目的：通过对首例甲型H1N1流感密切接触者临床医学观察发现二代患者,为大规模临床医学观察积累经验和参考。方法：对首例甲型H1N1流感患者密切接触者115例的临床医学观察资料进行回顾性分析。结果：115例密切接触者中,有6人出现不同程度咽充血、咽部疼痛症状,其中1例为糖尿病患者、2例为高血压患者;1例左前臂疱疹,1例口腔溃疡,4例结膜充血;观察第3天1例出现精神抑郁,1例出现情绪激动;观察第4天2例多次要求提前解除隔离,多例关心何时解除隔离。七日医学观察期间115例密切接触者均无咽痛、咳嗽、鼻塞等症状,体温均正常,情绪稳定,未发现二代患者。结论：对甲型H1N1流感患者的密切接触者进行临床医学观察是必要的,有助于发现二代患者,疾控中心(CDC)采样与临床医学观察和心理干预的有效结合,给传染病医学观察提供宝贵的经验和有效的工作模式。
目的:探讨甲型H1N1流感的诊治。方法:对中国内地首例输入性新甲型H1N1流感病例诊治经过临床分析并文献复习。结果:通过流行病学史、临床表现、甲型H1N1流感病毒的核酸检测(realtime RTPCR法)可明确诊断。经中西医积极治疗痊愈出院。结论:2009年中国内地首例输入性甲型H1N1流感病例临床表现较轻,病程短,无并发症;推测此次致病的甲型H1N1流感毒力小,病毒清除迅速,预后良好。
目的:探讨甲型H1N1流感患者安全转运中的消毒措施和防护流程。方法:对我国首例甲型H1N1流感患者转运的各个环节,包括工作人员的个人防护、车辆要求、物品消毒规范和操作流程进行分析。结果:应对首例甲型H1N1流感突发疫情的能力得到提高,转运顺利,安全将该例甲型H1N1流感患者接回医院,在转运过程中无交叉感染情况发生。结论:严格的消毒措施、规范的着装,以及有效的监督等措施,是我们面对突发疫情应急工作任务时,防止防止交叉感染的关键。
【摘要】 目的 了解甲型H1N1流感发热病区门诊就诊高峰期患者焦虑状况及相关因素，采取针对性护理措施减轻患者焦虑情绪。 方法 2009年11月上旬-12月上旬采用一般资料调查和Zung′s焦虑自评量表（SAS）对219例患者进行调查分析。 结果 219例患者SAS平均分为（33.70±8.60）分，其中17例SAS总分≥50分，存在焦虑情绪，发生率7.76%。多元回归分析结果显示，在年龄、性别、城乡差异、发热程度等因素中，与焦虑症状有关的主要因素为年龄和发热程度。 结论 甲型H1N1流感发热病区门诊就诊高峰期患者焦虑情绪明显高于常模，应引起重视，在门诊工作中加强心理护理，减轻和尽力消除患者的焦虑情绪，以免对病情产生不利影响，不利于控制流感疫情。【Abstract】 Objective To investigate the anxiety status and related factors of H1N1 patients at influenza peak of fever clinics,and to take specific measures to reduce anxiety in patients. Methods The general information and Zung′s self rating anxiety scale (SAS) were taken to analyze 219 patients from early November to early December 2009. Results The average SAS score of the 219 patients was 33.70±8.60, in which there were 17 patients (7.76%) with total scores ≥ 50 and anxiety. Multiple regression analysis showed that the age and temperature were related factors among age, gender, urban-rural differences, and fever. Conclusion The survey suggests that the pafients at the H1N1 influenza peak of fever clinics are significantly more anxious than normal anxiety. Out-patient work should strengthen psychological care to reduce and try to eliminate the anxiety of patients, in order to avoid adverse impact which is not conducive to control influenza outbreaks.
【摘要】 目的 总结甲型H1N1流感病毒性肺炎患者的胸部X线和CT表现特征。 方法 回顾分析2009年3月-11月3例经临床表现及病原学检查证实的甲型H1N1流感病毒性肺炎的胸部X线、CT表现。 结果 肺部病灶多呈散在小片状高密度影，边缘模糊，邻近胸膜；病变最常累及肺基底段；病灶多有少量胸腔积液；病灶有扩散迅速，合理用药后消失较快的特点；病灶吸收落后于临床表现。 结论 甲型H1N1流感病毒性肺炎的X线、CT表现具有一定的特点，总结并掌握这些特点，有利于早期诊断。其确诊有赖于实验室检查和流行病学调查。【Abstract】Objective To explore the chest X-ray, CT manifestations of pneumonia of patients with influenza virus A/H1N1 infection. Methods The pulmonary X-ray and CT findings of 3 patients who were confirmed by laboratory results and epidemiology with infection of influenza virus A/H1N1 were retrospectively analyzed between March 2009 to November 2009. Results Both sides of the lung field showed many small cloudy infiltration in chest X-ray and CT film. The lesions of the lung were mostly near the pleural. They were often found in basal segment. Pleural effusion may be observed. Radiology dynamic changes showed the diffusion of the lesions of the lung was quick in a short time, and scattered and disappeared quickly after rational use of drugs. The lesions vanished later than clinical disappearance. The lesions of the lung may appear fibrosis at the period of the end. Conclusion Some radiographic characteristics exist in the pneumonia of patients with influenza virus A/H1N1 infection. It will be helpful for early diagnosis when getting familiar with its X-ray and CT manifestations, but the final diagnosis depends on the laboratory results and epidemiological history.
目的 探讨甲型H1N1流感不同临床类型及不同阶段C反应蛋白（CRP）动态变化特征。 方法 回顾性分析2009年5月10日－2010年1月18日实验室确诊的271例甲型H1N1流感住院患者不同临床类型、疾病不同阶段CRP动态变化情况。 结果 甲型H1N1流感患者感染初期CRP较正常升高，且升高程度随着病情的加重而更明显；CRP在治疗第3天即明显下降或接近正常，其动态改变在不同疾病严重程度组间无明显差异；有脏器功能损害者CRP较无脏器功能损害者明显升高；多个脏器损害CRP较单一脏器损害组明显升高。 结论 甲型H1N1流感CRP升高程度可间接反映其疾病严重程度和脏器功能损害多少。
In order to investigate immune protection against swine-origin influenza virus (S-OIV) A H1N1, the helper-dependent adenovirus vector (HDAd) system was exploited to construct recombinant HDAd encoding hemagglutinin (HA). The HA gene was synthesized and cloned to the HDAd backbone. Then, the HDAd/HA DNA molecules were transfected into 293Cre4 cells with calcium phosphate. The cells were infected by helper virus 16 hours after the transfection. The 293Cre4 cells were coinfected with HDAd/HA and the helper virus for large-scale preparation of HDAd/HA. The HDAd/HA was obtained and purified twice with CsCl density ultracentrifugation and observed morphologically under transmission electron microscope, and the expression of HA protein was analyzed with RT-PCR. Recombinant HDAd/HA expressing HA protein was successfully constructed which could pave the way for in vivo investigation on immunogenicity and efficacy against S-OIV A H1N1 infection.