云南省瑞丽县药物滥用流行学普查报告

云南省瑞丽县因与“金三角”边缘相邻，成为云南省药物滥用较早和较严重的地区，１９８８年流行学调查显示，全县药物滥用者占全县总人口的３．４１％（２５７２／７５５０３），其中以男性、青壮年，少数民族（傣族、景颇族）及农村居民居多。海洛因滥用和静脉用药者也占有一定比例。

Migraine as a sex-conditioned inherited disorder: evidences from China and the world

Migraine is a complex and heterogeneous disorder. Although several genetic models has been proposed including autosomal-dominant/autosomal recessive, sex-linked, sex-limited, mitochondrial, and multi-gene, none of these models can well-explain the transmission of the disease. We hypothesied that migraine is a sex-conditioned inherited disorder （autosomal dominant in females and autosomal recessive in males）. This hypothesis is supported by the evidence such as the locations of genes associated with familial hemiplegic migraine, possibly ＂typical＂ migraine as well （dominantly on chromosome 19p, lq, and 2q）, male：female ratio of prevalence （1：2-1：4）, the mostly youth-onset, the provocation by the contraceptives, the induction by menstruation, and the self-limitation after menopause. Female sex-hormones appear to be the key contributor to a higher prevalence of migraine in female. Socio-environmental factors may also play an important role.

An epidemiologic study of Helicobacter pylori infection in three areas with high,medium or low incidence of gastric carcinoma

AIMS To study the relation of Helicobacter pylori (Hp) infection rate to the incidence of and mortality from gastric cancer. METHOD Hp infection rate of natural population in three areas was detected by measuring the specific IgG-antibody to Hp using indirect ELISA method. RESULTS Hp positive rate was 59.4%,55.9% and 34.5% in the areas with high,medium and low inci- dence of gastric carcinoma respectively. The differ- ences in incidence among the areas were significant (x^2 =25.029,P<0.05). In persons under 40 years of age,the Hp infection rate was the highest in high inci- dence area of gastric cancer. Hp infection rate was 50% in children under 5 years of age in the high inci- dence area. In the people under 40 years of age,the Hp infection rates showed no difference among the three areas. The average levels of anti-Hp IgG in high, medium and low incidence areas were 2.3±0.49, 2.04±0.47 and 1.84±0.46 respectively. Multivariate regression analysis showed that Hp infection is related to bad hygienic habit,low income,frequent use of an- tibiotics and mental depression. Single factor analysis showed that Hp infection may also be related to raising animals in home. CONCLUSION Gastric cancer is closely related to the incidence of Hp infection.

Epidemiological and histopathological study of relevance of Guizhou Maotai liquor and liver diseases

AIM: To explore the relevance of Maotai liquor and liver diseases. METHODS: Epidemiological study was conducted on groups of subjects, each consisting of 3 subjects from the Maotai liquor group consisting of 99 individuals and one from the non-alcoholic control group consisting of 33 individuals. Liver biopsy was performed on 23 volunteers from Guizhou Maotai Distillery who had a constant and long history of drinking Maotai liquor. Experimental histopathological study was conducted as follows: sixty male Wistar rats were divided into 3 groups randomly and fed with Maotai liquor, ordinary white wine, and physiological saline respectively for a period of 8 and 12 weeks. The rats were sacrificed in batches, then serum ALT, AST, TBil, and AKP were measured. Rat livers were harvested to measure the liver indexes, GSH, and MDA. Histopathological examinations were also performed. Another eighty mice were randomly divided into 4 groups and fed with Maotai (at different dosages of 10 ml.kg(-1) and 20 ml.kg(-1)), ethanol, and physiological saline. The animals were sacrificed after 4 weeks and serum ALT was determined. Then the livers were harvested and liver indexes and MDA were measured. RESULTS: The incidence rate of hepatic symptoms, splenomegaly, liver function impairment, reversal of Albumin/Globulin and increased diameter of portal veins in the Maotai liquor group were 1.0% 1/99 , 1.0% 1/99 , 1.0% 1/99 , 1.0% 1/99 , 0 0/99 and 0 0/99 , 0 0/99 ,0 0/99 , 0 0/99 , 0 0/99 , respectively. There was no significant difference between the Maotai group and the non-alcoholic control group P】0.05 . Various degree of fatty infiltration of hepatocytes was found in the 23 volunteers receiving liver biopsy, but there was no obvious hepatic fibrosis or cirrhosis. A comparison was made between the Maotai liquor group and the ordinary white wine group. It was found that hepatic MDA in rats and mice were 0.33+/-0.10 and 0.49+/-0.23 respectively in Maotai group and 0.61+/-0.22 and 0.66+/-0.32 in the ordinary white wine group; MDA had an obvious decrease in the Maotai liquor group (P【0.05); hepatic GSH were 0.12 mg.g(-1)+/-0.06 mg.g(-1) in rats of the Maotai liquor group and (0.08+/-0.02)mg.g(-1) in white wine group, it was obviously increased in the Maotai liquor group (P【0.05). After the 20 rats had been fed with ordinary white wine for 8 weeks consecutively, disarranged hepatocyte cords, fatty infiltration of hepatocytes, and fibrous septa of varying widths due to hepatic connective tissues proliferation were observed; after 12 weeks, the fibrous tissue proliferation continued and early cirrhosis appeared. Compared with the ordinary white wine group, fatty infiltration was observed in the 8-week and 12-week groups, but no necrosis or fibrosis or cirrhosis was found in the Maotai liquor group (P【0.05). CONCLUSION: Maotai liquor may cause fatty liver but not hepatic fibrosis or cirrhosis, and it can strengthen lipid peroxidation in the liver.

Hepatocellular carcinoma: Epidemiology, risk factors and pathogenesis

Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Given that the burden of chronic liver disease is expected to rise owing to increasing rates of alcoholism, hepatitis B and C prevalence and obesity-related fatty liver disease, it is expected that the incidence of HCC will also increase in the foreseeable future. This article summarizes the international epidemiology, the risk factors and the pathogenesis of HCC, including the roles of viral hepatitis, toxins, such as alcohol and aflatoxin, and insulin resistance.

Functional dyspepsia and irritable bowel syndrome,are they different entities and does it matter?

A high prevalence of overlap between functional dyspepsia and irritable bowel syndrome has been consistently and universally reported. Recent studies demonstrating shared common pathophysiological disturbances including delayed gastric emptying and visceral hypersensitivity involving more than one region, suggest that these patients have a generalised rather than regional, disorder of the gut. Furthermore, a study of the natural history of dyspepsia suggests that with time, a substantial proportion will evolve into IBS. The recognition of IBS in dyspeptic patients has potentially profound therapeutic importance. It could help to reduce the risk of unnecessary cholecystectomy in IBS patients. The ability to appreciate the extent of involvement could allow us to address the disturbances more comprehensively, and thereby achieve greater patient satisfaction with their treatment.

Gastric malignancies in Northern Jordan with special emphasis on descriptive epidemiology

AIM:To study the epidemiology of gastric malignancies in Jordan as a model for Middle East countries where such data is scarce. METHODS:Pertinent epidemiological and clinicopathological data for 201 patients with gastric malignancy in north of Jordan between 1991 and 2001 were analyzed. RESULTS:Male:female ratio was 1.8:1.The mean age was 61.2 years,and 8.5% of the patients were younger than 40 years of age.The overall age-adjusted incidence was 5.82/100 000 population/year.The age specific incidence for males raised from 1.48 in those aged 30-39 years to 72.4 in those aged 70-79 years.Adenocarcinomas, gastric lymphomas,malignant stromal tumors,and carcinoids were found in 87.5%,8%,2.5%,and 2% respectively.There was an average of 10.1-month delay between the initial symptoms and the diagnosis.Only 82 patients underwent“curative”gastrectomy.Among adenocarcinoma groups,Lauren intestinal type was the commonest(72.2%)and the distal third was the most common localization(48.9%).The mean follow up for patients with gastric adenocarcinoma was 25.1 mo(range 1-132mo).The 5-year survival rates for stages Ⅰ(n=15), Ⅱ(n=41),Ⅲ(n=59),and Ⅳ(n=53) were 67.3%,41.3%, 5.7%,and 0% respectively(P=0.0001).The overall 5 year survival was 21.1%. CONCLUSION:Despite low inddence,some epidemiological features of gastric cancer in Jordan mimic those of high- risk areas.Patients are detected and treated after a relatively long delay.No justification in favor of a possible gastric cancer screening effort in Jordan is supported by our study;rather,the need of an earlier diagnosis and subsequent better care.

Squamous Cell Carcinoma and Adenocarcinoma of the Esophagus–Di?erences in Etiology, Epidemiology and Prevention

In Germany, esophageal carcinoma is one of the ten most frequent causes of death. Normally the disease is found in men over the age of 50. Although squamous cell carcinoma (SCC) of the esophagus has been more commonly diagnosed over the past 30 years, there is increasing incidence of esophageal adenocarcinoma (AC) in Western industrialized countries. For SCC the known etiological risk factors are nicotine and alcohol abuse. For AC, they are moderate nicotine and alcohol consumption as well as gastro-esophageal re?ux and obesity.

Clinical and epidemiological features of patients with clonorchiasis

AIM:To study the clinical and epidemiological features of patients with clonorchiasis so as to provide scientific evidences for the diagnosis and prevention of clonorchiasis. METHODS:Stools from 282 subjects suspected of having clonorchiasis were examined for helminth eggs with modified Kato's thick smear and sedimentation methods,and their sera were tested for HAV-DNA,HBV-DNA,HCV-RNA,HDV- RNA and HEV-RNA with polymerase chain reaction (PCR). Clinical symptoms of patients with clonorchiasis only were analyzed,and their blood samples were tested for circulating antigen (CAg) with Dot-ELISA,esoinophilic granulocyte count, and alanine aminotransferase (ALT).Meanwhile,they were asked to provide data of occupation,eating habit,hygienic habit and knowledge of donorchiasis.In addition,the ecosystem of the environment in epidemic areas was surveyed. RESULTS:Among the 282 patients,61 (21.43%) were infected with clonorchis sinensis only,97 (34.64%) were co-infected with clonorchis sinensis and other pathogens, 92 (32.86%) were infected with hepatitis virus only and 31 (11.07%) neither with clonorchis sinensis nor hepatitis virus. Among the 61 patients with clonorchiasis only,there were 14 (22.95%) subjects with discomfort over hepatic region or epigasfrium,12 (19.67%) with general malaise or discomfort and inertia in total body,6 (9.84%) with anorexia,indigestion and nausea,4 (6.56%) with fever,dizziness and headache (6.56%),and 25 (40.98%) without any symptoms;sixty one (100%) with CAg (+),98.33% (59160) with eosinophilic granulocytes increased and 65.00% (39/60) with ALT increased.B-mode ultrasonography revealed 61 cases with dilated and thickened walls of intrahepatic bile duct,and blurred patchy echo acoustic image in liver.Twenty-six cases had stones in the bile duct,39 cases had slightly enlarged liver with diffuse coarse spots in liver parenchyma.Twenty cases had enlarged gallbladder with thickened coarse wall and image of floating plagues,9 cases had slightly enlarged spleen.By analysis of epidemiological data,we found that the ecologic environment was favorable for the epidemiology of clonorchiasis.Most patients with clonorchiasis were lack of knowledge about the disease.Their living environment, hygienic habits,eating habits and their occupations were the related factors that caused the prevalence of the disease. CONCLUSION:The clinical symptoms of clonorchiasis are non-specific,and the main evidences for diagnosis of clonorchiasis should be provided by etiologic examination, B-mode ultrasonography and clinical history.The infection of clonorchis sinensis is related to occupations,bad eating habits and lack of knowledge about prevention of the disease.

Changing patterns of hepatitis A prevalence within the Saudi population over the last 18 years

AIM： To determine the seroprevalence of Hepatitis A （HAV） amongst Saudi children and compare it with previously reported prevalence data from the same population. METHODS： A total of 1357 students were randomly selected between the ages of 16 and 18 years （689 males and 668 females） from three different regions of Saudi Arabia （Madinah, AI-Qaseem, and Aseer） and tested for anti-HAV-IgG.RESULTS： The overall prevalence of anti-HAV-IgG among the study population was 18.6%. There was no difference between males and females but there was a significant difference in the seroprevalence （P = 0.0001） between the three different regions, with Madinah region showing the highest prevalence （27.4%）. When classified according to socioeconomic status, lower class students had a prevalence of 36.6%, lower middle class 16.6%, upper middle class 9.6%, and upper class 5.9% （P = 0.0001）. Comparing the current study results with those of previous studies in 1989 and 1997 involving the same population, there was a marked reduction in the overall prevalence of HAV from 52% in 1989, to 25% in 1997, to 18.6% in 2008 （P 〈 0.0001）.CONCLUSION： Over the last 18 years, there has been a marked decline in the prevalence of HAV in Saudi children and adolescents. The current low prevalence rates call for strict adherence to vaccination policies in high-risk patients and raises the question of a universal HAV vaccination program.

The Latest Progress in Varying-coefficient Models

Varying-coefficient models are a useful extension of classical linear model. They are widely applied to economics, biomedicine, epidemiology, and so on. There are extensive studies on them in the latest three decade years. In this paper, many of models related to varying-coefficient models are gathered up. All kinds of the estimation procedures and theory of hypothesis test on the varying-coefficients model are summarized. Prom my opinion, some aspects waiting to study are proposed.

Serological and molecular study of hepatitis E virus among illegal blood donors

AIM： To investigate the seroprevalence and molecular characteristics of hepatitis E virus （HEV） in the illegal blood donors （IBDs） of central China in the early 1990s.

Reassessment of functional dyspepsia:A topic review

Dyspepsia itself is not a diagnosis but stands for a constellation of symptoms referable to the upper gastrointestinal tract. It consists of a variable combination of symptoms including abdominal pain or discomfort, postprandial fullness, abdominal bloating, early satiety, nausea, vomiting, heartburn and acid regurgitation. Patients with heartburn and acid regurgitation invariably have gastroesophageal reflux disease and should be distinguished from those with dyspepsia. There is a substantial group of patients who do not have a definite structural or biochemical cause for their symptoms and are considered to be suffering from functional dyspepsia （FD）. Gastrointestinal motor abnormalities, altered visceral sensation, dysfunctional central nervous system-enteral nervous system （CNS- ENS） integration and psychosocial factors have all being identified as important pathophysiological correlates. It can be considered as a biopsychosocial disorder with dysregulation of the brain-gut axis being central in origin of disease. FD can be categorizeo into different subgroups based on the predominant single symptom identified by the patient. This subgroup classification can assist us in deciding the appropriate symptomatic treatment for the patient.

Extranodal natural killer/T-cell lymphoma,nasal type:epidemiology study

Extranodal natural killer （NK）IT-cell lymphoma, nasal type （ENKTCL） is a rarely kind of non-Hodgkin lymphoma （NHL）. It is much more frequent in Asian and Latin American countries than other part of the world. It typically affects nasal cavity. In China, one of its endemically places, ENKTCL accounts for 74%-96% of nasal NHL. Patients with ENKTCL usually show a highly aggressive clinical course, and its etiology is unclear. However, it is already proved that ENKTCL is associated with Epstein-Barr virus （EBV） infection, regardless patients＇, ethnicity and areas. Some studies show that the risk will increase among several occupations, such as farmer, who are frequently exposure to pesticides and chemical solvent and risk can be cut down if taking some protective measures.

Adenocarcinoma of the Esophagogastric Junction:a New Topic for the Tumor Registry

Linzhou, Yangcheng, Shexian and Yangzhong counties are considered to be high-risk areas for esophageal carcinoma using traditional standards. However, based on the incidence of malignant tumors and death statistics from 1998-2002 in Chinese cities and counties, the incidence of esophageal carcinoma in these counties was not the most prominent. In these areas, the incidence of gastric cancer ranked first. So what are the differences between the above-mentioned areas and Changle in Fujina and Linqu in Shandong Province？ The authors have combined the defined norms for cardiac cancer, published by the WHO in 2000, with the epidemiological changes in high-risk areas of esophageal carcinoma. We propose to discuss the importance of cardiac cancer morbidity and death registration in tumor monitoring sites all over China, and to provide new views related to this topic of interest.

Study on the Biology and Epidemiology of Uncinula necator---The Causal Agent of Grape Powdery Mildew Disease

This study was carried out during 2007-2009 in the vineyards of Ardebil province of lran to study the biology and the epidemiology of Uncinula necator--the causal agent of grape powdery mildew disease. The study concentrated on the survival and the initiation of primary inoculum of the fungal causal agent. Results of histopathological experiments indicated that U. necator survived as mycelium in the dormant buds of the grapes during winter season. Results of study on the effect of environmental factors on fungus biology showed that the pathogenic activity of the fungus began when the temperature was between 16-19 ℃ with a relative humidity more than 50%. It was also found that optimum temperature and relative humidity for the sporulation of U.necator was 20-25 ~C and 50%-100% respectively. According to the results, fungal conidia were trapped during formation of 5-6 true leaves and first disease symptoms were observed on the clusters on late June after fruit formation. Fungal cleistothecia were observed abundantly at the end of season on the leaves, petioles and twigs but they were not able to survive during winter. Formation of ascospores on young leaves was proved but their role as the primary inoculum was not supported by the results of this study. Results of this study and the new findings on the biology and epidemiology of U.necator may be of national and international interests for the management of powdery mildew disease which is one of the most destructive diseases around the world including Iran.

AN EPIDEMIOLOGY AND MOLECULAR GENETIC STUDY ON BREAST CANCER SUSCEPTIBILITY

Objectives. To investigate the genetic susceptibility for breast cancer of Chinese, a hospital-based case-control study, pedigree survey and molecular genetic study were conducted. Methods. Logistic regression model and stratification methods were used in the risk factors analysis. Li-Mantel-Gart and Falconer methods were used to analyze the segregation ratio and heritability. Polymerase chain reaction(PCR) and polyacrylamide gel electrophoresis were used to detect AI, G-banding technique was used to detect the chromosome aberration of peripheral blood lymphocyte. Results. Family history of breast cancer is related to enhanced breast cancer risk significantly, OR is 3905(95%CI=1079～1413), and it widely interacts with other risk factors. Accumulative incidence of breast cancer in first degree relatives is 999%, which is larger than that in second, third degree and non-blood relatives. Segregation ratio is 0021, heritability among first degree relatives is 356±58%. Frequencies of LOH at BRCA1 and BRCA2 loci in sporadic breast cancer are 612% and 577% respectively. In the sibs, both of them show LOH at D13S173 locus, and high frequencies of chromosome aberrations were observed. Conclusions. Genetic susceptibility contributes to breast cancer occurrence of Chinese, and its racial variation may be one of the important reasons for the large difference of incidence between western and eastern countries.

Analysis of the features of TCM and western medicine in the diagnosis and treatment of subclinical hypothyroidism characteristics

The diagnosis and treatment of subclinical hypothyroidism are summarized by reviewing the related English and Chinese literature, the comparative analysis of traditional Chinese medicine （TCM） and western medicine in the understanding of subclinical hypothyroidism, the epidemiology, etiology, pathogenesis, the patterns addition to the therapeutic hypothyroidism, with a pr and the clinical manifestation in principle and drugs of subclinical ospect of providing insight in the clinical treatment of the disease.

Medical Virology in Malaysia

Virology is a branch of biological science dealing with the study of viruses,and medical virology focuses on the study and control of diseases due to viruses that is of medical importance. The development of medical virology in Malaysia has its beginning in the Institute for Medical Research(IMR) ,following the establishment of the Division of Medical Zoology and Virus Research in the institute on 23 March 1953. The second institution in the country to establish diagnostic and research work in medical virology was Department of Medical Microbiology,Faculty of Medicine,University Malaya. This was followed by University Kebangsaan Malaysia,University Sains Malaysia and University of Sarawak Malaysia. The National Public Health Laboratory(NPHL) is the latest institution to establish a laboratory in 2003 for virus isolation and services to support country surveillance and outbreak investigation of infectious diseases due to viruses. In the field of medical virology,Malaysia contributed substantially in the areas of virus diagnostic services,development and research ranging from survey and documentation on the existence and prevalence of viruses causing diseases in Malaysia,clinical presentation and epidemiological features of virus diseases,evaluation of new diagnostic tests to pathogenesis of viral diseases. Malaysia contributed to the discoveries of at least 12 new viruses in the world. ASEAN plus Three(China,Japan,Republic of Korea) Emerging Infectious Programme was established to overcome the challenges and impact of emerging and re-emerging infectious diseases in this region. Malaysia as the co-ordinator of the laboratory component of the programme,contributed to strengthen the regional laboratory capability,capacity,laboratory-based surveillance and networking. The future of medical virology in Malaysia in terms of integration of diagnostic,reference and research to support the country's need will be enhanced and strengthened with the on-going development of the National Centre for Disease Control and Prevention(CDC Malaysia) which also incorporates a futuristic Special Diagnostic and Reference Laboratory.

An epidemiological study of collagenous colitis in southern Sweden from 2001-2010

AIM： To estimate the incidence of collagenous colitis （CC） in southern Sweden during 2001-2010. METHODS： Cases were identified by searching for CC in the diagnostic registers at the Pathology Departments in the county of Skane. The catchment area comprised the south-west part of the county （394 307 inhabitants in 2010） and is a mixed urban and rural type with limited migration. CC patients that had under- gone colonoscopy during the defined period and were living in this area were included in the study regardless of where in Skane they had been diagnosed. Medical records were scrutinized and uncertain cases were re- assessed to ensure that only newly diagnosed CC cases were included. The diagnosis of CC was based on both clinical and histopathological criteria. The clinical crite-rion was non-bloody watery diarrhoea. The histopatho- logical criteria were a chronic inflammatory infiltrate in the lamina propria, a thickened subepithelial collagen layer ≥10 micrometers （um） and epithelial damage such as flattening and detachment. RESULTS： During the ten year period from 2001-2010, 198 CC patients in the south-west part of the county of Skane in southern Sweden were newly diagnosed. Of these, 146 were women and 52 were men, i.e., a female： male ratio of 2.8：1. The median age at diag- nosis was 71 years （range 28-95/inter-quartile range 59-81）, for women median age was 71 （range 28-95） years and was 73 （range 48-92） years for men. The mean annual incidence was 5.4/105 inhabitants. During the time periods 2001-2005 and 2006-2010, the mean annual incidence rates were 5.4/105 for both periods [95% confidence interval （CI）： 4.3-6.5 in 2001-2005 and 4.4-6.4 in 2006-2010, respectively, and 4.7-6.2 for the whole period]. Although the incidence varied over the years （minimum 3.7 to maximum 6.7/105） no increase or decrease in the incidence could be identi- fied. The odds ratio （OR） for CC in women compared to men was estimated to be 2.8 （95% CI： 2.0-3.7）. The OR for women 65 years of age or above compared to below 65 years of age was 6.9 （95% CI：5.0-9.7）, and for women 65 years of age or above compared to the whole group the OR was 4.7 （95% CI： 3.6-6.0）. The OR for age in general, i.e., above or 65 years of age compared to those younger than 65 was 8.3 （95% CI： 6.2-11.1）. During the last decade incidence figures for CC have also been reported from Calgary, Canada dur- ing 2002-2004 （4.6/105） and from Terrassa, Spain dur- ing 2004-2008 （2.6/105）. Our incidence figures from southern Sweden during 2001-2010 （5.4/10s） as well as the incidence figures presented in the studies during the 1990s （Terrassa, Spain during 1993-1997 （2.3/10s）, OI- msted, United States during 1985-2001 （3.1/10s）, Orebro, Sweden during 1993-1998 （4.9/10s）, and Iceland during 1995-1999 （5.2/10s） are all in line with a north- south gradient, something that has been suggested be- fore both for CC and inflammatory bowel disease.CONCLUSION： The observed incidence of CC is com- parable with previous reports from northern Europe and America. The incidence is stable but the female： male ratio seems to be decreasing.