中医综合治疗糖尿病足疗效观察

目的观察中医综合治疗糖尿病足的临床效果,探讨糖尿病足治疗办法。方法将86例糖尿病足患者按就诊顺序结合随机号码分为中医干预组和对照组,各43例,两组在糖尿病常规治疗的基础上分别采用中药内服、足浴、按摩足治疗和常规外科治疗,观察比较两组临床疗效和生活质量评价。结果治疗前两组各项指标差异均无统计学意义（P〉0．05）;治疗1个疗程后,中医干预组治愈率、有效率（34．9％、93．0％）与对照组相比（24．2％、83．7％）差异有统计学意义（RiditZ=8．739,P=0．006）;干预组DMQLS评分在总分和生理、心理、社会、疾病、满意度等6个维度均优于对照组（t=56．985、28．951、32．546、36．254、19．548、13．541,均P〈0．05）。结论中医综合治疗可以提高糖尿病足治疗效果,改善患者生活质量,值得临床推广应用。     

Implementation of Ventilator-Associated Pneumonia Clinical Guideline (Bundle)

BackgroundVentilator-associated pneumonia (VAP) and its prevention is a significant concern for ventilated patients in the intensive care unit.MethodsRetrospective chart review that evaluated VAP rates from August and September 2010 (control group). In addition, a chart review evaluated VAP rates from August through September 2011 (experimental group).OutcomesImplementation of the VAP bundle will decrease ventilator days, length of stay (LOS), and VAP rates. The variables include age, ventilator days, LOS.DesignSingle center retrospective chart review in a combined surgical and medical ICUConclusionThis study provided evidence that the implementation of a VAP bundle reduced LOS.     

复方甘草酸苷联合重组人表皮生长因子治疗湿疹60例疗效观察

目的 观察复方甘草酸苷联合重组人表皮生长因子治疗湿疹的疗效.方法 120例慢性湿疹患者随机分为治疗组（60例）和对照组（60例）,治疗组静脉注射复方甘草酸苷,60 ml/次,1次/d,联合重组人表皮生长因子喷撒患处,3次/d;对照组单纯给予静脉注射复方甘草酸苷,60 ml/次,1次/d;两组均连续治疗1个月后观察疗效和不良反应.结果 治疗组有效率91.67%,高于对照组的71.67%（Х^2=6.43,P＜0.05）.治疗组VAS积分较对照组、同组治疗前后差异均有统计学意义（t=2.77、2.13、2.42,均P＜0.05）.两组均无严重不良反应.结论 复方甘草酸苷联合重组人表皮生长因子治疗湿疹疗效显著,值得推广.     

原发性中枢神经系统恶性淋巴瘤MR表现分析

目的探讨原发性中枢神经系统恶性淋巴瘤（PCNSML）临床与影像学表现特点,提高本病的影像诊断水平。方法收集经手术、病理和免疫组化证实,资料齐全的颅内恶性非霍杰金淋巴瘤18例,回顾性分析其临床和MR表现。结果临床主要症状为头痛、恶心、偏瘫、肢体麻痹、视觉障碍等。18例患者单发肿瘤13例,多发肿瘤5例,肿瘤常常位于脑表面或近中线部位,T1WI呈略低或等信号,T2WI为低、等或略高信号,增强扫描病灶为明显均匀或不均匀强化,多呈“类圆形”或“团块状”。所有病灶都有占位效应,水肿程度不一。结论原发性中枢神经系统恶性淋巴瘤影像表现多样,但具有一定特征,MR扫描有助于该病变的诊断。     

2 118例湿疹患者住院费用灰色关联及结构变动度分析△

目的:通过分析湿疹患者住院费用中各类费用与总费用的关联程度及其变动情况对总费用构成的影响,为合理监管湿疹患者的住院费用、提高监管效率提供参考。方法:选取广东省某皮肤病医院2015—2019年湿疹已出院患者2118名,采用灰色关联分析法与结构变动度法对其住院费用进行整理分析。结果:湿疹住院患者总费用呈上升趋势,总费用构成中,其他费用均值最高。临床诊断费用与次均费用的关联度最高,达到了0.9307。其他费用、药费、实验室诊断费是引起住院费用结构变动的主要费用项目,累计贡献率为79.416%,其他费用拉力值最高,而药费拉力值呈负值。结论:其他费用在次均住院费用、结构贡献率中均占第一位,是费用监管工作的重要抓手。护理费用呈明显上升趋势,但其对住院均次费用的关联度仍居后位,提示医院在湿疹治疗方面应当采取相关措施,提升对护理工作的重视程度。     

Polio eradication in the African Region on course despite public health emergencies

The World Health Organization, African Region is heading toward eradication of the three types of wild polio virus, from the Region. Cases of wild poliovirus (WPV) types 2 and 3 (WPV2 and WPV3) were last reported in 1998 and 2012, respectively, and WPV1 reported in Nigeria since July 2014 has been the last in the entire Region. This scenario in Nigeria, the only endemic country, marks a remarkable progress. This significant progress is as a result of commitment of key partners in providing the much needed resources, better implementation of strategies, accountability, and innovative approaches. This is taking place in the face of public emergencies and challenges, which overburden health systems of countries and threaten sustainability of health programmes. Outbreak of Ebola and other diseases, insecurity, civil strife and political instability led to displacement of populations and severely affected health service delivery. The goal of eradication is now within reach more than ever before and countries of the region should not relent in their efforts on polio eradication. WHO and partners will redouble their efforts and introduce better approaches to sustain the current momentum and to complete the job. The carefully planned withdrawal of oral polio vaccine type II (OPV2) with an earlier introduction of one dose of inactivated poliovirus vaccine (IPV), in routine immunization, will boost immunity of populations and stop cVDPVs. Environmental surveillance for polio viruses will supplement surveillance for AFP and improve sensitivity of detection of polio viruses.     

Quantitation of strain-specific hemagglutinin trimers in mosaic quadrivalent influenza nanoparticle vaccine by ELISA

An enzyme linked immunosorbent assay (ELISA) method was developed to analyze the assembly of a tetravalent mosaic influenza nanoparticle (NP) vaccine, Flumos-v1, consisting of hemagglutinin trimers (HAT) from H1 (A/Idaho/07/2018), H3 (A/Perth/1008/2019), HBV (Vic-B/Colorado/06/2017) and HBY (Yam-B/Phuket/3073/2013) strains. The sandwich ELISA assay used lectin from Galanthus nivalis as a universal capture reagent for all HAT strains and specific monoclonal antibody (mAb) to detect corresponding hemagglutinin antigen. The mAb binding of HATs incorporated into NPs diverged from those for single HAT solutions, resulting in inaccurate quantitation of assembled HATs. An optimized zwittergent treatment was used to fully dissociate the influenza NP and aligned binding activities in each pair of single HAT and dissociated HAT from NP. The dissociated HATs were then quantified against their corresponding HAT standard solutions for three development lots of FluMos-v1 vaccine and the assembly ratio of all four HATs was calculated. The molar ratio of different HATs incorporated into this quadrivalent NP vaccine was consistent and determined as H3:H1: HBV: HBY ∼ 1.00:0.92:0.96:0.87, which was close the expected 1:1:1:1 ratio and confirmed a proper assembling of multivalent NP.     

Surveillance of Neisseria meningitidis carriage four years after menACWY vaccine implementation in the Netherlands reveals decline in vaccine-type and rise in genogroup e circulation

Carriage of Neisseria meningitidis is an accepted endpoint in monitoring meningococcal vaccine effects. We applied molecular methods to assess the impact of menACWY vaccine implementation on meningococcal carriage and genogroup-specific prevalence in young adults in Fall of 2022, four years after the introduction of the tetravalent vaccine in the Netherlands. The overall carriage rate of genogroupable meningococci was not significantly different compared to a pre-menACWY cohort investigated in 2018 (20.8 % or 125 of 601 versus 17.4 % or 52 of 299 individuals, p = 0.25). Of 125 carriers of genogroupable meningococci, 122 (97.6 %) were positive for either vaccine-types menC, menW, menY or genogroups, menB, menE, and menX, which are not targeted by the menACWY vaccine. Compared with a pre-vaccine-implementation cohort, there was 3.8-fold reduction (p < 0.001) in vaccine-type carriage rates and 9.0-fold increase (p < 0.0001) in non-vaccine type menE prevalence. We observe a reduction in menW and menY and an increase in menE, which suggest that implementation of menACWY vaccine affected carriage.     

Development of toxin-antitoxin self-destructive bacteria,aimed for salmonella vaccination

The most common source of foodborne Salmonella infection in humans is poultry eggs and meat, such that prevention of human infection is mostly achieved by vaccination of farm animals. While inactivated and attenuated vaccines are available, both present drawbacks. This study aimed to develop a novel vaccination strategy, which combines the effectiveness of live-attenuated and safety of inactivated vaccines by construction of inducible self-destructing bacteria utilizing toxin-antitoxin (TA) systems. Hok-Sok and CeaB-CeiB toxin-antitoxin systems were coupled with three induction systems aimed for activating cell killing upon lack of arabinose, anaerobic conditions or low concentration of metallic di-cations. The constructs were transformed into a pathogenic Salmonella enterica serovar Enteritidis strain and bacteria elimination was evaluated in vitro under specific activating conditions and in vivo following administration to chickens. Four constructs induced bacterial killing under the specified conditions, both in growth media and within macrophages. Cloacal swabs of all chicks orally administered transformed bacteria had no detectable levels of bacteria within 9 days of inoculation. By day ten, no bacteria were identified in the spleen and liver of most birds. Antibody immune response was raised toward TA carrying Salmonella which resembled response toward the wildtype bacteria. The constructs described in this study led to self-destruction of virulent Salmonella enteritidis both in vitro and in inoculated animals within a period which is sufficient for the induction of a protective immune response. This system may serve as a safe and effective live vaccine platform against Salmonella as well as other pathogenic bacteria.