我院2年间骨科髋关节置换术预防性应用抗菌药物的临床评价

目的:评价我院骨科髋关节置换术预防性应用抗菌药物整治活动的效果,以期逐步扩大抗菌药物专项整治成效,建立长效管理机制。方法:随机抽取我院骨科行髋关节置换术患者182例,其中2010年4月-2011年4月(整治活动前组)90例,2011年11月-2012年11月(整治活动后组)92例。对患者的自然情况、抗菌药物使用品种、使用时机、使用疗程等进行汇总及评价,并将结果应用SPSS 18.0软件进行统计分析,比较两组患者预防性应用抗菌药物的合理性。结果:开展抗菌药物专项整治后,抗菌药物预防性应用主要药物由第3代头孢菌素(31.11%)变为第1代头孢菌素(54.35%),其他各类药物的使用率均有显著下降(P<0.01);预防用药时机由大于术前2 h(58.89%)变为切皮前0.5² h(88.04%);用药疗程由平均(11.91±3.87)d变为(4.07±2.32)d;抗菌药物平均总费用下降71.06%。经过整治活动后药物选择不合理、术前用药不合理、更换药物不合理以及联合用药不合理的情况均有显著下降(P<0.01)。结论:抗菌药物专项整治活动后,我院骨科髋关节置换术预防性应用抗菌药物合理性得到明显改善,抗菌药物合理应用的长效管理机制已逐步建立。     

Primary structure of Euplotes raikovi pheromones: comparison of five sequences of pheromones from cells with variable mating interactions.

The amino acid sequences of five pheromones, Er-2, Er-3, Er-9, Er-11, and Er-20, secreted by cells of different mating types of the ciliated protozoa Euplotes raikovi, have been determined by automated Edman analyses of the whole proteins and germane fragments. In each case, the molecular mass was determined by plasma desorption or laser desorption mass spectrometry and was in excellent agreement with the calculated values. Where available, the determined sequences were also in accord with the corresponding segments of the precursor molecules predicted from relevant nucleic acid sequences. Of the five, two were found to be identical (Er-2 and Er-9) and one (Er-3) was identical to a pheromone previously sequenced (Er-1), even though mating pair formation was found to take place (although to a limited extent) when cells secreting those pheromones were combined in a mixture. Comparison of the five unique sequences suggested a closer relationship between Er-1 (Er-3) and Er-10 and between Er-11 and Er-20 (44% and 56% identity, respectively) than was generally observed among the other members. This pairing was also supported by hydrophobicity analyses. Interestingly, Er-20 cannot, as a rule, induce cell union in any of the other cell types, including cells secreting Er-11, despite the fact that Er-20 and Er-11 are the most similar of the five unique sequences. Thus sequence identity and secondary structure profiles are not a good indicator of biological relatedness as manifested in heterologous receptor interaction.     

Cytomegalovirus infection and disease after liver transplantation

Cytomegalovirus is the single most important pathogen in clinical transplantation. Although much progress has been made in our understanding of the molecular biology and epidemiology of CMV infection and in our ability to diagnosis and treat CMV disease, it remains a major cause of morbidity but is no longer a major cause of mortality after liver transplantation. Risk factors for CMV disease after liver transplantation include donor and recipient serologic status, the use of antilymphocyte therapy, and retransplantation. CMV disease occurs early after transplantation, and the most frequent site of disease is the hepatic allograft. We have treated 79 patients with intravenous ganciclovir, with ultimate control of disease achieved in 69 patients (87.3%). Preliminary results using intravenous immunoglobulin and oral acyclovir for CMV prophylaxis in high-risk patients have been encouraging. In addition to producing clinical syndromes, CMV may have direct immunologic effects and is a marker of the net state of immunosuppression.     

Rapid prenatal diagnosis of beta thalassemia using DNA amplification and nonradioactive probes

We used in vitro DNA amplification by the polymerase chain reaction and nonradioactive probes for prenatal diagnosis of beta thalassemia in Chinese from the Guangdong province. Exact molecular diagnoses were made in all 20 fetuses studied over a 6-month period. We conclude that this method of prenatal diagnosis for beta thalassemia is a viable approach in many parts of the world where this disease is common.     

Amino acid sequence homology among the 2-hydroxy acid dehydrogenases: mitochondrial and cytoplasmic malate dehydrogenases form a homologous system with lactate dehydrogenase.

The amino acid sequence of porcine heart mitochondrial malate dehydrogenase (mMDH; L-malate: NAD+ oxidoreductase, EC 1.1.1.37) has been compared with the sequences of six different lactate dehydrogenases (LDH; L-lactate: NAD+ oxidoreductase, EC 1.1.1.27) and with the "x-ray" sequence of cytoplasmic malate dehydrogenase (sMDH). The main points are that (i) all three enzymes are homologous; (ii) invariant residues in the catalytic center of these enzymes include a histidine and an internally located aspartate that function as a proton relay system; (iii) numerous residues important to coenzyme binding are conserved, including several glycines and charged residues; and (iv) amino acid side chains present in the subunit interface common to the MDHs and LDHs appear to be better conserved than those in the protein interior. It is concluded that LDH, sMDH, and mMDH are derived from a common ancestral gene and probably have similar catalytic mechanisms.     

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa

South Africa is one of the few developing countries with a national confidential inquiry into maternal deaths. 164 health facilities obtain audit data for stillbirths and neonatal deaths, and a new audit network does so for child deaths. Three separate reports have been published, providing valuable information about avoidable causes of death for mothers, babies, and children. These reports make health-system recommendations, many of which overlap and are intertwined with the scarcity of progress in addressing HIV/AIDS. The leaders of these three reports have united to prioritise actions to save the lives of South Africa's mothers, babies, and children. The country is off-track for the health-related Millennium Development Goals. Mortality in children younger than 5 years has increased, whereas maternal and neonatal mortality remain constant. This situation indicates the challenge of strengthening the health system because of high inequity and HIV/AIDS. Coverage of services is fairly high, but addressing the gaps in quality and equity is essential to increasing the number of lives saved. Consistent leadership and accountability to address crosscutting health system and equity issues, and to prevent mother-to-child transmission of HIV, would save tens of thousands of lives every year. Audit is powerful, but only if the data lead to action.     

鞍山市铁东区公共场所使用化妆品存在的主要卫生问题及对策

目的了解鞍山市铁东区公共场所使用化妆品卫生问题,保障使用者身体健康。方法对2013年度鞍山市铁东区卫生防疫站辖区内监管的公共场所随机抽检化妆品,对公共场所使用化妆品单位数及比例,化妆品标签标识卫生问题等进行描述。结果住宿业化妆品使用情况为56%,其他三种场所100%使用。化妆品标签标识检查住宿业合格率最低,仅为50%。国产特殊用途化妆品持有效证件率仅为65%,普通的仅为62%。标签标识问题突出,进货渠道复杂。化妆品抽检合格率低。结论公共场所的化妆品卫生质量令人担忧。     

鞍山市铁东区公共场所卫生基层问题及解决建议

笔者作为基层卫生监督工作人员经过十多年的公共场所卫生监督工作,通过对鞍山市铁东区公共场所卫生监督情况进行分析。发现当前存在许多公共场所卫生监督执法困难和难题,主要表现为卫生监督队伍薄弱,新兴公共场所剧增,公共场所执法依据不确定性（无法可依）等问题。笔者提出相应的解决建议,应转变卫生监督观念,提高监督管理质量。     

肝细胞生长因子对人脐带间充质干细胞增殖、黏附及迁移影响的体外研究

目的：探讨肝细胞生长因子( HGF)对人脐带间充质干细胞( hUCMSCs)增殖、黏附及迁移能力的影响。方法按照不同腺病毒感染 hUCMSCs 分为实验组( Ad-GFP-HGF )和对照组( Ad-GFP )。以最佳感染复数转染hUCMSCs,观察细胞形态变化以及GFP蛋白的表达。比较各组细胞增殖能力、黏附能力及迁移能力。 Western Bolt检测各组细胞HGF的表达水平。结果对照组和实验组均出现了GFP的表达,实验组hUCMSCs的增殖、黏附及迁移能力均较对照组增强(P<0．05)。实验组细胞HGF的表达水平显著高于对照组(P<0．05)。结论 HGF的高表达能明显促进hUCMSCs的增殖、黏附和迁移。