Self-narrative reconstruction after dilemma-focused therapy for depression: A comparison of good and poor outcome cases

Objective: The aim of this study is to improve the understanding of self-changes after an intervention for depression focused on implicative dilemmas, a type of cognitive conflict related to identity. As recent research has highlighted the relevance of identity-related dilemmas in clients with depression, we sought to assess the way in which clients resolve such inner conflicts after a tailored dilemma-focused intervention and how this is reflected in the clients’ self-narratives. Method: We used three instruments to observe differences between good (n?=?5) and poor (n?=?5) outcome cases: (i) the Repertory Grid Technique to track the resolution of dilemmas, (ii) the Change Interview to compile clients’ accounts of changes at posttreatment, and (iii) the Innovative Moments Coding System to examine the emergence of clients’ novelties at the Change Interview. Results: Groups did not differ in terms of the number and relevance of client-identified significantly helpful events. However, between-group differences were found for the resolution of dilemmas and for the proportion of high-level innovative moment (IM) types. Furthermore, a greater self-narrative reconstruction was associated with higher levels of symptom improvement. Conclusions: Good outcome cases seem to be associated with the resolution of conflicts and high-level IMs.     

氟尿嘧啶植入剂在原发性晚期上皮性卵巢癌术中的应用效果

目的 探讨氟尿嘧啶植入剂在原发性晚期上皮性卵巢癌（PAEOC）肿瘤细胞减灭术中的临床疗效。方法 回顾性分析安徽医科大学第一附属医院2007年6月至2012年12月收治并成功随访的162例PAEOC患者的临床资料，根据手术关腹前是否植入缓释氟脲嘧啶植入剂将患者分为试验组（术中腹腔植入缓释氟尿嘧啶600 mg）80例和对照组（术中未植入氟尿嘧啶植入剂）82例。观察两组患者的化疗副反应、术后并发症及生存率。结果 术后两组化疗副反应差异无统计学意义（P>0.05）；试验组与对照组近期生存率差异无统计学意义（χ²=2.865，P=0.091），而生存率的远期效应，试验组高于对照组，差异有统计学意义（χ²=4.911，P=0.027）。结论 术中植入氟尿嘧啶植入剂是一种安全、有效的腹腔局部化疗方法，可提高患者的远期生存率。     

儿童下呼吸道感染细菌分布及耐药性分析

目地了解本院儿童下呼吸道感染病原茸的分布及耐药情况，以指导临床舍理选用抗生素。方法将住院患儿的痰液、咽拭子进行细菌培养并鉴定，对培养阳性者应用K—B法进行药敏试验。结果送检标本467份，共分离出病原菌247株，阳性率为52．9％，其中以G-菌为主占68．4％，G＋菌占23．9％，真菌占7．7％。感染前5位的病原菌分别是大肠埃希氏菌、肺炎克雷伯氏菌、铜绿假单胞菌、金黄色葡萄球菌、真菌。药敏结果显示，G-菌对氨苄西林耐药率最高，肺炎克雷伯氏菌和大肠埃希氏菌产超广谱B内酰胺酶（ESBk）的比例较高，分别为53．2％和46．1％。G＋菌对大多数抗菌素耐药，对大环内酯类耐药率最高，金黄色葡萄球菌耐甲氧西林的分离率为29．2％。结论儿科下呼吸道感染病原菌主要为G-菌，且呈多重耐药性，G＋菌对大多数抗菌素耐药，临床应根据药敏结果，合理选用抗生素。     

Melanoma patient derived xenografts acquire distinct Vemurafenib resistance mechanisms

Variable clinical responses, tumor heterogeneity, and drug resistance reduce long-term survival outcomes for metastatic melanoma patients. To guide and accelerate drug development, we characterized tumor responses for five melanoma patient derived xenograft models treated with Vemurafenib. Three BRAF^V600E models showed acquired drug resistance, one BRAF^V600E model had a complete and durable response, and a BRAF^V600V model was expectedly unresponsive. In progressing tumors, a variety of resistance mechanisms to BRAF inhibition were uncovered, including mutant BRAF alternative splicing, NRAS mutation, COT (MAP3K8) overexpression, and increased mutant BRAF gene amplification and copy number. The resistance mechanisms among the patient derived xenograft models were similar to the resistance pathways identified in clinical specimens from patients progressing on BRAF inhibitor therapy. In addition, there was both inter- and intra-patient heterogeneity in resistance mechanisms, accompanied by heterogeneous pERK expression immunostaining profiles. MEK monotherapy of Vemurafenib-resistant tumors caused toxicity and acquired drug resistance. However, tumors were eradicated when Vemurafenib was combined the MEK inhibitor. The diversity of drug responses among the xenograft models; the distinct mechanisms of resistance; and the ability to overcome resistance by the addition of a MEK inhibitor provide a scheduling rationale for clinical trials of next-generation drug combinations.     

1183例泌尿生殖系统支原体检测及耐药性分析

目的了解该院泌尿生殖系统支原体感染及耐药情况。方法回顾性分析2012年1月至2015年12月1 183例患者支原体培养结果,并对体外药敏结果进行分析。结果 1 183例受检标本中有636例支原体培养呈阳性,阳性率为53.8%,男、女性标本的阳性率分别为26.3%和56.2%;其中解脲脲原体(Uu)感染、人型支原体(Mh)感染及两者混合感染的感染率分别为40.4%、1.2%和12.1%;67.8%的Uu感染者菌落计数≥104 cfu/mL,18.9%的Mh感染者菌落计数≥104 cfu/mL;药敏结果显示,支原体感染患者对原始霉素、交沙霉素、强力霉素和四环素具有较高的敏感性(98.3%、97.0%、92.5%、91.0%);对氧氟沙星和环丙沙星耐药性较高(65.1%,81.2%)。单一Uu感染患者对红霉素和克拉霉素具有一定的敏感性。结论本地区支原体感染率与以往比有所下降,但依然较高。耐药监测与以往无明显变化,临床应根据支原体培养及药敏结果合理用药。     

透明颤菌血红蛋白基因在龟裂链霉菌中的表达及其对土霉素合成的影响

目的 考察透明颤菌血红蛋白基因(vgb)在大肠埃希菌(E. coli)和龟裂链霉菌(S. rimosus)中的表达，研究在不同溶氧条件下表达的透明颤菌血红蛋白(VHb)对龟裂链霉菌生长和土霉素合成的影响。方法 将vgb插入表达型质粒pET-28a中，导入E. coli BL21(DE3)用以表达VHb并测定其活性。以整合型质粒pSET152为载体，利用ermE*启动子组成型表达vgb基因，将构建的质粒通过接合转移整合到S. rimosus M4018基因组上，利用CO差示光谱法和SDS-PAGE鉴定两个重组菌中的血红蛋白。在5L罐上考察不同溶氧条件下VHb的表达对重组龟裂链霉菌生长和土霉素合成的影响。结果 重组大肠埃希菌和重组龟裂链霉菌都能够表达具有生物活性的VHb，发酵结果表明，在117h时与对照菌相比，重组龟裂链霉菌在高氧和低氧条件下的干重分别提高了6%和32%，同时单位干重土霉素的产量分别提高了41%和93%。结论 VHb在重组龟裂链霉菌中成功表达，改善了菌体的生长和土霉素的合成，为解决工业发酵过程中氧限制问题提供了策略。     

Mutational effects of γ-rays and carbon ion beams on Arabidopsis seedlings

To assess the mutational effects of radiation on vigorously proliferating plant tissue, the mutation spectrum was analyzed with Arabidopsis seedlings using the plasmid-rescue method. Transgenic plants containing the Escherichia coli rpsL gene were irradiated with γ-rays and carbon ion beams (320-MeV ¹²C⁶⁺), and mutations in the rpsL gene were analyzed. Mutant frequency increased significantly following irradiation by γ-rays, but not by 320-MeV ¹²C⁶⁺. Mutation spectra showed that both radiations increased the frequency of frameshifts and other mutations, including deletions and insertions, but only γ-rays increased the frequency of total base substitutions. These results suggest that the type of DNA lesions which cause base substitutions were less often induced by 320-MeV ¹²C⁶⁺ than by γ-rays in Arabidopsis seedlings. Furthermore, γ-rays never increased the frequencies of G:C to T:A or A:T to C:G transversions, which are caused by oxidized guanine; 320-MeV ¹²C⁶⁺, however, produced a slight increase in both transversions. Instead, γ-rays produced a significant increase in the frequency of G:C to A:T transitions. These results suggest that 8-oxoguanine has little effect on mutagenesis in Arabidopsis cells.