儿童支气管扩张症101例临床分析

目的 探讨儿童支气管扩张症的临床特征,提高儿科医师对该病的认识。方法 回顾性分析2012年1月至2022年4月泉州市儿童医院确诊的101例支气管扩张症患儿的临床表现、影像学、病原学、基因检测等资料。结果 101例支气管扩张症患儿中,男61例,女50例,起病年龄（5.44±4.37）岁,病程（108.47±42.47）d;主要症状为湿性咳嗽（86.14%）、发热（55.45%）;肺部CT显示双下叶支气管扩张最常见;39例病原体阳性,肺炎支原体感染（24.75%）最常见;53例行支气管镜检查,23例（43.40%）可见“鱼骨样改变”;15例行肺功能检查,107例为阻塞性通气功能障碍,8例限制性通气功能障碍;15例行基因检测,阳性率为46.67%。最常见的病因是感染（66.34%）,其次是支气管异物（4.95%）,囊性纤维化（3.96%）,闭塞性支气管炎4例（3.96%）,原发性纤毛运动障碍（2.97%）,免疫缺陷病（2.97%）,哮喘（2.97%）。经过治疗,78例（77.23%）临床改善,22例（21.78%）无明显好转,1例（1.00%）死亡。结论 儿童支气管扩张症以湿性咳嗽为主要表现,双下肺最常受累,感染是最主要的病因,支气管异物、囊性纤维化、闭塞性支气管炎、原发性纤毛运动障碍、免疫缺陷病等病因亦不容忽视。     

13株中国麻疹野病毒血溶素蛋白基因特征分析

目的分析1999～2003年中国（未包括香港、澳门特别行政区和台湾地区,下同）流行的H,基因型麻疹野病毒代表株血溶素蛋白（Fusion Protein,F）基因的分子特征。方法从1999～2003年中国分离的麻疹野病毒株中,选取13株H1基因型代表株,包括H1a基因亚型麻疹野病毒8株和H1b基因亚型麻疹野病毒5株。使用逆转录一聚合酶链反应扩增病毒的F基因全长,并进行核苷酸序列测定,同时与中国疫苗株及其它国家的A、D2、D6、D7、E基因型参考株进行序列比对及基因亲缘性关系分析。结果1999～2003年13株中国流行麻疹野病毒代表株中,核苷酸同源性为98．1％～99．0％,氨基酸同源性为98．1％～100．0％,与中国疫苗株沪191相比,其核苷酸同源性为95．7％～96．2％,氨基酸同源性为96．9％～97．2％;而与其它基因型相比,核苷酸同源性为94．4％～96．2％。F基因3个糖基化位点（第32、64、70位氨基酸）、对病毒融合功能起着重要作用的第112位精氨酸、第195位亮氨酸未发生改变。结论1999～2003年中国流行的H1基因型麻疹野病毒的F基因无明显差异,F蛋白上已知的重要功能位点未发生变异,推测中国流行的麻疹野病毒F蛋白的结构和功能未发生较大改变,但由于F蛋白是重要的功能蛋白,对F蛋白核苷酸和氨基酸的变异规律进行常规监测,对了解麻疹野病毒流行特点及其遗传变异规律具有重要意义。     

海口市2010—2020年输入性登革热流行病学特征

Objective This study intends to understand the epidemiological characteristics of imported dengue fever in Haikou city from 2010 to 2020, we provide references for dengue fever prevention and control in Haikou city. Methods The epidemiological investigation and laboratory nucleic acid test data of dengue fever cases in Haikou City from 2010 to 2020 were collected, and analyzed by Excel 2010 and SPSS 20.0 software, to describe the epidemiological characteristics of imported dengue fever cases. Results A total of 72 cases of imported dengue fever were reported in Haikou City from 2010 to 2020, 53 cases were imported from abroad (73.61%) and 19 cases were imported domestically (26.39%), all of which were mild. The number of imported cases from 2017 to 2019 increased by 1 321.68% compared with the average annual imported cases from 2010 to 2016. The cases were concentrated in the main urban area (97.22%), distributed in the streets in the main urban area. The peak of case imported occurred in August-November,in addition, the domestic imported cases were concentrated in September-October. The ratio of male to female was 2.27∶1, and the average age was (34.93 ±1.55) years old. Working, doing business and visiting relatives accounted for 84.22% in China. Overseas workers, business and tourism accounted for 77.78%. There was a significant difference in the reasons for going out between domestic and overseas imported cases (χ2=75.10,P< 0.05). Among the imported sources, Southeast Asia accounted for 94.34% of overseas imported cases, and Guangdong Province accounted for 57.89% of domestic imported cases. The median of onset to diagnosis was 3 days, the first diagnosis rate was 77.78% (56/72), and the screening rate of people who have been infected before entering the country was 28.57%. Most of the dengue viruses infected were type I and type II, accounted for 84.72%. Conclusion The imported cases of dengue fever in Haikou city have gradually changed from scattered occurrence to rapid growth; we should strengthen the publicity and education of dengue fever among migrant workers, businessmen, tourists and relatives in the main urban area of Haikou City, and improve the awareness of disease prevention and medical treatment, strengthen quarantine inspection and medical examination of entry personnel from Southeast Asian countries as well as dengue fever diagnosis and treatment training in grass-roots medical institutions, which can effectively reduce the risk of local transmission caused by imported dengue fever cases. © 2021 Editorial Office of Chinese Journal of Schistosomiasis Control. All right reserved.     

胎儿窘迫宫内复苏治疗研究进展

本文综述了宫内复苏治疗胎儿窘迫的进展。     

动态监测降钙素原在老年重症肺炎的诊断和优化抗感染治疗中作用概述

摘 要 降钙素原（PCT）与老年肺部感染的严重程度密切相关,PCT的动态变化可作为老年重症肺炎(SP)的辅助诊断指标。本文综述了近年来血清PCT动态监测,在老年SP的早期快速鉴别、诊断、病程监测和预后评估,以及指导优化抗感染治疗等方面的作用和临床意义,表明PCT动态监测在老年SP诊断及抗感染治疗中的重要价值。     

温州市基层医务人员《精神卫生法》相关知识调查

目的了解温州市基层医务人员《精神卫生法》及相关知识的知晓水平。方法采用自制的《精神卫生法》基本知识、精神卫生与心理保健知识调查问卷和《精神疾病患者歧视态度量表》,通过微信对温州市10家二级医院、10家未评级社区医院和1家精神专科医院的医务人员进行问卷调查,分析不同类别医院的医务人员精神卫生知识掌握情况及影响因素。结果共发放问卷400份,回收393份,回收率为98.25%,有效问卷382份,有效率为97.20%。精神专科医院医务人员《精神卫生法》及相关知识总分为(82.12±5.55)分,未评级社区医院为(72.25±10.79)分,二级医院为(68.65±10.97)分,三者差异有统计学意义(P0.05)。精神专科医院医生《精神卫生法》及相关知识总分为(87.12±4.96)分,未评级社区医院为(78.13±8.74)分,二级医院为(69.24±12.63)分,三者差异有统计学意义(P0.05)。不同类别医院精神卫生相关科室医务人员《精神卫生法》及相关知识总分差异无统计学意义(P0.05)。从业年限是各级医院医务人员精神卫生与心理保健知识及精神疾病患者歧视态度量表得分的影响因素(P0.05)。结论《精神卫生法》及相关知识的知晓水平可能随从业年限的增加而提高。不同类别医院中二级医院医务人员《精神卫生法》及相关知识水平相对较低。     

台州地区成人血小板相关参数参考范围调查

目的调查台州地区健康成人汉族血小板相关参数参考范围。方法回顾性分析697例健康成人体检血常规结果,统计血小板相关参数,确定相关参考范围。结果血小板相关参数(MPV、PDW、PCT)参考区间分别为9. 25 fl～12. 81 fl、9. 26%～17. 03%、14. 72×10-4～32. 76×10-4。MPV和PDW在不同性别间比较差异无统计学意义(P0. 05),而PCT差异有统计学意义(P 0. 05);不同年龄段组间比较,差异有统计学意义(P 0. 05)。结论血小板相关参数参考区间存在性别和年龄差异,设置时应予以考虑。