Correlation of Hamstring Tendon Size in Pre-Operative MRI Measurement with Intra-Operative Graft Size in Primary Anterior Cruciate Ligament (ACL) Reconstruction

Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation of pre-operative MRI measurement of Hamstring tendons with the intra-operative ACL graft. Thus, it may help surgeons to anticipate the needs for graft augmentation should the final graft size be smaller than expected. Methods: We retrospectively re-viewed 41 cases of ACL reconstructions in which MRI were done pre-operatively, in Hospital Pakar Sultanah Fatimah (HPSF), Muar between January 2019 until December 2022. MRI measurements of Hamstring tendon (semitendinosus: ST, and gracilis) were done by a radiologist, and the in-tra-operative notes were reviewed for the final graft size. Pearson’s correlation coefficients were calculated to determine the relationship between graft size and tendon cross-sectional area. The intraclass correlation (ICC) by using two-way mixed model with type consistency, the reliability based on average measure was 0.41 (95% CI: ?0.10, 0.69). A p-value < 0.05 was considered sig-nificant. Results: Of 105 patients with primary ACL reconstruction done be-tween January 2019 to December 2022, only 41 patients were included in this study. There was fair correlation (p = 0.048) between pre-operative MRI measurement and the graft diameter intra-operatively. The mean of 17.0 mm of combined diameter of ST and gracilis tendon in MRI may results in graft diameter of 8.3 mm. There was also positive correlation between patients’ height and the intra-operative graft size. Conclusion: These results showed good correlation between pre-operative MRI measurement of Hamstring ten-don size with the intra-operative graft size, hence it is a reliable tool to predict the Hamstring autograft size in ACL reconstruction.

Bacteriological Profile of Effusion Fluids Infections at Charles De Gaulle University Pediatric Hospital from 2017 to 2020

Introduction: Microbiology of effusion fluids in children in Burkina Faso is characterized by the scarcity of data. This work aimed to study the bacteriological and antibiotics susceptibility profile of bacteria involved in effusion fluid infections in paediatrics in order to improve the choice of probabilistic antibiotics therapy. Methods: A cross-sectional, descriptive study was used in children aged 0 to 15 years from 2017 to 2020 at the Charles De Gaulle Pediatric University Hospital Center (CHUP-CDG) in Ouagadougou. Classical bacteriology methods such as macroscopy, Gram staining, identification galleries and antibiotics susceptibility testing were used. Results: Of 231 samples, 64 bacteria were isolated. The most common bacterial strains of pleural fluid were Staphylococcus aureus (25%) and 40% for Enterobacteriaceae. Of the peritoneal fluid, 77% were Enterobacteriaceae with 57% Escherichia coli;and from joint fluid, 33% were S. aureus and 22% for P. aeruginosa. The overall susceptibility profile showed 29% extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), 10% methicillin-resistant S. aureus (MRSA), and 8% carbapenemases. Conclusion: Bacteriological profile is characterized by ESBL-producing Enterobacteriaceae and MRSA. The most active antibiotics were macrolides, aminoglycosides, and cefoxitin (methicillin) for Gram-positive cocci, carbapenems, and aminoglycosides for Gram-negative bacilli. Then, the monitoring of antibiotics resistance must be permanent.

Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder

AIM:To investigate the preoperative factors that can predict neoplastic polypoid lesions of the gallbladder(PLGs) as well as malignant PLGs.METHODS:A retrospective analysis was conducted on the 210 consecutively enrolled patients who underwent cholecystectomy due to a PLG larger than 10 mm,as was determined by preoperative trans-abdominal ultrasonography or endoscopic ultrasonography.We ana-lyzed the medical,laboratory,radiologic data and the pathologic results.RESULTS:In 210 cases,146 had non-neoplastic polyps(69.5%) and 64 cases were neoplastic polyps(30.5%).An older age(≥ 65 years),the presence of diabetes mellitus(DM) and the size of polyp(≥ 15 mm) were revealed to be independent predictive variables for neoplastic polyps with odd ratios(OR) of 2.27(P = 0.044),2.64(P = 0.021) and 4.94(P < 0.01),respectively.Among the neoplastic PLGs,an older age(≥ 65 years),the presence of DM and polyp size(≥ 15 mm) were associated with malignancy with ORs of 4.97(P = 0.005),6.13(P = 0.001) and 20.55(P < 0.001),respectively.CONCLUSION:Among patients with PLGs larger than 10 mm in size,higher risk groups such as elderly patients more than 65 years old,those with DM or a large polyp size(≥ 15 mm) should be managed by cholecystectomy.

Hypo-Calories with Micronutrients and Fat Emulsion of Pre-Operative Peripheral Parenteral Nutrition in Malnutrition Risk Rectal Cancer Patients: A Retrospective Cross-Sectional Study

Malnutrition has been recognized as a significant risk factor for the post operated patients, especially for those patients undergoing abdominal operations. This study evaluated the effect of hypo-calories with micronutrients of pre-operative peripheral parenteral nutrition support (PPPN) for rectal cancer patients. Retrospective cross sectional study method was used to investigate. We screened rectal cancer patients past year pre-operative with malnutrition risk from our cancer database and divided into 2 groups, received or not received PPPN and compared the post-operative outcomes. The results showed that the post-operative serum albumin of the 25 patients received PPPN averaged 2.5 ± 0.32 g/dl;significantly better than those of the 15 patients not received PPPN (non-PPPN), which averaged 1.92 ± 0.42 g/dl. The first ambulatory time required 3.0 ± 0.8 days for the PPPN, significantly shorter than those for the non-PPPN, which averaged 4.9 ± 2.4 days. Post-operative hospital days for the patients received PPPN were 18.2 ± 10.5 day, also significantly fewer than the non-PPPN, which averaged 33.7 ± 20.0 day. More than 25% of the non-PPPN was infected with sepsis, while none was infected in the PPPN patients. In conclusion, this study verified the benefits of micronutrients of pre-operative peripheral parenteral nutrition support for rectal cancer patients.

The Influence of Jia Wei Cang Er San on the Postoperative Bacteriology of Chronic Rhinosinusitis: A Randomized, Placebo-Controlled, Double-Blind Study

Background: Antibiotics have been used routinely for postoperative care in patients with chronic rhinosinusitis (CRS). However, increased bacterial growth was found after antibiotic treatment. In traditional Chinese medicine, Jia Wei Cang Er San has been used to treat CRS. This study was to investigate the influence of Jia Wei Cang Er San on the postoperative bacteriology of CRS. Methods: Ninety-seven CRS patients who underwent functional endoscopic sinus surgery (FESS) were included. They were randomly divided into 3 groups. In the group of Chinese herbal medicine (CHM), patients were given a capsule of Jia Wei Cang Er San tid for 8 weeks and a placebo capsule for amoxicillin q8h for 4 weeks after FESS. In the amoxicillin group, patients were given a capsule of amoxicillin 250 mg q8h for 4 weeks and a placebo capsule for Jia Wei Cang Er San tid for 8 weeks. In the placebo group, patients were given both placebo capsules. Bacterial cultures were performed from bilateral middle meati before FESS, and 8 and 12 weeks after FESS. Results: In the CHM group, bacteria grew in 21 (46%) of 46 specimens pre-operatively, in 23 (50%) specimens 8 weeks and in 17 (37%) specimens 12 weeks after surgery. In the amoxicillin group, bacteria grew in 15 (28%) of 54 specimens pre-operatively, in 30 (56%) specimens 8 weeks and in 32 (59%) specimens 12 weeks after surgery. In the placebo group, bacteria were found in 13 (34%) of 38 specimens pre-operatively, in 16 (42%) specimens 8 weeks and in 12 (32%) specimens 12 weeks after surgery. The rates of bacterial growth did not change by Jia Wei Cang Er San 8 or 12 weeks after surgery, but increased significantly by amoxicillin 8 and 12 weeks after surgery. Conclusion: Our study showed that Jia Wei Cang Er San did not induce bacterial growth after FESS as amoxicillin.

Applications of Microscopy in Bacteriology

Bacteria are smallest primitive, simple, unicellular, prokaryotic and microscopic organisms. But these organisms cannot be studied with naked eyes because of their minute structure. Therefore in search for the information about the structure and composition of bacterial cells, cell biologist used light microscopes with a numerical aperture of 1.4 and using wavelength of 0.4 μm separation. But there are still certain cellular structures that cannot be seen through naked eyes, and for them electron microscope is used. There are certain improved types of light microscope which can be incorporated to improve their resolving power. Hence microscopy is playing a crucial role in the field of bacteriology.

Possibility of Extension of Pre-operative Patient Preparation by Antiseptic Shower at the University Hospital Brno

Ensuring complex pre-operative patient preparation before planned surgery is an essential preventive measure of SSIs （surgical site infections）. The aim of this study was to evaluate the difference in the effectiveness of the use of common soap and a tested product to reduce the occurrence of bacterial microorganisms on the skin surface in the area of the assumed surgical incision. Two hypotheses have been identified： H0： the tested product can be considered as beneficial for common pre-operative patient preparation in the incision area in order to significantly reduce the microbial load （decrease in CFU on a defined area of the blood agar by half of the original number and less）. H1： the tested product exceeds common soap by at least 20% when reducing the microbial load in the incision area. There were 80 microbiological prints examined on filter paper using the cultivation method on culture medium. The statistical method of the classic hypothesis test on the binomial distribution parameter versus the one-sided alternative has been used to process the results for the occurrence of microorganisms. The statistical processing of the results obtained by microbiological examination of prints allows for the confirmation of H0 and rejection of the H1 hypothesis. The results have shown the importance of proper pre-operative hygiene of the patient’s skin, regardless of the detergent base.

Pre-Operative Hyponatremia in a High Dependency Cardiovascular Surgical Center of a Tertiary Health Facility in Nigeria: Risk Factors, Prevalence, Clinical Correlates and Treatment Outcome. A Retrospective Cohort Study

Introduction: Hyponatremia is the commonest electrolyte derangement seen in medical and surgical wards and in high dependency treatment units. It is associated with prolonged hospital stay, high economic burden and increased morbidity and mortality. Hyponatremia is well reported in medical and surgical conditions but literature is scanty concerning its relationship with treatment outcome in patients managed in high dependency heart and vascular surgical centers. Objectives: To determine the prevalence, determinants, clinical correlates and outcome of pre-operative hyponatremia. Methods: Retrospective study involving patients that had surgery (cardiac and vascular) between January 2015 and December 2019. Data were obtained from patients’ case files, perioperative and intensive unit charts. All participants with preoperative hyponatremia had their serum sodium corrected to ≥135 mmol before surgical incision and those with hypernatremia had their sodium corrected to <145 mmol. The socio-demographic, clinical, laboratory findings were entered. Statistical analysis was done using student’s t-test and Chi square. Results: Of the 305 participants (186 males and 119 females), pre-operative hyponatremia was found in 30.8% and normonatremia in 59.7%. Pre-operative hyponatremia was more common in advance age, overweight, those presenting for open heart and other major surgeries and those with background chronic heart failure and chronic liver disease. Participants with pre-operative hyponatremia had shortened and also prolonged hospital stay and higher risk of death than with normonatremia. Conclusion: Pre-operative hyponatremia is common in high dependency surgical unit particularly in the elderly, those with comorbidities and those presenting for major heart surgeries. It impacts negatively on the morbidity and mortality as it could shorten hospital stay through death, and could prolong hospital stay with increased health burden on patients, their care givers and the general population. The impact of this finding across different races needs further evaluation.

Effective Communication in the Pre-Operative Environment

Introduction: Building a strong patient rapport is a founding principle instilled early on in medical education. For many specialties, this relationship can be developed through repeated encounters. However, anesthesiologists are limited in opportunity for which such rapport can be built. Therefore, it is critical that the pre-operative visit is used effectively to develop a strong patient-physician relationship and help relieve patient anxiety. Methods: The primary objective of this study was to determine what communication aspects are most important to patients in the pre-operative period. Secondary objectives were to evaluate the effectiveness of our current communication practices and their impact on patient’s anxiety. This study was an anonymous and voluntary survey conducted in the pre-operative area prior to elective surgical cases at Mayo Clinic Arizona from Dec. 2018-Jan. 2019. Patients completed a one-page questionnaire ranking the importance of various communication aspects and its subsequent impact on their anxiety level. Results: Of the communication qualities evaluated, patients most valued their physician’s thoroughness and ability to describe their anesthetic plan. Greater than 95% of patients felt “very satisfied” with their anesthesia provider encounter and on a 1 - 5 point scale, with 5 being the highest, there was an average reduction of 0.75 in anxiety level after completion of the anesthesia interview. Conclusion: Incorporation of and improving these communication aspects during your pre-operative evaluation can help improve rapport, reduce patient anxiety, and improve the patient’s overall experience. Implementing a communication-focused curriculum during training may prove beneficial in improving resident’s effectiveness in communicating.

Construction of Bilingual Teaching Mode of Aquatic Animal Bacteriology in the Context of the Belt and Road Initiative

Aquatic Animal Bacteriology is a basic course of Aquatic Animal Medicine discipline.Bacteriology is not only a frontier subject in the field of life sciences,but also one of the most rapidly developing scientific fields today.The Belt and Road Initiative has brought opportunities and challenges to the upgrading and development of this discipline,so this discipline faces many problems that need to be solved.In view of this,this study combined the development trend of the discipline,reorganized and optimized the course content,and prepared sophisticated multimedia courseware,to stimulate students'learning initiative and enthusiasm,expand the field of professional knowledge,improve their English translation and writing skills,so as to lay a solid foundation for their future service to the Belt and Road Initiative.

Transcutaneous acupoint electrical stimulation(TAES)for pre-operative anxiety:a prospective observational pilot investigation

Objective:Transcutaneous acupoint electrical stimulation(TAES)treatment is effective for post-operative anxiety.The investigation was designed to study the feasibility and effectiveness of TAES treatment for pre-operative anxiety.Methods:62 volunteered surgical patients were included in the pilot investigation.They all received TAES treatment for 30 minutes in the evening of the day before operation.Hegu(LI4)and Neiguan(PC6)of both sides were selected as the treatment acupoints.The anxiety degrees were measured by State-Trait Anxiety Inventory.Heart rate and blood pressure were also recorded.Results:After TAES,pre-operative anxiety measured by State-Trait Anxiety Inventory dropped by almost 12%,and both heart rate and systolic blood pressure decreased significantly.Conclusion:The pilot investigation of TAES for pre-operative anxiety can successfully test the feasibility of outcome measurements and provide necessary data for calculating the sample size of a subsequent randomized controlled trial.

Bacteriological Profile and Antimicrobial Susceptibility Pattern of Cervico-Facial Cellulitis at the Regional Teaching Hospital of Ouahigouya (Burkina Faso)

Context and Objective: Cervicofacial cellulitis is a lethal infection without treatment. The aim of this study is to establish the bacteriological and antimicrobial susceptibility profile of cervico-facial cellulitis at the Regional Teaching Hospital (RTH) of Ouahigouya, in order to guide practitioners in the development of effective probabilistic antibiotic therapy protocols. Subjects and Methods: This was a transversal descriptive study with prospective data collection from July 1 to December 31, 2021 at the RTH of Ouahigouya. All cases of suppurative cervicofacial cellulitis that had been the subject of pyoculture were retained. Results: A total of 63 patients were chosen including 41 men, with 40.91 years as the average age and the sex ratio was 1.86. In 90.48% of cases, the front door was dental. All patients took antibiotics before their admission. Pus culture was positive in 34/63 subjects (53.97%) and showed monomicrobial infection. The isolates were Gram-negative bacilli for 20.59% and Gram-positive cocci for 79.41%. These isolates were all resistant to certain beta-lactams (such as amoxicillin, amoxicillin + clavulanic acid). However, some isolates were susceptible to cefoxitin, ceftazidime and ceftriaxone. All isolates were sensitive to amikacin for aminoglycosides. As for macrolides, erythromycin had excellent activity (100%) against Gram-positive cocci. Indeed, some isolates were susceptible and others resistant to ciprofloxacin for quinolones. Conclusion: Bacteriological profile and antimicrobial susceptibility knowledge of cervicofacial cellulitis may propose an effective probabilistic antibiotic therapy protocol.

Level of Bacteriological and Physicochemical Pollution of Surface Waters in Rural Area: The Case of Mbankomo Municipality (Center Region, Cameroon)

A study aimed at evaluating the physicochemical and bacteriological quality of surface water was therefore carried out in a few watercourses in the municipality of Mbankomo, located in the Center Region (Cameroon). The physico-chemical parameters were measured according to the standard method. The organic pollution index (OPI) was determined from the contents of nitrates, phosphates, and ammoniacal nitrogen to characterize the level of organic pollution of the water. The microorganisms sought were total flora, indicators of faecal contamination like total coliforms, faecal coliforms, feacal streptococci and Escherichia coli, as well as the species Clostridium perfringens. The organic pollution index indicates a high-level organic pollution level during the small rainy season and high to moderate during the small dry season. High concentrations of the total and fecal coliforms, streptococci fecal, Escherichia coli and Clostridium perfringens respectively of 1712 × 105 CFU/100mL;82 × 105 CFU/100mL;10 × 105 CFU/100mL;27 × 105 and 40 × 103 CFU/100mL, all higher than WHO standards, indicate that the waterways of Mbankomo are subject to feacal pollution and harbor pathogenic microflora. The cell densities of main bacteria were significantly correlated with main abiotic parameters, such as Escherichia coli, which was significantly correlated with the pH of the water (r = 0.35;p < 0.05). The variation of organic pollution index category means correspond to a high level of organic pollution during the small rainy season and a high to moderate level during the small dry season. The deterioration of the quality of these waters is favored by their proximity to sources of pollution (toilets, plantation), the runoff of the waters contaminated, the use of detergents and wrong maintenance. These waters without any treatment are not recommendable for human consumption according to standards of the World Health Organization.

Epidemiological, Clinical, Bacteriological Profile of Urinary Tract Infection in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes

Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and resistance to amoxicillin and to the amoxicillin + clavulanic acid combination. Conclusion: Urinary tract infections are a major public health problem since they are responsible for significant morbidity and mortality and a high cost of care. Knowledge of the epidemiological-clinical and bacteriological profile of these infections is essential for efficient management.

Bacteriological and Physicochemical Quality of Groundwater of Mbankomo Municipality(Center Region,Cameroon)

A study to evaluate the physico-chemical and bacteriological quality of groundwater was carried out in the commune of Mbankomo(Centre-Cameroon)at 4 wells and 4 springs during the period from March to August.The physico-chemical parameters were measured by the standard method.Indicator bacteria of fecal contamination,namely HAB(Heterotrophic Aerobic Bacteria),total and faecal coliforms(Escherichia coli),and faecal streptococci were isolated by the surface spreading technique on PCA(Plate Count Agar),Endo and BEA(Bile Esculin Azide)agar respectively,and sulphite-reducing clostridia by the incorporation method on Tryptone Sulfite Cycloserine(TSC)agar.From a physico-chemical point of view,the groundwater in Mbamkomo is characterized by an average temperature(24.24±0.24°C);it is polluted with organic matter,acid and poorly mineralized.It was noted from a bacteriological point of view that these waters have a high and varied bacterial load with an average value of 100.8 × 10^(5) CFU/100 mL for coliforms,16.3 × 10^(5) CFU/100 mL for fecal streptococci,5.6 × 10^(5) CFU/100 mL for Escherichia coli and 4.8 ×10^(²)CFU/100 mL for Clostridium perfringens.These concentrations are all higher than the WHO(World Health Organization)standards which are set at 0 CFU/100 mL for coliforms,fecal streptococci and Clostridium perfringens and indicate fecal pollution of these waters.Escherichia coli cell densities were significantly correlated with dissolved oxygen in the water(r=0.510;p<0.05).The degradation of the quality of these waters is favored by their proximity to pollution sources,poor maintenance and poor protection of the wells.These waters,without any treatment,are not recommended for human consumption according to the standards of the WHO.

伴有骨质破坏的单侧慢性细菌性上颌窦炎的临床研究

目的探讨伴有骨质破坏的单侧慢性细菌性上颌窦炎的临床特点及其相关因素。方法对2021年1月至2022年12月宁夏医科大学总医院耳鼻咽喉头颈外科收治的44例伴有骨质破坏的单侧慢性细菌性上颌窦炎患者的电子鼻咽镜下特点、影像学特点、细菌培养结果等进行临床分析。结果44例患者的主要症状与其他鼻窦炎相比无特殊性。镜下所见患侧鼻腔中鼻道向内膨隆、黏膜水肿、大量白色脓涕潴留并脱向鼻咽部。影像学特点,CT表现为单侧上颌窦腔内均匀低密度影填充,上颌窦口周围有骨质破坏,其中钩突尾端破坏最显著;MRI表现为T1窦壁黏膜呈高信号,增强后明显强化,患侧上颌窦腔内呈均匀低信号,增强后无强化,T2患侧上颌窦腔内见囊液性信号填充,中心可见斑片状高信号影,窦壁黏膜呈结节样增厚。在结构上,与健侧相比,患侧筛泡截面积比健侧大(P<0.05),鼻窦炎在鼻中隔偏曲患者的狭窄侧比宽敞侧多(P<0.05);一般细菌培养阳性率为77.27%(34/44)。共分离出9种细菌,排在前3名的菌种依次为凝固酶阴性葡萄球菌40.91%(18/44)、草绿色链球菌31.82%(14/44)和星座链球菌9.09%(4/44)。结论单侧慢性细菌性上颌窦炎的骨质破坏仅限于上颌窦口周围,以钩突尾端破坏为主;患侧筛泡肥大、鼻中隔偏向患侧可能是窦口阻塞的影响因素;葡萄球菌与链球菌可能是此类鼻窦炎的致病菌。

VITEK■ 2 Compact全自动微生物鉴定药敏分析仪虚拟仿真教学软件的开发与应用

文章主要介绍了VITEK■2 Compact全自动微生物鉴定药敏分析仪虚拟仿真教学软件的设计与开发,以及虚拟仿真融合线上线下混合教学模式在医学微生物检验实验教学中的应用。结果表明,该仿真教学软件的实际应用既有利于培养学生的实践操作能力及思维方式,又能弥补学校实训环境与临床实际不符的缺陷,为微生物检验实验教学质量的提升开辟新的思路。

高原寒冷环境猪腹部肠管火器贯通伤后弹道细菌变化及药敏分析

目的探讨高原寒冷环境腹部肠管火器贯通伤后体温、弹道细菌学变化及药敏情况。方法将20只2~3个月龄(体重30~35 kg)实验猪以随机数字法分为高原寒冷组(HC组)及平原常温组(LN组),每组10只。分别将两组实验猪放置于西北特殊环境人工实验舱内,HC组调节海拔高度6000 m(大气压47.33 kPa,空气氧分压为9.87 kPa)温度10℃,LN组调节海拔高度800 m(大气压89.87 kPa,空气氧分压为18.8 kPa)温度25℃,停留48 h;麻醉后将其以腾空站立位悬吊于靶场,用半自动手枪射击实验猪右下腹部,致伤后简单包扎返回实验室,分别在2、4、8、12、24 h取弹道内部1 cm深的组织进行细菌培养、鉴定及药敏实验。结果HC组在伤后2、4、8 h时间点体温均显著高于LN组(P<0.001)。LN组体温在24 h超过HC组但差异无统计学意义(P>0.05)。HC组与LN组伤后弹道入口和弹道出口细菌均大量增殖,除HC组弹道出口12、24 h较前一时间点差异无统计学意义外(P>0.05),其余对比前一时间点细菌增殖差异均有统计学意义(P<0.05、P<0.01或P<0.001)。在同一时间点,HC组和LN组弹道出口处的细菌含量明显高于弹道入口处的细菌含量(P<0.01或P<0.001)。LN组除24 h弹道入口细菌计数与HC组无差异(P>0.05)外,其余相同时间点弹道入口和弹道出口的细菌计数均显著高于HC组(P<0.001)。LN组伤后弹道入口及出口早期主要是以大肠埃希菌为代表的肠道细菌,混合各类表皮细菌;入口12 h起,出口4 h起无表皮细菌检测出。HC组伤后弹道入口及出口早期主要是大肠埃希菌、屎肠球菌和粪肠球菌等为代表的肠道细菌,混合少量表皮细菌;入口24 h,出口8 h起无表皮细菌检测出。HC组检测出的14种细菌中,对氨苄西林、青霉素、亚胺培南、四环素、头孢他啶、氧氟沙星、阿奇霉素、庆大霉素耐药率在50%以上的细菌分别有7、9、1、11、2、6、9、3种。结论高原寒冷环境会降低腹部火器伤弹道细菌的繁殖速度,减少表皮细菌含量及种类,改变肠道菌群结构。高原寒冷环境肠管贯通伤需尽早清创,联合使用抗生素。

脑脊液宏基因组学第二代测序在颅内感染诊断与治疗中的应用

目的探讨脑脊液宏基因组学第二代测序(mNGS)在颅内感染诊断与治疗中的应用价值。方法纳入2020年1月至2022年12月广东省深圳市第二人民医院收治的117例颅内感染患者,均于启动经验性广谱抗生素治疗前收集脑脊液行微生物培养(常规培养组,58例)和(或)mNGS测序(mNGS组,59例),并根据结果回报调整抗生素治疗方案,对比两种检测方法的病原体检出率和结果回报时间、抗生素强度分级,以及重症监护病房(ICU)住院时间、总住院时间和病死率。结果本组117例患者经脑脊液微生物培养和(或)mNGS测序共检出65种病原体,尤以病毒占比最高,为49.23%(32/65),其次依次为革兰阴性菌(24.62%,16/65)、革兰阳性菌(18.46%,12/65)和真菌(7.69%,5/65)。脑脊液mNGS测序的病原体检出率高于(χ2=22.781,P=0.000)、结果回报早于(t=⁃32.588,P=0.000)微生物培养;根据结果回报,mNGS组有20例(33.90%)调整抗生素治疗方案,抗生素应用强度降级5例、升级15例,常规培养组有30例(51.72%)调整抗生素治疗方案,抗生素应用强度降级17例、升级13例,组间差异无统计学意义(Z=⁃1.917,P=0.055);两组ICU住院时间(Z=⁃0.716,P=0.474)、总住院时间(Z=⁃0.933,P=0.351)和病死率(Fisher确切概率法:P=0.496)差异亦无统计学意义。结论脑脊液mNGS测序可以有效提高颅内感染病原体检出率,尽可能减少广谱抗生素应用时间、降低抗生素总体应用强度,有助于临床准确诊断与精确治疗。

光合细菌处理苝系染料废水制备絮凝性菌体蛋白的研究

首先对光合细菌进行驯化,同时绘制光合细菌生长密度曲线,得到絮凝性菌体蛋白收获的最佳时间为10 d。取1 L苝系染料生产废水,在室温条件下,得到了最佳处理条件,即pH调节为7.5,加入碳酸钙0.8 g,最适基础营养液投加量为6 mL,处理时间为10 d,絮凝性菌体蛋白产量达到112.4 g/L(废水)。通过对菌体蛋白进行分析鉴定,得到该物质为糖蛋白。最后经过一个月的喂养对比实验,证明该絮凝性菌体蛋白可作为鱼的饲料。