河北省结核病医防合作策略实施效果评析

20世纪90年代以来,许多国家结核病流行逐渐增加,所有传染病中,结核病仍然是年轻人和成年人的最大杀手…。2000年全国结核病流行病学调查结果显示,河北省肺结核病患者约20万人,其中传染性肺结核患者8万,在导致农村群众因病致贫、因病返贫的诸病种中,结核病位居首位。研究发现,在活动性肺结核患者中,仅有7．5％的患者在结防机构登记和治疗管理。提高患者发现率,是做好结核病控制工作的前提,而做好结核病的归口管理则是提高患者发现率的有效措施。     

弋阳县流动人口结核病防治情况的调查分析

目的调查本县流动人口的结核病防治情况,为本县制订结核病防治措施提供一定的理论依据。方法统计分析江西省弋阳县2010年6月～2012年6月的结核病防治管理资料。结果流动人口肺结核病新涂阳患者的概率为10．8／10万,高于户籍人口的7．29／10万;流动人口患者的治愈率为63．77％,低于户籍人口的77．59％（P〈0．05）;流动人口患者完成全程督导的概率为85．5％,低于户籍人口的99．1％（P〈0．01）。结论注重提高流动人口肺结核患者的治愈率及全程督导率,以期有效提高本地区结核病的防治管理水平．     

76例结核病死亡原因调查分析

目的 分析结核病人死因结构的现状,为结核病防治提供科学依据。方法 对2000～2003年在某结核病防治专科医院住院期间76例结核病死亡病例进行回顾性调查分析。结果 结核病死亡以肺结核为主,肺结核死亡原因以慢性心肺功能不全、全身衰竭、咯血为主。死亡患者入院前不规律用药达73．8％,病程在10年及以上者占80．8％。死亡人数在50岁以上年龄组明显上升。结论 加强肺结核病人的归口管理和病人发现,广泛采纳和实施全程督导化疗;加强老年患者和流动人口结核病防治是降低结核病死亡率的重要方面。     

加强医疗机构发现并及时转诊结核患者的探讨

为了准确掌握全市结核病归口管理的情况,进一步完善并规范归口管理模式,从而促进结核病防治工作的可持续性发展,根据省卫生厅有关工作要求。2006年1月8～16日,洪湖市疾控中心组织有关对全市结核病归口管理情况进行了检查,现将有关情况报告如下。1材料与方法1.1资料将全市市级综     

西安市2008年肺结核病流行病学现状分析

目的：评价目前肺结核病防治措施的效果,掌握结核病疫情发展趋势和有效防控措施。方法：用描述性流行病学方法．分析西安市2008年13个区县结核病患者的资料。结果：2008年共接诊17268例初诊患者,涂阳1719例,其中新涂阳1719例。复发涂阳252例,15～45岁发病占71．40％,男女发病比例为512．4：1,农民占发病总数的46．12％。阎良区发病率5131．8／10万,高于其他区县;涂阳病例的治愈率5192．40％,新涂阳病例的治愈率5193．80％。结论：加强聚集人群结核病的管理和计划免疫接种工作。大力提高对结核病患者的检测和诊断是控制结核病的有效方法。     

盐都县农村实施结核病归口管理的效果评价

结核病是全球一大公共卫生问题,对结核病实行归口管理是国家卫生部1991年颁发的《结核病防治管理办法》的重要内容。盐都县于1992年开始对农村肺结核病人实行归口管理,现对实施9年的效果作一分析评价。     

“XDR”结核病——人类面临的新挑战

目的对"XDR"结核病的定义、产生原因、流行状况、治疗效果和防治对策进行探讨。方法通过收集国内外关于"XDR-TB"的文献来阐述"XDR-TB"。结论"XDR-TB"结核病虽然危害巨大,治疗难经取得较好疗效,但通过提高对"XDR"结核病产生原因的认识,认真贯彻实施现代结核病控制策略,加强肺结核病的归口管制,"XDR"结核病是完全可以预防的。     

结核病防治工作的几点体会

本县结核病防治工作广泛开展健康促进活动,普及结核病防治知识,加强业务培训,强化归口管理,加强督导管理,指标完成率高。     

浅析结核病归口管理的阻力及对策

笔者结合我市开展结控项目的实践,对结核病归口管理所遇到的阻力及其成因进行分析,并就如何排除这些阻力展开探讨。 1 归口管理的阻力成因分析 1.1 结控项目宣传力度不够。一方面,群众对结核防治知识欠了解,健康保护意识差,出现结核可疑症状时不清楚应到哪些医院就诊,也不知道项目免费诊治范围。另一方面,综合医院或个体医生对现代结核病控制策略和有关文件精神认识不足,法制观念淡薄,误认为结核病归口管理、实施结     

广州市东山区学校结核病患病调查

目的了解广州市东山区学生肺结核病患病情况、感染现状和流行因素，落实学校结核病管理措施。方法对2004年我院东山区防治所新登记菌阳学生肺结核患者在学校的密切接触者进行筛查（包括结核菌试验，胸部透视），并对可疑学生肺结核患者作胸部X线检查和痰结核菌检查，进一步诊断分型并规则治疗。结果2004年新登记学生肺结核患者13例，发现方式以因症就诊和健康检查为主，为Ⅲ型及Ⅳ型。并对菌阳学生肺结核患者在学校的密切接触者进行了结核菌素试验和胸部透视筛查，共调查了6间学校，应检对象为1096人，实检对象为1095人，受检率为99．9％。PPD试验实检对象为1088人，实验率为99．3％，阳性的学生数914例，阳性率为84％，强阳性的学生数124例，强阳性率为11．4％，阴性的学生数50例，阳性率为4．6％。胸部透视检查实检对象为1095人，其中异常者1人。结论应加强对学校结核病健康教育及健康促进策略，重视学生的结核菌素（PPD）试验及DOTS策略在学生肺结核管理工作中的应用与实施，这是控制学生结核病工作的关键。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.