糖尿病对白内障超声乳化术后角膜知觉改变的影响

目的 探讨糖尿病对白内障超声乳化吸除术后角膜知觉改变的影响。方法 选择行白内障超声乳化吸除手术的糖尿病患者42例（42只眼）,不伴有糖尿病的患者46例（46只眼）,分别观察白内障超声乳化手术前、术后1天、术后1周、术后1个月、术后3个月、术后6个月的角膜知觉。结果 与术前相比,糖尿病白内障患者角膜知觉在术后1天、术后1周、术后1个月、术后3个月明显降低,差异有显著性,术后6个月接近术前水平;不伴糖尿病的白内障患者角膜知觉在术后1天、术后1周、术后1个月降低,差异有显著性,术后3个月接近术前水平。两组患者术前角膜知觉比较,差异有显著性;术后角膜知觉最大降幅比较,差异有显著性。结论 糖尿病可降低患者的角膜知觉,增大白内障手术后角膜知觉的降幅,延长角膜知觉的恢复时间。     

518例泌尿生殖支原体感染的分类及药敏结果

应用支原体药敏试剂盒检测出的 5 18例支原体感染病例中 ,溶脲脲原体 (Uu)培养阳性为 30 8例 ,占5 9 4% ;人型支原体 (Mh)阳性 2 1例 ,占 4 1% ;Uu合并Mh感染者 189例 ,占 36 5 %。对大环内脂类的红霉素 (ery thromycin,Ery)、罗红霉素 (roxithromycin ,Rox)、交沙霉素 (josamycin ,Jos)、阿齐霉素 (azithromycin ,Azi)、四环素类的强力霉素 (doxycycline ,Dox)、美满霉素 (mincon ,Min)、喹诺酮类的氧氟沙星 (ofloxacin ,of1)、环丙沙星 (cipofloxacin ,Cip)等 8种抗生素进行药敏检测 ,发现Uu与Mh感染者对抗生素的敏感性有差异 ,Uu对大环内脂类较为敏感 ,Mh对喹诺酮类较为敏感 ,Uu合并Mh感染者对多种抗生素表现出耐药性。     

Trends of Prosthetic Joint Infection Organisms and Recurrence for a Single High-Volume Arthroplasty Surgeon Over 20 Years

BackgroundProsthetic joint infection (PJI) is a morbid complication following total joint arthroplasty (TJA). PJI diagnosis and treatment has changed over time, and patient co-management with a high-volume musculoskeletal infectious disease (MSK ID) specialist has been implemented at our institution in the last decade.MethodsWe retrospectively evaluated all consecutive TJA patients treated for PJI between 1995 and 2018 by a single high-volume revision TJA surgeon. Microbial identities, antibiotic resistance, prior PJI, and MSK ID consultation were investigated.ResultsIn total, 261 PJI patients (median age 66 years, interquartile range 57-75) were treated. One-year and 5-year reinfection rates were 15.8% (95% confidence interval [CI] 11.6-20.7) and 22.1% (95% CI 17.0-27.7), respectively. Microbial identities and antibiotic resistances did not change significantly over time. Despite seeing more prior PJI patients (53.3% vs 37.6%, P = .012), MSK ID-managed patients had similar infection rates as non-MSK ID-managed patients (hazard ratio [HR] 1.02, 95% CI 0.6-1.75, P = .93). Prior PJI was associated with higher reinfection risk (HR 2.39, 95% CI 1.39-4.12, P = .002) overall and in patients without MSK ID consultation, specifically (HR 2.78, 95% CI 1.37-5.65, P = .005). This risk was somewhat lower and did not reach significance in prior PJI patients with MSK ID consultation (HR 1.97, 95% CI 0.87-4.48, P = .106).ConclusionWe noted minimal differences in microbial/antibiotic resistances for PJI over 20 years in a single institution, suggesting current standards of PJI treatment remain encouragingly valid in most cases. MSK ID involvement was not associated with lower reinfection risk overall; however, in patients with prior PJI, the risk of reinfection appeared to be somewhat lower with MSK ID involvement.Level of EvidenceLevel IV–Case Series.     

杏贝止咳颗粒对豚鼠感染后咳嗽的治疗作用

目的 探讨杏贝止咳颗粒对豚鼠感染后咳嗽（post-infectious cough,PIC）的治疗作用。方法 除对照组外,将3～4周龄SPF级雄性Hartley豚鼠采用鼻滴脂多糖、烟熏、辣椒素雾化激发来构建PIC豚鼠模型。造模成功后分为模型组及杏贝止咳颗粒低、中、高剂量（0.93、1.86、3.72 g/kg）组、阿斯美（21.62 mg/kg）组和苏黄止咳胶囊（313.88 mg/kg）组,末次给药后24 h,通过辣椒素雾化诱咳测定咳嗽次数及潜伏期,采用ELISA法检测血清、肺泡灌洗液和肺组织中P物质（substance P,SP）、降钙素相关基因肽（calcitonin gene related peptide,CGRP）、神经肽A(neurokinin A,NKA)、神经肽B(neurokinin B,NKB)、神经生长因子（nerve growth factor,NGF）、前列腺素E2(prostaglandin E2,PGE2)和缓激肽（bradykinin,BK）含量,血液分析仪测定肺泡灌洗液中白细胞分类,并用苏木素-伊红（HE）染色法观察肺组织病理变化。结果 与对照组比较...     

Nerve Conduction Studies in Surgical Cubital Tunnel Syndrome Patients

Background: Electrodiagnostic studies (EDX) serve a prominent role in the diagnostic workup of cubital tunnel syndrome (CBTS), but their reported sensitivity varies widely. The goals of our study were to determine the sensitivity of EDX in a cohort of patients who responded well to surgical cubital tunnel release (CBTR), and whether the implementation of the Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) criteria improves the sensitivity. Methods: We identified 118 elbows with clinical CBTS who had preoperative EDX and underwent CBTR. The EDX diagnoses were CBTS, ulnar neuropathy (UN), and normal ulnar nerves. We divided the 118 elbows into those that received above-elbow stimulation (XE group) and those that did not (non-XE group). We calculated the sensitivities for all groups and reinterpreted the results according to the AANEM guidelines. Results: Cubital tunnel release provided significant relief in 93.6% of the elbows. Based on the EDX reports, 11% patients had clear CBTS, 23% had UN, and 66% showed no UN. The sensitivities were 11.7% for CBTS and 34.2% for any UN. In the XE group, the sensitivity of the EDX reports for CBTS and UN climbed to 33.3% and 58.3%, respectively. When we calculated the across-elbow motor nerve conduction velocity, the sensitivity for CBTS and UN was 87.5% and 100%, respectively. The XE and non-XE groups showed no difference except for sex, bilaterality, concomitant carpal tunnel release, and obesity (P < .05). Conclusion: Implementing AANEM guidelines results in significant improvement in correlation of clinical and electrodiagnostic findings of CBTS.     

The peril and promise of sensitivity in eating disorders

Differential susceptibility, a reconceptualization of the diathesis-stress model of psychopathology, describes gene–environment interactions that reflect individual differences in responsiveness to environmental influences, both detrimental and beneficial. This model has been described metaphorically by the classification of orchids, which thrive under optimal care but wither under adverse conditions, and dandelions, which weather broad environmental circumstances but are less responsive to careful cultivation. Etiological research in the field of eating disorders has largely focused on the identification of specific behavioral phenotypes, temperamental traits, genotypes and neurobiological processes that confer risk. In this article, we propose that these putative vulnerability factors represent phenotypes and endophenotypes of a genetic predisposition towards environmental sensitivity. We assert that this sensitivity not only transmits eating disorder risk but also confers resilience, depending on the circumstances. In particular, we propose that differential susceptibility can be used as a framework to organize disparate temperamental and neurobiological findings and their complex interplay with various developmental, environmental and sociocultural influences to increase eating disorder risk and treatment responsiveness. Finally, we assert that viewed through the lens of differential susceptibility, sensitivity can be leveraged to refine our interventions and develop novel treatment and prevention strategies to support favorable outcomes for individuals with eating disorders.     

2017—2019年包头医学院第一附属医院细菌耐药性监测

目的 了解包头医学院第一附属医院2017—2019年临床分离菌的分布及对临床常见抗菌药物的耐药性。方法 收集2017年1月1日至2019年12月31日临床分离的非重复菌株,采用自动化仪器法、纸片扩散法和E-试验法进行药敏试验。 结果 3年我院临床分离非重复菌共4679株,其中革兰阳性菌1358株（32.9%）,革兰阴性菌3141株（67.1%）。金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株（Methicillin-resistant Staphylococcus aureus,MRSA和Methicillin-coagulase negative staphylococcus,MRCNS）检出率分别为16.2%(96/592),56.5%(245/434）,未发现万古霉素、替考拉宁和利奈唑胺耐药葡萄球菌株。屎肠球菌对多数抗菌药物的耐药率高于粪肠球菌。 产ESBL的大肠埃希菌和克雷伯菌属细菌的检出率分别为48.2%（567/1177）和16.6%（140/841）,碳青霉烯耐药肠杆菌科细菌（Carbapenem resistant enterobacteriaceae bacteria,CRE）的检出率为0.8%（19/2411）。肠杆菌科细菌对碳青霉希类抗菌药物的耐药率仍然处于较低水平,总体低于0.8%（19/2411）。铜绿假单胞菌和嗜麦芽窄食单胞菌对常见抗菌药物的耐药率均较低,鲍曼不动杆菌对常用抗菌药物的耐药率较高,对环丙沙星和头孢他啶的耐药率均高于60.0%。结论 该院临床常见菌的耐药性仍然比较严峻,进行细菌耐药监测有助于及时了解本院耐药变迁情况,为临床合理使用抗菌药物提供依据。     

The SIMULTEST approach for testing mutagens in the Salmonella microtitre fluctuation assay

The concept of combining several histidine-dependent Salmonella strains in a single test, the SIMULTEST, has been applied to the microtitre fluctuation test. The activity of five mutagens was determined in strains TA97, TA98, TA100, and TA102 individually as well as in a SIMULTEST mixture. All five compounds were mutagenic in the SIMULTEST, demonstrating the utility of this time and labour-saving approach of combining strains for testing with this method. The microtitre fluctuation SIMULTEST results were quantitatively comparable to those of the SIMULTEST Salmonella/microsome plate test. The microtitre fluctuation test compared with the plate incorporation assay generally showed more favourable "sensitivity" and "quantity" indices in that four of the five chemicals tested in the fluctuation test were mutagenic at lower doses than in the plate test.     

合肥地区产超广谱β-内酰胺酶菌株的分布及药敏分析

目的：了解合肥地区产超广谱β-内酰胺酶（ESBL）的肺炎克雷伯菌、大肠埃希菌分布及耐药特点。方法：应用纸片扩散法对合肥地区4家较大的综合性医院从临床标本中分离的254株肺炎克雷伯菌和大肠埃希菌进行ESBL的确诊试验。结果：254株大肠埃希菌和肺炎克雷伯菌共检出69株产ESBL菌株（27.2%）,其中,血液感染ESBL检出率为54.5%（6/11）、烧伤科ESBL的检出率为48.6%(18/37）。亚胺硫霉素对产ESBL的大砀埃希菌和肺炎克雷伯菌的敏感率分别为94.5%和80%。头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和头孢西丁对产ESBLs的大肠埃希菌和产ESBLs的肺炎克雷伯菌的敏感率在40%-70%之间,阿米卡星对产ESBL的大肠埃希菌的敏感率为69.2%。结论：ESBL在血液感染的烧伤科标本中的检出率较高。治疗产ESBL菌株引起的感染可首选亚胺硫霉素,其次,选含酶抑制剂的复方制剂和头霉素类。对产ESBL的大肠埃希菌也可选阿米卡星。