地表温度和土地利用类型与海南省疟疾流行的相关性

目的:分析海南省疟疾流行空间分布与地表温度和土地利用类型的相关性,探索海南省疟疾流行空间分布的环境预测方法.方法:获取2000年海南省雨季(5-10月)各市县疟疾发病资料以及地表温度、土地利用类型构成比等数据,分析疟疾发病率与上述环境因素的相关性,应用负二项回归分析建立发病率的预测模型.结果:海南省2000年雨季各市(县)疟疾发病率与各地的有林地和高覆盖度草地的面积构成比显著正相关;与日间地表温度、夜间地表温度及水田、旱地、水库坑塘、农村居民点和其他建设用地的面积构成比显著负相关;与其他土地利用类型构成比无明显相关性.负二项回归分析引入方程的因子为夜间地表温度及水田、旱地、其他建设用地的面积构成比.结论:海南省疟疾流行空间分布与地表温度和土地利用类型有关,可以利用有关环境指标来预测疟疾流行的空间分布.     

基于地理信息系统的广东省食管癌地理流行病学研究

目的：在地理信息系统（GIS）及遥感（RS）支持下探讨广东省食管癌（EC）死亡率地理分布特征及与气候等地理环境因素之间的关系。方法：在GIS软件ArcInfo9．0中建立广东省EC死亡率GIS数据库，并与广东省电子地图连接。利用空间分析法提取广东省分县的气候等地理环境数据，对EC死亡率与相应地区的地理环境数据进行等级相关分析及多元回归分析。结果：广东省EC有明显的地区聚集性；EC的死亡率与多项气候因素、植被指数及海拔高度均里相关性；年平均降水量、年平均最低气温、水热指数、平均海拔、1，2，5-8，10月份平均风速最后进入回归方程。结论：广东省EC的死亡率分布与气候等地理环境因素有一定关系。运用GIS技术有助于肿瘤流行因索的空间分析，但与EC发病的内在联系有待进一步研究。     

近年来广西疟疾防治措施及其效果

目的分析2001年以来全区疟疾防治效果及流行特征，为制订防治措施提供科学依据。方法收集2001—2004年全区疟疾疫情资料和各种疟疾监测数据，按疟区类型进行统计分析。结果全区疟疾发病率从2001年的0．86／10万下降至2004年的0．44／10万，基本消除疟疾地区无本地感染的疟疾病例报告，控制疟疾地区和未达标地区常住户口居民血栓平均疟原虫阳性率分别为0．008％和0．016％。结论基本消除疟疾地区疟疾疫情较为稳定；控制疟疾地区疟疾传播尚未阻断；开发的林场、矿场民工，移民和流动人口疟疾监测是当前疟防工作的重点。     

海南省三亚市一起罕见的当地三日疟疫情分析及处置

目的对海南三亚市一起罕见的本地传播三日疟疫情调查和处置进行描述,以明确虫种、分布特征和流行程度。方法通过回顾性调查收集病例及相关数据,采用描述性统计学方法,阐明此次疟疾疫情的三间分布特征;通过镜检、RDT和PCR确定疟原虫虫种,媒介调查明确主要传播媒介,为及时规范治疗和媒介控制提供依据;对村民进行疟疾防治知识宣传,对村医进行疾病诊断和治疗知识培训,及时规范治疗患者和控制媒介,对疫情进行有效的控制。结果在疟疾流行季节通过镜检和PCR共确诊三日疟6例,间日疟1例,这是历史上首次在海南三亚发现本地三日疟病例,年龄主要在40岁以下,4—9月份为疫情发病期。在疫点村、周边居民和临近村庄的上山人群范围内开展主动病例调查,发现带虫者5例,带虫率0.39%。媒介调查发现村庄主要媒介为微小按蚊。经及时应急处理和规范治疗,患者全部治愈。通过对疫点村居民房舍进行溴氰菊酯滞留喷洒等综合性防制措施,有效控制了疫情的进一步蔓延。结论海南省三亚市首次发现本地感染三日疟为主的疟疾疫情,采取治疗患者、媒介防制等综合性措施后疫情得到控制。     

中部疫情不稳定地区疟疾发病特征及休止期策略

目的 分析安徽及其周边疟疾高发区疟疾发病特征,探讨休止期科学合理的服药策略.方法 收集相关省2004～2006年网络直报数据、年报数据及五省联防资料进行比对分析,通过Excel5.0和MapInfo Professional 7.8软件作图.结果 中部疫情不稳定地区疟疾发病特征包括病例分布广而散、中华按蚊疟区发病超过嗜人按蚊疟区并逐年上升、发病时症状典型、月分布明显和发病以新发病人为主.结论 症状典型有利于病人的及时诊断和治疗;休止期根治对防治有疟史者的复发是必要的,但对以长潜伏期发病为主的地区,达不到清理潜在传染源的目的,全民服药受到诸多因素制约,新的以“灶点”（如水体周围）为依据的服药范围划分方法值得研究.     

健康教育在海南控制疟疾流行的地位刍议

海南省自古是瘴病之地，举世闻名的高疟区。抗疟前，疟疾遍布全岛，流行猖撅，摧残人民健康，阻碍经济发展。经过40年的持续防治，虽然疟区已大面积缩小，疟疾发病逐年减少，死亡率也从1．04／万降至近十年来的0—0．03／万。但是，由于海南疟疾流行因素的复杂性和社会经济发展的限制，少数民族聚居的僻远山区，疟疾流行仍较严重。这些高症区虽局限于山林地带呈点状分布，人口仍有50多万，而残存在山区和丘陵区的中低疟区，人口也有30多万。对这些地区采取什么干预对策，才能更快更有效地控制疟疾流行并巩固下来，已成为奇生虫病防治科研工…     

海南疟疾70年——从肆虐走向消除

海南地处热带地区,曾是全国疟疾流行严重的地区之一,也是历史上有名的“瘴疬之地”,解放后,在党和政府的重视和领导下,海南的疟疾经历了调查研究、重点防治、大规模抗疟、试点防治等阶段,疟疾发病得到有效控制,疟疾流行区大幅减少,特别是建省后,在省委省政府的重视和支持下,在省卫生厅的直接领导下,经过全省几代疾控人员的艰苦努力和几十年的科学防治,取得了显著的成绩,海南疟疾流行面积大幅缩小,高度疟区、超高度疟区已不存在,疟疾流行只局限分布在岛中南部个别市县的偏僻山林区。为切实保障全省广大人民群众身体健康,促进国际旅游岛的建设和经济与社会协调发展,海南省从2010年开始全面开展消除疟疾行动,海南的疟疾从此走上消除阶段,各级医疗卫生机构按照要求开展发热病人血检工作,血检发现的疟疾病例均及时通过传染病报告信息管理系统上报,病例诊断后24 h网络直报率达到100%;所有病例均进行了抗疟疾治疗,疟疾病例规范治疗率为100%。对所有报告的疟疾病例开展了3 d内病原学确认和流行病学个案调查和病例分类,特别是对输入性病例进行甄别,并以此为线索,在7 d内对疫点进行传染源与传播媒介调查和疫点分类,并根据疫点分类,科学采取包括传染源控制、传播媒介控制和健康教育等措施。另外加强了媒介的监测工作。全省疟疾从有较全面疫情报告的1955年82 447例,死亡47例,到2005年 4 512例,死亡0,从此再无本地疟疾死亡病例,到2010年实现了无本地感染恶性疟目标,至2012年实现了无本地感染间日疟病例的目标,海南省历史上第一次呈现无本地感染疟疾病例情况,除了2015年有几例来源不明的三日疟病例外,海南省已连续7年无本地感染的恶性疟和间日疟病例,实现了消除疟疾的目标。建国70年来,海南的疟疾从肆虐走向消除,这一伟大成绩的取得,主要得益于党和政府的重视,得益于几代疟疾防治工作者的不懈努力和无私奉献。     

海南省2000～2008年疟疾防治、监测及疫情分析

目的了解海南省近年来疟疾防治和监测效果以及疟疾疫情的变化,为今后的疟疾工作提供科学资料。方法收集各市县2000～2008年疟疾防治、监测以及疫情资料并整理分析。结果海南省2000～2008年疟疾年发病率在2.22～11.52/万,2001～2004年疟疾年发病率上升,200～2008年疟疾年发病率逐年下降;2000～2008年现症疟疾病人治疗人数为100785人次,季节性抗疟集体服药248927人次,对象服药180130人次;季节性杀虫剂浸泡蚊帐113969张;发热病人镜检疟原虫1642509人次;流动人口发热病人镜检疟原虫303371人次。结论20世纪90年代以后,海南省疟疾在村内感染的机会越来越少,疟疾病例多为疟区上山作业的人员和进入疟区的非疟区流动人口,对这些人群进行疟疾监测和防治已成为海南省疟疾工作的主要内容。2003年实施全球基金疟疾项目以后,疟疾年发病率在逐年下降,且已连续4年无疟疾死亡病例发生。     

海南疟疾70年——从肆虐走向消除

海南地处热带地区,曾是全国疟疾流行严重的地区之一,也是历史上有名的"瘴疬之地",解放后,在党和政府的重视和领导下,海南的疟疾经历了调查研究、重点防治、大规模抗疟、试点防治等阶段,疟疾发病得到有效控制,疟疾流行区大幅减少,特别是建省后,在省委省政府的重视和支持下,在省卫生厅的直接领导下,经过全省几代疾控人员的艰苦努力和几十年的科学防治,取得了显著的成绩,海南疟疾流行面积大幅缩小,高度疟区、超高度疟区已不存在,疟疾流行只局限分布在岛中南部个别市县的偏僻山林区。为切实保障全省广大人民群众身体健康,促进国际旅游岛的建设和经济与社会协调发展,海南省从2010年开始全面开展消除疟疾行动,海南的疟疾从此走上消除阶段,各级医疗卫生机构按照要求开展发热病人血检工作,血检发现的疟疾病例均及时通过传染病报告信息管理系统上报,病例诊断后24 h网络直报率达到100%;所有病例均进行了抗疟疾治疗,疟疾病例规范治疗率为100%。对所有报告的疟疾病例开展了3 d内病原学确认和流行病学个案调查和病例分类,特别是对输入性病例进行甄别,并以此为线索,在7 d内对疫点进行传染源与传播媒介调查和疫点分类,并根据疫点分类,科学采取包括传染源控制、传播媒介控制和健康教育等措施。另外加强了媒介的监测工作。全省疟疾从有较全面疫情报告的1955年82 447例,死亡47例,到2005年4 512例,死亡0,从此再无本地疟疾死亡病例,到2010年实现了无本地感染恶性疟目标,至2012年实现了无本地感染间日疟病例的目标,海南省历史上第一次呈现无本地感染疟疾病例情况,除了2015年有几例来源不明的三日疟病例外,海南省已连续7年无本地感染的恶性疟和间日疟病例,实现了消除疟疾的目标。建国70年来,海南的疟疾从肆虐走向消除,这一伟大成绩的取得,主要得益于党和政府的重视,得益于几代疟疾防治工作者的不懈努力和无私奉献。     

寄生虫病学

1993年6月~1994年6月,我国寄生虫学及寄生虫病学在科研及防治方面都有了很大进展.现将10多种寄生虫病学的进展介绍如下.一、疟疾全国大部分地区疫情保持稳定和下降趋势,南方各省有部分地区发病率回升出现一些疟疾暴发点,恶性疟疾病例数和分布范围没有明显改变,由于流动人口增多,输入性疟疾的范围扩大引起病例扩散,恶性疟疾未得到有效控制,向外扩散的恶性疟疾的病例数逐年增多,恶性疟原虫对多种抗疟药产生抗药性,特别是海南、云南、广西3省(自治区)形势仍十分严峻,防治工作非常艰巨.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.