猪高致病性蓝耳病病毒诱发病毒性肺损伤动物模型初探

目的观察人工感染猪高致病性蓝耳病病毒发病猪肺组织的病理学变化，探讨猪高致病性蓝耳病用作SARS病毒性肺损伤动物模型的可行性。方法用高致病性蓝耳病毒株NVDC—JXA1株人工感染试验猪10头，制备、观察肺组织病理切片，并与报道的SARS病毒引起的肺损伤进行比较分析。结果人工感染高致病性蓝耳病病毒后试验猪全部发病死亡，肺脏均呈现典型的间质性肺炎变化，比较高致病性蓝耳病与SARS病毒所引起的肺损伤发现两者具有极高的相似性。结论猪高致病性蓝耳病或可用作SARS病毒性肺损伤的动物模型，对于研究SARS病毒致病机理具有一定意义。

痰热清注射液治疗病毒性肺炎(痰热郁肺证)40例疗效观察

目的：观察痰热清注射液治疗病毒性肺炎的疗效。方法：将急性病毒性肺炎80例（痰热郁肺证）随机分为治疗组与对照组各40例，两组分别静脉给予痰热清注射液20mL和病毒唑注射液400mg，每日1次，疗程为10-14d。结果：治疗组总疗效优于对照组。结论：痰热清注射液治疗病毒性肺炎（痰热郁肺证）疗效可靠。

穿琥宁与利巴韦林治疗病毒性肺炎的成本-效果分析

目的 :评价穿琥宁与利巴韦林治疗病毒性肺炎的疗效及成本 -效果比。方法 :选择63例病毒性肺炎患者 ,分为穿琥宁治疗组与利巴韦林对照组 ,运用药物经济学的成本 -效果分析方法进行评价。结果 :穿琥宁治疗病毒性肺炎优于利巴韦林 ,是一种成本 -效果较好的药物。结论 :药物经济学在优化治疗方案 ,指导合理用药 。

小儿病毒性肺炎痰热闭肺证中医治疗效果研究

目的:探讨小儿病毒性肺炎痰热闭肺症中医治疗效果。方法:随机选取2010年2月-2013年11月期间我院收治的诊断为病毒性肺炎痰热闭肺证患儿120例,将其随机平均分配为实验组和对照组,其中对照组患儿采用西药利巴韦林进行治疗,实验组患儿采用中医开肺化痰解毒疗法进行治疗,对比两组患儿的临床治疗效果。结果:实验组患儿的临床治疗总有效率明显高于对照组患儿,差异具有统计学意义(P<0.05)。结论:采用开肺化痰解毒法对病毒性肺炎痰热闭肺证患儿进行治疗,能够有效改善患儿临床症状,疗效安全可靠,建议在临床上进一步推广。

肿节风提取物不同部位对病毒性肺损伤小鼠氧化应激作用研究

目的:研究肿节风水提物不同浓度乙醇洗脱部位对H1N1流感病毒感染小鼠及其病毒性介导氧化应激肺损伤的保护作用和机制。方法:肿节风提取物经20%、30%、40%、70%乙醇洗脱,HPLC检识各部位主要化学成分。以小鼠平均存活时间、肺指数和肺病毒载量研究肿节风不同部位对感染小鼠的保护作用,比色法检测肺组织中丙二醛(MDA)、超氧化物歧化酶(SOD)和一氧化氮(NO)水平,Western blot检测肺组织中NPNrf2、HO⁃1蛋白表达。结果:肿节风不同部位能不同程度降低感染小鼠肺指数和病毒载量,减轻小鼠氧化应激水平,下调NH蛋白表达,上调Nrf2、HO⁃1蛋白表达。结论:肿节风提取物抗流感病毒主要部位是20%、30%乙醇洗脱部位,其可能通过激活Nrf2/HO⁃1通路减轻H1N1感染致肺损伤小鼠氧化应激水平,减轻流感病毒所致肺损伤。

厚朴大黄汤对小鼠病毒性肺热证的实验研究

目的通过厚朴大黄汤对病毒性肺热证小鼠作用的实验研究,探讨"肺与大肠相表里"理论中肺病(肺热证)从肠治的学术意义。方法应用30LD50病毒在昆明小鼠上建立病毒性肺热证模型,观测其咳嗽抑制率、肺指数及病理形态学变化。结果厚朴大黄汤有明显的止咳和降低小鼠肺指数作用,病理形态学所见,模型组肺泡间隔、肺泡腔内炎细胞浸润,可见灶性实变区,用药组肺间隔炎细胞浸润明显减轻;大部分肺泡腔内干净,仅少部分有少量炎细胞浸润,无实变区。结论病毒性肺炎肺热证时,通腑的方法可辅助肃肺,通过通导肠腑可辅助纠正肺热之证。

近10年经方治疗病毒性肺系疾病临床研究进展

病毒性肺系疾病具有病原体品种多、传染性强、季节性流行性、易感因素多样、高发病率等特点,其预防和控制工作已成为目前我国公共卫生事业中的重点。近10年来,经方在防治病毒性上呼吸道感染、流行性感冒、病毒性肺炎、麻疹、小儿口腔黏膜病(手足口病)等病毒性肺系疾病的过程中,起到改善病情,以及干预、阻断病情发展的关键作用。基于临床研究文献,将近10年经方辨治病毒性肺系疾病的临床研究进行总结,为中西医协作防治新型冠状病毒肺炎方案的制定提供思路。

疑似犊牛病毒性肺肠炎的临床观察

１９９８年２月份，南京某奶牛场的犊牛群突然爆发一种以呼吸系统病变为主，发病率、死亡率均高的疾病。经专家会诊，疑似犊牛病毒性肺肠炎（ＶｉｒａｌＰｎｅｕｍｏ－ｅｎｔｅｒｉｔｉｓｏｆＣａｌｖｅｓ）。因未见国内对该病的报道，故将有关发病情况总结如下，以供同行...

中西医结合治疗小儿病毒性肺炎风热郁肺证疗效观察

目的探讨中西医结合治疗小儿病毒性肺炎风热郁肺证的临床效果。方法选取梅州市中医院2018年3月至2019年2月收治的小儿病毒性肺炎风热郁肺证患儿84例进行研究,用数字随机表法分为对照组和观察组,各42例。对照组采用常规西医疗法治疗,观察组采用中西医结合治疗,比较两组治疗有效率。结果观察组的治疗有效率高于对照组(P<0.05),且症状消失时间及住院时间短于对照组(P<0.05)。结论用中西医结合治疗小儿病毒性肺炎风热郁肺证的效果显著。

基于TLR4-MyD88-TRAF6信号通路的麻杏石甘汤抗A型流感病毒感染小鼠所致的病毒性肺损伤研究

目的探索Toll样受体4(TLR4)在A型流感病毒所致肺组织损伤中的影响,并进一步探讨麻杏石甘汤的干预作用。方法以A型流感病毒滴鼻感染WT型小鼠为研究对象,实验设麻杏石甘汤低、中、高剂量(1.4、2.8、5.6 g/kg)组、奥司他韦(21.63 mg/kg)组、模型组和对照组,ig给予相应药物5 d后,处理动物。常规法检测小鼠体质量,计算肺指数、脾指数、胸腺指数,观察肺组织病理变化,ELISA法检测肺泡灌洗液中炎性因子肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)的量,real-time PCR(RT-PCR)法和Western blotting法检测肺组织中TLR4、My D88、TRAF6m RNA和蛋白的表达。结果麻杏石甘汤能上调A型流感病毒感染小鼠的体质量、脾指数、胸腺指数,改善肺组织病理损伤,降低肺泡灌洗液中促炎因子水平,下调肺指数和肺组织中My D88、TRAF6 m RNA和蛋白表达量,且存在一定的量效关系。其中麻杏石甘汤中、高剂量组的疗效与奥司他韦接近。结论麻杏石甘汤作为有效的抗流感病毒中药复方,能有效地减轻肺部炎症、保护免疫器官、调节细胞因子平衡,其可能的作用机制是通过抑制TLR4-My D88-TRAF6信号通路的激活而缓解A型流感病毒感染小鼠所致的肺损伤。

汉坦病毒疫苗的研究进展

汉坦病毒(hantaviruses,HVs)是啮齿动物传播的病毒,可引起肾综合征出血热(hemorrhagic fever with renal syndrome,HFRS)和汉坦病毒性肺综合征(hantavirus pulmonary syndrome,HPS)。HFRS发病机制复杂,临床表现多样,病情危重易变,并发症多,目前尚无获得WHO认证的HVs疫苗或者针对HVs的特异有效的抗病毒治疗方案。我国是受HFRS危害最严重的国家之一,对流行区人口进行疫苗接种是控制HVs流行的有效方案。HVs疫苗主要包括灭活疫苗、DNA疫苗、亚单位疫苗和病毒样颗粒疫苗,本文就国内外HVs疫苗研究进展进行综述。

流感病毒致小鼠急性肺损伤模型建立及利巴韦林干预作用研究

目的 建立A/FM/1/47/（H1N1）流感病毒感染诱导的小鼠急性肺损伤模型,并使用利巴韦林对其进行治疗,观察其保护机制.方法 将30只13-15g的昆明（KM）小鼠随机分为三组（正常组、模型组和利巴韦林组）,每组10只,模型组与利巴韦林组采用H1N1流感病毒经鼻腔接种,利巴韦林组小鼠配以药物治疗,定时称量各组小鼠的体质量、观察记录小鼠存活状态,连续观察15d;另取36只13-15g的KM小鼠,如上随机分为三组,每组12只,模型组与利巴韦林组采用H1N1流感病毒经鼻腔接种,利巴韦林组小鼠配以药物治疗,感染后第6d测量肺系数、肺湿/干重比、观察肺病理组织学变化、动脉血气分析、血清细胞因子含量和肺部病毒载量.结果 实验结果显示,流感病毒滴鼻感染可诱发小鼠病毒性肺损伤.利巴韦林可延长感染小鼠生存时间,降低肺水肿,改善低氧血症,抑制炎性细胞的分泌,抑制病毒在体内的复制.结论 本研究利用流感病毒感染小鼠的病毒性肺损伤,分析了利巴韦林对流感病毒诱发的病毒性肺损伤的保护作用.该模型对进一步开发抑制流感病毒性肺损伤的新药有重要意义.

岗藿抗感汤对流感病毒感染致小鼠急性肺损伤的保护作用研究

目的研究岗藿抗感汤对流感病毒FM1株感染致小鼠急性性肺损伤的保护作用。方法采用流感病毒滴鼻感染正常小鼠建立病毒性肺损伤模型。观察岗藿抗感汤对小鼠生存状态、生存时间,肺指数,肺组织病毒复制量,动脉血气分析的影响。结果岗藿抗感汤能明显改善病毒感染小鼠生存质量,延长小鼠平均生存时间;降低流感病毒感染小鼠的肺指数;减少病毒感染小鼠的病毒复制量;升高病毒感染小鼠动脉血中的含氧量、血氧饱和度,降低二氧化碳分压。结论岗藿抗感汤可减轻流感病毒感染引致的小鼠急性肺损伤,对流感病毒感染的小鼠具有显著的保护作用。

Antiviral Activity of the Effective Monomers from Folium Isatidis Against Influenza Virus in Vivo

In order to evaluate the anti-influenza virus activity of the effective monomer from Folium Isatidis (FI) in vivo,we established mice model with viral pneumonia and divided them into 3 different dose groups,then observed their lung indexes,pulmonary pathological changes,pulmonary virus hemagglitination titers,living time and death rates.The results showed that the monomer could reduce the pulmonary index from 2.64 to 1.93,1.63 and 1.40 (P<0.01) and decrease the hemagglitination titer from 1.15 to 0.84,0.70 and 0.59 (P<0.01).In addition,different groups of FI could significantly lessen the mortality rate from 100% to 30%,25% and 15%,and prolong the living time from 5.1d to 6.5d,8.4d and 8.9d respectively(P<0.01).The high dose (75 mg/kg/d) has the similar effect with 100 mg/kg/d dose of virazole(P>0.05),and more effective than 200 mg/kg/d dose of antiviral liquor (P<0.05).

Is transient elastography a useful tool for screening liver disease?

Transient elastography(TE)is a new non invasive tool for measuring liver stiffness,which is correlated to the histologic stage of liver fibrosis.Several studies in chronic liver disease(CLD)have determined a good accuracy of TE in predicting significant fibrosis and an optimal accuracy in predicting cirrhosis.Normal liver stiffness ranges between 3.3-7.8 KPa and using a cut off of 7.1 KPa,significant fibrosis and cirrhosis can be excluded with a very high negative predictive value(NPV).Positive predictive value(PPV)for the diagnosis of cirrhosis is lower using just a single scan but increases to 90% if high stiffness values are confirmed by a second independent scan.However the presence of fatty liver and metabolic syndrome slightly increases the readings and may reduce the accuracy of the test.It is uncertain if this increase is related to the presence of steatofibrosis or ifit is caused by steatosis itself.TE can be used in screening patients attending the liver clinics to identify those with signifi cant fi brosis or cirrhosis and may be particularly useful in discriminating HBV inactive carriers from chronic hepatitis B patients.TE,however,is not reliable in predicting the presence of esophageal varices in cirrhotics.Another potential indication for TE is the systematic screening of populations at high risk for CLD,such as intravenous drug users and alcoholics,but further studies are needed to determine its diagnostic accuracy in these settings.

Hepatitis C virus enhances incidence of idiopathic pulmonary fibrosis

AIM： To investigate the cumulative development incidence and predictive factors for idiopathic pulmonary fibrosis in hepatitis C virus （HCV） positive patients. METHODS： We studied 6150 HCV infected patients who were between 40-70 years old （HCV-group）. Another 2050 patients with hepatitis B virus （HBV） were selected as control （HBV-group）. The mean observation period was 8.0 ± 5.9 years in HCV-group and 6.3 ± 5.5 years in HBV-group. The primary goal is the development of idiopathic pulmonary fibrosis （IPF） in both groups. The cumulative appearance rate of IPF and independent factors associated with the incidence rate of IPF were calculated using the Kaplan- Meier method and the Cox proportional hazard model. All of the studies were performed retrospectively by collecting and analyzing data from the patient records in our hospital. RESULTS： Fifteen patients in HCV-group developed IPF. On the other hand, none of the patients developed IPF in HBV-group. In HCV-group, the cumulative rates of IPF development were 0.3% at 10th year and 0.9% at 20th year. The IPF development rate in HCV-group was higher than that in HBV-group （P = 0.021）. The IPF development rate in patients with HCV or HBV was high with statistical significance in the following cases： （1） patients ≥ 55 years （P 〈 0.001）; （2） patients who had smoking index （package per day x year） of ≥20 （P = 0.002）; （3） patients with liver cirrhosis （P = 0.042）. CONCLUSION： Our results indicate that age, smoking and liver cirrhosis enhance the development of IPF in HCV positive patients.

Resilience of nurses at the epicenter of the COVID-19 pandemic in Lebanon

Objective:The study aimed to investigate the level and factors associated with the resilience of nurses practicing at the main COVID-19 referral center in Lebanon.Methods:The study utilized a cross-sectional survey design.Data were collected electronically in the spring of 2020 from 265 nurses.The questionnaire included five sections:demographic characteristics,job satisfaction,turnover intentions,exposure to violence,and resilience levels.Multiple linear regression was used to determine factors associated with resilience.Results:Results showed that the overall score of resilience among nurses was 66.91±13.34.Most nurses were satisfied with their job(67.8%),and most nurses reported that it is unlikely for them to quit their present work in the coming year(76.2%).Over the last year,three-quarters of nurses(74.7%)reported being ever exposed to a form of occupational violence.The resilience of nurses was directly associated with job satisfaction and male gender and inversely associated with intention-to-quit and exposure to violence(P<0.05).Conclusions:Enhancing the resilience of nurses at the frontline of the COVID-19 pandemic improves their job satisfaction and retention and would help support the effectiveness and efficiency of care services.Nurse managers can regularly investigate the resilience of nurses and offer interventions that would strengthen it,especially at times of crisis.

Excretion and detection of SARS coronavirus and its nucleic acid from digestive system

AIM： To study whether severe acute respiratory syndrome coronavirus （SARS-CoV） could be excreted from digestive system.METHODS： Cell culture and semi-nested RT-PCR were used to detect SARS-CoV and its RNA from 21 stool and urine samples, and a kind of electropositive filter media particles was used to concentrate the virus in 10 sewage samples from two hospitals receiving SAILS patients in Beijing in China. RESULTS： It was demonstrated that there was no live SARS-CoV in all samples collected, but the RNA of SARS-CoV could be detected in seven stool samples from SARS patients with any one of the symptoms of fever, malaise, cough, or dyspnea, in 10 sewage samples before disinfection and 3 samples after disinfection from the two hospitals. The RNA could not be detected in urine and stool samples from patients recovered from SARS.CONCLUSION： Nucleic acid of SARS-CoV can be excreted through the stool of patients into sewage system, and the possibility of SARS-CoV transmitting through digestive system cannot be excluded.

Establishment of animal model for potency evaluationof inactivated SARS virus experimental vaccine

The purpose of this study was to test the effectiveness of source virus strain for the manufacture of the inactivated SARS virus vaccine, and establish an experimental method and preliminary standard for potency evaluation. Mice were divided into groups for being immunized with corresponding serially diluted experimental SARS virus inactivated vaccine. And the rabbits were immunized with undiluted vaccine. Challenge assay was conducted with a heterologous SARS virus. And the neutralization antibody was determined with plaque reduction neutralization test (PRNT), to which the neutralization antibody in the convalescent serum of SARS patients was compared. The experimental vaccine viral strains were proved to be suitable for manufacturing the vaccine. Mice immunized by vaccines of serial dilutions were able to elicit neutralizing antibody. The antibody titer from mice immunized with the undiluted vaccine could reach up to 1∶495.2, while those of rabbits immunized with the undiluted vaccine could reach a GMT of 55.0-79.9. The capability of the antibody to neutralize the virus from Guangdong is more efficient than that from Beijing. The GMT of neutralizing antibody in SARS convalescents living in south and north China ranged from 50.12 to 54.95, and the titers of convalescents from north China were higher than those from south China. Mice and rabbits used as the model for evaluation of potency are of sensitivity, and the test is of reproducibility. The candidate challenge viral strains showed a relatively consistent effect on evaluating antibodies produced by various batches and different vaccine-source strains, hence they can be used to evaluate potency of the vaccine. The method for testing the vaccine potency and the evaluation standard was established preliminarily.

Understanding the pregnant women’s experiences during the COVID-19 pandemic:A qualitative study

Objective To explore and interpret the experiences of pregnant women in Macao region,China during the COVID-19 pandemic.Methods Recruitment advertisements were published through multiple social platforms in Macao region,China.A purposive snowball sampling method was adopted to select interviewees.Eighteen women who were confirmed as pregnant from January to May 2020 participated in this qualitative study.Data was collected from November to December 2020 using in-depth personal interviews.One-to-one interviews were conducted by telephone to avoid personal contact.Thematic analysis was used to perform the data analysis and identify emergent themes.Results Five themes emerged from the data analysis:changes in daily life,psychological distress,unique experiences of pregnancy follow-up,trying to pay attention to health information but also feeling overwhelmed,and change in hygiene behaviors due to fear of infection.Six sub-themes were identified:being confined at home but understanding the reasons,financial pressures and timely support from the government,perceived risk of catching the infection,retaining optimism with various help and support,adequate personal protections,and obsessive hygiene behaviors.Conclusion During a pandemic,there is a risk of greater individual isolation,particularly for vulnerable groups such as women in pregnancy.The humanized attention to and support for the residents from the government buffered the adverse impact on the study participants.Preplanning for such events is needed to focus on psychological distress,financial constraints,and prenatal health services.Alternative service delivery,such as telemedicine,online counseling,and virtual reality(VR)technology,should be applied to offer pregnant women timely support and avoid a crisis.