摘要：Objective To investigate the clinical characteristics of epidemic cerebrospinal meningitis in Hotan, the Xinjiang Uygur Autonomous Region.Methods The data of 16 patients with epidemic cerebrospinal meningitis who were admitted to Hotan People’s Hospital from March 2014 to March 2015 were analyzed, retrospectively. Epidemic season, age, clinical characteristics, laboratory examination, treatment and prognosis of patients were analyzed, respectively.Results Cerebrospinal meningitis mainly occurred on April to June. There were 11 children (68.75%) and 5 adults (31.25%) in this research. And 14 cases were with common type and 2 cases with fulminating type. Compared with the adult patients, the clinical manifestations of children were severe, and procalcitonin of children patients was higher (t=-2.668,P = 0.028).Conclusions There is a high occurrence of epidemic cerebrospinal meningitis in south of Xinjiang. The peak incidence of epidemic cerebrospinal meningitis occurs from April to June. Children were susceptible to epidemic cerebrospinal meningitis. The infection of children were more severe than adults. The immunization strategies are to enhance the rates of vaccine inoculation for epidemic cerebrospinal meningitis.%目的：了解新疆维吾尔自治区和田地区流行性脑脊髓膜炎的临床特征。方法回顾性分析和田地区人民医院感染科2014年3月至2015年3月收治的16例流脑病例的临床资料。结果流行性脑脊髓膜炎全年均有发病，4～6月为发病高峰季节，本研究入组对象中儿童病例11例，占68.75%，成人病例5例，占31.25%。普通型14例，暴发型2例，暴发型均为儿童。儿童患者与成人患者临床症状相比，儿童患者表现较重，儿童患者的降钙素原较成人患者显著升高（t =－2.668，P =0.028）。结论南疆地区流行性脑脊髓膜炎发病率较高，患者多为儿童，且临床症状较成人重，应早期诊断及时治疗，并加强适龄儿童脑膜炎球菌疫苗免疫工作。
摘要：Objective To evaluate the effect of the comprehensive management and intervention for stroke patients with unilateral spatial neglect (USN) during the early hospitalization.Methods Total of 40 hospitalized patients with USN were selected and randomly divided into the control group and the observation group, with 20 cases in each group. The patients in control group received the routine management conventional conbines aerosol inhalation; on this basis, while the patients in observation group were taken comprehensivemanagement by theunilateral spatial neglect team.Results After the intervention of comprehensive management team of USN, the CBIT and MBI of patients in observation group were better than those of the control group (CBIT: 17.41 ± 18.17vs. 31.75 ± 16.33;t = 2.625,P = 0.01. MBI: 85.38 ± 14.25 vs. 71.49 ± 11.12;t = 3.437,P = 0.002). The integrated management of patients in intervention group after the hypostatic pneumonia incidence rate was only 6.67%, significantly lower than that of the control group (33.3%), with significant difference (χ2= 9.62,P = 0.01). The management satisfaction was signiifcantly higher than that of control group (χ2= 6.36,P = 0.001). The cure rate and the recovery of pateints in observation group were 70.00% and 25.00%, signiifcantly higher than those of the control group (40.00% and 15.00%), with signiifcant differences (χ2= 7.16,P = 0.012; χ2= 6.02,P = 0.01).Conclusions In the early days of hospitalization, the comprehensive management intervention for stroke patients with USN, had effectively reduced the degree of the patients with USN and leaded to long-term stay in bed and then hypostatic pneumonia incidence, with could greatly improve the self-care ability of the patient’s life, and improve the quality of life.%目的：评价住院早期对脑卒中单侧空间忽略（USN）患者进行综合性的管理与干预的效果。方法收集入住本院的40例USN患者，随机分为即观察组和对照组，每组患者各20例。对照组患者按照传统的常规管理联合雾化吸入；而观察组患者则在此基础上由单侧空间忽略小组进行综合管理干预联合雾化吸入。结果单侧空间忽略综合管理小组经过对观察组患者进行干预后，与对照组比较，发现观察组患者CBIT和MBI均存有一定的优势（CBIT：17.41±18.17vs.31.75±16.33，t =2.625、P =0.01；MBI：85.38±14.25vs.71.49±11.12，t =3.437、P =0.002）。观察组患者（综合管理干预后）坠积性肺炎发生率仅为6.67%，较对照组33.3%低，差异具有统计学意义（χ2=9.62、P =0.01），且管理满意率亦显著高于对照组（χ2=6.36、P =0.001），观察组患者治愈率和好转率分别为70.00%和25.00%，显著高于对照组的40.00%和15.00%，差异具有统计学意义（χ2=7.16、P =0.012，χ2=6.02，P =0.01）。结论住院早期对脑卒中单侧空间忽略患者实施综合管理干预，可有效地减轻患者单侧空间忽略的程度及长期卧床导致的坠积性肺炎发生率，有利于大大增强患者的生活自理能力，改善患者的生活质量。
摘要：目的 本研究拟通过残疾指数(DI)指标比较急诊胃镜治疗与手术治疗对肝炎后肝硬化后门脉高压致上消化道出血(BEV)患者预后及生活质量的影响.方法 选取2004年1月至2009年1月在首都医科大学附属北京地坛医院就诊的慢性肝硬化伴有急性上消化道出血患者共71例,其中33例行急诊脾切除 +贲门周围血管离断手术,38例行急诊胃镜下注射硬化剂治疗,随访评估均超过5年.比较两组患者5年生存率及治疗后1、3和5年残疾指数. 结果 急诊手术组和胃镜组的5年存活率分别为84.85％(28/33)和76.32％(29/38),两组比较差异无统计学意义(χ2= 0.797、P =0.350);手术组1年[251(7.61 ± 3.65)vs 797(20.97 ± 11.50)]、3年[558(16.91 ± 6.77)vs 1 554(40.89 ± 21.48)]及5年[967(29.30 ± 11.81)vs 2 623(69.03 ± 33.41)]的DI评分[总DI值(DI均数 ±标准差)]均显著低于胃镜组(P＜ 0.001).结论在治疗肝硬化后门脉高压致上消化道出血中,急诊手术治疗与胃镜治疗总5年存活率无显著性差异;但急诊手术患者治疗后具有更好的生活质量,有望成为门脉高压所致食管胃底静脉曲张破裂出血的一线治疗方法.%Objective To compare the emergency endoscopic therapy (EST) versus splenectomy-devascularization in the prognosis and the quality of life for cirrhosis patients with bleeding esophageal varices using disability index (DI).Methods Total of 71 patients with cirrhosis who suffered from bleeding esophageal varices in Beijing Ditan Hospital, Capital Medical University from January 2004 to January 2009 were selected, among whom, there were 33 were treated with splenectomy-devascularization and 38 with emergency endoscopic therapy. All patients underwent more than 5 years follow-up evaluation. The DI was detected to describe the overall quality of life in patients.Results The 5-year survival rate was 84.85％(28/33) after splenectomy-devascularization and was 76.32％ (29/38) after EST(χ2= 0.797,P = 0.350). The splenectomy-devascularization had a significantly better DI than the EST in the first year [251 (7.61 ± 3.65) vs 797 (20.97 ± 11.50)], the third year [558 (16.91 ± 6.77) vs 1 554 (40.89 ± 21.48)] and the fifth year [967 (29.30 ± 11.81) vs 2 623 (69.03 ± 33.41)] (P ＜ 0.001).Conclusions The 5-year survival rate showed no significant differences between the splenectomy-devascularization and the EST in the treatment for bleeding varices in cirrhosis. The splenectomy-devascularization results in a better quality of life and is expected to become the first-line therapy for bleeding varices in cirrhosis.
摘要：After human immunodeifciency virus (HIV) getting into body, it mainly infect CD4+T cells. At present, according to the difference of inducing factors and secreting factors, CD4+T cells could be divided into T helper (Th) 1 cells, Th2 cells, Th17 cells and regulatory T (Treg)cells. In this paper, the latest progress of the change of the subset of CD4+T cells in patients with HIV infection were summarized.%人免疫缺陷病毒（HIV）侵入人体后主要侵犯CD4+T淋巴细胞，CD4+T细胞根据诱导因子和分泌因子的不同，主要分为辅助性T（Th）1细胞、Th2细胞、Th17细胞、调节性T（Treg）细胞等4类。本文针对HIV对CD4+T亚群变化的最新进展进行综述。
摘要：目的：明确我国大陆地区基因1a亚型丙型肝炎病毒系统进化的情况。方法收集慢性丙型肝炎患者的血清标本，采用逆转录-巢式PCR扩增HCV基因组部分NS5B区和（或）部分核心/E1区片段。根据测序结果构建系统进化树，分析大陆地区基因1a亚型丙型肝炎病毒系统进化情况。结果共收集全国23个中心共1012例患者标本，其中970例标本分型成功，基因1a亚型患者4例。以美国国立卫生院丙型肝炎数据库中不同国家来源丙型肝炎病毒序列为参考构建系统进化树成功。系统进化分析提示，4株HCV 1a亚型部分NS5B区序列散在分布于进化树中的不同分支，来源于不同国家。结论基因1a型HCV由国外传播入我国，在中国丙型肝炎病毒感染者中所占比率低，在大陆地区随机流行。%Objective To investigate the phylogeny proifle of subgenotype 1a of hepatitis C virus in mainland China. Methods Serum samples and clinical data were collected from patients with chronic hepatitis C from 23 sites in mainland China. NS5B and/or Core/E1 region for sequencing were amplified by RT-nested PCR. Phylogenetic tree which built with reference sequences from NIH HCV database and phylogeny proifle of subgenotype 1a of hepatitis C virus in mainland China were analyzed. Results Serum sample and clinical data were collected from 1 012 enrolled patients with CHC. HCV subgenotype were identiifed in 970/1 012 patients. Total of 4 patients with subgenotype 1a were identiifed and phylogenetic tree were built with reference sequence for NIH HCV database. Phylogenetic analysis showed these 4 sugenotype 1a NS5B region sequences originated from different countries and scattered in different branches in the phylogenetic tree. Conclusions Subgenotype 1a of HCV in mainland China originated from abroad. The proportion of subgenotype 1a in all Chinese HCV subgenotypes is low and subgenotype 1a patients are scattered in mainland China, randomly.
