MRSA的医院感染暴发与RAPD分子流行病学分型

目的：了解院内感染分离的MRSA的同源性及其流行特征，对控制MRSA感染提供有利依据。方法：采用VITEK-2全自动微生物分析系统对各类临床标本分离出的MRSA进行鉴定和进行药敏试验；并用随机扩增多态性DNA分型法(RAPD)对院内分离的MRSA菌株作分子流行病学分型和同源性分析。结果：共分离出60株MRSA，RAPD分型分为Ⅰ、Ⅱ、Ⅲ、IV、V共5个主要型别，其中I型为优势型别。在调查期间，神经外科发生了两次MRSA院内感染暴发。结论：RAPD是监控和调查MRSA院感暴发及流行病学的较好的研究手段。     

MRSA的随机扩增多态DNA分型研究

目的：应用随机扩增多态性DNA技术（RAPD），对耐甲氧西林金黄色葡萄球菌（MRSA）进行基因分型研究，以确定医院内是否存在MRSA流行。方法：收集我院临床分离的40株MRSA，采用RAPD技术进行同源性分析。结果：40株MRSA经电泳可得到1～11条片段，分为6个基因型。结论：RAPD分型技术简便、快速，在医院感染流行病学调查中具有较大应用价值。     

耐甲氧西林金黄色葡萄球菌两种基因分型方法的对比研究

目的 比较耐甲氧西林金黄色葡萄球菌（MRSA）两种基因分型方法的特点，为MRSA流行病学调查选用合适的基因分型方法提供参考。方法用聚合酶链反应（PCR）扩增MRSA基因高变区（Hypervariable region，HVR），并根据扩增片段大小进行基因分型，同时与ERIC-2随机引物多态性DNA分型法进行比较，并观察不同退火温度条件下两种基因分型方法的差异。结果 50株MRSA以基因高变区（HVR）分型，可分为A、B、C、DE5种基因型，其中以B（47．3％）和D（32．1％）型多见，A（3．5％）、C（10．7％）、E（6．4％）型少见，当退火温度改变时，则不能分型；用ERIC-2随机引物对MRSA进行多态性DNA分型，在低退火温度下分为10种基因型，当退火温度明显改变时，仍能分型，但每型的扩增片断明显减少。结论随机引物多态性DNA分型和HVR基因分型两种方法均能用于MRSA感染的流行病学研究，HVR基因分型PCR反应温度控制严格，分型明确；而随机引物多态性ERIC-2的DNA分型随PCR退火温度的变化而变化，应用时需严格控制PCR退火温度等反应参数，否则重复性较差。     

金黄色葡萄球菌RAPD基因分型研究

目的了解医院内金黄色葡萄球菌RAPD基因分型,分析MRSA的流行传播情况。方法应用K-B纸片扩散法和随机多态性扩增DNA技术（Randomly amplified polymorphic DNA,RAPD）对医院分离的金黄色葡萄球菌进行MRSA鉴定和基因分型。结果 57株金黄色葡萄球菌中有MRSA31株,经RAPD扩增后,扩增产物在2~6条带之间,通过聚类分析57株菌产生10个基因型。结论Ⅵ型为本院金黄色葡萄球菌的流行优势基因型,不同来源菌株基因型分布有明显差异。RAPD分型技术简便、快速,在医院感染流行病学研究具有很大的应用前景。     

RAPD技术在肠炎沙门氏菌同源性分析中的应用

目的 研究2004年广州市3起肠炎沙门氏菌食源性疾病分离的20株菌株和来源于从业人员健康体检的18株肠炎沙门氏菌的分子特征,为肠炎沙门氏菌食源性疾病的流行病学溯源和疫情控制提供有效手段。方法 采用随机引物扩增多态性DNA分析（randomly amplified polymorphic DNA analysis,RAPD）对38株肠炎沙门氏菌进行分子分型,结合SPSS软件构建以上菌株的带型关系系统树状图,对菌株进行基因多态性分析。结果 38株肠炎沙门氏菌的RAPD结果经聚类分析可分为3个聚类群,分属3个不同的克隆。结论 RAPD技术可用于肠炎沙门氏菌食源性疾病的流行病学调查和溯源。     

重症监护病房感染阴沟肠杆菌的耐药性及基因型分析

目的了解我院重症监护病房（ICU）医院感染阴沟肠杆菌的耐药谱及分子流行病学特征，指导临床合理用药。方法基因分型采用优化反应体系的随机扩增多态性DNA（RAPD）法，耐药分析选用K—B法。结果RAPD分型将28株阴沟肠杆菌分为11种株型，耐药谱则将其分为12种不同的耐药型。结论基因分型和耐药分析显示ICU有多重耐药的阴沟肠杆菌株爆发流行现象，它为控制阴沟肠杆菌的医院内感染、追踪传染原、切断传播途径提供遗传学信息．指导临床医生选用敏感有效的抗生素。     

肺炎克雷伯菌随机扩增多态性DNA的分子流行病学研究

目的采用随机扩增多态性DNA（RAPD）基因分型方法监测肺炎克雷伯菌医院感染。方法对临床分离的36株肺炎克雷伯菌进行RAPD基因分型,并通过指纹图谱比较与分析,确证医院感染爆发。结果36株肺炎克雷伯菌共分得33型,肺炎克雷伯菌医院感染局部流行共1起。结论RAPD可对肺炎克雷伯菌进行分子流行病学调查。     

随机扩增多态性DNA分型法用于酵母菌基因分型

目的 研究酵母菌随机扩增多态性DNA分型法(RAPD)的最佳实验条件。方法 在改变引物、Mg^2 、模板浓度、Taq多聚酶用量等不同条件下，采用RAPD法对酵母菌进行基因分型。结果 经优化后的RAPD方法能清晰地对酵母菌进行基因分型。结论 RAPD是从分子水平对酵母菌感染进行病原学、流行病学研究的一种快速、可靠的分子生物学分型方法。     

肺炎克雷伯菌基因分型与药敏结果分析

目的对肺炎克雷伯菌各型菌株的耐药现状进行流行病学研究。方法采用改进的随机引物扩增多态性DNA分型法(RAPD)基因分型技术,对分离自门诊和住院患者的48株肺炎克雷伯菌进行基因分型,同时对菌株进行12种抗生素敏感试验。结果48株肺炎克雷伯菌41株有稳定的RAPD带型,共分16型,同型菌株药敏结果基本相同。结论该院呼吸科R ICU存在肺炎克雷伯菌的小流行;合理使用抗生素,加强重点病区的消毒隔离措施,是控制医院感染流行的重要措施。     

耐甲氧西林金黄色葡萄球菌SCCmec分型研究

目的检测耐甲氧西林金黄色葡萄球菌SCCmec基因分型,初步了解MRSA分子流行病学特征,从而进一步指导临床感染MRSA的治疗,更好地控制MRSA引起的感染,并减少耐药株的出现。方法以MRSA菌株65株为研究对象,使用多重PCR扩增技术检测SCCmec基因分型,PCR产物进行琼脂糖电泳凝胶检测,阳性株进行基因测序,与目的基因进行比对。结果65株MRSA的SCCmec基因分型均为Ⅲ型。结论我院耐甲氧西林金黄色葡萄球茵SCCmec基因分型,均为SCCmec-Ⅲ型,尚未发现CA-MRSA菌株。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.