1.Analysis of anticoagulation in 926 patients with atrial fibrillation
Linggang SUN ; Jian YU ; Zhengfei HE ; Zhiyun CHEN ; Qunhua LIU ; Qilong LING ; Weilyu HU
Chinese Journal of Primary Medicine and Pharmacy 2017;24(15):2304-2307
Objective To analyze the anticoagulation in patients with atrial fibrillation.Methods A retrospective analysis of anticoagulant therapy situation in 926 patients with atrial fibrillation was conducted,in order to sum up experience and improve the understanding of atrial fibrillation.Results In 926 patients with atrial fibrillation,there were no anticoagulant therapy in 675 patients,accounting for 72.89%,while only 251 cases received the treatment of anticoagulation,accounting for 27.11%.Only 66 patients aged>75 years were treated with anticoagulant therapy,accounting for 33.17%.The patients with coronary heart disease,in 17.60% and with anticoagulation treatment,the patients with diabetes in 28.37% and received anticoagulation therapy,28.32% patients with anticoagulation therapy in patients with hypertension,30.77% patients with cardiac insufficiency with anticoagulant therapy.Choice of treatment of aged>75,hypertension,coronary heart disease,clinical treatment strategies and patients were the main factors that affected the use of warfarin,but only>75 years of age,coronary heart disease,choice of treatment factors with statistical significance of three factors(OR=7.02,12.73,4.79,all P<0.05).675 cases without anticoagulant therapy in 101 patients with non warfarin treatment indications without the use of warfarin anticoagulation treatment,accounted for 14.96%.In addition,there were 574 AF patients with warfarin treatment indications and treatment with warfarin,analysis of its causes:63 cases had anticoagulant contraindications,172 cases for the doctor too much about bleeding complications,440 patients were not in accordance with the requirements of the detection of INR.Conclusion The positive effect of warfarin in prevention of ischemic stroke,but in basic hospital application of warfarin anticoagulation in patients with severe AF deficiency,should raise the awareness of risk of grassroots medical staff and patients of atrial fibrillation complicating embolism,do a good job of educating patients,to reduce the incidence of embolic events in patients with atrial fibrillation.
2.Epidemic characteristics and genetic analysis of hemorrhagic fever with renal syndrome in an industrial park in Daishan County, Zhejiang Province
Qilong TAN ; Ling YE ; Hong XU ; Jiwei SHU ; Zhiping WANG
Chinese Journal of Endemiology 2022;41(3):193-199
Objective:To analyze the epidemic characteristics and virus gene sequence of hemorrhagic fever with renal syndrome (HFRS) in an industrial park in Daishan County, Zhejiang Province, and to provide clues and basis for local HFRS prevention and control.Methods:According to the case questionnaire in the "National Surveillance Program for Hemorrhagic Fever with Renal Syndrome", general and epidemiological investigation of HFRS cases was carried out in the epidemic-related industrial park. Serum samples of the cases, people and host animals in the same living environment were collected for hantavirus antibody or nucleic acid detection, the M, S gene amplification and sequence determination. MEGAX 10.1.8 software was used to construct the phylogenetic tree of M and S genes for virus genotyping and evolutionary analysis.Results:A total of 3 confirmed cases of HFRS were reported. They were all workers in the epidemic-related industrial park, male, who lived in the park for more than half a year and had no history of HFRS vaccination. There were no rodent-proof facilities in the industrial park's dormitories and canteens, and the living items were placed in a disorderly manner, the rodents and its excrement could be seen; a total of 38 host animals were captured in the same living environment with cases, all of which were Rattus norvegicus. The 3 reported cases of HFRS were all mild, with atypical clinical manifestations in the early stage of onset, mainly fever and fatigue. The serum specific antibodies of hantavirus IgG and IgM were positive (3/3), and the antibodies of people in the same living environment were negative (100.0%, 100/100). The serum samples of 2 reported cases of HFRS and 4 Rattus norvegicus were positive for nucleic acid, all of which were SEOV type hantavirus. The M gene segment homology of 6 positive serum samples was 100.0%, which was closely related to Rod/2012/QHD/4/Gc isolated from Hebei and RuianRn180 isolated from Ruian Zhejiang Province; the homology of S gene segment was 99.6% to 99.8%, which was closely related to JiangxiXinjianRn-09-2011, a strain isolated from Jiangxi Province. Conclusions:The HFRS epidemic in the industrial park is caused by the transmission of SEOV type hantavirus to humans via Rattus norvegicus; poor living environment, poor hygiene habits of personnel and lack of vaccination are all related to the incidence of HFRS; the main epidemic strains shows high homology and geographical aggregation.