Production of penicillinase by staphylococcal strains of different origins

A total of 319 strains of S. aureus and 729 strains of S. epidermidis belonging to different biovars isolated from the skin and nasal mucosa of 349 persons representing 8 independent groups were tested. On the whole production of penicillinase was more often observed in the strains of S. aureus than in the strains of S. epidermidis. Within the first species this property was more often detected in the strains of biovar I as compared to the other biovars. However, the frequency of the penicillinase-producing strains within S. aureus and the biovars of S. epidermidis markedly varied.     

Perforation of the Nasal Septum as the First Sign of Histoplasmosis Associated with AIDS and Review of Published Literature

Disseminated histoplasmosis in South America is associated with AIDS in 70–90 % of cases. It is visceral and cutaneous, compromising the oral, pharynx, and laryngeal mucous membranes. The involvement of the nasal mucosa is unusual. Two patients with perforation of the nasal septum as the only sign of their disease were clinically and histopathologically diagnosed as leishmaniasis. The revision of the biopsies and the culture of nasal discharge secretions showed that the pathogens seen were not amastigotes but Histoplasma capsulatum. Other mycotic lesions were not detected, nor there was history of cutaneous leishmaniasis. The leishmanin skin test, available only for the male patient, was negative. The PCR and immunofluorescence antibody titers for Leishmania were negative in both patients. They were HIV positive; in the male, his CD4+ T cell count was 60/mm³ and in the female 133/mm³. The nasal ulcer was the only manifestation of histoplasmosis and the first of AIDS in both patients. The male patient recovered with amphotericin B and itraconazole treatment. The female has improved with itraconazole. Both patients received antiretroviral treatment. Nasal mucous membrane ulcers should include histoplasmosis among the differential diagnosis. In conclusion, two patients had perforation of their nasal septum as the only manifestation of histoplasmosis, a diagnosis confirmed by nasal mucosa biopsy and by culture of H. capsulatum, findings which demonstrated that both patients had AIDS.     

丙泊酚联合七氟醚麻醉在先天性心脏病介入手术患儿中的心肌保护作用及对苏醒质量和应激反应的影响

摘要 目的：研究丙泊酚联合七氟醚麻醉在先天性心脏病介入手术患儿中的心肌保护作用及对苏醒质量和应激反应的影响。方法：选择2020年1月~2022年4月期间在苏州大学附属儿童医院接受先天性心脏病介入手术患儿96例,按照双色球法将患儿分为对照组（n=48,接受瑞芬太尼、丙泊酚麻醉）和观察组（n=48,接受丙泊酚、七氟醚麻醉）。对比两组患儿心率、呼吸频率、平均动脉压、苏醒质量、心肌损伤指标、应激反应指标和不良反应发生率。结果：两组置喉罩时（T1）~拔除喉罩（T4）时间点心率、呼吸频率、平均动脉压下降后升高,观察组高于对照组同时间点（P<0.05）。观察组的苏醒时间、拔管时间均短于对照组（P<0.05）。两组术毕、术后24 h肌酸磷酸激酶同工酶（CK-MB）、心肌肌钙蛋白（cTnI）升高后下降,观察组低于对照组同时间点（P<0.05）。两组术毕、术后24 h血糖、皮质醇升高后下降,观察组低于对照组同时间点（P<0.05）。两组不良反应发生率组间对比,差异不显著（P>0.05）。结论：丙泊酚联合七氟醚麻醉应用于先天性心脏病介入手术中,可减轻患儿的应激反应,稳定机体血流动力学波动,同时还可发挥心肌保护作用,提高苏醒质量。     

Protective and defensive airway reflexes in premature infants

The incidence of respiratory reactions to stimulation of the nasal and propharyngeal mucose was studied in 44 newborn premature infants. The inhalation of menthol fumes or the administration of drops of Mukoseptonex to the nasal mucosa caused transient respiratory arrest or a drop in the respiration rate. The heart rate rose during chemical stimulation of the nasal mucosa, possibly in association with a general arousal reaction. Mechanical stimulation of the nasal mucosal with a nylon fibre elicited an expulsive reaction in 95% of the cases. As distinct from experimental animals, sneezing was not preceded by a deep initial inspiration. Stimulation of the oropharyngeal region produced transient apnoea in 24.5% of the cases, in 18% expiratory reactions reminiscent of the expiration reflex, in 33% independent, intensive inspiratory reactions and in 24.5% cough. Cough from both the oropharyngeal and the laryngeal region had a pronounced inspiratory component. Independent inspiratory reactions may to some extent be co-responsible for the high incidence of aspirations in the neonatal period.     

Proseal与Slipa喉罩在腹腔镜胆囊切除术中的麻醉效果比较

目的:比较proseal与slipa喉罩在腹腔镜胆囊切除术中的麻醉效果。方法:收集我院收治的68例胆囊行腹腔镜胆囊切除术患者,随机分为A组和B组,每组各34例,A组患者应用slipa喉罩,B组患者应用proseal喉罩进行麻醉。观察并比较两组患者各时间点血压、心率水平,患者麻醉时间、苏醒时间、喉罩插入时间与拔除时间以及患者的不良反应发生率。结果:与喉罩置入前相比,两组患者手术中收缩压(SBP)以及舒张压(DBP)水平均下降,差异具有统计学意义(P0.05)。两组患者各时间点的血压以、心率、麻醉时间及苏醒时间比较差异均无统计学意义(P0.05)。与B组相比,A组患者的喉罩插入时间较长,喉罩沾血的发生率较高,差异具有统计学意义(P0.05)。结论:Pro seal与Slipa喉罩在腹腔镜胆囊切除术中的麻醉效果相当,但Slipa喉罩的插入时间以及喉罩沾血的发生率更高。     

Comparative characterization of the microflora of the upper respiratory tract mucous membranes in bronchial asthma and allergic persistent rhinitis

A total of 250 patients with diagnosed bronchial asthma (BA) were examined by microbiological methods. Among them--188 children and 62 adults. In 87 patients the microflora of nasal mucosa was studied, in 40--of pharynx only and in 123 patients--both the nasal and the pharynx. For comparative analysis earlier data obtained in 69 patients with persistent allergic rhinitis (PAR) were used. The cultures isolated from the nasal mucosa of BA patients were shown to number 18 genera and 42 species, while among those isolated from pharynx mucosa 20 genera and 40 species. Monocultures were isolated from the nasal mucosa only in 23% of the examined patients and from the pharynx mucosa--only in 1.42%. Associations with different numbers of components were isolated from nasal and pharynx mucosa (2 to 6, 2 to 8 respectively). Staphylococcus aureus was regarded as the main species of nasal biocenosis in BA and PAR, as well as pharynx biocenosis in BA. Besides, in BA other Staphylococcus species (schleiferi, caprae, capitis, hominis, etc.), reversely related to the main species, could be isolated from both mucous membranes. Similarities and differences in microflora of biocenoses in both nosological forms, confirming links between PAR and BA, are considered.     

真菌球型上颌窦炎鼻内镜下两种手术路径的临床研究

目的:比较鼻内镜下中鼻道联合下鼻道小视窗双路径术和单独下中鼻道开窗术治疗真菌球型上颌窦炎的临床疗效。方法:采用前瞻性随机对照试验,将2013年8月~2015年5月在我院择期行手术治疗的50例真菌球型上颌窦炎患者分为观察组与对照组,每组25例,对照组行鼻内镜单独下中鼻道开窗术,观察组在对照组的基础上联合下鼻道小视窗术。术前及术后6个月采用鼻腔鼻窦结局测试20条量表(SNOT-20)对两组患者进行评分,术后6个月对鼻黏膜纤毛清除功能及疗效进行评估,比较两组手术时间及术中出血量。结果:术后6个月两组SNOT-20量表评分显著低于术前,且观察组显著低于对照组(P0.05)。术后6个月观察组粘膜纤毛传输时间(MTT)显著低于对照组(P0.05)。两组总有效率、手术时间及术中出血量比较,差异均无统计学意义(P0.05)。结论:鼻内镜下以上两种手术路径治疗真菌球型上颌窦炎的疗效相近,但鼻内镜下中鼻道联合下鼻道小视窗双路径术更有利于减轻患者症状及促进鼻黏膜纤毛清除功能恢复。     

喉罩通气下七氟醚全凭吸入麻醉在小儿先天性心脏病介入手术的临床麻醉效果

目的:探讨喉罩通气下七氟醚全凭吸入麻醉在小儿先天性心脏病介入手术的临床麻醉效果。方法:选取2017年4月～2019年5月期间我院收治的行先天性心脏病介入手术患儿98例,根据随机数字表法将其分为对照组(n=49)和研究组(n=49)。对照组给予氯胺酮诱导,全凭丙泊酚维持,面罩吸氧;研究组给予全凭七氟醚诱导、维持,喉罩通气。比较两组患儿麻醉前(T0)、切皮前(T1)、切皮后1 min(T2)、切皮后30 min(T3)、术后(T4)的血流动力学指标[平均动脉压(MAP)、心率(HR)]及应激反应指标[血糖、皮质醇],记录两组患儿手术时间、麻醉诱导时间、术后苏醒时间等围术期指标情况。记录两组围术期不良反应发生情况。结果:研究组手术时间、麻醉诱导时间、术后苏醒时间均短于对照组(P0.05)。两组T0时间点血糖、MAP、皮质醇、HR比较差异无统计学意义(P0.05);对照组T1～T4时间点MAP、血糖、皮质醇、HR均较T0升高(P0.05);研究组T1～T4时间点血糖、MAP、皮质醇、HR与T0时间点比较无差异(P0.05);研究组T1～T4时间点血糖、MAP、皮质醇、HR低于对照组(P0.05)。两组不良反应发生率比较无差异(P0.05)。结论:小儿先天性心脏病介入手术中应用喉罩通气下七氟醚全凭吸入麻醉,诱导迅速且安全、术后苏醒快、手术时间短,可有效维持血流动力学稳定,减少应激反应。     

Neuroendocrine cells in the nasal mucosa - preliminary report

The role of neuroendocrine cells (NC) in physiology and pathology of the human's respiratory tract is not fully understood. The aim of the study was the quantitative and morphometric assessment of NC in nasal mucosa in some pathological states. PATIENTS AND METHOD: 40 patients, aged 28-63 years, with clinical signs of chronic, hypertrophic rhinosinusitis were qualified for the study. Rhinitis chronica hypertrophica coexisted with aspirin triad or asthma in 10 patients (group I), with advanced obstructive sleep apnea syndrome (OSAS) in 10 patients (respiratory disturbance index, RDI>40, group II). Group III consisted of 10 patients with simple rhinitis chronica hypertrophica who habitually smoked cigarettes (at least 20 cigarettes a day) while 10 non-smoking patients with simple rhinitis chronica hypertrophica were qualified to the control group. Fragments of nasal mucosa of approximately 0.5 cm(2) were collected from medial or inferior turbinate during mucoplasty procedures. NC were detected immunohistochemically using antibodies against chromogranin A (DAKO). The microscopic sections were evaluated in the light microscopy. RESULTS: The study did not reveal the increased number of NC in examined fragments of nasal mucosa. Scattered NC were detected in single preparations of nasal mucous membrane in some patients in all groups. The number of detected neuroendocrine cells did not differ statistically between groups.     

Cervical lymphadenitis in guinea pigs: infection via intact ocular and nasal mucosa by Streptococcus zooepidemicus.

The traditional view regarding the pathogenesis of cervical lymphadenitis in guinea pigs is that Lancefield Group C Streptococcus gains access to cervical lymph nodes via an abraded oral mucosa. In this study, it is established that inoculation of intact nasal and conjunctival mucous membranes with Streptococcus zooepidemicus (Lancefield Group C) also can produce the disease. Weanling (SPF) guinea pigs (Cavia porcellus) were divided into two experimental groups of 10 and two control groups of four each. Guinea pigs from each group were individually housed in separate cubicles. Group I was inoculated with 0.05 ml of culture containing 2.8 x 10(7) CFU/ml of S. zooepidemicus into the conjunctiva of the left eye. Group II received a similar inoculum into the left nares. Control groups received 0.05 ml of TSB broth in the same sites. Five of ten guinea pigs in Group II died four to nine days postinoculation. Surviving guinea pigs were euthanatized at intervals between days 4-13 postinoculation. All guinea pigs were necropsied, cultured and examined for evidence of infection. S. zooepidemicus was recovered from 30/50 and 39/46 sites cultured from Groups I and II, respectively. Lymphadenitis was found in cervical lymph nodes from 8/10 guinea pigs in Group I and 10/10 in Group II. The conjunctival and nasal mucosa, therefore, represent potential sites of entry resulting in cervical lymphadenitis in guinea pigs.     

不同部位喉黏膜间充质细胞的分离培养

目的:探讨不同部位喉黏膜间充质细胞的分离、培养方法,为喉部组织工程提供更多的可供选择的种子细胞。方法:收集临床上喉部手术病人切下的不同部位的喉黏膜,主要是会厌的背侧黏膜和声带的黏膜,各3例,共计6例。对会厌背侧的黏膜采用消化培养的方法,对声带部位的黏膜采用组织块培养法。最后通过免疫荧光染色对两种方法所获得的细胞进行鉴定,确定其来源于喉黏膜的间充质。结果:通过两种方法均可以成功获得相应部位的细胞,免疫荧光染色vimentin均呈阳性表达且CK均呈阴性表达,证明了获得的细胞确实是来源于间充质。结论:本实验成功的培养出了喉部不同部位的间充质细胞,为喉部的组织工程提供了更多的可供选择的种子细胞。     

血红蛋白200g/L以上紫绀型先天性心脏病患者手术效果分析

目的:明确血红蛋白200 g/L以上紫绀型先天性心脏病患者的手术效果。方法:选取2009年3月至2012年3月于我中心就诊手术治疗的紫绀型先天性心脏病患者,按血红蛋白计数≥200 g/L和200 g/L分为A组和B组,完善术前检查后进行手术治疗。记录患者手术效果和随访情况;观察比较两组患者手术中情况包括:手术方式、手术时间、体外循环时间、心脏停搏时间、心脏自动复跳情况;记录并比较两组患者手术后恢复情况,包括机械通气时间、监护室滞留时间、手术后24小时内出血量、二次开胸止血例数和血管活性药物评分,以及监护室内肝肾功能异常和肺部并发症发生例数。结果:A组死亡3例(5.2%),23例术后3个月随访效果良好;B组死亡2例(5.8%),12例术后3个月随访效果良好。两组患者手术方式、手术时间、体外循环时间和心脏停搏时间、自动复跳例数均无明显差异(P0.05)。与B组比较,A组患者术后机械通气和监护室滞留时间长,术后24小时出血量多,血管活性药物使用评分高,肝肾功能异常例数和肺部并发症发生例数较多有统计学意义(P0.05),两组间二次开胸止血例数无统计学差异(P0.05)。结论:血红蛋白200 g/L以上紫绀型先天性心脏病患者与其他紫绀型先天性心脏病患者手术效果相似,但手术后恢复慢,并发症较多。     

不同部位喉黏膜间充质细胞的分离培养

目的：探讨不同部位喉黏膜间充质细胞的分离、培养方法,为喉部组织工程提供更多的可供选择的种子细胞。方法：收集临床上喉部手术病人切下的不同部位的喉黏膜,主要是会厌的背侧黏膜和声带的黏膜,各3例,共计6例。对会厌背侧的黏膜采用消化培养的方法,对声带部位的黏膜采用组织块培养法。最后通过免疫荧光染色对两种方法所获得的细胞进行鉴定,确定其来源于喉黏膜的间充质。结果：通过两种方法均可以成功获得相应部位的细胞,免疫荧光染色vimentin均呈阳性表达且CK均呈阴性表达,证明了获得的细胞确实是来源于间充质。结论：本实验成功的培养出了喉部不同部位的间充质细胞,为喉部的组织工程提供了更多的可供选择的种子细胞。     

The Composition of Microbiome in Larynx and the Throat Biodiversity between Laryngeal Squamous Cell Carcinoma Patients and Control Population

The throat is an ecological assemblage involved human cells and microbiota, and the colonizing bacteria are important factors in balancing this environment. However, this bacterial community profile has thus been poorly investigated. The purpose of this study was to investigate the microbial biology of the larynx and to analyze the throat biodiversity in laryngeal carcinoma patients compared to a control population in a case-control study. Barcoded pyrosequencing analysis of the 16S rRNA gene was used. We collected tissue samples from 29 patients with laryngeal carcinoma and 31 control patients with vocal cord polyps. The findings of high-quality sequence datasets revealed 218 genera from 13 phyla in the laryngeal mucosa. The predominant communities of phyla in the larynx were Firmicutes (54%), Fusobacteria (17%), Bacteroidetes (15%), Proteobacteria (11%), and Actinobacteria (3%). The leading genera were Streptococcus (36%), Fusobacterium (15%), Prevotella (12%), Neisseria (6%), and Gemella (4%). The throat bacterial compositions were highly different between laryngeal carcinoma subjects and control population (p = 0.006). The abundance of the 26 genera was significantly different between the laryngeal cancer and control groups by metastats analysis (p<0.05). Fifteen genera may be associated with laryngeal carcinoma by partial least squares discriminant analysis (p<0.001). In summary, this study revealed the microbiota profiles in laryngeal mucosa from tissue specimens. The compositions of bacteria community in throat were different between laryngeal cancer patients and controls, and probably were related with this carcinoma. The disruption of this bio-ecological niche might be a risk factor for laryngeal carcinoma.     

食管腺癌、Barrett 食管活检粘膜中TGF-β1 的表达

目的:研究食管腺癌、Barret食管(Barrett esophagus,BE)和正常食管粘膜中转化生长因子β1(transforming growth factor-betal,TGF-β1)的表达。方法:采用免疫组化方法检测35例食管腺癌患者、40例BE患者及30例健康对照组食管组织中TGF-β1的表达水平。结果:未在健康对照组食管粘膜中发现TGF-β1的表达,食管腺癌组TGF-β1的表达水平>BE组>健康对照组(P<0.05)。食管腺癌组中,TGF-β1在中-高分化腺癌及低分化腺癌患者食管粘膜中的表达无明显差异(Z=1.07,P>0.05)。结论:食管腺癌、BE食管粘膜中TGF-β1表达水平升高,在食管腺癌中的表达与细胞分化程度无关。     

In-vitro bacteriocin-mediated antagonism by oral streptococci against human carrier strains of staphylococci

All strains of oral streptococci tested and specially those of Streptococcus mutans, Strep. sanguis and Strep. mitior produced more than one distinct bacteriocin-like substance with variable inhibitory activity on 20 indicator staphylococci. Inhibitory activity was comparatively higher on nasal strains of Staph. aureus and Staph. epidermidis than on strains of both species isolated from the mouth. Nineteen of 20 staphylococcal indicators were inhibited by 1-12 of the 12 effector streptococci. Sensitivity of nasal staphylococci to bacteriocins (frequency of positive inhibitory tests and total inhibition zone diameters) was significantly higher (P less than 0.001, chi 2 test and P less than 0.05, t test respectively) than that of oral ones. The sensitivity of nasal over oral Staph. aureus (P less than 0.001 and P less than 0.01) and of oral Staph. epidermidis over oral Staph. aureus (P less than 0.01 and P less than 0.05) was also significantly higher. The evaluation of variability of inhibitory patterns of bacteriocins produced by streptococci (p-typing), of sensitivity patterns of staphylococci to bacteriocins (s-typing) and of the significantly higher sensitivity of nasal over oral staphylococci to bacteriocins from the epidemiological and ecological viewpoints are discussed.     

Aerobic bacteria from nasal discharge of goats suffering from clinical PPR: isolation and identification

Bacteriological isolation of aerobic bacteria from nasal discharge of achondroplastic West African dwarf goats showing clinical signs of peste des petits ruminants (PPR), and the laboratory procedures carried out for the identification of the isolates are described. From a total of forty nasal swabs obtained seventy five isolates were recovered. The percentage frequency of isolation of different organisms in descending order of occurrence is as follows: Staphylococcus 44.0%; Streptococcus 22.67%; Neisseria 12.00%; Pasteurella 10.67%; Pseudomonas 4.00%; Proteus 4.00% and Corynebacterium 1.33%. A further break-down using biochemical tests revealed that Staphylococcus aureus accounted for 30.67% of the total bacteria isolates; Staphylococcus epidermidis 13.33%; Streptococcus viridans 18.67%; Streptococcus pyogenes 4.00%; Neisseria catarrhalis 12.00%; Proteus mirabilis 2.67%; Proteus rettgeri 1.33%; Pseudomonas aeruginosa 5.33%; Pasteurella multocida 4.00%; Pasteurella haemolytica 6.67% and Corynebacterium pyogenes 1.33%.     

Epidemic of prosthetic valve endocarditis caused by Staphylococcus epidermidis.

In an epidemic of prosthetic valve endocarditis caused by Staphylococcus epidermidis the surgeon was found to be the source of contamination. The probable route was accidental puncture of gloves during operation. During the epidemiological investigation a second cluster of patients contaminated with Staph epidermidis during open heart surgery was found also related to one surgeon. This strain caused no detectable signs or symptoms of infection. Carriage of virulent staph epidermidis has rarely been recognised as a hazard but may have serious consequences.     

产前超声诊断结果与胎儿先天性心脏病结局的相关性及危险因素分析

摘要 目的：对比先天性心脏病胎儿与正常胎儿的产前超声差异，分析产前超声诊断结果与胎儿先天性心脏病的相关性及危险因素。方法：选取我院2018年12月到2020年12月共收治的80例有先天性心脏病胎儿的孕妇作为研究对象，将其分为观察组，另选取健康胎儿的80例孕妇进行对比研究，将其分为对照组，对所有孕妇进行彩色多普勒超声进行诊断，分析观察组超声诊断与最终结果，对比两组胎儿的超声诊断情况，并对孕期胎儿先天性心脏病的风险因素进行单因素与多因素logistic回归分析。结果：通过尸检和出生后随访最终确定结果与超声诊断结果对比无显著差异（P＞0.05），超声诊断中有3例漏诊；由于卵圆孔直径大于6 mm、心内膜垫缺损（Endocardial cushion defect, ECD）和单心房胎儿没有正常的四腔心结构，因此无法进行腔室内径的测量，对其他观察组患儿进行测量之后发现，观察组患儿左心发育不全综合征（hypoplastic left heart syndrome, HLHS）的左心房与左心室、法洛氏四联症（Tetralogy of Fallot, TOF）右心室、室间隔缺损（Ventricular Septal Defect, VSD）右心室内径明显低于对照组（P＜0.05）；对可能造成胎儿先天性心脏病的高风险因素进行分析发现，两组孕妇的孕期早期服药、高龄产妇以及家族心脏病史情况对比差异显著，观察组明显更高（P＜0.05）；对所有因素进行赋值，其中"是"或"有"为1，"否"或"无"为0。通过logistic回归分析发现只有孕期早期服药和家族心脏病史为胎儿先天性心脏病的独立危险因素（P＜0.05）。结论：对孕妇进行综合产前超声诊断胎儿先天性心脏病的准确率较高，与最终结果无明显区别；虽然高龄孕妇与胎儿先天性心脏病具有一定关系，但是只有孕期早期服药和家族心脏病史是胎儿先天性心脏病的独立危险因素。     

芪菊袋泡茶在慢性鼻窦炎伴鼻息肉功能性鼻内镜术后的临床疗效

目的:评估芪菊袋泡茶对功能性鼻内镜术(FESS)术后的临床疗效。方法:采用随机数字表法将纳入观察的FESS术后患者分为两组,对照组为常规处理,治疗组在常规处理的基础上给予芪菊袋泡茶雾化吸入及饮用:术后6h开始予芪菊袋泡茶治疗,以芪菊袋泡茶一袋配30 mL饮用水,作雾化吸入,另予一袋配100 mL饮用水泡服,每天2次,雾化联合饮用共1周。雾化疗程结束后,则以每次2袋,每天2次泡服,再饮用2周,并随访12周。比较两组间鼻窦炎相关症状(包括鼻塞、头痛、面痛、嗅觉障碍、鼻涕)评分、鼻腔粘膜改变和术腔上皮化程度、术后咽喉部症状(包括咽痛、异物感、排痰、咳嗽)评分。结果:术后2、4、8、12周,治疗组鼻窦炎相关症状总评分与对照组比较差异有统计学意义(P0.05);治疗组在术后4、8、12周鼻腔粘膜评分、上皮化程度较对照组显著改善,差异有统计学意义(P0.05);治疗组在术后1d、3d咽喉部症状总评分、咽痛和异物感症状评分显著较对照组改善,差异有统计学意义(P0.05)。结论:芪菊袋泡茶在慢性鼻窦炎伴鼻息肉FESS术后能取得良好的临床疗效,明显改善术后症状,值得临床推广。