夏幼周教授治疗黄疸肝炎的经验

夏幼周教授行医50余年,在诊治肝胆病症方面积累了丰富的经验。其治疗黄疸肝炎,重视清热利湿、宣畅三焦、调理肝脾、温通活血法的运用,证之临床,颇有经验,兹介绍如次。 一、湿热黄疸 宣通三焦 病毒性肝炎因湿热蕴结,熏蒸肝胆,肝失疏泄,胆汁外溢,极易形成肝胆湿热证。临床表现有右胁胀痛,胸脘痞闷,腹部胀气,发热口苫,渴欲饮水,纳呆厌油,身目俱黄,小便黄赤,身困乏力,大便粘腻臭秽不爽,或大便干结,舌红苔黄腻,脉弦滑数。治宜清利湿热,利胆退黄。夏老认为仲景有茵陈蒿汤、栀子柏皮汤等方,可     

儿泻暖脐膏抗鼠腹泻的药理研究

为研究中药制剂儿泻暖脐膏抗腹泻机制，对其抗腹泻，胃肠功能、镇痛及抗炎的药理作用进行了实验研究。结果儿泻暖脐膏能显著抑制小白鼠蓖麻油性及番泻叶性腹泻；显著抑制小白鼠小肠推进运动及皮下注射新斯的明的小肠推进运动；显著促进小白鼠胃排空运动；显著增加大白鼠血清D－木糖含量。     

肝泻宁治疗慢性肝病性腹泻41例

慢性肝病性腹泻是指肝脏的实质性病变所引起的慢性腹泻。目前尚缺乏特异性药物治疗。我们用自拟方肝泻宁治疗此类患者,收到较好的疗效,现报道如下。 1 临床资料 1.1 病例选择 选择同期门诊或住院患者71例,随机分成治疗组和对照组。治疗组41例,男29例,女12例;年龄18～65     

儿泻暖脐膏治疗婴幼儿急性腹泻的临床研究

为了观察中药治疗婴幼儿急性腹泻的临床效果，应用儿泻暖脐膏敷脐配合西药常规疗法（简称治疗Ⅰ组）治疗婴幼儿急性腹泻，并与十香暖脐膏敷脐配合西药常规疗法（简称治疗Ⅱ组）及西药常规疗法（简称对照组）对照。结果治疗Ⅰ组102例，治愈61例（59．8％），显效24例（23．5％），有效11例（10．8％），无效6例（5．9％），显效率83．3％，总有效率94．1％；治疗Ⅱ组54例，治愈25例（46．3％），显效15例（27．8％），有效11例（20．4％），无效3例（5．6％），显效率74．1％，总有效率94．4％；对照组55例，治愈22例（40．0％），显效12例（21．8％），有效9例（16．4％），无效12例（21．8％），显效率61．8％，总有效率78．2％。治疗Ⅰ组的治愈率、显效率和总有效率均高于对照组（P＜0．05或P＜0．01）；治疗Ⅱ组总有效率显著高于对照组（P＜0．05）。提示儿泻暖脐膏敷脐配合西药常规疗法能提高临床疗效。     

儿泻暖脐膏治疗婴幼儿急性腹泻的临床研究

为了观察中药治疗婴幼儿急性腹泻的临床效果，应用儿泻暖脐膏敷脐配合西药常规疗法（简称治疗１组）治疗婴幼儿急性腹泻，并与十香暖脐膏敷脐配合西药常规疗法（简称治疗Ⅱ组）及西药常规疗法（简称对照组）对照。结果治疗Ｉ组１０２例，治愈６１例（５９．８％），显效２４例（２３．５％），有效１１例（１０．８％），无效６例（５．９％），显效率８３．３％，总有效率９４．１％；治疗Ⅱ组５４例，治愈２５例（４６．３％），显     

儿泻暖脐膏抗鼠腹泻的药理研究

为研究中药制剂儿泻暖脐膏抗腹泻机制，对其抗腹泻，胃肠功能、镇痛及抗炎的药理作用进行了实验研究。结果儿泻暖脐膏能显著抑制小鼠蓖麻油性及番泻叶性腹泻；显著抑制小白鼠小肠推进运动及皮下注射新斯的明的小肠推进运动；显著促进小白鼠胃排空运动；显著增加大白鼠血清Ｄ－木糖含量。     

中药泻停饮治疗秋季腹泻的初步观察

我国每年5岁以下小儿腹泻病大约2．5亿人次，其中秋季腹泻占相当大的比例，是急性腹泻病中以水泻为其特点，造成水电紊乱，严重影响小儿身体健康的代表性疾病，也是世界上造成小儿死亡的重要原因之一。目前对于急性水泻性腹泻除采用ORS液和静脉补液防治脱水，及使用肠粘膜保护剂之外，尚无十分有效控制水泻的疗法。     

小儿腹泻的肠道菌群变化

小儿腹泻是小儿的常见病、多发病，也是在某些疾病的治疗过程中常伴发的病症之一．病因虽较复杂，但肠道菌群的紊乱是其重要因素．我们对34例腹泻小儿进行了临床和肠道菌群的调查，井与30例正常小儿肠道菌值进行对比分析，其结果报告如下。     

小儿腹泻的护理体会

小儿腹泻是由多种病因引起的以腹泻和水电解质紊乱为主的一组临床综合征，多见于2岁以下的婴儿。我科在多年的工作实践中，逐渐总结出一些护理体会，现报告如下。     

大断下片治疗慢性泄泻172例疗效观察

采用古方大断下片对脾胃虚弱型，胃阳虚衰型，脾虚夹湿型慢性泄泻患者进行厂治疗研究。１７２例中临床治愈１０４例，显效３０例，好转１９例，无数１９例、总治愈率为６０．４７％，有效率为８８．９５％。三型疗效比较Ｐ＞０．０５。     

Clinical Analysis for Long-Term Sporadic Bovine Viral Diarrhea Transmitted by Calves with an Acute Infection of Bovine Viral Diarrhea Virus 2

Bovine viral diarrhea virus (BVDV) is a viral pathogen associated with serious problems in the cattle industry. Cattle persistently infected (PI) with BVDV are mild or asymptomatic; however, they become a source of BVDV transmission to other cattle. Hence, it is important to rapidly identify and remove the PI animals from cattle herds. Whereas cattle acutely infected (AI) with BVDV have various symptoms, yet they generally recover within 3 weeks. However, there is a paucity of information concerning clinical characteristics of AI cattle. Further accumulation of information would be required to accurately diagnose AI cattle with BVDV. Here, we attempted to obtain valuable information via various analyses using a case report of BVD outbreak that occurred for approximately four months in Iwate Prefecture in 2017. Using eight calves and multiple tests (real-time RT-PCR, virus isolation, enzyme-linked immunosorbent assay, and virus neutralization assay) over 6 weeks, we diagnosed the continuous BVD outbreak as an acute infection and not a persistent one. Additionally, we revealed that the sporadic case was caused by low pathogenic BVDV2 via BVDV genotyping and phylogenetic analysis. The data suggest that BVDV2 AI animals might also be a source of transmission to susceptible calves; hence, it might persist for a long period owing to multiple AI animals. These findings provide useful information to diagnose AI and PI cattle with BVDV in the field.     

A Randomized Trial of Yogurt for Prevention of Antibiotic-Associated Diarrhea

Antibiotic-associated diarrhea (AAD) is the most common adverse effect of antibiotic therapy. Our aim was to determine the effectiveness of a dietary supplement of yogurt for prevention of AAD. Two hundred two hospitalized patients receiving oral or intravenous antibiotics were randomized to receive or not receive a dietary yogurt supplement, consisting of 227 grams of commercial yogurt, and followed for 8 days. Mean age of the study group was 70 years and 43% were male. Compliance and 8-day follow-up were 85% and 91%, respectively. Patients receiving yogurt reported less frequent diarrhea (12% vs 24%; P = 0.04), and significantly less total diarrheal days (23 vs 60). The cumulative proportions of patients without diarrhea were significantly different (P = 0.02) between patients receiving and not receiving yogurt. For conclusion, dietary supplementation with yogurt is a simple, effective, and safe treatment that decreases the incidence and duration of AAD.     

Risk Factors for Treatment Failure and Recurrence after Metronidazole Treatment for Clostridium difficile-associated Diarrhea

Background/Aims

The incidence of treatment failure or recurrence of Clostridium difficile-associated diarrhea (CDAD) following metronidazole treatment has increased recently. We studied the treatment failure, recurrence rate, and risk factors predictive of treatment failure and recurrence after metronidazole treatment for CDAD.

Methods

We retrospectively identified consecutive patients who were admitted and treated for CDAD at a single tertiary institution in Korea over a recent 10-year period (i.e., 1998-2008).

Results

Metronidazole was administered as the initial treatment to 111 of 117 patients (94.9%) with CDAD. Fourteen patients (12.6%) had no clinical response to the metronidazole treatment, and in 13 patients (13.4%) CDAD recurred after successful metronidazole treatment. Diabetes mellitus (p=0.014) and sepsis (p=0.002) were independent risk factors for metronidazole treatment failure. Patients who had received surgery within 1 month before CDAD developed were more likely to experience a recurrence after metronidazole treatment (p=0.032). Vancomycin exhibited a higher response rate after treatment failure, and metronidazole showed a reasonable response rate in the treatment of recurrence. Treatment failure and recurrence rates increased with time after metronidazole treatment for CDAD over the 10-year study period.

Conclusions

Our data suggest that diabetes mellitus and sepsis are independent risk factors for metronidazole treatment failure, and that operation history within 1 month of development of CDAD is a predictor of a recurrence after metronidazole treatment.     

Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13–17) than public providers and 12% points more likely to provide other treatments (95% CI 10–15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored.     

Double-Blind Pilot Study of Mesalamine vs. Placebo for Treatment of Chronic Diarrhea and Nonspecific Colitis in Immunocompetent HIV Patients

Chronic diarrhea and colitis are common in patients positive for human immunodeficiency virus (HIV) under highly active antiretroviral treatment (HAART). This prospective double-blind study explores the effect of mesalamine vs. placebo in HIV-positive patients. Thirteen HIV-infected patients with noninfectious chronic diarrhea and > 250 CD4+ cells/mm³ were randomized to mesalamine (2.4 g/day; n = 9) or placebo (n = 4) for 6 weeks. Colonoscopy was performed at baseline and week 6, and biopsies were obtained to calculate the Biopsy Activity Index (BAI). Diarrhea was assessed at baseline and end of treatment using the Disease Activity Index (DAI). Patients and clinicians completed Patient Global Improvement index (PGI) and Clinical Global Improvement index (CGI) at weeks 2 and 6. Comparisons at week 6 were statistically significant between mesalamine and placebo groups for BAI (P = 0.03), DAI (P = 0.007), PGI (P = 0.008), and CGI (P = 0.008). Furthermore, major improvements were documented in the mesalamine group at week 6 compared to baseline for all variables, whereas the placebo group did not have any. Mesalamine was effective for treatment of chronic diarrhea and moderate nonspecific colitis in HIV patients.     

Caring for the Severely Asthmatic Child and Family I. The Rationale for Family Systems Integrated Medical/Psychological Treatment

Comprehensive care for the severely asthmatic child includes psychological as well as medical treatment. Family therapy is a recognized modality of therapy. Investigations have examined the role of emotion and asthma as well as psychosomatic asthma. Pharmacological treatment of β₂-agonist and cromolyn prior to disciplining the child prevents psychosomatic asthma secondary to crying or shouting. Adherence to multiple asthma therapeutic modalities is imperative, and a psychological and medical team can address these important clinical issues in a high-risk population.