22例甲型H1N1流感确诊病例临床分析

目的观察甲型H1N1流感的临床特征和治疗特点。方法对22例甲型H1N1流感确诊病例的临床特征进行动态观察。结果22例患者中,男性15例,女性7例;1例发生肺部感染,21例发热患者平均发热持续1～4天,乏力、肌肉酸痛等全身症状轻,1例伴有消化道症状;中药可改善咳嗽、咽痛、头痛等临床症状。结论新甲型H1N1流感病毒株毒力较弱,患者全身中毒症状较季节性流感为轻。轻型病例可以对症处理为主要治疗手段。     

22例甲型H1N1流感确诊病例临床分析

目的观察甲型H1N1流感的临床特征和治疗特点。方法对22例甲型H1N1流感确诊病例的临床特征进行动态观察。结果22例患者中,男性15例,女性7例;1例发生肺部感染,21例发热患者平均发热持续1～4天,乏力、肌肉酸痛等全身症状轻,1例伴有消化道症状;中药可改善咳嗽、咽痛、头痛等临床症状。结论新甲型H1N1流感病毒株毒力较弱,患者全身中毒症状较季节性流感为轻。轻型病例可以对症处理为主要治疗手段。     

一起学校甲型H1N1流感疫情调查分析报告

[目的]分析一起学校甲型H1N1流感局部暴发的特点和原因,为制定学校甲型H1N1流感预防控制措施提供依据。[方法]按照卫生部办公厅《甲型H1N1流感流行病学调查和暴发疫情处理技术指南(试行)》和《甲型H1N1流感监测方案(第2版)》要求进行。[结果]本起疫情历时19d,全校累计发生急性发热呼吸道感染病例33例,罹患率为0.98%,确诊病例4例;病例主要集中在4个班,班级罹患率分别为15.49%、19.64%、6.94%和5.45%;男生、女生罹患率分别为1.09%、0.83%;主要临床症状发热100%、咳嗽51.52%、咽痛27.27%、流涕24.24%、鼻塞9.09%;采集鼻咽拭子9份,其中4例甲型H1N1流感病毒核酸阳性。[结论]此为一起由甲型H1N1流感病毒引起的学校局部流感暴发疫情,暴发原因主要为疫情报告迟缓,晨检制度不落实,隔离措施不彻底。     

38例甲型H1N1流感住院病例临床特征和治疗转归

目的:了解甲型H1N1流感病例的临床特征和治疗转归,为防治工作提供基础资料.方法:对泰州市2009年～2010年38例甲型H1N1流感住院病例的临床特征和治疗转归情况进行医学统计分析.结果:38例病例均有发热症状,其中中、高热病例占86.8%,伴有咽痛占42.1%、咳嗽占76.3%;使用过抗生素治疗的病例占81.6%、...     

重症甲型H1N1流感典型病例的临床特征和诊治经验

[目的]探讨重症甲型H1N1流感典型病例的临床特征和诊治经验.[方法]对收治的重症甲型H1N1流感确诊病例采取积极的诊断与治疗措施.[结果]所有确诊重症甲型H1N1流感病例均有流感样症状,包括发热(腋下温度≥37.5℃)、咽痛、流涕、肌内酸痛(100%);体温≥39℃并持续3 d以上16例;咳嗽、咳痰19例,头痛、头昏11例;胸闷、气促10例;水样便腹泻或呕吐5例;神志淡漠或烦躁7例;肺部湿性哕音5例.20例继发肺炎或支气管炎,其中2例为重症肺炎;急性呼吸衰竭1例;多器官功能障碍综合症1例.所有患者咽拭子甲型H1N1病毒核酸检测均阳性;WBC正常11例,WBC减少(<5.0×109/L)7例,WBC增高(>10.0×109/L)5例;淋巴细胞(L)正常(0.8～5.0×109L)17例,L减低(<0.8×109/L)5例;胸部CT斑片状浸润影19例,肺纹理增粗、紊乱3例;ECG正常16例;T波改变、ST-T压低7例.所有患者治疗时间7～15 d,平均时间(7.6±2.3)d.所有病例体温正常大于3 d,流感样症状消失,临床症状稳定.咽拭子甲型H1N1病毒核酸检测均阴性.所有患者均临床治愈.[结论]早期有效的诊断和治疗是降低重症甲型H1N1流感病死率的关键.     

海南省2009年甲型H1N1流感确诊病例流行特征分析

[目的]了解海南省2009年甲型H1N1流感确诊病例的流行病学特征。[方法]采用描述性流行病学方法对海南省2009年确诊的861例甲型H1N1流感病例的年龄、性别、职业、报告时间、地区分布、临床表现等流行病学特征及可能的影响因素进行分析。[结果]海南省2009年9月份甲型H1N1流感病例迅速攀升,10月底~11月份初达到新的高峰,报告的861例确诊病例中男性占58.54,年龄中位数为15岁;学生占82.58;病例主要集中在海口市(475例,占55.17),其次为三亚市(138例,占16.03)、文昌市(78例,占9.06);重症9例,占1.05;有个案资料的171例病例的临床表现以发热(91.81)、咳嗽(80.70)、咽痛(57.89)、头痛(30.99)等症状为主。[结论]海南省2009年甲型H1N1流感疫情主要经历了2个高峰,学生是主要的感染人群,病例以轻症为主,重症病例发生率低于全国总体水平。     

43例甲型H1N1流感确诊病例临床特点分析

目的 分析泰安市最初隔离观察甲型H1N1流感确诊病例的临床特征及诊治特点.方法 回顾性分析总结确诊病例流行病学及临床资料.结果 内源性感染41例,占95.35％,外源性感染2例,占4.65％; 39例(90.70％)患者以发热为最主要临床表现,伴有咳嗽、咳痰、鼻塞、流涕,咽痛等流感样症状;43例确诊患者均治愈出院.结论 对于甲型H1N1流感,只要早期诊断,早期治疗,绝大多数患者可以痊愈,预后良好;早发现、早诊断是甲型H1N1流感预防控制与有效治疗的关键.     

成都市1266例甲型H1N1流感分析

[目的]探讨甲型H1N1流感流行和发病规律,制定行之有效和切合实际的防控措施. [方法]对成都市1266例病例进行整理分析.从中国疾病预防控制系统、甲型H1N1流感信息管理系统及成都市疫情报送处理分析系统收集成都市甲型H1N1流感病例的相关信息、流感哨点监测数据和发热症状监测数据.采用Excel做统计描述. [结果]甲型H1N1流感流行的不同阶段有不同的流行病学特征.该市流感哨点监测和发热症状监测和甲型H1N1流感流行趋势相似.[结论]根据疫情的不同阶段,应采取不同的防控措施,有不同的防控重点.     

1起甲型H1N1流感暴发的调查

[目的]总结甲型H1N1流感暴发的经验、教训,为今后处理类似突发事件提供参考。[方法]采用现况调查的方法,对2009年10月发生在青岛某大学费县校区学生中的甲型H1N1流感暴发疫情进行调查。[结果]此次甲型H1N1流感暴发共发病16例,罹患率为0.28%。病例分布在2个年级、9个班,发病年龄为18-21岁,男生11例,女生5例,男女之比为2.20∶1。患者临床表现为发热、头痛、头晕、咳嗽、腰腿酸痛等症状。无明确与甲型H1N1流感病例和流感样病例接触史。[结论]这是1起发生在学校由甲型H1N1流感病毒感染引起的暴发疫情,控制措施及时有效。     

一起甲型H1N1流感暴发疫情的调查

[目的]了解甲型H1N1流感暴发流行规律,为疫情预防控制提供科学依据. [方法]采用暴发流行病学调查研究方法. [结果]5日内出现11例发热样流感病例中有8例为甲型H1N1流感确诊病例,采取隔离治疗措施后7例在1周内转阴,而1例病人前后带毒时间长达20 d,并经使用达菲治疗后一个疗程内转阴. [结论]甲型H1N1流感在人群中的传播速度快而凶猛,隔离治疗措施对控制甲型H1N1流感传播有较好效果,甲型H1N1流感病毒的致病性与季节性流感病毒是否一致,发病后7 d或症状消失后24 h所带毒是否有传染性值得进一步观察研究.     

H1N1 vaccination

Early results (January to April) from the 2010 Canadian Community Health Survey show that an estimated 41% of Canadians (excluding those in the territories) aged 12 or older had been vaccinated for H1N1 by April 2010. The percentages were higher in the Atlantic provinces, Quebec and Saskatchewan than in Canada overall. Relatively high percentages of females and people aged 45 or older were vaccinated; the percentage of immigrants who had done so was relatively low. Being in a priority group (health-care worker, having children younger than 5 in the household, or having a chronic condition that could increase the risk for complications from H1N1) increased the likelihood of vaccination. A history of seasonal flu vaccination and having a regular doctor were also associated with H1N1 vaccination. Nearly three-quarters of those who had not been vaccinated reported that they did not think it was necessary.     

被动吸烟与cyp1b1、gstp1、sult1a1基因多态性对乳腺癌发病的影响

目的 探讨被动吸烟、cyp1b1、gstp1、sult1a1基因多态性及其联合作用对乳腺癌发病的影响。方法 2014 - 2015年间,采用病例-对照研究方法,收集病例794例,对照805例。问卷调查收集研究对象信息。采用飞行质谱技术,进行cyp1b1、gstp1、sult1a1基因单核苷酸多态性分型检测。采用多因素非条件 logistic 回归,分析环境烟草烟雾暴露及cyp1b1、gstp1、sult1a1基因多态性与乳腺癌发病风险的关系。结果 调整年龄、教育程度、家庭年总收入、职业、婚姻状况后,环境烟草烟雾暴露与gstp1基因多态性未发现协同作用。以环境烟草烟雾低暴露且携带 cyp1b1 rs1056836 C等位基因为参照,环境烟草烟雾高暴露且携带 GG 基因在绝经前女性中乳腺癌风险明显增高（OR = 1.678,95%CI:1.039～2.711）。以环境烟草烟雾组合低暴露且携带sult1a1 rs9282861GG基因型为参照,环境烟草烟雾高暴露且携带A等位基因绝经前乳腺癌风险明显增高（OR = 2.389,95%CI:1.157～4.931）,但交互作用系数无统计学意义。结论 环境烟草烟雾高暴露与cyp1b1 及sult1a1基因对乳腺癌发病风险可能存在协同作用,但尚扩大样本进行验证。     

Echo-AM1-1 encephaloscope]

A new miniature model of the A-mode ultrasonic echoencephaloscope, 0.88 MHz, has been developed and adopted to practical use in neurology. The device contains a detector for amplitude determination of echopulsation and curve (echopulsograms) recording. It is highly sensitive, cost-effective, which enhances the quality of rapid diagnosis of central nervous diseases, including those of vascular genesis, in in- and outpatient settings.     

接种甲型H1N1流感疫苗后患甲型H1N1流感分析

目的 分析接种甲型H1N1流感疫苗后发生甲型H1N1流感感染的病例,探讨发病原因,为进一步提高疫苗预防效果提供参考依据.方法 对接种甲型H1N1流感疫苗后发生甲型H1N1流感感染148例,进行回顾性调查分析.结果 接种甲型H1N1流感疫苗11176例.发生甲型H1N1感染148例,感染率1.32%,其中1～14 d感染81例,感染率0.72%,＞15 d感染67例,感染率0.60%.结论 甲型H1N1流感病毒裂解疫苗是一种安全高效的疫苗,不足之处尚待进一步探讨、完善.     

NF1 gene and neurofibromatosis 1

Neurofibromatosis 1 (NF1), also known as von Recklinghausen disease, is an autosomal dominant condition caused by mutations of the NF1 gene, which is located at chromosome 17q11.2. NF1 is believed to be completely penetrant, but substantial variability in expression of features occurs. Diagnosis of NF1 is based on established clinical criteria. The presentation of many of the clinical features is age dependent. The average life expectancy of patients with NF1 is probably reduced by 10-15 years, and malignancy is the most common cause of death. The prevalence of clinically diagnosed NF1 ranges from 1/2,000 to 1/5,000 in most population-based studies. A wide variety of NF1 mutations has been found in patients with NF1, but no frequently recurring mutation has been identified. Most studies have not found an obvious relation between particular NF1 mutations and the resulting clinical manifestations. The variability of the NF1 phenotype, even in individuals with the same NF1 gene mutation, suggests that other factors are involved in determining the clinical manifestations, but the nature of these factors has not yet been determined. Laboratory testing for NF1 mutations is difficult. A protein truncation test is commercially available, but its sensitivity, specificity, and predictive value have not been established. No general, population-based molecular studies of NF1 mutations have been performed. At this time, it appears that the benefits of population-based screening for clinical features of NF1 would not outweigh the costs of screening.     

GSTM1及GSTT1和GSTP1基因多态性对尿中1-羟基芘水平的影响

目的 研究GSTM1、GSTT1和GSTP1基因多态性对多环芳烃接触工人尿中1-羟基芘(1-OHP)水平的影响.方法 分别选取2个炼焦厂共447名多环芳烃职业接触工人(接触组)和某线材厂220名非职业接触工人(对照组)作为研究对象,采用高效液相色谱法测定尿中1-OHP水平,采用线性回归统计模型分析GSTM1和GSTT1缺失型及GSTP1 I105V位点的多态性对不同人群尿中1-OHP水平的修饰作用.结果 接触组工人尿中1-OHP浓度为4.61 μmol/mol Cr,明显高于对照组(0.34μmol/mol Cr),差异有统计学意义(P＜0.05).接触类别和吸烟分别是影响尿中1-OHP水平的主要因素,在控制各混杂因素的影响后,线性回归分析显示,接触组尿中1-OHP水平和GSTP1 I105V位点多态性有关(单基因分析,P=0.012;多基因分析,P=0.011),对总体样本,单基因模型和多基因模型均显示,尿中1-OHP水平可能和GSTT1缺失型多态有关(P=0.055),多基因交互作用分析显示,GSTT1和GSTP1基因多态对接触组尿中1-OHP水平具有交互作用.结论 谷胱甘肽硫转移酶(GSTs)基因的多态性对接触多环芳烃工人尿中1-OHP水平有影响.

Abstract：

Objective To investigate the modification of GSTM1, GSTT1 and GSTP1 gene polymorphisms on urinary 1-hydroxypyrene (1-OHP) excretions in workers under different exposure levels. Methods Four hundred and forty-seven occupationally exposed workers from two coking plants and 220 control workers from a wire rod plant were genotyped to analyze the modification of GSTM1, GSTT1 and GSTP1 gene polymorphisms on urinary 1-OHP excretions. Results The urinary 1-OHP concentration in exposed group was much higher than that in control group (4.61 vs 0.34 μmol/mol Cr, P＜0.05). Occupational exposure levels and cigarette smoking were of the dominating factors affecting 1-OHP excretions in urine. After controlling potential confounders, decreased excretion of urinary 1-OHP was associated with GSTP1 I105V AG + GG genotype in coke oven workers (single-gene model, P=0.012; multi-gene model, P=0.011 ) and with GSTT1 null type in the analysis including all subjects (P=0.055 in both single-gene and multi-gene models). GSTT1 and GSTP1 were interacted on the urinary concentrations of 1-OHP. Conclusion Urinary 1-OHP concentrations can be modified by GSTM1, GSTT1 and GSTP1 gene polymorphisms, indicating that these genes are involved in the metabolism of polycyclic aromatic hydrocarbons.     

Co-circulation of pandemic 2009 H1N1, classical swine H1N1 and avian-like swine H1N1 influenza viruses in pigs in China

The pandemic A/H1N1 influenza viruses emerged in both Mexico and the United States in March 2009, and were transmitted efficiently in the human population. They were transmitted occasionally from humans to other mammals including pigs, dogs and cats. In this study, we report the isolation and genetic analysis of novel viruses in pigs in China. These viruses were related phylogenetically to the pandemic 2009 H1N1 influenza viruses isolated from humans and pigs, which indicates that the pandemic virus is currently circulating in swine populations, and this hypothesis was further supported by serological surveillance of pig sera collected within the same period. Furthermore, we isolated another two H1N1 viruses belonging to the lineages of classical swine H1N1 virus and avian-like swine H1N1 virus, respectively. Multiple genetic lineages of H1N1 viruses are co-circulating in the swine population, which highlights the importance of intensive surveillance for swine influenza in China.