阴道分泌物对尿常规临床检验结果的影响分析及应对措施

目的探讨尿常规临床检验中阴道分泌物对检测结果的影响。方法选取2019年3月—2020年1月我院收治64例妇科疾病患者,随机均分为观察组及对照组,每组32例。给予对照组患者常规尿液收集,观察组患者采用试验法进行尿液收集,对比观察两组患者尿中红细胞、白细胞、上皮细胞及尿蛋白检出率以及尿糖、pH值及尿蛋白质值等指标。结果两组患者尿液中红细胞(χ²=4.010,P=0.045)、上皮细胞(χ²=4.730,P=0.030)、尿蛋白(χ²=4.010,P=0.045)检出率比较差异具有统计学意义(P<0.05),白细胞检出率比较(χ²=0.350,P=0.554)差异无统计学意义(P>0.05);两组尿糖(t=15.031,P=0.000)、蛋白质(t=7.334,P=0.000)、pH值(t=16.724,P=0.000)比较中差异具有统计学意义(P<0.05)。结论阴道分泌物会对尿常规检查结果产生影响,使用试验法进行尿液收集可有效去除阴道分泌物,减少对结果的干扰。     

Effects of Lactobacillus plantarum CJLP55 on Clinical Improvement,Skin Condition and Urine Bacterial Extracellular Vesicles in Patients with Acne Vulgaris: A Randomized,Double-Blind,Placebo-Controlled Study

Lactobacillus plantarum CJLP55 has anti-pathogenic bacterial and anti-inflammatory activities in vitro. We investigated the dietary effect of CJLP55 supplement in patients with acne vulgaris, a prevalent inflammatory skin condition. Subjects ingested CJLP55 or placebo (n = 14 per group) supplements for 12 weeks in this double-blind, placebo-controlled randomized study. Acne lesion count and grade, skin sebum, hydration, pH and surface lipids were assessed. Metagenomic DNA analysis was performed on urine extracellular vesicles (EV), which indirectly reflect systemic bacterial flora. Compared to the placebo supplement, CJLP55 supplement improved acne lesion count and grade, decreased sebum triglycerides (TG), and increased hydration and ceramide 2, the major ceramide species that maintains the epidermal lipid barrier for hydration. In addition, CJLP55 supplement decreased the prevalence of Proteobacteria and increased Firmicutes, which were correlated with decreased TG, the major skin surface lipid of sebum origin. CJLP55 supplement further decreased the Bacteroidetes:Firmicutes ratio, a relevant marker of bacterial dysbiosis. No differences in skin pH, other skin surface lipids or urine bacterial EV phylum were noted between CJLP55 and placebo supplements. Dietary Lactobacillus plantarum CJLP55 was beneficial to clinical state, skin sebum, and hydration and urine bacterial EV phylum flora in patients with acne vulgaris.     

全国细菌耐药监测网2014—2019年尿标本细菌耐药监测报告

目的探讨全国尿标本分离细菌菌种分布及耐药变迁。方法按照全国细菌耐药监测网(CARSS)技术方案,应用WHONET5.6软件对2014—2019年所有CARSS成员单位上报的尿标本分离细菌及药敏结果数据进行分析。结果男性患者尿标本分离细菌居前5位者分别为大肠埃希菌(33.1%~34.6%)、粪肠球菌(9.2%~10.2%)、肺炎克雷伯菌(9.0%~9.4%)、屎肠球菌(7.8%~10.2%)和铜绿假单胞菌(5.6%~6.9%),女性患者尿标本分离细菌居前5位者分别为大肠埃希菌(57.0%~57.4%)、肺炎克雷伯菌(7.5%~8.3%)、屎肠球菌(6.8%~8.7%)、粪肠球菌(5.5%~6.0%)和奇异变形杆菌(3.3%~3.5%)。男性和女性患者尿标本分离粪肠球菌对氨苄西林和呋喃妥因耐药率分别<12%和7%,对万古霉素耐药率<3%;屎肠球菌对氨苄西林、左氧氟沙星耐药率均为90%左右,对万古霉素耐药率<4%。大肠埃希菌对头孢曲松耐药率>47%,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、呋喃妥因耐药率≤8%,对于β-内酰胺类耐药率男性比女性高,其中头孢曲松的耐药率高12个百分点左右。男性患者分离肺炎克雷伯菌对头孢曲松耐药率为58%左右,女性患者耐药率为45%左右。男性和女性患者尿标本分离铜绿假单胞菌对头孢哌酮/舒巴坦和哌拉西林/他唑巴坦的耐药率均<14%,对碳青霉烯类耐药率为15%左右。鲍曼不动杆菌对头孢哌酮/舒巴坦和米诺环素耐药率分别<27%和22%,对碳青霉烯类耐药率,男性为31.7%~47.7%,女性为26.5%~41.2%。结论尿标本分离细菌在不同性别构成上有所不同,且部分肠杆菌目细菌耐药率不同性别间也有一定差异,不同年度间部分细菌的耐药率也有一定变化。尿标本分离细菌的耐药监测,可为尿路感染抗菌药物合理应用提供参考数据。     

湖南省2019年碘缺乏病监测结果分析

目的 分析2019年碘缺乏病监测结果,掌握干预措施实施效果,为适时采取针对性防治措施和科学调整干预策略提供依据。 方法 2019年4—5月全省122个县(市、区,简称县)按东、西、南、北、中划分5个抽样片区,在每个片区各随机抽取1个乡(镇、街道,简称乡);每个乡各抽取1所小学校,每所小学抽取8～10岁儿童40名,采集尿样和儿童家中食用盐样,检测尿碘和盐碘含量,采用B超法测量儿童甲状腺容积。每个县在所抽取的5个乡中各随机抽取20名孕妇,采集孕妇随机尿样和家中食用盐,检测尿碘含量和盐碘含量。 结果 共收集36 667份盐样进行定量检测,盐碘均数(26.32±5.69)mg/kg,变异系数21.61%,碘盐覆盖率为99.68%,合格碘盐食用率为95.24%。共检测儿童尿样24 450份,儿童尿碘中位数为231.1 μg/L,共检测孕妇尿样12 204份,孕妇尿碘中位数为186.5 μg/L,共检测8 224名8～10岁儿童甲状腺容积,甲状腺肿大率为0.79%。 结论 监测重点人群碘营养状况处于适宜水平,湖南省处于持续消除碘缺乏病状态。以食盐加碘防治碘缺乏病的干预措施成效显著,应继续针对重点人群加强健康宣教,号召因地制宜,科学补碘和按需补碘。     

毛细管区带电泳测定尿17-羟皮质类固醇

目的 :应用高效毛细管区带电泳 (CZE)技术分离和检测人尿内 1 7-羟类皮质类固醇 (1 7-OHCS) ,以解决微色谱柱 -分光光度测定尿 1 7-OHCS时 ,多酚类化合物对测定的干扰。方法 :标本用活性高岭土吸附尿内色素 ,以茶碱作内标 ,中性苯乙烯 -二乙烯苯树脂微色谱柱吸附尿中 1 7-OHCS。乙醇解吸附 ,采用毛细管区带电泳进一步分离并测定。结果 :运用CZE法分离了人尿 1 7-OHCS ,皮质醇浓度在 2～ 5 0mg .L- 1 范围内具有良好的线性关系 (r=0 .994) ,方法平均回收率 96 .1 7% ,日内及日间CV均小于 5 % ,最低检测限度为 0 .3mg .L- 1 。结论 :与微色谱柱 -分光光度法相比 ,CZE法检测尿内 1 7-OHCS无干扰 ,方法简便、快速、可靠。     

Discovery and Validation of a Urinary Exosome mRNA Signature for the Diagnosis of Human Kidney Transplant Rejection

BackgroundDeveloping a noninvasive clinical test to accurately diagnose kidney allograft rejection is critical to improve allograft outcomes. Urinary exosomes, tiny vesicles released into the urine that carry parent cells’ proteins and nucleic acids, reflect the biologic function of the parent cells within the kidney, including immune cells. Their stability in urine makes them a potentially powerful tool for liquid biopsy and a noninvasive diagnostic biomarker for kidney-transplant rejection.MethodsUsing 192 of 220 urine samples with matched biopsy samples from 175 patients who underwent a clinically indicated kidney-transplant biopsy, we isolated urinary exosomal mRNAs and developed rejection signatures on the basis of differential gene expression. We used crossvalidation to assess the performance of the signatures on multiple data subsets.ResultsAn exosomal mRNA signature discriminated between biopsy samples from patients with all-cause rejection and those with no rejection, yielding an area under the curve (AUC) of 0.93 (95% CI, 0.87 to 0.98), which is significantly better than the current standard of care (increase in eGFR AUC of 0.57; 95% CI, 0.49 to 0.65). The exosome-based signature’s negative predictive value was 93.3% and its positive predictive value was 86.2%. Using the same approach, we identified an additional gene signature that discriminated patients with T cell–mediated rejection from those with antibody-mediated rejection (with an AUC of 0.87; 95% CI, 0.76 to 0.97). This signature’s negative predictive value was 90.6% and its positive predictive value was 77.8%.ConclusionsOur findings show that mRNA signatures derived from urinary exosomes represent a powerful and noninvasive tool to screen for kidney allograft rejection. This finding has the potential to assist clinicians in therapeutic decision making.     

Value of preoperative urine white blood cell and nitrite in predicting postoperative infection following percutaneous nephrolithotomy: a meta-analysis

BackgroundTo evaluate to what degree preoperative urine white blood cell (WBC) and urine nitrite (NIT) values are predictive of postoperative infections following percutaneous nephrolithotomy (PCNL).MethodsA systematic literature search was performed of the PubMed, Embase, Cochrane Library, Wanfang Data, National Knowledge Infrastructure (CNKI), and China Science and Technology Journal Database (CSTJ or VIP) online databases to identify relevant studies that examined the predictive value of urine WBC or NIT as risk factors for post-PCNL infection, and the search was finished on February 28, 2020. Two independent reviewers screened the relevant studies, extracted necessary data from the eligible case-control studies (CCS), and assessed the quality of included studies through the Newcastle-Ottawa scale (NOS). RevMan 5.3 software and the Stata 16.0 software were used to complete the statistical analysis of data. Results are expressed as odds ratio (OR) with 95% confidence intervals (CIs).ResultsAccording to the statistical analysis of 12 eligible studies involving 6113 patients, positive urine WBC (WBC+: OR =3.86, 95% CI: 3.03–4.91, P<0.001) and positive NIT (NIT⁺: OR =7.81, 95% CI: 5.44–11.21, P<0.001) in preoperative tests were identified as independent risk factors for postoperative infections following PCNL.ConclusionsIn summary, as risk factors for postoperative infections, the presence of preoperative urine WBC+ and NIT+ should be evaluated as part of clinical procedure, in order to reduce infections of PCNL.     

Immunoaffinity chromatography for purification of Salbutamol and Clenbuterol followed screening and confirmation by ELISA and GC-MS

Screening and confirmatory methods for the determination of Salbutamol (SAL) and Clenbuterol (CL) in swine urine were established. The polyclonal antibody against SAL was prepared, which was used to develop the indirect competitive enzyme-linked immunosorbent assay (ELISA) with the limit of detection of 0.5 ng/ml, and to prepare the immunoaffinity chromatography column. The immunoaffinity column could extract and purify SAL and CL simultaneously, with a binding capacity of 400 ng for SAL and 416 ng for CL. After purification, the swine urine samples were screened by ELISA for the presence of SAL and/or CL, and the positive samples were further confirmed and quantified by gas chromatography-mass spectrometry (GC-MS). The results showed that 95% of the positive samples were confirmed by GC-MS with various levels of SAL (1.1-4.6 ng/ml) and/or CL (1.9-229.1 ng/ml) residues in the incurred samples, and all the negative samples were confirmed with no SAL and/or CL residues.