1950-2012年中越边境龙州县疟疾防治效果评价

目的:分析评价中越边境原为疟疾高度流行区的龙州县历年的疟疾防治效果,为该县消除疟疾提供科学依据.方法:查阅收集全县1950-2012年的疟疾防治资料,包括历年疟疾疫情报告、防治方案、各乡镇卫生院疟疾患者诊断和治疗资料等,采用Excel软件进行统计和分析.结果:该县上世纪50年代至70年代当地居民疟疾发病率分别为1779.05/10万、307.88/10万和282.61/10万,疟原虫种类包括恶性疟、间日疟和三日疟,50年代三日疟病例多于间日疟病例,三日疟和恶性疟直到1975年和1978年在当地消失.80年代该县开始出现流动人口疟疾病例,但人群发病率下降至10.56/10万,90年代至本世纪疟疾发病率分别为4.98/10万和4.27/10万.本世纪在当地居民中未发现疟疾病例,疟疾病例均来自流动人口,并有恶性疟病例,疟疾病例多数来自东南亚国家.结论:该县自1993年达到基本消灭疟疾后,疟疾在当地居民中得到了有效控制,但流动人口中的疟疾患者呈现增多趋势,应该继续加强监测.     

1952-2010年广西宁明县疟疾防治效果评价

目的分析评价原为广西疟疾高度流行区的中国和越南边境县1952-2010年疟疾防治效果,为国际边界县疟疾防治提供依据。方法查阅收集全县历年疟疾防治资料,包括历年疟疾疫情报告、防治方案、各乡镇卫生院疟疾病人诊断和治疗资料等,采用Excel软件进行统计和分析。结果该县原为广西疟疾高度流行区,1953年疟疾患者达31 200例,人群发病率为19 074.87/10万,并有恶性疟(PM)、间日疟(PV)和三日疟(PF)流行。60年代下降为909.64/10万,70年代为424.54/10万,80年代为88.48/10万,90年代为1.44/10万,本世纪为0.16/10万。80年代初期在当地居民中未发现三日疟病例,后期未发现恶性疟病例。本世纪未发现当地居民疟疾患者。1982年对流动人口疟疾患者进行监测,90年代至本世纪主要以流动人口疟疾病例为主,并有恶性疟病例传入。结论该县自1995年基本消灭疟疾后,疟疾流行在当地得到有效控制,但在流动人口中近十年发现7例疟疾病人,并有恶性疟存在,仍需继续加强流动人口疟疾检测。     

云南省2010—2016年消除疟疾进展报告

云南省有史以来都是疟疾流行的高发区,1953年报告的疟疾发病率为237.96/万,2001—2010年报告疟疾病例93 745例。自中国消除疟疾行动计划实施以来,云南省消除疟疾工作取得了很大的成效。 2010—2016年,云南省疟疾发病数从2 112例,降到 331例,发病数减少了84.5%,发病率从4.63/10万下降到0.70/10万,发病率下降了84.88%。有本地疟疾病例的县（区）从39个缩小到1个,本地感染病例从2010年的729例减少到2016年的2例。至2016年底,全省16个州（市）已经完成10个省级消除疟疾考核评估,129个县（区）已完成114个州(市)级消除疟疾考核,建立了68个边境咨询站和疟疾三道边境防线等。但仍存在多种传疟媒介、流动人口管理困难、恶性疟抗药性影响、临床医生诊治能力和检验人员镜检技能不足等问题。做好监测,提高诊疗水平和镜检技能以及开展重点人群宣传教育等是顺利实现消除疟疾目标的重要措施 。     

云南潞西市2004～2008年疟疾流行态势分析

目的分析云南省潞西市疟疾流行态势,评价防治效果,提示下一步疟防工作重点。方法收集2004～2008年潞西市疟疾疫情报表和疟疾防治工作材料,按常规流行病学统计方法进行分析。结果 2004～2008年潞西市共报告疟疾病例3270例,占全市传染病报告数的37.27%,2004年疟疾发病率为264.89/10万,2008年发病率为51.87/10万,全市11个乡镇均有疟疾病例报告。境外人口发病占流动人口病例的比例由2004年的3.23%上升到2008年的50.70%。结论潞西市目前采取的抗疟措施有效,应加强疟疾病人服药的督导和开展疟史病人的清理复治,加强居民健康教育和流动人口的管理。     

广西东兰县1951年—2010年疟疾防治效果分析

目的分析评价广西东兰县60年疟疾防治效果。方法收集东兰县各乡镇卫生院1951年—2010年疟疾防治资料,采用Excel软件进行统计和分析。结果上世纪80年代以前的30年中疟疾病例总数占全县的97.14%,人群年均发病率为1 065.74/10万,疟疾死亡病例42例。疟疾病例最多的1954年发病率达到5 704.29/10万。疟疾病例的诊断98.74%为临床诊断病例。疟原虫种类包括有恶性疟、间日疟和三日疟,1982年在当地居民中发现最后1例恶性疟病例,2000年在当地居民中发现最后1例间日疟病例。80年代开始在流动人口中出现疟疾病例,90年代达到高峰,2008年至今当地无疟疾病例报告。结论东兰县通过长期的综合性防治措施后疟疾流行得到有效控制,但仍需加强流动人口中的疟疾病例监测。     

安徽省消除疟疾行动计划中期评估报告

安徽省是疟疾流行较严重的省份,属不稳定疟区,历史上曾多次发生疟疾暴发流行。间日疟在全省范围内流行,20世纪80年代恶性疟在北纬31°~33°之间的江淮丘陵地区的20个县、市中流行。20世纪60—70年代,疟疾发病率曾高达3 214/万。经多年积极防治,疟疾发病大幅度下降,全省自1991年以后未发现本地感染恶性疟病例,1999年疟疾发病率下降至1/10万左右。2000年起,全省疟疾疫情出现大幅回升,局部暴发时有发生,病例集中于沿淮及淮河以北地区,至2006年全省报告病例34 984例,发病率达57.2/10万,发病数和发病率均居全国首位,其中99%为本地感染的间日疟病例,其他为境外输入的恶性疟病例。2007年起采取以传染源清除行动为主的综合性防治措施后,疟疾疫情得到有效遏制,年发病率降为44.69/10万,2008—2013年疟疾疫情连年大幅度下降,年发病率从22.04/10万下降至0.32/10万,2013年,全省仅报告3例本地感染病例,2014年起至今,全省境内无本地感染疟疾病例报告。安徽省于2010年启动消除疟疾行动计划,计划于2018年在全省范围内消除疟疾。目前消除疟疾工作进展顺利,两个阶段性目标提前实现。至2016年底,全省已有94个县（市、区）和5个市完成了消除疟疾考核评估。     

苏州市2006年疟疾疫情分析

目的了解苏州市2006年疟疾流行态势,为制定疟疾防制策略提供参考依据。方法采用描述流行病学方法对苏州市2006年疟疾流行情况分析。结果2006年苏州市报告疟疾病例97例,发病率为0.1153/10万,报告流动人口病例90例。报告病例主要集中在15岁~40岁之间,男性63例占报告病例的64.95%。结论苏州市应该针对不同目标人去制定疟疾防制措施,探索和选择流动人口疟疾管理的有效方法。     

云南瑞丽市疟疾流行现状及防治能力调查

目的了解瑞丽市的实际疟疾疫情、居民的疟疾防治知识、防治能力及现状，为项目实施的效果评价提供科学依据。方法采用分层随机不等比例抽样方法，利用回顾性调查方式，对瑞丽市的实际疟疾疫情、居民的疟疾防治知识、防治能力及现状、边境流动人口的疟疾疫情和防治现状进行调查。结果瑞丽市2002年全市报告疟疾疫情616例，发病率55．27／万、恶性疟发病率14．09／万。调查3个乡镇上报疟疾疫情259例、发病率76．48／万，恶性疟发病率17．42／万。发热病人血检阳性率9．16％；疟疾规范治疗率12．55％，村民蚊帐及药帐使用率为96．54％和0.64％。疟疾疫情漏报率9．65％；边境口岸流动人口疟疾防治能力：调查3个口岸，能开展发热病人血栓的口岸有1个，血检率0．24％，检查处方43个，处方规范率11．63％；疟防知识调查：小学生、中学生和村民疟防知晓率分别为10．70％、29．95％和19．42％；疟疾间接荧光抗体阳性率2．39％。结论瑞丽市疟疾流行较为严重，疟疾癌情漏率较高，乡村医院、诊所的疟疾诊断及治疗能力较薄弱，当地居民和中小学生疟防知晓率普遍较低。     

湖北省2007-2009年疟疾流行态势分析

目的 掌握湖北省疟疾流行态势,为制定抗疟措施提供科学依据。方法 对2007-2009年全省网报疟疾疫情进行统计和描述性分析。结果 2007-2009年共报告疟疾3 570例,发病率为0.12～0.31/万,年平均下降幅度为36.67%,其中输入性疟疾106例(间日疟54例、恶性疟50例、卵形疟2例),占疟疾发病的2.97%,嗜人按蚊分布区发病占全省病例的82.58%,中华按蚊分布区占17.42%。6-9月,疟疾发病数占全年病例的57.96%。35～55岁年龄组疟疾发病占发病数的48.11%。2009年,仅枣阳市、广水市疟疾发病率在万分之一以上,发病数占全省病例的38.90%。近年来全省疟疾防治以控制传染源为重点,局部高发点同时采取药物浸帐灭蚊措施,有效降低了疟疾发病率。结论 全省疟疾发病呈下降态势,但输入性疟疾病例呈上升趋势,以控制传染源为主的抗疟措施有效。     

海南省疟疾流行现状及控制恶性疟措施

疟疾是海南省最主要的热带病,近三年的平均年发病率为５５／１０万,居全国之首,海南省疟疾发病人数占传染病总数的２２％－２９％,在传染病中排列前三位。疟疾主要流行于海南省中南部山区的少数民族居住区,主要传播媒介是大劣按蚊和微小按蚊,由于疟疾传播快,危害大,可引起局部暴发流行,特别是恶性疟可导致凶险型疟疾而造成死亡,对当地居民和外来流动人口形成极大的威胁,所以,做好疟疾防治工作,特别是控制恶性疟的流行,是海南省热带病防治研究工作的首要任务。１ 疟疾发病情况１．１ 疟疾疫情 根据近三年疫情报告,全省疟疾发…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.