三起甲型H1N1流感暴发疫情的流行病学分析

目的了解三起甲型H1N1流感暴发疫情现场流行病学特征。方法运用Epidata 3.0编制病例调查表进行数据录入,用SPSS13.0对数据进行统计学分析。结果三起甲型H1N1流感伴季节性流行性感冒疫情患者的临床症状以发热、咳嗽、头痛、咽痛等为主。三起疫情中,所有甲型H1N1流感和季节性流行性感冒疫情患者,除发热、头痛、肌肉酸痛、腹泻等全身症状外,其它如咳嗽、咽痛等上呼吸道感染症状差异均有统计学意义;三个时段甲型H1N1流感确诊患者症状分布,除鼻塞、流涕症状比较差异有统计学意义外,其他症状差异无统计学意义。结论在出现甲型H1N1流感暴发疫情时,存在其它类型季节性流感、上呼吸道感染等疾病混杂的现象;同一名患者感染甲型H1N1流感病毒的同时也有可能混合其它类型流感病毒感染;随着时间推移,并没有发现甲型H1N1流感病毒毒力加强的现象。     

年轻人群甲型H1N1病毒感染排毒规律研究

目的探讨年轻人群甲型H1N1病毒感染排毒规律。方法收集2009年10月-2010年1月医院就诊的67例甲型H1N1患者临床资料,对患者每天进行连续咽拭子采样,采用实时荧光定量PCR法检测甲型H1N1病毒,进而对两组患者临床特征、病毒排出规律进行分析;同期37例季节性流感患者作为对照。结果 H1N1组患者中82.1%出现发热症状,但高热发生率(7.5%)明显低于季节性流感组(21.6%),差异有统计学意义(P<0.05);H1N1组患者平均排毒天数为(6.390±1.466)d,但自发病之日起7 d仍有31.3%患者排出病毒;退热后平均排毒天数为(4.51±1.79)d,3.0%患者退热后7 d仍有病毒排出。结论年轻人群甲型H1N1病毒感染后临床症状与季节性流感相似,但自发病之日起7 d仍有31.3%患者排出病毒,这提示感染后经验性隔离7 d尚存在传播风险,应考虑适当延长;日常生活接触传播在所观察的轻症年轻人群中可能性较小。     

上海市闵行区甲型H1N1流感监测及临床相关特征分析

目的:了解上海市闵行区人群甲型H1N1流感流行病学和相关临床特征,为甲型H1N1流感防控提供科学依据。方法:收集闵行区2009年-2010年甲型H1N1流感监测哨点及流行病学资料,回顾性分析甲型H1N1流感病例的流行病学和临床特征。结果:闵行区于2009年8月-2010年3月发生甲型H1N1流感疫情,共报告甲型H1N1流感确诊病例232例,占同时期流感样病例(ILI)采样数的33.48%,甲型H1N1流感病毒是此次流感大流行的优势毒株。大部分甲型H1N1流感病例集中于区内中心区域,发病人群以青少年、青壮年为主,其中学生和干部职员占大部分,主要症状为发热、头痛、咽痛、咳嗽等类似季节性流感症状,无危重病例。结论:闵行区甲型H1N1流感感染人群以青少年和青壮年为主,发病具有明显年龄、人群差异,主要症状类似季节性流感。     

甲型H1N1流感感染的临床特点分析

目的 总结甲型H1N1流感和与普通的季节性流感的临床特点,有助于提高对甲型H1N1流感的认识,减少医护人员和住院患者被感染.方法 采用回顾性调查的方法,对医院收治的甲型H1N1流感感染患者的临床资料进行了总结,并与普通的季节性流感病例的体温变化、血常规及胸片作r对比分析.结果 甲犁H1N1流感感染患者的症状尤特殊性,体温变化、血常规与普通的季节性流感病例差异均无统计学意义(P>o.05);两组胸片均无异常;甲型H1N1流感感染患者的咽拭子标本在发热时检测为阳性,体温正常后检测为阴性,对照组在发热时和退热后均为阴性;两组患者预后均好,无并发症发生.结论 甲型H1N1流感感染患者的临床表现,与普通的季节性流感相似,无特殊的临床表现.     

拉萨190例甲型H1N1流感的流行病学特点及临床分析

目的 探讨2009年拉萨甲型H1N1流感的流行病学特征及临床特点.方法 对2009年9-12月我院收治的190例甲型H1N1流感确诊病例的流行病学、临床表现及实验室检查等资料进行回顾性分析.结果本次拉萨地区暴发的甲型H1N1流感主要发生在秋冬季,9、10月为高峰.190例病例中,男性106例(55.79%),女性84例(44.21%),患者的平均年龄(16.66±9.78)岁,以7～17岁为主,学生139例(73.16%),藏族144例(75.79%).临床表现以发热、咳嗽、咽痛、咽充血和扁桃体肿大为主,172例有发热(90.53%).所有病例均未接种过甲型H1N1流感疫苗,入院时甲型H1N1流感病毒核酸检测均为阳性,176例(92.63%)病毒快速检测阳性.174例(91.58%)使用利巴韦林等抗病毒治疗取得较好疗效,184例痊愈出院,无死亡病例.结论 本组患者均为易感人群,因此流行期间接种甲型流感疫苗,提高人群免疫力势在必行.     

社区甲型流感临床特征分析与比较

目的分析和比较社区散发新型甲型H1N1流感和季节性流感临床特征,为临床诊治甲型流感提供参考依据。方法回顾性分析2009年5-10月来医院发热门诊就诊的具有流感样症状的患者,均经实时荧光定量PCR检测。结果在确诊的129例甲型流感患者中,新型甲型H1N1流感65例,占50.4%,季节性甲型流感64例,占49.6%;新型甲型H1N1流感组平均年龄21岁,季节性甲型流感组36岁,两组差异有统计学意义(P<0.01);新型甲型H1N1流感组学生占47例,占72.3%,季节性甲型流感组13例,占20.3%,两组差异有统计学意义(P<0.01);从临床表现比较,除流涕、扁桃体肿大,两组差异有统计学意义(均P<0.01)外;其他差异均无统计学意义。结论医院确诊的甲型流感患者均为轻型;新型甲型H1N1流感以年轻学生为主;两组甲型流感临床特征相似,需经PCR检测确诊分型。     

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。     

甲型H1N1流感患者200例临床特征分析

目的研究甲型H1N1流感的临床特征,为今后的临床诊断提供依据。方法将于2017年10月-2018年10月期间在天津市津南区疾病预防控制中心进行PCR检测的甲型H1N1流感患者200例纳为H1N1流感组,将同时期在天津市津南区疾病预防控制中心进行PCR检测的季节性流感患者200例纳为季节性流感组。通过回顾性分析的方法,比较两组患者的一般资料、临床表现,总结出甲型H1N1流感患者的临床症状。结果 H1N1流感组和季节性流感组患者的临床表现主要均以头痛、咳嗽、咽喉痛、全身酸痛、关节疼痛为主,H1N1流感组患者的临床症状发生率高于季节性流感组,差异有统计学意义(P0.05);H1N1流感组患者的最高体温、发热天数明显高于季节性流感组,差异有统计学意义(P0.05)。结论甲型H1N1流感患者的临床症状与季节性流感类似,但二者在某些指标及症状方面存在差异。     

中学甲型H1N1流感暴发病原学检测与调查

目的 分析中学甲型H1N1流感暴发原因和流行特征,为今后类似疫情的防控提供参考和借鉴. 方法 采用流行病学调查分析此次疫情的流行病学特征,并采集咽拭子样本用RT-PCR方法进行病原学检测. 结果 共检出50例甲型H1N1流感疑似病例,其中男28例,女22例,男女比例为1.27∶1.临床上以发热、咽痛、咳嗽、头痛、全身酸痛、咽充血为主要症状.经实验室RT-PCR检测显示,9例甲型H1N1流感病毒阳性.由于及时处理,疫情很快被控制. 结论 在甲型H1N1流感流行期间,加强学校的病原学监测与预防知识的宣传,对疫情的控制很重要.     

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.