恶性肿瘤100例治疗前后真菌带菌情况的调查

恶性肿瘤患者由于广泛采用放疗、化疗、手术、广谱抗生素、皮质类固醇、免疫抑制剂治疗和身体衰竭而使全身免疫功能严重下降，极易引起真菌感染，一部分患者死于真菌感染。笔者自2002年4～11月对100例恶性肿瘤患者治疗前后真菌带菌情况进行了调查，现将调查结果报告如下。     

中药复方合剂在试管内抑制真菌情况的观察报告

<正> 关于复方中草药合剂在试管内抑制真菌的研究,除了曹松年(中华医学杂志1962;12:781)曾有报道外,至今尚未有类似的报道。鉴于祖国医学多用复方治疗疾病的特     

激素局封预防老年人带状疱疹后神经痛的疗效观察

带状疱疹愈后易遗留疱疹后神经痛 (Ｐｏｓｔｈｅｒｐｓｎｅｕｒａｌｇｉｎ ,ＰＨＮ) ,尤其在老年人 ,带状疱疹的发病率和疱疹后神经痛的发生率都较高。为了评价皮质类固醇预防老年人ＰＨＮ的效果 ,我们对老年人带状疱疹患者进行了常规治疗和加用激素局封治疗预防ＰＨＮ ,并进行了疗效观察。1　病例与方法1 1　病例选择　 6 0岁及以上有典型的带状疱疹表现及神经痛 ,在出现疱疹 3天以内就诊并能按本方案进行治疗者为入选病例 ,如患有严重高血压 ,活动性消化道溃疡 ,糖尿病的患者为排除病例 ,由于各种原因中断治疗为淘汰病例 ,不计算在内。1 2…     

波氏假性霉样真菌的光镜、电镜观察

应用马铃薯等三种低或无葡萄糖培养基培养波氏假性霉样真菌易诱生子囊果,辅以扫描、透射电镜术,清晰地显示子囊果形成和形态,有助于本菌的诊断和鉴别诊断。透射电镜下,成熟的子囊果壳由退行性变菌丝组成,不成熟者营养性菌丝层层环绕产囊丝,其多具双核,细胞器丰富,特别富含多聚核糖体、β糖原、蜂窝状小体、柱状膜片和分泌性小泡。它们与细胞分化、胞壁形成、质膜和核膜的构建密切相关。在子囊形成时,这种特殊结构逐渐减少和消失,并见大量球形颗粒和空泡,后者可能与子囊胞质胞裂、孢子形成有关。     

复方甘草甜素、他克莫司及雅漾等治疗面部激素依赖性皮炎40例疗效观察

目的观察序贯使用复方甘草甜素、他克莫司软膏、雅漾修护保湿霜配合雅漾活泉水冷喷治疗面部激素依赖性皮炎短期和长期疗效。方法将82例患者随机分为两组。对照组予复方甘草甜素注射液40mL静滴,1次/d,共2周;停用后外用0.03%他克莫司软膏继续治疗2周。治疗组在对照组基础上早晚使用雅漾活泉水冷喷。4周药物治疗后治疗组早晚使用雅漾活泉水冷喷基础上外涂雅漾修护保湿霜,对照组早晚使用维E霜,继续观察20周。对比两组患者短期和长期疗效。结果治疗2周后,治疗组红斑明显减轻28例(70.0%),水肿明显减轻30例(75.0%),瘙痒明显改善29例(72.5%);对照组分别为19例(46.3%),21例(51.2%)和19例(46.3%)。两组比较差异均有统计学意义(P<0.05)。治疗8周内治疗组和对照组疗效差异无统计学意义(P>0.05),12周、24周时,治疗组疗效均优于对照组(P<0.05,P<0.01)。结论序贯使用复方甘草甜素、他克莫司软膏、雅漾修护保湿霜配合雅漾活泉水冷喷治疗面部激素依赖性皮炎能够很快改善患者对激素的戒断反应,短时间达到很好的治疗效果,同时提高患者皮肤的长期稳定性。     

8例瘤型麻风达临床治愈后骨髓、淋巴结穿刺查菌的观察报告

虽然在人麻风病中,麻风杆菌首先侵犯皮肤和周围神经,但麻风杆菌几乎可在人体的每个系统中,尤其是网状内皮系统中被查到,中、晚期瘤型麻风常侵犯骨髓,在骨膜发生麻风性结节和浸润,在骨骺端骨髓和哈佛氏管等处有麻风瘤形成,在骨髓部呈粟粒样结节及豌豆大结节。大部份瘤型麻风患者骨髓中可查见麻风杆菌,但其中只有少数有     

用杀疥螨药后疥疮结节隧道的镜检观察(摘要)

<正> 本文观察了用杀疥螨药7～14天后,阴囊部疥疮结节上不同形态的隧道镜检的不同情况。一、一般资料共检查了60例男性阴囊部结节型疥疮患者。年龄12～68岁,病程6～150天,结节多数为黄豆大,少数为绿豆或豌豆大。患者检查前均未用过杀疥螨药物,也无感染。二、检查方法先找到结节上的隧道,在良好的光     

维A酸类药的临床应用、不良反应及对策

维A酸类药(retinoic acid，RA)是一组化合物的总称，包括了与维生素A作用相似的所有天然和人工合成的化合物。维生素A的广义概念也不是特指某一特定的化合物．而包含了正常生理情况下存在于人体中的一类生物化合物。RA分为三代——非芳香类、单芳香类、多芳香类。第一代为天然存在的RA，包括视黄醇(retinol)、视黄醛(retinal)、全反式维A酸(all-trans-retinoic acid，atRA，亦称维A酸即tretinoin)、9-顺-维A酸(9-cis-retinoic acid)、13-顺-维A酸(13-cis—retinoic acid．亦称异维A骏即isotretinoin)、维胺酯(viaminate)等。     

维A酸类药的临床应用、不良反应及对策

(接上期第486页)三、药物水平的监测在系统用RA时,每隔4周要对药物导致的皮肤、黏膜的副作用和患者的依从性进行评价。血沉、ALT、AST、γ-谷氨酰转移酶、血浆尿素氮、血肌酐、血脂水平每隔4~8周检查1次。如果上述各指标水平升高,则减少RA的剂量至原剂量的50%或停用此药。血脂升高常发生于年龄较大、尤其易发生于有遗传趋向或具有危险因素的患者中,这些危险因素包括:糖尿病、高血压、酗酒、吸烟、肥胖、口服避孕药和皮质类固醇。在采用RA治疗的起始阶段(2~3个月),每隔2周需监测血脂和胆固醇水平(进食后12h采血),以后每隔8周监测1次即可。为了减少高脂血症的发生率,有必要给患者指定合适的饮食计划。     

维A酸类药的临床应用、不良反应及对策

致畸是RA最严重的不良反应,摄入10000IU/d或低于此量的维生素A(视黄醇酯或视黄醇)是安全的。系统运用RA的安全阈值尚未确定,因此妊娠妇女中无使用该药物的最小安全量,停药后需避孕的时间在不同类型RA也不相同。     

The efficacy of low-dose oral corticosteroids in the treatment of vitiligo patients

BACKGROUND: One of the most probable pathogeneses of vitiligo is autoimmunity. Systemic corticosteroids suppress immunity and may arrest the progression of vitiligo and lead to repigmentation. The clinical efficacy of low-dose oral corticosteroids was assessed to minimize the side-effects in actively spreading vitiligo patients. METHODS: Eighty-one patients with vitiligo were evaluated. The patients took daily doses of oral prednisolone (0.3 mg/kg body weight) initially for 2 months; the dosage was then reduced to half of the initial dose for the third month and was halved again for the fourth and final month. The effects of treatment were evaluated using photographs of before and after the study. Side-effects were assessed at the first, second, third and fourth month of treatment. RESULTS: Arrested progression of vitiligo and repigmentation were noted in 87.7% and 70.4% of patients respectively. Male sex, a patient age of 15 years or under, and a duration of disease of 2 years or less showed increased repigmentation with statistical significance. The side-effects of treatment were minimal and did not affect the course of treatment. CONCLUSIONS: Low-dose oral corticosteroids are effective without serious side-effects in preventing the progression and inducing repigmentation of actively spreading vitiligo, which is difficult to treat with topical corticosteroids or photochemotherapy.     

Enoxacin as one day oral treatment of men with anal or pharyngeal gonorrhoea.

The efficacy of two regimens of oral enoxacin (400 mg as a single dose or two 200 mg doses 12 hours apart) to treat anal and pharyngeal gonorrhoea was compared. Fifty men with confirmed gonorrhoea (40 with anal, six with pharyngeal, and four with both) were treated and assessed three to five and seven to 14 days after treatment. Of 44 evaluable patients who attended the first follow up, including those who were infected with penicillinase producing Neisseria gonorrhoeae (PPNG), all were cured. No haematological or biochemical abnormality associated with enoxacin was observed. Nine patients reported minor adverse effects during the trial period, only one of which was considered probably related to the treatment. Both regimens of 400 mg enoxacin were effective in treating anal and pharyngeal gonorrhoea.     

Modulation of epidermal terminal differentiation in patients after long-term topical corticosteroids.

The expression of the various markers for terminal epidermal differentiation in atrophic skin of patients after long-term topical corticosteroids (TCS) was studied by electron microscopy, immunofluorescence using antibody to profilaggrin/filaggrin (PF/FG), immunoperoxidase staining using antibody to involucrin, and oil red O stain for neural lipids of the stratum corneum. Thirty-nine patients were subdivided into two groups: (A) 19 patients suffering from rebound phenomenon after stopping TCS and (B) 20 patients without rebound phenomenon. Biopsy specimens were taken before ending the use of TCS in both groups. In group A, both the morphological markers (including the different epidermal strata, keratohyalin granules, lamellar granules, and cornified cell envelopes) and the molecular markers (including involucrin, PF/FG, and neutral lipids) of terminal epidermal differentiation were significantly suppressed. On the other hand, the differentiational markers in the atrophic skin of patients without rebound phenomena were only slightly altered. These results suggest that potent TCS not only has antiproliferative actions but also inhibits the differentiation of epidermis, resulting in structural defects in the epidermis, especially the stratum corneum.     

The efficacy of low-dose oral corticosteroids in the treatment of vitiligo patient

Autoimmunity is one of the most probable pathogenesis of vitiligo. Systemic corticosteroids may arrest the progression of vitiligo and lead to repigmentation by suppressing immunity. The clinical efficacy of low-dose oral corticosteroids was assessed to minimize the side-effects in actively spreading vitiligo patients. One hundred (100) patients with vitiligo were evaluated. The patients took daily doses of oral prednisolone (0.3 mg/kg body weight) initially as a single oral dose after breakfast for the first 2 months. The dosage was then reduced to half the initial dose during the 3rd month and was halved again for the 4th and final month. After 4 months of treatment, 76% showed repigmentation while the arrest of progression (both repigmentation and stationary) was noted in 90% of patients. Male sex, and patients under 15 years of age showed pronounced repigmentation with statistical significance. According to this study low-dose oral prednisolone is an effective method in preventing progression and inducing repigmentation of fast-spreading vitiligo without the associated serious side-effects.     

Effect of simultaneous oral and vaginal treatment on the rate of cure and relapse in vaginal candidosis.

One hundred patients with vulvovaginal candidosis were entered in a double-blind trial to compare the effect of six days' local treatment with clotrimazole with that of the same treatment plus 10 days' oral treatment with nystatin. No significant differences were detected in the rate of cure or relapse between the treatment groups. The cure rate was lowest and the relapse rate highest in patients in whom vaginal candidosis had last been diagnosed during the preceding 12 months.     

Effect of simultaneous oral and vaginal treatment on the rate of cure and relapse in vaginal candidosis.

One hundred patients with vulvovaginal candidosis were entered in a double-blind trial to compare the effect of six days' local treatment with clotrimazole with that of the same treatment plus 10 days' oral treatment with nystatin. No significant differences were detected in the rate of cure or relapse between the treatment groups. The cure rate was lowest and the relapse rate highest in patients in whom vaginal candidosis had last been diagnosed during the preceding 12 months.     

The outcome of single-dose cefuroxime treatment in patients with pharyngeal gonorrhea

This study of single-dose cefuroxime treatment of pharyngeal gonorrhea included 13 patients from whose throat specimens taken on the day of treatment Neisseria gonorrhoeae was isolated and who returned for follow-up examinations one and two weeks later. The regimen used was cefuroxime (1.5 g im) plus probenecid (1 g orally). The treatment failed in six patients (46%). Failure of treatment was not associated with decreased in vitro susceptibility of the infecting strain to cefuroxime. In pharyngeal gonorrhea the diagnosis by culture and effective control of treatment require repeated sampling for bacteriologic examinations.     

Reduced anxiety and depression in cystic acne patients after successful treatment with oral isotretinoin

We evaluated the psychiatric morbidity and mood characteristics of a group (n = 72) of patients with cystic acne before and after treatment with one of three dosage schedules of isotretinoin. Although no excess psychiatric morbidity was observed, substantial evidence of psychologic distress was noted before treatment. Significant reductions in anxiety were observed on several measures of anxiety after treatment, with mitigation of anxiety and depression most robust in those patients with the greatest dermatologic improvement with isotretinoin.