An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. I. Clinical studies.

In a 22-month period, strains of Staphylococcus aureus resistant to methicillin and multiple aminoglycosides, (designated MARS) were recovered from 108 inpatients with nosocomial infections at a hospital in the midwestern United States. Sixty-six of these patients were staying in a burn unit, and 42 were on other hospital wards. Among the patients with burns, MARS were recovered from the burn wounds of 64%; 32% of the patients with burns had MARS bacteremia. The patients without burns were age-matched with patients with nosocomial infections caused by antibiotic-susceptible strains of S. aureus. Patients from whom MARS were isolated had a longer mean hospital stay (79.6 days vs. 36.9 days; P less than 0.01), developed infection later (26.5 days vs. 13.5 days after admission; P less than 0.01), and had received antibiotic therapy before infection more often (81% vs. 38% of patients; P less than 0.01) than patients in the comparative population. Types of infection and incidences of death and bacteremia were similar in the two groups. Antibiotic-resistant strains of S. aureus may cause serious infections and significant mortality.     

Lesional modulation of peripheral monocyte leucotactic responsiveness in leprosy.

Because the accumulation and activation of mononuclear phagocytes are critical to the host response to intracellular microbial pathogens, we evaluated mechanisms of peripheral monocyte leucotactic regulation in leprosy. Plasma from 53 of 67 patients was found to inhibit the locomotion of normal human monocytes. Neither the prevalence nor the magnitude of plasma leucotactic inhibitory activity correlated with disease histology or duration, type or duration of chemotherapy, or history of erythema nodosum leprosum. Plasma leucotactic inhibitory activity resided principally in a non-immunoglobulin, cell-directed inhibitor of 230,000 daltons molecular weight. Fractionation of plasma from patients with lepromatous leprosy revealed an additional, immunoglobulin-containing inhibitor of approximately 400,000 daltons weight, possibly an IgG-IgA immune complex. Production of leucotactic inhibitors by unstimulated and concanavalin A-stimulated peripheral mononuclear cells was normal; however, cutaneous explants from these patients spontaneously produced the 230,000 dalton leucotactic inhibitor in vitro. The ability of the lesions of leprosy to impede monocyte traffic may be an important pathogenetic mechanism.     

盐酸丁咯地尔对家兔全血粘度、血小板聚集和红细胞压积的影响

研究盐酸丁咯尔地对血液流变学的影响。方法：测定盐酸丁咯地尔静脉给药对全血粘度、血小板聚集率和红细胞压积的影响。结果盐酸丁咯地尔１０ｍｇ／ｋｇ组可使全血粘度在高切变率８０Ｓ＾－１时下降了１７．１％,在低切变率时下降２１．９％,血小板最大聚集率下降了２８．２％。结论盐酸丁咯地尔能有效地改善血液流变指标。     

Relationship of birth weight and length with growth in height and body diameters from 5 years of age to maturity

Birth weight and birth length were compared with several growth measures, including body height and weight, linear measures of limbs, body diameters, and head circumference, in 726 Melbourne schoolchildren of both sexes age 5–18 years. The analysis of relationships between three categories of birth length, weight, and growth measures were based on z-scores and performed by using analysis of variance and partial correlation. The data showed that birth length was correlated with body height and birth weight was correlated with head circumference; the relationships were weak and were less clear around the age corresponding to the peak height velocity in either sex. Further studies are needed to determine the common underlying mechanisms responsible for these associations. Am. J. Hum. Biol. 11:772–778, 1999. © 1999 Wiley-Liss, Inc.     

Psychological status in female carriers of premutation FMR1 allele showing a complex relationship with the size of CGG expansion

We utilized a sample of 299 adult females aged between 19 and 86 years, carrying fragile X mental retardation (FMR1) alleles with small CCG expansions ranging from 50 to 141 repeats to analyse the relationships between psychological symptoms as assessed by the Symptom Checklist‐90‐Revised (SCL‐90‐R) and the size of the CGG repeat in the FMR1 gene. There were highly significant (negative) correlations between the size of the CGG repeat and a great majority of SCL‐90‐R subscale scores and all the global indices, suggesting that carriers of premutations in the mid‐size CGG repeat range may be at greatest risk for the development of psychiatric disorder.     

跟骨定量超声骨质测量参数与骨密度及骨组织形态计量学指标的关系

目的:分析跟骨定量超声骨质测量中各参数与骨密度及形态计量学指标的相关性。方法:选择2004-01/2005-12广州市第六人民医院和中山大学三院骨科小腿以上截肢患者38例,将其跟骨定量超声测定的超声振幅衰减平均值与健康青年人骨峰值进行比较,>-2.5 SD者为骨量正常组(12例),<-2.5 SD者为骨质疏松组(26例)。分别进行跟骨定量超声、双能X线骨密度测量仪及骨形态计量学测量,应用直线相关分析法分析跟骨定量超声测定中各参数与骨密度及骨组织形态计量学各指标的相关性。结果:38例全部进入结果分析。①骨质疏松组跟骨超声振幅衰减平均值和骨硬度指数值均小于骨量正常组(P<0.01)。②骨量正常组跟骨骨密度值显著高于骨质疏松组[(352±16),(233±14)mg/cm2,P<0.01]。③骨量正常组跟骨平均骨小梁间距或弥散度低于骨质疏松组而松质骨体积高于骨质疏松组(P<0.05)。④超声振幅衰减平均值和骨硬度指数与骨密度呈直线正相关(r=0.814,0.326,P<0.01,0.05)。⑤超声传播速度与骨小梁游离末端、平均骨小梁间距呈直线负相关(r=-0.688,-0.712,P<0.01),与小梁间连点数、松质骨体积呈直线正相关(r=0.672,0.794,P<0.01);骨硬度指数与平均骨小梁间距呈直线负相关(r=-0.358,P<0.05),与松质骨体积呈直线正相关(r=0.513,P<0.01)。结论:跟骨定量超声测量中,超声振幅衰减平均值能较好地反映骨的密度,超声传播速度能较好地反映骨的质量,而骨硬度指数能较综合地反映骨强度的改变。     

三种移植物关节镜下重建膝关节前交叉韧带效果比较：2年随访

目的:采用自体骨-髌韧带、自体双股半腱肌腱半膜肌及同种异体跟腱移植重建膝关节前交叉韧带,比较不同移植物的临床疗效。方法:选择1998-06/2003-02中山大学附属第三医院骨科单纯前交叉韧带损伤后行关节镜下重建手术病例96例,患者均签署知情同意书。根据不同移植物分为3组:①自体骨-髌韧带组38例,应用自体中1/3骨-髌韧带-骨移植物。②自体双股半腱肌腱股薄肌腱组22例,应用自体双股半腱肌腱股薄肌腱。③同种异体跟腱组36例,应用同种异体跟腱。术后定期随访,对膝关节活动度、肌力恢复程度、Werner髌股痛评分(最差为0分,最高为55分)、Lysholm评分(0～100分,分数越高膝关节功能恢复越好)、国际膝关节文献委员会评分(按病情严重程度分类分为正常、接近正常、异常、严重异常4个等级)等进行对比观察。结果:①96例患者随访2年,无脱落。②全部患者无感染,未发生髌骨骨折。也未发现关节内粘连、下肢深静脉血栓形成和血管神经损伤等并发症。③膝关节活动度、肌力恢复情况、髌股痛评分:随访结束时3组差异均无显著性意义(P>0.05)。④Lysholm膝关节评分:随访结束时自体骨-髌韧带组由术前(68.2±6.3)分提高至(88.6±6.8)分,自体双股半腱肌腱股薄肌腱组由术前(66.5±6.5)分提高至(86.4±6.6)分,同种异体跟腱组由术前(68.2±6.3)分提高至(86.3±6.2)分,随访结束时各组评分均显著高于术前(P<0.05),3组比较差异无显著性意义(P>0.05)。⑤国际膝关节文献委员会评分(术后活动水平正常或接近正常):随访结束时自体骨-髌韧带组为87%,自体双股半腱肌腱股薄肌腱组为86%,同种异体跟腱组为89%,各组移植术后膝关节功能均有所改善,3组间差异无显著性意义(P>0.05)。结论:关节镜下采用自体骨-髌韧带、自体双股半腱肌腱股薄肌腱和同种异体跟腱移植重建前交叉韧带,均能明显改善膝关节运动功能,3种移植方法的临床疗效无明显差异,提示重建前交叉韧带的术后疗效与移植物种类的相关性不明显。     

高密度脂蛋白对HepG2细胞代谢综合征相关新基因MSRG表达的影响

目的:观察高密度脂蛋白对HepG2细胞代谢综合征相关新基因MSRG表达的影响。方法:实验于2006-03/10在四川大学华西基础医学与法医学院医学分子生物学省级重点开放实验室完成。设计MSRG引物及Taqman探针,构建标准质粒,建立RealtimePCR定量检测MSRG表达的方法。以含5%无脂蛋白血清的低糖DMEM培养基培养HepG2细胞,分别加入不同浓度的高密度脂蛋白(0,25,50,100,200mg/L)孵育24h;以含100mg/L高密度脂蛋白的5%LPDS低糖DMEM培养基孵育HepG2细胞不同时间(0,6,12,24,36h),分别以0mg/L及0h为对照,通过RealtimePCR检测MSRG的表达。结果:①不同浓度高密度脂蛋白孵育细胞时,在0～100mg/L范围,MSRG表达随高密度脂蛋白浓度的增加有下降趋势;与0mg/L组相比,MSRG在50,100mg/L组表达差异具有显著性意义(P<0.05);与100mg/L组相比,高密度脂蛋白200mg/L组基因表达有所回升,但差异无显著性意义(P>0.05)。②不同高密度脂蛋白孵育时间0～24h组,MSRG表达随时间延长有下降趋势;与0h相比,12,24,36h组基因表达降低(P<0.05),24h组MSRG表达最低;与24h组相比,MSRG在高密度脂蛋白孵育36h组表达有所回升,但差异无显著性意义(P>0.05)。结论:在低浓度(0～100mg/L)及短时间内(0～24h)高密度脂蛋白可以抑制HepG2细胞MSRG的表达。