天津武清区龙济男科医(尿道炎是怎么引起的武清龙济医院) (今日更新中)

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A pinch in the leg, a squeal and a trickle of tears. One baby after another in Malawi is getting the first and only vaccine against malaria, one of history’s deadliest and most stubborn of diseases.The southern African nation is rolling out the shots in an unusual pilot program along with Kenya and Ghana. Unlike established vaccines that offer near-complete protection, this new one is only about 40% effective. But experts say it’s worth a try as progress against malaria stalls: Resistance to treatment is growing and the global drop in cases has leveled off. With the vaccine, the hope is to help small children through the most dangerous period of their lives. Spread by mosquito bites, malaria kills more than 400,000 people every year, two-thirds of them under 5 and most in Africa.Seven-month-old Charity Nangware received a shot on a rainy December day at a health clinic in the town of Migowi. She watched curiously as the needle slid into her thigh, then twisted up her face with a howl.“I’m very excited about this,” said her mother, Esther Gonjani, who herself gets malaria’s aches, chills and fever at least once a year and loses a week of field work when one of her children is ill. “They explained it wasn’t perfect, but I feel secure it will relieve the pain.”There is little escaping malaria -- “malungo” in the local Chichewa language -- especially during the five-month rainy season. Stagnant puddles, where mosquitoes breed, surround the homes of brick and thatch and line the dirt roads through tea plantations or fields of maize and sugar cane. In the village of Tomali, the nearest health clinic is a two-hour bike ride away. The longer it takes to get care, the more dangerous malaria can be. Teams from the clinic offer basic medical care during visits once or twice a month, bringing the malaria shot and other vaccines in portable coolers. Treating malaria takes up a good portion of their time during the rainy season, according to Daisy Chikonde, a local health worker.“If this vaccine works, it will reduce the burden,” she said.Resident Doriga Ephrem proudly said her 5-month-old daughter, Grace, didn’t cry when she got the malaria shot.When she heard about the vaccine, Ephrem said her first thought was “protection is here.” Health workers explained, however, that the vaccine is not meant to replace antimalarial drugs or the insecticide-treated bed net she unfolds every night as the sun sets and mosquitoes rise from the shadows. “We even take our evening meals inside the net to avoid mosquitoes,” she said.It took three decades of research to develop the new vaccine, which works against the most common and deadly of the five parasite species that cause malaria. The parasite’s complex life cycle is a huge challenge. It changes forms in different stages of infection and is far harder to target than germs.“We don’t have any vaccines against parasites in routine use. This is uncharted territory,” said Ashley Birkett, who directs PATH’s Malaria Vaccine Initiative, a nonprofit that helped drugmaker GlaxoSmithKline develop the shot, brand-named Mosquirix. The bite of an infected mosquito sends immature parasites called sporozoites into the bloodstream. If they reach the liver, they’ll mature and multiply before spewing back into the blood to cause malaria’s debilitating symptoms. At that point, treatment requires medicines that kill the parasites.Mosquirix uses a piece of the parasite — a protein found only on sporozoites’ surface — in hopes of blocking the liver stage of infection. When a vaccinated child is bitten, the immune system should recognize the parasite and start making antibodies against it.Scientists also are searching for next-generation alternatives. In the pipeline is an experimental vaccine made of whole malaria parasites dissected from mosquitoes’ salivary glands but weakened so they won’t make people sick. Sanaria Inc. has been testing its vaccine in adults, and is planning a large, late-stage study in Equatorial Guinea’s Bioko Island.And the U.S. National Institutes of Health soon will start initial tests of whether injecting people periodically with lab-made antibodies, rather than depending on the immune system to make them, could offer temporary protection during malaria season. Think of them as “potentially short-term vaccines,” NIH’s Dr. Robert Seder told a recent meeting of the American Society of Tropical Medicine and Hygiene.For now, only babies in parts of Malawi, Kenya and Ghana are eligible for the Mosquirix vaccine. After the vaccine was approved in 2015, the World Health Organization said it first wanted a pilot roll-out to see how well it worked in a few countries — in real-world conditions — before recommending that the vaccine be given more widely across Africa. “Everyone is looking forward to getting it,” said Temwa Mzengeza, who oversees Malawi’s vaccine programs. Those eager for the shots include her husband, whom she had to stop from trying to get them, she said.Mzengeza used to come down with malaria several times a year until she started following her own advice to sleep under a net every night. Unlike many other kinds of infections, people can get malaria repeatedly, building up only a partial immunity.In the pilot program that began last year, 360,000 children in the three countries are meant to be vaccinated annually. The first dose is given at about age 5 months and the final, fourth booster near the child’s second birthday.Experts say it is too early to know how well the vaccine is working. They’re watching for malaria deaths, severe infections and cases of meningitis, something reported during studies but not definitively linked to the vaccine.“To do something completely new for malaria is exciting,” said researcher Don Mathanga, who is leading the evaluation in Malawi. The rainy season has brought new challenges, making some rural roads impassable and complicating efforts to track down children due for a shot. So far in Malawi, the first dose reached about half of the children targeted, about 35,000. That dropped to 26,000 for the second dose and 20,000 for the third. That’s not surprising for a new vaccine, Mzengeza said. “It will pick up with time.”At the health clinic in Migowi in Malawi’s southern highlands, workers see signs of hope. Henry Kadzuwa explains the vaccine to mothers waiting at the clinic. He said there was a drop in malaria cases to 40 in the first five months of the program, compared to 78 in the same period in 2018.Even though he wishes his 3-year-old daughter, Angel, could receive the vaccine, “it’s protecting my community. It also makes my work easier,” Kadzuwa said. The Migowi area has one of the country’s highest rates of malaria, and a worn paper register in the clinic’s laboratory lists scores of cases.At the clinic, Agnes Ngubale said she had malaria several years ago and wants to protect her 6-month-old daughter, Lydia, from the disease.“I want her to be healthy and free,” she said. “I want her to be a doctor.”And she has memorized the time for Lydia’s second dose: “Next month, same date.”___Neergaard reported from Washington.___The Associated Press Health and Science Department receives 7200

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American rapper A$AP Rocky has been charged with assault after a confrontation in Stockholm in June, prosecutors said.The 30-year-old -- whose real name is Rakim Mayers -- has been in custody since July 3, following a confrontation in the Swedish capital on June 30.The rapper's lawyer, Slobodan Jovicic, has maintained he was defending himself after being assaulted and that his client is innocent."We think it was self-defense, but the prosecutor has chosen to go with the injured party's version," Jovicic said, adding that his client is "very disappointed" that the prosecutor has "chosen to go with the other party's version" of events.Swedish public prosecutor Daniel Suneson claims A$AP Rocky and two other men assaulted the victim by kicking and beating him with a whole or part of a glass bottle, according to court documents seen by CNN.All three have been charged for their involvement in the brawl and will remain in custody until the trial, which will begin on Tuesday.Suneson said that he had determined the events constituted a crime "despite claims of self-defense and provocation" after reviewing video material and witness statements."It is worth noting that I have had access to a greater amount of material than that which has previously been available on the internet. In addition to video material, the injured party's statements have been supported by witness statements," Suneson said.The prosecutor is relying on cell phone videos, surveillance video from the Grand Hotel and a burger restaurant, text messages from A$AP Rocky's body guard where he talks about the assault and where they say they've recorded it, texts from the assistant's phone and DNA analysis from a bottle used in the assault.Footage posted by TMZ and others posted by A$AP Rocky of the brawl have been at the heart of the investigation.Video clips shared on Instagram by A$AP Rocky show the rapper and his companions repeatedly ask two men to stop following them. The rapper wrote in a caption that one of the men hit a member of his security "in the face with headphones," and reasserted that he was "innocent."But, in another video posted by TMZ, A$AP Rocky appears to grab one of the men and throw him to the ground. Another angle appeared to show the rapper and members of his entourage kicking and punching the man.Suneson said there were two injured in the assault, but allegations of one were dropped due to insufficient evidence and the prosecution only related to one injured party.Court documents claim that A$AP Rocky forcefully threw the victim to the ground before assaulting him.A counter allegation was also made by the rapper's bodyguard, but that case was closed, Suneson added.A$AP Rocky's case has drawn the attention of recording artists like Justin Bieber, as well as US President Donald Trump, who have called for his release. But authorities in Sweden have said they will not be swayed by international pressure."The Swedish judicial system is completely independent and does not take into consideration outside pressure from politicians or others," a spokesman for the Swedish prosecution authority told CNN on Sunday.And, while Trump has offered to personally vouch for the 30-year-old rapper's bail, the bail system does not exist in Sweden.As Dennis Martinsson, a legal expert in Sweden, told CNN: "If you know the Swedish legal system you know that there is no bail system.""Actually, the Swedish constitution prevents any minister, even the Prime Minister, getting involved, or even saying something about an individual case," he added.The President's involvement in the case came at the request of celebrities and the First Lady -- the latest incident in which star influence has swayed Trump to make certain decisions.Trump on Friday credited Melania Trump with bringing A$AP Rocky's plight to his attention.The President added: "Many members of the African American community have called me -- friends of mine -- and said, 'Could you help?'"Trump also revealed on Twitter that he spoke to Kanye West about the matter. On Thursday, Kim Kardashian West thanked Trump, Secretary of State Mike Pompeo and Trump's son-in-law and senior White House adviser Jared Kushner for their efforts in trying to get A$AP Rocky released.Asked about whether A$AP Rocky had any response to the support offered by President Trump, the rapper's lawyer said: "There has been a lot of support from a lot of different people, and Mayers is of course very thankful for everybody that has reached out." 4517

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