金黄色葡萄球菌胶乳凝集试验及spa基因序列改变与万古霉素耐药关系探讨

目的研究金黄色葡萄球菌（金葡菌）胶乳凝集试验及spa基因序列改变与万古霉素耐药的关系。方法检测体外诱导对万古霉素耐药金葡菌过程中的金葡菌胶乳凝集试验结果改变情况,并利用单链构象多态性（SSCP）技术及DNA测序分析金葡菌spa基因序列有无改变。结果3株对万古霉素产生中介耐药的金葡菌在诱导过程中胶乳凝集试验发生改变,其中2株金葡菌spa基因序列有改变。结论spa基因碱基序列的改变,可能与金葡菌对万古霉素耐药有一定关联。     

金黄色葡萄球菌临床分离株spa分型和耐药特征研究

目的研究临床分离金葡菌的耐药性和分子特征。方法对2011年511月在成都某医院分离的56株金葡菌进行抗菌药物敏感性检测,检测菌株携带mecA基因和pvl基因情况,并进行spa基因分型分析。结果56株金葡菌中,共检出耐甲氧两林金葡菌（MRSA）21株（37．5％）,其中mecA基因阳性20株（95．2％）;甲氧西林敏感金葡菌（MSSA）35株（62．5％）。与MSSA相比,MRSA对利福平、左氧氟沙星、莫西沙星、环丙沙星、庆大霉素和四环素的敏感率显著降低（P〈0．05）,MRSA对万古霉素、利奈唑胺、替加环素、喹奴普丁达福普汀和呋喃妥因全部敏感。MRSA分为6个spa型别,以t030（66．7％）为主,MRSA～t030、MRSA—t002具有突出的多药耐药特征。MSSA共分为18个spa型别,以t189、t377和t034列前3位,分别占14．3％、／4．3％和1I．4％,并在脓液标本榆出I株新spa基因型new1。检出5株杀白细胞毒素（PVL）阳性菌株,其中3株为MSSA—t189。结论t030是医院MRSA临床分离株中的spa优势型别,具有突出的多药耐药特征,在医院内广泛传播。MSSA遗传多样性高,以t189、t377和t034列前3位。     

指针疗法在中药肠浴治疗虚寒型慢性腹泻中的护理研究

目的:探讨指针疗法配合肠道水疗治疗虚寒型慢性腹泻的护理干预作用。方法:选择虚寒型慢性腹泻患者160例,随机分成对照组及观察组各80例。对照组在进行电脑肠道水疗后予中药灌肠治疗,配合常规的临床护理;观察组在进行电脑肠道水疗及中药灌肠治疗的基础上,选择长强穴及大肠俞穴行局部指针疗法行护理干预,两组均观察并记录患者的不良反应、疗程和治疗效果。结果:与对照组相比,指针组患者在治疗过程中无明显不适感,且疗程短,两组比较有显著性差异(P0.05)。结论:护理干预配合肠道水疗能明显提高虚寒型慢性腹泻患者的疗效,减少治疗过程中的不良反应,提高了患者治疗期间的舒适感。     

Selected Organizational and Managerial Aspects of Health and Nutrition Education of Various Types of Consumers of Spa Treatment Services in Poland

Consumer education, including nutrition education, understood as a process based on scientific principles, is becoming a very effective element in influencing the health of the population in the modern world. This work is based on direct research carried out in 2016–2018 in the form of a questionnaire interview among patients—consumers of educational services in spa treatment facilities. The research sample was N = 1000 (600 people were tested with the use of PAPI (Paper and Pencil Interview), and 400 people with the use of CAWI (Computer-Assisted Web Interview)) and concerned a representative group of spa patients in Poland. In addition, as a supplement, a direct survey was conducted in the form of a Computer-Assisted Telephone Interview with managers of spa treatment facilities (N = 50). Consumers of spa treatment services differ from each other, and types can be distinguished based on their professional activity status and the type of entity that pays for their stay in the spa, and, using cluster analysis, the status of professional activity in relation to their education level. The nutritional education system is based on highly specialized medical personnel. At the same time, it does not use the available assessment tools based on proven monitoring and evaluation indicators. Health education, which also includes nutritional education, apart from disease prevention, is the basic tool for health promotion in spa treatment conditions, enabling the introduction of a permanent change in the patients’ lifestyles, the additional advantages of which are low costs and relatively high efficiency. In the course of the study, several useful patient profiles were also distinguished, thanks to which it is possible to select dedicated educational methods for selected groups of recipients.     

Relationship of daily hot water bathing at home and hot water spa bathing with underlying diseases in middle-aged and elderly ambulatory patients: A Japanese multicenter cross-sectional study

The purpose of this study was to clarify the relationship of daily hot water bathing at home (DHW) and hot water spa bathing (HSPA) with the number of underlying diseases in middle-aged and elderly ambulatory patients.We defined the number of underlying diseases as the main outcome and dependent (criterion) variable. The frequency and time of DHW and the frequency of HSPA were set as explanatory variables. Multiple logistic regression analysis was performed for each frequency and time, adjusted age and sex. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated.Among the 1261 patients who participated, there was no significant difference in age between males (n = 508, 72.8 ± 6.8 years) and females (n = 753, 73.5 ± 6.9 years). There was also no significant age difference between males (number of diseases: 2.7 ± 2.0 pts.) and females (number of diseases: 2.7 ± 2.1 pts.) in the occurrence of underlying diseases. Frequency and time of DHW were not associated with the occurrence of underlying diseases. However, compared with participants who utilized hot water spa at least once a week, the occurrence of underlying diseases was significantly associated with bathing frequency: one to three times per month (OR 2.72, 95% CI 1.63–4.52); twice or five times a year (OR 1.92, 95% CI 1.25–2.94).In conclusion, lower frequency of HSPA was significantly associated with increased risk of the occurrence of underlying diseases in middle-aged and elderly ambulatory patients. However, the relationship between proactive use of hot water spa and patients’ mental and physical support should be clarified by well-designed cohort studies.The present study was registered as UMIN000033018 by the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) in Japan (refer: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037643).     

Molecular characterization of nasal methicillin resistant Staphylococcus aureus isolates from workers of an automaker company in southeast Iran

Colonization of methicillin resistant Staphylococccus aureus (MRSA) can occur more commonly in healthy people who live in close together or are in close physical contact with each other. Having knowledge about the molecular characteristics of these strains provides considerable discernment into the epidemiology of this important microorganism. A total of 806 nasal swabs were collected from healthy workers of an automaker company in the southeast of Iran and were analyzed to detect MRSA isolates. Multilocus sequence typing (MLST), spa typing, and detection of staphylococcal cassette chromosome mec (SCCmec) were performed. The presence of genes encoding Panton‐Valentine Leukocidin (PVL) and Arginine Catabolic Mobile Element (ACME) were also investigated. Carriage rate of S. aureus was 20%. Among 10 identified MRSA, no acme was found while high prevalence of pvl (60%) was of great concern. Seven different spa types including five new ones were identified. The most frequent sequence type was the novel one; ST 3373 (n = 3), followed by each of ST22, ST88, ST859 (n = 2) and ST1955 (n = 1). MRSA isolates were clustered into two main clonal complexes; CC22 (n = 6) and CC88 (n = 4). Low genetic diversity with the dominance of CC22, SCCmecIV was found. Distribution of previously found hospital‐associated MRSA was demonstrated among our isolates.     

临潼矿泉水质分析及医疗作用的研究概况

目的研究分析临潼矿泉的理化性质及对人体的生理、亚健康作用的调节,研究对慢性疾病的治疗及康复作用,为进一步发挥临潼疗养地矿泉的作用奠定基础。方法采取疗养地矿泉水质检测和分析,并选择从各地入伍的战士、疗养干部、飞行员,进行矿泉全身浸浴,检测对人体生理、心理、亚健康的调节作用,观察对颈腰背痛康复效果及高原部队睡眠障碍的影响。结果临潼矿泉部分理化性质其水文情况随着时间的推移发生了一定变化。对健康、亚健康、飞行员的生理变化有很好的调节作用,有增加左心收缩功能,改善微循环,增加肺功能,促进肝脏血液循环,增加脑血液循环,对血液有形成分、人体成分有调节作用。对飞行员体液免疫功能的改善,体能的增强,心境的调节有着积极的作用,对体内微量元素铅的排泄有促进作用。对高原军人的睡眠质量有较好的改善作用,对抗震救灾人员的颈、腰、背痛有较好的治疗作用。结论必须重视动态观察、定期检测疗养地矿泉资源,才能合理开发利用。研究证实矿泉可综合、全面地改善军人机体的功能状态,对部队（飞行员、高原官兵、抗震救灾人员）合理应用将对健康有非常好的促进作用,对多发性疾病有预防和治疗作用,对保障部队,提高战斗力起到了较好的作用。     

Nosocomial Staphylococcal scalded skin syndrome caused by intra‐articular injection

Background The pathogenic role of nasal carriage as a source for cutaneous and soft‐tissue Staphylococcus aureus (SA) infections, and Staphylococcal scalded skin syndrome (SSSS) in particular, is unclear. Observation We herein describe a nosocomial outbreak of SSSS in three orthopaedic patients who received intra‐articular injections by a single orthopaedic surgeon. Bacteriological samples from the index patients and medical personnel involved in their care were assessed by phage typing, polymerase chain reaction for exfoliative toxin genes, SmaI macro‐restriction analysis and molecular spa‐typing. These studies first revealed SA cultural growth in synovial fluid of all three patients as well as nasal mucosa of one medical assistant. Moreover, all SA isolates had the same phage typing and antibiotic susceptibilities and were positive for exfoliative toxin ETa by polymerase chain reaction. SmaI macro‐restriction and spa‐typing further confirmed all proband isolates to be identical. Conclusion These findings provide evidence that SA nasal colonization of otherwise healthy carriers is a risk factor for SA infections, including SSSS, in predisposed individuals.