Modern lineages of Mycobacterium tuberculosis in Addis Ababa,Ethiopia: implications for the tuberculosis control programe

Background

The genotyping of Mycobacterium tuberculosis strains is important to have unique insights into the dissemination dynamics and evolutionary genetics of this pathogen and for TB control as it allows the detection of suspected outbreaks and the tracing of transmission chains.

Objective

To characterize M. tuberculois isolates collected from newly diagnosed pulmonary TB patients in Addis Ababa

Methods

One hundred and ninety two sputum samples were cultured on Löwenstein-Jensen (LJ) slants and isolates were heat killed for molecular genotyping. The isolates were characterized using spoligotyping and were compared with the International SpoIDB4 database.

Result

T genotype constitutes the most predominant in our study (95, 49.5%) followed by the CAS genotype (42, 21.9%). Other genotypes found were Haarlem (H) (24, 12.5%), the LAM (3, 1.5%), the Beijing genotype (1, 0.5%); four (2.1%) isolates were designated as Unknown.

Conclusion

All the isolates belong to the modern lineage and there is high clustering in the genotype of isolates which indicated the presence of recent TB transmission. Therefore, the Tuberculosis Control Programme needs to do more in advocating and strengthening the health system for early detection and treatment of active TB cases as delay in treatment is the key factor in disease transmission.     

Liver remnant hypertrophy induction – How often do we really use it in the time of computer assisted surgery?

PurposeTo evaluate the significance of the hypertrophy concept in patients requiring extended liver resections for colorectal metastasis in the time of computer assisted surgery.MethodsRetrospective analysis of patient collective undergoing major liver surgery. 2D CT, 3D CAS with Fraunhofer MeVis Sofware. Portal vein embolisation (PVE) with the Amplazer Plug, portal vein ligation (PVL) as 1. Stage operative procedure.Results2D CT data identified 29 patients out of 319 (2002-2009) to be at risk for liver failure after resection. After 3D CAS analysis and virtual operation planning, only 7/29 were at true risk and were submitted to portal vein occlusion (PVO). Another 5 patients were submitted to the hypertrophy concept for intraoperative finding of insufficient parenchyma quality. In total, 12 patients underwent PVO (6 PVE/6 PVL). 9/12 patients went to stage 2 and were successfully operated. There was no difference in future remnant liver volume (FRLV) gain or waiting time to step 2 between the groups, though survival was better in the PVE group.ConclusionPVO is an effective approach if the patient's future remnant liver (FRL) is too small on 2D CT volumetry. 3D CAS has great impact on the analysis of FRL capacity and in augmenting resectability - in our experience only patients with insufficient FRLV on the virtual resection plan have to take the risk of PVO to maintain the chance of liver resection.     

不同全麻方法对鼻内镜手术患者全麻苏醒期躁动发生率的影响

目的观察不同全麻方法对鼻内窥镜下行鼻腔手术患者全麻苏醒期躁动发生率的影响。方法择期在全麻鼻内窥镜下行鼻腔手术患者60例（ASAⅠ～Ⅱ级）,年龄18～59岁,随机分为Ⅰ组（异氟醚组）、P组（异丙酚组）、PM组（异丙酚＋心理准备组）．排除引起躁动的一般原因后观察三组患者全麻苏醒期躁动的发生率和离室时间。结果与Ⅰ组相比,P组和PM组患者躁动的发生率明显减少（P〈0．05）。P组和PM组相比,差异无统计学意义（P〉0．05）,但临床观察而言．PM组患者躁动的发生率较P组少,躁动的程度亦有所减轻。结论鼻内窥镜手术用异丙酚静脉输注全麻替代异氟醚吸入麻醉可减少患者全麻苏醒期躁动的发生率,若同时辅以术前心理准备,则可能使此类患者全麻苏醒期恢复更趋于平稳。     

手术治疗自发性小脑出血深昏迷患者的预后相关因素分析

目的 探讨手术治疗白发性小脑出血深昏迷患者的必要性以及影响治疗效果的因素.方法 回顾性分析广东省肇庆市第一人民医院神经外科2002年3月至2012年1月收治的23例因自发性小脑出血导致深度昏迷患者的临床资料,将接受手术治疗的18例患者按预后分为2组,分析其治疗效果及预后影响因素.结果 预后较好组与预后差组患者发病后至接受手术的时间差异有统计学意义(P=0.023),2组患者间年龄、血肿量大小及住院时间差异无统计学意义(P＞0.05),2组患者并发脑积水、环池受压程度及呼吸循环紊乱差异亦无统计学意义(P＞0.05).结论 自发性小脑出血患者发病后迅速发展至深昏迷不是手术禁忌证,及时的手术解除脑干受压是降低自发性小脑出血患者病死率的关键因素.     

常规胸部CT扫描发现额外征象有助于预测心血管疾病事件

目的越来越多的CT检查可发现临床指征以外的异常征象,这些额外发现的临床意义尚不清楚。本项目为首次随访研究,研究常规胸部CT扫描显示无症状的冠状动脉     

洁净ICU病房人物流管理与医院内感染发生的研究分析

[目的]通过规范空气层流洁净病房内人员流动与物质流动,探讨洁净ICU区域人物流管理对医院内感染发生率的影响。[方法]制定ICU人物流进出的相关制度并严格执行,每月两次不定期对洁净ICU病区进行空气培养,与采取传统模式管理的专科ICU病区的空气培养进行对比分析。[结果]2009～2010年对洁净ICU及普通ICU各进行48次的空气培养,每月2次,洁净ICU细菌超标1次,合格率97.9%;普通ICU细菌超标7次,合格率85.4%两组的合格率相比差异有统计学意义(χ2=5.79,P﹤0.05)。[结论]规范的人员流动与物质流动管理能有效降低层流洁净环境的空气污染程度,控制或降低医院内感染发生。     

Genome-wide association study with 1000 genomes imputation identifies signals for nine sex hormone-related phenotypes

Genetic factors contribute strongly to sex hormone levels, yet knowledge of the regulatory mechanisms remains incomplete. Genome-wide association studies (GWAS) have identified only a small number of loci associated with sex hormone levels, with several reproductive hormones yet to be assessed. The aim of the study was to identify novel genetic variants contributing to the regulation of sex hormones. We performed GWAS using genotypes imputed from the 1000 Genomes reference panel. The study used genotype and phenotype data from a UK twin register. We included 2913 individuals (up to 294 males) from the Twins UK study, excluding individuals receiving hormone treatment. Phenotypes were standardised for age, sex, BMI, stage of menstrual cycle and menopausal status. We tested 7 879 351 autosomal SNPs for association with levels of dehydroepiandrosterone sulphate (DHEAS), oestradiol, free androgen index (FAI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, progesterone, sex hormone-binding globulin and testosterone. Eight independent genetic variants reached genome-wide significance (P<5 × 10⁻⁸), with minor allele frequencies of 1.3–23.9%. Novel signals included variants for progesterone (P=7.68 × 10⁻¹²), oestradiol (P=1.63 × 10⁻⁸) and FAI (P=1.50 × 10⁻⁸). A genetic variant near the FSHB gene was identified which influenced both FSH (P=1.74 × 10⁻⁸) and LH (P=3.94 × 10⁻⁹) levels. A separate locus on chromosome 7 was associated with both DHEAS (P=1.82 × 10⁻¹⁴) and progesterone (P=6.09 × 10⁻¹⁴). This study highlights loci that are relevant to reproductive function and suggests overlap in the genetic basis of hormone regulation.     

库普弗细胞在肝纤维化中作用的研究进展

本文综述了肝纤维化的发生机制、库普弗细胞的结构及其分泌的生物活性因子的主要作用,重点讨论了库普弗细胞在肝纤维化过程中的调控作用,探讨抗纤维化治疗可行的新途径。