无创血流动力学监测指导严重脓毒症患者血管活性药物的应用

目的:探讨无创血流动力学监测技术在严重脓毒症患者液体复苏后指导血管活性药物使用的意义。方法:选择2014年6月至2016年6月我院急诊处收治的严重脓毒症患者56例为研究对象,分为观察组和对照组,每组各28例。对照组进行常规对症治疗,观察组在对照组治疗基础上使用无创血流动力学监测仪指导治疗。观察两组患者在治疗前及治疗后6 h血流动力学及微循环灌注指标、液体复苏6 h后液体平衡量及血管活性药物使用量,及在重症监护病房(EICU)的入住时间。结果:治疗后两组患者尿量均大于30 m L/h,提示复苏成功。两组患者治疗后血液动力学指标和微循环灌注指标较治疗前均明显好转(均P0.05);治疗后,两组间血液动力学指标和微循环灌注指标比较无明显差异(P0.05)。观察组液体复苏6 h后液体平衡量明显少于对照组(P0.05),观察组血管活性药物用量均明显高于对照组(P0.05),观察组患者在EICU病房住院时间明显短于对照组(P0.05)。结论:无创血流动力学监测对严重脓毒症患者的液体恢复管理和治疗过程具有指导意义,使血管活性药物得到有效利用,精确进行液体管理,减少盲目补液,缩短病程,减少患者的住院时间,经济高效,是指导治疗和评估治疗疗效的重要手段。     

限制性输液与充分液体复苏在感染性休克患者围手术期麻醉中的应用研究

目的:探究限制性输液与充分液体复苏在感染性休克患者围手术期麻醉中的应用,从而为患者治疗提供相关科学依据。方法:回顾性分析2007年2月至2015年6月期间因感染性休克入院接受治疗的82例患者的临床资料,按输液方式的不同分为研究组(限制性输液)与对照组(充分液体复苏)各41例,观察两组患者转归情况,记录患者心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、动脉血氧分压(PaO_2)、出血量、总输液量、尿量、术后机械通气时间及ICU住院时间。结果:术后研究组患者出现弥散性血管内凝血(DIC)5例、成人呼吸窘迫综合征(ARDS)3例,2例病情控制不佳者转为多器官功能障碍综合征(MODS),1例死亡,总发生率为26.83%;对照组患者出现DIC 8例,ARDS 7例,MODS 5例,最终出现3例死亡,总发生率为56.10%,两组患者术后转归状况比较,差异有统计学意义(P0.05);研究组患者MAP、CVP、HR、出血量、总输液量及尿量等指标低于对照组,差异有统计学意义(P0.05),研究组患者PaO_2显著高于对照组,差异有统计学意义(P0.05);研究组患者术后机械通气时间及ICU住院时间比对照组短,差异有统计学意义(P0.05)。结论:限制性输液较充分液体复苏能够显著改善感染性休克患者组织血流灌流状况,术中出血量少、术后并发症少,效果更显著,更适合在围手术期麻醉中使用。     

The Role of Intercellular Contacts in the Initiation of Growth and in the Development of a Transiently Nonculturable State by Cultures of Rhodococcus rhodochrous Grown in Poor Media

It was found that the growth of Rhodococcus rhodochrous cells in a modified Saton’s medium strongly depends on the rate of culture agitation in the flask: agitation at 250 rpm in flasks with baffles stops cell multiplication, whereas slight agitation leads to pronounced culture growth. The growth retardation phenomenon was reversible and did not manifest itself in exponential-phase cultures or when the cells were grown in a rich medium; furthermore, it was not connected with the degree of culture aeration. When agitated at a moderate rate, the bacterial cells formed aggregates in the lag phase, which broke up into single cells in the exponential phase. The inhibitory effect of vigorous agitation was removed by the addition, to the medium, of the supernatant (SN) of a log-phase culture grown in the same medium with moderate agitation. Vigorous agitation is thought to interfere with cell contact, whose establishment is necessary for the development of an R. rhodochrous culture in a poor medium, which occurs in the form of (micro) cryptic growth. When grown in a modified Saton’s medium, R. rhodochrous cells were capable of transition, in the prolonged stationary phase, to a resting and transiently nonculturable state. Such cells could be resuscitated by incubation in a liquid medium with the addition of the supernatant or the Rpf secreted protein. The formation of transiently nonculturable cells was only possible under the conditions of a considerable agitation rate (250–300 rpm), which prevented secondary (cryptic) growth of the culture. This circumstance indicates the importance of intercellular contacts not only for the initiation of growth but also for the transition of the bacteria to a dormant state.__________Translated from Mikrobiologiya, Vol. 74, No. 4, 2005, pp. 489–797.Original Russian Text Copyright © 2005 by Voloshin, Shleeva, Syroeshkin, Kaprelyants.     

Structure of AscE and induced burial regions in AscE and AscG upon formation of the chaperone needle-subunit complex of type III secretion system in Aeromonas hydrophila

In the type III secretion system (T3SS) of Aeromonas hydrophila, the putative needle complex subunit AscF requires both putative chaperones AscE and AscG for formation of a ternary complex to avoid premature assembly. Here we report the crystal structure of AscE at 2.7 A resolution and the mapping of buried regions of AscE, AscG, and AscF in the AscEG and AscEFG complexes using limited protease digestion. The dimeric AscE is comprised of two helix-turn-helix monomers packed in an antiparallel fashion. The N-terminal 13 residues of AscE are buried only upon binding with AscG, but this region is found to be nonessential for the interaction. AscE functions as a monomer and can be coexpressed with AscG or with both AscG and AscF to form soluble complexes. The AscE binding region of AscG in the AscEG complex is identified to be within the N-terminal 61 residues of AscG. The exposed C-terminal substrate-binding region of AscG in the AscEG complex is induced to be buried only upon binding to AscF. However, the N-terminal 52 residues of AscF remain exposed even in the ternary AscEFG complex. On the other hand, the 35-residue C-terminal region of AscF in the complex is resistant to protease digestion in the AscEFG complex. Site-directed mutagenesis showed that two C-terminal hydrophobic residues, Ile83 and Leu84, of AscF are essential for chaperone binding.     

人工控制有限供水对冬小麦根系生长及土壤水分利用的影响

试验在中国气象局固城农业气象试验基地的大型人工控制农田水分试验场进行。在底墒充足的条件下采用3种供水处理：拔节期一次性供水75mm(I1);返青供水37．5mm和拔节期供水37．5mm(I2);返青后生长期内无水分供给(Ick)。全生育期内用电动防雨棚遮去自然降水。试验结果表明,表层土壤(0～30cm)水多根多,根系反应敏感。上层干旱促使根系向深层发育,利用下层水量较多。I1处理减少表土层(0～30cm)的根量和根长密度,促进根系下扎,较多地利用深层土壤水分,并减少无效分蘖。虽然总穗数减少,但同I2、Ick相比籽粒数和籽粒重有较大幅度增加,提高了产量和水分利用率。根系吸水效率随土层深度增加呈下降趋势,I1在30cm以下其根系吸水效率超过了I2处理,并在100～200cm土层表现最为明显。Ick除0～30cm土层外,其余土层有效底墒供水率均较低;I1和I2两处理30～100cm有效底墒供水率均在84％以上,1～2m土层内I。大于I2。Ick由于土壤水分不足并未造成千粒重的明显下降,相反,3个处理中最高;土壤水分不足导致穗数、穗粒重、籽粒重和籽粒数的显著降低,从而造成了最终产量的降低。产量水平上的水分利用效率I1比其余处理提高了将近14％,其次为Ick,最低的是I2。在灌溉效率上,I1比I2提高了将近19％;在相同灌溉量的前提下,蒸腾效率I1比I2提高约7％。I1水分利用效率高于I2和Ick处理。可以认为：配合充足底墒,前期控水,有限的一定量的水分拔节期(关键期)一次供给比在返青和拔节分别供给,更为有效科学。     

Arginine controls heat-induced cluster-cluster aggregation of lysozyme at around the isoelectric point

The process of protein aggregation has attracted a great deal of research attention, as aggregates are first of all a nuisance to preparation of high quality protein and secondly used as novel materials. In the latter case, the process of protein aggregation needs to be controlled. Here, we show how arginine (Arg) regulates the process of heat-induced protein aggregation. Dynamic light scattering and transmission electron microscopy revealed that heat-induced aggregation of lysozyme at around the isoelectric point occurred in a two-step process: formation of start aggregates, followed by further growth mediated by their sticking with diffusion-limited cluster-cluster aggregation. In the presence of Arg, the diffusion-limited regime changed to reaction-limited cluster-cluster aggregation. The data indicated that the solution additives that coexisted with proteins would affect the property of the formed product, such as morphology and mechanic strength.     

Drought-inhibited ribulose-1,5-bisphosphate carboxylase activity is mediated through increased release of ethylene and changes in the ratio of polyamines in pakchoi

To study the mechanisms of drought inhibiting photosynthesis and the role of PAs and ethylene, the photosynthetic rate (P_n), the maximal photochemical efficiency of PSII (F_v/F_m), the intercellular CO₂ concentration (C_i), photorespiratory rate (P_r), the amount of chlorophyll (chl), antioxidant enzyme activity, ethylene levels, RuBPC (ribulose-1,5-bisphosphate carboxylase) activity and endogenous polyamine levels of pakchoi were examined, and an inhibitor of S-adenosylmethionine decarboxylase (SAMDC) and an inhibitor of ethylene synthesis and spermidine (Spd) were used to induce the change of endogenous polyamine levels. The results show that drought induced a decrease in P_n and RuBPC activity, an increase in the intercellular CO₂ concentration (C_i), but no change in the actual photochemical efficiency of PSII (Φ_PSII), and chlorophyll content. In addition, drought caused an increase in the free putrescine (fPut), the ethylene levels, a decrease in the Spd and spermine (Spm) levels, and the PAs/fPut ratio in the leaves. The exogenous application of Spd and amino oxiacetic acid (AOAA, an inhibitor of ethylene synthesis) markedly reversed these drought-induced effects on polyamine, ethylene, P_n, the PAs/fPut ratio and RuBPCase activity in leaves. Methylglyoxal-bis(guanylhydrazone) (MGBG), an inhibitor of SAMDC resulting in the inability of activated cells to synthesize Spd and Spm, exacerbates the negative effects induced by drought. These results suggest that the decrease in P_n is at least partially attributed to the decrease of RuBPC activity under drought stress and that drought inhibits RuBPC activity by decreasing the ratio of PAs/fPut and increasing the release of ethylene.     

Mycobacterium tuberculosis RpfE crystal structure reveals a positively charged catalytic cleft

Resuscitation promoting factor (Rpf) proteins, which hydrolyze the sugar chains in cell‐wall peptidoglycan (PG), play key roles in prokaryotic cell elongation, division, and escape from dormancy to vegetative growth. Like other bacteria, Mycobacterium tuberculosis (Mtb) expresses multiple Rpfs, none of which is individually essential. This redundancy has left unclear the distinct functions of the different Rpfs. To explore the distinguishing characteristics of the five Mtb Rpfs, we determined the crystal structure of the RpfE catalytic domain. The protein adopts the characteristic Rpf fold, but the catalytic cleft is narrower compared to Mtb RpfB. Also in contrast to RpfB, in which the substrate‐binding surfaces are negatively charged, the corresponding RpfE catalytic pocket and predicted peptide‐binding sites are more positively charged at neutral pH. The complete reversal of the electrostatic potential of the substrate‐binding site suggests that the different Rpfs function optimally at different pHs or most efficiently hydrolyze different micro‐domains of PG. These studies provide insights into the molecular determinants of the evolution of functional specialization in Rpfs.