N6-甲基腺苷(N6-methyladenosine, m6A)修饰是真核生物信使 RNA中最丰富的表观遗传修饰,其失调会导致mRNA异常生物学行为如翻译和降解紊乱,从而调控肿瘤发生发展。近期研究表明m6A在免疫调控过程中可发挥重要作用,其不仅可调节免疫细胞的活化,还在肿瘤微环境中免疫应答发挥重要调控作用,从而影响免疫治疗效果。越来越多的证据表明m6A修饰可能是肿瘤免疫治疗的重要潜在干预靶点。本文阐述了免疫细胞中m6A修饰调控及其在肿瘤免疫微环境中相关调节作用,并进一步探讨了靶向m6A调控蛋白在肿瘤免疫治疗中的干预策略及潜在治疗价值。
N6-methyladenosine (m6A) modification is the most abundant epigenetic modification in eukaryotic messenger RNA (messenger RNA). Its dysregulation drives abnormal transcription and translation processes, which promotes the occurrence and development of tumors. Studies have shown that m6A modification can regulate the activation of immune cells and their infiltration into the tumor microenvironment (TME), which may affect the efficiency of immunotherapy. Therefore, m6A modification may be a potential target for tumor immunotherapy. This paper describes the modification of m6A in immune cells and the antitumor immune response associated with TME, and explores the potential therapeutic value of targeting m6A regulators in tumor immunotherapy.
近年来,由于抗生素的不合理使用,导致新型耐药性细菌不断出现,严重危害人类健康,迫使我们急需发现新型抗菌药物来对抗耐药性细菌引起的感染。FtsZ蛋白是细菌分裂的必需蛋白,在细菌分裂增殖过程中起着关键作用。当FtsZ的功能受到抑制时,细菌的分裂增殖亦会被抑制,最终导致细菌死亡。FtsZ蛋白是目前热门的抗菌新靶点之一。本文回顾了FtsZ蛋白的生物学功能,总结了以FtsZ为靶标的新型抗菌分子的研究进展。
Antibiotic-resistant bacterial infection has become epidemic all over the world. To overcome the drug resistance problem, antibacterial agents targeting at new binding sites become critical. FtsZ, a bacterial cell division protein, has become a new attractive target for antibacterial agents’ discovery because it is the most important and conserved protein in bacterial cell division. Cell division will be inhibited when the functions of FtsZ were disturbed. In this article, the biological functions of FtsZ have been reviewed, and recent advances in discovery of FtsZ inhibitors were summarized.
目的 研究白藜芦醇通过抑制T样受体4/核因子-κB(TLR4/NF-κB)通路对呼吸道合胞病毒(RSV)毛细支气管炎小鼠的保护作用。方法 选取30只小鼠随机分为对照组、RSV组、给药组,建立RSV毛细支气管炎小鼠模型,检测小鼠肺组织中TLR4、NF-κB的变化;利用肺组织HE染色、ELISA法检测白藜芦醇给药前后气道炎症病变、IL-6、TNF-α因子水平,Western Blot法及实时定量PCR法检测TLR4、 NF-κB蛋白及基因表达等相关变化。结果 与对照组相比,RSV组小鼠组肺组织中TLR4、NF-κB水平升高,肺组织切片HE染色显示气道炎症细胞浸润加剧,ELISA检测炎性因子IL-6、TNF-α升高;而给药组处理后,肺组织TLR4、NF-κB的表达下调,病理改变减轻,炎性因子IL-6、TNF-α下降。结论 白藜芦醇可通过抑制TLR4/NF-κB通路抑制炎性因子的释放,从而减轻毛细支气管炎小鼠的气道炎症反应。
Objective To study the protective effect of resveratrol on lung tissue of respiratory syncytial virus(RSV) bronchiolitis mice by regulating TLR4/NF-κB pathway. Methods Thirty mice were randomly divided into control group, RSV group and resveratrol group. The mice models of RSV bronchiolitis were established, and the changes of TLR4 and NF-κB levels in lung tissues of mice were detected. HE staining and ELISA were used to detect airway inflammation, IL-6 and TNF-α levels before and after resveratrol administration. TLR4 and NF-κB protein and gene expressions were detected by Western Blot and real-time quantitative PCR. Results Compared with the control group, the levels of TLR4 and NF-κB in the lung tissues of mice with bronchiolitis were significantly increased. Airway inflammatory cell infiltration was aggravated in HE staining of lung tissue sections, and inflammatory factors IL-6 and TNF-α were significantly increased showing by ELISA. The expressions of TLR4 and NF-κB in resveratrol group were down-regulated after treatment. Conclusions Resveratrol can inhibit the release of inflammatory factors by inhibiting the TLR4/NF-κB pathway, play a protective role in mice with bronchiolitis.
目的 为临床合理使用替考拉宁以及更好地管理接受替考拉宁治疗的患者。方法 从药学角度对2022年日本《2022 JSC/JSTDM临床实践指南:替考拉宁治疗药物监测》(简称《指南》)涉及替考拉宁治疗的9个临床问题进行解读。结果 《指南》指出药-时曲线下面积/最小抑菌浓度是替考拉宁的关键药动学/药效学参数。替考拉宁治疗药物监测(TDM)的目的是明确目标谷浓度(Cmin),对于严重或复杂的耐甲氧西林金黄色葡萄球菌(MRSA)感染,指南建议替考拉宁Cmin为20~40 mg/L。肾功能正常或轻度受损的非复杂性的MRSA感染,目标Cmin为15~30 mg/L。严重和/或复杂性MRSA感染,如感染性心内膜炎和骨髓炎,替考拉宁Cmin为20~40 mg/L。结论 《指南》针对不同病理状态下患者替考拉宁目标Cmin的确定,为临床治疗中替考拉宁TDM、个体化给药提供参考。
Objective To make rational use of teicoplanin and better management of patients treated with teicoplanin. Methods Nine clinical issues related to the treatment of teicoplanin in Clinical practice guidelines for therapeutic drug monitoring of teicoplanin: a consensus review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring (Japan, 2022) were interpreted from the perspective of pharmacy. Results The guidelines indicated that the area under drug-time curve/minimum inhibitory concentration was the key pharmacokinetic/pharmacodynamic parameters of teicoplanin.The purpose of therapeutic drug monitoring (TDM) of teicoplanin is to specify the target trough concentration (Cmin), which guidelines recommend for severe or complex methicillin-resistant Staphylococcus aureus (MRSA) infection is 20-40 mg/L.The target Cmin for uncomplicated MRSA infection with normal or mildly impaired renal function is 15-30 mg/L.For severe and/or complex MRSA infections, such as infective endocarditis and osteomyelitis, the Cmin of teicoplanin was 20-40 mg/L. Conclusions The guidelines are aimed at the determination of target Cmin of teicoplanin in patients with different pathological conditions, and provide reference for individual drug administration and teicoplanin TDM in clinical treatment.
目的 探讨关节外伤(扭伤和劳损)和痛风发作有无相关性。方法 选取自2017年1月—2020年5月间在我院中西医结合骨科门诊就诊的关节扭伤和劳损及痛风患者,采用《2015年美国风湿病协会/欧洲抗风湿联盟痛风分类标准》的痛风诊断标准,纳入76例门诊患者。采用SPSS 22.0软件进行Logistic回归分析。对单因素分析具有统计学意义(P<0.05)的因素,建立痛风主要危险因素的多元Logistic回归模型。结果 单因素Logistic回归分析中,性别、关节扭伤和劳损因素差异有统计学意义(P<0.05);多因素Logistic回归分析中,性别,关节扭伤和劳损因素差异有统计学意义(P<0.05)。结论 性别、关节扭伤和劳损是引起痛风发作的的危险因素。
Objective To explore the correlation between joint trauma (sprain or strain) and gout attack. Methods Patients with joint sprain, strain and gout treated in the orthopedic clinic of integrated traditional Chinese and Western medicine in our hospital from January 2017 to May 2020 were selected, 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative was adopted as diagnosing standard, 76 outpatients were included.Logistic regression analysis was carried out by SPSS 22.0 software.For the factors with statistical significance (P<0.05) in univariate analysis, a multivariate logistic regression model was established for the main risk factors of gout. Results In univariate logistic regression analysis, gender, sprain and strain were statistically significant (P<0.05).In multivariate logistic regression analysis, gender, joint sprain and strain were statistically significant (P<0.05). Conclusions Gender, joint sprain and strain can significantly increase the risk of gout attack.
目的 探究腔内微波消融(EMA)联合泡沫硬化剂治疗与腔内射频消融(RFA)联合泡沫硬化剂治疗下肢静脉曲张的临床疗效和并发症情况。方法 回顾性选择收集106例下肢静脉曲张患者的临床资料,其中54例患者(观察组)接受EMA联合泡沫硬化剂治疗,52例患者(对照组)接受RFA联合泡沫硬化剂治疗。比较2组患者相关临床指标及并发症发生情况。结果 观察组手术时间(34.92±2.35)min,对照组手术时间(46.33±2.71)min,观察组手术时间较短,差异有统计学意义(P＜0.05),其余手术参数差异不明显(P＞0.05)。观察组的住院费用(21 063.74±850.47)元,对照组住院费用(23 312.40±1 035.86)元,观察组住院费用较低,有统计学差异(P＜0.05)。2组间并发症发生率、总有效率和总满意度均无显著差异。对比2组患者手术前和手术治疗后1年的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分,组间对比没有统计学差异(P＞0.05);而在患者手术1年之后的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分均呈现出明显的下降趋势(P＜0.05)。结论 微波消融是有效治疗下肢静脉曲张的术式,与射频消融比较,具有同样良好的短期效果;微波消融所需的手术时间较短且费用较低。
Objective To compare the clinical efficacy and complications between endovascular microwave ablation (EMA) combined with foam sclerotherapy and radiofrequency ablation (RFA) combined with foam sclerotherapy in patients with varicose veins of lower extremity. Methods A total of 106 patients with varicose veins of lower extremity were included in the retrospective study.Among them, 54 patients (observation group) were treated with EMA combined with foam sclerotherapy, and 52 patients (control group) were treated with RFA combined with foam sclerotherapy.The related clinical indexes and complications between the two groups were compared. Results The observation group had a shorter procedure time than the control group (34.92±2.35 minutes vs 46.33±2.71 minutes, P＜0.05), and no significant differences were observed in the other procedure parameters.The hospitalization cost was (21063.74±850.47) yuan for the observation group and (23312.40±1035.86) yuan for the control group, and the hospitalization cost of the observation group was lower(P＜0.05).No significant differences were found in the total effective rate,total satisfaction and complication rate between the two groups.Comparison of venous clinical severity score (VCSS) and Aberdeen varicose vein questionnaire (AVVQ) scores before and one year after operation between the two groups showed no statistical differences (P＞0.05). While the VCSS and AVVQ scores of the patients showed a significant downward trend one year after operation (P＜0.05). Conclusions Microwave ablation is an effective treatment for varicose veins in the lower extremity, which has the same good short-term effect as radiofrequency ablation. Microwave ablation requires a shorter operation time and less cost.
目的 探索胸部CT值在胸腔积液鉴别诊断的价值。方法 81例胸腔积液患者纳入本研究,胸腔积液分为渗出液、漏出液、恶性胸腔积液及良性胸腔积液。建立平均CT值的ROC曲线,计算曲线下面积。结果 81例胸腔积液患者中59例为渗出液,22例为漏出液;恶性胸腔积液33例,良性胸腔积液48例。渗出液组平均CT值(16.68±6.76)Hu高于漏出液组(5.50±3.42)Hu(P<0.000 1)。ROC曲线分析结果显示,胸腔积液平均CT值对区分渗出液和漏出液具有较高的准确性(曲线下面积为0.944 5)。当最佳界值为≥9.99 Hu时,其敏感度为88.14%,特异度为90.91%;恶性胸腔积液组平均CT值(15.38±7.29)Hu与良性胸腔积液组平均CT值(12.45±8.03)Hu没有差异(P=0.098 1)。结论 在胸腔积液的鉴别诊断过程中,胸部CT的CT值在鉴别漏出液及渗出液中有一定的价值,但尚不能用于鉴别良性及恶性胸腔积液。
Objective To explore the value of chest CT value in the differential diagnosis of pleural effusion. Methods A total of 81 patients with pleural effusion were included in this study, including exudate, transudate, malignant pleural effusion and benign pleural effusion.The ROC curve of average CT value was established and the area under the curve was calculated. Results Among 81 patients with pleural effusion, 59 cases were exudative, 22 cases were transudative, 33 cases were malignant pleural effusion and 48 cases were benign pleural effusion.The mean CT value of the exudate group, (16.68±6.76) Hu, was significantly higher than (5.50±3.42) Hu of the transudate group (P<0.000 1).ROC curve analysis showed that the mean CT value of pleural effusion had high accuracy in distinguishing exudate from transudate (area under the curve was 0.9445).When the cut-off value for exudative effusion was over 9.99 Hu, the sensitivity and specificity were 88.14% and 90.91%, respectively.The mean CT value of malignant pleural effusion group, (15.38±7.29) Hu, was not significantly different from (12.45±8.03) Hu of benign pleural effusion group (P=0.098 1). Conclusions In the differential diagnosis of pleural effusion, the chest CT value can be used to identify transudate and exudate, but not benign and malignant pleural effusion.
目的 探讨暴露喉返神经的甲状腺手术后患者发生声音嘶哑的原因。方法 选取于2019年1月—2020年12月间在我院接受甲状腺手术且在术中暴露喉返神经的患者,对出现术后声音嘶哑的19例患者进行为期12个月的临床随访,观察研究对象术后声音嘶哑的发生特点、持续时间并进行直接喉镜及颈部超声检查。结果 发生声音嘶哑的19例患者中,5例存在术中喉返神经损伤情况,其余14例患者术中喉返神经暴露及保护良好。直接喉镜检查示,该14例患者中,4例存在声带充血水肿现象,1例发生勺状软骨半脱位。术后1周左右的超声检查显示,该14例患者中有11例存在不同程度的创腔内积液。结论 虽常规暴露喉返神经减少了术后声嘶的发生率,但术中喉返神经损伤仍然是造成患者术后声嘶的原因之一。此外,术后创腔积液、麻醉插管导致的声带损伤及其他插管相关并发症等非直接手术因素也是造成这些患者术后声嘶的重要原因,应引起临床重视。
Objective To explore the cause of hoarseness of voice in patients after thyroidectomy with recurrent laryngeal nerve exposure. Methods The patients from January 2019 to December 2020 underwent thyroidectomy with exposure of recurrent laryngeal nerve during operation were selected. There were 19 cases of hoarseness of voice after operation followed up for 12 months. Postoperative observations included the characteristics of the hoarseness of voice, duration, and direct laryngoscope neck ultrasonography. Results A total of 19 patients had voice hoarseness, only 5 of them had recurrent laryngeal nerve injury during operation, the other 14 patients had good exposure and protection of recurrent laryngeal nerve. Direct laryngoscope showed that 4 of 14 patients had vocal cord edema and 1 had subluxation of arytenoid cartilage. About 1 week after operation, ultrasound examination showed that 11 of 14 patients had varying degrees hydrops of wound cavity. Conclusions Although the routine exposure of recurrent laryngeal nerve reduces the incidence of postoperative hoarseness of voice, the injury of recurrent laryngeal nerve is still a cause of postoperative hoarseness of voice. In addition, non-operative direct factors, such as fluid accumulation in the operative field, vocal cord injury caused by anesthetic intubation and other intubation related complications, are also important reasons for postoperative hoarseness of voice in these patients, which we should pay more attention to.
目的 观察百令胶囊辅助缬沙坦治疗IgA肾病效果及对患者肾功能、细胞免疫调节、尿足细胞标志蛋白的影响。方法 选取2019年5月—2021年5月西部战区总医院肾内科收治经肾活检确诊为IgA肾病,筛选治疗方案中尚未使用激素及免疫抑制剂的80例患者,按住院先后顺序随机分为观察组和对照组,每组各40例。对照组给予缬沙坦治疗,观察组给予百令胶囊辅助缬沙坦治疗,治疗12周后,比较2组的疗效、治疗前后肾功能指标[24 h蛋白尿(24 h Upro)、尿素氮(BUN)、血肌酐(SCr)、尿红细胞(RBC)计数]、1型/2型辅助性T细胞(Th1/Th2)代表细胞因子[γ-干扰素(IFN-γ)、白介素-4(IL-4)]、尿足细胞标志蛋白[尿足萼糖蛋白(PCX)、尿足细胞B7-1分子(B7-1)]水平。结果 治疗12周后,观察组的治疗总有效率为95.0%,高于对照组的82.5%;观察组的24 h Upro、BUN、SCr、尿RBC计数低于对照组,IFN-γ、Th1/Th2低于对照组、IL-4高于对照组,尿PCX、B7-1水平低于对照组;差异均有统计学意义(P<0.05)。结论 百令胶囊辅助缬沙坦治疗IgA肾病患者,可以提高临床疗效,有效保护患者肾功能,调节其免疫状态,减轻肾损伤。
Objective To observe the effects of Bailing capsules assisting valsartan in the treatment of IgA nephropathy and its influence on renal function, cellular immune regulation and urine prodocytes marker protein. Methods From May 2019 to May 2021, 80 patients with IgA nephropathy confirmed by renal biopsy in the Nephrology Department of Western Theatre Command General Hospital, who had not used hormones or immunosuppressants in the treatment were selected.Patients were divided into observation group and control group according to the order of hospitalization, 40 cases in each group.The control group was given valsartan, and the observation group was given Bailing capsules and valsartan.After 12 weeks of treatment, the efficacy, the levels of renal function indexes [24 h proteinuria (24 h Upro), urea nitrogen (BUN), serum creatinine (SCr), urinary red blood cell (RBC) count], type 1/type 2 helper T cells (Th1/Th2) represent cytokines [interferon-γ (IFN-γ), interleukin-4 (IL-4)], urine prodocytes marker protein [urine podocalyxin (PCX), urinary podocyte B7-1 molecule (B7-1)] before and after treatment were compared between the two groups. Results After treatment, the total effective rate in observation group was higher than that in control group (95.0% vs 82.5%).The 24 h Upro, BUN, SCr levels and urine RBC count in observation group were lower than those in control group, IFN-γ and Th1/Th2 levels were lower than those in control group, the IL-4 level was higher than that in control group, and the levels of urine PCX and B7-1 were lower than those in control group.Those differences were statistically significant (P<0.05). Conclusions Bailing capsules assisting valsartan in the treatment of IgA nephropathy can improve clinical efficacy, effectively protect the renal function of patients, regulate the immune status, and alleviate renal injury.
目的 探讨低强度体外冲击波联合本体感觉训练治疗双侧颞下颌关节紊乱病的临床疗效。方法 给予1例双侧颞下颌关节紊乱病半年余患者低强度体外冲击波联合本体感觉训练治疗2周,比较治疗前、治疗2周后的最大张口度(MIO)、疼痛压力阈值(PPT)和Fricton颞下颌关节紊乱指数量表 (CMI),并于2个月后随访。结果 经过2周治疗,MIO、PPT和CMI均出现明显改善,2个月后随访未出现反弹,持续改善。结论 低强度体外冲击波联合本体感觉训练治疗颞下颌关节关节紊乱病临床疗效显著。
Objective To investigate the clinical efficacy of low intensity extracorporeal shock wave combined with proprioceptive training in the treatment of bilateral temporomandibular disorders (TMD). Methods A patient with bilateral TMD was treated with low intensity extracorporeal shock wave combined with proprioceptive training for 2 weeks.The maximal interincisal opening (MIO)、pain pressure thresholds (PPT), and Fricton's craniomandibular index (CMI) were compared before and after treatment,and followed up for 2 months. Results After 2 weeks of treatment, MIO, PPT and CMI were significantly improved, and there was no relapse after 2 months of follow-up. Conclusions Low intensity extracorporeal shock wave combined with proprioceptive training was effective in treating TMD.
目的 分析基于视觉传达理论的照顾者思维导图教育在宫颈环扎手术患者中的应用效果。方法 选取2018年1月—2020年1月在我院顺利完成宫颈环切手术的116例患者及主要照顾者为研究对象,采用简单随机法将其分为对照组和观察组,各58例。对照组照顾者给予常规健康教育,观察组照顾者给予基于视觉传达理论的照顾者思维导图教育。比较2组主要照顾者干预前后的照顾负担评分和家属照顾能力测量表(FCTI)评分,并比较2组患者干预前后的焦虑、抑郁水平和健康行为评分,比较2组患者的妊娠结局。结果 干预后较干预前2组主要照顾者的各项照顾负担评分、FCTI评分均降低,且观察组较低;干预后较干预前2组患者的焦虑自评量表、抑郁自评量表评分均降低,且观察组较低。干预后2组患者的各项健康行为评分较干预前均升高,且观察组较高,差异有统计学意义(P＜0.05)。观察组患者的流产、感染的发生率低于对照组,观察组患者的足月分娩产的发生率高于对照组,差异有统计学意义(P＜0.05)。结论 宫颈环扎手术患者的主要照顾者采用基于视觉传达理论的照顾者思维导图教育能够有效缓解其照顾负担,提升照顾能力,进而缓解患者的负性情绪,提高其健康行为,改善妊娠结局。
Objective To analyze the application effect of caregiver mind mapping education based on visual communication theory in patients undergoing cervical cerclage. Methods A total of 116 patients who successfully completed cervical cerclage in our hospital and their main caregivers from January 2018 to January 2020 were selected as the research objects.They were divided into control group and observation group by simple random method, with 58 cases in each group.The caregivers in the control group were given routine health education, and those in the observation group were given mind mapping education based on visual communication theory.The scores of care burden and family caregiver task inventory (FCTI score) of the two groups of main caregivers before and after intervention were compared, and the anxiety, depression levels and health behavior score of the two groups before and after the intervention were compared, and the pregnancy outcome of the two groups was also compared. Results After the intervention, the care burden score and FCTI score of the main caregivers of the two groups were lower than those before the intervention, and the observation group was lower; after intervention, the Self-Rating Depression Scale, Self-Rating Anxiety Scale scores of the two groups were lower than those before intervention, and the observation group was lower.The health behavior scores after intervention were higher than that before intervention, and the observation group were higher (P<0.05).The incidence of abortion and infection in the observation group was lower than that in the control group, and the incidence of full-term delivery in the observation group was higher than that in the control group (P<0.05). Conclusions The caregiver mind mapping education based on visual communication theory can effectively alleviate the care burden, improve the care ability, alleviate the negative emotion of patients, improve their health behavior and improve the pregnancy outcome.
目的 分析非小细胞肺癌化疗患者骨髓抑制发生状况及其影响因素。方法 回顾性分析2017年2月—2019年8月期间本院进行化疗治疗的80例非小细胞肺癌患者临床资料,统计非小细胞肺癌化疗患者骨髓抑制发生情况,并根据其情况分组;收集所有患者临床资料,分析非小细胞肺癌化疗患者骨髓抑制发生的相关影响因素。结果 80例非小细胞肺癌化疗患者中发生骨髓抑制45例,发生率为56.25%;经单因素及多项Logistic回归分析,年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移是非小细胞肺癌化疗患者发生骨髓抑制的影响因素(OR＞1,P＜0.05)。结论 年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移会增加非小细胞肺癌化疗患者骨髓抑制的发生风险,临床上可据此来制定合理的干预措施,以降低患者骨髓抑制的发生风险。
Objective To analyze the occurrence and influencing factors of bone marrow suppression in patients with non-small cell lung cancer (NSCLC) undergoing chemotherapy. Methods The clinical data of 80 patients with NSCLC who received chemotherapy in our hospital from February 2017 to August 2019 were retrospectively analyzed, the occurrence of bone marrow suppression in patients with NSCLC under chemotherapy was enrolled and grouped according to the situation; the clinical data of all patients were collected, the related influencing factors of bone marrow suppression in patients were analyzed. Results Among 80 cases of patients with NSCLC, 45 cases occurred bone marrow suppression, the incidence was 56.25%; after univariate and multivariate Logistic regression analysis, age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis were the influencing factors of bone marrow suppression in patients with NSCLC under chemotherapy (OR>1, P<0.05). Conclusions Age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis will increase the risk of bone marrow suppression in patients with NSCLC chemotherapy. Therefore, reasonable intervention measures can be carried out to reduce the risk.
目的 分析血红蛋白水平对上肢骨折患者深静脉血栓形成(DVT)的影响。方法 采用回顾性分析法,对2018年1月—2021年6月期间来我院进行治疗的386例上肢骨折患者展开研究,依据患者是否发生DVT分为DVT组(n=114)和对照组(n=272)。对2组患者的各项一般资料和临床资料进行比较,对有统计学意义的因素进一步行Logistic多因素回归分析,探究上肢骨折患者发生DVT的危险因素,并Pearson分析血红蛋白水平与各危险因素的相关性。结果 与对照组相比,DVT组患者为女性、年龄＞60岁、体质量指数(BMI)＞25 kg/m2、冠状动脉粥样硬化性心脏病、糖尿病、合并其他骨折、受伤至超声检查时间≥3 d、受伤至手术时间＞5 d、纤维蛋白降解产物(FDP)≥35 mg/L、凝血酶时间(TT)≥17 s、血红蛋白≤120 g/L、血小板计数/血红蛋白比值≥2.5、血糖≥8 mmol/L、全身麻醉、术后住院时间＜7 d的发生率升高,差异有统计学意义(P＜0.05)。Logistic多因素回归分析显示,年龄＞60岁、BMI＞25 kg/m2、受伤至手术时间＞5 d、血红蛋白≤120 g/L、血小板计数/血红蛋白比值≥2.5、血糖≥8 mmol/L是上肢骨折患者发生DVT的危险因素(P＜0.05)。上肢骨折患者的血红蛋白水平与年龄、BMI、受伤至手术时间、血小板计数/血红蛋白比值、血糖水平呈现负相关(P＜0.05)。结论 血红蛋白≤120 g/L是上肢骨折患者发生DVT的危险因素,与DVT的发生存在相关性。
Objective To analyze the influence of hemoglobin level on deep vein thrombosis (DVT) in patients with upper extremity fractures. Methods A retrospective study of 386 upper extremity fracture patients who came to our hospital for treatment from January 2018 to June 2021 was carried out.According to whether the patients had DVT or not, they were divided into DVT group (n=114) and control group (n=272).The general data and clinical data of the two groups were compared, and the statistically significant factors were further analyzed by Logistic multivariate regression analysis to explore the risk factors of DVT in patients with upper limb fractures, and analyzed the hemoglobin level and the risk factors correlation by Pearson. Results Compared with the control group, the DVT group had increased incidence in female, age >60 years old, body mass index (BMI) >25 kg/m2, coronary heart disease, diabetes mellitus, other fractures, injury to ultrasonic time ≥3 days, injury to operation time >5 days, fibrin degradation products (FDP) ≥35 mg/L, thrombin time (TT) ≥ 17 s, hemoglobin ≤120 g / L, platelet count / hemoglobin ratio ≥2.5, blood glucose ≥8 mmol/L, general anesthesia and postoperative hospital stay <7 days, and the difference was significant (P<0.05).Logistic multivariate regression analysis showed that age>60, BMI>25 kg/m2, time from injury to operation>5 days, hemoglobin≤120 g/L, platelet count/hemoglobin ratio ≥2.5, blood glucose ≥8 mmol/L were the risk factors of DVT in patients with upper extremity fractures (P<0.05).The hemoglobin level of those patients was negatively correlated with age, BMI, time from injury to operation, platelet count/hemoglobin ratio and blood glucose level (P<0.05). Conclusions Hemoglobin ≤120 g/L was a risk factor for DVT in patients with upper extremity fractures, and it was related to the occurrence of DVT.
目的 观察达雷妥尤单抗联合来那度胺及地塞米松(DRd)方案巩固治疗序贯达雷妥尤单抗和来那度胺两药维持治疗1例高龄高危初治多发性骨髓瘤患者的疗效、生存时间和不良反应。方法 回顾分析广州市第一人民医院老年病科血液肿瘤科2019年3月收治的1例高龄高危初治多发性骨髓瘤患者的临床资料,并复习相关最新文献。结果 患者应用伊沙佐米、来那度胺和地塞米松方案诱导治疗13疗程后只达到部分缓解的疗效,未能进一步缓解,且不良反应多且严重,后改为DRd方案巩固治疗2疗程后,达到完全缓解,继续使用达雷妥尤单抗联合来那度胺两药维持治疗,不良反应少,至随访结束总生存期和无进展生存期均为35个月。结论 含达雷妥尤单抗方案巩固和维持治疗可能会改善高龄高危初治多发性骨髓瘤患者的预后,延长生存时间,耐受性好。
Objective To observe the efficacy, survival time and adverse reactions of daratumumab combined with lenalidomide and dexamethasone (DRd) in the consolidation treatment of sequential daratumumab and lenalidomide maintenance treatment of an elderly patient with high-risk newly diagnosed multiple myeloma. Methods The clinical data of the elderly patient with newly diagnosed multiple myeloma treated in the Department of Geriatrics, Hematology & Oncology Ward, Guangzhou First People's Hospital in March 2019 were retrospectively analyzed, and the relevant latest literatures were reviewed. Results After 13 courses of induction treatment with isazomib, lenalidomide and dexamethasone, it only achieved partial remission, but failed to further remission, and there were many serious adverse reactions.Later, it was changed to DRd therapy to consolidate treatment.After 2 courses of treatment, it achieved complete remission.After that, we continued to use daratumumab combined with lenalidomide for maintenance treatment, with few adverse reactions.At the time of submission, the overall survival and progression free survival were 35 months. Conclusions Consolidation and maintenance therapy with daratumumab may improve the prognosis, prolong survival time and with good tolerance in elderly patients with high-risk newly diagnosed multiple myeloma.
目的 分析120例动眼神经麻痹患者的病因及临床特点。方法 收集2019年5月—2021年7月我科收治的120例动眼神经麻痹患者临床资料进行分析,统计所有患者的病因、临床特点、治疗结果。结果 120例患者均急性起病,单眼发病105例(87.50%)、双眼发病15例(12.50%),所有患者均有不同程度的上睑下垂、眼球外下斜视、眼球转动受限、复视,入选患者中年龄构成占比最大的为41~60岁(49例,40.83%);在120例动眼神经麻痹患者中,明确诊断103例(85.83%)、病因诊断未明确17例(14.17%),完全性动眼神经麻痹23例(19.17%)、不完全性动眼神经麻痹97例(80.83%)。病因占比最多的分别是糖尿病18例(15.00%)、动脉瘤16例(13.33%)、脑梗死15例(12.50%);持续治疗3个月后,痊愈者88例(73.33%)、有效者21例(17.50%),无效者11例(9.17%)。结论 动眼神经麻痹的病因以糖尿病、动脉瘤、脑梗死最为常见,临床表现可有不同程度的上睑下垂、眼球外下斜视、眼球转动受限、复视,大多数患者经过积极治疗后可痊愈或好转,在临床中需结合多种诊断技术及原发性疾病进行诊断和治疗。
Objective To analyze the etiology and clinical characteristics of 120 patients with oculomotor nerve paralysis. Methods The clinical data of 120 patients with oculomotor paralysis treated in our department from May 2019 to July 2021 were collected and analyzed, and the etiology, clinical characteristics and treatment results of all patients were summarized. Results All 120 patients had acute onset, 105 cases (87.50%) had monocular onset and 15 cases (12.50%) had binocular onset.All patients had different degrees of ptosis, exophthalmos, hypotropia, limited eye rotation and diplopia.The largest age composition among the selected patients was 41 ~ 60 years old (49 cases, 40.83%).Among 120 patients with oculomotor nerve palsy, 103 cases (85.83%) were clearly diagnosed, 17 cases (14.17%) were not, 23 cases (19.17%) were complete oculomotor nerve palsy and 97 cases (80.83%) were incomplete oculomotor nerve palsy.The most common causes were diabetes mellitus (18 cases, 15%), aneurysms (16 cases, 13.33%), and cerebral infarction (15 cases, 12.50%).After 3 months of continuous treatment, 88 cases (73.33%) were cured, 21 cases (17.50%) were improved and 11 cases (9.17%) had few changes. Conclusions The main causes of oculomotor nerve palsy were diabetes mellitus, aneurysm and cerebral infarction.The clinical manifestations could be varying degrees of ptosis, exophthalmos and strabismus, limited rotation of eyeball and diplopia.Most patients could be cured or improved after treatment.In clinical practice, a variety of diagnostic techniques and primary diseases should be combined to diagnose and treat those patients.
目的 研究颅内压(ICP)监测联合浮动骨瓣减压术在治疗颅脑损伤中对颅内压及脑血流指标的影响。方法 选取我院2019年3月—2021年3月收治的拟行骨瓣减压术的颅脑损伤患者106例作为研究对象,按照手术方法不同分为对照组(n＝53)、观察组(n＝53)。对照组采用传统去骨瓣减压术(DC)治疗,观察组采用ICP监测联合浮动骨瓣减压术治疗。对比2组ICP、脑血流指标[平均流速(Vm)、收缩期血流速度(Vs)、血管搏动指数(PI)]及并发症发生情况。结果 术后1、3、7 d观察组ICP、PI低于对照组,Vm、Vs高于对照组(P＜0.05);术后观察组并发症总发生率9.43%低于对照组37.74%(P＜0.05)。结论 采用ICP监测联合浮动骨瓣减压术治疗颅脑损伤能降低患者ICP,改善脑血流状态,降低术后并发症,避免二次手术,减轻患者经济负担。
Objective To study the effect of intracranial pressure (ICP) monitoring combined with floating bone flap decompression on intracranial pressure and cerebral blood flow index in the treatment of craniocerebral injury. Methods A total of 106 patients admitted to our hospital from March 2019 to March 2021 were selected as study subjects and divided into control group (n=53) and observation group (n=53).The control group was treated with traditional decompressed craniectomy (DC), and the observation group was treated with ICP monitoring combined with floating bone flap decompression.The ICP, cerebral blood flow index [mean flow velocity (Vm), systolic flow velocity (Vs), vascular pulsatility index (PI)] and complications were compared between the two groups. Results ICP and PI were lower in observation groups on 1,3 and 7 d, Vm and Vs were higher (P <0.05); the incidences of complications in observation group (9.43%), such as electrolyte disorder, pulmonary infection, abnormal renal function and incisional hernia, were lower in the control group (37.74%, P<0.05). Conclusions ICP monitoring combined with floating bone flap decompression could reduce ICP, improve cerebral blood flow, reduce postoperative complications, avoid secondary surgery and reduce economic burden.
目的 观察脓毒症患者血清胆碱酯酶(S-ChE)和T细胞程序性死亡分子-1(PD-1)以及炎症因子水平,并分析其与患者预后关系。方法 选取2018年8月—2021年5月在我院接受治疗的脓毒症患者为研究对象,同时选取同期在我院接受体检的健康人群为对照组。根据脓毒症患者的预后分为存活组和死亡组。比较脓毒症组和对照组、脓毒症存活组和死亡组患者S-ChE、PD-1水平和炎症因子水平的差异,并分析与患者预后的关系。结果 脓毒症患者的S-ChE水平低于对照组,PD-1水平高于对照组(P＜0.05)。脓毒症患者的CRP、PCT水平高于对照组,CD3+T、CD3+CD4+T和CD4+CD8+T水平低于对照组(P＜0.05)。死亡组患者的S-ChE水平低于存活组,PD-1水平高于存活组(P＜0.05)。死亡组患者的CRP、PCT水平高于存活组,CD3+T、CD3+CD4+T和CD4+CD8+T水平低于存活组(P＜0.05)。脓毒症患者S-ChE、PD-1水平呈负相关,(P＜0.05)。脓毒症患者的S-ChE与 CRP、PCT水平负相关,与CD3+T、CD3+CD4+T、CD4+CD8+T水平正相关(P＜0.05)。脓毒症患者的PD-1与 CRP、PCT水平正相关,与CD3+T、CD3+CD4+T、CD4+CD8+T水平负相关(P＜0.05)。S-ChE、PD-1预测脓毒症患者预后的AUC值为0.725(95%CI:0.605~0.825)、0.706(95%CI:0.585~0.809),P＜0.05。结论 脓毒症患者的S-ChE水平较低,PD-1水平较高,且与炎症因子水平和患者的预后相关。
Objective To analyze the levels of serum cholinesterase (S-ChE), programmed death 1 (PD-1) and inflammatory factors in patients with sepsis, and analyze the relationship between them and the prognosis of patients. Methods Patients with sepsis treated in our hospital from August 2018 to May 2021 were selected as the research subjects, and healthy people who received physical examinations in our hospital during the same period were selected as the control subjects.The differences in the levels of S-ChE, PD-1 and inflammatory factors between the sepsis group and the control group, the sepsis survival group and the death group were compared, and their relationship with the prognosis of the patients were analyzed. Results The level of S-ChE in patients with sepsis was lower than that of the control group, and the level of PD-1 was higher than that of the control group (P<0.05).The CRP and PCT levels of sepsis patients were higher than those of the control subjects, and the levels of CD3+T, CD3+CD4+T and CD4+CD8+T were lower (P<0.05).The S-ChE level of the death group was lower than that of the survival group, and the PD-1 level was higher than that of the survival group (P<0.05).The levels of CRP and PCT in the death group were higher than those in the survival group, and the levels of CD3+T, CD3+CD4+T and CD4+CD8+T were lower than those in the survival group (P<0.05).The levels of S-ChE and PD-1 in sepsis patients were negatively correlated (P< 0.05).S-ChE level in patients with sepsis was negatively correlated with CRP and PCT levels, and positively correlated with CD3+T, CD3+CD4+T, and CD4+CD8+T levels (P<0.05).PD-1 level in patients with sepsis was positively correlated with CRP and PCT levels, and negatively correlated with CD3+T, CD3+CD4+T, and CD4+CD8+T levels (P<0.05).The AUC values of S-ChE and PD-1 predicting the prognosis of patients with sepsis were 0.725 (95% CI: 0.605~0.825), 0.706 (95% CI: 0.585~0.809), P＜0.05. Conclusions Patients with sepsis had lower level of S-ChE and higher level of PD-1, which were related to the levels of inflammatory factors and the prognosis of patients.
目的 分析多元化团体互动健康教育在初产妇女围产期的应用效果。方法 选取2019年6月—2021年6月在我院顺利分娩的168例孕产妇为研究对象,采用随机数字表法分为观察组和对照组,各组均84例,2组围产期均给予常规健康教育,观察组同时给予多元化团体互动健康教育,比较2组的应用效果。结果 观察组孕产妇的各产程和住院时间均短于对照组;观察组产褥期后母亲角色适应情况优于对照组;产后1周和产后1个月较干预前2组的母乳喂养自信量表评分均升高,且观察组较高;干预后较干预前2组的焦虑自评量表和抑郁自评量表评分均降低,且观察组较低;观察组的子宫复旧、恶露量及便秘、尿潴留、切口感染发生率均低于对照组,差异有统计学意义(P＜0.05)。结论 初产妇女围产期给予多元化团体互动健康教育能够帮助其促进产后恢复,较快适应母亲角色,提高母乳喂养能力,缓解负性情绪,降低不良反应。
Objective To analyze the effect of diversified group interactive health education on perinatal period of primiparous women. Methods A total of 168 women who gave birth successfully in our hospital from June 2019 to June 2021 were selected as the research objects, and divided into an observation group and a control group by random number table method, with 84 cases in each group.Both groups were given routine health education during perinatal period, and the observation group was given diversified group interactive health education additionally, the effects of the two groups were compared. Results The duration of labor and hospital stay were shorter in the observation group than in the control group.The maternal role adaptation of observation group was better than control group after puerperium.The Breastfeeding Self-Efficacy Scale scores of 1 week postpartum and 1 month postpartum were higher than those of the two groups before intervention, and the observation group was higher.After intervention, Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of the observation group were lower than those before intervention, and the observation group was lower.Uterine involution, lochia volume, incidence of constipation, urinary retention and incision infection rate in the observation group were lower than those in the control group, and the differences were significant (P<0.05). Conclusions Primiparous women given diversified group interactive health education during the perinatal period can help them to promote postpartum recovery, adapt to being a mother quickly, improve breastfeeding ability, relieve negative emotions, and reduce adverse reactions.
目的 探讨专项调查重点科室医务人员手卫生依从性及知识知晓情况结合院感信息系统在降低医院感染中的应用效果。方法 选取2018年1月—2020年12月本院重点科室收治的患者527例,根据入院时间进行分组,对照组采取常规院感管理,观察组采取基于院感信息系统的管理方式,并对重点科室的100名医务人员手卫生依从性及相关知识知晓情况进行专项调查,比较2组医务人员手卫生依从性、手卫生知识知晓程度及医院感染率的差异。结果 观察组医务人员执行各项操作的手卫生依从性、手卫生知识评分均高于对照组(P<0.05);观察组患者医院感染率低于对照组(P<0.05)。结论 采用专项调查重点科室医务人员手卫生依从性及知识知晓结合院感信息系统,能有效提高医务人员的手卫生依从性及相关知识知晓程度,降低医院感染的发生风险。
Objective To discuss the effect of applying special investigation on the hand hygiene compliance and knowledge of medical staff in key departments combined with nosocomial infection information system in reducing nosocomial infections. Methods A total of 527 patients admitted to the key departments from January 2018 to December 2020 were selected, and were grouped according to the time of admission.The control group received routine nosocomial infection management, and the observation group received the management based on nosocomial infection information system.A special survey of hand hygiene compliance and related knowledge was carried out on 100 medical staff in those department, and the differences in hand hygiene compliance, hand hygiene knowledge and nosocomial infection rates between the two groups were compared. Results The hand hygiene compliance and hand hygiene knowledge scores of the medical staff in the observation group were significantly higher than those in the control group (P<0.05). The infection rate of observation patients was lower than control patients (P<0.05). Conclusions The use of special survey on hand hygiene compliance and knowledge of medical staff in key departments combined with nosocomial infection information systems can effectively improve medical staff's hand hygiene compliance and related knowledge, reduce the risk of nosocomial infections, which is worthy of promotion.
目的 统计分析茂名市2016—2021年各种成分血临床供血情况,分析不同成分ABO血型供血特点,总结供血趋势,为今后采供血工作提供参考。方法 通过血液信息管理系统和统计“血库库存监控”中血库预警情况,统计分析茂名市2016—2021年各类成分血临床供应情况。结果 2016—2021年茂名市中心血站临床供血总量1 635 494.5 U,年平均增长率10.74%;红细胞类、血浆类、冷沉淀和浓缩血小板临床供应量年平均增长速度分别为11.58%、8.68%、5.88%、19.41%,各血型占比均为O型>A型>B型>AB型;2018年后机采血小板临床供应量逐年增长;AB型浓缩血小板报废占比最大。结论 2016—2021年茂名市中心血站临床血液供应量逐年增长,O型用血在茂名地区所占比例最大,AB型所占比例最小。在未来采供血工作中,结合临床不同血型成分血使用特征,注意不同血型血液库存,优化血库库存警戒线,防止过多血液过期报废。
Objective To statistically analyze the clinical supply of various blood components in Maoming City from 2016—2021, analyze the characteristics of various ABO blood components supply, and summarize the trend of blood supply as a reference for future blood collection. Methods Using the blood information management system and the early warning situation of the blood bank in “blood bank inventory monitoring”, the clinical supply of various blood components from 2016 to 2021 was statistically analyzed. Results The total supply amount of clinical blood from Maoming Central Blood Bank in 2016-2021 was 1635 494.5 U, with an average annual growth of 10.74%; the percentage of each blood components (red cell, plasma, cryoprecipitate and pooled platelets) was O>A>B>AB, with an average annual growth rate of 11.58%, 8.68%, 5.88% and 19.41%.After 2018, the clinical supply of mechanically collected platelets increased year by year.Scrapped pooled platelets of AB type accounted for the largest proportion. Conclusions Clinical blood supply in Maoming central blood bank was increasing yearly from 2016 to 2021, with the largest proportion of blood type O in Maoming region and the smallest proportion of blood type AB.In the future blood collection and supply, we will pay attention to blood products for different blood types in stock by taking into account the different blood types usage,pay attention to the blood stocks of different blood types, optimize the alarm threshold of blood bank stocks, to prevent overmuch blood from expiring and being scrapped.
目的 比较宫腔镜下子宫内膜息肉切除术(TCRP)后采用地屈孕酮以及少腹逐瘀汤两种不同治疗方法对预防息肉复发的效果。方法 从北京中医药大学深圳医院(龙岗)妇科2019年1月—2020年7月间收治的子宫内膜息肉患者中随机选取150例作为研究对象,采取随机数字表法将患者随机分为对照组、地屈孕酮组和少腹逐瘀汤组,每组各50例。对照组患者实施TCRP治疗,地屈孕酮组实施TCRP+地屈孕酮治疗,少腹逐瘀汤组实施TCRP+地屈孕酮+少腹逐瘀汤治疗,术后对3组患者随访12个月,比较3组患者干预3、6、12个月息肉复发情况、子宫内膜厚度以及不良情况应发生率。结果 治疗第6、12个月时,地屈孕酮组及少腹逐瘀汤组复发率情况均低于对照组(P＜0.05),地屈孕酮组及少腹逐瘀汤组子宫内膜息肉复发率比较差异无统计学意义(P＞0.05)。少腹逐瘀汤组及地屈孕酮组3次复查子宫内膜厚度均小于对照组(P＜0.05);少腹逐瘀汤组治疗12个月时子宫内膜厚度小于地屈孕酮组(P＜0.05)。3组患者不良反应发生率比较,差异不具有统计学意义(P＞0.05)。结论 宫腔镜下息肉切除术后加服少腹逐瘀汤与地屈孕酮片对宫腔镜下子宫内膜息肉切除术后患者进行干预,可有效降低患者子宫内膜息肉复发率,促进患者术后月经恢复正常,且将两者联合应用疗效安全,具有较高的应用价值。
目的 观察超声心动图(UCG)+心肌损伤标志物水平检测在急性心肌梗死(AMI)患者诊断中的应用价值。方法 选取2020年6月—2021年9月我院收治的74例AMI患者为观察组,另选取同期65例疑似AMI患者为对照组,2组均进行UCG检测,并对比入院后0~2 h、2~12 h、12~24 h心肌损伤标志物[肌酸激酶同工酶(CK-MB)、氨基末端脑钠肽前体(NT-proBNP)、肌钙蛋白(cTnI)、心脏型脂肪酸结合蛋白(H-FABP)]水平,分析心肌损伤标志物与AMI病情程度的关联性及UCG+心肌损伤标志物水平检测对AMI诊断的应用价值。结果 UCG检查结果显示观察组阳性率86.79%高于对照组9.23%(P＜0.001);对照组入院后各时间段CK-MB、NT-proBNP、cTnI、H-FABP水平差异无统计学意义(P＞0.05)观察组入院后各时间段CK-MB、NT-proBNP、cTnI、H-FABP水平均高于对照组(P＜0.05);Spearman相关分析可知,血清CK-MB、NT-proBNP、cTnI、H-FABP水平与AMI患者病情程度呈正相关(r1=0.648,r2=0.692,r3=0.704,r4=0.683,P＜0.05);受试者工作特征曲线(ROC)曲线分析显示,UCG+血清CK-MB、NT-proBNP、cTnI、H-FABP联合检测对AMI患者的诊断敏感度(85.14%)、特异度(100.00%)较高(P＜0.05)。结论 UCG+心肌损伤标志物水平检测应用于AMI患者有利于提高诊断敏感度、特异度,诊断价值较高。
目的 分析接受永久性膀胱造瘘男性患者相关尿标本病原菌学分布特点及耐药性,进一步为药物防治导管伴随性尿路感染提供科学依据。方法 回顾性分析2019年1月—2021年8月我院收治的368例接受永久性膀胱造瘘男性患者尿标本病原菌分离培养结果,观察其病原菌构成和分布特征,进一步分析相关耐药性。结果 (1)本组接受永久性膀胱造瘘男性患者共368例,尿培养阳性316例,阳性率85.87%(316/368);共分离出病原菌112株,分离率30.43%(112/368),其中革兰阴性菌80株,占71.43%(80/112),以大肠埃希菌、铜绿假单胞菌为主;革兰阳性菌31株,占27.68%(31/112),以表皮葡萄球菌、粪肠球菌为主;真菌1株,占0.89%(1/112)。(2)大肠埃希菌对氨苄西林耐药率66.67%、哌拉西林64.71%、头孢曲松60.78%、头孢他啶60.78%、环丙沙星62.75%,对青霉素耐药率较低,仅为5.88%,对亚胺培南和美罗培南的耐药性为0。铜绿假单胞菌对氨苄西林、头孢噻肟完全耐药,耐药率高达100.00%;对头孢曲松83.33%、哌拉西林72.20%、头孢他啶72.22%;对庆大霉素的耐药率较低,仅为16.67%,对亚胺培南、美罗培南无耐药性。(3)表皮葡萄球菌对氨苄西林耐药性和青霉素的耐药性均为100.00%;对哌拉西林、头孢曲松、头孢噻肟耐药率＞60%;对磺胺甲噁唑／甲氧苄啶的耐药率较低,仅为12.50%,对万古霉素无耐药性。粪肠球菌对庆大霉素完全耐药,耐药率为100.00%;对头孢曲松、环丙沙星、左氧氟沙星、红霉素的耐药率＞60.00%;对头孢他啶的耐药性较低,耐药率仅为25.00%,对青霉素、万古霉素无耐药性。结论 永久性膀胱造瘘患者病原菌主要是大肠埃希菌、铜绿假单胞菌等革兰阴性菌,革兰阳性菌以表皮葡萄球菌为主,对于不同抗菌药物的耐药性差异较大。
