Resistance to macrolides, clindamycin and telithromycin in Streptococcus pyogenes isolated in Spain during 2004

OBJECTIVES: To study the antimicrobial susceptibility and prevalence of the different phenotypes and genotypes of macrolide resistance in group A streptococci isolated in Spain in 2004, and to compare the results with those obtained in 1998 and 2001 using the same methodology and centres. METHODS: A total of 530 unique isolates of Streptococcus pyogenes collected in 21 laboratories from 16 geographic areas (regions) in Spain were used. Antimicrobial susceptibility testing was performed using the agar dilution method. Discs containing erythromycin or clindamycin were used to recognize the phenotypes of macrolide-lincosamide-streptogramin (MLS) resistance. Genes encoding macrolide-lincosamide resistance were detected by PCR. RESULTS: Resistance to erythromycin was 21.7% [95% confidence interval (CI) 16.5-26.3]. The resistance to azithromycin was 21.5%, whereas the resistance to miocamycin and to clindamycin was 6.6% (95% CI 3.0-8.9). Thirty-one (5.8%) of the isolates were resistant to telithromycin. Of the 115 erythromycin-resistant isolates, 67.8% had the M phenotype, representing 14.7% of all the isolates tested. Thirty-five isolates (30.5% of the erythromycin-resistant strains and 6.6% of all the isolates) had the MLS(B) constitutive phenotype. There was a high prevalence of resistance to telithromycin (88.6%) among the 35 strains with the MLS(B) constitutive phenotype. When we compared these results with those from previous studies (1998 and 2001), we found a significant increase in the MLS(B) constitutive phenotype (P < 0.001), and a significant decrease in the M phenotype (P < 0.005) was noted. CONCLUSIONS: The significant increase in the prevalence of resistance to clindamycin and miocamycin, and the prevalence of resistance to telithromycin reached in a short period of time from the introduction of its use, underscore the need for continuous surveillance of antimicrobial resistance in S. pyogenes in Spain.     

中度低温体外循环对大鼠海马c-fos,bcl-2及bax mRNA表达的影响

目的:观察中度低温体外循环(CPB)对大鼠海马即刻基因c-fos、凋亡相关基因bcl-2和baxmRNA表达的影响。方法:雄性SD大鼠随机分为CPB组(n=6)及假手术对照组(Sham组,n=6)。所有动物在咪唑安定、芬太尼麻醉后经口插管控制呼吸,置入颈静脉流出管和尾动脉输入管,肝素抗凝(500U/kg)。CPB组采用中度低温CPB(26℃—28℃),经尾动脉灌注、颈静脉右心房-腔静脉引流,灌流量160mL·kg-1·min-1,总转流时间2h,Sham组除不经历CPB外,其余操作同CPB组相同。实验中进行动脉压、ECG及动脉血气监测。术后1h处死动物,立即断头取脑分离海马组织,放入-70℃液氮罐保存。基因mRNA检测采用逆转录多聚酶联反应(RT-PCR)方法。结果:海马c-fos、bcl-2和baxmRNA表达CPB组显著高于Sham组;bax与bcl-2mRNA表达比值CPB组显著高于Sham组。结论:中度低温体外循环可引起海马即刻基因c-fos、凋亡相关基因bcl-2和baxmRNA的表达增加。     

注意缺陷多动障碍血小板单胺氧化酶活性测定的初步研究

本文测定了注意缺陷多动障碍(ADHD)患者血小板单胺氧化酶活性,结果显示ADHD时该酶活性明显低于对照组,而在经哌醋甲酯治疗后无明显改变,与Conners量表也未显示出明显相关。文中还对单胺氧化酶与治疗的关系进行了讨论。     

病理诊断与失误

文章阐述了病理诊断作为最具权威性的金标准在基础医学与临床医学间的桥梁作用。病理学在诊断方法上吸收了解剖、组织胚胎、生化、微生物等基础知识，从细胞水平认识疾病本质，进而作出诊断与鉴别诊断。说明病理的发展对现代医学具有很大的推动作用，并同时提出病理误诊的原因、后果及减少误诊的措施。     

硬皮病的超声诊断—附12例观察

采用高频探头(7.5MHz)对12例限局性硬度病皮损超声观察并与正常皮肤比较,前者皮肤全层平均厚3.6±0.4mm,真皮层2.9±0.4mm;后者全层厚2.0±0.4mm,真皮层1.4±0.4mm。两组有显著性差异(P<0.001)。4例硬皮病皮损还进行了显微镜下测量并与超声测量结果比较。认为超声检查硬度病具有实用价值。     

先天性输尿管异常疾病的超声诊断

本文报告121例先天性输尿管异常疾病的超声诊断结果，经与手术和病理结果对比其病因诊断符合率92．6％。结果表明，超声能为临床诊治该类疾病提供可靠的依据，其中对某些疾病，超声检查具有明显的优越性和独特的诊断价值。     

影响腹膜透析患者社会回归因素的分析

目的：通过分析影响腹透患者社会回归的因素，探求促进腹透患者社会回归的途径。方法：分析16l例透析时间超过3个月的腹透患者的社会回归现状，分析患者的个人情况、临床治疗情况、社会心理及经济情况，探讨影响社会回归的可能因素。结果：社会回归为1级的患者占总患者数的13％，2级2912％，3级47．8％，4级12.4％。影响社会回归的因素为Charlson并发症指数、Hamilton抑郁积分、Engle系数。结论：加强慢性肾脏病的一体化治疗、改善患者的心理社会及经济因素可能是改善腹透患者社会回归的有效途径。     

Association of Community Health Nursing Educators: disaster preparedness white paper for community/public health nursing educators

ABSTRACT The Association of Community Health Nursing Educators (ACHNE) has developed a number of documents designed to delineate the scope and function of community/public health nursing educators, researchers, and practitioners. In response to societal issues, increased emphasis on disaster preparedness in nursing and public health, and requests from partner organizations to contribute to curriculum development endeavors regarding disaster preparedness, the ACHNE Disaster Preparedness Task Force was appointed in spring 2007 for the purpose of developing this document. Task Force members developed a draft of the document in summer and fall 2007, input was solicited and received from ACHNE members in fall 2007, and the document was approved and published in January 2008. The members of ACHNE extend their appreciation to the members of the Emergency Preparedness Task Force for their efforts: Pam Frable, N.D., R.N.; Sandra Kuntz, Ph.D., C.N.S.-B.C. (Chair); Kristine Qureshi, D.N.Sc., C.E.N., R.N.; Linda Strong, Ed.D., R.N. This white paper is aimed at meeting the needs of community/public health nursing educators and clarifying issues for the nursing and public health communities. ACHNE is committed to promotion of the public's health through ensuring leadership and excellence in community and public health nursing education, research, and practice.     

鼻咽癌患者淋巴细胞近端着丝粒染色体随体联合频率的分析

本文对60例鼻咽癌患者用银染及非银染方法比较分析了近端着丝粒染色体随体联合的频率(SAs及Ag-AA),发现每细胞平均出现的SAs及Ag-AA分别为0.55和1.29(P<0.01)。D、G组染色体在随体联合中的比例分别为DSAf0.620及0.597,GSAf为0.380及0.403,具有随机性。G显带证实13、14、21号染色体更多地参与随体联合。     

中医护理病历标准的研究

本文介绍了国家中医药管理局重点科研课题“中医护理病历标准化研究”的科研成果。翔实地阐述了该项研究的必要性以及研究过程。简要地介绍了该项成果的具体内容。同时从专家评价、推广应用、获奖情况等方面证实了该项成果的先进性、科学性、实用性和可行性。