肠杆菌科细菌SDD菌株特征及替加环素药敏结果分析

目的 分析医院肠杆菌科细菌剂量依赖性敏感(SDD)菌株的药物敏感性情况和检出分布特征,并检测产超广谱β内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌对替加环素的敏感性,以指导临床对SDD菌株的抗菌药物及对ESBLs产酶株替加环素的选择.方法 采用VITEK 2 COMPACT全自动微生物分析仪进行细菌鉴定及仪器法抗菌药物敏感性试验.对50株ES-BLs阳性大肠埃希菌和50株肺炎克雷伯茼分别采用微量肉汤稀释法、MTS测试条法、Vitek2仪器检测法、纸片扩散法检测替加环素的敏感性.结果 采用M100-S24标准头孢吡肟判断为敏感的肠杆菌科细菌有3.58％～12.50％的菌株为SDD菌株;ESBLs阳性大肠埃希菌和肺炎克雷伯菌的SDD菌株检出率分别为13.31％和8.60％,显著高于ESBLs阴性菌株(P＜0.05);所有肠杆菌科细菌SDD菌株最低抑菌浓度(MIC)4 mg/L菌株检出率显著高于SDD菌株MIC 8 mg/L茼株检出率(P＜0.05);ESBLs阳性大肠埃希菌和肺炎克雷伯采用微量肉汤稀释法和MTS测试条法的敏感率均为100％.结论 当肠杆菌科细菌头孢吡肟MIC为4 mg/L或8 mg/L时,实验室应在检验报告提示SDD菌株的检出.替加环素对ESBLs阳性大肠埃希菌和肺炎克雷伯菌的敏感率为100％.     

血管紧张素转换酶基因多态性与2型糖尿病颈动脉硬化性病变的关系

目的 :探讨血管紧张素转换酶 (angiotensinconvertingenzyme ,ACE)基因多态性与 2型糖尿病合并颈动脉硬化性病变之间的关系。方法 :应用聚合酶链反应技术检测 176名 2型糖尿病患者ACE基因 16内含子插入 /缺失(insertion/deletion ,I/D)型多态性 ,利用B型超声检测糖尿病患者颈动脉硬化性病变的情况 ,通过Logistic多元回归分析 ,筛选 2型糖尿病患者颈动脉硬化性病变的危险因素。结果 :(1)糖尿病颈动脉硬化性病变组ACE基因DD型和D等位基因频率显著高于无颈动脉硬化性病变组 (DD基因型频率 :0 .5 0vs 0 .18;D等位基因频率 :0 .71vs0 .38;P <0 .0 1)。 (2 )Logistic回归分析显示 ,ACE基因DD型、年龄、合并高血压及男性是糖尿病颈动脉硬化性病变的危险因素 (OR分别为 3 .86 9,1.0 81,2 .44 7,2 .173,P <0 .0 5 )。 (3)在控制了年龄、性别、高血压后的危险性分层分析显示 ,ACE基因DD型是颈动脉硬化性病变的独立危险因素。结论 :ACE基因I/D多态性与 2型糖尿病颈动脉硬化性病变的发病相关 ,且其作用独立于年龄、性别及高血压病史     

脑电图-功能磁共振成像同步联合记录在癫痫诊疗中的研究进展

精准定位致痫区是癫痫临床诊疗的关键。但目前尚没有可准确定位致痫区的技术方法。大量研究已表明癫痫发作引起的血氧水平依赖效应与癫痫起始区或致痫区的位置密切相关。EEG-功能核MRI同步联合记录技术结合了脑电信号的高时间分辨率和功能核磁信号的高空间分辨率,无创地描绘了与癫痫发作相关的全脑血流动力学响应,为提高致痫区的定位以及致痫网络的研究提供了一种强有力的辅助技术手段。本文将对EEG-功能MRI同步联合记录技术的发展、在癫痫诊疗领域中的研究现状、应用前景及面临的挑战进行简要综述。     

钙离子依赖型凝集素样受体2 (CLEC-2)研究进展

 钙离子依赖型凝集素样受体2(calcium dependent lectin like receptor 2,CLEC-2)是近年发现的血小板表面受体,相对分子质量(Mr)约32 000,是一种Ⅱ型跨膜受体。蛇毒蛋白Rhodocytin和唾液酸样糖蛋白Podoplanin是目前被分别鉴定出的CLEC-2的外源性和内源性配体。配体与受体相互作用后,通过Src及Syk依赖的酪氨酸激酶途径活化下游分子,最终激活PLCγ2,产生第二信使的生理效应,引起血小板活化聚集。研究表明CLEC-2与配体的相互作用和血栓性疾病、肿瘤转移和进展以及血小板捕获HIV 1并呈递给靶细胞等过程密切相关。因此,阻断两者相互作用可能成为治疗上述疾病的新靶点。     

Physiological variables involved in heart valve substitute calcification

Biochemical, histological and genetic studies using in vitro/in vivo models have demonstrated that pathological calcification of bioprosthetic heart valves (BHV) is regulated by various mechanisms associated with physiological variables. The major objective of this review is to characterize physiological variables involved in BHV calcification. This review examines our understanding of the systemic cellular behavior and physiological regulation processes behind BHV calcification and its clinical applications.     

Large-scale analysis of interindividual variability in single and paired-pulse TMS data

ObjectiveThis study brought together over 60 transcranial magnetic stimulation (TMS) researchers to create the largest known sample of individual participant single and paired-pulse TMS data to date, enabling a more comprehensive evaluation of factors driving response variability.MethodsAuthors of previously published studies were contacted and asked to share deidentified individual TMS data. Mixed-effects regression investigated a range of individual and study level variables for their contribution to variability in response to single and paired-pulse TMS data.Results687 healthy participant’s data were pooled across 35 studies. Target muscle, pulse waveform, neuronavigation use, and TMS machine significantly predicted an individual’s single-pulse TMS amplitude. Baseline motor evoked potential amplitude, motor cortex hemisphere, and motor threshold (MT) significantly predicted short-interval intracortical inhibition response. Baseline motor evoked potential amplitude, test stimulus intensity, interstimulus interval, and MT significantly predicted intracortical facilitation response. Age, hemisphere, and TMS machine significantly predicted MT.ConclusionsThis large-scale analysis has identified a number of factors influencing participants’ responses to single and paired-pulse TMS. We provide specific recommendations to minimise interindividual variability in single and paired-pulse TMS data.SignificanceThis study has used large-scale analyses to give clarity to factors driving variance in TMS data. We hope that this ongoing collaborative approach will increase standardisation of methods and thus the utility of single and paired-pulse TMS.     

Aerosol particle generation from solution-based pressurized metered dose inhalers: a technical overview of parameters that influence respiratory deposition

Abstract

There are a multitude of formulation factors to consider when developing a solution-based pressurized metered dose inhaler (pMDI). Evaluation of these variables and their underpinning driving force has been performed over the years. Key components, including formulation composition and device design, play significant roles in determining the aerosol performance of these solution-based formulations. This review outlines research efforts that have focused on these essential governing factors, how the aerosol performance changes when these variables are modified and fundamental mechanisms affecting the delivery efficiency of such formulations.     

Measuring socioeconomic health inequalities in presence of multiple categorical information

While many of the measurement approaches in health inequality measurement assume the existence of a ratio-scale variable, most of the health information available in population surveys is given in the form of categorical variables. Therefore, the well-known inequality indices may not always be readily applicable to measure health inequality as it may result in the arbitrariness of the health concentration index's value. In this paper, we address this problem by changing the dimension in which the categorical information is used. We therefore exploit the multi-dimensionality of this information, define a new ratio-scale health status variable and develop positional stochastic dominance conditions that can be implemented in a context of categorical variables. We also propose a parametric class of population health and socioeconomic health inequality indices. Finally we provide a twofold empirical illustration using the Joint Canada/United States Surveys of Health 2004 and the National Health Interview Survey 2010.     

Variables Associated With Breastfeeding Duration

Objective: To identify the variables associated with breastfeeding duration.
Data Sources: The health science reference databases of CINAHL, PubMed, and the Cochrane Database of Systematic Reviews.
Study Selection: Meta-analyses, Cochrane reviews, literature reviews, and quantitative and qualitative studies published in English from 1998 through 2008.
Data Extraction: Data included all variables, both positive and negative, that were found to influence the outcome of breastfeeding duration.
Data Synthesis: Demographic factors that influence breastfeeding duration are race, age, marital status, education, socioeconomics, and Special Supplemental Nutrition Program for Women, Infants, and Children status. Biological variables consisted of insufficient milk supply, infant health problems, maternal obesity, and the physical challenges of breastfeeding, maternal smoking, parity, and method of delivery. Social variables included paid work, family support, and professional support. Maternal intention, interest, and confidence in breastfeeding were psychological variables.
Conclusion: Human lactation is a complex phenomena and the duration of breastfeeding is influenced by many demographic, physical, social, and psychological variables.