肠球菌医院感染特征及新型抗菌药物耐药性研究

目的探讨肠球菌属细菌分布及耐药性特征,为指导临床合理用药及控制医院感染提供依据。方法对该院2011年1月至2013年12月年临床送检标本进行细菌分离培养、鉴定和药敏试验。结果共检出肠球菌属细菌140株,屎肠球菌71株(50.7%),粪肠球菌60株(42.9%),其他肠球菌9株(6.4%),其中尿液99株(70.7%);粪肠球菌对青霉素、氨苄西林、红霉素的耐药率为15.0%、12.5%和75.0%,屎肠球菌对青霉素、氨苄西林、左氧氟沙星、环丙沙星、红霉素耐药率大于80.0%,粪肠球菌和屎肠球菌对万古霉素(5.0%、4.2%)、利奈唑胺(8.4%、1.4%)极度敏感,喹奴普丁/达福普丁对粪肠球菌耐药率(100.0%)高于屎肠球菌(26.7%),达托霉素无耐药菌株。结论肠球菌属以泌尿系统感染为主,屎肠球菌检出率略大于粪肠球菌,屎肠球菌对大多数抗菌药物耐药率高于粪肠球菌,喹奴普丁/达福普丁仅对屎肠球菌有较高敏感性,万古霉素、利奈唑胺、达托霉素对肠球菌属细菌保持极高敏感性。     

CD4+CD25+调节T细胞与肿瘤免疫治疗策略

随着分子生物技术的不断发展,肿瘤的生物治疗在临床应用中的地位日渐突出,其中CD4+CD25+Foxp3+调节T细胞(CD4+CD25+Foxp3+regulatory T cell,Treg)在抑制肿瘤免疫方面起着重要作用,文章就其近年来在肿瘤免疫领域的研究进展作一综述.     

A crucial role for TNF-α in mediating neutrophil influx induced by endogenously generated or exogenous chemokines,KC/CXCL1 and LIX/CXCL5

Background and purpose:

Chemokines orchestrate neutrophil recruitment to inflammatory foci. In the present study, we evaluated the participation of three chemokines, KC/CXCL1, MIP-2/CXCL2 and LIX/CXCL5, which are ligands for chemokine receptor 2 (CXCR2), in mediating neutrophil recruitment in immune inflammation induced by antigen in immunized mice.

Experimental approach:

Neutrophil recruitment was assessed in immunized mice challenged with methylated bovine serum albumin, KC/CXCL1, LIX/CXCL5 or tumour necrosis factor (TNF)-α. Cytokine and chemokine levels were determined in peritoneal exudates and in supernatants of macrophages and mast cells by elisa. CXCR2 and intercellular adhesion molecule 1 (ICAM-1) expression was determined using immunohistochemistry and confocal microscopy.

Key results:

Antigen challenge induced dose- and time-dependent neutrophil recruitment and production of KC/CXCL1, LIX/CXCL5 and TNF-α, but not MIP-2/CXCL2, in peritoneal exudates. Neutrophil recruitment was inhibited by treatment with reparixin (CXCR1/2 antagonist), anti-KC/CXCL1, anti-LIX/CXCL5 or anti-TNF-α antibodies and in tumour necrosis factor receptor 1-deficient mice. Intraperitoneal injection of KC/CXCL1 and LIX/CXCL5 induced dose- and time-dependent neutrophil recruitment and TNF-α production, which were inhibited by reparixin or anti-TNF-α treatment. Macrophages and mast cells expressed CXCR2 receptors. Increased macrophage numbers enhanced, while cromolyn sodium (mast cell stabilizer) diminished, LIX/CXCL5-induced neutrophil recruitment. Macrophages and mast cells from immunized mice produced TNF-α upon LIX/CXCL5 stimulation. Methylated bovine serum albumin induced expression of ICAM-1 on mesenteric vascular endothelium, which was inhibited by anti-TNF-α or anti-LIX/CXCL5.

Conclusion and implications:

Following antigen challenge, CXCR2 ligands are produced and act on macrophages and mast cells triggering the production of TNF-α, which synergistically contribute to neutrophil recruitment through induction of the expression of ICAM-1.     

不同标准空腹血糖受损人群葡萄糖负荷后血糖代谢特征

目的：分析两种标准空腹血糖受损人群葡萄糖负荷后血糖代谢特点。方法：对3828名40岁以上居民进行流行病学调查,对空腹血糖≥5.6mmol/L者行75g葡萄糖负荷试验,据不同空腹血糖受损诊断标准分析负荷后2h血糖代谢情况。结果：在以空腹血糖为6.1mmol/L为切点诊断的245例空腹血糖受损（IFG）人群中,糖耐量减低（IGT）的患病率为41.22%,女性（25.71%）高于男性（15.51%）;2型糖尿病（T2DM）患病率为20.82%,女性（11.84%）高于男性（8.98%）。在以空腹血糖为5.6mmol/L为切点诊断的627例空腹血糖受损人群中,糖耐量减低的患病率为37.00%,女性（23.76%）高于男性（13.23%）;2型糖尿病患病率为13.88%,女性（9.52%）高于男性（4.63%）。结论：以空腹血糖为5.6mmol/L和6.1mmol/L为切点诊断的空腹血糖受损人群葡萄糖负荷后2h血糖代谢异常率分别为50.88%和62.04%,患病率女性均高于男性。     

于氨双唑钠对局部晚期非小细胞肺癌放射增敏作用的疗效观察

目的：探讨甘氨双唑钠（CMNa）对III期肺癌的放射增敏作用及不良反应。方法：采用随机分组的方法将经病理学确诊的Ⅲ期非小细胞肺癌（NSCLC）患者分为实验组（A组,放疗加甘氨双唑钠）及对照组（B组,单纯放疗）。两组放疗方法均一样。A组在放疗同时,加用CMNa（800mg／m^2）,每周3次,至疗程结束;B组为单纯放疗,评价两组疗效及观察不良反应。结果：A组的CR＋PR为82．6％（19／23）,显著高于B组的52．2％（12／23）,P〈0．05,差异有统计学意义。两组的不良反应比较,P〉0．05,差异无统计学意义。结论：甘氨双唑钠对局部晚期非小细胞肺癌有放射增敏作用．可提高有效率（CR＋PR）,但不增加不良反应。     

泌尿生殖道支原体感染情况及耐药性分析

目的:探讨泌尿生殖道支原体感染及耐药情况,为临床治疗提供合理、科学的抗生素用药依据.方法:应用支原体培养鉴定药敏试剂盒检测从患者中分离培养的支原体对10种抗生素的药敏情况,并对结果进行分析.结果:2 137例患者中1 163例支原体阳性,阳性率为54.42%;其中女性标本中阳性率为59.58%、男性标本中阳性率为38.78%,女性感染率明显高于男性,Uu、Mh、Uu+Mh阳性率分别为41.18%(880/2137)、3.88%(83/2137)、9.36%(200/2137),以Uu感染率最高,对Uu敏感率最高的抗生素为强力霉素,耐药率最高者为环丙沙星.结论:泌尿生殖道支原体的感染相当普遍,以Uu阳性率最高,女性高于男性,其耐药性已相当严重,应引起临床重视.     

应用荧光DDRT-PCR初探低剂量的ECPs诱导细胞适应性反应的机理

[目的]用荧光DDRT-PCR技术寻找低剂量环境化学污染物(ECPs)过氧化氢(H_2O_2)、甲醛(FA),三氯乙烯(TCE)诱导细胞适应性反应差异表达的基因,为进一步研究低剂量的环境化学污染物(ECPs)诱导机体的生物学效应及其机理提供科学依据。[方法]依据H_2O_2、FA、TCE对细胞毒性的剂量反应关系,建立适应性反应的模型。然后用荧光DDRT-PCR寻找对照组、低剂量组、高剂量组,适应性反应组差异表达的基因,并鉴定和验证部分差异表达的基因。[结果]按照对照组、低剂量组、高剂量组、适应性反应组处理细胞后,DDRT-PCR结果显示各处理组与对照组比较:H_2O_2有60个差异条带、FA有61个,TCE有52个。选择差异比较明显的条带进行2次PCR,然后通过进一步克隆、测序、同源性比较发现一些已知基因如BCL-2、EIF3S5、NDUFS4、RPS10等。[结论]低剂量环境化学污染物诱导机体的适应性反应可能有维持细胞稳态、抗氧化系统、DNA损伤修复级激活细胞信号分子等过程的参与。     

Hutchinson-Gilford progeria syndrome: oral and craniofacial phenotypes

Objective:  Hutchinson-Gilford progeria syndrome (HGPS) is a rare early-onset accelerated senescence syndrome. In HGPS, a recently identified de novo dominant mutation of the lamin A gene ( LMNA ) produces abnormal lamin A, resulting in compromised nuclear membrane integrity. Clinical features include sclerotic skin, cardiovascular and bone abnormalities, and marked growth retardation. Craniofacial features include 'bird-like' facies, alopecia, craniofacial disproportion, and dental crowding. Our prospective study describes dental, oral soft tissue, and craniofacial bone features in HGPS.
Methods:  Fifteen patients with confirmed p.G608G LMNA mutation (1–17 years, seven males, eight females) received comprehensive oral evaluations. Anomalies of oral soft tissue, gnathic bones, and dentition were identified.
Results:  Radiographic findings included hypodontia ( n  = 7), dysmorphic teeth ( n  = 5), steep mandibular angles ( n  = 11), and thin basal bone ( n  = 11). Soft tissue findings included ogival palatal arch ( n  = 8), median sagittal palatal fissure ( n  = 7), and ankyloglossia ( n  = 7). Calculated dental ages (9 months to 11 years 2 months) were significantly lower than chronological ages (1 year 6 months to 17 years 8 months) ( P  = 0.002). Eleven children manifested a shorter mandibular body, anterior/posterior cranial base and ramus, but a larger gonial angle, compared to age/gender/race norms.
Conclusion:  Novel oral-craniofacial phenotypes and quantification of previously reported features are presented. Our findings expand the HGPS phenotype and provide additional insight into the complex pathogenesis of HGPS.     

脑缺氧是影响严重颅脑创伤患者短期预后的独立危险因素(英文)

Background:Brain hypoxia(BH)can aggravate outcome after severe traumatic brain injury(TBI).Whether BH or reduced brain oxygen(Pbto2)is an independent outcome predictor or a marker of disease severity is not fully elucidated.Objective To analyze the relationship between Pbto2,intracranial pressure(ICP),and cerebral perfusion pressure(CPP)and to examine whether BH correlates with worse outcome independently of ICP and CPP.Methods We studied103patients monitored     

Digital colposcopy: ready for use? An overview of literature

The aims of this review were to summarise the various methods of digital colposcopy and to provide an overview of their efficacy. We conducted a literature search and focused on papers that described a technique for colposcopy, other than conventional colposcopy, and compared this with conventional colposcopy and/or histology and included digitalisation of the process. All papers have been classified in one of the following categories: digital imaging and telecolposcopy, spectroscopy, computerised colposcopy, optical coherence tomography and confocal microcolposcopy. Among the most promising developments is spectroscopy, allowing a more or less automated analysis and interpretation of the colposcopic image.