医齿科用海洋生物粘结剂的研究进展

目的：介绍未来医齿科用海洋生物粘结剂的研究状况。方法：通过提出医齿科用粘结剂的要求与目前存在的缺陷，介绍海洋生物粘结剂的优点；重点描述了贻贝海洋生物粘结蛋白（BP）的基础研究及其应用研究前景，对其主要成分及作用进行综述。结果：应用基因重组技术是目前制备BP最有效、经济的方法，可以解决天然胶难保存、获取量小的缺点，为未来生物粘结剥的制备奠定技术基础。结论：基因重组技术制备的海洋生物粘结荆，不久将有可能应用于医学与牙科临床。     

Forget Me Not

A 37-year-old man presented with a facial abscess that progressed to external ophthalmoplegia and proptosis. Neuroimaging was consistent with cavernous sinus thrombosis. The diagnosis, management options, and management controversies of septic cavernous sinus thrombosis are discussed, including neuroimaging, antibiotic choice, and the role of corticosteroids and anticoagulation.     

深圳近岸海域海洋动物稀土元素组成特征及配分模式研究

目的建立定量测定深圳近岸海域海洋动物稀土元素(REE)的方法,并对REE组成特征以及配分模式进行分析研究。方法在深圳近岸海域采集60份海洋动物样本,采用电感耦合等离子体质谱法(ICP-MS)测定钇、镧、铈、镨、钕、钐、铕、钆、铽、镝、铒、钬、铥、镱、镥等15种稀土元素,并选择国家一级标准物质茶叶(GBW10016)进行定量分析的质量控制。结果软体动物、藤壶、鱼类及虾类的REE平均测定值分别为(2.66±2.28)、(4.69±1.32)、(0.03±0.03)和(0.07±0.02)μg/g;所测海洋动物的稀土配分特征总体上都表现为轻稀土元素的富集。结论(1)球粒陨石标准化处理表明,藤壶、软体动物和虾类与南海北部陆坡海洋沉积物、香港土壤以及中国大陆土壤稀土平均值配分模式较接近,而鱼类的则有所差异;(2)双壳类软体动物由于体内REE总量较高而存在食用安全风险;(3)由REE富集能力、与海洋沉积物相似的REE配分模式以及附着生长特性等方面的特征显示,藤壶及牡蛎是较好的海洋环境REE指示动物。     

Use of nebulized antimicrobial agents in burned and mechanically ventilated patients with persistent Acinetobacter baumannii, Pseudomonas aeruginosa, or Enterobacteriacea

Background

Nebulized antibiotics are used to locally treat colonizations of multi-resistant organisms. Prior systemic nephrotoxic antibiotic use with serum creatinine rises warranted an alternative therapy in 69 ventilator-dependent patients with persisting sputum cultures and need for ventilatory support.

Materials and methods

Following IRB approval, retrospective patient data were reviewed. Analysis included comparison of these 69 patients (71 treatments) to 142 Gram-negative infected burn patients matched for age and burn size.

Results

Mean pooled age and burn wound percent for the 71 triplicates (n = 211 patients) were 55.6 ± 18.3 years and 27.4 ± 22.3% burns. Fifty-seven of 69 (83%) patients had inhalation injuries and 54 of 69 (78%) patients survived. Nebulizations averaged 6.8 ± 3.3 days (range 3–12 days). Serum creatinine rose in 2 patients receiving colistimethate nebulizations, known to cause nephrotoxicity following nebulization. Triplicate comparisons via ANOVA noted prolonged ventilatory support (F = 13.39; p ? 0.05) and length of stay (F = 6.11; p ? 0.5). Variance was attributed to the sicker nebulized patients. Twenty-four inhalation injury-only triplicates further confirmed that nebulized patient subgroup was more ill.

Conclusion

Short duration antibiotic nebulization may allow higher intra-tracheal antibiotic concentrations and may facilitate weaning from the ventilator by reducing bacterial bioburden.     

某二级综合性医院多重耐药菌感染监测情况及护理干预效果

目的 了解某二级医院多重耐药菌(MDR0)感染病例监测情况,并探讨护理干预措施的效果.方法 调查监测某医院2012至2015年送检标本中细菌耐药的情况,定期对医院容易出现多重耐药菌感染的行为进行干预,将措施落实情况进行分析反馈,干预前后MDRO感染情况比较.结果 全院送检标本总为64 004例,标本阳性2 702例,发生MDRO感染168例.全院多重耐药菌医院感染率从2012年的8.48％下降到2015年的3.90％,呈明显下降趋势.结论 通过采取综合护理干预措施,可有效减少医院多重耐药菌感染的发生.     

Periprosthetic Joint Infection: Are Patients With Multiple Prosthetic Joints at Risk?

Patients who present with a periprosthetic joint infection in a single joint may have multiple prosthetic joints. The risk of these patients developing a subsequent infection in another prosthetic joint is unknown. Our purposes were (1) to identify the risk of developing a subsequent infection in another prosthetic joint and (2) to describe the time span and organism profile to the second prosthetic infection. We retrospectively identified 55 patients with periprosthetic joint infection who had another prosthetic joint in place at the time of presentation. Of the 55 patients, 11 (20%) developed a periprosthetic joint infection in a second joint. The type of organism was the same as the first infection in 4 (36%) of 11 patients. The time to developing a second infection averaged 2.0 years (range, 0-6.9 years).     

环境样品中邻苯二甲酸酯类物质的测定与分析

目的了解环境中邻苯二甲酸酯类(phthalates)的污染情况。方法采集上海及周边杭州湾和运河地区的水样、土样、底泥及鱼、虾、蟹等水生生物样品,采用反相高效液相色谱法测定了其中邻苯二甲酸二乙酯(DEP)、邻苯二甲酸二丁酯(DBP)和邻苯二甲酸-2-乙基己基酯(DEHP)的含量。结果phthalates在水中的含量<土壤<底泥<水生生物;不同水生物对phthalates的生物富集程度不同,泥螺和虾较易富集DEP和DBP,而鱼类和河蚌较易富集DEHP。结合国内资料,推算60 kg成年人每日摄入量为3.4 mg,低于人每日安全摄入量。结论上述地区普遍存在phthalates的污染。     

An overview of ceftolozane sulfate + tazobactam for treating hospital acquired pneumonia

ABSTRACT

Introduction

Ceftolozane-tazobactam is a combination of a new cephalosporin, with activity similar to that of ceftazidime, and a known inhibitor of beta-lactamases. This compound shows excellent activity against most gram-negative organisms causative of hospital-acquired pneumonia (HAP) or ventilator-acquired pneumonia (VAP), including extended spectrum beta-lactamase (ESBL)-producing Enterobacterales and multidrug-resistant (MDR) Pseudomonas aeruginosa.