陕西省榆林市榆阳区大骨节病病情调查

目的　掌握陕西省大骨节病历史重病区病情动态 ,评价硒盐防治效果 ,指导防治工作。方法　选择榆林市榆阳区 6个病村为调查点 ,每年 9～ 10月份对 7～ 12岁儿童进行病情监测及发硒检测 ,并了解硒盐防治措施落实情况。结果　 4年来榆阳区大骨节病临床患病率在 4 .12 %～ 7.16 %之间波动 ,典型临床病例已少见 ;X线阳性率在 18.4 0 %～ 2 8.5 7%之间波动 ,历年骨端改变检出率均大于干骺端改变检出率。实施六万分之一硒盐防治后 ,儿童发硒由 1997年 0 .1193μg/ g上升到 2 0 0 0年 0 .2 332μg/ g,发硒升高与 X线病情变化无剂量效应关系。结论　榆阳区仍属大骨节病中等病区 ,是陕西省大骨节病防治和科研的重点地区。硒盐防治措施未取得预期效果 ,建议根据榆阳区病区特点 ,采取植树植草治沙 ,食用非病区粮食的防治措施。     

青海省兴海县国家大骨节病监测点10年监测结果分析

目的 掌握青海省大骨节病病情动态变化,为大骨节病防治提供基础资料.方法 采用资料回顾性方法,分析1997-2006年国家大骨节病监测点青海省兴海县唐乃亥乡(上、下鹿圈村)7～12岁儿童大骨节病临床检出率和X线检出率,比较2003年与2006年儿童发硒和家中粮食硒水平.结果 儿童大骨节病临床检出率在0～20.31%,X线检出率在25.86%～47.97%.2003年儿童发硒为(130.01±48.80)μg/kg,家中粮硒为(41.3±14.9)μg/kg;2006年儿童发硒为(93.71±39.68)μg/kg,家中粮食硒为(8.15±3.44)μg/kg.两年间发硒、粮硒比较差异有统计学意义(t=3.22、10.94,P＜0.01).结论 兴海监测点大骨节病病情活跃,病区居民食用自产粮以及粮食收割、储藏、加工不科学与大骨节病关系密切.     

2001～2003年陕西省榆林市榆阳区大骨节病病情监测

目的监测陕西省大骨节病历史重病区病情动态。方法选择榆林市榆阳区4个病区村，对7-12岁儿童进行临床检查、X线拍片及发硒检测。结果近3年榆阳区大骨节病临床患病率稳定在4．61％-6．25％，临床未检出Ⅰ度以上病例；X线阳性率在14．20％～18．89％设动，骨端改变检出率均大于干骺端改变检出率；儿童发硒由2000年的0．233mg／kg上升到2002年的0.316mg／kg。结论从1997年起，在榆阳区实施硒盐防治大骨节病后，虽然病情呈下降趋势，但仍在较高水平波动。建议在做好硒盐防治工作的基础上，根据当地特点，采取植树植草治沙、食用非病区粮食的防治措施。     

陕西省大骨节病国家监测点10年病情资料分析

目的掌握陕西省榆阳区大骨节病病情及防治现状，评估防治效果，指导防治工作。方法每年对监测点100名7～12岁儿童进行临床、X线检查及发硒检测，按国家诊断标准（GB）确诊病例，对10年间的病情资料进行分析。结果10年间榆阳区儿童大骨节病临床及X线检出率显著下降，2006年临床及X线检出率均为0，达到国家控制标准；儿童发硒水平显著上升，由1997年的0．118mg／kg上升到2005年的0．370mg／kg。结论食用合格硒盐及非病区粮食，群众经济收入增加，生活、卫生水平提高是大骨节病病情下降的主要原因，应继续加强病情监测工作，加强病区群众健康教育及成人大骨节病的防治。     

2009年青海省兴海县儿童大骨节病病情及影响因素调查

目的 调查青海省兴海县大骨节病相对活跃病区儿童大骨节病流行现状,以及当地儿童硒营养水平和家庭主食粮食T-2毒素污染水平.方法 2009年对兴海县唐乃亥乡上、中、下3个村7～ 12岁儿童进行右手X线拍片,根据《大骨节病诊断标准》(GB 16003-1995)进行诊断.同时采集拍片儿童的枕部发样、饮水以及主食粮食(小麦和/或面粉),2,3-二氨基萘荧光法测定其头发、饮水和主食粮食硒含量,酶联免疫吸附试验(ELISA法)检测主食粮食T-2毒素污染水平.结果 儿童大骨节病X线总检出率为12.20％(31/254),其中下村X线检出率达到14.97％(22/147),上村X线检出率为9.52％(6/63),中村X线检出率为6.82％(3/44).病区儿童内外环境硒水平普遍较低,头发、饮水、小麦、面粉硒含量分别为(0.250±0.136)mg/kg、(0.16±0.05)μg/L、(0.0045±0.0030)mg/kg、(0.0067±0.0116)mg/kg.病区儿童家庭主食粮食T-2毒素含量较高,小麦为(78.91±46.17)μg/kg;面粉为(47.47±46.47) μg/kg.结论 青海省兴海县大骨节病相对活跃病区7～ 12岁儿童内外环境硒水平较低,而主食粮食T-2毒素污染水平较高,与当地儿童大骨节病病情分布基本一致.     

西藏自治区大骨节病防治试点效果观察

目的通过补硒、换粮、搬迁、补维生素C等措施来观察对大骨节病的防治效果。方法对防治试点大骨节病区进行全民临床检查和4～12岁儿童右手正位X线拍片检查。结果补硒后病区群众大骨节病临床检出率和儿童大骨节病右手X线检出率分别比补硒前下降了35．8％和54．4％；换粮后病区群众临床检出率和儿童X线检出率分别比换粮前下降了0．63％和71．5％；搬迁后病区群众临床检出率和儿童X线检出率分别比搬迁前下降了12．1％和22．2％；补维生素C后病区群众临床检出率和儿童X线检出率分别比补维生素C前下降了73．8％和83．7％；昌都地区5所学校补硒后儿童X线检出率比补硒前下降了61．8％；昌都地区5所学校换粮后儿童X线检出率比换粮前下降了60．1％。结论补硒、换粮、搬迁、补维生素C等防治措施对大骨节病的防治均有显著效果，建议采用综合防治措施因地制宜开展大骨节病防治工作。     

在大骨节病区示范点采取预防措施防治大骨节病效果研究

目的 观察陕西省旬邑县大骨节病病区7～12岁儿童采用补硒及主食粮干燥措施预防大骨节病的效果。方法 在病区采用补硒及主食粮干燥措施,并分别在预防措施实施前后的2014年和2016年对病区儿童拍右手X线片,采集头发、小麦和水样,以西安市健康体检儿童为非病区对照,采用双道原子荧光和ELISA法等测定硒和T-2毒素含量及粮食含水率。结果 2014年旬邑县7～12岁儿童大骨节病X线检出率为9.9%,为大骨节病轻病区,小麦硒含量为7.03±5.94 ng/g,发硒含量为0.24±0.07μg/g,水硒含量为0.51±0.27 ng/mL。非病区对照小麦硒含量为22.43±6.38 ng/g,发硒含量为0.62±0.13μg/g,水硒含量为0.75±0.11 ng/mL。病区小麦T-2毒素含量为206μg/g,小麦含水率为16%。结果表明,旬邑县7～12岁儿童发硒含量显著低于西安地区儿童,小麦硒含量显著低于西安地区,采用补硒及主食粮干燥后,2016年预防组儿童发硒含量显著增加,粮食T-2毒素含量为96 ng/g,含水率为12%,均达到国家标准。结论 旬邑县大骨节病病区外环境处于低硒状态,大骨节病X线...     

2002年陕西省大骨节病现况调查

为全面掌握陕西省大骨节病病情现况，制定防治计划，进行卫生干预，抽样调查了31个县80个乡(镇)239个行政村16岁以上人群大骨节病病情，对7-15岁在校学生进行了普查，并调查了以食用硒盐为主的综合防治措施落实情况，结果显示：临床调查16岁以上人群90203人，检出大骨节病患8006人，平均检出率为8．88％；普查7～15岁在校学生485837人，检出Ⅰ度以上大骨节病患834人，平均检出率为0．17％；拍儿童X线手片1160张，检出X线阳性改变47例，平均x线检出率为4．07％。儿童发硒在0．198-0．360μg／g，儿童发硒较硒盐防治前升高。说明陕西省大骨节病经过近20年“服硒、吃杂、改水、讲卫生”的综合防治，新发病人减少，病情下降。现患病人以36岁以上人群为主，建议加强对成人大骨节病患的二级预防工作。     

2003-2008年青海省兴海县大骨节病监测结果分析

目的 掌握2003-2008年青海省兴海县国家大骨节病监测点(唐乃亥乡的上、下鹿圈村)病情动态,了解大骨节病病情变化及病区内、外环境硒水平.方法 按照<全国大骨节病监测方案>的要求,对兴海县监测点7～12岁儿童进行临床和X线拍片检查,同时采集发、粮样品,用2,3-二氨基萘荧光法进行含硒量测定.结果 2003-2008年,上鹿圈村临床检出率在0(0/34)～17.14%(6/35);X线检出率在11.11%(3/27)～20.59%(7/34),其中干骺端检出率在0(0/27)～13.21%(7/53),骨端检出率在2.63%(1/38)～11.43%(4/35).下鹿圈村临床检出率在2.94%(1/34)～13.33%(6/45);X线检出率在26.67%(12/45)～43.63%(24/55),其中干骺端检出率在8.33%(6/72)～26.47%(9/34),骨端检出率在13.33%(6/45)～38.18%(21/55).2003年上鹿圈村发硒为(139.92±92.27)μg/kg,下鹿圈村发硒为(134.98±63.77)μg/kg.2005年上鹿圈村粮硒为(12.90±7.18)μg/kg,下鹿圈村粮硒为(14.58±9.90)μg/kg.结论 兴海县大骨节病监测点病情居高不下,监测点致病因子十分活跃;监测点内、外环境硒水平较低.     

大骨节病区儿童8年病情与发硒监测分析

汉源县是全国大骨节病活跃重病区,病区处于低硒环境。按照《四川省大骨节病监测方案》要求,于1990～1997年对该病区7～12岁儿童进行了8年病情及发硒的监测,现将监测报道如下。1 材料与方法1.1 监测对象 汉源县双溪乡大骨节病病区7～12岁儿童。1.2 监测时间 1990～1997年。1.3 监测指标 儿童X线阳性检出率及发硒含量。1.4 监测方法     

1990~2008年南县国家级血吸虫病监测点疫情监测

1990～2008年湖南省南县对国家级血吸虫病疫情监测点新尚村开展了螺情及人畜病情监测。结果显示19年来,居民血吸虫感染率由8.52%下降至0.27%,家畜感染率由54.83%下降至3.33%,活螺密度由0.8200只/0.1 m2降至0.1581只/0.1 m2,感染螺密度由0.0500只/0.1 m2降至0。表明该监测点血吸虫病疫情呈逐年下降趋势,已达到疫情控制标准,但居民血检阳性率仍维持在较高水平,疫情形势依然严峻,需进一步加强防治力度,防止疫情回升。     

Intravascular large B‐cell lymphoma presenting as a pituitary mass with bilateral adrenal enlargement and haemophagocytic lymphohistiocytosis

‘Cure models’ offer additional information to traditional epidemiological approaches to assess survival for cancer patients by simultaneously estimating the proportion cured and the survival of those ‘uncured’. The proportion cured is a summary of long‐term survival while the median survival time of the uncured provides important information on those who are not long‐term survivors. Population‐based trends in the cure proportion and survival of the uncured for childhood acute lymphoblastic leukaemia (ALL) by clinical prognostic risk factors were estimated using flexible parametric cure models, based on overall survival and event‐free survival. Children aged 1–17 years diagnosed between 1990 and 2011 in Yorkshire, UK, were included (n = 492). The percentage cured increased from 77% (95% confidence interval 70–84%) in 1990–1997 to 89% (84–93%) in 2003–2011, while the median survival time of the uncured decreased from 3·2 years (2·2–4·1 years) to 0·7 years (0–1·5 years). Models based on event‐free survival showed a similar trend. The 5‐year cumulative incidence of relapse substantially decreased from 35% in 1990–97 to 9% in 2003–2011. These results show selective improvement in survival between 1990 and 2011 with a significant reduction in the risk of relapse alongside a reduced absolute duration of survival for those destined to be uncured.     

Improved survival after variceal bleeding in patients with cirrhosis over the past two decades

Over the past two decades, new treatment modalities have been introduced for the management of variceal bleeding. The aim of this retrospective study in a single center was to assess whether these treatments have improved the prognosis for cirrhotic patients with variceal bleeding. We reviewed the clinical records of all patients with cirrhosis admitted to our Liver Intensive Care Unit due to variceal bleeding during the years 1980, 1985, 1990, 1995, and 2000. Whereas balloon tamponade was still the first-line treatment in 1980, patients treated in 2000 received a vasoactive agent, an endoscopic treatment, and an antibiotic prophylaxis in, respectively, 90%, 100%, and 94% of cases. The in-hospital mortality rate steadily decreased over the study period: 42.6%, 29.9%, 25%, 16.2%, and 14.5% in 1980, 1985, 1990, 1995, and 2000, respectively (P < .05). Mortality decreased from 9% in 1980 to 0% in 2000 in Child-Turcotte-Pugh class A patients, from 46% to 0% in class B patients, and from 70% to 32% in class C patients. This improved survival was associated with a decrease of rebleeding (from 47% in 1980 to 13% in 2000) and bacterial infection rates (from 38% to 14%). On multivariable analysis, endoscopic therapy and antibiotic prophylaxis were independent predictors of survival. In conclusion, in-hospital mortality of patients with cirrhosis and variceal bleeding decreased threefold over the past two decades, in concurrence with an early and combined use of pharmacological and endoscopic therapies and short-term antibiotic prophylaxis.     

1991-2006年吉林省地方性氟中毒病情监测结果分析

目的 了解与掌握吉林省地方性氟中毒病情变化,为调整防治对策提供科学依据.方法 1991-2006年在吉林省乾安县选择改水时间不同的7个屯作为监测点.每年检测全部8～12岁儿童氟斑牙(Dean法)、尿氟(氟离子选择电极法),每3年临床调查全部16岁以上人群氟骨症,每5年拍摄其骨盆、前臂、小腿骨关节X线片.结果 改水较好的监测点监测结束后氟斑牙检出率比监测开始时明显下降(位字屯由11.3%降至2.2%、淡字屯由16.3%降至12.1%、后岂屯由53.7%降至37.5%、后鞠屯由38.6%降至33.3%).氟斑牙严重程度明显降低(东南竞屯中度氟斑牙检出率由11.3%降至7.8%、重度由2.8%降至0:后岂屯中度氟斑牙检出率由16.7%降至0,重度由1.9%降至0;后鞠屯中度氟斑牙检出率由1.4%降至0,重度由4%降至0),尿氟降至正常水平(<1.5 mg/L).持续饮用高氟水的监测点儿童氟斑牙检出率升高(大宾屯由61.7%升至70.0%,东宾-东鞠屯由52.7%升至71.1%),尿氟持续在较高水平(大宾屯由4.03 mg/L升至4.57 mg/L).7个监测点16岁以上人群临床氟骨症检出率在11.1%～25.7%,其中仅大宾屯呈逐年升高趋势(1991、1993、1995年分别为15.9%、21.6%、25.7%).有3个监测点X线氟骨症检查阳性率呈逐年下降趋势(大宾屯由54.9%降至24.0%,东宾-东鞠屯由40.7%降至23.5%、东南竞屯由28.6%降至20.4%).结论 改水降氟能使病区病情得到控制,持续饮用高氟水病区病情将持续增高,控制氟中毒应采取综合措施有效减少高氟摄入.     

Trends in antimicrobial resistance of clinical isolates of Streptococcus pneumoniae in Bellvitge Hospital, Barcelona, Spain (1979-1990).

From January 1979 to December 1990 we studied the susceptibility of 1,492 pneumococcal strains isolated from adult patients in Bellvitge Hospital, Barcelona, Spain, to nine antimicrobial agents. Among clinically significant pneumococci, the incidence of penicillin-resistant strains increased from 4.3% in 1979 to 40% in 1990, and that of erythromycin-resistant strains also rose from 0% in 1979 to 9.4% in 1990. On the other hand, the incidence of strains resistant to tetracycline decreased from 76.1% to 37.6%, as did that of chloramphenicol-resistant strains, from 56.5% to 29.4%. The incidence of co-trimoxazole-resistant strains was about 40% throughout the study. Even more alarming was the finding that about 70% of penicillin-resistant strains showed multiple resistance to non-beta-lactam antibiotics. All pneumococci were susceptible to vancomycin, and all but six were susceptible to rifampin. We observed that isolates from cerebrospinal fluid and the respiratory tract were significantly more resistant to penicillin than were isolates from blood. The majority of strains (95%) belonged to serogroups or serotypes included in the 23-valent pneumococcal vaccine and 77.6% of penicillin-resistant strains belonged to groups 23, 6, 9, and 19.     

褪黑素对胰腺癌细胞株SW1990体外增殖及凋亡的影响

目的 探讨褪黑素(MT)体外抑制胰腺癌细胞株SW1990增殖及诱导其凋亡的作用.方法 以不同浓度的MT(0.1、0.5、1.0、2.5及5.0 mmol/L)处理体外培养的胰腺癌细胞株SW1990细胞24、48、72 h.用MTT法测定细胞增殖,以Annexin V/PI检测细胞凋亡,流式细胞仪分析细胞周期及Western blotting检测细胞Bcl-2、Bax蛋白表达.结果 MT呈浓度和时间依赖性抑制SW1990细胞的增殖.0.1～5.0 mmol/L MT作用48 h后,细胞的增殖抑制率为7.4%～85.8%.1.0～5.0 mmoL/L MT作用48 h后,G0/G1期比例为72.6%～85.3%,细胞凋亡率为21.5%～41.7%,同时Bcl-2蛋白表达下调,Bcl-2/Bax比值下降.结论 MT可以抑制SW1990细胞增殖,其机制可能与上调Bax表达,下调Bcl-2表达,促进细胞凋亡,将细胞周期阻止于G0/G1期有关.     

哈尔滨医科大学附属第四医院细菌监测及分析

目的调查我院耐药细菌变迁趋势。方法收集各类标本分离的6202菌株,按照CLSI(2010版)判断标准。结果与2010年相比,2011年球菌比例明显增高到19.41%(P<0.005),粪肠球菌明显降低至9.28%(P<0.025),MSCON明显降低至4.4%(P<0.05),球菌前三位无变化,分别为MRSCON、MRSA、MSSA;2011年杆菌比例明显降低至80.59%(P<0.005),不动杆菌显著增加到21.66%(P<0.005),杆菌前三名分别为不动杆菌、ESBLs(-)及ESBLs(+)肺炎克雷伯杆菌,真菌前三位无变化,分别是白色假丝酵母菌、光滑假丝酵母菌及曲霉菌。结论细菌监测对临床合理应用抗生素及预防细菌耐药有重要的参考价值。     

表没食子儿茶素没食子酸酯对人胰腺癌细胞株SW1990增殖的影响

目的 探讨表没食子儿茶素没食子酸酯(EGCG)对人胰腺癌细胞株SW1990增殖及细胞凋亡、细胞周期的影响.方法 采用四甲基偶氮唑蓝(MTT)比色法检测不同浓度EGCG(6.25、12.5、25、50、100μg/ml)对体外培养的SW1990细胞增殖的影响;采用流式细胞仪检测EGCG(25μg/ml)对SW1990细胞凋亡及不同浓度的EGCG(0、10、20、30、40、50 μg/ml)对SW1990细胞周期的影响.结果 不同浓度EGCG(0、25、50μg/ml)作用SW1990细胞24 h后,吸光度值(A492)分别为0.46±0.04、0.42±0.04、0.27±0.03,48 h后分别为0.48±0.02、0.31±0.03、0.16±0.02,72 h后分别为0.51±0.01、0.24±0.04、0.14±0.04,EGCG呈浓度及时间依赖性抑制SW1990的增殖(P＜0.01).25 μg/ml EGCG作用于SW1990细胞24、48、72 h后的细胞凋亡率分别为(8.33±1.15)%、(19.77±0.81)%、(29.17±0.75)%,而对照组相应的细胞凋亡率分别为(2.77±0.45)%、(3.20±0.26)%、(3.67±0.35)%,两组差异具有统计学意义(P＜0.01).0、20、50 μg/ml EGCG作用SW1990细胞24 h后,G0/G1期细胞分别占(57.59±0.97)%、(62.99±1.91)%、(68.87±1.88)%,随着EGCG浓度的增加,Go/G1期细胞比例明显增加,而S期和G2/M期细胞比例相应下降(P＜0.01).结论 EGCG能明显抑制SW1990细胞的增殖,其机制可能与其诱导SW1990细胞凋亡及调控细胞周期有关.     

Relation of length of hospital stay in acute myocardial infarction to postdischarge mortality

Hospital length of stay (LOS) after acute myocardial infarction (AMI) has steadily decreased because of both improved treatments and cost considerations. Early discharge may adversely affect some patients who might benefit from extended monitoring. The Minnesota Heart Survey was a population-based study of patients with AMI in acute-care hospitals in the Minneapolis-St. Paul, Minnesota, metropolitan area. Medical records were abstracted for a random sample of patients hospitalized with AMI in 1985, 1990, 1995, and 2001. Case fatality rates, adjusted for age and gender, were identified using mortality data from the index hospitalization and Minnesota death certificates. A total of 4,940 patients with a validated AMI were identified from the combined 1985 (n = 1,306), 1990 (n = 1,550), 1995 (n = 1,087), and 2001 (n = 515) surveys. Median LOSs were 9, 8, 6, and 4 days, respectively. Patients hospitalized 相似文献   

Trends in blood pressure, hypertension control, and stroke mortality: the Minnesota Heart Survey

Objective

The study’s objective was to determine population trends in blood pressure, hypertension prevalence, hypertension control, and stroke mortality.

Methods

We performed population-based surveys of 2906 to 5630 adults from 1980 to 1982, 1985 to 1987, 1990 to 1992, 1995 to 1997, and 2000 to 2002, and stroke mortality from 1980 to 2002, in the Minneapolis/St Paul, Minn metropolitan area (2.63 million population according to the 2000 census). Randomly selected resident adults aged 25 to 74 years (n = 21 773) were each screened once. The main outcome measures were standardized measures of blood pressure, treatment and control of hypertension, and stroke mortality rates.

Results

The mean systolic blood pressure adjusted for age decreased in men (−1.5 mm Hg [95% confidence interval −0.3 to −2.7], P <.01) and women (−1.8 mm Hg [95% confidence interval −0.5 to −3.0], P <.001) from 1980 to 1982 and 2000 to 2002. The mean diastolic blood pressure was unchanged for men (0 mm Hg) and women (−0.4 mm Hg, not significant). The proportion of the population taking antihypertensive medications decreased in the 1990s but returned to 1980s levels from 2000 to 2002. The use of other methods to decrease blood pressure (diet, exercise, and weight loss) peaked in the 1990 to 1992 survey and then decreased. Proportions of hypertensive patients in the aware, treated, and/or controlled categories leveled in the 1980s and 1990s, but improved substantially from 1995 to 1997 and 2000 to 2002 with blood pressure controlled at the less than 140 and/or 90 mm Hg criteria in 44% of the men and 55% of the women. Population mortality trends for stroke paralleled those for hypertension control.

Conclusions

Population data beginning in 1980 to 1982 from the Minnesota Heart Survey indicate a leveling in the detection and control of hypertension in the 1990s followed by improvement from 2000 to 2002.