铜绿假单胞菌制剂腹腔给药对进展期胃癌患者细胞免疫水平的影响

目的 评价术中铜绿假单胞菌注射液腹腔置药对胃癌患者细胞免疫功能的影响及安全性.方法 将72例进展期胃癌患者随机分为铜绿假单胞菌腹腔置药组(实验组,41例)和对照组(31例).实验组术毕于瘤床放置铜绿假单胞菌注射液8～10ml.分别在术前、术后10、20、30 d采集两组患者的静脉血测定淋巴细胞总数、淋巴细胞亚群,观察患者围手术期并发症及药物不良反应.结果 实验组淋巴细胞总数[(1.77±0.58)×109/L]与对照组[(1.61±0.52)×109/L]比较明显提高,差异有统计学意义(P=0.042);实验组CD3+细胞(76.36±9.47)与对照组(68.63±10.34)比较明显提高,差异有统计学意义(P=0.027);实验组NK细胞(14.92±8.65)与对照组(14.61±10.31)比较明显提高(P=0.012),差异有统计学意义(P=0.027);实验组CD8+细胞(30.89±9.89)与对照组(30.53±9.26)比较明显下降,差异有统计学意义(P-0.037),而两组的CD4+细胞数和CD4+/CD8+相比差异无统计学意义(均P＞0.05).铜绿假单胞菌注射液对患者的血常规及肝、肾功能均无明显影响,实验组的1年生存率(94.9％)高于对照组(83.3％),两组相比差异有统计学意义(P=0.022).结论 铜绿假单胞菌注射液的腹腔给药方式安全可行,对进展期胃癌患者具有明显的免疫调节作用.     

Pseudomonas aeruginosa vaccine and pseudomonas antiserum in the treatment and prevention of infections in burned patients

Two hundred and ten patients with various severe burns were followed up clinically, bacteriologically and immunologically; 162 patients received a polyvalent pseudomonas vaccine (23 for treatment, 139 preventively), 5 patients received combined immunotherapy (polyvalent pseudomonas vaccine and serum) and 43 patients were not vaccinated (control group).Of the 23 patients treated immediately after the onset of pseudomonas infection, 18 recovered clinically and bacteriologically, the other 5 patients died after 39–137 days from Pseudomonas aeruginosa septicaemia (1 case) or other causes (4 cases). In the control group (25 non-vaccinated patients) 5 patients died from P. aeruginosa infections.The combined immunotherapy applied in 5 patients with severe burns predominantly infected with P. aeruginosa led to conspicuous improvement of their general condition and progress towards clinical and bacteriological recovery.Polyvalent pseudomonas vaccine applied preventively 2 years consecutively (1977, 1978) in the same hospital lowered the incidence of P. aeruginosa both in the vaccinated and non-vaccinated patients (from 47.6 per cent in 1977 to 7.2 per cent in 1978 in the vaccinated patients, and from 76 per cent in 1977 to 33.3 per cent in 1978 in the non-vaccinated patients).Active anti-pseudomonas immunity induced by the polyvalent pseudomonas vaccine (prepared from 11 different P. aeruginosa serotypes) in burned patients, systematically followed up in 167 cases, was confirmed by the steadily rising curve of serum immunoglobulin values (IgG, IgA, IgM) and seroprotection titres.     

甘露糖敏感型绿脓杆菌制剂对肝癌细胞周期的作用机制研究

目的 探讨甘露糖敏感性绿脓杆菌制剂(pseudomonasaeruginosa mannose sensitive haemagglutination vaccine,PA-MSHA)对肝细胞癌(hepatocellular carcinoma,HCC)细胞周期的作用及其机制.方法 培养人肝癌细胞株MHCC97L及HepG2,以不同剂量的PA-MSHA作用于肝癌细胞.MTT实验检测PA-MSHA对细胞增殖的影响.流式细胞技术检测PA-MSHA对细胞周期的作用.Western blot检测PA-MSHA作用前后细胞周期蛋白Cyclin D1、细胞周期蛋白依赖性激酶2(CDK2)、增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)以及细胞周期蛋白激酶抑制剂p21和p27的表达情况.结果 与对照组相比,PA-MSHA显著抑制MHCC97L和HepG2细胞的增殖,其作用呈剂量及时间依赖性(P＜0.05).PA-MSHA显著诱导肝癌细胞周期阻滞,PA-MSHA作用后G0-G1期和G2-M期细胞比例显著增高,而S期细胞比例则显著下降(P＜0.05).PA-MSHA显著抑制Cyclin D1、CDK2、PCNA蛋白的表达,而促进p21和p27的表达.外源性甘露糖可显著抑制PA-MSHA对肝癌细胞增殖和周期的作用(P＜0.05).结论 PA-MSHA通过调控细胞周期相关蛋白来诱导HCC细胞周期阻滞,抑制细胞增殖.这一作用是通过肝癌细胞表面的甘露糖的介导实现的.     

A large animal model of pseudomonas pneumonia

Studies of the pathophysiology of gram-negative pneumonia have been hampered by many different factors. These have included the use of small animal models, the accompaniment of anesthesia, and the problem of studying an animal at only one given point in the time course of the pneumonitis. We report here the development of a large animal model of pseudomonas pneumonia. The model allows one to study many of the pathophysiological changes associated with gram-negative pneumonia over a prolonged time frame. General anesthesia is not required. Light ketamine anesthesia was employed during the insertion of monitoring lines and during the endobronchial instillation of bacteria. During both of these procedures the animals were able to breathe spontaneously and no periods of respiratory depression or hypotension were observed. Once pneumonia was established, no sedation of any kind was required. Thus the model appears to have clinical relevance.     

Enhanced recovery of pseudomonas from blood cultures

Pseudomonas and staphylococcal septicaemia are frequent complications of paediatric patients with significant burns. Early diagnosis and appropriate treatment afford the greatest likelihood of clinical response. Blood cultures from these patients may be negative or may become positive only after prolonged incubation. To evaluate more rapid culture methods for precise diagnosis, an in vitro study was done. The effects of venting and/or rotating on low inocula blood cultures was evaluated. Both venting and rotating contributed to more rapid bacterial growth and the effects were additive, affording a much more rapid and, therefore, potentially more useful culture method.     

重症绿脓杆菌感染患儿的护理

对20例重症绿脓杆菌感染患儿在常规治疗及护理的基础上,联合应用炎滴油及黄柏液浸润纱布条填塞皮肤损伤处治疗皮肤软组织感染;对3例多器官功能障碍综合征患儿给予连续性床旁血液净化治疗,疗程为3~7d;13例肠穿孔患儿给予手术切除坏死肠组织,行肠造瘘术。结果 20例重症绿脓杆菌感染患儿住院15~50d好转出院,随访6个月,患儿皮肤损伤处愈合良好,脏器功能正常。提出在重症绿脓杆菌感染患儿的护理工作中应重视消毒隔离、基础护理和营养支持,积极治疗并发症。可采用炎滴油及黄柏液护理皮肤损伤,促进感染溃烂组织在短期内愈合,提高患儿治愈后生存质量。     

Keratotomy model of pseudomonas keratitis: gentamicin chemotherapy.

BACKGROUND: Chemotherapy of bacterial keratitis requires frequent application of antibiotic drops. Collagen shields containing antibiotics could reduce the need for frequent antibiotic application. To determine the effect of gentamicin-containing collagen shields and gentamicin drops on Pseudomonas keratitis, a new keratotomy model of infection was employed. METHODS: Model--contact lenses (58% water content) presoaked in 1% bovine serum albumin and exposed to 10(8) colony forming units per mL of Pseudomonas aeruginosa strain 27853, were found to reproducibly retain 5.9 (log base 10) colony-forming units. Rabbit corneas were scarified centrally with two perpendicular intersecting diamond knife cuts (5 mm x 5 mm x 0.2 mm), and bacteria-impregnated contact lenses were positioned and held in place for 24 hours with partial tarsorrhaphies. Treatment--Fourteen hours after lens removal (38 hours after infection), corneas were treated for 8 hours with collagen shields hydrated in saline (control), or shields impregnated with 800 micrograms gentamicin during manufacture, or one drop every 30 minutes of fortified gentamicin drops (14 mg/mL). The rabbits were killed and corneas collected for bacterial enumeration after 8 hours of treatment (46 hours after infection). RESULTS: Model--Slit-lamp examination and microbiologic confirmation showed uniformity of keratitis in all eyes. Treatment--Corneas treated with saline (controls) contained 6.4 (log base 10) Pseudomonas. Corneas treated with gentamicin-impregnated collagen shields (total drug = 800 micrograms) and fortified gentamicin drops (total drug = 21 mg) showed a reduction in viable bacteria of 2 logs and 6 logs, respectively, relative to the control. CONCLUSIONS: In this new model of Pseudomonas keratitis, the amount of gentamicin introduced into collagen shields during manufacture effectively reduced bacterial growth in infected rabbit corneas. However, larger amounts of drug applied as fortified drops on a frequent dosing schedule were more effective by a factor of three. Treatment of keratitis with antibiotic-impregnated collagen shields may reduce the need for very frequent application of topical drops, but may be more effective with topical drop supplementation to increase the amount of drug available over the course of therapy.