细菌对MLS类和糖肽类抗生素产生耐药性的作用机制

MLS类和糖肽类抗生素在人类与细菌感染性疾病的对抗中发挥着重要作用.与其他抗生素一样,随着这些抗生素的临床使用,细菌耐药性的出现和不断发展给人们带来新的挑战.本综述对这两类抗生素的细菌耐药性产生机制进行了剖析,并就已开发的若干个新型MLS类和糖肽类抗生素作了介绍.     

抗肿瘤药物致死病例分析

[目的]探索抗肿瘤药物致死的特点和规律,促进临床合理用药.[方法]检索1995～2004年中国医院数字图书馆(CHKD)期刊知识库收载的中文医药卫生期刊,对其报道的抗肿瘤药物致死病例作汇总性统计与分析.[结果]致死的患者中男性多于女性,而年龄在60岁以上年龄段的比例较大,阿霉素、甲氨蝶呤、平阳霉素、顺铂分别占致死药物的前4位,与之相对应的不良反应心脏毒性、骨髓抑制、过敏反应则占了致死原因的前3位,死亡发生的时间从2分钟到4个月不等,但分布均衡.[结论]加强临床监护,严密观察监测,注意不良反应的预防、发生及应对措施.     

Treatment of 1 case of brachial plexus injury by acupuncture of detecting peripheral nerve plus Tuina

Medical History A male patient, 37 years old, was wounded on the lateral and superior aspect of the right chest by the knife on Nov. 16 of 2003. The physical examination showed there was a wound 2 cm in length on the lateral and superior aspect of the right chest with active bleeding, the patient could flex and extend the right elbow, wrist,palm and metacarpophalangeal articulation, but felt numbness of five digits of right hand.     

白鲜皮质量标准研究

目的：为中药白鲜皮制定2005年版药典标准。方法：采用TLC法鉴别、反相高效液相色谱法测定白鲜皮中活性成分末梣酮含量，并对各地产白鲜皮药材的水分、总灰分、酸不溶性灰分、浸出物含量进行测定。结论：本方法操作简单，重现性好，可用于白鲜皮药材的质量控制。     

躯体症状自我筛查问卷在中国居民中的效度和信度

目的 评估躯体症状自我筛查问卷（SQSS）在中国普通居民中的效度和信度,分析功能躯 体症状检出阳性的受试者一般特征。方法 采用方便抽样法,于 2020 年 2— 3 月通过问卷星向中国居 民发送调查问卷,进行一般资料、SQSS、广泛性焦虑量表 -7（GAD-7）、9 项患者健康问卷（PHQ-9）和怀特 利指数 -7（WI-7）的施测。2 周后采用随机数字表法选取 100 名受试者进行 SQSS 的重测。采用条目得分 与量表总分的相关分析、极端组检验进行项目分析;采用探索性因素分析、验证性因素分析检验效度; 采用内部一致性 Cronbach''s α 系数、分半信度系数和重测相关系数检验信度;采用 χ2 检验、t检验比较 功能性躯体症状筛查阳性及阴性者的一般资料及临床资料。结果 共收集问卷 1 506 份,剔除无效问 卷 56 份,最终纳入 1 450 名（96.3%）受试者。SQSS 项目分析结果显示各条目得分与量表总分均呈正相关 （r=0.49～0.70,均P＜ 0.001）,量表各条目区分度分析结果显示差异均有统计学意义（t=15.337～27.862, 均P＜ 0.001）。探索性因素分析示 SQSS 可分为 4 个维度,验证性因素分析示 SQSS 的 4 因子结构模型拟 合良好,卡方 / 自由度（χ2 /df）为 5.79,拟合优度系数（GFI）为 0.94,近似误差均方根（RMSEA）为 0.06,均 方根残差（RMR）为 0.03,比较拟合指数（CFI）为 0.93,规范拟合指数（NFI）为 0.92,不规范拟合指数（NNFI） 为 0.92,Tucker-Lewis 指数（TLI）为 0.92;SQSS 的 Cronbach''s α 系数为 0.92,分半信度系数为 0.90;SQSS 总 分和 WI-7、PHQ-9、GAD-7 得分均呈正相关（r=0.67、0.68、0.61;均P＜ 0.01）。以 SQSS 29 分为划界分,功 能性躯体症状在普通居民中的检出率为 10.28%（149/1 450）。功能性躯体症状检出阳性者中女性、有精 神疾病者、有慢性躯体疾病者占比更高（χ2 =5.12、29.90、34.08;均P＜ 0.05）,检出阳性者的 SQSS、GAD- 7、PHQ-9、WI-7 得分高于阴性者（Z=20.03、14.51、13.03、15.27,均P＜ 0.001）。结论 SQSS 具有较好的 效度和信度,可用于在普通人群中进行功能性躯体症状的自我筛查。在中国普通居民中,功能性躯体 症状检出率较高。     

LAT1表达水平与非肌层浸润性膀胱癌患者术后复发风险的相关性研究

目的：探讨L型氨基酸转运蛋白1(L-type amino acid transporter 1,LAT)表达水平与非肌层浸润性膀胱癌患者术后复发风险的相关性。方法：选取2021年2月至2022年2月于重庆医科大学附属永川医院接受手术治疗的非肌层浸润性膀胱癌患者108例作为研究对象,采用反转录酶聚合酶链反应测定膀胱癌组织(取自肿瘤所在部位区域)和癌旁组织(取自邻近正常区域组织)LAT1表达含量,对比膀胱癌组织和癌旁组织LAT1表达水平。同时根据膀胱癌组织LAT1表达含量的二分位数将所有患者分为高表达组和低表达组,对比2组临床病理参数。随访观察12个月观察2组术后复发情况,采用Kaplan-Meier曲线分析对比2组术后复发风险,使用多变量Cox比例风险回归模型确定术后复发的影响因素。结果：膀胱癌组织LAT1表达水平(1.80±0.35)较配对的癌旁组织LAT1表达水平(1.05±0.17)高(P<0.05);LAT1高表达组吸烟史、临床分期T₁占比较LAT1低表达组高(P<0.05);108例膀胱肿瘤患者术后的平均随访时间为(10.84±1.94)个月,...     

真皮导管瘤一例

患者男,61岁,因头枕部丘疹3年就诊。患者于3年前无明显诱因下发现枕部丘疹,无自觉症状,后缓慢增大。否认病程中出血、溃疡、脱屑等。体检：一般情况好,各系统检查未见异常。皮肤科检查：枕部见一枚黄豆大小丘疹,直径约9 mm,淡红色,境界清晰,表面光滑,质地坚实（图1A）……     

Immunosuppressive Tumor Microenvironment and Immunotherapy of Epstein–Barr Virus-Associated Malignancies

The Epstein–Barr virus (EBV) can cause different types of cancer in human beings when the virus infects different cell types with various latent patterns. EBV shapes a distinct and immunosuppressive tumor microenvironment (TME) to its benefit by influencing and interacting with different components in the TME. Different EBV-associated malignancies adopt similar but slightly specific immunosuppressive mechanisms by encoding different EBV products to escape both innate and adaptive immune responses. Strategies reversing the immunosuppressive TME of EBV-associated malignancies have been under evaluation in clinical practice. As the interactions among EBV, tumor cells, and TME are intricate, in this review, we mainly discuss the epidemiology of EBV, the life cycle of EBV, the cellular and molecular composition of TME, and a landscape of different EBV-associated malignancies and immunotherapy by targeting the TME.     

Nanofused Hierarchically Porous MIL-101(Cr) for Enhanced Methyl Orange Removal and Improved Catalytic Activity

Hierarchically porous MIL-101(Cr) (H-MIL-101(Cr)) with meso/macro-pores was directly prepared via nanofusion progress by using butyric acid as a modulating agent. In the methyl orange (MO) adsorption experiments, H-MIL-101(Cr) showed a high adsorption capability of 369.8 mg g⁻¹, which was 1.52-fold greater than that of pristine MIL-101(Cr) (P-MIL-101(Cr)). While in the oxidation reaction of indene and 1-dodecene tests, H-MIL-101(Cr) presented much higher catalytic efficiency, with turnover frequency (TOF) values of 0.7242 mmol g⁻¹ min⁻¹ and 0.1492 mmol g⁻¹ min⁻¹, respectively, which were 28% and 34% greater than that in the case of P-MIL-101(Cr). Thus, compared with P-MIL-101(Cr), H-MIL-101(Cr) exhibited better removal efficiency and higher levels of activity in the oxidation reactions of indene and 1-dodecene. The unique structure of H-MIL-101(Cr) also contributed to its superior performance in these processes.     

Vitamin D Status Presents Different Relationships with Severity in Metabolic-Associated Fatty Liver Disease Patients with or without Hepatitis B Infection

Whether the associations between serum vitamin D (VitD) and metabolic-associated fatty liver disease (MAFLD) vary with chronic hepatitis B (CHB) infection has not been well established. This study aims to investigate the relationships between serum VitD and metabolism, liver fat content (LFC) and fibrosis among MAFLD patients with and without CHB. Consecutive subjects (healthy controls: 360, CHB: 684, MAFLD: 521, CHB with MAFLD: 206) were prospectively enrolled between January 2015 and December 2021. Anthropometric, laboratory, imaging, and histological evaluations were conducted, with LFC measured via magnetic resonance imaging-based proton density fat fraction (MRI-PDFF). Serum VitD levels were lower in MAFLD patients than in healthy controls and patients with CHB alone or overlapping with MAFLD (24.4 ± 8.1 vs. 29.0 ± 9.5 vs. 27.4 ± 9.6 vs. 26.8 ± 8.4 ng/mL respectively; p < 0.001 in one-way ANOVA test). After adjusting for confounding factors, including season, hypersensitive C-reactive protein, insulin resistance, liver stiffness measurements, sun exposure, exercise and dietary intake, multivariate linear regression analysis revealed that VitD remained significantly negatively correlated with LFC in MAFLD patients (β = −0.38, p < 0.001), but not in CHB with MAFLD patients. Moreover, quantile regression models also demonstrated that lower VitD tertiles were inversely associated with the risk of insulin resistance and moderate–severe steatosis in the MAFLD group (p for trend <0.05) but not in the MAFLD with CHB group. VitD deficiency was associated with the severity of metabolic abnormalities and steatosis independent of lifestyle factors in MAFLD-alone subjects but not in MAFLD with CHB subjects.