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     

Chronic diarrhea: Causes,presentation, and mangement

Important inroads are being made into understanding the pathophysiology of diarrhea. Clear understanding of key mechanisms should suggest new approaches to combat disease. Exciting developments are occurring in terms of super-ORS solutions, particularly with the promise of short chained glucose polymers and glutamine. Perhaps the most important development is the prospect of a good rotavirus vaccine being available before the end of the decade. Chronic diarrhea seems to be on the increase globally, probably because of the success of ORS. The mechanisms that lead to mucosal injury are elusive, and therapy still largely supportive and empiric. Celiac disease continues to be a puzzle, because of the uncomfortable feeling that a majority of cases may be missed because of atypical presentations. The successful use of long term parenteral nutrition has allowed survival and better charaterization of cases that otherwise would have perished as ‘lethal protracted diarrhea’. Microvillus inclusion disease may be the commonest congenital secretory diarrhea. The role of the recently reported high prevalence of glucoamlase deficiency may be important. Lastly, attention to micronutrients, particularly low vitamin A and probably zinc may prove to be important in prevention and amelioration of diarrhea and growth failure.     

Loperamide

In castor oil challenged rats, low doses of loperamide inhibit diarrhea and normalize intestinal propulsion. Unlike other opioids, loperamide is devoid of central opiate-like effects, including blockade of intestinal propulsion, up to the highest subtoxic oral dose. Nevertheless, the antidiarrheal action of loperamide can be considered to be -opiate receptor mediated, only a fewin vitro effects at rather high concentrations being not naloxone-reversible. There is little evidence that interactions with intestinal opiate receptors directly change epithelial cell function. When secretory stimuli increase mucosal tension, however, loperamide may reverse the elevated hydrostatic tissue pressure that opposes normal absorption. This antisecretory effect at the mucosal level is accompanied by motor effects when loperamide reaches the myenteric -opiate receptors. At therapeutic doses for the treatment of acute diarrhea, it is likely that the mucosal effect prevails.     

Unsere Erfahrungen mit der Infektionsprophylaxe und -therapie nach 53 Lebertransplantationen

Summary An attempt was made to reduce the risk of infection following liver transplantation by means of selective bowel decontamination with tobramycin, polymyxin E and amphotericin B, as well as short-term systemic antibiotics with cephotaxim and tobramycin. After 53 consecutive orthotopec hepatic transplants performed in 51 patients between 1985 and 1987, a total of eight pneumonias occurred as the clinically most significant infection. Two pneumonias were caused by cytomegalovirus, one by Pneumocystis carinii, one by Candida and the remaining four by various bacteria. In 6 patients, bacteria were cultured from the blood, but only in one case was an indwelling catheter identified as the source of the septicemia. Taking all samples together, Streptococcus faecalis was the bacterium most frequently cultured, which was not covered by the prophylactic antimicrobial regime applied. Pseudomonas, however, and gram-negative bacteria were demonstrated much less frequently. Vaginal and oral Candida infections, as well as oral and genital herpes simplex infections, responded well to topical therapy with fungicide and aciclovir, respectively. Three patients developed cytomegalovirus (CMV) hepatitis. All five CMV infections were successfully treated with ganciclovir and hyperimmunoglobulin, as well as reduction of prophylactic immunosuppression. Out of 15 patients transplanted for posthepatitic cirrhosis, 7 developed a recurrence of the infection (5 hepatitis B virus) 2 hepatitis C virus) in the graft. Two died of the cirrhosis, three are still alive with cirrhosis but sufficient graft function, and one patient is suffering from chronic active hepatitis. One patient grafted for acute hepatic failure was able to clear the delta virus within 1 year post-transplant. During the perioperative phase, however, we never lost a single patient to infectious complications. Therefore, bowel decontamination and antibiotic prophylaxis, including Streptococcus faecalis, are recommended.

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Unsere Erfahrungen mit der Infektionsprophylaxe und -therapie nach 53 Lebertransplantationen

Zusammenfassung Durch selektive Darmdekontamination mit Tobramycin, Polymyxin E and Amphotericin B über 8 Tage and kurzzeitige Antibiotikatherapie mit Cefotaxim und Tobramycin wurde versucht, die hohe Infektionsrate nach Lebertransplantation zu reduzieren. Nach 53 konsekutiven orthotopen Leberverpflanzungen bei 51 Patienten zwischen 1985 and 1987 traten als klinisch bedeutsamste Infekte 8 Pneumonien auf. Bei 4 Patienten waren these bakterieller Natur, 2 durch Cytomegalovirus verursacht, 1 durch Pneumocystis carnii and 1 durch Candida. 6 Patienten hatten eine Septikämie, wobei nur in 1 Fall ein Venenkatheter als Ausgangspunkt identifiziert werden konnte. Alle Proben zusammengenommen wurde am häufigsten Streptokokkus faecalis kultiviert, ein Keim, der durch das angewendete antimikrobielle Regime nicht erfaßt wird. Pseudomonaden hingegen und gramnegative Stäbchen wurden in einem wesentlich geringeren Prozentsatz nachgewiesen. Vaginale and orale Candidainfektionen erlangten ebenso wie orale and genitale Herpes simplex-Infektionen kaum Krankheitswert und wurden jeweils topisch mit einem Antimykotikum bzw. Acyclovir behandelt. Neben den 2 CMV-Pneumonien wurden auch 3 durch CMV verursachte Hepatitiden beobachtet. Alle CMV-Infekte konnten mit Gancyclovir und Hyperimmunglobulin bei gleichzeitiger Reduktion der Basisimmunosuppression beherrscht werden. Von 15 Patienten, die wegen posthepatitischer Zirrhose transplantiert wurden waren, entwickelten 7 eine Reinfektion des Transplantates (5 HBV, 2 HCV), wovon 2 an der Zirrhose verstarben, 3 mit einer Zirrhose and noch ausreichender Transplantatfunktion leben, wie auch der Patient, der eine chronisch aktive Hepatitis entwickelt hatte. Eine im akuten Leberversagen transplantierte Patientin hat das Deltavirus innerhalb eines Jahres eliminiert. In der perioperativen Phase wurde jedoch kein einziger Patient an einer infektiösen Komplikation verloren, so da auch bei fehlender Kontrollgruppe die Darmdekontamination sowie die antibiotische Kurzzeitprophylaxe empfohlen werden können.

     

合生元治疗肝硬化腹泻疗效观察

目的　观察合生元治疗肝硬化腹泻的疗效。 方法　74例病人随机分成两组 ,治疗组 37例 ,用合生元 1粒 ,po ,bid ;对照组 37例 ,用黄连素 0 .3g ,po ,tid ,疗程均为 2周。 结果　 治疗组临床有效率为 83.78% ,对照组为 4 3.2 4 % ;两组间有显著性差异 (P <0 .0 1)。 结论　合生元是治疗肝硬化合并腹泻的有效药物。     

整肠生治疗胃癌根治术后腹泻的临床观察

目的：从微生态角度现察胃癌根治术后腹泻临床治疗。方法：治疗组：27例胃癌根治术后腹泻患者用整肠生胶囊，2粒／次、3次／日口服。对照组：27例胃癌根治术后腹泻患者用吡哌酸0．58／次，3次／日口服。治疗前后观察粪便球杆菌比变化。结果：治疗组总有效率93％，以及恢复正常菌群高于对照组，有显著差异。结论：整肠生有效治疗胃癌根治术后腹泻。     

小儿腹泻的营养疗法研究

目的　探讨复方营养合剂对腹泻患儿的辅助治疗效果。方法　采用询问法对 10 2例腹泻患儿进行膳食调查 ,将患儿随机分为 2组 ,对照组予常规治疗 ,治疗组在常规治疗基础上加用复方营养合剂 ,观察两组疗效。结果　在改善患儿体温、体质量、精神状态、大便性状、纠正脱水等方面两组均无显著性差异 ,但治疗组腹泻次数明显减少 ,病程明显缩短 ,与对照组比较有显著性差异 (P <0 .0 5,P <0 .0 1)。结论　复方营养合剂对儿童腹泻有辅助治疗效果     

加替沙星与氧氟沙星治疗感染性疾病临床对比

目的:评价国产加替沙星片治疗急性细菌感染性疾病的有效性和安全性.方法:50例急性细菌感染性疾病患者随机分为治疗组25例,口服加替沙星片200 mg,bid,对照组25例,口服氧氟沙星片200 mg,bid.疗程均7～14 d.结果:治疗组与对照组痊愈率分别为84.0%与80.0%,有效率96.0%与88.0%,细菌清除率100.0%(20/20)与90.5%(19/21),不良反应发生率20.0%与24.0%,两组各项指标比较均差异无显著性(P＞0.05).结论:加替沙星抗菌谱广,抗菌活性强,能安全有效地用于急性细菌感染性疾病的治疗.     

传染性非典型肺炎23例心肌酶学分析

目的描述并分析传染性非典型肺炎的临床表现及心肌酶学改变。方法采集并分析了23例传染性非典型肺炎患者的临床表现及心肌酶学资料,分析死亡组及存活组出现心肌酶升高的比例的差异。结果患者具有肺炎症状体征,还出现心肌酶的升高。CKMB升高的比例存活组为44.4%,死亡组为80.0%,LDH1升高的比例存活组为22.2%,死亡组为80.0%。心肌酶升高的比例死亡组高于存活组,差异具有显著性意义。结论传染性非典型肺炎存在心肌损伤。