微生态制剂联合莫西沙星序贯疗法对老年慢性阻塞性肺疾病合并下呼吸道感染患者肠道菌群及免疫功能的影响

目的 探究微生态制剂联合莫西沙星序贯疗法对老年慢性阻塞性肺疾病(COPD)合并下呼吸道感染患者肠道菌群及免疫功能的影响。 方法 选取2016年2月到2019年2月我院收治的98例老年COPD合并下呼吸道感染患者为研究对象,按照随机数字表法分为观察组和对照组各49例。对照组患者采用莫西沙星序贯法进行治疗。观察组患者采用微生态制剂联合莫西沙星治疗。检测两组患者下呼吸道感染病原菌及肠道微生物变化,T淋巴细胞亚群(CD4+细胞,CD8+细胞,CD4+/CD8+)水平,并评价患者临床效果和并发症情况。 结果 治疗后两组患者CAT评分(8.23±3.64、10.41±4.08)和mMRC评分(1.35±0.82、1.77±0.61)均低于治疗前(23.01±4.47、22.87±5.26、2.79±0.54、3.04±0.74),且观察组下降幅度大于对照组,差异具有统计学意义(均P0.05)。治疗后两组患者肠道双歧杆菌、嗜酸乳杆菌、粪肠球菌数量均高于治疗前,大肠埃希菌数量均低于治疗前,且观察组改善情况优于对照组,差异有统计学意义(均P+细胞、CD4+/CD8+均高于治疗前,且观察组高于对照组,差异有统计学意义(均P+细胞数量治疗前后及组间比较差异无统计学意义(均P>0.05)。治疗后观察组患者腹胀(18.4%)、胃潴留(20.4%)发生率均低于对照组(36.7%、38.8%),差异有统计学意义(均P0.05)。 结论 微生态制剂联合莫西沙星序贯疗法治疗老年COPD合并下呼吸道感染能促进患者肠道微生态平衡,调节免疫功能,进而改善患者病情。     

干扰素阴道胶囊联合微波治疗宫颈炎合并高危型HPV感染对外周血Th17和Treg细胞及炎症因子的影响

目的探讨干扰素阴道胶囊联合微波治疗宫颈炎合并高危型人乳头瘤病毒(HPV)感染对外周血Th17和Treg细胞及炎症因子的影响。方法随机选择2015年1月-2018年1月在本院就诊的慢性宫颈炎合并高危型HPV感染患者90例,按随机数字表法分为观察组和对照组,每组45例。对照组给予重组人干扰素α2b栓,观察组给予重组人干扰素α2b栓联合微波治疗,治疗3个月后,观察两组患者的症状改善情况、HPV转阴率、血清炎性因子水平以及Th17和Treg细胞水平。结果观察组总有效为41例,占91.1%,对照组为73.3%,观察组显著高于对照组(P<0.05)。治疗后观察组的白带量改善率、白带脓性改善率、高危型HPV转阴率均显著高于对照组(P<0.05)。治疗前两组患者的白介素17(IL17)、肿瘤坏死因子β(TNFβ)、白介素23(IL23)水平比较,差异无统计学意义(P>0.05);治疗后两组患者的IL17、TNFβ、IL23水平均显著下降,且观察组下降更加显著(P<0.05)。治疗后观察组的Treg细胞、Th17细胞水平,Th17/Treg比值均较对照组低(P<0.05)。治疗前两组患者的滴虫、真菌、细菌性阴道炎、衣原体、解脲支原体感染人数比较差异无统计学意义(P>0.05),治疗后观察组的细菌性阴道炎、衣原体、解脲支原体感染显著降低,与对照组比较差异有统计学意义(P<0.05)。结论干扰素阴道胶囊联合微波治疗宫颈炎患者的治疗效果好,可显著改善患者症状,减轻体内炎症反应,增加HPV转阴率,调节Th17和Treg细胞,对预防宫颈癌有重要作用。     

circ_SEPT9, a newly identified circular RNA,promotes oral squamous cell carcinoma progression through miR‐1225/PKN2 axis

Circular RNAs (circRNAs) represent a newly discovered class of endogenous non‐coding RNAs which are widely expressed and play important roles in disease progression. However, the function of circRNAs in oral squamous cell carcinoma (OSCC) still remains largely unknown. In this research, we found that circ_SEPT9 was highly expressed in OSCC cell lines and tumour tissues. Results showed that circ_SEPT9 promoted OSCC proliferation and tumour growth. And, circ_SEPT9 also enhanced the migration and invasion of OSCC cells. Mechanically, we found that circ_SEPT9 acted as a sponge for miR‐1225 to rescue PKN2 expression in OSCC cells. Inhibition of circ_SEPT9/miR‐1225/PKN2 pathway could effectively block the proliferation and metastasis of OSCC cells. Our study provides strong evidence that circ_SEPT9/miR‐1225/PKN2 axis is a promising target for OSCC treatment.     

Prevalence of Plasmid-Mediated Quinolone Resistance and Aminoglycoside Resistance Determinants among Carbapeneme Non-Susceptible Enterobacter cloacae

Background

Simultaneous resistance to aminoglycosides and fluoroquinolones in carbapeneme non-susceptible (CNS) isolates will inevitably create problems. The present study was performed to characterize the prevalence of the plasmid-mediated quinolone resistance determinants (QRDs) and aminoglycoside resistance determinants (ARDs) among the CNS Enterobacter cloacae (E. cloacae) isolates in a Chinese teaching hospital, and to acquire their molecular epidemiological characteristics.

Methods

The β-lactamases genes (including class A carbapenemase genes bla_KPC and bla_SME, metallo-β-lactamase genes (MBLs) bla_IMP, bla_VIM and bla_NDM, and extended spectrum β-lactamases (ESBLs),bla_CTX-M, bla_TEM and bla_SHV), QRDs (including qnrA, qnrB, qnrS and aac(6′)-Ib-cr) and ARDs (including aac(6′)-Ib, armA and rmtB) of these 35 isolates were determined by PCR and sequenced bidirectionally. The clonal relatedness was investigated by pulsed-field gel electrophoresis (PFGE).

Results

Of the 35 isolates, 9 (25.7%) harbored a carbapenemase gene; 23 (65.7%) carried ESBLs; 24 (68.6%) were QRD positive; and 27 (77.1%) were ARD positive. Among the 5 bla_IMP-8 positive strains, 4 (80%) contained both ESBL and QRD genes, and all the 5 (100%) harbored ARD genes. Of the 23 ESBLs positive isolates, 6 (26.1%) were carbapenemase positive, 14 (60.9%) were QRD positive, and 18 (78.3%) were ARD positive. PFGE revealed genetic diversity among the 35 isolates, indicating that the high prevalence of CNS E. cloacae isolates was not caused by clonal dissemination.

Conclusion

QRD and ARD genes were highly prevalent among the CNS E. cloacae isolates. Multiple resistant genes were co-expressed in the same isolates. The CNS E. cloacae isolate co-expressing bla_NDM-1, bla_IMP-26, qnrA1 and qnrS1 was first reported.     

Two Novel Mutations in Myosin Binding Protein C Slow Causing Distal Arthrogryposis Type 2 in Two Large Han Chinese Families May Suggest Important Functional Role of Immunoglobulin Domain C2

Distal arthrogryposes (DAs) are a group of disorders that mainly involve the distal parts of the limbs and at least ten different DAs have been described to date. DAs are mostly described as autosomal dominant disorders with variable expressivity and incomplete penetrance, but recently autosomal recessive pattern was reported in distal arthrogryposis type 5D. Mutations in the contractile genes are found in about 50% of all DA patients. Of these genes, mutations in the gene encoding myosin binding protein C slow MYBPC1 were recently identified in two families with distal arthrogryposis type 1B. Here, we described two large Chinese families with autosomal dominant distal arthrogryposis type 2(DA2) with incomplete penetrance and variable expressivity. Some unique overextension contractures of the lower limbs and some distinctive facial features were present in our DA2 pedigrees. We performed follow-up DNA sequencing after linkage mapping and first identified two novel MYBPC1 mutations (c.1075G>A [p.E359K] and c.956C>T [p.P319L]) responsible for these Chinese DA2 families of which one introduced by germline mosacism. Each mutation was found to cosegregate with the DA2 phenotype in each family but not in population controls. Both substitutions occur within C2 immunoglobulin domain, which together with C1 and the M motif constitute the binding site for the S2 subfragment of myosin. Our results expand the phenotypic spectrum of MYBPC1-related arthrogryposis multiplex congenita (AMC). We also proposed the possible molecular mechanisms that may underlie the pathogenesis of DA2 myopathy associated with these two substitutions in MYBPC1.     

Ca2+ activation of RyR1 is not necessary for the initiation of skeletal-type excitation-contraction coupling

Although an elevation in myoplasmic Ca2+ can activate the skeletal muscle ryanodine receptor (RyR1), the function of this Ca2+ activation is unclear because extracellular Ca2+ influx is unnecessary for skeletal-type EC coupling. To determine whether Ca2+ activation of RyR1 is necessary for the initiation of skeletal-type EC coupling, we examined the behavior of RyR1 with glutamate 4032 mutated to alanine (E4032A-RyR1) because this mutation had been shown to dramatically reduce activation by Ca2+. Proc. Natl. Acad. Sci. USA. 98:2865-2870). Analysis after reconstitution into planar lipid bilayers revealed that E4032A-RyR1 was negligibly activated by 100 microM Ca2+ (P(o) too low to be measured). Even in the presence of both 2 mM caffeine and 2 mM ATP, P(o) remained low for E4032A-RyR1 (ranging from <0.0001 in 100 microM free Ca2+ to 0.005 in 2 mM free Ca2+). Thus, the E4032A mutation caused a nearly complete suppression of activation of RyR1 by Ca2+. Depolarization of E4032A-RyR1-expressing myotubes elicited L-type Ca2+ currents of approximately normal size and myoplasmic Ca2+ transients that were skeletal-type, but about fivefold smaller than those for wild-type RyR1. The reduced amplitude of the Ca2+ transient is consistent either with the possibility that Ca2+ activation amplifies Ca2+ release during EC coupling, or that the E4032A mutation generally inhibits activation of RyR1. In either case, Ca2+ activation of RyR1 does not appear to be necessary for the initiation of Ca2+ release during EC coupling in skeletal muscle.     

Hypercholesterolemia promotes a CD36-dependent and endothelial nitric-oxide synthase-mediated vascular dysfunction

Numerous studies have implicated either the presence or absence of CD36 in the development of hypertension. In addition, hypercholesterolemia is associated with the loss of nitric oxide-induced vasodilation and the subsequent increase in blood pressure. In the current study, we tested the hypothesis that diet-induced hypercholesterolemia promotes the disruption of agonist-stimulated nitric oxide generation and vasodilation in a CD36-dependent manner. To test this, C57BL/6, apoE null, CD36 null, and apoE/CD36 null mice were maintained on chow or high fat diets. In contrast to apoE null mice fed a chow diet, apoE null mice fed a high fat diet did not respond to acetylcholine with a decrease in blood pressure. Caveolae isolated from in vivo vessels did not contain endothelial nitric-oxide synthase and were depleted of cholesterol. Age-matched apoE/CD36 null mice fed a chow or high fat diet responded to acetylcholine with a decrease in blood pressure. The mechanism underlying the vascular dysfunction was reversible because vessels isolated from apoE null high fat-fed mice regained responsiveness to acetylcholine when incubated with plasma obtained from chow-fed mice. Further analysis demonstrated that the plasma low density lipoprotein fraction was responsible for depleting caveolae of cholesterol, removing endothelial nitric-oxide synthase from caveolae, and preventing nitric oxide production. In addition, the pharmacological removal of caveola cholesterol with cyclodextrin mimicked the effects caused by the low density lipoprotein fraction. We conclude that the ablation of CD36 prevented the negative impact of hypercholesterolemia on agonist-stimulated nitric oxide-mediated vasodilation in apoE null mice. These studies provide a direct link between CD36 and the early events that underlie hypercholesterolemia-mediated hypertension and mechanistic linkages between CD36 function, nitric-oxide synthase activation, caveolae integrity, and blood pressure regulation.     

In vitro release of growth hormone-releasing factor from rat hypothalamus: effect of insulin-like growth factor-1

The release of growth hormone-releasing factor (GHRF) from rat hypothalamus was investigated in vitro. After 60 min preincubation the released GHRF from sliced rat hypothalamic fragments during 60 min incubation was detected by a highly specific and sensitive radioimmunoassay for rat GHRF. The release of GHRF was Ca2+-dependent and enhanced by high concentration of K+. Insulin-like growth factor-1 (IGF-1) significantly decreased GHRF release to 65% and 84% of the control at concentrations of 10(-8) M and 10(-7) M, respectively. These results suggest that this in vitro system is useful for the investigation of the mechanism of GHRF release from the hypothalamus and that IGF-1 is probably involved in the feedback inhibition of growth hormone secretion by attenuating GHRF release from the hypothalamus besides countering the effect of GHRF on the pituitary.     

大鼠骨骼肌多催化功能蛋白酶的提取、鉴定及其抗血清的制备

为了研究多催化功能蛋白酶（ｍｕｌｔｉｃａｔａｌｙｔｉｃａｌｐｒｏｔｅｉｎａｓｅ,ＭＣＰ）在负氮平衡形成中的作用,以大鼠骨骼肌为原料,提取此酶并制备其抗血清．将大鼠骨骼肌粗提物经４５％～６５％饱和度硫酸铵分级盐析、阴离子交换层析和凝胶过滤,最后从Ｓｅｐｈａｒｏｓｅ４Ｂ层析柱上获得单一活性洗脱峰．酶活性用Ｃａｒｂｏｂｅｎｚｏｘｙ－Ｖａｌ－Ｇｌｙ－Ａｒｇ－４－ｎｉｔｒｉｎｉｌｉｄｅａｃｅｔａｔｅ作底物检测．非变性ＰＡＧＥ银盐染色显示单一区带的骨骼肌多催化功能蛋白酶,ＳＤＳ－ＰＡＧＥ银盐染色显示１０条亚基电泳区带,分子量在２５～３２ｋＤ之间．纯化的酶免疫兔８周后,抗血清效价达１３２,用分级盐析和离子交换层析纯化抗血清,显示单一电泳区带的ＩｇＧ．Ｗｅｓｔｅｒｎ－ｂｌｏｔ分析显示只在２５～３２ｋＤ之间出现多条亚基区带．这些结果提示已获得电泳纯ＭＣＰ及其较高特异性的多克隆抗体．