目的 对从淡水养殖鱼类、青蛙样品以及腹泻病人大便样品分离的菌株作临床常用抗生素的耐药性分析,为相关疾病的治疗提供实验依据。方法 获取临床腹泻病人的新鲜大便标本和在水产品市场采集淡水鱼和青蛙样品取肠道内含物分别涂布选择性培养基,选取疑似菌落进行生化鉴定和16S rRNA基因分子鉴定,确证为香港海鸥型菌的菌株采用纸片扩散法测定分离株对几类临床常见抗菌药物的敏感性。结果 本次检测的24株香港海鸥型菌分离株对八种常用的抗生素药物表现不同程度的耐药性。蛙源株对环丙沙星、阿米卡星、头孢他啶的耐药率高于鱼源株。其中分离的11株分离株(45.8%)对3个种类及以上抗生素表现耐药,为多重耐药株。结论 抗生素作为促生长剂和动物疾病防治被广泛加于动物饲料中,可能导致食源性细菌耐药性增加。人们有可能通过摄入含有香港海鸥型多重耐药株污染的食物而获得抗生素耐药性的潜在危险。

目的 探讨婚恋家庭取向心理干预对系统性红斑狼疮患者家庭功能和幸福感指数的效果。方法 将2012年6月1日—2014年5月31日就诊于东莞康华医院内分泌及风湿免疫中心的62名15~58岁的系统性红斑狼疮患者作为研究对象,根据随机化原则将其分成两组,其中30名为干预组,参加本研究设计的婚恋家庭取向的心理干预,余32名为对照组,采用家庭功能评定量表、幸福指数量表及狼疮活动指数量表,对两组进行干预前、干预后、干预后3月和干预后6月作问卷调查。采用重复测量的方差分析进行评估。结果 家庭功能中的问题解决、情感反应、情感介入、总的功能分量表和总分两组干预后重复测量的方差分析两两比较均有统计学差异(P<0.05)。幸福感指数总分两组重复测量的方差分析无统计学意义,但如扩大置信空间至P<0.1,则两组重复测量的方差分析两两比较中干预后3月及6月有一定统计学意义(P=0.08<0.1)。结论 本研究中婚恋家庭取向的心理干预对SLE患者即家庭功能中问题解决、情感反应、情感介入、总的功能及家庭功能总分均有显著的改善作用,对幸福感指数总分则有一定的增进作用,而对已通过心身疾病方式表达了的SLEDAI没有干预作用。

Objective To explore the effect of marital family-based psychological intervention in SLE patients on family assessment device FAD and index of well-being. Methods A total of 62 SLE patients, aged between 15 and 58, who were treated in out-patient of endocrine immune rheumatism center of Dongguan Kanghua hospital from June 1,2012 to May 31,2014. The experimental group was made up of 30 patients who, at random, volunteered to participate in an added marital family-based psychological intervention and the control group was composed of rest 32 cases. At the time of pre-intervention,post-intervention,3 months and 6 months after intervention, both groups were investigated with questionnaires of family assessment device, index of well-being, index of general affect, and systemic lupus erythematosus disease activity index. The results were analyzed with repeated measure variance analysis to explore the effect. Results There were significant multiple-comparison differences by repeated measure variance analysis in the score of FAD's total and sub-scale problem solving, affective responsiveness, affective involvement, general functioning(P<0.05) between experimental and control group after intervention. There were no significant repeated measure variance analysis differences in the score of index of well-being' total, but if enlarging confidence space to P<0.1, there were partial multiple-comparison differences between experimental and control group at the time of 3 months and 6 months after intervention(P=0.08<0.1). Conclusion Marital family-based psychological intervention may significantly improve FAD's problem solving, affective responsiveness, affective involvement, general functioning, and sum of FAD, and partially improve index of well-being, but can not improve SLEDAI which had developed by psychosomatic disease.

目的 研究鸟胞内分枝杆菌复合群(MAC)MAV3104基因编码蛋白与药物外排的关系。方法 以MAC标准株基因组为模板,扩增MAV3104基因,构建pMV261-MAV3104c重组质粒;测序正确后,转化重组质粒到大肠杆菌DH5并在MAC标准株中诱导表达, Western Blot鉴定MAV3104表达;按照CLSIM24-A2的操作要求检测MAC标准株对克拉霉素的敏感性及外排泵抑制试验。结果 经基因测序及Western Blot蛋白表达验证重组质粒构建成功;MAV3104过表达能提高鸟分枝杆菌对克拉霉素的MIC,且硫利达嗪能抑制该作用;MAV3104过表达也能提高胞内分枝杆菌对克拉霉素的MIC,但硫利达嗪对其没有抑制效应。结论 MAV3104转运蛋白介导的药物外排在鸟分枝杆菌耐克拉霉素中起重要作用。

Objective To investigate the association of the protein coded by Mycobacterium avium-Mycobacterium intracellulare complex in MAV3104 in drug efflux of Clarithromycin. Methods According to the Mycobacterium avium-Mycobacterium intracellulare complex standard strain, the MAV3104 gene was amplified by PCR and cloned into expression vector pMV261 to generate the recombinant plasmids. After verification by sequence analysis, the recombinant plasmids was transformed into E. coli DH5 andMycoba ctenum avium-Mycobacterium intracellulare complex standard strain. To identify the protein expression by western blotting and investigate the sensitivity of clarithromycin and efflux pump inhibition test in the light of CLSIM24-A2 protocol. Results It was verified by sequence analysis and western blotting that the recombinant plasmids were successfully constructed. Over expression of Mycobacterium avium MAV3104 gene could enhance clarithromycin MIC, which could be inhibited by thioridazine. Over expression of Mycobacterium intracellulare MAV3104 gene also could enhance clarithromycin MIC, but it could not inhibited by thioridazine. Conclusion This study demonstrates that efflux pumps mediated by MAV3104 protein play an important role in Mycobacterium avium resistance to clarithromycin.

急性肾损伤(acute kidney injury,AKI)是由各种因素导致的临床综合征,尽管科学在发展,发病率、死亡率一直居高不下,并且严重影响患者的预后,这主要是由于对肾脏损伤的早期诊断缺乏敏感的、特异性的指标,使得患者错过了最佳的治疗窗口。研究发现在AKI的早期给予干预,能够明显提高患者的预后,达到满意的治疗效果。所以AKI的早期诊断是提高患者的生活质量的关键措施,期间出现了一系列AKI 的早期分子标志物,包括NGAL、IL-18、miRNA、KIM-1、NAG、L-FABP、TIMP-1、IGFBP-7、TFF-3、GST-π、MYL12B等。本文就这些AKI分子标志物进行总结,阐述这些分子标志物在AKI 诊断及预后预测中的价值,以便于及早制定有针对性的 AKI 治疗及护理策略,使早期诊断、早期干预 AKI 成为可能。

目的 观察多西环素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗幽门螺杆菌(Hp)感染消化性溃疡的临床疗效和不良反应。方法 选取于2013年7月—2015年7月收治的98例Hp感染消化性溃疡患者,根据不同的治疗方式,随机将其分为治疗组和对照组,每组各49例,治疗组患者给予多西环素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗;对照组给予克拉霉素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗, 两组患者连续服用10天后,均口服泮托拉唑40 mg,每天1次,总疗程为4周。疗程结束4周后,予胃镜复查和Hp检查,观察两组患者的临床疗效、溃疡愈合率、Hp根除率及不良反应。结果 治疗组与对照组患者的临床效果总有效率分别是95.91％、81.63％;治疗组与对照组患者的溃疡愈合率分别是83.67％、61.22％ ;治疗组与对照组患者的Hp根除率分别是89.79％、65.30％;治疗组患者的临床疗效总有效率、溃疡愈合率和Hp根除率均明显优于对照组,差异均有统计学意义(P<0.05),两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 多西环素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗Hp感染消化性溃疡疗效显著、溃疡愈合率高、Hp根除率高、且安全无明显不良反应,值得临床广泛推广使用。

目的 了解脑卒中患者对社区康复的认知和需求情况。方法 对广州市从化区街口街社区475例脑卒中患者进行问卷调查,调查患者对社区康复认知和需求等相关内容。结果 对脑卒中社区康复知晓者293人,知晓率为61.7%。对社区康复有需求者258人,需求率为54.3%。在对社区康复知晓人群中,文化程度在中学以上、家庭经济≥5000元/月、付费方式为非自费者知晓率较高(P<0.05); 年龄及性别因素无差异(P>0.05)。在对社区康复有需求的人群中,年龄<60岁、男性、文化程度中学以上、家庭经济≥5000元/月、付费方式为非自费者需求率较高(P<0.05)。需求内容最多的是日常活动支持,达100%,需求内容最少的为专业器械支持,仅为26.0%。功能障碍程度越高的脑卒中患者对心理支持、药物支持、专业人员及专业器械支持的需求越高(P<0.05)。结论 脑卒中患者对社区康复的知晓和需要情况一般,仍需多方面的共同努力,促进脑卒中社区康复的开展和发展。

目的 探讨CYP2C19不同基因分型对急性冠状动脉综合征(ACS)患者服用氯吡格雷后血小板聚集率的影响。方法 选取2015年1月—2016年3月入住心内科的ACS患者258例为研究对象。入院时及服用氯吡格雷三日后分别抽取静脉血检测血小板聚集率及CYP2C19基因型。结果 快代谢型组(extensive metabolisers, EM)和中代谢型组(intermediate metabolisers, IM)服药前后血小板最大聚集率分别为(58.76±15.45)% vs(35.17±10.26)%和(59.35±11.58)% vs(47.66±12.59)%(P<0.05), 而慢代谢型组(poor metabolisers, PM)的血小板最大聚集率无明显降低。快代谢型组的最大血小板聚集率的降低幅度比慢代谢型组大(23.58±12.39% vs 11.65±13.56%,P<0.05)。 共有33例(12.79%)患者为氯吡格雷抵抗, 其中快代谢型组中氯吡格雷抵抗者2例(1.67%), 中代谢型组中氯吡格雷抵抗者3例(2.80%), 慢代谢型组中氯吡格雷抵抗者28例(90.32%) (三组比较P=0.038)。结论 ACS患者CYP2C19基因分型与服用氯吡格雷后血小板最大聚集率有关,与氯吡格雷抵抗有关。

Objective To explore the relationship between platelet aggregation rate and CYP2C19 gene polymorphisms. Methods A total of 258 cases diagnosed as acute coronary syndrome (ACS) from January 2015 to March 2016. The platelet aggregation rate was tested before and 3 days after taking clopidogrel. CYP2C19 gene polymorphisms was tested by Gene chip hybridization technique. Results The platelet aggregation rate before and after taking clopidogrel was(58.76±15.45)% vs(35.17±10.26)% and(59.35±11.58)% vs(47.66±12.59)%(P<0.05)in EM group and IM group. But there was no change in PM group. The PM group were associated with a significant increase risk of clopidogrel resistance compared with EM group and IM group. Conclusion CYP2C19 gene polymorphisms influence the rate of platelet aggregation rate after taking clopidogrel and are associated with clopidogrel resistance in ACS patients.

目的 研究灵芝孢子油抑制肿瘤细胞增生的作用。方法 通过“预防性”和“治疗性”喂食方法,观察并检测喂食过程中小鼠乳腺癌细胞生长速度及处死后的瘤重量。结果 灵芝孢子油喂食组肿瘤生长速度较对照组慢,且预防性喂食组抑瘤效果好于“治疗性”喂食组。结论 灵芝孢子油具有抑制小鼠乳腺癌生长的作用。

Objective To research the effect of tumor growth inhibition by Ganoderma spore oil. Methods Murine mammary cancer cells were inoculated and Ganoderma spore oil was given by preventing and therapeutic feeding respectively. Results Tumor growth speed of Ganoderma spore oil feeding group was slower than control group, and tumor weight was lighter than control group. In addition, tumor weight of preventing feeding was lighter than therapeutic feeding. Conclusion Ganoderma spore oil has the effect of anti - mammary cancer cell growth.

心肌梗死模型在心肌梗死病理发生机制、新药研发研究中占有重要地位。目前冠状动脉结扎法制作大鼠心肌梗死模型,模型稳定,操作简单,造价便宜,效果可靠,为最主要的心肌梗死造模方法,制作方法及具体操作中存在各自的优势和不足,影响着模型的进一步推广,有待继续进行改进和深入研究。