症状监测在伤寒和副伤寒防治中的应用

WHO一直把伤寒和副伤寒发病列为发展中国家重要的公共卫生问题1].伤寒和副伤寒的典型临床症状体征主要以持续性高热、玫瑰疹、相对缓脉、肝脾肿大及表情淡漠等为特征,但临床表现逐渐呈不典型化和轻型化,尤其是副伤寒常以持续发热为主要特征.这种早期非特异性的临床表现,如缺乏实验室检测,给临床及时正确诊断带来很大困难,误诊和诊断滞后会导致治疗效果不佳,传染源得不到及时控制,易引起暴发或地方性流行.症状监测(syndromic surveillance)近年在理论和实践方面取得长足的进步与发展,在很多疾病监测中得以运用.公共卫生工作者开始尝试利用症状监测的思想,针对伤寒和副伤寒以持续高热为主的临床特点,来设计发热症状监测系统,以提高伤寒和副伤寒防治水平.现将相关信息与研究进展综述如下.

Syndromic surveillance for typhoid and paratyphoid fever

Objective To investigate whether polymorphisms in CYP11B2 gene are associated with nonfamilial structural atrial fibrillation(AF) in Chinese Han population. Methods A free-designed pair-matched hospital based ease-control study was performed in 297 cases and 297 controls. We investigated two tagging single nucleotide polymorphisms (tSNPs)-rs4545, rs3802228 in CYP11B2 gene by using GenomeLab~(TM) SNPstream technique. Results Two tSNPs were consistent with Hardy-Weinberg expectations in case and control groups. Compared with controls, the left atrial diameter of cases was significantly higher(P<0.0001). No significant difference in genotype or allele frequencies of tSNPs in CYP11B2 gene was observed. However, at the site of rs3802228 in 3'' UTR of the case group, the left atrial diameter in AF patients with GG genotype was significantly higher than others. After adjusted for covariates age, smoking, Body mass index and hypertension, we did not observe the association of rs4545, rs3802228 with AE Conclusion Our result suggested that polymorphisms of rs4545 in CYP11B2 gene might not be associated with atrial fibrillation but polymorphism of 3'' UTR rs3802228 locus in CYP11B2 gone might be associated with atrial structural remodeling.