社区获得性和医院获得性MRSA感染的差异

目的了解某医院社区获得性和医院获得性耐甲氧西林金黄色葡萄球菌（MRSA）感染的特点及耐药性,为MRSA感染的预防控制与治疗提供依据。方法采用前瞻性调查方法,对2010年1-6月该院MRSA感染者资料进行调查和统计分析。结果社区获得性MRSA（CA MRSA）感染部位以皮肤软组织为主,占58.82%。MRSA呼吸道感染在社区和医院感染中的比例均较高,分别为29.41%和29.63%。CA MRSA与医院获得性MRSA（HA MRSA）感染者在年龄、住院天数、是否住重症监护室、是否手术、侵入性操作等方面存在明显差异（P＜0.05）。HA MRSA对利福平、庆大霉素、莫西沙星、环丙沙星的耐药率（74.19%～93.33%）显著高于CA MRSA（37.50%～52.94%）（P＜0.05）。结论CA MRSA 与HA MRSA感染特点及耐药性存在差异,应加强监测和防控,根据药敏试验结果合理使用抗菌药物。     

马齿苋生物碱的研究进展

马齿苋是一种药食同源的植物,其主要含有生物碱、黄酮、萜类、多糖等成分,因其生物碱结构类型多样,且具有较好的药理活性,近年来引起了广泛关注。主要针对马齿苋中生物碱类化合物的结构类型、药理活性、质量评价及体内代谢研究进展进行归纳总结,为马齿苋的开发利用及进一步研究提供参考。     

Influence of acute bupropion pre-treatment on the effects of intranasal cocaine

Aims The aim of this experiment was to determine the influence of acute bupropion pre‐treatment on subject‐rated effects and choice of intranasal cocaine versus money. Design A randomized, within‐subject, placebo‐controlled, double‐blind experiment. Setting An out‐patient research unit. Participants Eight cocaine‐using adults. Measurements Subjects completed nine experimental sessions in which they were pre‐treated with 0, 100 or 200 mg oral immediate release bupropion. Ninety minutes later they sampled an intranasal cocaine dose [4 (placebo), 15 or 45 mg] and made six choices between that dose and an alternative reinforcer (US$0.25), available on independent, concurrent progressive ratio schedules. Subjects also completed a battery of subject‐rated, performance and physiological measures following the sample doses of cocaine. Findings After 0 mg bupropion, the high dose of cocaine (45 mg) was chosen five of six times on average compared to 2.25 of six choices for placebo cocaine (4 mg) (P < 0.05). Active bupropion reduced choice of 45 mg cocaine to 3.13 (100 mg) or 4.00 (200 mg) out of six drug choices on average. Bupropion also consistently enhanced positive subject‐rated effects of cocaine (e.g. good effects; willing to take again) while having no effects of its own. Conclusions The atypical antidepressant, bupropion, acutely appears to reduce preference for intranasal cocaine versus a small amount of money but to increase reported positive experiences of the drug.     

Factors influencing humanitarian care and the treatment of local patients within the deployed military medical system: casualty referral limitations

BackgroundHumanitarian medical care is an essential task of the deployed military health care system. The purpose of this study was to analyze referral acceptance in treating injured local national patients during Operation Enduring Freedom.MethodsA prospective observation study of local nationals who were referred for humanitarian trauma care in Afghanistan from March through August 2009.ResultsSixty-six patients were referred for evacuation for suspected non–coalition-caused injuries. The bed status at the receiving hospital was defined as green (able to accept patients), amber (nearing capacity), and red (at capacity). The only factor associated with acceptance was the accepting hospital bed status (odds ratio = 1.57%, 95% confidence interval, 1.11–2.22; P = .009). Factors not significant were age, the province of origin, the type of referring facility, a prior operation before the request, patient status/affiliation, or the mechanism of injury.ConclusionsHumanitarian medical care is directly related to the capacity for high-acuity care because bed availability is the predominate reason for acceptance or rejection.     

Evaluation of an enzyme immunoassay kit for detecting cryptosporidium in faeces and environmental samples.

AIMS: To evaluate a commercially available enzyme immunoassay based on a monoclonal antibody to a genus specific Cryptosporidium (IDEIA Cryptosporidium; Dako) antigen for detecting Cryptosporidium oocysts in faecal and environmental samples. METHODS: 435 human faecal samples and post-filtration deposits from 10 reservoir samples, and from six tap water samples seeded with Cryptosporidium oocysts, were examined by EIA according to the manufacturer's instructions, and by microscopic examination of phenolauramine stained smears. Samples giving discrepant results were examined by specific immunofluorescence, before and after concentration of oocysts. RESULTS: Sixteen (3.6%) faecal samples were positive by both microscopy and EIA; five (1.1%) were positive by microscopy of auramine-phenol stained smears (but were not confirmed by specific immunofluorescence) and negative by EIA; one (0.2%) was positive by EIA alone, but confirmed by specific immunofluorescence; and 362 (83.2%) were negative by both microscopy and EIA. Compared with immunofluorescence positive faecal samples, the sensitivity of conventional microscopy and EIA were 94% and 100%, and specificity 76.4% and 100%, respectively. Fifty one (11.7%) were not examined by microscopy due to detection of other pathogens in a previous sample from that patient, but were found to be negative by EIA. Ten reservoir water samples (not suspected of being linked to cases of cryptosporidiosis) were negative by both microscopy and EIA. Of six samples of tap water seeded with varying concentrations of Cryptosporidium oocysts, two (10(2) and 10(3) oocysts/l) were positive by both microscopy and EIA, two (10 and 1/l) by EIA alone, and two (0.1/l and unseeded water) were negative by both microscopy and EIA. CONCLUSIONS: The kit is simple and rapid to use and offers a less subjective method than microscopy for detecting Cryptosporidium in faecal samples submitted to a busy diagnostic laboratory.     

Increased brain-derived neurotrophic factor immunoreactivity in rat dorsal root ganglia and spinal cord following peripheral inflammation

Our recent study showed that peripheral inflammation induced an increased expression of brain-derived neurotrophic factor (BDNF) mRNA which was mediated by nerve growth factor (NGF) in the dorsal root ganglion (DRG). In the present study, we evaluated the change of BDNF immunoreactivity in the DRG and spinal cord following peripheral inflammation by means of immunohistochemistry. Significant increases in the percentage of BDNF-immunoreactive (IR) neuron profiles in the L5 DRG and marked elevation in the expression of BDNF-IR terminals in the spinal dorsal horn were observed following peripheral tissue inflammation produced by an intraplantar injection of Freund's adjuvant into the rat paws. These findings suggest that peripheral tissue inflammation induces an increased BDNF synthesis in the DRG and an elevated anterograde transport of BDNF to the spinal dorsal horn. The functional role of this increased BDNF was discussed briefly.     

Aprophen: a substrate and inhibitor of butyrylcholinesterase and carboxylesterases

Aprophen, alpha-methyl-alpha-phenylbenzeneacetic acid-2-(diethylamino) ethyl ester, is a potent reversible inhibitor and a poor substrate of human serum butyrylcholinesterase (BuChE). Complex mixed competitive noncompetitive inhibition kinetics were observed; an apparent competitive inhibition constant was estimated to be 3.7 X 10(-7) M. BuChE hydrolysis of aprophen to diphenylpropionic acid and diethylaminoethanol did not appear to follow Michaelis-Menten kinetics. The BuChE turnover number for aprophen was 2.0 X 10(-3) sec-1. Rabbit liver oligomeric and monomeric carboxylesterases (CE) also hydrolyzed aprophen with a similar turnover number that varied from 1.4 X 10(-3) sec-1 to 4.3 X 10(-4) sec-1 respectively. Comparison of the catalytic rate of aprophen hydrolysis with butyrylthiocholine (BTC) and the neutral aromatic substrate, phenylthiobutyrate (phi TB), indicated that BuChE hydrolyzed BTC and phi TB 3.2 X 10(5) and 3.1 X 10(5) times more rapidly than aprophen respectively. Similarly, the CEs also hydrolyzed BTC and phi TB 17.6 and 1.9 X 10(5) times rapidly than aprophen. Acetylcholinesterases from bovine erythrocyte and electric eel were not inhibited by aprophen nor was aprophen hydrolyzed by these enzymes. The hydrolysis and inhibition reactions may best be described by a complex reaction scheme involving multiple binding sites for both the substrate and the inhibitor as well as positive cooperative ligand binding.