微通道经皮肾镜碎石术治疗感染性结石合并尿液CRPA感染两例

目的:总结一期行微通道经皮肾镜碎石术(microchannel percutaneous nephrolithotripsy,m PCNL)治疗上尿路感染性结石合并尿培养为耐碳青霉烯铜绿假单胞菌(carbapenem resistant pseudomonas aeruginosa,CRPA)的经验。方法:选择我院收治两例左肾结石合并尿培养为CRPA的患者,经积极抗感染治疗后,病例一行左侧经皮肾镜碎石术,病例二先行右肾穿刺造瘘术成功后行左侧经皮肾镜碎石术,观察分析两例患者术后结石清除情况,术中术后出现发热、腰痛、大出血、尿路损伤及肾功能衰竭等并发症情况。结果:两例患者术后复查双J管位置良好,结石基本清除;术中、术后均未出现发热、腰痛、大出血、尿路损伤及肾功能衰竭等并发症。结论:经过合适的围手术期处理,一期微通道经皮肾镜碎石术治疗感染性结石合并尿培养为耐药菌的患者是安全可行的。     

超微血流成像术用于肾移植患者术后评估的临床价值分析

目的:探讨超微血流成像术用于肾移植患者术后评估的临床价值。方法:选取我院2019年2月-2019年8月收治的60例肾移植患者的临床资料,根据术后恢复情况分为A、B、C三组,A组(27例,术后肾功能恢复良好)、B组(20例,术后发生过敏肾功能异常病变但治疗后肾功恢复正常)、C组(13例,术后血肌酐水平持续增高肾功能异常者),三组均采用超微血管流成像术检测血管指数,比较不同组患者的血管指数并分析其与血肌酐水平的关系。结果:三组患者的肾移植长径、前后径、左右径、皮质厚度、叶间动脉阻力指数比较无显著差异(P0.05)。C组患者的肾皮质血管指数(23.34±6.03%)明显低于A组(33.23±3.45%)、B组(31.23±4.23%)(P0.05)。肾功能异常患者肾皮质的血管指数较低,且随着血肌酐水平的升高而下降,两者呈显著负相关(r=-0.23,P0.05)。结论:超声微血流成像术用于肾移植患者术后评估可较好地反映肾皮质血供及术后肾功能的变化。     

肺癌患者生活质量调查及化疗期间发生抑郁的影响因素分析

目的:探讨肺癌患者化疗前后生活质量的变化及化疗期间发生抑郁的影响因素。方法:将2015年1月～2019年12月我院收治的80例肺癌患者纳入研究。所有患者均接受化疗干预,采用健康状况调查简表(SF-36)评分评估患者化疗前后生活质量,以抑郁自评量表(SDS)评估患者抑郁发生情况。对肺癌患者化疗期间发生抑郁的影响因素进行单因素以及多因素Logistic回归分析。结果:化疗后患者的各项生活质量评分均低于化疗前(P0.05)。80例肺癌患者化疗期间出现46例抑郁症,抑郁症发生率为57.50%。经单因素分析发现:性别、受教育程度、家庭月收入、疼痛程度、知晓病情均与肺癌患者化疗期间发生抑郁有关(P0.05)。经多因素Logistic回归分析可得:女性、家庭月收入2500元、Ⅰ度及以上疼痛、知晓病情均是肺癌患者化疗期间发生抑郁的独立危险因素(OR=7.295、1.692、3.952、4.015,P0.05)。结论:化疗会在一定程度上降低肺癌患者的生活质量,同时会增加患者抑郁症发生风险,女性、家庭月收入2500元、Ⅰ度及以上疼痛、知晓病情均是肺癌患者化疗期间发生抑郁的独立危险因素。     

人免疫球蛋白联合IMP/CS和PS/TS对重症肺部感染患者炎性因子及T细胞亚群的影响

目的:人免疫球蛋白(HIG)联合亚胺培南西司他丁钠(IMP/CS)和哌拉西林他唑巴坦钠(PS/TS)治疗重症肺部感染的临床疗效。方法:选择2013年3月～2018年7月复旦大学附属华山医院北院收治的重症肺部感染患者99例为研究对象,采用随机数字法分为A组(33例,采用HIG+IMP/CS+PS/TS治疗)、B组(33例,采用IMP/CS+PS/TS治疗)和C组(33例,采用PS/TS治疗),比较三组有效率、炎性因子、T细胞亚群和不良反应。结果:A组临床总有效率为96.97%,高于B组的78.79%,B组高于C组的60.61%(P0.05)。治疗7 d后,三组C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、CD8~+水平较治疗前降低,CD4~+和CD4~+/CD8~+较治疗前升高,差异有统计学意义(P0.05)。治疗7 d后,A组CRP、IL-6、TNF-α、CD8~+水平低于B组,B组低于C组(P0.05);治疗7d后,A组CD4~+和CD4~+/CD8~+高于B组,B组高于C组(P0.05)。三组治疗期间均无药物相关不良反应的发生。结论:HIG联合IMP/CS和PS/TS治疗重症肺部感染患者安全有效,能有效改善患者的炎性反应,调节免疫功能,促进患者恢复。     

穴位埋线联合益肾化痰方对多囊卵巢综合征患者T、E2、LH水平影响

摘要 目的：探讨穴位埋线联合益肾化痰方对多囊卵巢综合征患者睾酮(testosterone,T)、雌二醇(estradiol,E₂)、黄体生成素(luteinizing hormone,LH)水平影响。方法：选取2018年1月至2019年6月我院收治的120例多囊卵巢综合征患者作为研究对象,随机将其分为两组,对照组60例,给予益肾化痰方治疗,研究组60例,在对照组的基础上联合穴位埋线治疗。观察两组治疗后的疗效及不良反应率,检测两组治疗后子宫内膜厚度、成熟卵泡数以及治疗前后T、E₂、LH水平变化情况。结果：研究组治疗的总有效率为 98.33 %,显著高于对照组治疗的总有效率（85.0 %,P＜0.05）。两组治疗后子宫内膜厚度及成熟卵泡数比较,研究组明显高于对照组(P＜0.05)。两组治疗前T、E₂、LH水平指标比较差异无统计学意义（P>0.05）;两组治疗后T、E₂、LH水平指标比较差异有统计学意义（P<0.05）。对照组头痛3例,恶心4例,不良反应率为11.67 %;研究组头痛1例,不良反应率为1.67 %,两组患者不良反应率比较有统计学意义（P<0.05）。结论：埋线联合益肾化痰方治疗多囊卵巢综合征患者,能有效的提高治疗疗效,改善患者T、E2、LH水平,促进排卵,安全可靠,值得临床推广和应用。     

Human Monoclonal Antibodies: On the Menu of Targeted Therapeutics Against COVID-19

Virologica Sinica - Coronavirus disease 2019 (COVID-19), reminiscent of the severe acute respiratory syndrome (SARS) outbreak in 2003, has been a tragic disaster to people all over the world. As...     

Distinct lung microbial community states in patients with pulmonary tuberculosis

An improved understanding of the lung microbiome may lead to better strategies to diagnose, treat, and prevent pulmonary tuberculosis(PTB). However, the characteristics of the lung microbiomes of patients with TB remain largely undefined. In this study, 163 bronchoalveolar lavage(BAL) samples were collected from 163 sputum-negative suspected PTB patients. Furthermore, 12 paired BAL samples were obtained from 12 Mycobacterium tuberculosis-positive(MTB+) patients before and after negative conversion following a two-month anti-TB treatment. The V3–V4 region of the 16 S ribosomal RNA(rRNA) gene was used to characterize the microbial composition of the lungs. The results showed that the prevalence of MTB in the BAL samples was 42.9%(70/163) among the sputum-negative patients. The α-diversity of lung microbiota was significantly less diverse in MTB+ patients compared with Mycobacterium tuberculosis-negative(MTB–) patients. There was a significant difference in β-diversity between MTB+ and MTB– patients. MTB+ patients were enriched with Anoxybacillus, while MTB– patients were enriched with Prevotella, Alloprevotella, Veillonella, and Gemella. There was no significant difference between the Anoxybacillus detection rates of MTB+ and MTB– patients. The paired comparison between the BAL samples from MTB+ patients and their negative conversion showed that BAL negative-conversion microbiota had a higher α-diversity. In conclusion, distinct features of airway microbiota could be identified between samples from patients with and without MTB. Our results imply links between lung microbiota and different clinical groups of active PTB.     

Phylogenetic relationships and biogeographic history of the unique Saxifraga sect. Irregulares (Saxifragaceae) from eastern Asia

Saxifraga L. is the largest genus in Saxifragaceae and a characteristic component of the herbaceous flora of the temperate and alpine mountains in the Northern Hemisphere. Section Irregulares is a small group of 15–20 species, representing one of the early‐diverged lineages in the genus characterized with unique zygomorphic flowers. We used both nuclear internal transcribed spacer and chloroplast DNA regions (psbA‐trnH, trnL‐F, and matK) to reconstruct its species relationships, estimate divergence times, and infer its historical biogeography. Our phylogenetic results corroborate the monophyly of sect. Irregulares and its sister relationship to sect. Heterisia from North America. The section was well resolved into two lineages corresponding to their morphological features and biogeographic distributions. One represents ser. Stoloniferae including S. stolonifera Curtis and S. nipponica Makino with long‐creeping stolons/rhizomes and small petals with spots and the other comprises the remaining taxa (ser. Rufescentes) which lack long‐creeping rhizomes. Spots on leaves (abaxially spotted vs. abaxially without spots) and spots on petals (without spots vs. with spots) are inferred to be phylogenetically informative within ser. Rufescentes. Divergence time estimates and ancestral area analysis suggested a western North American origin of sect. Irregulares with migration into East Asia by way of the Bering land bridge in the Middle Oligocene. The development of drying and desertification belt in the late Miocene could have played an important role in the subsequent restriction and separation of the north and south lineages within eastern Asia.     

载氢-纳米氧化铈微泡对小鼠造血系统抗辐射作用的分析

为探讨载氢-纳米氧化铈微泡对小鼠辐射损伤的防护作用。本研究检测载氢-纳米氧化铈微泡的表征,并将60只BALB/c小鼠随机分为正常对照组、照射对照组、载氢-纳米氧化铈微泡组。小鼠经6Gy x射线一次性全身照射(剂量率2 Gy/min)。于照射后3 d和8 d处死小鼠,检测其外周血细胞数、脾脏和胸腺指数、骨髓和脾脏组织病理学变化。结果显示,照射后3 d和8 d,与正常对照组相比,载氢-纳米氧化铈微泡组和照射对照组的白细胞均明显下降,相比照射对照组,载氢-纳米氧化铈微泡组有改善(p<0.05或p<0.01);而载氢-纳米氧化铈微泡组和照射对照组的红细胞数和血红蛋白均略有下降,但差异无统计学意义。与正常对照组相比,微泡组的胸腺指数、脾脏指数均有下降,和照射对照组相比,载氢-纳米氧化铈微泡组的胸腺指数明显改善(p<0.05或p<0.01)。照射后3 d,与正常对照组相比,照射对照组的骨髓细胞较少,存在细胞碎片,载氢-纳米氧化铈微泡组骨髓细胞数量略有减少,存在细胞核松散现象。而照射后8 d,与正常对照组相比,照射对照组的骨髓细胞几乎找不到,载氢-纳米氧化铈微泡组骨髓细胞有一定数量,存在细胞凋亡现象。本研究表明,载氢-纳米氧化铈微泡通过保护造血组织、改善造血功能,对机体起到一定的辐射防护作用。     

The ROK-family regulator Rok7B7 directly controls carbon catabolite repression,antibiotic biosynthesis,and morphological development in Streptomyces avermitilis

Carbon catabolite repression (CCR) is a common phenomenon in bacteria that modulates expression of genes involved in uptake of alternative carbon sources. In the filamentous streptomycetes, which produce half of all known antibiotics, the precise mechanism of CCR is yet unknown. We report here that the ROK-family regulator Rok7B7 pleiotropically controls xylose and glucose uptake, CCR, development, as well as production of the macrolide antibiotics avermectin and oligomycin A in Streptomyces avermitilis. Rok7B7 directly repressed structural genes for avermectin biosynthesis, whereas it activated olmRI, the cluster-situated activator gene for oligomycin A biosynthesis. Rok7B7 also directly repressed the xylose uptake operon xylFGH, whose expression was induced by xylose and repressed by glucose. Both xylose and glucose served as Rok7B7 ligands. rok7B7 deletion led to enhancement and reduction of avermectin and oligomycin A production, respectively, relieved CCR of xylFGH, and increased co-uptake efficiency of xylose and glucose. A consensus Rok7B7-binding site, 5′-TTKAMKHSTTSAV-3′, was identified within aveA1p, olmRIp, and xylFp, which allowed prediction of the Rok7B7 regulon and confirmation of 11 additional targets involved in development, secondary metabolism, glucose uptake, and primary metabolic processes. Our findings will facilitate methods for strain improvement, antibiotic overproduction, and co-uptake of xylose and glucose in Streptomyces species.