腰椎间盘突出症患者术后下肢DVT形成的影响因素及LRRFIP1的表达意义

目的探索腰椎间盘突出症患者术后下肢深静脉血栓(deep vein thrombosis,DVT)形成的影响因素及富亮氨酸重复序列相互作用蛋白1(leucine rich repeat in flii interacting protein 1,LRRFIP1)的表达意义。方法分析2018年1月~2020年6月收治的119例腰椎间盘突出症患者,根据患者术后是否合并下肢DVT分为两组,即34例DVT组,85例非DVT组。对比两组一般资料后,经二元Logistic回归分析独立影响因素,再经Spearman相关性分析术后下肢DVT形成与独立影响因素的相关性,以分析LRRFIP1表达与DVT的相关性,用ROC曲线分析各项指标的预测价值。结果经二元Logistic回归分析,年龄、BMI、PLT、MPV、PT、APTT、FIB、D-二聚体水平是影响术后下肢DVT形成的独立影响因子。经Spearman相关性分析,术后下肢DVT形成与年龄、BMI、PLT、PT、APTT呈负相关性;与MPV、FIB、D-二聚体呈正相关性(P<0.05)。经Pearson法分析,LRRFIP1表达与PT、APTT呈负相关性,与FIB、D-二聚体呈正相关性。经ROC曲线分析,年龄、BMI、MPV、APTT、LRRFIP1表达、PLT、PT、FIB、D二聚体早期预测术后下肢DVT形成的AUC分别为0.665、0.662、0.733、0.773、0.94、0.984、0.817、0.673、0.976。结论年龄、BMI、凝血功能、血小板指标等均是影响腰椎间盘突出症患者术后下肢DVT形成的独立因子;LRRFIP1表达上调意味着腰椎间盘突出症患者存在血液高凝状态,与DVT发生率存在一定的相关性。

Activity of ciprofloxacin and azithromycin on biofilms produced in vitro by Haemophilus influenzae

Background It is recognized that Haemophilus influenzae isolated from patients with otitis media forms biofilms both in vitro and in vivo, suggesting that biofilm formation in vivo might play an important role in the pathogenesis and chronicity of otitis media, but the effect of antibiotics on biofilm has not been well studied. We investigated the impact of ciprofloxacin and azithromycin on bacterial biofilms formed by Haemophilus influenzae in vitro in this study. Methods Eleven strains of Haemophilus influenzae were isolated from sputum specimens collected from patients with acute exacerbation of chronic obstructive pulmonary diseases. Formation of bacterial biofUm was examined by crystal violet assay and a scanning electron microscope. Alterations of biofilms were measured under varying concentrations of azithromycin and ciprofloxacin. Results Striking differences were observed among strains with regard to the ability to form biofilm. Typical membrane-like structure formed by bacterial cells and extracellular matrix was detected. Initial biofilm synthesis was inhibited by azithromycin and ciprofloxacin at concentrations higher than two-fold minimal inhibitory concentration. Disruption of mature biofilms could be achieved at relatively higher concentration, and ciprofloxacin displayed more powerful activity. Conclusions Haemophilus influenzae is capable of forming biofilm in vitro. Sufficient dosage might control early formation of biofilms. Ciprofloxacin exerts better effects on breakdown of biofilm than azithromycin at conventional concentration in clinics.

Gemifloxacin for the treatment of community-acquired pneumonia and acute exacerbation of chronic bronchitis： a meta-analysis of randomized controlled trials

Background Gemifloxacin is a fluoroquinolone antibiotic with broad spectrum of antibacterial activity.The aim of the study was to evaluate the comparative effectiveness and safety of gemifloxacin for the treatment of patients with community-acquired pneumonia （CAP） or acute exacerbation of chronic bronchitis （AECB）.Methods We performed a meta-analysis of randomized controlled trials （RCTs） comparing gemifloxacin with other approved antibiotics.The PubMed,EMBASE,Chinese Biomedical Literature Database and the Cochrane Central Register of Controlled Trials were searched,with no language restrictions.Results Ten RCTs,comparing gemifloxacin with other quinolones （in 5 RCTs） and β-lactams and/or macrolides （in 5 RCTs）,involving 3940 patients,were included in this meta-analysis.Overall,the treatment success was higher for gemifloxacin when compared with other antibiotics （odds ratio 1.39,95% confidence interval 1.15-1.68 in intention-to-treat patients,and 1.33,1.02-1.73 in clinically evaluable patients）.There was no significant difference between the compared antibiotics regarding microbiological success （1.19,0.84-1.68） or all-cause mortality （0.82,0.41-1.63）.The total drug related adverse events were similar for gemifloxacin when compared with other quinolones （0.89,0.56-1.41）,while lower when compared with β-lactams and/or macrolides （0.71,0.57-0.89）.In subgroup analyses,administration of gemifloxacin was associated with fewer cases of diarrhoea and more rashes compared with other antibiotics （0.66,0.48-0.91,and 2.36,1.18-4.74,respectively）.Conclusions The available evidence suggests that gemifloxacin 320 mg oral daily is equivalent or superior to other approved antibiotics in effectiveness and safety for CAP and AECB.The development of rash represents potential limitation of gemifloxacin.

Secondary pulmonary alveolar proteinosis associated with myelodysplastic syndrome

Pulmonary alveolar proteinosis （PAP） IS an uncommon disease first reported by Rosen et al^1 in 1958, and characterized by the accumulation of surtactant proteins and phospholipids within the alveolar spaces. Acquired PAP is divided into two forms based on clinical features： idiopathic PAP and secondary PAE Secondary PAP is reported to be associated with haematological malignancies, Pneumocystis carinii pneumonia and inhalation of silica or titanium, and the most frequent underlying disease of secondary PAP is haematological malignancy. The exact incidence of PAP in haematological malignancies is still obscure, since there have been only sporadic reports of secondary PAP.^ 2, 3

Misdiagnostic analysis of clinically diagnosed severe acute respiratory syndrome after following up 197 convalescent patients

The severe acute respiratory syndrome （SARS） is an emerging and highly contagious infection caused by a newly discovered strain of coronavirus. Since the clinical case definition of SARS is similar to other severe atypical pneumonias, specific laboratory tests that can accurately diagnose SARS-associated coronavirus （SARS-CoV） infection are important. However, published data are insufficient to investigate whether clinically diagnosed SARS patients may include some non-SARS pneumonia. Therefore, we aimed to determine clinical and laboratory features to differentiate SARS patients from non-SARS pneumonias that could reduce misdiagnosis of SARS. A retrospective analysis of clinical and laboratory characteristics after the initial onset of SARS, as well as its convalescent-phase, was examined from clinically diagnosed 197 SARS patients.