菲律宾疟疾控制规划实施草案（1994～1998）

菲律宾疟疾控制规划实施草案（１９９４～１９９８）引言一、背景在菲律宾，疟疾是十大死亡原因之一，在全部７６个省份中，７２个省有疟疾流行。但９５％的病例和８５％的死亡例数集中在２４个省。自前，疟疾处于低度到中度流行，也有偶发性的高度流行。二、疟疾控制规划...     

斑点免疫金染色法检测恶性疟原虫循环抗原

应用胶体金探针建立了斑点免疫金染色法（Ｄｏｔ－ＩＧＳ）。以捕捉法Ｄｏｔ－ＩＧＳ检测３０份海南恶性疟病人全血，循环抗原阳性者２７份，阳性率为９０．０％；４０份其他寄生虫病血样全为阴性。结果表明，捕捉法Ｄｏｔ－ＩＧＳ在敏感性和特异性方面都优于间接法Ｄｏｔ－ＩＧＳ和斑点酶联免疫吸附测定，是检测疟疾循环抗原的理想方法。     

In vitro studies with recombinant Plasmodium falciparum apical membrane antigen 1 (AMA1): production and activity of an AMA1 vaccine and generation of a multiallelic response

Apical membrane antigen 1 (AMA1) is regarded as a leading malaria blood-stage vaccine candidate. While the overall structure of AMA1 is conserved in Plasmodium spp., numerous AMA1 allelic variants of P. falciparum have been described. The effect of AMA1 allelic diversity on the ability of a recombinant AMA1 vaccine to protect against human infection by different P. falciparum strains is unknown. We characterize two allelic forms of AMA1 that were both produced in Pichia pastoris at a sufficient economy of scale to be usable for clinical vaccine studies. Both proteins were used to immunize rabbits, singly and in combination, in order to evaluate their immunogenicity and the ability of elicited antibodies to block the growth of different P. falciparum clones. Both antigens, when used alone, elicited high homologous anti-AMA1 titers, with reduced strain cross-reactivity. Similarly, sera from rabbits immunized with a single antigen were capable of blocking the growth of homologous parasite strains at levels theoretically sufficient to clear parasite infections. However, heterologous inhibition was significantly reduced, providing experimental evidence that AMA1 allelic diversity is a result of immune pressure. Encouragingly, rabbits immunized with a combination of both antigens exhibited titers and levels of parasite inhibition as good as those of the single-antigen-immunized rabbits for each of the homologous parasite lines, and consequently exhibited a broadening of allelic diversity coverage.     

A Stochastic Nonlinear Autoregressive Algorithm Reflects Nonlinear Dynamics of Heart-Rate Fluctuations

Current methods for detecting nonlinear determinism in a time series require long and stationary data records, as most of them assume that the observed dynamics arise only from the internal, deterministic workings of the system, and the stochastic portion of the signal (the noise component) is assumed to be negligible. To explicitly account for the stochastic portion of the data we recently developed a method based on a stochastic nonlinear autoregressive (SNAR) algorithm. The method iteratively estimates nonlinear autoregressive models for both the deterministic and stochastic portions of the signal. Subsequently, the Lyapunov exponents (LE) are calculated for the estimated models in order to examine if nonlinear determinism is present in the deterministic portion of the fitted model. To determine if nonlinear dynamic analysis of heart-rate fluctuations can be used to assess arrhythmia susceptibility by predicting the outcome of invasive cardiac electrophysiologic study (EPS), we applied the SNAR algorithm to noninvasively measured resting sinus-rhythm heart-rate signals obtained from 16 patients. Our analysis revealed that a positive LE was highly correlated to a patient with a positive outcome of EPS. We found that the statistical accuracy of the SNAR algorithm in predicting the outcome of EPS was 88% (sensitivity=100%, specificity=75%, positive predictive value=80%, negative predictive value=100%, p=0.0019). Our results suggest that the SNAR algorithm may serve as a noninvasive probe for screening high-risk populations for malignant cardiac arrhythmias. © 2002 Biomedical Engineering Society. PAC2002: 8719Hh, 0545Tp, 8710+e     

The emerging role of the health information management professional in data quality and analysis of an electronic medical record system

The role of the health information management professional is changing with the advancement of the electronic medical record system (EMRS) and electronic financial database systems. The Medical ARchival System, a longitudinal EMRS developed at the University of Pittsburgh Medical Center, was used to describe the methodology that the health information management professional should use when performing data quality evaluations and data analysis of an EMRS. Specific examples of steps used to integrate databases to collect the data and generate appropriate reports and tables are also described and discussed.     

单克隆抗体ELISA检测班氏丝虫病人血清循环抗原

应用抗马来微丝蚴抗原4B_1株单克隆抗体(McAb)和抗马来成虫代谢抗原4B_7株McAb酶联免疫吸附试验(ELISA)检测班氏微丝蚴血症者血清中循环抗原,阳性率分别为78.46％(102/130)和87.13％(88/101);检测51例晚期丝虫病人血清,阳性率分别为3.92％和1.96％;36例经治疗后微丝蚴血症阴转者血清,阳性率分别为13.89％和8.33％。丝虫病非流行区99例肠道蠕虫感染者阳性率分别为16.16％和5.05％。结果表明抗马来成虫代谢抗原4B_7株McAb应用于诊断班氏丝虫感染的效果优于抗马来微丝螺4B_1株McAb。     

Individual, household and community factors associated with HIV test refusal in rural Malawi

Objective To investigate individual, household and community factors associated with HIV test refusal in a counselling and testing programme offered at population level in rural Malawi. Methods HIV counselling and testing was offered to individuals aged 18–59 at their homes. Individual variables were collected by interviews and physical examinations. Household variables were determined as part of a previous census. Multivariate models allowing for household and community clustering were used to assess associations between HIV test refusal and explanatory variables. Results Of 2303 eligible adults, 2129 were found and 1443 agreed to HIV testing. Test refusal was less likely by those who were never married [adjusted odds ratio (aOR) 0.50 for men (95% CI 0.32; 0.80) and 0.44 (0.21; 0.91) for women] and by farmers [aOR 0.70 (0.52; 0.96) for men and 0.59 (0.40; 0.87) for women]. A 10% increase in cluster refusal rates increased the odds of refusal by 1.48 (1.32; 1.66) in men and 1.68 (1.32; 2.12) in women. Women counsellors increased the odds of refusal by 1.39 (1.00; 1.92) in men. Predictors of HIV test refusal in women were refusal of the husband as head of household [aOR 15.08 (9.39; 24.21)] and living close to the main road [aOR 6.07 (1.76; 20.98)]. Common reasons for refusal were fear of testing positive, previous HIV test, knowledge of HIV serostatus and the need for more time to think. Conclusion Successful VCT strategies need to encourage couples counselling and should involve participation of men and communities.     

单克隆抗体免疫放射测定法检测丝虫抗原

应用抗马来丝虫成虫单克隆抗体（ＭｃＡｂ）结合免疫放射测定法（ＩＲＭＡ），对马来丝虫成虫抗原、马来丝虫成虫排泄－分泌抗原（ＥＳ抗原）、马来微丝蚴抗原及班氏丝虫病病人血清中循环抗原进行了检测。马来丝虫成虫抗原检出的最低含量为０．４８ｐｇ，ＥＳ抗原、马来微丝蚴抗原可测得抗原结合量分别为０．３５μｇ和０．０６５μｇ，班氏丝虫病人血清中循环抗原的检测结果阳性率为８０％（４０／５０），丝虫病流行区５０份微丝蚴阴性血清及丝虫病非流行区５０份肠道蠕虫感染者血清全部为阴性。