240例咽部细菌感染患者病原菌分布及耐药分析

目的:探讨咽部细菌感染患者病原菌分布及其耐药情况.方法:收集我院240例咽部细菌感染患者病原菌,采用常规方法进行鉴定,药敏试验采用K-B法.结果:占咽部感染病原菌分布前两位的为链球菌属(30.0％)和奈瑟菌属(18.3％),其次为肺炎克雷伯菌(12.5％)、铜绿假单胞菌(11.3％)和真菌(5.0％).药敏结果显示,致病菌肺炎克雷伯菌对环丙沙星、阿米卡星、头孢吡肟、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南和美罗培南有较低的耐药率(小于20.0％);铜绿假单胞菌对环丙沙星、阿米卡星和头孢吡肟有较低的耐药率(小于20.0％).结论:咽部细菌感染常见致病菌为肺炎克雷伯菌和铜绿假单胞菌,对喹诺酮类药物、氨基糖苷类药物和第四代头孢菌素都有较低的耐药率,可以做为治疗咽部主要致病菌感染的可选药物.     

ICU脑外伤及脑血管病合并肺部感染的病原分布及耐药性分析

探讨本院重症监护病房(ICU)中脑外伤、脑血管病合并肺部感染患者的病原菌分布及耐药情况。对本院2012年~2015年ICU中154例脑外伤、脑血管病合并肺部感染患者的痰液标本进行培养鉴定及药敏实验分析,了解本院ICU脑外伤、脑血管病合并肺部感染患者的病原菌分布及耐药菌群分布情况。本研究共计分离出570株病原菌,其中革兰阳性菌株220株(38.60%)、革兰阴性菌株284株(49.28%)、真菌66株(11.58%);铜绿假单胞菌、肺炎克雷伯菌及不动杆菌的耐药情况十分严重,对大多数抗生素均具有较高的耐药率,对美罗培南、亚胺培南的耐药率相对较低;表皮葡萄球菌、金黄色葡萄球菌的耐药情况十分严重,对大多数抗生素均具有较高的耐药率,对利奈唑胺、万古霉素及呋喃妥因的耐药率相对较低;白色念珠球菌、光滑念珠球菌对大多数抗真菌药物的耐药率均较低,对咪康唑的耐药率均较高。本院ICU肺部感染患者病原菌以革兰阳性菌为主,应根据病原菌药敏结果进行针对性治疗。     

呼吸机相关革兰阴性菌肺炎的多重耐药性及危险因素分析

目的:研究呼吸机相关多重耐药阴性菌肺炎的感染特点及危险因素.方法:回顾性分析本院呼吸内科ICU2005年至2009年呼吸机相关革兰阴性菌肺炎80例的临床资料,了解其病原体构成及药物敏感性,通过Logistic回归分析呼吸机相关多重耐药阴性菌肺炎感染的危险因素.结果:铜绿假单胞菌、不动杆菌属、肺炎克雷伯菌、大肠埃希菌和嗜麦芽窄食单胞菌等为主要革兰阴性致病菌,各和株(除嗜麦芽窄食单胞菌外)除对美罗培南、头孢哌酮/舒巴坦有较好的敏感性外,对其他抗生素均耐药明显.机械通气时间(≥5d)、入住ICU(＞7d)、抗生素的联用和频繁的更改是多重耐药菌产生的独立危险因素.结论:革兰阴性菌是呼吸机相关性肺炎(VAP)感染的主要病原体且大多呈现多重耐药.减少机械通气时间、严格掌握入住ICU指征和规范抗生素的使用,可以预防多重耐药菌的感染.     

2010年宜昌市铜绿假单胞菌的耐药性分析

了解宜昌市铜绿假单胞菌（Pseudomonas aeruginosa）临床分离株的耐药现状。宜昌市城区5所医院临床分离的铜绿假单胞菌菌株,用K-B法作药敏试验,并根据统计其耐药情况及耐药表型（模式）分析可能存在的耐药机制。临床分离的铜绿假单胞菌共1 575株,耐药率依次为阿米卡星7.1%、美罗培南17.2%、头孢吡肟20.4%、头孢哌酮/舒巴坦21.0%、哌拉西林/他唑巴坦22.5%、环丙沙星23.1%、庆大霉素23.4%、头孢他啶25.0%、亚胺培南25.2%、哌拉西林30.4%、氨曲南34.5%、复方新诺明59.0%、米诺环素75.6%。多重耐药（MDR）和泛耐药（PDR）株分别占41.5%和0.17%。对各种抗假单胞菌药物分别耐药的菌株仍有13%～25.7%对阿米卡星敏感,提示在严重铜绿假单胞菌感染患者的治疗中,β内酰胺类抗假单胞菌药加氨基糖苷类仍是一个很好的联合用药组合。细菌耐药性仍呈增长趋势,临床上感染多重耐药和泛耐药的铜绿假单胞菌的治疗仍很棘手,应合理使用抗生素,尽量延缓耐药菌株的出现。     

肾综合征出血热少尿期的肺部感染菌群分布及其耐药分析

目的了解肾综合征出血热少尿期的肺部细菌感染对临床治疗的意义。方法送检的所有痰液标本按常规方法进行细菌分离鉴定,药敏试验为K-B法,ESBLs以双纸片协同试验进行,MRS检测为纸片筛选法。结果痰液标本338份,细菌培养检出率68.9%,革兰阴性菌占优势,以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌为主。对碳青霉烯类、头孢哌酮/他唑巴坦均分别低于9.09%、12.5%,头孢吡肟为27.4%,其余抗生素的耐药率均高于31.3%。3种主要产ESBLs菌对碳青霉烯类、头孢哌酮/他唑巴坦均分别低于15.8%、17.2%,其余抗生素的耐药率均高于55.2%。革兰阳性菌主要以金黄色萄葡球菌为主。结论肺部感染以革兰阴性菌占优势,碳青霉烯类、头孢哌酮/他唑巴坦是抗感染治疗的首选药物。     

铜绿假单胞茵肺炎治疗和预后的临床研究

目的探讨感染铜绿假单胞菌肺炎患者的治疗和预后。方法选取2011年1月至2013年2月浙江大学医学院附属第一医院住院的铜绿假单胞菌肺炎患者,共211例作为研究对象。根据药敏试验结果,把铜绿假单胞菌株分为非多重耐药、多重耐药菌株,分别探讨非多重耐药、多重耐药铜绿假单胞菌所致肺炎的治疗和预后。结果非多重耐药、多重耐药铜绿假单胞菌肺炎治疗有效率分别为91.0% （144/155 ）,35. 7% （20/56 ）,差异有统计学意义（P 〈 0. 05）,死亡率分别为2. 6% （4/155）、32. 1%（ 18/56）,差异有统计学意义（P 〈0.05）。抗菌药单药或联合治疗方案对非多重耐药铜绿假单胞菌肺炎的临床有效率差异无统计学意义（P〉0.05）,联合治疗方案能缩短非多重耐药铜绿假单胞菌肺炎的平均住院天数（P〈0. 05）;抗菌药单药或联合治疗方案对多重耐药铜绿假单胞菌肺炎的临床有效率、平均住院天数差异无统计学意义（P 〉0.05）。结论非多重耐药铜绿假单胞菌肺炎治疗疗效好,死亡率低,联合治疗方案可缩短非多重耐药铜绿假单胞菌肺炎的平均住院天数。多重耐药铜绿假单胞菌肺炎治疗疗效差,死亡率高。     

仙居县ICU病房铜绿假单胞菌感染调查及耐药性分析

目的了解铜绿假单胞菌在仙居县ICU病房内感染现状及其对临床常用抗菌药物的耐药情况,为铜绿假单胞菌感染的防治提供依据。方法对2011-2013年仙居县人民医院ICU患者下呼吸道感染铜绿假单胞菌药敏情况进行分析,对泛耐药菌株感染危险因素进行单因素分析。结果 622株铜绿假单胞菌对常用的抗生素有不同程度的耐药性,耐药率分别为:哌拉西林28.41%、哌拉西林/他唑巴坦24.84%、阿米卡星8.57%、环丙沙星17.32%、庆大霉素11.23%、左旋氧氟沙星22.36%、妥布霉素3.73%、头孢他啶36.75%、头孢吡肟32.00%、头孢哌酮/舒巴坦15.38%、亚胺培南39.83%、美洛培南37.36%。铜绿假单胞菌是ICU患者下呼吸道感染的主要致病菌,位居第二位,检出率为19.92%。广谱抗生素的应用、气管插管/气管切开、多器官功能障碍综合征是ICU泛耐药铜绿假单胞菌感染主要的危险因素,泛耐药比例为:广谱抗生素的应用78.57%、气管插管/气管切开76.19%、MODS 76.19%。结论铜绿假单胞菌易引发ICU病房下呼吸道感染,且耐药现象严重,易产生泛耐药,临床应根据药敏结果合理用药,控制耐药株的流行。     

407例老年肺癌下呼吸道感染患者病原菌分布及耐药分析

目的 分析老年肺癌下呼吸道感染患者痰培养物的病原菌分布及耐药状况.方法 回顾性分析407例老年肺癌下呼吸道感染患者痰标本细菌培养、鉴定及药敏结果.结果 共分离出病原菌238株,革兰阴性菌163株,占68.49％;革兰阳性菌33株,占13.87％;真菌42株,占17.65％.主要病原菌为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、表皮葡萄球菌和金黄色葡萄球菌.其中,肺炎克雷伯菌和大肠埃希菌ESBLs阳性菌株的比例分别为36.73％、28.85％.结论 老年肺癌患者因长期使用抗生素,呼吸道菌群失调,不同病原菌对抗菌药耐药率均较高,以革兰阴性菌感染为主,肺炎克雷伯菌和大肠埃希菌产ESBLs的菌株有较高比例,二重感染比例较高;革兰阳性菌均对万古霉素敏感,未发现耐药菌株.因此临床医生根据药敏结果合理选用抗生素,对于改善患者肺部微生态失衡,延长生存时间具有重要指导意义.     

抗生素对耐药菌生长繁殖影响的观察

目的：观察耐药菌株在含抗生素的培养基中生长情况与规律,进一步探讨抗生素应用的某些方法以及细菌耐药性形成的机制。方法：将多重耐药性的金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌接种于含临床剂量的头孢唑啉、庆大霉素、红霉素、呋喃妥因培养基内;置温箱内37℃培养并在不同时间检测各菌的数量及培养基抗生素活性。结果：临床治疗浓度的头孢唑啉或庆大霉素对金黄色葡萄球菌,铜绿假单胞菌及肺炎克雷伯菌的耐药性菌株的生长繁殖具有短暂的抑制作用,随后培养基内虽然仍保留较高的抗生素活性,但细菌的数量却逐渐增多。结论：临床治疗浓度的抗生素对耐药性细菌的生长繁殖仍然具有短暂的抑制作用,以致经验性用药能够使感染症患者的症状缓解,经验性用药不能有效杀灭病原菌,易造成病原菌在宿主体内长期携带和疾病的慢性过程。     

ICU患者铜绿假单胞菌获得性肺炎耐药研究

目的监测重症监护病房（ICU）铜绿假单胞菌（Pseudomonas aeruginosa,PA）的感染状况及耐药变迁,指导临床合理使用抗菌药物。方法对2003年至2007年间,我院ICU收治的患者下呼吸道分泌物进行培养及体外耐药试验。结果铜绿假单胞菌是ICU下呼吸道感染的主导致病菌且感染率呈逐年上升的趋势（46．3％-81．0％）,细菌对三代头孢、亚胺培南及氨基糖苷类药物的耐药性也呈逐年上升的趋势,并呈现多重耐药的特性。结论铜绿假单胞菌是ICU院内下呼吸道感染的常见病原菌,其多重耐药性及应引起高度重视。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.