抗菌肽LL-37对鲍曼不动杆菌生物膜的抑制作用

目的研究抗菌肽LL-37 对鲍曼不动杆菌生物膜的影响,为将来在临床感染的控制和新抗菌药物的研发提供科学的依
据。方法运用平板结合结晶紫染色法体外建立鲍曼不动杆菌生物膜模型,肉汤稀释法检测LL-37的最小抑菌浓度;采用扫描
电镜和结晶紫染色定量法观察抗菌肽LL-37作用后生物膜结构和量的改变。结果成功体外建立鲍曼不动杆菌生物膜模型,测
得抗菌肽LL-37 MIC为64 μg/ml;经过抗菌肽LL-37作用后,鲍曼不动杆菌成熟生物膜结构被破坏。当LL-37浓度为2.5 μg/ml
时即可破坏生物膜结构,且随着LL-37浓度增加,生物膜的量逐渐减少。结论抗菌肽LL-37在浓度远小于其MIC时即可破坏
鲍曼不动杆菌生物膜结构。
     

桂皮醛联合万古霉素对耐甲氧西林金黄色葡萄球菌生物膜的抑制作用

目的 研究桂皮醛联合万古霉素对耐甲氧西林金黄色葡萄球菌 (methiciline-resistant Staphylococcus aureus, MRSA) 生物膜的影响.方法 96孔板法构建金黄色葡萄球菌标准菌株ATCC25923和5株临床分离MRSA菌株的体外生物膜模型, 结晶紫半定量法检测其成膜能力;选取标准菌株和强成膜临床菌株为实验菌株, 采用氯化三苯基四氮唑 (TTC) 法确定药物单用及联用的最低抑菌浓度 (minimum inhibitory concentration, MIC) ;微量棋盘稀释法测出两药联用的最小抑膜浓度 (s MIC) .结果 96孔板培养3 d可见成熟生物膜形成, 结晶紫半定量法测得编号为16187的实验菌株有较强的产生物膜能力;桂皮醛和万古霉素对标准菌株的MIC为256μg/m L和1μg/m L, 对MRSA16187菌株的MIC为128μg/m L和0.5μg/m L, 两药联用对标准菌株的MIC为16μg/m L和0.06μg/m L, 对MRSA16187菌株的MIC为16μg/m L和0.03μg/m L;MRSA16187在桂皮醛和万古霉素联用与单独用药后s MIC50相比差别有显著性 (P<0.05和P<0.05) , s MIC90相比差别有显著性 (P<0.05和P<0.05) ;ATCC25923在桂皮醛和万古霉素联用与单独用药后s MIC50相比差别有显著性 (P<0.05和P<0.05) , s MIC90相比差别有显著性 (P<0.05和P<0.01) .结论 桂皮醛能显著增强万古霉素抗MRSA生物膜的作用, 且两药具有协同抗菌作用.     

小檗碱体外抗耐甲氧西林金黄色葡萄球菌活性的研究

目的研究小檗碱体外抗耐甲氧西林金黄色葡萄球菌(MRSA)活性。方法运用琼脂扩散法、液体稀释法测定并分析小檗碱对MRSA的抑菌环大小、最低抑菌浓度(MIC)和最低杀菌浓度(MBC);运用96孔酶标板结晶紫法测定并分析小檗碱对MRSA的最小生物膜清除浓度(MBEC)。结果与DMSO比较,小檗碱与氯霉素(阳性对照药物)可显著增加MRSA的抑菌环半径(P0.01),小檗碱对MRSA的MIC为0.2 mg/m L,MBC为0.4 mg/m L;小檗碱对MRSA的MBEC为0.2 mg/m L。结论小檗碱对MRSA有比较明显的抗菌、抑菌作用,其效应机制可能与其抑制细菌生物膜的形成有关。     

黄芪、穿心莲单独或与抗菌肽LL-37联合应用对铜绿假单胞菌生物膜的影响

【目的】探讨黄芪、穿心莲对铜绿假单胞菌(PA)生物膜的抑制作用及与抗菌肽LL-37联合应用是否有协同作用。【方法】培养铜绿假单胞菌野生菌株PAO1生物膜,并采用紫外分光光度法进行鉴定。采用微量肉汤稀释法分别检测黄芪、穿心莲和抗菌肽LL-37对铜绿假单胞菌的最小抑菌浓度(MIC)。采用紫外分光光度法检测20、50、100 g/L黄芪,20、50、100 g/L穿心莲单独用药或分别与32、64μg/mL抗菌肽LL-37联合应用对PAO1生物膜的作用。【结果】成功构建体外PAO1生物膜模型。黄芪、穿心莲在3.125～200 g/L浓度范围内对PAO1无抑制作用。抗菌肽LL-37对PAO1的MIC为256μg/mL。黄芪、穿心莲单独用药对PAO1生物膜早期形成均具有抑制作用(P0.05),呈现浓度依赖性。黄芪/穿心莲与抗菌肽LL-37联合用药对PAO1生物膜的形成及对成熟生物膜的清除作用不明显,不具有协同作用。【结论】黄芪、穿心莲均能够早期抑制PAO1生物膜的形成并且在一定程度上对成熟生物膜结构有一定的破坏作用;与抗菌肽LL-37联合应用时,不具有协同作用。     

草决明对临床耐药金葡菌的抗菌作用及生物膜形成的影响

目的探讨草决明对耐药金葡菌的抗菌作用及其对细菌生物膜的抑制作用。方法以临床耐药菌株为研究对象,微量肉汤稀释法测定其最低抑菌浓度(MIC),96孔板法测定草决明对金葡菌生物膜的抑制作用,以氯化钠和蒸馏水测定草决明处理菌细胞壁渗透能力。结果草决明醇提液抗菌作用较强,其对金葡菌标准菌株和临床菌株的最低抑菌浓度分别为25μg/mL、6.25μg/mL,1/2~1/4MIC的草决明醇提液均可明显抑制耐药菌株生物膜的形成;1/2~1/8MIC草决明醇提液处理耐药金葡菌后,其细胞壁渗透力并无明显改变。结论草决明醇提液对耐药金葡菌具有抗菌作用,对耐药菌生物膜形成具有明显的抑制作用。     

大黄素抑制MRSA生物膜活性及其作用机制研究

目的 探究大黄素抗耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)生物膜作用及其机制.方法 微量肉汤稀释法测定大黄素对MRSA标准株及5种不同地区临床分离株的最低抑菌浓度(minimum inhibitory concentration,MIC...     

穿心莲内酯对金黄色葡萄球菌生物膜的体外抑制作用

目的：研究穿心莲内酯对金黄色葡萄球菌生物膜的体外抑制作用。方法从临床分离30株金黄色葡萄球菌,通过刚果红平板法筛选生物膜阳性菌株和结晶紫染色法半定量检测生物膜;以万古霉素为阳性对照药,微量肉汤二倍稀释法测定抗菌药物的最低抑菌浓度（MIC）和药物对细菌生物膜的最小抑膜浓度（SMIC）;XTT减低法评价穿心莲内酯对不同时间段金黄色葡萄球菌生物膜的早期黏附能力的影响。结果30株金黄色葡萄球菌中,刚果红平板法生物膜阳性菌株有12株,即生物膜形成率为40％,结晶紫染色法半定量生物膜实验阳性有22株（73.3％）;穿心莲内酯对金黄色葡萄球菌生物膜的SMIC50为125 mg／L,SMIC80为500 mg／L;1000、500和250 mg／L的穿心莲内酯对金黄色葡萄球菌生物膜的早期黏附能力均有较强的抑制作用。结论一定浓度的穿心莲内酯对金黄色葡萄球菌生物膜的形成和黏附有抑制作用,但效果不及万古霉素。     

鞣质联合环丙沙星对鲍曼不动杆菌生物膜形成的影响

目的研究石榴皮提取物鞣质联合环丙沙星（CIP）对鲍曼不动杆菌（Ab）生物膜形成的影响。方法采用2 倍稀释法测得石榴皮提取物鞣质和CIP 对Ab ATCC19606 的最低抑菌浓度（MIC）;将1/2MIC、MIC、2MIC浓度的鞣质和CIP单独及联合用药作用于Ab生物膜4、8、24 和48 h,采用结晶紫法和荧光显微镜法观察生物膜的形成。结果鞣质和CIP 对Ab 的MIC 值为1.95 和0.50 mg/ml;联合用药较单独用药对Ab 生物膜的形成影响大,且2MIC鞣质+2MIC CIP联合作用24 h,对生物膜形成影响最大。结论石榴皮提取物鞣质和 CIP联合用药对生物膜形成的影响比单独用药明显,且2MIC鞣质+2CIP联合用药对Ab生物膜作用24 h影响效果最佳。     

浮游态与生物膜态铜绿假单胞菌耐药性分析

目的分析人工建立的铜绿假单胞菌(PA)生物膜对临床常用抗菌药物的耐药情况。方法利用96孔微量平板建立PA生物膜模型,结晶紫染色法分析PA形成生物膜的能力,纸片扩散法测定浮游态与生物膜态PA的耐药性,微量倍比稀释法测定浮游态PA的最低抑菌浓度,生物膜PA的最小生物膜清除浓度。结果临床分离的63株PA中有62株(占98. 4%)形成生物膜,1株未形成生物膜。生物膜态阿米卡星、哌拉西林/他唑巴坦、替卡西林/克拉维酸、哌拉西林、头孢他啶、头孢哌酮/舒巴坦、头孢哌酮、头孢吡肟、亚胺培南、美罗培南、氨曲南、环丙沙星的PA耐药率均高于浮游态(P <0. 01)。生物膜菌最小生物膜清除浓度是浮游菌的10倍以上。结论通过平板培养法可建立PA生物膜模型,结晶紫染色法半定量得出大部分PA能形成生物膜,生物膜态的PA对临床常用抗菌药物的耐药性高于浮游菌。     

奥扎尼莫德抑制金黄色葡萄球菌生长和生物被膜形成的研究

目的 拟筛选可抑制金黄色葡萄球菌（以下简称“金葡菌”）生长和生物被膜形成的新型化合物。方法 通过96孔板法从美国FDA已经批准上市药物化合物库中筛选可抑制金葡菌生长的化合物。通过酶标仪测定600 nm波长吸光度值（OD₆₀₀）以检测培养上清液中浮游菌含量。通过微量肉汤稀释法检测奥扎尼莫德对临床分离金葡菌株的最低抑菌浓度（minimum inhibitory concentration, MIC）。通过结晶紫染色法检测亚抑菌浓度奥扎尼莫德对金葡菌生物被膜形成的抑制作用。结果 本研究筛选发现奥扎尼莫德可显著抑制金葡菌SA113株（筛选参考菌株）的生长,MIC为25.00 μmol/L。奥扎尼莫德对119株金葡菌临床株[甲氧西林敏感株（MSSA）为65株,耐甲氧西林株（MRSA）为54株]的MIC为12.50或25.00 μmol/L,MIC₅₀和MIC₉₀均为25.00 μmol/L。本研究发现6.25 μmol/L、12.50 μmol/L、25.00 μmol/L的奥扎尼莫德显著抑制了2株MSSA和2株MRSA生物被膜形成。亚抑菌浓度奥扎尼莫德（12.50 μmol/L）显著抑制了14株MSSA和11株MRSA生物被膜形成,但对这些菌株的浮游菌生长无抑制作用。结论 奥扎尼莫德可抑制金葡菌包括MRSA的生长,具有良好的抑菌活性。亚抑菌浓度的奥扎尼莫德可显著抑制金葡菌的生物被膜形成。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…