Update in the treatment of non-influenza respiratory virus infection in solid organ transplant recipients

Introduction: Despite the improved outcomes in solid organ transplantation with regard to prevention of rejection and increased patient and graft survival, infection remains a common cause of morbidity and mortality. Respiratory viruses are a frequent and potentially serious cause of infection after solid organ transplantation. Furthermore, clinical manifestations of respiratory virus infection (RVI) may be more severe and unusual in solid organ transplant recipients (SOTRs) compared with the non-immunocompromised population.

Areas covered: This article reviews the non-influenza RVIs that are commonly encountered in SOTRs. Epidemiologic and clinical characteristics are highlighted and available treatment options are discussed.

Expert opinion: New diagnostic tools, particularly rapid molecular assays, have expanded the ability to identify specific RVI pathogens in SOTRs. This is not only useful from a treatment standpoint but also to guide infection control practices. More data are needed on RVIs in the solid organ transplant population, particularly regarding their effect on rejection and graft dysfunction. There is also a need for new antiviral agents active against these infections as well as markers that can identify which patients would most benefit from treatment.     

足月胎膜早破孕妇的分娩方案与母婴结局研究

目的 探究足月胎膜早破孕妇的分娩方案与母婴结局.方法 选取2014年6月至2016年6月于南京市浦口区中心医院妇产科住院分娩的孕妇1254例,将其中157例足月胎膜早破孕妇设为观察组,另1097例无胎膜早破孕妇设为对照组,观察分析两组孕妇分娩方案(剖宫产、阴道自娩、阴道助产)与母婴结局(产后出血、胎盘早剥、绒毛膜羊膜炎、伤口愈合不良、产褥病率、胎儿早产、胎儿窘迫、胎粪吸入性肺炎、1 min及5 min的Apgar评分)情况.结果 观察组孕妇的剖宫产率为43.9%,明显低于对照组的57.0%,阴道自产率和阴道助产率分别为52.9%和3.2%,均明显高于对照组的42.8%和0.2%,差异均具有统计学意义(P<0.05);观察组孕妇产后出血、胎盘早剥、绒毛膜羊膜炎、伤口愈合不良的发生率分别为6.4%、9.6%、8.9%、3.8%,均明显高于对照组的3.4%、3.3%、3.5%、2.5%,差异均具有统计学意义(P<0.05);观察组孕妇胎儿早产、胎儿窘迫、胎粪吸入性肺炎发生率分别为8.3%、4.5%、4.5%,均明显高于对照组的3.3%、1.9%、2.1%,差异均具有统计学意义(P<0.05);两组孕妇产褥病率、新生儿1 min及5 min的Apgar评分比较差异均无统计学意义(P>0.05).结论 足月胎膜早破孕妇的产道自产与产道助产的几率明显提高,其不良的母婴结局主要体现在产后出血、产妇并发症以及新生儿的并发症方面.     

Effects of Putative Neurotransmitters of the Carotid Body on its Own Glomus Cells

Carotid body glomus cells produce and release acetylcholine (ACh), catecholamines, and neuropeptides, and there is biochemical evidence that these cells possess receptors for these substances. Thus, we studied the effects of cholinergics [ACh, nicotine (Nic), bethanechol (BN)] and peptides [met-enkephalin (ME), substance P (SP)] on the membrane potential (Em), voltage noise (Erms), and input resistance (Ro) of glomus cells. Sliced carotid bodies (for cell visualization) of cats, rabbits, and mice were used. The mean Em and Ro of rabbit glomus cells were lower than those of cat and mouse. Ro of mouse cells was the largest, whereas Erms was similar in all species. The various agents had qualitatively similar effects on the cells of the three species although some quantitative differences were sometimes observed. But, for simplicity, results were pooled. ACh depolarized most cells (effect depressed by zero [Ca2+]o and Mn2+), reduced their resistance, and induced variable changes in Erms. Different ACh doses produced non-linear effects on DeltaEm. Nic and BN also depolarized most cells, reducing Ro and Erms. Atropine depressed the cell responses to BN; alpha-bungarotoxin the depolarizing response to Nic. ME and SP depolarized most cells, but only ME significantly reduced Ro. Neither peptide significantly changed voltage noise. Comparing the effects of all drugs showed that BN was the most effective depolarizing agent, producing the largest reductions in Ro. There were negative correlations between DeltaEm and DeltaRo with the cholinergics and SP; correlations between DeltaErms and DeltaRo were significant and positive only with the cholinergics. These results confirm the presence of nicotinic, muscarinic, and peptidergic receptors in glomus cells. The similar effects of cholinergics and peptides and those of flow interruption and anoxia suggest that the latter may partly act via autoreceptors for the released transmitters.     

呼吸道合胞病毒G基因的扩增

用未纯化的呼吸道合胞病毒细胞混和物，采用改良胍－热酚法提取病毒ｍＲＮＡ，反转录合成ｃＤＮＡ，经ＰＣＲ扩增得到大小约９２０ｂｐ的产物。经ＰｓｔＩ酶切表明其中含有ＰｓｔＩ酶切应点，证实其产物确为ＲＳＶＧ基因。此法简便、特异、第三、快速、。由于ＲＳＶ极不稳定，ＲＮＡ甚易降解，此法值得推广应用。     

Renal adaptation to dietary amino acid alteration is expressed in immature renal brush border membranes

The transport of ions and solutes at the epithelial surface of the renal proximal tubule increases during periods of reduced dietary intake and decreases with dietary excess. We have used the sulfur-containing -amino acid, taurine, as a probe of this renal adaptive response to altered dietary sulfur amino acid intake to better understand the mechanisms of renal amino acid reabsorption. There exists an age-related precession of taurine uptake values by brush border membrane vesicles prepared from nursing rats from youngest to oldest. However, despite the immaturity of this transport mechanism, epithelial membranes become able to display a full renal adaptive response to altered sulfur amino acid intake sometime between the 7th and 14th day of life. This adaptive response is expressed in both up regulation and down regulation by means of a change in the initial rate of Na⁺-taurine cotransport. No changes in the lipid microenvironment of the membrane, as assessed by measurements of membrane fluidity, are evident. The lack of adaptation observed in 7-day-old pups may be due to immaturity of the Na⁺ transporting mechanism which energizes the uptake of amino acids.Supported in part by NIH grants AM 31682 and 37232     

Stereospecific3H-QNB binding to human erythrocyte membranes associated with muscarinic cholinergic receptors

Summary Specific binding of the muscarinic antagonist³H-QNB can be demonstrated on human erythrocyte membranes. Specific³H-QNB binding is stereospecific and can be inhibited by a variety of cholinergic agonists and antagonist with affinities similar to their affinities for muscarinic cholinergic receptor binding in other tissues. Accordingly, the data indicate the presence of muscarinic cholinergic receptors on human erythrocyte membranes. Their density is very low, varies between healthy persons, but seems to be an individual characteristic. The data reported are consistent with the assumption that the muscarinic cholinergic receptors on human erythrocyte membranes are mainly of the M₁ receptor subtype.Abbreviations used QNB quinuclidinyl benzilate - GppNHp guanyl-5-yl imidodiphosphate - N-QNB N-methyl-quinuclidinyl benzilate iodide Dedicated to Professor Dr. Dr. H. Häfner, Director of the Central Institut of Mental Health Mannheim, on occasion of his 60th birthday.     

Preliminary findings on calmodulin-stimulated Ca2+-ATPase of erythrocyte ghosts in psychotic patients

Summary Kinetic properties of the calmodulin-stimulated erythrocyte ghost Ca²⁺-ATPase seem to be altered in some sub-groups of affective and schizophrenic psychoses. The subgroup of affective disorders concerned mostly unipolar manic and bipolar psychoses with predominantly manic episodes. In the corresponding cases from schizophrenics hyper- and parakinetic basic syndromes were predominantly diagnosed. An evaluation of our preliminary results was undertaken in connection with our biochemical hypothesis on possible alterations in the regulation of Ca²⁺ concentrations and Ca²⁺-calmodulin-mediated processes under certain psychotic conditions.Our investigations were supported by the Ministerium für Hochund Fachschulwesen of the GDRParts of this paper were presented at the 5. Dresdner Symposion über Epilepsie und Antiepileptika, Dresden, November 1984. The authors wish to express their thanks to Prof. Emrich (Munich, FRG) for his assent and helpful discussions     

Characterization of Epidermal Growth Factor Receptors on Plasma Membranes Isolated from Rat Gastric Mucosa

The binding of human epidermal growth factor (hEGF), -urogastrone, to plasma membranes isolated from rat gastric mucosa was studied to characterize gastric EGF receptors. The binding of [¹²⁵I]hEGF was temperature dependent, reversible, and saturable. A single class of binding sites for EGF with a dissociation constant of 0.42 nM and maximal binding capacity of 42 fmol/mg protein was suggested. There was little change in the binding of [¹²⁵I]hEGF upon addition of peptide hormones (secretin, insulin), antiulcer drugs (cimetidine), or an ulcer-inducing reagent (aspirin). Cross-linking of [¹²⁵I]hEGF to gastric plasma membranes with the use of disuccinimidyl suberate resulted in the labeling of a protein of 150 kDa. These results indicate the presence of EGF receptors on plasma membranes of rat gastric mucosa.