我国带绦虫病和囊尾蚴病防治现状与挑战

WHO关于2021-2030年被忽视的热带病防控路线图将疾病控制目标分成4个层级,分别是控制、作为公共卫生问题被消除、消除和根除.带绦虫病和囊尾蚴病被列为需要控制的疾病.总体上,我国带绦虫病和囊尾蚴病人群感染率呈低水平,流行程度呈明显地区和人群分布差异,但消除带绦虫病和囊尾蚴病面临诸多挑战.在以往防控工作的基础上,还需...     

浅析新版GSP对医药流通企业的压力和挑战

药监局近日发布的新版《药品经营质量管理规范》简称GSP于2012年11月6日经卫生部部务会审议通过,将于2013年6月1日起正式实施。新版GSP与2000年发布的旧版GSP相比,在药品经营企业质量管理、信息化管理、文件管理体系等方面都有了全面的提升,药品流通企业面临着前所未有的压力与挑战。本文将结合新版GSP等新政的相关要求和内容针对医药流通企业的特点从企业的信息化管理、冷链设施管理和人员要求等软、硬件方面及如何应对挑战进行简要的探讨。     

脉冲震荡法与常规通气在支气管激发试验中的对比研究

目的：探讨用脉冲震荡法(Impulse Oscilbmetry IOS)测定呼吸阻力在支气管激发试验中的诊断价值。方法：对72例门诊及住院就诊有自觉症状，临床怀疑为支气管哮喘而不能确诊的患者进行支气管激发试验，用IOS测定5～35赫兹震荡频率时的粘性阻力(R5-R35)，5赫兹时的周边弹性阻力(X5)，共振频率(Fres)，阻抗(Zre)，与常规通气一秒量(FEV1)，呼气峰流速值(PEF)，1秒率(FEV1／FVC％)进行对比研究。结果：支气管激发试验阳性组患者FEV1比试验前FEV1基础值降低20％的同时呼吸阻力明显增加，且阻力增加较FEV1下降出现早，部分支气管激发试验通气功能阴性的患者而阻力增加。结论：脉冲震荡法为一种新型肺功能测定方法，用于支气管激发试验可大大减少以往常规通气测定中的不足，对支气管激发试验阴性的患者在鉴别诊断上增加了新的内容。     

Efficacy of a high potency O1 Manisa foot-and-mouth disease vaccine in cattle against heterologous challenge with a field virus from the O/ME-SA/Ind-2001 lineage collected in North Africa

Outbreaks of foot-and-mouth disease (FMD) in North Africa (2013) and the Gulf States (2013) of the Middle East have been caused by a FMD viral lineage (O/ME-SA/Ind-2001) that was before 2013 restricted to the Indian Sub-continent. This study was undertaken to assess the in vivo efficacy of a FMD virus emergency vaccine type O₁ Manisa against heterologous challenge with a representative field virus (O/ALG/3/2014) from this emerging lineage. This widely available vaccine was selected since in vitro vaccine-matching results gave inconclusive results as to whether or not it would be protective. Three groups of five cattle were vaccinated with O₁ Manisa (homologous potency ≥6PD₅₀/dose) using study guidelines outlined in the European Pharmacopeia, and challenged at 21 days post-vaccination by tongue inoculation. All animals that were vaccinated with the lowest dose (1/16) of vaccine developed generalised FMD, defined as vesicular lesions at the feet. One animal vaccinated with a 1/4 dose of the vaccine also developed generalised disease, as did two animals vaccinated with the full dose of vaccine. These results indicate that the heterologous potency of this high potency O₁ Manisa vaccine was approximately 3.5 PD₅₀/dose. These data support the use of the O₁ Manisa vaccine for FMD control in areas where FMDV is endemic e.g. North Africa, and motivate further studies to evaluate other vaccine candidates (or multivalent combinations) that might be potentially used for emergency purposes in FMD-free settings.     

Multiple Selectin Blockade With a Small-Molecule Selectin Inhibitor Does Not Affect Survival After a Second Inflammatory Challenge With Nonlethal LPS

The effects of anti-adhesion molecule antibodies on the blockade of leukocyte-endothelial interactions have the potential of decreasing survival through possibly increased infection vulnerability. The aim of this study was to determine the effect of a small-molecule selectin inhibitor (TBC-1269) on both liver response and survival to a nonlethal lipopolysaccharide (LPS) challenge after hemorrhagic shock. Ninety-six Sprague-Dawley rats were subjected to a model of uncontrolled hemorrhagic shock. Six groups of animals were included in this study ( n = 16 per group): sham/saline, sham/LPS, shock/saline, shock/LPS, shock/TBC1269, and shock/TBC-1269/LPS. Experimental design consisted of the development of hemorrhagick shock (3 mL/100 g) in a 15-min period, tail amputation and drug administration at 30 min, and subsequent resuscitation to maintain mean arterial pressure at 70mm Hg. A septic challenge was produced with 0.1 mg/kg of LPS ( Escherichia coli type 78H4086; Sigma Chemical, St. Louis, MO) given intravenously via penile vein at 20 h. Liver injury tests (alanine aminotransferase, ALT), liver myeloperoxidase, liver histology, and 21-day survival were evaluated. Statistical analysis included the Bartlett test for equality of variance, a two-way analysis of variance (ANOVA), and overall followed by pairwise log-rank test for survival. Significant improvements in liver function and histology were observed in animals treated with TBC-1269 with or without a nonlethal septic challenge. Neutrophil infiltration, as evidenced by liver myeloperoxidase (MPO) was significantly decreased in animals treated with TBC-1269 alone and those having LPS administration after TBC-1269 treatment. We conclude that TBC-1269, multisectin blocker, was effective in reducing liver damage even with the addition of a second inflammatory insult as the nonlethal LPS challenge used in this study.     

Four-segmented Rift Valley fever virus induces sterile immunity in sheep after a single vaccination

Rift Valley fever virus (RVFV), a mosquito-borne virus in the Bunyaviridae family, causes recurrent outbreaks with severe disease in ruminants and occasionally humans. The virus comprises a segmented genome consisting of a small (S), medium (M) and large (L) RNA segment of negative polarity. The M-segment encodes a glycoprotein precursor (GPC) protein that is co-translationally cleaved into Gn and Gc, which are required for virus entry and fusion. Recently we developed a four-segmented RVFV (RVFV-4s) by splitting the M-genome segment, and used this virus to study RVFV genome packaging. Here we evaluated the potential of a RVFV-4s variant lacking the NSs gene (4s-ΔNSs) to induce protective immunity in sheep. Groups of seven lambs were either mock-vaccinated or vaccinated with 10⁵ or 10⁶ tissue culture infective dose (TCID₅₀) of 4s-ΔNSs via the intramuscular (IM) or subcutaneous (SC) route. Three weeks post-vaccination all lambs were challenged with wild-type RVFV. Mock-vaccinated lambs developed high fever and high viremia within 2 days post-challenge and three animals eventually succumbed to the infection. In contrast, none of the 4s-ΔNSs vaccinated animals developed clinical signs during the course of the experiment. Vaccination with 10⁵ TCID₅₀ via the IM route provided sterile immunity, whereas a 10⁶ dose was required to induce sterile immunity via SC vaccination. Protection was strongly correlated with the presence of RVFV neutralizing antibodies. This study shows that 4s-ΔNSs is able to induce sterile immunity in the natural target species after a single vaccination, preferably administrated via the IM route.     

监测与响应: 中国消除疟疾后的核心干预措施

2021年6月,我国顺利通过WHO消除疟疾认证。但我国每年仍有数千例境外输入疟疾病例,因输入性疟疾病例引起的死亡病例每年均有报告;由输入性疟疾导致的继发病例时有发生,由于原疟疾流行区传疟媒介依然存在,在疟疾消除地区由输入性病例再次引起本地传播的风险依然较大。本文就消除后阶段我国疟疾防控工作面临的风险、监测与响应工作中面临的挑战进行分析,并对今后工作重点提出相应建议。     

Nursing Now 2020: the Nightingale Challenge

Global healthcare expenditure is increasing, along with the numbers of older patients with multiple comorbidities, while the numbers of health workers are hugely decreasing, and many nursing and midwifery vacancies remain unfilled. With the World Health Organization declaring 2020 the Year of the Nurse and Midwife, and commencing the Nursing Now campaign with partners including the International Council of Nurses and the International Confederation of Midwives, has allowed these professions to unite, encourage advocacy and the call for global investment in nursing and midwifery. These actions will permit these professions to address universal health coverage, global inconsistencies of professional practice, and recruitment and retention. The Nightingale Challenge seeks to place early career nurses and midwives at the forefront of transformation, calling on employers worldwide to invest and provide nursing leadership development, and to become a key part of the solution to address the issues of providing universal health coverage, promoting gender equality and supporting economic growth. This will help place them at the heart of tackling 21st century health challenges.