Epidemiology and virulence gene expression of intracellular group A streptococci in tonsils of recurrently infected adults

Intracellularly persistent group A streptococci (GAS, Streptococcus pyogenes) have been associated with recurrent tonsillopharyngitis and antibiotic treatment failure. As a supplementation of the published in vitro data, conventional bacteriology and molecular epidemiology was performed on material from 29 adult patients of a German army hospital with anamnestic signs of recurrent tonsillopharyngitis. Pre-surgery tonsil swabs and the surgically removed tonsils were examined with respect to growth of aerobic bacteria in absence and presence of antibiotics with exclusively extracellular activity. Under such antibiotic selection, Staphylococcus aureus and GAS were cultured from specimens of 13 and 3 patients, respectively. In every material GAS-positive by culture methods, the intracellular location of the penicillin-susceptible GAS isolates was confirmed by immunohistologic examination of tonsillar sections using a GAS-specific IgG antibody. The three intracellular GAS isolates were typed by emm gene sequencing and could be associated to types M6 and M49 (two isolates). The bacteria were serially passaged on sheep blood agar, and semiquantitative mRNA analysis from virulence genes was performed using bacteria of the 4th and 25th passage after isolation. An M-type-specific pattern of virulence gene expression and different gene expression levels in relation to the passage number were observed.     

Substance P regulates natural killer cell interferon-gamma production and resistance to Pseudomonas aeruginosa infection

Studies have shown that after Pseudomonas aeruginosa (P. aeruginosa) corneal infection, BALB/c mice that are capable of resolving the disease, locally produce IFN-gamma. As T cells are not detected in the infected cornea of these mice, antibody depletion was used to test whether NK cells produce the cytokine. After depletion, decreased corneal IFN-gamma mRNA and increased disease severity, bacterial load, and PMN infiltrate resulted. Further work determined if substance P (SP), a pro-inflammatory neuropeptide, participated in regulation of this response. To this end, mice were treated with the SP antagonist, spantide I that blocks SP interaction with neurokinin-1, its major receptor. The treatment significantly decreased corneal IFN-gamma and IL-18 protein levels and corneal perforation resulted. In vitro experiments using isolated splenic NK cells confirmed their ability to respond to IL-18 and SP and to secrete IFN-gamma protein. We conclude: that for development of the BALB/c resistance response, NK cells are required to produce IFN-gamma; that the cells express the neurokinin-1 receptor; and that SP directly regulates IFN-gamma production through this receptor. The data suggest a unique link between the nervous system and development of innate immunity in the cornea.     

败血症弥散性血管内凝血时的白细胞溶血毒性的探讨

分别以凝血活酶和活大肠杆菌诱发家兔DIC,观察到活菌组血浆血红蛋白显著升高。同时WBC、MDA升高,而SOD活性显著下降。另分别以家兔贫白细胞血和富白细胞血与内毒素温育,结果前者溶血轻微,而后者溶血显著,且MDA升高。这表明感染致DIC时,内毒素等物质激活白细胞,可能通过自由基机制表现出溶血毒性。     

Recombinant Sendai viruses with L1618V mutation in their L polymerase protein establish persistent infection, but not temperature sensitivity

The Sendai virus pi strain (SeVpi) isolated from cells persistently infected with SeV shows mainly two phenotypes: (1) temperature sensitivity and (2) an ability of establishing persistent infection (steady state). Three amino acid substitutions are found in the Lpi protein and are located at aa 1088, 1618, and 1664. Recombinant SeV(Lpi) (rSeV(Lpi)) having all these substitutions is temperature sensitive and is capable of establishing persistent infection (steady state). rSeVs carrying the fragment containing L1618V show both phenotypes. rSeV(L1618V), in which leucine at aa 1618 is replaced with valine, has the ability of establishing persistent infection, but is not a temperature-sensitive mutant, indicating that the ability of a virus to establish persistent infection can be separated from temperature sensitivity. The amino acid change at 1618(L-->V) coexisting with aa 1169 threonine is required for acquirement of a temperature-sensitive phenotype. Three amino acid substitutions are also found in the Ppi protein, but rSeV(Ppi) does not show these phenotypes.     

血清KL-6水平与常见结缔组织病并发肺间质病变的关系研究

目的 了解血清涎液化糖链抗原(KL-6)在常见结缔组织病(CTD)并发肺间质病变(ILD)患者中的表达水平及其临床意义。方法 选取2021年4～11月蚌埠医学院第一附属医院收治的187例CTD患者为研究对象,按照结缔组织病有无肺间质病变分为结缔组织病并发肺间质病变(CTD-ILD)组116例,结缔组织病无肺间质病变(CTD-NILD)组71例;选取41例同期本院体检健康者为对照组。在CTD-ILD组中,根据肺高分辨CT(HRCT)表现分为急性组和慢性组;根据HRCT显示的ILD累及范围进行分级(1级,累及范围≤25%;2级,25%<累及范围≤50%;3级,50%<累及范围≤75%;4级,75%<累及范围≤100%);随后根据CTD-ILD患者是否合并有肺部感染分为有肺部感染组和无肺部感染组。采用乳胶凝集法测定血清KL-6水平,比较不同分组血清KL-6水平差异。结果 CTD-ILD组血清KL-6水平高于CTD-NILD组和对照组,差异有统计学意义(P<0.05)。CTD-ILD患者血清KL-6水平在急性组高于慢性组(P<0.05),在有肺部感染组和无肺部感染...     

Antigenemia,immunoblotting, and enzyme immunoassay for early diagnosis of cytomegalovirus infection in renal transplant patients

Timely and rapid diagnosis of cytomegalovirus (CMV) infection is important for the management of transplant patients. We compared three serological assays, IgM immunoblot and IgG/IgM enzyme immunoassay (EIA), as well as the detection of CMV antigens in polymorphonuclear blood leukocytes (antigenemia), for their value in the early diagnosis of CMV infection. Thirty-one patients were monitored longitudinally for 3 months after renal transplantation. Laboratory documented CMV infection occurred in 20 patients. All of these cases showed a positive IgM immunoblot result that was confirmed by at least one of the other test assays (IgG EIA 19/20, antigenemia assay 13/20, and IgM EIA 12/20). All of the ten patients whose clinical picture was compatible with symptomatic CMV disease were positive for CMV infection according to IgM immunoblot and IgG EIA, nine were positive according to the antigenemia assay, and seven were positive according to IgM EIA. With reference to the temporal pattern, the antigenemia assay indicated CMV infection significantly earlier than the serological tests (P0.05). In symptomatic patients CMV antigen-positive leukocytes were, on the average, detected on the day of onset of symptoms, whereas detection by IgM immunoblot, IgG EIA, and IgM EIA followed 8, 13, and 14 days later, respectively. These results show that: (1) the CMV antigenemia assay is very useful for the early diagnosis of symptomatic CMV infections; (2) CMV antibodies, as an indicator of CMV infection, are detectable earlier and more frequently by IgM immunoblot than by IgG/IgM EIA; (3) compared to CMV anti-genemia, the IgM immunoblot indicated CMV infection more often but significantly later; and (4) only a combination of several diagnostic methods allows optimal detection of CMV infections in renal transplant patients.     

Investigation of infection risk and the value of urine endotoxin during extrac orporeal shock wave lithotripsy

目的　探讨体外冲击波碎石 (ESWL)导致机体感染的可能性及测定尿液内毒素的价值和意义。方法　 16 4例上尿路结石病人分成 5组。A组 :4 8例肾结石病人 ,结石 1- 4枚 (直径均≤ 2cm)。B组 :2 4例肾结石病人 ,结石 1- 3枚 (直径均 >2cm)。C组 :2 2例肾结石病人 ,结石 1- 3枚 ,伴 1- 2枚输尿管结石。D组 :51例输尿管结石病人 ,结石 1- 3枚 (直径为 0 5- 1 2cm)。E组 :19例复杂性肾结石病人。除A组外均有不同程度尿流梗阻。ESWL治疗前均无尿路感染。所有患者ESWL治疗前后取血、尿作细菌培养及以鲎试验测内毒素浓度。结果　所有病人ESWL治疗前、后血液内毒素浓度均无显著性变化 ,血液细菌培养均为阴性。B、C和E组ESWL治疗后尿液内毒素均较治疗前显著性升高。A和D组ESWL治疗前后尿液内毒素浓度均无显著性改变。ESWL治疗后B、C和E组尿液细菌培养阳性率较A和D组显著升高 ,或非常显著升高。结论　直径≤ 2cm、对引流系统无明显影响的肾结石或直径 0 5- 1 2cm的输尿管结石 ,ESWL治疗导致泌尿系感染的可能性较小 ;但复杂性、直径 >2cm的肾结石、或肾结石伴输尿管结石 ,即使ESWL治疗前无菌尿症 ,ESWL导致泌尿系感染的可能性大 ,预防性使用抗生素是必要的。另外 ,尿液内毒素测定是诊断ESWL病人泌尿系是否感染的一个     

腹部切口裂开32例临床分析

[背景 ]探讨腹部手术切口裂开的防治 .[病例报告 ]3 2例腹部切口裂开的病人中恶性肿瘤病人 8例 ,肠梗阻病人 6例 ,消化道、阑尾穿孔病人各 4例 ;5例存在明显肠胀气 ,4例有明显切口感染 .[讨论 ]全身营养状态不良和局部因素是切口裂开的主要原因 .加强营养支持 ,注意提高缝合技术和增加组织抗张力的强度 ,避免危险因素和加强对危险因素的围手术期处理 ,可以有效减少腹部手术后切口裂开 ,提高手术成功率 .     

皮肤撕脱伤临床治疗的探讨(附34例报告)

目的：探讨皮肤撕脱伤的治疗方法,方法：通过34例不同皮肤撕脱伤临床资料分析,对其诊治方法进行了总结。结果：皮肤撕脱伤的治疗关键是创面的处理,治疗方法的选择。结论：在判断撕脱皮瓣血运基础上,最大限度地保留撕脱皮瓣,保持完整而健康的外覆盖组织,对后遗畸形的预防尤为重要。     

A clinical observation of early short-term use of potent antibiotics in severely burned patients

Objective: To evaluate the effect of early and short-term use of potent antibiotics following extensive severe burn injury. Methods: Seventeen severely burned patients hospitalized in the same period (Nov.,1998 to Oct., 2000) wer esame treatment in Group 2 (n=8) was discontinued until day 15 postburn. The survival rate, blood bacterial culture, body temperature and white blood cell and platelet counts were compared between the 2 groups. Results: All the 17 patients survived and all blood bacterial cultures were negative. No significant difference of body temperature and white blood cell and platelet counts between the 2 groups was observed (P＞0.05). Conclusion: Early use of high-potency antibiotics at short treatment course after extensive severe burn is effective to prevent infection and reduce the cost.