贵州省首例重症人感染高致病性H5N1亚型禽流感致急性呼吸窘迫综合征患者的机械通气策略探讨

目的 探讨重症高致病性H5N1人禽流感病例急性呼吸窘迫综合征(ARDS)机械通气策略.方法 对2009年1月15日本院收治的1例重症高致病性H5N1亚型禽流感感染患者的资料进行分析、总结.结果 患者男性,29岁,发病前有家禽宰杀史,以畏寒、发热起病,持续高热,继之出现进行性呼吸困难.1月19日(发病5 d)胸部影像学可见以左下肺为主的双肺炎症表现,迅速进展出现ARDS样肺部表现.立即给予机械通气为主的综合治疗措施,通气模式为同步间歇指令通气+压力支持+呼气末正压(SIMV+PS+PEEP),采用小潮气量肺通气保护策略,病情逐日好转,无多器官功能降碍发生,2月6日痊愈出院.结论 早发现、早诊断、早治疗是成功救治高致病性H5N1人禽流感的前提,小潮气量加最佳PEEP通气策略改善氧合是治疗的关键.     

2011-2015年九江市职业暴露人群血清学和环境禽流感病原学监测结果分析

目的 了解九江市2011年至2015年职业暴露人群H5N1禽流感病毒抗体水平和环境中禽流感病毒的感染状况,以期为九江市人感染高致病性禽流感的防控提供技术支持.方法 马红细胞血凝抑制试验(HI)检测禽类养殖人群H5N1血凝素抗体;real-time PCR对环境标本进行A型检测,对A阳性进一步检测H5、H7和H9亚型;结果 1340份职业人群血清H5N1血凝素抗体均为阴性;5个年度中1461份环境标本禽流感病毒核酸检测A型阳性率为30.94%,其中H5、H7、H9阳性率分别为10.47%(153/1461)、0.55%(8/1461)、21.77%(318/1461),A未分型阳性率为3.90%(57/1461).结论 九江市禽类中存在H5、H7、H9亚型感染,存在人感染高致病性禽流感的风险,应加强禽流感病毒感染监测.     

1例人禽流感患者的观察与护理

H5N1亚型高致病性禽流感发病快,病情进展迅速,病死率高。我院2006年2月18日收治1例不明原因肺炎合并ARDS人禽流感患者,后经中国疾病预防控制中心确认为HSN1亚型高致病性人禽流感。经精心治疗和护理,患者于2006年3月23日治愈出院。现将其护理体会报告如下。     

2012年全球动物与人相关流行性感冒病毒感染人类的最新情况

1人感染高致病性禽流感（I-15N1）1．1时间和地区分布2012年,尽管一些国家家禽病毒持续广泛流行,但实验室确诊的人感染高致病性禽流感（H5N1）病例数下降。从2009年的73例、2010年的48例和2011年的62例下降到2012年的32例。32例人感染高致病性禽流感（H5N1）病例中有11例发生在埃及,9例发生在印度尼西亚,4例发生在越南,3例发生在柬埔寨,3例发生在孟加拉国,2例在中国。根据联合国粮农组织（FAO）情报,高致病性禽流感（H5N1）病毒在孟加     

高致病性H5N1亚型人禽流感病毒性肺炎的影像学表现特点

目的探讨高致病性H5N1亚型人禽流感病毒性肺炎的影像学检查方法及胸部X线与CT影像表现特点。方法回顾性分析2006年6月深圳接诊的首例由卫生部确诊,并经过抢救治疗痊愈的高致病性H5N1亚型人禽流感病毒性肺炎患者的相关临床及影像学资料。结果胸部影像学特点是：①磨玻璃样影、大小片状影及肺实变影是人禽流感病毒性肺炎较早出现的影像表现;②病灶侵犯肺组织广泛,表现为多叶多段的两肺广泛受累;③病灶蔓延变化迅速;④肺实质、肺间质及胸膜受累可同时存在;⑤病灶吸收慢、迁延时间长,恢复期有肺纤维化的影像表现。结论影像学检查与诊断仍然是人禽流感病毒性肺炎的临床诊断、鉴别诊断、疗效评价及预后分析的重要手段。动态观察人禽流感病毒性肺炎的影像学变化及影像学表现特点,监测ARDS和肺部继发感染等并发症的发生,利于指导临床及时有效地进行治疗。     

高致病性禽流感的临床特点及预防措施

人感染高致病性禽流感是由禽甲型流感病毒某些亚型中的一些毒株如H5N1、H7N7等引起的人类急性呼吸道传染病。近年来H5N1型禽流感病毒在全球蔓延,不断引起人类发病,并且推测这一病毒可能通过基因重配或突变演变为能引起人类流感大流行的病毒,当前已成为全球关注的焦点。由于疾病     

1例人感染H7N9高致病性禽流感患者的护理

H7 N9亚型禽流感病毒是甲型流感中的一种。2013年3月底,在上海和安徽两地率先发现3人感染H7 N9禽流感病例。H7 N9型禽流感是全球首次发现的新亚型流感病毒,故在临床上护理人感染H7 N9型高致病性禽流感患者仍缺乏一定的经验。2013年4月本院收治了1例人感染H7 N9高致病性禽流感患者,现将护理体会报道如下。     

护理管理在救治高致病性禽流感患者中的作用

人感染高致病性禽流感A（H5N1）（人禽流感）是人类在接触该病毒感染的病／死禽或暴露在被A（H5N1）感染的环境后发生的感染。我院收治了一例高效病性禽流感患者经全力救治，成功挽救了患者生命。现将护理管理在救治高致病性禽流感患者中的作用报告如下。     

动物源性流感病毒的抗原遗传学特性和应对流感大流行的疫苗候选病毒研究动态 (2013年2月)

自从2003年再次出现以来,高致病性禽甲型流行性感冒（流感）（H5N1）病毒在一些国家的动物间传播,在家禽中持续引起暴发疫情,并出现散发的人感染病例。为做好禽流感（H5N1）大流行的应对准备,针对禽流感（H5N1）病毒遗传抗原学的多样化需要候选多类型疫苗病毒。本文摘要报告了从禽类和人类分离的甲型流感（H5N1）病毒特性最新情况,介绍了甲型流感（H5N1）疫苗候选病毒的研究情况。     

H5N1型高致病性人禽流感重症肺炎患儿的护理

1997年香港地区发生H5N1型人禽流感，导致6人死亡。在世界范围内引起了广泛关注。近年人们又先后获得H9N2、H7N2、H7N3亚型禽流感病毒感染人类的证据。2003年末至今，我国大陆及亚洲多个国家和地区爆发H5N1高致病性禽流感，同时高致病性禽流感病毒H5N1亚型向接触人群传播。造成多人死亡。本次暴发的规模、传播速度、波及范围是40年来最严重的。截止2006年3月8日，卫生部报告我国有15例感染高致病性禽流感H5N1患者，其中10例死亡。在4例治愈出院的患者中有2例患儿在我院救治成功，现报道如下。     

A Km mutant of arylsulfatase A

Semi-micro techniques are presented for the genotyping of galactokinase and galactose-1-phosphate uridyltransferase. Radioactive assays are used to quantitate the levels of enzyme activity, while agarose gel electrophoresis is used to type the variants of galactose-1-phosphate uridyltransferase. All three methods can be performed on 1 ml whole blood, making the procedures ideal for use in confirmation of galactosemia or galactokinase deficiency in newborn screening programs.     

Hepatitis A: A preventable threat

Hepatitis A is a major public health problem, particularly in the pediatric population. Although hepatitis A infection does not cause chronic liver disease, it is associated with significant morbidity. The virus is transmitted primarily by person-to-person contact via the fecal-oral route. The infection can be inapparent, subclinical, anicteric, or icteric. In general, the severity of the disease is inversely correlated with the age of the child. Occasionally, fulminant hepatitis, which is associated with a high mortality rate, may result. The diagnosis of acute hepatitis A is most commonly made through the detection of immunoglobulin M (IgM) anti-hepatitis A antibody. Treatment is generally supportive. General preventive measures include improved standards of hygiene and sanitation. Universal childhood vaccination is the most effective method for eradicating hepatitis A and preventing its transmission.     

RHD845A/1227A基因型个体家系调查分析

本研究对1例RHD845A/1227A基因型个体进行家系调查分析,并分析他们的遗传特性。通过盐水法和间接抗人球蛋白试验（IAT）检测RH（D）抗原,PCR—SSP法检测RHD1227A和RHD845A等位基因以及RHD合子型,基因测序方式分析RIHD基因编码区序列。研究结果表明：血清学检测发现1例RH（D）抗原盐水法检测阴性、IAT法检测阳性样本,经RHD基因编码序列分析发现,RHD第845位与第1227位均出现G／A碱基杂合现象,推测该个体基因型可能为RHD845A／1227A。家系调查显示,先证者父亲为RHD阴性,母亲为RHD阳性。PCR-SSP检测结果显示,父亲携带RHDl227A等位基因,基因型为RHD845A／RHD-;母亲携带RHD845A等位基因,基因型为RHD845A／RHD＋,证明先证者分别从父亲和母亲遗传RHD1227A和RHD845A等位基因,基因型为RHD845A／1227A。结论：经过家系调查分析发现了1例罕见的RHD845A／1227A基因型个体。根据家系调查证明,RHD845A和RHD1227A等位基因分别由遗传获得,而非由个体基因变异形成。     

Potential Therapeutic Applications of Adenosine A2A Receptor Ligands and Opportunities for A2A Receptor Imaging

Adenosine A_2A receptors (A_2ARs) are highly expressed in the human striatum, and at lower densities in the cerebral cortex, the hippocampus, and cells of the immune system. Antagonists of these receptors are potentially useful for the treatment of motor fluctuations, epilepsy, postischemic brain damage, or cognitive impairment, and for the control of an immune checkpoint during immunotherapy of cancer. A_2AR agonists may suppress transplant rejection and graft‐versus‐host disease; be used to treat inflammatory disorders such as asthma, inflammatory bowel disease, and rheumatoid arthritis; be locally applied to promote wound healing and be employed in a strategy for transient opening of the blood–brain barrier (BBB) so that therapeutic drugs and monoclonal antibodies can enter the brain. Increasing A_2AR signaling in adipose tissue is also a potential strategy to combat obesity. Several radioligands for positron emission tomography (PET) imaging of A_2ARs have been developed in recent years. This review article presents a critical overview of the potential therapeutic applications of A_2AR ligands, the use of A_2AR imaging in drug development, and opportunities and limitations of PET imaging in future research.     

A PHYSIOLOGICO-PATHOLOGICAL STUDY OF A CASE OF HEART-BLOCK OCCURRING IN A DOG AS A RESULT OF NATURAL CAUSES

What is believed to be the first known case of heart-block arising in a dog as a result of an ingenerate pathological lesion is here reported. The auriculo-ventricular dissociation was of that degree known as relatively complete block and became apparent on section of the right vagus nerve. Stimulation of the peripheral end of the cut vagus failed to inhibit the ventricles, although complete inhibition of the auricles occurred. The same results were obtained during the ventricular acceleration produced by strophanthin, so that the failure of the vagus to inhibit the ventricles is not due to the latter''s infrequent action, but more probably to a normal lack of direct chronotropic influence upon the ventricular muscle. These findings are similar to those obtained by Erlanger in experimental heart-block. To small repeated doses of strophanthin injected intravenously the heart reacted as follows: (a) irregular slowing of the auricles and conversion of the relatively complete into an absolutely complete a-v block; (b) a rise in the irritability of the cardiac muscle manifested by a rapidly progressing auricular and ventricular frequency, the ventricular frequency surpassing ultimately the auricular frequency; (c) complete arrest of the auricles, the ventricles continuing at their high rate; (d) sudden fibrillation of the ventricles and shortly afterwards arrest in diastole. There were found post mortem myxomatous-like thickenings at the free edge of the septal tricuspid leaflet and at the attached margin of the posterior aortic leaflet and along part of the right anterior aortic leaflet. There was also a grayish patch on the right side of the auricular septum above the auriculo-ventricular junction. The thickenings at the edge of the valves consisted of dense, circumscribed masses of what appeared to be new connective tissue. The same tissue was found pressing against the bundle along the greater part of the latter''s course. There was considerable fatty infiltration of the auricular musculature immediately above the bundle and, to a slight extent, of the bundle itself. The fibers of communication between the auricular muscle and the node of Tawara were relatively few as compared with those of the normal heart. A review of the pathology of heart-block is appended, showing the present status of the question, concerning the relationship existing between disease of the a-v conducting system and the various grades of heart-block.