江西省城乡低档暗娼性病艾滋病相关知识现状及行为特征

目的了解江西省农村低档暗娼性病艾滋病相关知识知晓、行为及干预服务情况,以城市低档暗娼为参照,为农村开展性病艾滋病防控提供依据。方法于2014年4-12月,采用分层抽样法,对江西省5个县区低档暗娼的性病艾滋病知识、态度、安全套使用、干预服务现状进行了调查,采用X~2检验进行统计分析。结果共调查543名低档暗娼,其中城市297人、农村246人。与城市低档暗娼相比,农村低档暗娼呈现年龄大、文化程度低、已婚者多、流动性大等特征(均P0.05)。农村暗娼艾滋病知识总体知晓率为95.12%,高于城市暗娼的89.90%(P0.05)。农村暗娼"劝客人使用安全套"的意识及态度低于城市暗娼(P0.05)。农村暗娼"最近一次"和"最近一个月"与客人发生性行为时的安全套使用频率均低于城市暗娼(均P0.05)。安全套免费发放、演示使用、同伴教育、艾滋病检测等干预服务,农村暗娼均明显少于城市暗娼(均P0.05),且选择到正规妇保机构就诊者较低。结论宜以安全套免费发放、演示使用、同伴教育等干预服务为抓手,加强对农村暗娼的干预,强化安全套使用信念,提升安全套使用频率,有效遏止性病艾滋病的发生。     

上海市虹口区小型娱乐场所暗娼人群艾滋病综合干预效果评价

目的评价在小型娱乐场所暗娼人群中开展预防艾滋病综合干预措施的效果。方法在上海市虹口区选择G和X街道小型娱乐场所,对G街道娱乐场所的暗娼实施面对面宣传、安全套推广使用、医疗转介等综合性干预措施,对X街道的暗娼采用常规宣传干预措施。通过问卷调查和血清学检测,对干预前后两条街道暗娼的艾滋病防治知识、态度及行为进行评估。结果干预前共有244人接受基线调查,其中G街道131人,X街道113人。干预后共有360人接受评估,其中G街道197人,X街道163人。干预后G街道艾滋病防治知晓率78.17%(154/197),最近一次性行为安全套使用率42.13%(83/197),综合性医院或妇女保健所就医选择率91.37%(180/197),均明显高于X街道(P<0.05);近一月与客人性行为时安全套从不使用率(43.15%)显著低于X街道66.87%(P<0.05);两街道HIV及梅毒感染率无显著差异。结论综合干预效果在艾滋病防治的知信行方面明显优于常规宣传,但对降低艾滋病性病发病效果方面的作用需要做进一步的研究。     

2009-2011年上海市金山区暗娼哨点监测分析

目的了解金山区暗娼艾滋病性病流行状况及相关危险因素,为评估艾滋病性病防治工作及制定暗娼人群干预策略提供科学根据。方法采用问卷调查,现场收集金山区哨点监测对象的相关行为信息,并采集血液标本进行艾滋病病毒(HIV)、梅毒抗体检测。结果 2009-2011年,金山区暗娼艾滋病防治知识知晓率分别为82.0%、97.3%、86.3%,不同年龄段的暗娼对艾滋病知识知晓程度差异有统计学意义(χ2=47.35,P<0.01),且20～40岁年龄段艾滋病知识知晓率高于<20岁和>40岁年龄段。暗娼最近一次安全套使用率分别为56.9%、79.0%、87.3%,最近一次安全套使用率呈逐年上升趋势,差异有统计学意义(χ2=108.83,P<0.01)。暗娼对艾滋病防治知识知晓率不同与最近一次安全套使用率差异有统计学意义(χ2=18.04,P<0.01),安全套使用率随知晓率上升而上升。HIV抗体阳性率均为0,梅毒抗体阳性率分别为2.3%、3.8%、2.5%。结论通过采取综合性防治措施,暗娼艾滋病知识知晓率和商业性行为坚持使用安全套的比例在逐步上升。虽然HIV处于低流行态势,但存在性病流行,因此疫情存在上升风险,需不断开展干预和综合防治工作。     

喀什市暗娼人群艾滋病相关知识及行为调查分析

目的了解新疆喀什市暗娼对艾滋病防治知识的掌握程度及相关行为,为在暗娼人群中开展有针对性的艾滋病防治策略提供科学依据。方法2008年对喀什市娱乐场所的451名暗娼人员实施艾滋病调查,采用面对面问卷调查的方式。结果喀什市暗娼人群对于艾滋病知识的整体认知水平较高,最近1个月安全套每次使用率为77.7%,正确就医比例为67.1%;获取艾滋病知识来源主要通过电视（74.77%）、免费宣传材料（68.18%）、广播（27.27%）等。结论对喀什市暗娼人群进行监测和综合干预取得一定效果,但还必须加强医生干预和同伴教育的作用,加强100%安全套的推广使用,倡导正确的求医行为等多方位的健康教育。     

来宾市945名低档暗娼艾滋病感染状况及影响因素调查分析

目的分析广西来宾市945名低档暗娼的艾滋病感染状况及其影响因素,为制定干预措施提供决策依据。方法对来宾市辖区的945名低档暗娼进行问卷调查,收集调查对象的社会人口学资料、艾滋病知识知晓率、性行为等基本信息,采集调查对象的血样,检测HIV抗体。结果来宾市低档暗娼平均年龄(38.2±7.6)岁,以小学及小学以下文化为主(89.2%);最近一次性行为安全套使用率为93.2%,最近1个月性行为时坚持使用安全套比例为88.4%;HIV抗体阳性检出率为2.6%;多因素logistic回归分析结果显示,最近1个月使用安全套频率是HIV感染的保护因素。结论来宾市低档暗娼年龄偏大,文化程度低,与客人发生商业性行为时坚持使用安全套频率不高,艾滋病危害意识淡薄,应加强对低档暗娼人群进行艾滋病宣传教育,提高其安全意识。     

济南市MSM和暗娼人群AIDS相关知识和危险行为调查

目的 了解男男性行为者(MSM)和暗娼(FSW)两类高危人群艾滋病相关知识和危险行为状况.方法 在知情同意的前提下,对MSM人群和暗娼进行面对面的问卷调查及采样检测.结果 调查MSM人群656人,平均年龄(26.28±6.79)岁,艾滋病知识知晓率81.38%,最近6个月有85.98%的人与男性发生过肛交性行为,每次都使用安全套的占28.37%,艾滋病病毒(HIV)感染率2.17%,梅毒感染率为8.68%.调查FSW人群405人,平均年龄(23.98±4.56)岁,文化程度较低,艾滋病知识知晓率71.22%,最近5次与嫖客发生性行为时全部使用安全套的占78.27%,经偏相关分析,仅场所与其有关(偏相关系数r'=-0.2180,P＜0.01).路边店、出租屋的FSW安全套使用率较低.检测53人,HIV抗体均阴性.结论 济南市艾滋病有从MSM和FSW人群向普通人群扩散的潜在危险.建议加大对高危人群行为干预工作的力度.     

哈尔滨市2006-2009年暗娼艾滋病知识行为情况及HIV梅毒感染状况调查

目的了解2006-2009年哈尔滨市暗娼(FSW)人群艾滋病知识认知水平、行为特征和艾滋病病毒(HIV)、梅毒感染率,为开展有针对性的行为干预和宣教工作提供线索。方法对暗娼人群进行分层抽样,在知情同意后对她们进行面对面的问卷调查和采样检测,所有资料经Epi Data 3.0版软件进行双录入,使用SPSS 13.0进行统计分析。结果 2006-2009年,暗娼的艾滋病知识知晓率分别为42.4%、57.7%、68.5%和90.6%,最近一次商业性行为时安全套使用率分别为43.0%、76.2%、91.4%和91.9%,梅毒检出率分别为1.2%、3.4%、2.4%和2.5%,4年间均未检出HIV抗体阳性者。结论哈尔滨市暗娼人群存在HIV传播的危险因素,应加强该人群艾滋病性病的宣传教育及干预工作。     

哈密市卫九项目暗娼人群艾滋病性病干预效果分析

目的 通过对哈密、和田两地暗娼人群性病相关知识和患病率的调查分析,评价卫九项目在此人群中的干预效果,为今后暗娼干预提供科学依据.方法 性病相关知识、安全套使用、正确就医等采用问卷调查方法,性病患病情况采用实验室和临床诊断方法.结果 卫九项目地区哈密市暗娼干预覆盖率(94.2%)、相关知识知晓率(75%)、最近一次安全套使用率(82.5%)、正确就医率(99.2%)明显高于非卫九项目地区和田市;性病患病率(10.8%)明显低于和田市.结论 通过8年的综合干预,哈密市暗娼性病相关知识知晓率、安全套使用率、正确就医率得到明显提高,使性病患病率逐渐减少,有效控制艾滋病在此人群中的传播速度.     

2011─2013年新疆巴州暗娼人群HIV哨点监测分析

目的分析新疆巴音郭楞蒙古自治州（巴州）暗娼人群艾滋病相关行为的变化特征及艾滋病防治知识的知晓情况,为开展综合干预工作提供依据。方法按《国家艾滋病哨点监测方案》的要求,对2011─2013年巴州暗娼人群进行问卷和血清学调查。结果巴州暗娼人群艾滋病知晓率为88.93%,不同年龄段暗娼人群艾滋病知识知晓率,随年龄增加而上升;最近一次商业性性行为安全套使用率为69.36%,最近一个月商业性性行为每次坚持使用安全套率58.16%,安全套的使用率随知晓率的上升而增加;最近一年接受艾滋病干预措施覆盖率为59.41%,HIV抗体阳性率0.42%,梅毒抗体阳性率4.66%,HCV抗体阳性率0.79%。结论新疆巴州暗娼人群安全套使用率、艾滋病知识知晓率较低,要进一步加强对该人群的行为干预,降低发病率。     

辰溪县娱乐服务场所暗娼高危行为干预效果评价

目的了解辰溪县娱乐场所暗娼的艾滋病高危行为干预前后的效果,为全县娱乐场所艾滋病防治工作提供科学依据。方法2003年9—10月进行基线调查,然后每两个月进行一次高危行为干预,每年的9—10月进行一次问卷调查,进行统计分析。结果2003—2006年娱乐场所暗娼艾滋病防治相关知识知晓率逐年提高:过去3个月与客人发生性行为每次都使用安全套分别为24.0%、63.8%、83.3%、81.2%,最近一次与客人发生性行为使用安全套的分别为59.4%、71.3%、88.9%、91.8%,到正规公立医院就诊率为32.6%、55.0%、66.0%、85.1%,性病发病率为53.84/10万、34.62/10万、27.69/10万、18.68/10万。结论开展娱乐场所高危行为干预工作,切实改变高危人群的高危行为,是预防控制艾滋病的有效措施。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.