目的 了解从化地区儿童人冠状病毒((human coronavirus,HCoV)流行情况和临床特点,观察人冠状病毒分型OC43(HCoV-OC43)基因分布特点,探讨从化地区小儿呼吸道感染HCoV-OC43分离株与国内的HCoV-OC43分离株的同源性与基因分型,探讨HCoV-OC43与小儿呼吸道感染疾病的关系,为预防和控制呼吸道疾病提供依据。方法 本研究从化地区2017年1月—2019年6月门诊就诊的6个月~14岁的儿童610例,采集鼻咽拭子标本,病毒检测阳性的患者,这些标本取自患有急性上呼吸道感染或下呼吸道感染疾病的患者,表现出呼吸道感染的症状,例如发热(体温> 37.5℃)、咽痛、流涕、鼻塞、咳嗽和咳痰等。采用荧光定量PCR方法,对HCoV-OC43病毒核酸进行分析和测序。采用直接免疫荧光法检测其他7种常见呼吸道病毒;包括:流感病毒 A、B型(influenza virus,IVA、B)、副流感病毒Ⅰ、Ⅱ、Ⅲ 型 (parainfluenza virus, PIVⅠ、Ⅱ和Ⅲ)、呼吸道合胞病毒(respiratory syncytial virus, RSV)、腺病毒(ad enovirus, ADV)共七种常见呼吸道病毒进行检测,通过HCoV-OC43和常见呼吸道病毒的病毒监测,找出从化地区呼吸道感染患儿HCoV-OC43的N蛋白编码基因的特征。结果 从化地区6月~14岁的呼吸道感染儿童610例,采集鼻咽拭子标本,病毒检测阳性的患者,分析了8种呼吸道病毒,重点分析HCoV-OC43的临床特点。从发病时间月份分布可以看出,人HCoV-OC43主要是在春季流行, HCoV-OC43全年均可检出,春季4月份和5月份检出率较高,冬季较低,但不同月份的检出率无差异。各种常见病毒的发病率,流感病毒A(IVA)111例(18.20%)、流感病毒B(IVB)61例(10.00%)、副流感病毒Ⅰ(PIVⅠ)42例(6.89%)、副流感病毒Ⅱ(PIVⅡ)34例(5.57%)、副流感病毒Ⅲ(PIVⅢ)77例(12.62%)、呼吸道合胞病毒(RSV)135例(22.14%)、腺病毒(ADV) 82例(13.45%),冠状病毒(HCoV-OC43)68例(11.14%)。呼吸道感染多为流感病毒(A+B)和副流感病毒(Ⅰ,Ⅱ,Ⅲ)共325例(53.28%),其次是合胞病毒感染135例(22.14%),腺病毒(ADV) 82例(13.45%),冠状病毒感染最低68例(11.14%)。建立荧光定量PCR方法检测HCoV-OC43 病毒分离及基因分型测序,阳性PCR 产物测序,与HCoV-OC43中N 蛋白基因序列进行比较分析,该地区冠状病毒具有临床多样性,与国内已发表的菌株HCoV-OC43相比具有很高的同源性。结论 人冠状病毒OC43的检出率与以前的报道相符,未发现新的传染性冠状病毒,冠状病毒HCoV-OC43的流行趋势稳定,所有呼吸道感染者均表现出正常的呼吸道感染症状。常见呼吸道病毒检测, 对临床早期诊断和合理用药具有重要意义。

目的 了解住院老老年心房颤动(atrial fibrillation,AF)患者的临床特征及抗凝现况。方法 收集2015年6月—2017年9月住院老老年(≥80岁)房颤患者的抗凝用药,合并疾病,合并用药等临床信息,统计并分析,非正态分布的计量资料以中位数表示,采用秩和检验,两组计数资料采用χ²检验。结果 621例老老年患者根据性别分为男女两组,男354人,女267人,159例患者(25.6%)使用华法林,33例患者(5.31%)使用达比加群,30例患者(4.83%)使用利伐沙班,抗凝总人数为222例(35.75%)。174例患者(28.02%)使用阿司匹林,27例患者(4.35%)使用氯吡格雷,抗血小板总人数为201例(32.37%)。余198例患者(31.89%)未使用任何抗血小板或抗凝药物。结论 老老年房颤患者目前抗凝率低,抗凝药物以华法林为主。

Objective This study investigated the clinical characteristics and antithrombotic status in elderly patients with atrial fibrillation AF. Methods In this study, we collected, analyzed and characterized the data of the patients hospitalized at the First Affiliated Hospital of Shihezi Medical University from June 2015 to September 2017. Results 621 cases of elderly patients were divided into two groups according to their gender between men and women, 159 patients (25.6%) take warfarin, 33 patients (5.31%) with dabigatran, 30 patients (4.83%) uses of rivaroxaban, the total number of anticoagulation is 222 (35.75%),174 patients (28.02%) were treated with aspirin, and 27 patients (4.35%) used clopidogrel, and the total number of antiplatelet agents was 201 (32.37%). 198 patients (31.89%) did not use any antiplatelet or anticoagulant drugs. Conclusion patients with atrial fibrillation anticoagulant rate is low, and the anticoagulant is mainly warfarin.

目的 分析、探讨正常压力性脑积水发病机制、临床特点、手术指征及疗效。方法 回顾性分析我院自2005年1月—2015年1月采用侧脑室-腹腔分流术治疗53例正常压力性脑积水患者临床资料。结果 随访0.5~3年,总有效率为79.2%,无效率为20.8%,不良反应发生率为5.6%,不同临床特点患者的疗效有显著性差异(P＜0.05)。结论 提高对正常压力性脑积水认识,尽早确诊,选用合适压力的分流管,及时行脑室-腹腔分流术,注意防治并发症,以提高手术疗效。

Objective To explore the pathogenesis, clinical features, operation indication as well as therapeutic effect of hydrocephalus with normal pressure. Methods 53 patients underwent the ventriculo-peritoneal shunt from our hospital from Jan 2005 to Jan 2015 were retrospectively studied. Results Follow-up period was 0.5 to 3 years. Total efficacy rate was 79.2%; The failure rate was 20.8%; The incidence rate of adverse reaction was 5.6%. There were significance statistically for therapeutic effect between different groups(P＜0.05). Conclusion It is important to strengthen the awareness and diagnosis for hydrocephalus with the normal pressure. The suitable shunt duct and the ventriculo-peritoneal shunt in time will decrease complications and improve surgical therapeutic effect.

目的 探讨皮罗氏序列征伴先天性心脏病的临床特点。方法 我院2011年1月—2015年12月共收治141例皮罗氏序列征的患儿,将患儿分成单纯皮罗氏序列征组、皮罗氏序列征伴腭裂组及皮罗氏序列征伴听力损伤组,对3组患儿均行心电图及彩色多普勒超声心动图检查,对检查结果进行分析。结果 141例皮罗氏序列征患儿中共检出先天性心脏病19例,总发生率为13.47%,其中单纯皮罗氏序列征组患儿先天性心脏病的发生率为12.82%,伴腭裂组和伴听力损伤组患儿先天性心脏病的发生率分别为13.56%、25%。主要的先天性心脏病为:房间隔缺损(ASD)、室间隔缺损(VSD)、动脉导管未闭(PDA)、肺动脉瓣狭窄(PS)。通过统计学分析,3组患儿先天性心脏病的发生率差异无显著性。结论 先天性心脏病在皮罗氏序列征患儿中发生率较高,心电图及彩色多普勒超声心动图检查能清楚准确地诊断各类型的先天性心脏病,可用于皮罗氏序列征患儿常规检查,做出早期诊断、治疗,可以改善患儿的预后。

Objective To explore the clinical characteristics of congenital heart diseases in patients with Pierre-Robin sequence. Methods From January 2011 to December 2015, Guangzhou Women and Children's Medical Center has treated 141 patients with Pierre-Robin sequence. They were divided into 3 groups: Pierre-Robin sequence group, Pierre-Robin sequence and cleft palate group, and Pierre-Robin sequence and hearing impairment group. Electrocardiogram and colour Doppler echocardiogram was performed in each group and the results were analysed with statistics. Results 19 patients were found to have congenital heart diseases in 141 patients, the occurrence rate was 13.47%. The occurrence rate of congenital heart diseases in the group with Pierre-Robin sequence was 12.82%. The occurrence rate of congenital heart diseases in the group with Pierre-Robin sequence and cleft palate was 13.56%. The occurrence rate of congenital heart diseases in the group with Pierre-Robin sequence and hearing impairment was 25%. Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA),and pulmonary valve stenosis (PS) were the most common lesions. Through statistical analysis, the occurrence rate of congenital heart diseases has no significant difference among the three groups of patients. Conclusion The occurrence rate of congenital heart diseases in patients with Pierre-Robin sequence is high. Electrocardiogram and colour Doppler echocardiogram are the useful and reliable tool in diagnosing congenital heart diseases in patients with Pierre-Robin sequence.

目的 探讨儿童登革热(DF)合并肝功能损害的临床特征。方法 对2014年8—12月我院感染科收治住院的78例儿童DF的临床资料进行回顾性分析。结果 并发肝功能损害36例(46.15%),其中血清丙氨酸转氨酶(ALT)升高24例(30.77%),血清天冬氨酸转氨酶(AST)升高33例(42.31%);27例(75%)ALT/AST病程2周内恢复正常,9例于1月复查恢复正常。仅有1例总胆红素(TBIL)升高80.8 μmol/L,直接胆红素升高为主,1周后恢复正常。肝功能损害组较无肝功能损害组在外周血白细胞水平、血小板水平差异有统计学意义(P<0.05)。结论 儿童DF并肝功能损害较普遍,以轻度损害为主。与年龄、性别、皮疹、外周血白细胞、血小板有相关性。

Objective To approach the clinical characteristics of children dengue fever combined liver function damage. Methods Clinical data of 78 cases of children dengue fever in our hospital were retrospectively analyzed from August to December in 2014. Results 36 cases (46.15%) complicated with liver function damage. Among them 24 cases (30.77%) of serum alanine aminotransferase (ALT) increased, 33 cases (42.31%) of serum aspartate aminotransferase (AST) increased; 27 cases (75%)ALT/AST returned to normal within 2 weeks, 9 cases were recovered to normal in 1 month. Only 1 cases of total bilirubin (TBIL) increased to 80.8 mol/L, recovered after 1 week. Liver injury group and non liver injury group of peripheral blood leukocytes, platelets level comparison was statistically significant (P<0.05). Conclusion Children dengue fever combined liver function damage was common, mainly mild. There was correlation with age, gender, skin rash, peripheral blood leukocytes and platelets.