目的总结43例新生儿化脓性脑膜炎的临床特点及诊治方法。方法回顾性分析43例化脓性脑膜炎患儿的临床资料。结果43例患儿中,发热35例(81.4%),病理性黄疸18例(41.9%),皮肤发花18例(41.9%),反应差14例(32.6%),腹胀12例(27.9%),纳差11例(25....目的总结43例新生儿化脓性脑膜炎的临床特点及诊治方法。方法回顾性分析43例化脓性脑膜炎患儿的临床资料。结果43例患儿中,发热35例(81.4%),病理性黄疸18例(41.9%),皮肤发花18例(41.9%),反应差14例(32.6%),腹胀12例(27.9%),纳差11例(25.6%),泌尿道感染9例(20.9%),贫血9例(20.9%),前囟膨隆2例(4.7%)。血清C反应蛋白(CRP)异常31例(72.1%),外周血白细胞计数异常15例(34.9%),脑脊液白细胞计数升高29例(67.4%),脑脊液蛋白定性阳性30例(69.8%),葡萄糖含量降低19例(44.2%)。患儿入院后均使用易透过血脑屏障的抗生素治疗(头孢曲松、头孢噻肟、头孢他啶、美罗培南等)。住院时间<14 d 4例(9.3%),14~21 d 27例(62.8%),22~28 d 12例(27.9%)。37例(86.0%)患儿治愈出院;4例(9.3%)经治疗后病情好转,未完成足疗程治疗,家属要求出院;2例(4.7%)放弃治疗后72 h内死亡。结论新生儿化脓性脑膜炎临床表现多样,主要表现为发热、病理性黄疸、皮肤花斑、反应差、腹胀等症状;实验室检查血清CRP、外周血白细胞计数异常,脑脊液白细胞计数升高,脑脊液蛋白定性阳性,葡萄糖含量降低;结合临床表现和实验室检查结果可以确诊。治疗上首先经验性选择易进入脑脊液的杀菌药,再根据药敏试验结果、临床表现及血、脑脊液培养结果进行调整。展开更多
Caprine arthritis-encephalitis virus(CAEV) is an under-studied virus infecting caprines and ovines worldwide. Over the last four decades, CAEV has spread in China, obtaining genomic data on CAEV strains circulating in...Caprine arthritis-encephalitis virus(CAEV) is an under-studied virus infecting caprines and ovines worldwide. Over the last four decades, CAEV has spread in China, obtaining genomic data on CAEV strains circulating in China is of importance for developing diagnostic methods and eradicating associated diseases. However, there is limited information on the genome, including characterizations, and the probable origin. This work aimed to characterize Chinese CAEV genomes and population structures. Five CAEV strains isolated from infected dairy goats between 1989and 1994 in Gansu, Guizhou, Shaanxi, Shandong and Sichuan provinces were cloned and sequenced. The Chinese CAEV had a 58–93% genome similarities to strains outside of China, and they belonged to subgenotype B1. The highest similarity levels(98.3–99.3%) were with two other Chinese strains, and they shared a 91.8–92.3% similarity with the strain Clements(GenBank accession no. NC_001463.1) from outside of China. The Chinese CAEV strains isolated from different provinces over five years were still highly homologous and contained unique ancestral population components,indicating that these Chinese strains had a common origin that differed from other known strains. Our results provide genomic data on circulating Chinese CAEV strains and will be useful for future epidemiological investigations and CAEV eradication programs.展开更多
文摘目的总结43例新生儿化脓性脑膜炎的临床特点及诊治方法。方法回顾性分析43例化脓性脑膜炎患儿的临床资料。结果43例患儿中,发热35例(81.4%),病理性黄疸18例(41.9%),皮肤发花18例(41.9%),反应差14例(32.6%),腹胀12例(27.9%),纳差11例(25.6%),泌尿道感染9例(20.9%),贫血9例(20.9%),前囟膨隆2例(4.7%)。血清C反应蛋白(CRP)异常31例(72.1%),外周血白细胞计数异常15例(34.9%),脑脊液白细胞计数升高29例(67.4%),脑脊液蛋白定性阳性30例(69.8%),葡萄糖含量降低19例(44.2%)。患儿入院后均使用易透过血脑屏障的抗生素治疗(头孢曲松、头孢噻肟、头孢他啶、美罗培南等)。住院时间<14 d 4例(9.3%),14~21 d 27例(62.8%),22~28 d 12例(27.9%)。37例(86.0%)患儿治愈出院;4例(9.3%)经治疗后病情好转,未完成足疗程治疗,家属要求出院;2例(4.7%)放弃治疗后72 h内死亡。结论新生儿化脓性脑膜炎临床表现多样,主要表现为发热、病理性黄疸、皮肤花斑、反应差、腹胀等症状;实验室检查血清CRP、外周血白细胞计数异常,脑脊液白细胞计数升高,脑脊液蛋白定性阳性,葡萄糖含量降低;结合临床表现和实验室检查结果可以确诊。治疗上首先经验性选择易进入脑脊液的杀菌药,再根据药敏试验结果、临床表现及血、脑脊液培养结果进行调整。
基金funded by the National Key Research and Development Program of China(2016YFD0500908)。
文摘Caprine arthritis-encephalitis virus(CAEV) is an under-studied virus infecting caprines and ovines worldwide. Over the last four decades, CAEV has spread in China, obtaining genomic data on CAEV strains circulating in China is of importance for developing diagnostic methods and eradicating associated diseases. However, there is limited information on the genome, including characterizations, and the probable origin. This work aimed to characterize Chinese CAEV genomes and population structures. Five CAEV strains isolated from infected dairy goats between 1989and 1994 in Gansu, Guizhou, Shaanxi, Shandong and Sichuan provinces were cloned and sequenced. The Chinese CAEV had a 58–93% genome similarities to strains outside of China, and they belonged to subgenotype B1. The highest similarity levels(98.3–99.3%) were with two other Chinese strains, and they shared a 91.8–92.3% similarity with the strain Clements(GenBank accession no. NC_001463.1) from outside of China. The Chinese CAEV strains isolated from different provinces over five years were still highly homologous and contained unique ancestral population components,indicating that these Chinese strains had a common origin that differed from other known strains. Our results provide genomic data on circulating Chinese CAEV strains and will be useful for future epidemiological investigations and CAEV eradication programs.
