桃红四物汤合七味白术散治疗糖尿病合并冠心病50例

目的：观察桃红四物汤合七味白术散治疗气阴两虚兼血瘀型糖尿病合并冠心病的临床疗效。方法：将100 例糖尿病合并冠心病患者随机分为治疗组和对照组,每组各50 例。对照组给予西医常规治疗,治疗组在对照组基础上加用桃红四物汤合七味白术散治疗。治疗12周后,观察2组的综合疗效,中医证候积分,实验室指标［空腹血糖（FBG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C)、 C反应蛋白（CRP）、同型半胱氨酸（HCY）］,颈动脉内膜中层厚度（IMT）,颈部血管斑块大小以及安全性。结果：总有效率治疗组为94.0%（47/50）,对照组为72.0%（36/50）,2组比较,差异有统计学意义（P<0.05）。2组中医证候积分、TC、TG、LDL-C、CRP、HCY、IMT、斑块大小均较治疗前改善,且组间比较（除TC外）,差异均有统计学意义（P<0.05）。2组均未发生不良反应。结论：桃红四物汤合七味白术散治疗气阴两虚兼血瘀型糖尿病合并冠心病疗效显著,可减轻患者的临床症状,改善血管内皮功能,降低IMT水平,缩小颈部血管斑块,从而达到预防和减缓心血管事件发生的目的。     

中国手足口病时空分异特征及影响因素

健康中国战略是中国新时期的重大战略之一,手足口病作为全球关注的公共卫生问题,已成为中国影响范围较为广泛和普遍的典型传染性疾病,尤其对婴幼儿健康造成巨大威胁。本文构建健康地理学视角下的传染病研究理论框架,采用集中度和空间分析方法解析中国2008—2017年手足口病发病时空分异特征和变化规律,对18个影响其发病的风险因子进行空间相关和地理探测,揭示手足口病地理分异的主要影响因素和作用机理。结果表明：① 健康地理学视角下的传染病研究理论框架由传染病发病的基本环节、影响因素和分布扩散状态3个子系统构成,各子系统之间及子系统内部相互影响相互作用。② 2008—2017年中国手足口病发病率呈现波动上升、两年为一周期且偶数年份高于奇数年份的发病规律,春末夏初及秋末冬初为发病高峰。③ 2008—2010年手足口病发病率未体现明显的空间集聚特征;2011—2017年发病率存在较强的空间自相关性,热点地区主要集中在广东、广西、海南等地区,且呈现自北向南、自小而分散向大而集中的演变趋势;发病典型地区可以总结为气候湿热区、经济落后且医疗水平低的地区和易集聚感染的人口密集区3种。④ 有12项因素通过了相关分析和地理探测的显著性检验,与手足口病发病率体现正向作用的因素解释力从大到小依次为“气温>年降水量>湿度>气压>人口密度>路网密度>人均GDP”,负向相关关系作用大小依次为“日照时数>风速>AQI指数>海拔>千人床位数”,气温和降水量与其他因子的交互作用最为明显。本文为健康地理学、手足口病病理学、流行病学的相关研究提供实证检验基础,为服务健康中国战略和流行病预防与控制提供重要科学支撑和政策参考。     

Relational distance,neoliberalism and the regulation of animal health

Using quantitative and qualitative data, this paper contributes to debates on the uneven geographies of neoliberal animal disease regulation. Specifically, the paper analyses the impacts of neoliberal reforms to animal disease regulation in Great Britain. Focussing on the case of bovine tuberculosis (bTB), the paper analyses how changes to ‘relational distance’ in animal disease regulation have led to closer relationships between regulators (veterinarians) and regulatees (farmers) which in turn has led to a departure from standardised disease regulation to approaches that emphasise greater flexibility and judgement. The paper presents quantitative analysis of bTB testing data revealing the gradual erosion of government control of bTB regulation and significant variations in disease diagnosis between vets in the private and public sectors. Drawing on interviews with senior veterinarians in Government and veterinary organisations, the paper shows how these regulatory structures evolved and came to be accepted despite their limitations. The paper concludes by considering how relational distance contributes to an understanding of the nature of disease and its implications for the wider regulation of animal disease.     

鲁西南地区高氟地下水特征及成因探讨

在鲁西南地区,由于饮用高氟地下水而导致的地氟病,严重影响了当地群众的身心健康。地下水中氟元素的富集是一个非常复杂的水文地球化学过程。水化学测试结果表明,氟含量为0.05~6.7 mg/L,平均1.20 mg/L,高氟分布区主要集中在嘉祥黄河冲洪积平原与山前冲洪积平原交接部位和曹县、单县、菏泽黄河冲洪积平原河间洼地;地下水中氟含量与pH、矿化度之间的相关性不明显、与K++Na+和Ca2+相对含量分别呈正相关和负相关关系、与Ca2+含量相关性显著。本文从地质环境、水文地质环境、水文地球化学角度探讨了浅层高氟地下水的水文地球化学成因,研究了黄泛平原高氟地下水的形成机理,对于确定地氟病的成因及制定地氟病的防治措施,寻找适用饮用的低氟地下水,具有重要的理论和现实意义。     

Challenges to global surveillance of disease patterns

Surveillance systems for foodborne disease vary in capacity by country, especially for marine-related illnesses. Generally, the more developed the country is, the more funding that is put into its surveillance programs, but no country has an outstanding system that could serve as a model for all others. An additional problem is lack of consistency. Approaches to surveillance and available resources change over time, so that apparent trends may reflect more of an administrative function. Most countries have some passive system that allows data on foodborne illnesses to be sent to centralized authorities where summaries are generated. However, these depend on the uneven quality of the source data that vary according to the resources allocated at the local level. Active surveillance systems collect data targeted to answer specific epidemiological questions more efficiently, but at such a high cost that most countries do not have the resources, except on a occasional basis. There is also the issue of what to do with the collected data. There has to be a conscious effort to translate the problems identified from the surveillance programs to consider strategies for prevention and control of foodborne disease. Otherwise, there is little value in having these kinds of monitoring programs. Another problem is lack of coordination in surveillance systems between most countries, so that information can be rapidly and efficiently shared. That being said, surveillance over the years had generated much interesting information on how disease agents are transmitted through the food supply, and where contamination and growth by pathogens in the food production and preparation chain typically occur. In addition, attempts are being made to create regional networks in different parts of the world usually initiated by organizations like WHO and PAHO. The kinds of information collected and programs being introduced are discussed in examples taken from both the developed and less developed world, followed by a series of recommendations for improving surveillance on a global basis. A recent burden in the surveillance system is the potential for a deliberate attack on the food supply with agents not usually involved with foodborne illness. At least in the US, a major concern is for the rapid detection and containment of a massive contamination of the food supply.     

无人机影像辅助下的路桥病害智能检测

路桥表面病害状况评估是路桥养护的一项重要内容。目前病害检测主要基于移动测量车和目视判断,具有工作量大、获取危险度高的缺点,而低空飞行的六旋翼无人机能够拍摄到人工无法获取到的多角度路桥照片,在路桥检测方面具有巨大的优势。本文基于无人机影像开展路桥病害检测相关研究,提出了一种新的路桥病害检测方法。首先通过多部件形变模型模拟病害目标,并在无人机影像中全局搜索,检测出潜在路桥病害区域。试验表明,本文算法在复杂背景下能够有效检测病害,目标检测精度达80%,具有很高的效率和鲁棒性。     

一株可诱导海带配子体产生白化病的细菌的分离与鉴定

海带(Saccharina japonica)是一种重要的经济养殖海藻。中国海带与褐藻胶的产量分别占世界总产量的60%和90%。与高等农作物相似,在海带育苗及养殖过程中常常会暴发病害,严重时可造成20%~50%的减产。分离、鉴定致病菌及其致病因子是预防和控制病害发生的前提条件。由于海藻的致病菌大多是条件致病菌,迄今为止,海带致病菌的分离和鉴定仍是一个瓶颈问题。本研究运用传统微生物分离培养方法从脱苗病海带幼苗藻体分离出一株致病菌LJ2-4,经过复染实验及科赫法则验证,证实该菌株在实验室条件下可使健康海带雌、雄配子体产生白化的病症。LJ2-4菌落圆形、边缘完整,呈浅橙色。扫描电镜和透射电镜观察表明:LJ2-4菌体呈球形/杆状,长0.5~1.2µm,宽0.4~0.7µm无鞭毛。经16S rDNA分子鉴定,其与Planococcus okeanokoites IFO 12536^T的相似性为99.45%。结合LJ 2-4的生理生化特性,将该菌株命名为Planomicrobium okeanokoites LJ2-4。P.okeanokoites LJ2-4是在实验室条件下可引起健康海带配子体产生白化病的条件致病菌。本研究为海带致病菌致病机理的研究奠定了前期工作基础,同时也可为预防与控制海带苗期脱苗病的暴发提供理论依据。     

大连地区中国对虾“红腿病”病原体及其感染寄主细胞的电镜观察

对虾红腿病国内最早发现于１９８１年８月下旬山东潍坊市一养虾场,１９８８年８月在辽宁庄河、东沟县一带虾场开始流行［２］。此病流行广、发病期短、死亡率比较高,是危害对虾主要病害之一。作者自１９９０年８月～１９９２年９月,对大连地区养虾场流行的红腿病进行了调查、采样,并着重作了病原菌的形态及其侵染寄主细胞的病变观察,为虾病防治提供了科学依据。１材料与方法１·１材料来源典型对虾红腿病样品采自大连市金州区重家沟、营城区西小磨两个虾场。１,２样品的处理１．２．１病原菌的分离与菌种鉴定,病原菌的分离分别由辽宁…     

中国东西部两县域气象要素对呼吸系统疾病影响的分层对比研究

利用安徽省阜南县以及贵州省锦屏县2015—2016年医保住院数据，细化两县呼吸系统疾病住院人群年龄分层，并从月份、节气、候不同时间尺度逐步递进的角度，采用描述性研究方法与相关性分析方法，探析两地各年龄段人群住院人数分布及其地域差异。结果表明：（1）两县9岁以下儿童呼吸系统疾病高发，20~39岁人群住院率较低。（2）两县各人群呼吸系统疾病入院高峰基本出现在2—3月（立春—清明、第10-20候）和11—12月（大雪—冬至）。除个别人群外，两县均是夏、秋两季呼吸系统疾病入院人数较少。（3）阜南县50~59岁人群呼吸系统疾病秋季入院风险的增加与当地气温日较差增大和相对湿度降低有关，滞后5 d左右影响明显。（4）总体来看，干冷环境可能会造成两县居民呼吸系统疾病入院人数的增多。此外，锦屏县居民还需格外防范春季相对低温高湿天气及暖季较低气温日较差所带来的呼吸系统疾病风险。