尿路感染的病原菌种类及耐药性分析

目的探讨尿路感染的病原菌种类,分析其耐药性,提高尿路感染的临床治疗水平。方法对386例尿路感染患者的清洁中段尿细菌培养及耐药性结果进行回顾性调查分析。结果清洁中段尿细菌培养阳性率为23.8%。其中大肠埃希菌占62.0%,克雷伯菌占13.0%,变形杆菌占6.5%,假单胞菌占5.4%,葡萄球菌占7.6%,肠球菌占5.4%。产超广谱β-内酰胺酶(ESBLs)菌平均检出率为11.6%。革兰阴性杆菌对复方新诺明、氨苄西林和环丙沙星的耐药率较高,对亚胺培南、阿米卡星、头孢三嗪的耐药率低。革兰阳性球菌对红霉素、青霉素耐药率高,对万古霉素敏感率为100%。产ESBLs大肠埃希菌及肺炎克雷伯菌对氨基糖苷类、第三代头孢菌素和氨苄西林耐药率较高,而对亚胺培南及酶抑制剂的复合药敏感。结论引起尿路感染的主要病原菌为大肠埃希菌;临床上要特别重视尿路感染的病原菌检查及药敏试验,合理使用抗生素,以减少产ESBLs细菌的产生,提高治愈率。     

Coping with Impending Stress: Psychophysiological and Cognitive Correlates of Choice

When faced with threat of shock, individuals were allowed to choose to distract themselves by listening to Muzak or to monitor cues predicting shock. Preference for monitoring information or for distraction was investigated concurrently with electrodermal and subjective arousal. Subjects preferred to monitor rather than distract themselves, particularly when shock was avoidable. Even when shock was not avoidable, some preference for information was found. Arousal, physiological and subjective, was consistently higher under monitoring conditions, and this was most pronounced when shock was unavoidable. Higher arousal accompanying information is contrary to the three major theories explaining choice of predictable threat, and the outline of a new hypothesis was proposed to account for these data.     

Ryff心理幸福感量表在我国城市居民中的试用研究

目的 对Ryff心理幸福感量表的测量学特性进行检验．探讨在此量表基础上生成一套适用于我国城市居民的心理幸福感量表的可能性。方法 在山东泰安和烟台市区取样(n=390),对该量表的信度和效度进行检验,采用探索性因素分析对该量表所含项目进行了分析与筛选。结果 Ryff心理幸福感量表运用于我国城市居民时同质信度较好,全量表的内在一致性系数为0．94、各分量表内在一致性系数也在0．67以上．效标效度尚可,但构想效度不理想。在Ryff心理幸福感量表基础上生成的中国城市居民心理幸福感量表具有较好的构想效度。结论 Ryff心理幸福感量表及其派生而来的中国城市居民心理幸福感量表,具有在我国城市居民中进一步试用的价值。     

潮州地区高危型人乳头瘤病毒载量与宫颈病变的关系

目的探讨高危型人乳头瘤病毒(high risk human papillomavirus,HR-HPV)载量与宫颈病变级别之间的关系。方法采用RT-PCR对农村35～60岁女性进行HR-HPV DNA定量检测并记录CT值,2 731例阳性者再进行核酸分子快速导流杂交分型技术(HybriMax)和液基薄层细胞学(thinprep liquid-based cytologic test,LCT)检查;对低级别鳞状上皮内病变(low grade squa-mous intraepithelial lesion,LSIL)及以上病变行阴道镜下组织病理学活检。根据LCT及病理活检结果按病变级别分成5组:无上皮内瘤变或恶性病变(non-squamous intraepithelial lesion or neoplasia,NILM)、未明确诊断意义的不典型鳞状上皮细胞(atypi-cal squamous cells of undetermined significance,ASCUS)、LSIL、高级别鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)和鳞状细胞癌(squamous cell cacinoma,SCC)。在同级别宫颈病变中,按照HPV感染的类型分为4组:HPV52、HPV16、HPV58和多重HPV感染。采用方差分析的方法对各组平均CT值进行统计分析。结果随宫颈病变级别的升高,CT均值降低,5组CT均值间差异均具有显著性(P<0.05)。在同级别宫颈病变中,NILM组HPV58和多重HPV差异有显著性(P<0.05),ASCUS组HPV16和多重HPV差异有显著性,其余病变级别各HPV感染组间差异均无显著性(P>0.05)。结论 HR-HPV载量与宫颈病变级别呈正相关,高HR-HPV载量是影响宫颈病变级别的危险因素。     

病人健康问卷和广泛性焦虑量表在非心源性胸痛患者中筛查抑郁焦虑的效度和信度

目的:分析病人健康问卷(PHQ-9)和广泛性焦虑量表(GAD-7)在非心源性胸痛(non-cardiac chest pain, NCCP)患者中应用的效度和信度,探索快速筛查焦虑抑郁的可行性。方法:连续选取2017-2018年就诊的非心源性胸痛患者343人。完成PHQ-9和GAD-7评定,随机抽取30人重测。采用Cronbach α系数评估内部一致性,以精神科医生应用简明国际神经精神访谈(MINI),根据ICD-10做出的诊断为"金标准"评估效标效度,采用受试者工作特征曲线(ROC)检验诊断效能。结果:PHQ-9 Cronbach’α系数为0.89,重测信度为0.85,最佳分界值11分,灵敏度81%,特异度84%,ROC曲线下面积(AUC)为0.90。GAD-7 Cronbach α系数为0.92,重测信度为0.83。最佳分界值8分,灵敏度为96%,特异度为38%,ROC的AUC为0.61。结论:NCCP患者抑郁评估中PHQ-9具有良好的效度和信度,焦虑评估中GAD-7特异度不理想。     

Differential effect of the expression of TGF-β pathway inhibitors, Smad-7 and Ski, on invasive breast carcinomas: relation to biologic behavior

The aim of our study was to investigate the expression of Smad-7 and Ski proteins in invasive breast carcinomas, to determine their clinicopathological value and their influence on carcinomas biologic behavior. Immunohistochemistry was applied on 150 invasive breast carcinomas to detect the expression of Smad-7 and Ski. Their correlation to clinicopathologic parameters and markers of metastasis was statistically processed using chi-squared test. Overall and disease-free survival was assessed using Kaplan-Meier test and log-rank statistics. Smad-7 was immunodetected in the cytoplasm of cancer cells in 60%, whereas Ski was immunodetected in the cytoplasm and nuclei in 44.5% and 17.6% of the cases, respectively. Smad-7 expression was positively correlated with tumor size, stage, matrix metalloproteinase (MMP)-9, and MMP-14. Cytoplasmic Ski expression was negatively associated with tumor size, stage, and lymph node status, and its nuclear expression was negatively related to histologic grade. Cytoplasmic Ski expression was associated with longer overall and disease-free survival. It appears that two negative regulators of the transforming growth factor-β pathway, Smad-7 and Ski, behave differentially in invasive breast carcinomas. Smad-7 appears to be related with an aggressive phenotype, whereas Ski expression is related to a less aggressive behavior and positively influences patients' survival.     

Case 5

A 53-year-old man with a heavy exposure to asbestos 25 years earlier was admitted to the East Orange Veterans Administration Medical Center with a rapidly enlarging chest wall mass of 4-5 weeks duration.

The mass, overlying the ninth and tenth ribs in the infraaxillary area, was firm. On X-ray the ribs appeared eroded and the mass was seen to extend into the pleural space. A chest wall resection was performed, and the tumor was sharply dissected from the diaphragm to which it was firmly adherent. Grossly, it measured 7.5 X 5.0 X 3.0 cm and was yellow-tan with homogeneous and nodular areas The inferior aspect of the ninth rib was obviously involved and the tumor extended between the pleura and intercostal muscle.

The patient did not receive further therapy and was asymptomatic 7 months after surgery.     

髂前上棘、耻骨联合及股骨头中心的影像定位与体表关系

目的通过X线骨盆平片测量,计算股骨头中心与这两点的关系。分析其特点,找到一个简便、相对准确的体表确定股骨头运动中心的方法。方法门诊选取健康男女性各20人﹙无腰髋症状及病史﹚,得到年龄、身高、体重。摄标准骨盆正位片,拍照前体表找到髂前上棘、定位,于其上放置参照物。使用测量软件测量骨盆宽度、高度、髂耻线及股骨头中心数据。将各项参数收集后进行统计学分析。结果股骨头中心距髂耻连线距离平均为2.72cm左右。股骨头中心在髂耻连线的投影点均位于髂耻连线中点的外侧,距离髂耻中点1.08cm左右。结论股骨头运动中心是髋膝关节置换及骨折手术的重要标志,通过髂前上棘、耻骨联合等体表标志确定股骨头中心简便易行、值得推广,可作为临床手术定位的辅助。     

Adaptation to destabilizing dynamics by means of muscle cocontraction

Adaptive control of wrist mechanics was investigated by means of destabilizing dynamics created by a torque motor. Subjects performed a 20 degrees movement to a 3 degrees target under the constraint that no motion should occur outside of the target zone once 800 ms had elapsed from movement onset. This constraint served as the minimum acceptable level of postural stability. The ability of subjects to modify their muscle activation patterns in order to successfully achieve this stability was investigated by creating three types of destabilizing dynamics with markedly different features: negative stiffness, negative damping, and square-wave vibration. Subjects performed sets of trials with the first type of destabilizing dynamics and were then required to adapt to the second and third. The adaptive response was quantified in terms of the rms electromyographic (EMG) activity recorded during various phases of the task. Surface EMG activity was recorded from three muscles contributing to wrist flexion and three muscles contributing to wrist extension. With negative stiffness, a significant compensatory increase in cocontraction of wrist flexor and extensor muscles was observed for slow movements, but there was little change in the muscle activity for rapid movements. With negative damping, muscle cocontraction was elevated to stabilize rapid movements, declining only gradually after the target was reached. For slow movements, cocontraction occurred only when negative damping was high. The response to square-wave vibration (10 Hz, +/-0.5 Nm), beginning at movement onset, was similar to that of negative damping, in that it resulted in elevated cocontraction. However, because the vibration persisted after the target was reached, there was no subsequent decrease in muscle activity. When the frequency was reduced to 5.5 Hz, but with the same torque impulse, cocontraction increased. This is consistent with greater mechanical instability. In summary, agonist-antagonist cocontraction was adapted to the stability of the task. This generally resulted in less of a change in muscle activity during the movement phase, when the task was performed quickly compared with slowly. On the other hand, the change in muscle activity during stabilization depended more on the nature of the instability than the movement speed.     

基于投影的视网膜眼底图像视盘检测方法

充分利用血管的分布特性和视盘区域的外观特性,本研究提出一种易于实现的基于一维投影的视盘检测方法。首先利用2倍主血管宽度的垂直窗计算各水平位置的血管散布度值,并绘出相应的水平投影曲线,投影曲线的最小值点被确定为视盘的水平坐标,然后在确定的水平位置,通过边长为视盘直径的矩形窗获取局部区域内的亮度和血管边缘梯度特征,并绘出相应的垂直投影曲线,该曲线最大值点即为视盘垂直坐标。将本方法在4个公开的眼底图像数据集和1个自选数据集上进行了测试,在整个380幅眼底图像中,检测准确率达到94%,在STARE数据库中平均用时13.2 s,综合准确率和效率来看,本方法易于实现,鲁棒性好,符合实际系统处理要求。     

Effect of unilateral somatosensory stimulation prior to sleep on the sleep EEG in humans

SUMMARY  The hypothesis that local activation of brain regions during wakefulness affects the EEG recorded from these regions during sleep was tested by applying vibratory stimuli to one hand prior to sleep. Eight subjects slept in the laboratory for five consecutive nights. During a 6-h period prior to night 3, either the left or the right hand was vibrated intermittently (20 min on-8 min off), while prior to night 5 the same treatment was applied to the contralateral hand. The sleep EEG was recorded from frontal, central, parietal and occipital derivations and subjected to spectral analysis. The interhemispheric asymmetry index (IAI) was calculated for spectral power in nonREM sleep in the frequency range 0.25-25.0 Hz for 0.5-Hz or 1-Hz bins. In the first hour of sleep following right-hand stimulation, the IAI of the central derivation was increased relative to baseline, which corresponds to a shift of power towards the left hemisphere. This effect was most prominent in the delta range, was limited to the first hour of sleep and was restricted to the central derivation situated over the somatosensory cortex. No significant changes were observed following left-hand stimulation. Although the effect was small, it is consistent with the hypothesis that the activation of specific neuronal populations during wakefulness may have repercussions on their electrical activity pattern during subsequent sleep.     

粤北地区泌尿生殖道支原体感染现状及其耐药性分析

目的了解本地区泌尿生殖道支原体感染状况及对抗菌药物的耐药性。方法对1187例可疑非淋病性尿道炎患者及不孕不育症患者的泌尿生殖道分泌物标本进行支原体培养及药敏试验。结果支原体培养阳性率为37.6%,其中解脲脲支原体（Ureaplasma urealyticum,Uu）检出率最高,占25.2%;人型支原体（Mycoplasmahominis,Mh）检出率占2.6%;Uu＋Mh感染检出率为9.8%。药敏试验显示：在所选的抗生素中,Uu对环丙沙星的耐药率最高,对美满霉素、强力霉素、交沙霉素及克拉霉素较敏感;Mh对罗红霉素、克拉霉素、环酯红霉素及阿奇霉素有较高的耐药率,对强力霉素、美满霉素、交沙霉素及甲砜霉素较敏感;Uu和Mh混合感染仅对交沙霉素、强力霉素及美满霉素具有较高的敏感率,而对其它抗生素均具有较高的耐药率。结论 Uu是引起人类泌尿生殖道感染的主要类型;不同类型的支原体感染对抗生素的敏感性不同,临床上应根据不同类型的支原体感染选择合适的药物进行治疗。     

Histological analysis and the pathogenesis of mucocutaneous leishmaniasis

A series of over 400 well-documented biopsies of mucocutaneous leishmaniasis was evaluated to elucidate the histological processes associated with the elimination of parasites, and their correlation with the course of the disease. Non-specific inflammation was the most frequent and least effective response; its onset might be delayed, and in this event particularly the incidence of metastasis from skin to mucosa was high. Lysis of parasite-laden macrophages appeared to be the basic mechanism of parasite reduction, even when it was not overt. When it was acute the onset was usually rapid, and though it resulted in much tissue destruction the prognosis was generally better and mucosal metastasis rare. Lysis and non-specific inflammation both led to the formation of a post-necrotic type of granuloma, but reversion of the process was almost as common as progression. Ultimately a tuberculoid granuloma evolved and proceeded to resolution. In about 5 per cent of cases, macrophage activation appeared to bring about early resolution; neither reversion nor mucosal metastasis was seen.     

Allergen cross-reactivity between Pityrosporum orbiculare and Candida albicans

Pityrosporum orbiculare and Candida albicans extracts were separated bySDS-PAGE, and IgE binding was detected by immunoblotting with 21 patient sera that were RAST positive to both yeasts. Cross-wise inhibition was performed of IgE binding of a serum pool containing IgE antibodies to both yeasts. The pool was mixed with serial dilutions of P. orbiculare or C. albicans extracts, and incubated with strips containing separated allergen. IgE binding was quantified by densitometric scanning and percent inhibition was calculated as well as the respective ratios between required extract concentration for 50% inhibition in heterologous compared to homologous inhibition for each component 'inhibition ratio). Ten componentsof P. orbiculare were detected by more than 60% of the sera. IgE binding toC. albicans was weak, and only to four bands was IgE binding detected by more than 30% of the sera. The most important C. albicans allergen was a 48-kDa band, to which IgE of half of the patient sera bound. There was little inhibition of IgE binding to P. orbiculare with C. albicans. Thus, all but three components exhibited an inhibition ratio higher than 100.The inhibition ratio of the 48-kDa C. albicans compound was 50, thus indicating some degree of cross-reactivity. Significant cross-reactivity was shown by C. albicans compounds of 18, 24, 26, 34, and 38 kDa, the inhibition ratios of which were less than 10. There was some degree of cross-reactivity between apparent protein allergens of the two yeasts, but IgE antibodies to C. albicans donot merely reflect sensitization to P. orbiculare.     

湖南侗族的容貌特征观察

目的　探讨湖南侗族的容貌特征。方法　对湖南侗族头面部眼、耳、口、鼻、面部及毛发等 31项指标进行活体观察分析。结果　湖南侗族的容貌特征主要是 :发浓密、黑直 ,前额发际多呈三角形 ,眉毛中等 ;大多数人有蒙古褶和双眼皮 ;鼻根低平 ,鼻基上翘 ,鼻背直形或凹形 ,鼻翼宽阔且凸出 ;口裂中等 ,红唇较厚 ;颧骨体多不突出 ,颏部多后斜或直型 ,面宽 ,多为卵圆面形 ;多数人有达尔文结节 ,耳壳外展且多为椭圆形和卵圆形 ,耳垂为三角形或方形。结论　湖南侗族鼻的形态是区别于其它民族的主要容貌特征     

Neuroticism, cortisol reactivity, and antibody response to vaccination

This study examined whether neuroticism was related to the antibody response to influenza vaccination and whether the relationship was mediated by cortisol reactions to acute laboratory mental stress. Antibody status was assessed at baseline and to a trivalent influenza vaccination in 57 students at 5-week and 5-month follow-up. Neuroticism was also measured at baseline. Cortisol was measured at rest and in response to a pressurized mental arithmetic task. At both follow-ups, higher neuroticism scores were associated with poorer A/Panama antibody response, following adjustment for baseline antibody titer. Higher neuroticism scores were also associated with blunted cortisol reactivity, and blunted cortisol reactivity was associated with poorer A/Panama antibody response, but only at 5 months. However, there was no conclusive evidence that cortisol reactivity mediated the association between neuroticism and antibody response.     

Myocardin重组蛋白表达及其在人骨髓间充质干细胞重编程为血管平滑肌细胞中的作用

目的:研究心肌素(myocardin)重组蛋白的表达及分离纯化方法,并探讨myocardin重组蛋白对人骨髓间充质干细胞(human bone marrow mesenchymal stem cells,h BMSCs)向血管平滑肌细胞转分化的作用。方法:构建myocardin原核表达载体,摸索最佳诱导myocardin重组蛋白表达的方法及优化分离纯化方式。使用纳米转导试剂包裹myocardin形成纳米-蛋白复合体,转染h BMSCs,观察蛋白转导效率;蛋白转导成功后,检测血管平滑肌的特异性标志物平滑肌肌球蛋白重链的表达情况,观察h BMSCs向平滑肌细胞转化情况。结果:与传统方法相比较,高浓度法诱导myocardin重组蛋白的表达量更高,新采用的洗脱方式能获取更多的myocardin重组蛋白;纳米-myocardin复合体可成功转染h BMSCs并诱导其向血管平滑肌样细胞转化。结论:Myocardin重组蛋白能被高效转导到细胞内,并促使h BMSCs重编程为血管平滑肌样细胞。     

THE CARDIAC RESPONSE TO A PERCEPTUAL COGNITIVE TASK IN THE YOUNG CHILD

It has been argued that an important determinant of the cardiac response is the subject's intended transaction with his environment. The present study was designed to investigate whether cardiac deceleration would accompany the solution of a perceptual discrimination problem, whether the degree of cardiac deceleration would be related to the accuracy of the response, and the relationship between general intellectual ability and the cardiac response to the problem. Fifty-one subjects, 44 months of age, were each given 20 trials of a matching figures task. This task required that S match a figure (called standard) to one of four variations (one of which was identical to the standard). EKG was continuously recorded along with the latency and the accuracy of the response. If the first response was incorrect, S was asked to choose again. The results indicated: (1) There was a significant cardiac deceleration from the time S received the standard until he made his first choice. If the first response was correct, the cardiac rate, within 1–3 beats, returned to resting level; however, if S was told to guess again, the cardiac rate remained decelerated. (2) While accuracy of response was found to be related to the cardiac response, the effect was eliminated when response speed was controlled. (3) The degree of cardiac deceleration was correlated with general intellectual function as measured by a standard IQ test; however, it was significant only for girls.     

大鼠尾壳核、边缘区和苍白球生后发育的计算机三维重建研究

为研究大鼠脑的尾壳核、苍白球和边缘区在出生后的三维立体形态的发育变化规律 ,在脑连续冠状切片的基础上进行Nissl染色 ,然后对脑的整个外轮廓、尾壳核、苍白球和边缘区进行计算机三维重建和数据处理。结果表明 :尾壳核生后 (P0 1～P3 60 )的发育变化 :体积从 (1.40± 0 .2 0 ) mm3到 (4 4 .5 2± 0 .10 ) mm3,最大吻尾径从 3 .1mm到 6.8mm;最大背腹径从 1.5 8mm到5 .0 41mm;最大内外径从 1.0 5 mm到 3 .64 1mm。苍白球生后 (P0 1～P3 60 )的发育变化 :体积从 (0 .2 5± 0 .0 2 ) mm3到 (4 .84± 0 .0 8)mm3,最大吻尾径从 1.0 mm到 3 .3 mm;最大背腹径从 1.175 mm到 2 .5 5 1mm;最大内外径从 0 .80 5 mm到 1.5 98mm。边缘区生后 (P0 1～ P3 60 )的发育变化 :体积从 (0 .0 3 0 0 2± 0 .0 0 3 6) mm3到 (0 .5 6± 0 .0 1) mm3,最大吻尾径从 0 .8mm到 1.76mm;最大背腹径从 1.15 6mm到 2 .3 60 mm;最大内外径从 0 .0 65 mm到 0 .185 mm。提示 ,在生后一年中 ,尾壳核、苍白球和边缘区的形态基本未发生明显变化 ,在各个方向上基本呈均匀增长     

Sensitization of the rat parotid gland to secretagogues following either parasympathetic denervation or sympathetic denervation or decentralization

The sensitivity of the rat parotid gland to chemical agents was examined 2–3 weeks after either parasympathetic denervation or sympathetic denervation or decentralization. The parasympathetically denervated gland was markedly sensitized towards methacholine; a nonspecific supersensitivity mainly mediated via α-adrenoceptors was also demonstrated. The sympathetically denervated gland had developed a supersensitivity which was both of the pre-and the postjunctional type; it was predominantly of the former type to noradrena-line and adrenaline, and entirely so to phenylephrine; it was of the latter type to isoprene-line, and also to methacholine. The sympathetically decentralized gland was mainly sensitized towards noradrenaline, adrenaline and isoprenaline. The postjunctional super-sensitivity developed towards the sympathomimetic drugs after sympathetic decentralization was of about the same magnitude as that observed after sympathetic denervation; this type of supersensitivity was mainly mediated via β-adrenoceptors.