血栓弹力图参数联合D-二聚体对胸腰椎结核术后并发深静脉血栓形成的预测作用

目的 分析血栓弹力图参数联合D-二聚体(D-D)对胸腰椎结核术后并发下肢深静脉血栓形成(DVT)的预测作用.方法 选取2017年3月—2020年4月三二〇一医院创伤关节外科收治胸腰椎结核术后患者132例的临床资料进行回顾性分析,根据术后1个月内是否发生DVT分为DVT组22例和无DVT组110例.比较2组患者抗凝治疗前...     

中药饮片对多重抗生素耐药细菌的抑菌作用

目的 探究中药饮片对多重抗生素耐药细菌的抑菌作用.方法 使用稀释法对22种常见的中药饮片的水煎液对大肠杆菌的敏感菌种和多重抗生素耐药菌种的抑菌成效进行检测,标本纳入时间为2019年1月—2020年1月.结果 大部分中药对于耐药菌及敏感菌的抑菌效果并不存在较大差异,其中,决明子、连翘和甘草的抑菌差别较大,和敏感菌相比,耐...     

Ag85B DNA/H37Ra序贯免疫效果的探讨

目的：初步探讨含结核分枝杆菌Ag85B成熟蛋白的DNA（pTB30m）和结核菌H37Ra序贯免疫小鼠产生的特异性免疫应答。方法：重组质粒pTB30m用碱裂解法制备后进行质量鉴定。用pTB30m肌注初次免疫小鼠2周后,H37Ra皮内加强免疫作为DNA-85B/H37Ra组,同时设定DNA-85B/BCG组、H37Ra组、BCG组及未免疫组。免疫4周或8周后,用ELISA法检测小鼠血清中抗PPD IgG抗体的水平和MTT法检测其脾淋巴细胞的刺激指数（SI）。结果：酶切鉴定pTB30m所含外源基因片段大小正确,并且纯度较高。DNA-85B/H37Ra组小鼠血清中抗PPD IgG水平、脾淋巴细胞的SI均显著高于未免疫组（P〈0.05）;其抗PPD IgG水平稍高于DNA-85B/BCG组、H37Ra组及BCG组,但它们之间无显著性差异（P〉0.05）;其脾淋巴细胞的SI显著高于H37Ra、BCG组（P〈0.05）,而与DNA-85B/BCG组比较,仅在4周有显著性差异。在DNA-85B/H37Ra组内,SI在4周显著高于8周（P〈0.05）,而血清中抗PPD IgG水平8周均显著高于4周（P〈0.05）。结论：DNA-85B/H37Ra序贯免疫策略可以诱导小鼠产生特异性体液免疫和细胞免疫,初步证明其免疫效果略优于BCG。     

不孕症妇女衣原体和支原体感染及其耐药性研究

目的:了解不孕症妇女生殖道沙眼衣原体(CT)、解脲脲原体(UU)和人型支原体(MH)感染状况并分析支原体对常用抗生素的耐药性.方法:对2186例不孕症患者(不孕组)和210例早孕妇女(对照组)进行CT抗原检测和UU、MH培养及药敏试验,并对结果进行临床分析.结果:不孕组CT阳性173例,阳性率7.9%;支原体总阳性1102例,阳性率50.4%,其中UU感染987例,MH感染115例;CT、UU、MH的总感染数1275例,总感染率58.3%.对照组CT阳性率1.4%,支原体阳性率6.2%,对照组总感染率为7.6%,两组比较差异有显著性意义(P＜0.01).UU、MH、UU MH培养前三位敏感的抗生素分别是交沙霉素、美满霉素、克拉霉素.耐药率最高的抗生素是喹诺酮类,居前三位的分别是司帕沙星、诺氟沙星、氧氟沙星.结论:不孕症妇女生殖道衣原体、支原体感染率显著高于正常已孕妇女,这说明生殖道衣原体、支原体感染可能是引起不孕症的原因之一;支原体对常用抗生素,特别是喹诺酮类和部分大环内酯类的敏感性下降.     

Lipid metabolism of cancer stem cells

Cancer stem cells (CSCs), also termed cancer-initiating cells, are a special subset of cells with high self-replicating and self-renewing abilities that can differentiate into various cell types under certain conditions. A number of studies have demonstrated that CSCs have distinct metabolic properties. The reprogramming of energy metabolism enables CSCs to meet the needs of self-renewal and stemness maintenance. Increasing evidence supports the view that alterations in lipid metabolism, including an increase in fatty acid (FA) uptake, de novo lipogenesis, formation of lipid droplets and mitochondrial FA oxidation, are involved in CSC regulation. In the present review, the metabolic characteristics of CSCs, particularly in lipid metabolism, were summarized. In addition, the potential mechanisms of CSC lipid metabolism in treatment resistance were discussed. Given their significance in cancer biology, targeting CSC metabolism may serve an important role in future cancer treatment.     

Risk factor for 31-day unplanned readmission to hospital in patients with pulmonary tuberculosis in China

Objectives:To evaluate risk factors associated with 31-day unplanned readmission(s) for pulmonary tuberculosis (TB) in China.Methods:This retrospective study enrolled patients (age, >14 years) with pulmonary TB who experienced 31-day unplanned readmissions to a specialized hospital for TB between January 2018 and December 2019. For each confirmed readmission, 2 control subjects were randomly selected from among patients with pulmonary TB but did not experience an unplanned readmission within 31 days.Results:A total of 402 pulmonary TB patients (5.9%) experienced unplanned readmission within 31 days after discharge. In univariate analysis, readmission was associated with gender, age, insurance coverage, residing in a rural area, active smoking, chronic obstructive pulmonary disease (COPD), drug-induced hepatitis, and leaving hospital against medical advice. The final logistic regression model revealed that higher risks for unplanned readmissions were associated with male gender (odds ratio [OR] 1.44, [95% confidence interval (CI) : 1.06-1.95]), age >65 years (OR 2.94, 95%CI: 2.03-4.27), rural residence (OR 8.86, 95%CI: 6.61-11.87), active smoking (OR 2.15, 95% CI 1.37-3.40), COPD (OR 2.77, 95%CI: 1.59-4.81), and leaving hospital against physician advice (OR 4.11, 95%CI: 1.43-11.83). The median time to 31-day unplanned readmission was 24 days. Major reasons for unplanned readmission included fever, exacerbation of dyspnea, and hemoptysis.Conclusion:Unplanned readmission for pulmonary TB within 31 days of discharge was higher among older males residing in rural areas, active smokers, and those leaving hospital against medical advice.     

结核分枝杆菌稳定L型利福平耐药性基因的研究

目的探讨细胞壁缺陷结核分枝杆菌形成利福平耐药性的分子机制。方法将结核分枝杆菌分别接种于含利福平与不含利福平的非高渗透压液体培养基内培养,逐日在倒置显微镜下观察L型的形成情况。L型形成和生长后,滤过培养物分离L型,在不含诱导剂的非高渗液体培养基内传代培养获得L型纯培养物。用结核分枝杆菌利福平耐药性相关基因(rpoB基因)引物分别对自发形成的稳定L型及诱导形成的稳定L型的染色体DNA进行PCR扩增,扩增产物分别以琼脂糖凝胶电泳及PCR-DS方法进行检测和分析。结果结核分枝杆菌既可在非高渗透压培养基内自发形成细胞壁缺陷细菌并成为稳定L型,也可在最低抑菌浓度的利福平作用下发生细胞壁缺陷并成为稳定L型。PCR扩增产物琼脂糖凝胶电泳可见自发形成和诱导形成的稳定L型均形成与其亲代细菌型一致的DNA条带,序列分析显示具有与其亲代细菌型相同的碱基序列。结论结核分枝杆菌在非高渗透压培养基内既可以自发地形成L型,也可以被利福平诱导形成L型。结核分枝杆菌稳定L型具有明显的利福平耐药性,但其相关rpoB基因并没有发生突变。提示结核分枝杆菌的利福平耐药性变异不一定同rpoB基因突变有关,细胞壁缺陷也是导致结核分枝杆菌形成利福平耐药性的一个重要机制。     

Tuberculosis treatment in children: The changing landscape

Traditionally children have been treated for tuberculosis (TB) based on data extrapolated from adults. However, we know that children present unique challenges that deserve special focus. New data on optimal drug selection and dosing are emerging with the inclusion of children in clinical trials and ongoing research on age-related pharmacokinetics and pharmacodynamics. We discuss the changing treatment landscape for drug-susceptible and drug-resistant paediatric tuberculosis in both the most common (intrathoracic) and most severe (central nervous system) forms of disease, and address the current knowledge gaps for improving patient outcomes.     

与结核相关的脂膜炎研究进展

【摘要】 脂膜炎病因繁多而复杂,感染为重要病因之一,在欧美等结核低发区,以链球菌感染最为常见,但在结核高发地区如我国,结核杆菌感染是脂膜炎的重要因素,以Bazin硬红斑和结节性红斑最为常见。Bazin硬红斑与结核关系最为密切,常表现为下肢屈侧结节、斑块,可出现溃疡,病理表现为小叶性脂膜炎。结节性红斑可作为结核的早期症状出现,可作为结核的预测指标,常表现为双下肢伸侧红斑、结节,极少破溃,间隔性脂膜炎是其病理特征。Bazin硬红斑和结节性红斑的抗结核治疗常可取得理想效果。因此,明确结核分支杆菌与脂膜炎的关系,在脂膜炎的治疗及预后方面,尤其在结核高发地区有着重要意义。