N-乙酰半胱氨酸的抗菌活性及对细菌生物被膜的抑制作用

N-乙酰半胱氨酸(N-acetylcysteine,NAC)是临床常用化痰药.除此之外,NAC还有一定的抗菌活性,可以抑制细菌的黏附,减少细胞外多糖蛋白复合物的产生,破坏已生成的生物被膜,对被膜下细菌也有一定的杀菌作用,并与某些抗菌药物存在协同作用,引起国内外学者越来越多的关注.研究结果提示临床上可以将NAC与抗生素联合应用治疗某些感染性疾病尤其是慢性呼吸道感染,不过尚需进一步大样本临床研究来证明.     

阿奇霉素和鱼腥草治疗小儿下呼吸道感染

目的　探讨静脉点滴阿奇霉素和鱼腥草治疗小儿下呼吸道感染的临床疗效及其安全性。方法　采用随机对照分组研究 ,观察组使用阿奇霉素 5～ 10mg/kg ,每日 1次 ,加鱼腥草 1～ 3ml/ (kg·d) ,每日 1次静脉滴注 ,疗程 5～ 7d。对照组选用头孢拉定 5 0～ 10 0mg/ (kg·d)加利巴韦林 10mg/ (kg·d)静脉滴注 ,每日 2次 ,疗程 5～ 7d。结果　观察组痊愈率和有效率分别为 72 .5 %和 89.8% ,而对照组的痊愈率和有效率分别为 4 5 .3%和 73.6 % (P <0 .0 1) ,观察组和对照组的不良反应发生率分别为 13.5 %和 10 .8% (P >0 .0 5 )。结论　阿奇霉素加鱼腥草静脉滴注治疗小儿下呼吸道感染临床疗效确切 ,不良反应较少     

Prosthetic joint infectionsin the elderly

Total joint arthroplasty is among the most remarkable advances in orthopaedic surgery for the elderly, enabling themto regain physical function and be free of pain. Although uncommon, infection of the prosthetic joint causes serious morbidity leading to poor functional outcome with a mortality approaching 8% in the elderly. Most infections occur through inoculation of the prosthesis at the time of implantation and are due to Gram-positive cocci, although a third of the episodes are due to Gram-negative bacilli from a secondary focus. The management presents a major clinical and therapeutic challenge due to systemic and local comorbid conditions in the elderly. Medical and surgical treatment decisions for infected joint prosthesis are complex and should be individualized in each case. Optimal nutrition is essential for a successful outcome. Adverse reactions to medications are more common in the elderly due to end organ dysfunction and drug-drug interactions.     

Prevalence of anti-HCV in institutionalised mentally handicapped subjects

Data on the prevalence of antibody to hepatitis C virus among 278 subjects in an institution for the mentally handicapped were analysed by risk factors. A prevalence of 4% was found, higher than blood donors belonging to the same area (1.4%). No differences in prevalence with regard the length of residence, age, sex, degree of retardation or for presence of HBV markers were observed.     

Sternal abscess due to Bartonella (Rochalimaea) henselae in a renal transplant patient

 Bartonella henselae, previously called Rochalimaea henselae, is the causative agent of cat scratch disease (CSD) in immunocompetent subjects and bacillary angiomatosis in immunocompromised ones. Bone lesions are common in bacillary angiomatosis, but not in CSD. We present the case of a patient with a renal transplant treated by immunosuppressive therapy who developed a sternal abscess with a histological pattern of CSD. The CT pattern was that of a lytic bone lesion with adjacent fluid collection. The diagnosis was made on the basis of a polymerase chain reaction amplification performed on bone material. Bartonella henselae is a newly described bacteria that causes CSD in a normal host and bacillary angiomatosis in immunocompromised patients. We report a case of an osteolytic lesion of the sternum with adjacent fluid collection related to CSD, which occurred in a patient with a renal transplant.     

Adhesins of uropathogenic bacteria: Properties,identification and use for new antibacterial strategies

Adherence is a major virulence factor in the complex pathogenesis of urinary tract infections (UTI). Colonization of the urinary tract and subsequent spread of infection ascending to the kidneys depends not only on the expression of adhesins by bacteria but also on the presence of host factors which may either contribute to or inhibit infection. The presence of certain types of adhesins expressed by the bacteria and their interactions with epithelial cells play a role in determining where bacteria localize in the urinary tract, the kind and severity of symptoms and how the disease progresses. The knowledge of the molecular mechanisms underlying adherence may be useful for epidemiological research in the pathogenesis of UTI, for the diagnosis of different types of UTI and, in some cases, for prognosis. Furthermore, attachment to epithelia is a promising target for developing new methods in prophylaxis and therapy.     

长春地区儿童急性呼吸道感染的病原趋势

目的:探讨北方地区小儿急性呼吸道感染(ARIs)病原构成特点,为临床诊断及治疗提供依据。方法:采用酶联免疫吸附试验(ELISA)方法,对574例ARIs患儿进行了肺炎支原体(Mp)、沙眼衣原体(CT)、肺炎支原体(CP)、呼吸道合胞病毒(RSV)、腺病毒(Adv)、流感病毒A型(Inf-A)、副流感病毒(PIV)等7种病原同步进行急性期血清特异性抗体IgM检测,同时设立健康对照组。结果:574例患儿共334例检出特异性IgM抗体,阳性率58.2%。按检出频率的高低依次为Mp28.9%(166/574),RSV13.6%(78/574),CP5.9%(34/574),CT4.4%(25/574),Adv3.3%(19/574),Inf-A1.2%(7/574),PIV0.9%(5/574),分别占阳性例数的49.7%(166/334)、23.3%(78/334)、10.2%(34/334)、7.5%(25/334)、5.7%(19/334)、2.1%(7/334)和1.5%(5/334);病原分布具有年龄差别。健康对照组仅检出1例MP-IgM阳性(1.7%)。结论:Mp、RSV及CT为小儿ARI的常见病原。Mp感染率逐渐增高,发病年龄有逐渐变小的趋势。     

Role of cytokines and chemokines in prion infections of the central nervous system

Prion infections of the central nervous system (CNS) are characterised by a reactive gliosis and the subsequent degeneration of neuronal tissue. The activation of glial cells, which precedes neuronal death, is likely to be initially caused by the deposition of misfolded, proteinase K-resistant, isoforms (termed PrP(res)) of the prion protein (PrP) in the brain. Cytokines and chemokines released by PrP(res)-activated glia cells may contribute directly or indirectly to the disease development by enhancement and generalisation of the gliosis and via cytotoxicity for neurons. However, the actual role of prion-induced glia activation and subsequent cytokine/chemokine secretion in disease development is still far from clear. In the present work, we review our present knowledge concerning the functional biology of cytokines and chemokines in prion infections of the CNS.     

Erythema multiforme during cytomegalovirus infection and oral therapy with terbinafine: a virus–drug interaction

The authors report a case of erythema multiforme in a 32-year-old woman who was also taking oral terbinafine for an onychomycosis. The patient data analysis showed serological positivity for cytomegalovirus (IgM and IgG) and hepatitis C virus and serological titre of antinuclear antibody was elevated. After a brief review of the literature the authors propose the possibility of virus-drug interaction as a model of adverse drug reactions.