艾灸对直肠癌术后低位前切除综合征相关腹泻的疗效观察

目的:观察艾灸对直肠癌术后低位前切除综合征(LARS) 相关腹泻的临床疗效。方法:选取2019 年3 月—2020年12 月在上海市嘉定区中医医院外科病房就诊的直肠癌术后LARS 相关脾虚型腹泻患者80 例,根据随机数字表法分为对照组和治疗组,每组40 例。对照组口服思密达,1 次/d,每次1 袋,持续治疗2 周;治疗组用艾条温和灸足三里( 双)、关元、神阙,每穴20 min,1 次/d,持续治疗2 周。采用徐氏肛门功能评价、LARS 量表评价、中医症候评价以及临床疗效评价,分别对对照组和治疗组停药后1 周、2 周以及1 个月后的情况进行疗效评估。结果:在干预结束第1 周后,2 组患者在肛门功能、LARS 量表、中医症候评分中差异无统计学意义(P ＞ 0.05);治疗2 周、1 个月后,治疗组的肛门功能评分[(6.15±1.97)分、(9.29±0.58)分] 高于对照组[(3.99±1.48)分、(4.67±1.74)分],差异有统计学意义(P ＜ 0.05);治疗2 周、1 个月后,治疗组的LARS 评分[(15.50±9.61)分、(20.11±9.60)分] 低于对照组[(3.94±5.16)分、(16.85±9.57)分],治疗组的中医症候评分[(6.62±3.95)分、(10.09±4.11)分] 低于对照组[(3.65±2.66)分、(8.83±4.28)分],差异有统计学意义(P ＜ 0.05);在干预结束后,治疗组的有效率为90%,高于对照组的63%,差异有统计学意义(P ＜ 0.05)。结论:艾灸可有效改善直肠癌术后LARS 相关腹泻患者的肠胃功能,且相比于药物,艾灸的疗效更持久,有效提高了患者的脾胃功能,改善了脾虚症状。     

洛匹那韦/利托那韦联合干扰素治疗新型冠状病毒肺炎的疗效

目的　探讨洛匹那韦/利托那韦联合干扰素治疗新型冠状病毒肺炎（新冠肺炎）的有效性及安全性。方法　选取2020年1月3日—4月7日于我中心住院治疗的62例新冠肺炎确诊患者作为研究对象,并将其分为治疗组（43例）和对照组（19例）,其中对照组采用常规对症支持治疗,治疗组在对照组常规治疗基础上使用洛匹那韦/利托那韦抗病毒治疗;同时,根据患者临床分型对上述患者实施非重症组与重症组亚组分析。比较对照组和治疗组核酸转阴时间、住院时间、退热时间、症状缓解时间及药物不良反应发生情况。结果　在非重症组患者中,治疗组与对照组在退热时间、症状缓解时间、核酸转阴时间及住院时间方面的差异均无统计学意义（P均＞0.05）;而在重症组患者中,治疗组核酸转阴时间显著长于对照组[（23.62±2.12 ）d vs.（9.25±0.95）d],差异有统计学意义（P＜0.05）。在药物不良反应方面,治疗组腹泻发生率为46.5%,显著高于对照组,差异有统计学意义（P＜0.05）,但均为轻到中等程度腹泻,经对症治疗后腹泻症状消失。结论　洛匹那韦/利托那韦联合干扰素治疗新冠肺炎非重症患者效果不明显,治疗重症患者,核酸转阴时间更长,虽临床应用总体安全性较好,但存在腹泻等不良反应,不推荐使用。     

葡萄糖酸钙锌口服液联合布拉酵母菌散剂治疗轮状病毒性腹泻的效果

目的　观察葡萄糖酸钙锌口服液联合布拉酵母菌散剂对轮状病毒感染患儿症状控制及胃肠功能的影响,为临床治疗提供参考。方法　选取2017年8月—2019年10月三亚市人民医院收治的120例轮状病毒感染患儿作为研究对象,根据治疗方法分为常规组与联合组,各60例,其中常规组给予饮食指导、合理补液、抗病毒、预防或纠正电解质紊乱等常规治疗,联合组在常规组治疗基础上给予葡萄糖酸钙锌口服液联合布拉酵母菌散剂治疗。记录2组患儿治疗前后粪便标本中肠道菌群含量、血清中胃肠激素水平变化,并统计分析2组患儿临床治疗总有效率、症状改善时间（退热、止泻、止吐、大便性状正常）及住院时间。结果　治疗后,联合组总有效率为93.33%,高于常规组的80.00%（P＜0.05）,退热时间[（1.69±0.42）d]、止泻时间[（2.28±0.45）d]、止吐时间[（1.92±0.44）d]、大便性状正常时间[（2.30±0.45）d]、住院时间[（4.82±1.37）d均短于常规组,差异均有统计学意义（P均＜0.05）。治疗前,2组粪便标本中肠道菌群含量、血清中胃肠激素水平比较,差异均无统计学意义（P均＞0.05）。治疗后,2组粪便标本中双歧杆菌、乳酸杆菌含量较治疗前上升,肠杆菌含量及血清中胃泌素、胃动素、血管活性肠肽水平较治疗前下降,且联合组粪便标本中肠道菌群含量改善程度及胃肠激素水平下降幅度均高于常规组（P均＜0.05）。结论　葡萄糖酸钙锌口服液联合布拉酵母菌散剂可促进轮状病毒感染患儿临床症状的消失,改善胃肠激素水平,平衡肠道菌群,提高疗效。     

Screening for Escherichia coli O157:H7 in Illinois

Objective: To determine the incidence of infection with Escherichia coli O157:H7 in a tertiary referral center in Chicago, where a similar study had been performed in 1984, to evaluate cases of disease reported to the Illinois Department of Public Health (IDPH) in 1993, and to determine laboratory practices used to detect this infection throughout the state.
Methods: During a 6-month period in 1993, all stool specimens at Rush-Presbyterian-St Luke's Medical Center (RPSLMC) were tested for E. coli O157:H7. Reports of diagnosed E. coli O157:H7 cases investigated by IDPH were also reviewed. A survey of 73 hospitals in the Chicago area was performed to determine routine culturing practices, specifically, the selection of stool specimens for evaluation for this pathogen.
Results: In the RPSLMC survey, two cases were identified among 1985 samples (incidence 0.1%), similar to the 0.08% incidence detected in a similar study conducted at the same institution in 1984. Through passive surveillance, the IDPH received 44 reports of E. coli O157:H7 in 1993. The hospital survey revealed that, in the seven labs testing all stool specimens for E. coli O157:H7, an incidence of 16/8137 specimens (0.2%) was determined.
Conclusions: These data suggest that sporadic E. coli O157:H7 remains uncommon in Illinois and that the incidence may not have changed over a 9-year period. The low yield and substantial cost of culturing all stools suggest that only specimens from patients with bloody diarrhea should be evaluated routinely in areas of low endemicity.     

Molecular characterization and genetic variation of the VP7 gene of human rotaviruses isolated in Paraguay

Rotavirus is the main cause of acute diarrhea in infants and young children worldwide. In Paraguay, acute diarrhea ranks fourth among the causes of mortality in children under 4 years of age. Rotavirus was detected in 93 out of 410 patients admitted to three main hospitals in Asunción, Paraguay from August 1998 to August 2000. Samples from 64 patients were analyzed by RT-PCR for G and P typing. G4P[8] (46.9%; 30/64) was the most common strain detected, followed by G9P[8] (17.2%; 11/64) and G1P[8] (10,9%; 7/64). Since G4 was predominant during the epidemiological peaks of 1998 and 1999, four samples were sequenced and all grouped into sublineage Ic. This sublineage was reported for the first time in 1998 in Argentina, southern border of Paraguay, and it was shown to be responsible for the increased prevalence of G4 during the epidemiological season of 1998 in that country. In addition, Paraguayan G1 strains grouped in different lineages (I and II). However, G9 was predominant during the rotavirus epidemiological peak of 2000, and phylogenetic analysis of five samples grouped into a common emergent/reemergent lineage that circulates worldwide. Since vaccination could reduce the severity and the number of cases of rotavirus disease, this study suggests that a vaccine containing recently isolated variants of the most prevalent types (G1-G4) together with the emerging G9 type, might be sufficient to elicit a protective immune response against the rotavirus types circulating currently in Paraguay.     

辅以钙剂治疗急性腹泻52例临床疗效观察

目的：探讨在常规综合治疗基础上辅以钙剂治疗急性腹泻的疗效。方法：采用随机单盲平行对照方式,１０４例急性腹泻患者按病后诊治顺序随机分为两组,对照组５２例给常规综合治疗,治疗组５２例在常规综合治疗基础上加用钙剂治疗３天（１０％葡萄糖酸钙针剂２０ｍｌ,缓慢ｉｖ,ｑｄ）。结果：经ｘ＾２检验,两者疗效有显著性差异（Ｐ〈０．０５）。结论：在常规综合治疗基础上钙剂治疗急性腹泻可提高疗效。     

Helicobacter pylori-induced diarrhea post-ileogastrostomy

A retrospective study of all ileogastrostomy procedures (n=26) performed in 1993 by one surgeon (IGMC) was carried out to investigate the hypothesis that Helicobacter pylori may be implicated in certain severe cases of postoperation nausea and diarrhea. Ten of 26 persons (38.5%) displayed nausea and notable diarrhea (greater than or equal to ten bowel movements per day), seven of which warranted upper GI investigation. One hundred per cent (seven of seven) of these persons were found to possess H. pylori upon C-14 breath test. In four of six cases eradication therapy (1 g amoxicillin b.i.d./20 mg omeprazole b.i.d. for 2 weeks) corresponded with a resolution of severe nausea and diarrhea (one additional case involved omeprazole use only), suggesting that H. pylori should be considered as a possible cause of these symptoms post-ileogastrostomy. Additionally, in four of seven cases persons were re-tested (C-14 breath analysis) at least 1 month post-therapy and in this group three persons were found to be free of the organism. All three cases of notable diarrhea and nausea resolved with treatment, providing the strongest evidence for a possible association between infection and these symptoms.     

陕西省眉县健康教育干预5岁以下儿童腹泻效果评价

为了探讨适合我国农村社区的健康教育方法,陕西省眉县被确定为西北地区的试点。本文运用格林模式,采取健康教育、改水、改厕三位一体方法,通过２年的健康教育综合性干预,实验乡５岁以下儿童腹泻发病率较对照乡及干预前均有明显下降,儿童母亲防治儿童腹泻的知、信、行水平也显著提高（Ｐ＜００１）,进一步证实综合干预在农村社区健康教育中运用的可行性。同时,初步探索出了一些适合我国农村社区的健康教育实施经验。     

大狼把草止泻作用的实验研究

目的:研究大狼把草的止泻作用。方法:通过小鼠肠推进实验、对小鼠排便时间和数量影响的实验,观察大狼把草的止泻作用。结果:大狼把草醇提液、水煎醇沉液有较好的抑制小鼠肠推进率(P<0.05～0.01),延长小鼠排蓝便的时间(P<0.05),减少排蓝便数量的作用(P<0.05～0.01)。结论:大狼把草醇提液、水煎醇沉液均有较好的止泻作用,且醇提液作用优于水煎醇沉液。     

热带气候对海南省小儿腹泻影响的研究

目的：地海南省小儿急性腹泻的影响因素及发病规律。方法：１９９７年度在海南省东西南北中及海口市各设一个监测点对５岁以下小儿１６５４人进行腹泻流行病学调查,采用每三日法。并将腹泻月平均发病率与相应月份气象指标进行相关分析。结果：月平均发病率２０．１９％,年发病率为２４２．２９％,线人每年腹泻发病次数为２．４２±０．０８,年死亡率０．６０‰,发病高峰在１－３月份,与气温、雨量呈显著负相关。结论：海南海１