治疗乙状结肠直肠烧伤一例

患女，38岁，因子宫肌瘤似行手术治疗。术前常规清清洁灌肠时误将80℃软皂液（未兑冷水）500ml灌入结肠内，患当即感疼痛不适，但未引医护人员重视，留置10min后排便。当晚患感下腹部剧痛，肛周皮肤可见水疱。此后，连续数日自肛门排出大量淡红色血性液体，伤后1周行电子结肠镜检查见：乙状结肠距肛缘17cm以下（含直肠）黏膜充血、水肿、糜烂，     

浙江省2008-2009年三起诺如病毒胃肠炎暴发的病原分子特征分析

目的 分析浙江省3起病毒性胃肠炎暴发疫情的诺如病毒分子特征.方法 收集监测期间病毒性胃肠炎暴发疫情患者的粪便标本,采用荧光定量RT-PCR方法检测诺如病毒,并选择部分阳性标本扩增部分多聚酶区(RdRp)和衣壳蛋白区,同时采用3′RACE(rapidamplification of cDNA 3′ends)扩增诺如病毒基因组3′末端,获得完整的开放读码框架(ORF)2和ORF3序列.结果 3起暴发疫情共检测标本62份,诺如病毒阳性41份,其中诺如病毒Ⅰ(G Ⅰ)基因组阳性27例,Ⅱ基因组(GⅡ)阳性9例,G Ⅰ+GⅡ阳性5例.结果 显示,引起浙江省2008-2009年3起病毒性胃肠炎暴发疫情的诺如病毒具有病毒基因型的多样性,包括G Ⅰ.8、GⅡ.b、GⅠ.2与GⅠ.6重组株、GⅠ.8和GⅡ-b混合感染.结论 诺如病毒是浙江省病毒性腹泻暴发疫情的重要病原体,呈现出病毒基因型的多样性,并在省内首次检测到诺如病毒的重组和混合感染毒株.

Abstract：

Objective To study the molecular characteristic of norovirus in 3 outbreaks of gastroenteritis in Zhejiang province. Methods During January 2008 and December 2009, fecal specimens of patients were collected from 3 outbreaks of acute viral gastroenteritis. Noroviruses were detected by Real-time RT-PCR. Part of the positive samples were randomly selected and detected by RT-PCR. PCR products were sequenced. Sequence analysis was undertaken based on partial sequence of RNA dependent RNA polymerase(RdRp)and capsid protein gene. Some positive samples were amplified by 3' RACE(rapid amplification of cDNA 3' ends), 3200 bp in length. The exact whole ORF2, ORF3 and 3' untranslation regions(UTR)gene of norovims were identified. Results There were in total 3 outbreaks of viral gastroenteritis caused by norovirus being reported. A total of 62 stools were obtained from cases with acute gastroentefitis. Noroviruses were detected in 41 cases including 27 strains of genogroup Ⅰ norovirus and 9 strains of genogroup Ⅱ norovirus, 5 strains of genogroup Ⅰ + Ⅱ norovirus. Four genotypes including G Ⅰ .8, G Ⅱ .b, G Ⅰ .2/0 Ⅰ .6 recombination together with co-infection of G Ⅰ .8 and G Ⅱ .b were detected. Conclusion Norovirus was confirmed as the major cause of outbreaks of viral gastroenteritis in Zhejiang province and multiple genotype of norovirus were identified from the outbreaks. It was the first time to have found a recombinant of G Ⅰ .6 capsid and G Ⅰ .2 polymerase norovims as well as the co-infection of G Ⅰ .8 and G Ⅱ .b norovirus in the same sample.     

血府逐瘀汤在缺血性中风治疗中的疗效观察

目的分析血府逐瘀汤治疗缺血性中风的临床疗效。方法我院2012年1月至2013年12月间收治的缺血性中风患者67例,按照治疗方案分为对照组和观察组,对照组采用维脑路通胶囊治疗,观察组给予血府逐瘀汤治疗,对两组治疗效果进行比较。结果观察组总有效率达到88.24%(30/34),明显高于对照组60.61%,差异具有统计学意义(P0.05)。结论血府逐瘀汤治疗缺血性中风效果较好,值得临床推广应用。     

浙江省1995年脊髓灰质炎实验室监测

浙江省１９９５年共检测急性弛缓性麻痹（ＡＦＰ）病例２１２例，双份粪便标本１４天内采集率为７５．２％。脊髓灰质炎（脊灰）病毒分离阳性６例，分离率２．８％，其中Ⅰ型Ⅰ例，Ⅱ型３例，Ⅲ型２例，经型内鉴定均为疫苗株。自１９９１年以来已连续４年未分离到脊灰野病毒。２１２例ＡＦＰ病例粪便标本中分离出其他肠道病毒１９例，分离率９．０％。不同月份、不同年龄组、不同采便时间，其他肠道病毒的分离率虽不同，但无显著性差异。全省１９９５年共确诊临床符合病例３例，２例采集双份粪便标本，仅１例为合格标本，病毒分离结果均为阴性。     

HIV 初筛阳性标本确认试验结果分析

ＨＩＶ初筛阳性标本确认试验结果分析郭志宏徐宝祥严菊英龚黎明卢亦愚浙江省卫生防疫站（杭州市３１０００９）自１９９５年２月至今，浙江省ＨＩＶ确认实验室共收到７２份各级医疗单位送检的初筛阳性标本，经确认检测，最后确诊ＨＩＶ抗体阳性者１１例，假阳性６１例。现...     

浙江省2013年病毒性脑膜脑炎病原学及分子流行病学特征

目的 分析2013年浙江省监测点病毒性脑膜脑炎病原学及分子流行病学特征。方法 从浙南和浙北监测点医院采集疑似病毒性脑膜脑炎患者脑脊液和/或粪便样本,用荧光定量PCR方法检测样本中人类肠道病毒(HEV)、流行性乙型脑炎病毒(JEV)、腮腺炎病毒(MuV)、单纯疱疹病毒(HSV)和巨细胞病毒(CMV)核酸,采用人横纹肌瘤细胞(RD)和人喉表皮样癌细胞(Hep-2)分离HEV,对HEV阳性分离物或核酸阳性样本扩增VP1基因并测序,然后进行同源性与进化分析。结果 在229例患者共计239份样本中检测到病毒核酸阳性92份(38.5%),其中HEV阳性87份,MuV、HSV和CMV阳性分别为1、2和2份;87份HEV中柯萨奇病毒(CV)38份和埃可病毒(E)49份;239份样本中分离到56株(23.4%)HEV;在31份HEV核酸阳性但病毒分离阴性的脑脊液样本中,检出最多的为E9(9份),其次为CVA9(8份);HEV血清型分别为CVA9、CVB4、CVB5、E6、E7、E9、E11、E14、E16、E25和E30;浙南监测点优势流行株为CVB5,浙北为E6。VP1区进化分析显示,浙江省HEV均为B组EV。结论 2013年浙江省监测点病毒性脑膜脑炎的主要病原为HEV-B,涉及11个血清型,首次在浙江省分离到E7;浙南优势流行株为CVB5,浙北为E6;核酸检出率明显高于病毒分离率,采用常规EV分离法存在漏检E9和CVA9的风险。     

温州地区引起重症手足口病EV71的分子流行病学研究

目的:通过对温州地区引起重症手足口病EV71型的分子流行学研究,监测基因的变异,为科学防治手足口病工作提供依据。方法:对生物标本提取病毒RNA,检测阳性标本进行病毒分离得到毒株,对EV71型VP1片段、全基因组进行测序和分析。结果:临床诊断重症病例核酸检测阳性中,EV71阳性占所有手足口病阳性的比例为81.10%。从中分离到毒株,证实均为EV71 C4亚型。结论:温州全市手足口病疫情的防控形势非常严峻,主要以2周～3周岁儿童为主,5月-7月高发。温州的重症手足口病主要由EV71导致,为C4亚型。重症和死亡病例,可能与EV71病毒5’UTR的空间结构变异有一定的相关性。     

浙江省2008-2009年三起诺如病毒胃肠炎暴发的病原分子特征分析

Objective To study the molecular characteristic of norovirus in 3 outbreaks of gastroenteritis in Zhejiang province. Methods During January 2008 and December 2009, fecal specimens of patients were collected from 3 outbreaks of acute viral gastroenteritis. Noroviruses were detected by Real-time RT-PCR. Part of the positive samples were randomly selected and detected by RT-PCR. PCR products were sequenced. Sequence analysis was undertaken based on partial sequence of RNA dependent RNA polymerase(RdRp)and capsid protein gene. Some positive samples were amplified by 3' RACE(rapid amplification of cDNA 3' ends), 3200 bp in length. The exact whole ORF2, ORF3 and 3' untranslation regions(UTR)gene of norovims were identified. Results There were in total 3 outbreaks of viral gastroenteritis caused by norovirus being reported. A total of 62 stools were obtained from cases with acute gastroentefitis. Noroviruses were detected in 41 cases including 27 strains of genogroup Ⅰ norovirus and 9 strains of genogroup Ⅱ norovirus, 5 strains of genogroup Ⅰ + Ⅱ norovirus. Four genotypes including G Ⅰ .8, G Ⅱ .b, G Ⅰ .2/0 Ⅰ .6 recombination together with co-infection of G Ⅰ .8 and G Ⅱ .b were detected. Conclusion Norovirus was confirmed as the major cause of outbreaks of viral gastroenteritis in Zhejiang province and multiple genotype of norovirus were identified from the outbreaks. It was the first time to have found a recombinant of G Ⅰ .6 capsid and G Ⅰ .2 polymerase norovims as well as the co-infection of G Ⅰ .8 and G Ⅱ .b norovirus in the same sample.     

急性出血性结膜炎病原学分子特征分析

目的 检测分析引发浙江省急性出血性结膜炎(AHC)爆发流行的病原学及毒株的分子特征。方法 采用荧光定量逆转录-聚合酶链反应方法直接从AHC患者眼拭子样本中检测肠道病毒(EV)和柯萨奇病毒A24变异株(CA24v)核酸;用Hep-2细胞分离病毒,对阳性分离物扩增病毒VP1基因和3C区片段,测定核苷酸序列,应用DNA-MAN和MEGA软件进行同源性和进化分析。结果 3株浙江CA24v分离株VP1基因全长915个核苷酸(nt),3C区全长549 nt,均没有nt的插入和缺失;浙江分离株Zhejiang/13/08与CA24v原型株EH24/70在VP1和3C区核苷酸同源性分别为85.3%和86.5%,与2005年新加坡分离株Singapore/DSO-26/05和2007年广东分离株Guangdong/332/07株在VP1区和3C区的核苷酸同源性分别为97.0%～99.1%和96.7%～99.5%;浙江CA24v分离株在3C区进化树的Ⅲ基因亚型B分支上(GⅢ/B),在VP1进化树的CA24v Group2分支上。结论 引起2007-2008年浙江省急性出血性结膜炎爆发流行的病原为CA24v GⅢ亚型,该病毒最有可能来源于新加坡。     

多重逆转录-聚合酶链反应检测麻疹风疹流行性腮腺炎病毒基因的研究

目的　探索麻疹、风疹、流行性腮腺炎 (腮腺炎 )病毒感染的快速诊断方法。方法　利用多重逆转录 聚合酶链反应 (MRT PCR)方法对麻疹、风疹、腮腺炎病毒的相关基因检测进行研究。结果　直接从麻疹疫苗沪1 91 株 ,风疹疫苗BRDⅡ株 ,腮腺炎疫苗S79株 ,冻干麻疹、腮腺炎、风疹联合减毒活疫苗及临床麻疹、风疹、腮腺炎患者的标本中 ,同时检测出麻疹、风疹、腮腺炎病毒 6 3 5bp、4 1 1bp、5 1 9bp的特异性核酸片段 ,MRT PCR 1次扩增灵敏度均可分别达到 1TCID50 。结论　该方法能特异、敏感地检测临床标本中麻疹、风疹、腮腺炎病毒 ,是快速诊断麻疹、风疹、腮腺炎病毒感染的理想方法