8例甲型H1N1流感致重症肺炎患者的护理

总结8例甲型H1N1流感致重症肺炎患者的护理,机械通气过程中加强呼吸道的脱机前、脱机中、脱机后的气道管理,以减少并发症缩短带机时间,同时在体外膜肺氧合辅助治疗期间,密切监护患者生命体征及管路,切实做好消毒隔离,避免患者、医护人员之间的交互感染.     

B型流感病毒相关研究进展

B型流感病毒为季节性流感病毒的一种,每年在人群中呈不同程度的流行。B型流感病毒与A型流感病毒在基因结构和编码蛋白等方面存在差异,主要引起局部暴发和流行,并倾向于感染特定人群,因此除典型的感染症状外还易引起并发症。在一些流行季节,B型流感病毒造成的疾病负担甚至超过A型流感病毒。应加强B型流感病毒的监测和相关研究工作,为B型流感疫苗的推荐和新型药物的研发提供更多的科学依据。     

The antioxidant system in patients with influenza and influenza pneumonia

The paper deals with the topical theme--the state of antioxidant protective components in influenza infection. The values of catalase in red blood cells and those of ceruloplasmin in plasma were studied as an indicator of antiperoxide defense. The patients were grouped according to the severity of their condition and associated complications. The studies revealed a regular reduction in plasma ceruloplasmic levels at the height of influenza. In the waning period of clinical symptoms and in early convalescence, the parameter under study did not differ from that of healthy individuals. At the same time, the trend in influenza showed a significant increase in red blood cell catalase levels with the maximum values at the height of the disease and their normalization in early and late convalescence.     

Parasympathetic versus sympathetic control of the cardiovascular system in young patients with type 1 diabetes mellitus

Autonomic neuropathy and cardiovascular dysregulation are common complications of the diabetes mellitus (DM). The aim of the study was to test the hypothesis that cardiovascular regulation is abnormal in young patients with type 1 DM. Patients with type 1 DM (17, 10 females, 7 males) aged 12.9-31.5 years (mean+/-SEM: 22.4+/-1.0 years) were investigated. The mean duration of DM was 12.4+/-1.2 years. The control group consisted of 17 healthy probands matched for sex and age. The length of R-R intervals was measured using telemetric system (VariaCardio TF4; Sima Media) where ECG signal (sampling frequency 1000 Hz) from thoracic belt was transferred into PC for further analysis. Systolic blood pressure (SBP) was monitored beat-to-beat using volume-clamp method by Finapres 2300 (Ohmeda). Spectral power in HF band of HRV (HRV-HF) was taken as an index of parasympathetic control and spectral power in LF band of systolic BPV (BPV-LF) as an index of sympathetic control. In young patients with type 1 DM significant reduction of spectral power in HF band of the heart rate variability was found, whereas no significant difference between DM group and control group was observed in spectral power in LF band of blood pressure variability. In conclusion, we found impaired parasympathetic control of heart rate in young patients with type 1 DM. No differences in blood vessels sympathetic control were detected using spectral analysis of BPV. We suggest that abnormalities in cardiac parasympathetic regulation precede impairment of blood vessels sympathetic control in young diabetics.     

血液透析致心血管合并症2212例次临床观察及护理

目的探讨血液透析致心血管合并症治疗护理措施.方法对2212例次血液透析出现的心血管合并症给予相应的治疗护理.结果2212例次血液透析中出现心血管合并症.经治疗护理后94%患者症状明显改善,均能顺利完成血液透析.结论熟悉血液透析中出现心血管合并症的原因,给予相应的治疗护理,可促进血液透析顺利完成.     

血液透析致心血管合并症2212例次临床观察及护理

目的:探讨血液透析致心血管合并症治疗护理措施。方法:对2212例次血液透析出现的心血管合并症给予相应的治疗护理。结果:2212例次血液透析中出现心血管合并症。经治疗护理后94%患者症状明显改善,均能顺利完成血液透析。结论:熟悉血液透析中出现心血管合并症的原因,给予相应的治疗护理,可促进血液透析顺利完成。     

荧光RT-PCR对乙型流感病毒爆发的检测

目的探讨荧光RT-PCR方法对乙型流感病毒爆发的诊断价值。方法采集暴发性疫情的流感样病例的咽拭子,提取病毒RNA,PCR方法分别检测甲型和乙型流感病毒的核酸。然后,对核酸检测阳性标本进行MDCK培养,经红细胞凝集和凝集抑制试验对病毒进行鉴定和分型。结果 18份咽拭子中15份乙型流感病毒核酸呈阳性,甲型流感病毒未检出;15份乙型流感病毒核酸阳性标本经MDCK培养,9份标本发生细胞病变,经鉴定和分型,都属于乙型流感病毒Victoria系。结论 RT-PCR方法对乙型流感病毒爆发的检测具有快速、敏感和高度特异性的特点。本地区爆发的乙型流感病毒为乙型流感病毒Victoria系,提示在今后决定我国疫苗成份时应考虑地区流行的特点。     

Intravenous peramivir for treatment of influenza A and B virus infection in high-risk patients

Influenza virus infections are known to persist longer in patients with underlying diseases, including respiratory tract diseases, and tend to become complicated by secondary influenza-associated infections, such as pneumonia. To assess the efficacy and safety of the novel anti-influenza virus drug peramivir in high-risk patients, we conducted a clinical trial of patients with diabetes or chronic respiratory tract diseases and patients being treated with drugs that suppress immune function. In this multicenter, uncontrolled, randomized, double-blind study, peramivir was intravenously administered at 300 or 600 mg/day for 1 to 5 days, as needed. Efficacy was investigated in 37 patients (300 mg, n = 18 patients; 600 mg, n = 19 patients). The median durations of influenza illness were 68.6 h (90% confidence interval, 41.5 to 113.4 h) overall, 114.4 h (90% confidence interval, 40.2 to 235.3 h) in the 300-mg group, and 42.3 h (90% confidence interval, 30.0 to 82.7 h) in the 600-mg group. The hazard ratio for the 600-mg group compared to the 300-mg group was 0.497 (90% confidence interval, 0.251 to 0.984), and the duration of influenza illness was significantly shorter in the 600-mg group than in the 300-mg group. Among the 42 patients in the safety analysis set, adverse events occurred in 73.8% and adverse drug reactions in 33.3%. No adverse events were particularly problematic clinically, and all patients recovered quickly from all events. The measured blood drug concentrations showed no tendency toward accumulation. Drug accumulation with repeated doses was thus considered to be of little concern. Intravenous peramivir appears to offer a potentially useful treatment for high-risk patients in the future.     

Efficacy of laninamivir octanoate in mice with advanced inflammation stage caused by infection of highly lethal influenza virus

Four neuraminidase (NA) inhibitors and an RNA synthesis inhibitor were recently approved and are currently in clinical use for influenza. Among NA inhibitors, oseltamivir phosphate (OSE, Tamiflu^®) and zanamivir are approved worldwide, whereas peramivir and laninamivir octanoate (LAN, Inavir^®) are regionally approved for human use. Therefore, OSE has been used to treat infections of highly pathogenic influenza viruses, such as H5N1 and H7N9, which caused epidemic in southeast Asia and Egypt, and China, respectively. Generally, OSE is administered twice daily for 5 days by oral administration, and LAN once by inhalation for completing influenza therapy. In this study, we compared the efficacy of OSE and LAN administered according to the regimens in mice infected with highly lethal influenza viruses. The drugs were administered at the early and late stages of infection, which correspond to mild and severe inflammation in the lungs, respectively. Based on the drugs’ regimens for human, a single administration of LAN at both stages of inflammation showed superior efficacy to repeated administration of OSE. LAN, as in OSE, could also be efficacious in treating severe influenza in humans.     

Status of the cardiovascular system in patients with subacute thyroiditis

In thirty patients with subacute thyroiditis the authors examined cardiovascular system with the use of the ECG as the most accessible and informative enough method. The clinical and ECG alterations were compared before and after the treatment with glucocorticoids. It was established that the patients with subacute thyroiditis had clinico-electrocardiographic alterations attesting to the presence of myocardiodystrophy. The alterations seen on the ECG mirrorred fully enough the impairment of the cardiovascular system. Myocardiodystrophies associated with subacute thyroiditis undergo reverse development as the remission of the underlying disease is attained as a result of specific therapy with glucocorticoids. This is confirmed by the electrocardiographic findings in the course of the treatment.     

The reversibility of the O-D type of influenza virus variation

Data are presented which enhance the idea that the influenza virus is an unstable agent. They indicate that the O-D type of variation is not a discontinuous mutation but rather is a reversible phenomenon. The O and the D forms of virus both appear to be inherent in the virus particle; the dominance of one or the other form seems to be subject to chance occurrences, but is influenced by the conditions under which the virus is propagated. The capacity of the O form of virus to agglutinate guinea pig but not chicken crythrocytes is a relative, not an absolute phenomenon; allantoic fluids which exhibit clear-cut O form hemagglutination may be made to exhibit D form merely by addition of suitable buffer to the test system. That point is of importance from the viewpoint of the mechanism of influenza virus hemagglutination.     

Sex difference in clinical presentation of patients with infectious mononucleosis caused by Epstein-Barr virus

IntroductionThere are few studies on sex difference in patients with infectious mononucleosis caused by Epstein-Barr virus (EBV-IM). We performed a retrospective study to evaluate the sex difference in clinical presentation of patients with EBV-IM.MethodsWe performed a single-center retrospective study evaluating >14-year-old patients with serologically confirmed EBV-IM during 2006–2017. We compared the patients’ age, symptoms, physical findings, and laboratory data between male and female patients. To adjust for confounding factors, we performed a logistic regression analysis based on the results of univariate comparisons.ResultOf the 122 eligible patients (56 male and 66 female, ratio: 1:1.2), the median ages were 26 years old (interquartile range [IR], 22–31.5 years old]) and 22 years old (IR, 20–25 years old) for males and females, respectively (p < 0.001). Headache was significantly more prevalent in males (25.0% vs. 10.6%, p = 0.036). Leukocyte count was also significantly higher in males (11,400/mm³ [IR, 7,600–14,100/mm³] vs. 9,400/mm³ [IR, 6,600–11,600/mm³], p = 0.021). The prevalence of periorbital edema (male: 3.6% vs. female: 18.1%, p = 0.012) and severity of transaminase elevation were significantly higher in females. The regression analysis evaluating clinical characteristics of male patients showed that age >30 years old, headache, and leukocyte >11,000/mm³ had high odds ratios.ConclusionOur single-center retrospective study suggests that older age of onset, headache, and leukocytosis are more likely to be characteristics of male patients with EBV-IM. Our study also underscores the importance of periorbital edema as a clue for early diagnosis of EBV-IM, especially in female patients.     

由维多利亚系乙型流感病毒引起的流感暴发疫情流行病学调查分析

目的 了解乙型维多利亚系(Victoria)流感病毒引起的暴发疫情的发生、发展和危害,制定科学的防治措施.方法 通过三间分布调查、临床体征、核酸检测法、病毒分离、基因变异分析进行疫情研究.结果 乙型Victoria系统流感病毒引起的暴发疫情传播速度快、波及范围广;罹患率高,核酸检测阳性率高;随着疫情发生时间推移,罹患率、阳性检出率呈下降趋势;临床症状较轻,预后良好.结论 对乙型Victoria系流感病毒应引起高度重视,应尽早采取科学、有力的应对措施.