老年护理医院院内获得性肺炎185例分析

目的作者调查上海市卢湾区老年护理医院院内获得性肺炎(HAP)的发病情况和探讨其防治措施。方法回顾性调查了2008年1月至2011年12月的4年期间在卢湾区老年护理医院发病的185例HAP患者的临床资料,分析患者的中、重度基础疾病,发生HAP的危险因素和致病菌情况等。结果①HAP发生率为8.5%(185/2164例),死亡率为31.89%(59/185例)。②HAP的主要危险因素为年龄>70岁、中风后遗症、营养不良、晚期肿瘤、慢性阻塞性肺病(COPD)等。③主要致病菌为肠杆菌族,铜绿假单胞菌,草绿色链球菌+奈瑟菌及金黄色葡萄球菌等。结论老年护理医院院的HAP易发生于年龄>70岁,有中、重度基础疾病的患者,死亡率高,其主要致病菌为革兰阴性(G-)杆菌。治疗原则是提高机体免疫力,积极治疗基础病和有效抗炎。     

An in vitro study on antiproliferative and antiestrogenic effects of Boerhaavia diffusa L. extracts

Ethnopharmacological relevance

Boerhaavia diffusa L. (Nyctinaceae) is a plant of tropical region used in Indian traditional medicine for the treatment of human ailments including abdominal tumor, jaundice, dyspepsia, menstrual disorders, etc. This plant also has antilymphoproliferative, antimetastatic and immunomodulatory effects.

Aim of the study

This study aimed to assess the antiproliferative and antiestrogenic properties of methanol extract of Boerhaavia diffusa (BME) in MCF-7 breast cancer cell lines.

Materials and methods

The effective concentration range of BME on cell viability was analyzed using MTT assay. Hydroxylapatite assay (HAP) was carried out to confirm the competitive binding of BME to the estrogen receptor (ER). The effect of BME on the expression of a selected estrogen responsive gene pS2 was analyzed by RT-PCR. The ability of BME to alter the cell cycle phases and distributions were studied using FACS analysis.

Results

Treatment with varying concentrations of BME (20–320 μg/mL) resulted in moderate to very strong growth inhibition in MCF-7 cell lines. BME competed with [³H]-estradiol for binding to ER with IC₅₀ value of 320 ± 25 μg/mL. RT-PCR analysis revealed that BME reduced the mRNA expression of pS2 indicating the antiestrogenic action of BME. BME treatment for 48 h resulted in a remarkable increase in the number of MCF-7 cells in the G0-G1 fraction from 69.1% to 75.8%, with a reciprocal decrease of cells in all other phases indicating cell cycle arrest at G0-G1 phase.

Conclusions

The results demonstrate that Boerhaavia diffusa possess antiproliferative and antiestrogenic properties and suggest that it may have therapeutic potential in estrogen dependent breast cancers.     

急性脑梗死合并医院内获得性肺炎后血栓调节蛋白变化及其与血浆TNF-α的相关性

目的:观察脑梗死合并医院内获得性肺炎患者血栓调节蛋白含量的变化及其与血浆肿瘤坏死因子的相关性,探讨脑梗死合并医院内获得性肺炎对脑梗死后内皮细胞损伤和凝血机制的影响。方法:初发脑梗塞患者分为单纯脑梗塞组(24例)和脑梗塞合并医院内获得性肺炎组(16例)。健康对照13例。脑梗死发病后第1、3、5、7、14、21天分别采血。血栓调节蛋白(TM)检测采用ELISA法。TNF-α检测采用放免法。结果:1血栓调节蛋白(TM):脑梗死合并医院内获得性肺炎后第1周、14天TM与单纯梗死组相比下降(P<0.05);21天与单纯梗死组无统计学差异但高于健康对照组。2肿瘤坏死因子(TNF-α):单纯脑梗死组与脑梗死合并医院内获得性肺炎组第1天无统计学差异,两组均高于健康对照组。脑梗塞合并医院内获得性肺炎发生第1周和14天TNF-α明显增高,高于单纯脑梗死组(P<0.05);21天虽然HAP已控制TNF-α仍高于单纯梗死组(P<0.05)。3脑梗死合并HAP组TM与TNF-α有相关性。随着TNF-α增高,血栓调节蛋白有下降趋势,两者相关关系以Gompertz曲线拟合满意,在高浓度TNF-α时TM降低较快,而低浓度TNF-α时TM降低较慢。结论:脑梗塞合并医院内获得性肺炎后血浆TNF-α增高,可能导致脑血管内皮细胞的损伤和抗凝机制的抑制,表现为血栓调节蛋白的下调。这可能是获得?     

神经内科老年患者医院获得性肺炎危险因素分析

目的探讨神经内科老年患者获得性肺炎的临床特点及相关危险因素和防止措施。方法对本院2004年1月～2009年12月381例神经内科老年患者获得性肺炎的患者进行回顾性分析。结果脑血管病、痴呆、帕金森病在神经科老年患者发生医院获得性肺炎的比例高,临床特点不典型。381例患者并发HAP 78例,感染率20.5%;感染组死亡37例,死亡率47.43%,非感染组死亡64例,占非感染组21.10%;痰培养分离出的致病菌以革兰阴性杆菌为主,前5种主要病原菌分别是铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌、金黄色葡萄球菌,且对多种抗菌素存在耐药。结论神经内科老年患者获得性肺炎的临床表现不典型,感染率和死亡率高,要控制感染危险因素,监测病原菌,重视药物的选择和治疗策略。     

Terapias intervencionistas en hipertensión pulmonar

Despite advances in drug therapy, pulmonary hypertension—particularly arterial hypertension (PAH)—remains a fatal disease. Untreatable right heart failure (RHF) from PAH eventually ensues and remains a significant cause of death in these patients. Lowering pulmonary input impedance with different PAH-specific drugs is the obvious therapeutic target in RHF due to chronically increased afterload. However, potential clinical gain can also be expected from attempts to unload the right heart and increase systemic output. Atrial septostomy, Potts anastomosis, and pulmonary artery denervation are interventional procedures serving this purpose. Percutaneous balloon pulmonary angioplasty, another interventional therapy, has re-emerged in the last few years as a clear alternative for the management of patients with distal, inoperable, chronic thromboembolic pulmonary hypertension. The current review discusses the physiological background, experimental evidence, and potential clinical and hemodynamic benefits of all these interventional therapies regarding their use in the setting of RHF due to severe pulmonary hypertension.     

Evaluation of Plasmodium vivax HAP2 as a transmission-blocking vaccine candidate

Transmission-blocking vaccine (TBV) is a promising strategy to interfere with the transmission of malaria. To date, only limited TBV candidate antigens have been identified for Plasmodium vivax. HAP2 is a gamete membrane fusion protein, with homology to the class II viral fusion proteins. Herein we reported the characterization of the PvHAP2 for its potential as a TBV candidate for P. vivax. The HAP2/GCS1 domain of PvHAP2 was expressed in the baculovirus expression system and the recombinant protein was used to raise antibodies in rabbits. Indirect immunofluorescence assays showed that anti-PvHAP2 antibodies reacted only with the male gametocytes on blood smears. Direct membrane feeding assays were conducted using four field P. vivax isolates in Anopheles dirus. At a mean infection intensity of 72.4, 70.7, 51.3, and 15.6 oocysts/midgut with the control antibodies, anti-PvHAP2 antibodies significantly reduced the midgut oocyst intensity by 40.3, 44.4, 61.9, and 89.7%. Whereas the anti-PvHAP2 antibodies were not effective in reducing the infection prevalence at higher parasite exposure (51.3–72.4 oocysts/midgut in the control group), the anti-PvHAP2 antibodies reduced infection prevalence by 50% at a low challenge (15.6 oocysts/midgut). Multiple sequence alignment showed 100% identity among these Thai P. vivax isolates, suggesting that polymorphism may not be an impediment for the utilization of PvHAP2 as a TBV antigen. In conclusion, our results suggest that PvHAP2 could serve as a TBV candidate for P. vivax, and further optimization and evaluation are warranted.     

Plasmodium berghei HAP2 induces strong malaria transmission-blocking immunity in vivo and in vitro

Fertilization in Plasmodium is a complex process that occurs in the gut of the female Anopheles mosquito upon uptake of a bloodmeal. It requires the emergence of the gametocyte from the RBC and release of eight flagellate male gametes from each male cell, and subsequent fertilization of a similarly emerged immotile extracellular female macrogamete. Previous studies have demonstrated that antibodies against male gamete surface proteins ingested from the blood of an infected and immunized host inhibit parasite transmission. Gene disruption studies in Plasmodium berghei and complimentary studies on the green alga Chlamydomonas have shown that a conserved male gamete sterility gene, HAP2, is essential for fusion of male and female gametes. Genetic disruption of the HAP2 locus revealed that parasite fertilization is prevented, yet hap2 KO male gametes still retained the ability to form tight pre-fusion membrane attachments with females.We demonstrate that heterologous expression of the P. berghei HAP2 protein in Escherichia coli, and subsequent immunization of rabbits, has produced anti-sera that react specifically with recombinant HAP2, and with the native protein on the male gamete. Additionally, anti-HAP2 sera reduces in vitro formation of ookinetes by up to 81%, and, using standard membrane feeding assays, reduces oocyst burden within the mosquito host by up to 81.1%, and prevalence of in vivo infection by up to 34%. Inhibition is dose dependent. These results indicate that HAP2 should be considered as a potential target for any future anti-malarial transmission-blocking vaccine.     

Novel Bisphosphonated Methacrylates: Synthesis,Polymerizations, and Interactions with Hydroxyapatite

Five novel methacrylates containing either bisphosphonate ( 1 and 2 ), bisphosphonic acid (3), carboxylic acid (4) , or both bisphosphonic and carboxylic acid together (5) , are synthesized. The monomers 1 and 2 are synthesized by the reactions of tetraethyl 1‐hydroxyethane‐1,1‐diyl­diphosphonate with ethyl α‐bromomethacrylate and tert‐butyl α‐bromomethacrylate; the same procedure fails with tetraethyl hydroxy(phenyl)methylenediphosphonate. 1 is converted to 3 by hydrolysis with trimethylsilyl bromide (TMSBr), and 2 is converted to 4 by hydrolysis with trifluoroacetic acid (TFA). Monomer 5 is obtained by hydrolysis of 2 first with TMSBr and then with TFA. The hydrolytic stability, the properties of the copolymerizations with commercial dental monomers, and HAP interactions make these monomers promising candidates for dental adhesives.

     

电化学共沉积制备有机高聚物/钙磷复合陶瓷膜层-Ⅰ XRD、SEM表征及生物活性研究

首次提出在NH4H2PO4－Ca(NO3)2溶液中添加溶性乙烯类有机高聚物，实现了通过电化学共沉积法制备具有生物活性的有机高聚物／钙磷陶瓷复合膜层。用XRD、SEM等对膜层的组分和形貌进行表征，证明陶瓷膜层表面形貌发生明显的变化。有机高聚物的引入，并不影响电沉积制备的羟基磷灰石（HAP）晶体在（002）晶面生长存在的晶面择优取向，体外细胞实验表明，HAP／有机高聚物复合膜层具有优良的生物活性。