重症急性胰腺炎合并腹腔感染患者病原菌分布、药物敏感性分析及其院内死亡的危险因素探讨

摘要 目的：观察重症急性胰腺炎（SAP）合并腹腔感染（IAI）患者病原菌分布,分析药物敏感性,同时探讨其院内死亡的危险因素。方法：本研究纳入2017年1月~2022年1月期间来解放军联勤保障部队第九二二医院接受治疗并确诊的SAP合并IAI患者100例,采集患者腹水标本,观察其病原菌分布,分析药物敏感性。入院后收集患者人口学特征、实验室检查等资料,探讨患者院内死亡的危险因素。结果：100例SAP合并IAI患者腹水标本中,分离出186株病原菌,其中革兰阴性菌有108株,占比58.06%。革兰阳性菌51株,占比27.42%。真菌27株,占比14.52%。鲍曼不动杆菌对不同抗菌药物的敏感性均较低,大肠埃希菌对厄他培南、亚胺培南、哌拉西林／他唑巴坦、庆大霉素、美罗培南的敏感性较高,肺炎克雷伯菌对亚胺培南、美罗培南的敏感性较高,葡萄球菌属对替加环素、万古霉素、利奈唑胺的敏感性较高,屎肠球菌对替加环素、利奈唑胺的敏感性较高,粪肠球菌对氨苄西林、万古霉素、环丙沙星、替加环素的敏感性较高。单因素分析显示,SAP合并IAI患者院内死亡与器官障碍数目、膀胱压、入院时急性生理学与慢性健康状况评分（APACHE II）评分、白细胞计数（WBC）、血钙、红细胞压积（HCT）、总胆固醇（TC）、甘油三醋（TG）、降钙素原（PCT）、C反应蛋白（CRP）、动脉二氧化碳分压（PaCO₂）、动脉氧分压（PaO2）有关（P<0.05）。多因素Logistic回归分析结果显示：器官障碍数目偏多、血钙偏低、CRP偏高、APACHE II评分偏高、膀胱压偏高、PaO₂偏低、WBC偏高是导致SAP合并IAI患者院内死亡的危险因素（P<0.05）。结论：SAP合并IAI患者病原菌分布以革兰阴性菌为主,主要的革兰阴性菌、革兰阳性菌耐药率高。此外,器官障碍数目偏多、血钙偏低、CRP偏高、APACHE II评分偏高、膀胱压偏高、PaO₂偏低、WBC偏高是影响SAP合并IAI患者院内死亡的危险因素。     

Mycoplasma orale infection affects K+ and Cl− currents in the HSG salivary gland cell line

Summary The relations between K⁺ channel and Cl⁻ channel currents and mycoplasma infection status were studied longitudinally in HSG cells, a human submandibular gland cell line. The K⁺ channel currents were disrupted by the occurrence of mycoplasma infection: muscarinic activation of K⁺ channels and K⁺ channel expression as estimated by ionomycin- or hypotonically induced K⁺ current responses were all decreased. Similar decreases in ionomycin- and hypotonically induced responses were observed for Cl⁻ channels, but only the latter decrease was statistically significant. Also, Cl⁻ currents could be elicited more frequently than K⁺ currents (63% of cases versus 0%) in infected cells when tested by exposure to hypotonic media, indicating that mycoplasma infection affects K⁺ channels relatively more than Cl⁻ channels. These changes occurred in the originally infected cells, were ameliorated when the infection was cleared with sparfloxacin, and recurred when the cells were reinfected. Such changes would be expected to result in hyposecretion of salivary fluid if they occurredin vivo.     

艾滋病合并隐球菌感染17例尸检材料的临床病理学研究

在１５１例艾滋病尸检材料中发现１７例合并隐球菌感染,均经病理学确诊,患者男１５名,女２名,平均４３．６岁。１２例发生脑膜炎、肺炎和淋巴结炎各７例,尚见脾（６例）、肾（５例）等器官受累。９例为播散性感染。病变为慢性肉牙肿性,其中见有隐球菌。本文描述隐球菌性脑膜炎、肺炎等临床病理学表现,并讨论其病变特征与病理诊断问题。     

Factors affecting Citrus tree isozyme-gene expression

Ten enzymatic systems of Citrus species and cultivars have been evaluated for identification purposes and for genetic variability studies. The following factors that could affect their expression were studied: season of sampling, location, rootstock, position of the branch, infection, and age of the tree. Differences involving the presence-absence of the Cu/Zn SOD within the same tree were found. This difference is mainly related to the position of the leaf relative to the sunlight. No change was observed at any of the ten enzymatic systems assayed regarding the location, the rootstock, the growing condition, the season, or the infection with most virus and virus-like pathogens. Viroids induced noticeable changes on 6PG and PRXa zymograms in C. medica. A new peroxidase (not present in healthy plants) was detected that could be related to appearance of symptoms. This may induce errors when trees without sanitary control are characterized by this enzymatic system. On the other hand, it provides a new possibility for studying the plant response to the presence of viroids. An effect of age, from 3 months up to 12 years, was observed on citrange Troyer and mandarin Cleopatra PRX, MDH and 6PG patterns. An important change occurs around the first year, most likely related to the end of the seedling stage. This is followed by a long transition phase, the end of which (around 9 years later) coincides with a change in the PRX pattern. These age-related changes seem to involve post-translational modifications of pre-existing isozymes.     

Experimental Oesophagostomum dentatum infection in the pig: Worm populations resulting from single infections with three doses of larvae

This report describes the effect of different dose levels of infection upon worm burdens and development and fecundity of the parasites. Three groups each of 40, 9-week-old, helminth naïve pigs were inoculated once with either 2000 (group A), 20,000 (group B), or 200,000 (group C) infective third stage larvae of Oesophagostomum dentatum. Subgroups of 5 pigs from each major group were killed 3, 6, 11, 14, 18, 25, 34 and 47 days post inoculation (p.i.) and the large intestinal worm burdens were determined. Faecal egg counts were determined at frequent intervals after day 13 p.i. There were no overt clinical signs of gastrointestinal helminthosis during the experiment. Faecal egg counts became positive in groups A and B at around day 19 p.i., whereas most pigs in the high dose group C did not have positive egg counts until day 27–33 p.i. and some pigs remained with zero egg counts until the end of the study. Throughout the experiment the worm populations in group C consisted mainly of immature larval stages, while those in groups A and B were predominantly adult stages after days 14–18. Adult worms from the low dose group A were significantly longer than those from group C. At high population densities, stunted development of worms and reduced fecundity among female worms were found. Furthermore, there was a tendency for the distribution of the worms within the intestine to be altered with increasing population size.     

Disinfection Alternatives for Control of Ditylenchus dipsaci in Garlic Seed Cloves

Hot-water dips with and without the additives abamectin and sodium hypochlorite were evaluated for control of Ditylenchus dipsaci infection of garlic seed cloves. All treatments were compared to hot water-formalin clove dip disinfection and to nontreated infected controls for garlic emergence, midseason infection, bulb damage, and yield at harvest in field plots in 12 experiments. Hot-water treatments without additives only partially controlled D. dipsaci when a warming presoak dip (38 C) of 30, 45, or 60 minutes'' duration was followed by a hot-water dip (49 C) of 15-30 minutes'' duration. Exposure to 49 C for 30 minutes caused slight retardation of garlic emergence, although normal stand was established. Abamectin at 10-20 ppm as the 20-minute hot dip (49 C) or as a 20-minute cool dip (18 C) following a 20-minute hot-water dip and sodium hypochlorite at 1.052-1.313% aqueous solution as the 20-minute hot dip were highly effective in controlling D. dipsaci and were noninjurious to garlic seed cloves. None of these treatments was as effective as a hot water-formalin dip and were noneradicative, but showed high efficacy on heavily infected seed cloves relative to nontreated controls. Abamectin was most effective as a cool dip. These abamectin cool-dip (following hot-water dip) and sodium hypochlorite hot-dip treatments can be considered as effective alternatives to replace formalin as a dip additive for control of clove-borne D. dipsaci. Sodium hypochlorite was less effective as the cool dip, and at concentrations of 1.75-2.63% was phytotoxic to garlic.     

Prevention of Vascular Graft Infection by Sisomicin Incorporated into Fibrin Glue

To examine the efficacy of sisomicin (SISO) incorporated into fibrin glue (FG) for the prevention of graft infection in animal models, the susceptibility to infection of Dacron grafts (control) and SISO-FG Dacron grafts following the inoculation of Staphylococcus aureus or S. epidermidis was compared. The results showed that SISO-FG Dacron grafts displayed resistance to graft infection.