重度牙周炎患者拔牙同期植入颧种植体的围术期护理

目的: 分析重度牙周炎患者拔牙同期颧种植体植入术的围术期护理特点,总结该类患者的临床护理经验。方法: 选择8例全麻术下实施颧种植术的患者,对患者术前进行心理疏导,口腔卫生、环境准备等全面评估;术中熟练医护手术操作配合;术后在颧种植体创面观察,疼痛、冰敷护理,饮食指导,出院随访等方面进行护理干预。结果: 8例患者种植体初期稳定性良好,未出现伤口裂开和切口出血。出现Ⅱ级疼痛1例,面部中度肿胀1例。术后48 h内患者完成上颌义齿的临时修复,咬合关系及咀嚼功能恢复良好。结论: 对于重度牙周炎拔牙同期颧种植患者,开展全面的围术期护理干预,可降低并发症发生率,提高手术成功率。     

An unusual case of cardiac tamponade: Bronchogenic cyst infection due to Salmonella bredeney

We present an unusual case of cardiac tamponade in a 17-year-old girl immunocompetent patient due to Salmonella enterica ssp. bredeney following infection of a bronchogenic cyst.The patient was admitted to hospital with pleuritic chest pain, dyspnoea and fever. Pulmonary angio-CT showed a bronchogenic cyst compressing the left atrium. The echocardiography showed diffuse pericardial effusion with right ventricular collapse consistent with cardiac tamponade. Pericardiocentesis was performed and microbiological cultures of the pericardial fluid became positive for Salmonella species confirmed later as bredeney subspecies by PCR. Empirical antibiotherapy was started with intravenous (IV) ceftriaxone. Bronchogenic cyst infection was suspected and confirmed by ¹⁸FDG PET CT. The patient was successfully treated by complete resection of the cyst and continuation of IV ceftriaxone followed by oral amoxicillin/clavulanate for a total duration of 6 weeks. She then completely recovered and didn't present any relapse after 6 months of follow up.     

A case of intestinal MALToma with co-existent tuberculosis and Peutz-Jeghers polyp

A 22-year-old male patient underwent a segmental resection of the ileum due to clinical symptoms of bowel obstruction and radiological evidence of ileal wall thickening and enlarged mesenteric nodes. Histopathological examination of the resected specimen revealed an extranodal marginal zone B-cell lymphoma(MALToma) of the intestine and tuberculous lesions along with a solitary Peutz-Jeghers polyp. The case is presented for its rarity and to stress upon the clinical and radiological challenges that arise when lymphomas and tuberculous lesions co-exist at the same site.KEY WORDS: Intestinal lymphoma, MALToma, marginal zone lymphoma, Peutz-Jeghers polyp, tuberculosis     

Polymyxin B Resistance and Biofilm Formation in Vibrio cholerae Are Controlled by the Response Regulator CarR

Two-component systems play important roles in the physiology of many bacterial pathogens. Vibrio cholerae''s CarRS two-component regulatory system negatively regulates expression of vps (Vibrio polysaccharide) genes and biofilm formation. In this study, we report that CarR confers polymyxin B resistance by positively regulating expression of the almEFG genes, whose products are required for glycine and diglycine modification of lipid A. We determined that CarR directly binds to the regulatory region of the almEFG operon. Similarly to a carR mutant, strains lacking almE, almF, and almG exhibited enhanced polymyxin B sensitivity. We also observed that strains lacking almE or the almEFG operon have enhanced biofilm formation. Our results reveal that CarR regulates biofilm formation and antimicrobial peptide resistance in V. cholerae.     

Enhanced immunostimulatory activity of cyclic dinucleotides on mouse cells when complexed with a cell‐penetrating peptide or combined with CpG

Recognition of pathogen‐derived nucleic acids by immune cells is critical for the activation of protective innate immune responses. Bacterial cyclic dinucleotides (CDNs) are small nucleic acids that are directly recognized by the cytosolic DNA sensor STING (stimulator of IFN genes), initiating a response characterized by proinflammatory cytokine and type I IFN production. Strategies to improve the immune stimulatory activities of CDNs can further their potential for clinical development. Here, we demonstrate that a simple complex of cylic‐di‐GMP with a cell‐penetrating peptide enhances both cellular delivery and biological activity of the cyclic‐di‐GMP in murine splenocytes. Furthermore, our findings establish that activation of the TLR‐dependent and TLR‐independent DNA recognition pathways through combined use of CpG oligonucleotide (ODN) and CDN results in synergistic activity, augmenting cytokine production (IFN‐α/β, IL‐6, TNF‐α, IP‐10), costimulatory molecule upregulation (MHC class II, CD86), and antigen‐specific humoral and cellular immunity. Results presented herein indicate that 3′3′‐cGAMP, a recently identified bacterial CDN, is a superior stimulator of IFN genes ligand than cyclic‐di‐GMP in human PBMCs. Collectively, these findings suggest that the immune‐stimulatory properties of CDNs can be augmented through peptide complexation or synergistic use with CpG oligonucleotide and may be of interest for the development of CDN‐based immunotherapeutic agents.     

Comparison of risk factors for cardiovascular disease in hemodialysis and peritoneal dialysis patients

OBJECTIVE:

In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients.

METHODS:

Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student''s t test, the chi-square test and the Mann-Whitney U test, as appropriate.

RESULTS:

No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively).

CONCLUSION:

In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients.