目的:了解本地区小儿败血症的病原菌种类、不同病原菌在各年龄段的分布情况及主要病原菌药物敏感状况,为指导临床诊断及合理使用抗生素提供依据。方法:对本院儿科近3年经血培养分离出的310株阳性菌株的构成比及对抗生素的药物敏感状况进行回顾性分析。结果:310株检出菌中G+菌201株占64.8%;G杆菌106株占34.2%;前5位病原菌依次为凝固酶阴性葡萄球菌(CNS)、沙门菌、大肠埃希菌、金黄色葡萄球菌(简称金葡菌)、链球菌属,分别占40.97%、21.61%、6.45%、4.51%、4.19%;新生儿败血症病原菌以CNS为主 (101株),其次为大肠埃希菌、肠球菌、克雷伯氏菌;6个月内小婴儿败血症致病菌与新生儿近似;婴幼儿各种细菌败血症均有发生;学龄前及学龄期儿童败血症病原菌依次为沙门菌、链球菌、金葡菌;药敏结果显示,大多数G+菌对青霉素、红霉素、苯唑西林、氨苄西林、头孢唑啉、头孢他啶、复方新诺明、庆大霉素耐药率超过60%;对万古霉素、利福平、阿米卡星、头孢西丁、喹诺酮类敏感。G杆菌中沙门菌对亚胺培南、氨曲南、三代头孢菌素、酶抑制剂复方制剂、喹诺酮类、复方新诺明保持高度敏感;大肠埃希菌多重耐药,对氨苄西林、哌拉西林、复方新诺明耐药率超过80%,对氨曲南、环丙沙星、庆大霉素、妥布霉素、头孢吡肟、头孢噻肟耐药率超过50%;其他G杆菌大多数对亚胺培南、呋南妥因、阿米卡星、奎诺酮类、头孢西丁敏感,酶抑制复合制剂的敏感率明显提高。结论:(1)CNS是新生儿及小婴儿败血症的主要病原菌,低毒力条件致病菌在该阶段小儿中感染率高;沙门菌是本地区近三年学龄期儿童败血症的主要病原菌,其感染呈逐年下降趋势。(2)不同病原菌的药敏状况差异很大,应高度重视感染病例的病原学检查,以利于制定临床抗感染方案,合理使用抗生素。(3)万古霉素、利福平、亚胺培南、氨曲南、第3代头孢菌素、阿米卡星及喹诺酮类目前仍为敏感抗生素。
ObjectiveTo study the correlation between CYP1A1 MspI gene polymorphisms and the risk of breast cancer (BC) in Chinese population.MethodsThe case-control studies on the correlation between polymorphisms of CYP1A1 MspI and BC in Chinese population were electronically retrieved in online English database (PubMed and Web of Science) and Chinese database (Chinese National Knowledge Infrastructure, Wanfang, and VIP database) from the date of their establishment to December 31, 2018. Two reviewers completed literature screening according to the inclusion and exclusion criteria, data extraction, and methodological quality assessment of the included studies independently. Reman 5.3 software was used to meta-analysis.ResultsA total 14 case-control studies involving 3 372 cases and 3 510 controls were finally included. The meta-analysis results showed that the CYP1A1 MspI gene polymorphism was associated with BC in Chinese population. Dominant genetic model [OR=1.24, 95%CI was (0.98, 1.58), P=0.08] and heterozygote model [OR=1.11, 95%CI was (0.89, 1.39), P=0.37] had no association with BC in Chinese population, while recessive genetic model [OR=1.66, 95%CI was (1.28, 2.14), P=0.000 1], homozygote model [OR=1.76, 95%CI was (1.26, 2.45), P=0.000 9], and allele contrast genetic model [OR=1.30, 95%CI was (1.08, 1.56), P=0.005] increased the risk of BC in Chinese population.ConclusionIt is demonstrated that in Chinese population, CYP1A1 MspI gene polymorphisms related to the risk of BC, recessive genetic model, homozygote model, and allele contrast genetic model might be the risk factor for BC.
Based on the noninvasive detection indeices and fuzzy mathematics method, this paper studied the noninvasive, convenient and economical cardiovascular health assessment system. The health evaluation index of cardiovascular function was built based on the internationally recognized risk factors of cardiovascular disease and the noninvasive detection index. The weight of 12 indexes was completed by the analytic hierarchy process, and the consistency test was passed. The membership function, evaluation matrix and evaluation model were built by fuzzy mathematics. The introducted methods enhanced the scientificity of the evaluation system. Through the Kappa consistency test, McNemer statistical results (P = 0.995 > 0.05) and Kappa values (Kappa = 0.616, P < 0.001) suggest that the comprehensive evaluation results of model in this paper are relatively consistent with the clinical, which is of certain scientific significance for the early detection of cardiovascular diseases.