复发性口腔溃疡口腔微生态探索

目的 研究和探索复发性口腔溃疡患者口腔微生态菌群情况,分析口腔微生态与复发性口腔溃疡的相关性.方法 收集20例复发性口腔溃疡患者唾液,21例复发性口腔溃疡愈合患者唾液,20例健康志愿者唾液,以Gb-作为革兰阴性杆菌标记,Gb+作为革兰阳性杆菌标记,Gc-作为革兰阴性球菌标记,Gc+作为革兰阳性球菌标标,比较各组口腔菌群构成,并进行定量对比分析.对三组唾液中的奈瑟氏菌、链球菌、韦荣氏菌的含量变化进行分析,研究口腔微生态变化情况.结果 溃疡组韦荣氏菌和链球菌的含量对数值明显低于健康对照组(P＜0.05);愈合组和溃疡组的奈瑟氏菌和韦荣氏菌含量具有显著差异(P＜0.05);愈合组链球菌对数值明显低于健康对照组(P＜0.05).结论 复发性口腔溃疡与口腔微生态具有相关性,韦荣氏菌含量情况与复发性口腔溃疡发病关系密切,可能具有维持口腔环境稳定的作用.     

一清胶囊联合重组牛碱性成纤维细胞生长因子凝胶治疗复发性口腔溃疡的临床研究

目的探讨一清胶囊联合重组牛碱性成纤维细胞生长因子凝胶治疗复发性口腔溃疡的临床疗效。方法选取2019年6月—2020年2月郑州市口腔医院收治的复发性口腔溃疡132例,随机分为对照组和治疗组,每组各66例。对照组患者局部涂擦重组牛碱性成纤维细胞生长因子凝胶,3次/d。治疗组患者在对照组基础上口服一清胶囊,2粒/次,3次/d。两组患者均治疗1周。观察两组患者临床疗效,同时比较治疗前后两组患者溃面愈合和溃疡疼痛持续时间,炎性因子白细胞介素-12(IL-12)、IL-17和肿瘤坏死因子-α(TNF-α)水平,及链球菌、韦荣氏菌和奈瑟氏菌数量水平。结果治疗后,对照组临床有效率为81.82%,显著低于治疗组的93.94%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组溃面愈合时间、溃疡疼痛持续时间明显低于对照组(P<0.05)。治疗后,两组患者IL-12水平均显著升高,IL-17、TNF-α水平显著下降(P<0.05),且治疗组上述指标改善幅度更明显(P<0.05)。治疗后,两组链球菌、韦荣氏菌、奈瑟氏菌数量均显著升高(P<0.05),且治疗组升高更明显(P<0.05)。结论一清胶囊联合重组牛碱性成纤维细胞生长因子凝胶可显著促进复发性口腔溃疡恢复,减轻患者疼痛,纠正口腔微生态环境紊乱,临床疗效较好,且安全性较高。     

下呼吸道及肺胸膜厌氧菌感染

存无氧或氧分压很低的环境中才能生长繁殖的细菌,称为厌氧菌。无芽胞厌氧菌是人体口腔、上呼吸道、肠道、泌尿生殖道正常寄殖菌群的重要组成。其中常见致病者主要有:革兰氏阴性染色的核粒梭形杆菌,胨链球菌,胨球菌,黑色素类杆菌,微嗜氧链球菌,脆弱类杆菌,以及一些革兰氏阳性染色的厌氧杆菌等。     

重症监护病房呼吸道感染常见致病细菌的耐药性调查

目的　调查我院重症监护病房 ( ICU )引起呼吸道感染的致病菌菌群分布及其耐药情况。方法　将 2 0 0 0年 5月～ 2 0 0 3年 9月我院重症监护病房送检的呼吸道标本中接种于血培养基和巧克力培养基 ,分离出的致病菌用 VITEK AMS- 6 0鉴定 ,药敏用 K- B法。结果　共分离出 4 94株致病细菌 ,其中革兰氏阴性杆菌30 7株占 6 2 .1% ,革兰氏阳性球菌 187株占 37.9%。革兰氏阴性杆菌中铜绿假单胞菌 12 2株 ,肺炎克雷伯氏菌和大肠埃希氏菌 5 2株 ,鲍氏不动杆菌 4 4株 ,嗜麦芽寡养单胞菌 2 7株 ,阴沟肠杆菌 2 3株。革兰氏阳性球菌 187株 ,其中金黄色葡萄球菌 115株 ,凝固酶阴性葡萄球菌 5 2株 ,粪肠球菌 14株。药敏试验结果提示各主要致病革兰氏阴性杆菌对亚胺培南、头孢哌酮 /舒巴坦、头孢他啶敏感性较高 ;各主要致病革兰氏阳性球菌对万古霉素、替考拉宁、氯霉素的敏感性较高。结论　铜绿假单胞菌是引起我院重症监护病房病人呼吸道感染的主要致病革兰氏阴性杆菌 ,金黄色葡萄球菌为主要致病革兰氏阳性球菌。各主要致病菌均耐药严重且呈多重耐药 ,提示合理运用抗生素 ,对提高临床治疗效果 ,有效控制病人的感染尤为关键。     

249株自泌尿道分离的病原菌菌群分布及药敏分析

目的　了解从我院的门诊和住院病人的尿液标本中所分离的 2 4 9株病原菌的菌群分布及其药敏分析。方法　将中段尿标本定量接种于CLED培养基 ,用VITEKAMS 60全自动细菌培养仪进行鉴定 ,药敏用K B法 ,用WHONET4软件进行数据分析。结果　共从门诊和住院病人中分离出 2 4 9株病原菌。其中革兰氏阴性杆菌 2 0 7株占 83 1 % ,革兰氏阳性球菌 42株占 1 6 9% ;分离率由高到低为大肠埃希氏菌 46 2 % ,肺炎克雷伯氏菌 9 6 % ,铜绿假单胞菌 9 2 % ,粪肠球菌 8 0 % ,阴沟肠杆菌 5 2 % ,无乳链球菌 2 4% ,鲍氏不动杆菌1 2 % ,其它占 1 8 2 %。药敏试验提示引起泌尿道感染的常见革兰氏阴性杆菌对亚胺培南和美罗培南的敏感性最高 ,粪肠球菌对替考拉宁、氨苄西林、青霉素、万古霉素最为敏感。结论　革兰氏阴性杆菌在泌尿道感染中占绝对优势 ,其中大肠埃希氏菌、肺炎克雷伯氏菌、铜绿假单胞菌最为常见 ,革兰氏阳性球菌中粪肠球菌最为多见 ,合理使用抗生素对有效控制泌尿道感染和避免耐药菌株的产生尤为关键     

烧伤创面细菌培养与抗菌素敏感性的变化

从1983～1989年我院对烧伤创面进行332次细菌培养和药物敏感试验,结果表明,烧伤感染菌中革兰氏阴性杆菌(63.31％),仍多于革兰氏阳性球菌(30.23％),霉菌仅为(6.46％)。在革兰氏阴性杆菌中位次为;绿脓杆菌(37.31％、肺尖克雷白氏菌(21.41％)、变形杆菌(20.32％)、肠杆菌(10.25％)、沙雷氏菌(serratia)(9.27％)、其它革兰氏阴性杆菌(1.44％)。在革兰氏阳性球菌中,位次为金黄色葡萄     

合成青霉素的分类及其特征

前言青霉素是由弗莱明在1928年发现,从青霉菌中的点青霉(Penicillium notatum)或产黄青霉(Penicillium chrysogenium)及其相似的菌产生的。初期的青霉素 G 对于葡萄球菌、链球菌、肺炎球菌、白喉菌等的革兰氏阳性球菌、杆菌和淋菌、髓膜炎菌等的革兰氏阴性球菌类及梅毒螺旋体属等引起的感染症有着极好的效果。但是,另方面,青霉素自发现至今,己尝试过几次改革,即针对由青霉素引起的过敏性或变态反应的发生、耐药葡萄球菌的出现而进行的耐酸性的口服剂、抗青霉素酶的异(口恶)唑类青霉素的研制,再进一步就是由扩大抗菌谱而产生的新青霉素对革兰氏阴性杆菌感染症的应用。     

桥本甲状腺炎伴甲状腺肿患者的肠道菌群特征研究

目的 探讨桥本甲状腺炎伴甲状腺肿与肠道菌群物种分布及丰度是否相关。方法 收集31例临床粪便样本,其中健康受试者10例(A组),桥本甲状腺炎伴甲状腺肿组9例(B组),桥本甲状腺炎不伴甲状腺肿组12例(C组),进行16S rRNA基因测序检测,描述3组肠道菌群的特征。结果 3组共聚类16 941个操作分类单元(OTU),其中A组肠道菌群样本OUT组成分布相对集中,B组及C组的菌群多样性下降,但3组间比较差异无统计学意义(P>0.05)。在科水平上,B组的拟杆菌科(Bacteroidaceae)丰度显著低于A组和C组,而普雷沃氏菌科(Prevotellaceae)、韦荣氏球菌科(Veillonellaceae)丰度显著高于A组和C组,差异均有统计学意义(P<0.05);在属水平上,B组患者的拟杆菌属(Bacteroides)显著低于A组和C组,而普氏菌属(Prevotella)显著高于A组和C组,差异均有统计学意义(P<0.05)。结论 桥本甲状腺炎伴甲状腺肿患者物种分布和丰度发生改变,存在肠道菌群失调,其中拟杆菌科及菌属、普雷沃氏菌科、韦荣氏球菌科、普氏菌属可能是区别桥本...     

呼吸科患者痰培养菌群分布及耐药性分析

目的了解呼吸科患者痰培养菌群分布及耐药性,帮助临床合理用药。方法对2006年1月-2008年12月呼吸科2714例痰标本细菌培养和药敏试验进行回顾性分析。结果2714例痰标本培养出病原菌1421例,阳性率为52.4%,其中452例分离出2种或2种以上病原菌,占阳性标本的31.8%。1986株分离菌中革兰氏阴性(G-)杆菌占67.4%,革兰氏阳性(G+)球菌占22.6%,真菌占10.0%。G-杆菌以铜绿假单胞菌、鲍曼不动杆菌和大肠埃希菌为主,分别占病原菌的23.7%、17.9%和16.0%;G+球菌中以血浆凝固酶阴性葡萄球菌和金黄色葡萄球菌为主,占12.1%和8.9%。革兰阴性杆菌仅对亚胺培南耐药率较低,铜绿假单胞菌为39.3%,不动杆菌为32.4%,大肠埃希氏菌为0。葡萄球菌几乎全部为MRS,对万古霉素敏感,对利福平较敏感,对复方新诺明凝固酶阴性葡萄球菌的耐药率高(85.2%),金黄色葡萄球菌耐药率低(18.5%)。大肠埃希氏菌ESBL检出率为86.5%。结论呼吸道感染以革兰阴性杆菌为主,铜绿假单胞菌为首,多重感染及多重耐药现象严重。合理选用抗菌药物,对治疗呼吸道感染具有重要意义。     

白塞病的口腔护理

白塞病是以口腔溃疡、外阴溃疡、眼炎及皮肤损害为临床特征的,累及多个系统的慢性疾病。复发性口腔溃疡是本病最基本的症状。而口咽部又是最易发生感染的部位,有文献报道其感染发生率高达66%,居各部位感染之首。口腔是病原微生物侵入肌体内的主要门户之一,由于口腔的湿度、温度和酸碱度适宜微生物的生长繁殖,因此正常人的口腔中也存在一定数量的细菌,虽然大部分是非致病菌,但在某些条件下致病菌也可以大量繁殖,特别是在患有口腔疾病的情况下,白塞病的口腔溃疡是由于免疫功能紊乱造成的,所以更容易继发病原微生物的感染。目前的病原学研究表明,致病菌主要为革兰氏阴性杆菌、白色念珠菌和厌氧菌,少数为革兰氏阳性球菌。     

New oral solid dosage form for furosemide oral administration

Furosemide (FURO) is a drug labeled in class IV of the Biopharmaceutics Classification System (BCS) as it is both poor soluble and poor permeable. The aim of this work was to improve FURO biopharmaceutical properties by its formulation in a new solid oral dosage form. It consists in the realization of the composite MgAl-HTlc-FURO, obtained by FURO intercalation into the inorganic matrix hydrotalcite (MgAl-HTlc), and its successive formulation in tablets intended to be swallowed whole and to disintegrate rapidly in the stomach. These formulations were prepared by direct compression of a simple powder mixture constituted by MgAl-HTlc-FURO, a super disintegrant (Explotab, PolyplasdoneXL, PolyplasdoneXL-10, PolyplasdoneINF 10 or L-HPCLH-21) and a filler. The prepared formulations were submitted to disintegration time tests, and only those displaying the lowest disintegration time in gastric medium were submitted to in vitro release studies. Drug dissolution profiles from MgAl-HTlc-FURO tablets were compared with those containing crystalline FURO alone or physically mixed to MgAl-HTlc instead of MgAl-HTlc-FURO. The results revealed that tablets containing MgAl-HTlc-FURO give the best dissolution profile and that L-HPCLH-21 is able to promote the highest drug release in gastric medium, resulting in the most suitable super disintegrant in comparison with the other tested.     

呼吸机相关性肺炎及口腔感染的口腔预防护理分析

目的 针对呼吸机相关性肺炎及口腔感染的口腔预防护理进行分析研究.方法 随机选择于2012年12月至2015年9月期间,本科收治实施呼吸机辅助呼吸治疗的患者180例,将其平均分为对照组和观察组.对照组实施常规口腔护理,观察组实施口腔预防冲洗护理.针对两组患者呼吸机相关性肺炎发生率、口腔并发症发生率、护理满意度、口腔清洁度、口臭改善情况等指标进行观察分析.结果 在本次研究中,观察组患者治疗3天和治疗7天后的呼吸机相关性肺炎的发生率分别为1.11％、2.22％,对照组的发生率分别为7.78％、14.44％,经比较,差异有统计学意义(P＜0.05).观察组患者治疗7天后的口腔并发症发生率为5.56％,对照组为20.00％,差异有统计学意义(P＜0.05).观察组和对照组患者的口腔并发症中口腔感染发生率分别为1.11％、7.78％,差异有统计学意义(P＜0.05).观察组患者的护理满意度为97.78％,对照组为83.33％,差异具有统计学意义(P＜0.05).观察组与对照组患者的口腔清洁度评分以及口臭评分比较,差异有统计学意义(P＜0.05).观察组患者与对照组患者护理后的口臭发生率,与护理前比较,差异具有统计学意义(P＜0.05).观察组患者与对照组患者护理后的口臭发生率比较,差异具有统计学意义(P＜0.05).结论 在临床呼吸机辅助治疗的过程中,为了防止口腔并发症的产生,对患者实施口腔预防护理,可以降低口腔感染、呼吸机相关性肺炎等口腔并发症的发生率,提高患者的口腔卫生清洁度,提高患者的临床护理满意度,促进患者的康复,值得推广.     

口腔癌前病变早期癌变的脱落细胞学检测

目的　脱落细胞学检查对于口腔癌前病变监测的意义。方法　口腔白斑、糜烂型扁平苔癣及口腔鳞癌患者病变可疑部位刮片固定送检。结果　脱落细胞学检查对口腔癌的诊断率达 85 % ,对白斑的分级也有重要帮助。结论　脱落细胞学检查对白斑及扁平苔癣的监测有重要意义 ,使患者在无创基础上实现对早期癌的早发现、早治疗     

Abstracts oral communications

International Journal of Clinical Pharmacy -     

口腔扁平苔藓和口腔白斑患者口腔真菌的检出率及分类

目的检测口腔扁平苔藓（OLP）和口腔白斑（OK）患者口腔念珠菌的驻菌情况。方法分别取30例OLP患者、OK患者及健康者的口腔含漱液,并以形态学和酵母菌鉴定系统等方法进行分型鉴定,计算不同念珠菌的检出率。结果健康对照组、扁平苔藓组和白斑组中念珠菌的检出率分别为30%、30%、26.7%,白色念珠菌的检出率分别为16.7%,20%、20%,热带念珠菌检出率分别为10%、6.7%、10%,光滑念珠菌检出率分别为6.7%、3.3%、0,3组间比较均无显著性差异。结论念珠菌与口腔扁平苔藓及口腔白斑的发病无强相关性。     

Midazolam oral self-administration

The technique of chronic schedule-induced drug solution intake was used to determine the possible addiction liability of the short-acting benzodiazepine midazolam. Schedule-induction produces polydipsia over a wide range of fluids as a function of the imposed schedule of food availability. The inducing schedule used presented food pellets automatically once per minute, fixed time (FT) 1-min, for 3 h daily. Two groups of rats, drinking either water or 0.05 mg/ml midazolam solution, were exposed to schedule-induction sessions for approx. 2 months. Then, other FT-values (0, 0.5, 3 and 5 min) were instituted on occasion for single sessions. Each of these 'probe' session determinations was done twice. Although midazolam concentration had been adjusted so that the mean group intakes were equal at FT 1-min, probe values greater than 1 min revealed a greater acceptance of midazolam compared to water. This technique produced session midazolam intakes as great as 25 mg/kg. In the next phase, the entire experiment was repeated except both groups were offered a choice between water and midazolam solution during sessions. Only at FT 0 and FT 5-min was there an indication that midazolam was preferred over water. Two additional groups of animals were exposed to the same schedule-induced polydipsia regimen, drinking water and midazolam solution, respectively. Pre-session administration of doses of Ro 15-1788, CGS 8216 (benzodiazepine antagonists) or midazolam had no effects on either water or midazolam intakes, although the higher dose of midazolam (2 mg/kg, s.c) had a moderately suppressive effect on the non-tolerant water-polydipsic group. All groups were tested on occasion for physical dependence on midazolam with an auditory stimulus as the precipitator and midazolam polydipsic groups were found to have a mild to moderate dependence (clonic seizures, running fits).     

Novel oral cephalosporins

The therapeutic use of oral cephalosporins to treat infectious diseases continues to challenge clinicians; many attempts have been made over recent years to improve the efficacy and spectrum of these anti-infectives. Many oral cephalosporins are in development and include cefdinir, cefprozil, cefetamet pivoxil, cefcapene pivoxil, cefcanel daloxate hydrochloride in Phase II trials, S-1090 in Phase III trials and the novel compounds E1100, E1101 and BRL-57347. Differences between these drugs are sometimes subtle and the improvement over existing compounds modest, although recent cephalosporins have shown greater activity against Gram-negative bacterial infections. A better knowledge of the pharmacodynamic and pharmacokinetic interrelationships of existing oral cephalosporins is demanded for a more rational use of these compounds and to avoid the subsequent development of resistance. Perhaps with such an approach, the perceived need for new cephalosporins will diminish.     

Novel oral cephalosporins

The therapeutic use of oral cephalosporins to treat infectious diseases continues to challenge clinicians; many attempts have been made over recent years to improve the efficacy and spectrum of these anti-infectives. Many oral cephalosporins are in development and include cefdinir, cefprozil, cefetamet pivoxil, cefcapene pivoxil, cefcanel daloxate hydrochloride in Phase II trials, S-1090 in Phase III trials and the novel compounds E1100, E1101 and BRL-57347. Differences between these drugs are sometimes subtle and the improvement over existing compounds modest, although recent cephalosporins have shown greater activity against Gram-negative bacterial infections. A better knowledge of the pharmacodynamic and pharmacokinetic interrelationships of existing oral cephalosporins is demanded for a more rational use of these compounds and to avoid the subsequent development of resistance. Perhaps with such an approach, the perceived need for new cephalosporins will diminish.