冠心病患者血清同型半胱氨酸和尿酸水平变化及临床意义分析

目的探讨冠心病患者血清同型半胱氨酸(Hcy)和尿酸(UA)水平变化及其临床意义。方法选择120例冠心病患者为研究对象(冠心病组),并按照冠心病类型分为稳定性心绞痛组(SA组,n=32)、不稳定性心绞痛组(UA组,n=74)和急性心肌梗死组(AMI组,n=14);另选择同期在本院体检科就诊的100例健康者为对照组。采用免疫比浊法检测所有研究对象的血清Hcy、UA和C-反应蛋白(CRP)水平,比较各组间差异,并分析血清Hcy和UA与CRP的相关性。结果冠心病组患者血清Hcy[冠心病组和对照组分别为(18.64±6.42)和(5.52±1.64)mg/L]、UA[冠心病组和对照组分别为(418.64±42.53)和(312.32±22.46)μmol/L和CRP[冠心病组和对照组分别为(9.85±2.12)和(2.25±0.84)mg/L]水平均明显高于对照组患者,差异均有统计学意义(均P0.05)。AMI组患者血清Hcy[AMI组、SA组和UA组分别为(24.83±5.23)、(12.54±2.52)和(17.64±3.84)mg/L]、UA[AMI组、SA组和UA组分别为(442.53±45.25)、(343.63±23.54)和(389.46±36.72)μmol/L]和CRP[AMI组、SA组和UA组分别为(12.27±2.53)、(3.72±1.32)和(7.47±1.64)mg/L]水平明显高于SA和UA组患者,3组间差异有统计学意义(均P0.05)。相关性分析结果显示血清Hcy、UA水平和CRP水平呈正相关(相关系数r值分别为0.384、0.362,均P0.05)。结论冠心病患者血清Hcy和UA水平明显升高,并且与冠心病的严重程度密切相关,检测血清Hcy和UA水平有助于预测心血管事件的发生。     

血清VILIP-1、尿酸、CRP、NSE水平与脑梗死患者预后的关系研究

目的探讨血清视锥蛋白样蛋白-1(VILIP-1)、血尿酸(UA)、C反应蛋白(CRP)、神经元特异性烯醇化酶(NSE)的水平与脑梗死患者预后的关系。方法选取2018年11月至2019年4月该院收治的首次发病脑梗死患者90例为试验组,选取同期来该院体检的健康者90例为对照组。采用酶联免疫吸附试验(ELISA)测定血浆VILIP-1水平,酶法测定血清UA水平,免疫透射比浊法检测CRP水平,电化学发光法测定血清NSE水平。然后在患者接受治疗的第1天及第90天分别进行Rankin评分。结果试验组患者血清VILIP-1、UA、CRP、NSE水平均明显高于对照组(P<0.05);经统计学分析,随着脑卒中病情的加重及梗死面积的扩大,血清VILIP-1、UA、CRP、NSE水平升高(P<0.05);预后良好的患者血清VILIP-1、UA、CRP、NSE水平明显低于预后不良的患者(P<0.05);ROC曲线分析结果显示,VILIP-1的临界值、灵敏度和特异度分别为7.27μg/L、0.835、0.807,UA的临界值、灵敏度和特异度分别为326.42μmol/L、0.693、0.722,CRP的临界值、灵敏度和特异度分别为1.85mg/L、0.685、0.713,NSE的临界值、灵敏度和特异度分别为20.65ng/L、0.785、0.862,4项指标联合检测的曲线下面积最大,为0.922。结论血清VILIP-1、UA、CRP、NSE异常表达参与了急性脑梗死发病过程,且与患者脑损伤严重程度、预后密切相关,早期联合检测可作为预测急性脑梗死预后的重要标志物。     

血清C反应蛋白联合红细胞压积对急性重症胰腺炎的早期预测价值

目的:探讨血清C反应蛋白(CRP)联合红细胞压积(Hct)检测对早期预测急性重症胰腺炎(AP)的临床价值。方法:选择2011年4月一2014年12月因急性胰腺炎住院治疗的患者75例,比较轻型急性胰腺炎(MAP)和重型急性胰腺炎(SAP)患者24 h内CRP和Hct的差异,建立受试者工作特征曲线(ROC),评估早期CRP、Hct及两者联合检测对重症胰腺炎的诊断效率。结果:SAP组患者的CRP和Hct水平均明显高于MAP组,差异有统计学意义(P0.05)。CRP和Hct诊断SAP的敏感性分别为61.56%、49.57%,特异性分别为83.27%、80.23%,阳性预测值分别为53.52%、40.35%,阴性预测值分别为90.37%、85.26%。CRP联合Hct诊断SAP的敏感性为51.23%,特异性为94.29%,阳性预测值为76.12%,阴性预测值为87.23%。结论:CRP联合Hct有助于急性胰腺炎严重程度的早期诊断,具有重要的临床应用价值。     

血清C反应蛋白联合红细胞压积对重症急性胰腺炎的早期预测价值

目的:探讨血清C反应蛋白(CRP)联合红细胞压积(Hct)检测用于早期预测重症急性胰腺炎(SAP)的临床价值。方法:选择2011年4月—2014年12月因急性胰腺炎住院治疗的患者75例,比较轻症急性胰腺炎(MAP)和SAP患者入院24 h内CRP和Hct的差异,建立受试者工作特征(ROC)曲线,评估早期CRP、Hct单项检测及两者联合检测对SAP的诊断效率。结果:SAP组患者的CRP和Hct水平均明显高于MAP组,差异有统计学意义(P0.05)。CRP和Hct诊断SAP的敏感性分别为61.56%、49.57%,特异性分别为83.27%、80.23%,阳性预测值分别为53.52%、40.35%,阴性预测值分别为90.37%、85.26%。CRP联合Hct诊断SAP的敏感性为51.23%,特异性为94.29%,阳性预测值为76.12%,阴性预测值为87.23%。结论:CRP联合Hct有助于急性胰腺炎严重程度的早期诊断,具有一定的临床应用价值。     

CD4+/CD8+比值、PCT、CRP水平与感染性休克患者疾病转归的关系

目的 探讨CD4⁺/CD8⁺比值、血清降钙素原(PCT)、C反应蛋白(CRP)水平与感染性休克患者疾病转归的关系。方法 选取2019年8月至2021年8月于该院就诊的214例感染性休克患者作为研究对象,根据转归情况将其分为病死组62例,生存组152例,统计两组临床资料及入院时、治疗48 h后CD4⁺/CD8⁺比值、血清PCT、CRP水平,采用Logistic回归分析感染性休克患者预后的影响因素,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析治疗48 h后CD4⁺/CD8⁺比值、血清PCT、CRP对感染性休克患者病死的预测价值。结果 两组在有无糖尿病史,是否合并急性呼吸窘迫综合征(ARDS)、真菌感染、急性肾损伤(AKI),有无抗凝治疗,急性生理学及慢性健康状况Ⅱ评分,多器官功能障碍综合征评分,以及入院时、治疗48 h后CD4⁺/CD8⁺比值、血清PCT、CRP水平方面比较,差异均有统计学意义(P<...     

急性冠状动脉综合征患者血浆晚期蛋白氧化产物升高的机制及意义

目的 通过检测急性冠状动脉综合征(ACS)患者体内晚期蛋白氧化产物(AOPP)的水平来探讨氧化应激损伤与冠状动脉粥样硬化发生发展的关系.方法 入选102例冠心病患者及10例非冠心病患者,冠心病组分为AMI择期经皮冠状动脉介入治疗(PCI)35例、AMI急诊PCI 24例、不稳定型心绞痛(UA)43例;分别于入院即刻、24 h和48 h 3个时间点采集外周静脉血标本,在紫外荧光340 nm及酸性条件下测定血清标本的吸光度,并以相应氯胺T浓度来表示AOPP浓度.结果 AMI择期PCI组入院即刻、入院24 h和入院48h AOPP浓度分别为(236.42±30.41)、(207.84±29.50)、(227.79±35.18)mmol/L,UA组分别为(239.95±39.94)、(175.92±29.46)、(156.54±28.29)mmol/L,非冠心病组分别为(57.41±13.60)、(56.11±11.90)、(61.75±12.28)mmol/L,AMI急诊PCI组分别为(97.58±23.41)、(91.77±17.40)、(113.39±17.24)μmol/L.AMI择期PCI组、UA组分别与非冠心痛组对应各时间点比较,AOPP浓度明显升高(均P<0.05);入院即刻与入院24 h(P均<0.01)及入院48 h(P<0.05),AMI择期PCI组较急诊PCI组AOPP浓度显著升高;AMI急诊PCI组与UA组比较差异无统计学意义(P>0.05);治疗前后AOPP浓度比较,仅UA组48 h后有明显下降(P<0.05).结论 ACS患者血清AOPP浓度显著升高,氧化应激是AS发生发展过程中的重要环节,AOPP是反映体内氧化应激水平较好的血清学指标.     

SYBR Green Ⅰ荧光定量PCR检测类风湿关节炎患者血清miR-146a的表达及意义

目的用SYBR GreenⅠ实时荧光定量PCR法检测类风湿关节炎(RA)患者血清miR-146a的表达水平,探讨其在RA诊断中的意义。方法以U6为内参照,用SYBR GreenⅠ实时荧光定量PCR检测RA患者48例(活动期30例、缓解期18例)、骨性关节炎(OA)患者22例和体检健康者25例血清miR-146a的表达水平,并进行ROC曲线分析;对各组进行红细胞沉降率(ESR)检测。结果 SYBR GreenⅠ实时荧光定量PCR检测结果表明,活动期RA患者血清miR-146a水平为(2.42±0.75),显著高于缓解期RA患者(1.66±0.29)、OA患者(1.12±0.43)和体检健康者(1.01±0.34),差异均有统计学意义(P均0.05);miR-146a诊断活动期RA的ROC曲线下面积(AUCROC)为0.914(95%CI:0.872~0.926);以1.96为cut off值,敏感性为95.0%、特异性为87.5%、准确性为91.9%。活动期RA组ESR为(37.5±5.2)mm/h,缓解期RA组为(14.4±4.7)mm/h,OA组为(11.6±5.1)mm/h,健康对照组为(9.6±3.9)mm/h,各组间差异有统计学意义(F=177.01,P0.01)。结论建立的SYBR GreenⅠ实时荧光定量PCR可用于RA患者血清miR-146a的检测。miR-146a可用于诊断活动期RA。     

血清肌红蛋白、cTnI检测在急性心肌梗死的临床诊断价值及炎症因子水平

目的探讨血清肌红蛋白(Myo)和心肌肌钙蛋白(cTnI)在诊断急性性心肌梗死(AMI)的价值及炎症因子水平变化及临床意义。方法选取西南石油大学校医院急诊科和心血管内科收治的60例AMI患者作为AMI组,另选取年龄、性别基本与之匹配的60例健康体检者作为对照组,检测AMI组的血清Myo、cTnI及炎症因子水平并与对照组进行比较。结果 AMI组患者入院时、入院12h、24h和72h时的血清Myo分别为(57.30±18.26)、(152.70±39.12)、(173.85±41.46)、(209.43±33.82)、(162.06±43.75)μg/L,血清cTnI分别为(0.11±0.03)、(2.21±0.39)、(2.67±0.40)、(3.98±0.72)、(3.74±0.69)μg/L,AMI组患者入院时、入院12、24、72h时的血清Myo、cTnI检测值均显著的高于对照组(P0.05),AMI患者的血清Myo、cTnI检测值在入院后24h时达到最高值。AMI组患者入院12、24、72h时的血清IL-6分别为(168.85±47.76)、(168.85±47.76)、(241.20±58.35)、(183.63±62.27)μg/L,IL-8分别为(0.17±0.06)、(0.21±0.06)、(0.20±0.07)pg/L,ICAM-1分别为(446.94±87.15)、(522.30±93.08)、(483.20±85.57)μmol/L,CRP分别为(29.28±7.36)、(51.14±16.33)、(37.26±11.30)mg/L,AMI组患者入院12、24、72h时的血清IL-6、IL-8、ICAM-1、CRP的水平均显著地高于对照组(P0.05),AMI患者的血清IL-6、IL-8、ICAM-1、CRP的水平在入院后24h时达到最高值。AMI组患者入院24h的血清Myo检测阳性率最高(88.33%),cTnI检测值在入院后24h检测阳性率最高(100.00%);AMI组患者入院时、入院12、24、72h Myo阳性率分别为70.00、78.33、88.33、73.33%,cTnI的阳性率分别为65.00%、96.67%、100.00%和100.00%,AMI组患者入院24h的血清Myo检测阳性率最高(88.33%),cTnI检测值在入院后24h检测阳性率最高(100.00%),入院时,血清Myo和cTnI检测阳性率相当,与Myo比,入院12h、24h和72hcTnI的检测阳性率较高(P0.05);24h时采用血清Myo、cTnI诊断AMI患者的灵敏度分别为98.27%和99.16%,特异度分别为89.20%和87.33%。血清Myo与IL-6(r=0.59)、IL-8(r=0.43)、ICAM-1(r=0.52)、CRP(r=0.46)均呈正相关关系(P0.05),cTnI与IL-6(r=0.72)、IL-8(r=0.56)、ICAM-1(r=0.61)、CRP(r=0.59)均呈正相关关系(P0.05)。结论 AMI患者血清Myo、cTnI水平早期及发生显著变化,均可在AMI发病24h达到最高值,Myo、cTnI水平对AMI患者的早期诊断具有重要的临床价值,与Myo比,cTnI的灵敏度和特异度更高,可更早期地诊断AMI,血清炎症因子水平也有升高,可辅助诊断AMI。     

血清红细胞压积、C反应蛋白在重症急性胰腺炎诊断中的应用价值

目的:探讨血清C反应蛋白(CRP)及红细胞压积(HCT)在重症急性胰腺炎诊断中的应用价值。方法:纳入70例急性胰腺炎患者为病例组,其中轻型胰腺炎(MAP)组40例,重症胰腺炎(SAP)组30例。选择同期住院非感染、肝脏、胆道、胰腺疾病30例患者为对照组。测定各组患者入院24 h内血清HCT及CRP水平,比较其在不同分组间的差异及通过ROC曲线了解其在重症胰腺炎诊段中的价值。结果:MAP组、SAP组患者血清HCT、CRP水平明显高于对照组(P0.05)。SAP组患者血清HCT、CRP水平明显高于MAP组(P0.05)。ROC曲线显示入院血清HCT及CRP水平诊断重症胰腺炎曲线下面积(AUC)分别为0.783、0.828。结论:血清HCT及CRP水平可有效评估急性胰腺炎患者病情的严重程度,其可作为诊断重症胰腺炎的早期指标。     

剖宫产术后产褥感染的病原菌分布、耐药性及PCT、CRP水平变化

目的探讨剖宫产术后产褥感染的病原菌分布及耐药性,观察血清降钙素原(PCT)、C反应蛋白(CRP)变化并分析其预测价值。方法择取剖宫产术后伴或不伴产褥感染患者各130例,分别设为观察组与对照组。比较两组产前、产后PCT、CRP水平变化,分析预测术后产褥感染的价值,并明确病原菌分布及耐药性情况。结果产后24h,观察组PCT明显高于对照组(P0.05);产后48h、72h、96h,观察组PCT、CRP均明显高于对照组(P0.05)。产后24h PCT、48h PCT、产后48h CRP、联合指标1、联合指标2预测剖宫产术后产褥感染的ROC曲线下面积AUC分别为0.714、0.923、0.893、0.892、0.924,产后24h PCT预测价值一般,产后48h PCT、48h CRP、联合指标1、联合指标2预测价值较高。当取最佳截断值时,产后48h PCT、48h CRP、联合指标1、联合指标2敏感度分别为92.3%、86.2%、92.3%、90.8%,特异度分别为90.8%、86.2%、79.2%、91.5%。130例标本分离得到病原菌136株,革兰阴性菌98株(72.06%),以大肠埃希菌与阴道加德纳菌为主;革兰阳性菌38株(27.94%),以溶血性链球菌、粪肠球菌为主。结论对于行剖宫产术后患者,术后3d内需密切监测PCT、CRP水平变化;术后感染病原菌以革兰阴性菌为主,大肠埃希菌、阴道加德纳菌居多,应根据病原菌种类及耐药性合理用药以确保疗效。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.     

Molecular characterization of virulence and antimicrobial resistance profile of Shigella species isolated from children with moderate to severe diarrhea in northeastern Brazil

Molecular characterization of virulence and antimicrobial resistance profiles were determined for Shigella species isolated from children with diarrhea in Fortaleza, Brazil. Fecal specimens were collected along with socioeconomic and clinical data from children with moderate to severe diarrhea requiring emergency care. Shigella spp. were isolated by standard microbiological techniques, and we developed 4 multiplex polymerase chain reaction assays to detect 16 virulence-related genes (VRGs). Antimicrobial susceptibility tests were performed using disk diffusion assays. S. flexneri and S. sonnei were the predominant serogroups. S. flexneri was associated with low monthly incomes; more severe disease; higher number of VRGs; and presence of pic, set, and sepA genes. The SepA gene was associated with more intense abdominal pain. S. flexneri was correlated with resistance to ampicillin and chloramphenicol, whereas S. sonnei was associated with resistance to azithromycin. Strains harboring higher numbers of VRGs were associated with resistance to more antimicrobials. We highlight the correlation between presence of S. flexneri and sepA, and increased virulence and suggest a link to socioeconomic change in northeastern Brazil. Additionally, antimicrobial resistance was associated with serogroup specificity in Shigella spp. and increased bacterial VRGs.     

护理干预对面部中重度寻常型痤疮的临床疗效影响分析

目的研究护理干预对面部中重度寻常型痤疮的临床疗效影响。方法选取本院在2014年4月~2016年7月诊治的136例面部中重度寻常型痤疮患者,随机分为研究组与对照组,每组68例;所有患者均依据其情况给予对应的治疗,其中对照组在治疗期间给予常规护理,研究组在对照组的基础上再给予综合性护理干预,比较两组的治疗效果及护理满意度情况等。结果患者在接受治疗和护理后,研究组中度与重度患者的治疗效果较对照组均明显提高(P0.05),研究组护理满意度较对照组明显增高(P0.05)。结论对面部中重度寻常型痤疮患者在其治疗期间给予综合性护理干预,具有良好的效果。