Epidemiological Investigation of the Jaundice Outbreak in Lalkuan,Nainital District,Uttarakhand

Background:

In March 2013, cases of acute hepatitis were reported from Lalkuan, Nainital district. We investigated the outbreak to identify the source of infection and to facilitate control measures.

Objectives:

To study the distribution of hepatitis cases, to find the source of infection, and to initiate the control measures in the affected area.

Materials and Methods:

We defined a case of acute hepatitis as those cases that had jaundice with at least one of the following symptoms: Dark urine, fever, pain in abdomen, vomiting, and loss of appetite in the affected area between January and March 2013. Door-to-door survey was carried out. Thirteen blood samples were randomly collected from jaundice cases for immunoglobulin M (IgM) antibody for hepatitis A virus (HAV) and hepatitis E virus (HEV). Water samples were collected to test residual chlorine.

Results:

Total 2,785 individuals were surveyed; of which 240 were suffering from acute viral hepatitis (attack rate (AR) = 8.61%). Out of 13 serum samples, 10 were found positive for HEV IgM antibodies and three cases had IgM antibodies for both HAV and HEV, which confirmed a hepatitis E outbreak. The difference in attack rate of hepatitis of both the sexes was statistically significant (P < 0.001). The attack rate was significantly higher in age groups >12 years of age (P < 0.001). Environmental investigation also confirmed the sewage contamination of drinking water in the distribution system. The attack rate was much higher (29.4%) among those who were exposed to the leaking pipeline than the nonexposed (χ² = 574.26, P < 0.01).

Conclusion:

HEV was confirmed as the major etiological agent in this outbreak that was transmitted by contaminated drinking water. The recognition of early warning signals, timely investigation, and application of specific control measures can contain the outbreak.     

Influence of Strain Route Changes on the Microstructure and Mechanical Properties of CuZn36 Alloy during Cross Channel Extrusion CCE

This study evaluates the impact of changing the deformation routes of the extrusion process in a cross-shaped die (CCE) on the structure and properties of a CuZn36 alloy (% at.). Samples with dimensions of Ø8 × 36 mm were subjected to extrusion at room temperature according to two variants: straight extrusion in the A route (2-, 4-, 8- and 12-pass) and extrusion with interoperative rotation by 90° in the B_C route (2- and 4-pass). The improvement of strength properties was obtained as a result of grain fragmentation in the CCE process. Changes in the microstructure were observed using a light microscope, and mechanical properties were measured in the microhardness test and a static tensile test. The obtained results showed that the mechanical properties of the alloy depend on the number of passes and the material deformation route. This observation was related to the fragmentation of its structure and strengthening, which resulted in changes in its properties. The highest strength was characterized by the material pressed four times with the rotation of 90° (B_C route), whose properties were comparable and even slightly better than the material squeezed twelve times without rotation (A route).     

寄生虫DNA疫苗免疫途径和剂量的研究进展

DNA疫苗又称核酸疫苗或基因疫苗,能在体内引起特异性细胞免疫和体液免疫应答。免疫应答的水平受多种因素的影响。该文就影响寄生虫DNA疫苗免疫效果的途径和剂量等方面的研究进展作一综述。     

经动脉途径应用Onyx胶栓塞治疗硬脑膜动静脉瘘(附16例报告)

目的探讨经动脉途径应用Onyx胶栓塞治疗颅内硬脑膜动静脉瘘(DAVF)的可行性及疗效。方法回顾性分析2007年3月至2010年10月收治的16例DAVF患者的临床资料及随访结果。经动脉途径采用Onyx胶栓塞治疗15例,动静脉联合途径1例。结果 16例患者共栓塞17次,栓塞结束即时解剖治愈14例(87.5%),另2例栓塞不全者术后辅以手术治疗。栓塞后出现动眼神经麻痹3例,面部感觉麻木3例,随访1月后症状消失;口咽部疼痛2例,应用糖皮质激素治疗后症状消失。本组无死亡病例。10例患者术后2～24个月复查DSA,1例DAVF复发,9例完全闭塞;6例门诊随访2～24个月均未见复发。结论经动脉途径应用Onyx胶栓塞治疗颅内DAVF是可行、有效的方法,效果良好。     

胶囊内镜检查对双气囊小肠镜进镜方式选择的指导作用

目的:探讨胶囊内镜检查对双气囊小肠镜进镜方式选择的指导作用．方法:胶囊内镜检查阴性或可疑病变者20例行双气囊小肠镜检查(均在麻醉下进行),包括经口和经肛进镜方式．根据胶囊内镜时间指数 (胶囊内镜从幽门至病灶的通过时间／幽门至回盲瓣的通过时间)选择首次进镜方式,时间指数>0．50时首先考虑经肛进镜检查,对未发现异常者择期改换方式再行检查．分析按胶囊内镜时间指数选择双气囊小肠镜进镜方式的准确性．结果:胶囊内镜检查阴性者5例,行经口双气囊小肠镜检查,有1例在改为经肛检查后检出病灶．胶囊内镜检查怀疑小肠病变者15例,有 12例(80．0％)经双气囊小肠镜结合活检病理确诊．以时间指数>0．50为标准,4例(分别为0．99, 0．8,0．65和0．59)首选经肛进镜检查,后二者(时间指数分别为0．65和0．59)需换从口侧进镜检查而检出病灶;如以时间指数>0．75为标准,该 2例不再需要改换方式再行检查,另2例病变部位被判断为回肠远端,经肛进镜即可准确到达病灶．结论:胶囊内镜检查可指导对双气囊小肠镜进镜方式的选择,时间指数>0．75提示首选经肛进镜检查．     

南水北调东线工程高邮段调水前血吸虫病疫情监测

目的 目的 了解南水北调东线工程输水干线高邮段调水前钉螺分布和血吸虫病流行现状。方法 方法 选择南水北调东 线工程输水干线高邮段大运河、 三阳河及其两岸3 km 范围, 以及输水干线毗邻的高邮湖区为监测区, 采用常规法进行钉螺 和人畜血吸虫病监测。同时在大运河和三阳河各设立3个水体钉螺监测点, 采用网捞法和稻草帘诱螺法进行监测。结 结 果 果 2006-2012年南水北调东线工程高邮段未查出感染性钉螺以及当地感染的血吸虫病人和病畜; 大运河钉螺面积呈下 降趋势, 三阳河未发现钉螺。水体钉螺监测点打捞漂浮物270 kg, 投放稻草帘720 块, 均未发现钉螺。结论 结论 南水北调东 线工程高邮段残存钉螺未发现北移扩散。     

台州市无偿献血者艾滋病病毒抗体阳性情况调查

目的:了解台州地区无偿献血人群艾滋病病毒(HIV)感染特征及感染途径。方法:统计2010-01-2013-09台州市无偿献血者HIV感染率,分析HIV感染者情况。结果:台州市献血人群中HIV感染者24例,平均感染率为0.014%。结论:在进行献血者筛选时,对多次献血者也应认真做好献血前咨询、体检,应慎重甄别和界定低危人群。     

经阴道三维超声成像诊断宫外孕的应用价值

目的 探讨经阴道三维超声成像诊断宫外孕的临床价值。方法 34例宫外孕患者用经阴道三维超声成像技术进行检查并与二维超声图像比较，其中25例手术证实，9例保守治疗。结果 经阴道三维超声成像图像清晰，能显示病灶的立体形态及内部细微结构，提高了卵黄囊的显示率。结论 经阴道三维超声成像技术为宫外孕的诊断提供了更丰富的信息，提高了诊断正确率。