泌尿生殖道感染病例中支原体检出率及其耐药性分析

目的了解本地区泌尿生殖道感染患者中支原体感染及耐药性状况。方法采集1317例患者泌尿生殖道标本,接种支原体培养、鉴定、药敏一体化试剂盒进行检测。结果1317份标本中支原体阳性541份（41．07％）;其中女性阳性460例,阳性率46．2％;男性阳性81例,阳性率25．1％。解脲支原体（uu）单一感染362例（占66．9％）：人型支原体（Mh）单一感染78例（占14．4％）,两种支原体混合感染的101例,（占18．7％）。药敏结果显示uu对米诺环素、克拉霉素敏感率分别为85．4％、53．3％;Mh对米诺环素、阿奇霉素、壮观霉素敏感率分别为82．1％、48．7％、46．1％;Uu、Mh混合感染对14种抗生素耐药率明显高于单纯性感染。结论本地区泌尿生殖道感染患者分离出的支原体多为多重耐药菌株,临床上对于疑似支原体感染患者应进行支原体培养及药敏实验,避免经验用药,以提高治愈率和控制耐药菌株的产生。     

下调长链非编码RNA肺腺癌转移相关转录本-1调控星形胶质细胞水通道蛋白4表达改善脑缺血/再灌注损伤

目的 探讨下调长链非编码RNA(lncRNA)肺腺癌转移相关转录本-1(MALAT1)调控星形胶质细胞水通道蛋白4(AQP4)表达水平改善脑缺血/再灌注(CIR)损伤的机制。方法 采用大脑中动脉闭塞法制作大鼠脑缺血模型：(1)将SD大鼠分成假手术组、缺血/再灌注组、阴性对照(Lv-NC)组和细胞感染慢病毒干扰载体(Lv-RNAi)组。进行大鼠神经功能评分,检测脑组织含水量,用qRT-PCR方法检测MALAT1表达,TTC染色法检测脑梗死体积,Western blot法检测AQP4表达,ELISA法检测TNF-α、IL-6、IL-1β水平。(2)分离大鼠星形胶质细胞分为：对照组、缺氧复氧(H/R)组、sh-NC组、sh-MALAT1组、sh-AQP4组、sh-MALAT1+Vector组和sh-MALAT1+AQP组。MTT法检测细胞增殖活性,检测TNF-α、IL-6、IL-1β、MALAT1和AQP4表达水平。结果 (1)与假手术组比较,缺血/再灌注组MALAT1表达量升高,神经功能评分、脑组织含水量、脑梗死体积、AQP4蛋白表达量和TNF-α、IL-6、IL-1β含量升高(均P<...     

芬太尼和舒芬太尼对左旋甲状腺素钠预处理大鼠心肌保护作用的影响

目的 评价芬太尼和舒芬太尼对左旋甲状腺素钠预处理大鼠心肌保护作用的影响.方法 幼鼠采用随机数字表法随机分为7组(每组8只):空白对照组(BC组)、对照组(C组)、左旋甲状腺素钠10 μg组(10 μg组)、芬太尼组(F组)、舒芬太尼组(S组)、芬太尼联合左旋甲状腺素钠组(F+L组)和舒芬太尼联合左旋甲状腺素钠组(S+L组).采用Langendorff装置建立离体心脏缺血/再灌注损伤(ischemia/reperfusion injury,I/RI)模型,F组和F+L组灌注液中芬太尼浓度为30 μg/L,S组和S+L组灌注液中舒芬太尼浓度为3 μg/L.结果 再灌注30 min时血流动力学F组和S组明显差于BC组;10 μg组、F+L组和S+L组优于C组、F组和S组.BC组、C组、10 μg组、F组、S组、F+L组和S+L组再灌注期的冠脉流量分别是(19±2)、(16±1)、(21±2)、(17±1)、(17±1)、(21±1)、(22±1)ml/min,并且10 μg组、F+L组和S+L组的冠脉流量高于C组、F组和S组.冠脉流出液中的肌酸激酶同工酶(creatine kinase,CK-MB)活性C组、F组和S组高于10 μg组、F+L组和S+L组.心肌热休克蛋白70(heatshock proteins70,HSP70)和肌球蛋白重链(myosin heavy-chain,MHC)α mRNA表达10 μg组、F+L组和S+L组明显强于C组、F组和S组.但是所有检测指标在10 μg组、F+L组和S+L组之间差异无统计学意义. 结论芬太尼和舒芬太尼对左旋甲状腺素钠预处理的心肌保护作用均无明显影响.     

扩髓与非扩髓髓内钉固定治疗胫骨闭合性骨折的系统评价

[目的]系统评价扩髓髓内钉(reamed intramedullary nailing,RTN)与非扩髓髓内钉(unreamed intr-amedullary nailing,UTN)治疗胫骨闭合性骨折的疗效。[方法]通过计算机检索、手工检索和其他检索方法,收集RTN与UTN治疗胫骨闭合性骨折的随机对照试验(randomized controlled trials,RCT)和半随机对照试验(quasi-ran-domized controlled trials,CCT),按Cochrane协作网推荐的方法进行系统评价。[结果]共纳入6个RCT研究,总病例数为1214例。Meta分析显示:(1)RTN组的骨折不愈合率低于UTN组,差异有统计学意义(RR=0.41;95%CI(0.21,0.78),P=0.007);(2)RTN组的内置物失败率低于UTN组,差异有统计学意义(RR=0.32;95%CI(0.20,0.50),P<0.000 1);(3)RTN组与UTN组术后畸形愈合率及感染率差异无统计学意义,两者相对危险度分别为0.45(95%CI(0.16,1.22),P=0.12)、0.45(95%CI(0...     

迷走神经电刺激后处理对大鼠心肌缺血再灌注损伤的影响

目的 评价迷走神经电刺激后处理对大鼠心肌缺血再灌注损伤的影响.方法 雄性SD大鼠60只,体重250～350 g,采用随机数字表法,将其随机分为3组(n＝20):假手术组(S组)、缺血再灌注组(I/R组)和迷走神经电刺激后处理组(POES组).I/R组和POES组采用结扎左冠状动脉前降支30 min和再灌注120 min的方法制备心肌缺血再灌注损伤模型,S组仅穿线.POES组在心肌缺血15 min时对右侧迷走神经干实施电刺激30 min,电刺激参数:波宽2ms,频率10 Hz,电流强度随大鼠HR进行调整,以保持HR较刺激前降低10％.于缺血前(基础状态)、缺血1、10 min和再灌注30、60、120 min时记录HR和MAP,计算HR和MAP的乘积(RPP).各组随机取10只大鼠,于再灌注120 min时,采集颈动脉血样,采用ELISA法检测血清cTnI、CK-MB、TNF-α、高迁移率族蛋白1(HMGB1)、细胞间粘附分子1(ICAM-1)、IL-1、IL-6和IL-10的浓度;颈动脉采血后,采用伊文蓝和TTC双重染色法测定心肌梗死体积.再灌注120 min时,各组随机处死10只大鼠,取缺血区和非缺血区心肌组织,采用ELISA法检测TNF-α、HMGB1、ICAM-1、IL-1、IL-6和IL-10的含量.结果 与S组比较,I/R组缺血10 min和再灌注30 min时HR增快,缺血1min时MAP和RPP降低,心肌梗死体积、血清cTnI、CK-MB、TNF-α、HMGB1、ICAM-1、IL-1和IL-6的浓度、缺血区和非缺血区心肌组织TNF-α、HMGB1、ICAM-1、IL-1、IL-6和IL-10的含量升高;POES组缺血10 min时HR增快,血清TNF-α浓度降低,心肌梗死体积、血清cTnI、CK-MB、ICAM-1和IL-10的浓度、缺血区心肌组织ICAM-1、IL-1、IL-6和IL- 10的含量、非缺血区心肌组织HMGB1、ICAM-1、IL-1、IL-6和IL-10的含量升高(P<0.05);与I/R组比较,POES组HR、MAP和RPP差异无统计学意义(P＞0.05),心肌梗死体积、血清cTnI、CK-MB、TNF-α、HMGB1、ICAM-1、IL-1和IL-6的浓度、缺血区和非缺血区心肌组织TNF-α、HMGB1、ICAM-1、IL-1和IL-6的含量降低,IL- 10含量升高(P<0.05).结论 迷走神经电刺激后处理可减轻大鼠心肌缺血再灌注损伤,其机制与抑制局部和全身炎性反应有关.     

类鼻疽骨、关节及骨髓感染的临床特点

目的 分析类鼻疽骨、关节及骨髓感染的临床特征,为类鼻疽骨、关节及骨髓感染的诊治提供参考,减少漏诊和误诊,提高患者预后.方法 回顾性分析21例类鼻疽骨、关节及骨髓感染患者的流行病学和临床特点;采用Etest法检测致病菌对抗菌药物的敏感性.结果 21例患者中男19人,女2人,年龄范围35～80岁,8人职业为农民,11人在台...     

联合应用缺血后处理、远隔缺血后处理和纳洛酮后处理对大鼠脑缺血-再灌注损伤的影响

Objective To assess the effects of ischemic postconditioning, remote ischemic postconditioning and naloxone postconditioning on focal cerebral ischemia-reperfusion injury in rats.Methods A total of 110 adult SD rats were randomly divided into 5 groups (n =22 each). The focal cerebral ischemia-reperfusion injury was induced by a 90-minute occlusion of right middle cerebral artery (MCA) and a 24-hour reperfusion sequentially. Group 1 was of ischemia-reperfusion control; Group 2 ischemic postconditioning induced by three 30-second cycles of MCA occlusion followed by a 30-second reperfusion; Group 3 remote ischemic postconditioning performed via a transient occlusion of right femoralartery at 5 min before the initiatlon of reperfusion:Group 4 naloxone posteonditioning with naloxone 10 mg/kg intraperitoneaUy injected at the initiation of reperfusion;Group 5 combined ischemic,remote ischernic & naloxone postconditioning performed simultaneously in accordance with the methods used in Groups 2,3 & 4.The neumlogie deftcit scores(NDS)were obtained at 2 h & 24 h post-reperfusion.At 24 h post-reperfusion.the anesthetized rat was sacrificed by decapitation and the brain rapidly extracted to asseSS the size ofcerebral infaret(n=10),detect the cerebral expression of microtubule-associated protein2(MAP2)(n=6),measure the plasma volume of cerebral tissues and quantify the diameter and segment artery at 5 min before the initiation of reperfusion; Group 4 naloxone postconditioning with naloxone 10 mg/kg intraperitoneally injected at the initiation of reperfusion; Group 5 combined ischemic, remote ischemic & naloxone postconditioning performed simultaneously in accordance with the methods used in Groups 2, 3 & 4. The neurologic deficit scores ( NDS) were obtained at 2 h & 24 h post-reperfusion. At 24 h post-reperfusion, the anesthetized rat was sacrificed by decapitation and the brain rapidly extracted to assess the size of cerebral infarct (n = 10), detect the cerebral expression of microtubule-associated protein2 ( MAP2) (n =6) , measure the plasma volume of cerebral tissues and quantify the diameter and segment length of cerebral microvessel (n = 6 ). Results There were no significant differences in the heart rate (HR) and mean arterial pressure (MAP) among the above five groups at all observed time points (P ＞ 0. 05). At 24 h post-reperfusion, the percentage of ischemic cerebral infarct size was 43% ±6% , 31% ±4% , 32% ±5% , 28% ±6% & 21% ±7% in ipsilateral hemisphere area (i. e. , cerebral infarct severity)in Groups 1-5 respectively. Compared with Group 1, the levels of NDS and cerebral infarct severity significantly decreased at ischemic side in Groups 2-5 ( P ＜ 0. 05 ). And the cerebral expression of MAP2,plasma volume of cerebral tissues, diameter and segment length of cerebral microvessel significantly increased at the ischemic side (all P＜0. 05). However, there were no significant differences in the abovementioned parameters at ischemic side among Groups 2, 3 and 4 (all P ＞0. 05). The parameters of NDS,cerebral infarct severity, cerebral expression of MAP2 and plasma volume of cerebral tissues in the ischemic side significantly increased in Group 5 compared with Groups 1,2,3 and 4 (all P ＜ 0. 05). The diameter and segment length of cerebral microvessel at ischemic side were not different among Groups 2,3,4 and 5 (all P＞0. 05). Conclusion In focal cerebral ischemia-reperfusion rats, ischemic, remote ischemic and naloxone postconditioning may produce significant neuroprotective effects of reduced cerebral infarct severity and improved neurologic dysfunctions. A combination of three postconditioning approaches enhances the above neuroprotective effects.     

经尿道钬激光膀胱肿瘤切除术与经尿道膀胱肿瘤电切术治疗浅表层膀胱癌的疗效和安全性比较

目的 探究经尿道钬激光膀胱肿瘤切除术(HOLRBT)与经尿道膀胱肿瘤电切术(TURBT)治疗浅表层膀胱癌的疗效和安全性.方法 选取2017年12月至2019年12月于本院治疗的60例浅表层膀胱癌患者作为研究对象,随机分为观察组与对照组,每组30例.对照组行TURBT术式治疗,观察组行HOLRBT术式治疗,比较两组手术相关指标、住院时间、炎症因子水平及并发症发生率.结果 观察组出血量明显低于对照组,膀胱冲洗、尿管留置、住院等时间均明显短于对照组(P<0.05);观察组IL-6、IL-8、TNF-α水平均明显低于对照组(P<0.05);观察组并发症发生率为3.33％,明显低于对照组的20％,差异有统计学意义(P<0.05).结论 浅表层膀胱癌患者采取HOLRBT术式治疗可降低出血量,缩短术后恢复时间,减少并发症发生,与TURBT术式比较具有一定优势.     

HPLC法测定复方地米水杨酸酊中醋酸地塞米松的含量

目的:建立以反相高效液相色谱法测定复方地米水杨酸酊中醋酸地塞米松含量的方法。方法:色谱柱为HypersilC18,流动相为乙腈-水(50∶50),流速为1.0mL·min-1,检测波长为240nm,柱温为30℃。结果:醋酸地塞米松的检测浓度线性范围为0.01184～0.2960mg·mL-1(r=0.9998);平均回收率为98.57%(RSD=1.34%,n=9)。结论:所建立方法简便、准确、重复性好,可用于复方地米水杨酸酊中醋酸地塞米松的含量测定。     

超声新技术在甲状腺良恶性结节诊断中的价值分析

目的探析超声新技术在甲状腺良恶性结节诊断中的价值。方法在2015年2月—2017年8月我院外科收治的甲状腺结节患者中随机抽取出120例,全部患者均经手术病理确诊,接受常规超声检查和超声弹性成像检查,统计两种检查方法的诊断符合率等。结果超声弹性成像诊断甲状腺良恶性结节的准确率、灵敏度以及特异度均明显高于常规超声检查,P0.05;在常规超声检查的声像图特征上:良性结节与恶性结节在形态、血流信号、微钙化、纵横比、边界、结节回声上均差异有统计学意义,P0.05。结论常规超声检查是甲状腺良恶性结节的基本评估方法,超声弹性成像技术具有更高的鉴别诊断作用,有助于临床医师早期进行良恶性鉴别诊断,便于后续检查治疗的开展。