臭氧·紫外线器械消毒柜消毒效果与影响因素的实验研究

目的探讨臭氧*紫外线消毒柜的机器性能和消毒效果与影响因素. 方法按卫生部<消毒技术规范>测定开机不同时间消毒柜中臭氧浓度、工作环境空气中臭氧浓度和消毒柜中臭氧残留浓度,以及消毒柜对不同微生物的杀灭效果. 结果按消毒柜自动程序开机20min柜内臭氧浓度达253.69mg/m3,柜中平均紫外线照射强度为1 862μW/cm2;消毒柜开机工作35min对不锈钢载体上金黄色葡萄球菌、大肠埃希菌、白色念珠菌杀灭率达100%;开机40min对不锈钢载体上枯草杆菌黑色变种芽胞杀灭率达100%,对染于手术剪和镊子上的金黄色葡萄球菌杀灭率达99.99%,消毒效果可靠而且安全. 结论肯格王牌臭氧*紫外线消毒柜容量大、自动、安全、消毒效果可靠、适用范围广泛的医疗器械消毒产品.     

大肠埃希菌、克雷伯菌产超广谱β-内酰胺酶的检测及耐药性分析

目的研究本院3年中大肠埃希菌、克雷伯菌ESBLs的检出率及对常用抗生素的耐药情况。方法对山西医科大学第二医院2001～2003年分离的837株大肠埃希菌、216株克雷伯菌用标准纸片扩散确证法检测其ESBLs产生率；采用K-B法进行药敏检测。结果大肠埃希菌产ESBLs分离率为2001、2002、2003分别为12．27％、15．90％、30，85％；克雷伯菌产ESBLs分离率为2001、2002、2003分别为23．88％、28．81％、30．00％；产ESBLs株对头孢菌素类、氨基糖苷类、氟喹喏酮类耐药率均高于非产ESBLs菌株；未发现对亚胺培南耐药的菌株。结论近年来大肠埃希菌、克雷伯菌产ESBLs菌株逐年升高，应引起足够的重视，采取有效措施控制产ESBLs菌的感染。     

大肠埃希菌感染的临床分布与耐药性

目的调查医院大肠埃希菌感染的临床分布及耐药,为临床合理使用抗菌药物提供科学依据.方法对358株临床分离的大肠埃希菌对药物敏感试验结果进行回顾性分析.结果大肠埃希菌感染的部位主要见于伤口、泌尿道、呼吸道、血液、引流液等;大肠埃希菌耐药率低的抗菌药物是亚胺培南、阿米卡星、哌拉西林/他唑巴坦,耐药率<10%;对氟喹诺酮类及头孢菌素耐药率较高.结论治疗大肠埃希菌感染时,需根据药敏结果及患者病情选用碳青酶烯类、氨基糖苷类、β-内酰胺类抗生素/β-内酰胺酶抑制剂等.     

改良的纸片表型筛选法用于AmpC酶的检测

目的 建立并评价一种检测大肠埃希菌和肺炎克雷伯菌产AmpC酶的新方法.方法 采用改良的纸片表型筛选法,以头孢西丁三维试验和多重PCR法作为对照,对临床分离的耐第三代头孢菌素的164株大肠埃希菌和40株肺炎克雷伯菌进行AmpC酶的检测.结果 164株大肠埃希菌中,改良的纸片表型筛选法检出8株产AmpC酶的阳性菌株（8/164,4.88%）,其中有2株同时产ESBLs酶;40株肺炎克雷伯菌中未检出产AmpC酶菌株,但检出2株（2/40,5.00%）诱导产AmpC酶菌株.头孢西丁三维试验在大肠埃希菌中检出AmpC酶阳性菌株8株（8/164,4.88%）,在肺炎克雷伯菌中未检出产AmpC酶株.多重PCR法检出大肠埃希菌AmpC酶耐药基因阳性9株（9/164,5.49%）,肺炎克雷伯菌阳性2株（2/40,5.00%）.结论 改良的纸片表型筛选法可用于检测大肠埃希菌和肺炎克雷伯菌产AmpC酶和诱导产酶株,并可同时检测产ESBLs酶菌株,该法操作简便、结果可靠、无需特殊仪器,可在普通临床实验室应用.     

Mutation Spectrum of Familial Adenomatous Polyposis Patients in Turkish Population: Identification of 3 Novel APC Mutations

BackgroundFamilial adenomatous polyposis (OMIM #175100) and MUTYH-associated polyposis (OMIM #608456) are rare cancer-prone disorders characterized by hundreds of adenomatous polyps in the colon and rectum, which have a high probability of malignant transformation. Attenuated familial adenomatous polyposis is a variant of familial adenomatous polyposis, which is a term used for the condition in which patients have less than 100 colorectal polyps. Germline heterozygous Adenomatous polyposis coli (APC) and biallelic MUTYH (mutY DNA glycosylase) pathogenic variations are responsible for familial adenomatous polyposis and MUTYH-associated polyposis respectively. The aim of this study is to discuss the clinical manifestations of patients having pathogenic APC and MUTYH variations.MethodsWe included 27 probands who have more than 10 colonic polyps in this study. After evaluation of their clinical and family histories, the probands were screened for APC and MUTYH variations via next generation sequencing. The family members of the probands carrying pathogenic variations were screened via Sanger sequencing. ResultsAmong 27 probands, pathogenic APC and MUTYH variations were detected in 3 and 6 probands respectively. In the APC gene, 3 novel truncating variations (p.Leu360*, p.Leu1489Phefs*23, and p.Leu912*) were detected in 3 unrelated probands. In the MUTYH gene, only 2 distinct pathogenic variations were detected (p.Pro295Leu and p.Glu480del) in the homozygous or compound heterozygous state.ConclusionIn this study, molecular etiology was clarified in 9 familial polyposis patients. The p.Pro295Leu and p.Glu480del variations seem to be common in the Turkish population and may be considered as a first-step genetic test in Turkish familial polyposis patients showing autosomal recessive inheritance. However more studies are needed to reveal the exact frequency of these variations.     

取环致宫腔化脓性感染引发腰椎间盘炎一例报道并文献复习

宫腔化脓性感染是一种严重的盆腔炎性疾病(PID),主要表现为发热、腹痛、阴道分泌物增多等症状。椎间盘炎是发生于椎间盘间隙和邻近椎体或软骨板的感染性病变,其症状及体征缺乏特异性,临床上容易诊断延迟直至出现椎体骨质破坏及下肢肌力减弱。本文报道了1例因取环手术引发宫腔化脓性感染进而引发腰椎间盘炎,出现腰痛伴行走障碍的患者,并进行了文献复习,加深了对PID的病原体、感染传播途径、诊断标准、治疗原则及其严重不良后果的认识。对于非特异性椎间隙感染,临床医生除实验室检查及影像学检查之外,还应仔细询问病史并了解病情的演变过程,及时诊断并进行手术治疗。     

大肠埃希菌和铜绿假单胞菌的耐药性分析

目的:通过分析临床标本中大肠埃希菌和铜绿假单胞菌的分布及耐药性,了解细菌耐药性的变化趋势以及2种细菌的耐药率与抗菌药物用药频度的相关性,认识细菌耐药性变化与抗菌药物使用之间的关系。方法:调查某医院2009年至2013年临床标本中分离出的大肠埃希菌和铜绿假单胞菌,采用SPSS 17.0软件分析2种细菌耐药率与抗菌药物用药频度的相关性。结果:细菌耐药率与多种抗菌药物用药频度的关系较为复杂,但存在相关性。结论:所研究医院的大肠埃希菌及铜绿假单胞菌对于常用抗菌药物的耐药率高并与抗菌药物的用药频度有一定关系。因此,在临床工作中应严谨的使用抗菌药物以降低抗菌药物的用量,从而有效控制细菌耐药性的进展。     

Functionalization of Se-Te Nanorods with Au Nanoparticles for Enhanced Anti-Bacterial and Anti-Cancer Activities

The use of medical devices for therapeutic and diagnostic purpose is globally increasing; however, bacterial colonization on therapeutic devices can occur, causing severe infections in the human body. It has become an issue for public health. It is necessary to develop a nanomaterial based on photothermal treatment to kill toxic bacterial strains. Appropriately, high photothermal conversion and low-cost powerful photothermal agents have been investigated. Recently, gold nanocomposites have attracted great interest in biological applications. Here, we prepared rod-shaped Se-Te@Au nanocomposites of about 200 nm with uniform shape and surface-coated with gold nanoparticles for the first time showing high anti-bacterial and anti-cancer activities. Se-Te@Au showed proper structural consistency and natural resistance to bacterial and cancer cells. The strong absorption and high photothermal conversion efficacy made it a good photothermal agent material for the photothermal treatment of bacterial and cancer cells. The Se-Te@Au rod showed excellent anti-bacterial efficacy against Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus, with highest recorded inhibition zones of 25 ± 2 mm and 22 ± 2 mm, respectively. More than 99% of both types of strains were killed after 5 min with a near-infrared (NIR) laser at the very low concentration of 48 µg/mL. The Se-Te@Au rod’s explosion in HeLa cells was extensively repressed and demonstrated high toxicity at 100 µg/mL for 5 min when subjected to an NIR laser. As a result of its high photothermal characteristics, the exceptional anti-bacterial and anti-cancer effects of the Se-Te@Au rod are considerably better than those of other methods previously published in articles. This study could open a new framework for sterilization applications on the industrial level.     

A Bacterial DNA Repair Test Evaluating the Genotoxicity of Light Sources

A DNA repair test was used in order to assess its applicability for detecting the genotoxicity of sunlight and of the light emitted by halogen lamps and fluorescent lamps. This experimental system compares the lethality of test agents in the Escherichia coli wild-type WP2 and its isogenic counterparts lacking, either individually or in combination, various DNA repair mechanisms. DNA repair-deficient strains included WP2uvrA (uvrA^-), WP67 (uvrA^- polA^-), CM561 (lexA^-), CM571 (recA^-), WP100 (uvrA^- recA^-), and CM871 (uvrA^- recA^- lexA^-). All light sources produced a substantial killing of repair-deficient strains, with a maximum activity in the triple mutant CM871, at doses that did not affect survival of the wild type. The genotoxicity of uncovered quartz halogen bulbs was particularly potent, compared to fluorescent lamps and sunlight. Moreover, the mechanisms involved in repairing the DNA damage induced by halogen lamps were similar to those of a 254 nm UV source. The spectrum of genetic damage produced by sunlight and fluorescent lamps was conversely more comparable to that of a 365 nm UV source. These data demonstrated a harmful emission of appreciable amounts of genotoxic far-UV wavelengths by halogen lamps, thereby confirming our previous results in the his^-Salmonella typhimurium mutagenicity test. Genotoxicity of halogen lamps could be easily prevented in both experimental systems by suitable glass or plastic covers. Compared to the mutagenicity end point, the differential lethality end point provided even more clear-cut results in detecting the DNA-damaging ability of all light sources. Moreover, parallel assays provided evidence that the bacterial DNA repair test was far more sensitive than the mutagenicity test in evaluating the genotoxicity of the light produced by halogen lamps. On the whole, the DNA repair test in E. coli is even simpler and faster (24 vs. 48 h) than the Salmonella mutagenicity test, and compares favorably in terms of sensitivity to genotoxic light sources.     

头孢西酮钠对临床分离细菌感染小鼠的保护作用

目的 探讨头孢西酮钠对临床分离菌株感染小鼠的保护作用。方法 给小鼠腹腔注射临床分离的金黄色葡萄球菌、铜绿假单胞菌和大肠埃希菌，感染后皮下注射头孢西酮钠，观察记录感染后小鼠的生存率。结果 头孢西酮钠10mg／kg、20mg／kg和40mg/kg能显著降低中间葡萄球菌R1725株、金黄色葡萄球菌R1743株、铜绿假单胞菌R1620株、铜绿假单胞菌R1598株、大肠埃希菌R1598株、大肠埃希菌W1867株和D群肠球菌W1999株感染小鼠的死亡率。结论 头孢西酮钠对临床分离的金黄色葡萄球菌、铜绿假单胞菌和大肠埃希菌感染小鼠有显著的保护作用。