济宁市某医院呼吸道感染患者病原菌分布及耐药性分析

目的了解济宁市第一人民医院呼吸道感染的病原菌菌群分布及耐药性,为临床治疗提供依据。方法采取生物梅里埃APISystem鉴定和VitekAmSystena微生物自动分析仪进行细菌鉴定,抗生素耐药性分析采用K—B纸片法,20eAUX酵母菌法测定真菌。MIC评价其耐药性。结果从148例呼吸道感染患者留取的痰标本中共分离出菌株120株,病原菌以革兰阴性菌为主,占66．7％,前5位分别为铜绿假单胞、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌及阴沟肠杆菌和嗜麦芽寡养单胞菌;革兰阳性菌占23．3％,主要为金黄色葡萄球菌、肺炎链球菌及粪肠球菌和肺炎链球菌;真菌占10．0％,以白念珠菌为主。大多数革兰阴性菌对头孢哌酮／舒巴坦、左氧氟沙星、亚胺培南的耐药率较低,耐药率为5．8％～33．3％;头孢唑林、头孢曲松、氨苄西林的耐药率较高,耐药率均在50％以上。革兰阳性致病菌对万古霉素较敏感,对其他抗菌药物耐药程度均较低。结论济宁市第一人民医院呼吸道感染的病原菌以革兰阴性杆菌为主,且耐药菌株所占比例较高,应合理地应用抗菌药物。     

Intracellular expression of the Salmonella plasmid virulence protein,SpvB, causes apoptotic cell death in eukaryotic cells

The spv genes carried on the Salmonella virulence plasmid are commonly associated with severe systemic infection in experimental animals. The SpvB virulence-associated protein has been shown to ADP-ribosylate actin, and this enzymatic activity is essential for virulence in mice. Here, we present evidence that intracellular expression of SpvB protein induces not only disruption of actin filaments but also apoptotic cell death in eukaryotic cells.     

Clomiphene Citrate as An Adjuvant to hMG Stimulation of the Ovaries in Mid-to-late Follicular Phase and Subsequently Pregnancy Outcome of Frozen-thawed Embryo Transfers

Objective To compare the results of a novel regimen of human menopausal gonadotrophin (hMG) in combination with clomiphene citrate (CC) in mid-to-late follicular phase with those of a short protocol of GnRH agonist (GnRHa) and hMG used for IVF. Methods In the retrospective study, 842 patients undergoing IVF were collected and classified into two groups: hMG in combination with CC in mid-to-late follicular phase (group A, n=319) and short protocol of GnRHa-hMG (group B, n=523). The main outcome measures were ovarian responses in stimulation cycles and pregnancy outcomes in subsequent frozen-thawed embryo transfer (FET) cycles. Results In group A, the serum LH concentration on day 8-10 was similar with that on the day of hCG administration (2.43 ± 1.92 IU vs 2.51 ± 2.05 IU). The number of mature follicles and oocytes retrieved was significantly lower in group A than in group B while the fertilization rate and the cleavage rate were comparable. The clinical pregnancy rate (47.79% vs 48.04%), the implantation rate (32.49% vs 33.11%) and the cumulative pregnancy rate (58.09% vs 60.22%) were respectively similar in group A and group B. Conclusion hMG in combination with CC in mid-to-late follicular phase results in the same pregnancy outcome as short protocol. The novel protocol may take the advantage of eliminating the occurrence of a premature endogenous LH surge.     

中心静脉-动脉血二氧化碳分压差对感染性休克液体复苏指导作用的研究

目的研究中心静脉-动脉血二氧化碳分压差[P(cv-a)CO2]在指导感染性休克患者液体复苏的意义。方法选择2009年9月至2011年9月江西萍矿总医院中心ICU收治的感染性休克患者128例,入选68例。随机分组为A组(ScvO2组)30例,维持中心静脉压(CVP)8～12mm Hg(1mm Hg=0.133kPa),平均动脉压(MAP)65～90mm Hg,ScvO2≥70%,尿量大于或等于0.5mL.kg-1.h-1,治疗6h。B组[ScvO2+P(cv-a)CO2组]38例。维持CVP 8～12mm Hg,MAP 65～90mm Hg,ScvO2≥70%,尿量大于或等于0.5mL.kg-1.h-1,P(cv-a)CO2<6mm Hg,治疗6h。比较两组的疗效。结果两组患者在液体复苏6h后B组乳酸清除率、CI、ScvO2和CVP及液体平衡高于A组(P<0.05)。A组血管活性药物多巴酚丁胺及去甲肾上腺素用量较B组多(P<0.05)。结论 P(cv-a)CO2用于指导感染性休克患者液体复苏可以更好地评价有效循环血流量及组织灌注状态,也是作为判断感染性休克严重程度、治疗效果和预后的敏感指标。     

不同来源救必应药材的质量评价

目的 对收集的22批救必应药材进行性状、显微、HPLC指纹图谱鉴别。方法 以粉末显微特征为主,并采用HPLC法,色谱柱为Dikma C₁₈（200 mm×4.6 mm,5 μm）,以乙腈（A）-0.1%磷酸水溶液（B）为流动相,进行梯度洗脱,体积流量为1.0 mL/min;检测波长210 nm;柱温35 ℃。结果 性状、粉末鉴别评价所得出的药材质量优劣结果与指纹图谱相似度评价结果相一致,所建立的指纹图谱精密度、重复性、稳定性良好,可反映救必应药材的整体特征。结论 所建立的性状、粉末鉴别方法可以用于救必应药材及其混淆品的鉴别,HPLC指纹图谱可用于救必应药材的质量评价。     

婴幼儿支气管肺炎对心电图P波的影响

目的探讨婴幼儿支气管肺炎心电图P波振幅的特点,为心电图诊断提供科学依据。方法患有支气管肺炎的婴幼儿共143例,分为二组：其中轻症患儿组84例;重症患儿组59例。对照组为同时期门诊查体的正常同龄婴幼儿共96例。对支气管肺炎婴幼儿入院当日、一周PⅡ振幅及一周内心律失常发生率进行比较。结果入院当日PⅡ振幅重症组、轻症组分剐较正常组增高,重症组较轻症组增高（P〈0．01）;入院1周各组间比较,PⅡ振幅重症组较正常组、轻症组增高（P〈0．01）;二组支气管肺炎患儿入院1周内心律失常比较,重症组较轻症组室上性心律失常发生率增高,差异有统计学意义（P〈0．05）。结论婴幼儿支气管肺炎对心电图P波振幅有影响,与病情相关。     

Bone morphogenetic protein-7 inhibits silica-induced pulmonary fibrosis in rats

Bone morphogenetic protein-7 (BMP-7) has been shown to inhibit liver and renal fibrosis in in vivo and vitro studies. There is no study to investigate BMP-7's role in the development of pulmonary fibrosis induced by silica. In the current study, we used the rat model to explore the potential antifibrotic role of BMP-7 and its underlying mechanism in silica-induced pulmonary fibrosis. Sixty Wistar rats were randomly assigned into three groups. Control group received saline, silica group received silica and BMP-7 treated group received silica and BMP-7. BMP-7 was administered to silica-treated rats intraperitoneally at a dose of 300 μg/kg/injection from day 8 to day 30 every other day. After the animals were sacrificed on day 15 and 30, hydroxyproline levels, the protein expressions of BMP/Smad and TGF-β/Smad signaling, and histopathology in lung tissues were analyzed. The hydroxyproline contents in BMP-7 treated groups were significantly lower than the silica groups (P < 0.05). Histopathological results showed BMP-7 could reduce the progression of silica induced fibrosis. Furthermore, the expression of p-Smad1/5/8, a marker of BMP/Smad signaling, was significantly up-regulated in BMP-7 treated groups (P < 0.05) compared with the silica groups. On the contrary, the expression of p-Smad2/3, a marker for TGF-β/Smad signaling, reduced significantly in BMP-7-treated groups compared with silica groups (P < 0.05). In conclusion, the pulmonary fibrosis induced by silica in rats was significantly reduced with the therapeutic treatment of BMP-7. The antifibrotic effect of BMP-7 could be related to the activation of BMP/Smad signaling and inhibition of TGF-β/Smad pathways.     

The Antitumor Effect of a New Docetaxel-Loaded Microbubble Combined with Low-Frequency Ultrasound In Vitro: Preparation and Parameter Analysis

Purpose

To develop a novel docetaxel (DOC)-loaded lipid microbubbles (MBs) for achieving target therapy and overcoming the poor water-solubility drawback of DOC.

Methods

A novel DOC-loaded microbubble (DOC + MB) was prepared by lyophilization and the physicochemical properties including ultrasound contrast imaging of the liver were measured. The anti-tumor effect of the DOC + MBs combined with low-frequency ultrasound (LFUS; 0.8Hz, 2.56 W/cm², 50% cycle duty) on the DLD-1 cancer cell line was examined using an MTT assay.

Results

The physicochemical properties of the two tested formats of DOC + MBs (1.0 mg and 1.6 mg) was shown: concentration, (6.74?±?0.02)?×?10⁸ bubbles/mL and (8.27?±?0.15)?×?10⁸ bubbles/mL; mean size, 3.296?±?0.004 μm and 3.387?±?0.005 μm; pH value, 6.67?±?0.11 and 6.56?±?0.05; release rate, 3.41% and 12.50%; Zeta potential, ?37.95?±?7.84 mV and ?44.35?±?8.70 mV; and encapsulation efficiency, 54.9?±?6.21% and 46.3?±?5.69%, respectively. Compared with SonoVue, the DOC + MBs similarly enhanced the echo signal of the liver imaging. The anti-tumor effect of the DOC + MBs/LFUS group was significantly better than that of DOC alone and that of the normal MBs/LFUS groups.

Conclusions

The self-made DOC + MBs have potential as a new ultrasound contrast agent and drug-loaded microbubble, and can obviously enhance the antitumor effect of DOC under LFUS exposure.     

尼扎替丁氯化钠注射液的制备、质量控制、稳定性及安全性考察

目的 制备尼扎替丁氯化钠注射液,建立质量控制方法并考察其稳定性和安全性。方法 优化处方组成与制备工艺,并进行性状、鉴别、检查等质量研究,采用高效液相色谱法测定尼扎替丁含量,滴定法测定氯化钠含量,影响因素试验、加速试验和长期试验考察其稳定性,并进行生物安全性评价。结果 尼扎替丁在0.55～1.31mg·mL^-1与峰面积线性关系良好,其平均回收率为99.9%,RSD为0.44%。恒温加速试验6个月和长期留样试验12个月,其性状、pH值、溶液颜色、有关物质、不溶性微粒、无菌、内毒素、主药含量等均未见明显改变,安全性良好。结论 该制剂处方合理,制备工艺简便可行,质量可控,稳定性良好,用药安全。