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[Rotavirus infection: epidemiology, pathology, vaccination]. [轮状病毒感染:流行病学、病理学、疫苗接种]。
Q3 Medicine Pub Date : 2015-01-01 DOI: 10.15690/vramn.v70i1.1231
N A Mayanskiy, A N Mayanskiy, T V Kulichenko

Diarrheal infections remain the major cause of morbidity and mortality among children under 5 years of age. The rotavirus holds the leading position among principal diarrheal pathogens that include also norovirus, enteropathogenic and enterotoxigenic Escherichia coli. Rotaviruses are transmitted by the fecal-oral route and are extremely contagious and stable in the environment. This facilitates viral transmission, particularly in daycare centers and hospitals. Rotavirus infection causes acute gastroenteritis with diarrhea and dehydration of various degrees resulting primarily from destruction of intestinal villus enterocytes with subsequent impairment of the ion transport and absorption. The incidence of rotavirus infection peaks during the winter and spring in countries with temperate climate. Many children have asymptomatic infection that supports rotavirus circulation in the popula- tion. Several vaccines have been developed for specific prophylaxis of rotavirus infections and demonstrated protection from severe acute rotavirus gastroenteritis and all-cause diarrheal mortality.

腹泻感染仍然是5岁以下儿童发病和死亡的主要原因。轮状病毒在包括诺如病毒、肠致病性和产肠毒素大肠杆菌在内的主要腹泻病原体中处于领先地位。轮状病毒通过粪口途径传播,具有极强的传染性,在环境中很稳定。这促进了病毒的传播,特别是在日托中心和医院。轮状病毒感染引起急性胃肠炎,并伴有腹泻和不同程度的脱水,主要是由于肠绒毛肠细胞被破坏,随后离子运输和吸收受损。在气候温和的国家,轮状病毒感染的发病率在冬季和春季达到高峰。许多儿童无症状感染,支持轮状病毒在人群中传播。针对轮状病毒感染的特殊预防已经开发了几种疫苗,并证明可预防严重急性轮状病毒胃肠炎和全因腹泻死亡。
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引用次数: 9
[Topical issues of food allergy diagnosis in pediatric practice]. [儿科实践中食物过敏诊断的热点问题]。
Q3 Medicine Pub Date : 2015-01-01 DOI: 10.15690/vramn.v70i1.1230
S G Makarova, L S Namazova-Baranova, E A Vishneva, A K Gevorkyan, A A Alekseeva, M I Petrovskaya

Food allergy (FA) in children, especially in infancy, is still a significant public health problem. The severity and prognosis of disease progression associated with FA considerably depends on the correct and early diagnostics of this pathology, as well as on the following management of a child. At the same time delayed elimination diet administration, unreasonable or overlong dietary intervention might have become abuse management of a patient and have a negative impact on the development of a child and reduce the quality of life. The article summarizes the current practical approaches to the diagnosis of FA based on evidence-based medicine and adopted European and Russian national consensus documents, as well as on our own experience of management of patients with this pathology. FA diagnosis in a child usually includes clinical laboratory tests and clarification of clinical and anamnestic data. Unfortunately, it is a fact that preference is given to laboratory methods for diagnosis based on specific IgE determination or skin samples. However, the basis for cause-significant allergen identifying is detecting detailed medical history and clinical picture of a disease which still appears to be the most reliable tool for FA diagnosis.

儿童食物过敏(FA),特别是在婴儿期,仍然是一个重大的公共卫生问题。与FA相关的疾病进展的严重程度和预后在很大程度上取决于对这种病理的正确和早期诊断,以及对儿童的后续处理。同时,延迟消除饮食管理,不合理或过长的饮食干预可能成为对患者的虐待管理,对儿童的发育产生负面影响,降低生活质量。本文总结了目前基于循证医学和采用欧洲和俄罗斯国家共识文件的FA诊断的实际方法,以及我们自己对这种病理患者的管理经验。儿童FA的诊断通常包括临床实验室检查和澄清临床和记忆资料。不幸的是,在基于特定IgE测定或皮肤样本的诊断中,人们更倾向于使用实验室方法。然而,鉴别致敏原的基础是检测疾病的详细病史和临床表现,这仍然是诊断FA最可靠的工具。
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引用次数: 9
[Role of Bradikynin in the Mechanism of Ischemic Preconditioning of the Heart. Prospects of Bradykinin Application in Cardiosurgical Praxis]. Bradikynin在心脏缺血预处理机制中的作用。缓激肽在心外科实践中的应用前景[j]。
Q3 Medicine Pub Date : 2015-01-01 DOI: 10.15690/vramn.v70i2.1312
L N Maslov, N V Naryzhnaia, Iu K Podoksenov, A S Gorbunov, Y Zhang, J-M Pei

Bradykinin level is increased in myocardium in response to short-term ischemia/reperfusion that is one of the evidences of its trigger role in ischemic preconditioning (IP). Pharmacological induced increase of endogenous bradykinin and kallidin-like peptide levels in myocardium enhances cardiac tolerance to impact of ischemia/reperfusion. Experiments with genetically modified mice indicate that kinins are involved in preconditioning but they are not the only trigger of IP. The B2-receptor blocking abolishes antiarrhythmic, infarct reducing effects ofpreconditioning, eliminates IP-induced cardiac tolerance to oxidative stress. Exogenous bradykinin mimics inotropic and cardioprotective effects of IP but does not mimic antiarrhythmic effect of preconditioning. The intracoronary or intravenous bradykinin infusion enhances human heart resistance to ischemia/reperfusion. Implementation of the cardioprotective effect of IP is provided by the activation of multiple signaling pathways that involve: B2-receptor, calcitonin gene-related peptide, NO-synthase, guanylyl cyclase, cGMP, protein kinase G, mitochondrial KATP channels, reactive oxygen species, kinases C, ERK andAkt. To increase of the human heart tolerance to ischemia/reperfusion is necessary to develop B2-receptor agonists devoid hypotensive and pro-inflammatory properties.

缓激肽水平在心肌中响应短期缺血/再灌注而升高,这是其在缺血预处理(IP)中触发作用的证据之一。药物诱导心肌内源性缓激肽和kallidin样肽水平升高,增强心脏对缺血/再灌注影响的耐受性。对转基因小鼠的实验表明,激肽蛋白参与了预处理,但它们不是IP的唯一触发因素。b2受体阻断可消除预处理的抗心律失常、减少梗死的作用,消除ip诱导的心脏对氧化应激的耐受性。外源性缓激素模拟IP的肌力和心脏保护作用,但不模拟预处理的抗心律失常作用。冠状动脉内或静脉输注缓激肽可增强人心脏对缺血/再灌注的抵抗力。IP的心脏保护作用是通过激活多种信号通路来实现的,这些信号通路包括:b2受体、降钙素基因相关肽、no合成酶、guanyyl环化酶、cGMP、蛋白激酶G、线粒体KATP通道、活性氧、激酶C、ERK和akt。为了提高人类心脏对缺血/再灌注的耐受性,有必要开发不具有降压和促炎特性的b2受体激动剂。
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引用次数: 2
[Current Concepts of Human Microsporidiosis]. [当前人类微孢子虫病的概念]。
Q3 Medicine Pub Date : 2015-01-01 DOI: 10.15690/vramn.v70i2.1321
S A Timofeev

Microsporidiosis is an ubiquitous opportunistic disease that usually appears in immunocompromised patients: AIDS patients or organ-transplant recipients. The infectious agents of disease are fungi-related obligate intracellular parasites - microsporidia. Alongside with Cryptosporidium and Cytomegalovirus, these parasites are the most common causative agents of diarrhea in HIV-infected patients. Intestinalform of microsporidiosis has been mostfrequently observed, but microsporidia can affect almost any organs of the human body, eyes, lungs, muscles, organs of the nervous system. The present paper overviews the current data on the etiology, pathogenesis, epidemiology, clinical presentation, diagnosis and treatment methods of microsporidiosis.

微孢子虫病是一种普遍存在的机会性疾病,通常出现在免疫功能低下的患者:艾滋病患者或器官移植受者。疾病的传染媒介是真菌相关的专性细胞内寄生虫-微孢子虫。与隐孢子虫和巨细胞病毒一起,这些寄生虫是hiv感染患者腹泻的最常见病原体。微孢子虫病的肠道形式是最常见的,但微孢子虫几乎可以影响人体的任何器官,眼睛,肺,肌肉,神经系统的器官。本文就微孢子虫病的病因、发病机制、流行病学、临床表现、诊断和治疗方法等方面的研究进展作一综述。
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引用次数: 1
[L.A. Iakovleva]. (洛杉矶Iakovleva]。
Q3 Medicine Pub Date : 2015-01-01
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引用次数: 0
[Transpalpebral Tetrapolar Reoophtalmography in the Assessment of Parameters of the Eye Blood Circulatory System]. [经睑四极眼成像在评估眼部血液循环系统参数中的应用]。
Q3 Medicine Pub Date : 2015-01-01 DOI: 10.15690/vramn.v70i3.1336
P V Luzhnov, D M Shamaev, E N Iomdina, E P Tarutta, G A Markosyan, L A Shamkina, A A Sianosyan

Background: Quantitative assessment of hemodynamic parameters is an important element of ophthalmic diagnostics especially in early detection of myopia, glaucoma, diabetic retinopathy. The assessment of hemodynamic changes is essential in evaluating of the efficiency of treatment. Objective: Our aim was to determine the adequate of eye hemodynamics assessment using reoophtalmography in patients with various clinical refractions.

Methods: A controlled study was carried out. All tests were performed using transpalpebral tetrapolar method. Signal registration lasted for 20 seconds in the supine position, and then the diagnostic parameters were calculated.

Results: We present the results of examination of 76 patients aged 5 to 22 years (average age 13.0 ± 1.1). 32 patients had low myopia (62 reoophtalmography records), 23 patients had moderate myopia (42 records) and 5 patients had high myopia (12 records). The control group was composed of 16 patients. The main differences were found in the rheographic index, which is equal to 58.1 ± 4.1 mOhm in the control group. It is significantly reducing with refraction increase, from 47.8 ± 3.2 mOhm in low myopia to 34.0 ± 2.5 mOhm in high myopia (p = 0.050). This is an evidence of blood supply deficiency in the myopic eyes.

Conclusion: Rheographic index was shown to differ in different breathing phases, which agrees with the known physiological regularities. The proposed method is highly informative and sufficiently accurate what allows assessing the eye blood supply state objectively. It is easy to apply and requires no contact with the eye surface, which is especially important in pediatric practice.

背景:血液动力学参数的定量评估是眼科诊断的重要内容,特别是在早期发现近视、青光眼、糖尿病视网膜病变方面。血流动力学变化的评估是评价治疗效果的必要条件。目的:探讨各种临床屈光患者的眼血流动力学评估是否足够。方法:采用对照研究。所有试验均采用经椎体四极法进行。仰卧位信号配准持续20秒,然后计算诊断参数。结果:我们报告了76例5 ~ 22岁(平均年龄13.0±1.1岁)患者的检查结果。低度近视32例(62例),中度近视23例(42例),高度近视5例(12例)。对照组16例。差异主要表现在流变指数上,对照组流变指数为58.1±4.1 mOhm。屈光度随屈光度的增加而显著降低,由低近视眼的47.8±3.2 mOhm降至高度近视眼的34.0±2.5 mOhm (p = 0.050)。这是近视眼血液供应不足的证据。结论:不同呼吸期流变学指标存在差异,符合已知的生理规律。所提出的方法信息量大,准确度高,能够客观地评估眼部血液供应状态。它易于使用,不需要与眼表面接触,这在儿科实践中尤为重要。
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引用次数: 22
[The Prevalence of Metallo-β-Lactamases and Efflux-Mediated Mechanisms in Carbapenem Nonsusceptible Nosocomial Pseudomonas aeruginosa Isolated in Moscow in 2012-2015]. 2012-2015年莫斯科地区碳青霉烯类非敏感医院内铜绿假单胞菌金属β-内酰胺酶的流行及外排介导机制
Q3 Medicine Pub Date : 2015-01-01

Background: Pseudomonas aeruginosa, the major nosocomial opportunistic pathogen, is an important cause of infectious morbidity and mortality among immunocompromised patients.

Objective: To establish the role of metallo-β-lactamases (MBL) and efflux-mediated mechanisms in confer- ring carbapenem resistance in nosocomial isolates of P. aeruginosa.

Methods: We analyzed carbapenem nonsusceptible nosocomial P. aeruginosa isolates obtained from pediatric and adult patients at three hospitals in Moscow in 2012-2015. Carbapenem susceptibility was assessed using the E-test. In addition, minimal inhibitory concentrations (MICs) of meropenem were tested by the broth microdilution method. The presence of MBL was determined using the ED TA-mediated suppression test. Efflux-dependent resistance was measured using an assay based on MIC modification by an ionophore carbonyl cyanide 3-chlorophenyl hydrazine (CCCP).

Results: A total of 54 carbapenem nonsusceptible P. aeruginosa isolates was examined. The presence of an MBL was detected in 37 (69%) isolates, 29 (54%) isolates had efflux-mediated resistance. In 10 (19%) isolates neither MBL nor efflux activity was found. Five out of 6 isolates (83%) with highly active efflux were MBL-positive. Among isolates with low efflux activity, 74% (17/23) possessed MBL, whereas in isolates with no efflux the rate of MBL-positivity was 60% (15/25).

Conclusion: The prevalence of MBL- and efflux-mediated carbapenem resistance in nosocomial P. aeruginosa is high. Moreover, our results reveal that several resistance mechanisms may combine at the isolate level. These data may contribute to the development of novel strategies in combating carbapenem resistance.

背景:铜绿假单胞菌是主要的院内条件致病菌,是免疫功能低下患者感染性发病和死亡的重要原因。目的:探讨金属β-内酰胺酶(MBL)在铜绿假单胞菌(P. aeruginosa)院内分离株对碳青霉烯耐药中的作用及其外排介导的机制。方法:对2012-2015年从莫斯科3家医院的儿童和成人患者中分离的碳青霉烯类不敏感铜绿假单胞菌进行分析。采用E-test评价碳青霉烯类药物的敏感性。此外,采用肉汤微量稀释法测定美罗培南的最低抑菌浓度(mic)。使用ED ta介导的抑制试验来确定MBL的存在。采用离子载体羰基氰化物3-氯苯基肼(CCCP)修饰的MIC法测定外排依赖性耐药性。结果:共检出54株碳青霉烯不敏感铜绿假单胞菌。在37株(69%)分离株中检测到MBL的存在,29株(54%)分离株具有外排介导的耐药性。在10株(19%)分离株中,既没有发现MBL,也没有发现外排活性。6株高活性外排株中有5株(83%)为mbl阳性。在外排活性低的分离株中,74%(17/23)具有MBL,而在无外排的分离株中,MBL阳性率为60%(15/25)。结论:院内铜绿假单胞菌中MBL和外排介导的碳青霉烯类耐药发生率较高。此外,我们的研究结果表明,几种抗性机制可能在分离水平结合在一起。这些数据可能有助于开发抗碳青霉烯耐药的新策略。
{"title":"[The Prevalence of Metallo-β-Lactamases and Efflux-Mediated Mechanisms in Carbapenem Nonsusceptible Nosocomial Pseudomonas aeruginosa Isolated in Moscow in 2012-2015].","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pseudomonas aeruginosa, the major nosocomial opportunistic pathogen, is an important cause of infectious morbidity and mortality among immunocompromised patients.</p><p><strong>Objective: </strong>To establish the role of metallo-β-lactamases (MBL) and efflux-mediated mechanisms in confer- ring carbapenem resistance in nosocomial isolates of P. aeruginosa.</p><p><strong>Methods: </strong>We analyzed carbapenem nonsusceptible nosocomial P. aeruginosa isolates obtained from pediatric and adult patients at three hospitals in Moscow in 2012-2015. Carbapenem susceptibility was assessed using the E-test. In addition, minimal inhibitory concentrations (MICs) of meropenem were tested by the broth microdilution method. The presence of MBL was determined using the ED TA-mediated suppression test. Efflux-dependent resistance was measured using an assay based on MIC modification by an ionophore carbonyl cyanide 3-chlorophenyl hydrazine (CCCP).</p><p><strong>Results: </strong>A total of 54 carbapenem nonsusceptible P. aeruginosa isolates was examined. The presence of an MBL was detected in 37 (69%) isolates, 29 (54%) isolates had efflux-mediated resistance. In 10 (19%) isolates neither MBL nor efflux activity was found. Five out of 6 isolates (83%) with highly active efflux were MBL-positive. Among isolates with low efflux activity, 74% (17/23) possessed MBL, whereas in isolates with no efflux the rate of MBL-positivity was 60% (15/25).</p><p><strong>Conclusion: </strong>The prevalence of MBL- and efflux-mediated carbapenem resistance in nosocomial P. aeruginosa is high. Moreover, our results reveal that several resistance mechanisms may combine at the isolate level. These data may contribute to the development of novel strategies in combating carbapenem resistance.</p>","PeriodicalId":39355,"journal":{"name":"Vestnik Rossiiskoi Akademii Meditsinskikh Nauk","volume":" 6","pages":"679-83"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34414801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Kidney Injury in Newborns with Abdominal Compartment Syndrome]. [新生儿腹膜间室综合征肾损伤]。
Q3 Medicine Pub Date : 2015-01-01 DOI: 10.15690/vramn482
D A Morozov, O L Morozova, A A Tsyplakov, Yu A Melnikova

The review represents the problems of a damage to the vital organs in newborns with the Abdominal Compartment Syndrome (ACS). Particular attention is paid to the key predisposing factors and key links of the renal damage's pathogenesis in newborns with ACS. This review presents the latest data about the role of the hypoxia at the initiation of damage of the renal parenchyma, the prospectsfor the use of various molecular markers for early diagnostics of nephropathy. Creation of molecular cell test system for the diagnostics and monitoring of renal damage in newborns with ACS is a promising trend in the treatment and prevention nephropathy in newborns.

本文综述了新生儿腹膜隔室综合征(ACS)的重要器官损害问题。重点探讨ACS新生儿肾损害发病的关键易感因素和关键环节。本文综述了关于缺氧在肾实质损害起始中的作用的最新数据,以及各种分子标记在肾病早期诊断中的应用前景。建立分子细胞检测系统诊断和监测ACS新生儿肾损害是治疗和预防新生儿肾病的一个有希望的趋势。
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引用次数: 1
[The Destruction of Pharmaceutical Products as an Element of the Efficiency of State Control (Supervision) Over the Circulation of Medicines]. 【药品销毁作为国家对药品流通控制(监督)效率的一个要素】。
Q3 Medicine Pub Date : 2015-01-01 DOI: 10.15690/vramn585
F N Bidarova

Background: The modern system of state quality control over medicine makes it possible to reveal and withdraw drugs, that do not meet the requirements. However the problem of the turnover of substandard andfake drug and their destruction in the Russian Federation is still urgent.

The aim of the study: to evaluate the effectiveness of state quality control over medicine and the practice offake medicine destruction.

Methods: data of the official websites of the Ministry of Health of the Russian Federation and the Republic of North Ossetia--Alania, Russian Sanitary Inspection, National Center of Quality control and Certification of Drugs were included in the investigation. Method of unrepeated samples was used in sociological investigations. 225 questionnaires have been worked out. The research was carried out in the North-Ossetian State Medical academy during the periodfrom 2013 to 2015 with the help of the National Center of Quality Control and Certification of Drugs.

Results: The shortcomings of the state quality control over the rules of fake drug destruction were studied. It was found out that the mechanism ofpermanent data collection monitoring of revealing, moving and destruction of substandard and fake drug destruction has not been determined. The ineffectiveness of controlling measures under the condition of critical legal base deficiency has been confirmed. The analysis of terminology characterizing the order of fake drug destruction was carried out.

Conclusion: deficiencies related to the implementation of the state quality control over the fake drug destruction rules revealed during the course of investigations prove the necessity of adopting measures in creating new model of controlfunctions, increasing the results of activity.

背景:现代国家药品质量管理体系使不符合要求的药品的发现和撤销成为可能。然而,在俄罗斯联邦,伪劣药品的周转和销毁问题仍然十分紧迫。本研究的目的是评价国家药品质量管理的有效性和假药销毁的做法。方法:调查数据包括俄罗斯联邦和北奥塞梯-阿拉尼亚共和国卫生部、俄罗斯卫生检验局、国家药品质量控制和认证中心的官方网站。社会学调查采用非重复抽样法。共编制问卷225份。该研究于2013年至2015年在国家药品质量控制与认证中心的帮助下在北奥塞梯国立医学院进行。结果:分析了国家质量管理在假药销毁规则方面存在的不足。发现不合格假药销毁披露、转移、销毁的永久数据采集监测机制尚未确定。在法律基础严重不足的情况下,控制措施的有效性已得到证实。对表征假药销毁顺序的术语进行了分析。结论:在调查过程中发现的假药销毁国家质量管理规定执行中存在的不足,说明有必要采取措施,建立新的管理职能模式,提高活动成效。
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引用次数: 0
[Epidemiological Surveillance of Cholera in Russia During the Period of the Seventh Pandemic]. [第七次大流行期间俄罗斯霍乱流行病学监测]。
Q3 Medicine Pub Date : 2015-01-01 DOI: 10.15690/vramn.v70i2.1320
G G Onishhenko, E A Moskvitina, V D Kruglikov, S V Titova, O L Adamenko, A S Vodop'ianov, S O Vodop'ianov

In this work basic stages of formation of the epidemiological surveillance of cholera in Russia are described. In 1990-s for the first time zoning by epidemic manifestations of cholera was carried out at the level of subjects forming parts of Russia and other Republics of the Soviet Union with the introduction of differential tactics of epidemiological surveillance. Improvement of epidemiological surveillance of cholera was aimed at harmonization with the IHR (2005), integration of epidemiological surveillance of cholera and social-hygienic monitoring of water objects of I and II categories. Characterization of isolated Vibrio cholerae strains (1990-2014) on the genomic basis determined the emergence of new VNTR-genotypes of V. cholerae O1 ctxAB+ tcpA+, responsible for outbreaks, simultaneously with isolation of V. cholerae 01 ctxAB-tcpA-strains during monitoring of environmental objectsfor cholera. A viewpoint is considered of the beginning of the eighth cholera pandemic in the context of emergence of V. cholerae El Tor strains with CTXφ prophage carrying ctxB gene of cholera toxin of classical biovar. Main directions offurther enhancement ofepidemiological surveillance include the study of basic data structures used in the epidemiological surveillance system, the use of zoning of municipal units offederal subjects with corresponding surveillance tactics and expected economic effect.

在这项工作的基本阶段形成的流行病学监测霍乱在俄罗斯被描述。1990- 90年代,首次在俄罗斯部分地区和苏联其他共和国进行了霍乱流行表现的分区,采用了不同的流行病学监测策略。改进霍乱流行病学监测的目的是与《国际卫生条例(2005)》保持一致,将霍乱流行病学监测与第一类和第二类水对象的社会卫生监测结合起来。在基因组基础上对分离的霍乱弧菌菌株(1990-2014)进行了鉴定,确定了造成疫情的霍乱弧菌O1 ctxAB+ tcpA+新的vntr基因型的出现,同时在监测霍乱环境目标期间分离出了霍乱弧菌01 ctxAB-tcpA-菌株。在出现携带经典生物变种霍乱毒素CTXφ原噬菌体ctxB基因的霍乱弧菌El - Tor菌株的背景下,考虑了第八次霍乱大流行开始的观点。进一步加强流行病学监测的主要方向包括研究流行病学监测系统中使用的基本数据结构,使用城市单位提供的对象分区和相应的监测策略以及预期的经济效果。
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引用次数: 6
期刊
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk
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