β-lactamase producing bacteria in adult periodontitis

Abstract In 23 untreated adult periodontitis patients, the occurrence of β-lactamase producing periodontal bacteria was determined. In addition to non-selective isolation media, selective isolation and growth of β-Mactamase positive subgingival bacterial species was carried out on blood agar plates supplemented with amoxicillin and plates with amoxicillin + clavulanic acid. Porphyromonas gingivalis, Prevolella intermedia, Actinobacillus actinomycetemcomilans, Peplostreploc-occus micros, Fusobaclerium nucleatum, Bacleroides forsythus and Campylo-bacter rectus isolates from the non-selective medium were tested for β-Mactamase activity by a nitrocefin disk method (DrySlide®) and by a laboratory chromo-genic nitrocefin- based test. Isolates from the amoxicillin plates that were absent on the amoxicillin/clavulanic acid plates were identified and tested for β-Mactamase production. Based on the non-selective plates, six of 23 P. intermedia isolates, 2 of 19 B. forsythus isolates and 3 of 23 F. nucleatutm isolates were β-Mactamase positive. The β-Mactamase positive species Prevoleila loescheii, Prevotella buccae, Prevolella buccalis and Actinomvces spp were recovered from the selective amoxiciliin plates. β-Lactamase positive subgingival species were recovered from 17 of 23 patients (74%) but usually comprised low proportions of the sub gingival microbiota (range < 0.01–15%). Comparison of the DrySlide® test and the nitrocefin-based laboratory test revealed full agreement of test results. β-lactamase activity in whole sub gingival plaque was detected in 12 patient samples (52%). It was concluded that β-Mactamase activity in sub gingival bacteria in adult periodontitis is a common feature. However, since the majority of the samples showed only low-level enzymatic activity, the clinical relevance of this observation with regard to therapy with unprotected enzyme-susceptible β-lactamase is uncertain, though failure on the other hand, is difficult to rule out when a mechanism of resistance is present. The majority of β-Mactamase positive strains was found among species of the Prevotella genus.     

成人正畸患者心理健康状况调查分析

目的:探讨成人正畸患者的心理健康状况,为临床诊治工作提供帮助和参考。方法:将61例成人正畸患者作为研究对象,60例正常颌成人作为对照组,分别对其进行症状自评量表(SCL-90)、抑郁自评量表(SDS)和焦虑自评量表(SAS)的测定,比较两组中各指标的差异性。结果:成人正畸患者SCL-90各因子评分均显著高于正常对照组,按显著性高低排列,前4位分别为抑郁、焦虑、偏执、精神病性,SDS、SAS评分也明显增高,差异显著(P<0.01)。结论:成人正畸患者存在心理卫生问题。     

Neuropsychological studies of late onset and subthreshold diagnoses of adult attention-deficit/hyperactivity disorder.

BACKGROUND: Diagnosing attention-deficit/hyperactivity disorder (ADHD) in adults is difficult when the diagnostician cannot establish an onset prior to the DSM-IV criterion of age 7 or if the number of symptoms recalled does not achieve the DSM-IV threshold for diagnosis. Because neuropsychological deficits are associated with ADHD, we addressed the validity of the DSM-IV age at onset and symptom threshold criteria by using neuropsychological test scores as external validators. METHODS: We compared four groups of adults: 1) full ADHD subjects met all DSM-IV criteria for childhood-onset ADHD; 2) late-onset ADHD subjects met all criteria except the age at onset criterion; 3) subthreshold ADHD subjects did not meet full symptom criteria; and 4) non-ADHD subjects did not meet any of the above criteria. RESULTS: Late-onset and full ADHD subjects had similar patterns of neuropsychological dysfunction. By comparison, subthreshold ADHD subjects showed few neuropsychological differences with non-ADHD subjects. CONCLUSIONS: Our results showing similar neuropsychological underpinning in subjects with late-onset ADHD suggest that the DSM-IV age at onset criterion may be too stringent. Our data also suggest that ADHD subjects who failed to ever meet the DSM-IV threshold for diagnosis have a milder form of the disorder.     

注重成人学生特点,强化实习教学管理

论述在成人高等医学教育中，根据成人学生的职业化特点，注重实践，注重专业化动手能力的培养。认为，临床实习管理工作针对性要强，特色鲜明，要重视学生实习前专业课学习阶段知识和能力的培养，合理选择实习医院，加强临床生产实习主要环节的管理，只有这样才能提高学生职业素质和职业能力。     

硫化氢/胱硫醚-γ-裂解酶体系在脂多糖诱导大鼠急性肺损伤中的作用

目的探讨硫化氢/胱硫醚-γ-裂解酶(H_2S/CSE)体系在脂多糖(LPS)诱导大鼠急性肺损伤(ALI)中的作用。方法健康雄性SD大鼠48只,随机分为4组:空白对照组(Ⅰ组,n=16)、LPS诱导ALI组(Ⅱ组,n=16)、LPS CSE抑制剂炔丙基甘氨酸(PPG)组(Ⅲ组,n=8)和LPS NaHS组(Ⅳ组,n=8)。分别于给药后(生理盐水或LPS)3h和6h,Ⅰ组和Ⅱ组各处死8只大鼠;于LPS给药后3h,Ⅲ组腹腔注射PPG 30mg/kg(2ml/kg),Ⅳ组腹腔注射NaHS 28μmol/kg,观察3h后处死。观察肺组织病理学结果,计算肺系数、肺湿/干重比(W/D),测定血浆H_2S浓度、肺组织CSE活性、血清IL-1β浓度、肺组织IL-1βmRNA表达和NF-κB p65活性。结果Ⅰ组肺泡结构完整,Ⅱ组出现病理损伤,Ⅲ组病理损伤程度加重,Ⅳ组病理损伤程度较Ⅱ组减轻。与Ⅰ组比较,Ⅱ组和Ⅲ组H_2S浓度和CSE活性降低,IL-1β浓度、IL-1βmRNA表达和NF-κB p65活性升高;Ⅳ组IL-1βmRNA表达和NF-κB p65活性升高,CSE活性降低;Ⅱ组～Ⅳ组肺系数和肺W/D升高。与Ⅱ组比较,Ⅲ组肺系数、肺W/D、IL-1β浓度、IL-1βmRNA表达和NF-κB p65活性升高,H_2S浓度和CSE活性降低;Ⅳ组肺系数、肺W/D降低、H_2S浓度和CSE活性升高,IL-1β浓度、IL-1βmRNA表达和NF-κB p65活性降低(P<0.05或0.01)。结论内源性H_2S/ CSE体系功能下调可能参与了LPS诱导ALI的病理生理过程,外源性NaHS治疗后可在一定程度上减轻大鼠ALI。     

α珠蛋白基因3′HVR在成人型多囊肾病基因诊断中的应用

本文采用Southern blot方法,利用3′HVR/PvuⅡ,3′HVR/Bg1 Ⅱ RFLPs对9个成年型多囊肾病家系74名成员进行连锁分析,发现3′HVR呈高度多态性,它的Pvu Ⅱ、Bg1 Ⅱ和PvuⅡ+Bg1 Ⅱ RFLPs限制性片段的杂合率分别为92％、84.7％和98.6％,3′HVR与致病基因之间的重组率为0.045,最大Lods值为9.71,并成功地对有症状期患者和7名症状前期患者进行了基因诊断。     

医疗设备接地系统的探讨

本文分析了医疗设备分开接地的缺点和共用接地的优点，倡导医疗设备接地与其它接地系统共用接地体，并以实例说明医疗设备共用接地系统的设计，施工和安装方法。     

肾移植术后巨细胞病毒肺炎伴急性呼吸窘迫综合征的治疗

[目的]探讨肾移植术后巨细胞病毒肺炎伴急性呼吸窘迫综合征的治疗方法。[方法]1992年至2001年我院肾移植术后巨细胞病毒肺炎合并急性呼吸窘迫综合征患者42例,全部给予呼吸机辅助呼吸、氧疗,以及抗病毒治疗,丙氧鸟苷10 mg/(kg·d),分2次静滴,7~10 d无好转加用或改用磷钾酸钠180 mg/(kg·d),分3次静滴;调整免疫抑制剂:泼尼松减量至10 mg/d,环孢素剂量减至发病前的1/3~1/4,或停用环孢素,全部停用霉酚酸酯或硫唑嘌呤,直至体温正常、症状消失;其中12例患者在此治疗基础上,给予胸腺肽(日达先)治疗,1.6 mg皮下注射,每天或隔天1次至体温正常。[结果]42例患者总存活率38％(16/42),给予胸腺肽治疗的患者存活83％(10/12),明显高于没有接受胸腺肽治疗的患者的20％(6/30)(P<0.01)。所有存活病人肾功能正常,仅1例于1个内发生急性排斥。[结论]为提高肾移植术后巨细胞病毒肺炎合并急性呼吸窘迫综合征的疗效,应给予抗病毒治疗、调整免疫抑制剂、呼吸机辅助呼吸等综合治疗;免疫增强剂胸腺肽可能提高存活率,不增加急性排斥反应的发生。