一项针对儿童的研究显示——流感疫苗保护效果达60%

广东省广州市疾病预防控制中心持续对流感疫苗对儿童的保护效果进行研究,发现儿童全程接种流感疫苗可有效减少流感的发生,近五年流感疫苗保护效果平均约达60%,相关研究论文日前陆续发表在《疫苗》等国际权威杂志上。

Analysis of the Current situation of Syphilis in a Sexually Transmitted Disease Clinic

Objective： To analyze the current situation of syphilis in the sexually transmitted diseases （STDs） clinic, from January 1994 to December 2002 was studied. Methods： All syphilis patients were confirmed by history, physical examination, dark-field microscopy of samples taken from the chancre or satellite lymph nodes,or positive serological tests. Results： From 1994 to 2002, there were 2067 cases of early syphilis, accounting for 20.01% （2067/10330） of all STD cases. The annual proportion of syphilis cases among all STD cases from 1994 to 2002 was 0.57%, 0.53%, 3.54%, 16.20%, 31.29%, 27.88%, 25.63%, 17.11%, 10.48%, respectively. Of 2067 syphilis patients,49.64% （1026/2067） were male and 50.36% （1041/2067） were female. 44.75% （925/2067） of all cases presented with primary syphilis, 44.90% （928/2067） with secondary syphilis, 9.77% （202/2067） with latent syphilis （without any conspicuous clinical signs or symptoms）, and 0.58% （12/2067） with congenital syphilis. The 30-39 year old cohort accounted for the largest proportion, at 37.68% （779/2067） of all syphilis cases. The 20-29 year old cohort also accounted for a large proportion, at 37.20% （769/2067） of all cases,followed by the 40-49 year old cohort, at 17.95% （371/2067）. Syphilis was most prevalent among the unemployed,self-employed laborers, and office workers in decreasing order. The majority of cases were graduates of either primary school, high school, or college. Of all syphilis cases, 87.86% （1816/2067） were married, and 12.14%（251/2067, including children） were unmarried. 76.78% （1587/2067） of all cases were acquired through extramarital intercourse. 14.03% （290/2067） of cases were infected by their spouses. 0.58% （12/2067） of cases were due to vertical transmission. 8.61% （178） of cases were acquired through indirect contact. Conclusion： The proportion of syphilis infection among all STDs remained stable from 1994 to 1995,quickly and dramatically increased from 1996 to 1999,and then gradually tapered down from 2000 to 2002. The incidence of congenital syphilis infections increased throughout the study period.

视力尚好的严重糖尿病性视网膜病变患者后Tenon囊下注射曲安奈德可防止全视网膜光凝引起的视功能下降

Purpose: To evaluate prospectively the efficacy of a single sub-Tenon’ s capsule injection of triamcinolone acetonide (TA) against panretinal photocoagulation (PRP)-induced macular thickening and visual disturbance in patients with severe diabetic retinopathy and good vision. Design: Prospective, comparative, interventional case series. Participants: Twenty eyes of 10 patients with severe nonproliferative diabetic retinopathy or non-high-risk proliferative diabetic retinopathy whose visual acuity was 20/40 or better (< 0.3 in logarithm of the minimum angle of resolution LogMAR acuity) before the PRP, whose retinopathy was bilateral and symmetrical. The averaged parafoveal retinal thickness was more than 300 μ m, leading to a worse visual prognosis after PRP. Intervention: Sub-Tenon’ s capsule injection of 20 mg TA. Main Outcome Measures: Best-corrected visual acuity (BCVA) with logMAR chart and averaged foveal thickness (FT) using the retinal mapping program of optical coherence tomography. Methods: In all patients, PRP was performed every other week for 4 sessions on both eyes, and 1 week before PRP; 1 eye received the TA injection, and the other eye served as a control. The clinical course of BCVA and FT was monitored for up to 24 weeks after beginning PRP. Results: Before TA injection, BCVA and FT were 0.055± 0.072 and 235.5± 37.5 μ m in the TA-injected eye and 0.065± 0.071 and 233.7± 39.8 μ m in the control eye, respectively; there was no significant difference between eyes. After the TA injection, FT in the TA-injected eyes was significantly decreased. During and after the PRP, FT in the control eye increased dramatically and reached 312.0± 68.2 μ m at 24 weeks, which was significantly different from that in the TA-injected eyes (235.3± 38.6 μ m at 24weeks). Best-corrected visual acuity in the control eye decreased with time to 0.24± 0.13; in contrast, and BCVA in the TA-injected eye was good (to 0.085± 0.11) . Conclusions: As a pretreatment for PRP, a single sub-Tenon’ s capsule injection of TA has beneficial effects for preventing PRP-induced foveal thickening and visual dysfunction in patients with severe diabetic retinopathy and good vision.

Successful photodynamic therapy for biliary papillomatosis:A case report

Papillomatosis of the bile duct is a rare disease with a high risk of malignant transformation. Therapeutical options include partial hepatectomy and liver trans- plantation. A previously healthy 65-years old male developed jaundice and right upper abdominal quadrant pain in 1996. A villous adenoma of the distal bile duct was diagnosed. A Whipple procedure was performed. In 2002 the patient turned symptomatic again. An- other adenoma was found in the right hepatic duct resulting in a right hepatectomy. Two years later the patient again developed cholestasis. Alter drainage of the left hepatic duct with a percutaneous transhepatic cholangial drainage （PTCD） catheter, a recurrent biliary adenomatosis was diagnosed by cholangioscopy. As there was no surgical option left, the patient received photodynamic therapy （PDT） for the recurrent biliary papillomatosis. Three mo alter he received further photodynamic therapies, the bile duct epithelium appeared normal and the patient had no signs of adenomatosis, both macroscopically and histologically. The follow-up cholangioscopy in late 2005 revealed only a small papil-loma without the need for intervention. In early 2006, the patient died of multi organ failure without signs of extrahepatic cholestasis or cholangitis at the age of 75, 10 years after the diagnosis of biliary papillomatosis was established. The patient exceeded the average life expectancy of patients with biliary papillomatosis by far. Thus, PDT might be a sufficient therapeutic option for recurrent papillomatosis patients with no significant side effects.

Cervical cellulitis and mediastinitis following esophageal perforation:A case report

Chicken bone is one of the most frequent foreign bodies (FB) associated with upper esophageal perforation. Upper digestive tract penetrating FB may lead to life threatening complications and requires prompt management. We present the case of a 52-year-old man who sustained an upper esophageal perforation associated with cervical cellulitis and mediastinitis. Following CT-scan evidence of FB penetrating the esophagus, the impacted FB was successfully extracted under rigid esophagoscopy. Direct suture was required to close the esophageal perforation. Cervical and mediastinal drainage were made immediately. Naso- gastric tube decompression, broad-spectrum intravenous antibiotics, and parenteral hyperalimentation were administered for 10 d postoperatively. An esophagogram at d 10 revealed no leak at the repair site, and oral alimentation was successfully reinstituted. Conclusion: Rigid endoscope management of FB esophageal penetration is a simple, safe and effective procedure. Primary esophageal repair with drainage of all affected compartments are necessary to avoid life-threatening complications.

Review of salt consumption and stomach cancer risk:Epidemiological and biological evidence

Stomach cancer is still the fourth most common cancer;thus,it remains an important public health burden worldwide,especially in developing countries.The remarkable geographic variations in the rates of stomach cancer indicate that dietary factors,including a range of food groups to which salt and/or nitrates have been added,may affect stomach cancer risk.In this paper,we review the results from ecologic,case-control and cohort studies on the relationship between salt or salted foods and stomach cancer risk.The majority of ecological studies indicated that the average salt intake in each population was closely correlated with gastric cancer mortality.Most case-control studies showed similar results,indicating a moderate to high increase in risk for the highest level of salt or salted food consumption.The overall results from cohort studies are not totally consistent,but are suggestive of a moderate direct association.Since salt intake has been correlated with Helicobacter pylori(H pylori) infection,it is possible that these two factors may synergize to promote the development of stomach cancer.Additionally,salt may also cause stomach cancer through directly damaging gastric mucus,improving temporary epithelial proliferation and the incidence of endogenous mutations,and inducing hypergastrinemia that leads to eventual parietal cell loss and progression to gastric cancer.Based on the considerable evidence from ecological,case-control and cohort studies worldwide and the mechanistic plausibility,limitation on salt and salted food consumption is a practical strategy for preventing gastric cancer.

Non-steroidal anti-inflammatory drugs and statins in relation to colorectal cancer risk

AIM： To investigate the association between individual or combined use of non-steroidal anti-inflammatory drugs （NSAIDs） or statins and colorectal cancer risk.METHODS： In a population-based case-control study in women, we examined the association between NSAIDs and statin use and the risk of colorectal cancers. We further investigated whether the use of statins modifies the protective effect of NSAIDs. Female cases （n = 669）of colorectal cancer aged 50-74 years were identified from a storewide registry in Wisconsin during 1999-2001. Community control women （n = 1375） were randomly selected from lists of licensed drivers and Medicare beneficiaries. Medication use and risk factor information were gathered during a structured telephone interview. A multivariable logistic regression model was used to calculate odds ratio （OR） and 95% confidence interval （CI）.RESULTS： Overall, NSAIDs users had a 30% reduction in risk of colorectal cancer （95% CI： 0.56-0.88）. Statin use was not associated with colorectal cancer risk （OR = 1.17, 95% CI： 0.74-1.85）, regardless of structural type （lipophilic or hydrophilic）, duration of use, or recency. There was no evidence of an interaction between NSAIDs and statins and colorectal cancer risk （P-interaction = 0.28）.CONCLUSION： Although our results confirm the inverse association between NSAIDs use and colorectal cancer risk, they do not support a risk reduction in statin users, or an interaction effect of combined NSAIDs and statin use.

Preoperative diagnosis of colonic angiolipoma: A case report

Angiolipoma, a common benign tumor mostly seen in the subcutaneous tissue, is a rare pathological condition in the gastrointestinal tract that is usually diagnosed postoperatively. In this case report, an angiolipoma was diagnosed preoperatively by imaging （including CT scans, abdominal echo, barium enema, and colonoscopy）. This pathology was confirmed postoperatively. Computed tomography scan, abdominal echo, and barium enema images were presented.

External application of Chinese medicine formula combined with analgesic drugs to treat lung squamous cell carcinoma pain： A case study with mixed methods

Objective： To investigate the effectiveness of the external application of Chinese medicine combined with analgesicdrugs to treat lung squamous cell carcinoma pain. Methods： A 54-year-old patient with upper lobe of the left lungsquamous cell carcinoma was studied, who suffered from severe cancer pain with the initial numeric rating scale （NRS）7 point when admitted. Exterior-use formula was applied to pain spot to relieve the pain. Mixed methods approachcomprising NRS, Short-form of McGill Pain Questionnaire, quality of life scale, times of breakout pain, records ofadverse reactions and semi-structured interviews were utilized to evaluate the effect. Results： With the combination useof the formula and analgesic drugs, the patient’s NRS score dropped from 7 to 3 point. Quality of life scale scoreimproved from 33 to 42 point. Times of breakout pain reduced from twice to none. The amount of oxycodone decreasedfrom 30 mg Bid to 10 mg Bid. No adverse effect appeared. The patient’s felt more energetic with good sleep and appetite.Conclusion： This formula is effective and safe for pain relief when combined with analgesic drugs, and may be a goodoption in dealing with local cancer pain. Future randomized, controlled studies are needed to better evaluate the efficacy.

Vascular endothelial growth factor polymorphisms and risk of lung cancer

Objective:We investigated the potential association between vascular endothelial growth factor(VEGF) polymorphisms and the risk of lung cancer.Methods:In the case-control study, we used PCR-RFLP technique to determine two VEGF genotypes-2578C/A and 936C/T in 171 lung cancer patients and 172 healthy controls for conformation, and constructed haplotypes of the two gene sites by PHASE1.0 software.Unconditional logistic regression model was used to analyze the statistical association of genontypes or haplotypes in the two groups adjusted by gender and age.Results:Compared with at least one-2578A allele, individuals with-2578CC genotype found associated with a significantly decreased risk of lung cancer P=0.001;adjusted odds ratio(OR), 0.391;95% confidence interval(95% CI), 0.226-0.686.Analyses stratified by gender showed that the combined-2578 CA and AA genotype were also associated with a significantly decreased risk of lung cancer.(P = 0.016;OR = 0.303;95% CI = 0.153-0.601 and P = 0.018;OR = 0.547;95% CI = 0.331-0.903, respectively).The distribution of the two haplotypes(936C/-2578C and 936C/-2578A) were significantly different between case-and-control groups(P = 0.016, OR = 0.317, 95% CI = 0.124-0.809 and P = 0.018, OR = 0.547, 95% CI = 0.331-0.903).Analyses categorized by tumor histology showed that Haplotype C-C was associated with a significantly decreased risk of adenocarcinoma compared with the reference haplotypes.(P = 0.004;OR = 0.237;95% CI = 0.090-0.627).Conclusion:These results suggest that the VEGF polymorphisms may be a critical factor for the risk of lung cancer.

A Preliminary Study of The Value of Quantitative Testing of TP-DNA In The Treatment of Patients with Syphilis

Objectives: To explore the relationship betweenquantitative Treponema pallidum DNA (TP-DNA) PCR testingand the Toludine Red Unheated Serum Test (TRUST) inpatients with syphilis before and after treatment, and evaluatethe clinical value of quantitative TP-DNA testing in thediagnosis and treatment evaluation of syphilis. Methods: 29 patients with primary (12 cases) or secondary(17 cases) syphilis, who met the criteria set for this study wererecruited as subjects. All patients were treated with 2.4 millionunits benzathine penicillin IM weekly for 3 weeks.Quantitative tests of TP-DNA in the patients' plasma wereperformed using FQ-PCR before and after the treatment.Serologic tests including TRUST and TPPA were alsoperformed. Results: Before the treatment, 9 out of 12 primary syphilispatients (75%) and all secondary syphilis patients (17/17)tested positive for Treponema pallidum (TP) by TP-DNAtesting. The average quantitative test values of TP-DNA inprimary and secondary syphilis patients were (3.38±2.34)×10~4and (5.73±1.33)×10~6 copies/ml, respectively. After threemonths of treatment, 1 of the 9 primary and 5 out of 17secondary syphilis patients were positive upon TP-DNAtesting, respectively. The average quantities of TP-DNA were2.01×10~2 copies/ml in primary and 5.87×10~2 copies/ml insecondary syphilis patients with positive TRUST and TP-DNAtests, and 3.09×10~2 copies/ml for those with negative TRUSTrespectively. After nine months of treatment, all the primaryand secondary syphilis patients were negative upon TP-DNAtesting, while all primary and 14 of 17 (82.35%) secondarysyphilis patients showed negative TRUST results. Conclusion: That the results of TP-DNA tests are notconsistent with those or TRUST before and after treatmentindicates that quantitative TP-DNA testing may have valuableclinical significance in the early diagnosis and evaluation oftreatment regimens for syphilis.

Status of Clinical Application of Yufeng Ningxin Preparations and the Meta-Analysis of Its Efficacy and Safety in the Treatment of Cardiovascular and Cerebrovascular Diseases

Objective The objective of this study was to analyze the status of the clinical application of Yufeng Ningxin(YFNX)preparations and systematically evaluate their efficacy and safety in the treatment of cardiovascular and cerebrovascular diseases.Methods Through searching databases of China National Knowledge Infrastructure,Wanfang,SinoMed,VIP,PubMed,Embase,and the Cochrane Library,the literature of clinical research on YFNX preparations in treating malignant tumors of cardiovascular and cerebrovascular diseases from the establishment of the databases to February 2021 was collected.The clinical randomized controlled trials and case-control studies of cardiovascular and cerebrovascular diseases treated with these preparations were analyzed.Two reviewers independently screened literature,extracted data,and assessed the risk of bias in the included studies,and meta analysis was performed by using ReMan 5.3 software to analyze the eficacy and safety of YFNX preparations in the treatment of cardiovascular and cerebrovascular diseases.Results A total of 29 clinical studies were finally included.The dosage forms were dropping plls,tablets,capsules,and granules.The preparations were used for the treatment of coronary heart disease,hypertension,neuropathic headache,etc.This study systematically evaluated the efficacy and safety of YFNX preparations in the treatment of coronary heart disease,hypertension,and nervous headache.A total of 1,162 cases were included in 13 studies,582 cases of the YFNX preparation group and 580 cases of the Western medicine group.The results of meta-analysis showed that the clinical efficacy of YFNX preparations combined with the Western medicine group in the treatment of coronary heart disease and hypertension,improving electrocardiogram and reducing the frequency and duration of angina attacks,was better than that of the simple Western medicine group,and the difference was statistically significant.Conclusion YFNX preparations are effective for coronary heart disease,hypertension,and neuropathic headache,and the adverse reactions are few.

A Case of Multiple Sexually Transmitted Diseases (STDs),with Stevens-Johnson Syndrome and Mediastinal Tumor

A 29-year-old man was admitted for erythema, papules and erosions. Erosions and purulent secretions were seen in the circumference of the mouth, eyes, oral mucosa,tongue, and preputium. Conjunctivas were swollen and the urethral orifice was red, both were accompanied by purulent secretions. Multiple vesicles were shown in the penis.The patient was diagnosed with:①Stevens-Johnsonsyndrome;②gonococcal ophthalmoblennorrhea;③nongonococcal urethritis, gonococcal urethritis;④genital herpes;⑤mediastinal tumor.

Biovars and Serotypes of Ureaplasma Urealyticum among Chinese Women Undergoing Routine Gynecologic Exam, Women with Sexually Transmitted Infections, and Female Sex Workers

Objectives: To characterize the distribution pattern of biovars and scrotypes or Ureaplasma urealyyicum in normalhealthy women, sexually transmitted infections clinic clients,and in sex workers. Methods: We cultured cervical swabs taken from 261physical check-up clients, 599 STI clinic outpatients and 98 sexworkers using commercial selective medium. Some positivecultures were further biotyped and serotyped by PCR. Results: (1) U. urealyticum is more commonly isolated in sexworkers (90.8%) than in the physical check-up group (60.9%)or the STI outpatient group (61.3%) (P<0.001). (2) Biovar 1of U. 'realyticum (95.0%), especially single infection ofserotype 1. 3, and 6 of biovar 1, is commonly found in healthywomen. (3) Biovar 2 infection of U urealyticum is moreprevalent in sex workers (28.1%) and STI outpatients group(26.6%) than that in the physical check-up group (4.9%) (P<0.001). (4) Mixed infection caused by more than one serotypeof U urealyticum increased from physical check-up group(8.6%) to STI utpatients (12.4%) to sex workers (23.9%) (P<0.01). (5) There is no statistically significant difference in thedistribution of serotype 1, 3, and 6 of biovar 1 among thesethree groups (P=0.763). (6) The PCR method described here isrelatively simple, rapid and specific for the biotyping andserotyping of biovar 1 of U urealyticum. Conclusion: We should pay more attention to biovar 2 andmixed infections of U. urealyticum than single infection ofhiovar 1 in clinic practice. PCR is a good method for biotypingand serotvping.

Observation of the Ultrastructure in Syphilitic Chancres

Objective: To study the occurrence and development ofprimary syphilis from a morphological and structural aspect.Method: The ultrastructural pathological changes of syphiliticchancre were examined by transmission electron microscopy(TEM). Results: The pathological changes of syphilitic chancreoccur mainly in the dermal layer, manifested as partialthinning or lysis of the capillary basal membrane,proliferation of capillary endothelial cells, thickening of somecollagen fibers and rupture of collagen fibers surrounding Tpallidum, structural disruption of the axons of terminal nerves,disarrangement of the sheath of the myelinated nerve fiberswith separation of laminae and the attachment of T pallidumon its outer membrane, appearance of slightly swollen Tpallidum in the plasma of the capillary endothelial cells andfibroblasts, and infiltration of neutrophils, macrophages andplasma cells containing T pallidum and its debris frequentlylined by a clear sheath. Conclusion: The pathogenesis and injury of mechanism inprimary syphilis can be explained morphologically by itscharacteristic ultrastructural pathological changes.

Detection of HSV-2 Antibody in STD Patients

In order to acknowledge the multi-infectiondata of STD patients and improve the prophylaxis andtherapy for STDs, 297 patients and 30 healthy people wereexamined using the HSV-2 plasma antibody. The resultsshowed that all kinds of STD patients were infected byHSV-2 in different ratios, the highest ratio occurring insyphilis patients.

Relationship Between Apoptosis and PCNA Expression of Keratinocytes in Condylomata Acuminata

Objecrive: To investigate the relationship between apoptosis and proliferating cell nuclear antigcn (PCNA)expression of keratinocytes in Condylomata acuminata (CA). Methods: PCNA expression was observed byimmunohistochemistry technique (ABC method) in 51 CAspecimens and 1 normal specimens of foreskin or vaginalmucosae. 55 specimens (40 in the CA group and 15 in thecontrol group) were randomly sampled for in situ labelingof apoptotic cells using the TUNEL method. Results: Positive expression of PCNA in CA and controlgroups were 90.2% and 77.8%, respectively, and theproliferation index in CA group was significantly higherthan that in the control group (P<0.001). The positive rateof apoptosis was 42.5% in the LA group and 53.3% in thecontrol group, and there were no significant differences inthe apoptotic index and apoptosis-proliferation ratiobetween two groups (P>0.05). The proliferation indexshowed a significant negativc correlation with theapoptosis-proliferation ratio (r=-0.62, P=0.01) in the CAgrp. Conclusion: It is suggested that the proliferativeappearance of CA could be due to the imbalance betweencell growth and cell death which is caused by moreproliferation and less apoptosis in keratinocytes.

He-Ne laser acupuncture for 30 cases of unilateral nervous tinnitus

Objective： To observe the clinical effects of the unilateral nervous tinnitus treated by He-Ne laser acupuncture.Methods： A total of 30 patients of unilateral nervous tinnitus were treated with He-Ne laser acupuncture.The disposable filiform needles of 0.40 mm × 25 mm were used. Ermén（耳门 TE 21）, Tīnggōng（听宫 SI 19）,Tinghui（听会 GB 2）, Yìfēng（翳风 TE 17）,Shuàigǔ（率谷 GB 8） and Zhōngzhǔ（中渚 TE 3） were adopted on the affected side. The input and output ends of the fiber-optic catheter of the laser instrument were connected at a pair of acupoints（TE 21 connect to SI 19, GB 2 connect to TE 17, GB 8 connect to TE 3）.Each pair of acupoints was stimulated with He-Ne laser irradiation for 10 min, 8-10 mW in the output power and 6328 A in the wavelength. The needles were retained for 30 min totally. The treatment was given once a day, 5 times a week, continuously for 2 weeks.Results： Of 30 cases, 19 cases were cured clinically, accounting for 63.3%（19/30）; 7 cases effective remarkably, accounting for 23.3%（7/30） and 4 cases failed, accounting for 13.3%（4/30）.Conclusion： He-Ne laser acupuncture achieves the satisfactory effects on treating nervous tinnitus and it is easily accepted by the patients. Hence, this therapy deserves to be promoted in clinical application.