Molecular epidemiological analysis of the acinetobacter baumannii isolates from blood and sputum specimens of patients with ventilator-associated pneumonia北大核心CSCD

Objective To investigate the molecular epidemiological characteristics of the Acinetobacter baumannii strains isolated from blood and sputum samples of patients with ventilator-associated pneumonia (VAP) in ICU. Methods The patients were analyzed in two groups: Group A, A. baumannii was isolated from both blood and sputum, and Group B, A. baumannii was isolated only from sputum. Clinical data of the patients were collected, including the results of antimicrobial susceptibility test. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were performed for the strains. Results During the study period from June 2015 to December 2105, 28 nonduplicate A. baumannii strains were collected from 14 patients in group A and 28 nonduplicate strains from 28 patients in group B. The 56 A. baumannii strains were multidrug-resistant (MDR). More than 80% of the strains were resistant to carbapenem, third-generation cephalosporins or aminoglycoside, but highly sensitive to tigecycline. No significant difference was found for the resistance rates between group A and group B. The nonduplicate A. baumannii isolates from blood and sputum samples of the same patient in group A were all homologous strains confirmed by PFGE. Six pulsotypes were identified from the 28 strains in Group A and 9 pulsotypes in Group B. Five pulsotypes were shared between the two groups. MLST analysis showed that there were 9 ST types (ST195, ST208, ST229, ST369, ST373, ST457, ST836 and two new phenotypes ST N2, ST N5) in Group A and 8 ST types (ST195, ST208, ST381 and 5 new phenotypes ST N1, ST N2, ST N3, ST N4, ST N5) strains in group B. There was no significant difference in the proportion of the main ST types between the two groups. eBURST analysis indicated that ST195, ST208, ST457, ST369, ST N1, ST N2, ST N51 belonged to CC92 prevalent strain. Conclusions The antimicrobial susceptibility profile and genotype of A. baumannii isolates from blood and sputum samples are similar. There was CC92 prevalent strain in the ward. There is no direct relation between the risk factors for bloodstream infection in VAP patients and the genotype of A. baumannii strain. It is particularly important to reinforce infection control for prevention and treatment of A. baumannii bloodstream infections. © 2018, Editorial Department of Chinese Journal of Infection. All rights reserved.     

电针结合穴位敷贴治疗肛肠手术后便秘临床观察

目的观察电针结合穴位敷贴治疗肛肠手术后便秘的临床疗效。方法 100例肛肠手术后便秘患者随机分为两组。治疗组采用针刺双侧天枢、足三里、上巨虚,同时在两侧天枢及上巨虚采取电针治疗,治疗30min后,将中药敷贴贴于神阙穴上;对照组采用开塞露灌肠治疗。2个疗程后比较两组治疗效果,及治疗前后排便次数、排便困难程度的变化。结果治疗组总有效率与对照组比较有明显差异(P0.05);治疗后两组排便次数较治疗前有明显变化(P0.05);治疗组治疗后排便困难程度积分较治疗前比较有明显差异(P0.05),对照组无明显变化。结论电针结合穴位敷贴是一种治疗肛肠手术后便秘的有效方法。     

中药灌肠治疗胃肠术后腹胀疗效观察

目的观察中药灌肠治疗胃肠术后腹胀的临床疗效。方法 90例胃肠术后腹胀患者随机两组。治疗组采用中药灌肠治疗,对照组口服西沙比利,连续治疗5d后评定疗效。结果治疗组总有效率明显优于对照组(P0.01)。结论中药灌肠治疗胃肠术后腹胀疗效可靠。     

原花青素对肢体缺血再灌注后大鼠肠黏膜屏障功能的保护作用

目的探讨原花青素对大鼠肢体缺血再灌注(limb ischemia reperfusion,LIR)后肠黏膜屏障功能的保护作用。方法健康成年SD大鼠21只,随机分为三组:假手术组(n=7),肢体缺血再灌注组(n=7)和原花青素组(n=7);原花青素组给予原花青素[100 mg/(kg·d)]预处理7 d,假手术组和肢体缺血再灌注组给予等量色拉油,预处理7 d。肢体缺血再灌注组和原花青素组采用止血带结扎大鼠左后肢3 h后再灌注18 h的方法建立肢体缺血再灌注动物模型。假手术组行止血带结扎操作后立即剪断止血带。测定各组动物的血清二胺氧化酶(DAO)活性和前列环素(PGI2)含量,以及肠组织的分泌型免疫球蛋白A(sIgA)含量。结果与假手术组比较,肢体缺血再灌注组大鼠血清DAO活性显著升高(P<0.05),血清PGI2含量显著增多(P<0.01),肠组织中sIgA含量显著减少(P<0.05);与肢体缺血再灌注组比较,原花青素组大鼠血清DAO活性显著降低(P<0.05),血清PGI2含量显著减少(P<0.01),肠组织中sIgA含量显著增加(P<0.05)。结论原花青素对LIR所致的肠黏膜屏障功能损伤具有保护作用。     

Bidirectional Relationships Between Weight Change and Sleep Apnea in a Behavioral Weight Loss Intervention

Objective

To examine the bidirectional relationship between weight change and obstructive sleep apnea (OSA) in the context of a behavioral weight loss intervention.

Effects of perioperative statins on patient outcomes after noncardiac surgery: a meta-analysis

Background: Cardiovascular complications are strongly correlated with a higher risk of mortality during follow-up after noncardiac surgery. However, controversy remains regarding whether perioperative administration of hydroxymethylglutaryl-CoA reductase inhibitors (statins) has a beneficial effect on patient outcomes.

Objective: We performed a meta-analysis to validate the hypothesis that perioperative statins improve patient outcomes after noncardiac surgery.

Methods: Electronic databases (PubMed, Web of Science, EMBASE, and the Cochrane Library) were searched for randomized controlled trials (RCTs) published up to 10 November 2017. RCTs were eligible for inclusion if they compared perioperative statin treatment with control treatment in patients scheduled for noncardiac surgery and reported data pertaining to clinical outcomes.

Results: Twelve RCTs involving 4707 patients (2371 in the perioperative statin group and 2336 in the control group) were ultimately included in this meta-analysis. The incidences of postoperative myocardial infarction, composite of death/myocardial infarction/stroke and new cases of atrial fibrillation were all lower in patients treated with statins than in control group patients, as shown by the fixed-effects model (odds ratio (OR)?=?0.460, 95% confidence interval (CI)?=?0.324–0.653, p?=?0 for myocardial infarction; OR?=?0.617, 95% CI?=?0.476–0.801, p?=?0 for composite of death/myocardial infarction/stroke; OR?=?0.406, 95% CI?=?0.247–0.666, p?=?0 for new atrial fibrillation). No significant differences in the incidences of stroke or transient ischemic attack, all-cause mortality and cardiovascular mortality were observed between the statin and control arms.

Conclusions: This meta-analysis supports the hypothesis that perioperative statins effectively reduce the incidences of postoperative myocardial infarction, composite of death/myocardial infarction/stroke and new cases of atrial fibrillation in patients undergoing noncardiac surgery.

• Key Messages

• Cardiovascular complications are strongly correlated with a higher risk of mortality during follow-up after noncardiac surgery.

• We performed a meta-analysis to confirm the hypothesis that perioperative statins improve patient outcomes after noncardiac surgery.

     

中西医结合治疗烧烫伤临床研究

目的：探讨中西医结合法治疗烧烫伤的临床疗效。方法：选取100例Ⅱ度和Ⅲ度烧烫伤患者,随机分为对照组50例、治疗组50例,对照组运用常规法处理,治疗组在对照组基础上予以中药烧伤2号酊做内敷料,外用棉垫包扎。观察两组患者临床疗效及不良反应发生情况。结果：治疗组有效率为96％,平均显效病程为4．1 d;对照组有效率为60％,平均显效病程为7．8 d,两组有效率及平均显效病程比较,差异均有统计学意义（P＜0．05）。结论：中西医结合法治疗烧烫伤具有良好的临床效果。文献引用：唐政．中西医结合治疗烧烫伤临床研究[J]．中医学报,2015,30（5）：668－669．     

Dietary polyphenol canolol from rapeseed oil attenuates oxidative stress-induced cell damage through the modulation of the p38 signaling pathway

Canolol (CAO) is a main phenolic compound with remarkable antioxidative properties that is generated in rapeseed oil during microwave pressing. The objective of this study was to identify the protective effect of CAO in hydrogen peroxide (H₂O₂)-triggered oxidative stress and reveal the role of the p38 MAPK pathway during the protective process. CAO treatment showed an observable cytoprotective effect. Results showed that CAO significantly improved H₂O₂-stimulated cell death, and diminished ROS production and malondialdehyde (MDA) level. Moreover, CAO increased glutathione (GSH) content and promoted the activities of superoxide dismutase (SOD) and catalase (CAT). As a result, apoptosis was ameliorated and depletion of the mitochondrial membrane potential was restored. Western blotting analysis demonstrated CAO downregulated the expression of caspase-3 and decreased the ratio of Bax/Bcl-2. Notably, the phosphorylation of p38 MAPK was inhibited by CAO in H₂O₂-induced apoptosis, which was confirmed by its inhibitor (SB203580). Taken together, our study demonstrated the pivotal role of the p38 MAPK pathway in the cytoprotective effect of CAO on oxidative stress-induced cell damage, suggesting CAO is a promising antioxidant in food and health-related fields.

Canolol extracted from rapeseed oil attenuated oxidative stress-induced apoptosis and cellular redox status imbalance by inhibition of p38 phosphorylation.