目的 研究母代不同孕期巨细胞病毒（CMV）感染对自身精神及行为的影响。方法 72只BALB/c雌鼠随机分为12组（A1、A2、A3、B1、B2、B3、C1、C2、C3、D1、D2、D3,每组6只）,A为孕期再感染、B为既往感染、C为孕期原发感染、D为空白对照,1为孕早期、2为孕中期、3为孕晚期。母鼠腹腔注射小鼠CMV（murine CMV,MCMV）Smith株建立播散性感染模型,或注射无菌生理盐水建立对照模型。母鼠产仔后同笼合养,产后22 d分笼;母鼠做行为学试验。试验结束,每组随机处死3只母鼠;测量子宫、肝、脑脏器重量系数及唾液腺中MCMV含量。结果 A、B、C组母鼠产后次日体质量均低于D组（均P<0.05）,其中C2、C3组母鼠低体质量情况持续至产后22日（均P<0.05）。A、B、C组母鼠唾液腺组织均测出MCMV。与D组母鼠相比,A1、C1组母鼠活胎率降低（均P<0.05）,A、C组母鼠的子宫、肝、脑脏器系数升高（均P<0.05）且脑组织有病损表现。产后6天时,A3、B3、C组母鼠水平运动总距离和直立次数减少（均P<0.05）,糖水偏好量降低（均P<0.05）,悬尾不动时间延长（P<0.05）;其中,C2、C3组母鼠以上行为退缩情况至产后22天仍存在,且有逃避潜伏时间延长（均P<0.01）,穿越原平台位置次数减少（均P<0.01）情况。结论 孕期CMV感染损害母代身心健康,有可能增加子代不良抚养的风险。

Objective To investigate the effects of cytomegalovirus（CMV）infection in different stages of maternal pregnancy on its own spirit and behavior．Methods A total of 72 female BALB/c mice were randomly divided into 12 groups（each group had 6 mice）：A1-A3,B1-B3,C1-C3,D1-D3（group A had re-infection,group B had previous infection,group C had primary infection,group D was blank control,group 1 was in early pregnancy,group 2 was in middle pregnancy,group 3 was in late pregnancy）．The disseminative infection model was established by intraperitoneal inoculation of murine CMV（MCMV）Smith strain,and the blank control model was established by intraperitoneal inoculation of 0.9% sterile saline（NaCl）．After 21 days of parturition,the mothers and offspring were reared in separate cages,mothers were selected for the behavior experiments．At the end of all the behavior tests,3 mothers in each group were killed randomly．Weighed and calculated the organ coefficients of the uteri,livers and brains,and detected the expression levels of MCMV in salivary gland．Results On the first day after delivery,the weights of mothers in groups A,B and C were lower than those in group D（all P<0.05）,the low body weight of mice in C2 and C3 groups lasted to the 22th day（all P<0.05）．The MCMV in salivary gland tissue were found in groups A,B and C,but not in group D．The live fetus rates of groups A1 and C1 were significantly lower than that of group D．The organ coefficients of uteri,livers and brains in groups A and C were higher than those in group D（all P<0.05）．And the lesions of brain tissues in groups A and C were more serious than in the other groups．On the 6th day,compared with the other groups,the mothers of groups A3,B3 and C were significantly abnormal in the open field test,the tail suspension test and the sugar preference test（all P<0.05）．But on 22th day,only the mothers of groups C2 and C3 were significantly abnormal in those tests（all P<0.01）,and even in the water maze test（all P<0.01）．Conclusions Maternal CMV infection in different stages pregnancy have impacts on mother mice's physical and mental health．Those bad situations may bring poor parenting to the offspring．

目的 分析不同年龄、不同季节河源市源城区呼吸道感染的病原学情况,指导临床用药。方法 回顾性研究2020年3月—2022年2月2 468例呼吸道感染的住院患儿,取咽部分泌物送广州达安临床检验中心进行呼吸道核酸六项检测并分析结果。包括：肺炎链球菌（Sp）、呼吸道合胞病毒（RSV）、卡他莫拉菌（MC）、流感嗜血杆菌（Hi）、肺炎支原体（LP）、腺病毒（ADV）。结果 （1）2 468例患儿的标本中阳性率52.8%,其中RSV最高,其他依次为Sp、Hi、MC、MP、ADV。而混合感染仅次于RSV。（2）婴儿组和幼儿组以RSV感染为主,在学龄前组和学龄组儿童中,以Sp感染为主,各病原体的混合感染组合很多,一种细菌合并一种病毒多见。（3）秋冬季是河源市源城区呼吸道感染的高发季节,RSV是秋冬季呼吸道感染最主要的病原体。结论 秋冬季节为河源市源城区呼吸道感染的高发季节,RSV为该季节的主要病原体。RSV也是婴幼儿组感染的主要致病菌,随着年龄增大,细菌感染导致的呼吸道疾病逐渐占优势。混合感染在各年龄组中均占比较高,值得临床诊疗的重视。

Objective To analyze the etiology of respiratory tract infection in Yuancheng District of Heyuan City ,which was in different ages and seasons,and to provide guidance of clinical drug usage．Methods Cases of 2 468 hospitalized children with respiratory tract infection from March 2020 to February 2022 were analyzed．The secretion from pharynx was collected and sent to Guangzhou Da’an Clinical Examination Center for six respiratory nucleic acid tests and then the results were analyzed,including Streptococcus pneumoniae（Sp）,respiratory syncytial virus（RSV）,Moraxella catarrhalis（MC）,Haemophilus influenzae（Hi）,Mycoplasma pneumonia（MP）,adenovirus（ADV）．Results The positive rate of 2 468 hospitalized children with respiratory tract infection was 52.8%,of which the highest was RSV,followed by Sp,Hi,MC,MP,ADV．Meanwhile the mixed infection rate was second to RSV．RSV infection was the main infection in infant group and early-aged children group,while in preschool group and school-aged group,Sp infection was the main infection．There were many mixed infection of pathogen,and one bacteria combined with one virus was more common．Respiratory tract infection had high incidence in autumn and winter in Yuancheng District of Heyuan City,RSV was the major pathogen．Conclusions Autumn and winter were the seasons with high respiratory tract infection incidence in Yuancheng District of Heyuan City,and RSV was the main pathogen in these two seasons．RSV was also the main pathogen of infant group infection．But with the increase of children’s age,bacterial infection became the main reason of respiratory tract diseases．Mixed infection accounts for a high proportion in all age groups,which should be valued in clinical diagnosis and treatment．

目的 探讨慢性乙型肝炎病毒（HBV）感染对妊娠期糖尿病（GDM）孕妇的妊娠并发症、孕晚期生殖道B族链球菌（GBS）感染情况以及妊娠结局的影响。方法 选取2020年1月1日—12月31日在广州市妇女儿童医疗中心定期产检、足月、单胎妊娠的GDM孕妇共583例,其中合并HBV感染者（GDM+HBV组）48例,无合并者（GDM组）535例。比较2组的妊娠期并发症、妊娠晚期（妊娠35~37周）生殖道GBS感染情况、妊娠结局以及阴道分娩者的母儿结局。结果 与GDM组患者相比,GDM+HBV组患者出现妊娠期肝内胆汁淤积症、孕晚期生殖道GBS感染者比例较高,孕期出现胎盘早剥者比例较高,阴道分娩过程中出现产时发热、羊水粪染和新生儿入住NICU者比例均较高（均P<0.05）。结论 与无合并慢性HBV感染的GDM患者相比,合并慢性HBV感染的GDM患者在围产期的母儿风险升高。

Objective To investigate the effects of chronic hepatitis B virus（HBV）infection on pregnancy complications,group B streptococcus（GBS）infection in third trimester and pregnancy outcome in pregnant women with gestational diabetes mellitus（GDM）．Methods A retrospective study of 583 pregnant women with GDM,singleton gestation and cephalic presentation delivered at term in Guangzhou Women and Children’s Medical Center was carried out．Including 48 GDM women complicated with chronic HBV infection（GDM+HBV group）and 535 GDM women without HBV infection（GDM group）．Pregnancy complications,GBS infection in third trimester（gestation 35-37 weeks）,pregnancy outcomes,maternal and neonatal outcomes of vaginal delivery were compared between the two groups．Results GDM+HBV group had a higher proportion of intrahepatic cholestasis of pregnancy（ICP）and GBS infection in third trimester than GDM group,and a higher proportion of placental abruption during pregnancy．GDM+HBV group showed a significantly increased proportion in intrapartum fever,meconium-stained amniotic fluid and neonatal intensive care unit admission during vaginal delivery than GDM group（all P<0.05）．Conclusions GDM women with chronic HBV infection are associated with increased maternal and fetal risk during pregnancy and delivery．

目的 探讨精细化管理模式对消毒供应中心风险事件发生率的影响。方法 选取2020年6月—2022年5月为研究阶段,抽取本院消毒供应室1 000件医疗器械作为研究对象,随机分为对照组和研究组,各500件。对照组采用常规管理模式,研究组采用精细化管理模式,对比2组医疗器械不良事件发生率,观察30名工作人员分别在不同管理模式下发生职业风险暴露人数的变化,并进一步比较工作效率的不同。结果 研究组发生数量不等、物品过期、标签错误、型号错误、零部件差错等不良事件发生率均低于对照组（P<0.05）。研究组工作人员利器损伤和血制品污染者发生率低于对照组（P<0.05）,研究组工作人员工作效率评分高于对照组（P<0.05）。结论 精细化管理模式可有效减少消毒供应室医疗器械不良事件,降低工作人员职业暴露风险事件发生率,提高工作人员工作效率,改善管理工作质量。

Objective To explore the influence of refined management mode on the incidence of risk events in disinfection supply center. Methods From June 2020 to May 2022,1 000 pieces of medical devices were selected from the disinfection supply room of our hospital as the research object,and were randomly divided into control group and research group,with 500 pieces in each group. The control group adopted the conventional management mode,while the research group adopted the refined management mode. The incidence of adverse medical device events in the two groups was compared,and the changes in the number of 30 staff exposed to occupational risks under different management modes were observed,and the differences in work efficiency were further compared. Results The incidences of adverse events involving unequal quantities,expired items,mislabeling,modeling errors and parts errors were lower in the study group than in the control group(P<0. 05). The number of sharps injuries and blood product contamination among the staff in the study group was significantly lower than that in the control group(P<0. 05),and the staff efficiency scores of the study group were higher than those of the control group(P<0. 05). Conclusions Refined management mode can effectively reduce the adverse events of medical devices in disinfection supply room,reduce the number of occupational exposure risk events of staff,improve the work efficiency of staff and improve the quality of management.

目的 探讨广州地区儿童2019新型冠状病毒(2019 novel coronavirus, 2019-nCoV)感染筛查/疑似病例的流行病学特点、发病特点、可能的原因及防控建议。方法 回顾性分析2020年1月20日—2020年2月29日广州市唯一一家儿童2019-nCoV感染隔离定点医疗单位隔离病房收治住院的符合儿童2019-nCoV感染筛查/疑似病例129例,对其流行病学、发病特点、临床特征、实验室检查及转归、随访等进行总结分析。 结果 男 79例,女 50例,最小1个月,最大13岁,中位数2岁,51例(39.5%)有武汉疫区旅游或居住史,20例(15.5%)有与来自疫区有呼吸道症状人员接触史,17例(13.1%)周边或社区有确诊病例,3例(2.3%)有确诊病人接触史(其中2例为家庭确诊病例密切接触史),38例(29.5%)为临床符合或聚集性发病;临床症状:发热121例(93.8%),咳嗽92例(71.3%),流涕50例(38.8%),32例伴有腹泻、呕吐/腹痛(24.8%),102例(79.0%)白细胞降低或正常,C反应蛋白(C-reactive protein,CRP)＜20 mg/L有103例(79.8%),57例(44.2%)胸片或CT示肺部斑片状影或实变;病原学检查:2019-nCoV实时荧光定量反转录PCR检测结果:所有患儿及陪同家属都有行咽拭子检查,只有21例患儿(16.3%)有行肛拭子检查,仅有1例(0.78%)家庭确诊病例密切接触者肛拭子阳性,但连续多次咽拭子结果阴性,余患者肛拭子和咽拭子及陪同家属咽拭子结果均阴性。其他病原学检查结果61例(47.3%),包括14例RSV阳性,9例流感病毒A,8例人偏肺病毒,6例肠道病毒,6例流感病毒B,6例肺炎支原体,4例副流感病毒1型,1例副流感病毒3型,2例人博卡病毒,3例腺病毒,1例肺炎克雷伯菌,1例人型葡萄球菌,其中1例合并副流感病毒1型及人博卡病毒。跟踪唯一1例确诊患者咽拭子多次检查均阴性,肛拭子持续19天后才转阴,一直无任何症状。其余患者好转出院后第3天、7天及14天进行随访,无异常发现。结论 儿童2019-nCoV感染筛查/疑似病例临床多表现为呼吸道或消化道症状,确诊主要依靠核酸检测,新冠病毒感染确诊率极低,而其将近50%病例能找到除新冠病毒外的其它相关病原体;高危患者为密切接触者,但存在漏诊的可能,肛拭子阳性率或高于咽拭子。

Objective To explore the epidemiological characteristics, onset characteristics, pathogenic mechanism of 2019-nCoV infection in children, and its control and prevention in Guangzhou. Methods From January 20, 2020 to February 29, 2020, a retrospective analysis was carried out on 129 suspected cases of 2019-nCoV infection admitted to the isolation ward of the only medical unit designated for children in Guangzhou. The epidemiology, disease characteristics, clinical characteristics, laboratory examination, outcome and follow-up were summarized and analyzed. Results There were 79 males and 50 females, with a minimum age of 1 month and a maximum age of 13 years. Anong them, 51 cases (39.5%) had a history of tourism or residence in the epidemic area of Wuhan, 20 cases (15.5%) had a history of contact with people with respiratory symptoms from the epidemic area, 17 cases (13.1%) with a confirmed case in the surrounding area or community, 3 cases (2.3%) had a history of contact with a confirmed patient (2 of them were family clustering cases), 38 cases (29.5%) were clinically suspected cases. Clinical symptoms: 121 cases with fever (93.8%), 92 cases with coughing (71.3%), 50 cases with runny nose (38.8%), 32 cases with diarrhea, vomiting or abdominal pain (24.8%). In 102 cases (79.0%), white blood cells were decreased or normal, 103 cases (79.8%) with CRP＜20 mg/L, and 57 cases (44.2%) showed focal infection on chest X-ray or CT scan. Etiological examination: only one case (0.78%) of the family confirmed cases had positive anal swab result, but the throat swab results were negative all the time. The anal swab and throat swab results of other patients and the throat swab results of their accompanying family members were negative. Other pathogens were detected in 61 cases (47.3%), including 14 RSV positive cases, 9 influenza A positive cases, 8 human metapneumovirus positive cases, 6 enterovirus positive cases, 6 influenza B positive cases, 6 Mycoplasma pneumoniae positive cases, 4 parainfluenza virus type 1 positive cases, 1 parainfluenza virus type 3 positive cases, 2 human bocavirus positive cases, 3 adenovirus positive cases, 1 Klebsiella pneumoniae positive cases, 1 Human Staphylococcus positive case, and 1 case with parainfluenza virus type 1 and human bocavirus. The only confirmed patient was followed up while multiple pharyngeal swab results were negative, and the positive anal swab results lasted for 19 days before turning negative and remained asymptomatic. Other patients were followed up on the 3rd, 7th and 14th day after discharge, and no abnormal findings were found. Conclusion Screening/suspected cases of 2019-nCoV infection in children were mostly clinically manifested as respiratory or gastrointestinal symptoms. The diagnosis rate of nucleic acids was extremely low, and there was a possibility of missed diagnosis. Nearly 50% of cases could find other relevant pathogens excluding the 2019-nCoV. The positive rate of anal swab results was higher than that of pharyngeal swab.

目的 分析阴道灌洗液中炎性因子表达水平与高危型人乳头瘤病毒(HPV)持续感染的相关性。方法 选择本院2019年3月—2021年3月接诊的80例高危型HPV持续感染患者作为试验组,以病理组织检查结果分组,将19例宫颈癌患者作为试验组1、将30例宫颈上皮不典型增生(CIN)I级患者作为试验组2,将31例CIN II、III级患者作为试验组3,选取同期门诊体检的30例健康女性作为对照组,均进行TGF-β、IFN-γ、IL-17、IL-6表达水平检测,比较4组TGF-β、IFN-γ、IL-17、IL-6水平、高危型HPV负荷量,Pearson分析TGF-β、IFN-γ、IL-17、IL-6水平与高危型HPV负荷量的相关性。结果 阴道灌洗液炎症因子水平、高危型HPV负荷量4组相比较,差异均有统计学意义(P<0.05)。TGF-β、IL-17、IL-6水平与高危型HPV负荷量呈正相关性,与IFN-γ水平呈负相关性,P＜0.05。结论 高危型HPV持续感染患者机体阴道灌洗液中炎性因子水平与高危型HPV负荷量存在一定的相关性,高危型HPV负荷量与IFN-γ水平呈负相关性,与TGF-β、IL-17、IL-6水平呈正相关性,通过检测阴道灌洗液中炎性因子水平,可评估HPV感染程度。

Objective To analyze the correlation between the expressions of inflammatory factors in vaginal lavage fluid and persistent infection of high-risk human papillomavirus(HR-HPV). Methods A total of 80 patients with HR-HPV persistent infection in our hospital from March 2019 to March 2021 were selected as the experimental group. According to the pathological examination results, 19 patients with cervical cancer were selected as the experimental group 1, 30 patients with CIN grade I were selected as the experimental group 2, and 31 patients with CIN grade II and III were selected as the experimental group 3. Thirty healthy women in the same period were selected as the control group. HR-HPV load, TGF- β, IFN-γ, IL-17 and IL-6 levels were detected and were compared among the four groups. Pearson analysis of correlation between TGF- β, IFN-γ, IL-17, IL-6 levels and HR-HPV load was carried out. Results There were significant differences in the levels of inflammatory factors in vaginal lavage fluid and HR-HPV load among the four groups (P<0.05). TGF- β、IL-17 and IL-6 levels were positively correlated with HR-HPV load and negatively correlated with IFN-γ (P<0.05). Conclusions There is a certain correlation between inflammatory factors in vaginal lavage fluid and HR-HPV load in patients with HR-HPV persistent infection. HR-HPV load is negatively correlated with IFN-γ, and positively correlated with TGF-β, IL-17 and IL-6. The degree of HPV infection could be evaluated by detecting the inflammatory factors in vaginal lavage fluid.

目的 探讨负性调节细胞CD4⁺CD25⁺T及其相关细胞因子在慢性阻塞性肺病(COPD)患者外周血中的表达与合并细菌感染的相关性。方法 纳入2018年1月—2019年12月间收治的66例COPD患者作为研究对象,其中急性加重期COPD患者(AECOPD)36例、稳定期患者30例,并纳入同期体检健康者30例作为对照组。对所有纳入的研究对象外周血标本中的CD4⁺CD25⁺T调节性T细胞及其相关细胞因子[白介素-4(IL-4)、白介素-10(IL-10)、干扰素-γ(IFN-γ)]表达水平进行检测,分析相关指标水平与COPD是否合并细菌感染的关系,及预测细菌感染的效能。结果 AECOPD和稳定期COPD患者CD4⁺、CD4⁺CD25⁺、IFN-γ/IL-4水平均低于对照组(P<0.05),IL-4、IL-10水均高于对照组(P<0.05);AECOPD患者IFN-γ水平高于对照组(P<0.05);AECOPD患者CD4⁺、CD4⁺CD25⁺水平低于稳定期COPD患者(P<0.05),IL-4、IL-10、IFN-γ均高于稳定期COPD患者(P<0.05);CD4⁺、CD4⁺CD25⁺水平与IL4、IFN-γ均呈负相关关系(P<0.05),CD4⁺水平与IL-10呈负相关关系(P<0.05);COPD合并感染者CD4⁺水平低于未合并感染者(P<0.05),IL-4、IFN-γ水平均高于未合并感染者(P<0.05);COPD合并革兰氏阴性菌感染者CD4⁺CD25⁺水平低于未合并感染者(P<0.05),IL-10水平均高于未合并感染者(P<0.05);CD4⁺、IL-4、IL-10、IFN-γ均是预测COPD患者合并细菌感染的有效指标(P<0.05),其中IL-4和IFN-γ效能较高。结论 CD4⁺、CD4⁺CD25⁺Treg细胞及其相关细胞因子参与COPD发生发展和患者细菌感染,监测其水平变化有利于为临床诊治提供信息。

Objective To investigate the correlation between the expressions of negative regulatory cell CD4⁺CD25⁺T and its related cytokines in peripheral blood and bacterial infection of patients with chronic obstructive pulmonary disease (COPD). Methods Sixty-six COPD patients admitted between January 2018 and December 2019 were included as the research subjects, including 36 patients with acute exacerbation of COPD (AECOPD) and 30 patients with stable COPD. Another 30 healthy people undergoing physical examination during the same period were included in control group. The expression levels of CD4⁺CD25⁺ regulatory T cell and its related cytokines [interleukin-4 (IL-4), interleukin-10 (IL-10), interferon-γ (IFN-γ)] in the peripheral blood samples were detected among the included subjects. The relationship between levels of related indicators and presence or absence of bacterial infection in COPD and the efficacy of predicting infection were analyzed. Results The levels of CD4⁺, CD4⁺CD25⁺ and IFN-γ/IL-4 in patients with AECOPD and patients with stable COPD were lower than those in control group (P<0.05), while the levels of IL-4 and IL-10 were higher than those in control group (P<0.05). The IFN-γ level of AECOPD patients was higher than that of control group (P<0.05). The levels of CD4⁺ and CD4⁺CD25⁺of AECOPD patients were lower than those of stable COPD patients (P<0.05), while the levels of IL-4, IL-10 and IFN-γ were all higher than those of stable COPD patients (P<0.05). The levels of CD4⁺ and CD4⁺CD25⁺were negatively correlated with IL-4 and IFN-γ (P<0.05), and the CD4⁺level was negatively correlated with IL-10 (P<0.05). The CD4⁺ level in COPD patients with infection was lower than that in patients without infection (P<0.05), while the levels of IL-4 and IFN-γ were higher than those in patients without infection (P<0.05). The CD4⁺CD25⁺level of COPD patients with Gram-negative bacteria infection was lower than that of patients without infection (P<0.05), while the IL-10 level was higher than that of patients without infection (P<0.05). CD4⁺, IL-4, IL-10 and IFN-γ were effective indicators in predicting bacterial infection in COPD patients (P<0.05), and IL-4 and IFN-γ had higher efficacy. Conclusions CD4⁺, CD4⁺CD25⁺ T cell and related cytokines are involved in the occurrence and development of COPD and bacterial infection in patients. Monitoring changes of those levels is helpful to provide information for clinical diagnosis and treatment.

目的 了解遵义地区住院新生儿TORCH感染状况、发病率,为相关疾病的早期预防和治疗提供重要参考依据。方法 采用回顾性研究方法,对遵义市妇幼保健院2018—2019年住院新生儿弓形虫(TOX)、风疹(RV)、巨细胞(CMV)和单纯疱疹病毒(HSV)Ⅰ型感染结果进行分析。结果 遵义地区4 604例住院新生儿TORCH-IgM的总体阳性率为1.35%,其中CMV、TOX、RV、HSV Ⅰ的阳性率分别是1.00%、0.20%、0.13%和0.02%;对应TORCH-IgG的阳性率分别是67.38%、0.91%,54.54%、22.22%。对2018—2019年住院新生儿TORCH感染筛查结果显示:CMV-IgM阳性率分别从1.47%下降到0.43%(χ²=4.981,P=0.026),RV-IgM的阳性率从0.24%下降到0.00(χ²=12.446,P<0.001),差异均有统计学意义。在研究的2 607例男性患儿中,CMV、TOX、RV、HSV Ⅰ的IgM阳性率率分别是0.19%、0.11%、0.96%和0.04%,其IgG的阳性率为1.07%、55.20%、67.93%和22.48%。在研究的1 997例女性患儿中,CMV、TOX、RV、HSV Ⅰ的IgM阳性率分别是0.20%、0.15%、1.05%和0.00%,其IgG的阳性率为0.70%、53.68%、66.65%和21.88%。不同CMV-IgM感染对谷丙转氨酶(ALT)和谷草转氨酶(AST)的活性影响研究中,CMV-IgM抗体阳性对照组的ALT活性高于阴性组(t=-2.793,P<0.05),AST的活性无差异(t=0.067,P>0.05) 结论 遵义地区4 604例住院新生儿中以CMV感染率相对较高,不容忽视。2018—2019年CMV和RV的新近感染率呈下降趋势。CMV-IgM的感染能引起ALT活性的升高。

Objective To reveal the TORCH infection status and incidence of hospitalized newborns in Zunyi area, and provide important reference for early prevention and treatment of related diseases. Methods The retrospective research method was used to analyze the infection results of toxoplasma gondii (TOX), rubella virus (RV), cytomegalovirus (CMV) and herpes simplx virus (HSV) type I in hospitalized newborns in Zunyi Maternal and Child Health Hospital from 2018 to 2019. Results The overall positive rate of TORCH-IgM in 4 604 hospitalized newborns in Zunyi area was 1.35%, of which the positive rates of CMV, TOX, RV, and HSV Ⅰ were 1.00%, 0.20%, 0.13% and 0.02%, respectively; the corresponding TORCH-IgG positive rates were 67.38%, 0.91%, 54.54%, 22.22%. The TORCH infection screening results of neonates hospitalized in 2018—2019 showed that the CMV-IgM positive rate decreased from 1.47% to 0.43% (χ²=4.981, P=0.026), and the RV-IgM positive rate decreased from 0.24% to 0.00 (χ²=12.446, P< 0.001), the differences were statistically significant. In 2 607 male children, the IgM positive rates of CMV, TOX, RV and HSVⅠwere 0.19%, 0.11%, 0.96% and 0.04%, respectively; and the corresponding IgG positive rates were 1.07%, 55.20%, 67.93% and 22.48%. In 1 997 female children, the IgM positive rates of CMV, TOX, RV and HSVⅠwere 0.20%, 0.15%, 1.05% and 0.00,respectively; and the corresponding IgG positive rate was 0.70%, 53.68%, 66.65% and 21.88%. In the study of effects of different CMV-IgM infection on alanine aminotransferase(ALT) and aspartate aminotransferase(AST) activity, the ALT activity of CMV-IgM positive group was significantly higher than that of negative group (t=-2.793, P<0.05), and there was no difference in AST activity between the two groups (t=0.067, P>0.05). Conclusions The CMV infection rate among 4 604 hospitalized newborns in Zunyi area was relatively high, which should not be ignored. The recent infection rates of CMV and RV showed a downward trend from 2018 to 2019. CMV-IgM infection could cause an increase in ALT activity.

目的 分析探讨健康驿站新冠病毒肺炎病例感染来源,评估驿站站内感染风险,规范驿站管理,降低感染风险。方法 对驿站2022年2月21日—3月9日全部14例新冠肺炎病例自入境到报告进行全链条风险分析。结果 14例病例为7批次不同时间入住,其中病例1、2、3、4、5、6、7、8、9、10、12、13共12例病例入境后即确诊,病例11入住5天(其共同入境、同住人员病例10,入境后即确诊)确诊、病例14入住10天发病确诊,其余病例均未呈现感染发病时间特异性,未呈现入境后交叉感染时间特异性,未见入住后空间、通风系统、排污系统交集,未见交叉感染情况。结论 该驿站目前报告新冠肺炎病例均有相关旅居史,主要在香港本土感染。13名病例大概率均在香港感染,入境隔离时发病确诊,其中病例1、2、3、4,病例6、7、8,病例10、11是3起呈现家庭聚集性感染发病,病例5、9是独立个案,病例14需要进一步排除,驿站未规范管理会导致误报及进一步扩大站内感染风险。

Objective To investigate and analyze the source of infection of COVID-19 cases in health station, assess the risk of infection, standardize the management and reduce the risk of infection. Methods From February 21 to March 9, 2022, the whole chain risk analysis of all 14 COVID-19 cases from entry to reporting was carried out. Results Fourteen cases were admitted in 7 batches at different times. Except for case 11 who diagnosed at the 5th day (the case of co-entry and co-resident case 10 was diagnosed after entry), and case 14 who diagnosed at the 10th day, the rest of the cases were diagnosed after entry, which did not show infection-onset time specificity, no time specificity of cross-infection after entry, no intersection of space, ventilation system and sewage system after entry, and no cross-infection. Conclusions The COVID-19 cases reported by the station were mainly infected in Hong Kong. Those 13 cases were highly likely infected in Hong Kong, all were diagnosed at the time of entry quarantine, while cases 1~4, cases 6~8, and cases 10~11 were 3 cases of family cluster infection, case 5 and 9 were an independent case, and case 14 needed to be further investigation. Failure to standardize the management of the station will lead to false alarms and further increase the risk of infection in the station.

目的 研究未成熟血小板分数(IPF)、高荧光未成熟血小板比例(H-IPF)指标在血流感染中的早期诊断价值。方法 选取2020年7月—2021年1月广州市第一人民医院的血培养阳性患者100例作为主要的研究对象,重症病人对照50例,健康对照50例。收集各组患者IPF、H-IPF、大型血小板比率(P-LCR)、血小板体积分布宽度(PDW)、粒/淋、粒/单指标的数值,采用单因素方差分析、构建ROC曲线的方法分析比较各组的IPF、H-IPF、P-LCR、PDW、粒/淋、粒/单比值的差异及其与血流感染效能的关系。结果 IPF、H-IPF、粒/淋、粒/单比值在血流感染组高于其他2组,差异有统计学意义(χ²分别是15.190,10.250,39.490,12.850;P<0.05),而 P-LCR、PDW在3组之间无统计学意义。其中,IPF与H-IPF对血流感染诊断效能较高,其中IPF的AUC为0.855(95% CI为0.737～0.973),H-IPF的AUC为0.845(95% CI为0.722～0.968)。结论 IPF、H-IPF与血流感染密切相关,这2个指标对血流感染患者具有一定的诊断价值。

Objective To explore the early diagnosis value of immature platelet fraction (IPF) and high fluorescent immature platelet fraction (H-IPF) in bloodstream infection.Methods A total of 100 patients with positive blood culture result from July 2020 to January 2021 in Guangzhou First People's Hospital were selected as the research objects,in the mean while,50 critically ill patients and 50 healthy patients were enrolled as two control groups.The values of IPF,H-IPF,platelet-large cell rate (P-LCR),platelet distribution width (PDW),neutrophils/lymphocytes,neutrophils/monocyte ratio of patients in each group were collected,and one-way analysis of variance and ROC curve were used to compare the data,to further analyze their relationship with the bloodstream infection.Results The IPF,H-IPF,neutrophils/lymphocytes,neutrophils/monocyte ratio in the bloodstream infection group were significantly higher than control groups,with statistical significance (χ²=15.190,10.250,39.490,12.850; P<0.05),while P-LCR and PDW had no statistical significance.Among them,IPF and H-IPF were highly effective in diagnosing bloodstream infection,the AUC of IPF was 0.855 (95% CI: 0.737-0.973) and the AUC of H-IPF was 0.845 (95% CI: 0.722-0.968).Conclusions IPF and H-IPF were closely related to bloodstream infection,and these two indicators had a certain value in diagnosing patients with bloodstream infection.