“肺炎1号”联合西医常规治疗新型冠状病毒肺炎的回顾性研究

目的回顾性分析"肺炎1号"联合西医常规治疗新型冠状病毒肺炎的临床疗效。方法采取回顾性临床研究方法,按治疗方法的不同,将湖北省中医院收治的47例患者病历资料作为治疗组,汉川市人民医院早期收治的40例患者病历资料作为对照组。观察两组患者的临床疗效相关指标,包括退热时间、核酸转阴时间、临床症状积分、病情转归。结果两组退热时间无显著差异(P>0.05),两组新冠病毒核酸转阴时间差异显著(P<0.05),两组症状积分治疗后均明显降低(P<0.05),且治疗组治疗后较对照组下降更明显(P<0.05)。治疗组死亡0例,对照组死亡1例,两组由普通型转重型各1例,无显著差异(P>0.05),通过治疗全部治愈出院。结论"肺炎1号"能缩短新冠病毒核酸转阴的时间,缓解患者的临床症状。

“肺炎1号”治疗新型冠状病毒肺炎的研究

目的分析“肺炎1号”联合西医常规治疗新型冠状病毒肺炎(COVID-19)的临床疗效。方法按治疗方法的不同,将使用“肺炎1号”治疗的173例COVID-19患者作为“肺炎1号”治疗组,单纯使用西医常规治疗的105例患者作为西医对照组。观察两组患者的临床疗效相关指标,包括临床症状、退热时间、核酸转阴时间、白细胞计数、淋巴细胞绝对值、中性粒细胞绝对值、超敏C反应蛋白、降钙素原、肺部CT、病情转归等。结果治疗后,两组患者发热、乏力主要症状较治疗前显著降低且有显著性差异(P<0.05)。西医对照组治疗后咳嗽较治疗前无显著性差异,“肺炎1号”治疗组治疗后较治疗前明显改善,且有显著性差异(P<0.05),与西医对照组治疗后对比有显著性差异(P<0.05)。在改善患者乏力、咳嗽方面,“肺炎1号”治疗组明显优于西医对照组(P<0.05)。治疗后西医对照组咽部不适、纳差、呼吸困难、胸闷、恶寒、头晕、头痛症状较治疗前显著改善且有显著性差异(P<0.05),“肺炎1号”治疗组咽部不适、纳差、呼吸困难、胸闷、呕吐、恶心、肌肉酸痛、关节疼痛、大便稀溏、恶寒、头晕、头痛、鼻塞、流涕、打喷嚏症状较治疗前显著改善且有显著性差异(P<0.05)。同西医对照组相比,在改善咽部不适、纳差、呕吐、恶心方面“肺炎1号”治疗组更为明显(P<0.05)。在症状积分方面,两组治疗后均明显降低,且有显著性差异(P<0.05),“肺炎1号”治疗组治疗后优于西医对照组治疗后,有显著性差异(P<0.05)。治疗后,两组白细胞计数、淋巴细胞绝对值与治疗前比较有显著性差异(P<0.05),且“肺炎1号”治疗组治疗后与西医对照组治疗后比较有显著性差异(P<0.05)。两组C反应蛋白治疗后与治疗前比较明显降低,有显著性差异(P<0.05),且“肺炎1号”治疗组治疗后与西医对照组治疗后比较有显著性差异(P<0.05)。两组降钙素原治疗后无显著性差异(P>0.05)。两组退热时间、新型冠状病毒核酸转阴时间有显著性差异(P<0.05)。西医对照组95例(90.48%)肺部CT较前好转,“肺炎1号”治疗组160例(92.49%)肺部CT较前好转,两组比较无显著性差异(P>0.05),均主要表现在病灶面积减小,变薄变淡。在总有效率方面,西医对照组为87.62%,“肺炎1号”治疗组为94.80%,“肺炎1号”治疗组的总有效率明显高于西医对照组,且有显著性差异(P<0.05)。在死亡率方面,西医对照组死亡4例(3.81%),“肺炎1号”治疗组死亡I例(0.58%),西医对照组的死亡率高于“肺炎1号”治疗组,无显著性差异(P>0.05)。在轻型、普通型向重型、危重型转化方面,西医对照组转重症8例(7.62%),“肺炎1号”治疗组转重症3例(1.73%),西医对照组明显高于“肺炎1号”治疗组(P<0.05)。结论“肺炎1号”能缩短退热时间、新冠病毒核酸转阴的时间,缓解患者的临床症状,较好促进肺部炎症吸收,提高治愈率,阻断轻型、普通型向重型、危重型转化,且使用安全可靠。

探讨老年肺炎患者临床诊断中检验血清C反应蛋白(CRP)、血沉(ESR)、以及D-二聚体(D-D)水平的临床价值

目的探讨老年肺炎患者临床诊断中检验血清C反应蛋白(CRP)、血沉(ESR)、以及D-二聚体(D-D)水平的临床价值。方法随机选择该院2015年1月—2016年12月期间收治的50例老年肺炎病例为观察组研究对象,并以同期自愿参与研究的50名健康老年体检者为对照组研究对象,比较两组血清C反应蛋白(CRP)、血沉(ESR)、以及D-二聚体(D-D)水平。结果观察组老年患者血清CRP(103.2±23.4)mg/L、ESR(35.8±6.5)μg/L、D-D(1 152.4±43.1)mm/h水平均显著高于对照组(8.9±1.2)mg/L、(10.2±1.4)μg/L、(182.6±14.8)mm/h,差异有统计学意义(P<0.05)。将观察组以80岁为临界值分组,80岁以上患者CRP(102.4±21.8)mg/L、ESR(34.8±5.8)μg/L、D-D(1 148.7±45.2)mm/h与80岁以下患者(103.8±22.1)mg/L、(35.4±6.2)μg/L、(1 142.3±43.9)mm/h,差异无统计学意义(P>0.05)。结论临床上可行血清C反应蛋白、血沉及D-二聚体检测来诊断老年肺炎的情况,为治疗和预后提供有效依据。

如何鉴别“肺炎”与“感冒”

肺炎与感冒的症状确有几分相似,因此教师和家长很有必要掌握鉴别这两种小儿常见病的知识。鉴别小儿肺炎与感冒,关键是掌握“一测”“二看”“三听”。一测:测体温。小儿肺炎大多发热。

基于真实世界“肺炎1号”治疗新型冠状病毒肺炎的临床研究

目的观察“肺炎1号”治疗新型冠状病毒肺炎的临床疗效。方法选取新型冠状病毒肺炎患者,按照治疗方法,“肺炎1号”治疗组采用“肺炎1号”联合西医常规治疗,西医对照组采用西医常规治疗,观察两组患者治疗前后的临床分型、退热时间、核酸转阴时间、临床症状、实验室检查结果及肺部CT改善情况。结果共纳入237例患者,其中“肺炎1号”治疗组95例,西医对照组142例。在转重率方面,西医对照为16例(11.27%),其中6例由普通型转为重型,2例由普通型转为危重型,8例由重型转为危重型;“肺炎1号”治疗组1例(1.05%)由普通型转为重型。在死亡率方面,西医对照组为7例(4.9%),“肺炎1号”治疗组为0例。两组转重率、死亡率有显著性差异(P<0.05)。西医对照组退热时间为3(1,3.75)d,“肺炎1号”治疗组退热时间为1(1,2)d,两组退热时间有显著性差异(P<0.05);西医对照组新型冠状病毒核酸转阴时间为7(5,11)d,“肺炎1号”新型冠状病毒核酸转阴时间为5.5(2.25,9)d,两组新型冠状病毒核酸转阴时间有显著性差异(P<0.05)。两组症状积分治疗后两组均明显降低,且有显著性差异(P<0.05)。治疗后,两组淋巴细胞绝对值与治疗前比较显著升高,且有显著性差异(P<0.05)。两组肺部CT改善情况无显著性差异(P>0.05)。结论“肺炎1号”结合西医常规治疗对新型冠状病毒肺炎有较好的治疗作用,能够快速稳定病情,阻断轻型、普通型向重型、危重型转化;缩短退热时间和新型冠状病毒核酸转阴时间,明显改善患者临床症状;较好促进肺部炎症吸收;使用安全可靠。

平息谣言 化解危机——关于“肺炎事件”报道的启示

在信息社会,传言、谣言如何迅速扩散,以至造成社会危机,又如何迅速将其平息,化解危机?恐怕是值得传媒、乃至社会管理机构、政府官员关注和研究的一个新问题.在羊年春节后,广东传媒遇到了"肺炎事件"引起的抢购药品、食醋风潮.不过两天时间内,就在政府和传媒等方面的努力下,把其平息了,危机得到了化解.社会恢复平静,有秩.现在回顾广东报纸对这次危机报道的经过和处理,有许多宝贵经验,值得总结、借鉴.

中西医结合护理干预在肺炎支原体肺炎患者中的应用研究

目的:本次研究主要探讨中西医结合护理干预在肺炎支原体肺炎患者中的应用效果及价值。方法:选取自2015年6月-2016年7月来我院医治的126例肺炎支原体肺炎患者,将其随机分为对照组和观察组,每组63例患者,对照组采取常规护理干预方法,而观察组采取中西医结合护理干预方法。对两组患者的护理效果进行比较分析。结果:观察组有效治愈率明显高于对照组,经过统计学方法分析,两组数据差异具有统计学意义。结论:通过本次研究得出,中西医护理干预对肺炎支原体肺炎的治愈效果显著优于常规护理方法,值得在临床中广泛应用。

Antibody Detection on Mycoplasma capricolum subsp. Capripneumoniae in Qinghai Province

[Objective] The aim was to investigate the prevalence of Mycoplasma capricolum subsp. Capripneumoniae in Qinghai Province. [Method] By using indirect hemagglutination test kit for detecting Mycoplasma capricolum subsp. Capripneumoniae,208 goat serums were detected. [Result] The positive rate of goat sera was 16.3%,and the positive rate of sera from different regions ranged from 6.7% to 24.3%. [Conclusion] The infection rate of Mycoplasma capricolum subsp. Capripneumoniae was high in Qinghai Province,so it is necessary to strengthen the prevention and control of this disease.

Epidemiological Investigation of Actinobacillus Pleuropneumoniae in Western Shandong

[ Objective ] The aim of this study was to investigate the epidemic status of porcine pleuropneumonia in western Shandong and establish the PCR method of actinobacillus pleuropneumoniae （APP）. [ Method] The epidemic status of APP in lesion tissues of 186 death pigs and 545 health pigs without clinical symptoms was analyzed by PCR method. [ Result] APP positive rate in 186 samples accounted for 43.0% （80/186）, while that in 545 porcine serums accounted for 9.4% （51/545）. [ Conclusion] This PCR method can be used as one of the important means for APP clinical diagnosis.

Secretory Expression of Mycoplasma hyopneu-moniae P97R1 Gene in Pichia pastoris and Primary Application of the Expression Product

[Objective] This study aimed to investigate the secretory expression of P97R1 gene of Mycoplasma hyopneumoniae（Mhp） in Pichia pastoris expression system and the primary application; of the expression product. [Method] A pair of specific primers was designed to conduct PCR according to the Mhp P97R1 gene sequence in Genbank, and the amplified P97R1 gene was cloned into the pPICZa-A yeast expression vector to construct the secretory recombinant expression vector pPICZa-A-P97R1. The plasmid pPICZa-A-p97R1 linearized by Sac I was transformed into P. pastoris GSl15 by electroporation. Positive transformant identified by PCR was incubated to express P97R1 protein after methanol induction. And the expression product was identified using SDS-PAGE and Western-blotting anal.wsis. [Result] P97R1 protein was successfully expressed in the P. pastoris system, with a secre- tory amount of 499μg/ml, and revealed good reactogenicity. Meanwhile, an indirect ELISA method was established with P97R1 protein after the optimization of each reaction factor, which showed good specificity and repeatability according to repeated tests. [Conclusion] This study provides bases for developing the ELISA Kit for anti- body detection and genetically engineered vaccine to Mhp.

Establishment of a Collection and Detection Technology of Mycoplasma hyopneumoniae in Aerosol

ObjectiveThis study was to establish a simple method for collecting and detecting Mycoplasma hyopneumoniae （Mhp） in aerosol. MethodBased on the mechanisms of liquid impinger and filtration sampler, a double concentration aerosol sampler was designed for collecting Mhp aerosol. Firstly, the collection was performed in a closed environment full of artificial aerosol of Mhp. Secondly, collection efficiency was detected by real-time PCR. Thereafter, the clinical feasibility of the designed equipment was tested by collecting aerosol samples in different pig herds. In one assay, the samples were collected at different times from one pig house challenged with Mhp. In another assay, the samples was collected from the delivery room, nursery and fattenning house of a MPS outbreak farm as well as a Mhp infection positive pig farm without obvious clinical symptoms. All the aerosol samples were then detected by real-time PCR or nested PCR. ResultThe collection efficiency of the designed bioaerosol sampler was （37.04±6.43） %, Mhp could be detected 7 d after intratracheal challenge with pneumonic lung homogenate suspension. Aerosol samples of 11 pig houses from the two Mhp positive pig farms with or without clinical symptoms all showed a positive result of PCR, the positivity rate was 100%. ConclusionA high sensitive collecting and detecting technology of aerosol was successfully established, which can be applied to clinical detection of Mhp in aerosol.

Advances in the Detection of Mycoplasma hyopneumoniae by Polymerase Chain Reaction (PCR) Technology

Mycoplasma hyopneumoniae is an important pathogen causing Mycoplasmal pneumonia of swine, which generally causes secondary infections and mixed infections, thus seriously threats the development of swine industry and resulting in huge economic losses. Using PCR technology has very important significance to the correct diagnosis of Mycoplasmal pneumonia at the early stage. In this paper, specific target genes of Mycoplasma hyopneumoniae, methods for clinical sample collection, key technical factors of DNA sample processing method, and the research progress, main advantages and disadvantages, and application of general PCR technology, multiple PCR technology, nested-PCR technology, real-time fluorescence quantitative PCR technology, gene chip detection technology and loop-mediated isothermal amplification in detection of Mycoplasma hyopneumoniae were summarized, which provided convenience for the effective diagnosis and prevention of Mycoplasmal pneumonia of swine.

Effect of Osmotic Pressure on Mycoplasma hyopneumoniae Strain 168

[Objective] This study aimed to investigate the effect of hypertonic solution on the morphology,size,incubation time and cell viability of Mycoplasma hyopneumoniae（Mhp）.[Method] Mhp was stimulated by using NaCl hypertonic solution with a final concentration of 1.8% for 1,2,4,6 and 8 min,respectively.After staining and microscopic examination,the particle size and CCU（color change unit） were determined,and PCR identification was conducted.[Result] After treated with hypertonic solution for different time,Mhp was shrunken and turned round,the particle size was reduced,and the cell number rapidly decreased or even disappeared after 2 min.CCU was reduced by a gradient,and the observation time was extended for 1 d.The target band of Mhp could be amplified from samples after treated with hypertonic solution for different time.After treated with 1.8% NaCl solution for 1-6 min,Mhp changed in the morphology and size but still had viability.[Conclusion] This study provided reference data for exploring the entrance of Mhp into blood circulation after intramuscular injection and a new immunization route of swine Mycoplasma pneumonia vaccine.

Development and Application of a Quantitative Competitive PCR Assay for Detecting Mycoplasma hyopneumoniae

[Objective] This study aimed to develop a quantitative competitive assay for detecting Mycoplasma hyopneumoniae in culture. [Method] One pair of Mhp-specific primers was designed for detecting Mhp in culture. Another pair of primers was designed based on the conserved gene sequences of Mycoplasma. The competitive template, which carried the same primer binding site with the target fragment, was constructed using enzyme digestion method. [Result] The logarithm of concentration of competitive template was treated as the abscissa（X-axis）, and the logarithm of corrected optical density ratio between amplification products by competitive template and target template was treated as the ordinate（Y-axis）. Thus the standard curve was drawn, and the regression equation was also obtained. When Y was assigned as 0, the concentration of the competitive plate was calculated, and then the concentration of Mhp was deduced. The logarithms of Color change unit（CCU） were treated as the abscissa（X-axis）, and the copy numbers of Mhp were treated as the ordinate（Y-axis）, so the standard curve was generated. It was found that the copy number of Mhp was highly correlated to CCU. [Conclusion] A quantitative competitive PCR assay was successfully established for the rapid detection of Mhp in culture.

Establishment of an Indirect ELISA with the Major Epitope Domain of ApxⅡ of Actinobacillus pleuropneumoniae Expressed in Prokaryotic Cells

[Objective] This study aimed to develop an indirect ELISA to detect the antibodies against Actinobacil us pleuropneumoniae （APP） using the recombinant ApxⅡA1 protein expressed in prokaryotic cells as the antigen. [Method] The major epi-tope domain of ApxⅡ was cloned into the prokaryotic expression vector pET-28a （＋） to obtain the recombinant plasmid pET-ApxⅡA1, which was then transformed into E. coli BL21 （DE3） for expression. The immunogenicity of the recombinant pro-tein was analyzed by western-blotting. After that, the purified recombinant protein was used as the coating antigen in the indirect ELISA for detecting the antibodies against APP. Final y, the concentration of coated antigen and the dilution of serum were optimized. [Result] Proved by enzyme digestion and sequencing, the recombi-nant plasmid pET-ApxⅡA1 was constructed successful y. The recombinant protein was highly expressed in prokaryotic cells, and Western-blotting analysis showed that it was recognized specifical y by positive serum of APP. The indirect ELISA could detect the antibody against APP with the purified recombinant protein as the coating antigen. The optimal concentration of coated antigen was 1.23 μg/ml and the opti-mal dilution of serum was 1：100. Compared with a commercial ELISA kit detecting antibody against ApxⅣ, the coincidence rate of the indirect ELISA was 90.4%. [Conclusion] Our results indicated that the indirect ELISA is sensitive and specific, and suitable for evaluating the effect of APP vaccine and epidemiological surveys.

Preparation of Monoclonal Antibody against P65 Protein of Mycoplasma hyopneumoniae

P65 protein, the major immunodominant protein of Mycoplasma hyopneu-moniae （Mhp） exhibiting no cross-reaction with other mycoplasmas, is general y used as a target protein for Mhp detection. In this study, BALB/c mice were immunized with prokaryotical y expressed P65 recombinant protein to prepare monoclonal anti-body. After screening with Mhp whole-cel protein and P65 protein, a specific hy-bridoma cel line, 3G12, was obtained by ELISA. Identification results indicated that the antibody secreted by 3G12 hybridoma cel s could react with P65 protein and Mhp whole-cel protein. According to indirect ELISA assay, 3G12 cel culture super-natant possessed a titer of 1∶12 800 against P65 protein and 1∶3 200 against Mhp whole-cel protein; 3G12 ascites possessed a titer of above 1∶4 000 000 against P65 protein and above 1∶20 000 against Mhp 168 whole-cel protein. After long-term in vitro culture and continuous freezing-thawing, 3G12 cel line could stably secrete antibodies. A monoclonal antibody against P65 protein and Mhp whole-cel protein was successful y obtained in the present study, which provided basis for further in-vestigating the pathogenic mechanism of Mhp and establishing diagnostic methods of Mycoplasmal pneumonia of swine （MPS）.

Comparative Analysis for the Detection and Monitoring of Mycoplasma hyopneumoniae Infection by Nested PCR(n-PCR) and Real time PCR(q-PCR) from Field Swine Herds

[Objective] 303 nasal swabs samples were collected from pigs in farms located in Taizhou city, Jiangsu Province, China from March to December 2012 for the purpose of detecting the presence of Mycoplasma hyopneumoniae, the primary agent of Enzootic porcine pneumonia （EPP） in pig herds using the nested PCR and Real time PCR techniques. [Method] Nasal swabs were collected from pigs of different ages＇ i.e. 7, 14, 21, 28, 30 and 35 days old, soaked in sterile 1 xPBS overnight at 4 ℃ and DNA extracted using the TIANamp（R） bacterial DNA kit. The DNA samples underwent amplification under the Mhyo 183 q-PCR and P36 primer Nested PCR systems. [Result] With the Nested PCR assay, 38 （12.5%） out of 303 samples tested positive for the presence of M. hyopneumoniae; with the real time PCR assay 152 （50.2%） tested positive for M. hyopneumoniae. The two assays matched to positively detect Mhyo in 22 （7.3%） samples and again matched in 127 （41.9%） samples negative for Mhyo infection. The pattern of infection in both assays was similar where 7- and 35-day-old piglets in both assays had the highest rates of infection i.e. 15.6% and 18.4% for n-PCR and 53.1% and 56.6% for q-PCR for 7- and 35-day-old piglets respectively. [Conclusion] The results highlight the suitability of both PCR assays in establishing the herd infection status of pigs in field conditions.

Protective effects of erythropoietin against acute lung injury in a rat model of acute necrotizing pancreatitis

AIM： TO investigate the effect of exogenous erythro- poietin （EPO） administration on acute lung injury （ALI） in an experimental model of sodium taurodeoxycholate- induced acute necrotizing pancreatitis （ANP）. METHODS： Forty-seven male Wistar albino rats were randomly divided into 7 groups： sham group （n = 5）, 3 ANP groups （n = 7 each） and 3 EPO groups （n = 7 each）. ANP was induced by retrograde infusion of 5% sodium taurodeoxycholate into the common bile duct. Rats in EPO groups received 1000 U/kg intramuscular EPO immediately after induction of ANP. Rats in ANP groups were given 1 mL normal saline instead. All animals were sacrificed at postoperative 24 h, 48 h and 72 h. Serum arnilase, IL-2, IL-6 and lung tissue malondialdehyde （MDA） were measured. Pleural effusion volume and lung/body weight （LW/BW） ratios were calculated. Tissue levels of TNF-a, IL-2 and IL-6 were screened immunohistochemically. Additionally, ox-LDL accumulation was assessed with immune-fluorescent staining. Histopathological alterations in the lungs were also scored.RESULTS： The mean pleural effusion volume, calculated LW/BW ratio, serum IL-6 and lung tissue MDA levels were significantly lower in EPO groups than in ANP groups. No statistically significant difference was observed in either serum or tissue values of IL-2 among the groups. The level of tumor necrosis factor-（~ （TNF-（~） and IL-6 and accumulation of ox-LDL were evident in the lung tissues of ANP groups when compared to EPO groups, particularly at 72 h. Histopathological evaluation confirmed the improvement in lung injury parameters a^er exogenous EPO administration, particularly at 48 h and 72 h. CONCLUSION： EPO administration leads to a significant decrease in ALI parameters by inhibiting polymorphonuclear leukocyte （PMNL） accumulation, decreasing the levels of proinflammatory cytokines in circulation, preserving microvascular endothelial cell integrity and reducing oxidative stress-associated lipid peroxidation and therefore, can be regarded as a cytoprotective agent in ANP-induced ALI.