血液或无菌体液培养阳性标本中病原菌检测结果分析

目的：了解血培养（包括血液、无菌体液培养,下同）阳性标本中病原菌的分布及阳性报警时间,为临床及时明确病原菌和正确用药提供参考依据。方法：无菌条件下采集血培养标本注人相应的培养瓶,经仪器扫描后放入血培养仪进行检测,报警后及时进行菌种鉴定和药敏试验。结果：364例阳性报警标本中真阳性标本为176例,其中革兰阳性菌占61．7％,革兰阴性菌占35．0％,真菌占3．3％;188例为假阳性标本,其中革兰阳性菌占54％,革兰阴性菌占41．9％,真菌占4．0％;新生儿科的感染阳性率最高;不同种类病原菌的阳性报警时间多重叠;临床医生经验用药正确或根据药敏结果更换用药的百分比为78．2％。结论：本院引起血液、无菌体液感染的病原菌以革兰阳性细菌为主,病原菌种类较多,存在一定的污染;当新生儿有局部感染时要警惕脓毒血症;单独靠血培养仪报警时间来鉴定区分病原菌与污染菌不一定可靠,及时了解血培养结果及标准药敏结果可以辅助找出感染性疾病的病因,尽早正确合理的使用抗菌药物,从而优化抗菌治疗。     

Trait adaptation promotes species coexistence in diverse predator and prey communities

Species can adjust their traits in response to selection which may strongly influence species coexistence. Nevertheless, current theory mainly assumes distinct and time‐invariant trait values. We examined the combined effects of the range and the speed of trait adaptation on species coexistence using an innovative multispecies predator–prey model. It allows for temporal trait changes of all predator and prey species and thus simultaneous coadaptation within and among trophic levels. We show that very small or slow trait adaptation did not facilitate coexistence because the stabilizing niche differences were not sufficient to offset the fitness differences. In contrast, sufficiently large and fast trait adaptation jointly promoted stable or neutrally stable species coexistence. Continuous trait adjustments in response to selection enabled a temporally variable convergence and divergence of species traits; that is, species became temporally more similar (neutral theory) or dissimilar (niche theory) depending on the selection pressure, resulting over time in a balance between niche differences stabilizing coexistence and fitness differences promoting competitive exclusion. Furthermore, coadaptation allowed prey and predator species to cluster into different functional groups. This equalized the fitness of similar species while maintaining sufficient niche differences among functionally different species delaying or preventing competitive exclusion. In contrast to previous studies, the emergent feedback between biomass and trait dynamics enabled supersaturated coexistence for a broad range of potential trait adaptation and parameters. We conclude that accounting for trait adaptation may explain stable and supersaturated species coexistence for a broad range of environmental conditions in natural systems when the absence of such adaptive changes would preclude it. Small trait changes, coincident with those that may occur within many natural populations, greatly enlarged the number of coexisting species.     

蛙类声音通讯研究进展

声音通讯包含鸣声的产生、传播及对鸣声的感知与行为响应。对大多数无尾两栖类而言,雄性个体间的竞争(即雄雄竞争)、雌性配偶识别与选择几乎完全依赖声音通讯,因此准确及时的声音信息传递与接收对蛙类的生存和繁殖起着决定性作用。本文总结了蛙类鸣叫特征及其产生机制,归纳了声音通讯在蛙类性选择中的功能及协同进化,探讨了鸣声感知的神经机制及声音通讯的内分泌机制。最后对蛙类声音通讯研究方向进行了展望,并提出了可能的解决方案。     

Vegetation,herbivores and fires in savanna ecosystems: A network perspective

The dynamics of savanna ecosystems depends on the interplay between multiple factors such as grazing, browsing, fires, rainfall regime and interactions between grass and woody vegetation. In most modelling applications this interplay may not be fully understood because some of these drivers enter the models as dynamically independent factors. In this paper we consider such factors as dynamic variables. To analyze their interplay we focus on the structure of the interactive network of variables and exploit the properties of signed digraphs using the algorithm of Loop Analysis. Qualitative signed digraphs for the savanna ecosystem are developed and their predictions used to interpret patterns of abundance observed in case studies selected from the literature. The outcomes of this exercise unveil that: 1) the structure of the interactions is appropriate locus for the explanation of patterns observed in savannas; 2) signed digraph can help disentangling causative mechanisms by linking correlation patterns, source of change and network structure. This study highlights that central to the understanding of savanna dynamics is our ability to diagram the important relationships and understand how they interrelate with sources of variations to cause ecosystem change.     

A specific inhibitor of lactate dehydrogenase overcame the resistance toward gemcitabine in hypoxic mesothelioma cells,and modulated the expression of the human equilibrative transporter-1

ABSTRACT

Malignant pleural mesothelioma (MPM) is a very hypoxic malignancy, and hypoxia has been associated with resistance towards gemcitabine. The muscle-isoform of lactate dehydrogenase (LDH-A) constitutes a major checkpoint for the switch to anaerobic glycolysis. Therefore we investigated the combination of a new LDH-A inhibitor (NHI-1) with gemcitabine in MPM cell lines. Under hypoxia (O₂ tension of 1%) the cell growth inhibitory effects of gemcitabine, were reduced, as demonstrated by a 5- to 10-fold increase in IC₅₀s. However, the simultaneous addition of NHI-1 was synergistic (combination index < 1). Flow cytometry demonstrated that hypoxia caused a G1 arrest, whereas the combination of NHI-1 significantly increased gemcitabine-induced cell death. Finally, the mRNA expression levels of the human equilibrative transporter-1 (hENT1) were significantly down-regulated under hypoxia, but treatment with NHI-1 was associated with a recovery of hENT1 expression. In conclusion, our data show that hypoxia increased MPM resistance to gemcitabine. However, cell death induction and modulation of the key transporter in gemcitabine uptake may contribute to the synergistic interaction of gemcitabine with the LDH-A inhibitor NHI-1 and support further studies for the rational development of this combination.     

绍兴地区2型糖尿病尿路感染病原菌及其耐药性分析

摘要：目的 回顾分析本院2型糖尿病伴尿路感染患者的病原菌分布特点及其耐药性,为指导临床用药提供参考。方法 收集2013年1月至2014年1月2型糖尿病合并尿路感染患者186例,留取中段尿分离培养病原菌,用VITEK-2细菌鉴定仪鉴定,纸片扩散法（K-B）测定药物敏感性。结果 186例患者中段尿共培养出病原菌137株,其中革兰阴性菌102株（74.45%）,革兰阳性菌21株（15.33%）,真菌14株（10.22%）。革兰阴性菌以大肠埃希菌为主,检出79株占57.66%,对青霉素类,头孢菌素类,喹诺酮类抗菌药耐药率较高均＞50.00%,对头霉素类药物如头孢替坦、含酶抑制剂复合物如哌拉西林/他唑巴坦以及碳青霉烯类药物敏感率均达100.00%;革兰阳性球菌以无乳链球菌为主,检出10株占7.30%,对克林霉素及红霉素耐药率较高,耐药率＞50.00%,而对氯霉素、呋喃妥因、利奈唑烷、替加环素、万古霉素敏感率均达100.00%。除1株光滑假丝酵母菌对氟康唑和伊曲康唑中介,其余13株真菌对两性霉素B、5-氟胞嘧啶、伏立康唑、氟康唑、伊曲康唑这5种抗真菌药物均敏感。结论 2型糖尿病患者发生尿路感染的病原菌以大肠埃希菌为主,且有较高的耐药率。     

生境异质性对鼎湖山常绿阔叶林群落功能多样性的影响

物种共存机制一直以来是群落生态学的研究热点。为了探讨异质生境条件下鼎湖山常绿阔叶林群落功能多样性变化,找到其变化的主要环境驱动因子,该研究利用位于鼎湖山20 hm~2监测样地第2次群落调查数据并选择代表不同生境(海拔和地形)的27个样方(20 m×20 m),于2013年夏季在样地内所选样方中测定所有胸径≥1 cm树种的叶片功能性状。所测性状包括形态学性状(比叶面积、叶片干物质含量、叶面积以及叶片长宽比)和化学计量学性状(叶片碳、氮、磷的含量),结合地形和土壤数据并通过分析功能多样性随环境梯度的变化,探讨了环境过滤和竞争在鼎湖山群落物种共存中的相对重要性。结果表明:功能分歧度和群落权重平均值与环境因素关系密切,尤其是海拔、凹凸度和土壤养分。环境条件较好区域(微尺度高海拔、高凹凸度和土壤养分含量)的植物采取统一的养分有效保存(低SLA,高LDMC)的适应策略(功能分歧度低),环境过滤所起作用更强;植物在相反的环境条件下,采取快速生长策略(高SLA,低LDMC),能够更好地适应环境的变化,且性状变化是多样的(功能分歧度高),在该条件下竞争作用更为显著。叶面积和叶片氮含量的分歧度在环境条件较好的区域增大,这与其他功能性状不一致,说明不同生态位轴(环境因素)影响不同性状的分歧度变化,并且在局域尺度上植物为了更好地适应环境变化采取了多样的适应策略。     

急性心肌梗死合并肺部感染患者多药耐药菌分布特征及心肌酶谱指标与炎性因子的关系分析

目的:分析急性心肌梗死合并肺部感染患者多药耐药菌分布特征及炎性因子与心肌酶谱指标的关系。方法:选择2015年2月~2018年10月期间中国人民解放军联勤保障部队第940医院收治的67例急性心肌梗死合并肺部感染患者作为感染组,选取同期收治的60例单纯急性心肌梗死患者作为未感染组,分析感染组多药耐药菌的分布及其耐药性,比较两组炎性因子与心肌酶谱指标水平,采用Pearson相关性分析感染组患者炎性因子与心肌酶谱指标的相关性。结果:67例患者痰培养标本中共分离出136株病原菌,其中有64株属于多药耐药菌,多药耐药菌中革兰阴性菌38株,占59.37%,革兰阳性菌26株,占40.63%。其中主要革兰阴性菌对哌拉西林/舒巴坦、头孢哌酮/舒巴坦、阿米卡星、美罗培南、亚胺培南等较为敏感,主要革兰阳性菌对替考拉宁、万古霉素、利福平等较为敏感。感染组患者白细胞介素-6(IL-6)、乳酸脱氢酶(LDH)、促血管生成素-2(Ang-2)、肌酸激酶(CK)、肿瘤坏死因子-α(TNF-α)、谷草转氨酶(AST)、肌酸激酶同工酶(CKMB)水平均高于未感染组患者(P0.05)。经Pearson相关性分析可得,感染组患者血清IL-6、Ang-2、TNF-α水平与AST、LDH、CK、CK-MB水平均呈正相关(P0.05)。结论:急性心肌梗死合并肺部感染患者心肌酶谱与炎性因子水平关系密切,有助于判断患者病情严重程度,且急性心肌梗死合并肺部感染患者多药耐药现象较为严重,临床应针对病原菌合理选取抗菌药物。     

Mental illness and well‐being: an affect regulation perspective

Mental health crucially depends upon affective states such as emotions, stress responses, impulses and moods. These states shape how we think, feel and behave. Often, they support adaptive functioning. At other times, however, they can become detrimental to mental health via maladaptive affect generation processes and/or maladaptive affect regulation processes. Here, we present an integrative framework for considering the role of affect generation and regulation in mental illness and well‐being. Our model views affect generation as an iterative cycle of attending to, appraising and responding to situations. It views affect regulation as an iterative series of decisions aimed at altering affect generation. Affect regulation decisions include identifying what, if anything, should be changed about affect, selecting where to intervene in the affect generation cycle, choosing how to implement this intervention, and monitoring the regulation attempt to decide whether to maintain, switch or stop it. Difficulties with these decisions, often arising from biased inputs to them, can contribute to manifestations of mental illness such as clinical symptoms, syndromes and disorders. The model has a number of implications for clinical assessment and treatment. Specifically, it offers a common set of concepts for characterizing different affective states; it highlights interactions between affect generation and affect regulation; it identifies assessment and treatment targets among the component processes of affect regulation; and it is applicable to prevention and treatment of mental illness as well as to promotion and restoration of psychological well‐being.