急诊科临床分离细菌耐药性分析

目的了解北京大学第一医院急诊科2012年至2015年临床分离细菌的分布及抗菌药物耐药情况。方法收集急诊科2012年至2015年临床分离的非重复细菌,用纸片扩散法或自动化仪器法进行抗菌药物敏感性试验,按照美国临床和实验室标准协会(CLSI)2015标准判定药物敏感结果,用WHONET5.6软件进行统计分析。结果临床共分离1283株细菌,其中革兰氏阳性菌占30.6%,革兰氏阴性菌占69.4%。分离最多的前5位细菌分别是大肠埃希菌(18.4%),鲍曼不动杆菌(15.2%),金黄色葡萄球菌(13.3%),铜绿假单胞菌(12.7%)和肺炎克雷伯菌(8.8%)。耐甲氧西林金黄色葡萄球菌(MRSA)的平均检出率为75.6%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的平均检出率为83.1%,葡萄球菌中未发现对利奈唑胺、万古霉素耐药菌株。粪肠球菌对所测试的大多数抗菌药物的耐药率均明显低于屎肠球菌。超广谱β内酰胺酶(ESBLs)阳性大肠埃希菌的检出率为64.8%,克雷伯菌属细菌为40.5%。铜绿假单胞菌对亚胺培南、美罗培南耐药率分别为30.1%,28.4%,鲍曼不动杆菌对亚胺培南、美罗培南耐药率分别为83.5和83.0%。结论临床分离细菌对抗菌药物耐药性较高,MRSA、耐万古霉素肠球菌、泛耐药肠杆菌科细菌、泛耐药鲍曼不动杆菌、泛耐药铜绿假单胞菌的检出率较高,给临床治疗带来一定挑战。     

红芪不同提取物对环磷酰胺所致免疫低下小鼠的影响及相关成分含量研究

目的对比研究红芪不同提取物对环磷酰胺(CTX)所致免疫低下小鼠的影响及相关化学成分含量。方法按照体重将昆明种小鼠随机分为空白组、模型组、对照组、醇提物组、水提物组、醇沉物组、残留物组。用CTX 40 mg·kg^-1造成免疫低下模型。对照组灌胃参芪颗粒5 g·kg^-1,其他各组灌胃相应受试样品2 g·kg^-1,正常组和模型组灌胃等量0.9%Na Cl,每天给药1次,连续15 d。称重计算小鼠脏器指数,腹腔注射5%鸡红细胞悬液(CRBC)测定腹腔巨噬细胞吞噬百分率及吞噬指数,用50%二硝基氯苯(DNCB)丙酮溶液致迟发型超敏反应测定OD值,用5%CRBC致敏测定血清溶血素OD值,尾静脉注射印度墨汁测定网状内皮系统吞噬指数及吞噬系数。用UV法测定多糖、总皂苷含量。结果模型组各指标与正常组比较,差异均有统计学意义(均P<0.01)。给药后,正常组、模型组与醇提物组、水提物组、醇沉物组、残留物组的胸腺指数(g·kg^-1)分别为2.55±0.88,1.04±0.74,1.24±0.79,1.81±0.62,1.97±0.83,1.09±0.75,水提物组、醇沉物组与模型组比较,差异均有统计学意义(均P<0.05);水提物组、醇沉物组与残留物组比较,差异均有统计学意义(P<0.05)。这6组的腹腔巨噬细胞吞噬百分率(%)分别为48.58±5.51,28.54±3.15,35.28±6.03,36.99±6.78,39.89±8.33,27.91±8.02,醇提物组、水提物组、醇沉物组的吞噬百分率与模型组比较,差异均有统计学意义(P<0.05或P<0.01);水提物组、醇沉物组与残留物组比较,差异均有统计学意义(P<0.05或P<0.01)。这6组的迟发型超敏反应OD值分别为0.53±0.16,0.23±0.09,0.30±0.10,0.37±0.10,0.36±0.11,0.28±0.14,水提物组、醇沉物组与模型组比较,差异均有统计学意义(P<0.05或P<0.01)。各提取物中多糖和总皂苷含量:醇提物(6.35%;6.57%),水提物(22.64%;7.68%),醇沉物(42.15%;1.86%),残留物(4.33%;5.37%)。结论红芪水提物和醇沉物均能对抗CTX的免疫抑制作用,有一定的增强体液免疫和细胞免疫作用,可增强机体的非特异性免疫和特异性细胞免疫功能。推测多糖是其对抗CTX免疫抑制作用的主要活性部位。     

Review of the Applications of Biomedical Compositions Containing Hydroxyapatite and Collagen Modified by Bioactive Components

Regenerative medicine is becoming a rapidly evolving technique in today’s biomedical progress scenario. Scientists around the world suggest the use of naturally synthesized biomaterials to repair and heal damaged cells. Hydroxyapatite (HAp) has the potential to replace drugs in biomedical engineering and regenerative drugs. HAp is easily biodegradable, biocompatible, and correlated with macromolecules, which facilitates their incorporation into inorganic materials. This review article provides extensive knowledge on HAp and collagen-containing compositions modified with drugs, bioactive components, metals, and selected nanoparticles. Such compositions consisting of HAp and collagen modified with various additives are used in a variety of biomedical applications such as bone tissue engineering, vascular transplantation, cartilage, and other implantable biomedical devices.     

Maternal humoral factors associated with perinatal human immunodeficiency virus type-1 transmission in a cohort from Kigali, Rwanda, 1988-1994

OBJECTIVES: to study different parameters of humoral immunity responses in the serum of 39 human immunodeficiency virus type-1 infected pregnant women from Kigali, (Rwanda) in correlation with perinatal transmission. METHODS: this study was done between 1988 and 1994. Thirty nine HIV-1 infected women, 18 transmitting (T) and 21 non-transmitting (NT) mothers, have been chosen based on the quantity of sera available for analysis. Maternal data were collected at the time of delivery or during the preceding month. Quantification of viral load was performed by the signal amplification bDNA assay. Specific reactivity of antibody was tested against recombinant p24 protein and five different synthetic peptides from gp120 and gp41 based on HIV LAI-strain sequences. Neutralization assays were performed against laboratory (RII strain of the HIV-1 C subtype) and primary strains (two NSI and one SI of the HIV-1 A subtype). Antibody Dependent Cellular Cytotoxicity assay was performed with CEM.NK(R) cells against a laboratory HIV-1 strain. RESULTS: absence of correlation regarding maternal viral load, or viral subtype and vertical transmission was observed. By contrast, the CD4/CD8 ratio was significantly higher in non-transmitting mothers compared to transmitting mothers. Moreover, high anti-p24 antibody avidity was correlated with a lower risk of perinatal transmission. Furthermore, transmission risk appeared significantly higher with reactivity of serum samples to linear epitopes of gp41 (amino acids 566-582, 578-594), whereas risk appeared lower with reactivity to the immunodominant domain of gp41 (amino acids 597-609). No significant difference was observed in titres of antibody neutralizing primary isolates (two NSI (non syncitium inducer) and one SI (syncitium inducer) of the HIV-1 A subtype) and laboratory strain (RII strain, of the HIV-1 C subtype) between transmitting and non-transmitting mother's sera. In addition, titres of Antibody Dependent Cellular Cytotoxicity were similar in transmitting versus non-transmitting mothers. However, high Antibody Dependent Cellular Cytotoxicity titres were correlated with a good clinical status of children. CONCLUSIONS: three parameters such as high CD4/CD8 ratio, high anti-p24 antibody avidity and high reactivity against the immunodominant epitope of gp41 have been shown to be correlated with no perinatal transmission. High Antibody Dependent Cellular Cytotoxicity titres appeared to be linked to a good clinical status of children after birth. One parameter, reactivity against two linear epitopes of gp41, appeared to be correlated with vertical transmission.     

The local immune phenotype influences prognosis in patients with nodal-positive rectal cancer after neoadjuvant chemoradiation

International Journal of Colorectal Disease - The local immune contexture in patients with locally advanced rectal cancer (LARC) has important prognostic value after neoadjuvant chemoradiation and...     

Comparison of Antigen Tests and qPCR in Rapid Diagnostics of Infections Caused by SARS-CoV-2 Virus

Diagnostics of the coronavirus disease 2019 (COVID-19) using molecular techniques from the collected respiratory swab specimens requires well-equipped laboratory and qualified personnel, also it needs several hours of waiting for results and is expensive. Antigen tests appear to be faster and cheaper but their sensitivity and specificity are debatable. The aim of this study was to compare a selected antigen test with quantitative polymerase chain reaction (qPCR) tests results. Nasopharyngeal swabs were collected from 192 patients with COVID-19 symptoms. All samples were tested using Vitassay qPCR SARS-CoV-2 kit and the Humasis COVID-19 Ag Test (MedSun) antigen immunochromatographic test simultaneously. Ultimately, 189 samples were tested; 3 samples were excluded due to errors in taking swabs. The qPCR and antigen test results were as follows: 47 positive and 142 negative, and 45 positive and 144 negative, respectively. Calculated sensitivity of 91.5% and specificity of 98.6% for the antigen test shows differences which are not statistically significant in comparison to qPCR. Our study showed that effectiveness of the antigen tests in rapid laboratory diagnostics is high enough to be an alternative and support for nucleic acid amplification tests (NAAT) in the virus replication phase in the course of COVID-19.     

Hyaluronic acid skin fillers: Adverse reactions and skin testing

BACKGROUND: Hyaluronic acid (HA) fillers have been proposed as alternatives to other temporary skin fillers, such as bovine collagen, for treating facial skin lines and for providing lip augmentation. Several types of commercial HA fillers are now available in many countries. They include Restylane, which is produced by microbiologic engineering techniques, and Hylaform, which is HA extract derived from rooster combs. They have been approved for use in several countries, but not currently in the United States. There are no recommendations to perform pretreatment skin testing by the manufacturers. OBJECTIVE: Our purpose is to describe and comment on our experiences with Hylaform and Restylane fillers. Observation of any side effects and skin testing results were documented. METHODS: Between September 1996 and September 2000, 709 patients were treated with Hylaform and Restylane and were followed up clinically for at least 1 year. Three of these patients (0.42%) developed delayed skin reactions. Three other patients were referred for evaluation of their skin reactions from other practitioners. Five of these 6 patients agreed to skin testing of their forearms. RESULTS: In the 5 patients tested, challenge intradermal skin testing was positive in 4 patients; the reactions started approximately 8 weeks after injection. CONCLUSIONS: There was a slight incidence of delayed inflammatory skin reactions to two HA fillers. Both of these reactions occurred after the first and repeat injections. Challenge skin testing was positive in 4 of 5 tested patients.     

宫颈癌患者 Kruppel 样因子 6，p21 蛋白表达水平与病理特征及化疗敏感性的相关性分析

目的　探讨宫颈癌患者 Kruppel 样因子 6（KLF6）,p21 蛋白表达水平与病理特征及化疗敏感性的相关性。方法　回顾性分析 2016 年 1 月 ~2018 年 12 月接受化疗的 40 例宫颈癌患者,化疗结束后根据化疗效果将患者分为化疗敏感组（CR+PR）、化疗抵抗组（SD+PD）。采用免疫组化检测宫颈癌组织 KLF6,p21 蛋白的表达,分析其与临床病理特征、化疗敏感性及总生存期（OS）的关系。结果　宫颈癌中 KLF6,p21 蛋白阳性率与病理分期、肿瘤直径、分化类型及化疗敏感性相关（χ 2 =2.14~5.74,均 P<0.05）。KLF6+/p21- 者 ORR 为 85.71%,显著高于非 KLF6+/p21- 者 42.11%（χ 2 =8.33,P<0.05）。宫颈癌患者的中位 OS 为 11.20 个月（95%CI: 9.73~12.71）,其中 KLF6 阳性者中位 OS 为 11.90个月（95%CI: 10.81~12.99）,显著高于阴性表达者 9.20 个月（95%CI: 9.05~9.35）;p21 蛋白阳性者中位 OS 为 9.14 个月（95%CI: 8.26~10.22）,显著低于 p21 阴性表达者 11.62 个月（95%CI: 9.63~13.58）（χ 2 =11.50,6.23,均 P<0.05）。结论　宫颈癌患者 KLF6,p21 表达水平与其临床病理特征相关。KLF6 高表达、p21 低表达者化疗敏感性高,且预后更好,可作为预后、个体化治疗方案选择的评价指标。