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新生儿重症监护病房中早产儿的侵袭性真菌感染(invasive fungal infection,IFI)发生率较高,且早期临床诊断困难,一旦发生,病情重,疗程长,花费高,病死率较高,预后差。因此预防IFI尤为重要。目前临床常选氟康唑作为预防早产儿IFI的一线药物,但具体剂量、疗程尚不统一,使用对象及预防效果也存在争议。该文对近年来新生儿重症监护病房中药物预防早产儿IFI的研究进展进行综述,供临床医生参考。  相似文献   
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目的 揭示乌头内生细菌的菌群组成及其与生物碱含量的相关性。方法 运用高通量测序分析不同产地乌头叶、茎和根组织内生细菌的16S rDNA V4区,基于测序结果进行内生细菌的多样性分析、物种分类、差异及相似性分析。运用高效液相色谱法分析不同产地乌头叶、茎和根组织乌头类生物碱含量,并对乌头各组织的内生细菌相对丰度和生物碱含量之间进行相关性分析。结果 乌头内生细菌主要由4门,9纲,16目,36属组成;不同产地乌头的内生细菌丰度和多样性均存在差异,但核心菌群组成相似,以变形菌门(Proteobacteria)占主导;共发现6种操作分类单元(operational taxonomic units,OTU)与乌头根组织生物碱含量之间存在相关性。结论 不同产地乌头内生细菌组成存在差异但核心菌群相似,部分内生细菌丰度与生物碱含量之间显著相关。  相似文献   
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黄晓云  陈玲 《现代肿瘤医学》2022,(21):3944-3947
目的:探讨初诊急性白血病患者化疗期间应用伏立康唑进行预防侵袭性真菌病(IFD)的临床疗效及安全性。方法:回顾性分析2016年02月至2018年03月期间我院血液科收治的初诊急性白血病行化疗的患者166例,按照是否使用抗真菌药进行预防性治疗分为观察组(应用伏立康唑进行预防治疗,n=103)和对照组(未应用抗真菌药物,n=63),比较两组患者IFD发生率差异,并分析抗真菌药物应用的不良反应。结果:观察组IFD发生率为10.7%,对照组为33.3%,两组患者的IFD发生率有明显差异(P<0.05);所有应用伏立康唑进行预防治疗的患者均未出现严重的不良反应。结论:伏立康唑可以有效减低急性白血病患者化疗期间IFD发生率,并且有着较好的安全性,值得在临床推广应用。  相似文献   
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《Cancer cell》2022,40(2):153-167.e11
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Novel biobased materials from fungal hyphae and cellulose fibers have been proposed to address the increasing demand for natural materials in personal protective equipment (PPE). Materials containing commercially available kraft fibers (KF), laboratory-made highly fibrillated hemp fibers (HF) and fungal fibers (FF) obtained from fruiting bodies of lignicolous basidiomycetes growing in nature were prepared using paper production techniques and evaluated for their mechanical and air permeability properties. SEM and microscopy revealed the network structure of materials. The tensile index of materials was in the range of 8–60 Nm/g and air permeability ranged from 32–23,990 mL/min, depending on the composition of materials. HF was the key component for strength; however, the addition of FF to compositions resulted in higher air permeability. Chemical composition analysis (Fourier-transform infrared spectroscopy) revealed the presence of natural polysaccharides, mainly cellulose and chitin, as well as the appropriate elemental distribution of components C, H and N. Biodegradation potential was proven by a 30-day-long composting in substrate, which resulted in an 8–62% drop in the C/N ratio. Conclusions were drawn about the appropriateness of fungal hyphae for use in papermaking-like technologies together with cellulose fibers. Developed materials can be considered as an alternative to synthetic melt and spun-blown materials for PPE.  相似文献   
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A severe pandemic of Coronavirus Disease (COVID-19) has been sweeping the globe since 2019, and this time, it did not stop, with frequent mutations transforming into virulent strains, for instance, B.1.1.7, B.1.351, and B.1.427. In recent months, a fungal infection, mucormycosis has emerged with more fatal responses and significantly increased mortality rate. To measure the severity and potential alternative approaches against black fungus coinfection in COVID-19 patients, PubMed, Google Scholar, World Health Organization (WHO) newsletters, and other online resources, based on the cases reported and retrospective observational analysis were searched from the years 2015–2021. The studies reporting mucormycosis with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) coinfection and/or demonstrating potential risk factors, such as a history of diabetes mellitus or suppressed immune system were included, and reports published in non-English language were excluded. More than 20 case reports and observational studies on black fungus coinfection in COVID-19 patients were eligible for inclusion. The results indicated that diabetes mellitus, hyperglycemic, and immunocompromised COVID-19 patients with mucormycosis were at a higher risk. We found that it was prudent to assess the potential risk factors and severity of invasive mycosis via standardized diagnostic and clinical settings. Large-scale studies need to be conducted to identify early biomarkers and optimization of diagnostic methods has to be established per population and geographical variation. This will not only help clinicians around the world to detect the coinfection in time but also will prepare them for future outbreaks of other potential pandemics.  相似文献   
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目的 分析应用伏立康唑治疗肝衰竭并发肺部真菌感染患者疗效及其安全性情况。方法 2016年2月~2018年8月我院收治的26例肝衰竭并发肺部真菌感染患者,接受伏立康唑治疗14例,接受伊曲康唑治疗12例,观察12 w。采用ELISA法检测血清白细胞介素(IL)-6和肿瘤坏死因子-α(TNF-α)水平,使用流式细胞仪检测外周血淋巴细胞亚群。结果 在治疗第4 w时,伏立康唑治疗患者血清TBIL水平为(96.2±54.3) μmol/L,显著低于伊曲康唑治疗组[(178.3±89.4) μmol/L,P<0.05];伏立康唑治疗组血清IL-6水平为(11.5±6.7) pg/ml,显著低于伊曲康唑治疗组[(18.5±6.8) pg/ml,P<0.05];所有患者发生真菌感染的时间为(27.21±15.96) d,其中慢加急性/亚急性肝衰竭患者发生真菌感染的时间为(17.8±6.9) d,显著早于慢性肝衰竭患者[(37.2±16.4) d,P<0.05];两组生存患者外周血淋巴细胞亚群和肝肾功能变化无显著性差异(P>0.05);两种抗真菌药物治疗均未引起严重的不良反应;在治疗12 w时,6例(42.9%)伏立康唑治疗患者生存,显著高于伊曲康唑治疗组的3例(25.0%,P<0.05)。结论 应用伏立康唑能更早、更有效地控制肝衰竭并发肺部真菌感染患者的病情,不影响肝肾功能,提高生存率,可能与及时控制感染后降低了血清细胞因子水平有关。  相似文献   
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Breakthrough invasive fungal infections (IFIs) have emerged as a significant problem in patients receiving systemic antifungals; however, consensus criteria for defining breakthrough IFI are missing. This position paper establishes broadly applicable definitions of breakthrough IFI for clinical research. Representatives of the Mycoses Study Group Education and Research Consortium (MSG‐ERC) and the European Confederation of Medical Mycology (ECMM) reviewed the relevant English literature for definitions applied and published through 2018. A draft proposal for definitions was developed and circulated to all members of the two organisations for comment and suggestions. The authors addressed comments received and circulated the updated document for approval. Breakthrough IFI was defined as any IFI occurring during exposure to an antifungal drug, including fungi outside the spectrum of activity of an antifungal. The time of breakthrough IFI was defined as the first attributable clinical sign or symptom, mycological finding or radiological feature. The period defining breakthrough IFI depends on pharmacokinetic properties and extends at least until one dosing interval after drug discontinuation. Persistent IFI describes IFI that is unchanged/stable since treatment initiation with ongoing need for antifungal therapy. It is distinct from refractory IFI, defined as progression of disease and therefore similar to non‐response to treatment. Relapsed IFI occurs after treatment and is caused by the same pathogen at the same site, although dissemination can occur. These proposed definitions are intended to support the design of future clinical trials and epidemiological research in clinical mycology, with the ultimate goal of increasing the comparability of clinical trial results.  相似文献   
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