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Clinical Analysis of H1N1 Influenza in Pregnant Women

目的 探討妊娠期甲型H1N1流感的臨床特點。 方法 對烏魯木齊市婦幼保健院2009年11月-2010年1月收治的妊娠期甲型H1N1流感臨床資料進行回顧性分析。 結果 同期住院非甲流孕產婦1 856例，確診甲型H1N1流感52例，發病率2.7%。妊娠期甲型H1N1流感的發熱時限及不同孕期與病程時限均無相關關系。使用磷酸奧司他韋(達菲)治療23例，較未使用此藥物患者病程顯著縮短[(4.79±2.04) d比(7.26±3.77) d，Plt;0.05]。合并肺炎6例，病程較無合并癥患者顯著延長[(9.83±4.70) d比(5.37±2.54) d，Plt;0.05]。 結論 妊娠期甲型H1N1流感應予以高度重視，在早預防、早診斷及早治療的基礎上，提早預防合并癥的發生。明確診斷后及早使用磷酸奧司他韋可縮短療程。

Concentrating the clinical practice of H1N1 influenza in china

重視和總結我國臨床診治甲型H1N1流感的經驗

重癥甲型H1N1流感患兒的治療與護理

【摘要】　目的　了解重癥甲型H1N1流感的臨床特點，總結其治療及護理方法。　方法　回顧性分析2009年11月－2010年2月期間收治的20例1.6~10.2歲重癥甲型H1N1流感患兒的臨床資料、臨床規律及特點。　結果　20例重癥甲型H1N1流感中5例為危重型患兒，均予口服奧司他韋及對癥支持治療，其中19例患兒治愈出院，1例患兒合并左下肺膿腫轉外科接受手術治療。　結論　重癥甲型H1N1流感起病急，進展快，早診斷、早期積極合理治療，總體預后較好。

Epidemiologic and Clinical Characteristics of 400 Patients with H1N1 Influenza A in Beijing

【摘要】　目的　了解北京地區400例新型甲型H1N1流感患者的流行病學和臨床特征，總結規律，進一步指導臨床診治。　方法　2009年5-12月期間，收治400例甲型H1N1流感確診病例，主要采用描述性流行病學方法對患者資料進行回顧性分析，并運用單因素方差分析的方法對結果進行檢驗。　結果　患者以青年和兒童人群為主，47.0%的患者有明確甲型H1N1流感接觸史，主要癥狀包括發熱（98.8%）、咳嗽（85.8%）、咽痛（58.5%）。咽部充血（94.0%）和扁桃體腫大（49.5%）為主要體征。外周血白細胞正常或偏低，349例（82.3%）患者血清鐵降低，268例（72.6%）患者C反應蛋白升高。在發病后不同時間內給予奧司他韋治療的患者發熱持續時間和咽拭子的陰轉時間有顯著差異（Plt;0.001）。　結論　新型甲型H1N1流感發病多以青年和兒童人群為主，以流感樣癥狀為主，多數癥狀輕微，預后良好，C反應蛋白和血清鐵的變化可能對于早期診斷有指導價值，奧司他韋早期抗病毒治療可以縮短病程。【Abstract】　Objective　To investigate the clinical and epidemiologic characteristics of pandemic influenza A (H1N1) virus infection in Beijing.　Methods　The epidemiological information and clinical characteristics of 400 patients with pandemic influenza A (H1N1) virus infection hospitalized in Beijing 302 Hospital from May to December, 2009 were analyzed retrospectively by descriptive epidemiology. One-way ANOVA was used to assess the results.　Results　H1N1 virus infection preferentially affected adolescents and young adults. The mean age of the patients was 23 years. A total of 189 (47.0%) of the patients had an identifiable epidemiologic link to another confirmed patient. The most common symptoms were fever (98.8%), cough (85.8%) and sore throat (58.5%). The main physical signs were pharyngeal portion congestion (94.0%) and antiadoncus (49.5%). The number of leukocytes in the peripheral blood was normal or low. The decreased serum iron and elevated C-reaction protein were found in 82.3% and 72.6% of the patients. There was significant difference in the duration of fever and viral shedding from throat swabs among the patients who accept the antiviral medication within the different time.　Conclusion　H1N1 virus infection preferentially affects adolescents and young adults, and presents with influenza-like illness. The clinical course of H1N1 virus infection is generally mild. The change of C-reaction protein and serum iron may be favorable for the diagnosis of H1N1. Early antiviral treatment may shorten the duration of fever and viral shedding.

Nursing Intervention for Patients with Severe Influenza A

【摘要】 目的 探討甲型H1N1流感重癥與危重癥的護理干預。 方法 回顧分析2009年10月-2010年2月收治的20例甲型H1N1流感重癥與危重癥患者的治療方案及其護理干預措施。 結果 16例治愈出院， 4例死亡。其中7例需要呼吸機輔助通氣。 結論 甲型H1N1流感重癥與危重癥需要綜合治療，同時，有效的護理干預也是提高甲型H1N1流感危重癥患者治愈率和降低死亡率的關鍵。【Abstract】 Objective To evaluate the nursing intervention for patients with severe influenza A (H1N1). Methods The clinical data of 20 patients with severe influenza A (H1N1) from October 2009 to February 2010 were retrospectively analyzed. Results In 20 patients, 16 were cured and four died. A total of seven patients needed ventilation assisted with ventilators. ConclusionsThe patients with severe influenza A (H1N1) needs combined modality therapy. At the same time, active and effective nursing intervention is the key point of increasing the recovery rate and decreasing the mortality rate.

The Hospital Infection Control Strategy of Treated Influenza A (H1N1) Infection Patients

目的：探討醫院收治甲型H1N1流感患者的感染控制策略。方法：通過扎實的全員培訓、考核,使所有工作人員掌握醫院感染控制技能;并在收治中國內地首例甲型H1N1流感的診療過程中,對醫療操作全過程的醫院感染控制措施和手段,實施層級監督。結果：在收治中國內地首例甲型H1N1流感的診療過程中未發生院內感染,無第二代患者出現。結論：應急工作常態管理,及時制定應急預案,監督落實醫院感染控制措施,是患者成功有序診療和院感控制的有力保證。

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

目的:探討甲型H1N1流感的診治。方法:對中國內地首例輸入性新甲型H1N1流感病例診治經過臨床分析并文獻復習。結果:通過流行病學史、臨床表現、甲型H1N1流感病毒的核酸檢測(realtime RTPCR法)可明確診斷。經中西醫積極治療痊愈出院。結論:2009年中國內地首例輸入性甲型H1N1流感病例臨床表現較輕,病程短,無并發癥;推測此次致病的甲型H1N1流感毒力小,病毒清除迅速,預后良好。

重癥甲型H1N1流感肺炎合并侵襲性真菌感染的診治體會

重慶市中青年呼吸醫師沙龍“重癥甲流救治策略專題討論會”

2009 年11 月13 日, 重慶市中青年呼吸醫師沙龍舉行“重癥甲流救治策略探討”專題討論會。會議由重慶醫科大學附屬第一醫院呼吸內科郭述良教授、重慶醫科大學附屬第一醫院呼吸科王璞副教授和第三軍醫大學新橋醫院呼吸科李琦副教授共同主持, 全市60 余位呼吸、感染、重癥監護、公共衛生救治、疾病控制、血液及兒科等專業中青年學科主任及醫學專家參會, 特邀重慶市甲型H1N1 流感防控專家組組長、重慶醫科大學附屬第一醫院呼吸內科吳亞梅教授參會指導。會議就重癥甲流患者救治工作中“無創與有創機械通氣的指征與策略、激素的使用、液體管理與營養支持、重要臟器的保護、彌散性血管內凝血( DIC) 的預防與處理、抗感染藥物的應用時機、隔離的解除”等10 余個議題展開了激烈的討論并達成部分共識。

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.