目的 了解经济发达地区孕产妇接受艾滋病、梅毒和乙肝咨询检测服务的现状,监测孕产妇这3种疾病感染水平,为政府及卫生部门进一步促进母婴阻断提供科学依据.方法 以江苏省常州市2018年1至12月孕产妇为研究对象,利用国家预防艾滋病、梅毒和乙肝母婴传播管理信息系统中《预防艾滋病母婴传播工作月报表》和《预防梅毒、乙肝母婴传播工作月报表》的监测数据,并对其进行统计分析.结果 2018年,42778名孕产妇中,孕期艾滋病、梅毒和乙肝检测率达到98.06％(41950/42778),阳性检出率分别为2.38/10万(1/41950)、2.86‰(120/41950)、4.06％(1705/41950).只有1.94％ 的孕妇仅在产时才进行艾滋病、梅毒、乙肝检测,阳性检出率分别为0、7.25‰和5.31％.结论 常州市孕产妇艾滋病、梅毒、乙肝检测率较高,但仍有部分妇女寻求孕期保健服务的意识不强,需要加强社会宣传,有针对性地开展健康教育,以提升育龄妇女预防母婴传播疾病的素养,从而进一步有效地减少艾滋病、梅毒、乙肝母婴传播的发生.

目的 探索脂肪酸分型方法对嗜麦芽窄食单胞菌同源性分析的可能性.方法 收集南京市某医院住院患者痰液样本分离的嗜麦芽窄食单胞菌,经化学方法提取菌体脂肪酸后用气相色谱与飞行时间质谱联用仪(GC-TOF-MS)分析,获得该菌脂肪酸成分的数据资料,并利用SPSS 22.0软件进行聚类统计分析.结果 28株嗜麦芽窄食假单胞菌可根据脂肪酸组成及其含量分为4个型,A型18株,包括A1亚型5株,A2亚型13株,B型6株,包括B1亚型4株,B2亚型2株,C型3株,包括C1亚型2株,C2亚型1株,D型1株.主要脂肪酸为C14∶0,C15∶0,C16∶0,C18∶0,其中含量最高的脂肪酸成分是C16∶0.结论 基于GC-TOF-MS的嗜麦芽窄食假单胞菌脂肪酸分析具有操作简单、省时、自动化程度高等特点,可为细菌同源性分析提供有效的数据信息,为预防控制嗜麦芽窄食假单胞菌的医院内感染,实施有效的管理措施提供指导性意见.

Objective To analyze the clinical features of influenza B viral pneumonia among elderly patients and the molecular characteristics of the virus, so as to provide the basis for clinical diagnosis and treatment as well as disease prevention. Methods The respiratory tract samples were collected from hospitalized elderly patients with pneumonia in the Nanjing First Hospital from December, 2017 to March, 2018. Fluroscent quantitative RT-PCR was used in the nucleic acids testing for the screening of influenza B infection cases. The clinical data of the cases were collected. The whole genomes of influenza B virus were sequenced by high-throughput sequencing. Analyses of molecular characteristics for HA and NA were carried out by bioinformatic methods. Results For the 20 patients, 85％ of them had at least one underlying disease. Lesions in both lungs were found in 70％ of the patients, and the case fatality rate was 25％. The differences in the peripheral blood lymphocyte percentage and total serum bilirubin between death patients and survived patients were statistically significant (P<0.05). The results of sequence analysis for the 17 strains influeuza B showed that 16 strains were belong to Yamagata lineage while 1 strain was in Victoria lineage. The NA gene of the strain in Victoria lineage was originated from the Yamagata lineage, indicating that reassortments may occur. Conclusions Most of the elderly patients with influenza B virus infection were combined with underlying diseases. Decreased peripheral blood lymphocytes percentage indicated poor prognosis. Both Yamagata and Victoria lineages were detected in elderly patients infected by influenza B virus, and stains in Yamagata lineage were predominant.

目的:以大肠杆菌血流感染者为例,基于电感耦合等离子体质谱(inductively coupled plasma mass spectrometry,ICP-MS)方法建立血流感染患者血清中金属元素谱,并筛选关键金属元素,为早期诊断及治疗血流感染提供依据.方法:以6Li、89Y、45SSc、115In、159Tb和209Bi做内标,采用ICP-MS法测定199例正常人血清中68种金属元素,建立元素谱;同时基于金属组学对大肠杆菌感染者和健康对照者做进一步研究,运用主成分分析和偏最小二乘判别分析等进行多元统计分析,筛选出差异性元素.结果:基于ICP-MS建立了血流感染患者及健康人群血清中的金属元素谱,筛选出大肠杆菌血流感染者与健康对照者血清中的差异性元素Zn、Ce、Pd、Cu、Sn、Se、Ba、Au和Fe.结论:采用ICP-MS可以快速高通量地检测并建立人血清中的金属元素谱;筛选出大肠杆菌血流感染患者和健康对照者血清中的差异性元素,为从金属组学角度诊断、预防和治疗血流细菌感染提供研究基础.

>患者因胸痛于我院心胸外科住院确诊为主动脉夹层(IDebakeyⅠ型),2012年3月23日行升主动脉+全弓人工血管置换+远端支架象鼻植入术治疗。术后转ICU,气管插管接呼吸机。因神志未完全清醒,3月26日予胃管鼻饲,次日开始注入肠内营养液能全力1000 ml/d。4月1日气管切开脱离呼吸机,4月2日和3日胃管不畅分别更换胃管,继续胃管鼻饲营养液。4月8日患者开始出现呕吐,有食糜。

目的探讨慢性乙型病毒性肝炎(CHB)及肝炎后肝硬化(LC)患者胆囊B超声像改变及肝脏病变轻重与胆囊病变程度的关系。方法156例CHB及LC患者和同期体检的246例非肝炎体检者进行胆囊B超检查,比较其胆囊病变情况。结果CHB及LC组胆囊改变明显高于无肝炎病变的体检组(P<0.01)。结论CHB及LC患者易并发胆囊病变。

目的 探讨慢性乙型肝炎(CHB)及乙肝后肝硬化(LC)病人胆囊B超声像改变及肝脏病变程度与胆囊病变的关系.方法 对156例慢性乙型肝炎病人、乙肝后肝硬化病人和同期的246例非肝炎体检者进行胆囊B超检查,比较其胆囊病变情况.结果 慢性乙型肝炎与乙肝后肝硬化组胆囊改变明显高于无肝炎病变的体检组(P＜0.01),且其病变程度越重,胆囊病变的发生率越高,在统计学上有非常显著意义(P＜0.01).结论 慢性乙型肝炎及乙肝后肝硬化病人易并发胆囊病变.