耐甲氧西林金黄色葡萄球菌感染的流行病学调查、耐药性监测与预后因素分析

肥目的探讨耐甲氧西林金黄色葡萄球菌（MRSA）的流行分布和多药耐药趋势及预后相关因素，采取有效的医院管理措施。方法采用回顾性调查方法，VITEK-60全自动微生物分析系统进行细菌鉴定，K—B法做体外药敏试验，采用Logistic回归分析危险因素。结果445株金黄色葡萄球菌中MRSA检出率为46．96，其分离率有逐年增长的趋势（P〈0．05）；MR—SA检出率以老年痛科最高，其次重症监护病房，神经外科；药敏结果显示MRSA对万古霉素、利奈唑胺、替考拉宁全部敏感之外，对另外10种抗生素均不同程度耐药；多器官功能衰竭、住院时间长、长期大剂量使用广谱抗菌药物、机械通气、高龄、MRSA未清除、近期手术史是MRSA的独立危险因素，万古霉素、替考拉宁、利奈唑胺是MRSA感染的保护性因素。结论金黄色葡萄球菌耐药严重，MRSA的高检出率给临床治疗及控制医院感染带来较大困难；糖肽类抗菌药物可作为多药耐药金黄色葡萄球菌感染的首选抗菌药；MRSA感染的危险因素较多，尽早进行痛原学监测，及时发现、隔离和治疗对疾病预后有重要影响。     

Effect of Exercise on Taxane Chemotherapy–Induced Peripheral Neuropathy in Women With Breast Cancer: A Randomized Controlled Trial

BackgroundChemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting adverse effect of taxanes. We sought to evaluate the effect of exercise on taxane CIPN in women with breast cancer.Patients and MethodsWomen (n = 27) were randomized to immediate exercise (IE, during taxane chemotherapy) or delayed exercise (DE, after chemotherapy). Supervised aerobic, resistance, and balance training was offered 3 days a week for 8-12 weeks. CIPN symptoms and quality of life were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30 and CIPN20 (scored from 0 to 100). The percentage of participants reporting moderate to severe sensory symptoms (‘3/4’ or ‘4/4’ for CIPN20 sensory items) was also evaluated, along with clinical sensory testing at the lower limb (vibration sense and pinprick). Taxane treatment adherence, including relative dose intensity, was extracted from patient medical records. Assessments occurred at: baseline (before taxane chemotherapy), pre-cycle 4 (before the final taxane cycle), the end of chemotherapy, and follow-up (10-15 weeks after chemotherapy).ResultsNo differences in the EORTC QLQ CIPN20 symptom scores were detected between groups at any time point. At pre-cycle 4, there was a significant difference between groups in patient-reported moderate to severe numbness in the toes or feet (IE: n = 1, 9%, DE: n = 7, 50%, P = .04) and impaired vibration sense in the feet (IE: n = 2, 18%, DE: n = 10, 83%, P < .01). Overall global health status/quality of life was higher in IE compared to DE at the end of chemotherapy (P = .05), yet both groups had worse CIPN20 sensory (Δ24.3 ± 4.6, P < .01) and motor symptom scores (Δ10.5 ± 1.9, P < .01) relative to baseline. By the end of chemotherapy, no differences between groups were found for moderate to severe numbness in the toes or feet (P = 1.0) or impaired vibration sense in the feet (P = .71). More IE participants received ≥ 85% relative dose intensity (IE: n = 12, 100%, DE: n = 10, 67%, P < .05).ConclusionExercise may attenuate CIPN over the course of taxane chemotherapy and possibly improve taxane adherence in women with breast cancer. These findings, as well as whether exercise can attenuate CIPN by the end of taxane chemotherapy, should be confirmed in larger trials.     

“Mad Scared” versus “I Was Sad”: Emotional expression and response in urban adolescent males

Decades of masculinity research have concluded that society places higher demands on males to adhere to norms for low emotional expression; yet, countless studies find that emotional expression is integral to well-being. Unfortunately, this contradiction places boys and men in a tenuous position as they must navigate a bombardment of societal messages about the importance of emotional stoicism and invincibility. For urban adolescents, the situation is more complicated as they encounter environmental stressors that place greater emphasis on projecting a tough façade. Thus, our primary aim was to assess to what degree dyads of close adolescent male friends from urban, low-income neighborhoods are able to engage in emotional expression and response and to explore some of the underlying mechanisms and interpersonal processes. Qualitative findings from our sample suggest that urban boys exhibit a wide range of behaviors when participating in dyadic emotional disclosure and response, including being highly emotionally expressive and supportive in the context of close male friendship.     

Perspectives on phytoremediation of zinc pollution in air,water and soil

In this article, we discuss the phytoremediation of Zn pollution in the environment and the mechanism of plant resistance focusing on the mycorrhiza and subcellular mechanisms affecting metal binding and efflux in plants. Phytoremediation is a green low-cost technology that use plants to remove heavy metals (HMs) from soil. As part of this, it is necessary to consider the plant's tolerance to for example zinc (Zn) together with the plant's ability to accumulate and adapt to the specific local environment. During the process of restoring ecosystem contaminations, pH, organic matter, root exudates and microbial biomass affect the efficiency of phytoremediation while considering chemical modification, biosynthesis, microbial assistance and gene technology. However, obstacles remain in terms of for example chemical modifications that may cause either new pollution or disrupt the plant-microorganism symbiosis while other applications such as genetic engineering to change plant traits and function thereby improving heavy metal tolerance and absorption. The selection of gene fragments is complicated and requiring careful considerations due to environmental and human health side effects. Furthermore, using biochar may help to reduce the costs and increase the efficiency of plant phytoremediation. At the same time, there is an urgent need to combine nanotechnology and use of artificial chelating agents and plant hormones to screen the microbiome conducive to plant Zn absorption in order to improve the efficiency of phytoremediation.     

Effects of exercise on sleep among young women with Generalized Anxiety Disorder

Statement of the problemGeneralized Anxiety Disorder (GAD) and disturbed sleep are prevalent, debilitating, and frequently comorbid problems for which successful treatment remains limited. Exercise can promote sleep but whether it does among GAD patients is unknown.MethodsThirty sedentary women (18−37 y) with a primary DSM-IV diagnosis of GAD were randomized to six weeks of resistance (RET) or aerobic exercise training (AET), or waitlist (WL). RET and AET involved twice-weekly sessions of either lower-body weightlifting or leg cycling matched on multiple features of exercise. Outcomes included total sleep time (TST), lights out time, awakening out of bed time, time in bed (TIB), sleep onset latency (SOL), wakefulness after sleep onset, and sleep efficiency. Hedges' d effect sizes and 95% confidence intervals were calculated for each exercise condition compared to WL. Regression examined baseline associations between anxiety and sleep and associated change.ResultsTwenty-two of 26 participants reported poor baseline sleep (Pittsburgh Sleep Quality Index > 5). RET significantly decreased weekend TIB (d = −1.79; [−2.89,−0.70]) and SOL (d = −1.30; [−2.32,−0.28]), and significantly increased weekend sleep efficiency (d = 1.30; [0.29,2.32]). AET significantly reduced weekend TIB (d = −1.13; [−2.16,−0.11]) and SOL (d = −1.08; [−2.09,−0.06]). Reduced GAD clinical severity rating was significantly associated with improved weekend sleep efficiency among RET (t₆ = −3.48, p ≤ 0.013).ConclusionsShort-term exercise training improves sleep outcomes among GAD patients, especially for RET and weekend sleep. Findings suggest improved sleep may be associated with reduced clinical severity among GAD patients.     

耐多药结核病患者抑郁倾向相关因素研究进展

抑郁倾向是耐多药结核病患者现存的主要问题之一,对患者的治疗依从性、生命质量、精神和经济均有影响。严重的抑郁倾向会促使患者产生极端行为甚至走向自杀。作者对耐多药结核病患者抑郁倾向的相关因素及干预措施进行综述,从患者个人、家庭、社区、医院和国家多方面考虑,提出缓解患者心理负担、降低抑郁倾向的发展方向和建议。     

Effects of upper-body resistance exercise training on serum nesfatin-1 level,insulin resistance,and body composition in obese paraplegic men

Background

As a recently discovered adipokine, nesfatin-1 is conducive to insulin sensitivity, lipid profile, energy balance, and probably obesity.