嗜乳酸杆菌联合兰索拉唑阿莫西林克拉霉素治疗顽固性幽门螺杆菌感染的临床研究

目的探讨嗜乳酸杆菌制剂(乐托尔)联合兰索拉唑阿莫西林克拉霉素三联疗法对幽门螺杆菌(Helicobacter pylori,Hp)顽固性感染的治疗效果。方法将80例Hp顽固性感染患者分为两组,分别采用兰索拉唑三联疗法、乐托尔联合兰索拉唑三联疗法治疗10天。结果两组患者治疗10天后,兰索拉唑三联组和乐托尔联合兰索拉唑三联组Hp清除率分别为94.8%和97.56%,两组间无明显统计学差异;然而,兰索拉唑三联治疗组中,13例患者出现不同程度的不良反应,明显高于乐托尔联合兰索拉唑三联组(4例)(P<0.05)。结论乐托尔联合兰索拉唑三联治疗方案治疗不仅具有良好的Hp清除效果,而且不良反应少,因此,为顽固性Hp感染患者的治疗提供了新的思路。     

瑞士乳杆菌发酵乳对去卵巢大鼠骨密度和骨强度的影响

<正>瑞士乳杆菌发酵乳较普通酸乳能更好提高血清钙的含量[1],本研究探讨长期食用瑞士乳杆菌发酵乳对去卵巢大鼠的骨密度、骨矿物质及骨强度影响。     

Fine-needle aspiration cytology in lesions related to ornamental body procedures (skin tattooing,intraoral piercing) and recreational use of drugs (intranasal route)

Body adornment through tattooing and body piercing and the use of recreational drugs are on the increase, producing a variety of secondary lesions, the etiology of which often remains undetected, as the medical community is not yet aware of the extent of the morbidity of such procedures and practices. Three cases are presented, which underscore the problem and also the role that fine-needle aspiration (FNA) can play in clarifying the etiology of such lesions. Two of these cases were lymphadenopathies, one secondary to tattooing and the other to tongue piercing, while the third was a deep intranasal lesion, which in all probability had resulted from intranasal use of recreational drugs. Although the clinical diagnosis of these lesions was problematic, the FNA performed by a pathologist, by associating the cytologic findings with the corresponding clinical setting, was quite indicative of their relation to the aforementioned procedures or practices.     

Probiotic effects on faecal inflammatory markers and on faecal IgA in food allergic atopic eczema/dermatitis syndrome infants

Probiotic bacteria are proposed to alleviate intestinal inflammation in infants with atopic eczema/dermatitis syndrome (AEDS) and food allergy. In such infants we investigated effects of probiotic bacteria on faecal IgA, and on the intestinal inflammation markers tumour necrosis factor-alpha (TNF-alpha), alpha1-antitrypsin (AT), and eosinophil cationic protein (ECP). A total of 230 infants with AEDS and suspected cow's milk allergy (CMA) received in a randomized double-blinded manner, concomitant with elimination diet, Lactobacillus GG (LGG), a mixture of four probiotic strains (MIX), or placebo for 4 wk. Four weeks after treatment, CMA was diagnosed with a double-blind placebo-controlled milk challenge. Faecal samples of 102 infants, randomly chosen for analysis, were collected before treatment, after 4-wk treatment, and on the first day of milk challenge. After treatment, IgA levels tended to be higher in probiotic groups than in the placebo group (LGG vs. placebo, p=0.064; MIX vs. placebo, p=0.064), and AT decreased in the LGG group, but not in other treatment groups. After challenge in IgE-associated CMA infants, faecal IgA was higher for LGG than for placebo (p=0.014), and TNF-alpha was lower for LGG than for placebo, but non-significantly (p=0.111). In conclusion, 4-wk treatment with LGG may alleviate intestinal inflammation in infants with AEDS and CMA.     

Probiotika in der Prävention und Behandlung der akuten Gastroenteritis bei Kindern

Probiotics are live microbial food supplements (bacteria, yeast) with a beneficial effect on health. They have been studied mainly for the prevention and treatment of acute infectious diarrhea in children. In recent years there have been preliminary reports that probiotic bacteria may also play a role in the prevention and treatment of inflammatory bowel diseases as well as allergic conditions. Most randomized controlled clinical studies as well as a recently published meta-analysis and a systematic review confirm a modest but significant effect of probiotics, in particular of Lactobacillus GG, in the treatment of acute infectious diarrhea in children. However, it is premature to give practical recommendations for the use of probiotics for several reasons such as limited numbers of controlled studies as well as heterogeneity concerning study design und probiotic strains.     

Administration of yoghurt or lactobacillus casei to malnourished mice: Comparative effect on lymphoid cells and mucosal reconditioning of the intestine

The comparative effect of the administration of viable Lactobacillus casei and yoghurt on mucosal immunity, body weight and the recovery of intestinal microvilli was studied in malnourished mice. L. casei and yoghurt induced an increase in the number of cells producing IgA and IgM, yoghurt being more effective than L. casei. In both treatments, the number of CD4⁺ or CD8⁺ T‐lymphocytes did not reach the levels found in well‐nourished mice. However, yoghurt administration induced a slight increase in the number of CD8⁺cells and a significant increase in CD4⁺ helper T‐cells, compared with the malnourished control. Yoghurt was more effective than L. casei in improving the condition of intestinal microvilli and in the stimulation of mucus production. Yoghurt administration also induced an increase in body weight and avoided bacterial translocation of the normal intestinal microflora.     

A rare case of Lactobacillus acidophilus presenting as mitral valve bacterial endocarditis

Lactobacillus acidophilus is a gram-positive rod that is a commensal of human mucosal tissues. They are usually considered nonpathogenic flora of the mouth, gut, and female genital tract. Lactobacillus is a rare cause of endocarditis with less than 50 cases reported in the world literature to date. We report the case of a 63-year-old woman who developed native mitral valve endocarditis secondary to L. acidophilus, and examine the literature regarding this rare entity.     

No effect of oral treatment with an intestinal bacterial strain, Lactobacillus rhamnosus (ATCC 53103), on birch-pollen allergy: a placebo-controlled double-blind study

BACKGROUND: Oral probiotic bacteriotherapy with Lactobacillus rhamnosus has given promising results in small children with food allergy. We studied the effects of similar therapy in teenagers and young adults, who were allergic to birch pollen and apple food and had intermittent symptoms of atopic allergy and/or mild asthma. METHODS: We conducted a double-blind, placebo-controlled study, in which respiratory and eye symptoms and use of medications in two groups were compared. Open oral challenge tests with a slice of apple were performed trice: before, during and after the birch-pollen season. There were 18 patients in each group. They used Lactobacillus rhamnosus for 5.5 months; 2.5 months before the pollen season, 1 month during the season (May), and 2 months after. RESULTS: The results were negative. The treatment did not alleviate the symptoms of the patients or reduce their use of medication during the birch-pollen season or the subsequent 2 months. The treatment did not significantly affect the symptoms caused by apple in the oral challenge tests. CONCLUSIONS: We found no indication of a beneficial treatment effect in our patients. As the number of patients was relatively small, conclusions should be drawn with caution.     

Effect of spermicides on Lactobacillus acidophilus in vitro-nonoxynol-9 vs. Sapindus saponins

Saponins extracted from the fruit pericarp of Sapindus mukorosii were tested for their bactericidal/bacteriostatic property against Lactobacillus acidophilus. Nonoxynol-9 was used as a reference compound for the comparison of activity. Lactobacillus colonies were grown on specific medium (Rogosa SL agar) containing different concentrations of saponins and nonoxynol-9 in an atmosphere of 5% CO2/95% air at 37 degrees C for 72 h. The number and size of colonies were recorded at the end of the experiment and compared with controls. Results indicated that nearly 90% of Lactobacillus colonies with minor reduction in size thrived at 0.05% concentration of saponins whereas only 18% of colonies with approximately 75% reduction in size grew in dishes containing 0.05% nonoxynol-9. At higher concentrations of saponins, there was a gradual, dose-dependent reduction in the number and size of colonies and at 2.5% concentration there was an approximately 55% reduction in the number and 60% reduction in the size of surviving colonies. No lactobacillus colonies, however, grew in dishes containing 0.1% and higher concentrations of nonoxynol-9. The studies indicate that Sapindus saponins as compared to nonoxynol-9 are far less toxic to lactobacillus species and therefore saponins containing spermicidal preparations are likely to be more vaginal-friendly than equivalent nonoxynol-9 preparations.     

Non-Viable Lactobacillus reuteri DSMZ 17648 (Pylopass?) as a New Approach to Helicobacter pylori Control in Humans

Prevalence of infections by Helicobacter pylori, a pathogen involved in a number of gastrointestinal diseases, remains high in developing countries. Management of infections by eradication is not always an option. Lactobacillus reuteri (L. reuteri) DSMZ17648 (Pylopass™/Lonza) specifically co-aggregates H. pylori in vitro and was shown to reduce ¹³C urea breath test in vivo. In this pilot study, we tried to replicate previous findings in an independent sample and to evaluate effects of spray-drying vs. freeze-drying of cultures. A single-blinded, placebo-controlled study was done in 22 H. pylori positive, asymptomatic adults. H. pylori levels were determined by ¹³C-urea-breath method after 14 days of supplementation, as well as after 6, 12, and 24 weeks follow-up. In the test group, but not in the placebo group, a significant reduction of H. pylori was observed. For the first time, spray-dried cells of L. reuteri DSMZ17648 have been used in a human study and results are in line with the first study results, supplementing with freeze-dried material. This is of special interest as spray-drying results in dead cell material, meaning that the effect of L. reuteri must be independent of its probiotic activity. These results confirm the potential of Pylopass™ as a novel way to reduce the load of H. pylori.