邵阳市首次检出福氏4c志贺菌(新菌型)

目的研究福氏志贺4c(F4c)新菌型的生物学特性及其毒力。方法采用F2a株作为参照,以生化反应、噬菌体裂解试验、血清分型进行菌种鉴定;采用K-B法进行药敏试验;对豚鼠角膜进行侵袭力测定;恢复期病人血清与分离菌进行特异性凝集试验。结果血清学反应志贺氏四种多价( )、福氏多价( )、福氏Ⅳ( )、群7( )、对四环素、氯霉素、复方新诺明、氨苄青霉素等耐药。豚鼠角膜侵袭力试验阳性,恢复期病人血清相应抗体为1:320。结论经鉴定分离的该菌为福氏志贺4c(F4c),生物学特性与F2a一致,毒力极强,是一个少见的福氏流行株,为湖南省首次检出。     

宁波地区福氏c亚型志贺菌的病原学特征

目的了解宁波地区福氏c亚型志贺菌的生化特征、耐药性和毒性情况。方法从腹泻病人中分离菌株,生化鉴定采用API生化条;血清分型采用玻片凝集法;药敏试验采用纸片法;毒力基因采用PCR技术法。结果 3种福氏c亚型志贺菌45株的生化结果与ATCC标准株一致,血清凝集抗原结构式分别为福氏1c亚型志贺菌[Ⅰ∶7(8)]、福氏2c亚型志贺菌[Ⅱ∶3,4;7(8)]和福氏4c亚型志贺菌[Ⅳ∶7(8)];对多种抗生素耐药,为多耐药性菌株(ESBLs);福氏1c亚型志贺菌携带ipa H、setl A、setl B毒力基因。结论生化结果显示福氏c亚型志贺菌生化特征未发生变异,福氏c亚型志贺菌以4c亚型最多,并检出国内较少见的福氏1c亚型志贺菌。福氏c亚型志贺菌具有多重耐药性,携带多种毒力基因,有较强的致病力,应引起关注。     

福氏志贺菌菌型变异分析

目的 了解在盐城市人群中流行的福氏志贺菌变异情况.方法 采用肠道致病菌检验方法对收集到的菌株进行鉴定,用多种因子血清进行血清学鉴定.结果 共鉴定出福氏志贺菌48株,F2a占29.2％、F4c占25％,其他菌型有F1b、Fy和F?型(均为8.3％)、F2c等等.结论 盐城市流行的福氏志贺菌中有新的福氏亚型菌F2c、F4c、F?型等,其中F4c已经成为主要流行菌株之一.     

福氏志贺菌4c亚型深圳分离株的生物学和分子特性分析

[目的]对深圳市首次分离的福氏志贺菌4c亚型菌株进行生物学和分子特性分析,了解该类新菌型生物学特征及分子特征。[方法]采用生化反应、血清学分型、刚果红侵袭试验、药敏分析等方法对患者、厨工肛拭及物体表面的17株福氏志贺菌分离株进行病原学分析,采用质粒图谱和毒力基因分析方法进行分子特性分析。[结果]所得到的福氏志贺菌4c亚型分离菌均分解葡萄糖产酸不产气,甘露醇阳性,血清学鉴定为福氏志贺菌IV型,7群菌株;刚果红侵袭试验均阳性;对氨卞西林、四环素、甲氧苄啶、阿莫西林耐药,而对阿米卡星、环丙沙星、庆大霉素、头孢噻肟、头孢噻吩和诺氟沙星敏感;所有菌株的质粒电泳图谱相同,但与F4a、F4b质粒电泳图谱差异较大;所有菌株均携带ipaH和set1基因,而仅有23.5%(4/17)的菌株携带ial和sen基因。[结论]该福氏志贺菌4c亚型深圳分离株的的生化、血清学鉴定结果与现有报道基本相符,该菌具备一定毒力。所有菌株均为同一来源,但4c亚型并非变异于F4a和F4b。ipaH和set1毒力基因携带情况与相关报道相符,ial和sen基因携带情况低于现有报道。     

福建省2005年-2009年细菌性痢疾病原学监测结果分析

目的:了解掌握福建省2005年-2009年细菌性痢疾病原学特征及耐药特点,为制订细菌性痢疾预防控制措施,指导临床合理用药提供科学依据。方法:复核鉴定监测点送检的阳性菌株,按《全国细菌性痢疾监测方案》提供的方法进行系统检测。结果:四年共复核鉴定菌株137株检出志贺菌97株。其中宋内志贺菌61株,福氏志贺菌36株。分别占检出菌株数的62.9%和37.1%。药敏试验显示9,7株志贺菌对头孢噻肟、头孢克洛、痢特灵及环丙沙星高度敏感,并对萘啶酸、四环素、利福平及复方新诺明等耐药。结论:2005年-2009年福建省分离的菌株以宋内志贺菌所占比重较大,其次为福氏志贺菌。D群宋内志贺菌取代了继往的B群福氏志贺菌,B群志贺菌的F4c亚型取代了继往的福氏2a1、b亚型成为新的流行血清型。并对目前常用的抗菌药物表现一定的耐药性,应引起重视。     

宁波地区福氏志贺菌1c新亚型检出与分析

目的了解宁波地区检出的新亚型福氏志贺菌1c的生化特征、耐药性和毒性等情况,为防控菌痢提供依据。方法菌株分离采用常规方法,生化鉴定采用API生化条,血清分型采用玻片凝集法,药敏试验采用K-B纸片法,耐药基因与毒力基因检测采用PCR法。结果福氏志贺菌1c亚型的生化结果与标准株一致;血清凝集抗原结构式为(FI:7,8);对多种抗生素耐药,为多耐药性产超广谱β-内酰胺酶(ESBLs)菌株,携带ipaH、shET1和shET2毒力基因。结论福氏志贺菌1c亚型是宁波地区检出的新亚型。在治疗上应关注菌株的多重耐药性,在防控细菌性痢疾工作中应进一步加强监测,及时发现新亚型及血清型变化。     

宁波福氏c亚型志贺菌病原学特征、耐药性和毒力基因分布

目的了解宁波地区福氏c亚型志贺菌病原学特征、耐药性和毒力基因分布,为细菌性痢疾的有效防控提供依据。方法收集来自腹泻患者的志贺菌株,对其进行生化鉴定、血清分型、药敏试验和5种毒力基因检测。结果 149株菌株中福氏(B群)志贺菌占63.76%,其中福氏1c、2c和4c亚型占36.91%;宋内(D群)志贺菌占36.24%;未检出A群和C群志贺菌。福氏1c、2c和4c亚型菌株生化结果与ATCC标准菌株一致;血清凝集抗原结构式分别为Ⅰ∶7(8)、Ⅱ∶3,4∶7(8)和Ⅳ∶7(8),均为多耐药性菌株;5种毒力基因(ipa H、set1、sen、ial和vir A)的阳性率分别为100.00%、85.45%、85.45%、90.91%和87.27%。43株菌株(78.18%)携带全部毒力基因。结论福氏c亚型志贺菌已成为宁波地区主要流行株之一,除血清变异外,生化等生物学特性未变异,菌株为多重耐药菌,携带多种毒力基因,有较强的致病力,应加强志贺菌检测与菌型分析。     

湖北省部分志贺氏菌基因检测结果分析

目的 检测分析志贺氏细菌基因型,追踪传染源,为科学控制志贺氏细菌类重点肠道传染病提供科学依据.方法 用脉冲场凝胶电泳方法检测志贺氏菌基因,用软件分析电泳图谱.结果 检测8株为宋内志贺氏菌,检测8株宋内志贺氏菌DNA基因有3个基因型,2地区宋内志贺氏DNA基因型相近;检测29株福氏志贺氏菌来源鄂西南、鄂西北、江汉平原部分志贺氏菌DNA基因型相近,基因型分布相对复杂.武汉市的福氏志贺氏菌DNA基因分属于2个基因型和F1a和F4c血清型;宜昌市的福氏志贺氏菌DNA基因分属于1个基因型;十堰市福氏志贺氏菌DNA基因分属于3个基因型和F1a、F2a和F4c血清型;襄阳市福氏志贺氏菌DNA基因分属于2个基因型和F1a和F4c血清型;黄冈市福氏志贺氏菌DNA基因分属于2个基因型和2个血清型.结论 志贺氏菌基因型分布复杂,基因型结果与血清型存在差异,应该把志贺氏菌DNA基因型的检测工作纳入重点监测工作范围.     

福氏志贺菌血清型单重PCR鉴定方法的建立及应用

目的 建立基于O抗修饰基因的福氏志贺菌血清型PCR鉴定方法.方法 根据福氏志贺菌O抗原合成及修饰特异基因设计引物,以常见的14种福氏志贺菌血清型(包括1a、1b、1c、2a、2b、3a、3b、4a、4b、5a、Y、X、Xv和F6)为标准菌株,建立福氏志贺菌血清型单重PCR鉴定方法;并以痢疾志贺菌、宋内志贺菌、鲍氏志贺菌和腹泻相关的其他菌属菌株验证特异性;应用该方法对106株福氏志贺菌临床分离株进行PCR血清分型.结果 建立一种福氏志贺菌血清型单重PCR鉴定方法,通过8个PCR反应,能够鉴定目前已知的15种血清型中的14种(Xv除外).检测灵敏度在10 pg至1 ng DNA(20μl反应体系).对106株福氏志贺菌临床分离株的检测结果提示,PCR分型方法与玻片凝集法具有很高的一致性.结论 本研究建立的福氏志贺菌血清型单重PCR鉴定方法具有特异性、灵敏性,可用于临床检测.     

福氏志贺菌4C亚型生物学特性研究及ipaH基因检测

目的：了解福氏志贺菌4C亚型(F4c)的生物学特性及毒力情况。方法：以生化反应、噬菌体裂解试验、血清分型鉴定菌种；按K-B法进行药敏试验；采用PCR技术检测ipaH基因；同时观察对动物的侵袭力。结果：该菌型具有志贺菌属的基本特点，靛基质等试验传代后有变化，能被Ent噬菌体溶原化而出现型抗原变异现象，ipaH基因和动物侵袭力试验阳性，对四环素、TMP等耐药。结论：F4c是一个少见的血清型，生物学特性与F2c相近，一定条件下能出现型抗原和生化特性变异。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。     

244株真菌鉴定结果分析

目的 了解某院2000～2001年各类真菌的检出率。方法 用酵母样真菌同化试验编码鉴定板TH-15进行编码鉴定。结果 真菌分离率为8．85％；244株真菌分为10种，其中以白色念珠菌和热带念珠菌较高，分别占真菌总数的75．41％和11．47％；检出真菌的主要标本是痰和阴道分泌物。结论 及时进行真菌培养，有利于合理使用抗菌药物和控制真菌感染。