Serum interleukin-6 levels as an indicator of aseptic meningitis among children with enterovirus 71-induced hand,foot and mouth disease

Objectives: The enterovirus EV71 is a major pathogen of hand, foot, and mouth disease (HFMD) in children. Aseptic meningitis is the most common neurologic complication of EV71-induced HFMD. Lumbar puncture is a crucial procedure in the diagnosis of aseptic meningitis. It is often performed based on physicians’ clinical suspicion. A diagnostic method that can aid in deciding whether this procedure should be performed is necessary. Cytokines are speculated to be associated with neurologic complications. In this study, we aimed to find an indicator of the presence of aseptic meningitis in children with EV71-induced HFMD.

Methods: This cross-sectional study included children with EV71-induced HFMD. The children underwent lumbar puncture due to suspected aseptic meningitis. They were categorized into an aseptic meningitis complicated group (n = 54) and uncomplicated group (n = 47) based on the results of cerebrospinal fluid examination. Healthy children were included as controls (n = 51). The sample serum levels of tumor necrosis factor-α, interferon-γ, interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, and IL-13 were detected using multiplexed fluorescent bead-based immunoassays.

Results: The levels of all cytokines were significantly higher in children with EV71-induced HFMD complicated with aseptic meningitis than in children with uncomplicated EV71-induced HFMD and controls (p < 0.001). Binary logistic regression analysis demonstrated that IL-6 had the strongest association with aseptic meningitis of all cytokines examined. According to receiver operating characteristic analysis, the optimal cutoff value for IL-6 was 66 pg/mL with maximum sensitivity and specificity.

Conclusions: The results of this study suggest the association between higher production of cytokine and aseptic meningitis among children with EV71-induced HFMD. IL-6 was also suggested as an indicator of aseptic meningitis. Rapid measurement of IL-6 could be useful in deciding whether physicians should perform lumbar puncture on children.     

脉搏指数连续心输出量技术在重型颅脑损伤液体管理中的应用分析

目的 探究脉搏指数连续输出量技术(PICCO)在重型颅脑损伤液体管理中的临床应用.方法 选取入住ICU的重型颅脑损伤患者50例,采用随机数字表分为3组.实验组17例,采用脉搏指数连续输出量技术(PICCO)分析指导液体管理;对照A组17例,采用检测中心静脉压技术(CVP)指导液体管理;对照B组16例,采用无创伤脑血管血液动力学检查分析仪(CBA)指导液体管理.各组通过不同方式检测患者血液动力学参数,通过观测结果进行液体管理.比较3组患者ICU住院时间、格拉斯哥昏迷评分、神经源性肺水肿发生率以及患者病死率等参数.结果①3组患者ICU住院时间比较:实验组患者住院时间显著小于对照组,差异有统计学意义(P＜0.05);对照A组患者的住院时间与对照B组患者住院时间相仿,差异无统计学意义(P＞0.05);②3组患者格拉斯哥昏迷评分(GCS)情况:治疗后,3组患者GCS评分均有所升高,且实验组较对照组显著增高,差异有统计学意义(P＜0.05);对照A组与对照B组GCS评分相仿,差异无统计学意义(P＞0.05);③3组患者神经源性肺水肿发生率及病死率比较:治疗后,实验组患者的神经源性肺水肿发生率(3.3％)显著低于对照组(A:10％、B:10％),差异有统计学意义(P＜0.05);实验组患者病死率(3.3％)显著低于对照组(A:6.7％、B:6.7％),差异有统计学意义(P＜0.05).结论 脉搏指数连续输出量技术(PICCO)能精确、全面地反映患者血液动力学各项指标,医护人员通过PICCO显示的各项参数,可对患者进行准确的血液管理,有效减少患者ICU住院时间、提高格拉斯哥昏迷评分、降低患者神经源性肺水肿发生率及患者病死率,对重型颅脑损伤患者的血液管理具有重要价值,值得推广.     

以数据挖掘为核心的医院数据管理平台建设初探

以建设基于精细化管理的医院决策支持系统为目的,利用数据仓库等信息化技术对各业务系统数据进行采集、清洗、整合,建立数据中心进行综合管理,保证数入一门、数出一门。有效消除信息孤岛、解决数据混乱状态、缓解信息化应用瓶颈。以数据挖掘为手段以病种为核心着重分析医疗核心指标及医保的总额预付管理两个主题,通过深入分析明确管理目标、缩小管理范畴、抓住主要矛盾,提高医院科学管理水平。     

以财富指数测量生活水平的相关问题研究

目的:研究以不同方法构建的财富指数的一致性,及其与传统方法测量的生活水平结果的比较。方法:利用2011年对宁夏回族自治区6 612户农村家庭(共28 886人)开展的入户调查数据,分别采取主成分分析、等权重等不同的赋权方法并纳入不同变量类型,构建4种不同的财富指数,对其结果的一致性进行分析;并分别与家庭总消费、家庭人均消费和家庭等值人均消费这三种传统方法得到的人群生活水平结果进行比较。结果:采用不同方法构建的财富指数间一致性较强;财富指数与消费指标间一致性较弱。结论:反映生活水平的不同指标各有优缺点,其测量结果间的一致性也较弱,因此当生活水平作为主要研究结果或影响结果的主要因素时,应结合采用不同生活水平指标得到的研究结果以及专业知识和经验,选择合适的生活水平指标。     

Twenty Years of Active Bacterial Core Surveillance

Active Bacterial Core surveillance (ABCs) was established in 1995 as part of the Centers for Disease Control and Prevention Emerging Infections Program (EIP) network to assess the extent of invasive bacterial infections of public health importance. ABCs is distinctive among surveillance systems because of its large, population-based, geographically diverse catchment area; active laboratory-based identification of cases to ensure complete case capture; detailed collection of epidemiologic information paired with laboratory isolates; infrastructure that allows for more in-depth investigations; and sustained commitment of public health, academic, and clinical partners to maintain the system. ABCs has directly affected public health policies and practices through the development and evaluation of vaccines and other prevention strategies, the monitoring of antimicrobial drug resistance, and the response to public health emergencies and other emerging infections.     

血小板源生长因子受体结合域基因与乙型肝炎核心抗原基因融合克隆的构建

血小板源生长因子在动脉粥样硬化发生中起着重要的作用为了阻断血小板源生长因子致动脉粥样硬化的作用，我们利用基因工程技术试图制备血小板源生长因子受体结合域与乙型肝炎核心抗原的融合蛋白，并以此蛋白作为疫苗，探讨了基防治动粥样硬化发生发展是可能性，本文报道血小板源生长因子受体结合域基因的化学合成以及与乙型肝炎核心抗原基因的融合克隆的构建，经双酶切，序列分析证实，这两种基因融合成功。