甲型H1N1流感患者C反应蛋白及白细胞计数的变化及意义

目的 分析甲型H1N1流感患者C反应蛋白和白细胞计数的变化及临床意义.方法 选取医院的甲型H1N1流感确诊患者95例(观察组),同期入院非甲型H1N1流感患者95例(对照组).检测所有患者的C反应蛋白、白细胞计数、中性粒细胞、中性粒细胞比率及体温的变化.结果 观察组患者的各项检测指标较对照组明显降低,各项检测指标的患者构成比,观察组均低于对照组,其比较差异均有统计学意义(P<0.05).结论 甲型H1N1流感患者的C反应蛋白及白细胞计数,能协助临床判断病情及指导用药,应在临床普及检测.     

2009年秋季北京市3家哨点医院甲型H1N1流感病毒监测结果特征分析

目的回顾分析2009年秋季北京市3家哨点医院甲型H1N1流感监测结果,为科学防控提供指导。方法回顾分析2009年5月8日～12月31日北京市西城区、海淀区、朝阳区3家哨点医院对甲型H1N1流感病毒监测情况,共计2632例流感样病例入选。其中,男性1418例,女性1214例,年龄1～98岁;采用real-time PCR方法对入选病例咽拭子标本进行甲型H1N1病毒核酸检测,同时全血细胞计数仪检测血常规。结果 2632例流感样病例中,甲型H1N1流感病例占流感样调查人群的14.7%。其中,男性H1N1病例占其调查人群的15%,女性H1N1病例占其调查人群的14.3%,二者统计学无显著性差异(P<0.01)。易感人群以7～18岁中小学生为主(占甲型H1N1流感病例的53.4%);5～7月份甲型H1N1流感病例以输入性病例为主(占同期甲型H1N1流感病例的88.5%),9、10月份多起聚集性疫情致本地感染病例达到高峰(占甲型H1N1流感病例的37.2%);甲型H1N1流感病例主要以发热(98%),咳嗽(95%),喉咙痛(81%),流涕(76%)为主要症状就诊,甲型H1N1流感组与病毒检测阴性组比较,H1N1患者白细胞总数与血小板计数明显偏低,差异具有统计学意义。而与非H1N1型甲型流感组比较,血常规各指标无显著性差异(P>0.05)。结论本次甲型H1N1流感的临床表现及血常规检查与普通季节性流感相似,北京地区9、10月份是其最适流行季节,最适温度范围12～23℃,7～18岁中小学生是主要防控对象。     

杭州新型甲型H1N1流感住院病例调查

[目的]研究杭州地区新型甲型H1N1流感的临床表现和流行病学特点。[方法]用统计指标和图表来描述杭州地区104例新型甲型H1N1流感住院病例的临床表现和血液化验数据,比较各年龄组和不同时间段组的新型甲型H1N1流感的临床表现。[结果]在104例病例中20岁及20岁以下的人群占57.7%。20岁及20岁以下与20岁以上的新型甲型H1N1流感病人的病程长短和白细胞计数的差异没有统计学意义(P>0.05),不同时期发病的新型甲型H1N1流感病人的病程长短和白细胞计数的差异没有统计学意义(P>0.05)。[结论]杭州地区的新型甲型H1N1流感青少年、学生较多,65岁以上老年人较少;重症和死亡病人较少,咳嗽是新型甲型H1N1流感的主要症状,各年龄层次新型甲型H1N1流感的临床表现差异不大。     

甲型H1N1流感轻症病例118例临床分析

目的 总结甲型H1N1流感病例临床表现及治疗特点.方法 对顺义区传染病院从7月末开始收治的甲型H1N1流感确诊病例118例的临床资料进行回顾性分析.结果 绝大多数有一过性或间断发热,大多数患者有咽痛、咳嗽症状,血常规检查示近一半患者白细胞(WBC)低于正常,WBC分类示多数患者淋巴细胞百分比(LYM%)高于正常,而中性粒细胞百分比(GRA%)低于正常,多于1/3的患者单核细胞百分比(MON%)高于正常.血生化检查示有4.46%患者肌酸激酶(CK)高于正常,所有患者全部治愈,44.07%患者接受抗生素治疗,26.27%患者接受奥司他韦治疗.结论 甲型H1N1流感符合病毒感染特点,致病性较为温和,但聚集性发病明显,要高度重视,但又不必过度恐慌,要在卫生部甲型H1N1流感诊疗方案的基础上做好防治工作,最大可能减少重症病例发生.     

惠州市2009～2012年甲型H1N1流感流行状况调查

目的 了解惠州市甲型H1N1流感流行状况,为有效防控甲型H1N1流感提供参考依据. 方法 运用描述流行病学方法分析2009～2012年惠州市甲型H1N1流感流行状况;用血清流行病学方法调查惠州市人群甲型H1N1流感病毒的感染水平. 结果 2009 ～ 2012年惠州市流感监测哨点医院的平均ILI就诊百分比(ILI％)为7.88％,共报告甲型H1N1流感279例.采集鼻咽拭子2 230份,甲型H1N1流感核酸检测阳性219份,阳性率为9.82％,阳性率最高的年龄组为15～岁组(24.45％),最低的年龄组为0～岁组(3.43％).三次横断面调查共抽取调查对象480人,甲型H1N1流感病毒抗体阳性人数121人,阳性率为25.21％.三次调查抗体阳性率分别为30.0％,36.25％和9.38％,人群甲型H1N1流感抗体阳性率在年龄、性别及职业间差异有统计学意义(P＜0.05);接种过甲型H1N1流感疫苗和未接种过甲型H1N1流感疫苗之间的抗体阳性率差异有统计学意义(x2=71.76,P＜0.05). 结论 惠州市甲型H1N1流感疫情通过采取综合性措施得到有效防控,今后应定期在人群中开展流感病毒抗体监测,以便了解人群对流感流行株的免疫保护和病毒抗原变化,为防控流感提供重要依据.     

98例甲型H1N1流感患者的临床分析报告

目的观察重症新型甲型H1N1流感患者、危症新型甲型H1N1流感患者、孕产妇新型甲型H1N1流感患者的临床特征。方法将2009年11月～2009年12月确诊的98例新型甲型H1N1流感患者,分为重症新型甲型H1N1流感组、危症新型甲型H1N1流感组以及孕产妇新型甲型H1N1流感组,分别记录各组患者年龄、性别、总住院天数、病毒转阴时间、患者发病时的最高体温、体温恢复正常时间、血常规等项目数据并进行相关比较。结果 3组患者年龄比较差别无统计学意义（P〉0.05）;在总住院天数中,重症新型甲型H1N1流感组较孕产妇新型甲型H1N1流感组比较差别有统计学意义（P〈0.05）;危症新型甲型H1N1流感组较孕产妇新型甲型H1N1流感组比较差别有统计学意义（P〈0.05）;从发病到病毒转阴时间,无论重症新型甲型H1N1流感组、危症新型甲型H1N1流感组、孕产妇新型甲型H1N1流感组中,两两比较,均P〉0.05。在体温下降方面,重症新型甲型H1N1流感组经治疗后体温恢复正常时间较危症新型甲型H1N1流感组、孕产妇新型甲型H1N1流感组有统计学意义（P〈0.05）,而危症新型甲型H1N1流感组较孕产妇新型甲型H1N1流感组差异无统计学意义（P〉0.05）。在血象白细胞方面,重症新型甲型H1N1流感组治疗前后差异有统计学意义（P〈0.05）。结论在病毒转阴时间方面,重症新型甲型H1N1流感组经治疗后体温恢复正常时间较危症新型甲型H1N1流感组、孕产妇新型甲型H1N1流感组均无明显差异。重症新型甲型H1N1流感组在体温下降等方面优于其他各组,孕产妇新型甲型H1N1流感患者应高度重视。     

流感样病例外周血象临床意义探讨

目的通过对流感样病例的外周血象各项指标的分析,探讨外周血象检验对流感样病例的临床诊断价值。方法采用STKS5分类全自动血细胞计数仪,对49例甲型H1N1流感病例、51例季节性流感病例及143例非流感病例外周血象白细胞计数、中性粒细胞百分比分别进行对比观察。结果甲型H1N1流感组、季节性流感组与非流感组白细胞计数结果比较,差异有统计学意义（P〈0．05）;甲型H1N1流感组、季节性流感组与非流感组中性粒细胞百分比结果比较有统计学意义（P〈0．05）。结论流感样病例的外周血象检测可以做为流感样病例的辅助诊断手段。     

甲型H1N1流感35例临床分析

目的 研究我市甲型H1N1流感病例的特点、治疗疗效及临床预后.方法 回顾总结我市2009年9月至2009年12月,经实验窜确诊的35例甲型H1N1流感病例的临床资料进行分析.结果 35例甲型H1N1流感病例中,轻型23例占65.72%、重型10例占28.57%、危重型2例占5.71%.轻型病例白细胞总数偏低或正常,平均4.62x109/L.分类中性粒细胞最低者25.6%,最高者64.5%,平均56.6%.危重型病例白细胞总数增高,平均15.42x109/L、白细胞分类,中性粒细胞均升高,平均86.6%.35例胸部X照片中肺纹理增多且模糊者15例占42.8%、胸腔积液2例占5.71%、肺炎6例占17.1%、皮下气肿并纵隔气肿1例占2.85%.心肌酶谱检查,有异常改变者14例(40%),发生呼吸衰竭及中枢神经系统受者损各1例各占2.85%.使用抗病毒药物,奥司他韦治疗甲型H1N1流感临床效果明确,治疗后,1～3d体温正常,35例患者全部治愈.结论 九江地区甲型H1N1流感病例学生占83%.部分甲型H1N1流感病例可迅速出现呼吸衰竭和中枢神经系统损害;重型、危重型病例及易发展为重症的人群,应早期使用奥司他韦,可明显改善患者的预后.     

长沙市开福区甲型H1N1流感大流行与肺炎发病的相关性

目的分析长沙市开福区甲型H1N1流感大流行期间疫情情况,了解大流行对肺炎的影响,为评估流感大流行影响提供科学依据。方法系统收集大流行期间开福区辖区内甲型H1N1流感病例资料,按月份收集住院患者总数、肺炎病例数、重症肺炎病例数、因重症肺炎死亡数,采用Pearson相关进行甲型H1N1流感与各类肺炎发病与死亡的月份直线相关关系分析。结果流感大流行在开福区历时10个月,流行主要集中在2009年9月～2010年1月的4个月时期内。全球大流行期间,开福区肺炎患者占住院患者的5.59%,重症肺炎病例占肺炎总数的4.49%,重症肺炎病死率为4.21%。甲型H1N1流感与肺炎、重症肺炎、因重症肺炎死亡的相关系数分别为0.536、-0.338、0.505,仅前者存在统计学意义,后两者无统计学意义。开福区大流行期间肺炎百分比高于对照期间的肺炎百分比。结论甲型H1N1流感大流行可能引起肺炎病例增加,但对重症肺炎及其死亡影响不大。     

甲型H1N1流感大流行与肺炎关系分析

目的掌握长沙市甲型H1N1流感大流行期间疫情情况,了解大流行对肺炎的影响,为评估流感大流行影响提供科学依据。方法系统收集大流行期间长沙市辖区内甲型H1N1流感病例资料,按月份收集住院患者总数、肺炎病例数、重症肺炎病例数、因重症肺炎死亡数,采用Pearson相关进行甲型H1N1流感与各类肺炎发病与死亡直线相关关系分析。结果流感大流行在长沙市历时约10个月,流行主要集中在2009年9月-2010年1月,累计发病7 201例,累计发病率为108.41/10万;其中重症和危重病例67例,占总病例数的0.93%;死亡病例9例,病死率为0.12%。大流行期间,长沙市肺炎患者占住院患者的6.81%,重症肺炎病例占肺炎总数的7.36%,重症肺炎病死率为6.57%。甲型H1N1流感与肺炎相关系数为0.768,两者存在相关关系,且大流行期间肺炎百分比高于对照期间的肺炎百分比,可以认为甲型H1N1流感能够引起肺炎增加,但甲型H1N1流感仅能解释肺炎变化的58.98%。甲型H1N1流感与重症肺炎、因重症肺炎死亡的相关系数分别为-0.123和-0.181,无统计学意义。结论甲型H1N1流感大流行能够引起肺炎病例增加,但对重症肺炎发病及其死亡影响不明显。     

甲型H1N1患者循环血白细胞VCS参数分析

目的探讨VCS（Volume Conductivity Scatter）参数在甲型H1N1患者白细胞中的变化及其辅助诊断价值。方法用Beckman Coulter LH750型全自动血液分析仪,分别测定基因扩增法确诊甲型H1N1患者（实验组）和健康人群（对照组）白细胞VCS的参数。结果甲型H1N1患者VCS参数MMV（171.615±9.156）明显高于对照组（157.157±10.026）（P〈0.001）;MLS（62.003±6.916）比对照组（54.263±3.817）明显增加（P〈0.001）;MNS（114.946±1.603）较正常对照组（154.263±3.817）明显减低（P〈0.001）。结论甲型H1N1患者白细胞VCS参数改变不同于健康人群,对早期诊断有一定参考价值。     

Influenza A (H1N1) pneumonia: an analysis of 63 cases by chest CT

Background  In early April 2009, cases of human infection with 2009 pandemic influenza A (H1N1) virus were identified in Mexico. The virus then spread rapidly to other regions of the world. From October 2009, sporadic imported cases of novel influenza A (H1N1) were continuously confirmed in Suzhou. The aim of the study was to review the chest CT findings in 63 patients with laboratory-confirmed novel swine-origin influenza A (H1N1) virus (S-OIV) infection.

Methods  Chest CT examinations were collected from 63 S-OIV infected patients during their hospital stay. Three experienced radiologists inspected images to qualitatively and quantitatively characterize S-OIV induced image changes. CT scores of lesion severity were calculated based on the percentage of affected area to determine severity of infectious lesions. Patients were divided into two groups based on the leukocyte counts. Lesion patterns, local distributions, and quantitative measures were investigated and compared between the two groups.

Results  Various degrees of bilateral multifocal lesions of ground-glass opacities were found with or without consolidations on the chest CT images. The lesions were both bronchocentric and centrilobular. Patients with elevated leukocyte counts had more extensive lesions, in terms of severity and affected area, than the patients with normal leukocyte counts. The lesion severity scores of patients in the elevated leukocyte group were significantly higher than those of the normal leukocyte group in terms of the entire lung area (P <0.01), and upper (P <0.05) and lower (P <0.01) lobes as well. There were changes in the CT characteristics seen at follow-up as demonstrated by lesions absorption (P <0.01), especially in the upper lobe of the lung (P <0.01), but less so in the middle lobe/lingual and lower lobe of the lung (P >0.05).

Conclusions  The most common CT findings in S-OIV infection patients were bilateral multifocal distributed ground-glass opacities and consolidations. The lesions were located dominantly at bronchocentric and centrilobular areas. Lung lesions were more obviously absorbed in upper lobes between two examinations. The observations and analysis from this study provide information that may be useful in image understanding and patient management for future pandemic influenza.

     

21例危/重症甲型H1N1(2009)流感患者临床特征治疗及转归

目的探讨危/重症甲型H1N1流感的临床特征、治疗和转归情况。方法设计调查表,了解安徽医科大学第一附属医院甲流专病病房21例危/重症甲型H1N1流感病例（研究组）的人口学特征、临床症状和体征、实验室检测、治疗及转归,同时使用曹彬等关于中国2009大流行甲型流感（H1N1）病毒感染最初病例的研究样本作为对照,其中危/重症诊断按照卫生部颁布的诊断标准进行,对不同时间点的相关指标也进行比较分析,采用SPSS17.0软件进行统计学分析。结果两组间性别、年龄分布差异无统计学意义,研究组发热持续时间较长,肝功能不良事件发生率也明显高于对照组（P〈0.01）;研究组入院时高热、咳嗽、咳痰、疲乏、腹泻/腹痛、呼吸困难、咽充血、扁桃体肿大发生率均明显高于对照组（P〈0.05）;与对照组相比,研究组更容易出现白细胞升高（P〈0.01）及C反应蛋白升高（P〈0.01）,血清CK、CK-MB、LDH、ALT、AST以及胸部X线检查异常均明显增加（P〈0.05）,血清钾、血清钠也较对照组低（P〈0.05）;随治疗时间延长,患者氧分压有所升高、心率降低、血小板增加;痊愈出院20例,死亡1例。结论危/重症甲型H1N1流感病例与普通感染者有较大差异,体温高、热期长,容易出现多器官系统损害及继发感染,经良好治疗,大多数可以痊愈。     

NFATc1对非小细胞肺癌细胞增殖、迁移和上皮间质转化的影响

目的:检测活化T细胞c1核因子（NFATc1）对非小细胞肺癌（NSCLC）细胞增殖、迁移和上皮间充质转化（EMT）的影响。方法:qRT-PCR检测NSCLC细胞H1650、H460、H1299及正常人支气管上皮细胞BEAS-2B中NFATc1表达水平,将si-NFATc质粒转染至H1650细胞中,通过CCK-8增殖及集落形成实验、划痕和Western 印迹实验分别检测转染后H1650细胞增殖、迁移及EMT的影响。结果:NFATc1 mRNA在H1650、H460、H1299细胞中的相对表达水平高于BEAS-2B细胞（t=10.732,P<0.001;t=4.705,P=0.009;t=4.792,P=0.009）,且H1650细胞中NFATc1 mRNA表达水平高于H460、H1299细胞（t=3.593,P=0.023;t=7.505,P=0.002）;转染si-NFATc1组NFATc1 mRNA（t=9.325,P<0.001）,NFATc1蛋白（t=10.254,P<0.001）,细胞的OD值（t=7.954,P<0.001）均低于si-NC组,细胞集落形成数（t=12.210,P<0.001）,迁移率（t=8.951,P<0.001）低于si-NC组;si-NFATc1组E-cadherin蛋白表达水平高于si-NC组（t=6.352,P<0.001）,Vimentin和N-cadherin蛋白的表达（t=6.012,P<0.001;t=10.241,P<0.001）低于si-NC组。结论:NFATc1在H1650细胞中表达水平增加,敲低其表达水平后可减弱细胞增殖、迁移和EMT。     

HLA-DQA1基因拷贝数变异与乙型肝炎病毒感染后不同转归的易感性

目的 探讨人类白细胞抗原(HLA)DQAl基因拷贝数变异(CNV)与中国汉族人群乙型肝炎病毒(HBV)感染后不同转归和疾病进展的关系.方法 采用AccuCopy CNV检测技术检测825例慢性HBV感染患者和287例急性自限性HBV感染者的HLA-DQAl基因CNV,采用χ2检验等分析HLA-DQA1 CNV与HBV感染后慢性化和疾病进展的发病风险.结果 在HBV感染后急慢性转归方面,急性自限性HBV感染组HLA-DQA1拷贝数>2的比例显著高于慢性HBV感染组(15.3% vs 6.9%,χ2=25.22,P<0.001).在慢性HBV感染后疾病进展方面,随疾病进展,HLA-DQAl基因拷贝数<2的比例在慢性乙型肝炎(CHB)组、肝硬化(LC)组和肝癌(HCC)组3组间逐渐增加,分别为10.1%,15.3%和27.9%,差异有统计学意义(χ2=25.66,P<0.001).根据E抗原分组分析显示,E抗原阳性患者组和E抗原阴性患者组HLA-DQA1 CNV的比例无显著性差异.结论 HLA-DQA1基因CNV是HBV感染慢性化的遗传易感因素,HLA-DQA1基因拷贝数减少可能是HBV感染慢性化和疾病进展的危险因素.     

392例甲型H1N1流感患者血清补体C3、C4和CH50的变化

目的探讨甲型H1N1流感患者病程初期血清补体C3、C4和CH50的变化及临床意义。方法采用免疫透射比浊法及脂质体免疫测定法分别检测369例轻症甲型H1N1流感（轻症组）和23例重症甲型H1N1流感（重症组）患者病程5d内血清中补体C3、C4水平及总补体活性（CH50）。结果轻症组C3值为（1.10±0.18）g/L,重症组为（1.10±0.19）g/L;轻症组C4值为（0.29±0.08）g/L,重症组为（0.29±0.08）g/L;76%的患者病程早期CH50出现轻微上升,15%出现明显下降;轻症组CH50值为（48.84±19.38）U/ml,重症组为（57.48±13.25）U/ml（P=0.036）。结论甲型H1N1流感患者病程早期血清C3和C4水平均在正常较高水平,CH50多轻微上升,部分明显下降。重症甲型H1N1流感CH50水平较轻症升高,有一定预警意义。     

支气管哮喘患者诱导痰中HMGB1和RAGE水平的变化及临床意义

目的 探讨HMGB1蛋白和晚期糖基化终产物受体(RAGE)与支气管哮喘发病机制及严重程度的关系.方法 按标准纳入急性发作期哮喘患者64例(哮喘组),健康体检者20名(对照组);哮喘组给予布地奈德与福莫特罗的联合制剂吸入治疗4周.治疗前后分别对各组进行肺功能检测和诱导痰检查,记录第1秒用力呼气容积(FEV1)占预计值的百分比(FEV1%),行诱导痰中中性粒细胞分类计数,酶联免疫吸附法检测诱导痰中HMGB1和RAGE水平.结果 治疗前哮喘组诱导痰中中性粒细胞百分比、HMGB1和RAGE水平均高于对照组(均P<0.01);重度哮喘者诱导痰中中性粒细胞百分比及HMGB1水平均高于轻度哮喘者(均P<0.01),但RAGE水平在轻、中、重度哮喘者之间差异无统计学意义(P>0.05).治疗后哮喘组诱导痰中中性粒细胞百分比及HMGB1和RAGE水平均低于治疗前(均P<0.01);治疗未控制者诱导痰中中性粒细胞百分比、HMGB1和RAGE水平高于完全控制者(均P<0.05);哮喘组HMGB1、RAGE均与FEV1%呈负相关(r=-0.830和r=-0.632,均P<0.01);诱导痰中HMGB1、RAGE均与中性粒细胞百分比呈正相关(r=0.820和r=0.623,均P<0.01);诱导痰中HMGB1水平与RAGE水平呈正相关(r=0.929,P<0.01).结论HMGB1和RAGE参与了哮喘的气道炎症过程,HMGB1与哮喘的严重程度相关;诱导痰中HMGB1和RAGE水平可作为观察疗效的参考指标.

Abstract：

Objective To explore the relationship between HMGB1 (high mobility group box-1) protein and receptor for advanced glycosylation end products (RAGE) and the nosogenesis and severity of bronchial asthma.Methods Based on the criteria, the asthma group included 64 acute-onset asthma patients while the control group had 20 healthy cases. The asthma group received a 4-week combination inhalation therapy of budesonide and formoterol. Lung functions and induced sputum examinations were conducted before and after treatment. The percentage of a second forced expiratory volume in the predicted value (FEV1%) was recorded. A differential count of neutrophilic leukocyte in reduced sputum was performed. And the sputum levels of HMGB1 and RAGE were detected by ELISA (enzyme linked immunosorbent assay).Results Prior to treatment, the neutrophilic leukocyte percentage and the levels of HMGB1 and RAGE were all higher than those of control group (P<0.01). The induced sputum of severe asthma patients had higher levels of neutrophilic leukocyte percentage and HMGB1 than those of mild cases (P<0.01). But the level of RAGE showed no statistical significance among mild, moderate or severe asthma cases (P>0.05). The post-treatment levels of neutrophilic leukocyte percentage, HMGB1 and RAGE were lower as compared with the pre-treatment ones (P<0.01). These three parameters in uncontrolled cases were higher than those in completely controlled cases (P<0.05);in asthma group, both HMGB1 and RAGE had a negative correlation with FEV1% (r=-0.830, r=-0.632, P<0.01);in induced sputum, both HMGB1 and RAGE had a positive correlation with FEV1% (r=0.820, r=0.623, P<0.01). The levels of HMGB1 and RAGE were positively correlated (r=0.929, P<0.01).ConclusionBoth HMGB1 and RAGE participate in the inflammatory process of asthmatic airway. HMGB1 is correlated with the severity of asthma. And the levels of HMGB1 and RAGE in induced sputum may be employed as reference indices for the observation of therapeutic effects.     

Clinical features in adult patients with in-hospital cardiovascular events with confirmed 2009 Influenza A (H1N1) virus infection: Comparison with those without in-hospital cardiovascular events

BackgroundComprehensive data regarding in-hospital cardiovascular events of adults with confirmed 2009 influenza A (H1N1) (2009 H1N1) infections are limited. The aim of this study was to determine the clinical characteristics, laboratory parameters, and electrocardiographic (ECG) findings for adults with 2009 H1N1 infections and to assess the differences in these parameters among adult patients with and without in-hospital cardiovascular events.MethodsSeventy-one patients were enrolled from the 2009 H1N1 registry database (our hospital registry of confirmed 2009 H1N1 infection during the year 2009) and divided according to the presence of in-hospital cardiovascular events. Six patients had cardiovascular events (CV group) and 65 did not (NCV group).ResultsThe CV group was more likely to be old (p = 0.023). Regarding co-morbidities, underlying coronary heart disease (p = 0.001), congestive heart failure (p = 0.001), diabetes (p = 0.001), and hypertension (p = 0.014) had significant influences on cardiovascular events. The CV group was also more likely to have chest pain (p = 0.034), dyspnea (p = 0.045), higher leukocyte count (p = 0.014), higher C-reactive protein (p = 0.010), higher glucose level (p = 0.001), and higher N-terminal probrain natriuretic peptide level (p = 0.010) than the NCV group. In addition, the CV group had a significantly higher in-hospital mortality rate (p = 0.010) and cardiac mortality rate (p = 0.001) than the NCV group. However, there were no significant differences in ECG findings between the two groups.ConclusionOur study demonstrated that the CV group had higher in-hospital and cardiac mortality rates than the NCV group. A meticulous therapeutic approach should be considered for elderly patients with 2009 H1N1 infections having coronary heart disease, congestive heart failure, diabetes, hypertension, and high levels of leukocyte count, hs-CRP, glucose, and NT-proBNP at the time of admission.     

Aristolochic acid I-induced apoptosis in LLC-PK1 cells and amelioration of t he apoptotic damage by calcium antagonist

Objective To examine the effect of different concentrations of aristolochic acid I (AAI) in inducing apoptosis of cultured porcine renal cell line LLC-PK1 and to investigate the relationship between intracellular free calcium concentration (［Ca(++) ］i) and LLC-PK1 apoptosis induced by AAI and the influence of a calcium antagonist, lacidipine on apoptosis and ［Ca(++) ］i. Methods LLC-PK1 cells were treated in different groups: a.the normal group without treatment; b.the group with AAI alone (0.01 g·L(-1) , 0.02 g·L(-1) , 0.04 g·L(-1) , 0.08 g·L(-1) ); c.the group with lacidipine alone (10 ng·L(-1) , 10(2) ng·L(-1) ,) 10[3 ng·L(-1) ]; d.the group with AAI (0.04 g·L(-1) ) plus lacidipine (10 ng·L(-1) , 10(2) ng·L(-1) , 10(3) ng·L(-1) ).Light microscopy, agarose gel electrophoresis, Annexin-V-Flous apoptosis detection kit and flow cytometry using propidium iodide staining to identify or quantify the apoptosis of LLC-PK1 cells.Mean ［Ca++］i was measured by laser confocus microscopy using Fluo-3/AM staining. Results A series of morphologic changes that were characteristic of apoptosis, Annexin-V-Flous staining positive apoptotic cells and 'DNA ladder' were identified in AAI　(0.02 g·L(-1) -0.08 g·L(-1) ) treated LLC-PK1 cells.Quantitative analysis of apoptotic cells showed that the percentage of apoptotic cells in AAI (0.02 g·L(-1) , 0.04 g·L(-1) or 0.08 g·L[-1]) group was significantly higher than that in normal group (5.3%, 48.5%, 78.7% vs 2.6%, P&lt;0.001).Mean ［Ca++］i was significantly higher in cells treated with AAI (0.04 g·L(-1) ) than that in normal cells (58.01±18.89 vs 22.66±4.78, P&lt;0.001).In group treated with AAI plus lacidipine (102 ng·L(-1) , 103 ng·L(-1) ), mean ［Ca++］i was significantly lower than that treated with AAI alone (35.47±12.85, 28.55±10.16 vs 58.01±18.89, P&lt;0.001).And the percentage of apoptotic cells in group treated with AAI plus lacidipine ](10(2) ng·L(-1) , 10(3) ng·L(-1) ) was also significantly lower than that treated with AAI alone (19.0%, 27.8% vs 34.7%,P&lt;0.001). Conclusions High concentrations of AAI may induce apoptosis of LLC-PK1 cells.The mean ［Ca++］i in AAI-treated LLC-PK1 cells was increased significantly, sugguesting that the increase of ［Ca++］i may be related to apoptosis in LLC-PK1 cells.Lacidipine may decrease the raised mean ［Ca++］i levels caused by AAI and the percentage of apoptotic cells, and lacidipine may ameliorate AAI-induced apoptotic damage by inhibiting the increase of ［Ca++］i in LLC- PK1 cells.     

轻型新型冠状病毒肺炎患者临床特征分析

目的：分析轻型COVID-19患者的流行病学和临床特点。方法：对2020年1月21日至3月6日在浙江省多家医院收治的11例轻型COVID-19患者及117例非轻型患者进行回顾性分析,对比分析轻型患者在流行病学、人口学、临床表现和实验室检查方面的特征。结果：11例轻型COVID-19患者中位潜伏期为10（7～14）d,非轻型COVID-19患者为6（3～9）d,差异有统计学意义（Z=-4.520,P＜0.001）。轻型组女性患者（8例）较男性（3例）多,与非轻型组相反。轻型组患者中位年龄（28岁）较非轻型组（48岁）小（Z=-4.070,P＜0.001）。轻型组基础病史1例（占9.1%）,非轻型组40例（占34.2%）。轻型组发热患者比例较非轻型组低（36.4% vs. 73.5%,χ2=4.984,P=0.026）。轻型组CRP升高患者比例较非轻型组低（9.1% vs. 59.0%,χ2=8.184,P=0.004）。2组白细胞减少患者比例相近。轻型患者接受氧气吸入治疗比例、糖皮质激素治疗比例较非轻型组低（36.4% vs. 96.7%,0 vs. 6%,均P＜0.001）。截至2020年3月6日,10例（占90.9%）轻型患者已治愈出院,明显高于非轻型组（18例,占15.4%,P＜0.001）。1例病情缓解,无死亡及加重病例。2组患者中位病程相近,但轻型组女性患者中位病程较男性短4 d。结论：轻型COVID-19患者表现隐匿,潜伏期长、症状轻、CRP正常率高、CT正常,可能引起漏诊,增加病毒传播风险。轻型患者预后好,但仍需综合治疗,密切观察。此外,女性轻型患者可能较男性多,且预后更好。