WR-1065对不同辐射敏感性人肿瘤细胞的保护作用

目的 :研究抗辐射药 WR- 10 6 5对两种不同辐射敏感性的人恶性胶质瘤细胞系的辐射防护作用。方法 :M0 5 9J和 M0 5 9K恶性胶质瘤细胞系来源于同一肿瘤标本的不同部位 ,M0 5 9J和啮齿类 xrs5突变体细胞为辐射敏感型及双链断裂 (DSB)修复缺陷型细胞 ,而 M0 5 9K和野生型 CHO- K1细胞为抗辐射型细胞。 M0 5 9J和 M0 5 9K细胞在 DMEM/ F12培养基中培养 ,当细胞达到 80 %～ 90 %汇合时分瓶 ,每瓶重新接种 3× 10 5 细胞。两种细胞在Mc Coy′s 5 A培养基中培养 ,当细胞达到 80 %～ 90 %汇合时 ,再分瓶 ,每瓶重新接种 2× 10 6 细胞。…     

抗生素相关性腹泻患者艰难梭菌的鉴定和敏感药物治疗

目的　鉴定所致抗生素相关性腹泻的艰难梭菌并用敏感药物进行治疗。方法　新鲜粪便标本在厌氧条件下进行细菌分离鉴定 ,可疑菌经小鼠毒素致死试验。用K -B法进行药敏试验并用敏感药物进行治疗。结果　 11例腹泻患者检出艰难梭菌 ,其检出率为 2 .9%。该菌对庆大霉素、氟哌酸、黄连素、痢特灵耐药各 11株 (10 0 % ) ,对甲硝唑、万石霉素、杆菌肽敏感各 11株 (10 0 % )。用敏感药物经 2周治疗 ,11例患者全部治愈。结论　细菌鉴定和药敏试验比较实用 ,对临床选择合理治疗药物提供依据。     

氯霉素治疗伤寒、副伤寒162例

目前 ,由于伤寒耐药菌株大量出现 ,其用药选择较为棘手。 1998～ 2 0 0 0年 ,我们共收治经培养证实为伤寒、副伤寒 16 2例 ,药敏示对氯霉素敏感 ,故采用以氯霉素为主的联合抗菌治疗 ,效果较好。1　临床资料1 1　一般情况　 16 2例均为散发病病例 ,男 114例 ,女 4 8例 ;年龄 2 5 4± 4 8岁。实验室检查 :(1)白细胞正常 133例 (82 1% ) ,<4× 10 9/Ｌ者 2 6例(16 0 % ) ,>10× 10 9/Ｌ者 3例 (1 9% ) ,嗜酸性粒细胞下降或消失共 15 5例 (95 9% ) ;(2 )肥达试验阳性 15 7例 ,Ｈ在 1∶16 0以上 ,Ｏ在 1∶80以上 ;(3)伤寒、副伤寒杆菌培养及…     

温度和二甲亚砜对放射诱导哺乳动物DNA双链断裂的影响

目的 :研究放射引起人乳腺癌细胞株 (MCF- 7)和完整细胞的染色体 DNA双链断裂 (DSB)时 ,亚生理辐射温度 (2℃～ 2 8℃ )的效应和自由基清除剂二甲亚砜 (DMSO)的影响 ,以及细胞在 2℃或 37℃照射后 DSB的重接。方法 :1MCF- 7细胞用含 10 %胎牛血清的 EME培养液于 37℃、5 % CO2 培养 ,传 12～ 2 0代后用 1 4 C胸腺嘧啶核苷(1k Bq/ m L )标记 DNA 7d;2染色体 DNA制备 :制细胞数为0 .5× 10 6 / m L～ 1.0× 10 6 / m L的琼脂糖凝胶块 ,EDTA- NL S-蛋白酶 K缓冲液于 37℃裂解凝胶块中的细胞 48h,冷藏10 d;3染色体 DNA照射 :…     

激光削除表皮瘢痕在医疗美容中的应用探讨

资料 :本组共 13例 17块瘢痕 ,男性 10例 13块 ,女性 3例 4块 ;年龄 17～ 5 5岁 ,病程 2～ 30年。病变大小 1 0ｃｍ×0 7ｃｍ× 1 0ｃｍ～ 8 0ｃｍ× 2 0ｃｍ× 1 2ｃｍ。全部病例经病理检查确诊。方法 :(1)对皮肤瘢痕小于 7 0ｃｍ× 2 0ｃｍ者 ,应用功率为 18Ｗ的ＣＯ2 激光 ,根据病变情况采用清扫法或切削法治疗。 (2 )对不突出皮肤表面的病变 ,由表层开始逐层向深部扫描照射 ,将病变烧灼干净 ,直达健康组织为止 ,切勿达真皮以下 ,以免引起新的瘢痕。结果 :随访 3个月至 8年 ,治愈 12块病损 ,治愈率 71% ;显效 5块 ,显效率 2 9%。激光…     

103Pd放射性支架持续照射犬胆管的放射性损伤的实验研究

目的　寻找动物胆管金属内支架植入方法 ,观察动物胆管植入1 0 3 Pd放射性支架 ,胆管腔内照射的放射性损伤。方法　实验动物为雄性健康杂种犬 ,体重 1 5～ 2 0kg。麻醉下经手术植入1 0 3 Pd放射性金属支架于犬的胆管腔内 ,1 0 3 Pd的放射性活度分别为 1 2 5× 1 0 4kBq、1 6 6× 1 0 4kBq、2 2 2× 1 0 4kBq、2 5 9× 1 0 4kBq、2 9 6× 1 0 4kBq和 3 7× 1 0 5kBq ,植入后 30d取出1 0 3 Pd放射性金属支架和胆管 ,后者经组织切片HE染色 ,光镜下进行放射性损伤的评价。结果　放射性活度为 1 2 5× 1 0 4kBq ,光镜下可观察到黏膜损伤 ;放射性活度为 2 2 2× 1 0 4kBq时胆管放射性损伤达肌层 ;放射性活度为3 7× 1 0 5kBq时放射性损伤达胆管壁外膜 ,出现胆管穿孔。根据不同放射性活度照射后 ,胆管的放射性损伤的放射性活度效应曲线得出 ,ED50 为 2 8 2× 1 0 4kBq。结论　1 0 3 Pd金属支架胆管腔内近距离照射有明显的剂量 效应关系 ,为该放射性支架应用于临床治疗胆管良、恶性狭窄提供重要的实验依据     

高渗糖外用治疗慢性创面46例疗效观察

1　临床资料1 1　一般资料　本组病人 46例 ,男 2 9例 ,女 17例 ,年龄2 1～ 5 0岁 ,2处以上创面 2例。对照组 42例 ,男 2 2例 ,女2 0例 ,年龄 2 0～ 48岁 ,2处以上创面 1例。 2组病人均为外伤所致的四肢小创面 ,无糖尿病史。受伤距换药时间2 5～ 6 8ｄ。创面共同特点是呈灰褐色伴有少量炎性渗出 ,皮肤周围红肿明显。治疗前对病人创面评估情况见表 1。表 1　治疗前创面评估情况组别ｎ创面评估结果创面数 (处 )深度 (ｃｍ)范围 (ｃｍ×ｃｍ)治疗组 465 3 0 .3～ 2 .0 0 .5× 1.0～ 5× 10对照组 42 45 0 .3× 2 .2 0 .5× 1.0～ 3× 101 2　换…     

乳酸左氧氟沙星引起一过性白细胞减少1例

患者 ,男 ,48岁。因“发热、咳嗽伴胸闷 3ｄ“疑支气管炎” ,于 2 0 0 0年 3月 13日在我门诊部就诊。实验室检查 :白细胞总数 10 .3× 10 9/Ｌ ,中性粒细胞 84% ,淋巴细胞16 %。给乳酸左氧氟沙星 0 .2 /ｄ ,静滴 ,连用 3ｄ。白细胞数 2 9× 10 9/Ｌ ,中性粒细胞 30 % ,即停药。 2 4ｈ复查 ,白细胞 4.0× 10 9/Ｌ中性粒细胞 6 3 % ,淋巴细胞 37%。 48ｈ后白细胞 5 .4× 10 9/Ｌ ,中性粒细胞 73 % ,淋巴细胞 2 7%。以后连续复查 3次均正常。讨论　本例白细胞减少 ,发生在乳酸左氧氟沙星静滴过程中 ,停药后白细胞计数逐渐升高 ,1～ 2ｄ恢复正常…     

高效液相色谱法测定异维倍克气雾剂中丙酸倍氯米松含量

目的　建立高效液相色谱法测定异维倍克气雾剂中丙酸倍氯米松含量的方法。方法　IntersilC18色谱柱 (4 .6mmID×2 5 0mm ,5 μm) ;流动相 :乙腈 -水 (6 7∶33) ;流速 :1.5ml/min ,检测波长 :2 39nm。 结果　丙酸倍氯米松的理论板数为 5 6 0 0 ,回归方程Y =2 .2 6 7× 10 6X - 0 .3435 ,r=0 .9999,线性范围 4 7.6 0～ 2 38.0 μg·ml-1,平均回收率为 10 0 .1% ,RSD1.2 %。最低检出浓度约为 0 .1μg·ml-1。结论　该法操作简便 ,结果准确 ,可用于测定异维倍克气雾剂中丙酸倍氯米松的含量。     

军训致外伤性睾丸积液10例

自 1 990年 3月～ 2 0 0 0年 4月 ,我科共收治因军训致外伤性睾丸积液 1 0例 ,经穿刺抽液治疗 ,均取得良好效果 ,现报告如下。1　资料和方法1 1　临床资料　本组 1 0例均为军人 ,1～ 2ａ军龄 6例 ,3～ 4ａ 2例 ,5ａ以上 2例 ,年龄 1 8～ 3 6岁 ,均有因军训而致睾丸外伤史。其中踢伤 6例 ,骑跨伤 4例 ,均为单侧 ,合并阴囊积血 4例。伤后入院时间 2ｈ～ 2周 ,入院查体患侧睾丸均明显增大 ,体积约 7 0ｃｍ× 5 0ｃｍ× 4 5ｃｍ～ 6 0ｃｍ× 4 5ｃｍ× 4 5ｃｍ触之坚硬 ,触痛明显 ,副睾不能明显触及 ,活动时坠痛明显 ,伤后 3ｄ内住院患者 ,先…     

Management of postirradiation infection: lessons learned from animal models

Ionizing radiation depresses host defenses and enhances susceptibility to local and systemic infection due to endogenous or exogenous microorganisms. Exposure of mice to a lethal dose of ionizing 60Co-gamma radiation induces a dose-related reduction in the number of both aerobic and anaerobic bacteria from 10(10-12) to 10(4-6) per gram of stool within 4 days. The number of anaerobic bacteria stays low, but the number of Enterobacteriaceae per gram of stool increases significantly up to 10(9) by the 12th day after irradiation. This increase is associated with bacterial translocation of these organisms and fatal bacteremia. The use of quinolones in the irradiated animals was effective in controlling systemic endogenous Gram-negative infection after irradiation. Supplementation with penicillin prevented treatment failures due to Streptococcus spp. and increased survival. Quinolones given for 21 days also were effective in management of systemic exogenous infections due to orally ingested Klebsiella pneumoniae and Pseudomonas aeruginosa. Effectiveness of quinolones may be attributed to inhibition of exogenous organism growth within the gut lumen while preserving the anaerobic gut flora as well as their systemic antibacterial activity. Based on these findings, antimicrobial agents recommended for therapy of infection after exposure to irradiation are: ciprofloxacin, levofloxacin, ceftriaxone, cefepime, gentamicin +/- amoxicillin, or vancomycin.     

急性重症脑卒中患者并发院内获得性肺炎的病原菌分布及耐药性分析

目的了解医院急性重症脑卒中患者并发院内获得性肺炎（hospital acquived peneumonia,HAP）的病原菌分布及耐药性,以指导临床抗生素的合理使用。方法回顾分析湖北省武汉市第一医院神经内科重症监护病房自2011年1月—2012年5月收治的225例急性重症脑卒中并发HAP患者的临床资料。结果在225例患者中分离出11种共121株致病菌,其中以革兰阴性杆菌为主,占68.60%,主要为铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌等;革兰阳性菌占29.75%,主要为金黄色葡萄球菌;真菌占1.65%,为白假丝酵母菌。鲍曼不动杆菌和铜绿假单胞菌的耐药率高,对碳青霉烯类抗生素已分别产生了78.4%、83.3%的耐药率,而大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗生素保持了100%的敏感性,金黄色葡萄球菌对青霉素类抗生素的耐药率达90%以上,但尚未发现对万古霉素的耐药菌株。结论急性重症脑卒中患者并发HAP的主要致病菌为革兰阴性菌。这些主要致病菌多为条件致病菌,且都有很强的耐药性。因此临床上应结合药敏试验科学合理用药,神经内科重症监护病房加强监测与控制,以期快速治愈患者。     

Cell Population Kinetics of the Rhabdomyosarcoma R1H of the Rat after Single Doses of X-rays

Summary

The kinetics of depopulation and repopulation of the solid transplantable rhabdomyosarcoma R1H of the rat following local irradiation with single subcurative X-ray doses of 7·5, 15 and 30 Gy was studied. Several parameters were sequentially measured over a time interval of 4 weeks after irradiation: the ratio of the number of tumour to host cells, and the cellular DNA content of tumour and host cells, were determined by flow cytometry; the amount of DNA per gram of tumour tissue was determined biochemically; the clonogenic fraction of tumour cells was obtained from in vitro colony assay; and the tumour volume was assessed by in situ caliper measurements. From the amount of DNA per gram and the average DNA content per cell, the total number of cells per gram of tumour tissue was obtained. From this and the other parameters measured, the number of clonogenic tumour cells, non-clonogenic tumour cells and nucleated host cells per tumour, as well as their variation with time and dose, could be derived. The results showed that there was a lag period prior to depopulation amounting to 3·8 ± 1·4, 1·4 ± 0·8 or 0 ± 0·7 days for 7·5, 15 or 30 Gy, respectively. The rate of depopulation of non-clonogenic tumour cells increased with dose; the halving times of non-clonogens were 4·7 ± 1·8, 2·6 ± 0·7 or 2·1 ± 0·4 days for the three doses applied. There were no indications that proliferation of doomed cells contributed significantly to tumour growth after irradiation. After lag periods that were similar in length to those prior to depopulation, a massive immigration of host cells was observed. Under certain conditions more than 97 per cent of the cells present in irradiated tumours were found to be of host origin. There was a lag period before the onset of repopulation by clonogenic tumour cells, the length of which increased from 2·7 ± 0·7 to 5·0 ± 0·8 or 6·3 ± 1·0 days for 7·5, 15 or 30 Gy, respectively. The initial rate of repopulation increased with radiation dose; after the end of the lag period the doubling time of clonogenic tumour cells (in controls amounting to 3·7 ± 0·2 days) was 3·1 ± 0·1, 2·1 ± 0·1 and 1·1 ± 0·1 days for the three doses applied. Nevertheless, all repopulation curves could be described by one particular Gompertz function (whose parameters also give a good fit to the volume growth of the undisturbed tumour), indicating that the rate of repopulation corresponds to the growth rate of untreated tumours that contain a comparable number of clonogens as are left in the irradiated tumours.     

A system for in vivo measurement of bone calcium by local neutron activation of the hand

A ²⁵²Cf neutron-irradiation facility designed specifically for clinical in vivo measurement of calcium in the hand is described. Results of preliminary measurements are presented. Hand phantoms were exposed to the neutron beam for 10 min and the induced ⁴⁹Ca activities were counted for 10 min after an elapsed time of 2 min. The results indicate that with a 2 × 100 μg ²⁵²Cf neutron source and two 20.3 × 12.7 cm NaI crystals, the counts per gram of bone mineral mass changes by about 4% for each 100 cm³ change in the overall volume (soft tissue plus bone) of the hand. For hands of equal volumes the counts per gram are expected to be almost indepdendent of the bone volume. With an absorbed dose equivalent of 150 mSv (15 rem), the sensitivity is about 200 counts per 10 min per gram Ca. The statistical reproducibility of the results is better than 3% for the average value of 11 g Ca in the normal hand.     

烧伤病房病原菌分布及耐药性分析

目的了解烧伤病房病原菌分布特点及其耐药性,指导临床用药。方法回顾性总结2012年1月-2013年12月本院收治的305例烧伤住院患者的病例资料,统计分析其感染病原菌的种类及药敏试验结果。结果检出的920株病原菌中,革兰氏阳性球菌441株(47.9%),主要包括凝固酶阴性葡萄球菌175株,金黄色葡萄球菌106株,肠球菌87株;革兰氏阴性杆菌472株(51.3%),主要包括鲍曼不动杆菌122株,铜绿假单胞菌78株,肺炎克雷伯菌73株,大肠埃希菌72株,变形杆菌属68株;真菌7株(0.8%)。其中,耐甲氧西林金黄色葡萄球菌的发生率为34.3%;非发酵菌耐药现象严重,对大多数药物的耐药率大于40.0%;肠杆菌科细菌耐药现象也较为严重,对三代、四代头孢菌素的耐药率均大于40.0%,对喹诺酮类药物的耐药率大于60.0%。结论烧伤病房病原菌耐药问题严重,应不断进行耐药性监测,合理使用抗菌药物。     

ICU产ESBLs革兰阴性杆菌的耐药性分析

目的：分析重症监护病房（ICU）产超广谱β内酰胺酶（ESBLs）革兰阴性杆菌的分布特点及其对抗菌药物的耐药性。方法选择2008年2月-2013年2月ICU临床分离的革兰阴性杆菌共325株,采用双纸片协同试验确诊产ESBLs阳性细菌,采用K-B法做药物敏感试验。结果325株革兰阴性杆菌中分离出产ESBLs菌71例（21.8%）,依次为大肠埃希菌（38.9%）、肺炎克雷伯菌（37.7%）、阴沟肠杆菌（33.3%）和产气肠杆菌（20.0%）;71例产ESBLs革兰阴性杆菌主要从痰液（45例）和术后引流液（11例）中分离而来,痰液和术后引流液产ESBLs革兰阴性杆菌株分离率分别为16.2%、13.4%,明显高于尿液、血液及静脉导管的分离率,所致院内感染主要在下呼吸道和外科手术部位;药敏结果显示产ESBLs革兰阴性杆菌对亚胺培南高度敏感,而对绝大多数青霉素类和头孢菌素类抗生素呈耐药性表现。结论产ESBLs所致ICU院内感染现象较为严重,主要发生在下呼吸道和外科手术部位,仅对亚胺培南高度敏感,应根据药敏试验选择合适抗生素予以治疗。     

Index of Authors (with Titles)

Summary

Mice exposed to 10 Gy cobalt-60 radiation were given intramuscular antimicrobial therapy of gentamicin, or metronidazole, or a combination of the two. Mortality in the mice treated with metronidazole alone or in combination with gentamicin occurred earlier than in the controls (P < 0·001). Microorganisms were recovered from the blood, spleen, and liver of the metronidazole-treated mice earlier than from other groups. The predominant organisms recovered from these animals were Enterobacteriaceae. Quantitative cultures of the ileal flora showed a decrease in the number of aerobic, facultative anaerobic and strict anaerobic bacteria after irradiation, and a subsequent increase only in the number of strict aerobic bacteria. As compared to untreated mice, a rapid decrease (by 8·8 logs) in the number of anaerobic flora occurred in the mice treated with metronidazole 5 days after irradiation. This was followed by a rapid increase in the number of aerobic organisms which coincided with the earlier mortality in this group. These data suggest that antimicrobial agents that decrease the number of the strict anaerobic component of the gut flora enhance systemic infection by aerobic or facultative anaerobic bacteria, and this facilitates mortality after irradiation.     

东南沿海海域细菌分布及抗菌药物敏感性研究

目的 了解我国东南沿海海域细菌的种类、分布情况,以及细菌对抗菌药物的敏感性.方法 无菌采集海水,经增菌培养、细菌分离,进行细菌学鉴定和药敏试验.结果 102份海水分离出细菌34种203株;其中弧菌科细菌159株(78.33%),肠杆菌科细菌24株(11.82%),非发酵菌15株(7.39%),革兰阳性球菌3株(1.47%),厌氧菌2株(0.99%).药敏结果显示,157株致病性弧菌对亚胺培南、奈替米星、左氟氧沙星及头孢哌酮-舒巴坦的敏感率为100%,对头孢他啶、头孢噻肟、庆大霉素、环丙沙星、复方磺胺甲唑和替卡西林-克拉维酸的敏感率为90.45%～97.45%,对头孢唑林和氨苄西林的敏感率分别为25.48%和27.39%.结论 东南沿海海域细菌种类繁多、分布广泛,此项研究为该海域海水细菌感染的防治提供了依据.     

Change in Platelet Count after Transjugular Intrahepatic Portosystemic Shunt Creation: An Advancing Liver Therapeutic Approaches (ALTA) Group Study

PurposeTo evaluate recovery of platelet count after transjugular intrahepatic portosystemic shunt (TIPS) creation and patient factors predicting platelet recovery after TIPS creation.Materials and MethodsAdults with cirrhosis who underwent TIPS creation at 9 U.S. hospitals from 2010 to 2015 were included in this retrospective analysis. Change in platelets from before TIPS to 4 months after TIPS creation was characterized. Logistic regression was used to assess factors associated with top quartile percentage platelet increase after TIPS. Subgroup analyses were performed among patients with a pre-TIPS platelet count of ≤50 ×10⁹/L.ResultsA total of 601 patients were included. The median absolute change in platelets was 1 × 10⁹/L (−26 × 10⁹/L to 25 × 10⁹/L). Patients with top quartile percent platelet increase experienced ≥32% platelet increase. In multivariable analysis, pre-TIPS platelet counts (odds ratio [OR], 0.97 per 10⁹/L; 95% CI, 0.97–0.98), age (OR, 1.24 per 5 years; 95% CI, 1.10–1.39), and pre-TIPS model for end-stage liver disease (MELD) scores (OR, 1.06 per point; 95% CI, 1.02–1.09) were associated with top quartile (≥32%) platelet increase. Ninety-four (16%) patients had a platelet count of ≤50 × 10⁹/L before TIPS. The median absolute platelet change was 14 × 10⁹/L (2 × 10⁹/L to 34 × 10⁹/L). Fifty-four percent of patients in this subgroup were in the top quartile for platelet increase. In multivariable logistic regression, age (OR, 1.50 per 5 years; 95% CI, 1.11–2.02) was the only factor associated with top quartile platelet increase in this subgroup.ConclusionsTIPS creation did not result in significant platelet increase, except among patients with a platelet count of ≤50 × 10⁹/L before TIPS. Lower pre-TIPS platelet counts, older age, and higher pre-TIPS MELD scores were associated with top quartile (≥32%) platelet increase in the entire cohort, whereas only older age was associated with this outcome in the patient subset with a pre-TIPS platelet count of ≤50 × 10⁹/L.     

Susceptibility testing of biliary bacteria obtained before bile duct manipulation

Over a 3 3/4-year period, bile culture and susceptibility studies were performed on 41 patients before any instrumentation or manipulation of the biliary tract for retained biliary stone extraction. At least one bile bacterium was identified in 90% of the patients examined. As many as seven organisms were identified in one patient. Of the organisms, 62% were Gram-negative aerobes, the most representative being Klebsiella pneumonia; 27% were Gram-positive aerobes, the Enterococcus grouping being the most representative. Nine percent of the isolates were anaerobic bacteria and 2% yeast. Fifteen percent of the patients developed signs of sepsis. Three of these patients had manipulation of their bile ducts with a choledochoscope and grew out positive blood cultures; all were treated successfully and recovered uneventfully. Susceptibility testing on all aerobic bacteria was performed, indicating 97% effective coverage of both Gram-positive and Gram-negative bacteria using synergistic antibiotics of ampicillin and an aminoglycoside. Even with 9% of the isolated bacteria being anaerobes, the effective coverage using the same two drug combinations was about 88%. Because of the relatively high percentage (15%) of patients developing signs and symptoms of sepsis, synergistic prophylactic antimicrobial therapy is recommended in patients who are debilitated, in instrumentation of obstructed bile ducts, or with choledoschoscopy.