手足口病的流行现状及挑战

手足口病是由肠道病毒所致的全球性传染病.自20世纪90年代后期由肠病道毒所致的手足口病在亚太地区频繁暴发流行,其严重的神经系统并发症以及神经源性肺水肿致患者残疾和死亡.我国自2008年起每年发生全国范围的手足口病暴发流行,其中肠道病毒71型(EV71)是引起暴发而致死亡的主要病原体.目前手足口病已成为我国各类传染病中发病数最高的丙类传染病,给公共卫生带来严峻挑战.虽然绝大多数手足口病为自限性疾病,但约0.05％的患儿病情变化迅速并死亡,目前尚缺乏有效的抗病毒药物和疫苗来防治.因此,早期识别危重病例、早期进行合理临床管理和诊疗干预·以及采取及时有效的防控措施是降低手足口病所致危害的最主要策略.我国已在积极研发EV71疫苗,这将给手足口病流行暴发及其重症疾病的预防带来希望,并有望有效降低社会经济负担.     

突发传染病涉外患者强制医疗护理实践中伦理冲突及对策

目的总结分析突发传染病涉外患者强制医疗护理实践中的伦理冲突及护理对策。方法对来自不同国家及地区的涉外传染患者在接受强制隔离治疗过程中出现的伦理冲突的原因进行分析,并针对存在的知情同意及强制隔离治疗、个体利益与公众利益、风险暴露与患者安康的冲突,在实践中遵循生命伦理学的基本原则,如尊重、有利、公正、互助互利。根据涉外传染患者的特点,采取相应的护理措施。结果涉外传染病患者愿意接受强制隔离治疗,全部痊愈出院,院内零感染,医患纠纷及差错事故零发生。患者对护理工作满意度达100%。结论有效的培训及流程管理、以人为本,为涉外患者提供人性化的跨文化护理以及多部门及社会家庭的互助合作等措施可有效应对传染病涉外患者接受医疗期间所出现的伦理冲突。     

2015-2020年海口市重症手足口病流行病学特征及影响因素分析

海口市是手足口病的高发地区,为阐明海口市手足口病重症病例的流行病学特征及影响因素,本研究利用2015-2020年海口市所有手足口病病例资料、重症病例个案调查及病原学监测资料进行描述性统计分析.结果表明,2015-2020年海口市重症手足口病呈现明显的下降趋势(R2趋势=0.77);发病呈现春末夏初(4-7月)和秋末冬初(9-11月)双峰型特征;91.67％的重症病例为3岁及以下婴幼儿;男性重症率高于女性;城区病例最多(占37.12％),其次是城乡结合部(占33.33％);病原体以其他肠道病毒感染为主,但EV-A71型病毒感染致重症率更高;93.18％的重症手足口病伴有神经系统受损表现;男性、低年龄、就诊时病程短、EV-A71感染是重症手足口病的危险因素;持续加强病原学监测、健康教育等防控措施,积极推广3岁及以下重点人群EV-A71疫苗接种,有利于控制和减少重症和死亡病例的发生.     

急性传染病休克的临床诊治与转归分析

目的:探讨急性传染病休克患者的诊治策略,提高救治成功率.方法:回顾分析急性传染病休克患者的人口学、流行病学、病因分类、传染病发生至休克出现时间、早期临床诊治与转归等情况,总结诊治经验.结果:本组68例急性传染病休克主要来自呼吸道、消化道传染病,细菌和病毒是休克发生的主要病原,分别占54.4％和30.9％,仅25％的病例病前有明确的传染病接触史.51.9％的患者存在误诊误治现象.在明确休克发生病理机制的前提下,早期快速有效的抗休克、抗感染治疗,短期使用糖皮质激素,积极纠正酸碱、电解质紊乱,并给予必要的对症支持治疗,治愈出院率92.6％,平均康复住院时间3～11天,平均(5.8±2.4)天.结论:急性传染病休克早期误诊现象突出;给予积极抗体克、抗感染、激素治疗,纠正酸碱和电解质紊乱,结合对症支持治疗,可在短期内治愈患者.     

剑阁县2001～2010 年法定传染病流行特征及防治对策分析

目的:通过分析10年法定传染病疲情的流行趋势和三间分布特征,为制定传染病预防控制策略和措施提供依据.方法:采用描述性流行病学方法分析疫情趋势和三间分布情况,数据资料用SPSS10.0和Excel 2003进行统计分析.结果:2001～2010年共报告乙、丙类传染病25种26 129例,年均发病率386.89/10万,年均死亡率0.15/10万,10年间报告法定传染病以血源及性传播传染病和呼吸道传染病为主,居第1位的是血源及性传播传染病,共报告5种12 453例,占53.03％;其次是呼吸道传染病,共报告5种9828例,占41.85％,近3年发病居于各类传染病首位;第三位的是肠道传染病,共报5种1149例,占4.89％.发病居前5位的传染为乙肝、肺结核、流行性腮腺炎、痢疾、麻疹,主要传染病以乙肝、肺结核为主,近年性传播疾病呈快速增长趋势.结论:血源及性传播传染病和呼吸道传染病是今后重点防控传染病.     

493例手足口病的临床治疗体会

近年来,部分省市发生了手足口病的局部流行,该病为肠道病毒引起的以皮疹为主要临床特征的传染性疾病。手足口病在我国已经纳入了丙类传染病进行管理。我院自2007年3月至2009年10月共收治手足口病493例。经观察治疗,效果满意,现报告如下。     

村医基本公共卫生管理知识和服务情况调查分析

目的:了解乡村基本公共卫生服务知识和服务情况,为有效提高乡村基本公共卫生服务水平提供依据.方法:采用课堂集中填写问卷的方式对某县1046名村医就服务知识和服务能力进行调查.结果:乡村基本公共卫生服务知识调查显示,慢性病服务知识知晓率最高,为78.0％,传染病报告及处理知识知晓率最低,为50.7％,农村居民健康档案管理知识知晓率为56.4％,健康教育服务知识知晓率为51.7％.基本公共卫生服务能力调查显示,55.1％的村医能较为熟练操作微机,99.7％的乡村曾对患者进行过健康教育.结论:某县乡村慢性病服务知识知晓率较高,服务能力尚可,但需进一步强化乡村传染病防治法、慢性病随访内容、健康教育服务内容和健康档案有效使用的专项培训和全员培训.     

手足口病的流行病学特征及防治对策

手足口病是由多种肠道病毒引起的常见传染病,多发生于学龄前儿童。近年来我国许多地方不断报道有手足口病的暴发流行,且并发症发生率和病死率也有增高的趋势。2008年,我国将手足口病纳入《传染病防治法》丙类传染病管理。本文对手足口病的病原学及流行病学特征、临床症状及诊断、预防、治疗措施等进行了综述。     

提高医院传染病管理的实践

目的：总结解放军第302医院在防控传染病方面所践采取的措施,提高医院传染病管理相关工作。方法：完善传染病管理组织,明确责任;认真落实传染病管理相关制度;加强相关知识培训,强化医护人员责任意识,提高能动性、自觉性。总结分析以上相关措施实施后,2005年-2010年期间传染病报告情况。结果：2005年-2010年每年传染病疫情报告卡填写完整率逐渐提高,医院传染病报告漏报率呈逐年下降趋势,近两年呈现填写完整无漏报的情况。结论：提高医院传染病管理的相关措施的实施,使医护人员对的传染病防控意识有所提高,做到早发现、早报告、早隔离、早治疗,降低传染病传播风险,有效减少了医院交叉感染的发生,保障人们的生命健康和社会的发展稳定。     

加强传染病管理与医院感染管理

目的:探讨传染病防治管理措施的应用价值与效果.方法:以2009年1月至2010年6月间的院内管理为对照组;以2010年7月至2011年12月间的院内管理措施为研究组,采用传染病防治管理措施.结果:两组管理方法传染病患者发生率无显著差异(P＞0.05);研究组传染病预防管理措施院内感染发生率明显低于对照组,数据经统计学比较具有显著差异(P＜0.05).研究组管理方法下患者临床满意度明显高于对照组,数据经统计学比较具有显著差异(P＜0.05).结论:传染病预防管理措施有利于有效阻断院内感染源的传播,进而减少交叉感染发生率,提高患者满意度.     

壳聚糖酶的克隆表达与壳寡糖的制备分析

目的:克隆壳聚糖酶基因于大肠杆菌中实现高表达,制备壳寡糖。方法:以枯草芽孢杆菌总DNA为模板扩增壳聚糖酶基因(CSN),克隆至载体pET23a(+)上,转化菌株BL21(DE3)。重组子经0.5 mmol/L IPTG诱导后,SDS-PAGE和质谱检测与鉴定重组酶。酶纯化后水解壳聚糖,薄层色谱分析其水解产物。结果:质谱证明壳聚糖酶(31.5kDa)成功表达,表达量占菌体总蛋白的45%左右。纯化后重组酶浓度为900 mg/L,纯度95%、回收率85%,酶活力为10 000 U/mg。壳聚糖降解产物为壳二糖至壳四糖。结论:原核表达载体pET23a(+)-CSN构建正确,壳聚糖酶表达量与活性高,适用于水解壳聚糖制备壳寡糖。     

国内外蝗害治理技术现状与展望

本文首先概述了国内外蝗虫发生与为害的态势,总结了现阶段我国蝗虫发生与为害的主要特点:即农田飞蝗暴发频繁而且严重,草原土蝗的发生时常造成严重的经济损失,而且侵入城市干扰市民生活,我国与周边国家之间蝗虫过境迁移频繁,使用化学农药污染环境和农产品;分析了国内外蝗虫防治对策与技术的发展现状,重点介绍了应急防治和可持续治理对策、...     

Synthesis and turnover of cerebrosides and phosphatidylserine of myelin and microsomal fractions of adult and developing rat brain.

The synthesis and turnover of cerebrosides and phospholipids was followed in microsomal and myelin fractions of developing and adult rat brains after an intracerebral injection of [U-14C]serine. The kinetics of incorporation of radioactivity into microsomal and myelin cerebrosides indicate the possibility of a precursor-product relationship between cerebrosides of these membranes. The specific radioactivity of myelin cerebrosides was corrected for the deposition of newly formed cerebrosides in myelin. Multiphasic curves were obtained for the decline in specific radioactivity of myelin and microsomal cerebrosides, suggesting different cerebroside pools in these membranes. The half-life of the fast turning-over pool of cerebrosides of myelin was 7 and 22 days for the developing and adult rat brain respectively. The half-life of the slowly turning-over pool of myelin cerebrosides was about 145 days for both groups of animals. The half-life of the rapidly turning-over microsomal cerebrosides was calculated to be 20 and 40 h for the developing and adult animals respectively. The half-life of the intermediate and slowly turning-over microsomal cerebrosides was 11 and 60 days respectively, for both groups of animals. The amount of incorporation of radioactivity into microsomal cerebrosides from L-serine was greatly decreased in the adult animals, and greater amounts of the precursor were directed towards the synthesis of phosphatidylserine. In the developing animals, considerable amounts of cerebrosides were synthesized from L-serine, besides phosphatidylserine. The time-course of incorporation indicated that a precursor-product relationship exists between microsomal and myelin phosphatidylserine. The half-life of microsomal phosphatidylserine was calculated to be about 8 h for the fast turning-over pool in both groups of animals.     

Identification and composition of the tonsillar and anal enterococcal and streptococcal flora of dogs and cats

Enterococcus faecalis was the most frequently isolated enterococcal species from anal swabs and tonsils of dogs and cats, although in the anal samples from dogs Ent. hirae was found almost as often as Ent. faecalis. Most Ent.faecium strains from dog tonsils differed from those associated with humans and other animals in that they fermented sorbitol. Typical Ent. avium as well as atypical Ent. avium -like strains were seen in dogs, while the related species Ent. raffinosus was associated with cat tonsils. Enterococcus cecorum also occurred mainly in cats. Certain atypical strains, presumptively identified as Ent. cecorum , shared characteristics with Ent. columbae.
The most frequent streptococcal species in tonsils of cats and dogs were Streptococcus suis and Strep. canis. Streptococcus canis and Strep. bovis predominated in anal swabs. The canine Strep. suis differed from the common porcine strains in fermenting mannitol.
Forty-seven of the 288 isolates examined could not be identified or related to known species. The characteristics of two groups of these bacteria, provisionally called 'Ton 31 group' and 'O7 group' are described.     

Molecular characterisation of species and genotypes of Cryptosporidium and Giardia and assessment of zoonotic transmission

The molecular characterisation of species and genotypes of Cryptosporidium and Giardia is essential for accurately identifying organisms and assessing zoonotic transmission. Results of recent molecular epidemiological studies strongly suggest that zoonotic transmission plays an important role in cryptosporidiosis epidemiology. In such cases the most prevalent zoonotic species is Cryptosporidium parvum. Genotyping and subtyping data suggest that zoonotic transmission is not as prevalent in the epidemiology of giardiasis. Molecular characterisation of Cryptosporidium and Giardia is a relatively recent application that is evolving as new genes are found that increase the accuracy of identification while discovering a greater diversity of species and yet unnamed taxa within these two important genera. As molecular data accumulate, our understanding of the role of zoonotic transmission in epidemiology and clinical manifestations is becoming clearer.     

白术同源四倍体的诱导和鉴定及其与二倍体过氧化物酶的比较

以白术（Atractylodes macrooephala Koidz.）二倍体组培苗为材料,对其四倍体诱导方法进行研究,共获得45个白术同源四倍体株系,为优良株系的选育提供了材料。此外,还分析比较了其中8个白术四倍体株系与二倍体的过氧化物酶同工酶（POD）的酶谱差异,发现四倍体各株系过氧化物酶同工酶谱比二倍体的均多了Rf0.310的谱带,且总过氧化物酶比活力也发生了很大改变,对探讨白术四倍体优良株系的生理生化机理具有一定的参考价值。     

Kinetics and thermodynamics of peroxidase- and laccase-catalyzed oxidation of N-substituted phenothiazines and phenoxazines

N -substituted phenothiazines (PTs) and phenoxazines (POs) catalyzed by fungal Coprinus cinereus peroxidase and Polyporus pinsitus laccase were investigated at pH 4–10. In the case of peroxidase, an apparent bimolecular rate constant (expressed as k _cat/K _m) varied from 1 ×10⁷M⁻¹s⁻¹to 2.6×10⁸M⁻¹s⁻¹ at pH 7.0. The constants for PO oxidation were higher in comparison to PT. pH dependence revealed two or three ionizable groups with pK _a values of 4.9–5.7 and 7.7–9.7 that significantly affected the activity of peroxidase. Single-turnover experiments showed that the limiting step of PT oxidation was reduction of compound II and second-order rate constants were obtained which were consistent with the constants at steady-state conditions. Laccase-catalyzed PT and PO oxidation rates were lower; apparent bimolecular rate constants varied from 1.8×10⁵M⁻¹s⁻¹ to 2.0×10⁷M⁻¹s⁻¹ at pH 5.3. PO constants were higher in comparison to PT, as was the case with peroxidase. The dependence of the apparent bimolecular constants of compound II or copper type 1 reduction, in the case of peroxidase or laccase, respectively, was analyzed in the framework of the Marcus outer-sphere electron-transfer theory. Peroxidase-catalyzed reactions with PT, as well as PO, fitted the same hyperbolic dependence with a maximal oxidation rate of 1.6×10⁸M⁻¹s⁻¹ and a reorganization energy of 0.30 eV. The respective parameters for laccase were 5.0×10⁷M⁻¹s⁻¹ and 0.29 eV. Received: 20 September 1999 / Accepted: 24 February 2000