肠内营养支持对妊娠合并重症胰腺炎患者肠道菌群和妊娠结局的影响

目的分析肠内营养支持对妊娠合并重症胰腺炎患者肠道菌群和妊娠结局的影响。方法选取2014年1月-2019年11月收治的95例妊娠合并重症胰腺炎患者,按照数字表法随机分为观察组(48例)和对照组(47例)。观察组给予肠内营养支持,对照组给予肠外营养支持。比较两组肠道菌群结构、治疗效果、不良妊娠结局及营养状况。结果治疗后,观察组双歧杆菌、乳酸杆菌、大肠埃希菌及肠球菌数量分别为(6.69±1.94)×10~7CFU/g、(7.59±1.75)×10~7CFU/g、(7.14±1.51)×10~7CFU/g及(5.03±0.64)×10~7CFU/g,对照组双歧杆菌、乳酸杆菌、大肠埃希菌及肠球菌数量分别为(4.32±1.63)×10~7CFU/g、(5.11±1.42)×10~7CFU/g、(8.75±1.63)×10~7CFU/g及(6.61±0.95)×10~7CFU/g,两组双歧杆菌、乳酸杆菌、大肠埃希菌及肠球菌数量比较差异均有统计学意义(t=6.439,P=0.000;t=7.575,P=0.000;t=4.995,P=0.000;t=9.344,P=0.000)。观察组APACHEⅡ评分为(5.06±1.22)分,显著低于对照组的(7.42±3.17)分,差异有统计学意义(t=4.808,P=0.000);观察组肠功能恢复时间、SIRS改善时间及住院时间分别为(3.06±0.39)d、(4.94±1.23)d及(21.03±5.28)d,均显著短于对照组的(6.19±1.58)d、(8.06±2.19)d及(30.42±6.87)d,差异均有统计学意义(t=13.318,P=0.000;t=8.584,P=0.000;t=7.479,P=0.000)。观察组不良妊娠结局发生率为10.40%,显著低于对照组的27.56%(χ~2=4.598,P=0.032)。治疗后,观察组血清白蛋白、前白蛋白水平分别为(34.16±3.21)g/L和(0.35±0.06)g/L,均显著高于对照组的(29.05±1.57)g/L和(0.26±0.05)g/L,差异均有统计学意义(t=9.822,P=0.000;t=7.669,P=0.000)。结论肠内营养支持能改善患者妊娠结局,影响肠道菌群,值得推广。     

益生菌对肠道致病菌肠粘附抑制作用

目的评价三联活菌片中的益生菌对大肠埃希菌K1株和肺炎克氏菌在肠上皮粘附的抑制作用。方法将40只BALB/c小鼠随机分为益生菌组、益生菌和致病菌组、致病菌组和对照组,应用实时荧光定量聚合酶链式反应(SYBR Green I Real-time PCR)方法 ,对各组益生菌/双歧杆菌和保加利亚乳杆菌、致病菌/大肠埃希菌K1株和肺炎克氏菌进行定量检测,观察益生菌定植及其对致病菌的拮抗作用,对益生菌组小鼠肠道菌群进行变性梯度凝胶电泳图谱(DGGE)分析。结果随益生菌服用剂量增加,在肠道定植的益生菌逐渐增加,第7 d时定植达到稳定;益生菌组双歧杆菌、保加利亚乳杆菌含量(log10N/g)分别为5.33±0.37,3.32±0.49;益生菌+致病菌组分别为5.31±0.36,3.29±0.46;均高于对照组(分别为3.98±0.23,0.00±0.00),差异有统计学意义(P0.01);益生菌+致病菌组的大肠埃希菌K1和肺炎克氏菌基因拷贝数(log10N/g)分别为3.85±0.41,3.39±0.32,均低于致病菌组(分别为4.79±0.48,4.28±0.37),差异有统计学意义(P0.01);DGGE电泳图谱分析显示,服用益生菌后小鼠肠道菌群构成一致性增加。结论活菌片中益生菌能粘附于肠粘膜,并能明显抑制致病菌粘附,可提高肠道微生态的稳定性。     

航校空军学员飞行训练前后肠道菌群的对比研究

目的 探讨飞行训练对航校空军学员肠道菌群的影响.方法 通过微生态学方法对120名航校空军学员飞行前后肠道菌群中9种细菌进行定性定量分析,并与30名地勤人员进行对比研究,结合多种因素的填表调查分析各种因素对航校学员肠道菌群的影响.结果 双歧杆菌属航校学员训练后为(7.38±1.54)Log10×CFU/g,训练前为(8.92±1.86) Log10×CFU/g,地勤组为(9.51±2.44)Log10×CFU/g,航校空军学员训练后消化球菌属与训练前及地勤组相比,显著下降(P＜0.05),肠球菌属、拟杆菌属数量显著上升(肠球菌属P＜0.01;拟杆菌属P＜0.05)；其他菌差异无统计学意义；精神紧张的学员与精神放松的学员相比,双歧杆菌属、肠球菌属、消化球菌属、拟杆菌属的数量差异有统计学意义(P＜0.05)；腹部胀气显著的学员与胀气不明显的学员相比,双歧杆菌属、肠球菌属、消化球菌属数量差异有统计学意义(P＜0.05).结论 饮食是造成空军飞行学员员肠道菌群变化的原因之一,而精神状态、腹部胀气情况也是肠道菌群失调的重要原因.     

不同培养时间对大肠埃希菌生物膜形成影响

目的 建立密闭式连续循环培养系统以制备大肠埃希菌生物膜,探讨不同培养时间对其形成的影响.方法 运用菌落计数测定及扫描电镜观察生物膜内大肠埃希活细菌量及生物膜的变化.结果 3次建模测定的第5、7、10 d的实际菌落计数分别为(1.72 ±2.14)×105、(1.18 ±1.32) ×105、(5.45 ±6.84)×104 CFU/cm2,生物膜细菌平均标准菌落计数分别为(4.98±0.47)、(4.82±0.46)、(4.43±0.52) lg CFU/cm2,总体差异有统计学意义(F=5.10,P=0.01),第5、7d比较差异无统计学意义,两者分别与第10 d比较,差异均有统计学意义(P＜0.05);扫描电镜观察,持续灌流5d的Teflon管腔内表面,生物膜细菌间粘丝样胞外基质形成并交联呈网状,细菌紧密黏附;灌流7d,胞外多聚物基质黏附单个细胞形成微生物菌落;灌流10 d则形成稳定成熟的生物膜.结论 大肠埃希菌在Teflon管内表面生物膜的形成与培养时间有密切关系,随着时间延长,生物膜细菌量逐渐减少,形成了成熟稳定的生物膜.     

珠江水域微生物的分布特征

目的 了解珠江水域指示菌和常见致病菌的时空分布规律以及相关性.方法 分别于2010年7月(丰水期)和2011年3月(枯水期)采集珠江水域上游、中游和下游5个断面的岸边和中心共20个水样,分别对水样中5种卫生指示菌(菌落总数、总大肠菌群、粪大肠菌群、大肠埃希菌和肠球菌)和4种常见致病菌(沙门菌、志贺菌、弧菌和大肠杆菌O157∶H7)进行检测和分析.结果 珠江水域中除菌落总数和肠球菌外,各项指示微生物指标均呈现下游＞中游＞上游的规律.水体上、中和下游总大肠菌群(4.20× 103～9.49× 104 cfu/ml)、粪大肠菌群(1.84×103～3.09×104 cfu/ml)和大肠埃希菌(6.45× 102～ 1.30× 104 cfu/ml)均存在统计学差异(P＜0.05).珠江岸边指示菌和致病菌均高于中心,丰水期的指示菌和致病菌均不低于枯水期,但差异均无统计学意义(P＞0.05).除菌落总数外,总大肠菌(P＜0.05)、粪大肠菌群(P＜0.01)、大肠埃希菌(P＜0.01)和肠球菌(P＜0.01)均与致病菌总数呈正相关.结论 珠江水域从上游至下游其微生物污染逐渐加重,指示菌与致病菌呈一定的相关性.     

炎症性肠病患者肠道菌群变化与发病关系研究

目的探讨炎症性肠病患者肠道菌群结构变化与相关炎性指标的关系,为临床治疗提供参考依据。方法选取2013年1月-2014年3月于医院就诊的121例溃疡性结肠炎患者和34例克罗恩病患者为研究对象,57名正常志愿者为对照组,采集受试者的新鲜粪便进行菌群分析,比较菌群变化与炎性指标的相关性,采用SPSS18.0软件进行统计分析。结果与对照组相比,溃疡性结肠炎患者肠内酵母菌属(2.29±0.41)CFU/g、双歧杆菌属(5.20±0.53)CFU/g、乳杆菌属(5.62±0.12)CFU/g、肠球菌属(6.58±0.23)CFU/g、拟杆菌属(5.64±0.28)CFU/g、消化球菌属(6.35±0.25)CFU/g、小梭菌(3.61±0.30)CFU/g的数量明显增加,而真杆菌属(1.62±0.24)CFU/g的数量下降,差异均有统计学意义(P<0.05);培养结果阳性检出率与菌群数量变化结果基本相附;而菌群与炎性指标有相关性。结论炎症性肠病患者的肠道菌群失衡,其发病与真杆菌属数量的减少有关。     

急性骨与软组织感染脉冲冲洗术清除创面病原菌的临床研究

目的探究脉冲冲洗术对于急性骨与软组织感染创面病原菌清除率的影响,为临床合理选择创面清除措施提供依据。方法选取2012年1月-2014年1月外科急性骨与软组织感染116例住院患者,随机分为两组,各58例,对照组患者采用常规方法清除创面,试验组患者采用脉冲冲洗术清除创面病原菌,采用不同清洗措施后,分别观察两组患者的细菌数、肿瘤坏死因子(TNF-α)、白介素-6(IL-6)水平和伤口愈合等效果,并进行统计分析。结果对照组患者术后创口表面铜绿假单胞菌(2.01±0.57)×108 CFU/g、金黄色葡萄球菌(1.49±1.14)×108 CFU/g、大肠埃希菌(1.08±0.62)×108 CFU/g、TNF-α为(69.47±11.32)pg/L、IL-6为(80.35±13.18)pg/L,创口愈合甲级占37.9%、乙级占46.6%、丙级占15.5%;试验组患者术后创口表面铜绿假单胞菌(1.47±0.35)×108 CFU/g、金黄色葡萄球菌(0.76±0.18)×108 CFU/g、大肠埃希菌(0.61±0.22)×108 CFU/g,TNF-α为(42.13±7.44)pg/L、IL-6为(52.41±8.27)pg/L,创口愈合甲级占58.6%、乙级占36.2%、丙级5.2%;试验组患者创面铜绿假单胞菌和金黄色葡萄球菌的数目明显少于对照组,对照组TNF-α、IL-6水平明显高于试验组,试验组治疗后创口甲级愈合率明显高于对照组,差异均有统计学意义(P<0.05)。结论急性骨与软组织感染时,脉冲冲洗术可有效减少创口病原菌,降低感染率,增加伤口愈合效果,在临床治疗中具有重要价值。     

2015—2016年全国网售自制即食食品中微生物污染状况

目的了解中国网售自制即食食品中微生物污染状况。方法从全国范围内采集网售自制即食食品3573份,按照《食品微生物学检验》(GB 4789)的规定,对样品中大肠埃希菌、单核细胞增生李斯特菌、沙门菌、金黄色葡萄球菌和蜡样芽胞杆菌进行检验。根据《即食食品微生物含量指引》和《食品中致病菌限量》(GB 29921—2013)进行评价。结果网售自制即食食品中大肠埃希菌计数>100 CFU/g的样品比例为11.28%;单核细胞增生李斯特菌检出率为1.82%,沙门菌检出率为0.36%;金黄色葡萄球菌计数>10~3 CFU/g的样品比例为0.67%,最大值9.2×10~6 CFU/g;蜡样芽胞杆菌计数>10~5 CFU/g的样品比例为0.52%,最大值6.0×10~6 CFU/g。主要样品中凉拌菜的污染相对严重。共有275家网店检出不满意样品,占全部调查网店的20.72%,其中64家网店有多份样品检出致病菌。结论部分网售自制即食食品存在食品安全隐患,特殊人群应谨慎食用。     

中药提取物水苏糖对冰水灌胃应激后肠功能紊乱大鼠作用的实验研究

目的 观察中药提取物水苏糖对冰水灌胃应激后肠功能紊乱大鼠的排便粒数、粪便含水量、小肠推进率和肠道菌群的影响,探讨中药提取物水苏糖对应激后肠功能紊乱的作用及机制.方法 应用冰水灌胃应激法建立便秘型肠易激综合征大鼠模型,灌胃给予水苏糖1.5 g/（kg·bw）,检测给药第7天及第14天大鼠12 h内的粪便粒数、粪便含水量、小肠推进率的变化及给药14 d肠道菌群的变化.结果 水苏糖治疗组大鼠第14天12 h内的粪便粒数、粪便含水量及小肠推进率明显增加,肠道菌群中双歧杆菌、乳酸杆菌等优势菌群的数量明显增加,与便秘型肠易激综合征模型对照组比较差异有统计学意义[（38.43±4.57）粒VS（32.21±3.43）粒,F=3.892,P＜0.05;（47.88±3.43）%VS（43.18±6.85）%,F=6.724,P＜0.01;（1.04±0.11）弧度VS（0.88±0.08）弧度,F=4.965,P＜0.05;（10.77±0.44）1g（CFU/g） VS（9.85±0.43）lg（CFU/g）,F=7.613,P＜0.01;（10.96±0.35）lg（CFU/g）VS（9.84±0.35）lg（CFU/g）,F=10.413,P＜0.01].结论 中药提取物水苏糖具有改善冰水应激后肠功能紊乱大鼠便秘及调节肠道菌群功能的作用,调节机体微生态平衡可能是中药提.取物水苏糖治疗应激后肠功能紊乱的机制之一.     

一起产气荚膜梭菌和致泻大肠埃希菌混合感染引起食源性疾病暴发事件调查

目的调查和分析某校教职工中发生的一起食源性疾病暴发事件的原因,为预防和处理类似事件提供参考。方法制定病例定义,开展病例搜索和个案调查;采用描述性流行病学方法分析事件特征;开展病例对照研究和现场卫生学调查追溯原因;采集病例标本、环境样品和剩余食品进行致病菌检测。结果本次事件共搜索到病例73人,罹患率35.27%。患者主要症状为腹泻、腹痛,流行曲线显示病例为多次暴露,未确定可疑餐次和可疑食品。56件粪便/肛拭子标本有10件检出产气荚膜梭菌,其中有1件粪便计数结果为10~6 CFU/g,3件为10~5 CFU/g;9件检出致泻大肠埃希菌(其中7件检出肠道聚集性大肠埃希菌,2件检出肠道侵袭性大肠埃希菌)。结论此事件可能是一起产气荚膜梭菌和致泻大肠埃希菌混合感染引起的食源性疾病暴发事件。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.