Recurrent systemic bacterial infections in homozygous C2 deficiency

Homozygous deficiency of the second component of complement (C2) occurs in one in 10, 000 individuals. Its clinical manifestations range from essentially no symptoms to recurrent infections or evidence of collagen-vascular disease. We present here a case report and a review of the literature focusing on recurrent systemic infections in C2-deficient individuals. Thirteen of 20 patients vi'ith C2 deficiency and a history of invasive bacterial infections have had recurrent episodes of bacteremia or meningitis. Most of these patients were children, and Streptococcus pneumoniae was the most common pathogen reported. The use of prophylactic antibiotics. Haemophilus influenzae type b and pneumococcal vaccines, and prompt medical attention for any febrile illness should be encouraged in children with documented C2 deficiency. Although there are no studies to date to document their efficacy, the above measures may serve to diminish the frequency of recurrent systemic bacterial disease in these children.     

不动杆菌败血症的血清学研究

作者对6例Lwoff不动杆菌败血症患者做了血清外—斐氏反应(Ox19)结果均为阳性。经动物免疫、交叉吸收试验证明,Lwoff不动杆菌与变形杆菌Ox19有部分共同抗原成份,表明不动杆菌感染可致外—斐氏反应阳性。对150名健康人行血清学检测,结果为:不动杆菌凝集试验血清效价均不高于1:40(+)。由此结合临床提出,凝集试验血清效价高于1:40(+)为不动杆菌感染的寺参考诊断效价。     

血清miR-16与新生儿败血症患儿心功能障碍及炎症反应的关系

目的探究血清miR-16与新生儿败血症患儿心功能障碍及炎症反应的相关性。方法回顾性分析119例新生儿败血症患儿(败血症组)的临床资料,另选取100例同期住院的普通感染新生儿(对照组)作为对照,评估2组患儿心功能、血清炎症因子及血清miR-16表达水平。根据左室射血分数(LVEF)将败血症组患儿分为心功能障碍组及无心功能障碍组,采用多因素Logistic回归分析血清miR-16表达水平对新生儿败血症患儿发生心功能障碍的影响,采用受试者工作特征(ROC)曲线分析血清miR-16表达水平对新生儿败血症患儿发生心功能障碍的诊断价值,采用Pearson法分析新生儿败血症患儿血清miR-16表达水平与炎症因子及心肌损伤标志分子的相关性。结果败血症组患儿的血清miR-16表达水平显著高于对照组患儿(P<0.001)。心功能障碍组患儿的血清miR-16表达、白细胞介素-6(IL-6)、C反应蛋白(CRP)、心肌肌钙蛋白Ⅰ(cTnⅠ)、乳酸脱氢酶(LDH)、肌酸激酶心肌同工酶(CK-MB)、心脏型脂肪酸结合蛋白(H-FABP)水平及QT离散度、Tie指数均显著高于无心功能障碍组患儿,而LVEF则显著低于无心功能障碍组患儿(P<0.001)。多因素Logistic回归分析显示,血清miR-16表达水平是新生儿败血症患儿发生心功能障碍的独立危险因素(P<0.05)。经ROC曲线分析,采用血清miR-16表达水平诊断新生儿败血症患儿发生心功能障碍的曲线下面积(AUC)为0.901(95%CI0.846~0.956),特异度和灵敏度分别为80.7%和85.5%。经Pearson相关性分析,新生儿败血症患儿的血清miR-16表达水平与IL-6、CRP、cTnⅠ、LDH、CK-MB、H-FABP水平呈显著正相关性(r=0.439、0.341、0.325、0.842、0.683、0.705,P<0.001)。结论新生儿败血症患儿血清miR-16升高与炎症反应有关,检测血清miR-16表达水平对新生儿败血症患儿发生心功能障碍有一定诊断价值。     

多系统脏器衰竭和败血症患者肿瘤坏死因子和白细胞介素6的水平和意义

应用单克隆抗体的ELISA法检测12例多系统脏器衰竭(MSOF)患者、14例败血症患者血清肿瘤坏死因子(TNF)水平,同时应用MTT比色法测定患者血清白细胞介素6(IL-6)活性。结果:MSOF和败血症患者的TNF和IL-6水平明显高于正常(P均<0.01),两者的升高呈显著相关(r=0.68),并且伴有高乳酸血症。MSOF患者TNF和IL-6水平与生存率成反比,死亡组(n=5)均高于生存组(n=7),P均<0.01。败血症患者的生存率与TNF水平成反比且伴高乳酸血症。上述研究表明:TNF与IL-6在MSOF的发病过程中起着重要作用,同时也是判定MSOF和败血症患者预后方面的重要指标。     

Intravascular Lead Extraction Using Locking Stylets and Sheaths

BYRD, C.L., ET AL.: Intravascular Lead Extraction Using Locking Stylets and Sheaths. Chronic lead extraction using intravascular countertraction techniques was studied in patients with over 65 different lead models including passive and active fixation devices. Indications for removal of 115 leads implanted 5 days to 264 months (mean 58 months) in 62 patients (mean 65 years) included septicemia, subcutaneous tissue infection, preerosion, free-floating lead, lead trapped in valve, too many leads, pain, and vein thrombosis. The superior vena cava (SVC) approach was attempted in 101 leads and was successful in 82 attempts (71% of total leads). The inferior vena cava (IVC) approach via the femoral vein was required to extract 14 (12%) leads inaccessible to the SVC approach and the 19 leads that failed the SVC approach (29% of total leads). The SVC procedure includes a sized stylet locked at the tip and telescoping sheaths advanced over the lead to the heart. An IVC procedure includes placement of a 16 F sheath workstation via a femoral vein into the right atrium. A deflection catheter and Dotter snare in an 11 F sheath were advanced through the workstation into the right atrium. The lead was maneuvered into position, snared, and pulled into the workstation. For both the SVC and IVC approaches, the leads were removed by applying traction on the lead and countertraction with the sheaths. In experienced hands, these techniques have proven safe and effective for removing chronic transvenous leads.     

FatalVibrio parahemolyticus septicemia in a patient with cirrhosis

Summary Vibrio parahemolyticus has been well documented to cause outbreaks of infectious diarrhea, usually related to poor food handling; only rarely has it been reported to cause fatal septicemia. In contrast,Vibrio vulnificus is a well-known cause of septicemia, especially in patients with cirrhosis. A 31-year-old woman with cirrhosis who developed fatalV. parahemolyticus sepsis after ingesting raw seafood is described. We review the clinical syndromes associated with sepsis caused by these two organisms. Leg pain and bullous skin lesions may be a clue to the diagnosis. Febrile patients with cirrhosis should be questioned regarding recent seafood ingestion, and appropriate antibiotics chosen if this history is obtained. Physicians should inform patients at risk to avoid raw seafood in an attempt to prevent this potentially lethal syndrome.     

多形皮疹性葡萄球菌败血症1例并文献复习

目的探讨以多形性皮疹为主的葡萄球菌败血症的临床表现、诊断、治疗方法。方法报道1例以多形性皮疹为主的葡萄球菌性败血症的诊疗过程,结合文献,对葡萄球菌的致病性、皮疹特点及其诊断、治疗方法进行总结。结果经过及时的诊疗,患者康复出院。结论部分葡萄球菌性败血症者症状不典型,应加强对本病的认识,及时采取有效的诊疗方法。     

包头市布鲁氏菌病防治现状分析

目的调查包头市2002～2008年布鲁氏菌病疫情的状况,评价防治效果,制定合理的防治措施。方法通过对包头市2002～2008年9月布鲁氏菌病疫情资料的搜集整理,统计其发病率,从地区、时间、人群的分布情况分析其流行规律和趋势。结果从2002-2008年9月底,发病例数为286例。结论布鲁氏菌病疫情总体上呈上升趋势。应加大畜间疫情处理力度,加强布鲁氏菌病防治知识宣传,确保人民群众身体健康。     

Septicemia due to Yersinia pseudotuberculosis—a case report

A case report is presented concerning Yersinia pseudotuberculosis septicemia presenting as an acute abdominal emergency in an elderly diabetic man with multiple medical problems.     

降钙素原和超敏C反应蛋白联合检测在新生儿败血症早期诊断的价值研究

目的：探讨联合测定降钙素原（PCT）和超敏C 反应蛋白（hs-CRP）对新生儿败血症早期诊断和病情评估的应用价值。方法收集2011年11月至2013年5月期间收治于鄂尔多斯市中心医院的新生儿败血症患儿48例,记录患儿的 PCT、hs-CRP 及血培养等资料,并与同期48例非败血症新生儿的血清 PCT 和 hs-CRP 检测结果作对比分析。结果败血症患儿血清PCT（93．75％）、hs-CRP（10．42％）明显高于非败血症患儿血清 PCT（79．17％）、hs-CRP（50％）,两组间阳性率比较差异有统计学意义（P ＜0．05）。结论PCT 和 hs-CRP 在新生儿败血症早期有显著改变,血清 PCT 和 hs-CRP 的联合测定可以作为诊断新生儿败血症的早期诊断指标,且 PCT 的灵敏度和特异度均较 hs-CRP 高,两者的联合检测能为临床提供准确、快速的诊断依据。