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重庆市中青年呼吸医师沙龙“重症甲流救治策略专题讨论会”

2009 年11 月13 日, 重庆市中青年呼吸医师沙龙举行“重症甲流救治策略探讨”专题讨论会。会议由重庆医科大学附属第一医院呼吸内科郭述良教授、重庆医科大学附属第一医院呼吸科王璞副教授和第三军医大学新桥医院呼吸科李琦副教授共同主持, 全市60 余位呼吸、感染、重症监护、公共卫生救治、疾病控制、血液及儿科等专业中青年学科主任及医学专家参会, 特邀重庆市甲型H1N1 流感防控专家组组长、重庆医科大学附属第一医院呼吸内科吴亚梅教授参会指导。会议就重症甲流患者救治工作中“无创与有创机械通气的指征与策略、激素的使用、液体管理与营养支持、重要脏器的保护、弥散性血管内凝血( DIC) 的预防与处理、抗感染药物的应用时机、隔离的解除”等10 余个议题展开了激烈的讨论并达成部分共识。

重症甲型H1N1流感肺炎合并侵袭性真菌感染的诊治体会

妊娠期合并甲型H1N1流感肺炎诊治进展

Process of Diagnosis and Treatment of the First Imported Case of Mainland China Influenza A/ H1N1 and Review of Literatures

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(realtime RTPCR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。

重症甲型H1N1流感患儿的治疗与护理

【摘要】　目的　了解重症甲型H1N1流感的临床特点，总结其治疗及护理方法。　方法　回顾性分析2009年11月－2010年2月期间收治的20例1.6~10.2岁重症甲型H1N1流感患儿的临床资料、临床规律及特点。　结果　20例重症甲型H1N1流感中5例为危重型患儿，均予口服奥司他韦及对症支持治疗，其中19例患儿治愈出院，1例患儿合并左下肺脓肿转外科接受手术治疗。　结论　重症甲型H1N1流感起病急，进展快，早诊断、早期积极合理治疗，总体预后较好。

Concentrating the clinical practice of H1N1 influenza in china

重视和总结我国临床诊治甲型H1N1流感的经验

Disinfection and Protection in the Process of Transports of the First Influenza A (H1N1) Infection Patient

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。

Role of Corticosteroids in the Treatment of Influenza A (H1N1)Infection

糖皮质激素在甲型H1N1流感中的应用探讨

The Anxiety Status and Related Factors of H1N1 Patients at the Influenza Peak of Fever Clinics

【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.

Construction and Identification of Helper-Dependent Adenoviral Vector Encoding Hemagglutinin Protein of Swin-Origin Influenza Virus A H1N1

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.