Objective:To explore the relationship between arrhythmogenic right ventricular cardiomyopathy (ARVC) desmosomal protein gene mutations and Yunnan unexplained sudden death (hereinafter referred to as Yunnan sudden death) by detecting 5 common ARVC desmosomal protein gene mutations of Yunnan sudden death cases and their relatives in Heqing County, Yunnan Province.Methods:In January 2021, the autopsy heart cavity blood was collected from Yunnan sudden death cases in 8 villages in Heqing County, and peripheral venous blood samples of relatives of the cases were collected. Blood samples' DNA was extracted, after PCR amplification, 97 exons of 5 desmosomal protein genes [desmoplakin (DSP), desmoglein-2 (DSG2), plakophilin-2 (PKP2), junction plakoglobin (JUP) and desmocollin-2 (DSC2)] were sequenced by Sanger method to analyze gene mutations.Results:Three blood samples of Yunnan sudden death cases and 36 blood samples of relatives were collected. A total of 26 gene mutation sites were detected in 39 blood samples, with a total mutation rate of 26.80% (26/97). There were 13, 5, 3, 3 and 2 mutation sites in DSP, DSG2, PKP2, JUP and DSC2 genes, respectively. Among them, 19 were reported mutations and 7 were new mutations: DSP gene exon 3 c.372G>A, exon 15 c.2090A>G, exon 17 c.2371C>A, exon 24-I c.8458T>G; DSG2 gene exon 8 c.861C>T; PKP2 gene exon 3 c.892C>A, exon 8 c.1725G>T. Three Yunnan sudden death cases and 36 relatives were all carriers of compound gene mutation, and the same person carried 3 - 9 gene mutation sites at the same time.Conclusion:Mutations of ARVC desmosomal protein genes DSP, DSG2, PKP2, JUP and DSC2 exist in Yunnan sudden death cases and their relatives, which may be the genetic background factors of some Yunnan sudden death.

目的 了解云南省大理州鹤庆县肺结核的流行现状及空间分布特征,为结核病防治工作的开展提供依据.方法 从"传染病疫情信息网络直报系统"导出2005—2018年鹤庆县肺结核病例的相关数据,对数据进行整理及描述性流行病学分析,用MapInfo 12.0软件制作病例分布地图,用GeoDa 1.4.6软件进行空间自相关分析.结果 2005—2018年鹤庆县累计报告肺结核病例1777例,年平均报告发病率为50.19/10万,年平均报告死亡率为1.41/10万.年龄分布主要集中在25～64岁组,性别以男性为主,职业构成以农民为主.肺结核报告发病率呈现先缓慢上升后下降的趋势,9个乡镇历年均有病例报告,且病例空间分布存在聚集性,病例热点区域主要集中在鹤庆县中部的松桂镇、 六合乡和龙开口镇.结论 鹤庆县近3年来肺结核报告发病率均有所下降,但松桂镇、 龙开口镇和六合乡等几个乡镇仍为病例聚集的热点区域.今后应加大对热点区域的防治力度,合理配置卫生资源,从而全面控制鹤庆县的肺结核疫情.

目的 了解鹤庆县(1999～2018)年HIV/AIDS人群特点及空间分布特征,为今后艾滋病预防控制工作提供理论依据.方法 从艾滋病综合防治信息系统中导出鹤庆县(1999～2018)年HIV/AIDS相关数据,用Microsoft Excel 2010软件对数据进行整理、分析,并用MapInf0 12.0软件进行地图的制作.结果 鹤庆县(1999～2018)年间,共报告368例HIV/AIDS病例,HIV感染者235例,AIDS患者133例,死亡62例.自2006年起,历年新报告HIV/AIDS病例数呈总体上升趋势,传播途径由注射吸毒逐渐转变为异性传播.不同时期和不同感染途径下HIV/AIDS病例乡镇分布不同,2006年以前HIV/AIDS病例主要集中在金墩乡和云鹤镇,仅4个乡镇有病例报告;至2011年9个乡镇均出现病例,草海镇和云鹤镇病例数相继超过金墩乡;截至2018年鹤庆县HIWAIDS形成以草海镇、云鹤镇、金墩乡为聚集中心,其余乡镇散在发生的流行趋势.结论 鹤庆县艾滋病疫情呈总体上升趋势,集中在主要城区与城乡结合部,正在向周围的乡镇扩散和蔓延,需要进一步加强各乡镇的艾滋病监测和宣传教育,从而全面控制HIWAIDS的流行.

目的 分析和总结云南省鹤庆县1952-2014年疟疾防治经验和取得成绩,为通过消除疟疾考核评估验收后继续巩固已取得的消除疟疾成果提供科学依据.方法 系统地收集自1952年防疫站成立以来鹤庆县各年度疟疾疫情、不同疟疾发病时期采取的防治策略和措施,分析总结取得的成绩和经验.结果 鹤庆县1952-2014年共发生疟疾病例18 593例,发病率从3 737.05/10万下降至1997年及以后的5/10万以下,1997年起已无本地感染疟疾病例,2010年启动消除疟疾行动计划,于2014年通过评估验收,达到卫生部颁布的消除疟疾标准.结论 鹤庆县在1952-2014年间根据不同疟疾发病阶段特点,采取不同的疟疾防治策略,并落实相应不同阶段的各项疟防措施,实践证明取得了明显防治效果.经过几代疟疾防治人员的不懈努力,现已通过评估验收达到卫生部颁布的消除疟疾标准.

Objective to sum up epidemiological features ,clinical manifestations ,experimental results and pathological characteristics of the accident to provide basis for discussing etiology of the sudden unex-plained death in Yunnan and preventing such death .Methods A field epidemiological survey was conduc-ted and four physical examinations (4 th ,5 th ,6 th and 18 th August ) were arranged for the family and vil-lagers of the departed ,including electrocardiography .Serum was collected from 28 family members and resi-dents ,which was sent to a provincial people's hospital within 12 hours after collection for testing electrolyte , liver&kidney functions ,glucose ,blood lipid ,myocardial enzyme ,troponin ,myoglobin and C-reactive pro-tein ,etc .Materials were collected from cases meeting the corresponding conditions by corpse dissection .Epi-demiological materials of cases suffering from the same disease and all materials produced during hospitaliza-tion were gathered for meticulous ,objective and systematic analysis .Results this accident happened in a season (August ) with a high incidence of sudden unexplained death in Yunnan . Four out of seven family members suddenly died within 20 hours and there presented a phenomenon of familial aggregation .All sudden deaths were young peasants ,among whom there were more females than males (3/1) .They neither had spe-cial clinical manifestations nor felt sick before death ,who died merely several minutes after the onset of ill-ness and whose families had no special dietary histories within 1 month before death .After examining the health of family members and villagers ,42 cases felt faint ,suffered from chest tightness and fatigue ,all of whom were treated .There exhibited significant changes in four electrocardiogram results .The change rate was the highest on the 2nd day (77 .27% ) ,followed by the 1st day (69 .75% ) ,3rd day (58 .82% ) and the 15th day (35 .71% ) .The greatest changes occurred to ST-T (abnormality) ,Q-T interval (prolonged) and frequent premature ventricular contractions ,etc .Regarding the results of serum ,the myocardial enzyme five of one of the bereaved slightly increased ,and the myocardial enzyme three and alkaline phosphatase of anoth-er member of the bereaved both slightly increased .In terms of pathological diseases ,3 cases suffered from lymphocytic myocarditis and 2 cases were diagnosed with acute pulmonary edema .Meanwhile ,1 case's lumens were narrow due to fibrous centric wall thickening of intima of atrioventricular node .Besides ,focal infiltra-tion was discovered on one case's lymphatic cells of liver and kidney ,while one case's foramen oval was un-closed ,with congestion in liver ,kidney and lung .Toxicants were tested negative .Cases suffering from the same diseases accidentally fainted on the ground in providing help in the family of the departed on the after-noon of 5th August ,who were sent into the county hospital for treatment at 21∶40 .Their vital signs were stable and they were discharged from hospital on 13th August .Conclusion there were no apparent clinical manifestations for these cases of sudden deaths before their death ,so known intoxication and specific causes may be excluded .As indicated by survey results ,this event conforms to the diagnostic criterion for sudden un-explained deaths in Yunnan and shall be handled and reported as sudden unexplained death in this area .

规范疾病预防控制中心实验室建设与质量控制管理是加强疾病预防控制体系建设,提高公共卫生体系应急处置能力的重要组成部分.特别是进几年来,中央和各级政府投入了大量资金用于各级疾病预防控制机构实验室的装备,改善了基础设施建设.对如何管好、用好这些设备,发挥好其效益,以及对实验室的科学化、规范化管理提出了要求.

云南不明原因心源性猝死曾用名有:病毒性心肌炎、云南暴发性病毒性心肌炎、云南地方性猝死、云南地方性暴发性心肌炎.