恩度治疗小细胞肺癌脑转移瘤瘤周水肿1例报告及文献复习

目的:探讨治疗脑转移瘤瘤周水肿的方法。方法:总结1例小细胞肺癌脑转移患者的临床资料及恩度治疗脑转移瘤瘤周水肿的效果，并对治疗脑水肿相关文献进行复习。结果:恩度抗血管生成治疗小细胞肺癌脑转移瘤瘤周水肿有很好的临床效果，能够控制脑水肿，减轻临床症状，提高生活质量。结论:恩度可以作为治疗脑转移瘤瘤周水肿的有效药物选择。     

IFN-γ enhances the anti-tumour immune response of dendritic cells against oral squamous cell carcinoma

Objective

To investigate the expression of antigen processing-1 (Tap-1) and Tapasin in oral squamous cell carcinoma (OSCC), and observe the immune response against OSCC by use of IFN-γ-antigen induced dendritic cells (DCs) in vitro and in vivo.

Design

Expression of Tap-1 and Tapasin in different cell lines was analysed. CAL27 cells were treated with IFN-γ. Antigen from the treated cells was presented by DCs. Pulsed DC was then co-cultivated with CD8+ T lymphocyte to induce antigen specific cytotoxic lymphocytes (CTLs). The immune response elicited by CTLs against OSCC was observed.

Results

A significant lower expression of Tap-1 and Tapasin was observed in OSCC cell lines. IFN-γ exerted time-dependent effect for increasing the expression of these genes. Antigen from the treated CAL27 cells was presented by DCs. CTLs were induced and generated a strong immune response in vitro and in vivo.

Conclusions

Tap-1 and Tapasin were downregulated in OSCC. IFN-γ increased the expression of these genes. Use of IFN-γ-antigen induced DCs could induce stronger immune response in vitro and in vivo.     

维持性血液透析合并菌血症患者病原菌分布及耐药性分析

目的探讨维持性血液透析（MHD）合并菌血症患者病原菌分布和细菌耐药情况。 方法回顾性分析2016年6月至2021年5月于南京医科大学第二附属医院肾脏病中心就诊的254例维持性血液透析合并菌血症患者的基本信息、病原菌种类以及药敏试验结果,使用SPSS 19.0软件进行分析,并对病原菌菌群变化采用Mann-Kendall趋势检验分析。 结果入组MHD合并菌血症患者中男性130例、女性124例,平均年龄为（64.0 ± 13.0）岁,合并糖尿病患者107例（42.1%）;肾脏基础疾病、血管通路类型和感染原发病灶分别以慢性肾小球肾炎[126例（49.6%）]、中心静脉导管[159例（62.6%）]和导管所致血流感染[121例（47.6%）]为主。入组患者累计分离出革兰阳性球菌175株（68.9%）、革兰阴性杆菌60株（23.6%）、真菌6株（2.4%）以及其他菌属13株（5.1%）。革兰阳性球菌群为本院MHD合并菌血症患者2016至2020年主要致病菌群,患病例数呈现显著的上升趋势（Z = 2.20、P = 0.03）;其中居前3位的依次为金黄色葡萄球菌[96株（54.9%）]、表皮葡萄球菌[32株（18.3%）]和人葡萄球菌[12株（6.9%）],对青霉素耐药率分别为90.6%（87/96）、100.0%（32/32）和100.0%（12/12）;而对万古霉素和利奈唑胺均无耐药。革兰阴性杆菌中检出前3位分别为肺炎克雷伯菌肺炎亚种[19株（31.7%）]、大肠埃希菌[13株（21.7%）]和铜绿假单胞菌[8株（13.3%）],对氨苄西林耐药率分别为94.7%（18/19）、84.6%（11/13）和75.0%（6/8）;肺炎克雷伯菌肺炎亚种对庆大霉素和妥布霉素耐药率较低,均为10.5%（2/19）,大肠埃希菌和铜绿假单胞菌对哌拉西林/他唑巴坦和亚胺培南均未见耐药。 结论维持性血液透析患者菌血症以革兰阳性球菌感染为主,部分临床经验用抗菌药物出现不同程度的耐药性,应加强对该人群的细菌耐药性监测。     

新型布尼亚病毒感染六例临床分析

近年来,我国多个省份相继报道了一些以发热伴血小板减少为主要临床表现的感染性疾病病例,其中少数重症患者因多脏器损害而救治无效死亡。早些年曾经认为是嗜吞噬细胞无形体所致人粒细胞无形体病,后在一些疑似人粒细胞无形体病病例的样本中发现了一种新型布尼亚病毒,所致疾病现称为发热伴血小板减少综合征。我院近年来收治了6例确诊为新型布尼亚病毒感染所致发热伴血小板减少综合征患者,为提高对该疾病临床特征的认识,现将其临床特征总结如下。     

自体骨髓干细胞移植治疗失代偿期肝硬化的护理体会

目的:探讨自体骨髓干细胞移植治疗失代偿期肝硬化的护理经验。方法:自体骨髓干细胞作为供体,在体外分离纯化后移植患者肝内,使损伤的肝功能得以恢复和重构,对20例患者实施有效的护理措施,增强了患者的自我保护能力,积极配合治疗。结果:20例患者未出现不良反应及并发症,围手术期成功率100%。结论:在自体骨髓干细胞移植治疗失代偿期肝硬化过程中,护士的充分准备、医护患间的良好沟通与配合以及健康教育和指导是自体骨髓干细胞移植得以顺利进行的重要保证。     

Genetic diversity of Alkhurma hemorrhagic fever virus in Western Asia

Alkhurma hemorrhagic fever, caused by Alkhurma hemorrhagic fever virus (ALKV), is an arboviral infection which is further expanding in tropical and subtropical regions of the Western Asia. A number of Alkhurma hemorrhagic fever virus (ALKV) strains have been isolated from clinical cases representing Saudi Arabia and Egypt; however, the phylogenetic relationship of these particular isolates to those reported previously elsewhere in the world remains elusive. Based on the analysis of the envelope (E), and non-structural gene (NS3 and NS5), the phylogenetic and PASC analysis revealed the circulation of three sub-lineages (I-III) suggesting a continuous evolution. Also, the comparative genome analysis revealed the envelope gene to be a reliable genetic marker to elucidate the molecular epidemiology and genetic diversity of discrete strains of ALKV.