摘要:目的: 金黄色葡萄球菌(金葡菌)的感染近年来已成为医院内的主要致病菌,而其耐药性也呈逐渐升高的趋势,为了解该菌在我院的感染和耐药情况,为临床合理使用抗生素提供科学依据。 方法 : 用经典生理生化鉴定方法,对各种临床标本主要来源于痰液和各种伤口脓液标本分离到的102株金葡菌进行生物学特性及药敏试验。 结果 : 从我们医院2007年5月至2009年8月所分离出来的102株金葡菌中青霉素耐药性8923%,氨苄青霉素耐药率为9385%,没有发现万古霉素耐药菌。 结论 : 除万古霉素外,耐药率较低的依次是利福平、苯唑青霉素、环丙沙星、呋喃妥因、阿米卡星、磺胺甲基异恶唑、红霉素,而青霉素G、氨苄青霉素、四环素耐药性情况非常严重,并且多重耐药,耐药性强,应引起临床的高度重视。Abstract: Objective: To analyze the bionomics and antimicrobial susceptibility of staphylococcus aureus, which was the main pathogenic bacterium with high drug tolerance in our hospital, in order to provide the rational use of antibiotics. Methods : Samples of one hundred and two staphylococcus aureus cases from sputamentum and pus were evaluated by classic physiology and biochemistry methods to test the bionomics and antimicrobial susceptibility. Results : The drug resistance rate to penicillin, penbritin and vancomycin was 8923%, 9385% and 0, separately. Conclusion : Besides vancomycin, the drug resistance rate of rifampicin, oxazocilline, ciprofloxacin, furadantin, amikacin, sulfamethoxazole and sulfamethoxazole increased one by one. The resistance to penicillin G, penbritin and tetracycline was serious, including multidrug resistant, which should be paid highly attention.
ObjectiveTo observe Leber's hereditary optic neuropathy (LHON) microperimetry features, discuss its significance in diagnosis and treatment of LHON assessment. MethodsA retrospective clinical study. A total of 13 LHON patients (25 eyes) diagnosed in Department of Ophthalmology of the First Affiliated Hospital of Army Medical University from May 2015 to May 2020 (disease group) were included in the study, including 9 males (18 eyes) and 4 females (7 eyes), and beginning with the age of 15.0 (10.0, 57.0). Ten healthy volunteers (19 eyes) were selected as the normal group, including 7 males (13 eyes) and 3 females (6 eyes), aged 22.0 (6.0, 46.0) years at the first diagnosis. According to the course is divided into: asymptomatic group (carriers), subacute (＜6 months), the dynamic group (6-12 months), chronic group (＞12 months). There were 7, 6, 5 and 7 eyes, respectively. All eyes underwent best corrected visual acuity (BCVA) and microperimetry. BCVA test was performed using the international standard visual acuity chart, which was statistically converted to the logarithm of the minimum Angle of resolution (logMAR) visual acuity. MP-3 microperimetry was used to perform microperimetry, and the mean sensitivity (MS) values of five regions were recorded: center, superior, temporal, inferior, and nasal. Mann-Whitney U test was used for comparison between two groups, and Kruskal-Wallis H test was used for comparison between multiple groups. ResultsCompared with the normal group, MS in the center, superior, temporal, inferior and nasal of the diseased group decreased, and the differences were statistically significant (Z=－5.629, －4.906, －5.630, －5.631, －5.227; P＜0.05). There were significant differences in different regions of MS between different course groups (H=12.296, 11.583, 10.110, 12.994, 8.663; P＜0.05). There were significant differences in logMAR BCVA and central MS between asymptomatic group and subacute group (P=0.040, 0.007). There were significant differences in temporal, inferior and superior MS between subacute group and dynamic group (P=0.026, 0.017, 0.018). Dynamic and chronic group, MS above the difference was statistically significant (P=0.031). Idebenone treatment significantly improved visual field defects in 4 of 23 eyes. ConclusionsIn the early stage of LHON, the central visual field defect gradually progresses to the temporal, inferior and superior areas, and the temporal and inferior areas are more severe. Visual field defects reached a stable level at 6-12 months. MP-3 can assist in early diagnosis of LHON, and provide reliable basis for efficacy evaluation.
Objective To study the retinal light sensitivity of central visual field in normal children. Methods The QZS-Ⅱ automated perimetry was used to assess the visual field of centro-30deg;and centro-6deg; in normal or ametropic eyes in 60 eyes of 5～9 years old children. Results The mean sensitivity(MS)was not influenced by sex,age and laterality and ametropia of the eye.The normal type of dB distribution was obviously higher than the abnormal(P＜0.01).We set normal range as 30deg;MS＞19.3 dB, 6deg;MS＞22.5 dB.The abnormality of value or distribution didnprime;t appear in the same field. Conclusions In normal children,the dB distribution of visual field was mainly of the normal type.We suggest that in evaluating function of visual filed of the children,the dB distribution of centro-30deg;and centro-6deg;field and the value of MS should be included. (Chin J Ocul Fundus Dis, 1999, 15: 137-138)
ObjectiveTo investigate the relation between preoperative peripheral blood neutrophil/albumin (NEU/ALB) or hypersensitive C-reactive protein (hs-CRP)/ALB ratio and seroma after laparoscopic transabdominal preperitoneal (LTAPP) hernia repair. MethodsThe patients diagnosed with inguinal hernia and underwent LTAPP hernia repair admitted to the Heji Hospital Affiliated to Changzhi Medical College from June 2020 to June 2023 were retrospectively collected. The multivariate logistic regression analysis was conducted to identify the risk factors affecting the occurrence of seroma after LTAPP hernia repair. The area under receiver operating characteristic curve (AUC) and 95% confidence interval (95%CI) were used to evaluate the discriminatory value of preoperative peripheral blood NEU/ALB ratio and hs-CRP/ALB ratio for seroma after LTAPP hernia repair. Delong test was used to compare the discriminatory value of these indicators. The test level was α=0.05. ResultsA total of 357 patients who met the inclusion criteria were included in this study, and the seroma occurred in 42 cases (11.8%). The results of multivariate logistic regression analysis showed that the larger the diameter of the hernia sac [OR (95%CI)=4.654 (2.829, 7.657), P<0.001], the more intraoperative bleeding [OR (95%CI)=3.021 (1.498, 6.094), P=0.002], and the higher NEU/ALB ratio [OR (95%CI)=2.585 (1.618, 4.130), P<0.001] or hs-CRP/ALB ratio [OR (95%CI)=1.874 (1.239, 2.834), P=0.003], the higher the probability of seroma after LTAPP hernia repair. The AUC (95%CI) of NEU/ALB or hs-CRP/ALB indicator for predicting seroma after LTAPP hernia repair was 0.750 (0.702, 0.794) and 0.762 (0.715, 0.806), respectively. The optimal cutoff values were 2.970 and 4.001, with sensitivity of 78.6% and 73.8%, and specificity of 60.3% and 65.7%, respectively. The AUC (95%CI) of the NEU/ALB in combination with hs-CRP/ALB in predicting seroma after LTAPP hernia repair was 0.851 (0.810, 0.886), with sensitivity and specificity of 71.4% and 87.0%, respectively. The AUC of the NEU/ALB in combination with hs-CRP/ALB in predicting seroma after LTAPP hernia repair was higher than that of NEU/ALB (Z=2.864, P=0.004) or hs-CRP/ALB alone (Z=2.956, P=0.003). ConclusionFrom the data analysis results of this study, the occurrence rate of seroma after LTAPP hernia repair is not low, and the occurrence of seroma should be paid close attention to patients with larger hernia sac diameter, more intraoperative bleeding, and higher NEU/ALB or hs-CRP/ALB ratio.
Although anaphylaxis induced by vitamin K1 seldom happens, 4 allergic cases were observed in the patients we treated recently who were given intramuscular injection of vitamin K1 before renal biopsy. To provide the best clinical evidence, we searched MEDLINE （-May 2005） and evaluated the studies. The studies were only case reports and retrospective reviews which showed the anaphylaxis were mainly allergic dermatitis with different manifestation and reaction time. The serious reactions such as allergic shock was very rare. We conclude that although vitamin K1 anaphylaxis is rare, strict indications should be followed and the drug surveillance on adverse events should be strengthened.
Objective To investigate the expression and clinical significance of soluble triggering receptor expression on myeloid cells-1（sTREM-1） in sepsis patients.Methods Serum concentrations of sTREM-1，procalcitonin（PCT），tumor necrosis factor alpha（TNF-α） and interleukin-10（IL-10） were measured by enzyme-linked immunosorbent assay，while high sensitivity C-reactive protein （hsCRP） level was detected by immunoturbidimetry in 68 patients with sepsis，40 patients with no-infective SIRS，and 20 normal individuals. The diagnostic and prognostic value of sTREM-1 and its comparison with PCT and hsCRP were analyzed. The sequential organ failure assessment （SOFA） score system was used to evaluate the severity of sepsis. The relationship between sTREM-1, PCT , hsCRP , SOFA score，TNF-α ,and IL-10 of the sepsis patients was analyzed，respectively. Results The differences in the serum concentrations of sTREM-1，PCT，hsCRP，IL-10 and IL-10/TNF-α ratio had statistical significance among three groups（Plt;0.05）. The differences in the serum concentration of TNF-α had no statistical significance among three groups （Pgt;0.05）. However，the serum levels of sTREM-1，PCT and hsCRP in the sepsis group were significantly higher than those in the SIRS group （Plt;0.05）. The receiver operating characteristic curve （ROC） analysis showed the area under the curve （AUC） for sTREM-1，PCT and hsCRP were 0.772 （95%CI 0.674-0.871），0.718 （95%CI 0.601-0.835） and 0.664 （95%CI 0.532-0.797），respectively. The serum levels of sTREM-1 and PCT in the non-survivors were significantly higher than the survivors in the sepsis group （Plt;0.01），but the differences in the serum concentration of hsCRP had no statistical significance between the non-survivors and the survivors in the sepsis group （Pgt;0.05）. There were significantly positive correlations between sTREM-1 and SOFA score，IL-10 or IL-10/TNF-α ratio（r value of 0.453，0.301，0.417，Plt;0.05），but no correlation between sTREM-1 and TNF-α（Pgt;0.05）. There was significantly positive correlation between PCT and SOFA score （r=0.436，Plt;0.05），while no relationship between hsCRP and SOFA score（Pgt;0.05）. Conclusions The serum level of sTREM-1 not only be valuable in the diagnosis of sepsis，but also may be used as a prognostic marker in sepsis，as it can reflect the severity of sepsis in certain degree. Furthermore，sTREM-1 or PCT may be superior to hsCRP in diagnosis，prognostic judgment and severity assessment of sepsis.
In the development of radio frequency (RF) coils for better quality of the mini-type permanent magnetic resonance imager for using in the small animal imaging, the solenoid RF coil has a special advantage for permanent magnetic system based on analyses of various types of RF coils. However, it is not satisfied for imaging if the RF coils are directly used. By theoretical analyses of the magnetic field properties produced from the solenoid coil, the research direction was determined by careful studies to raise further the uniformity of the magnetic field coil, receiving coil sensitivity for signals and signal-to-noise ratio (SNR). The method had certain advantages and avoided some shortcomings of the other different coil types, such as, birdcage coil, saddle shaped coil and phased array coil by using the alloy materials (from our own patent). The RF coils were designed, developed and made for keeled applicable to permanent magnet-type magnetic resonance imager, multi-coil combination-type, single-channel overall RF receiving coil, and applied for a patent. Mounted on three instruments (25 mm aperture, with main magnetic field strength of 0.5 T or 1.5 T, and 50 mm aperture, with main magnetic field strength of 0.48 T), we performed experiments with mice, rats, and nude mice bearing tumors. The experimental results indicated that the RF receiving coil was fully applicable to the permanent magnet-type imaging system.
ObjectiveTo review the effects of desensitizing toothpaste containing NovaMin for dentine hypersensitivity. MethodsSuch databases as CNKI, WanFang Data, CBM, VIP, PubMed, Web of Science and The Cochrane Library (Issue 11, 2013) were searched, and meanwhile Google Scholar was used for supplementary search up to December 2013. Randomized controlled trials (RCTs) on treating dentine hypersensitivity with NovaMin-containing toothpaste were retrieved. Literature screening, data extraction and quality assessment were completed independently by two reviewers. Meta-analysis was then performed using RevMan 5.2 software. ResultsSix RCTs involving 283 patients (experiment:140 patients; control:143 patients) were included. The results of meta-analysis showed that at 4 weeks, NovaMin-containing toothpaste was significantly better than potassium-containing toothpaste in alleviating patients' cold sensitivity (SMD=-1.60, 95%CI-2.14 to-1.05, P=0.01) and air blast (SMD=-1.12, 95%-1.64 to-0.60, P=0.02). ConclusionCurrent evidence shows that, NovaMin-containing toothpaste is effective in treating dentine hypersensitivity, compared with other toothpaste that has been proved to be effective in clinic. However, due to the limited quantity and quality of the included studies, more high quality and large-sample RCTs are needed to further verify the above conclusion.
Medical whole-body positron emission tomography (PET), one of the most successful molecular imaging technologies, has been widely used in the fields of cancer diagnosis, cardiovascular disease diagnosis and cranial nerve study. But, on the other hand, the sensitivity, spatial resolution and signal-noise-ratio of the commercial medical whole-body PET systems still have some shortcomings and a great room for improvement. The sensitivity, spatial resolution and signal-noise-ratio of PET system are largely affected by the performances of the scintillators and the photo detectors. The design of a PET system is usually a trade-off in cost and performance. A better image quality can be achieved by optimizing and balancing the key components which affect the system performance the most without dramatically increases in cost. With the development of the scintillator, photo-detector and high speed electronic system, the performance of medical whole-body PET system would be dramatically improved. In this paper, we report current progresses and discuss future directions of the developments of technologies in medical whole-body PET system.
Objective To investigate the clinical features of hypersensitivity pneumonitis and misdiagnosis causes. Methods The morbidity, misdiagnosis, progression, treatment, recovery, relapse and experience of treatment of a case with hypersensitivity pneumonitis was retrospectively analyzed. Results Patients with hypersensitivity pneumonitis usually have a contact history of organic dust, and clinical manifestations are nonspecific. Chest radiography shows wandering pattern of multiple reticular or patchy infiltration shadows. Lung function tests showrestricted ventilation and impaired diffusion. Blood eosinophil is usually normal. Lymphocyte and sedimentation antibody in serum and bronchoalveolar lavage fluid may still be normal. Pathohistology is complicated, with a progression from acute inflammation to chronic fibrosis. Systemic steroid should be prescribed as soon as possible. Antigen avoidance should be emphasized. Conclusions Clinical symptoms of hypersensitivity pneumonitis is atypical, which may be easily misdiagnosed. The contact history, clinical features, chest radiography, laboratory examination and pathological changes should all be considered in such cases.