肝病患者合并希瓦菌感染的临床分析

目的 总结肝病患者希瓦菌感染的临床因素及耐药情况.方法 回顾性分析2009年1月至2015年12月无菌部位希瓦菌培养阳性的肝病患者的临床资料,并采用表型实验和质谱仪对希瓦菌进行再鉴定.结果 共收集7例非重复希瓦菌感染者的资料,其中希瓦菌所致血流感染2例,腹膜炎4例,胆道感染1例.经鉴定,4株为海藻希瓦菌,3株为腐败希瓦菌.在临床治疗过程中,希瓦菌易对碳青霉烯类药物不敏感,而对左氧氟沙星和阿米卡星敏感.结论 希瓦菌可引起重症肝病患者多个无菌部位的感染,左氧氟沙星或阿米卡星可取得较好的抗菌效果.     

Safety and efficacy of mezlocillin: a single-drug therapy for penetrating abdominal trauma

This study was done to determine if a single drug, mezlocillin (Mezlo), is as safe and as effective as combined clindamycin (Clind) and gentamicin (Gent) in the treatment of penetrating abdominal wounds. One hundred seventy-three patients received either Mezlo or Clind/Gent combined therapy as assigned by computer-generated randomization. Of these, 147 patients were evaluable. Of 73 patients treated with Clind/Gent the mean duration of hospital stay was 8.9 +/- 4.0 days. Infectious complications developed in 18 patients of whom five failed to respond promptly, but only one required change in therapy. Of 74 patients treated with Mezlo, the mean duration of hospital stay was 9.1 +/- 5.0 days. Infectious complications occurred in 17, in whom four patients failed to eliminate their infections, and two needed changes in antibiotic therapy. None of the patients in either antibiotic group failed because of Enterococcus or Pseudomonas infections. There were no deaths. Twelve isolates of Bacteroides were found in peritoneal fluid cultures and all these patients had colon injuries. The overall therapeutic response was excellent to good in 94% on Clind/Gent and 93% on Mezlo. Azotemia developed in one patient on Clind/Genet and one on Mezlo but no other adverse reactions occurred. The differences shown between the two groups were not statistically significant. We conclude that a single drug mezlocillin is as safe and as effective in the treatment of abdominal trauma as combined clindamycin and gentamicin.     

Does glutathione-S-transferase dethiolate lens protein-thiol mixed disulfides?-A comparative study with thioltransferase.

Protein S-thiolation is a process in which under oxidative stress, vulnerable sulfhydryl groups of proteins are conjugated to non-protein thiols such as glutathione (GSH) or cysteine resulting in the formation of protein-thiol mixed disulfides, protein-S-S-glutathione (PSSG) and protein-S-S-cysteine (PSSC). This process spontaneously disrupts the redox homeostasis of the cells, which in turn leads to functional disturbances in the respective tissue. In the ocular lens, such modification of proteins may trigger a cascade of events starting with the alteration of protein conformation, protein/enzyme deactivation, protein-S-S-protein aggregation and eventually lens opacification or cataract. Generally, the first line of defense system in the cells protects the lens proteins against such damage. Recent studies in our laboratory have shown that in addition to this defense system, lens cells also possess a well developed system to repair the oxidative damage to the lens proteins. We have identified this repair system as thioltransferase (TTase) and have proved that TTase by its dethiolase activity reverses the protein S-thiolation process which returns the oxidatively damaged lens proteins/enzymes to their original reduced state and restores their physiological functions. We investigated if this repair mechanism was mediated by enzymes other than TTase. We studied glutathione S-transferase (GST) and report here for the first time the cloning, high level expression, and purification of human lens mu and pi isoforms of GST. A comparative study of recombinant human lens TTase and GST (mu and pi) on their dethiolating abilities using lens crystallin-thiol mixed disulfides showed that the lens TTase is 60-70% more efficient in the dethiolation/repair process than GST. When TTase and GST were tested in conjunction for the dethiolation of thiol mixed disulfides, there was no significant enhancement of dethiolase activity. These findings suggest that TTase by itself is an efficient enzyme in the dethiolation/repair process and hence can be considered a crucial system to counteract oxidative stress in the lens.     

ELBOW JOINT MEDIAL COLLATERAL LIGAMENT INJURY A PRELIMINARY REPORT

The medial collateral Iigament injury of elbow joint may be produced by valgus stre4ss with the arm in extension and abduction or in extension, abduction and slight backward incli- nation The injury presents definite clinical fea- tures If injury is severe, the abnormal passive vajgus movement of elbow joint is at least 30 degrees. Operative technic for repairing the ruptured medial collateral ligament is intro- duced. From the operative findings of traumatic pathologic changes, the rapid recovery of normal function in 10 cases after operation and simp- licity of the operative technic, surgical repair is recommended in severe injury of the medial collateral ligament.     

玻璃体内注射曲安奈德联合玻璃体切割术治疗玻璃体积血

目的探讨玻璃体内注射曲安奈德(TA)联合玻璃体切割术治疗玻璃体积血的临床应用。方法对因玻璃体积血住院手术的患者192例进行回顾性分析,比较玻璃体内注射TA联合玻璃体切割术和单纯行玻璃体切割术治疗前和治疗后ld、10d、1个月、3个月时患者的最佳矫正视力、眼压、眼内炎症反应和眼底改变。结果TA注射组在1个月、3个月最佳矫正视力高于单纯手术组,术后眼内炎症反应较单纯手术组降低,差异有统计学意义。结论与单纯玻璃体切割术比较,玻璃体内注射TA联合玻璃体切割术治疗玻璃体积血能在短期内获得更高的最佳矫正视力,并减少眼内炎症反应。     

谈脑中风失语患者早期语言强化训练的康复护理

目的：评价50岁以下急性冠脉综合征的临床特征及其与老年人群息性冠脉综合征的差异。方法：回顾性分析我院2007年至2011年出院诊断为急性冠脉综合征的患者的危险因素、冠脉造影结果、治疗、预后。结果：50岁以下急性冠脉综合征患者共60例（中青年组）,除1例女性外均为男性;年龄分布为34—49岁,其中8例≤40岁。60岁以上急性冠脉综合征患者共584例（老年组）,年龄分布为60—82岁,男性391例,女性193例。与老年组比较,中青年组有更高的吸烟率（86．7％VS57．8％）和阳性心血管病家族史30％VS：15．1％）,较低的血脂异常率（33．3％vs46．7％）,糖尿病（5％vs26．4％）和高血压（10％vs62．5％）。中青年组的0—1支冠脉病变（72．4％vs40．2％）及ST抬高的心肌梗塞更多见（66．7％vs24．8％）。此外,接受冠脉介入诊疗率（96．7％vs60．4％）和左室射血分数（52．4±12．1vs39．8±14．6）显著高于老年组;中青年组N末端B型利钠肽原（NT—proBNP）水平和住院期间死亡率（4．11％VS0％）显著低于老年组。结论：①吸烟是50岁以下急性冠脉综合征患者最重要的危险因素;②与老年组比较,50岁以下急性冠脉综舍征患者更易于接受冠脉介入诊疗;心功能和预后相对良好。     

“伏九”穴位敷贴治疗常年性变应性鼻炎41例总结

目的:观察“伏九”穴位敷贴治疗常年性变应性鼻炎的临床疗效.方法:将125例患者随机分为“伏九”组41例、三伏组44例和三九组40例,“伏九”组在三伏、三九进行穴位敷贴,三伏组在三伏进行穴位敷贴,三九组在三九进行穴位敷贴.结果:“伏九”组总有效率为97.5％,三伏组为84.09％,三九组为72.50％:“伏九”穴位敷贴优于单独三伏和三九穴位敷贴,三伏穴位敷贴疗效优于三九穴位敷贴(P＜0.05);且皮肤出现发泡的患者疗效优于皮肤未发泡的患者(P＜0.05).结论:“伏九”敷贴治疗变应性鼻炎有较好疗效.     

Hepatoprotective and antiviral properties of isochlorogenic acid A from Laggera alata against hepatitis B virus infection

Ethnopharmacological relevance

The aim of this study was to determine the anti-hepatitis B effect of isochlorogenic acid A isolated from Laggera alata (Asteraceae), a traditional Chinese herbal medicine.

Materials and methods

The anti-hepatitis B activity of isochlorogenic acid A was evaluated by the d-galactosamine (D-GalN)-induced HL-7702 hepatocyte damage model and the HBV-transfected HepG2.2.15 cells.

Results

Isochlorogenic acid A significantly improved HL-7702 hepatocyte viability and markedly inhibited the productions of HBsAg and HBeAg. The inhibitory rates of isochlorogenic acid A on the HBsAg and HBeAg expressions were 86.9% and 72.9%, respectively. In addition, isochlorogenic acid A declined markedly the content of hepatitis B virus covalently closed circular DNA (HBV cccDNA) and induced significantly the heme oxygenase-1 (HO-1) expression in HepG2.2.15 cells.

Conclusions

Isochlorogenic acid A was verified to possess the potent anti-hepatitis B activity. The anti-HBV target of isochlorogenic acid A is probably associated with blocking the translation step of the HBV replication. Overexpression of HO-1 may contribute to the anti-HBV activity of isochlorogenic acid A by reducing the stability of the HBV core protein and thus blocking the refill of nuclear HBV cccDNA. Additionally, the hepatoprotective effect of isochlorogenic acid A could be achieved by its antioxidative property and induction of HO-1.