急性感染性门静脉血栓形成的临床分析

目的：探讨急性感染性门静脉血栓形成的临床特点及早期诊治方法。方法：回顾性分析中南大学湘雅二医院2003-2013年间收治的5例急性感染性门静脉血栓的临床资料。结果：5例患者均有腹部原发感染性疾病,超声检查发现门静脉血栓1例,增强CT检查发现5例。全部患者均予抗生素治疗,合用抗凝治疗3例。4例患者病情好转,其中2例血管部分或全部再通,1例因多器官功能衰竭放弃治疗。结论：急性门静脉血栓形成是腹部感染疾病少见但非常严重的并发症,早期表现为发热、腹胀、呕吐、腹泻,病情进展可有感染性休克、血性腹水、腹膜炎、肠梗阻或肠坏死、多器官功能衰竭;腹部超声及增强CT检查有助于早期确诊;积极抗感染、抗凝治疗并及时切除坏死肠段可有效实现血管再通及降低病死率。     

Relationship between climate conditions and nosocomial infection rates

Background

Nosocomial infections constitute a global health problem.

Objectives

To explore the relationship between nosocomial infection rates (NIRs) and climatic factors including temperature and relative humidity in Guangzhou area of China.

Methods

30892 patients in our hospital in 2009 were investigated for nosocomial infection status, and the contemporaneous temperature and relative humidity were analyzed statistically. NIRs increased with relative humidity and temperature in central ICU and geriatric department.

Results

No statistical differences were found between each quarter of 2009 in the distribution of nosocomial infection sites. There were no statistical differences in the pathogenic species of nosocomial infections between high-temperature and low-temperature months in different departments. NIRs had a correlation with temperature and relative humidity in geriatric department and central ICU.

Conclusions

To decrease NIRs and improve health care quality, it is necessary to strengthen the control of temperature and humidity especially for geriatric department and central ICU.     

Cytokine immunomodulation for the treatment of infectious diseases: lessons from primary immunodeficiencies

Traditionally, management of infectious diseases focuses on identification of the causative microbe and the use of pathogen-targeted therapy. With increasing antimicrobial resistance, novel approaches are required. One strategy is to modulate those natural host immune responses that critically mediate resistance to specific microbes. Clinically, this host-directed tactic could be used either alone or in combination with antimicrobial therapy. While conceptually attractive, there is potential concern that the pathways governing host resistance to pathogens in animal models may not extrapolate linearly to humans. Targeting these immune processes clinically may precipitate damaging, epiphenomenal responses. The field of Primary Immunodeficiencies focuses on the characterization of humans with inborn errors of immunity. These rare conditions permit the identification of those molecular and cellular processes that are central to human susceptibility to microbes. In efforts to compensate for defective host responses, this field has also provided a wealth of clinical experience in the effective use of cytokines to treat various active infections, while demonstrating their safety. In this review, we provide a historical perspective of the treatment of infectious diseases, evolving from a focus on the microbe, to an understanding of human immunity; we then outline the growing contribution of Primary Immunodeficiencies to the rational use of adjunctive cytokine immunotherapy in the management of infections.     

Infection Rates in HIV-HCV Patients Treated with Interferon Are Similar to Those in HCV Mono-Infection and Not Related to Neutropenia

Abstract

Method: Infectious complications were assessed in 25 HIV-HCV coinfected patients receiving 29 courses of HCV therapy (786 person-weeks). Results: The infection rate (1.3 infections/100 person-weeks) was similar when compared to the rate in HIV-negative patients. HIV status and neutrophil nadir did not predict infection risk or rate. Conclusion: Interferon dose reduction and/or G-CSF in HCVtreated HIV patients with neutropenia are not justified.     

一种新型手术器械干燥柜的设计研究

目的针对现有手术器械干燥设备存在某些技术缺陷和不能普及使用的问题,拟研制新型手术器械干燥柜。方法通过对手术器械干燥过程中的空气清洁度、温度和速度等特性进行研究,创建手术器械干燥新技术,并以获得的新技术为基础,研制一种造价低、功能先进和可操作性强的新型手术器械干燥设备。结果成功研制出一种新型手术器械干燥柜样机,并在满载器械的条件下进行加温和干燥处理试验,其中采用“70℃”程序的平均加温时间和最短干燥处理时间分别为5．1min和15．6min,采用“90℃”程序的平均加温时间和最短干燥处理时间分别为7．8min和14．2min,同比传统器械干燥设备具有明显的优势。结论新型手术器械干燥柜具备较高的推广应用价值和较好的产业化前景,并可成为医院消毒供应中心和手术室等部门的基础设备。     

Deoxycytidine kinase promotes the migration and invasion of fibroblast-like synoviocytes from rheumatoid arthritis patients

Rheumatoid arthritis (RA) is a complex, multi-system disease whose primary site of inflammatory tissue damage is the joint. The increasing evidences indicate that activated RA fibroblast-like synoviocytes (FLS) play a critical role in the development of pannus by migrating into cartilage and bone. Furthermore FLS and T cells can activate each other in vitro and in vivo, which is crucial for the progress of RA. Deoxycytidine kinase (DCK) has been linked to peripheral T cell homeostatic proliferation and survival, which is very important for RA. Yet, the function of DCK in FLS is still unknown. Here, we present a story that DCK could regulate the migration and invasion of FLS through AKT pathway in RA patients. Moreover, DCK seems to be the upstream of AKT and FAK, and AKT inhibitor exerted the similar effect on FLS motility. In summary, our study characterized the new role of DCK in human primary FLS cells, and figured out the possible pathway DCK involved in, and these findings might propose DCK as a novel target for controlling joint destruction of RA.     

Breastfeeding: An overview of oral and general health benefits

Background

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Breastfeeding is the reference against which alternative infant feeding models must be measured with regard to growth, development and other health outcomes. Although not a systematic review, this report provides an update for dental professionals, including an overview of general and oral health–related benefits associated with breastfeeding.Types of Studies ReviewedThe authors examined the literature regarding general health protections that breastfeeding confers to infants and mothers and explored associations between breastfeeding, occlusion in the primary dentition and early childhood caries. To accomplish these goals, they reviewed systematic reviews when available and supplemented them with comparative studies and with statements and reports from major nongovernmental and governmental organizations.ResultsWhen compared with health outcomes among formula-fed children, the health advantages associated with breastfeeding include a lower risk of acute otitis media, gastroenteritis and diarrhea, severe lower respiratory infections, asthma, sudden infant death syndrome, obesity and other childhood diseases and conditions. Evidence also suggests that breastfed children may develop a more favorable occlusion in the primary dentition. The results of a systematic review in which researchers examined the relationship between breastfeeding and early childhood caries were inconclusive.Conclusions and Clinical ImplicationsThe American Academy of Pediatric Dentistry, Chicago, suggests that parents gently clean infants' gums and teeth after breastfeeding. The American Academy of Pediatrics, Elk Grove Village, Ill., recommends that breastfeeding should be exclusive for about the first six months of life and should continue, with the introduction of appropriate complementary foods, to at least age 12 months or beyond, as desired by mother and child. Dentists and staff members can take steps to ensure they are familiar with the evidence and guidelines pertaining to breastfeeding and to oral health. They are encouraged to follow the surgeon general's recommendations to promote and support optimal breastfeeding and oral health practices among their patients.     

口腔颌面部间隙感染病原菌研究现状

<正>感染是一种古老的疾病,17世纪初对人类疾病病死率的统计中,牙源性感染较高的病死率就引起了人们的重视。20世纪初期,口腔颌面部的感染疾病病死率在10%～40%,当时的常见病原菌为革兰阳性球菌,如金黄色葡萄球菌。随着20世纪20年代抗生素的发明与应用,口腔颌面部感染所致的严重并发症及病死率大幅下降。     

Periprosthetic joint infection: Current concept

Periprosthetic joint infection (PJI) is one of the most devastating and costly complications following total joint arthroplasty (TJA). Diagnosis and management of PJI is challenging for surgeons. There is no “gold standard” for diagnosis of PJI, making distinction between septic and aseptic failures difficult. Additionally, some of the greatest difficulties and controversies involve choosing the optimal method to treat the infected joint. Currently, there is significant debate as to the ideal treatment strategy for PJI, and this has led to considerable international variation in both surgical and nonsurgical management of PJI. In this review, we will discuss diagnosis and management of PJI following TJA and highlight some recent advances in this field.