结核分枝杆菌药敏试验方法改进的探讨

目的 探讨改进结核分枝杆菌药敏试验方法。方法 以ＢＡＣＴＥＣ法７Ｈ１２Ｂ液体培基分离５０例临床结核分枝杆菌菌株，经不同稀释后，直接接种于改良罗氏药敏培基上，与ＢＡＣＴＥＣ法药敏结果对比，观察其耐药性。结果 １．７Ｈ１２Ｂ液体培基中结核分枝杆菌菌液ＧＩ值５００～９００时，１ｍｌ相当于１ｍｇ结核分枝杆菌湿重的活菌（菌数１０＾６～７）。２．取７Ｈ１２Ｂ液体培基的菌液直接接种于罗氏药敏培养基，其耐药结果与     

手术标本中结核分枝杆菌检测及临床意义研究

目的 探讨结核病患者手术切除标本进行结核分枝杆菌检测的临床意义。 方法 应用罗氏培养、液体培养及定量RT-PCR方法检测12例不同化疗疗程后行手术,术中取材的标本中结核分枝杆菌。 结果不同化疗疗程的手术标本中可以应用罗氏培养法及液体培养法检测到结核分枝杆菌,并有病例存在结核分枝杆菌持留菌特征性ICL及ACR的高表达。 结论 手术标本是结核菌培养及持留菌检测的很好材料,对患者术后化疗指导有指导意义。     

手术标本中结核分枝杆菌检测及临床意义研究

目的探讨结核病患者手术切除标本进行结核分枝杆菌检测的临床意义。方法应用罗氏培养、液体培养及定量RT—PCR方法检测12例不同化疗疗程后行手术,术中取材的标本中结核分枝杆菌。结果不同化疗疗程的手术标本中可以应用罗氏培养法及液体培养法检测到结核分枝杆菌,并有病例存在结核分枝杆菌持留菌特征性ICL及ACR的高表达。结论手术标本是结核菌培养及持留菌检测的很好材料,对患者术后化疗有指导意义。     

MPB64抗原检测快速诊断结核分枝杆菌的临床价值

目的比较痰涂片抗酸染色、改良酸性罗氏培养、MPB64的免疫胶体金法用于检测结核分枝杆菌特异性的分泌蛋白质MPB64,评价MPB64的免疫胶体金法在结核分枝杆菌快速检测中的应用价值。方法选取438例确诊肺结核患者痰液,进行痰涂片抗酸染色、7H9液体培养基和改良酸性罗氏培养基培养、基于MPB64的免疫胶体金法检测,对结果进行比较分析。并选取痰涂片确认为阳性的标本33例,用米氏7H9液体培养和基于MPB64的免疫胶体金法进行检出时间对比。结果痰涂片阳性率为14.8%,罗氏培养阳性率为20.7%,7H9液体培养阳性率24.8%,MPB64的免疫胶体金法阳性率为25.1%。基于MPB64的免疫胶体金法在培养的第15天检出32例阳性;而单纯的7H9液体培养加抗酸染色检测法在第15天只检出11例阳性。结论7H9液体培养配合基于MPB64的免疫胶体金法可以作为一种较为敏感和特异的检测结核分枝杆菌感染的方法,并可以有效的区分结核分枝杆菌和非结核分枝杆菌。     

手术标本中结核分枝杆菌检测及临床意义研究

目的探讨结核病患者手术切除标本进行结核分枝杆菌检测的临床意义。方法应用罗氏培养、液体培养及定量RT—PCR方法检测12例不同化疗疗程后行手术，术中取材的标本中结核分枝杆菌。结果不同化疗疗程的手术标本中可以应用罗氏培养法及液体培养法检测到结核分枝杆菌，并有病例存在结核分技杆菌持留菌特征性ICL及ACR的高表达。结论手术标本是结核菌培养及持留菌检测的很好材料，对患者术后化疗指导有指导意义。     

结核分枝杆菌快速培养法

仅在长期培养后才能得到可靠的结核病化验室诊断。在改良罗氏(Lowenstein-Jensen)固体培基上,结核分枝杆菌常于40～45天生长。为此迫切需要寻找结核菌快速生长的途径。经初步实验,作者偏重于使用氏建议的液体培基,而液体培基和固体     

超声分散比浊法处理BACTEC MGIT 960培养阳性的菌液标本用于药物敏感性试验的价值

目的分析应用超声分散比浊法处理的BACTEC MGIT 960(简称"MGIT 960")培养阳性的液体培养物菌液标本用于分枝杆菌药物敏感性试验(简称"药敏试验")的价值。方法搜集2018年1—12月西安市胸科医院经MGIT 960液体分枝杆菌培养阳性的标本,共计1086份。其中,818份菌液标本进行MGIT 960液体药敏试验,包括MGIT 960推荐方法处理的菌液标本100份、超声分散比浊法处理的菌液标本718份;268份菌液标本进行比例法药敏试验,包括采用传统磨菌法处理的菌液标本30份、超声分散比浊法处理的菌液标本238份。与传统菌液标本处理方法比较,分析超声分散比浊法处理后的菌液标本用于MGIT 960液体药敏试验和比例法药敏试验的效果。结果超声分散比浊法处理后的0.6～1.0麦氏单位菌液标本进行MGIT 960液体药敏试验报告结果的时间主要集中在8～10 d,而MGIT 960法处理后的菌液标本报告结果时间则较均匀分布在5～14 d。浊度为0.6、0.7、0.8、0.9、1.0麦氏单位菌液标本系统检测X200(标本活菌量少)报告率[分别为0.00%、0.00%、0.00%、0.72%(1/138)、1.31%(2/153)]均低于MGIT 960菌液处理法[11.00%(11/100)],差异均有统计学意义(χ~2值分别为11.41、9.94、12.43、12.79、11.28,P值均<0.01)。进行二线抗结核药物比例法药敏试验时,增菌6～7 d后,应用超声分散比浊法处理的菌液标本基本可以达到目标浊度,而传统磨菌法处理的标本在增菌第7天时仅有80%达到目标浊度。应用超声分散比浊法处理后的浊度为0.7、0.8、0.9、1.0麦氏单位的菌液标本,药敏试验成功率分别为82.61%(19/23)、82.69%(43/52)、94.00%(47/50)、96.00%(48/50),与传统磨菌法处理的菌液标本药敏试验成功率[83.33%(25/30)]相近,差异均无统计学意义(χ~2值分别为0.01、0.01、2.37、3.77,P值均>0.05)。结论应用超声分散比浊法处理MGIT 960液体培养阳性的菌液标本,可提高MGIT 960液体药敏试验成功率,缩短比例法药敏试验时间。     

牛分枝杆菌肺结核17例报告

为提高对牛分枝杆菌结核病的认识，现将它的分布情况、诊断、治疗探讨如下。1材料与方法1.1观察对象1993年7月～1997年10月本所门诊因症就诊病例。1.2细菌学检验1.2.1采用厚涂片法（美尼氏）1.2.2痰菌培养痰标本经酸处理，接种于改良罗氏（L—J）培养基。1.2.3菌型鉴别人、牛型结核分枝杆菌鉴别，采用对硝基苯甲酸（PNB）培养基（0·sing／ml）和喷吩谈酸动（TCH、T。H，sing／ml）鉴别培养基，用以区分人、牛型结核分枝杆菌与非结核分枝杆菌，并辅以硝酸还原，荣酸产生等其他特征。1.2.4耐药性测定以绝对浓度法间接法测定全部分离株对5…     

MODS技术快速检测结核分枝杆菌左氧氟沙星耐药性研究

目的探讨MODS技术快速检测左氧氟沙星耐药性的效果。方法用24孔细胞培养板进行结核分枝杆菌（MTB）液体药敏检测，并对最佳检测条件进行探讨；将建立的MODS技术用于测定60株MTB临床分离株左氧氟沙星耐药性，并与传统罗氏绝对浓度法药敏结果进行比较。结果本法与罗氏绝对浓度法药敏结果相符58株，不符2株；符合率为96．7％；如以罗氏绝对浓度法药敏结果为判断标准，MODS检测左氧氟沙星耐药性的敏感性、特异性、阳性预测值、阴性预测值、准确性分别为100％、96．0％、83．3％、100％、96．7％。结论MODS技术检测左氧氟沙星耐药性具有快速、操作简便、价廉等优点，可作为结核分枝杆菌左氧氟沙星耐药性的检测新方法之一。     

噬菌体生物扩增法检测痰标本结核分枝杆菌及耐药性测定

目前常规结核分枝杆菌（MTB）细菌学检查和药敏检测尚无法充分满足临床需要。以噬菌体为基础的结核分枝杆菌裂解试验,利用噬菌体生长快、特异性高的特性,快速准确地检测MTB,并进行药敏检测,近年来在结核病研究中备受关注^[1-2]。本研究采用噬菌体裂解法快速检测肺结核患者痰标本中的MTB,同时检测对异烟肼（H）、利福平（R）、链霉素（S）、乙胺丁醇（E）的敏感性,并与改良罗氏培养法分离细菌及比例法药敏结果进行比较,现报告如下。     

Presynaptic m1 muscarinic receptors are necessary for mGluR long-term depression in the hippocampus

To investigate the role of M1 muscarininc acetylcholine receptors (m1 receptors) in metabotropic glutamate receptor (mGluR)-mediated long-term depression (LTD), we produced mouse lines in which deletion of the m1 gene is restricted to the forebrain (FB–m1KO) or hippocampal CA3 pyramidal neurons (CA3–m1KO). Stimulation in FB–m1KO hippocampal slices resulted in excitatory postsynaptic potentials and long-term synaptic plasticity (long-term potentiation and LTD) similar to controls. The mice were deficient in (S)-3,5-dihydroxyphenylglycine hydrate (DHPG)-induced mGluR LTD, which correlated with a presynaptic increase in the release of neurotransmitters. Protein kinase C (PKC) activity, which is downstream from both mGluRs and m1 receptors, was reduced in CA3 but not in CA1. The presynaptic requirement of m1 receptors was confirmed by the lack of DHPG-induced mGluR LTD in the CA1 of slices from CA3–m1KO mice. mGluR LTD was rescued by stimulating PKC activity pharmacologically in CA3–m1KO mice. These data confirm a role for PKC activation in presynaptic induction of mGluR LTD and distinguish between the roles of mGluRs and m1 receptors.     

Recurrent Hepatitis C After Living Donor Liver Transplantation Detected by Tc-99m GSA Liver Scintigraphy

Recurrence of hepatitis C virus (HCV) after living donor liver transplantation was investigated using technetium-99m- diethylenetriaminepentaacetic acid-galactosyl human serum albumin (Tc-99m-GSA) liver scintigraphy. Four patients with decompensated cirrhosis due to HCV infection were retrospectively reviewed in this study. Scintigraphy was performed to determine the hepatic uptake ratio of the tracer corrected for disappearance from the blood, as well as the maximal removal rate of the tracer by hepatocytes, as parameters of hepatic functional reserve. In all patients, serum HCV ribonucleic acid (RNA) was detected 3 months after transplantation. The corrected hepatic uptake ratio and removal rate showed little change after transplantation in two patients without the recurrence of HCV infection. In another two patients, these levels were decreased at 3 months after transplantation. In one patient, recurrent HCV infection was diagnosed by confirmatory histologic examination at 12 months after transplantation. In the other patient, both levels declined further at 8 months. Although treatment was initiated with a combination of interferon plus ribavirin, this patient died of progressive hepatic failure. In conclusion, a decrease in scintigraphic parameters at 3 months after transplantation suggests recurrent HCV infection affecting the graft. Tc-99m-GSA liver scintigraphy is a useful noninvasive method for evaluating graft functional reserve.     

Technetium-99m pyrophosphate myocardial uptake in patients with stable angina pectoris.

99m-technetium (Tc) pyrophosphate myocardial scintigrams of 55 patients with stable angina pectoris were compared with those of 13 normal subjects. The mean scintigraphic score, obtained by averaging the blinded interpretations of four readers scoring on an integral scale from 0 to 4, was significantly higher for the patients with angina than for the control subjects (1.36 compared with 0.48, P less than 0.001). Among the patients with angina, those who had a prior myocardial infarction had a higher mean scintigraphic grade than those without a previous infarction (1.73 versus 1.15, P less than 0.005), and the mean grade in both groups was higher than that of control subjects (P less than 0.001). Radionuclide uptake was predominantly diffuse in the patients with angina pectoris (70%), although in those with greater uptake accumulation tended to be localized. Three of the 68 subjects had high levels of radionuclide uptake but no clinical evidence of acute myocardial injury. This study demonstrates that excess myocardial accumulation of 99m-Tc pyrophosphate can occur in patients with stable angina pectoris.     

Invagination intestinale sur métastase d’un mélanome cutané

The authors reported a case of ileal invagination secondary to metastasis of a cutaneous melanoma. This complication is exceptional On the occasion of this observation, the authors point out the jejuno-ileal preferential localization, the difficulties of diagnosis and management of intestinal metastasis of cutaneous malignant melanoma also the poor prognosis of these lesions. The princeps treatment of these metastases is surgical, to compensate for the possible occlusive emergency and permit carcinologic resection. This surgery will be coupled with adjuvant chemotherapy.     

Discordant results in Tc-99m tetrofosmin and Tc-99m sestamibi parathyroid scintigraphies

Parathyroid scintigraphies have been used to detect pathological parathyroid glands either before as well as after the parathyroid resection surgery in patients with hyperparathyroidism. One of the most utilized techniques to perform the studies is the double-phase images with Tc-99m sestamibi, which has been shown to be very accurate in the localization of enlarged parathyroid glands. Similar to Tc-99m sestamibi, Tc-99m tetrofosmin is a radiopharmaceutical initially developed to perform myocardial perfusion study that has been used to perform parathyroid scintigraphies. Although most of the papers suggest that the overall sensitivities of both radiopharmaceuticals are similar, there are some papers questioning the accuracy of Tc-99m tetrofosmin to detect abnormal parathyroid glands. In the present article, we report a case with discordant results by both methods.