老年患者革兰阴性杆菌性肺炎的病原菌分布及耐药性监测

目的探讨老年患者革兰阴性杆菌性肺炎的病原菌分布及耐药状况,制定预防与控制措施。方法对368例老年革兰阴性杆菌性肺炎患者的痰及下呼吸道分泌物进行常规细菌培养,用琼脂扩散法进行体外药物敏感试验并统计分析。结果铜绿假单胞菌检出率占首位,达25.0%;除流感嗜血菌对常用抗菌药物保持较好的敏感性外,其他病原菌均已产生了较高的耐药性;产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌检出率达30.2%。结论临床微生物室必须做好感染病原菌的监测工作,为临床医师合理用药提供参考依据。     

顶空气相色谱法检测他达拉非原料药中4种溶剂残留量

目的建立测定他达拉非原料药中4种常见溶剂(甲醇、乙腈、异丙醇、四氢呋喃)残留量的顶空气相色谱法。方法采用顶空进样方式,分离柱采用DB-624柱(30 m×0.53 mm,3.0μm),程序升温,进样口温度为230℃,分流比为5∶1,载气为高纯氮气(纯度为99.999%),载气流速为1.8 mL/min;采用氢火焰离子化检测器检测,检测器温度为250℃。外标法定量。结果甲醇、乙腈、异丙醇、四氢呋喃的质量浓度线性范围分别为0.66~1.5 mg/mL,0.0082~0.205 mg/mL,0.06~1.5 mg/mL,0.0144~0.36 mg/mL;平均加样回收率分别为101.22%,100.59%,97.74%,100.73%,RSD分别为4.67%,2.63%,1.01%,2.28%(n=6);检测限分别为2μg/mL,8μg/mL,5μg/mL,6μg/mL。结论该方法操作简单,灵敏度高,准确性好,为可他达拉非中有机溶剂残留量的控制提供依据。     

痰热清和血必净治疗慢性阻塞性肺疾病急性加重期的疗效比较

目的比较痰热清注射液和血必净注射液治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法选取2013年10月—2015年5月在黄石市中心医院呼吸科治疗的AECOPD患者150例,随机分为对照组、痰热清组和血必净组,每组各50例。对照组给予吸氧、注射用多索茶碱止咳、吸入糖皮质激素平喘、注射用头孢哌酮钠舒巴坦抗感染、纠正电解质和酸碱失衡等常规治疗。痰热清组在对照组的基础上静脉滴注痰热清注射液,20 m L加入到0.9%氯化钠注射液250 m L中,1次/d。血必净组在对照组的基础上静脉滴注血必净注射液,30 m L加入到0.9%氯化钠注射液250 m L中,1次/d。3组均治疗7 d。观察3组临床疗效,比较3组肺功能和炎性因子。结果治疗后,对照组、血必净组和痰热清组的总有效率分别为52.0%、76.0%、82.0%,血必净组和痰热清组的总有效率均显著高于对照组,3组比较差异性具有统计学意义(P0.05);但痰热清组和血必净组的总有效率比较差异无统计学意义。治疗后,3组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)和FEV1/FVC均显著升高,同组治疗前后比较差异有统计学意义(P0.05);且痰热清组和血必净组这些观察指标的上升程度明显优于对照组,3组比较差异具有统计学意义(P0.05);但痰热清组和血必净组这些观察指标比较差异无统计学意义。治疗后,3组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子(TNF-α)和C-反应蛋白(CRP)均显著下降,而白细胞介素-10(IL-10)均显著上升,同组治疗前后比较差异有统计学意义(P0.05);且痰热清组和血必净组这些观察指标的改善程度明显优于对照组,3组比较差异具有统计学意义(P0.05);且血必净组这些观察指标的改善程度明显优于痰热清组,两组比较差异具有统计学意义(P0.05)。结论痰热清注射液和血必净注射液均能显著提高AECOPD患者的临床疗效,改善肺功能和抑制炎性因子释放,但血必净注射液抑制炎性因子释放更显著,具有一定的临床推广应用价值。     

Anti-diabetic Activity of Zhenqing Recipe and Ligustri Lucidi Fructus in Type 2 Diabetic Rats

Objective To investigate the influence of Zhenqing Recipe(ZQR)and Ligustri Lucidi Fructus(LLF)on diabetic rats and its possible mechanism.Methods The model of type 2 diabetic rats was established by feeding a high-sucrose-high-fat diet and injecting a low dose of Streptozotocin in Wistar rats.The model rats were randomly divided into three groups:diabetic model,ZQR-treated,and LLF-treated groups for 8-weeks treatment.The normal Wistar rats were as a normal control group.Results The level of fasting blood glucose in ZQR and LLF groups was decreased compared with model group(P<0.01,0.05,respectively).Both ZQR and LLF markedly reduced serum triglycerides(P<0.01,0.05,respectively),and increased the insulin sensitivity index(P<0.05).Histopathology revealed that ZQR and LLF reduced pancreatic damage.Immunohistochemistry evaluation showed that the percentage of insulin positive cells in pancreatic island was higher than model group(P<0.01,0.05,respectively).The mRNA and protein expression of SREBP-1c in pancreas were significantly decreased in ZQR and FLL group(P<0.01).Conclusion ZQR has therapeutic effect on type 2 diabetes,it ameliorates the histopathological changes of pancreas,protectsβcells,improves insulin resistance,and attenuates the expression of SREBP-1c.This study also provides the anti-diabetic evidence of FLL even its effects are weaker than ZQR.     

银葛双解剂抗甲型H1N1流感病毒的作用机制

目的:研究银葛双解剂体内外抗甲型H1N1流感病毒作用机制。方法:体外实验以利巴韦林为阳性对照药物,采用流式细胞术检测银葛双解剂对甲型H1N1流感病毒所致狗肾细胞凋亡的抑制作用;体内试验以SPF级小鼠滴鼻建立肺炎模型,随机分为6组,正常对照组、模型对照组、利巴韦林组、银葛双解剂高剂量组、银葛双解剂低剂量组、银葛双解剂预防+治疗组,用流式细胞术检测各组小鼠全血中T细胞亚群分类、放射免疫法测定小鼠血清中白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的表达水平。结果:在体外试验中,银葛双解剂可抑制甲型H1N1流感病毒诱导的MDCK细胞凋亡,药物浓度越高,细胞凋亡抑制率越大,银葛双解剂浓度越高,抑制作用越强;体内实验中,银葛双解剂可通过下调甲型H1N1流感病毒感染小鼠血清中炎性细胞因子TNF-α、IL-6的表达水平,升高甲型H1N1流感病毒感染小鼠全血中CD3+、CD4+T细胞的表达百分比,降低CD8+T细胞的表达,上调CD4+/CD8+比值。结论:银葛双解剂具有良好的抗甲型H1N1流感病毒的作用。     

胃癌组织Id-1和VEGF表达及其临床意义的探讨

目的:研究分化抑制因子-1(Id-1)和血管内皮生长因子(VEGF)在胃癌组织中的表达及其与胃癌临床病理学指标间的关系,探讨其临床病理意义.方法:应用免疫组化SP法检测60例胃癌组织、60例癌旁组织及30例正常胃黏膜中Id-1和VEGF的表达.结果:胃癌组织、癌旁组织和正常胃黏膜组织的Id-1阳性表达率分别为73.3%(44/60)、21.7%(13/60)和6.7%(2/30);VEGF阳性表达率分别为78.3%(47/60)、28.3%(17/60)和13.3%(4/30).在胃癌不同分化程度、TNM分期和有无淋巴结转移,Id-1和VEGF表达有统计学意义,P＜0.05;而与年龄、性别差异无统计学意义,P＞0.05.结论:Id-1和VEGF的表达增多与胃癌的发生发展存在着密切的关系,胃癌组织中Id-1高表达可能是通过VEGF途径来实现对肿瘤血管生成起促进作用.     

紫外分光光度法测定尿液中枸橼酸的浓度

目的:建立紫外分光光度法,测定人尿液中枸橼酸药物浓度,以适应于大样本的尿样样本的测定。方法:柠檬酸(又名枸橼酸)在柠檬酸裂解酶的作用下,生成α-酮酸(草酰乙酸),在弱酸条件下,α-酮酸与苯肼生成相应的α-酮酸苯腙,α-酮酸苯腙在330nm处有强的吸收峰,吸光度的变化程度可反映出柠檬酸含量。结果:线性范围为0.1~4mmol/L,γ=0.9953;平均回收率大于90%,低、中、高浓度样品的日内和日间RSD均小于9.00%,且各种条件下血浆样品的稳定性良好。结论:该方法适用于枸橼酸大样本尿药浓度测定。     

OCT在社区健康档案黄斑病变筛查中的应用

目的：探讨光学相干断层扫描（OCT）在社区老年人群健康档案中建立黄斑部疾病早期筛查-干预- 随访的健康管理模式的意义。方法：回顾性研究。选取2016年1月到2017年12月在华中科技大学 同济医学院附属梨园医院公共卫生科建立健康档案的中老年人群1 206人，其中男520人，女686 人，年龄50～82（58.3±5.7）岁。运用OCT对视网膜黄斑部进行检查。采用χ2 检验和多因素Logistic 回归分析进行数据分析。结果：通过OCT检出视网膜黄斑部病变216人，检出率17.91%。阳性人 群中性别差异无统计学意义（χ2 =0.166，P=0.684）。50～59岁人群OCT检出阳性率为8.48%，60～69 岁人群为18.43%，>70岁人群为27.53%，差异有统计学意义（χ2 =36.269，P<0.001）。多因素Logistic 回归分析结果显示，高血压（OR=0.272，95%CI=0.084～0.880，P=0.030）和糖尿病（OR=0.131， 95%CI=0.039～0.440，P=0.001）是引起黄斑病变的危险因素。结论：应用OCT检查视网膜黄斑部， 能早期发现视网膜黄斑部病变，进行早期干预，是防盲治盲中不可缺少的检测手段。     

HIF-1α、MMP2在大肠癌中的表达及相关性研究

目的观察缺氧诱导因子1-α(HIF-1α)、基质金属蛋白酶2(MMP2)在大肠癌发生发展过程中的表达情况及其相关性,探究其与大肠癌临床病理特征的关系。方法运用免疫组织化学(SABC)法检测HIF-1α、MMP2在46例大肠癌组织及20例正常组织中的表达情况。结果 HIF-1α、MMP2在大肠癌的阳性表达率明显高于正常大肠组织,差异有统计学意义(P0.001)。HIF-1α、MMP2的表达均与Dukes分期及是否有淋巴结转移有关(P0.05);通过相关性分析,两者呈正相关(r=0.357,P0.05)。结论HIF-1α、MMP2可能与大肠癌的发生、浸润及转移有关,两者的协同作用可能参与了大肠癌的发生、发展。     

Salidroside improves endothelial function and alleviates atherosclerosis by activating a mitochondria-related AMPK/PI3K/Akt/eNOS pathway

Salidroside (SAL) is a phenylpropanoid glycoside isolated from the medicinal plant Rhodiola rosea. A recent study has reported that SAL can efficiently decrease atherosclerotic plaque formation in low-density lipoprotein receptor-deficient mice. This study was to investigate the molecular mechanism of antiatherogenic effects of SAL. Given the importance of endothelial nitric oxide synthase (eNOS) in atherosclerosis, we sought to elucidate whether SAL could stimulate eNOS activation and also to explore its upstream signaling pathway. Six-week old apoE^−/− male mice were fed a high-fat diet for 8 weeks and then were administered with SAL for another 8 weeks. SAL significantly improved endothelial function associated with increasing eNOS activation, thus reduced the atherosclerotic lesion area. SAL increased eNOS-Ser1177 phosphorylation and decreased eNOS-Thr495 phosphorylation, indicative of eNOS activation in endothelium. The aortic sinus lesions in SAL treated mice displayed reduced inflammation. SAL significantly activated AMP-activated protein kinase (AMPK). Both AMPK inhibitor and AMPK small interfering RNA (siRNA) abolished SAL-induced Akt-Ser473 and eNOS-Ser1177 phosphorylation. In contrast, LY294002, the PI3k/Akt pathway inhibitor, abolished SAL-induced phosphorylation and expression of eNOS. High performance liquid chromatography (HPLC) analysis revealed that SAL decreased cellular ATP content and increased the cellular AMP/ATP ratio, which was associated with the activation of AMPK. SAL was found to decrease the mitochondrial membrane potential (ΔΨm), which is a likely consequence of reduced ATP production. The action of SAL to reduce atherosclerotic lesion formation may at least be attributed to its effect on improving endothelial function by promoting nitric oxide (NO) production, which was associated with mitochondrial depolarization and subsequent activation of the AMPK/PI3K/Akt/eNOS pathway. Taken together, our data described the effects of SAL on mitochondria, which played critical roles in improving endothelial function in atherosclerosis.