侵袭性肺部真菌感染68例临床分析

目的 探讨侵袭性肺部真菌感染(IPFI)的临床特征与高危因素及其诊断和治疗。方法 回顾性分析2007年1月至2011年3月我院68例IPFI患者的临床资料。结果 68例患者平均年龄为(53.2±10.6)岁,痰真菌培养中白色念珠菌属占首位(共36株,52.94％),其次是曲霉菌(18株,26.47％)和隐球菌(10株,14.71％),原发性IPH以肺隐球菌为主。严重的基础疾病、长期联合应用抗生素、糖皮质激素应用成为IPFI的主要危险因素。68例IPFI经抗真菌治疗痊愈或好转47例,未愈7例,死亡14例。结论 采取支持疗法,治疗原发疾病、减少侵入性诊疗、合理使用抗菌药物和激素、及时抗真菌治疗等措施,能有效降低IPH的发病率和病死率。     

真菌引起支气管哮喘发展和加重的免疫学机制

支气管哮喘（简称哮喘）是常见的气道慢性炎症性疾病,多种环境因素可引起哮喘恶化加重,其中真菌感染是一个很重要的因素。有很多证据显示哮喘患者存在真菌致敏,且在真菌致敏和哮喘严重度之间存在强的相关性。近年来很多研究主要从真菌对免疫细胞和上皮细胞的影响两个方面阐释了真菌引起哮喘加重的免疫学机制。此免疫学机制的阐明对于探索治疗重症哮喘的新途径有重要的意义。     

真菌变应原疫苗治疗变应性支气管哮喘的临床研究

目的评价真菌疫苗特异性免疫治疗变应性支气管哮喘（简称哮喘）的临床疗效。方法选择60例真菌过敏的轻、中度哮喘患者临床观察一年,治疗组（36例）和对照组（24例）分别皮下注射真菌变应原疫苗和盐酸组胺。观察治疗前后症状评分、用药计分、PD20FEV1、PEF、FEV1pred%等指标。并进行统计分析。结果两组治疗后症状评分均有所下降,但差异无统计学意义;与治疗前比较治疗组补救药物计分下降,PD23FEV1增加,差异有统计学意义（P〈0．01）;两组PEF、FEV1pred％较治疗前差异均无统计学意义。治疗期间未发生一例严重不良反应事件。结论对轻至中度的哮喘患者用真菌变应原疫苗进行特异性免疫治疗有效、安全。     

Fast detection of Candida albicans and/or bacteria in blood plasma by “sample-self-focusing” using capillary electrophoresis-laser-induced fluorescence

Detection of microbial contamination in blood plasma is critical and necessary in different medical and research fields. Most of the current standard procedures for the detection of bacteria and fungi can be time-consuming, for example, direct inoculation methods of microbial cultures in respective growth media can take a few days to several weeks. A fast analysis method with high sensitivity output such as CE-laser-induced florescence becomes an attractive alternative. Previously, a spacer-injection method with the use of zwitterionic surfactant (SB3-10) as a blocking agent to negate the cells’ mobility, induce aggregation and single microbial peak formation in a buffer solution was reported. Here, a fast, simple direct method for microbial detection in blood plasma without using the spacer and blocking agent is reported. To compensate for the natural electrophoretic heterogeneity of microbes, a CTAB additive was used to sweep all microbial cells towards the plasma peak where a single sharp microbial peak is formed and detected. With the use of BacLight™ Green bacterial stain, the microbial peak, generally, can be detected within 10 min in front of the plasma peak using capillary electrophoresis coupled with laser-induced florescence detection. The LOD of microbes detectable were 5 cells per injection. This technique provides a great advantage over traditional, time-consuming microbial inoculation methods.     

驻岛军人皮肤屏障功能与皮肤癣菌感染及相关影响因素研究

目的分析驻岛军人皮肤屏障功能与真菌感染的相关性及影响因素。方法对81名患有皮肤癣菌感染的官兵,进行真菌镜检加培养及皮肤屏障功能(经表皮失水量、油脂含量、角质层含水量)检测。结果真菌阳性组和真菌阴性组的经表皮水分丢失量(P=0.0018)、皮脂含量(P=0.0079)、年龄(P=0.0351)比较具有统计学差异;两组角质层含水量(P=0.1881)、驻岛时间比较(P=0.2269)无统计学差异。两组官兵经表皮水分丢失量与驻岛时间有相关性(r=0.054,P=0.0370),其余指标与驻岛时间和年龄均没有相关性(P>0.05)。结论驻岛官兵皮肤癣菌感染与皮肤经表皮水分丢失量、皮脂含量、年龄有关。年龄和驻岛时间与官兵的皮肤屏障功能无明显相关性,驻岛时间对经表皮水分丢失量有影响。     

2002～2012年阴道分泌物真菌检出变化趋势

目的 了解阴道分泌物真菌检出变化趋势及女性生殖道真菌感染现状.方法 对2002～2012年我院门诊和住院患者阴道分泌物涂片妇科多项检查记录资料回顾性统计分析,对阴道分泌物真菌年度检出率对比分析.结果 2002～2012年11年间阴道分泌物真菌检出率依次为12.76％、13.26％、17.48％、18.89％、15.32％、14.93％、14.10％、13.55％、9.87％、8.65％、9.53％,平均阳性率为13.68％;18～44岁年龄组真菌检出率14.98％,44～70岁年龄组真菌检出率9.49％.结论 2002～2005年4年间阴道分泌物真菌检出率总体呈上升趋势,2005 ～2012年7年间阴道分泌物真菌检出阳性率总体呈下降趋势;44岁以下年龄组妇女阴道真菌感染率高于45岁以上年龄组;合理使用抗菌药物,良好的生活、卫生习惯对降低阴道真菌感染有积极作用.     

Evaluation of antibacterial activity of Australian basidiomycetous macrofungi using a high-throughput 96-well plate assay

Context: The production of antimicrobial compounds by macrofungi is not unexpected because they have to compete with other organisms for survival in their natural hostile environment. Previous studies have indicated that macrofungi contain secondary metabolites with a range of pharmacological activities including antimicrobial agents.

Objective: To investigate macrofungi for antimicrobial activity due to the increasing need for new antimicrobials as a result of resistance in the bacterial community to existing treatments.

Materials and methods: Forty-seven different specimens of macrofungi were collected across Queensland, Australia. Freeze-dried fruiting bodies were sequentially extracted with three solvents: water, ethanol, and hexane. These extracts were tested against representative Gram+ve, Staphylococcus aureus and Gram?ve, Escherichia coli bacteria.

Results and discussion: Overall water and ethanol extracts were more effective against S. aureus than E. coli, whereas a small number of hexane extracts showed better results for their antimicrobial potential against E. coli at higher concentrations only. Encouraging results were found for a number of macrofungi in the genera Agaricus (Agaricaceae), Amanita (Amanitaceae), Boletus (Boletaceae), Cantharellus (Cantharellaceae), Fomitopsis (Fomitopsidaceae), Hohenbuehelia (Pleurotaceae), Lentinus (Polyporaceae), Ramaria (Gomphaceae), and Strobilomyces (Boletaceae) showing good growth inhibition of the pathogens tested.

Conclusion: The present study establishes the antimicrobial potential of a sample of Australian macrofungi that can serve as potential candidates for the development of new antibiotics.     

广州地区女性阴道分泌物的常规检验及分析

目的了解广州地区女性阴道健康状况和阴道清洁度、阴道毛滴虫以及真菌在不同年龄段、不同季节的流行变化情况,探讨阴道分泌物检查作为女性妇科常规筛查指标的重要意义。方法对2009年7月至2010年6月于就诊的27 660例广州地区女性患者进行阴道分泌物标本涂片和显微镜检查,并按照年龄、季节进行分组比较。结果在27 660例标本中,清洁度Ⅰ~Ⅱ度的检出率65.13%,清洁度Ⅲ~Ⅳ度的检出率34.87%,两者差异有统计学意义（P〈0.05）。检出阴道毛滴虫107例（0.39%）,真菌2 322例（8.39%）,两者差异具有统计学意义（P〈0.05）。清洁度Ⅲ~Ⅳ度、毛滴虫和真菌的检出率在不同年龄组差异均有统计学意义（P〈0.05）,清洁度Ⅲ~Ⅳ度的检出率在≤20岁年龄组最高（37.65%）,在≥51岁年龄组最低（28.27%）;阴道毛滴虫检出率在41~50岁年龄组最高（0.76%）,在21~30岁年龄组最低（0.27%）;真菌检出率在21~30岁年龄组最高（10.35%）,在≥51岁年龄组最低（2.11%）。清洁度Ⅲ~Ⅳ度、毛滴虫和真菌的检出率在不同季节差异均有统计学意义（P〈0.05）,但各季节实际差异不大。结论当前女性阴道健康状况不容乐观,阴道分泌物检验是妇科最简单、最常用的检查手段,有利于及时发现疾病和早期治疗,应定期进行阴道分泌物检查。     

妇科门诊阴道分泌物检测与分析

目的 对妇科门诊患者阴道分泌物的检测结果进行分析,探讨阴道炎的发病规律.方法 对516例妇科门诊患者的阴道分泌物标本做霉菌、滴虫、清洁度以及细菌性阴道病的测定,对其结果进行统计分析.结果 在全部受检患者中,检出霉菌、滴虫以及细菌性阴道病的阳性率为51.16%,其中细菌性阴道病(BV)感染者在总感染者中构成比最高;3项指标以7～9月阳性率最高,且与1～3月、4～6月、10～12月相比差异有统计学意义;随着清洁度级别的增加BV阳性率随之增加,且各清洁度等级之间比较差异均有统计学意义;3项指标以20～29岁年龄组阳性率最高,20～29岁组及30～39岁组与＜20岁组、40～49岁组、50～59岁组差异有统计学意义.结论 阴道炎是妇科门诊的多发病,处于生育期的妇女在夏季更容易造成生殖道感染.