基于代谢组学分析的18-三体妊娠羊水差异代谢物

摘要:目的通过 非靶向代谢组学方法分析18-三体( trisomy 18,T18) 妊娠母体羊水样本,探索其差异代谢物。方法采用病 例-对照研究,以8例18-三体妊娠母体羊水样本为病例组,40例正常胎儿母体羊水样本为对照组,采用气相色谱飞行时间质 谱技术( GC-T0F/MS)检测两组羊水样本。采用主成分分析(PCA)和正交偏最小二乘法判别分析(OPIS-DA)模型分析代谢谱 差异,通过单维统计分析寻找差异代谢物。结果PCA 和OPLS-DA模型分析均显示病例组与对照组之间无明显分离趋势。 通过单维分析在两组间共发现5种差异代谢物,分别为甘油醛、葡萄糖酸、硫酸吲哚酚.磷酸盐和泛酸(P<0.05)。结论羊水 代谢组学证实18-三体妊娠存在多种代谢物水平的差异,为疾病的发生机制的探索提供了更多研究思路。     

艰难梭菌毒素B受体结合区CDB3融合蛋白诱导表达条件优化及其纯化

目的：优化艰难梭菌毒素B受体结合区CDB3融合蛋白诱导表达条件，在获得高表达融合蛋白后对其进行纯化，为艰难梭菌毒素B受体结合区CDB3单克隆抗体的制备奠定基础。方法以诱导前菌液600 nm处的光密度值（OD600）、诱导温度、诱导剂异丙基-β-D巯基半乳糖苷（IPTG）浓度和诱导时间为单变量，分别诱导融合蛋白的表达，在此基础上采用正交试验对融合蛋白的诱导表达条件进行优化，通过十二烷基磺酸钠-聚丙烯酰胺凝胶电泳半定量分析融合蛋白的表达量及表达形式，以Western blot对融合蛋白进行鉴定，以GST 亲和层析柱对融合蛋白进行纯化。结果融合蛋白诱导表达的最佳条件为诱导前菌液OD6000．8、IPTG浓度0．6 mmol/L、诱导时间12 h、诱导温度30℃，融合蛋白以可溶性蛋白表达形式为主，经纯化后，融合蛋白纯度超过90％。结论本研究成功优化了艰难梭菌毒素B受体结合区CDB3融合蛋白的诱导表达条件，获得大量表达，并成功对其进行了纯化，为后续单克隆抗体的制备奠定了基础。     

重点学校和民工子弟学校9～10岁学生近视状态及相关因素分析

目的：研究重点学校和民工子弟学校9～10岁学生近视状态和近视相关因素。方法选取苏州市重点小学（n=156）和民工子弟小学（n=178）部分4年级学生，给予1%环戊通药水，5 min滴1次，共3次后等待45 min，进行检影验光，确定验光结果。针对父母双方是否有近视、有无不良的用眼习惯、每天和每周户外活动时间、多媒体教学使用情况、电脑及电子产品使用情况、家长的认知和重视程度六方面设计调查问卷，由受试者和家长共同填写。结果（1）重点学校156例（312眼）近视者比例为25.6%，近视眼比例为22.4%，近视平均屈光度为（-2.07±1.04）D；民工子弟学校178例（356眼）近视者比例为16.3%，近视眼比例为15.7%，近视平均屈光度（-1.71±1.29）D。（2）重点学校和民工子弟学校近视发生人群比例相比，χ2=4.433，差异有统计学意义（P＜0.05），近视眼只数发生比例，χ2=4.885，差异有统计学意义（P＜0.05）。2所学校近视眼屈光度对比差异，无统计学意义。（3）78.2%近视学生有父母一方或双方近视、较多的多媒体课程和电子产品使用、不良的用眼习惯、课外活动时间较少等。结论减少多媒体教学时间和电子产品使用、增加课外活动时间、家长和学校重视学生的用眼习惯和近视情况，可以减少近视眼的发生。     

A Taxonomic Review of Clostridium difficile Phages and Proposal of a Novel Genus, “Phimmp04likevirus”

Currently, only three phages that infect the medically important bacterium Clostridium difficile have been discussed by the International Committee of Viral Taxonomy (ICTV). They are all myoviruses, and have been assigned to the genus “phicd119likevirus”. An additional nine phages have since been described in the literature with their genome data available. The Phicd119likevirus is named after the type species: the myovirus ΦCD119 which was the first C. difficile phage to be sequenced. The two additional myoviruses, ϕCD27 and φC2, also fall into this genus based on the similarity of their genome and morphological characteristics. The other nine phages have not been assigned to this genus, and four of them do not fit the criteria for the current taxonomic grouping. We have applied protein clustering analysis to determine their phylogenetic relationships. From these results we propose an additional myoviridae genus, that we term “phiMMP04likevirus”.     

毛霉目病原真菌的实验室鉴定及体外抗真菌药物敏感 性分析

摘要:目的以分子测序为参考 ,评估形态学、基质辅助激光解吸电离飞行时间质谱对毛霉目真菌的鉴定能力,分析毛霉目真菌对两性霉素B、泊沙康唑的体外药敏特点。方法收集 2018年1月-2022年2月广东省人民医院25例毛霉病住院患者标 本,进行镜检并对培养的茵落行形态学鉴定、质谱鉴定、分子测序和体外药敏试验。结果KOH 湿片法阳性率(76%)高于革兰染色法(32%),差异有统计学意义(P<0.05);形态学鉴定可将68%的菌株鉴定到属水平,3株鉴定错误,2株无法鉴定;将所 有菌株进行质谱鉴定,单用IVD和RUO数据库鉴定率分别为56%和44%,两库联合可将鉴定率提高为64%。毛霉目真菌对两性霉素B的抑制50%菌株生长的最小抑菌浓度(MIC3o)为1μg/mL,根霉属相比其他属对两性霉素B表现出较高的MIC 值,其中2株MIC>32 μg/mL,另2株MIC为8 μg/mL;根霉属对泊沙康唑的MICso为0.5 μg/mL,横梗霉属MICgo为4 μg/ mL,小克银汉霉属MICg0为2 μg/mL,有部分菌株表现出较低MIC值,同样亦有部分菌株对泊沙康唑表现出较高的MIC 值。结论 将传统镜检、培养与质谱技术和分子技术相结合,尽量将毛霉目真菌准确鉴定到种,并积极开展毛霉体外药敏试验,可为临床治疗提供参考依据。     

重点肋骨内固定联合机械通气治疗连枷胸伴创伤性湿肺临床疗效

目的分析重点肋骨内固定联合机械通气治疗连枷胸伴创伤性湿肺的临床效果。 方法选取2014年1月至2015年10月江苏省新沂市人民医院胸心外科收治的连枷胸伴创伤性湿肺患者50例作为研究对象，其中男性35例，女性15例；年龄20~68岁，平均(43.40±2.40)岁。所有患者行重点肋骨内固定术并联合机械通气治疗，术后对比患者治疗前后动脉血气指标变化情况，并详细评估患者治疗前后疼痛和呼吸改善情况。 结果术后患者心率(P)、呼吸频率(RR)、收缩压(SBP)、舒张压(DBP)等体征指标及二氧化碳分压(PaCO₂)、动脉血氧分压(PaO₂)、酸碱度(PH)等动脉血气指标均优于术前(P<0.05)；术后所有患者经CT三维成像复查无二次撕裂或移动松脱并发症发生，内固定均牢固。术后疼痛评分及呼吸困难均明显改善。 结论重点肋骨内固定术联合机械通气治疗可改善患者的呼吸循环状况，加速促进患者的康复，值得临床推广使用。     

Current updates in management of Clostridium difficile infection in cancer patients

Background: Clostridium difficile infection (CDI) is a significant health burden, now recognized as the leading cause of acquired diarrhea in patients receiving antibiotic therapy. Complications of infection with this pathogen include severe diarrhea, causing electrolyte imbalances, dehydration, hemodynamic instability, toxic megacolon, shock, and death. Hence it is extremely paramount to stay updated on management options for this infection, especially in cancer patients.

Review: This article presents an in-depth review of literature on the treatment modalities available for CDI in cancer patients. Relevant articles highlighting therapeutic and symptomatic management of CDI patients with underlying malignancy have been summarized.

Conclusions: Despite the current options available, more studies are needed to assess the newer therapeutic options that are being employed for populations other than cancer patients.     

Empyema caused by Clostridium bifermentans: A case report

A case of pneumonia with associated empyema caused by Clostridium bifermentans is described. C bifermentans is an anaerobic, spore-forming, Gram-positive bacillus. This organism is infrequently reported as a cause of infection in humans, and older publications tended to regard it as nonpathogenic. However, in more recent reports, C bifermentans has been documented as a cause of septic arthritis, osteomyelitis, soft tissue infection, abdominal infections, brain abscess, bacteremia and endocarditis. The present case is the third reported case of empyema caused by C bifermentans, and it serves to further define the spectrum of illness due to this uncommon organism.