一起蜡样芽孢杆菌弓l起食物中毒的病原学检测

蜡样芽孢杆菌（Bacillus cereus,Bc）是常见的食品污染菌,广泛存在于土壤、水、空气以及动物肠道等处,其能导致两种类型的食物中毒：腹泻型和呕吐型,在我国以呕吐型多见。虽然由蜡样芽孢杆菌引起的食物中毒通常症状较温和而且可自愈,但国内外也有报道因蜡样芽孢杆菌引起食物中毒而致死的案例。     

一起蜡样芽孢杆菌食物中毒的调查报告

目的对1起蜡样芽孢杆菌引起的食物中毒的发生原因进行分析。方法根据流行病学调查、临床症状和实验室检验结果进行判断分析。结果从采集的8份呕吐物标本中检出5份蜡样芽孢杆菌,检出率为63%。在剩余米饭中也检出了蜡样芽孢杆菌。蜡样芽孢杆菌计数为2.8×106 cfu/g。其余均未检出蜡样芽孢杆菌。结论这是1起由蜡样芽孢杆菌污染米饭而引起的食物中毒,提示应加强食品卫生监督工作。     

一起由蜡样芽孢杆菌引起食物中毒的病原学调查

2004年8月25日，沈阳市和平区某职工食堂发生一起食物中毒事件，患者11人，临床表现为恶心、呕吐、腹痛、腹泻轻重不等。结合流行病学调查和实验结果，确认本次食物中毒由蜡样芽孢杆菌引起，现将检测过程及阳性菌株的分离、鉴定结果报告如下：     

一起蜡样芽胞杆菌食物中毒分离株的毒力基因分析研究

目的 对红河州发生的一起蜡样芽孢杆菌食物中毒分离株进行毒力基因分析研究。方法 本次食物中毒从一位病人肛拭子标本和三种剩余食物中分离出4株蜡样芽孢杆菌,利用PCR检测分离株的腹泻型毒力基因:hbl(ACD)、nhe（ABC）、cytK、entFM、bceT 和呕吐型毒力基因:NRPS 。结果 病人（肛拭子）和剩余食物（火腿烩乳饼）分离株均携带有hbl(ACD)、nhe（ABC）、cytK、entFM、bceT 基因;剩余食物（虾）分离株携带有nhe（ABC）、entFM 基因;剩余食品（冰木瓜凉水）分离株携带有hbl(CD)、nhe（ABC）、cytK、entFM、bceT 基因;所有分离株均不携带有呕吐型毒力基因NRPS 。结论 本次食物中毒根据毒力基因检测结果,可以确定为由蜡样芽孢杆菌引起的腹泻型食物中毒。     

一起由蜡样芽孢杆菌引起的食物中毒的病原学检测

目的:快速分离病原菌,追溯其食源性疾病的来源。方法:采集食物中毒者剩余食物、呕吐物、粪便,进行病原学检测,同时采集病人的双份血清进行相应的抗体检测。结果:在1份凉皮、1份呕吐物、2份大便中检出蜡样芽孢杆菌。其中凉皮、呕吐物中蜡样芽孢杆菌菌落总数>106cfu/g,病人双份血清中,蜡样芽孢杆菌抗体有四倍以上的增高。结论:按照WS/T.82-1996诊断标准,这是一起被蜡样芽孢杆菌污染的凉皮引起的食物中毒。     

一起小学蜡样芽孢杆菌食物中毒的调查报告

[目的]通过对一起小学食物中毒流行病学调查探讨流行因素及病原学。[方法]采集大米、米粑粑、酱、乳腐、呕吐物进行实验室细菌学和有机磷农药检测。[结果]81例食用米粑粑中毒患者,临床表现以恶心、头晕、呕吐、腹痛为主;病原学检查为蜡样芽孢杆菌。[结论]蜡样芽孢杆菌在适宜温度下生长繁殖,污染食品,产生毒素,引起食物中毒。     

蜡样芽胞杆菌实验室诊断技术进展

蜡样芽胞杆菌广泛分布于自然界及食品中,并可在其中生长繁殖,引起人类食物中毒.引起的食物中毒有两型,一类由不耐热肠毒素引起的腹泻型,临床表现为腹痛、腹泻和里急后重,与产气荚膜梭菌引起的食物中毒相似;另一类由耐热肠毒素引起的呕吐型,临床表现为恶心、呕吐,似葡萄球菌食物中毒.临床上不容易区别,须通过实验室检测确证,蜡样芽胞杆菌分离培养及鉴定耗时,操作繁琐.近年来出现的新型免疫学方法和聚合酶链反应具有较高的敏感性和特异性,作者将蜡样芽胞杆菌实验室诊断检测技术进展进行综述.     

一起蜡样芽孢杆菌引起的食物中毒的调查报告

目的为预防食物中毒发生，提高突发公共卫生事件应急处理能力。方法对北京某区发生的一起食物中毒全部资料进行统计分析。结果134名病例全部是学生，共同进食某快餐公司配送的营养餐，发病曲线呈典型的对数常态分布；临床表现以腹痛、腹泻为主；在留样食品、加工人员及现场工作台等处检出蜡样芽孢杆菌；可疑餐次为2005年3月217午餐。结论根据病人临床症状、潜伏期、共同进餐史、流行病学资料、现场卫生学调查、实验室检验分析后认定，此事件为一起蜡样芽孢杆菌污染食品引起的蜡样芽孢杆菌食物中毒。     

静海县沿庄镇一起食物中毒的调查

目的 通过对一起食物中毒的流行病学调查和实验室检验探讨流行因素及病原学.方法 按现场流行病学调查方法,结合临床表现和实验室检验鉴定方法.结果 本次食物中毒,中毒食物为炒米饭;临床表现以呕吐为主,占发病人数的70%;病原学检查为蜡样芽孢杆菌,中毒食物中蜡样芽孢杆菌计数为6.O×10 8cfu/g.结论 蜡样芽孢杆菌污染食品,在适宜的温度下生长繁殖,产生毒素,引起食物中毒,应引起人们的关注.     

1起蜡样芽孢杆菌引起的小学生食物中毒流行病学分析

目的 为查明某小学食物中毒发生的原因,为学校今后预防食物中毒提供科学依据. 方法 通过与学校相关负责人座谈和现场访谈了解疫情及学校情况,采取调查问卷的方法掌握学生暴露其发病情况,实验室检测按照《食品卫生微生物学检验标准》进行判定. 结果 本次食物中毒罹患率2.16％,病例以恶心、呕吐、头晕、四肢乏力等症状为主,发病学生共同食用豆浆和包子均检出蜡样芽孢杆菌;1名学生肛试检出蜡样芽孢杆菌. 结论 该事件是食用蜡样芽孢杆菌污染豆浆和包子引起的食物中毒.     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

西林瓶装注射用水的装量检查分析

为了检查西林瓶装注射用水的实际分装量是否符合2005年版《药典》三部要求,按照2005年版《药典》三部中“生物制品分装和冻干规程”,分装规格为0．8ml的西林瓶装注射用水10000瓶,随机在分装过程的前、中、后阶段共抽取100瓶,轧盖、目检。分别用1ml标定注射器及1ml普通无菌注射器抽取每瓶注射用水的实际体积,以t检验法对实际抽取量与标示量的差值进行统计学分析,结果显示其与2005年版《药典》三部要求分装附加量为0．1ml相比有显著性差异（P〈0．001）。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。