赣湘边境地区蛇类检出沙门氏菌的血清型分布

从铜鼓县蛇养殖场的590份蛇类肠内容物标本中检出367株沙门氏菌,分属于5个DNA同源群,共22个O群41个血清型,其中DNA同源群114个,同源群Ⅱ3个,同源群Ⅲ。1个,同源群Ⅲ。20个,同源群Ⅳ3个。其中65:Z:Z_(55)系国际上尚未报告的血清型,6个血清型是国内首次发现。本调查结果表明.蛇体内可检出大量的沙门氏菌,不仅有少见菌种,而且还有许多同源群Ⅰ的常见血清型,都是人类沙门氏菌感染的重要传染源,应引起重视。     

糖尿病肾病患者肾组织中AT1、AT2、MAS受体表达的临床意义

选取2018年1月-2019年5月经肾穿刺活检病理诊断为DN患者124例,病理分型分布为Ⅰ型-Ⅱa型15例,Ⅱb型26例,Ⅲ型76例,Ⅳ型7例。结果肾小球和肾小管的AT1受体表达水平以Ⅲ型最高,且肾脏血管的AT1受体表达水平以Ⅰ型-Ⅱa型最高;Ⅱb型、Ⅰ型-Ⅱa型、Ⅲ型及Ⅳ型的肾脏血管AT2受体表达水平大致持平,肾小球和肾小管AT2受体表达水平主要以Ⅱb型最高;Ⅰ型-Ⅱa型肾小球MAS受体表达水平最高,且Ⅱb型和Ⅲ型大致持平,Ⅳ型最低,肾小管和肾脏血管的MAS受体表达水平与肾小球相似。结论 DN患者肾组织中AT1、AT2、MAS受体可对患者的病情情况进行反馈。     

胆石性胰腺炎的一种简易临床分型法

目的 探讨胆石性胰腺炎合理的临床分型方法,以更好地指导临床选择治疗方案.方法 依据胰腺炎的病情严重程度和胆管有无梗阻,将273例胆石性胰腺炎分成4个临床类型:非梗阻性轻型(Ⅰ型)、梗阻性轻型(Ⅱ型)、梗阻性重型(Ⅲ)、非梗阻性重型(Ⅳ型);再依据胆总管内是否存在结石,将每一类型分成a、b两个亚型.然后对临床分型结果、治疗方法、预后进行分析.结果 Ⅰa型34例,Ⅰb型112例;Ⅱa型59例,Ⅱb型11例;Ⅲa型6例,Ⅲb型4例;Ⅳa型3例,Ⅳb型44例.全组总病死率为3.3%(9/273),Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型的病死率分别为0、0、10%(1/10)、17.0%(8/47),组间差别具有统计学意义(P<0.05).早期手术、传统非手术以及早期区域动脉灌注治疗Ⅳ型的病死率分别为30.8%(4/13)、25%(3/12)、4.5%(1/22),区域动脉灌注组病死率显著低于其他两组(P<0.05).结论 4型2分法是一种较为合理的胆石性胰腺炎临床分型法.以临床分型为依据细化胆石性胰腺炎治疗原则,可提高临床疗效.但在治疗过程中还需重视临床类型的转变.     

抗菌药最新知见（一）

1、MRSA与VRSA甲氧青霉素敏感性金葡球菌(MSSA)一旦产生葡萄球菌盒染色体(SCC)mec，即变为MRSA。自1990年以来，具有极其多样性遗传学背景的金葡球菌以Ⅳ及Ⅴ型SCCmec而变化为MRSA，现已有Ⅰ～Ⅴ之5型和Ⅱb、Ⅲrev、Ⅳb、Ⅳc与Ⅳd之5个亚型(Ito2004)。如今，此已     

国内首次发现带有表面K抗原的沙门氏菌Ⅲb（48：a：Z55）

本文报道从蛇体内检出一株沙门氏菌，该菌经系统的培养性状，生化学反应及血清学试验，证实是一株带有表面Ｋ抗原的新血清型的沙门氏菌Ⅲｂ（４８：ａ：Ｚ_５５）。本菌为国内首次检出。带有Ｋ抗原的沙门氏菌Ⅲｂ的发现与检出，对提高沙门氏菌检验技术具有重要的理论意义和现实意义。     

单纯米索前列醇在终止早期妊娠失败中的应用观察

选择早期妊娠失败的患者525例,随机分为三组。Ⅰ组口服米索前列醇,Ⅱ组阴道后穹窿置入米索前列醇,Ⅲ组采用人工流产术;再将Ⅰ、Ⅱ组随机分为三个亚组,即Ⅰa、Ⅰb、Ⅰc组与Ⅱa、Ⅱb、Ⅱc组,米索前列醇分别给予400、600、800μg。Ⅰa、Ⅰb、Ⅰc组完全流产率分别为78.57%、94.67%、95.71%,Ⅰb、Ⅰc组与Ⅰa组相比,P均〈0.01;Ⅰa、Ⅰb、Ⅰc组药物不良反应发生率分别为17.14%、26.67%、37.14%,Ⅰa组与Ⅰc组相比,P均〈0.05;Ⅱa、Ⅱb、Ⅱc组完全流产率分别为80.00%、95.00%、95.71%,Ⅱb、Ⅱc组与Ⅱa组相比,P均〈0.01;Ⅱa、Ⅱb、Ⅱc组药物不良反应发生率分别为8.57%、13.75%、27.14%,Ⅱa组与Ⅱc组相比,P〈0.05;Ⅲ组完全流产率为97.78%,与Ⅰb、Ⅱb组相比,P〉0.05;Ⅱb、Ⅰb组药物不良反应发生率相比,P〈0.05;Ⅰb、Ⅱb、Ⅲ组流产并发症发生率分别为2.67%、3.75%、13.33%,Ⅰb、Ⅱb组与Ⅲ组相比,P均〈0.01。认为单纯米索前列醇终止早期妊娠失败是安全、有效的方法,剂量以600μg最佳,阴道给药不良反应发生率低于口服给药。     

碱性成纤维细胞生长因子促进肺癌新生血管形成的机制

目的探讨碱性成纤维细胞生长因子促进肺癌新生血管形成的机制。方法选择115例该院肿瘤科活检或外科手术切除的肺癌组织标本,均经病理确诊。应用免疫组化法检测血清碱性成纤维细胞生长因子表达及微血管密度,并与病理分期进行比较,分析其相关性。结果Ⅰ期碱性成纤维细胞生长因子表达平均值为(20.44±16.01)pg/ml,Ⅱ期、Ⅲa期、Ⅲb期及Ⅳ期的碱性成纤维细胞生长因子表达平均值分别为(45.33±21.58)、(77.29±29.57)、(81.44±30.04)、(98.63±39.48)pg/ml,Ⅱ期与Ⅰ期比较差异无显著性,但Ⅲa期、Ⅲb期及Ⅳ期均与Ⅰ期比较差异有统计学意义(P<0.05),其中Ⅳ期与Ⅰ期具有极显著性差异(P<0.01)。I期11例微血管密度平均值为(22.83±7.42)个/高倍视野,Ⅱ期、Ⅲa期、Ⅲb期及Ⅳ期癌肿内微血管密度平均值分别是(28.43±13.46)、(33.27±14.04)、(36.02±21.11)及(40.63±15.26)个/高倍视野,Ⅱ期略高于Ⅰ期值,但无显著性差异(P>0.05)。结论碱性成纤维细胞生长因子在癌肿的新生血管形成中有重要作用,为新药研发提供了方向。     

沙门氏菌属的一个新血清型——沙门氏菌11∶1,w:—

从江西省铜鼓县定江河水中检出一株沙门氏菌S.3217,经血清学试验证明其抗原式为11:1,W:—。根据生化反应特性将其归于沙门氏菌属亚种Ⅰ,系国际上首次发现的一个新血清型,建议将该菌暂定名为江西沙门氏菌。     

一株沙门氏菌——Ⅳ(43:Z_4Z_(23):-)的鉴定

<正> 1989年6月,作者在进行赣湘边境地区蛇体沙门氏菌分布调查中,从乌梢蛇肠内容物中分离出1 株沙门氏菌,经噬菌体、生化和血清学鉴定为沙门氏菌Ⅳ(43:Z_4Z_(23):-),现将鉴定结果报告如下。 一、菌株 从铜鼓县蛇业养殖场乌梢蛇体内分离,菌号 890152,国家鉴定号 S3341。 二、噬菌体和血清 肠杆菌科分属诊断噬菌体由江西省卫生防疫站供给;沙门氏菌诊断血清为兰州生物制品研究所产品。     

冠状动脉造影适应证与冠状动脉造影结果分析

目的:探讨采用ACC和AHA冠状动脉造影(CAG)委员会1999年制定的CAG适应证标准与CAG结果的关系。方法:对332例行CAG患者按ACC和AHA的CAG委员会1999年制定的CAG适应证的标准进行分类:Ⅰ级、Ⅱa级、Ⅱb级和Ⅲ级,分析其与CAG结果的关系。结果:Ⅰ级与Ⅱa级适应证患者CAG阳性率(161/164,98·2%和35/37,94·6%,P>0·05)Ⅰ级、Ⅱa级的阳性率明显高于Ⅱb级(27/41,65·9%,均P<0·01)和Ⅲ级(5/90,5·6%,P<0·01)。Ⅱb级适应证组与Ⅲ级适应证组比较差异有统计学意义(P<0·01)。Ⅰ级加Ⅱa级适应证患者的3支或左主干血管病变检出率(46/201,22·9%)明显高于Ⅱb级(3/41,7·3%,P<0·05)和Ⅲ级(0/90,P<0·01),Ⅱb级适应证组与Ⅲ级适应证组比较差异有统计学意义(P<0.05)。结论:对准备进行CAG的冠心病或怀疑冠心病患者Ⅰ级、Ⅱa级适应证是恰当的,Ⅱb级适应证是不确定的,而Ⅲ级适应证是不恰当的,CAG适应证可以预测CAG阳性率和血管病变数。     

The changing epidemiology of salmonella: trends in serotypes isolated from humans in the United States, 1987-1997

Salmonellosis is a major cause of illness in the United States. To highlight recent trends, data for 1987-1997 from the National Salmonella Surveillance System were analyzed. A total of 441,863 Salmonella isolates were reported, with the highest age-specific rate among infants (159/100,000 infants at 2 months). Annual isolation rates decreased from 19 to 13/100,000 persons; however, trends varied by serotype. The isolation rate of Salmonella serotype Enteritidis increased until 1996, whereas declines were noted in Salmonella serotypes Hadar and Heidelberg. Overall, serotypes that increased in frequency were significantly more likely than those that decreased to be associated with reptiles (P=.008). Salmonella infections continue to be an important cause of illness, especially among infants. Recent declines in food-associated serotypes may reflect changes in the meat, poultry, and egg industries that preceded or anticipated the 1996 implementation of pathogen-reduction programs. Additional educational efforts are needed to control the emergence of reptile-associated salmonellosis.     

Antimicrobial drug resistance in Salmonella enterica

PURPOSE OF REVIEW: This review addresses the changing patterns of antimicrobial resistance in Salmonella. RECENT FINDINGS: Resistance to chloramphenicol, amicillin and cotrimoxazole is common in Salmonella Typhi and Paratyphi A in Asia and a few countries of Africa. In some countries, the isolation of multidrug resistant strains appears to be declining. R-type ACSSuT Salmonella Typhimurium DT104 is common in animal and human infections in many industrialized countries. Strains with additional trimethoprim and low-level ciprofloxacin resistance are increasingly seen. Resistance is appearing in new Typhimurium phage types, such as DT204b, and is common in serotypes Hadar and Virchow but not Enteritidis. A variety of Ambler class A and class C beta-lactamase enzymes have now been described causing extended spectrum cephalosporin resistance in different Salmonella serotypes. The overall level of extended spectrum cephalosporin resistance currently appears low. Low-level ciprofloxacin resistance, associated with point mutations in the gyrA gene, is inceasingly common in typhoidal and non-typhoidal serotypes isolated from humans and animals and has been associated with treatment failures. Sporadic reports describe human infections with non-Typhi Salmonella that are fully fluoroquinolone resistant. There is increasing support for the call to revise the fluoroquinolone breakpoints for Salmonella. A study from Denmark suggested that infections with drug resistant Salmonellae are associated with a poorer outcome than drug susceptible infections. SUMMARY: Resistance is increasing to several critical antimicrobials used to treat invasive salmonellosis including extended spectrum cephalosporins and quinolones. In resource poor countries, such drug resistant Salmonella infections may become effectively untreatable.     

Prevalance and resistance pattern of Salmonella serotypes in India

During the period 1990-91, 3222 Salmonella strains were identified at the National Salmonella and Escherichia Centre (NSEC) at Central Research Institute, Kasauli. Of these, 2894 were from humans, 226 from poultry, 84 from animals and remaining 18 from reptiles, birds and other sources. These strains belonged to 53 different serotypes. These include 4 serotypes reported for the first time in India, namely S. kedogou, S. VP. bornheim, S. kisarawe and S. madras. Drug resistance studies revealed that 573 strains were sensitive to all the antibiotics commonly used, 1351 single drug resistant, 594 resistant to two drugs and 704 were multidrug resistant. One strain from human stool was resistant to all the antibiotics used. Prevalence of various Salmonella serotypes and their response to various drugs is discussed.     

Pulmonary circulatory disturbance on magnified peripheral pulmonary wedge angiography in chronic pulmonary emphysema

Magnified peripheral pulmonary wedge angiography was performed in chronic pulmonary diseases. We classified the wedge angiography into five types based on the changes of capillary background (CBG) findings. Type I (normal), Type II (CBG is scattered and pulmonary arterial branches are tortuous), Type IIIa (CBG is decreased and pulmonary arterial branches are normal), Type IIIb (CBG and pulmonary arterial branches are also decreased or disappeared), Type IV (totally convergent). Using this classification, wedge angiography was performed in 42 patients out of 66 patients with chronic pulmonary emphysema diagnosed by selective alveolo-bronchography (SAB). Each type was compared in terms of hemodynamic data, blood gases and pulmonary function. Pulmonary emphysema was classified into types II, IIIa, and IIIb. There was no relation between SAB findings and wedge angiography classification. Severe hemodynamic data cases were found in types II and IIIb. The PaO2 of type II and IIIb were significantly lower than that of type IIIa. In pulmonary function tests, the mixed impairment type of ventilation was more frequently seen in type IIIb than IIIa. There was no relationship between SAB findings (66 cases) and hemodynamic data. These results suggest that classifying wedge angiography into five types (I, II, IIIa, IIIb, IV) may be useful for evaluating severity and determining prognosis and therapeutic measures in chronic pulmonary emphysema.     

Viruses infecting reptiles

A large number of viruses have been described in many different reptiles. These viruses include arboviruses that primarily infect mammals or birds as well as viruses that are specific for reptiles. Interest in arboviruses infecting reptiles has mainly focused on the role reptiles may play in the epidemiology of these viruses, especially over winter. Interest in reptile specific viruses has concentrated on both their importance for reptile medicine as well as virus taxonomy and evolution. The impact of many viral infections on reptile health is not known. Koch's postulates have only been fulfilled for a limited number of reptilian viruses. As diagnostic testing becomes more sensitive, multiple infections with various viruses and other infectious agents are also being detected. In most cases the interactions between these different agents are not known. This review provides an update on viruses described in reptiles, the animal species in which they have been detected, and what is known about their taxonomic positions.     

Bone and joint infections due to Salmonella.

A search of the records at the New York City Department of Health and the charts of patients at Columbia Presbyterian Hospital identified 37 cases of bone infection and nine cases of joint infection due to Salmonella between 1964 and 1978. Factors that apparently contributed to the development of either osteomyelitis or septic arthritis in 23 of the patients included hemoglobinopathy, previous trauma or surgery, connective tissue disorder, and lymphoma. Salmonella typhimurium and Salmonella enteritidis were the most common serotypes involved with bone infections, whereas members of the C1 serogroup were the most common cause of septic joint infections. Isolates of C1 serogroup Salmonella were represented in both bone and joint infections with frequencies (24% and 67%, respectively) disproportionate to the numbers of Salmonella isolated from other sources during this period. Therapy for joint infections was usually successful, with minimal residual damage. Therapy for acute osteomyelitis was unaccountably inadequate, with many patients (47%) developing chronic infections. Use of inappropriate therapy or an insufficient period of therapy were the most important factors contributing to poor outcome.     

Domestic reptiles as source of zoonotic bacteria: a mini review

Captive reptiles, always more often present in domestic environment as pets, may harbor and excrete a large variety of zoonotic pathogens. Among them, Salmonella is the most wellknown agent, whereas there are very scant data about infections by mycobacteria, chlamydiae and leptospirae in cold-blooded animals. However, the investigations that found antibody reactions and/or the bacteria in samples collected from free-ranging and captive reptiles show that herpetofauna may be involved in the epidemiology of these infections. The present review reports the updated knowledge about salmonellosis, mycobacteriosis, chlamydiosis and leptospirosis in reptiles and underlines the risk of infection to which people, mainly children, are exposed.     

上海市沙门菌血清型流行特征

目的建立本市沙门菌数据库,初步了解本地区部分沙门菌血清型的流行特征。方法以1999-2007年于从业人员体检、食品、腹泻病人质控(QC)和沙门菌监测对象分离的1078株沙门菌的血清型进行回顾性分析;其中2006年和2007年按照全球沙门菌监测(GSS)方案进行连续性腹泻病例监测。结果血清型谱显示本市不同来源的沙门菌型在分布上存在优势交叉,GSS分离菌株中有7个型为国内首次报告;通过分子分型证明本市2006年的山夫登堡和2007年的汤卜逊病例分别属于2个和1个克隆型。结论肠炎、鼠伤寒仍是本市优势致泻性血清型,山夫登堡和汤卜逊病例符合沙门菌性相对散发和集中暴发的分子流行特征。加强对沙门菌综合监测和准确及时的血清、分子分型能力有助于检索和追溯流行菌型。     

Salmonella Isolates from wild-caught Tokay Geckos (Gekko gecko) imported to the U.S. from Indonesia

Reptiles account for ～10% of live animal shipments imported to the United States (U.S.), the majority of which are sold in the pet trade. Characterizing Salmonella shedding by imported reptiles is of value to public health, the pet industry, and veterinary medicine. Here we report results of a pilot survey of Salmonella serotypes isolated from wild-caught Indonesian Tokay geckos (Gekko gecko) imported to the U.S. Upon arrival, the geckos were individually housed until a fecal sample was acquired for Salmonella culture. The geckos were divided into three groups with variable numbers to investigate density effects. A second group was imported after 3 months and combined with the previous groups. A total of 88 Salmonella isolates were obtained from 110 geckos surveyed, representing 14 serogroups and 17 unique serotypes. Group prevalence ranged from 31-73%. A significant increase in prevalence and a change in serotype richness were detected between the time of import and 6 months later at necropsy. Six isolates (6.8%) expressed resistance to more than one antibiotic. All S. enterica subsp. enterica Adelaide isolates were resistant to nalidixic acid and sulfisoxazole, one S. enterica subsp. arizonae 61:k:z35 isolate was resistant to ampicillin and sulfisoxazole, and another 61:k:z35 isolate was resistant to streptomycin and sulfisoxazole. Forty-three additional isolates expressed resistance only to sulfisoxazole. The mechanisms for increased prevalence and apparent change in serotype richness are unknown, but could be due to stress associated with trade, transport, and captivity, increased transmission from unnaturally high densities, or contact with other species shedding Salmonella along the trade route. Future studies to differentiate the physical, social, and physiological effects of trade-related conditions on Salmonella shedding and transmission among reptiles will benefit the industry by identifying ways to reduce mortality, and safeguard the individuals handling animals along the transport chain and other species encountered en route.