血清骨桥蛋白水平与类风湿关节炎活动性的关系及在伴肺间质病变中的意义

Objective To investigate the association between serum level of osteopotin (OPN) and disease activity of rheumatoid arthritis (RA) patients, and explore the importance of OPN in the pathogenesis of interstitial lung disease (ILD) in RA. Methods Sixty-five RA patients and 20 healthy controls were pros-pectively enrolled. RA patients were divided into active group (n=43) and inactive group (n=22), and ILD groups (n=24) and non-ILD group (n=41). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of OPN in patients with RA and healthy controls, and the relationship between OPN and other clinical and laboratory findings were analyzed. Results ① Serum OPN tended to be significantly higher in RA patients (median, 18.0 ng/ml) than in the healthy controls (median, 14.3 ng/ml), P<0.01; ②The serum level of OPN in RA patients showed a significant positive correlation with the course of disease, numbers of tender joints , ESR and CRP, but no positive relationship was found in number of swollen joints; ③ The serum level of OPN was significantly higher in RA-ILD patients (median, 20.0 ng/ml) than that in non-lLD (median, 17.0 ng/ml, P<0.05). And there was remarkable negative correlation between the concentration of serum OPN and the value of PaO2, but no association was found with pulmonary function %VC and %DLCO. ④ Compared with the non-ILD group, the ILD group had more active disease in terms of tender joint counts and swollen joint counts, ESR, CRP (P<0.01) and the serum titer of RF-IgM, (P<0.05). Conclusion OPN plays a role in the pathogenesis of RA and is related to the disease activity. It may serve as an active disease inflammatory marker of RA . OPN may be involved in the pathogenesis of RA related ILD and is associated with the severity of pulmonary damage.     

血清骨桥蛋白水平与类风湿关节炎活动性的关系及在伴肺间质病变中的意义

Objective To investigate the association between serum level of osteopotin (OPN) and disease activity of rheumatoid arthritis (RA) patients, and explore the importance of OPN in the pathogenesis of interstitial lung disease (ILD) in RA. Methods Sixty-five RA patients and 20 healthy controls were pros-pectively enrolled. RA patients were divided into active group (n=43) and inactive group (n=22), and ILD groups (n=24) and non-ILD group (n=41). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of OPN in patients with RA and healthy controls, and the relationship between OPN and other clinical and laboratory findings were analyzed. Results ① Serum OPN tended to be significantly higher in RA patients (median, 18.0 ng/ml) than in the healthy controls (median, 14.3 ng/ml), P<0.01; ②The serum level of OPN in RA patients showed a significant positive correlation with the course of disease, numbers of tender joints , ESR and CRP, but no positive relationship was found in number of swollen joints; ③ The serum level of OPN was significantly higher in RA-ILD patients (median, 20.0 ng/ml) than that in non-lLD (median, 17.0 ng/ml, P<0.05). And there was remarkable negative correlation between the concentration of serum OPN and the value of PaO2, but no association was found with pulmonary function %VC and %DLCO. ④ Compared with the non-ILD group, the ILD group had more active disease in terms of tender joint counts and swollen joint counts, ESR, CRP (P<0.01) and the serum titer of RF-IgM, (P<0.05). Conclusion OPN plays a role in the pathogenesis of RA and is related to the disease activity. It may serve as an active disease inflammatory marker of RA . OPN may be involved in the pathogenesis of RA related ILD and is associated with the severity of pulmonary damage.     

血清骨桥蛋白水平与类风湿关节炎活动性的关系及在伴肺间质病变中的意义

Objective To investigate the association between serum level of osteopotin (OPN) and disease activity of rheumatoid arthritis (RA) patients, and explore the importance of OPN in the pathogenesis of interstitial lung disease (ILD) in RA. Methods Sixty-five RA patients and 20 healthy controls were pros-pectively enrolled. RA patients were divided into active group (n=43) and inactive group (n=22), and ILD groups (n=24) and non-ILD group (n=41). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of OPN in patients with RA and healthy controls, and the relationship between OPN and other clinical and laboratory findings were analyzed. Results ① Serum OPN tended to be significantly higher in RA patients (median, 18.0 ng/ml) than in the healthy controls (median, 14.3 ng/ml), P<0.01; ②The serum level of OPN in RA patients showed a significant positive correlation with the course of disease, numbers of tender joints , ESR and CRP, but no positive relationship was found in number of swollen joints; ③ The serum level of OPN was significantly higher in RA-ILD patients (median, 20.0 ng/ml) than that in non-lLD (median, 17.0 ng/ml, P<0.05). And there was remarkable negative correlation between the concentration of serum OPN and the value of PaO2, but no association was found with pulmonary function %VC and %DLCO. ④ Compared with the non-ILD group, the ILD group had more active disease in terms of tender joint counts and swollen joint counts, ESR, CRP (P<0.01) and the serum titer of RF-IgM, (P<0.05). Conclusion OPN plays a role in the pathogenesis of RA and is related to the disease activity. It may serve as an active disease inflammatory marker of RA . OPN may be involved in the pathogenesis of RA related ILD and is associated with the severity of pulmonary damage.     

对确诊人感染H7N9禽流感患者的护理

人感染H7N9禽流感是由H7N9亚型禽流感病毒引起的急性呼吸道传染病。本病区为一所综合性医院的感染科病房,设有负压隔离病房,可收治呼吸道传染性疾病。对收治的确诊人感染H7N9亚型禽流感病毒感染的患者的消毒隔离、重症护理、终末处理的护理工作,并将工作中对负压病房的日常管理、医务人员的培训、防护用品的准备的经验进行介绍。     

2015年1月全国突发公共卫生事件及需关注的传染病风险评估

目的 评估2015年1月国内外突发公共卫生事件及需要关注传染病的风险. 方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省(直辖市、自治区)疾病预防控制中心专家参与评估. 结果 根据近期传染病和突发公共卫生事件监测数据,结合既往突发公共卫生事件发生情况及传染病流行特点分析,预计1月将是全年突发公共卫生事件报告数较少的月份之一,预计全国总报告事件数和病例数将较去年12月有所下降.2015年1月,埃博拉出血热病例输入我国的风险依然存在,在我国发生较大规模扩散的可能性极低;我国内地将继续出现人感染H7N9禽流感散发病例,不排除其他可感染人类的禽流感散发病例报告;流行性感冒等呼吸道传染病将出现季节性升高;目前正值诺如病毒等病毒性腹泻病发病高峰期,1-2月可能仍将出现暴发疫情;猩红热疫情已达冬季最高峰,随着学校和托幼机构放假,预计病例数将会有所减少;因燃煤取暖导致的非职业性一氧化碳中毒事件仍将持续一段时间. 结论 2015年1月我国的突发公共卫生事件及传染病疫情发生态势与往年相似,处于全年较低水平;需关注埃博拉出血热、人禽流感、流行性感冒、诺如病毒感染性腹泻病、猩红热等传染病疫情以及非职业性一氧化碳中毒引发的公共卫生风险.     

双链季铵盐消毒剂对内镜中心物体表面消毒效果的评价

目的:探讨双链季铵盐消毒剂对医院内镜中心物体表面的消毒效果。方法:按照2012年版《医疗机构消毒技术规范》要求,应用含氯消毒剂及双链季铵盐两种消毒剂对医院内镜中心不同区域的物体表面进行消毒,并作细菌学检测,对两种消毒剂的消毒效果进行观察。结果:两种消毒剂消毒后,物体表面消毒合格率均为100%。结论:0.34%季铵盐类消毒剂杀菌谱广、化学性能稳定、环保安全,以其作为医院内镜中心物体表面的常用消毒剂具有可行性。     

出院患者护理满意度测评体系的建立与应用

目的：探讨建立有效的出院患者护理满意度测评体系,提高护理质量。方法护理部成立精神文明建设管理委员会和满意度工作小组,系统地建立了患者满意度评价体系。并分析患者满意度评价体系应用前后患者满意度的情况。结果完善出院患者满意度相关工作的监督和支持系统,重视客观数据,有效的提高出院患者满意度。应用出院患者满意度评价体系后患者满意度由2009年的83．2％提高到2013年的94．5％。2012—2013年出院患者对护理服务、操作技能和病区巡视的意见数下降,差异均有统计学意义（ P＜0．05）。结论建立出院患者护理满意度测评体系,可督促解决有关护理问题,提高护理质量,进而提高出院患者满意度,值得推广。     

应用经胸超声心动图评估快速左心耳起搏心房颤动模型心脏结构及功能的变化

目的:应用经胸超声心动图观察高频率左心耳起搏致猪慢性心房颤动模型心脏结构和功能的变化。方法:实验于2005-09/2006-08在南京医科大学第一附属医院江苏省实验动物中心完成。①12只苏钟种猪随机分为实验组及对照组各6只,所有动物均开胸,将起搏电极固定在左心耳根部,高频率脉冲发生器植入左侧胸部囊袋。实验组术后恢复1周后起搏器以500次/min的频率快速起搏左心耳8周;对照组始终不起搏。②术后心电图定期监测起搏、心房颤动的发生情况;于术前、起搏后1周、起搏后4,8周超声心动图观察实验动物左房内径、心室收缩及舒张末左房面积、左房和左室射血分数、左室舒张及收缩末内径、左心室短轴缩短率等变化。结果:①实验组5只完成了实验,术后2周复查心电图,1只动物发生房颤,起搏8周3只发生阵发性房颤,1只未发生房颤;对照组则未发生任何心律失常情况。②左心房相关指标:起搏后1周,实验组左房内径、收缩末期左心房面积和舒张末期左房容积均较起搏前增加[(2.70±0.12),(2.50±0.12)cm;(6.78±0.81),(6.21±0.93)cm2;(4.66±0.53),(3.78±0.57)mL;P均<0.05],左房射血分数较起搏前下降[(55.6±6.0)%,(63.8±4.0)%,P<0.01],至起搏4,8周,左房射血分数进一步降低,左房内径等指标则继续增大。③左心室相关指标:起搏后1周,实验组左室舒张、收缩末期内径较起搏前增加[(3.64±0.13),(3.46±0.15)cm;(2.48±0.08),(2.14±0.09)cm;P均<0.01],左心室短轴缩短率和左室射血分数较起搏前下降[(31.6±2.0)%,(37.8±3.0)%;(60.8±2.0)%,(69.2±4.0)%;P均<0.01];至起搏4,8周,左心室短轴缩短率和射血分数进一步降低,左室舒张、收缩末期内径则继续增大,与对照组比较也差异显著(P<0.05,0.001)。结论:①超声心动图是监测房颤模型建立过程中心房、心室结构和功能变化的有效手段。②高频起搏左心耳是建立猪心房颤动模型的有效方法,快速心房起搏可导致左心房左心室增大及心功能减退。     

云南省边境地区2008-2017年急性传染病输入病例流行病学特征分析

目的 分析2008-2017年云南省边境地区急性传染病输入病例的流行病学特征,为制定云南省境外输入传染病的防控策略和措施提供科学依据。方法 收集发病日期在2008年1月至2017年12月中国CDC传染病报告信息管理系统的急性传染病输入病例个案信息,结合临床医生的病例诊断记录,描述输入病例的构成、时间、地区和人群分布等流行病学特征。结果 2008-2017年云南省边境地区共报告急性传染病输入病例13 157例,占边境地区急性传染报告病例数的6.03%（13 157/218 284）,病种以疟疾、登革热和手足口病为主,分别占输入病例总数的56.05%（7 374/13 157）、21.82%（2 871/13 157）和4.62%（608/13 157）。输入病例的疟疾占比逐年下降,登革热占比逐年上升。输入病例中,男性占73.22%（9 634/13 157）,中国籍占54.91%（7 225/13 157）,15~44岁青壮年占67.12%（8 829/13 157）,≤ 14岁儿童占19.26%（2 535/13 157）,职业以农民（45.23%,5 596/13 157）、民工（21.30%,2 802/13 157）和散居儿童（11.12%,1 463/13 157）为主。每年5月和10月是输入传染病的高峰期,5月以疟疾为主,10月以登革热为主。输入病例主要来源国是缅甸。输入病例数位居前3位的市（县）是中国云南省瑞丽市、腾冲市和盈江县。境外输入病例数占当地报告急性传染病病例数>10%的市（县）有瑞丽市、腾冲市、镇康县和芒市。结论 2008-2017年云南省边境地区急性传染病境外输入疫情较为严重。疟疾、登革热和手足口病是主要病种,输入病例以中国籍、男性、青壮年、农民为主。应加强边境地区的出入境务工人员的急性传染病监测和防控工作。     

建立快速检测鼠疫耶尔森菌的胶体金免疫层析法

〔目的〕　建立检测鼠疫耶尔森菌 (鼠疫杆菌 )的胶体金标记免疫层析方法。〔方法〕　采用柠檬酸三钠还原法制备胶体金颗粒 ,并标记鼠疫杆菌的抗体 ,制成免疫层析检测试纸条 ,进行特异性和敏感性评价 ,并对面粉、土壤、奶粉、淀粉等不同材料进行模拟添加鼠疫菌检测。〔结果〕　用多种不同的常见细菌或近缘细菌进行测试 ,未出现非特异性反应 ,检测鼠疫杆菌的灵敏度为 1× 10 5cfu/ml,对水、土壤、奶粉、面粉、淀粉、酵母粉等不同材料中鼠疫杆菌进行检测也取得同样结果 ,10～ 15min即可得到结果。〔结论〕　建立了 1种可以用于现场快速检测鼠疫杆菌的胶体金免疫层析方法 ,为进一步大规模应用奠定了基础。