90例非轮状病毒腹泻患儿粪便中诺瓦克样病毒的检测

目的了解90份婴幼儿腹泻病人轮状病毒分子生物学方法检测阴性的粪便标本中诺瓦克样病毒感染状况。方法应用酶联免疫吸附实验方法(ELISA)进行诺瓦克样病毒抗原检测。结果90份粪便标本中诺瓦克样病毒I型(G1)和Ⅱ型(G2)阳性分别检出6例和19例,阳性率分别为6.67%和21.11%,两者差异有显著性。结论诺瓦克样病毒感染可能是武汉地区婴幼儿腹泻的重要病因之一,其中基因Ⅱ型为主要流行株。     

1760例婴幼儿腹泻中轮状病毒检出率及临床意义

目的了解沙井地区婴幼儿腹泻中轮状病毒(RV)感染现状,为临床诊断和治疗提供可靠依据。方法采用胶体金法对1760例来我院就诊的腹泻患儿的粪便标本进行RV抗原检测,并比较检测结果。结果1760例腹泻标本中有852例RV结果阳性,阳性率为48.41%;其中0.5-1岁组腹泻患儿阳性率可达69.96%;以每年11、12月份为发病高峰。结论轮状病毒是本地区婴幼儿腹泻的主要病原,且有明显的季节性。     

慢性放射性肠炎并发肠梗阻的治疗

目的探讨放射性肠炎并发肠梗阻的治疗方法及临床效果。方法对2001年8月至2006年12月间收治的51例慢性放射性肠炎并发肠梗阻患者的临床资料进行总结。结果本组患者放射性肠炎并发肠梗阻均为肿瘤切除后盆腔、腹腔接受放射治疗所致,从放疗结束到肠梗阻症状出现的时间为(11.9±22.6)个月。分别采用了保守治疗(方案包括禁食、胃肠减压、抑制消化液分泌、营养支持、灌肠、补液、对症等,对于有感染征象的患者选用敏感的抗生素)、肠切除吻合术、肠造口术及短路手术。2例患者因肿瘤广泛转移未行有效手术治疗,1例患者术后因腹腔出血死亡,48例患者得到治愈,治愈率达94.1%。结论慢性放射性肠炎并发肠梗阻的治疗方案应该根据患者的营养状况及肠管损伤情况进行选择。     

沙棘干乳剂联合布拉氏酵母菌治疗儿童轮状病毒性肠炎的效果及对免疫功能的影响

目的 探讨沙棘干乳剂联合布拉氏酵母菌治疗儿童轮状病毒性肠炎的临床效果。方法 以随机数字表法,将2019年10月—2021年2月收治的106例轮状病毒性肠炎患儿予以分组,对照组53例,给予布拉氏酵母菌治疗,观察组53例,在对照组基础上,加用沙棘干乳剂治疗,对2组临床疗效,症状消失时间,治疗前、后免疫功能变化及用药安全性予以观察。结果 治疗总有效率观察组为96.23%,与照组治疗总有效率84.91%比较,明显较高,差异有统计学意义(χ²=3.975,P<0.05);观察组患儿发热、腹泻、呕吐消失时间为(2.14±0.36)d、(2.75±0.48)d、(1.86±0.31)d,与对照组(2.59±0.42)d、(3.19±0.51)d、(2.24±0.39)d比较,明显较短,差异有统计学意义(t =5.922、4.574、5.553,P 均<0.05);治疗 3 d 后,观察组血清免疫球蛋白 A(IgA)、免疫球蛋白 M(IgM)、免疫球蛋白 G(IgG)水平为(1.58±0.39)g/L、(1.45±0.33)g/L、(9.82±1.06)g/L,与同期...     

中药灌肠并针灸佐治小儿病毒性肠炎60例疗效观察

目的：观察中药灌肠并针灸对小儿病毒性肠炎的疗效。方法：临床上将110例病儿随机分为治疗组和对照组,对照组不用抗生素,纠正水电解质及酸碱平衡紊乱,并常规口服思密达12包-1包;治疗组：在对照组相同治疗的基础上加用中药30m l-50m l灌肠2次/d,针灸1次/d,观察患儿治疗后症状缓解情况。结果：治疗后,治疗组总有效率96.7%,对照组总有效率68.0%,疗效明显优于对照组,且减少了不良反应。结论：中药灌肠并针灸治疗小儿病毒性肠炎操作简单,使用方便,不良反应少的优点,可明显提高治愈率。     

扶正活血清热方对急性放射性肠炎大鼠血清SOD活性的影响

目的探讨SOD在扶正活血清热方治疗大鼠急性放射性肠炎（ARE）中的作用机理。方法将48只成年健康Wistar雄性大鼠随机分为6组（8只／组），即空白对照组（BC）、生理盐水组（PS；9g／L）、地塞米松组（DS；1．425mg／kg）、扶正活血清热方高、中、低剂量组（HF、MF和LF；16．67g／kg、12．5g／kg和8．33g／kg）。各组大鼠于造模后第2天开始用生理盐水或相应药物灌肠干预5d（5毫升／只），7d后麻醉采血测定血清中SOD活性，取放射区域直肠组织进行组织学观察。结果组织学变化证实DS、HF和MF组均可有效治疗模型大鼠ARE；DS和MF组血清中SOD活性水平略低于BC组（P〉0．05），但明显高于PS和LF组（F=14．199，P〈0．001）。结论有效维持体内SOD活性的正常水平可能是扶正活血清热方治疗ARE作用机制中的重要环节之一。     

Intra-genotypic diversity of archival G4P[8] human rotaviruses from Washington, DC

Group A human rotaviruses (RVs) remain the most frequently detected viral agents associated with acute gastroenteritis in infants and young children. Despite their medical importance, relatively few complete genome sequences have been determined for commonly circulating G/P-type strains (i.e., G1P[8], G2P[4], G3P[8], G4P[8], and G9P[8]). In the current study, we sequenced the genomes of 11 G4P[8] isolates from stool specimens that were collected in Washington, DC during the years of 1974–1991. We found that the VP7–VP4–VP6–VP1–VP2–VP3–NSP1–NSP2–NSP3–NSP4–NSP5/6-encoding genes of all 11 G4P[8] RVs have the genotypes of G4-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1. By constructing phylogenetic trees for each gene, extensive intra-genotypic diversity was revealed among the G4P[8] RVs, and new sub-genotype gene alleles were identified. Several of these alleles are nearly identical to those of G3P[8] isolates previously sequenced from this same Washington, DC collection, strongly suggesting that the RVs underwent gene reassortment. On the other hand, we observed that some G4P[8] RVs exhibit completely different allele-based genome constellations, despite being collected during the same epidemic season; there was no evidence of gene reassortment between these strains. This observation extends our previous findings and supports the notion that stable, genetically-distinct clades of human RVs with the same G/P-type can co-circulate in a community. Interestingly, the sub-genotype gene alleles found in some of the DC RVs share a close evolutionary relationship with genes of more contemporary human strains. Thus, archival human RVs sequenced in this study might represent evolutionary precursors to modern-day strains.     

Development and evaluation of an antigen-capture ELISA for detection of the UL24 antigen of the duck enteritis virus, based on a polyclonal antibody against the UL24 expression protein

An antigen-capture enzyme-linked immunosorbent assay (AC-ELISA) method was developed for the efficient detection of the UL24 antigen of the duck enteritis virus (DEV) using polyclonal antibodies. Ducks and rabbits were immunized, respectively, with expressed UL24 recombinant protein. The IgG antibodies against UL24 from ducks and rabbits were purified and used as the capture antibodies. The specificity of the optimized AC-ELISA was evaluated by use of DEV, duck hepatitis virus (DHV), duck hepatitis B virus (DHBV), gosling plague virus (GPV), Riemerella anatipestifer (R.A.), Escherichia coli (E. coli), Pasteurella multocida (P.M.) and Salmonella Enteritidis (S.E.). Only DEV specimens yielded a specific and strong signal. The limit of the sensitivity of this method for the detection of DEV was 46 ng/100 μl. Compared with PCR and virus isolation, the rate of agreement for the detection of experimentally infected sera was 100%. A comparative test used on clinical specimens between the neutralization test and the AC-ELISA showed that the proportions of true positives and true negatives by the AC-ELISA were 0.90 and 0.67 respectively. These results indicated that the AC-ELISA approach is rapid, sensitive, and reliable for specific detection of DEV antigen.     

自拟中药贴敷神阙穴佐治小儿轮状病毒性肠炎

目的：观察自拟止泻Ⅰ号方贴敷神阙穴辅助治疗小儿轮状病毒性肠炎的临床疗效。方法：将符合轮状病毒性肠炎诊断标准的患儿120例随机分为治疗组60例,对照组60例。两组均常规给予炎琥宁等抗病毒及静脉补液治疗,治疗组在此基础上加用自拟止泻Ⅰ号方贴敷神阙穴。结果：治疗组腹泻持续时间（3.15±1.35）d,对照组（4.35±1.30）d,时间明显缩短（P〈0.05）;治疗组总有效率为93.33%,对照组为80.00%（P〈0.05）,两组比较差异有统计学意义。结论：应用自拟腹泻Ⅰ号方贴敷神阙穴佐治婴幼儿轮状病毒性肠炎是一种安全有效的治疗方法。     

Attendance and vaccination at immunization clinics in rural Gambia before and during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic has affected the delivery of essential health services, such as routine immunization. We assessed the impact of the pandemic on the uptake of routine immunization in rural Gambia.MethodsWe collected real-time vaccine administration data in the Basse and Fuladu West Health & Demographic Surveillance Systems from September 01, 2019, to December 31, 2020. We assessed the monthly number of Expanded Program on Immunization (EPI) clinic attendances and vaccines administered, comparing data during the baseline period (September 01, 2019–March 31, 2020), COVID-19 interruption period (April 01–June 30, 2020), initial recovery period (Jul 01–September 30, 2020) and the late recovery period (October 01–December 31, 2020).ResultsCompared to the baseline period, there was an overall average monthly decline of 13.4% in EPI attendance and 38.3% reduction in average monthly immunizations during the interruption period. This decrease was particularly noticeable for Bacille Calmette-Guérin (BCG) (47.2%), birth dose hepatitis B (Hep B) (46.9%), 1st dose pentavalent (Penta1) (43.1%), 1st dose pneumococcal conjugate vaccine (PCV1) (42.4%), and measles vaccines (15.5%). Comparing the late recovery to baseline period, average monthly EPI attendance was 5.3% higher, with 1.9% increase in average monthly immunizations. Monthly immunizations for BCG were 3.0% greater, 2.5% greater for Hep B, 22.7% greater for oral polio vaccine (OPV1), 2.0% less for Penta1, 19.2% less for Penta2, and 2.6% less for PCV1.ConclusionThe reduced EPI attendance during the pandemic interruption period lasted only 3 months. Significant recovery in EPI attendance occurred during the late recovery period, while rates of monthly immunization returned to pre-pandemic levels for most antigens. EPI programmes should implement strategies to deliver missed antigens when infants do present to EPI clinics, aware that missed doses may be age dependent.