胰腺癌对化疗药物敏感性的分析

目的 :通过体外药敏试验 ,研究胰腺癌细胞对化疗药物的敏感性 ;筛选敏感的化疗药物 ,指导临床化疗方案的制定 ,并讨论胰腺癌化疗个体化方案的意义。方法 :用MTT比色法检测 40例原代培养的胰腺癌细胞对氨甲蝶呤、5 氟脲嘧啶、丝裂霉素、长春地辛、羟基喜树碱、依托泊甙、顺铂、表阿霉素、吡柔比星和健择等 1 0种药物的敏感性。结果 :以上 1 0种药物对 40例原代胰腺癌细胞生长抑制率分别为 2 8 6± 1 7 9%、41 3± 2 0 7%、45 4± 2 3 0 %、38 4± 2 4 6 %、37 3± 2 1 5 %、39 5± 2 0 7%、37 0± 1 9 0 %、33 7± 2 1 0 %、38 4± 1 8.3%和 42 8± 1 9.5 % ,共有 33例 (83 % )筛选到了抑制率 >60 %的药物。结论 :体外培养的胰腺癌细胞对 1 0种化疗药物的敏感性较差 ;不同的胰腺癌细胞对不同的药物敏感。通过体外药敏试验筛选敏感药物行个体化化疗是提高胰腺癌化疗效果的一条有希望的途径     

AIDS病人真菌菌种分离鉴定及体外抗真菌药敏分析

目的了解新疆地区艾滋病(AIDS)病人真菌感染的菌种分布和优势菌株,并检测AIDS病人病原真菌对不同抗真菌药物的体外敏感性,为临床早期诊断及合理用药提供科学依据,并发现该地区的耐药情况。方法分别取AIDS病人口咽、呼吸道、消化道及泌尿、生殖道的标本,采用常规方法做真菌培养,用科玛嘉显色培养基进行鉴定,药敏试验采用ATBTMFUNGUS3试剂盒测定50株分离酵母菌对5-氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑、伏立康唑的体外敏感性。结果100株分离菌株中,念珠菌属为97株,其他菌属3株;其中白念珠菌85株,克柔念珠菌6株,热带念珠菌2株,光滑念珠菌1株。曲霉菌属2株,分别为烟曲霉和土曲霉;接合菌属1株,为根霉。结论新疆地区AIDS病人真菌感染仍以白念珠菌为优势菌种,并有罕见菌种出现。抗真菌药物以5-氟胞嘧啶、两性霉素B敏感性较高,而唑类存在不同程度的耐药。     

Predictors of antibiotic use in African communities: evidence from medicines household surveys in five countries

Objectives To investigate antibiotic use in five national household surveys conducted with the WHO methodology to identify key determinants of antibiotic use in the community. Methods Data from The Gambia, Ghana, Kenya, Nigeria and Uganda surveys were combined. We used logistic regression models that accounted for the clustered survey design to identify the determinants of care seeking outside the home and antibiotic use for 2914 cases of recent acute illness. Results Overall, 95% of individuals with acute illness took medicines, 90% sought care outside their homes and 36% took antibiotics. In multivariate analyses, illness severity was a strong predictor of seeking care outside the home. Among those who sought outside care, the strongest predictor of antibiotic use was the presence of upper respiratory symptoms (OR: 3.02, CI: 2.36–3.86, P < 0.001), followed by gastrointestinal symptoms or difficulty breathing, and antibiotics use was less likely if they had fever. The odds of receiving antibiotics were higher when visiting a public hospital or more than one healthcare facility. Conclusions The nature and severity of symptoms and patterns of care seeking had the greatest influence on decisions to take antibiotics. Antibiotics were widely available and inappropriately used in all settings. Policies to regulate antibiotics distribution as well as interventions to educate prescribers, dispensers and consumers are needed to improve antibiotic use.     

烧伤感染病原菌群的分布及药敏分析

目的:分析我院烧伤患者菌群分布及药敏实验结果。方法:对2003年~2005年间烧伤患者皮肤创面分离到的124株致病菌进行鉴定及药敏实验,按NCCLS标准。结果:致病菌前5位依次为凝固酶阴性葡萄球菌、阴沟肠杆菌、金黄色葡萄球菌、大肠埃希氏菌、产气肠杆菌。对上述革兰氏阴性菌敏感的药物依次为亚胺培南、丁胺卡那、头胞哌酮/舒巴坦等,对上述革兰氏阳性菌敏感的药物依次为万古霉素、利福平、头胞哌酮/舒巴坦等。结论:应加强细菌培养和药敏检测,这对正确使用抗生素具有重要意义。     

160例小儿细菌性痢疾菌群分布药敏试验及临床意义

目的　探索对细菌性痢疾最佳治疗方案。方法　将１６０ 例经细菌学证实的小儿急性菌痢分为１９８９～１９９３ 年和１９９４～１９９８ 年两个阶段，比较痢疾杆菌的菌群分布及药敏试验。结果　前后段均以福氏所占比例大，其次为宋氏，后段氯霉素敏感率较前段显著上升（ Ｐ＜ ００１），而庆大霉素、丁胺卡那、妥布霉素、氟哌酸则略有下降（ Ｐ＞ ００５），多重耐药性比较无明显差异（ Ｐ＞ ００５）。结论　９０ 年代福氏痢疾杆菌已成为主要流行菌群，临床上应合理、交替选用敏感性高的药物，氟喹酮类较为理想