无菌水清洗法减低中段尿培养假阴性的效果观察

目的 比较高锰酸钾溶液清洗消毒法与无菌水清洗法对中段尿培养结果的影响. 方法采集2002年1月-2006年12月符合留取中段尿培养指征的住院患者的尿标本,将采用1:5000高锰酸钾溶液清洗、消毒法留取的尿样本列为消毒组(n=1572);将采用无菌反渗水(血透用)清洗法采集的尿标本列为清洗组(n=544);观察2组标本微生物培养阳性率及污染率的变化;培养出2种以上细菌定义为污染.结果 5年共入选830例尿路感染患者,收集中段尿标本2116例,共检出病原体53I株;消毒组和清洗组尿标本的微生物阳性检出率分别为20.04%和39.71%,2组比较差异显著;消毒组同一患者2次培养检出相同致病微生物的百分比为0.012%,清洗组则为0.105%,二者比较差异显著.但是同一患者2次培养检出不同和仅单次致病微生物的发生率比较差异不显著.消毒组的污染率(0.028%)显著高于清洗组(0.007%).结论 无菌水清洗留取中段尿在没有增加污染率的情况下,可显著提高尿培养致病微生物的阳性率;高锰酸钾溶液消毒法可能是导致培养高假阴性的原因.     

Ischémie reperfusion en transplantation rénale

Ischemia-reperfusion injury is an inescapable phenomenon in kidney transplantation. It combines lesional processes of biochemical origin associated with oxydative stress and of immunological origin in connection with the recruitment and activation of innate immunity cells. Histological lesions associate acute tubular necrosis and interstitial œdema, which can progress to interstitial fibrosis. The extent of these lesions depends on donor characteristics (age, expanded criteria donor, etc.) and cold ischemia time. In the short term, ischemia-reperfusion results in delayed recovery of graft function. Cold ischemia time also impacts long-term graft survival. Preclinical models, such as murine and porcine models, have furthered understanding of the pathophysiological mechanisms of ischemia-reperfusion injury. Due to its renal anatomical proximity to humans, the porcine model is relevant to assessment of the molecules administered to a donor or recipient, and also of additives to preservation solutions. Different donor resuscitation and graft perfusion strategies can be studied. In humans, prevention of ischemia-reperfusion injury is a research subject as concerns donor conditioning, additive molecules in preservation solutions, graft reperfusion modalities and choice of the molecules administered to the recipient. Pending significant advances in research, the goal is to achieve the shortest possible cold ischemia time.     

Rapid identification of nonblood sterile site broth cultures using the FilmArray blood culture identification panel

The FilmArray Blood Culture Identification Panel was validated for nonblood sterile site specimens with clinical impact of rapid identification compared to conventional diagnostics. The panel accurately identified target organisms from 98% of positive broth cultures a median 1.1?day faster than conventional techniques (P?<?0.0001) with potential clinical impact in 22% of cases.     

3种培养基运用于饮料无菌冷灌装生产线无菌验证效果的评价

目的通过比较LG培养基(LG)、胰酪胨大豆肉汤(TSB)和改良马丁培养基(MMB)对细菌和真菌的检测灵敏度和促生长能力,评价LG培养基是否适用于PET瓶无菌冷灌装生产线的无菌验证。方法选用4株细菌和2株真菌分别对LG、TSB和MMB培养基的检测灵敏度和促生长能力进行评估。结果4种细菌在LG与TSB中的检测灵敏度相当,两者略优于MMB;2种真菌在LG与MMB中的检测灵敏度与促生长能力相当,两者略优于TSB。结论LG培养基无论对细菌还是真菌,均具有较高的检测灵敏度及较优的促生长能力,而且该培养基成本比较低,非常适用于需要使用大量培养基的无菌冷灌装生产线的无菌验证。     

急性坏死性胰腺炎的非手术治疗

目的探讨非手术方法治疗急性坏死性胰腺炎,以提高疗效。方法非手术治疗急性坏死性胰腺炎１５８例,病例选择为全身情况稳定或经短期纠正后基本好转。其中无菌性胰坏死１３７例,感染性胰坏死２１例。有４种治疗方案：１．用善得定;２．介入疗法;３．用中药;４．善得定与中药结合。结果１５８例中治愈１５１例（９５．６％）,死亡７例（４．４％）,疗效明显高于同期手术组（Ｐ＜０．０１）。结论急性坏死性胰腺炎有选择地采用非手术治疗,效果满意。     

不孕不育患者泌尿生殖道支原体感染及药敏分析结果

目的：通过对623例不孕不育患者标本支原体和药敏检测,了解该群体支原体（Uu）和人型支原体（Mh）的感染情况及其对抗生素的药敏性,以指导临床合理用药.方法：采用珠海浪峰生物制品公司生产的支原体培养及鉴定药敏试剂盒检测.结果：623例标本中,阳性标本156例,占25.1%;Uu＋Mh混合感染标本23例,占3.7%;单一Uu感染129例,占20.8%,单一Mh感染4例0.64%.药敏结果：支原体对交沙霉素、强力霉素、美满霉素最敏感对环丙沙星、壮观霉素、氧氟沙星耐药率高.结论：：该人群支原体感染Uu感染率最高,临床首选药物应为交沙霉素、强力霉素、美满霉素,以便指导临床选择用药.     

Peripheral sterile corneal infiltrate in two brothers after photorefractive keratectomy

This is a report of two brothers who underwent bilateral photorefractive keratectomy and developed bilateral peripheral corneal infiltrate on the third day following surgery. The patients were treated with antibiotics and low concentration steroid until negative culture was reported 48 h later, when intensive topical steroid was started. The infiltrate resolved by day 10 with residual subepithelial haze that was apparent 8 months after surgery. Sterile infiltrate has been reported as complication of photorefractive keratectomy and can be managed successfully with excellent outcome. The fact that it happened in two brothers may raise the possibility of genetic predisposition.     

注射用地塞米松固体脂质纳米粒冻干粉末的处方与工艺研究及质量评价

目的:研究注射用地塞米松(DXM)固体脂质纳米粒(SLN)冻干粉末的处方及工艺并评价其质量。方法:优选支架剂处方,确定冻干工艺制备冻干制剂;采用高效液相色谱法测定其中DXM的含量,并对其质量进行研究。结果:以3%甘露醇作为支架剂,DXM-SLN的粒径为340nm,Zeta电位为—25·2mV,包封率为92·10%,载药量为7·10%,于2~8℃环境下可保存3个月。结论:该制备工艺简便、可行,质量控制方法准确、可靠。     

‘Tough love’: The experiences of midwives giving women sterile water injections for the relief of back pain in labour

ObjectiveTo explore midwives’ experiences of administering sterile water injections (SWI) to labouring women as analgesia for back pain in labour.DesignA qualitative study, which generated data through semi-structured focus group interviews with midwives. Data were analysed thematically.SettingTwo metropolitan maternity units in Queensland, Australia.ParticipantsEleven midwives who had administered SWI for back pain in labour in a randomised controlled trial.FindingsThree major themes were identified including: i. SWI, is it an intervention?; ii. Tough love, causing pain to relieve pain; iii. The analgesic effect of SWI and impact on midwifery practice.Key conclusionsWhilst acknowledging the potential benefits of SWI as an analgesic the midwives in this study described a dilemma between inflicting pain to relieve pain and the challenges encountered in their discussions with women when offering SWI. Midwives also faced conflict when women requested SWI in the face of institutional resistance to its use.Implications for practiceThe procedural pain associated with SWI may discourage some midwives from offering women the procedure, providing women with accurate information regarding the intensity and the brevity of the injection pain and the expected degree of analgesic would assist in discussion about SWI with women.