人感染H7N9禽流感26例临床特征与病毒基因分析研究

目的探讨人感染H7N9禽流感病毒患者的流行病学和临床特征,以及病毒分子生物学特征。方法收集湖南省2013、2014年确诊的26例人感染H7N9禽流感病毒患者的资料,对人和禽分离的H7N9病毒进行鉴定和测序分析。结果26例患者中,发热和咳嗽是最常见的起病症状,所有患者均存在肺炎;20例(76.92%)出现急性呼吸窘迫综合征(ARDS),25例(96.15%)初诊时白细胞下降或正常,发病至开始进行抗病毒治疗的平均时间为10 d。10例死亡,病死率达38.46%。患者分离的H7N9病毒株测序分析表明,发生了H7基因Gln226Leu和Gly186Val替换,PB2基因Asp701Asn突变。结论急性呼吸系统损害是人感染H7N9禽流感的主要临床表现,活禽暴露是人感染H7N9禽流感的重要危险因素,H7N9禽流感病毒基因发生了部分位点的适应性突变,更容易从禽类向人跨种传播引起人类严重疾病,需加强病原学监测。     

不同培训方式对医护人员手卫生依从性的影响

目的采用常规培训与联合手污染状况调查的培训方法对医护人员进行宣教,评价两种方法对医护人员手卫生依从性的影响。方法 2013年11月—2014年4月,选择心血管内科两个病房的全体医护人员作为宣教对象并分别设为实验组与对照组。培训前1个月对两组进行手卫生依从性摸底调查,培训后第1个月两组均采用常规宣教培训方法,第2个月至第5个月在常规宣教培训方法的基础上实验组增加手卫生污染状况调查培训方法,分别统计两组医护人员的手卫生依从率。结果培训前实验组与对照组手卫生依从率分别为42.63%(107/251)、41.80%(102/244),差异无统计学意义(P0.05);培训后第1和第2个月,实验组医护人员手卫生依从率分别为55.70%(132/237)、63.11%(154/244),对照组分别为56.52%(130/230)、62.61%(149/238),与培训前比较,差异均有统计学意义(均P0.05),但两组间差异无统计学意义(P0.05);培训后第3个月至第5个月,实验组医护人员手卫生依从率分别为60.73%(150/247)、61.44%(145/236)、61.22%(150/245),对照组分别为51.68%(123/238)、51.02%(125/245)、52.32%(124/237),两组间差异有统计学意义(P0.05)。结论采用常规培训同时联合手污染状况调查的培训方式可以更好地促进医护人员手卫生依从性的提高。     

慢性戊型肝炎相关研究进展

戊型肝炎散发于世界各地,多为急性自限性疾病,但近年来不断有文献报道在HIV感染者、器官移植和放化疗患者等免疫力低下人群中发现基因3型戊型肝炎病毒感染导致的戊型肝炎慢性化疾病,其临床表现类似急性戊型肝炎,但症状及肝功能损伤均较轻.目前研究发现,人群感染戊型肝炎病毒后肝炎慢性化的机制主要包括宿主因素和病毒因素.此文就慢性戊型肝炎的定义、临床表现、患者特征、感染慢性化的病毒因素及治疗等方面的进展进行综述.     

连翘苷元对四氯化碳大鼠急性肝损伤的保护作用

目的探讨连翘苷元对四氯化碳(CCl4)所致急性肝损伤的保护作用。方法用CCl4诱导化学性急性肝损伤模型,测定血清中丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)水平;肝脏组织切片,苏木精-伊红(HE)染色,光镜观察病理学改变;用试剂盒测定肝组织中SOD、GSH-Px和GSH的活性及脂质过氧化产物MDA含量。ELISA法检测血清中TNF-α、IL-8含量。结果在CCl4诱导的大鼠急性肝损伤模型中,连翘苷元(0.05、0.15、0.5mg·kg-1,sc)明显降低血清ALT、AST和TBIL水平;明显改善肝脏病理组织状况;连翘苷元(0.05、0.15、0.5 mg·kg-1,sc)明显降低CCl4诱导的急性肝损伤大鼠的肝组织匀浆中MDA的含量,明显增加SOD、GSH-Px和GSH的活性。连翘苷元(0.15、0.5 mg·kg-1,sc)明显降低TNF-α、IL-8含量。结论连翘苷元对CCl4诱导大鼠急性肝损伤具有保护作用,该作用与其增加肝组织中抗氧化酶的活性、降低脂质过氧化水平、降低TNF-α、IL-8等促炎因子水平有关。     

Adsorption characteristics of metal–organic framework MIL-101(Cr) towards sulfamethoxazole and its persulfate oxidation regeneration

A metal–organic framework, MIL-101(Cr), was used to adsorb sulfamethoxazole (SMZ) in water and activated persulfate (PS) oxidation was investigated to regenerate SMZ-saturated MIL-101(Cr). Adsorption and oxidation were combined in this study. MIL-101(Cr) was characterized by SEM, BET, XPS and FT-IR analyses. Effects of various operating parameters on adsorption efficiency were studied. The dosages of persulfate for SMZ desorption and oxidation were investigated. The results showed that the recommended pH was 6–8 for SMZ adsorption and optimum MIL-101(Cr) dosage was 0.1 g L⁻¹. SMZ adsorption by MIL-101(Cr) was a spontaneous process and nearly exothermic. Saturation adsorption capacity was achieved in 180 s and the adsorption followed the pseudo-second-order model. The maximum adsorption amount of MIL-101(Cr) to SMZ was 181.82 mg g⁻¹ (Langmuir). MIL-101(Cr) also showed good adsorption capacities for sulfachloropyridazine (SCP), sulfamonomethoxine (SMM), and sulfadimethoxine (SDM). Persulfate was helpful for SMZ desorption from the surface of saturated MIL-101(Cr) and sufficient persulfate could simultaneously oxidize the SMZ. XPS analysis showed that the structure of MIL-101(Cr) was stable after the persulfate oxidation process. Regenerated MIL-101(Cr) had the same level of adsorption capacity as fresh MIL-101(Cr). An adsorption–oxidation combined process may be set up based on the results. This study provides basic data for the deep treatment of organic micropollutants in urban water bodies.

A metal–organic framework, MIL-101(Cr), was used to adsorb sulfamethoxazole (SMZ) in water and activated persulfate (PS) oxidation was investigated to regenerate SMZ-saturated MIL-101(Cr).     

5-羟色胺5-HT_(2C)受体激动剂抑制吗啡依赖小鼠纳洛酮诱导的戒断行为

目的观察5-羟色胺2C受体(5-HT2CR)激动剂WAY对吗啡依赖小鼠纳洛酮诱导戒断症状的防治作用,探讨5-HT2CR在吗啡成瘾导致的躯体依赖中的作用。方法采用Etho Vision动物行为分析系统观察5-HT2CR激动剂WAY对正常小鼠自发活动的影响;剂量递增法诱导小鼠吗啡依赖模型,观察WAY对吗啡依赖小鼠纳洛酮诱导戒断症状的影响。结果 WAY(0.5、0.75、1.0 mg·kg-1,i.p.)对小鼠自发活动没有明显影响。慢性吗啡诱导依赖小鼠运动距离、速度和跳跃等行为活动增加。WAY(0.5、0.75、1.0 mg·kg-1)和可乐定(0.2 mg·kg-1,i.p.)对吗啡依赖小鼠纳洛酮催促出现的打洞、跳跃、清理皮毛、站立、"湿狗"样抖动、摇头、清理脸部、抓挠戒断症状有明显的抑制作用(P<0.05)。结论药物激活5-HT2CR可明显的抑制吗啡依赖小鼠纳洛酮催促的戒断症状。5-HT2CR可能是潜在的治疗吗啡躯体依赖、渴求和复吸的靶点。     

量子点作为荧光探针在生物样品检测中的应用及进展

量子点(半导体纳米微晶体)作为一种新型荧光探针,在生物医学领域中的应用引起极大关注。本文主要概括了量子点的优势,及其在蛋白质、DNA、环磷酸腺苷、维生素C、大肠杆菌、金黄色葡萄球菌等生物样品检测中的应用,并对其应用前景进行了展望。     

Slug和SRF在食管癌中的表达及临床意义

目的研究锌指转录因子Slug和血清反应因子(SRF)在食管鳞癌中的表达及其临床意义。方法收集2010年9月至2013年9月食管鳞癌手术根治标本120例,术前均未行放疗、化疗,术后常规取食管鳞癌组织包埋制备蜡块;另取距离肿瘤5 cm的食管组织60例做正常对照。按食管鳞癌诊治规范分析相关资料。所有组织蜡块常规切片三张,一份行常规HE染色,常规病理观察;另两份采用免疫组化法(SABC)检测Slug和SRF蛋白的表达水平,分析其与肿瘤大小、分化程度、浸润深度、淋巴结转移等临床生物学行为的关系。结果 Slug蛋白在食管鳞癌组中的阳性表达率显著高于正常食管黏膜组,差异有统计学意义(P>0.05);SRF蛋白在食管鳞癌组中的阳性表达率显著高于正常食管黏膜组,差异有统计学意义(P<0.05);Slug在食管鳞癌组织中的蛋白表达与肿瘤大小、分化程度、浸润深度以及淋巴结转移差异无统计学意义(P>0.05);SRF在食管鳞癌中的蛋白表达与肿瘤大小、分化程度和是否淋巴结转移无关,差异无统计学意义(P>0.05)。浸润深度中,浆膜+浆膜外组表达阳性率显著高于黏膜+肌层组(P<0.05)。结论 Slug、SRF在食管鳞癌中高表达,并与浸润深度相关,可能参与了食管鳞癌的发生、发展,并在食管鳞癌的侵袭中起到重要的调节作用。     

静脉药物集中调配模式的应用及体会

目的：总结静脉输液制剂集中调配模式的运行工作,进一步提高我院药学服务质量。方法：采用“统排统配法”集中调配全院静脉用药,临床药师以静脉输液加药调配中心（PIVAS）为平台,制定个体化输液计划,实施条形码扫描“后计费”模式收取药费和配置费。结果与结论：全院不合理用药现象明显改善,药品调剂和配置效率大大提高,一次性耗材消耗量明显减少;药品“后计费”模式大大减少了病区静脉药物的退药现象。PIVAS的应用,获得了巨大的社会效益和经济效益,使我院药学服务步入一个新的台阶。     

Tandem autologous hematopoietic stem cell transplantation for treatment of adult T-cell lymphoblastic lymphoma: a multiple center prospective study in China

T-cell lymphoblastic lymphoma (T-LBL) is a highly aggressive form of lymphoma with poor clinical outcomes and no standard treatment regimen. In this study, we assessed the safety and efficacy of tandem autologous hematopoietic stem cell transplantation (auto-HSCT) for adult T-LBL and evaluated prognostic factors affecting survival. A total of 181 newly-diagnosed adult T-LBL patients were enrolled: 89 patients were treated with chemotherapy alone, 46 were allocated to the single auto-HSCT group, 46 were treated with tandem auto-HSCT. Median follow-up time was 37 months; the 3-year progression/relapse rate of the tandem auto- HSCT group was significantly lower than that of the single auto-HSCT and chemotherapy groups (26.5% vs. 53.1% and 54.8%). The 3-year progression- free survival (PFS) and overall survival (OS) rates of the tandem auto- HSCT group (73.5% and 76.3%) were significantly higher than those of the single auto-HSCT group (46.9% and 58.3%) and the chemotherapy group (45.1% and 57.1%). In the tandem auto-HSCT group, age and disease status after the first transplant impacted OS and PFS. Multivariate analysis identified that disease status after the first transplant was the only independent prognostic factor for patients treated with tandem-HSCT. In addition, diagnostic models of the initial CD8⁺CD28⁺/CD8⁺CD28^– T-cell ratio in predicting the disease status were found to be significant. Taken together, tandem auto- HSCT can be considered an optimal strategy for adult T-LBL patients. (Study registered at: ChiCTR-ONN-16008480).