Emergence of infections with Schistosoma mansoni in the Dhofar Governorate, Oman

Infections with Schistosoma mansoni were identified in an area of Dhofar (Oman), where this parasite had been virtually absent during recent years and was reported only very sporadically before 1992. In the present survey, performed late in 2001, between 1 and 13% of children (n=519) were found to excrete eggs (one Kato-Katz-smear) in four schools, from four different villages, but no infections were detected in additional five schools (n=281). Infections were light (<72 eggs/g of faeces) in 19 of the 36 children found infected. Serologic examination of sera (n=511) was done by ELISA (based on soluble worm antigen) and immunofluorescence tests (IFT, based on cryostat sections of adult S. mansoni). The prevalence according to serological tests was between 3 and 43% in the four schools with infected children. Positive test results were taken to reflect active infections, since false positive reactions could largely be excluded. According to ultrasound (US) examinations performed on 96 individuals (children and adults) from the four villages, livers were normal in all except three cases of mild pathology, which could be assigned to schistosomiasis mansoni (pattern C, ages 32-40 years). All data suggest that transmission of S. mansoni has been re-introduced only recently in Dhofar and that this emergence of schistosomiasis is limited to at most a few foci.     

江苏省男男性行为人群HIV新发感染及影响因素分析

目的 分析江苏省MSM的HIV新发感染及影响因素。方法 根据2019年全国艾滋病哨点监测方案,2019年4-7月在江苏省13个城市招募MSM,进行问卷调查及实验室检测,应用限制性抗原亲和力酶联免疫法（LAg-Avidity EIA）检测HIV新发感染者,根据中国CDC推荐的基于亲和力方法的计算公式及参数计算新发感染率;采用多因素logistic回归模型分析HIV新发感染的影响因素。结果 研究对象MSM 4 469人,HIV新发感染率为4.5%（95%CI：3.4%~5.5%）。多因素logistic分析结果显示,相比于≥ 40岁年龄组、招募途径来自MSM活动场所、艾滋病知识知晓、最近6个月未发生无保护肛交、无梅毒现症感染,18~24岁年龄组（aOR=2.083,95%CI：1.087~3.990）、招募途径来自VCT门诊（aOR=2.125,95%CI：1.175~3.843）、艾滋病知识不知晓（aOR=2.456,95%CI：1.109~5.437）、最近6个月发生无保护性肛交（aOR=3.553,95%CI：2.143~5.889）、梅毒现症感染（aOR=2.414,95%CI：1.033~5.462）的HIV新发感染风险较高。结论 江苏省MSM人群HIV新发感染率较高。MSM的艾滋病预防控制,需加强健康教育、推广使用安全套和促进HIV/梅毒筛查工作。     

洛铂联合紫杉醇同步放化疗对中晚期食管癌的近期疗效

 目的　观察洛铂联合紫杉醇同步放化疗对中晚期食管癌的近期疗效及患者不良反应。方法　回顾性分析2010年4月至2011年5月收治的首程行同步放化疗的中晚期食管鳞状细胞癌患者26例,化疗方案：紫杉醇135 mg／m2,第1天;洛铂35 mg／m2,第2天,3周重复;放疗于第1周期化疗结束后第2天进行,中位总剂量60 Gy,30次,共6周。结果　全组共化疗52个周期,平均每例2个周期。近期疗效：完全缓解（CR）7例（26.9 %）,部分缓解（PR）17例（65.4 %）,疾病稳定（SD）2例（7.7 %）,总有效（CR+PR）率为92.3 %。患者不良反应：骨髓抑制方面,白细胞下降Ⅰ～Ⅱ度46.1 %（12例）,Ⅲ～Ⅳ度46.1 %（12例）,血小板下降Ⅰ～Ⅱ度30.8 %（8例）,Ⅲ～Ⅳ度7.7 %（2例）,血红蛋白下降Ⅰ～Ⅱ度42.3 %（11例）,Ⅲ度15.4 %（4例）;脱发84.6 %（22例）;肌肉或关节痛69.2 %（18例）;胃肠道反应Ⅰ～Ⅱ度11.5 %（3例）;放射性食管炎88.5 %（23例）;放射性气管炎19.2 %（5例）。结论　洛铂联合紫杉醇同步放化疗对中晚期食管癌的近期疗效好,患者不良反应能够耐受,值得临床进一步研究。     

山东省男男性行为人群新型毒品滥用和HIV新发感染的相关因素分析

目的 分析MSM新型毒品滥用和HIV新发感染的相关因素,为制定艾滋病防控措施提供参考依据。方法 2021年4-7月在山东省9个城市监测哨点招募MSM,每个城市招募样本量为400人。开展面对面问卷调查,收集MSM社会人口学特征、行为学和接受HIV干预服务等信息,采集血样进行HIV和梅毒抗体检测。采用限制性抗原亲和力酶联免疫法进行HIV新发感染检测,并计算HIV新发感染率指标。结果 共调查MSM 3 624人,年龄（32.70±9.33）岁,以≥30岁（59.52%,2 157/3 624）、高中及以下文化程度（55.99%,2 029/3 624）、未婚/离异/丧偶（57.70%,2 091/3 624）和性取向为同性恋者为主（86.26%,3 126/3 624）。最近6个月发生无保护肛交占32.95%（1 194/3 624）;曾使用新型毒品占27.48%（993/3 613）;HIV抗体阳性率为3.12%（113/3 624）,HIV新发感染率为2.61%（95%CI：1.73%~3.49%）。多因素logistic回归分析结果显示,MSM新型毒品滥用的相关因素包括未婚/离异/丧偶（相比于已婚/同居,aOR=1.43,95%CI：1.22~1.69）、大专及以上文化程度（相比于高中及以下文化程度,aOR=1.47,95%CI：1.25~1.72）、主要寻找男性性伴场所为互联网/交友软件（相比于酒吧/浴池/公园等,aOR=1.76,95%CI：1.41~2.19）、最近6个月发生无保护肛交（相比于未发生无保护肛交,aOR=1.33,95%CI：1.13~1.57）、最近1年患过性病（相比于未患性病,aOR=2.77,95%CI：2.04~3.76）。MSM HIV新发感染的相关因素包括最近6个月发生无保护肛交（相比于未发生无保护肛交,aOR=2.51,95%CI：1.25~5.01）、最近1年未接受HIV干预服务（相比于接受HIV干预服务,aOR=3.89,95%CI：1.30~11.60）、梅毒阳性（相比于梅毒阴性,aOR=8.18,95%CI：2.98~22.48）、曾使用新型毒品（相比于未使用新型毒品,aOR=4.75,95%CI：2.32~9.70）。结论 山东省MSM新型毒品滥用现象较为普遍,新型毒品滥用会增加HIV新发感染风险。     

云南省德宏州2005—2009年新报告HIV-1感染者中新近感染比例及其影响因素分析

目的 了解云南省德宏州2005-2009年新报告HIV-1感染者中新近感染者构成比及其影响因素.方法 对该州2005-2009年所有新报告HIV-1感染者的血清样本用BED HIV-1发病率捕获酶联法(BED-CEIA)检测以确定新近感染者.结果 2005-2009年德宏州共新报告HIV感染者9367例,对其中7252例(77.4%)进行BED-CEIA检测,其中954例(13.2%)为新近感染者,各年新报告HIV感染者中新近感染者所占比例依次是:2005年为11.21%、2006年为11.87%、2007年为17.55%、2008年为13.22%、2009年为12.22%.logistic多因素回归分析显示,在控制了各变量间的潜在混杂作用影响后,2009年度不同性别、不同年龄、不同户籍的HⅣ感染者中新近感染者所占比例显著不同,女性显著高于男性、11～19岁组显著高于50岁以上组、外地户籍(不含外籍)显著高于本地户籍、外籍(主要为缅甸籍)则显著低于本地户籍.结论 2005-2009年云南省德宏州新报告HIV感染者中HⅣ新近感染构成比呈历年小幅波动态势,其长期趋势尚有待进一步观察研究.2009年度不同社会人口学特征的新报告HIV感染者中新近感染所占比例显著不同.     

创新社区卫生服务中心 持续综合发展内涵建设

就当前的形势讲,社区卫生服务在政策方面已经没有问题,国家高层高度关注这个事业。当前的首要任务是如何加强内涵建设,提高服务功能。笔者认为,作为社区卫生服务的主体——社区卫生服务中心,今后建设应该有四个层面的创新,即管理创新、功能创新、科技创新和文化创新。     

腰椎间盘突出症中医治疗近况

腰椎间盘突出症是腰椎间盘退变、纤维环破裂、髓核突出等刺激、压迫神经根或马尾神经所致的综合征候群,随着医学影像技术的发展,对该病的准确诊断不难,但是治疗方法较多。中医药方法是治疗椎间盘源性疼痛的重要措施,本文阐述了近十年腰椎间盘突出症中医治疗的新进展。     

The potential of alkaloids in drug discovery

Alkaloids are an important group of diversely distributed, chemically, biologically and commercially significant natural products. This article suggests why now, with the presently available technology, and the remaining biome available and reasonably accessible, is an opportune moment to consciously focus on the discovery of further alkaloids with pharmacophoric utility.     

Six important themes in amyotrophic lateral sclerosis (ALS) research, 1999

My assignment was to identify the 6 most important ALS papers published in 1999 but, great to relate, there were too many excellent candidates. Rather than confining the search to individual papers, six major themes seemed appropriate for discussion: 1) The study of transgenic mice that carry a mutated human gene for superoxide dismutase-1 (SOD1) has led to many far-reaching advances in ALS research. The mice are regarded as the best test system to evaluate potential therapies, including creatine. Inconsistencies between efficacy in mice and people are noted, however. 2) Transgenic mice have also been used to evaluate the role of glutamate toxicity in the pathogenesis of ALS, a dominant theory. 3) The role of mitochondria in the pathogenesis of ALS is gathering increasing attention. 4) The role of neurofilaments in the pathogenesis of ALS has provided new twists in mice and people. 5) Motor neuropathy is the most important differential diagnosis of ALS. 6) Gene therapy, as exemplified by the use of stem cells, has been applied successfully to animal models of other inherited diseases of the central nervous system.     

调强放疗联合培美曲塞和顺铂同期化疗局部晚期非小细胞肺癌的临床研究

目的 探讨调强放疗结合培美曲赛和顺铂同期化疗局部晚期非小细胞肺癌的疗效及副反应.方法 42例Ⅲ期非小细胞肺癌患者(ⅢA期25例,ⅢB期17例)接受DT66 Cy调强放疗,疗中给予培美曲塞500 mg/m2静脉滴注第1天,顺铂75 mg/m2静脉滴注第1天,21 d为1个周期,共4个周期.放化疗在同大开始进行,先化疗后放疗.2例放疗总量54 Gy,2例56 Gy;3例完成了2周化疗,1例完成了 3周化疗.结果 34例患者完成了治疗计划.全组总有效率为79%,1年总生存率为65%.≥3级骨髓抑制2例,3级放射性食管炎3例,≥2级放射性肺炎4例,3级黏膜炎1例.结论 培美曲赛和顺铂同期放化疗局部晚期非小细胞肺癌患者具有较好的近期疗效,副反应可耐受.

Abstract：

Objective To observe the therapeutic effect and toxicity of chemoradiation of locally advanced non-small cell lung cancer by intensity modulated irradiation combined with pemetrexed and cisplatin. Methods Fourty-two patients presented with Ⅲ - stage non-small cell lung cancer(Ⅲ、 25 patients, ⅢB 17 patients)received concurrent chemoradiotherapy. Intensity modulated irradiation technique was used to the total dose of 66 Gy and concurrent chemotherapy consisted of pemetrexed 500 mg/m2 on Day 1 and cisplatin 75 mg/m2 on Day 1 by intravenous infusion once every 3 weeks at the initiation of radiation.Patients received 4 cycles of chemotherapy. Results Thirty-four patients finished the whole of therapeutic schedule. And 2 patients received radiation with total dose of 54 Gy, 2 patients 56 Gy;3 patients received 2 cycles of chemotherapy, 1 patients 3 cycles of chemotherapy. Total effective rate was 79%. There were 2 patients with ≥3 grade marrow depression, 3 patients with 3 grade radiation esophagitis, 4 patients with ≥2 radiation pneumonitis, and 1 patient with 3 grade mucositis. The 1-year survival rate was 65%.Conclusion Recent effect was favourable and toxicity was tolerable for chemoradiation of locally advanced non-small cell lung cancer by intensity modulated irradiation combined with pemetrexed and cisplatin.