神经内科住院患者感染病原菌分布及其耐药性

目的了解神经内科住院患者感染的病原菌分布特点,产生β-内酰胺酶情况及其药敏特点。方法分析2002年3月至2004年12月白求恩国际和平医院神经内科住院患者临床感染有关的病原学资料。结果共811例住院患者,有71例发生医院内感染,感染率为8．75％;60岁以上老年人51例,占71．8％;基础疾病以脑梗塞为主,有40例（占56．3％）。主要引起肺部感染（49例,69．0％）和尿路感染（20例,28．2％）。共检出103株病原菌,其中：革兰阳性球菌10株（9．71％）,肠杆菌科42株（40．78％）,非发酵菌41株（39．80％）,真菌10株（9．71％）。其中较常见的病原菌为：大肠埃希菌（23．3％）、铜绿假单胞菌（20．4％）、鲍曼不动杆菌（12.6％）、肺炎克雷伯菌（9．71％）、金黄色葡萄球菌（8．7％）、白色念珠菌（6．8％）。革兰阴性杆菌产超广谱β-内酰胺酶占40．9％,AmpC酶占14．5％,金属酶占2．4％。结论大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌成为神经内科临床感染的主要病原菌,其耐药性不断增强,应当引起足够重视。     

乙肝病毒基因组克隆及其线性分子侵染力研究

乙肝病毒基因组为环状双链DNA,常态环状分子侵染能力很强。为了探讨乙肝病毒基因组线性分子对人肝的侵染和复制能力,克隆了德国病人Brandt携带的乙肝病毒全长基因组,定名为HBV-Brandt。Multiplex PCR基因型鉴定表明HBV-Brandt属于乙型肝炎病毒A型。细胞转染和荧光定量PCR分析证明乙肝病毒HBV-Brandt的基因组线性DNA分子可以侵染HepG2细胞,并进行大量复制。     

Absence of mitogen-activated protein kinase family member c-Jun N-terminal kinase-2 enhances resistance to Toxoplasma gondii

The function of mitogen-activated protein kinase (MAPK) family member c-Jun N-terminal kinase (JNK)-2 in resistance and pathology during infection has not been greatly studied. Here, we employed Jnk2^−/− mice to investigate the role of JNK2 in resistance and immunity during oral infection with the protozoan pathogen Toxoplasma gondii. We found increased host resistance in the absence of JNK2 as determined by lower parasite burden and increased host survival. Lack of JNK2 also correlated with decreased neutrophil recruitment to the intestinal mucosa and less pathology in the small intestine. In the absence of JNK2, IL-12 production was slightly but significantly increased in restimulated splenocyte populations as well as in purified splenic dendritic cell cultures. These results provide evidence that expression of JNK2 plays a role in T. gondii-induced immunopathology, at the same time in promoting susceptibility to this parasitic pathogen.     

Bacterial endotoxin induced hypothermia in pregnant rats: Role of tumor necrosis factor-α

Intraperitoneal (ip) administration of the lowest dose of Escherichia coli lipopolysaccharide (LPS) that elicits a maximal febrile response in non-pregnant rats when studied in a neutral ambient temperature (EC₁₀₀—160 μg/kg) produces a transient “regulated” hypothermia in near-term pregnant rats. The current experiments have been carried out to determine the role of tumor necrosis factor-α (TNF-α) in mediating this hypothermic response. Chronically instrumented non-pregnant and pregnant rats were housed and studied in a neutral ambient temperature and allocated to one of two experimental series depending upon whether they received ip recombinant rat TNF-α (rrTNF-α) in doses ranging from 0.1 to 1000 μg/kg or they received an antibody to tumor necrosis receptor I (TNF R1 Ab) – which neutralizes its cell surface mediated activity – before receiving an EC₁₀₀ dose of E. coli LPS. Intraperitoneal rrTNF-α elicited fevers in non-pregnant but not in near-term pregnant rats. In near-term pregnant rats, transient hypothermias predominated following ip rrTNF-α and occurred at doses ranging from 10 to 1000 μg / kg. As well, ip administration of TNF RI Ab eliminated the transient hypothermia following ip administration of an EC₁₀₀ dose of E. coli LPS in near-term pregnant rats. These data taken together provide evidence that TNF-α plays an important role in mediating the transient regulated hypothermia that occurs in near-term pregnant rats following ip administration of an EC₁₀₀ dose of E. coli LPS.     

关于HCMV潜伏感染与激活感染研究的新进展

人巨细胞病毒（HCMV）是疱疹病毒科中最大的病毒,结构复杂,其感染在人群中非常普遍,近年来免疫妥协（immunocompmmised）群体尤其是移植群体中的HCMV潜伏感染和激活感染越来越受到临床重视。本文就HCMV的感染与免疫、HCMV的致病机制、宿主的抗感染与免疫、HCMV的免疫逃逸、HCMV的潜伏与激活及HcMV相关研究的困境与展望近年来此方面研究新进辰作一简要综述。     

Local phenotypic variation in amphibian-killing fungus predicts infection dynamics

Environmental factors can limit the distribution of organisms if they are not able to respond through phenotypic plasticity or local adaptation. Batrachochytrium dendrobatidis (Bd) is a broadly distributed pathogen, which shows spatially patterned genotypic and phenotypic variation; however, information on the functional consequences of this variation on disease dynamics in natural hosts is limited. We genotyped and quantified variation in Bd phenotypes across an elevational gradient and quantified host infection dynamics at each site. All Bd strains were members of the global panzootic lineage yet differed in phenotype. We hypothesize that this phenotypic variance results from adaptive processes due to the interaction between pathogen, hosts, and environment. We detected a correlation between zoospore and zoosporangia sizes and a positive association between zoosporangia size and Bd prevalence. Given that Bd phenotype predicted disease status in our wild populations, we developed an index to identify critical environments where the fungus could be more deleterious.     

神经外科手术中大量输血患者红细胞压积及凝血状态研究

摘要 目的：探讨神经外科手术中大量输血患者采用不同输血方法对红细胞压积及凝血状态的影响。方法：选择2017年2月至2019年12月在本院进行手术的神经外科患者104例,根据随机数字表法把患者分为观察组与对照组各52例。观察组给予自体输血治疗,对照组给予异体输血治疗,记录和比较患者红细胞压积及凝血状态变化情况。结果：所有患者都完成手术,两组的手术时间、术中输血量与补液量对比差异无统计学意义(P>0.05)。两组术后1 d的红细胞压积低于术前1 d(P<0.05),组间手术前后对比差异都无统计学意义(P>0.05)。两组术后1 d的凝血酶原时间(prothombin time,PT)与活化部分凝血活酶时间(activited partial thomboplastin time,APTT)值高于术前1 d(P<0.05),组间手术前后对比差异都无统计学意义(P>0.05)。观察组输血后7 d的感染发生率为1.9 %,显著低于对照组的15.4 %(P<0.05)。结论：神经外科手术中大量输血中采用自体输血并不会影响患者的红细胞压积与凝血状态,不会增加输血难度与输血量,但能有效减少感染等不良反应。     

改良Masquelet技术治疗胫骨感染性缺损的临床疗效分析

摘要 目的：探讨和分析使用改良Masquelet技术在胫骨感染性缺损中的临床疗效。方法：回顾性分析2018.01-2022.01范围内,使用改良Masquelet治疗胫骨感染性缺损的共计21患者。通过骨愈合(Samantha X 线评分),软组织愈合,感染控制,下肢功能,并发症等方面对临床疗效进行评价。结果：21例患者均获得完整随访,随访时间为12-36个月,平均为18.6个月。所有患者均达到骨愈合标准（3.2±8.3个月）。Samantha X 线评分：1例为4分,8例为5分,12例6分。PALEY功能评分为：优9人,良11人,可1人,差0人,优良率为95.2%。患者中均未出现严重并发症(P>0.05)。结论：在胫骨感染性缺损的治疗中,改良Masquelet技术是一种简单,安全,有效的治疗方法,在临床中可以进一步推广。     

轮状病毒致乳鼠肝脏IFN-γ/IL-10的变化研究

目的建立乳鼠感染的模型,检测轮状病毒（Rotavirus,RV）肠道内、外感染乳鼠肝脏IFN-γ和IL-10水平,比较肝脏IFN-γ和IL-10在轮状病毒肠道内外感染,以及不同时间点变化的差异性,进一步探讨IFN-γ和IL-10免疫自稳失衡与轮状病毒肠道外感染发病的关系,推测以恢复细胞因子平衡为目标的治疗策略可能是治疗轮状病毒肠炎的一种新方法。方法实验动物选用35日龄的清洁级BALB/C乳鼠,将54只乳鼠随机分为3组,每组18只,即实验组,包括肠道外组：通过腹腔注入0.10 mL（1×10-5）TCID50感染性滴度计量的SA-11株病毒;肠道内组：通过口腔灌入0.10 mL相同病毒;对照组无特殊处理。感染后,各组动物隔离饲养。观察乳鼠的活动、饮食、体型、毛色和大便变化情况等,收集大便经胶体金法检测其中RV抗原。在接种后的3、5和8 d处死乳鼠,留取肝脏,免疫组化方法检测IFN-γ和IL-10水平。结果对照组2种细胞因子表达量较少,肠道内组IFN-γ水平在接种RV后的第3天明显增多,第3天至第8天缓慢减少;IL-10水平较正常组增高但整个过程未见明显变化。肠道外组IFN-γ水平与肠道内组比较差异无统计学意义;IL-10水平在感染第3天也明显增多,第3天至第8天有所减少但仍存在且高于正常组。结论 BALB/C乳鼠肠道内外感染RV动物模型建立成功。乳鼠肠道外感染早期及后期肝脏内细胞因子呈现出不同改变。所以在肠道外组,肝脏细胞因子平衡机制失衡,进一步阐明这种失衡可能是RV肠道外播散的重要机制。     

骨科假体表面涂层技术现状

由植入物界面处的相互作用可能引起无菌性松动和假体周围感染。而无菌性松动和假体周围感染仍然是一个难以治疗的问题,并且最终可能导致假体植入失败,引起严重后果。理想的植入物应能促进骨整合,防止细菌粘附,减少细菌感染。骨科植入技术主要基于生物材料的开发和使用,随着材料科学和细胞生物学的发展,已可以用新的植入物表面涂层的进展来解决这些问题。本文回顾总结了时下骨科常见的假体涂层设计和相关问题,以期为进一步研究提供借鉴。