细菌性角膜炎患者的护理措施

细菌性角膜炎是由细菌感染引起的角膜炎症.是常见的角膜炎之一.通常起病急、发展迅速,病情多较危重.临床上常见的有匐行性角膜炎和铜绿假单胞菌(绿脓杆菌)性角膜炎.病理改变主要是角膜缘血管充血扩张,炎症细胞及炎性渗出侵入病变区,角膜形成灰白色浸润灶,称为角膜浸润,如炎症及时控制,角膜仍能恢复透明.     

病案灭菌和防止危害接触者的探讨与研究

目的了解病案染菌情况,评价臭氧消毒灭菌效果,探讨防止接触病案的人员免受相关感染的方法。方法分别对灭菌前后半小时的病案取样,进行细菌培养计数及鉴定。结果消毒灭菌前平均细菌菌落数5.3CFU/ml,消毒后灭菌平均细菌菌落数0.4CFU/ml。灭菌前细菌除表皮葡萄球菌、芽胞杆菌、棒状杆菌属、真菌(霉菌)等环境中常见菌之外,金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌等院内感染最常见病原菌也大量存在。芽胞杆菌、真菌消毒效果应该相对较差。结论病案在形成、使用过程中,受到各种细菌污染,因此要重视病案灭菌,减少使用病案人员免受细菌感染的机会。     

眼部分泌物中158株检出苗及其药敏分析

细菌性眼部结膜炎患者眼部分泌物中检出１５８株细菌。其中金黄色葡萄球菌１８株，表皮葡萄球菌１３株，铜绿假单胞菌１６株，其他假单胞菌６６株。分析结果可见假单胞菌感染率最高，眼部的正常菌群表皮葡萄球菌也可引发感染，细菌对庆大霉素的敏感较高，对氯霉素敏感率较低。     

青橄榄叶提取物体外抑菌活性研究

[目的]测定青橄榄叶提取物及大孔树脂AB-8不同极性洗脱产物对供试菌株的体外抑菌活性.[方法]采用96孔板微量稀释法测定青橄榄叶总提取物及不同极性洗脱产物对白色念珠菌、铜绿假单胞杆菌、耐甲氧西林金黄色葡萄球菌、耐药白色念珠菌、酿酒酵母和金黄色葡萄球菌的最低抑菌浓度(MIC).[结果]大孔树脂水洗极性部位对白色念珠菌的MIC为20.62 g/ml,50％乙醇洗脱部分对铜绿假单胞杆菌的MIC为82.5 μg/ml,90％乙醇洗脱部分对白色念珠菌、铜绿假单胞菌、耐甲氧西林金黄色葡萄球菌、耐药白色念珠菌、酿酒酵母和金黄色葡萄球菌的MIC分别为41.25,20.62,20.62,10.32,165.0和2.58μg/ml.[结论]青橄榄叶洗脱产物的水、50％乙醇及90％乙醇洗脱部分对白色念珠菌、铜绿假单胞杆菌、耐甲氧西林金黄色葡萄球菌、耐药白色念珠菌、酿酒酵母和金黄色葡萄球菌有较好的抑菌活性,尤其是90％乙醇洗脱部位的抑菌范围广,活性强且呈现量效依赖关系.     

细菌性角膜炎诊治进展

细菌是化脓性角膜炎的最常见病因 ,细菌性角膜炎是主要的致盲眼病之一。到目前为止其确切发病率尚不清楚。在发展中国家 ,细菌性角膜炎是角膜盲第一位的病因。细菌性角膜炎发生往往有危险因素 ,或称为相关因素存在 ,任何能够破坏泪液、角膜上皮、角膜缘血管及角膜内皮细胞完整性的因素均可为细菌感染提供机会。最常见的相关因素有外伤、配戴角膜接触镜、眼表疾病、角膜手术、局部或全身性疾病等。造成角膜炎的细菌种类众多 ,其中以微球菌科 (主要是葡萄球菌属和微球菌属 )、链球菌属、假单胞菌属及肠杆菌科为主 ,约 87%的细菌性角膜炎是由上…     

盐酸左氧氟沙星眼用即型凝胶治疗兔金黄色葡萄球菌角膜炎

目的 盐酸左氧氟沙星眼用即型凝胶治疗兔金黄色葡萄球菌角膜炎的药效学研究.方法 选取60只双眼均正常的新西兰大白兔,给予左眼角膜基质内注射10μL含105个菌落形成单位(colony-forming unit,CFU)的金黄色葡萄球菌菌液,建立角膜炎动物模型.挑选炎症程度相近的48只兔,采用完全随机设计方法分为4组,即24 h基线组、磷酸盐缓冲液(PBS)空白对照组、盐酸左氧氟沙星滴眼液组及盐酸左氧氟沙星眼用即型凝胶组,每组12只.观察24 h基线组兔眼临床炎症情况并评分,观察角膜病理变化及进行细菌菌落计数;其余3组每日治疗3次,至第7天最后一次给药后2h对3组兔的处理同24 h基线组.各组角膜临床炎症评分和角膜细菌菌落计数值比较均使用多个样本均数比较中的完全随机设计资料的方差分析,即F检验.结果 第7天时,相对于PBS空白对照组,盐酸左氧氟沙星滴眼液与盐酸左氧氟沙星眼用即型凝胶均降低角膜炎感染的临床症状(P=0.00),角膜炎临床评分分别为4.21±1.10和3.63±0.86;第7天时,盐酸左氧氟沙星滴眼液组与盐酸左氧氟沙星眼用即型凝胶组兔眼角膜菌落数均降低(P=0.00),角膜菌落计数分别为(4.87±0.05)和(4.64±0.10)CFU,差异有统计学意义(P=0.00).结论 盐酸左氧氟沙星眼用即型凝胶局部给药治疗金黄色葡萄球菌角膜炎可明显改善临床症状、降低角膜菌落数,其作用优于常用的盐酸左氧氟沙星滴眼液,是一种有效的新型眼用制剂.     

银黄健肤露抗炎抑菌作用研究

目的：观察银黄健肤露对金黄色葡萄球菌（金葡菌）及铜绿假单胞杆菌所致皮肤感染和二甲苯所致小鼠耳廓炎症的影响，以了解其抗炎作用。方法：利用试管二倍稀释法测定对部分细菌的MIC，与痱子水相比较，以了解其体外抑菌作用。结果：银黄健肤露对金葡菌及铜绿假单胞杆菌皮肤感染的抑菌作用大中剂量组作用强度与痱子水基本相似，而小剂量组弱于痱子水；银黄健肤露对二甲苯所致的耳廓肿胀有明显的抑制作用，大剂量（0．2ml／只）作用强于痱子水；银黄健肤露对肺炎克雷伯氏杆菌及白色念珠菌的作用要强于痱子水，对其他细菌无明显差别。结论：银黄健肤露对家兔皮肤感染和铜绿假单胞杆菌感染所致的炎症及二甲苯所致的小鼠耳廓炎症均有抑制作用。     

医院致病菌检测及药敏的临床分析

目的 分析致病菌的演变情况,及细菌耐药性的变化趋势.方法 回顾性分析2006年1月至2012年12月住院患者痰培养、尿培养、血培养等方法中分离的细菌标本来源、科室分布及耐药情况.结果 7年间共培养出致病菌11 827株,其中铜绿假单胞菌3857株,位列第1,大肠埃希菌1977株、肺炎克雷白杆菌1381株,鲍曼不动杆菌1081株及金黄色葡萄球菌794株分别位列第2～5位.临床中细菌对于常用抗菌药物的耐药率,总体呈现增长趋势,其中对头孢哌酮/舒巴坦耐药率增长较为缓慢,其耐药率大多低于20%,铜绿假单胞菌及鲍曼不动杆菌耐药状况较为严重,对多种β-内酰胺类,氨基糖苷类及喹诺酮类药物耐药,耐药率多波动于50%～70%之间.结论 临床中常见主要致病菌仍为铜绿假单胞菌、大肠埃希菌、肺炎克雷白杆菌、鲍曼不动杆菌及金黄色葡萄球菌,其中铜绿假单胞菌仍居首位.细菌耐药率逐年增加,其中鲍曼不动杆菌耐药最为严重,耐药率增长最为迅猛.     

1998～2000年954株烧伤感染菌耐药性调查分析

目的调查烧伤创面分离菌对抗菌药物的耐药状况.方法收集临床分离的致病菌,采用纸片扩散法进行药敏试验. 结果在检出的954株细菌中,金黄色葡萄球菌居首位,检出率为27.5%;其次为铜绿假单胞菌,检出率为19.5%;以后依次为表皮葡萄球菌、粪肠球菌、肺炎克雷白杆菌和阴沟肠杆菌,检出率分别为10.4%、6.8%、4.1%和2 6%.万古霉素对金黄色葡萄球菌100%敏感;铜绿假单胞菌对第三代头胞菌素和亚胺培南耐药性显著增加;除铜绿假单胞菌外,其它细菌对阿米卡星的耐药率都有不同程度的降低. 结论细菌耐药性日益严重,随时进行细菌耐药性监测、合理应用抗生素是控制和延缓细菌耐药性的关键.     

痔瘘洗液体外抑菌作用

目的探究痔瘘洗液的体外抑菌作用。方法滤纸片扩散法。用痔瘘洗液浸泡过滤纸片覆盖于种植了金黄色葡萄球菌、铜绿假单胞菌、大肠杆菌、甲型链球菌、乙型链球菌的培养基表面,观察痔瘘洗液对上述各种细菌的抑制作用。结果痔瘘洗液对金黄色葡萄球菌、铜绿假单胞菌、大肠杆菌、甲型链球菌、乙型链球菌等细菌均有抑制作用。结论痔瘘洗液能够抑制金黄色葡萄球菌、铜绿假单胞菌、大肠杆菌、甲型链球菌、乙型链球菌的生长。     

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.     

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.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.