云浮市2006-2012年恙虫病流行病学分析

目的分析云浮市2006-2012年恙虫病疫情资料,为开展预防控制工作提供参考。方法对云浮市2006-2012年恙虫病疫情资料采用描述性流行病学方法进行分析。结果 2006-2012年云浮市全市共报告恙虫病例567例,死亡3例,年均报告发病率为3.42/10万,2006-2012年各年报告发病率依次为0.13/10万、0.26/10万、2.70/10万、2.67/10万、3.30/10万、5.21/10万和9.54/10万,发病率逐年升高。5-11月为发病高峰期,病例主要集中在云安县(346例)和云城区(176例),所报告病例数占总数的92.06%;男性247例,女性320例,男女性别比为1∶1.30;40岁以上年龄组为主报告病例数472(占83.25%);职业以农民为主报告病例数498(占87.83%)。结论云浮市恙虫病发病率呈逐年增长趋势,建议加强恙虫病的监测,对高危人群开展健康教育以降低发生恙虫病流行的风险。     

The Role of Streptococcal Cell-Envelope Proteases in Bacterial Evasion of the Innate Immune System

Bacteria possess the ability to evolve varied and ingenious strategies to outwit the host immune system, instigating an evolutionary arms race. Proteases are amongst the many weapons employed by bacteria, which specifically cleave and neutralize key signalling molecules required for a coordinated immune response. In this article, we focus on a family of S8 subtilisin-like serine proteases expressed as cell-envelope proteases (CEPs) by group A and group B streptococci. Two of these proteases known as Streptococcus pyogenes CEP (SpyCEP) and C5a peptidase cleave the chemokine CXCL8 and the complement fragment C5a, respectively. Both CXCL8 and C5a are potent neutrophil-recruiting chemokines, and by neutralizing their activity, streptococci evade a key defence mechanism of innate immunity. We review the mechanisms by which CXCL8 and C5a recruit neutrophils and the characterization of SpyCEP and C5a peptidase, including both in vitro and in vivo studies. Recently described structural insights into the function of this CEP family are also discussed. We conclude by examining the progress of prototypic vaccines incorporating SpyCEP and C5a peptidase in their preparation. Since streptococci-producing SpyCEP and C5a peptidase are responsible for a considerable global disease burden, targeting these proteases by vaccination strategies or by small-molecule antagonists should provide protection from and promote the resolution of streptococcal infections.     

106株泌尿系统感染病原菌分布及耐药性分析

目的探讨我院泌尿系感染的病原菌分布及其耐药性，为临床合理使用抗生素提供科学依据。方法收集2002年2月-2004年11月住院的中段尿细菌培养阳性的泌尿系感染患者。回顾性分析这些患者的病原菌分布和药敏试验结果。结果共106例泌尿系感染患者尿细菌培养阳性，男37例，女69例。培养出106株病原菌，革兰阳性菌29株，革兰阴性菌77株。绝大多数病原菌均具有多重耐药性。结论泌尿系感染的致病菌对常用的抗生素有很高的耐药率，因此临床应结合药敏试验和特殊耐药株的报告结果，合理选择抗生素。     

系统护理干预对鼻内镜下治疗鼻窦炎鼻息肉患者的影响分析

目的:探讨围手术期系统护理干预对使用鼻内镜治疗鼻窦炎鼻息肉患者的影响,以提高临床护理工作水平。方法:将我院收治的230例鼻内镜下进行鼻窦炎鼻息肉的患者随即分为两组。对照组患者实施一般护理,实验组患者实施我院系统护理干预,比较两组患者的治疗效果和患者的手术前后焦虑状态。结果:实验组患者并发症发生3.33%;对照组患者并发症发生14.54%,实验组明显低于对照组,P<0.05;实验组患者手术前焦虑状态和手术后焦虑状态均低于对照组患者,P<0.05。结论:实施围手术期规范、系统的护理干预,能够便于护士给予患者更加优质的护理服务,促进患者更好地康复。     

高龄患者围手术期护理安全管理

目的探讨高龄患者围手术期安全护理管理。方法通过参加术前病例讨论,了解病情,准备齐全手术物品,手术前访视与患者沟通建立良好的护患关系,术中认真细致的配合和耐心、细心的护理保证围手术的安全。结果对326例〉80岁高龄患者围手术期采取安全护理管理,使患者顺利渡过围手术期。结论手术前参加病例讨论,访视患者和术中细致、耐心、细心的安全护理措施保证了高龄患者手术恢复顺利。     

531例患者泌尿生殖道支原体感染及药敏情况分析

目的：探讨解脲支原体（UU）和人型支原体（MH）在性病门诊患者中感染及耐药情况，为临床合理用药以及控制脲路感染提供依据。方法：采用上海奥普生物医药有限公司生产的支原体培养鉴定药敏试剂盒，对531例非淋茵性尿道炎（nongonococcal urethritis，NGU）患者分泌物进行检测。结果：531例NGU患者，支原体阳性125例，感染率为23．5％，其中单纯UU阳性83例，占15．6％，单纯MH阳性6例，占1．1％，UU＋MH阳性36例，占6．8％，UU、MH总检出率分别是22．4％、7．9％。女性的感染率高于男性（P〈0．01）。UU、MH、UU＋MH对强力霉素、交沙霉素、美满霉素较为敏感。对于MH和UU混合感染者，各种药物的体外敏感性显著降低。结论：泌尿生殖道支原体感染以UU为主，UU、MH、UU＋MH的耐药率存在一定的差异。药物治疗支原体以强力霉素、交沙霉素最好、其次是美满霉素。     

继发性胰腺感染的诊治(附6例报告)

继发性胰腺感染是急性出血性坏死性胰腺炎最常见的严重并发症,其死亡率高,诊断困难,治疗棘手,是外科临床的疑难课题。本文报告近4年收治的6例,占同期急性胰腺炎134例的4.48％,占出血性胰腺炎15例的40％。全组6例在诊断后及时施行胰腺坏死组织清创和腹腔持续开放引流术,有的病例视病情需要反复清创。治疗结果3例死亡,占50％。本文对继发性胰腺感染的发病率、致病原因、发病机理、诊断和治疗进行了分析讨论。     

院内与院外泌尿系感染病原菌及临床分析

目的 了解医院内与医院外泌尿系细菌感染致病菌与临床特点,为合理应用抗菌药物提供临床依据。方法 从泌尿系感染病原学阳性的患者中,取符合诊断标准完整病例157例,对其临床情况和192株病原菌进行分析。结果 发现医院外泌尿系感染患者致病菌以大肠埃希菌为主的G-杆菌占多数,医院内泌尿系感染患者多有慢性病、导尿、糖耐量异常、长期卧床史,且有抗菌药物使用史者多,致病菌因真菌、G＋菌增多,G-杆菌低于院外泌尿系感染,特别是泌尿系真菌感染医院内感染比例明显高于医院外感染,且耐药菌较多。结论 医院内外泌尿系细菌感染有着不同特点,注意病原学检查,及时了解泌尿系感染致病菌和药物敏感状况,对避免盲目应用抗菌药物造成菌群失调、真菌感染增加是有益的。     

快速康复外科护理新路径在痔疮患者围手术期的应用研究

目的：探讨快速康复外科护理新路径在痔疮患者围手术期的应用。方法：将2013年－2014年我科室收治的200例痔疮手术患者随机分为观察组与对照组,每组各100例患者,对观察组痔疮患者采用快速康复护理新路径进行护理,对照组采用传统常规护理方案进行护理,对两组护理方式的康复结果进行对比。结果：两组患者在愈合时间、首次排便时间、健康教育知晓率、患者满意度、术后并发症发生率等方面的差异具有统计学意义（ P ＜0．05）。结论：快速康复外科护理新路径在痔疮患者围手术期的应用可缩短伤口愈合时间、减少术后并发症,有利于患者康复,具有良好的社会效益。     

Application of metagenomic next-generation sequencing for bronchoalveolar lavage diagnostics in patients with lower respiratory tract infections

ObjectiveMetagenomic next-generation sequencing (mNGS) has the potential to overcome the shortcomings of traditional culture methods. This study aimed to assess the diagnostic value of mNGS in patients with lower respiratory tract infections (LRTIs).MethodsThis retrospective observational study sequentially enrolled 47 patients with LRTIs admitted to Shenzhen Hospital of Southern Medical University between February 2019 and November 2020. Pathogens in bronchoalveolar lavage fluid (BALF) samples were investigated to compare diagnoses by mNGS with culture methods.ResultsCompared with culture methods, mNGS had a diagnostic sensitivity of 80% and a specificity of 35.13% with an agreement rate of 44.68% between these two methods. mNGS significantly increased the pathogen detection rate.ConclusionsmNGS may show some advantages in identifying a wide range of LRTI pathogens, improving the sensitivity for viruses and atypical pathogens. The clinical application of NGS technology is worth looking forward to.