鄂西北十堰市斯氏狸殖吸虫病的分布及流行趋势分析

目的了解十堰地区斯氏狸殖吸虫病的分布及流行趋势,为制定防治策略提供科学依据。方法流行区采获溪蟹镜检囊蚴,检查动物体内斯氏狸殖吸虫的感染情况,收集既往资料与现场肺吸虫抗原和酶联免疫吸附试验调查的数据作统计,分析人群肺吸虫感染情况。观察人类行为、局部环境的改变对中间宿主孳生的影响。结果环境因素、特别是人类的行为对肺吸虫中间宿主的孳生有较大的影响,局部流行的区域已不具备中间宿主孳生所需的环境,水位的提升可形成更多的溪沟和山涧,有利于螺和溪蟹的孳生。调查显示人群感染率为23.37%,经防治人群肺吸虫和中间宿主囊蚴感染率都有较大幅度降低。结论鄂西北地区作为斯氏肺吸虫病的流行区,原有的部分斯氏狸殖吸虫第二中间宿主孳生环境己发生了改变,动物宿主肺吸虫囊蚴的感染率及人群感染率呈现逐渐下降的趋势。同时随着退耕还林的实施,区域生态环境将得到进一步改善,适合中间宿主的繁殖和野生动物的活动,肺吸虫病的疫源地也将会长期存在。     

新疆奎屯地区地方性砷中毒致癌致突变远期作用的干预研究

目的:探讨防治新疆奎屯地方性砷中毒干预实验前后患者砷中毒病情与癌变之间的关系。方法 :以皮肤癌变、内脏癌变、染色体畸变和微核率作为评价指标 ,对奎屯砷中毒地区改水防病干预 15年后进行致癌、致突变流行病学调查研究。 结果 :干预实验 15年来 ,77%的病区饮用水已符合卫生学要求 ,90 %以上砷中毒患者病情有了好转 ,无新发病例 ,但原有的中度和重度砷中毒患者中仍有癌症发生 ,染色体畸变率和微核率也明显高于对照人群。 结论 :砷致癌、致突变的远期效应是明显的。     

安徽省学生隐孢子虫感染特征的研究

目的 调查安徽省学生隐孢子虫感染情况、流行特点及主要临床表现，为在学生中防治隐孢子虫病的感染提供依据。方法采集安徽省各地市不同教育层次学生粪便标本共4048份，采用金胺-酚染色法和改良抗酸染色法检查隐孢子虫卵囊。结果隐孢子虫感染率为1．33％（54／4048）。幼儿、小学生、中学生和大学生隐孢子虫的感染率分别为3．15％（28／889）、0．82％（9／1098）、0．82％（9／1092）和0．83％（8／969），幼儿与其他学生相比均有显著性差异（P〈0．01）。男生与女生隐孢子虫的感染率分别为1．49％（28／1880）和1．20％（26／2168），差异无显著性（P〉0．05）。城、乡学生隐孢子虫检出率分别为0．75％（13／1740）和1．78％（41／2308），差异有显著性（P〈0．01）。隐孢子虫感染以亚临床感染为主，主要临床表现为间断性轻度腹痛、轻度腹泻、稀便。结论安徽省学生隐孢子虫感染以幼儿多见，农村较城市多见；隐孢子虫病缺乏特异的临床表现，亚临床感染是其主要表现形式，易误诊和漏诊。     

缺碘牲地甲肿防治效果的指数曲线y=ae~(bx)的模拟

采用指数曲线方程y=aeb(?)对临沂地区1979年～1989年10年的碘盐防治地甲肿效果资料进行了数学模拟,并建立了地甲肿防治效果数学模型。该模型探讨了地甲肿人群患病率、肿大率与碘盐防治年限的定量关系。利用该模型可对地甲肿防治效果进行预测预报和评价工作,可描绘出地甲肿患病率、肿大率在不同防治年限的理论分布轨迹。     

饮水型氟病区人体总摄氟量与发病关系的研究

通过对丹江口市饮水型型地氟病区两个村改水前后环境氟含量,人体总摄氟量及８－１２岁儿童氟玉牙发病率的调查与相关分析,发现改水后人群总摄氟量中食中氟所占比例约为４０％－５０％,总摄氟量与８－１２岁儿童氟斑牙率,氟斑牙指数,尿氟均呈正相关,总一比单纯水氟或粮食氟更能反映出人群总体氟水平。     

Diverse genotypes of Kaposi's sarcoma associated herpesvirus (KSHV) identified in infant blood infections in African childhood-KS and HIV/AIDS endemic region

Kaposi's sarcoma-associated herpesvirus (KSHV or HHV-8) has been associated with several neoplasias, including childhood endemic Kaposi's sarcoma (KS). It is possible that strain genotypes could contribute to the differences in regional presentation (mainly sub-Saharan Africa), childhood infection, lack of male sex bias, distinct disseminated forms and rapid fatality observed for childhood endemic KS. Early studies, at the advent of the HIV/AIDS epidemic, identified only the K1-A5 genotype in childhood KS biopsies as well as blood of a few HIV positive and negative febrile infants in Zambia, a highly endemic region. This current enlarged study analyses blood infections of 200 hospitalized infants (6-34 months age) with symptoms of fever as well as upper respiratory tract infection, diarrhoea, rash or rhinitis. KSHV and HIV viraemia and were prevalent in this group, 22% and 39%, respectively. Multiple markers at both variable ends of the genome (K1, K12, and K14.1/K15) were examined, showing diverse previously adult-linked genotypes (K1 A2, A5, B, C3, D, with K12 B1 and B2 plus K14.1/K15 P or M) detected in both HIV positive and negative infants, demonstrating little restriction on KSHV genotypes for infant/childhood transmission in a childhood endemic KS endemic region. This supports the interpretation that the acquisition of childhood KSHV infections and subsequent development of KS are due to additional co-factors.     

Study of induction of activation of human peripheral blood mononuclear cells with a non-activating form of anti-CD3 MoAb in autoimmune thyroid disease (AITD).

Anti-CD3 (OKT3) MoAb is a mitogenic agent which activates lymphocytes. We have studied the effects of murine anti-human OKT3 MoAb (IgG1) alone or in combination with IL-2, human thyroglobulin (Tg) and thyroperoxidase (TPO) antigens on the proliferation of whole peripheral blood mononuclear cells (PBMC) (including monocytes) or subtypes (T, CD4+, CD8+, B) as measured by tritiated thymidine (3H-TdR) incorporation. B cell differentiation was studied by measuring numbers of IgG-secreting cells and specific anti-TPO/anti-Tg-secreting cells by SPOT ELISA. PBMC or lymphocyte subtypes, obtained from 45 patients with Hashimoto's thyroiditis (HT), 40 Graves' disease (GD) and 51 normal controls were cultured in 96 microtitre plates for 6 days in the presence of OKT3 MoAb at final concentrations 25-250 ng/ml, IL-2 15 U/ml, Tg and TPO (1 micrograms/ml). Then cultures were pulsed with 0.2 microCi 3H-TdR/well and incorporation was measured after 18 h. IgG and anti-TPO/Tg-secreting cells were detected at 7 days. Higher proliferative responses from whole PBMC preparations in response to any of the combinations including OKT3 MoAb were observed in the HT preparations, while the basal values were the lowest. IL-2 alone increased these responses markedly, but equally in all groups. IL-2 in combination with OKT3 had an additive effect on proliferation, with higher responses in HT. Tg and TPO antigens did not change these responses. Most HT preparations responded with their maximum proliferation to the lowest concentration of OKT3 MoAb (25 ng/ml), whereas in GD and control preparations of PBMC these responses were shifted to higher concentrations (250 ng/ml); even with those, proliferation was not so enhanced in controls when compared with HT and GD preparations. In contrast, the proliferative responses of T cells alone and subpopulations of CD8+ suppressor/cytotoxic cells were decreased in HT preparations compared with controls. Monocytes were necessary for proliferation. In the subpopulation of B cells (> 95% pure) and CD4+ helper/inducer cells, differences did not reach significance. In spite of the effect on proliferation, OKT3 MoAb only mildly but significantly increased the numbers of IgG-secreting cells in HT and GD preparations and did not stimulate synthesis of specific antibodies. Our data suggest that the increased proliferative responses of whole PBMC to OKT3 MoAb in HT preparations might be due to insufficient activation of T suppressor/cytotoxic cells.     

西部开发中的虫媒病传播问题

西部开发地区存在许多虫媒病 ,即昆虫和蜱螨传播的疾病 ,为了保障开发人群的健康 ,首先需要对这些疾病的传播 ,特别是有些疾病的自然疫源地或流行区有所了解。本文列述了 13种虫媒病及其在这个地区的分布 ,对其中值得我们更重视的 4类重要疾病 ,包括鼠疫、莱姆病、疟疾和登革热的病原体传播媒介或有的贮存宿主以及重要性等作了扼要的介绍。本文并提出了这类疾病在开发中和开发后可能产生的危害性 ,以及防止或减少它们危害的建议。作者认为从开发地区的长远利益出发 ,应该重视开发中自然环境改变对上述虫媒病传播影响的研究     

Molecular epidemiological and clinical aspects of hepatitis D virus in a unique triple hepatitis viruses (B,C, D) endemic community in Taiwan

The molecular epidemiological and clinical aspects of hepatitis D virus (HDV) in a unique HBV, HCV, and HDV triple virus endemic community in southern Taiwan were investigated. A total of 2,909 residents aged 45 or older were screened for hepatitis B surface antigen (HBsAg), anti-HCV antibody, and anti-HDV antibody (specifically for HBsAg-positive carriers). Factors that might be associated with HDV infection, viral nucleic acid detection, and genotyping of HBV, HCV, and HDV were investigated. The prevalence of HBsAg and anti-HCV were 12.6% (366/2,909) and 41.6% (1,227/2,909), respectively. For HBsAg carriers, 15.3% (56/366) were positive for anti-HDV assay. Living in a higher endemic district of HCV infection (odds ratio [OR] = 3.2; 95% confidence interval [CI] = 1.7-6.3), male gender (OR = 1.9; 95% CI = 1.1-3.6) and co-infection with HCV (OR = 1.8; 95% CI = 1.0-3.3) were significantly independent factors associated with HDV infection. The detection rate of HDV RNA among anti-HDV-positive patients was only 12.7% (7/55). The mean HBV titer of triple infection group was significantly lower than in the HBV/HDV co-infection group (2.23 vs 3.05 in log(10), copies/ml, P = 0.046). HCV RNA detection among the triple infection group showed 47.4% (9/19) viremia rate and viral loads of 579,121 IU/ml in median (16,803-1,551,190 IU/ml). The prevalent genotype of HBV was type B (23/25); HCV was 1b (7/9) and HDV was IIa/IIb (4/4). Only the presence of HCV RNA predicted the presence of elevated ALT significantly (OR = 25.0; 95% CI = 3.39-184.6). In conclusion, the geographical aggregation of HDV infection paralleled that of HCV infection in this community. HCV suppressed the replication of HBV among triple vital infection patients. HBV and HDV lapsed into a remission or nonreplicative phase in most cases, and HCV acted as a dominant factor in triple viral-infected individuals. Only the presence of HCV RNA was associated with elevated ALT values, but not HBV or HDV.