随着广谱抗生素、激素、免疫抑制剂以及侵入性诊断治疗普遍应用,深部真菌感染的发病率日益增加,我院假丝酵母菌分离率居所有感染菌的第五位。但目前临床上应用的西药抗真菌药物,存在毒性大、费用高、耐药性增加等缺点。不少学者致力于中药的抗细菌、抗真菌方面的研究,笔者对黄连、茵陈、黄芪进行了体外抑菌试验,寻求中药在抗真菌感染方面的功效,旨在能更好的服务和指导临床用药。1材料1.1菌株2013年3月至2014年3月河北省中医院微生物室分离

目的 探讨高糖状态下巨噬细胞株THP-1经TLR4不同配体刺激后信号通路激活的改变,明确巨噬细胞激活在糖尿病肾病中的炎症机制.方法 用正常和高糖培养THP-1细胞,用TLR4的配体LPS和HSP60刺激,收集上清和细胞,采用ELISA和Real-time PCR检测IL-10、IL-1β、TNF-α的蛋白及mRNA的表达水平,用Western blot检测NF-κB(P65)、AKT(Ser473)介导的信号通路分子的表达水平.结果 高糖刺激下IL-10 mRNA表达的高峰值晚于正常组,出现延迟现象,但蛋白表达无明显变化.而IL-1β和TNF-α无论mRNA和蛋白水平的表达均高于正常对照组.Western blot结果显示LPS刺激细胞0、15、30、60、120、180 min,正常组P-NF-κB p65的表达于60 min达到高峰,而高糖组15 min时达到高峰,P-AKT的表达于60 min时表达增高,高糖组在同一时间点总体高于正常组;高糖状态下LPS和HSP60刺激细胞0、30、60、180 min后,P-NF-κB p65、P-AKT(Ser473)均高于对照组.结论 高糖状态能促进TLR4介导的促炎因子的表达,不同配体刺激的结果相似.

Objective To observe the interfering effect of irbesartan on the levels of cytokines correlated with inflammation,interleukin-8 and interleukin-10 in diabetic nephropathy rats,and to investigate the possible drug action mechanism of irbesartan.Methods 36 Wistar rats were randomly divided into three groups:control group of right kidney nephrectomized,diabetic nephropathy group and irbesartan treatment group.There were 12 rats in each group.At the 8th and the 12th week ends,serum and urine of the rats were collected.The levels of interleukin 8,interleukin 10,glucose,creatinine,urea nitrogen in serum and 24-hour urinary albumin in urine were determined.At the same time,the ratio of kidney mass/body mass was determined.Results At the 8th and the 12th week ends,the levels of interleukin 8 in irbesartan treatment group and diabetic nephropathy group were all significantly higher than those in control group,and the level of interleukin 8 in diabetic nephropathy group was significantly higher than that in irbesartan treatment group(26.51±2.34) ng/L vs(16.12±2.11) ng/L,(59.32±1.28) ng/L vs(21.46±2.59) ng/L(P<0.01);In irbesartan treatment group and diabetic nephropathy group,the level of interleukin 8 at the 12th week ends was both significantly higher than that at the 8th week end(21.46±2.59) ng/L vs(16.12±2.11) ng/L,(59.32±1.28) ng/L vs(26.51±2.34) ng/L(P<0.01);However,the rising format in irbesartan treatment group was less than that in diabetic nephropathy group.At the 8th and the 12th week ends,the levels of interleukin 10 in irbesartan treatment group and diabetic nephropathy group were all significantly lower than that in control group,and the level of interleukin 10 in diabetic nephropathy group was significantly lower than that in irbesartan treatment group(21.27±2.49) ng/L vs(25.58±3.52) ng/L,(18.05±3.55) ng/L vs(33.22±2.97) ng/L(P<0.01).In diabetic nephropathy group,the level of interleukin 10 at the 12th week end was significantly lower than that at the 8th week end(18.05±3.55) ng/L vs(21.27±2.49) ng/L(P<0.01).But in irbesartan treatment group,the level of interleukin 10 at the 12th week end was significantly higher than that at the 8th week end(33.22±2.97) ng/L vs(25.58±3.52) ng/L(P<0.01).At the 8th and the 12th week ends,the levels of interleukin 8 and interleukin 10 in control group showed no significant difference(P>0.05).IL-10 was significantly negative correlated with IL-8(r=-0.659,P<0.01).IL-8 was significantly positive correlated with glucose,creatinine,urea nitrogen,24-hour urinary albumin and the ratio of kidney mass/body mass(r=0.596,0.764,0.845,0.635,0.830,P<0.01),IL-10 was significantly negative correlated with glucose,creatinine,urea nitrogen,24-hour urinary albumin and the ratio of kidney mass/body mass(r=-0.835,-0.739,-0.757,0.745,-0.810,P<0.01).Conclusion Irbesartan makes proinflammatory cytokines IL-8 secretion decreased through suppressing the immune inflammatory reaction,meanwhile,it stimulates the secretion of anti-inflammatory cytokines IL-10.Thus,it will contribute to improving renal hypertrophy and decreasing proteinuria of the rats with diabetic nephropathy,react on the protective effect to renal function.

Objective To investigate the protective effect of kidney of irbesrtan in diabetic nephropathy rats.Methods 36 Wistar rats were randomly divided into three group,including control group,diabetic nephropathy group and irbesartan group.At the weekends of the 8th and the 12th,serum and urine of the rats was collected.The levels of C reactive protein,interleukin 6,glucose,creatinine,urea nitrogen in serum and 24-hour urinaryalbumin were determined.Result The levels of C reactive protein,interleukin 6,glucose,creatinine,urea nitrogen and 24-hour urinaryalbumin in diabetic nephropathy group were significantly higher than that in control group.However,the levels of C reactive protein,interleukin 6,glucose,creatinine,urea nitrogen and 24-hour urinaryalbumin in irbesartan treatment group were significantly lower than that in diabetic nephropathy group.Conclusion Irbesartan can delay the progress of the renal function impairment of diabetic nephropathy rats.It may be associated with the mechanism that irbesartan inhibits the production of C reactive protein and interleukin 6 in blood of diabetic nephropathy rats.

糖尿病肾病(DN)是糖尿病常见而严重的慢性微血管病变的并发症,是引起终末期肾病的最常见病因之一.在DN的发生发展过程中,糖或脂代谢紊乱、氧化失衡、血管活性物质、遗传因素以及细胞因子等均起着重要作用.目前,炎性反应在DN发病中的作用越来越受到人们的关注.本实验旨在观察DN大鼠血液细胞因子白介素(IL)-6、IL-8、IL-10、C-反应蛋白(CRP)变化并从炎症方面探讨其可能的发病机制.

葡萄球菌已是引起医院内和社区化脓性感染甚至全身感染的常见病原菌.近年来,葡萄球菌对大环内酯类抗生素的耐药率呈明显上升趋势,且红霉素(属大环内酯类)具有诱导克林霉素耐药的作用.临床上常有体外克林霉素敏感而治疗失败的病例发生.为此,我们对临床分离的红霉素耐药、克林霉素敏感株进行D-试验检测,以了解诱导型克林霉素耐药在我院的发生情况.

检测,并探讨其与HBV血清标志物的关系,现报道如下.

作为医院感染的重要致病菌,革兰阴性杆菌由于产生质粒介导的超广谱β-内酰胺酶(ESBLs),不仅对β-内酰胺类药物耐药,而且也对氨基糖苷类、喹诺酮类药物耐药,引起临床抗感染治疗困难.

血小板(Plt)是由骨髓巨核细胞浆裂解出来的无核细胞,其量和质在止血过程中有很重要的作用.Plt计数、血小板平均容积(MPV)、血小板比积(PCT)、血小板分布宽度(PDW)是血小板质与量的检测指标.临床常作为诊断各种出血性疾病的重要参数.

Objective To investigate the antimicrobial activity of Scutellaria baicalensis Georgi,Coptis chinensis Franch,Prunus mume Sieb,Lonicera japonica Thunb,Patrinia scabiosaefolia Fisch on bacteria producing AmpC β-lactamases.Methods Antimicrobial activity of Scutellaria baicalensis Georgi,Coptis chinensis Franch,Prunus mume Sieb,Lonicera japonica Thunb,Patrinia scabiosaefolia Fisch was detected by M-H agar dilution method.Results The results showed that they had different antimicrobial activity,the effects of Scutellaria baicalensis Georgi,Coptis chinensis Franch,Prunus mume Sieb were better,their MIC90 was 15.62,31.25,31.25 mg/mL,respectively.Conclusion Scutellaria baicalensis Georgi,Coptis chinensis Franch,Prunus mume Sieb can be used to treat the infection caused by bacteria producing AmpC β-lactamases.

肝炎肝硬化是临床常见的慢性进行性疾病.慢性肝病绝大多数有肝纤维化,其中25%～40%最终发展为肝硬化[1,2].早期可出现乏力、腹胀、纳差、胁痛等症状,逐渐加重,可累及多个脏器,引起上消化道出血、腹水、感染、肝性脑病、肝肾综合征等多种并发症.目前,西医对肝硬化尚无特效药物,仍处于对症治疗阶段.2007-01-2007-12,我们应用健脾益气活血汤治疗肝炎肝硬化52例,观察其对肝硬化患者血小板相关参数的影响,现报告如下.

Objective To investigate the incidence of clinical isolates of gram-negative bacilli producing AmpC β-lactamases and its drug resistance.Methods AmpC β-lactamases were identified by three-dimensional test;and the susceptibilities of antimicrobial agents were detected by KirbyBauer disk diffusion test.Results Of 236 gram-negative bacilli,29 strains produced β-lactamases with three-dimensional test,17 strains(7.2%) only had AmpC β-lactamases,8 strains(3.4%) only had extended-spectrum beta-lactamases(ESBLs),2 strains(0.8%) had both ESBLs and AmpC,2 strains(0.8%) had no AmpC-ESBLs β-lactamases.Therefore,19 strains produced AmpC β-lactamases,the frequency of AmpC β-lactamases was 8.1%.The susceptibility test showed that the drug resistant rate of AmpC producer was higher than non-AmpC producer except imipenem and cefepime.Conclusion The frequency of AmpC β-lactamases was 8.1% in the hospital.Multiple drug resistance appeared in AmpC producer.The fourth-generation cephalosporins and carbapenems should be considered to treat the infection caused by AmpC producer at first.

作为医院感染的重要致病菌,革兰阴性杆菌对第三代头孢菌素耐药的主要原因是由于细菌产生AmpCβ-内酰胺酶(Ampicillin beta-lactamases,简称"AmpC酶")和质粒介导的超广谱β-内酰胺酶(extended-spectrum beta-lactamases,ESBLs).革兰阴性杆菌不仅产生染色体介导的AmpC酶,而且还产生质粒介导的AmpC酶,国外已发现数十种质粒介导的AmpC酶的耐药基因型,国内对质粒介导AmpC酶的报道尚少见.

乙型肝炎病毒(hepatitis B virus,HBV)属嗜肝脱氧核糖核酸科不完全双链DNA病毒,是引起病毒性肝炎的主要病原.我国约有2亿人口感染HBV,而受HBV慢性感染的人群患原发性肝癌的相对危险性至少增加300倍.所以,对HBV感染的防治仍是我国健康与传染病控制中的首要问题[1].

肿瘤的发生发展与细胞凋亡有着非常密切的关系,细胞凋亡的发生涉及到促凋亡基因以及抑制凋亡基因的表达,细胞凋亡的改变与这两种基因的异常表达有关.Survivin是一个新发现的凋亡蛋白抑制剂(IAP)家族成员,具有抑制细胞凋亡和调节细胞有丝分裂的双重功能.白细胞介素23(IL-23)是Oppmann等在2000年新发现的一种新的细胞因子,已有研究证实[1-3],IL-23有一定的抗肿瘤作用.有关细胞因子抑制肿瘤对Survivin表达的影响尚未见详细报道.本研究目的是探讨逆转录病毒介导的小鼠IL-23对结肠癌细胞细胞凋亡率及Survivin表达的影响.

尿路感染是常见的感染性疾病,绝大部分由细菌引起.随着抗生素和免疫抑制剂、激素及介入诊断的广泛应用,细菌感染和耐药逐年上升,患者免疫功能下降,致真菌感染日益增多,因此合理应用有效抗生素是非常必要的.为了配合临床医生及时诊断和治疗,掌握细菌感染的种类及耐药情况收集了我院3年间尿路感染菌培养阳性患者332例,对其细菌菌群分布及耐药性进行分析.现报道如下.

[目的]了解临床分离金黄色葡萄球菌(金葡菌)的耐药现状及感染特点,为选择治疗药物提供依据.[方法]对2001～2002年从河北医科大学中医院临床标本中检出的165株金葡菌,分析菌株来源,进行抗菌药物敏感性测定.[结果]165株金葡菌感染者的基础疾病主要为尿路感染、恶性肿瘤、皮肤软组织感染,55.8%为甲氧西林耐药金葡菌(MRSA).菌株均对万古霉素敏感,对其他15种药物均有不同程度的耐药.[结论]MRSA的耐药率均明显高于甲氧西林敏感金葡菌(MSSA).治疗金葡菌感染要首选万古霉素,但要监测菌株耐药性的变化.

近年来,非淋菌性尿道炎(NGU)的发病率呈上升趋势,而支原体是引起该病的主要病原体之一.为了解支原体感染及耐药情况,从而指导临床用药,我们采用支原体培养+药物敏感性测定对199例泌尿生殖道标本进行了检测,结果报告如下.

目的:了解2001～2002年我院泌尿生殖道支原体感染及耐药情况.方法:采用法国生物-梅里埃公司生产的试剂盒进行支原体培养、鉴定和药敏试验.结果:199例患者中,解脲支原体(Uu)阳性率为33.2%,解脲支原体(Uu)和人型支原体(Mh)共同感染(Uu+Mh)的阳性率为7.5%,男性Uu和Uu+Mh的阳性率为26.1%和3.6%,女性的分别为49.2%和16.4%,女性Uu及Uu+Mh的阳性率明显高于男性.支原体对红霉素和氧氟沙星的敏感性较差.Uu单独感染者与Uu+Mh混合感染者的耐药性有显著性差异.结论:临床应根据药敏实验选择敏感药物正规用药或联合用药.

[目的]了解慢性前列腺炎细菌感染及耐药性现状.[方法]采用法国生物-梅里埃试剂盒对351例慢性前列腺炎患者前列腺液进行细菌培养及药敏试验.[结果]187例标本细菌培养阳性,占53.3%.共培养出15种细菌,金黄色葡萄球菌、大肠杆菌分别占致病菌总株数的73.5%和10.3%,对阿米卡星、妥布霉素、西力欣、万古霉素等耐药率较低.[结论]金黄色葡萄球菌、大肠杆菌是慢性前列腺炎的主要病原体,临床治疗要参考细菌培养及药敏试验结果.