AED训练机辅助心肺复苏培训在麻醉科专业住院医师规范化培训中的效果观察

目的 探讨AED训练机辅助心肺复苏培训在麻醉科专业住院医师规范化培训中的效果。方法 选择该院麻醉科专业基地2022级住院医师共48人,随机分为观察组和对照组,观察组采用传统授课法+高级复苏模拟人配合监测反馈系统与AED训练机结合,对照组采用传统授课法+高级复苏模拟人配合监测反馈系统,比较两组理论及技能操作考核成绩,并进行满意度调查。结果 两组住院医师年龄、性别、理论考核成绩比较差异无统计学意义(P> 0.05),技能操作成绩差异有统计学意义(P<0.05)。观察组的技能学习、教学方法和教学效果满意度评分高于对照组,差异有统计学意义(P<0.05)。结论 传统授课法+高级复苏模拟人配合监测反馈系统与AED训练机结合模式应用于住院医师心肺复苏的日常培训能增强培训效果,使住院医师更好地掌握心肺复苏技术并能有效地应用于临床实践。

Current resistance status of Aedes aegypti and Aedes albopictus populations in Penang Island,Malaysia

Objective:To determine the current insecticide resistance status of Aedes(Ae.)aegypti and Ae.albopictus to four insecticides,namely 0.05%deltamethrin,0.75%permethrin,5%malathion and 0.25%pirimiphos-methyl using the World Health Organisation(WHO)susceptibility test kit.Methods:Adult bioassays were carried out using the standard protocol of the World Health Organisation.All F1 generation urban and suburban field strains of Ae.aegypti and Ae.albopictus were tested against pyrethroid and organophosphate insecticides,including the presence of piperonyl butoxide(PBO)in four replicates of 25 non-blood-fed female mosquitoes ranging from 3 to 5 days old.The Vector Control Research Unit(VCRU)laboratory strain served as a reference strain.Results:In this study,0.05%deltamethrin demonstrated a lower value of knockdown time when 50%of the mosquito population died(KT50)and knockdown time when 95%of the mosquito population died(KT95),which is significantly more effective compared to 0.75%permethrin against adult female Ae.aegypti(urban and suburban)and Ae.albopictus(urban and suburban)(ANOVA,P<0.01).Meanwhile,5%malathion was a more effective insecticide,amounting to the shorter KT50 and KT95 compared to 0.25%pirimiphos-methyl against Ae.aegypti(urban and suburban)and Ae.albopictus(urban and suburban).Ae.aegypti urban and Ae.aegypti suburban performed a higher resistance ratio(RR)towards both 0.05%deltamethrin and 0.75%permethrin due to the wide use of permethrin in dengue vector control programs in Malaysia.However,Ae.albopictus urban and suburban have lower resistance than Ae.aegypti urban and suburban towards 0.05%deltamethrin and 0.75%permethrin at 24 hours post-treatment.The addition of PBO with these insecticides successfully reduced knockdown time(KT50 and KT95)values of most of the Ae.aegypti and Ae.albopictus field strains except PBO+0.75%permethrin against Ae.aegypti suburban.Conclusions:The addition of PBO to insecticides has significantly reduced the knockdown time(KT50 and KT95)values on most of Ae.aegypti and Ae.albopictus urban strain except PBO+5%malathion against Ae.albopictus urban strain and PBO+0.75%permethrin against Ae.albopictus suburban strain in comparison to exposure to insecticides without PBO.Ae.aegypti showed a higher resistance ratio of 50(RR50)when compared with the VCRU laboratory reference strain(susceptible strain)at the exposure to the deltamethrin,including with pre-exposure to PBO.This study found that the addition of PBO with organophosphates(5%malathion and 0.25%pirimiphos-methyl)was significantly more effective than pyrethroids against Ae.aegypti and Ae.albopictus(urban and suburban)due to their high mortality rate at 24 hours.It can be concluded that the usage of PBO can help reduce resistance alteration in Aedes mosquitoes.

江西省口岸区域白纹伊蚊特异性病毒Aedes albopictus anphevirus基因组序列研究

目的昆虫特异性病毒在白纹伊蚊中与致病性传染病病原体如登革病毒、基孔肯雅病毒和寨卡病毒等的传播和复制有着密切联系,本文对其基因组序列进行研究,为研发新型虫媒病毒防治策略提供理论基础。方法本研究利用二代测序技术,对江西省3个口岸区域(南昌昌北机场、九江城西港和赣州陆港)采集的野外白纹伊蚊种群携带的昆虫特异性病毒进行高通量测序。结果3个白纹伊蚊种群中广泛存在昆虫特异性病毒Aedes albopictus anphevirus(AealbAV)。利用MEGAHIT软件对这些病毒reads进行组装,得到2株AealbAV全基因组序列,与美国株MW147277.1高度同源(相似度均大于98%),基因登录号分别为九江株OR715784,赣州株OR729834,南昌株仅拼接出部分序列。结论AealbAV在江西白纹伊蚊种群中普遍存在,其全基因组研究为口岸区域利用昆虫特异性病毒进行白纹伊蚊综合防治提供了理论基础。

身体、基础设施与城市:广州AED普及中的行动者媒介实践

作为曾被批评为国内普及AED首批城市中唯一缺席的一线城市,广州实际在近年探索了一条有别于由政府牵头的普及路径:原先并不处于特定结构中的地铁、媒体、法律界、政府、社会组织等行动者,在猝死身体的多次征召下互相联结,织就一张去中心的AED普及网。本研究引入行动者网络理论(ANT)以观察广州个案中身体的能动性,并拆解多行动者参与下人工技术物“嵌入身体”与“嵌入城市”的“黑箱”。本文认为,作为一种意涵复杂的人类病理症状,猝死使现代身体在文化意义上从人转为非人行动者,而猝死身体在现代城市语境中能动定义的“现场急救”“新闻表征”等超越人类意图的转译问题,为AED相关的媒介实践提供了动力。本文通过广州个案的基础设施研究,尝试省思本土新闻传播ANT经验研究过度凸显“人类能动性”而遮蔽“非人能动性”的弊端,并以此重启ANT与媒介研究的学术对话。

Geographical Distribution of Arboviruses, Aedes aegypti and Aedes albopictus Vectors and Their Resistance to Insecticides in Africa: A Systematic Review

Background & Objectives: Epidemics of arboviruses such as Dengue, Chikungunya and Zika have been recorded in recent years indicating that Aedes aegypti and Aedes albopictus are both important and very active vectors in Africa. For vector control, insecticides are on the front line, unfortunately, reported resistance jeopardizes the effectiveness of this strategy. The objective of this review was to determine the geographical distribution and insecticide resistance mechanisms of Ae. aegypti and Ae. Albopictus in Africa. Methods: A systematic review of the literature in scientific databases (PubMed, Google Scholar, ScienceDirect, Hinari) allowed us to identify relevant articles on the geographical distribution of Aedes aegypti, Aedes albopictus and arboviral diseases. On the other hand, studies related to insecticides used in vector control against Aedes, associated resistances and their molecular and metabolic mechanisms. Results: A total of 94 studies met the inclusion criteria for this search. Aedes aegypti is reported in most of Africa, and Aedes albopictus in part. There is a re-emergence and outbreak of Arbovirus epidemics in West and Central Africa. The insecticides used were organochlorines, carbamates, organophosphates and pyrethroids. In Aedes, target site insensitivity and metabolic resistance would be the 2 main mechanisms of resistance to these insecticides. Interpretation & Conclusion: Resistance has been recorded in all four major classes of insecticides recommended by WHO for vector control and eradication. New vector control methods such as the use of plant extracts with larvicidal and adulticidal activities, advanced modern biotechnology techniques, and nanobiotechnology need to be developed.

Screening of Environmental Bacterial Strains for Wild Aedes Mosquito Larval Biocontrol

The effectiveness of current control measures against Aedes mosquitoes remains low, resulting in persistent epidemics in urban areas. The emergence of resistant mosquito populations to chemical insecticides highlights the need for novel, environmentally friendly, cost-effective control strategies. This study explored the potential of environmental bacterial isolates to biocontrol wild Aedes larvae. Initially, we collected bacterial samples from infectious masses of Aedes fluviatilis larvae. The isolated bacteria were identified using biochemical, enzymatic, and molecular methods, including 16S rRNA sequencing and MALDI-TOF. Previously, Aeromonas hydrophila and Bacillus thuringiensis isolated from these infectious masses showed limited Aedes larval inhibition. Consequently, we screened additional environmental isolates from the bacteriotheque. Six isolates previously identified were tested: Chromobacterium violaceum, Enterobacter cloacae, Bacillus cereus, Bacillus sphaericus, and two strains of Bacillus thuringiensis israelensis. Among these strains, B. thuringiensis and C. violaceum exhibited significant inhibitory activities against wild Aedes larvae. Bacillus thuringiensis cultures grown under daylight conditions showed a slight ability to inhibit Aedes larvae. The potential of B. thuringiensis and C. violaceum strains studied, along with optimized culture growth conditions, will be further investigated to develop bioinsecticide products to provide safer and more sustainable alternatives for controlling larvae of Aedes mosquitoes.

Modelling the probability of presence of Aedes aegypti and Aedes albopictus in Iran until 2070

Objective:To determine the suitable ecological habitats of Aedes(Ae.)aegypti and Ae.albopictus in Iran due to climate change by the 2070s.Methods:All data relating to the spatial distribution of Ae.aegypti and Ae.albopictus worldwide,which indicated the geographical coordinates of the collection sites of these mosquitoes,were extracted from online scientific websites and entered into an Excel file.The effect of climatic and environmental variables on these mosquitoes was evaluated using the MaxEnt model in the current and future climatic conditions in the 2030s,2050s,and 2070s.Results:The most suitable areas for the establishment of Ae.aegypti are located in the southern and northern coastal areas of Iran,based on the model outputs.The modelling result for suitable ecological niches of Ae.albopictus shows that in the current climatic conditions,the southern half of Iran from east to west,and parts of the northern coasts are prone to the presence of this species.In the future,some regions,such as Gilan and Golestan provinces,will have more potential to exist/establish Ae.albopictus.Also,according to the different climate change scenarios,suitable habitats for this species will gradually change to the northwest and west of the country.The temperature of the wettest season of the year(Bio8)and average annual temperature(Bio1)were the most effective factors in predicting the model for Ae.aegypti and Ae.albopictus,respectively.Conclusions:It is required to focus on entomological studies using different collection methods in the vulnerable areas of Iran.The future modelling results can also be used for long-term planning to prevent the entry and establishment of these invasive Aedes vectors in the country.

Insecticide resistance status of Aedes aegypti and Aedes albopictus in Malaysia(2010 to 2022):A review

This review aimed to determine the prevalence of the insecticide resistance status of the field-collected Aedes(Ae.)aegypti and Ae.albopictus in Malaysia from 2010 to 2022 towards carbamates,organochlorines,organophosphates and pyrethroids.Biological and environmental controls were summarized with an emphasis on the mosquito vector control strategies in Malaysia.The information in this review was extracted from several databases such as PubMed(MEDLINE),Science Direct and Scopus by using keywords including“insecticide resistance”,“carbamate resistance”,“organochlorine resistance”,“organophosphate resistance”,“pyrethroid resistance”,“Aedes”and“Malaysia”,between January 2022 and December 2022.Distribution of resistant Ae.aegypti and Ae.albopictus in Malaysia was mapped using QGIS software.Insecticide resistance in both Ae.aegypti and Ae.albopictus is widespread in Malaysia,although the rates vary by states.The most notable was the steep increase in permethrin resistance of Ae.aegypti in Selangor,Malaysia,over the past decade.Ae.albopictus also displayed moderate resistance to permethrin,though not as widespread as Ae.aegypti in Selangor,but showed sign of resistance in Sarawak,East Malaysia.Resistance towards four main classes of insecticides have been widely documented in Malaysia.The extensive resistance towards permethrin in Malaysia which is one of the current insecticides used in Malaysia suggested that policies supporting the widespread use of permethrin fogging needs further evaluation.

Surveillance of arthropod-borne viruses in Benin,West Africa 2020–2021:detection of dengue virus 3 in Aedes aegypti(Diptera:Culicidae)

Dear Editor,Dengue virus(DENV,family Flaviviridae,genus Flavivirus)serotypes 1 to 4(DENV-1,-2,-3,and-4)are responsible for more than 100 million infections per year worldwide.Symptoms of DENV infection can be diverse,reaching from an acute febrile illness to the more severe,sometimes fatal dengue haemorrhagic fever/dengue shock syndrome.

健康中国战略视角下急救医疗设施的空间分布研究——以南京市AED设施为例

党的二十大报告提出我国在2035年的总体目标之一为建成健康中国,合理的公共医疗设施配置对贯彻健康中国战略、提升全民身体素质具有重要意义。在中国大约每2000多人里有一个人因心脏疾病发生死亡。降低心脏性猝死发生率的方法除了心血管手术等措施之外,最行之有效的方法就是在公共场所配置AED (公众体外除颤仪)。文章结合POI数据,采用空间自相关、可达性分析等空间统计方法,对南京市AED的空间分布特征及其与人口、相关设施点布局的关系进行探究。结论如下:(1)AED设施在秦淮、玄武和鼓楼区等中心区呈现高密度和“高—高”集聚分布特征;在高淳、溧水和六合区等边缘区呈现低密度和“低—低”集聚的分布特征;(2)AED配备情况满足其人口数量需求特征的街道数量占全市街道总量的2/3以上;(3)通过对住房与公共设施这两类设施点对AED的可达性分析发现,大部分设施点对AED的可达性较低,远远低于目前医学界规定标准。基于此,文章分析了导致南京市AED配置现状的原因,并且提出了改进建议。

“救命神器”AED,你会用吗?

据某媒体报道,近日,在国内某一地铁站内有一名男子突然晕倒在地,全身抽搐。一名路过的周姓女子先简单地查看患者的情况,然后请地铁站工作人员立即取来自动体外除颤仪(AED),并对患者的心脏进行监测、除颤。周女士通过AED对患者进行了10分钟左右的急救后,患者的生命体征逐渐稳定,患者缓慢地睁开了眼睛。

AED:一种用于DTN的增强型Earliest-Delivery算法

DTN(Delay-Tolerant Network)是人们在近年出现的众多网络实例中抽象出来的网络模型。在这种网络模型中,经常出现长时间的网络分割,以至于在给定的时间段内端到端的路径不一定存在。由于DTN这种独特的拓扑性质,其路由机制和传统的网络模型有很大不同。该文详细研究了DTN的一种路由算法ED(Earliest-Delivery)算法,然后引入了对节点运动精确性(相对于时间)的考虑,给出了精确性因子p(Δ)的定义,并以之作为ED算法中"链接"(contact)1)代价的权重,进而提出一种更稳健的路由算法——AED(Advanced ED)。实验表明,当节点运动不确定性增加时,AED维持较好的性能,而ED的性能则明显下降。

应用GC/AED技术分离检测主流烟气粒相物中含氮成分

应用气相色谱法/原子发射检测器(GC/AED)分离检测主流烟气粒相物中的含氮碱性成分。3种类型烟叶(典型烤烟、白肋烟和香料烟)、不同香型烤烟烟叶和成品卷烟经过吸烟机抽吸后,收集主流烟气粒相物。粒相物经过连续萃取和反萃取分离,得到含氮的碱性成分,进行GC/AED检测。结果表明,GC/AED能够检测出主流烟气中吡嗪类、吡啶类和烟草微量生物碱类成分。比较了不同样品含氮成分的异同,结果表明,白肋烟烟叶主流烟气粒相物中含氮成分较多,含量最高,烤烟和香料烟烟叶主流烟气粒相物中含氮成分相对较少,含量较低;不同香型烤烟烟叶主流烟气粒相物中主要含氮成分基本类似;不同品牌卷烟主流烟气粒相物中主要含氮成分基本类似,烤烟型卷烟假木贼碱相对百分含量较高(3.84%～4.62%),而混合型卷烟降烟碱相对百分含量较高(5.22%)。

自动体外除颤器AED的安全性

自动体外除颤器AED是一种安全有效的急救设备.对AED安全性的相关研究和技术发展做了回顾.从算法和非专业人士使用两方面讨论了AED整体的安全性,从人因设计、自检、电池和充电电路、电磁兼容、半自动除颤模式等方面介绍了AED厂商提升设备安全性相关的一些改进措施,分析了两种特殊的AED使用场景,即儿童AED和家用AED的安全性.

非医学专业人群使用AED的可行性和需求分析

目的:探讨非医学专业人群使用自动体外除颤仪(Automated External Defibrillator,AED)的可行性,依据群众对AED设备的需求进行分析。方法:在三个社区开展心源性猝死抢救和心肺复苏(Cardiopulmonary resuscitation,CPR)知识的宣教和培训,并采用AED模型训练志愿者。通过问卷调查群众对培训效果的反馈,分析其对于AED设备的需求。结果:在讲解后认为自己可以熟练操作AED的达到70.5%,小部分(26.3%)没把握,不会者仅3.2%。87.6%的群众表示价格合适的情况下愿意家庭购买AED。结论:通过培训,绝大多数学历在本科以下的居民均能学会AED的使用。在家庭中配备AED,在未来将为相关生产企业创造一个巨大的市场。

公众对AED使用认知度调查

目的了解公众对AED的认知情况，为采取针对性提高策略提供依据。方法采用自行设计AED使用认知调查问卷对5039名公众进行AED知晓程度、获取AED信息途径、AED使用等方面的调查。结果公众正确回答AED名称、AED用途和AED可提高猝死患者生存比率的人数分别占总被调查人数的比例为37．6％、48．2％和46．7％；接受过AED正确使用培训和见过AED使用的人分别为5．2％和8．4％；正确回答安装AED的合适距离和AED可使用对象的临床表现的人数为9．6％和1．2％。结论我国公众AED认知程度较低，需要在公众中采取更加广泛AED的知识培训和教育。

院外AED成功救治呼吸心跳骤停患者1例报告

就院外使用自动体外心脏除颤器(automated external defibrillator,AED)成功救治1例呼吸心跳骤停患者并送至医院观察,全程报告。患者32岁男性,在北京市西城区某景区游玩时突然倒地,意识丧失,呼之不应,现场“第一目击者”立即给予心外按压、人工呼吸,并及时取来AED,进行电除颤,“120”急救人员到达时,患者恢复自主心律。通过调取AED资料,记录显示患者当时为心室颤动,先后经过7次电除颤,患者恢复自主心律,为进一步生命支持创造了条件。本例救治经过,提示院外早期心肺复苏、及早使用AED,是抢救呼吸心跳骤停成功的关键。

Larvicidal efficacy of crude and fractionated extracts of Dracaena loureiri Gagnep against Aedes aegypti, Aedes albopictus, Culex quinquefasciatus, and Anopheles minimus mosquito vectors

Objective:To evaluate the larvicidal efficacy of crude and fractionated extracts of Dracaena loureiri endocarp against Aedes aegypti,Aedes albopictus,Culex quinquefasciatus,and Anopheles minimus mosquitos.Methods:Larvicidal activity was tested according to World Health Organization standard protocol.The third-stage larvae of each mosquito species were exposed to various concentrations of Dracaena loureiri crude extract and six groups of Dracaena loureiri fractionated extracts(RC-DT 009-014).Larval mortality rates were observed after 24 h and48 h of exposure.Then,a computerized probit analysis of the mortality data was performed to determine lethal concentration 50(LC_(50))and lethal concentration 90 values.Results:Anopheles minimus larvae(24-h LC_(50)77.88 mg/L)had the highest susceptibility to crude extract,whereas others(Aedes aegypti,24-h LC_(50)224.73 mg/L;Aedes albopictus,24-h LC_(50)261.75 mg/L;and Culex quinquefasciatus,24-h LC_(50)282.86 mg/L)were significantly less susceptible.The most effective groups of fractionated extracts were RC-DT 012 and RC-DT 013.The mosquito species most susceptible to fractionated extracts was Culex quinquefasciatus,with 24-h LC_(50)values of 0.66 and 0.94 mg/L for RC-DT 012 and RC-DT 013,respectively.Conclusions:The larvicidal activity of fractionated extracts is more effective than that of crude extract against all tested mosquito species.For the most effective alternative larvicide,purification and a phytochemical constituent analysis must be performed.

DHEA及其代谢产物AED和AET的辐射防护作用

脱氢表雄酮(dehydroepiandrosterone,DHEA)是人体内多种激素合成的前体,有研究表明,DHEA开辟了通过调节免疫系统抗致死性感染的途径,其代谢产物雄烯二醇(androstenediol,AED)和雄烯三醇(androstenetriol,AET)具有更强的抗病毒和细菌感染的能力,降低机体的发病率和死亡率。