血吸虫病低度流行区三种免疫诊断方法现场应用效益分析

运用卫生经济学方法,对胶体染料试纸条法(DDIA)、环卵沉淀试验(COPT)和酶联免疫吸附试验(ELISA)等3种免疫诊断方法在血吸虫病低度流行区现场应用的成本—效益进行分析,证实了胶体染料试纸条法更经济实用。     

郴州市1992-2006年自然疫源性传染病分析

目的了解郴州市近15年来自然疫源性传染病的流行特征,为有效制定防治措施提供科学依据。方法采用描述流行病学方法,运用Excel进行数据整理,分析甲乙类自然疫源及虫媒传染病的三间分布特点及其变化规律。结果该市15年来共报告甲乙类自然疫源及虫媒传染病7种共4747例,年平均发病率为7.06/10万,死亡530例,年平均死亡率为0.79/10万,年平均病死率为11.16%。该类传染病发病率总体呈下降趋势,除狂犬病稍有上升外,其他均有不同程度的下降。结论该类传染病在法定传染病中发病率较低,但病死率较高,防治工作不容忽视。狂犬病占此类传染病死亡构成的71.32%,狂犬病的控制尤其重要。该类传染病有明显的季节特点和人群特征,应做好重点地区高危人群的防治干预。该类传染病经过多年的防治,基本得到控制,但应高度警惕新发传染病的发生。     

Studies on exposure status of inhabitants to water-arsenic valence states in areas with endemic arsenism in the Datong basin in Shanxi

This study aimed to describe the distribution of water-arsenic (As) valence states and its relationship to areas with endemic arsenism in the Datong basin. Drinking water samples of patients with endemic arsenism and a control group were examined using hydride generation atomic fluorescence spectrometry (HG-AFS). We analyzed the data using SPSS10.0 for Windows. The As(III)/As ratio was 52.1% in the water sample, exceeding the national standard of 0.05 mg/L. The As(III)/As ratio significantly varied among the different stages in the disease-state groups, and with the control group (χ ² = 22.4, P<0.01). The As(III)/As(V) ratio significantly varied in the four groups (χ ² = 26.19, P<0.01), with a tendency to increase along with the seriousness of the disease state. The most common type of drinking water arsenic valence state was As(III) in the endemic disease-areas. Endemic arsenism was positively correlated with As(III). This led us to conclude that the fraction of each water-arsenic valence state should be studied when determining the arsenic content of drinking water. Translated from Chinese Journal of Endemiology, 2006, 25(1): 64–66 [译自: 中国地方病学杂志]     

2005年滨州市地方性氟中毒病情调查

[目的]了解滨州市饮水型地方性氟中毒(地氟病)病区病情现状,为今后的防治工作提供科学依据.[方法]2005年,对滨州市惠民、博兴、邹平3县地氟病病区进行儿童氟斑牙患病情况调查与饮用水氟含量检测.[结果]合计调查8～12岁儿童1467名,检出可疑氟斑牙225人、氟斑牙患者653人(极轻氟斑牙225人,轻度氟斑牙204人,中度氟斑牙194人,重度氟斑牙30人),患病率为44.51%,斑釉指数为0.99;氟斑牙缺损率为9.82%.氟斑牙患病率,改水降氟工程报废病区(63.50%)、改水降氟工程正常运转病区(58.20%)均高于未改水病区(25.20%)(P＜0.01);改水工程报废停用病区不同年龄儿童氟斑牙患病率的差异无统计学意义(P＞0.05).饮用水含氟量(mg/L),改水工程报废病区为(2.24±1.21),改水工程正常病区为(1.34±1.05)(P＜0.05);未改水病村为(1.00±0.76),低于改水工程报废病区(P＜0.01).[结论]滨州市地氟病病区病情仍然较重.     

Thyroid surgery in the tropics

In the tropics thyroid surgery is carried out either by general surgeons or ear, nose and throat surgeons and there are few places with a subspecialist endocrine or head and neck surgeon. The aim of this review is to determine the pattern of thyroid pathology, surgery and surgical outcomes in the tropics. A review of thyroid surgery in tropical regions was carried out based on published articles in English in Medline (1965-2004). The findings are also discussed in the light of the authors' own experience of thyroid disease and thyroid surgery in four continents. The pattern of thyroid pathology varies in the tropics, particularly in regions where endemic goitre is common. Endemic goitre usually regresses with iodine therapy. There is a rising incidence of thyroid autoimmune disease, particularly Graves' disease and Hashimoto's thyroiditis, probably related to an environmental immunological stimulus associated with development. Surgery is indicated for the same reasons as in the developed countries: thyrotoxicosis (more often in the absence of radioactive iodine therapy), solitary thyroid nodule and multinodular or malignant goitre. However, a preoperative cytological diagnosis will only be available in important centres where there is a pathologist. Malignancy appears more prevalent in nodules and goitres in the tropics than in the developed countries, perhaps because patients with malignancy are more likely to be referred to a surgeon. Nonetheless, the evidence suggests that thyroid surgery can be carried out safely with a minimum of complications even in remote mission hospitals with limited facilities for investigation. Standards can be set in terms of surgical outcomes; for example, mortality (0%), permanent recurrent laryngeal nerve (RLN) injury (<2%), re-exploration for haematoma(<2%), permanent hypocalcaemia (<5%) and wound infection (2.5%). The choice of operation depends on the local pathology and the likelihood of being able to obtain lifelong thyroxine. Total thyroidectomy should be avoided whenever possible if thyroxine supplies are unreliable. Advanced thyroid cancer presents a therapeutic challenge and some cases will be unresectable. The management options are limited by the resources available. Similar surgical outcomes should be able to be achieved no matter where the surgery is carried out.     

The potential risk and control strategy in low endemic area of schistosomiasis in China

OBJECTIVE: to describe and analyze the potential risk and suggest the corresponding control strategy in low endemic of schistosomiasis in China. METHODS: referring the 'national criteria of control and elimination of schistosomiasis' and the 'national criteria of classification of endemic area for chemotherapy'; collecting the data of the re-infection of schistosomiasis in lake region and residual snails in mountain areas and evolution of endemic situation in 'snail ridden areas without schistosomiasis'; analyzing the potential risk in different types of low endemic area and suggesting the control strategies according to the analysis results and historical experiment. RESULTS: the re-infection rate of schistosomiasis in residents is usually higher in high, medium and low endemic areas in the lake region, once chemotherapy is stopped, the infection rate may rise again to the initial level 2 years later and bovine chemotherapy and snail control in susceptible zone will be selected as the optimal strategies for controlling the endemic situation; the potential risk in mountain areas is the enlargement of snail habitats due to residual snail's reproduction and the control strategy will be to strengthen the surveillance and elimination of residual snails; inputting the infective sources of schistosomiasis is the potential risk in 'snail ridden area without schistosomiasis' and the main control strategy should be put the regular monitoring on the infection sources from hyper-endemic areas and treat the infected domestic animals in time.     

聚类分析在地方性氟中毒病区分类研究中的应用

目的：探讨地方性氟中毒病区分类方法。方法：根据地方性氟中毒地区人群氟斑牙患病率、氟斑牙指数，以及尿氟、煤氟、稻谷氟、玉米氟和辣椒氟含量等指标，采用聚类分析方法对病区严重程度进行分类。结果：黔南州龙里、贵定、长顺和惠水四县20个乡镇被划分为轻度病区、中等病区和重度病区三种类型。结论：聚类分析是地方性氟中毒病区分类研究中的一种简便易行的方法，值得推广。     

吡喹酮治疗56例华枝睾吸虫病患者的纵向观察

目的 探讨采用低剂量吡喹酮（７５ｍｇ／ｋｇ×１ｄ）反复治疗华枝睾吸虫重流行区人群的效果。方法 采用Ｋａｌｏ－Ｋａｔｚ法对人群进行普查。结果 人群肠道寄生虫感染率为７３．１％,其中华枝睾吸虫感染率为３７．３％。通过两年四查三治,５６例被观察者的虫卵阴转率为７６．８％,虫卵减少率达９１．６％。结论 在华枝睾吸虫轻、中度流行区,采用该剂量组治疗人群,安全易行,效果满意。     

Spatial clustering of endemic Burkitt's lymphoma in high-risk regions of Kenya

Endemic Burkitt's lymphoma (eBL), the most common childhood cancer in sub-Saharan Africa, occurs at a high incidence in western Kenya, a region that also experiences holoendemic malaria. Holoendemic malaria has been identified as a co-factor in the etiology of this cancer. We hypothesized that eBL may cluster spatially within this region. Medical records for all eBL cases diagnosed from 1999 through 2004 at Nyanza Provincial General Hospital were reviewed for case residential information to examine this hypothesis. Two cluster detection methods, Anselin's Local Moran test for spatial autocorrelation and a spatial scan test statistic, were applied to this residential data to determine whether statistically significant high- and low-risk areas were present in the Province. During the 6-year study period, 272 children were diagnosed with eBL, with an average annual incidence of 2.15 cases per 100,000 children. Using Empirical Bayes smoothed rates, the Local Moran test identified 1 large multi-centered area of low eBL risk (p-values < 0.01) and 2 significant multi-centered clusters of high eBL risk (p-values < 0.001). The spatial scan detected 3 small independent low-risk areas (p-values < 0.02) and 2 high-risk clusters (p-values = 0.001), both similar in location to those identified from the Local Moran analysis. Significant spatial clustering of elevated eBL risk in high-malaria transmission regions and of reduced incidence where malaria is infrequent suggests that malaria plays a role in the complex eBL etiology, but that additional factors are also likely involved.     

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。