乳山市两所医院鲍曼不动杆菌耐药性及流行性分析

目的分析乳山市两所医院鲍曼不动杆菌的耐药性及流行特点。方法收集乳山市人民医院、乳山市中医院2015年1-12月临床分离鲍曼不动杆菌,进行药敏试验,选取50株鲍曼不动杆菌采用脉冲场凝胶电泳分析菌株同源性。结果共收集鲍曼不动杆菌158株,其中乳山市人民医院108株,乳山市中医院50株。标本来源以痰液(59.9%)为主,分布科室以呼吸科(39.8%)和ICU(25.3%)为主。药敏结果显示,所检测菌株对氨曲南、氨苄西林、头孢西丁100.0%耐药,对多黏菌素B、替加环素均敏感。50株鲍曼不动杆菌可分为A~E共5种型别,其中A型又分为A1、A2、A3等3个亚型,为主要流行型别。结论乳山市两所医院鲍曼不动杆菌耐药问题较严峻,主要存在于呼吸科、ICU等科室,以引起呼吸道感染为主,在两所医院不同科室间存在播散流行。     

Cell attenuated porcine epidemic diarrhea virus strain Zhejiang08 provides effective immune protection attributed to dendritic cell stimulation

Since 2010, the porcine epidemic diarrhea coronavirus (PEDV) has caused significant damage to the global pork industry. However, classical PEDV vaccine strains only provide limited protection against emerging strains. In this study, we successfully isolated and attenuated the PEDV epidemic strain Zhejiang08, which was characterized by good cell adaptation and high-titer production 48 h post infection in Vero E6 cells. The attenuated virus induced a high level of virus-specific neutralizing antibodies until 120 days after immunization in piglets and provided complete protection when challenged with an emerging virus strain on day 14 post immunization. Moreover, the capability to activate dendritic cells (DCs) of this isolate was identified. Higher expression levels of IL-12 and IFN-γ were recorded in DCs after treatment with Zhejiang08 for 24 h. Furthermore, genome sequencing and phylogenetic analysis revealed high homology between the main antigen epitopes of Zhejiang08 and PEDV pandemic isolates following 2011. Combining the glycosylation site prediction results and their distribution within the spatial structure of the S protein, led to the conclusion that the observed more effective host immune response of Zhejiang08 compared to CV777 was possibly associated with a lack of the potential glycosylation site in the 296 amino acids of the S protein. In summary, we illustrated that the attenuated virus represents a promising vaccine candidate.     

Cross-neutralization between vaccine and circulating wild-type mumps viruses in Korea

Mumps is a contagious disease caused by the mumps virus. It can be prevented using mumps vaccines, administered as a measles-mumps-rubella (MMR) vaccine. For first and second dose immunization, children aged 12–15 months and 4–6 years have been administered this vaccine since 1997 in Korea. Nevertheless, mumps outbreaks still occur in vaccinated populations worldwide. Hence, immunity against these diseases may be attenuated, or there are antigenic differences between currently available vaccine strains and circulating wild-type viruses. After the introduction of national immunization programs in Korea, mumps cases became sporadic. Viral genotypes F, H, and I have emerged since 1998 whereas the vaccine strains belong to genotype A. Here, we compared the amino acid sequences of the haemagglutinin-neuraminidase (HN) gene from wild-type viruses and the mumps vaccine and measured the cross-neutralization titers between them. We selected the F, H, and I wild-type mumps strains circulating in Korea from 1998 to 2016 and analyzed changes in the amino acid sequence of the protein encoded by the HN gene. We measured mumps virus-specific IgG and rapid focus reduction neutralization test (FRNT) titers in Korean isolates and sera obtained from 50 children aged 1–2 years who had been administered a single dose of MMR vaccine. Analysis of the HN protein sequences disclosed no changes in the glycosylation sites but did reveal 4–5 differences between the Korean isolates and the genotype A vaccine strain in terms of the neutralizing epitope sites on their HN proteins. Post-vaccination FRNT titers were significantly lower against genotypes F, H, and I than they were against genotype A. This finding highlights the possibility of a recurrence of mumps outbreaks in vaccinated populations depending on the degree of genetic conservation of the HN gene. Further research into this issue is needed to prevent the resurgence of mumps.     

Porcine Epidemic Diarrhea Virus among Farmed Pigs,Ukraine

An outbreak of porcine epidemic diarrhea occurred in the summer of 2014 in Ukraine, severely affecting piglets <10 days of age; the mortality rate approached 100%. Full genome sequencing showed the virus to be closely related to strains reported from North America, showing a sequence identity of up to 99.8%.     

Development of a duplex SYBR GreenⅠ based real-time PCR assay for detection of porcine epidemic diarrhea virus and porcine bocavirus3/4/5

The duplex real-time PCR assay based on SYBR Green І was developed for detection of porcine epidemic diarrhea virus (PEDV) and porcine bocavirus (PBoV) 3/4/5 genotypes simultaneously. Two pairs of specific primers were designed targeting the N gene sequence of PEDV and VP1 gene sequence of PBoV3/4/5. PEDV and PBoV3/4/5 could be distinguished by their different melting temperatures (Tm) in one sample. The Tm value of PEDV was 83.5 °C, and the Tm value of PBoV3/4/5 was 78.5 °C, while other swine pathogens showed no specific melting peaks. The detection limits of this assay were 10 copies/μL for both PEDV and PBoV3/4/5. A total of sixty-three intestinal tissue samples were collected from piglets suffering from diarrhea, and the viral nucleic acids detected and identified by the real-time PCR assay and conventional PCR assay. The duplex real-time PCR detection results showed that the prevalence of PEDV and PBoV3/4/5 was 85.7% and 46%, respectively, and the co-infection rate of the two viruses was 28.6%. These results indicated that this duplex real-time PCR assay was a sensitive, specific and reproducible method for differentiating PEDV and PBoV3/4/5 or their co-infection.     

基于中医临床证候探讨新型冠状病毒肺炎在岭南地区的疫性特点

目的:通过分析广东省第二人民医院收治的新型冠状病毒肺炎(以下简称新冠肺炎)患者的临床资料,从中医临床证候探讨该病在岭南地区的疫性特点,更好地指导临床辨证治疗。方法:收集广东省第二人民医院收治的36例新冠肺炎患者的临床资料,其中输入病例20例,本地病例16例,分析全部病例、输入病例和本地病例的临床资料和证候特点。结果:新冠肺炎患者年龄分布较广,平均年龄45岁,以男性居多,55.56%的患者为外地输入病例,44.44%的患者为本地感染病例。全部病例证型以湿邪郁肺型和邪热壅肺型为主,分别占44.44%和38.89%;91.67%的患者呈现“湿”的病理特点,72.22%的患者呈现“热”的病理特点。其中输入病例证型以湿邪郁肺型为主,占65.00%,100%的患者呈现“湿”的病理特点,55.00%呈现“热”的病理特点;本地病例证型以邪热壅肺为主,占56.25%,93.75%的患者呈现“热”的病理特点,81.25%呈现“湿”的病理特点。结论:本次疫病在岭南地区的疫性属于以湿邪和热邪为主导的“湿热疫”,病机特点为湿热并重;输入性病例多表现为以湿邪为患的“湿疫”,有化热的趋势和倾向,病机特点为湿重于热;本地病例多表现为以热邪为主的“温热疫”,病机特点为热重于湿。此次新冠肺炎不同地区存在不同疫性的可能,辨证和治疗要遵守三因制宜的原则。     

Obesity,neoliberalism and epidemic psychology: critical commentary and alternative approaches to public health

Obesity and neoliberalism are two concepts that generate plenty of concern and debate, arguably leading to more heat than light when terms like ‘epidemic’ are thrown into the fray. Drawing from critical weight studies, this paper offers critical commentary on the recent designation of obesity as a ‘neoliberal epidemic’ that can be attributed to energy-dense foods and a toxic mode of political economic organization. After delineating neoliberalism and the use of this concept in health studies, discussion turns towards contrasting invocations in the ‘fat field’ before seeking to navigate a course through this terrain. In addition to contributing to critical weight studies and the obesity debate, this commentary engages discussions on the perils of invoking neoliberalism in public health critique. In conclusion, we move from critique to hope with reference to epistemologies derived from alternative health practices, notably frameworks incorporating Indigenous knowledge(s).     

新型冠状病毒肺炎疫情期间发热门诊的护理管理

新型冠状病毒肺炎疫情防控期间,发热门诊作为疾病诊治的重点部门,其防护工作是保障医护人员安全工作的重中之重,防护用品的使用、诊治流程以及呼吸机操作等环节的护理管理均要严格规范化、科学化。     

新型冠状病毒肺炎疫情下生理学线上教学的探索与反思

面对新型冠状病毒肺炎疫情向课堂教学提出的挑战，齐齐哈尔医学院生理学教学团队构建了基于"小规模限制性在线课程（small private online course，SPOC）+同步直播"的混合式教学，开展线上教学。经过团队成员的共同努力，开展线上教学4周以来教学秩序稳定，教学效果良好。本文以236名2019级护理本科生生理学教学为例，介绍了疫情形势下线上教学的教学设计、实施措施、教学效果以及教学反思，为进一步推进疫情防控期间医学高等院校线上教学工作提供实践经验。     

医护人员暴发肺炎衣原体肺炎12例临床特征分析

目的总结肺炎衣原体(CP)肺炎暴发流行的临床特征及治疗方法。方法收集2009-01-04—2009-03-01中国医科大学附属第四医院暴发流行的12例医护人员CP肺炎咽试纸标本,应用聚合酶联反应(PCR)检测DNA,使用微量免疫荧光技术检测CP的IgG和IgM抗体,同时对肺高分辨CT结果进行分析,并评价疗效。结果本组暴发流行的CP肺炎其病原学介于CP与鹦鹉热衣原体之间的一种变异的衣原体种,且更倾向于鹦鹉热衣原体。临床表现为乏力10例,周身酸痛10例,发热6例,咳嗽、咳少量白痰2例,心悸、气短2例,皮疹1例,稀水样便1例,12例均无咯血、胸痛、呼吸困难及精神症状,肺部体征均为阴性。所有患者肺部高分辨CT均有改变,表现为多发或单发以小叶为中心阴影和腺泡状结节影3例,病变可发生在两肺各个叶段,多以外、中带分布;以小叶分布的气腔实变和磨玻璃样阴影分别为4例和1例,伴有支气管血管束增厚3例;球形影1例;结节影与实变影混合存在3例。结论医护人员CP肺炎的暴发流行具有群体发病,早期高分辨CT检查更能真实地反映病变大小、多少和分布范围。对氟喹诺酮类联合大环内酯类药物治疗有效。诊断时应与严重急性呼吸综合征、禽流感、支原体肺炎等进行鉴别。