大肠埃希菌和白念珠菌混合感染小鼠中性粒细胞和巨噬细胞功能的研究

目的 :研究大肠埃希菌和白念珠菌混合感染小鼠中性粒细胞和巨噬细胞的功能。方法 :建立大肠埃希菌和白念珠菌单独及混合感染小鼠模型 ,以多粘菌素B拮抗内毒素活性 ,分离各组小鼠中性粒细胞和巨噬细胞 ,检测中性粒细胞黏附功能、吞噬功能和巨噬细胞杀菌功能 ,用酶联免疫吸附试验 (ELISA)检测巨噬细胞分泌肿瘤坏死因子α(TNFα)水平。结果 :大肠埃希菌和白念珠菌混合感染组小鼠中性粒细胞黏附率较各自单独感染组明显升高 (P <0 .0 5 ) ,而吞噬率较各自单独感染组明显降低 (P <0 .0 5 ) ,大肠埃希菌和白念珠菌混合感染组小鼠巨噬细胞杀菌率较各自单独感染组明显降低 (P <0 .0 5 ) ,分泌TNFα水平较各自单独感染组明显升高 (P <0 .0 5 )。结论 :大肠埃希菌和白念珠菌混合感染小鼠中性粒细胞和巨噬细胞清除细菌能力低下 ,巨噬细胞分泌过量TNFα可削弱机体抵抗力。     

血浆纤维结合蛋白对血液除菌功能的影响

目的体外观察血浆纤维结合蛋白(PFn)对血液清除细菌功能的影响。方法用全血杀菌试验及中性粒细胞吞噬试验,研究PFn对金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌的调理吞噬作用与血液清除细菌功能间的关系。结果PFn对血液清除铜绿假单胞菌及金黄色葡萄球菌有明显的促进作用,其细菌存活率与对照组相比有显著性差异(P<0.05),且铜绿假单胞菌存活率随PFn含量的增加而降低,加入抗人Fn血清后则升高;对金黄色葡萄球菌的中性粒细胞吞噬试验显示:观察组与对照组吞噬率无显著性差异(P>0.05),但吞噬指数由0.37提高到0.43,有显著性差异(P<0.01)。而PFn对血液清除大肠埃希菌的作用不显著(P>0.05)。结论PFn对细菌的调理吞噬作用存在菌种差异性,能促进中性粒细胞对金黄色葡萄球菌的吞噬。     

血浆纤维结合白对血液除菌功能的影响

目的体外观察血浆纤维结合蛋白(PFn)对血液清除细菌功能的影响.方法用全血杀菌试验及中性粒细胞吞噬试验,研究PFn对金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌的调理吞噬作用与血液清除细菌功能间的关系.结果PFn对血液清除铜绿假单胞菌及金黄色葡萄球菌有明显的促进作用,其细菌存活率与对照组相比有显著性差异(P＜0.05),且铜绿假单胞菌存活率随PFn含量的增加而降低,加入抗人Fn血清后则升高;对金黄色葡萄球菌的中性粒细胞吞噬试验显示观察组与对照组吞噬率无显著性差异(P＞0.05),但吞噬指数由0.37提高到0.43,有显著性差异(P＜0.01).而PFn对血液清除大肠埃希菌的作用不显著(P＞0.05).结论PFn对细菌的调理吞噬作用存在菌种差异性,能促进中性粒细胞对金黄色葡萄球菌的吞噬.     

肝硬化患者中性粒细胞吞噬及细胞内杀菌功能的研究

目的 :探讨肝硬化患者中性粒细胞吞噬和细胞内杀菌功能。方法 :采用普通酵母菌对 44例肝硬化患者及 3 8例正常人进行中性粒细胞吞噬和细胞内杀菌功能试验。结果 :3 8例正常人中性粒细胞吞噬率和杀伤率均值分别为 (2 3± 7) %和 (3 9± 3 ) % ,44例肝硬化患者中性粒细胞吞噬率和杀伤率分别为 (15± 5 ) %和 (3 0± 7) % ,明显低于正常对照组。 2 4例失代偿期肝硬化患者与 12例代偿期肝硬化患者 ,及 8例肝硬化合并肝癌患者与 3 6例肝硬化非合并肝癌患者中性粒细胞吞噬及杀伤功能均无明显差异。结论 :肝硬化患者中性粒细胞吞噬和杀伤功能明显减退     

光动力作用对人外周血中性粒细胞免疫影响的研究

目的　探讨光动力作用对人类外周血中性粒细胞免疫功能的影响。方法　采用酵母菌粘附试验 ,观察光动力作用对正常人中性粒细胞的粘附功能的影响 ,以及在光动力作用下 ,正常人红细胞对中性粒细胞吞噬功能的促进作用。实验将正常人的外周血中性粒细胞分离后 ,短时间暴露于小剂量的血卟啉衍生物及红光下 ,通过光镜观察活化的中性粒细胞与致敏酵母多糖的免疫粘附。结果　小剂量光动力作用可以显著增强中性粒细胞的免疫粘附功能 ,其C3b受体花环率为 (2 2 .5 2±5 .79) % ,明显大于对照组 (14.33± 4.5 6 ) % (P <0 .0 1) ,同时可增强红细胞促进中性粒细胞的粘附吞噬功能。结论　小剂量光动力作用可以促进人类外周血中性粒细胞及红细胞表面C3b受体活性 ,增强其免疫粘附功能。     

肠聚集大肠埃希菌在瑞士腹泻和无腹泻儿童中的流行[英]／Pabst WL，Altwegg M，Kind C，et al．／／Journal of Clinical Microbiology

引起腹泻的大肠埃希菌可分为6种，包括肠聚集大肠埃希菌(enteroadherent estherichia coli，EAEC)、肠出血性大肠埃希菌(EHEC)、肠致病性大肠埃希菌(enterophathogenic escherichia coli，EPEC)、肠产毒性大肠埃希菌(enterotoxin of escherichia coli，ETEC)、肠侵袭性大肠埃希菌(enteroinvasive escherichia coli，EIEC)和弥散性粘附大肠埃希菌。EAEC作为儿童腹泻源的重要性仍有争论，     

清远地区大肠埃希菌ESBLs的检测及其对20种抗生素的耐药性与治疗策略

目的　观察清远市地区产超广谱 β-内酰胺酶 (ESBL s)大肠埃希菌的耐药性和流行情况 ,指导临床用药。方法　应用 Micro Scan Auto SCAN- 4、专用 NC2 1鉴定板检测 180例大肠埃希菌 ESBL s的产生和其体外对抗生素的耐药性。结果　产 ESBL s大肠埃希菌阳性率 5 1.1% ,以儿科 (10 0 % )最高、重症监护病房 (81.8% )次之 ,对头孢菌素类、氨苄西林、哌拉西林、环丙沙星、妥布霉素、复方新诺明呈多重耐药、耐药率 42 .4%～ 91.3% ,显著高于非产 ESBL s大肠埃希菌 (P<0 .0 5～ 0 .0 1) ;对亚胺培南、哌拉西林 /三唑巴坦具有高敏感性。结论　清远地区具有较高的产 ESBL s大肠埃希菌检出率 ,对于产 ESBL s大肠埃希菌应用亚胺培南、哌拉西林 /三唑巴坦等含 β-内酰胺酶抑制剂的复合抗生素有效     

肠聚集大肠埃希菌在瑞士腹泻和无腹泻儿童中的流行

引起腹泻的大肠埃希菌可分为6种,包括肠聚集大肠埃希菌(enteroadherent escherichia coli,EAEC)、肠出血性大肠埃希菌(EHEC)、肠致病性大肠埃希菌( enterophathogenic esche richia coli,EPEC)、肠产毒性大肠埃希菌(enterotoxin of esche richia coli,ETEC)、肠侵袭性大肠埃希菌(enteroinvasive esche richia coli,EIEC)和弥散性粘附大肠埃希菌。EAEC作为儿童腹泻源的重要性仍有争论,本文采用 PCR方法检测 EAEC的质粒 pCVD432,从而判定EAEC在瑞士腹泻儿童中的重要性。1.资料与方法:用标准的培养方法和 PCR方法测定 Zu…     

阀控多通道微流控芯片高通量快速检测大肠埃希菌O157:H7

摘要：目的：建立一种基于气阀控制的多通道微流控芯片系统,实现高通量、低成本、快速检测大肠埃希菌O157:H7。 方法：采用集成多条反应通道和控制气阀的微流控芯片,用气阀控制芯片通道内反应的顺序,在通道交叉处构建出10个检测区。然后以免疫荧光技术为检测手段,检测水和粪便标本中的大肠埃希菌O157:H7。 结果：成功建立了一种基于气阀控制的多通道微流控芯片系统,并应用于大肠埃希菌O157:H7的快速检测。此芯片一次可同时检测10个样本,单个样本检测时间少于10 min、试剂消耗量仅为0.5 μL,对大肠埃希菌O157:H7的最低检测限为1×10³ CFU/mL。检测大肠埃希菌O157:H7组的荧光信号（4 122±164）与大肠埃希菌ATCC 25922（2.67±0.45）及伤寒沙门菌（3.33±0.94）比较,差异有统计学意义（t分别为35.78和30.79,P均<0.01）。批内精密度为5.2%。将本法用于模拟临床样品中大肠埃希菌O157:H7的测定,敏感性和特异性分别为62%和100%,与培养法的总体符合率为81%。 结论：于气阀控制的多通道微流控芯片系统可实现高通量、低成本、快速检测大肠埃希菌O157:H7,有望成为一种高效和快捷的新检测方法。     

致泻大肠埃希菌及其毒力岛研究进展

在大肠埃希菌中有些菌株能引起小儿和成人腹泻的称为致泻大肠埃希菌 (DDEC)。根据致泻大肠埃希菌的致病特点 ,目前公认的至少有 6类 :肠致病性大肠埃希菌 (EPEC) ;肠出血性大肠埃希菌 (EHEC) ;肠产毒素大肠埃希菌 (ETEC) ;肠集聚性大肠埃希菌 (EAggEC) ;肠侵袭性大肠埃希菌 (EIEC) ;产志贺样毒素大肠埃希菌 (SLTEC)等[1]。在国内腹泻病原学研究中 ,还不断有新的致泻大肠埃希菌被发现 ,如高毒力岛大肠埃希菌 (HPIEC)等[2 ]。毒力岛也称致病岛 (PAI)是近年来在医学细菌学领域中出现的一个新名词 ,各种病原菌的毒力因子都有一个…     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.