,072 (62.0%) had PPD readings of 5–10 mm of induration, 8864 (32.2%) had readings of 10–15 mm, 815 (3.0%) had readings of 15–20 mm, and 87 (0.3%) had readings of >20 mm of induration. The size of PPD reaction varied significantly with the geographic location, gender, season of vaccination, and grade of hospital administering the BCG vaccine (P < 0.001). 97.8% of the infants with a BCG scar of >1 mm had a positive TST reaction. However, only 56.9% of infants without a BCG scar had a positive PPD reaction. Our results demonstrate that the BCG immunization among newborn infants in China induces satisfactory immune response. In addition, BCG scars provide a useful indicator of vaccination response in Chinese infants.     

Delayed hypersensitivity. A critical evaluation of five recall antigens in a large reference population

The reactivity to five recall antigens, candida, mumps, PPD, varidase and trichophyton and the corresponding diluents was tested in 840 healthy persons aged between 17 and 101 years. Candida antigen was tested in a lower (l) and a higher (h) dose. The size of reactions did not follow a Gaussian distribution and we therefore used the 10th and 5th percentiles instead of standard deviation to define the limits between positive, weak and negative reactions. The number of positive reactions to each of candida-h, mumps, PPD and varidase was between 80 and 95 per cent in patients less than 60 years of age and above this age it varied between 0 and 85 per cent. The number of positive reactions to candida-l and trichophytin was low in all ages. The reactivity was regarded as normal if there was a positive reaction i.e.sum of right angle diameters >10 mm to atl east one antigen, relatively anergic if there was only a weak reaction (7-9 mm) and anergic if there was a negative reaction (0-6 mm) to all antigens. A normal reaction was found in 100 per cent of subjects up to 60 years of age, and in 95 per cent up to 30 years. Among those with normal reactivity, positive results were found with candida-h alone in between 67-93 per cent, candida-h + mumps between 92-100 per cent and candida + mumps + PPD in 100 per cent irrespective of age.     

北京市西城区2004-2011年大学新生结核菌素监测与结核病预防性治疗价值评价

目的探讨北京市大学新生实施PPD监测及对其中PPD反应硬结≥15mm者实施免费拍摄X线胸片检查和采取预防性治疗的必要性、可行性。方法对北京西城区三所大学自2004-2011年8年间入学新生做PPD试验,PPD反应≥15mm者摄胸部X线片并动员结核病预防性治疗,方案:3H2L2。结果 8年间共有新生14 833人,PPD试验人数14 504人,复验人数14 010人(占PPD试验人数的96.59%)。PPD反应≥15mm者1 689人(12.06%),全部摄胸部X线片,检出活动性肺结核病人4人(其中3人入学体验时已发现肺部病变),实际仅检出1人,活动性肺结核检出率(0.06%)。105人(6.22%)同意接受预防性治疗,但仅51人(48.57%)完成治疗。全部学生在校期间未发现肺及肺外结核病。为检出这名病人实际花费291 095.49元。结论北京市大学入学新生实施PPD监测及预防性治疗措施耗资巨大而无实效,不太符合费用/效益原则决策者应进一步调查研究以审核该项措施的可行性。     

HIV/AIDS病人预防和治疗结核病双重感染的研究

目的调查HIV/AIDS病人结核菌素(PPD)试验反应状况及与免疫系统受损程度的联系,并探讨其预防和治疗结核病的意义。方法采用前瞻性病例对照研究方法,对40例HIV(+)者和202例HIV(-)者做结核菌素试验,并对HIV(十)者做CD4、CD8细胞计数测定,对HIV(+)分组服药,观察胸部病变情况。结果HIV(+)与HIV(-)者PPD阳性率分别为12.5%、28.2%(P<0.05)。当CD4细胞计数下降时,PPD反应减弱。CD4<200个/mm3时PPD均无反应(0×0).病例服药组经化学药物预防治疗后其肺部病变异常率小于病例对照组。结论HIV(+)者中PPD阳性率显著低于HIV(-)者。CD4细胞数下降可能是艾滋病并发结核的主要原因.对HIV/AIDS患者使用化学药物预防和治疗结核是有效的。     

Survey of tuberculin skin test positivity among Israeli pediatric hospital workers.

Tuberculin skin test (TST) was performed in 374 healthcare workers. TST results of induration of 10 mm or more and 20 mm or more were noted in 44.9% and 10.4%, respectively. Positive TST (> 10 mm) was found to be significantly associated with age, country of origin, and duration of employment.     

2001—2010年南京市雨花台区乙类传染病的发病趋势

目的分析南京市雨花台区乙类传染病疫情动态和流行特征,为制定和完善传染病防治策略和措施提供科学依据。方法采用描述流行病学方法进行分析。结果 2001—2010年共报告乙类传染病15种,累计发病5 882例,死亡5例,年平均发病率为221.25/10万,年平均死亡率为0.16/10万。痢疾、肺结核、梅毒10年中一直位居发病率的前5位。发病分类构成以血源及性传播传染病所占比例最高,为35.02%,结论 2001—2010年该区乙类传染病报告发病率总体呈现下降趋势,呼吸道传染病呈上升趋势,肠道传染病呈下降趋势。痢疾、肺结核、梅毒是雨花台区传染病防治的工作重点,同时进一步关注和控制血源及性传播传染病。