2017年安徽省某三甲医院细菌耐药性监测

目的 了解铜陵市人民医院2017年临床分离细菌对抗菌药物的耐药状况。方法 对2017年1-12月临床分离菌采用纸片扩散法(KB)进行药敏试验，按CLSI 2017年版标准判读药敏试验结果，采用WHONET 5.6软件进行数据分析。结果 临床分离细菌共3436株，其中革兰阳性菌719株，占20.9%；革兰阴性菌2717株，占79.1%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为23.8%和72.3%，耐甲氧西林株对β-内酰胺类抗生素和其他测试抗菌药物的耐药率显著高于甲氧西林敏感株，未发现对万古霉素和替考拉宁耐药的葡萄球菌。粪肠球菌对青霉素、氨苄西林和呋喃妥因的耐药率较低，屎肠球菌对氯霉素的耐药率较低，5.3%屎肠球菌对万古霉素耐药。大肠埃希菌、克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)和奇异变形菌中ESBLs的检出率分别为41.4%、50.7%和19.4%。肠杆菌科细菌中克雷伯菌属和沙雷菌属对碳青霉烯类抗生素耐药率较高，分别为37.5%和36.0%，其他菌属的耐药率低于3%。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别80.3%和79.1%；铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为29.7%和28.4%。肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌中广泛耐药株的检出率分别为31.3%(171/546)、0.6%(3/508)和0.7%(3/416)。结论 本院革兰阴性菌呈增多趋势，尤其广泛耐药的肺炎克雷伯菌应引起高度关注，做好细菌耐药性监测，加强临床抗菌药物的合理使用和医院感染控制。     

Detrended fluctuation analysis detects altered coordination of running gait in athletes following a heavy period of training

Objectives

To investigate whether functional overreaching affects locomotor system behaviour when running at fixed relative intensities and if any effects were associated with changes in running performance.

压电基因传感器阵列检测MRSA的实验研究

目的：探讨以压电传感阵列技术检测耐甲氧西林葡萄球菌的可行性。方法：收集临床64株葡萄球菌标本，对其耐药标志基因mecA基因和金黄色葡萄球菌特有基因femA增后应用压电传感器阵列进行检测，并以PCR电泳检测作参照，与目前采用的常规药物敏感试验进行对比分析。结果：传感器分析与PCR电泳分析结果完全一致，而此两种方法与常规培养加药敏法比较。结果略有差异。所有64株葡萄球菌中，2株耐甲氧西林金黄色葡萄球菌（MRSA）的mecA为阴性，2株甲氧西林敏感金黄色葡萄球菌（MSSA)的mecA为阳性，1株耐甲氧西林凝固酶性葡萄球菌（MRCNS）的mecA为阴性；2株甲氧西林敏感凝固酶阴性葡萄球菌（MSCNS）的mecA为阳性。结论：以压电传感阵列技术同时检测femA基因和mecA基因，既可鉴定出是否为金黄色葡萄球菌，又可判断其耐药类型，能为危重病人感染MRSA时的诊断和治疗提供依据。     

Chronic fatigue of the small enterprise workers participating in an occupational health checkup center in southern Taiwan

Purpose  There has been increasing interest in the occupational health of workers in small enterprises, especially in developing countries. This study examines the association between psychosocial job characteristics and fatigue, and attempts to identify risk factors for fatigue among workers of small enterprises in southern Taiwan. Methods  A structured questionnaire was administered to workers receiving regular health examinations between August 2005 and January 2006. The questionnaire collected demographic information and data on working conditions, personal health status and life styles. It also collected information on psychosocial job characteristics, fatigue and psychological distress using three instruments. Results  A total of 647 workers with mean age of 43.7 were completed. Probable fatigue was found in 34.6% of the sample. Fatigue was found by multiple logistic regressions to be associated with the lack of exercise, working in shifts, depression score and lack of social support at workplace. Conclusions  This study found associations between life style, psychosocial job characteristics and fatigue. Because the high prevalence of probable fatigue was found in such small enterprises, the authors suggest that a short interview with some quick questionnaires in health checkup for these small enterprise workers are helpful to early detect psychosocial and fatigue problems.     

薄壁构件的高温低周疲劳寿命的预测与验证

提出了文题的计算模型,它采用非线性弹塑性蠕变有限元法,计算构件危险点在高温及周期保载的交变载荷谱作用下的应力应变响应,以应变范围区分法累积损伤,从而求出构件的疲劳寿命,并以带孔矩形薄板为例作了计算与验证,结果吻合较好,可供工程应用。     

ALP方案治疗86例耐多药结核病的疗效分析

目的通过对耐多药结核病例化疗疗效的分析,探讨MDR-TB的治疗方法.方法 86例住院的MDR-TB病人中,浸润型肺结核72例,慢性纤维空洞型肺结核14例.痰标本经Bactec-960培养、鉴定均有结核杆菌生长,药敏试验耐异烟肼、利福平(HR)26例,耐异烟肼、利福平、链霉素(HRS)及耐异烟肼、利福平、乙胺丁醇(HER)者38例,耐异烟肼、利福平、链霉素、乙胺丁醇(HRSE)22例.应用丁胺卡那霉素(A)、左旋氧氟沙星(L)及对氨基水杨酸钠(P)为基础化疗方案,加用1～2种未曾应用过的抗痨药物,平均治疗3个月.结果 86例病人痰菌阴转率70.9%,病灶吸收好转率77.9%,空洞治疗有效率58.3%.疗效较好,治疗过程中未出现严重的药物不良反应.结论 ALP组成的化疗方案对细胞内外的结核菌都有杀灭作用,三药联用协同作用好,副作用不多,是治疗MDR-TB的较好的化疗方案.     

Isolation and characterization of a monoclonal anti-P30 antibody resistant mutant of Toxoplasma gondii

Of the possible iodine-labelled Toxoplasma gondii surface proteins, P30 (apparent Mr 30,000) is the principal one recognized by acute and convalescent anti-toxoplasma sera. This protein which comprises from 3 to 5% of the total parasite protein was used to raise a panel of parasiticidal monoclonal anti-P30 antibodies. One of these monoclonal antibodies was able to select a resistant mutant from a large population of chemically mutagenized wild-type P strain parasites. This mutant retained the wild type sensitivity to other non-P30 parasiticidal monoclonal antibodies as well as polyclonal anti-P30 rabbit sera. Analysis of surface radioiodinated wild type and mutant parasites showed that the mutant had a quantitative reduction in the amount of P30. A comparison of surface biotin labelled wild type and resistant parasites by two dimensional electrophoresis showed that the mutant lacked one and possibly two of several proteins that make up wild type P30. Western blot analysis indicated that the mutant was devoid of antigenically reactive P30. These findings further support the hypothesis that antigenic variants of T. gondii can be induced and may involve the major surface membrane antigens of the parasite.