Clinical features and complications of viridans streptococci bloodstream infection in pediatric hemato-oncology patients.

BACKGROUND AND PURPOSE: Viridans streptococci (VS) are part of the normal flora of humans, but are fast emerging as pathogens causing bacteremia in neutropenic patients. The clinical features, outcomes, and antibiotic susceptibilities of VS bloodstream infections in children with hemato-oncological diseases are reported in this study. METHODS: A retrospective chart review of pediatric patients (< or =18 years) diagnosed with VS infections between January 1998 and December 2004 was conducted at the National Taiwan University Hospital. RESULTS: Among the 26 episodes noted in 25 pediatric patients, the incidence rate of VS bacteremia was found to be significantly higher in pediatric patients with acute myeloid leukemia compared with other hemato-oncological conditions. Most of the patients had profound neutropenia related to chemotherapy for a median of 5 days on the day of positive blood culture. Eight of the 25 patients had undergone stem cell transplantations. Streptococcus mitis was the most common bloodstream isolate and only 12 (44%) of the 27 isolated strains of VS were penicillin-susceptible. Empirical antibiotic treatments were not effective in half of the episodes, but did not affect overall mortality. Isolated bacteremia (63%) and pneumonia (22%) were the two leading clinical presentations. Complications were recognized more frequently in patients with pneumonia. Hypotension and mechanical ventilation each developed in 8 patients (31%). The overall mortality rate was 23%. CONCLUSIONS: Penicillin non-susceptible VS infection has emerged as a threat in children with hemato-oncological diseases, especially those with acute myeloid leukemia. S. mitis is the most common spp. of VS causing bacteremia in children and is associated with serious complications. The development of pneumonia resulted in clinical complications and higher mortality. Empirical antibiotic treatments with activity against the infecting strains did not reduce the overall mortality rate in this study.     

α2，6-唾液酸转移酶（ST6GalⅠ）的表达对结肠癌细胞唾液酸化的影响

目的 研究结肠癌细胞LS174T转染正义和反义的α2，6唾液酸转移酶(ST6GalⅠ)cDNA对结肠癌细胞表面唾液酸化及肿瘤细胞粘附功能的影响．方法 结肠癌细胞株LS174T转染正义ST6GalⅠcDNA或反义ST6GalⅠcDNA的部分序列的表达载体pcDNA3.1，以RT—PCR检测转染子ST6GalⅠmRNA的表达．流式细胞仪检测细胞表面α2，6唾液酸含量．结果 转染正义ST6GalⅠcDNA的克隆显示ST6GalⅠmRNA的表达增强以及接骨木凝集素(SNA)与细胞表面成分的结合增加；而转染反义ST6GalⅠcDNA的部分序列的细胞克隆的ST6GalⅠmRNA的表达减少．SNA与细咆表面成分的结合力降低．结论 ST6GalⅠ的表达直接影响细胞表面α2．6-连接的唾液酸水平并调节肿瘤细胞的粘附功能利用反义核酸技术抑制ST6GalⅠ的表达并降低肿瘤细咆表面α2，6-唾液酸水平可能成为减少癌细胞转移的一种手段．     

颈深筋膜及筋膜间隙的计算机三维重建

目的 :对颈深筋膜及深筋膜间隙进行计算机三维重建以显示其立体结构。方法 :用生物塑化技术制作薄层断面标本 ,在SGI工作站上 ,采用双线提取筋膜及间隙轮廓的方法对颈深筋膜及其间隙进行了三维重建。结果 :重建出咽后间隙、颈动脉间隙和内脏间隙及颈部的大血管和重要器官。重建结构均能单独显示、任意搭配显示或总体显示 ,可在三维空间位置上绕任意轴旋转任意角度。结构 :用双线法提取筋膜及间隙轮廓 ,能重建出筋膜间隙并能同时清楚显示间隙内的结构 ,为筋膜间隙的计算机三维重建提供了一种新的方法     

氟达拉宾对系统性红斑狼疮BXSB小鼠狼疮活动的影响

目的 :探讨氟达拉宾对系统性红斑狼疮BXSB小鼠狼疮活动的影响 ,氟达拉宾治疗重型系统性红斑狼疮的可能性、有效性及其可能的机制。方法 :用 30mg (m2 ·d) ,连续 3天氟达拉宾尾静脉注入BXSB小鼠体内 ,用血液分析仪分析用氟达拉宾前后不同时间小鼠外周血白细胞的变化 ,用ELISA方法测定BXSB小鼠血清抗ds DNA抗体、抗核抗体的变化 ,免疫荧光检查肾组织的病理改变 ,尿蛋白试纸检测用氟达拉宾前后BXSB小鼠的蛋白尿 ,流式细胞仪分析T淋巴细胞表面CD4 + Fas+ 、CD8+ Fas+ 、、CD4 5RO+ Fas+ 表达的变化。结果 :用氟达拉宾后BXSB小鼠外周血白细胞数从第 3天开始下降 ,至第 7天时白细胞下降至最低值〔(0 5± 0 2 )× 10 9L- 1 〕 ,白细胞上升至 1 0× 10 9L- 1 的时间是用药后 19天 ;BXSB小鼠血清抗ds DNA抗体、抗核抗体的水平明显下降 ,分别出现在用氟达拉宾后第 14、2 1天时 ;用药后第 2 8天氟达拉宾组 72 7%的BXSB小鼠肾组织进行免疫荧光病理检查 ,其荧光强度由 +～ ++→± ;用氟达拉宾后第 2 1、2 8天尿蛋白从 ++～ +++转±～ -占 81 8% ;用Flu后BXSB小鼠CD4 + Fas+ 、CD8+ Fas+ 、CD4 5RO+ Fas+ 的表达均明显低于用Flu前。结论 :氟达拉宾可明显减少BXSB小鼠血清抗ds DNA抗体、抗核抗体的水平 ,减少BXSB小     

CD40L表达在异基因造血干细胞移植中GVHD发生的意义

目的：初步探讨在异基因造血干细胞移植（HSCT）中发生移植物抗宿主病（GVHD）患者DC40L表达的变化以及意义。方法：HSCT治疗重型β-地中海贫血（n=12）和遗传性溶血性贫血（n=1）成功植入的儿童患者，其中脐血移植（UCBT）8例，异基因外周血造血干细胞移植(allo-PBSCT)5例，在移植前、移植后发生GVHD时采用流式细胞仪检测和比较外周血中CD40L和CD40的表达。结果：3例UCBT无GVHD，其余均发生了Ⅰ-Ⅳ度急性GVHD。急性GVHD发生时CD4^ CD40L^ 和CD8^ CD40LT细胞表达明显升高，allo-PBSCT者更明显；慢性GVHD发生时患者的CD40L^ 、CD25^ 和CD69^ 在CD4^ 和CD8^ T细胞上的表达亦增加。CD19^ CD40^ B细胞的表达在UCBT和allo-PBSCT的3个月内则一直处于低于正常的水平。结论：CD40L高表达与GVHD的发生相关，提示CD40-CD40L共刺激途径在GVHD的发生中可能起着重要作用。     

Anatomic basis of venous drainage in donor flaps

Summary The venous architecture in donor flaps was observed in 17 fresh cadavers by injection of latex or ink into the vessels or by making corrosion-cast specimens. The pattern of the veins resembles that of the arteries, with the difference that there is another set of venous trunks which do not accompany the arteries. Because these trunks are of larger caliber, they are the main drainage route for flaps. There are three types of drainage based on the anatomical architecture: 1) the superficial trunk is the main drainage path; 2) the deep trunk is the main path; 3) both superficial and deep veins are involved. These morphological considerations are the basis for selection of veins for anastomosis in microsurgery. The axial veins in temporal, frontal and facial flaps on the dorsum of the hand and the foot usually loosely accompany the axial arteries. The characteristics of these vascular pedicules should be studied in transplant operation.

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Bases anatomiques du drainage veineux des lambeaux cutanés libres

Résumé Le drainage veineux des lambeaux cutanés libres a été étudié sur 17 cadavres frais par injection de latex ou d'encre dans les vaisseaux, ou en réalisant des moulages par injection-corrosion. La distribution des veines ressemble à celle des artères à la différence près qu'il existe des troncs veineux qui n'accompagnent pas les artères. Ces troncs ont un calibre plus important et représentent une voie de drainage principale pour les lambeaux. On peut individualiser trois types de drainages basés sur l'architecture veineuse : 1. Le tronc superficiel est la principale voie de drainage ; 2. le tronc profond est la principale voie; 3. les veines superficielles et profondes sont impliquées simultanément. Ces considérations morphologiques sont les bases de la sélection des axes veineux pour les anastomoses en micro-chirurgie. Les veines axiales au niveau temporal, frontal et facial et pour les lambeaux de la face dorsale de la main et du pied sont habituellement relativement éloignées du trajet artériel. Les caractéristiques de ces pédicules veineux doivent être précisées pour la réalisation des lambeaux.

     

Acylation of the lipooligosaccharide of Haemophilus influenzae and colonization: an htrB mutation diminishes the colonization of human airway epithelial cells

Haemophilus influenzae is a commensal and opportunistic pathogen of the human airways. A number of surface molecules contribute to colonization of the airways by H. influenzae, such as adhesins, including structures found in the lipooligosaccharide (LOS). A human bronchiolar xenograft model was employed to investigate the host-bacterial interactions involved in the colonization of the airway by H. influenzae. Differential display was used to identify H. influenzae mRNA that reflect genes which were preferentially expressed in the xenograft compared to growth. Eleven mRNA fragments had consistent increased expression when the bacteria grew in xenografts. On sequencing these fragments, eight open reading frames were identified. Three of these had no match in the NCBI or the TIGR database, while an additional three were homologous to genes involved in heme or iron acquisition and utilization: two of the mRNAs encoded proteins homologous to enzymes involved in LOS biosynthesis: a heptosyl transferase (rfaF) involved in the synthesis of the LOS core and a ketodeoxyoctonate phosphate-dependent acyltransferase (htrB) that performs one of the late acylation reactions in lipid A synthesis. Inoculation of human bronchiolar xenografts revealed a significant reduction in colonization capacity by htrB mutants. In vitro, htrB mutants elicited lesser degrees of cytoskeletal rearrangement and less stimulation of host cell signaling with 16HBE14o(-) cells and decreased intracellular survival. These results implicate acylation of H. influenzae lipid A as playing a key role in the organisms' colonization of the normal airway.     

类风湿性关节炎RF阳性与阴性患者外周血CD4+细胞基因表达的差异

目的:研究RF因子阳性及阴性RA患者之间是否存在基因组学的差异,探询差异存在的基因表达基础.方法:应用基因表达谱方法来检测上述两型患者CD4 淋巴细胞基因表达情况.结果:RF因子阳性与阴性患者之间有55条基因表达差异有统计学意义.结论:RF因子阳性与阴性RA患者之间存在差异表达基因,这些差异基因多与免疫应答相关.     

小鼠β_2m反义核酸重组荧光蛋白表达载体的构建及表达研究

本研究应用分子生物学技术 ,构建小鼠 β2 m反义核酸重组荧光蛋白表达载体pEGFP β2 mAN ,经过酶切、PCR鉴定 ,以及序列分析证实克隆的正确性。然后用脂质体转染NIH3T3细胞 ,经过RT PCR及Westernblot检测 ,观察重组质粒对细胞β2 mmRNA和蛋白表达的影响 ,同时在荧光显微镜下直接观察细胞转染的结果。结果证明pEGFP β2 mAN已成功导入NIH3T3细胞中 ,且有效表达 ,在荧光显微镜下可见梭形绿色荧光细胞 ;与同步转染的小鼠 β2 m正、反义核酸表达载体pcDNA3 β2 mSN、pcDNA3 β2 mAN的转染结果一起进行分析 ,转染pcDNA3 β2 mSN细胞的 β2 mmRNA和蛋白表达水平升高 ,而转染pcD NA3 β2 mAN和pEGFP β2 mAN的细胞 β2 mmRNA和蛋白表达水平降低。小鼠 β2 m反义核酸重组荧光蛋白表达载体pEGFP β2 mAN的转染结果显示 :它不但可以降低NIH3T3细胞 β2 m基因的表达 ,而且为观察脂质体转染效果提供了直观、即时的方法