流感防控管理在预防院内流感样病例中的作用分析

目的研究流感防控管理在预防院内流感样病例中的作用。方法以我县第一人民医院和第三人民医院于2016年7月-2018年7月期间收治的394例住院患者作为研究对象,第一医院为研究组,第三医院为对照组,两组患者均为197例,将常规卫生管理模式应用于对照组,在此基础上将流感防控管理应用于研究组,研究比较两组患者各项临床指标。结果研究组患者院内流感样症状发生率低于对照组(P<0.05),发热(体温≥38 oC)伴咳嗽、咽痛发生率低于对照组(P<0.05)。结论采用流感防控管理措施可有效预防院内流感发生,临床效果显著,值得推广应用。     

脓毒症细菌快速诊断检测的研究现状与展望

脓毒症是复杂的病理生理状态,是当今危及患者生命的主要原因之一.脓毒症与细菌感染密切相关,早期诊断、合理治疗能有效减少患者病死率.细菌检验方法包括传统方法如细菌培养、分子生物学核酸扩增、质谱、基因芯片、生物传感器等.尽管诊断实验方法多样,病原学实验室检测仍不能满足临床早期诊断的需求,快速检测仍是困扰临床工作的一大难题.本文拟对实验方法学做一简要综述,为临床工作诊疗提供参考,为探索细菌学快速检测提供思路.     

甲型H1N1流感的医院感染防控

目前,甲型H1N1流感正处于快速流行期,为确保住院病人就医和医务人员的安全,作为本次甲型流感定点收治医院,坚持病人就诊流程,做好住院病人隔离,认真执行消毒隔离规范,诊疗护理病人时实施有效防护,可以有效预防甲型H1N1流感医院感染的发生.     

中国内地首例甲型H1N1流感患者住院防控措施

2009年3月墨西哥和美国先后暴发流感疫情,并出现死亡病例.4月30日世界卫生组织(以下简称WHO)宣布将流感大流行警告级别提高为5级.本次发生的甲型H1N1流感是由变异后的新型甲型H1N1流感病毒所引起的急性呼吸道传染病,通过飞沫、气溶胶、直接接触或间接接触传播.     

发热门诊应对甲型H1N1流感的对策

根据国家法律法规及传染病流行特征，做好传染病预防控制、监测、接诊、治疗、报告、消毒隔离、咨询、指导，积极应对爆发传染性疾病的蔓延，发热门诊始终坚持早发现、早报告、早诊断、早隔离、早治疗的原则，合理的设施与布局是保证接诊工作正常进行的基础；其中，严格的就诊流程管理及医护人员的严密防护，病人转诊后的严格消毒，每个环节都是不能忽视的重要工作之一。     

关于进一步完善甲型H1N1流感防控措施的通知

为更科学、更积极主动、更有效地做好下一阶段全国甲型H1N1流感防控工作．更加突出防控措施的针对性和持续性，切实保障人民群众健康和生命安全，现就完善疫情防控工作有关措施提出以下要求。     

发热门诊甲型流感患病人群分布特点

目的探讨发热门诊甲型流感患病人群分布的特点。方法对2009年11月1日～10日空军总医院发热门诊共1084例发热患者,使用甲型流感病毒检测试剂盒（胶体金法）检测患者鼻黏膜分泌物,进行甲型流感初筛,对患病人群的性别、年龄、感染率等进行统计学分析。结果1084例就诊患者中292例甲流筛查阳性,阳性率为26．9％。男性甲流阳性率为28．2％,女性为25．6％,男、女甲流患病率差异无统计学显著性意义（P〉0．05）;不同年龄组阃进行R&#215;C表资料的妒检验：各年龄组在总体上差异有统计学显著性意义（P〈0．05）;0～15岁组感染人数占总感染数的44．4%,为感染率最高组;其他各年龄组感染率分别为：16～20岁,32．8％;21～30岁,20．8％;≥31岁,12．0%。结论甲流感染无性别差异;感染人群趋向于低龄人群,感染率随年龄增高呈逐渐下降趋势。提醒人们要对青少年儿童实施加倍的防护,以杜绝群体感染。     

血液透析患者甲型H1N1流感的防控

目的研究血液透析患者甲型H1NI流感的防控措施。方法通过分批隔离和病房临时隔离管控措施,对在本医院血液净化中心作血液透析的甲型H1N1流感患者实施防控。结果在甲型H1N1流感流行期间,本医院血液净化中心确诊3例甲型H1N1流感患者,占同期68例血透患者的4.41%。实施防控干预措施后,血透患者中未出现续发病例。结论血透患者是甲流的易感高发人群,早期采取措施能够有效控制甲流的流行。     

发热门诊应对甲型H1N1流感患者的护理体会

目的：防止甲型H 1N 1流感引起医院内感染。方法：加强护理人员的培训,严格执行消毒隔离制度,做好发热患者和医务人员的个人防护,实行人性化护理与管理。结果：2009年10月27日—2009年11月31日共收治发热患者253例,其中8例确诊为甲型H 1N 1流感患者,疑似6例,医务人员达到零感染。结论：无论是疑似患者、确诊患者,还是发热待诊的患者,只要高度重视,严格执行消毒隔离措施,遵守各项工作流程,就可以防止医院内感染,提高护理质量和满意度。     

综合医院发热门诊应对甲型H1N1流感的做法与效果

目的 积极有效应对甲型H1N1流感疫情的蔓延。方法坚持早发现、早报告、早诊断、早隔离、早治疗的原则,严格按接诊流程管理,实施标准预防,规范终末消毒。结果确诊甲型H1N1流感病例3例,未发生因防护不当出现院内感染的二代病例。结论科学防护、严格管理是有效应对甲型H1N1流感行之有效的方法。     

流感病毒快速诊断的临床应用价值

目的 评估流感病毒快速检测法在临床应用中的价值.方法 从2010年10月至2012年5月,在该院发热门诊每日随机选择年龄在2～8岁符合卫生部流感样病例患者7～10例留取鼻咽分泌物进行流感病毒抗原快速检测,同时调查患者基本信息、临床症状、诊治情况等,并对在该院流感病毒快速检测达到3次阳性的患者进行细菌培养和耐药性分析.另从在该院诊治为流感样病例3次及以上的2～8岁患者中随机选取从未进行流感病毒抗原快速检测的相同例数作为对照组,调查内容同实验组.结果 留取鼻咽分泌物进行流感病毒抗原快速检测人次为5 122例,阳性报告1 885例,阳性报告率为36.8%;达3次阳性的患者进行细菌培养和耐药分析最终有208例纳入分析.结果 如下:在对照组按流感病毒阳性报告率36.8%计算,实验组及对照组的抗菌药物使用率分别为5.8%(12/208)剧增至26.9%(56/208);细菌感染比例由4.3%(9/208)大幅提升到24.0%(50/208),耐药比例由2.9%(6/208)增加到13.9%(29/208),差异具有统计学意义(P<0.05).结论 对流感样病例进行流感病毒快速检测,可明显降低抗菌药使用率和患者的细菌感染率,并提高患者的药敏水平,降低患者的耐药程度.同时,有利于指导临床医生在患者临床早期进行有效的抗病毒治疗以减少目前医疗机构广泛存在的抗生素滥用现象.     

微量血糖仪在快速诊断新生儿低血糖中的应用价值

目的:评价微量血糖仪在快速诊断新生儿低血糖中的应用价值。方法:对725例新生儿同时采用微量血糖仪纸片法测定毛细血管全血血糖水平和生化室己糖激酶法测定静脉血浆血糖水平,微量血糖仪纸片法全血血糖<2.2mmol/L和生化室己糖激酶法血浆血糖<2.6mmol/L为各自诊断新生儿低血糖的标准,以生化室己糖激酶法血浆血糖<2.6mmol/L为金标准,采用Yerushalmy四格表评价模式,计算敏感度、特异度、准确度、阳性似然比和阴性似然比。结果:微量血糖仪纸片法诊断新生儿低血糖敏感度欠佳(56.0%),特异度高(99.2%)。结论:微量血糖仪纸片法在诊断新生儿低血糖时误诊率极低,但可能会漏诊,可考虑适当提高诊断阈值来降低漏诊率。     

细胞学在术中快速病理诊断中的应用价值

目的探讨细胞学在术中快速病理诊断中的应用价值。方法对458例术中病理标本同时做细胞学涂片检查和冷冻切片检查,并与术后石蜡切片对比,分析各自的准确性。结果冷冻切片和细胞学涂片的准确率分别为96.5%和92.4%,二者相结合诊断的准确率为99.1%。结论细胞学是一种较好的快速诊断方法,能够与冷冻切片相互弥补不足,结合冷冻切片可提高诊断的准确性。     

Development and evaluation of multiplex PCR in rapid diagnosis of abdominal tuberculosis

The clinical features of abdominal tuberculosis (TB) are non-specific and establishing a diagnosis remains a challenge. A delay in diagnosis is likely to increase the morbidity in these patients. We developed a multiplex polymerase chain reaction (PCR) using 16SrRNA, IS6110, and devR, and evaluated it in comparison with other conventional tests in clinical suspects of abdominal TB. A total of 183 patients with clinical suspicion of abdominal TB (96 patients with intestinal TB and 87 with peritoneal TB) were enrolled for the study. Endoscopic or intraoperative biopsies were collected from patients suspected of intestinal TB and ascitic fluid was collected from patients with a suspicion of peritoneal TB. Of the intestinal tuberculosis group, there were 40 confirmed cases and 56 controls, while of the peritoneal tuberculosis group there were 37 confirmed cases and 50 controls. Multiplex PCR showed a high sensitivity and specificity in both the intestinal TB and peritoneal TB groups. When combined with histopathology, multiplex PCR could detect 97.5% of all the cases in the intestinal tuberculosis group, while in combination adenosine deaminase levels (ADA) in cases of peritoneal tuberculosis it increased the specificity of diagnosis of peritoneal tuberculosis to 95%. In combination with histopathology in suspected intestinal TB cases, and ADA testing in suspected peritoneal TB cases, it can be used as a highly sensitive, specific, and rapid diagnostic tool with the ability to supplement the limitations of other diagnostic modalities.     

印片细胞学在病理诊断中的应用价值

目的探讨印片细胞学检查在术中快速病理诊断的应用价值：方法对341例术中送检新鲜标本进行印片细胞学快速诊断，并与术后石蜡切片相对照。结果与常规切片诊断对比分析，印片细胞学诊断准确率为97．07％。结论术中印片细胞学检查是适合基层医院开展的一种快速、简便、准确率高的术中快速病理诊断方法。     

Influenza viral load and rapid influenza diagnostic tests in children and adults

We compared children and adults with regard to rapid influenza test sensitivity and viral load. Specimen volumes were measured, rapid tests were conducted, and viral load was determined. There was no difference between children and adults in test sensitivity or viral load, but children had higher specimen volumes.     

Evaluation of a rapid strip and a particle agglutination tests for syphilis diagnosis

The availability of new diagnostic approaches, which are easier and faster to perform than conventional tests, offers the opportunity to improve the attention given to public health problems as syphilis. This study aimed to evaluate a rapid immunochromatographic strip test (Determine TP; Abbott Laboratories, Chicago, IL) and a nonequipment demanding particle microagglutination test (Serodia TP-PA; Fujirebio, Japan) for qualitative detection of treponemic antibodies. Sera from 548 women belonging to 3 population groups were tested; one of them showing low syphilis seroprevalence (1.5%) and the other 2 showing higher seroprevalences (>15%). By comparison with the gold standard (Venereal Disease Research Laboratories plus fluorescent treponemal antibody absorption), sensitivity and specificity values for both diagnostic tests were calculated. Sensitivity values of both tests evaluated were higher than 95% for 2 groups of 3 addressed; in one of the high syphilis prevalence groups, Serodia TP-PA showed 88.6% sensitivity. Specificity values were above 95% for all 3 groups. The use of simple/rapid treponemic tests as those included here may prove to be a suitable replacement for the traditional syphilis serology diagnosis approach, particularly at primary care settings.     

Evaluation of influenza vaccination in health-care workers, using rapid antigen detection test

A study was conducted to assess the effectiveness of trivalent influenza vaccine in preventing influenza and reducing absenteeism in health-care workers of Gifu Red Cross Hospital during the 2002–2003 influenza season. Questionnaires were distributed to 370 health-care workers, and 366 were returned showing that 237 had received influenza vaccine and 129 were unvaccinated. The criterion for influenza was febrile episodes with a positive reaction on a rapid antigen detection test. Among vaccine recipients, the number of influenza infections was 3.4 per 100 subjects, compared with 8.5 per 100 subjects in nonrecipients (P = 0.034), and the number of days absent from work per 100 subjects was 9.5, compared with 15.1 per 100 subjects in nonrecipients (P = 0.0003). The prevalence of adverse reactions to the vaccine was rather low. No serious adverse reactions were recorded and no one was absent from work because of adverse reactions. It is concluded that influenza vaccine is effective in preventing influenza and reducing absenteeism in health-care workers. The results of this study support recommendations for influenza vaccination in health-care workers.     

Xpert Flu for point-of-care diagnosis of human influenza in industrialized countries

Respiratory infections, particularly those caused by influenza viruses, represent the third-most important cause of death in the world due to infectious diseases. Nevertheless, despite the enormous publicity attracted by epidemics due to these viruses, laboratory diagnosis, documentation and recording of respiratory diseases is still unsatisfactory. Available diagnostic tests capable of providing results rapidly are either limited and insufficiently sensitive or highly sensitive and specific but insufficiently rapid. Considerable investment and research efforts have been made towards the development of new diagnostics for influenza A and B viruses and the Xpert^® Flu assay (Cepheid^®, CA, USA) has emerged as one of the most promising. In this article, we review current knowledge of the Xpert Flu test, discuss its potential value as a point-of-care test and outline the potential leads for future development.     

Influenza vaccine, anti-influenza drugs, and rapid diagnosis in Japan

The percentage of individuals receiving influenza vaccine is markedly lower in Japan than in many other economically advanced countries. To increase the rate of coverage, the current practice of giving people two inoculations instead of one needs to be changed. In addition, free vaccination services for the elderly and high-risk patients need to be offered. Amantadine is available for the treatment of influenza type A infection in Japan. Moreover, zanamivir, a neuraminidase inhibitor effective against both influenza type A and B viruses, has been approved in Japan. A rapid diagnosis kit for influenza type A virus is available in Japan. With the current threat of new pandemic influenza viruses emerging, it is necessary to actively confront influenza in Japan by increasing the vaccine coverage rate, by employing amantadine and neuraminidase inhibitors for influenza virus infection, and by providing rapid diagnosis of influenza. Received: January 13, 2000 / Accepted: January 31, 2000