萘替芬酮康唑乳膏治疗儿童花斑糠疹的疗效观察

目的：观察萘替芬酮康唑乳膏治疗儿童花斑糠疹的疗效及安全性。方法：129例儿童花斑糠疹患儿随机分为两组,治疗组67例,对照组62例,两组在病程、性别、年龄上无统计学差别;治疗组每天外搽萘替芬酮康唑乳膏2次,对照组外搽酮康唑乳膏2次,两组疗程均6周。于治疗前、治疗结束后分别记录患儿皮损情况、真菌检查及有无不良反应。结果：治...     

花斑癣患者皮屑中马拉色菌的巢式PCR法分析

目的　用巢式 PCR法检测马拉色菌特异的 DNA从而快速准确的检测并鉴定马拉色菌的各菌种 ,并应用于花斑癣 (Pityriasis Versicolor,PV)患者皮屑中马拉色菌携带情况中的研究。方法　从 PV患者的皮屑中提取马拉色菌的 DNA,以马拉色菌属 r RNA内转录间隔区设计属的引物和各个种的特异性引物分别进行巢式多聚酶链反应 (nest-PCR) ,检测 10 5例 PV患者皮屑中的马拉色菌的目的 DNA片断。结果　 10 5例 PV患者共检测到 5例种的共 32 1株马拉色菌的 DNA。每例患者平均检测到约 3种马拉色菌的 DNA。各种马拉色菌的检出率依次为 :球形马拉色菌 80 .0 % ,限制马拉色菌 81.9% ,合轴马拉色菌 77.1% ,糠秕马拉色菌 4 1.9% ,钝形马拉色菌 15 .2 %。未检测到厚皮马拉色菌和斯洛菲马拉色菌。结论　 PV皮屑中存在多种马拉色菌 ,球形马拉色菌、合轴马拉色菌和限制马拉色菌是 PV患者皮损处的主要马拉色菌种     

脂溢性皮炎与马拉色菌的关系及相关治疗研究进展

脂溢性皮炎好发于皮脂腺丰富区,是一种慢性炎症性皮肤病。症状包括出现鳞屑,片状皮屑,瘙痒,以及潮红或红斑。普通人群中发病率为3%,虽然病因尚未完全清楚,但已知马拉色菌(Malassezia)是其主要致病因素之一。因此,文章将针对性地对脂溢性皮炎与马拉色菌的关系进行综述,并且在分析过去对马拉色菌性脂溢性皮炎的治疗方法的利弊基础上,提出新的治疗思路。     

酮康唑乳膏治疗浅部真菌病疗效分析

目的:探讨酮康唑乳膏治疗皮肤浅部真菌病的临床疗效。方法:249例皮肤浅部真菌病患者采用酮康唑乳膏治疗,早晚各1次,连用2～4周,观察临床症状和体征。结果:249例皮肤浅部真菌病患者中,体股癣有效率94.7%;手足癣有效率94.3%;花斑癣有效率97.7%;皮肤念珠菌病有效率95.4%,没有发现不良反应。结论:酮康唑乳膏治疗皮肤浅部真菌病有较高的疗效。     

气温、饮食习惯、舌象与马拉色菌毛囊炎中医辨证相关性的研究

目的探讨气温、饮食习惯、舌诊在马拉色菌毛囊炎中医辨证方面的意义。方法观察马拉色菌毛囊炎患者发病例数与气温的关系,对马拉色菌毛囊炎组与对照组进行饮食习惯、舌象的比较。结果日平均气温15～29℃区间时,随着气温的升高,发病例数呈指数上升趋势;马拉色菌毛囊炎组患者舌质红、舌苔增厚,与对照组相比有明显差异;马拉色菌毛囊炎组患者食辛辣的饮食习惯与对照组相比无差异。结论马拉色菌毛囊炎为外感火热之邪引起的实热证,病位在肌肤。食辛辣的饮食习惯对于马拉色菌毛囊炎的发病没有影响。     

Isolation of dermatophytes, Candida species and systemic fungi from dermatologic specimens in Montréal, 1963 to 1973.

Of 10 057 specimens of scrapings from skin, nails and scalp examined for dermatophytes, yeasts, pityriasis versicolor and systemic mycoses between 1963 and 1973, 30.4 percent were positive for fungi. Skin produced the highest proportion (68.6 percent) of positive scrapings, scalp the lowest (4.2 percent). Trichophyton rubrum was the predominant species (23.6 percent); of lesser prevalence were Microsporum canis (9.3 percent), T. mentagrophytes (8.4 percent) and Epidermophyton floccosum (4.8 percent). Double infections were encountered on 102 occasions; T. rubrum and Candida parapsilosis were the most frequent cohabiting species. The introduction in 1966 of periodic acid-Schiff staining for routine examination of scrapings resulted in better diagnostic results, particularly in the case of culturally nonproductive specimens and cases of pityriasis versicolor. Blastomyces dermatitidis and Cryptococcus neoformans were isolated from two patients in the course of routine investigation for dermatophytes.     

马拉色菌对角质形成细胞分泌黑素合成相关细胞因子的影响

目的探讨引起花斑癣不同临床色素表现的马拉色菌与角质形成细胞共培养,导致与黑素合成相关的细胞因子的变化。方法MTT法筛选不同比例的马拉色菌对角质形成细胞增殖率的影响;用色沉和色减区分离的马拉色菌与角质形成细胞共培养,在不同时间段收集上清液,ELISA法测定碱性成纤维细胞因子（b-FGF）、内皮素-1（ET-1）、神经生长因子-β（NGF-β）、白介素-1α（IL-1α）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和干细胞因子（SCF）的动态变化。结果角质形成细胞与马拉色菌在1∶10比例以下,角质形成细胞的生长状况不受马拉色菌的影响（P〉0.05）。当比例提高至1∶20以上时,角质形成细胞的生长受到显著抑制（P〈0.01）。马拉色菌刺激角质形成细胞分泌IL-1α、IL-6、TNF-α、ET-1增加（P〈0.01）。未检测到b-FGF、NGF-β和SCF的产生（P〉0.05）。色沉区马拉色菌刺激产生的ET-1显著高于色减区（P〈0.01）。结论马拉色菌刺激角质形成细胞分泌黑素合成相关因子的能力不同。ET-1在花斑癣色素沉着中可能起了一定作用。     

从马拉色菌毛囊炎患者皮损和非皮损区分离和鉴定马拉色菌

目的研究马拉色菌毛囊炎患者皮损区和非皮损区马拉色菌菌种的检出以及菌种的构成。方法采用菜子油培养基,根据菌落形态和生理生化特点进行菌种鉴定。结果从毛囊内共分离出326株马拉色菌,其中球形马拉色菌255株,占78.22%;合轴马拉色菌54株,占16.56%;糠秕马拉色菌17株,占5.22%。从皮损部位疹间皮肤皮屑分离马拉色菌298株,其中合轴马拉色菌221株,占74.16%;糠秕马拉色菌43株,占14.43%;球形马拉色菌30株,占10.07%;钝形马拉色菌4株,占1.34%。菌种检出率和菌种构成差异均有显著性(P<0.05和P<0.0001)。结论球形马拉色菌是马拉色菌毛囊炎的优势致病菌,正常皮肤则以合轴马拉色菌为主。     

TOICAL TREATMENT OF DERMATOMYCOSES WITH CLOTRIMAZOLE CREAR REPORT OF 824 CASES

824 patients of clinically and mycologically iproved dermatoruycoses ot various liinds were treated with lt:}e clotrimazole cream ir,iitl 55fi cases were followed up for more than l month, with cure or improvement in 87.9% 0f the .patients. The predominance of Trichophytan rubrum as the causative organism of dcrmatophytoses .tend the slow response ot hypcrkeratotic tinca mannum and pedis to clotrimazole therapy may partially explain the rejativt:ly low cure and imprnvement rate.s of dermatophytoses (87.ZTd as compared with those in cutaneous candidiasis (95XS) and pityriasis versicolor {94.4To). The treatment was well tolera~ed with only 1% of the cases developjng coiitact dcrmatitis and having to discontinuc therapy.     

Coronary artery spasm: An often overlooked diagnosis

Coronary vasospasm can lead to myocardial injury and even sudden cardiac death. It has generally been overlooked as a diagnosis since atherosclerosis is a more common cause of acute coronary syndromes and because of the dilemma involved in its diagnosis. A middle-aged man with a history of smoking and cocaine use presented to the emergency department with left-sided arm/chest discomfort and diaphoresis. The electrocardiogram showed anterior ST elevation and hyper-acute T waves, which completely resolved shortly after sublingual nitroglycerin was administered. Subsequent angiogram revealed a 70% focal stenosis in the mid-left anterior descending artery. Coronary vasospasm occurs more commonly in arteries with underlying atheromatous disease, although normal vessels are not excluded. Cigarette smoking and cocaine use are among the major culprits that have been implicated as risk factors for the occurrence of coronary vasospasm. Eventually, the patient had percutaneous coronary intervention of his left-anterior descending artery and remained asymptomatic.     

鼻息肉发病机制及治疗的新进展

 鼻息肉是鼻部最常见的炎症性疾病之一,在成年人中的发病率为1%～2%,主要表现为鼻塞、流涕、嗅觉障碍等,也会有头痛、听力下降以及面部疼痛等症状。大量研究表明,鼻息肉的发病可能与变态反应、阿司匹林耐受不良、遗传因素、真菌感染、细菌感染、囊性纤维化以及不动纤毛综合征等有关。鼻息肉通常采用药物和手术等综合治疗手段。药物治疗中糖皮质激素治疗(全身用和局部用)的效果得到了广泛的肯定,而鼻息肉的病程具有迁延性,需要持续控制,但长期全身或局部应用糖皮质激素均会产生严重的不良反应,故其应用受到一定的限制。手术治疗一般用于药物治疗无效或术后复发的病例。鼻息肉的发病机制需要进一步研究,以便能够开发出治疗该病的相对安全有效的新药。近年来,一些以嗜酸性粒细胞、免疫球蛋白E、真菌及金黄色葡萄球菌为潜在性靶点的药物治疗方法正逐步引入临床。本文系统回顾了鼻息肉的发病机制和近些年来应用于治疗鼻息肉的新方法和新手段。     

伊曲康唑、采乐洗剂治疗马拉色菌毛囊炎疗效观察

目的　观察伊曲康唑与采乐洗剂治疗马拉色菌毛囊炎的疗效。　方法　选择门诊马拉色菌毛囊炎患者110例 ,随机分为两组 :治疗组 5 5例 ,采用伊曲康唑口服与采乐洗剂外洗。对照组 5 5例 ,单纯用采乐洗剂外洗。 2周后观察疗效。　结果　治疗组总有效率 94 40 % ,对照组总有效率 5 8 10 %。两组总有效率比较差异有显著性 (x2 =3 3 5 0 ,P <0 0 0 1)。治疗组疗效优于对照组。　结论　口服伊曲康唑与外用采乐洗剂联合治疗马拉色菌毛囊炎疗效满意 ,安全性高 ,副作用少     

中医药为主治疗儿童髋关节滑膜炎研究概况

儿童髋关节滑膜炎(transient synovitis of the hip in children,TSH)是儿童常见病、多发病,是造成儿童髋关节疼痛、跛行的最常见病因。目前国内外对本病的发病原因尚未达成共识,在治疗方法上亦未形成统一标准。西医学认为本病的发病原因与细菌或病毒感染、髋关节外伤、过度疲劳、变态反应等诸多因素有关。治疗方法多采用抗生素或抗病毒类药物、皮肤牵引、物理疗法等。对于保守治疗无效者,可采用关节镜手术治疗。上述治疗方法临床疗效值得肯定,但其药物毒、副作用及手术风险等负面问题正逐渐受到学者的重视。中医学认为本病的发病原因在于儿童正气不足,复感外邪,痹阻于髋部而发病,属于中医“痹证”范畴。中医治疗本病的方法具有多样性,如中药内服、中药外用(中药熏蒸、膏药外敷、药膏涂擦等)或二者相结合进行治疗。笔者通过查阅近年相关有价值文献并进行筛选、总结。研究结论提示:中医药为主治疗儿童髋关节滑膜炎,效果显著、安全简便,在治疗方法和疗效方面有其独特优势。现从儿童髋关节滑膜炎的病因病机,诊断,中医内治为主治疗,中医外治为主治疗,中医药为主、内外兼治五个方面进行综述,以期为临床治疗提供参考。      

大环内酯类抗生素在皮肤科的应用

大环内酯类抗生素具有抗炎作用,其机制尚未完全阐明,其抗炎机制的研究已引起广泛兴趣。目前认为主要通过影响PMN及抑制IL-8的分泌而发挥疗效,一些临床研究已表明,大环内酯类抗生素在某些炎症性皮肤病如痤疮、玫瑰糠疹,脓疱疮,银屑病等治疗中有较好的序效。     

特比萘芬乳膏与维A酸胶囊联合治疗马拉色菌毛囊炎

目的 观察外用特比萘芬乳膏和口服维A酸胶囊联合治疗马拉色菌毛囊炎的疗效.方法 治疗组172例,采用维A酸胶囊 20 mg顿服,1次/d,同时皮损处外用特比萘芬乳膏,2次/d,连续治疗14 d.对照组126例,单纯口服维A酸胶囊,方法及疗程同治疗组.结果 治疗组:治愈59例,显效66例,有效28例,无效19例.治愈率77.27%,总有效率为93.94%,对照组:治愈27例,显效32例,有效31例,无效36例.治愈率53.3%,总有效率为78.33%.两组治愈率和总有效率比较差异有显著性(P<0.05).结论 维A酸胶囊联合外用特比奈芬乳膏治疗马拉色菌性毛囊炎效果理想,副作用少而轻微.     

Primary haematogenous osteomyelitis of the patella: a rare cause for anterior knee pain in an adult

Acute osteomyelitis of the patella is a very rare condition, which commonly affects children between the ages of 5-15 years. Primary haematogenous osteomyelitis in an adult usually occurs in patients with associated risk factors like intravenous drug abuse, HIV infection, and trauma. This report discusses a similar condition in a 46 year old women with no associated predisposing risk factors. The rarity of this condition and its atypical presentation should be borne in mind while treating an adult patient with anterior knee pain. Point tenderness over the patella should alert a physician to the possibility of osteomyelitis of the patella. The value of bone scan and computed tomography in the early stages to help diagnose this condition has been stressed. The literature has been reviewed and discussed briefly.     

How I use coal tar in dermatology

Coal tar has been used in dermatology for over a hundred years. It was the main therapeutic agent for the treatment of various skin orders before the introduction of topical steroid. Since the advent of topical steroid the use of coal tar has reduced considerably. It is still being used a lot in the treatment of psoriasis. In this paper I will describe how I use coal tar not only in psoriasis, which is well known, but also in acne, folliculitis, eczema and seborrheic dermatitis and vitiligo, which are less well known.     

Advances in atopic dermatitis

Atopic dermatitis (AD) is a highly pruritic, chronic, and relapsing inflammatory skin disorder affecting 10-20% of children worldwide. During the past year there have been significant advances in our understanding of the cellular and immunologic mechanisms underlying AD as well as the immunologic triggers involved in its pathogenesis. The introduction of a new class of topical anti-inflammatory medications, topical calcineurin inhibitors, has significantly increased our treatment options and led to the rethinking of potential management approaches in AD.     

Ciclopirox nail lacquer and podiatric practice

Ciclopirox 8% nail lacquer has recently been approved by the US Food and Drug Administration (FDA) for the management of mild-to-moderate dermatophytic onychomycosis not involving the lunula. Previously, the agents that were approved for the treatment of dermatophytic pedal onychomycosis--griseofulvin, itraconazole, and terbinafine--were administered orally. When ciclopirox nail lacquer is used, it is recommended that the infected nail undergo debridement by a health-care professional as frequently as monthly. It is important to be aware of the circumstances under which debridement of the mycotic nail may be considered medically necessary and therefore potentially eligible for reimbursement by third-party payers. For many nail presentations, nail debridement is an important component of a treatment protocol involving either the oral medications or the topical lacquer, as it serves to reduce the fungal load and ameliorate symptoms. With the availability of a new FDA-approved topical treatment alternative, it remains to be seen if podiatrists will embrace the definitive treatment of onychomycosis using the newer oral agents, the new nail lacquer, or both in combination with nail debridement to treat the disease.     

骨桥蛋白在子宫内膜及其相关病变中的表达

骨桥蛋白是一种磷酸化糖蛋白,存在于多种组织及体液中,有多种受体,因而具有多种生理和病理功能。近来发现其在生理周期的子宫内膜、妊娠期子宫内膜、子宫内膜异位症、子宫内膜癌及水泡状胎块中有着广泛的表达,通过不同的作用途径发挥不同的生理、病理功能,几乎参与了生殖的全过程,其在子宫内膜功能的维持和相关疾病的发病机制中具有重要意义。