磁共振内耳水成像的临床应用价值

目的探讨磁共振(MRI)内耳水成像在内耳病变患者中的临床价值。方法对45例怀疑内耳病变患者,行磁共振内耳水成像扫描,并进行最大密度投影(MIP)、多平面重建(MPR)、容积重建(VR)后处理。结果 45例患者均能清晰显示内耳结构,其中内耳畸形8例,结构正常37例。结论内耳水成像能清晰、立体的显示内耳膜迷路及内听道精细解剖结构,并显示其发育状况及通畅程度,能够为内耳病变患者的诊断和术前评估提供重要的影像学依据。     

下呼吸道感染主要革兰阴性菌分布与耐药性分析

目的探讨医院下呼吸道感染主要革兰阴性菌的分布及其耐药性,为下呼吸道感染患者的治疗提供用药借鉴。方法选取2011年1月-2013年12月住院治疗的下呼吸道感染患者82例,采集所有患者合格痰标本,采用VITEK-2Compact全自动微生物分析系统对病原菌进行鉴定及药敏试验,使用WHONET5.4软件进行统计分析。结果 82例呼吸道感染患者痰液标本中共分离出革兰阴性菌105株,前4位依次为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、鲍氏不动杆菌,分别占20.00%、19.05%、17.14%、17.14%;肺炎克雷伯菌与大肠埃希菌对头孢唑林、头孢他啶、氨曲南、呋喃妥因的耐药率均<30.00%;对亚胺培南耐药率均<6.00%;肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌对氨苄西林、头孢替坦耐药率较高,均>80.00%。结论医院患者下呼吸道感染的主要革兰阴性菌以肺炎克雷伯菌、铜绿假单胞菌等为主,药敏差异较大,临床应根据药敏结果针对性选择用药,减少耐药菌株出现。     

患儿呼吸道感染肺炎支原体分布及药敏分析

目的了解患儿呼吸道感染肺炎支原体(Mp)培养阳性率及药敏特点,为临床诊断及治疗提供依据。方法对2013年2月-2013年7月1 023例呼吸道感染患儿送检标本进行Mp培养及药敏试验,数据采用SPSS13.0统计软件进行处理。结果 1 023例呼吸道感染患儿送检标本Mp培养阳性354例,阳性率为34.6%;其中急性支气管炎Mp培养阳性率最高,达65.0%,其次是上呼吸道感染和毛细支气管炎,阳性率分别为50.0%和45.9%,其他呼吸道疾病Mp培养阳性率为20.0%~40.0%,上呼吸道感染和肺炎患儿Mp阳性率比较,差异有统计学意义(P<0.01);Mp对多西环素敏感率最高为99.2%,对大环内酯类药物的敏感性相对较低,对罗红霉素、红霉素的敏感率分别为68.6%、66.1%。结论对发病初期患儿及早做Mp培养及药敏,做到早发现、早诊断、早治疗,避免并发症的发生,并根据药敏试验结果选择合理的抗菌药物。     

莫西沙星联合头孢氨苄治疗老年患者下呼吸道细菌感染的临床疗效

目的探讨莫西沙星联合头孢氨苄治疗老年患者下呼吸道细菌感染的临床疗效及安全性,为临床治疗提供依据。方法收集2013年3月-2014年3月接受治疗的老年下呼吸道细菌感染患者100例,按照随机数字表格法分为观察组与对照组,每组各50例,其中观察组给予莫西沙星联合头孢氨苄治疗,对照组给予头孢氨苄治疗,比较两组患者的临床疗效及不良反应的发生,数据采用SPSS17.0统计软件进行处理。结果下呼吸道感染老年患者共检出病原菌103株,其中革兰阴性菌64株、革兰阳性菌20株、真菌19株,分别占62.1%、19.4%、18.5%;观察组患者治疗总有效率为92.0%,明显高于对照组的72.0%,两组比较差异有统计学意义(P<0.05);两组患者在体温恢复、咳嗽消失、肺部啰音消失、白细胞计数恢复等临床症状、体征消失时间比较,差异有统计学意义(P<0.05);不良反应发生观察组有4例、对照组有5例,两组不良反应发生比较,差异无统计学意义。结论莫西沙星联合头孢氨苄治疗老年患者呼吸道感染的效果明显,不良反应小,可将其作为治疗老年呼吸道感染重要方法。     

泌尿生殖道感染患者性传播疾病病原体分布及耐药性分析

目的分析医院泌尿生殖道感染患者沙眼衣原体(Ct)、淋菌(NG)、解脲脲支原体(Uu)性传播疾病病原体分布特点,为临床用药提供参考。方法采集2013年1月-2014年5月647例泌尿生殖道感染患者的尿道或宫颈分泌物,采用多重荧光定量PCR(FQ-PCR)技术检测Ct、NG、Uu基因,分析3种病原体分布并进行药敏试验。结果 647份标本中有311份检出病原体,阳性率为48.07%;单一感染204例占65.59%、混合感染107例占34.61%,女性总阳性率为52.57%,高于男性的42.76%,差异有统计学意义(P<0.05);20~40岁患者总阳性率高于其他年龄段患者总阳性率,差异有统计学意义(P<0.05);Ct对氯霉素、多西环素敏感率分别为97.22%、95.83%;NG对阿奇霉素、左氧氟沙星的敏感率均为96.30%;Uu对交沙霉素、米诺环素的敏感率分别为96.55%、95.40%。结论医院泌尿生殖道感染患者Ct、NG、Uu感染率较高,临床应结合3种病原体感染差异及药敏试验,制定治疗方案。     

Lipidome is lipids regulator in gastrointestinal tract and it is a life collar in COVID-19: A review

The term lipidome is mentioned to the total amount of the lipids inside the biological cells. The lipid enters the human gastrointestinal tract through external source and internal source. The absorption pathway of lipids in the gastrointestinal tract has many ways; the 1^st way, the lipid molecules are digested in the lumen before go through the enterocytes, digested products are re-esterified into complex lipid molecules. The 2^nd way, the intracellular lipids are accumulated into lipoproteins (chylomicrons) which transport lipids throughout the whole body. The lipids are re-synthesis again inside the human body where the gastrointestinal lipids are: (1) Transferred into the endoplasmic reticulum; (2) Collected as lipoproteins such as chylomicrons; or (3) Stored as lipid droplets in the cytosol. The lipids play an important role in many stages of the viral replication cycle. The specific lipid change occurs during viral infection in advanced viral replication cycle. There are 47 lipids within 11 lipid classes were significantly disturbed after viral infection. The virus connects with blood-borne lipoproteins and apolipoprotein E to change viral infectivity. The viral interest is cholesterol- and lipid raft-dependent molecules. In conclusion, lipidome is important in gastrointestinal fat absorption and coronavirus disease 2019 (COVID-19) infection so lipidome is basic in gut metabolism and in COVID-19 infection success.     

Cathepsin L,transmembrane peptidase/serine subfamily member 2/4, and other host proteases in COVID-19 pathogenesis – with impact on gastrointestinal tract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) seems to employ two routes of entrance to the host cell; via membrane fusion (with the cells expressing both angiotensin converting enzyme 2 (ACE2) and transmembrane peptidase/serine subfamily member 2/4 (TMPRSS2/4)) or via receptor-mediated endocytosis (to the target cells expressing only ACE2). The second mode is associated with cysteine cathepsins (probably cathepsin L) involvement in the virus spike protein (S protein) proteolytic activation. Also furin might activate the virus S protein enabling it to enter cells. Gastrointestinal tract (GIT) involvement in SARS-CoV-2 infection is evident in a subset of coronavirus disease 2019 (COVID-19) patients exhibiting GIT symptoms, such as diarrhea, and presenting viral-shedding in feces. Considering the abundance and co-localization of ACE2 and TMPRSS2 in the lower GIT (especially brush-border enterocytes), these two receptors seem to be mainly involved in SARS-CoV-2 invasion of the digestive tract. Additionally, in vitro studies have demonstrated the virions capability of infection and replication in the human epithelial cells lining GIT. However, also furin and cysteine cathepsins (cathepsin L) might participate in the activation of SARS-CoV-2 spike protein contributing to the virus invasiveness within GIT. Moreover, cathepsin L (due to its involvement in extracellular matrix components degradation and remodeling, the processes enhanced during SARS-CoV-2-induced inflammation) might be responsible for the dysregulation of absorption/ digestion functions of GIT, thus adding to the observed in some COVID-19 patients symptoms such as diarrhea.