2020年宁夏新冠疫情期间SARS-CoV-2与常见发热呼吸道病原流行特征比较分析

目的 了解2020年宁夏新冠疫情期间SARS-CoV-2与常见6种发热呼吸道病原的检出情况、流行规律和感染特点,为新冠疫情常态化防控提供理论依据。方法 应用Real time RT-PCR技术对2020年1月20日至2020年2月16日期间宁夏疾病预防控制中心收检的COVID-19筛查样本进行SARS-CoV-2和Flu等常见发热呼吸道病原进行定性检测,并收集各病原阳性患者人口学特征资料。结果 529例COVID-19筛查样本中,SARS-CoV-2阳性检出率为13.23%（70/529）。对COVID-19筛查样本中180份符合条件的FRS病例样本进行6种其他呼吸道病毒病原检测,阳性检出率为12.78%（23/180）,其中检出率较高的病原为Flu和HRSV,阳性率分别为5.00%和2.78%。各时间段内SARS-CoV-2阳性检出率存在两个较为明显的峰值,其他呼吸道病毒总阳性检出率稳中有降。SARS-CoV-2阳性检出率男性和女性差异无统计学意义,41~ 60岁组及60岁以上组阳性率较高,分别为25.00%和24.39%,阳性病例在宁夏五市均有分布,银川市最多;其他呼吸道病原男性检出率显著高于女性,41~ 60岁组阳性率最高,其次为0~20岁组,阳性率分别为33.33%和12.20%,阳性主要集中于银川与中卫两市。结论 在常态下防控新冠疫情的背景下,应加强呼吸道传播病原快速筛查体系的建设以达到精准防控传染病的迫切需求。     

Safety of measles and pertussis-containing vaccines in children with autism spectrum disorders

ObjectivesTo determine whether children aged 4–7 years with a diagnosis of autism spectrum disorders (ASD) were at increased risk of fever, febrile seizures, or emergency department (ED) visits following measles- or pertussis-containing vaccines compared with children without ASD.MethodsThe study included children born between 1995–2012, aged 4–7 years at vaccination, and members of six healthcare delivery systems within Vaccine Safety Datalink. We conducted self-controlled risk interval analyses comparing rates of outcomes in risk and control intervals within each group defined by ASD status, and then compared outcome rates between children with and without ASD, in risk and control intervals, by estimating difference-in-differences using logistic regressions.ResultsThe study included 14,947 children with ASD and 1,650,041 children without ASD. After measles- or pertussis-containing vaccination, there were no differences in association between children with and without ASD for fever (ratio of rate ratio for measles-containing vaccine = 1.07, 95% CI 0.58–1.96; for pertussis-containing vaccine = 1.16, 95% CI 0.63–2.15) or ED visits (ratio of rate ratio for measles-containing vaccine = 1.11, 95% CI 0.80–1.54; for pertussis-containing vaccine = 0.87, 95% CI 0.59–1.28). Febrile seizures were rare. Pertussis-containing vaccines were associated with small increased risk of febrile seizures in children without ASD.ConclusionChildren with ASD were not at increased risk for fever or ED visits compared with children without ASD following measles- or pertussis-containing vaccines. These results may provide further reassurance that these vaccines are safe for all children, including those with ASD.     

《伤寒杂病论》合方运用探讨

重点阐述了《伤寒杂病论》所创合方的这一方剂变化的特殊形式及其运用。并对合方的源流,涵义,组方原则,作用及意义进行了探讨。认为合方虽源于《内经》,但成形于《伤寒杂病论》。合方具有单方所不具备的优势和疗效,如治疗面广,作用性强,产生新疗效,调整作用功能等。     

《伤寒论》外治法举隅

汉·张仲景著《伤寒论》中辨证论治体系也包括外治法的内容 ,《伤寒论》中的外治法有针、灸、温覆、熏、导、温粉等治疗方法 ,在临床上用于解表、泻下、和解、清热、温里、固涩、祛湿、预防传变等若干方面。     

Amikacin and ceftazidime as empirical antibiotic therapy in severely neutropenic patients: analysis of prognostic factors

This study aimed to evaluate the efficacy of amikacine and ceftazidime as an empirical antibiotic therapy for neutropenic patients affected by haematological neoplasms and to investigate the presence of prognostic features suggesting a poor outcome with this antibiotic combination at the onset of infection. This could allow the identification of subgroups of patients with a low rate of response to amikacin/ceftazidime therapy; in these patients different initial empirical therapy may be indicated. The study population comprised 166 severely neutropenic (absolute neutrophil count below 500/l) oncohaematological patients with fever or clinical signs of infection. Multivariate analysis confirmed four negative prognostic factors: 3 or more days of hospitalization at the onset of an infectious episode, a diagnosis of acute myeloid leukaemia, a haematological disease status different from complete remission, the presence of pneumonia. Depending on how many factors are present, cases can be stratified into three groups, of significantly different prognosis: favourable (0 or 1 factor) 76% success; intermediate (2 factors) 52% success; unfavourable (3 or 4 factors) 19% success. At the onset of an infectious episode a subgroup of patients with a very low response rate to empirical amikacin/ceftazidime antibiotic therapy is identifiable, for whom a different therapy is indicated. Because of the high rate of proven or probable fungal infections in this group, the immediate administration of a systemic antifungal therapy, in addition to antibacterial agents, could be considered in these high-risk patients. Studies should be specifically addressed to evaluating a stratification of empirical antibiotic therapy according to risk factors present at the onset of infection.     

The family attitudes towards febrile convulsions

Giving adequate information about febrile convulsion and its prognosis would be helpful in alleviating parental stress, and would contribute to decrease in the morbidity of febrile convulsion. In this study, the knowledge level of parents on taking body temperature, and decreasing high fever, their attitudes during febrile convulsion and the impact of febrile convulsion on parents are evaluated. One hundred seventy-four parents of 132 children with FC were enrolled in the study. Twenty-seven per cent of parents had no thermometer at home, 32.8% of them did not know how to take a temperature, 72.2% of them did not know the minimum range of increased body temperature, and 69.5% of them did not know how to decrease the increased body temperature. Thirty-six percent of parents recognised the convulsions when their children suffered from them, the others assumed the convulsion were fainting spells (6.9%), near death state (38.5%) and suffocation (18.4%). Thirty-six per cent of parents brought their children to the hospital without doing anything themselves. Most parents (91.4%) had a fear of a recurrence of febrile convulsion in their children. Seventy-four per cent of parents complained of insomia, 24.3% parents had dyspeptic symptoms even 14 parents had weight loss due to dyspepsia.     

补肾健脾法治疗胎怯的临床研究

目的:研究补肾健脾法治疗胎怯的临床疗效。方法:以补肾健脾方药制成助长口服液为治疗组,以不用药为对照组,进行治疗胎怯的临床对照观察。结果:治疗组疗效(78%)显著优于对照组(52%),P<0.001;治疗组在改善体重、身长、头围、胸围、上臂围等方面显著优于对照组,P<0.05～0.01;治疗组治疗后血清T3升高,T4下降,与对照组相比,P<0.05;在降低患病率方面,治疗组(43%)优于对照组(72%),P<0.05;治疗组远期疗效优于对照组,P<0.05。结论:补肾健脾法治疗胎怯有显著的临床疗效。     

《伤寒论》研究层面探索与剖析

从伤寒的体质、病因、病理、诊法、辨证、治则、治法、方药及其临床等方面对《伤寒论》研究层面进行分析,对《伤寒论〗研究思路、方法及未来研究发展趋势进行了讨论。     

《伤寒论》方临床运用刍议

对如何正确使用《伤寒论》方进行了讨论 ,围绕方证相应、方证病机、方药性能以及剂量等问题提出了自己的看法 ,认为方证相应中特别要善于处理抓主证、一方多证、知常达变 ;分析病机和深谙方药功能是加深对原文理解和拓展方剂应用范围的关键 ;剂量是方剂的组成部分 ,衡器虽然发生了变化 ,但其药物间的剂量比例不可变     

低性血症和热性惊厥的关系

目的：判断发热惊厥小儿在发作期血锌水平的变化。方法：全部病儿分为Ａ、Ｂ、Ｃ３ 组,分别检测血锌浓度,其中Ａ组有高热惊厥组两次采血送检。结果：发热惊厥时血锌值明显减低（ Ｐ＜０－０１） ,且在１ 周后检测依然偏低。结论：发热惊厥患儿应及时检测血清锌水平以及时确定是否补锌,对预防高热惊厥发生可能有益。