BACKGROUND & AIMS: :A prospective collection of positive antimicrobial cultures was performed over 12 consecutive months in the medical intensive care unit of a cancer hospital. In all, 144 infections and 163 pathogens were documented during 87 of the 528 admissions. Lung, urinary, ENT (ear, nose and throat) infections and bacteraemia were the most frequently documented. Staphylococcus species, Streptococcus species, Escherichia coli, Klebsiella species and Pseudomonas species were the most common pathogens. Gram-positive strains were observed predominantly during monomicrobial bacteraemia (48.9%). Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE) were found in 58% and 92% of the isolated strains respectively. No particular outbreak was identified. A further prospective study will be necessary to evaluate the impact of the antibiotic use on the selection of resistant strains in our ICU.

背景与目标： ：在癌症医院的医疗重症监护室连续12个月进行了前瞻性抗菌药物阳性培养。在528例入院病例中，总共记录了144例感染和163种病原体。肺，尿，耳鼻喉（耳，鼻和喉）感染和菌血症的记录最频繁。葡萄球菌，链球菌，大肠杆菌，克雷伯菌和假单胞菌是最常见的病原体。革兰氏阳性菌株主要在单微生物菌血症期间观察到（48.9％）。分别在58％和92％的分离菌株中发现了耐甲氧西林的金黄色葡萄球菌（MRSA）和表皮葡萄球菌（MRSE）。没有发现特定的爆发。有必要进行进一步的前瞻性研究，以评估抗生素使用对我们ICU中耐药菌株选择的影响。

BACKGROUND & AIMS: :Human immunodeficiency virus (HIV) binds to cells via an interaction between CD4 and the virus envelope glycoprotein, gp120. Previous studies have localized the high affinity binding site for gp120 to the first domain of CD4, and monoclonal antibodies (mAbs) reactive with this region compete with gp120 binding and thereby block virus infectivity and syncytium formation. Despite a detailed understanding of the binding of gp120 to CD4, little is known of subsequent events leading to membrane fusion and virus entry. We describe two new mAbs reactive with the third domain of CD4 that inhibit steps subsequent to virus binding critical for HIV infectivity and cell fusion. Binding of recombinant gp120 or virus to CD4 is not inhibited by these antibodies, whereas infection and syncytium formation by a number of HIV isolates are blocked. These findings demonstrate that in addition to virus binding, CD4 may have an active role in membrane fusion.

背景与目标： 人类免疫缺陷病毒（HIV）通过CD4和病毒包膜糖蛋白gp120之间的相互作用与细胞结合。先前的研究已经将gp120的高亲和力结合位点定位在CD4的第一个域，并且与该区域反应的单克隆抗体（mAb）与gp120结合竞争，从而阻断了病毒的感染性和合胞体的形成。尽管对gp120与CD4的结合有详细的了解，但对导致膜融合和病毒进入的后续事件知之甚少。我们描述了与CD4的第三个域具有反应性的两个新的单克隆抗体，可抑制继病毒结合后对HIV感染性和细胞融合至关重要的步骤。重组gp120或病毒与CD4的结合不受这些抗体的抑制，而许多HIV分离株的感染和合胞体形成却被阻止。这些发现表明，除病毒结合外，CD4可能在膜融合中发挥积极作用。

BACKGROUND & AIMS: :Gliomas are highly lethal neoplasms that cannot be cured by currently available therapies. Temozolomide is a recently introduced alkylating agent that has yielded a significant benefit in the treatment of high-grade gliomas. However, either de novo or acquired chemoresistance occurs frequently and has been attributed to increased levels of O6-methylguanine-DNA methyltransferase or to the loss of mismatch repair capacity. However, very few gliomas overexpress O6-methylguanine-DNA methyltransferase or are mismatch repair-deficient, suggesting that other mechanisms may be involved in the resistance to temozolomide. The purpose of the present study was to generate temozolomide-resistant variants from a human glioma cell line (SNB-19) and to use large-scale genomic and transcriptional analyses to study the molecular basis of acquired temozolomide resistance. Two independently obtained temozolomide-resistant variants exhibited no cross-resistance to other alkylating agents [1,3-bis(2-chloroethyl)-1-nitrosourea and carboplatin] and shared genetic alterations, such as loss of a 2p region and loss of amplification of chromosome 4 and 16q regions. The karyotypic alterations were compatible with clonal selection of preexistent resistant cells in the parental SNB-19 cell line. Microarray analysis showed that 78 out of 17,000 genes were differentially expressed between parental cells and both temozolomide-resistant variants. None are implicated in known resistance mechanisms, such as DNA repair, whereas interestingly, several genes involved in differentiation were down-regulated. The data suggest that the acquisition of resistance to temozolomide in this model resulted from the selection of less differentiated preexistent resistant cells in the parental tumor.

背景与目标： ：胶质瘤是高度致死性的肿瘤，目前尚无法治愈。替莫唑胺是最近引入的烷基化剂，已在治疗高级神经胶质瘤中产生了显着的益处。然而，从头或获得性化学抗性经常发生，并且归因于O6-甲基鸟嘌呤-DNA甲基转移酶水平的增加或失配修复能力的丧失。但是，极少的神经胶质瘤过表达O6-甲基鸟嘌呤-DNA甲基转移酶或错配修复缺陷，提示其他机制可能与对替莫唑胺的抗性有关。本研究的目的是从人类神经胶质瘤细胞系（SNB-19）产生抗替莫唑胺的变体，并使用大规模的基因组和转录分析来研究获得的替莫唑胺抗性的分子基础。两个独立获得的替莫唑胺抗性变体对其他烷基化剂[1,3-双（2-氯乙基）-1-亚硝基脲和卡铂]无交叉抗性，并且共有遗传变异，例如2p区域丢失和扩增丢失染色体4和16q区域。核型改变与亲本SNB-19细胞系中先前存在的抗性细胞的克隆选择相容。基因芯片分析显示，在17,000个基因中，有78个在亲代细胞和两种替莫唑胺耐药变体之间差异表达。没有人参与已知的抗性机制，例如DNA修复，而有趣的是，参与分化的几个基因被下调。数据表明，在该模型中获得对替莫唑胺的抗药性是由于在亲本肿瘤中选择了分化程度较低的抗药性细胞而引起的。

BACKGROUND & AIMS: Environmental pollution has become a major concern for the future of life on our planet; medical care, especially in hospitals, contributes significantly to this pollution. The increasing usage of highly-developed medical devices, drugs and disposable products are a drain on natural resources as well as financial ones. In this situation, it is a major task for hospital epidemiologists to maintain high standards of hygiene while reducing environmental pollution, reducing consumption of limited natural resources, and minimizing costs. The reduction of hospital waste, the control of polluting and toxic emissions, the avoidance of unnecessary disinfection procedures and disposables, the implementation of energy and water saving technologies are practicable measures in hospital ecology. To realize a sustainable development within hospitals, it is necessary that the need to maintain a balance between effective infection control and a good ecological environment is recognized and supported by health-care workers and the hospital management.

背景与目标： 环境污染已经成为我们星球上未来生活的主要关注点；医疗服务，尤其是医院的医疗服务，是造成这种污染的重要原因。高度发达的医疗设备，药物和一次性产品的使用日益增加，这既浪费了自然资源，也浪费了金融资源。在这种情况下，医院流行病学家的主要任务是保持较高的卫生标准，同时减少环境污染，减少有限自然资源的消耗并最大程度地降低成本。减少医院浪费，控制污染和有毒物质排放，避免不必要的消毒程序和一次性用品，实施节能节水技术是医院生态学中的切实可行的措施。为了实现医院内部的可持续发展，必须在卫生保健工作者和医院管理人员的认识和支持下，在有效的感染控制和良好的生态环境之间保持平衡。

BACKGROUND & AIMS: :IL-7 signals are crucial for the survival of naive and memory T cells, and the IL-7R is expressed on the surface of these cells. Following viral infection, the IL-7R is expressed on only a subset of effector CD8 T cells, and has been demonstrated to be important for the survival of these memory precursors. IL-7 message levels remain relatively constant during the T cell response to lymphocytic choriomeningitis virus, but a short-lived burst of GM-CSF is observed soon after infection. Retroviral expression of a chimeric GM-CSF/IL-7R, in which binding of GM-CSF by T cells leads to IL-7 signaling, allows for the delivery of an IL-7 signal in all effector T cells expressing the receptor. In mice infected with lymphocytic choriomeningitis virus, CD8 and CD4 T cells transduced with this chimeric receptor underwent an enhanced proliferative response compared with untransduced populations in the same host. Similarly, TCR transgenic CD8 cells expressing the chimeric receptor produced higher effector numbers during the peak of the T cell response to infection. Surprisingly, the enhanced proliferation did not lead to higher memory numbers, as the subsequent contraction phase was more pronounced in the transduced cell populations. These findings demonstrate that artificial IL-7 signaling during an infection leads to significantly increased Ag-specific effector T cell numbers, but does not result in increased numbers of memory progeny. The extent of contraction may be dictated by intrinsic factors related to the number of prior cell divisions.

背景与目标： ：IL-7信号对于幼稚和记忆T细胞的存活至关重要，而IL-7R在这些细胞的表面表达。病毒感染后，IL-7R仅在效应CD8 T细胞的一部分上表达，并已证明对这些记忆前体的存活很重要。在对淋巴细胞性脉络膜脑膜炎病毒的T细胞应答过程中，IL-7信息水平保持相对恒定，但是感染后不久就观察到了短暂的GM-CSF爆发。嵌合GM-CSF / IL-7R的逆转录病毒表达（其中T细胞与GM-CSF的结合导致IL-7信号传导）允许在表达该受体的所有效应T细胞中传递IL-7信号。在感染了淋巴细胞性脉络膜脑膜炎病毒的小鼠中，用该嵌合受体转导的CD8和CD4 T细胞与同一宿主中未转导的种群相比，具有增强的增殖反应。同样，表达嵌合受体的TCR转基因CD8细胞在感染的T细胞反应高峰期间产生更高的效应子数量。出人意料的是，增强的增殖并未导致更高的记忆数，因为随后的收缩期在转导的细胞群中更为明显。这些发现表明，感染期间的人工IL-7信号转导会导致Ag特异性效应T细胞数量显着增加，但不会导致记忆后代数量增加。收缩的程度可以由与先前细胞分裂数有关的内在因素决定。

BACKGROUND & AIMS: :Thirty-three consecutive liver-transplant recipients were prospectively studied over a 37-mo period for evidence of cytomegalovirus infection. Sixteen (48%) episodes of cytomegalovirus infection were identified; 9 were primary infections and 7 were recurrent infections. Beginning with patient 8, gamma-globulin prophylaxis was routinely administered to most patients. Twelve potential risk factors for cytomegalovirus infection were evaluated and included pretransplant cytomegalovirus serological status of donor and recipient; recipient's age, sex, race, and liver disease; number and type of blood products transfused; type and intensity of immunosuppression; and occurrence of rejection. The Cox proportional hazards model identified positive donor cytomegalovirus serology as the single most important risk factor for subsequent development of cytomegalovirus infection, regardless of recipient cytomegalovirus serological status. In addition, use of gamma-globulin prophylaxis seemed to be protective against the occurrence of disseminated cytomegalovirus disease.

背景与目标： ：在37个月内对33例连续肝移植接受者进行了前瞻性研究，以发现巨细胞病毒感染的迹象。鉴定出十六例（48％）巨细胞病毒感染； 9例是原发性感染，7例是复发性感染。从患者8开始，常规对大多数患者进行了γ-球蛋白的预防。对巨细胞病毒感染的十二种潜在危险因素进行了评估，包括供体和受体移植前巨细胞病毒的血清学状况。接受者的年龄，性别，种族和肝脏疾病；输血产品的数量和类型；免疫抑制的类型和强度；和拒绝的发生。 Cox比例风险模型将阳性供体巨细胞病毒血清学确定为随后发展成巨细胞病毒感染的唯一最重要的危险因素，而与受体巨细胞病毒血清学状况无关。另外，使用γ-球蛋白预防似乎可以预防弥漫性巨细胞病毒病的发生。

BACKGROUND & AIMS: :Two cases of iatrogenic acquired Brown's syndrome are presented, and other causes of this disorder and its treatment are discussed. Care should be taken not to cause damage when operating in the region of the trochlea.

背景与目标： ：介绍了两例医源性获得性布朗综合征，并讨论了该病的其他原因及其治疗方法。在滑车区域操作时，应注意不要造成损坏。

BACKGROUND & AIMS: BACKGROUND:Granulocyte apheresis is a safe and effective method for granulocyte collection. We present a five year experience (2006-2010) of the Blood Center, Faculty Hospital Ostrava, Czech Republic. Donor granulocyte transfusion is one treatment option for haemato-oncology patients with severe neutropenia complicated by bacterial/fungal infections unresponsive to standard antibiotic/antifungal treatment. In this study, we describe the experiences of the Blood Centre at the Faculty Hospital in Ostrava of granulocyte apheresis. METHODS AND RESULTS:A total of 149 granulocyte units were collected for 33 patients from the Department of Haemato-oncology, University Hospital Olomouc, over a 5-year period (2006-2010). Information on donor selection, laboratory screening, mobilization regimen and granulocyte yield was obtained and analyzed. All mandatory screening tests for infection markers, AB0 and Rh and abnormal erythrocyte antibodies were performed. The cytomegalovirus status of the donors was not investigated. Steroids were the only mobilization regimen used, and were generally well accepted. The mean granulocyte yield was 12.6×10(9)/per transfusion unit (range 5.4-30.3). All granulocyte concentrates were irradiated and transfused according to AB0 Rh compatibility within 24 h after collection. CONCLUSION:Based on our experience, granulocytapheresis is a safe and effective method for obtaining granulocytes but the yield can be significantly influenced by other variables. From the recipients' perspective, the use of donor granulocytes supports an effective therapeutic modality.

背景与目标： 背景：粒细胞单采是一种安全有效的收集粒细胞的方法。我们介绍了捷克共和国俄斯特拉发学院医院血液中心的五年经验（2006-2010）。供体粒细胞输注是严重中性粒细胞减少症并发细菌/真菌感染而对标准抗生素/抗真菌治疗无反应的血液肿瘤患者的一种治疗选择。在这项研究中，我们描述了粒细胞单采的俄斯特拉发大学医院血液中心的经验。
方法与结果：在5年期间（2006-2010年），从Olomouc大学医院血液肿瘤科收集了149粒粒细胞单位，用于33例患者。获得并分析了有关供体选择，实验室筛查，动员方案和粒细胞产量的信息。进行了所有感染标志物，AB0和Rh和异常红细胞抗体的强制性筛查测试。没有研究捐赠者的巨细胞病毒状况。类固醇是唯一使用的动员方案，并且普遍被接受。平均粒细胞产量为12.6×10（9）/每输血单位（范围5.4-30.3）。收集后24小时内，按照AB0 Rh相容性对所有粒细胞浓缩物进行辐照和输血。
结论：根据我们的经验，粒细胞穿刺术是一种安全有效的获取粒细胞的方法，但产量会受到其他变量的显着影响。从接受者的角度来看，使用供体粒细胞支持有效的治疗方式。

BACKGROUND & AIMS: GENERAL PURPOSE:To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). TARGET AUDIENCE:This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES:After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. ABSTRACT:BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. OBJECTIVE:The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. DATA SOURCES:Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. DATA EXTRACTION:Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. DATA SYNTHESIS:The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. CONCLUSIONS:Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review revealed a need for additional high-quality studies that adhere to commonly used standards of both currently utilized and emerging ways to prevent hospital-acquired PIs.

背景与目标： 一般目的：提供文献综述中有关压力伤害预防策略（PIs）的经济评估的信息。
目标听众：此继续教育活动面向医师，医师助理，护士从业人员以及对皮肤和伤口护理感兴趣的护士。
学习目标/结果：参加此教育活动后，参与者应能够：1。确定本研究的目的和方法2。比较与预防PI有关的成本和有效性。
摘要：背景：压力伤害（PI）是全球急诊医院普遍且资源密集的挑战。尽管许多预防策略都有可能降低医院获得的PI的成本，但尚不清楚哪种方法最有效。
目的：作者对预防策略的经济评估文献进行了叙述性回顾，以调查当前发现并确定经济评估中的重要因素。
数据来源：Ovid，MEDLINE，NHS经济评估数据库和Cochrane系统评价数据库选择标准：考虑了潜在相关的原始研究文章和系统评价。
数据摘录：选择标准包括英语撰写的文章，提供有关急性护理中PI预防策略的成本或经济评估的数据，并于2004年1月至2015年9月之间发表。如何处理《综合卫生经济评估报告标准》清单中的项目。
数据综合：这些搜索确定了192篇参考文献。选择了33篇原创文章进行全文审查。这些文章中有19个提供了对干预措施，研究方法和所考虑结果的清晰描述。
结论：现有文献的局限性阻止了关于预防PI的各种方法的相对经济价值的确切结论。作者的评论表明，有必要进行更多高质量的研究，这些研究既要遵循目前使用的标准，又要采用新的方法来预防医院获得的PI。

BACKGROUND & AIMS: :We describe a case of faecal microbiota transplantation (FMT) used for severe binary toxin-positive Clostridium difficile infection in an intensive care setting. The patient was admitted to the ICU of a tertiary hospital and failed traditional maximal pharmacological management. Adjunctive therapy with FMT given through gastroscopy resulted in resolution of the C. difficile-related symptoms. Although there is a growing experience with FMT for recurrent C. difficile infection, published evidence in severe disease is very limited. In a landscape of increasingly severe C. difficile infection, adjunctive FMT may be considered a useful early treatment option.

背景与目标： ：我们描述了在重症监护室中用于严重二重毒素阳性艰难梭菌感染的粪便微生物菌群移植（FMT）的情况。该患者入院于一家三级医院的ICU，传统的最大药物治疗失败。通过胃镜进行FMT的辅助治疗可解决艰难梭菌相关症状。尽管对于复发性艰难梭菌感染，FMT有越来越多的经验，但有关严重疾病的公开证据非常有限。在艰难梭菌感染日益严重的情况下，辅助性FMT可能被认为是一种有用的早期治疗选择。

BACKGROUND & AIMS: Objective:To estimate the cumulative incidence of persistent arthralgia at 6 months from acute Chikungunya virus (CHIKV) infection and to evaluate the association of clinical markers with the risk of long-term arthralgia. Methods:This multicenter retrospective cohort study was conducted in the Mexican state of Colima. A total of 136 individuals aged 15 years and older with serologically confirmed CHIKV infection were enrolled. Participants were interviewed at 6 months from the onset of symptoms, and self-reported persistent arthralgia (PA) was the main binary outcome. A self-report numeric rating scale (NRS) ranging from 0 to 10 was used to estimate the severity of articular pain. Results:The cumulative incidence of PA was 41.9%. Severe pain (NRS ≥ 7) presented in 36.8% of participants with PA. In multiple analysis, individuals aged 40 years and older (risk ratio (RR) = 1.60; 95% confidence interval (CI), 1.03-2.48) and those with articular pain at 3 months post-infection (RR = 3.95; 95% CI, 1.95-8.01) had a significantly increased risk of PA at 6 months from CHIKV infection. Conclusions:To the best of our knowledge, this is first report of a CHIKV-associated long-term outcome in Mexico, where the incidence of the infection has been high. This is also the first study in Latin America evaluating several factors associated with the risk of PA. Our findings may be useful in health care settings to stratify the risk of chronic arthralgia secondary to CHIKV infection and to identify patients who would benefit clinically from early medical intervention.

背景与目标： 目的：评估急性基孔肯雅病毒（CHIKV）感染六个月后持续性关节痛的累积发生率，并评估临床标志物与长期关节痛风险之间的关系。
方法：这项多中心回顾性队列研究在墨西哥科利马州进行。共有136位年龄在15岁及以上且经血清学证实为CHIKV感染的患者入组。从出现症状开始的六个月就对参与者进行了采访，自我报告的持续性关节痛（PA）是主要的二元结局指标。使用自我报告的数字评分量表（NRS），范围从0到10，以评估关节痛的严重程度。
结果：PA的累积发生率为41.9％。严重疼痛（NRS≥7）在PA参与者中占36.8％。在多重分析中，年龄在40岁以上（风险比（RR）= 1.60； 95％置信区间（CI），1.03-2.48）以及感染后3个月时出现关节痛的患者（RR = 3.95； 95％CI） ，1.95-8.01）在CHIKV感染后6个月时患PA的风险显着增加。
结论：据我们所知，这是墨西哥CHIKV相关的长期结局的首次报道，该国的感染发生率很高。这也是拉丁美洲首次评估与PA风险相关的几个因素的研究。我们的发现可能在医疗机构中有用，以对继发于CHIKV感染的慢性关节痛的风险进行分层，并确定可从早期医疗干预中受益的患者。

BACKGROUND & AIMS: :Vitamin D hormone (1,25-dihydroxyvitamin D) is involved in innate immunity and induces host defense peptides in epithelial cells, suggesting its involvement in mucosal defense against infections. Chlamydia trachomatis is a major cause of bacterial sexually transmitted disease worldwide. We tested the hypothesis that the vitamin D endocrine system would attenuate chlamydial infection. Vitamin D receptor knock-out mice (VDR(-/-)) and wild-type mice (VDR(+/+)) were infected with 10(3) inclusion forming units of Chlamydia muridarum and cervical epithelial cells (HeLa cells) were infected with C. muridarum at multiplicity of infection 5:1 in the presence and absence of 1,25-dihydroxyvitamin D3. VDR(-/-) mice exhibited significantly higher bacterial loading than wild-type VDR(+/+) mice (P<0.01) and cleared the chlamydial infection in 39 days, compared with 18 days for VDR(+/+) mice. Monocytes and neutrophils were more numerous in the uterus and oviduct of VDR(-/-) mice than in VDR(+/+) mice (P<0.05) at d 45 after infection. Pre-treatment of HeLa cells with 10nM or 100nM 1,25-dihydroxyvitamin D3 decreased the infectivity of C. muridarum (P<0.001). Several differentially expressed protein spots were detected by proteomic analysis of chlamydial-infected HeLa cells pre-treated with 1,25-dihydroxyvitamin D3. Leukocyte elastase inhibitor (LEI), an anti-inflammatory protein, was up-regulated. Expression of LEI in the ovary and oviduct of infected VDR(+/+) mice was greater than that of infected VDR(-/-) mice. We conclude that the vitamin D endocrine system reduces the risk for prolonged chlamydial infections through regulation of several proteins and that LEI is involved in its anti-inflammatory activity.

背景与目标： ：维生素D激素（1,25-二羟基维生素D）参与先天免疫，并诱导上皮细胞中的宿主防御肽，表明其参与粘膜防御感染。沙眼衣原体是全世界细菌性传播疾病的主要原因。我们检验了维生素D内分泌系统会减轻衣原体感染的假设。维生素D受体敲除小鼠（VDR（-/-））和野生型小鼠（VDR（/））感染了衣原体衣原体的10（3）个包涵体形成单位，并感染了宫颈上皮细胞（HeLa细胞）在存在和不存在1,25-二羟基维生素D3的情况下，感染C. muridarum的感染复数为5：1。 VDR（-/-）小鼠比野生型VDR（/）小鼠表现出明显更高的细菌载量（P <0.01），并且在39天后清除了衣原体感染，而VDR（/）小鼠为18天。感染后第45天，VDR（-/-）小鼠的子宫和输卵管中的单核细胞和中性粒细胞比VDR（/）小鼠中的单核细胞和中性粒细胞更多（P <0.05）。用10nM或100nM 1,25-二羟基维生素D3预处理HeLa细胞可降低muridarum C. muridarum的感染性（P <0.001）。通过用1，25-二羟基维生素D3预处理的衣原体感染的HeLa细胞的蛋白质组学分析，检测到几个差异表达的蛋白斑点。白细胞弹性蛋白酶抑制剂（LEI），一种抗炎蛋白，被上调。 LEI在受感染的VDR（/）小鼠的卵巢和输卵管中的表达高于受感染的VDR（-/-）小鼠。我们得出的结论是，维生素D内分泌系统通过调节几种蛋白质降低了衣原体感染时间延长的风险，并且LEI参与了其抗炎活性。

BACKGROUND & AIMS: INTRODUCTION:The most severe complication of parenteral nutrition (PTN) is catheter-related infection (CRI). OBJECTIVES:To study the incidence rate and factors associated to CRI. MATERIAL AND METHODS:271 patients followed at the Nutrition Unit for 6 months. The composition of the PTN was calculated according to the metabolic demands. 20.3% received a lipid solution enriched with omega-3 fatty acids (SMOF Fresenius Kabi®) and 79.7% with olive oil (Clinoleic Baxter®). RESULTS:The rate of CRI was 25 per 1,000 days of PTN (55 patients: 61.7±17.8 years, 60.3% males, 29.3±10.6 days of hospital stay and 10.4% mortality). Coagulase-negative Staphylococcus was the most frequently isolated microorganism. There were no differences by age, gender, mortality, or composition of the PTN between patients with or without infection. The patients treated with omega-3 received more calories with the PTN, at the expense of higher intake of glucose and lipids. However, the rate of infection was similar, although there was a not significant trend towards a lower infection rate when using the omega-3 composition (14.5% vs. 23.1%, respectively, p = 0.112). The duration of the nutritional support was higher in patients with CRI (13.0 ± 9.7 vs. 9.3 ± 8.1, p = 0.038). Total mortality (16.9%) was independent of the presence or absence of CRI (10.4% vs. 18.7%, p = 0.090) or of the use of omega-3 lipids or olive oil in the PTN (10.9% vs. 18.5%, p = 0.125). CONCLUSION:Patients submitted to PTN have a high rate of CRI. The presence of infection is related to the duration of the PTN, being independent of the age, gender, and composition of the solution. The use of omega-3 lipid solutions may be beneficial although further studies are needed to confirm this.

背景与目标： 简介：肠胃外营养（PTN）的最严重并发症是导管相关感染（CRI）。
目的：研究CRI的发生率及相关因素。
材料与方法：271例患者在营养科接受了6个月的随访。根据代谢需要计算PTN的组成。 20.3％的人接受了富含omega-3脂肪酸（SMOF FreseniusKabi®）的脂质溶液，而79.7％的接受了橄榄油（ClinoleicBaxter®）的脂质溶液。
结果：PTN的CRI率为每1000天25（55例患者：61.7±17.8岁，男性为60.3％，住院时间为29.3±10.6天，死亡率为10.4％）。凝固酶阴性葡萄球菌是最常分离的微生物。在有或没有感染的患者之间，PTN的年龄，性别，死亡率或组成没有差异。用omega-3治疗的患者接受PTN吸收的卡路里更多，但要以增加葡萄糖和脂质的摄入为代价。但是，感染率相似，尽管使用omega-3组合物时感染率降低的趋势并不明显（分别为14.5％和23.1％，p = 0.112）。 CRI患者的营养支持持续时间更长（13.0±9.7与9.3±8.1，p = 0.038）。总死亡率（16.9％）与是否存在CRI（10.4％对18.7％，p = 0.090）或PTN中是否使用omega-3脂质或橄榄油无关（10.9％对18.5％， p = 0.125）。
结论：提交PTN的患者的CRI率很高。感染的存在与PTN的持续时间有关，而与溶液的年龄，性别和组成无关。尽管需要进一步的研究来证实这一点，但使用omega-3脂质溶液可能是有益的。

BACKGROUND & AIMS: :Cyst infection is a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD) because of the lack of specific manifestations and limitations of conventional imaging procedures. Still, recent clinical observations and series have highlighted common criteria for this condition. Cyst infection is diagnosed if confirmed by cyst fluid analysis showing bacteria and neutrophils, and as a probable diagnosis if all four of the following criteria are concomitantly met: temperature of >38°C for >3 days, loin or liver tenderness, C-reactive protein plasma level of >5 mg/dL and no evidence for intracystic bleeding on computed tomography (CT). In addition, the elevation of serum carbohydrate antigen 19-9 (CA19-9) has been proposed as a biomarker for hepatic cyst infection. Positron-emission tomography after intravenous injection of 18-fluorodeoxyglucose, combined with CT, proved superior to radiological imaging techniques for the identification and localization of kidney and liver pyocyst. This review summarizes the attributes and limitations of these recent clinical, biological and imaging advances in the diagnosis of cyst infection in patients with ADPKD.

背景与目标： ：由于常染色体显性多囊肾病（ADPKD）患者缺乏特异​​性表现和常规成像程序的局限性，因此对囊性感染的诊断是一项挑战。尽管如此，最近的临床观察和系列研究突显了这种情况的共同标准。如果囊肿液分析证实存在细菌和中性粒细胞，则可以诊断为囊肿感染，并且同时满足以下四个条件都可以诊断为囊肿：温度> 38°C持续3天以上，腰部或肝脏压痛，C反应性血浆血浆蛋白水平> 5 mg / dL，计算机断层扫描（CT）尚无囊内出血的证据。另外，已经提出血清碳水化合物抗原19-9（CA19-9）的升高作为肝囊肿感染的生物标志物。静脉注射18-氟脱氧葡萄糖后与CT结合进行正电子发射断层扫描，证明其优于放射成像技术可用于肾脏和肝囊肿的鉴定和定位。这篇综述总结了ADPKD患者囊肿感染诊断中这些最新的临床，生物学和影像学进展的属性和局限性。

BACKGROUND & AIMS: BACKGROUND:Surface contamination in hospitals is involved in the transmission of pathogens in a proportion of healthcare-associated infections. Admission to a room previously occupied by a patient colonized or infected with certain nosocomial pathogens increases the risk of acquisition by subsequent occupants; thus, there is a need to improve terminal disinfection of these patient rooms. Conventional disinfection methods may be limited by reliance on the operator to ensure appropriate selection, formulation, distribution and contact time of the agent. These problems can be reduced by the use of 'no-touch' automated room disinfection (NTD) systems. AIM:To summarize published data related to NTD systems. METHODS:Pubmed searches for relevant articles. FINDINGS:A number of NTD systems have emerged, which remove or reduce reliance on the operator to ensure distribution, contact time and process repeatability, and aim to improve the level of disinfection and thus mitigate the increased risk from the prior room occupant. Available NTD systems include hydrogen peroxide (H(2)O(2)) vapour systems, aerosolized hydrogen peroxide (aHP) and ultraviolet radiation. These systems have important differences in their active agent, delivery mechanism, efficacy, process time and ease of use. Typically, there is a trade-off between time and effectiveness among NTD systems. The choice of NTD system should be influenced by the intended application, the evidence base for effectiveness, practicalities of implementation and cost constraints. CONCLUSION:NTD systems are gaining acceptance as a useful tool for infection prevention and control.

背景与目标： 背景：医院中的表面污染在一定比例的医疗保健相关感染中与病原体的传播有关。进入先前由某些医院病原体定植或感染的患者所居住的房间，会增加随后的乘员被获取的风险；因此，需要改善这些患者房间的终端消毒。常规消毒方法可以通过依赖于操作者的限制，以确保试剂的适当选择，制剂分布和接触时间。通过使用“非接触式”自动房间消毒（NTD）系统，可以减少这些问题。
目的：总结与NTD系统有关的公开数据。
方法：对相关文章进行公开搜索。
结果：已经出现了许多NTD系统，这些系统消除或减少了对操作员的依赖，以确保分配，接触时间和过程可重复性，并旨在提高消毒水平，从而减轻前房客带来的增加的风险。可用的NTD系统包括过氧化氢（H（2）O（2））蒸气系统，雾化的过氧化氢（aHP）和紫外线辐射。这些系统在其活性剂，递送机制，功效，处理时间和易用性方面具有重要差异。通常，NTD系统之间在时间和有效性之间进行权衡。 NTD系统的选择应受预期的应用，有效性的证据基础，实施的实用性和成本约束的影响。
结论：NTD系统已被接受为预防和控制感染的有用工具。