多肽在前体药物与药物载体方面的应用

多肽是一种生物活性物质 ,无毒 ,具有良好的生物降解性 ,已经受到许多研究者的关注。多肽主要应用于前体药物 ,利用肿瘤细胞的选择性激活机制 ,用于癌症治疗或将其引入缓释系统 ,制成各种载体材料 ,控制药物释放。本文将介绍国外最近几年关于多肽在前体药物以及药物载体方面的应用研究     

成年手术患者手术部位多重耐药菌感染及影响因素分析

目的 探讨手术部位多重耐药（MDRO）菌感染情况及危险因素,为手术部位感染的预防和治疗提供循证参考。方法 以2019—2020年焦作市某医院行手术治疗的成年患者作为研究对象,收集基本情况、疾病患者情况,从医院病历信息系统中调取患者手术及术前相关检测指标、用药情况等内容,对出现发热、切口红肿、引流液异常等疑似感染症状体征患者采集感染部位生物样本用于病原学培养及检测。采用描述流行病学分析方法对MDRO菌感染情况进行分析,并采用单、多因素分析方法对MDRO菌感染影响因素进行分析。结果 7 820例进行手术治疗患者共发生MDRO菌感染250例,感染率为3.20%,其中金黄色葡萄球菌感染6例,鲍曼不动杆菌感染14例,铜绿假单胞菌感染29例,肺炎克雷伯菌感染34例,大肠埃希菌感染167例。多因素Logistic回归分析显示,糖尿病（OR=3.578）、肿瘤（OR=4.135）、贫血（OR=4.701）、入住ICU（OR=5.045）、脏器穿孔（OR=2.414）、切口分类为Ⅱ或Ⅲ类（OR=2.284、3.013）、手术有风险（OR=5.135）、抗菌药物应用≥2种（OR=2.340）、抗菌药物疗程≥5 d（OR=4.759）、再手术（OR=2.036）是成年手术患者发生MDRO菌感染的危险因素。结论 成年手术患者手术部位MDRO菌感染较为常见,相关危险因素较多,临床可根据以上因素加强围手术管理,减少MDRO菌感染的发生。     

老年重症肺炎病原菌及其影响因素

目的探讨老年重症肺炎病原菌及其影响因素。方法回顾性分析2016年11月-2019年12月海南省儋州市中医医院收治的老年肺部感染患者269例,分为重症肺炎组和非重症肺炎组,收集患者临床资料和临床症状,采集痰液标本进行病原菌检查、药敏试验。结果重症肺炎发生率27.14%(73/269)。血氧分压降低为最常见临床表现(76.71%)。痰液标本分离出104株病原菌,革兰阴性菌76株(73.08%),最常见为铜绿假单胞菌(26.92%)。铜绿假单胞菌对氨苄西林的耐药率96.43%,不动杆菌属对氨苄西林的耐药率100.00%。老年重症肺炎和老年非重症肺炎患者在年龄、多脏器功能受损、合并慢性阻塞性肺疾病(COPD)、出现意识障碍具有统计学差异(P<0.05)。年龄、多脏器功能受损、合并COPD、出现意识障碍、糖尿病,均成为老年肺部感染重症的独立危险因素(P<0.05)。结论老年重症肺炎患者临床症状表现不十分典型,革兰阴性菌是老年重症肺炎的主要致病菌而且耐药率高。年龄、多脏器功能受损,合并COPD、意识障碍、糖尿病,是老年肺部感染成为重症的独立危险因素,可针对这些患者采取针对性的措施进行防范和干预。     

300例慢性前列腺炎患者病原菌检测及复合药敏试验

目的分析慢性前列腺炎(chronicprostatitis,CP)致病菌及复合药敏试验规律,探索治疗方法.方法对300例无菌采集的前列腺液(EPS)标本同时接种需氧菌,厌氧菌、L型菌培养基鉴定并做药敏试验.结果表皮葡萄球菌(58.3%)、丙酸杆菌(29.3%)为CP致病的两大优势菌;二者在致病过程中具有协同作用;表皮葡萄菌随年龄增大而感染率降低,三组间有显著性差异(P＜0.05),L型菌是疾病复发、难以治愈的原因之一;治疗首选利福平、氟哌酸而青霉素、洁霉素几乎是无效的.结论多种形式的细菌检测和复合药敏试验是非常必要的,目前尚无他法替代.     

广西壮族人群血清HBsAg阳性与 ABO血型相关性研究

目的 探讨广西壮族人群血清HBsAg与ABO血型分布之关系。方法 采用卡方（x^2）检验方法与Woolf统计方法对578例HBsAg阳性携带者血清的ABO血型分布及男女性别的关系进行系统分析。结果 男性携带者血型呈O＞B＞A＞AB型分布,女性携带者呈O＞A＞B＞AB型分布。A、B、O和AB血型人相对危险率分别为1．1531、1．0458、0．9238和0．7365。结论：血清HBsAg阳性携带者与ABO血型间存在一定关系且与性别有关,尤以A型血女性感染乙肝病毒的危险性更大,具有重要流行病学意义。     

偶氮聚合物作为结肠靶向药物载体的研究进展

在人体消化道中,偶氮键仅能被结肠厌氧菌代谢的偶氮还原酶还原在耐断裂,偶氮聚合物可作为潜在的高定位性的结肠靶向药物缓释载体,根据合成方法和最终的释药方式,偶氮聚合物药物释放体系可分为水凝胶体系,胞衣体系和聚合物前药体系。     

Epidemiology and virulence gene expression of intracellular group A streptococci in tonsils of recurrently infected adults

Intracellularly persistent group A streptococci (GAS, Streptococcus pyogenes) have been associated with recurrent tonsillopharyngitis and antibiotic treatment failure. As a supplementation of the published in vitro data, conventional bacteriology and molecular epidemiology was performed on material from 29 adult patients of a German army hospital with anamnestic signs of recurrent tonsillopharyngitis. Pre-surgery tonsil swabs and the surgically removed tonsils were examined with respect to growth of aerobic bacteria in absence and presence of antibiotics with exclusively extracellular activity. Under such antibiotic selection, Staphylococcus aureus and GAS were cultured from specimens of 13 and 3 patients, respectively. In every material GAS-positive by culture methods, the intracellular location of the penicillin-susceptible GAS isolates was confirmed by immunohistologic examination of tonsillar sections using a GAS-specific IgG antibody. The three intracellular GAS isolates were typed by emm gene sequencing and could be associated to types M6 and M49 (two isolates). The bacteria were serially passaged on sheep blood agar, and semiquantitative mRNA analysis from virulence genes was performed using bacteria of the 4th and 25th passage after isolation. An M-type-specific pattern of virulence gene expression and different gene expression levels in relation to the passage number were observed.     

Differential effects of zidovudine and zidovudine triphosphate on mitochondrial permeability transition and oxidative phosphorylation

1. The effects of zidovudine (ZDV) and zidovudine triphosphate (ZDV-3P) on Ca²⁺-induced mitochondrial permeability transition (MPT), respiratory control ratio (RCR) and ATP synthesis have been investigated on isolated rat liver mitochondria.
2. ZDV slightly but significantly decreased RCR and ATP synthesis but was ineffective in inhibiting MPT. In contrast, ZDV-3P did not alter RCR and ATP synthesis but strongly inhibited MPT (IC₅₀=3.0±0.9 μM).
3. The effect of ZDV-3P on mitochondrial swelling required a preincubation time. When incubated 10 min with mitochondria, ZDV-3P (8 μM) totally inhibited the rate of swelling.
4. ADP, ATP and atractyloside, which are agents known to interact with the mitochondrial adenine nucleotide carrier (ANC), antagonized the effect of ZDV-3P on mitochondrial swelling. Indeed, the IC₅₀ value of ZDV-3P increased from 3.0 to 17.4, 93.6 and 66.5 μM, in the presence of 20 μM, ADP, ATP or atractyloside, respectively.
5. ZDV-3P did not displace [³H]-ATP from its mitochondrial binding site(s) whereas ADP and atractyloside did, suggesting that ZDV-3P and [³H]-ATP do not share the same binding sites.
6. ZDV-3P did not affect either mitochondrial respiration or ATP synthesis but inhibited Ca²⁺-dependent mitochondrial swelling. It was concluded that mitochondrial toxic effects observed during the chronic administration of ZDV cannot be related to its active metabolite (ZDV-3P).

     

条件致病菌与非淋菌性尿道炎的关系初探

目的：为了解非淋菌性尿道炎和条件致病菌感染的关系。方法：采用常规细菌培养,Ｋ－Ｂ药敏试验法,支原体培养及衣原体直接免疫荧光染色法检测患者尿道分泌物或前泌物或前列腺液标本。结果：２３８例非淋菌性尿道炎病人标本中,细菌培养阳性２１１例（８８．６％）,支原体培养阳性３７例（１５．６％）,其中与细菌共同阳性３０例,衣原体阳性２４例（１０．８％）,其中与细菌共同阳性１４例,与念珠菌共同阳性１例,念珠菌阳性７     

HBV无症状携带者与ABO血型关系的探讨

目的：探讨ＨＢＶ无症状携带者与ＡＢＯ血型间关系。方法：采用Ｗｏｏｌｆ统计方法与卡方（ｘ＾２）检验方法对１７４例ＨＢＶ无症状携带者的ＡＢＯ血型分布以及男女性别的关系进行系统分析。结果：男性携带者血型呈Ｂ〉Ｏ〉Ａ〉ＡＢ型分布,女性携带者呈Ｂ〉Ａ〉Ｏ〉ＡＢ型分布。Ａ、Ｂ、Ｏ和ＡＢ血型人相对危险率分别是０．４８７０、２．０４１４、０．９６６８和１．７９５０。结论：ＨＢＶ无症状携带者与ＡＢＯ血型间存在一定关