Infection of a total knee joint prosthesis by peptostreptococcus micros and propionibacterium acnes in an elderly RA patient: Implant salvage with longterm antibiotics and needle aspiration/irrigation

Summary We describe the favourable long-term outcome after late total knee joint prosthesis infection in an elderly RA patient.Peptostreptococcus micros andPropionibacterium acnes were cultured from the synovial fluid, and the finding of a coexistent abscess at the root of a wisdom tooth suggested a dental origin to the joint infection. Long-term antibiotics in conjunction with aspiration/irrigation resulted in salvage of the implant and an excellent functional outcome.     

玉容消痤颗粒对金黄地鼠性激素水平与皮脂腺斑的影响研究

目的 通过观察玉容消痤颗粒对金黄地鼠皮脂腺斑体积、组织形态和睾酮及雌二醇的影响,探讨其治疗痤疮的机制。方法 健康雄性金黄地鼠60只随机分为6组,各组分别灌胃给蒸馏水/蒸馏水、螺内酯及玉容消痤颗粒低、中、高剂量溶液,连续给药30 d。除空白对照组外,其余5组每4天肌注丙酸睾酮1次,共7次。测量试验前后金黄地鼠皮脂腺斑体积,并检测其血清睾酮、雌二醇的含量;试验结束时取皮脂腺斑组织活检,镜下观察其组织学改变。结果 玉容消痤颗粒中、高剂量组及螺内酯组血清睾酮含量明显降低（P<0.05）,金黄地鼠皮脂斑体积明显缩小（P<0.05）,光镜下金黄地鼠皮脂腺显微结构(皮脂腺重叠叶数、厚度及液化小囊)明显改善。结论 玉容消痤颗粒有明显的抗雄激素作用,部分揭示了其治疗痤疮的机制。     

Pathogen characteristics and its sensitivity against antimicrobial agents in fatal bacterial granuloma after eyelid trauma in vitro

AIM: To understand the pathogen characteristics and its sensitivity against antimicrobial agents in fatal bacterial granuloma after eyelid trauma (FBGT) in vitro, and to provide laboratory evidence for diagnosis. METHODS: The FBGT pathogens were isolaated and cultured with reformed rabbit-brain anaerobic enriched broth (RRAB), and identified by ATB/API 20A system. The minimum inhibiting concentration (MIC) was determined by anaerobic broth dilution method. RESULTS: A total of 22 strains of pathogen were separated from 21 patients with FBGT and identified as Propionibacterium acnes (PA) by ATB/API 20A system. The MIC of ciprofloxacin for 22 PA strains was 0.0625-0.5mg/L, the MIC of penicillin, ampicillin, ampicillin/sulbactam, cefoperazone, lincomycin, and imipenem/cilastatin were 0.125-0.5mg/L, the MIC of ticarcillin/clavulanic acid was 0.250-1.000 mg/L ,and the MIC of metronidazole was 64-256mg/L. The pathogen of FBGT was strictly anaerobic PA, which growed slowly and better in nutritious RRAB broth. All PA were resistant to metronidazole, but susceptive to other routine antimicrobial agents, such as penicillin, ampicillin and lincomycin. CONCLUSSION: FBGT should not be treated with metronidazole. Clinicians should choose combined use of drugs or operation to treat FBGT according to patients’ individual condition and the results of drug sensitivity test.     

中药综合方剂与维胺酯治疗痤疮的对比分析

[目的]研究一种对各型痤疮均有疗效的中药方剂。[方法]使用以龙胆泻肝汤合四物汤加减为主的中药综合方剂对146例各型痤疮患者进行治疗,与维胺酯治疗痤疮患者116例进行对照研究。[结果]治疗组及对照组有效率各为92％、89％,经统计学处理无显著性差异(P>0．05)。[结论]中药综合方剂与维胺酯对痤疮的治疗同样有较好的疗效,副作用相对较低。     

针灸治疗痤疮临床随机对照试验疗效及安全性评价

目的:评价针灸治疗痤疮的临床疗效及安全性,分析目前临床研究的现状.方法:检索PubMed、Cochrane图书馆、CBM数据库、CNKI数据库等收集针灸治疗痤疮的临床随机对照试验,选择符合纳入标准的临床试验,以Cochrane系统评价手册5.0进行质量评价,统计学分析采用RevMan 4.2.8.结果:17篇文献符合纳入标准,共1 613例患者.17项研究采用治愈率为评价指标,Meta分析显示针灸治疗痤疮对照常规西药,组间比较差异有统计学意义[合并RR(随机效应模型)=2.96,95%CI(1.63,4.91),Z=4.08,P＜0.000 1];针灸综合疗法对照针灸单一疗法,组间比较差异有统计学意义[合并RR(固定效应模型)=2.51,95%CI(1.76,3.57),Z=5.11,P＜0.000 01].结论:针灸治疗痤疮安全、有效,对照常规西药可能有一定优势,针灸综合疗法优于单一疗法,但因纳入部分文献质量较低,结论尚不确定;今后应对其不同分级和证型进行高质量研究,进一步验证针灸治疗痤疮的优势性,对针灸不同疗法应进行对比研究,以提高疗效.