600例肺炎支原体感染咽拭子培养结果的分析

目的 探讨肺炎支原体（MP）快速鉴定培养基在肺炎支原体感染鉴定中的临床价值.方法 采用肺炎支原体快速鉴定培养基对600例急性呼吸道感染患者的咽拭子标本进行肺炎支原体培养,并对结果进行统计学分析.结果 600例急性呼吸道感染患者的咽拭子标本肺炎支原体培养阳性148例,总阳性率为24.7％;男性阳性例数为76例,阳性率为25.3％,女性阳性例数为72例,阳性率为24.0％,男、女阳性率比较,差异无统计学意义（P＞0.05）.在各年龄组中,0～15岁组、16～35岁组、36 ～70岁组阳性例数分别为123例、16例、9例,阳性率分别为61.5％、8.0％、5.0％;0～15岁组阳性率与16～35岁组、36～70岁组组间比较,差异有统计学意义（P＜0.01）,16～35岁组与36～70岁组比较,差异无统计学意义（P＞0.05）.结论 肺炎支原体快速鉴定培养基检测结果准确、简便、快速,尤其对0～15岁患者检出阳性率高,可作为一般实验室诊断肺炎支原体感染的首选试验.     

儿童急性呼吸道感染血清IgM测定与分析

目的：探讨儿童急性呼吸道感染血清免疫球蛋白M(IgM)测定与分析。方法240例急性呼吸道感染患儿,以酶联免疫吸附测定ELISA方式对患儿血清中IgM抗体进行检测,并以患儿年龄、性别等为依据相应的统计分析。结果急性呼吸道感染病原体阳性检出率和患儿性别差异无统计学意义(P>0.05);而不同年龄组比较其肺炎支原体(Mp)、肺炎衣原体(Cpn)、呼吸道合胞病毒(RSV)指标差异有统计学意义(P<0.05),其中年龄<3岁的儿童其阳性率为31.3%,以RSV检出为主,其次为Mp;年龄>3岁的儿童其阳性率为44.8%,以Mp为主,其次为Cpn。结论血清中特异性IgM抗体监测可作为急性期感染的一项重要指标,其可为临床诊疗及合理用药提供有效的依据。     

泉州地区急性呼吸道感染儿童肺炎支原体抗体结果分析

目的 对福建泉州地区14岁以下儿童进行肺炎支原体的检测,探讨其在本地区的流行情况及规律.方法 回顾性分析2015年1-12月于本地区因急性呼吸道感染就诊的门诊及住院的14岁以下儿童血清标本1665份,采用间接免疫荧光法进行检测.结果 ①检出肺炎支原体阳性222份,阳性率为13.3%,男童与女童阳性率分别为13.9%、12.6%,差异无统计学意义(P>0.05).②四季阳性率分别为16.0%、9.7%、15.1%、11.7%,夏季与春季、秋季阳性率比较差异有统计学意义(P<0.05).③不同年龄段儿童对肺炎支原体的易感性不同,按<1岁(婴幼儿期)、1~2岁(幼儿期)、3~5岁(学龄前期)、6~14岁(学龄期)的阳性率分别为6.5%、10.7%、15.3%、20.8%,差异有统计学意义(P<0.05).结论 肺炎支原体在泉州地区全年散发,男女童无差异,有明显的季节性,发病高峰期为春秋季节,夏季最低,<1岁阶段阳性率最低,6~14岁学龄期儿童为高发人群,为本地区儿童急性呼吸道感染的防治提供了数据资料.     

合肥地区儿童呼吸道感染病原体情况分析

目的 了解合肥地区儿科就诊病人呼吸道感染病原体分布特征以及流行特点.方法 收集2018年9—12月安徽省立医院儿科就诊疑似呼吸道感染病人的呼吸道标本共257例,包括250份咽拭子和7份肺泡灌洗液.利用13种呼吸道病原体多重聚合酶链式反应(PCR)检测试剂盒对所有标本进行检测.结合临床诊疗资料,对多重PCR检测结果进行统计学分析.结果 257份标本总阳性率为66.1％(170/257),其中病毒阳性率为60.7％(156/257),以呼吸道合胞病毒(RSV)、鼻病毒(HRV)和腺病毒(ADV)为主,阳性率分别为31.5％(81/257)、17.5％(45/257)、5.1％(13/257);非典型病原体阳性率为8.2％,以肺炎支原体(MP)为主,阳性率为7.8％(20/257).23例标本检出2种及以上病原体,以呼吸道合胞病毒和鼻病毒同时感染较为常见.男性呼吸道感染病原体阳性率为67.81％(99/146),女性呼吸道感染病原体阳性率为63.96％(71/111),呼吸道病原体感染性别间阳性率差异无统计学意义(χ2=0.416,P=0.519).呼吸道合胞病毒感染多发生在1～2岁组儿童(χ2=16.562,P=0.001),各年龄组间阳性率依次为37.8％(34/90)、40.9％(36/88)、13.7％(7/51)、14.3％(4/28),其阳性率随着年龄的增长而降低.肺炎支原体感染多发生在6～15岁组儿童(χ2=34.346,P<0.001),各年龄组间阳性率依次为0.0％(0/90)、3.4％(3/88)、13.7％(7/51)、35.7％(10/28),其阳性率随年龄的增长而上升.结论 呼吸道合胞病毒、腺病毒、鼻病毒、肺炎支原体在儿童呼吸道感染病原体中较为常见,病原体感染在性别间不存在差异,呼吸道合胞病毒和肺炎支原体感染在年龄组间存在差异.     

256例肺炎支原体感染患儿咽拭子标本细菌培养结果及其耐药性分析

目的:分析肺炎支原体感染患儿咽拭子标本细菌培养结果及其对不同抗菌药物的耐药性。方法:抽取2018年5月—2019年5月间医院诊治的呼吸道感染患儿987例资料,分析其采集的咽拭子标本的细菌培养结果及其药敏试验结果。结果:987例呼吸道感染患儿咽拭子标本细菌培养结果中,256例患儿为肺炎支原体阳性,其阳性率为25.94%,其中不同性别肺炎支原体阳性患儿的阳性率经组间比较其差异无统计学意义(P>0.05);不同年龄段肺炎支原体阳性患儿中,≤1岁患儿肺炎支原体阳性率低于>6～12岁患儿经组间比较其差异有统计学意义(P<0.05);不同季节小儿肺炎支原体阳性率冬季高于春、夏、秋季(P<0.05);256例肺炎支原体培养阳性标本的患儿对米诺环素、莫西沙星治疗高度敏感疗效较好,而对罗红霉素、阿奇霉素、克拉霉素、克林霉素、交沙霉素治疗中度敏感,但是其对红霉素、乙酰螺旋霉素、环丙沙星高度耐药。结论:冬季为肺炎支原体感染高发季节,对肺炎支原体感染患儿应采集标本进行药敏试验,可为临床科学、合理用药提供参考依据;在充分考虑患儿生长发育需求、药物不良反应的前提下,可选用罗红霉素、阿奇霉素、克拉霉素、克林霉素作为经验性用药。     

某院2018年-2020年不同季节与不同年龄段患儿肺炎支原体感染的现状及其耐药性分析

目的:分析医院不同季节与不同年龄段患儿肺炎支原体感染的现状及其耐药性.方法:选取医院2018年1月-2020年12月收治的急性呼吸道感染患儿90例病历资料,统计其患儿接受咽拭子支原体检测及其药敏试验结果,分析其检测结果对不同抗菌药物的耐药、敏感特点.结果:90例患儿咽拭子中,支原体培养结果呈现阳性患儿78例,其感染率为86.67％;女性患儿感染率(37.18％)高于男性患儿(62.82％,P＜0.05);冬季感染率明显高于春、夏、秋季(P＜ 0.05);上下呼吸道的感染率无明显差异(P＞0.05);10～14岁年龄段患儿支原体阳性率高于其他年龄段患儿(P＜0.05);药敏结果发现肺炎支原体对罗红霉素、克拉霉素、红霉素的耐药率分别为38.46％、42.31％和35.90％,而对阿奇霉素的耐药率仅为8.97％.结论:急性呼吸道支原体感染患儿以女性为主,易在冬季发病,且肺炎支原体检测阳性率随着患儿年龄的增长而发生率逐渐上升,肺炎支原体对罗红霉素、克拉霉素、红霉素均具有较高的耐药率,而阿奇霉素的耐药率相对较低,临床应根据药敏结果合理选用抗菌药物治疗.     

不同检测方法对肺炎支原体感染患儿检测阳性率的影响及其对策

目的:探究和比较不同检测方法(微生物快速培养鉴定、快速血清学)对肺炎支原体感染患者肺炎支原体检测阳性率的影响及其对策。方法:选取2018年10月—2019年4月间收治的肺炎支原体感染患儿90例资料,按照检验方法的不同将其分为对照组和观察组患者,每组45例;对照组患者肺炎支原体检测采用快速血清学检验法,而观察组患者肺炎支原体检测则采用微生物快速培养检测法,比较两组患儿不同检测法的阳性检出率、不同年龄段检测阳性率和不同病程检测阳性率的差异。结果:观察组患者阳性检出率为86.67%高于对照组为62.22%(P<0.05),<2岁患儿阳性检出率为94.74%高于对照组为50.00%(P<0.05),>5岁患儿阳性检出率低于对照组(P<0.05);观察组患者病程<7 d患儿阳性检出率为93.33%高于对照组(P<0.05),≥7 d患儿阳性检出率略高于对照组(P>0.05)。结论:采用微生物快速培养鉴定法检测肺炎支原体感染的检测阳性率高于快速血清学检验法,可将其作为鉴定肺炎支原体感染的检测手段。     

某市4908例呼吸道感染儿童肺炎支原体抗体检测结果的分析

目的了解本地区呼吸道感染儿童中肺炎支原体的感染情况。方法对2015年7月至2016年7月一年内就诊的4908例呼吸道感染儿童采用被动凝集发进行血清肺炎支原体抗体的检测,并对结果进行分析。结果在4908例感染儿童中,共检出肺炎支原体阳性2757例,阳性率56.17%,男童阳性例为2886例,阳性率51.11%,女童阳性例为2022例,阳性率63.40%,各个年龄组阳性例为:≤1岁组1649例,1～4岁组2107例,4～7岁组765例,7～14岁组387例,冬春季节阳性率较高,分别为64.44%和54.17%,与夏秋两季差异有统计学意义(P<0.01)。结论厦门地区儿童呼吸道感染患者中肺炎支原体的感染率较高,全年均可发病,并以冬春季节为高发,随着年龄增高,MP感染率越高,高发年龄段在7～14岁。     

秋冬季小儿呼吸道感染的病原学检测及其分布特点分析

目的对秋冬季小儿呼吸道感染的非细菌性病原学检测并对其分布特点进行分析,为临床针对性治疗提供参考依据。方法随机选取广州市妇女儿童医疗中心呼吸道感染患儿共1047例,并对其呼吸道分泌物和血清学进行病原学检查,对结果进行统计分析。结果在1047例患儿血清病原学检查中,单项感染326例,阳性率为31.14%,混合感染202例,阳性率为19.29%,单项感染比例明显高于多项感染(P0.05);在326例单项感染的患儿中,MP具有最高的阳性检测率,为18.05%,其次为RSV(3.25%)、ADV(3.25%)、INFB(2.96%);在202例混合感染中,MP+INBF具有最高的阳性率,为10.32%,其次为MP+LP(2.77%),MP+LP+INBF(2.01%),MP+ADV(0.96%);6~12个月的患儿的阳性率(52.36%)明显高于3~6个月患儿(P0.05),1~3周岁患儿的阳性率(85.45%)明显高于3~6个月患儿和6~12个月患儿(P0.05)。在1047例患儿中经咽拭子病原学检查发现,阳性患者为476例,阳性检出率为45.46%。其中RSV具有最高的阳性检测率,为19.87%,构成比为0.44,其次为RHV、RBOV、ADV;发现6~12个月的患儿的阳性率(48.21%)和构成比(0.40)均明显高于3~6个月患儿(P0.05),1~3周岁患儿的阳性率(75.45%)和构成比(0.52)均明显高于3~6个月患儿和6~12个月患儿(P0.05)。结论秋冬季我院呼吸道感染患儿以呼吸道合胞病毒、肺炎支原体感染为主,1~3岁患儿具有更高的阳性率。     

婴幼儿肺炎支原体肺炎的临床特征分析

目的探讨小儿肺炎支原体感染的临床特征。方法随机对门急诊患急性上呼吸道感染的200例小儿取咽拭子做肺炎支原体培养,以60例健康小儿为对照组。结果观察组咽拭子肺炎支原体阳性率31%,明显高于对照组的8.3%(P<0.05),婴儿组阳性率明显低于l岁以上各年龄组(P<0.05);肺炎支原体阳性患儿与阴性患儿的相比,咳嗽、扁桃体红肿的比例高(P<0.05),发热、卡他症状、胃肠道症状、疱疹、皮疹等症状体征少(P<0.05);16.12%的阳性患儿发展为肺炎,明显高于阴性组(P<0.05)。结论肺炎支原体小儿急性上呼吸道感染的主要病原体之一,临床表现不典型,早期诊断困难。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.