酪酸梭菌活菌片在电切肠息肉围手术期中的应用

[目的]观察酪酸梭菌活菌片在电切肠息肉围手术期中的应用效果。[方法]选择肠息肉择期手术患者61例,按随机数字表随机分为对照组(30例)和观察组(31例)。2组患者均给予围手术期的常规治疗,观察组在此基础上于手术前2d给予酪酸梭菌活菌片口服(与抗菌药同时应用时,先用抗菌药,2h后再服用酪酸梭菌活菌片),3片/次,3次/d,服用至手术后第7天。观察2组患者手术后肠黏膜修复、伤口愈合及术后出血等情况。[结果]术后出血率:观察组(9.7%)明显低于对照组(33.3%),2组比较差异有统计学意义(P0.05);肠黏膜修复率:观察组(96.8%)明显高于对照组(66.7%),2组比较差异亦有统计学意义(P0.05)。[结论]酪酸梭菌活菌片可以加速肠黏膜修复,促进手术后创面愈合及预防术后出血,疗效显著,值得临床推广使用。     

二联活菌联合蒙脱石散剂与葡萄糖酸锌片治疗婴幼儿轮状病毒性肠炎的疗效分析

目的观察枯草杆菌肠球菌二联活菌联合蒙脱石散剂与葡萄糖酸锌片联合治疗婴幼儿轮状病毒性肠炎的疗效。方法 110例轮状病毒性肠炎患儿按随机双盲法分为治疗组和对照组。治疗组给予蒙脱石散剂、枯草杆菌肠球菌二联活菌多维颗粒剂、葡萄糖酸锌片联合应用。对照组单独应用蒙脱石散剂或枯草杆菌肠球菌二联活菌多维颗粒剂或葡萄糖酸锌口服液。两组患儿均不用抗生素、止泻收敛药,均给予口服补液盐或静脉补液纠正脱水及酸中毒。结果治疗组与对照组平均治愈时间比较,治疗组时间短;治疗组与对照组复发率比较,复发率低于对照组;治疗组疗效优于对照组。结论蒙脱石散剂、枯草杆菌肠球菌二联活菌多维颗粒剂、葡萄糖酸锌片联合治疗婴幼儿轮状病毒性肠炎较快缓解病情,缩短疗程。     

消旋卡多曲和酪酸梭菌二联活菌散在急性轮状病毒腹泻中的疗效和安全性

目的探究消旋卡多曲和酪酸梭菌二联活菌散在急性轮状病毒腹泻中的疗效和安全性。 方法选取新疆维吾尔自治区人民医院2017年6月至2018年6月诊断及就诊的急性轮状病毒腹泻患儿100例,使用随机数表法分为对照组(50例)和观察组(50例),对照组予以抗病毒、补液及纠正酸碱平衡等常规治疗,观察组在此基础上予以消旋卡多曲和酪酸梭菌二联活菌散治疗。比较两组治疗疗效、治疗后症状改变情况、治疗前后肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、白细胞介素6(interleukin 6,IL-6)及内毒素水平及治疗期间不良反应发生情况。 结果观察组治疗总有效率显著高于对照组(98%比78%;χ²＝5.892,P＝0.014)。观察组腹泻时间、住院时间、发热时间、呕吐时间显著小于对照组(t＝13.875、12.438、7.348、9.382;P＝0.000、0.007、0.012、0.008),同时需静脉补液治疗及治疗7 d后仍腹泻的人数显著少于对照组(t＝5.005、5.982;P＝0.025、0.014)。治疗后观察组外周血中TNF-α、IL-6及内毒素显著小于对照组(t＝5.619、7.838、4.169;P＝0.000、0.000、0.001)。观察组治疗不良反应发生发生率显著小于对照组(18.00%比4.00%;χ²＝5.005,P＝0.025)。 结论消旋卡多曲联合酪酸梭菌二联活菌散治疗急性轮状病毒腹泻的疗效显著,能有效改善症状及炎症水平,且具有较好安全性。     

蒙脱石散联合双歧杆菌四联活菌片对儿童腹泻肠黏膜5-HT和血浆NPY、VIP的影响

目的研究蒙脱石散联合双歧杆菌四联活菌片对儿童腹泻肠黏膜5-羟色胺(5-HT)和血浆神经肽Y(NPY)血管活性肽(VIP)的影响。方法选择西安济仁医院进行诊治的腹泻患儿80例,随机分为两组,对照组予以口服蒙脱石散治疗,观察组予以蒙脱石散联合双歧杆菌四联活菌片治疗,观察两组的临床症状和疗效,并检测肠黏膜5-HT和血浆NPY、VIP水平。结果观察组的有效率为90.0%,明显高于对照组的72.5%(P0.05);观察组的腹泻次数正常时间、大便性状变稠时间、腹痛停止时间、腹泻停止时间、大便细菌培养恢复正常时间和大便镜检正常时间均明显短于对照组(P0.05);治疗3 d后,两组肠黏膜5-HT和血浆VIP水平明显降低(P0.05),血浆NPY明显升高(P0.05),而观察组的改善程度明显优于对照组(P0.05)。结论蒙脱石散联合双歧杆菌四联活菌片能明显降低腹泻患儿肠黏膜5-HT和血浆VIP水平,促进血浆NPY的生成,改善临床症状,缩短治疗时间,提高治疗效果,值得应用推广。     

双歧杆菌三联活菌肠溶胶囊治疗小儿腹泻的疗效观察

目的观察双歧杆菌三联活菌肠溶胶囊治疗小儿腹泻的疗效。方法将102例腹泻患儿随机分为两组,每组51例。对照组给予蒙脱石散治疗,观察组给予蒙脱石散联合双歧杆菌三联活菌肠溶胶囊治疗,对比两组患儿治疗效果、临床症状改善时间、住院时间、住院费用等。结果观察组治疗总有效率为94.1%,明显高于对照组的74.5%,差异显著(P0.05);观察组临床症状改善时间、住院时间、住院费用均低于对照组,差异显著(P0.05)。结论双歧杆菌三联活菌肠溶胶囊治疗小儿腹泻疗效显著,能有效改善患儿临床症状,缩短治疗时间,增强患儿抵抗能力,促进病情恢复。     

酪酸梭菌、婴儿型双歧杆菌二联活菌制剂治疗儿科最常见3种不同类型腹泻的疗效观察

[目的]探究酪酸梭菌、婴儿型双歧杆菌二联活菌制剂治疗儿科3种不同类型腹泻（小儿生理性、喂养不当、乳糖不耐受所致）的疗效观察.[方法]选取40例腹泻患儿,按照治疗方式的不同将其分为对照组和试验组,每组20例.对照组采用常规治疗方式,试验组在对照组治疗的基础上给予酪酸梭菌、婴儿型双歧杆菌二联活菌制剂.观察并比较2组患儿3种不同类型腹泻的临床疗效.[结果]经治疗后,试验组的总有效率（95.00％）明显高于对照组的总有效率（70.00％）、试验组的不良反应率（5.00％）明显低于对照组的不良反应率（30.00％）,差异均有统计学意义（P＜0.05）.[结论]运用酪酸梭菌、婴儿型双歧杆菌二联活菌制剂治疗最常见3种不同类型腹泻患儿,临床疗效明显好于常规治疗方式,值得临床推广应用.     

口服锌制剂辅治急性婴幼儿腹泻20例疗效观察

目的观察补锌对急性婴幼儿腹泻的辅助治疗效果。方法将40名急性腹泻患儿分为两组,两组患儿均给予蒙脱石散剂、乳杆菌三连活菌片、思密达或金双歧进行常规治疗,然后服用氧氟沙星胶囊,观察组口服锌制剂,1周后比较两组疗效及止泻时间。结果观察组疗效优于对照组(P<0.05);观察组腹泻症状持续时间短于对照组(P<0.05)。结论急性腹泻婴幼儿口服锌制剂能够减轻腹泻症状,并改善胃肠道环境。     

枯草杆菌、肠球菌二连活菌多维颗粒联合蒙脱石散治疗小儿抗生素相关性腹泻的临床疗效分析

目的分析枯草杆菌、肠球菌二连活菌多维颗粒联合蒙脱石散治疗小儿抗生素相关性腹泻的效果。方法选择我院2010年2月—2012年12月收治的52例小儿抗生素相关性腹泻患儿,将其随机分成试验组和对照组,各26例。试验组患儿在一般治疗的基础上,口服枯草杆菌、肠球菌二联活菌多维颗粒和蒙脱石散;对照组患儿在一般治疗的基础上服用蒙脱石散。对两组患儿的治疗效果进行比较和分析。结果试验组治疗总有效率为92.3%,高于对照组的69.2%,差异有统计学意义(P<0.05)。结论采用枯草杆菌、肠球菌二联活菌多维颗粒联合蒙脱石散治疗小儿抗生素相关性腹泻,具有非常好的效果,值得在临床上推广和应用。     

蒙脱石散联合双歧三联活菌胶囊对小儿腹泻的疗效观察及机理探讨

目的探讨蒙脱石散联合双歧三联活菌胶囊治疗小儿腹泻的疗效及对VIP、NPY及5-HT的影响。方法本研究选取90例腹泻患儿,对照组(43例)给予蒙脱石散治疗,观察组(47例)采用蒙脱石散联合双歧三联活菌胶囊治疗。观察治疗后72 h内的疗效、腹泻症状消退时间、及对血浆中血管活性肠肽(vasoactive intestinal peptide,VIP),神经肽Y(neuropeptide Y,NPY)及肠黏膜5-羟色胺(5-hydroxytryptamine,5-HT)水平的影响以及探讨其疗效机理。结果治疗后72 h,观察组治疗有效率明显高于对照组(P0.05);治疗后,观察组患儿腹泻症状消退时间总体上要明显短于对照组,与治疗前相比,治疗后观察组和对照组的VIP、5-HT水平均明显降低,NPY水平明显增高(P0.05),且观察组治疗后VIP、5-HT水平明显低于对照组,NPY水平明显高于对照组(P0.05)。结论综上所述,双歧杆菌三联活菌胶囊与蒙脱石散联用能迅速、有效改善小儿腹泻症状,有效调控VIP、NYP、5-HT的分泌和释放,减少胃肠道蠕动,减轻肠道炎症反应,从而改善腹泻症状,值得临床推广使用。     

谷氨酰胺联合益生菌对肝硬化肠黏膜屏障和肝功能的影响

背景:肝硬化患者易并发自发性腹膜炎、肝性脑病、感染性休克等并发症,与肠黏膜屏障功能受损、肠道菌群紊乱密切相关。目的:探讨谷氨酰胺(Gln)联合益生菌对肝硬化患者肠黏膜屏障和肝功能的影响。方法:选取2011年4~12月安徽省蚌埠医学院第一附属医院收治的肝硬化患者80例,随机分为Gln组、益生菌组、联合组、对照组,各组给予相同的常规保肝、利尿治疗,Gln组、益生菌组、联合组在常规治疗的基础上给予相应药物。Gln组:复方Gln肠溶胶囊400 mg tid,疗程14 d;益生菌组:酪酸梭菌二联活菌散1 500 mg tid,疗程14 d;联合组:复方Gln肠溶胶囊400 mg tid+酪酸梭菌二联活菌散1 500 mg tid,疗程14 d。试验第1、14 d采用Child-Pugh分级标准评估肝功能;以活性比色法定量检测血清二胺氧化酶(DAO)水平;以显色基质鲎试剂检测血清内毒素水平;以改良的酶学分光光度法检测血清D-乳酸水平;以全自动生化仪检测血清AST、ALT水平。结果:治疗14 d后,Gln组、益生菌组、联合组的血清DAO、内毒素、D-乳酸水平均较治疗前显著下降(P0.05),Gln组、益生菌组、联合组的血清内毒素、D-乳酸水平均较对照组显著下降(P0.05),且联合组又明显低于Gln组和益生菌组(P0.05)。治疗14 d后,联合组的Child-Pugh评分较治疗前显著下降(P0.01);联合组的Child-Pugh评分、血清AST、ALT水平均较其余三组显著下降(P0.05)。结论:Gln与益生菌联合应用可有效改善肝硬化患者的肠黏膜屏障功能和肝功能。     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.