Outcome measures in inflammatory rheumatic diseases

Inflammatory rheumatic diseases are generally multifaceted disorders and, therefore, measurement of multiple outcomes is relevant to most of these diseases. Developments in outcome measures in the rheumatic diseases are promoted by the development of successful treatments. Outcome measurement will increasingly deal with measurement of low levels of disease activity and avoidance of disease consequences. It is an advantage for patient management and knowledge transfer if the same outcomes are used in practice and in trials. Continuous measures of change are generally the most powerful and, therefore, are preferred as primary outcomes in trials. For daily clinical practice, outcome measures should reflect the patients' state and have to be easily derivable. The objective of this review is to describe recent developments in outcome measures for inflammatory rheumatic diseases for trials and clinical practice, with an emphasis on rheumatoid arthritis.     

海南温郁金的主要病虫害及防治方法

海南省自1997年引进种植温郁金以来,温郁金病虫害流行愈发严重.本文针对近年来温郁金发生的主要病虫害进行田间调查和研究,提出科学防治方法及措施,以期为海南温郁金产业的可持续发展提供技术支持和参考借鉴.     

从医联体到康联体防控慢性病策略的变化——以上海市闵行区为例

本文介绍了复旦大学附属上海市第五人民医院在不断巩固区域医疗联合体的基础上,试图建立一种以预防疾病,控制慢性疾病如慢性呼吸道感染、慢性肝病、糖尿病等,加强健康教育为目的的社区健康联合体(简称康联体)。这是一项卫生服务可持续发展的模式,其建立是基于复旦大学和闵行区的长期合作,以智慧医疗技术为依托,以"防大病、管慢病、促健康"为核心服务内容,以期及早预防社区居民严重疾病的发生,对社区慢性病患者进行方便、有效的监控,并向社区介绍先进的人口健康理念,实现全方位、全生命周期保障社区居民健康,为闵行区康联体的扩大与完善提供参考依据。希望这些方法能促进优质医疗服务的合理布局,使社区居民终身健康关怀得到发展,并在防控慢性疾病及慢性感染中发挥有效作用,在今后也能应用于其他区域。     

Cardiovascular risk in pediatric-onset rheumatological diseases

Cardiovascular morbidity and mortality are becoming major health concerns for adults with inflammatory rheumatic diseases. The enhanced atherogenesis in this patient population is promoted by the exposure to traditional risk factors as well as nontraditional cardiovascular insults, such as corticosteroid therapy, chronic inflammation and autoantibodies. Despite definite differences between many adult-onset and pediatric-onset rheumatologic diseases, it is extremely likely that atherosclerosis will become the leading cause of morbidity and mortality in this pediatric patient population. Because cardiovascular events are rare at this young age, surrogate measures of atherosclerosis must be used. The three major noninvasive vascular measures of early atherosclerosis - namely, flow-mediated dilatation, carotid intima-media thickness and pulse wave velocity - can be performed easily on children. Few studies have explored the prevalence of cardiovascular risk factors and even fewer have used the surrogate vascular measures to document signs of early atherosclerosis in children with pediatric-onset rheumatic diseases. The objective of this review is to provide an overview on cardiovascular risk and early atherosclerosis in pediatric-onset systemic lupus erythematosus, juvenile idiopathic arthritis and juvenile dermatomyositis patients, and to review cardiovascular preventive strategies that should be considered in this population.     

我国鲑鳟鱼类养殖常见流行疫病研究概况

鲑鳟鱼类是典型的冷水性鱼类,经济价值高,市场前景广阔,是世界重要经济鱼类之一。我国鲑鳟鱼类养殖近年来蓬勃发展,产量及规模不断提高,养殖模式不断创新,与此同时,各地鲑鳟鱼类流行疾病的暴发日趋频繁,国内疫病防控体系与挪威、智利等主产国仍存在较大差距,严重制约了产业的健康发展。基于此,概述了细菌、病毒及其他病原引起的鲑鳟鱼类主要流行性疫病的发病症状、发病条件等方面的研究成果,系统介绍了相应的诊断技术,并重点介绍了国内鲑鳟鱼类免疫防控手段,以期为研究人员提供较为系统的鲑鳟鱼类常见流行疫病相关基础知识、常用的检测技术以及免疫防控手段,为从业者和研究人员对鲑鳟鱼类疫病防控提供参考。     

实验猴麻疹预防和治疗方案初探

实验猴麻疹是造成断奶仔猴死亡的重要传染病之一,本文对该病的临床诊断、护理、预防和治疗方案进行了初步研究,并提出了行之有效的预防、护理及治疗措施。经临床实践证明,该方案对实验猴麻疹的治愈率可达90%以上,值得在国内实验猴生产及科研单位推广应用。     

Expert Opinion on the Perceived Effectiveness and Importance of On-Farm Biosecurity Measures for Cattle and Swine Farms in Switzerland

Biosecurity is crucial for safeguarding livestock from infectious diseases. Despite the plethora of biosecurity recommendations, published scientific evidence on the effectiveness of individual biosecurity measures is limited. The objective of this study was to assess the perception of Swiss experts about the effectiveness and importance of individual on-farm biosecurity measures for cattle and swine farms (31 and 30 measures, respectively). Using a modified Delphi method, 16 Swiss livestock disease specialists (8 for each species) were interviewed. The experts were asked to rank biosecurity measures that were written on cards, by allocating a score from 0 (lowest) to 5 (highest). Experts ranked biosecurity measures based on their importance related to Swiss legislation, feasibility, as well as the effort required for implementation and the benefit of each biosecurity measure. The experts also ranked biosecurity measures based on their effectiveness in preventing an infectious agent from entering and spreading on a farm, solely based on transmission characteristics of specific pathogens. The pathogens considered by cattle experts were those causing Bluetongue (BT), Bovine Viral Diarrhea (BVD), Foot and Mouth Disease (FMD) and Infectious Bovine Rhinotracheitis (IBR). Swine experts expressed their opinion on the pathogens causing African Swine Fever (ASF), Enzootic Pneumonia (EP), Porcine Reproductive and Respiratory Syndrome (PRRS), as well as FMD. For cattle farms, biosecurity measures that improve disease awareness of farmers were ranked as both most important and most effective. For swine farms, the most important and effective measures identified were those related to animal movements. Among all single measures evaluated, education of farmers was perceived by the experts to be the most important and effective for protecting both Swiss cattle and swine farms from disease. The findings of this study provide an important basis for recommendation to farmers and policy makers.     

泰安市维持无脊髓灰质炎状态的策略与效果分析

目的调查泰安市保持无脊髓灰质炎(简称无脊灰)状态所采取的策略和取得的效果,为证实无脊灰提供依据,并为其他疫苗针对传染病的控制与消除提供借鉴。方法采用描述流行病学研究方法,对该市2001—2011年保持无脊灰状态所采取的策略和效果进行回顾性分析。结果证实泰安市2001年实现无脊灰以来,始终正确地实施脊髓灰质炎疫苗免疫策略,加强对急性弛缓性麻痹病例监测,完善免疫规划科学管理,巩固了自1991年5月以来无脊髓灰质炎野病毒感染病例发生的成果。结论持续做好免疫、监测、管理三大策略对维持无脊髓灰质炎状态至关重要,并为其他疫苗针对疾病的控制提供了理论借鉴。     

防护措施下一类高传染性多潜伏期传染病的高维动态模型

传染病给人们的生命带来了极大的威胁,对于高传染性的疾病,政府总会采取一些防护措施．本文针对防护措施下的高传染性且具有潜伏期等特性的一类传染病,结合传染病模型,在一定假设条件下给出了这类疾病单日新收治的直接确诊病例及疑似病例的高维动态模型,并使用最小二乘法进行了参数辨识．最后以SARS为例,利用网上公布的SARS数据给出了5月22日-5月31日的预测结果并将预测结果和实际数据进行了比较,说明了模型的有效性．     

Prevention of acute enteric infections and viral hepatitis A in the Stavropol Territory in connection with a natural disaster

Materials on the organization and realization of prophylactic measures with respect to acute enteric infections (AEI) and viral hepatitis A (VHA) at the period of the liquidation of medico-sanitary consequences of the high flood are presented. As shown in these materials, the epidemiological surveillance on AEI and VHA in the areas affected by the emergency situation included the effective system of monitoring on these diseases. On the basis of monitoring optimum decisions were taken and concrete prophylactic measures were realized. This made it possible to detect the foci of infectious diseases in due time and efficiently liquidate them, as well as to prevent the development of the epidemiological consequences of the high flood.     

The guinea pig as a model of infectious diseases

The words 'guinea pig' are synonymous with scientific experimentation, but much less is known about this species than many other laboratory animals. This animal model has been used for approximately 200 y and was the first to be used in the study of infectious diseases such as tuberculosis and diphtheria. Today the guinea pig is used as a model for a number of infectious bacterial diseases, including pulmonary, sexually transmitted, ocular and aural, gastrointestinal, and other infections that threaten the lives of humans. Most studies on the immune response to these diseases, with potential therapies and vaccines, have been conducted in animal models (for example, mouse) that may have less similarity to humans because of the large number of immunologic reagents available for these other species. This review presents some of the diseases for which the guinea pig is regarded as the premier model to study infections because of its similarity to humans with regard to symptoms and immune response. Furthermore, for diseases in which guinea pigs share parallel pathogenesis of disease with humans, they are potentially the best animal model for designing treatments and vaccines. Future studies of immune regulation of these diseases, novel therapies, and preventative measures require the development of new immunologic reagents designed specifically for the guinea pig.     

Printed information for the lay public on cardiovascular disease.

Booklets from several countries on various aspects of cardiovascular disease, intended for distribution to the public and to patients, could be classified into three categories dealing with primary prevention, secondary prevention, and management. Much material was duplicated, whereas some diseases were completely ignored. Only two types of booklets should be available. One would deal with preventive measures for all cardiovascular diseases, while the other would be a series of booklets on individual conditions, combining information on secondary prevention and on management.     

进境蜜蜂疫病传入风险分析

为有效防范疫病传入,保护国内生态和环境安全,本文根据新西兰风险分析模型,从传入释放的可能性、定殖和扩散的可能性以及对经济和生态的潜在危害性3个方面对进境蜜蜂所可能携带的病毒、细菌、真菌、寄生物和敌害等危害进行风险分析。结果表明,蜂群崩溃失调病Colony Collapse Disorder、美洲幼虫腐臭病American Foulbrood、欧洲幼虫腐臭病European Foulbrood、武氏蜂盾螨Acrapis woodi、小蜂螨Tropilaelaps spp.、狄斯瓦螨Varroa destructor、蚤蝇Apocephalus borealis和蜂巢小甲虫Small Hive Beetle(Aethina tumida Murray,SHB)等8种病虫害能给国内蜜蜂带来一定的风险,根据风险评估结果,提出了相应的风险管理措施。研究结果能为制定相应的检疫措施提供科学依据。     

国内鱼类病毒病研究进展

病毒性疾病是危害水生动物最严重的一类疾病,是水产养殖业发展的重大障碍。近年来,中国水生动物病毒病的研究取得了一定成就,但是还有许多方面的研究有待加强,有很多未知领域需要进行探索与研究。本文综述了近年来国内鱼类病毒病的研究进展,主要介绍了草鱼出血病、传染性胰脏坏死病、淋巴囊肿病、传染性脾肾坏死病、鳗鲡病毒病、真鲷病毒病等不同鱼类病毒病的临床症状、流行病学、检测手段、致病机理、防治措施以及引起该病的病原体的形态结构、理化性质等,旨在为鱼类病毒病的防治提供参考。     

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction

Background

Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence.

Methodology

The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response.

Conclusions

The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy.     

养殖对虾病害生态防治的探讨

养殖对虾病害的生态防治尚处于探索研究阶段。从养殖水环境控制、养殖方式和结构调整等方面,综合分析了近年虾病生态防治研究工作的成果,提出要建立一套科研、生产、推广的完整生态防治体系应从以下几方面着手：调查虾池及近海水域生态环境,加强近海环境保护;利用复合生态渔业提高虾池能量转换效率,达到生态效益和经济效益的统一;用模拟试验研究,为评价和完善对虾养殖管理对策提供根据。     

Founder mutations in Tunisia: implications for diagnosis in North Africa and Middle East

ABSTRACT: Background Tunisia is a North African country of 10 million inhabitants. The native background population is Berber. However, throughout its history, Tunisia has been the site of invasions and migratory waves of allogenic populations and ethnic groups such as Phoenicians, Romans, Vandals, Arabs, Ottomans and French. Like neighbouring and Middle Eastern countries, the Tunisian population shows a relatively high rate of consanguinity and endogamy that favor expression of recessive genetic disorders at relatively high rates. Many factors could contribute to the recurrence of monogenic morbid trait expression. Among them, founder mutations that arise in one ancestral individual and diffuse through generations in isolated communities. Method We report here on founder mutations in the Tunisian population by a systematic review of all available data from PubMed, other sources of the scientific literature as well as unpublished data from our research laboratory. Results We identified two different classes of founder mutations. The first includes founder mutations so far reported only among Tunisians that are responsible for 30 genetic diseases. The second group represents founder haplotypes described in 51 inherited conditions that occur among Tunisians and are also shared with other North African and Middle Eastern countries. Several heavily disabilitating diseases are caused by recessive founder mutations. They include, among others, neuromuscular diseases such as congenital muscular dystrophy and spastic paraglegia and also severe genodermatoses such as dystrophic epidermolysis bullosa and xeroderma pigmentosa. Conclusion This report provides informations on founder mutations for 73 genetic diseases either specific to Tunisians or shared by other populations. Taking into account the relatively high number and frequency of genetic diseases in the region and the limited resources, screening for these founder mutations should provide a rapid and cost effective tool for molecular diagnosis. Indeed, our report should help designing appropriate measures for carrier screening, better evaluation of diseases burden and setting up of preventive measures at the regional level.     

Public health measures and mortality in U.S. cities in the late nineteenth century

In this paper we examine the decline in mortality rates by cause of death in U.S. cities during the last decade of the. 19th century. Causes of death are grouped according to their probable relationship to specific public health measures. The reduction which occurred in the death rates from some diseases, e.g., typhoid and diarrheal diseases, can probably be attributed in part to the provision of sewers and waterworks. Large declines also occurred in the death rates from tuberculosis and diphtheria, but the relationship between the declines in these diseases and public health practices designed to combat them is more ambiguous. We therefore conclude that public health measures had some impact on the decline in mortality, but that these measures do not provide a complete explanation of the mortality decline.The research on which this paper is based was supported by NICHD Grant 1-R01-HD-05427. A version of this article was presented at the meetings of the American Sociological Association, New York, August 30–September 3, 1976.     

Current directions of studies for development of methods for specific diagnostics of allergic diseases in vitro

Results of studies as well as perspectives for development and use of modern in vitro methods of allergic diseases diagnostics are presented. High prevalence of allergic diseases dictates the need of high-quality etiologic diagnosis for conducting relevant etiopathogenetic treatment - allergen-specific immunotherapy and prophylactic measures. Interest to in vitro diagnostic methods due to their high specificity and commonality is rising. They are directed to identification of various elements of "material substrate" of allergic reaction - specific antibodies, cell elements, cytokines as well as genes, which encode them. Intensively developing methods based on immunoenzyme, immunofluorescent, and immunochemiluminescent reactions are widely used now. Methods based on the use of various monoclonal antibodies for identification of lymphocytic markers, cytokines, antigen-presenting cells by laser flowcytometry are also very promising. ELISPOT technology is also intensively used for diagnostics of allergic diseases. From immunogenetic methods great potential belongs to molecular biologic methods of assessment of genome specificity characterizing sensitization to given antigen.     

Corruption of the Intra-Gene DNA Methylation Architecture Is a Hallmark of Cancer

Epigenetic processes - including DNA methylation - are increasingly seen as having a fundamental role in chronic diseases like cancer. It is well known that methylation levels at particular genes or loci differ between normal and diseased tissue. Here we investigate whether the intra-gene methylation architecture is corrupted in cancer and whether the variability of levels of methylation of individual CpGs within a defined gene is able to discriminate cancerous from normal tissue, and is associated with heterogeneous tumour phenotype, as defined by gene expression. We analysed 270985 CpGs annotated to 18272 genes, in 3284 cancerous and 681 normal samples, corresponding to 14 different cancer types. In doing so, we found novel differences in intra-gene methylation pattern across phenotypes, particularly in those genes which are crucial for stem cell biology; our measures of intra-gene methylation architecture are a better determinant of phenotype than measures based on mean methylation level alone (K-S test in all 14 diseases tested). These per-gene methylation measures also represent a considerable reduction in complexity, compared to conventional per-CpG beta-values. Our findings strongly support the view that intra-gene methylation architecture has great clinical potential for the development of DNA-based cancer biomarkers.