Changes in bladder function following a surgical alteration in outflow resistance

The changes in bladder function occurring after a surgical alteration in bladder outflow resistance were studied in 20 males undergoing transurethral prostatectomy (TURP) and in 20 females undergoing an endoscopic bladder neck suspension (EBNS). Serial cystometrograms (CMG) were performed before operation, and on alternate days after spontaneous micturition was re-established, for 5 days in the males and for 21 days in the females. CMGs were repeated at 3 months and 1 year after operation. After TURP voiding pressures (P_det) fell rapidly from a mean of 118 cm H₂O before operation to 57 cm H₂O at 5 days, with an increase in flow rate during this time from 10.5 ml/s to 24 ml/s. Detrusor instability that had been present in 14 patients resolved within 2 days in 12. There was no further significant urodynamic change over the 1-year study period. After EBNS, there was an early rise in voiding pressure (P_det rose from 26 cm H₂O before operation to 42 cm H₂O at 3 days). This continued to increase up to 21 days particularly in those patients with initial large residuals. Three patients developed detrusor instability. Flow rates were greatly reduced at first (27 ml/s before operation and 13 ml/s at 3 days), and gradually increased in line with voiding pressures, yet were still diminished 1 year after operation. The urodynamic changes following a reduction in bladder outflow resistance by TURP are immediate and sustained and unlikely to be the result of structural changes within the bladder wall. EBNS produces an increase in outflow resistance and it can be several weeks before balanced voiding is achieved, with significantly increased detrusor pressures needed to achieve complete bladder emptying at a reduced flow rate.     

Methicillin-resistant Staphylococcus aureus: investigation of a hospital outbreak using a case-control study

A retrospective case-control study of 50 MRSA-positive patients was carried out during an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) at an acute general hospital in London. Controls were randomly selected from MRSA-negative patients admitted during the outbreak period. Risk factors investigated included length of admission prior to screening, number of ward changes, main diagnosis, extent of staff contact, pressure sores, surgical and other invasive procedures and antibiotic treatment. Outcome variables examined were rates of infection (versus colonization) with MRSA and mortality. Patients with MRSA were in hospital longer before microbiological specimens were taken and moved wards more often than controls. In a logistic regression analysis, length of stay in hospital, pressure sores, physiotherapy and surgical procedures were associated with a significantly increased risk of acquiring MRSA. Odds ratios (and 95% confidence intervals) for having acquired MRSA were: 8·3 (1·02−71·43) if a patient had pressure sores; 3·7 (1·10−12·5) if they received physiotherapy; and 3·2 (1·82−10·0) if they underwent surgical procedures. The rate of clinical infection amongst patients with this strain of MRSA was 26% and included life-threatening infections such as septicaemia, underlining the potential virulence of MRSA. Surgery and physiotherapy may have been markers of debility. Physiotherapy was probably a marker of increased rates of contact with all hospital staff, and high standards of hand hygiene should be promoted amongst all staff as the most important factor in controlling an outbreak of MRSA. Good bed management is essential for hospital infection control.     

Hereditary Hypertriglyceridemic Rat: A New Animal Model of Metabolic Alterations in Hypertension

Hereditary hypertriglyceridemic rats (hHTg) were developed as a new genetic model for the study of relationships between blood pressure (BP) and metabolic abnormalities. This strain has been produced by selective inbreeding from Wistar rats according to the rise of plasma triglycerides induced by a high-sucrose diet. Though hHTg rats display hypertriglyceridemia, impaired glucose tolerrance, hyperinsulinemia, insulin resistance and increased BP even without nutritional stimuli, high sucrose feeding further aggravates these symptoms. High plasma triglycerides levels in hHTg rats seem to be a consequence of their hyperproduction. Impaired insulin action is responsible for the defective glucoregulation in this strain. The loss of insulin responsiveness might be due to a reduction in the number of glucose transporters. Highly significant relationships among plasma triglycerides, ouabain-resistant Na⁺ transport and BP were demonstrated in the hHTg rats. Segregating populations (F2 hybrids) should be used for genetic analysis of the primary role of lipid and/or ion transport abnormalities in the pathogenesis of this form of genetic hypertension.     

Posture-induced nasal obstruction in patients with allergic rhinitis

Nasal resistance is affected by posture. In this study, the effects of supine and lateral recumbent positions were investigated in eight normal subjects and 31 patients with allergic rhinitis. Of the 31 patients with allergic rhinitis, five showed unilateral complete nasal obstruction and one patient showed bilateral complete obstruction during the change of posture. Total nasal resistance had a tendency to increase with repeating the change of posture (a paired t-test, P < 0.05). The supine and lateral recumbent positions did not induce variable changes in total nasal resistance in normal subjects. Posture induces complete nasal obstruction in the supine or lateral recumbent positions in some patients with allergic rhinitis.     

HIV/AIDS合并深部真菌感染的调查与耐药研究

目的：了解艾滋病病毒／艾滋病(HIV／AIDS)合并深部真菌感染的临床状况、病原菌分类及耐药现状。方法：总结近年来收治的131例HIV/AIDS患者的临床资料，分析深部真菌感染的发生情况及药敏试验结果。结果：HIV／AIDS患者合并深部真菌感染48例，感染率为36．6％，其中以念珠菌为主，占61％，感染部位以消化道为主，占62．7％。随着CD4^ T淋巴细胞的减少，合并深部真菌感染的感染率逐渐增加。念珠菌对益康唑(ECO)、酮康唑(KET)、咪康唑(MIC)、制霉菌素(NYS)、氟康唑(FLU)、伊曲康唑(ITR)、5-氟胞嘧啶(5-FC)、两性霉素B(AMB)耐药率分别为69．4％、66．7％、58．3％、44．4％、43．8％、36．4％、14．3％、13．9％。结论：HIV／AIDS患者合并深部真菌感染率高，且多有药耐药性，特别是对咪唑类抗真菌药物已呈明显耐药，应引起临床医生的高度警惕。     

乌鲁木齐市家蝇抗药性现状及发展趋势分析

目的 分析乌鲁木齐市家蝇对化学杀虫剂的抗药性现状及发展趋势，探讨防制对策。方法 常规微量点滴法。结果 对溴氰菊酯的抗性系数在24．00-253．67；对敌敌畏的抗性系数在11.44-53.24;对二氯苯醚菊酯抗性系数在9.29-36.10，对氯氰菊酯的抗性系数在2.32-9.62。结论：8年来家蝇对4种杀虫剂的抗药性在不断上升，仍保持较高水平，但迅速上升的趋势开始减缓。     

Correlation between Cyclin A Gene Expression in Adult Patients with Acute Leukemia and Drug Resistance

Adultacuteleukemia (AL)isoneofthemostcommonmalignanttumorsofhematology .Withtherecentprogressinchemotherapyandsupportivether apy ,theremissionandsurvivalrateinALhavebeenmarkedlyimproved .However ,drugresistanceandrelapsearestillimportantfactorsaffectinglongsur vivalofthese patients .Theabnormalregulationofcellcycleisanotherfactorthatcannotbeignoredex ceptformultipledrugresistance (MDR) .WedetectcyclinA ,multidrugresistantgene (mdrl) ,topoiso meraseⅡα(TopⅡα)andbcl 2inadultpatientswithA…     

致倦库蚊有机磷抗性相关扩增酯酶B基因的多样性

本实验从佛山和成都两地的致倦库蚊群体中筛选出３个酯酶类型不同的有机磷（ＯＰ）抗性品系，ＦＳ－１、ＦＳ－２和ＣＤ－１品系。各品系的酯酶基因Ｂ扩增水平、酯酶活性和ＯＰ抗性水平三者一致。各品系酯酶Ｂ基因限制性酶切片段比较分析表明，我国的ＯＰ抗生库蚊群体中不仅有世界性分布的酯酶Ｂ１和Ｂ２，而且在佛山和成都地区各有一个新的独立扩增的酯酶Ｂ，分别命名为Ｂ６和Ｂ７。     

Growth hormone resistance in uremia

Growth retardation is a major complication in children with uremia. Protein restriction, calorie deficit, metabolic acidosis, renal osteodystrophy, and endocrinologic disturbances contribute to the growth failure. The effect of these factors on growth retardation can be attenuated in part by therapy with vitamin D metabolites, adequate nutrition, alkalization, and dialysis. Linear growth in children with uremia is markedly retarded despite normal or increased levels of circulating serum growth hormone. An increased growth hormone level in children with uremia is due to normal growth hormone secretion from the pituitary gland and impaired growth hormone clearance in the kidney. However, the elevated growth hormone level does not lead to a commensurate rise in serum insulin-like growth factor I (IGF-I); the serum IGF-I level is decreased or normal in relation to the degree of renal failure. This discrepancy suggests growth hormone resistance in the liver in uremia. Recent molecular techniques open a new era in studying the gene expression for growth hormone or IGF-I. There is no doubt today that growth hormone treatment has the beneficial effect of growth promotion in children with uremia, which also suggests endogenous growth hormone resistance in target organs or target cells in uremia.     

Effects of Repeated Deep Inspirations on Recovery from Methacholine-Induced Airway Narrowing in Normal Subjects

Background. A single deep inspiration (DI) is known to be a potent bronchodilator but it is not known if repeated DI can accelerate sustained recovery from bronchoconstriction. Methods. We induced sustained bronchoconstriction using increasing concentrations of nebulized methacholine (Mch) during tidal breathing and assessed airway narrowing by measuring respiratory resistance (Rrs) using forced oscillation in six healthy subjects. On separate days we examined the effects of DI every 3 minutes and of prohibition of DI on recovery of Rrs for 30 minutes after the end of Mch nebulization. Results. Bronchoconstriction (Rrs ∼ 150% above baseline) was induced. DI during recovery had a transient bronchodilator effect but no cumulative effect. At 30 minutes after end of nebulization (and 2 minutes after the last DI) Rrs was 87% above baseline compared to 93% above baseline when DI was prohibited. Conclusion. Recovery from induced bronchoconstriction with methacholine was slow (∼ 2%/min) and not accelerated by frequent DI.