变应性支气管肺曲霉菌病的HRCT表现

目的评价变应性支气管肺曲霉菌病的HRCT表现。方法 回顾性分析7例变应性支气管肺曲霉菌病患者的肺部高分辨率CT图像,结果 7例（100％）患者均可见到中心性支气管扩张,共累及28/35个（80％）肺叶和70/126个（55％）肺段;7例（100％）扩张支气管腔内均可见粘波嵌塞,呈指套样、牙膏状改变,其中5例（71%）为稍高密度,1例（14％）可见到钙化;4例（57％）可见肺实变;2例（28％）合并肺叶含气不全;3例（42％）合并肺门淋巴结增大。结论长期哮喘的病人如果HRCT上发现中心性支气管扩张,同时管腔内可见稍高密度的粘液嵌塞或高密度钙化,需考虑ABPA的可能。     

湖北地区1132例铁路职工浅部真菌病及病原菌种类分析

目的:了解湖北地区铁路职工浅部真菌病的流行状况及病原菌分布,为临床治疗提供参考。方法:收集1 132例湖北地区铁路职工浅部真菌病患者的标本共1 293例,对真菌涂片阳性的浅部真菌病标本进行分离培养、菌种鉴定。结果:共分离培养出红色毛癣菌685株(53.00%)、须癣毛癣菌333株(25.75%)、犬小孢子菌31株(2.40%)、铁锈色小孢子菌37株(2.86%)、絮状表皮癣菌8株(0.62%)、石膏样小孢子菌8株(0.62%)、紫色毛癣菌6株(0.46%)、玫瑰毛癣菌6株(0.46%)、断发毛癣菌11株(0.85%)、念珠菌168株(12.99%)。结论:1 132例湖北地区铁路职工浅部真菌病患者中,红色毛癣菌、须癣毛癣菌、念珠菌为检出比例最高的前三种菌种,念珠菌所占比例有增高趋势。     

The pathogenetic significance of intestinal Candida colonization--a systematic review from an interdisciplinary and environmental medical point of view

The etiological significance of intestinal Candida colonization continues to be controversial. This is a systematic review to determine the pathogenetic significance of intestinal Candida colonization. The search was essentially performed from 1990 to 12/7/2000 in Medline and the Cochrane-Library. The data source was restricted to articles in English and German. Selection criteria covered the topics "Epidemiology", "Infectious Diseases", "Candida-Syndrome" and "Therapy" and were essentially confined to in-vivo examination of immunocompetent adults. Two reviewers extracted independently data using predefined criteria. In total, 96 citations that proved suitable for use in the systematic review were found. Depending on the localization in the gastrointestinal tract, the recovery technique employed, and transport times, Candida colonization is frequently detected in healthy, immunocompetent adults (prevalence: 4-88%). None of the studies available so far furnish any evidence that nutritional factors, food additives, pollutants, anti-ovulants, other types of medication or diabetes mellitus might be predisposing factors for intestinal Candida colonization. However, therapeutic studies point to the possibility of Candida playing a role in antibiotic-associated diarrhea. On the other hand, antibiotics seem to favor bacterial dysbiosis, and this, like the direct side effects of drugs, offers a more plausible explanation for diarrhea or gastrointestinal symptoms. The role of intestinal colonization by Candida in Candida-associated vulvovaginitis and IgE-mediated disorders remains contradictory. Nevertheless, neither epidemiological nor therapeutic studies provide evidence for the existence of the so-called "Candida-syndrome" or "Candida-hypersensitivity-syndrome". At present, there are no proven treatment indications for antifungal "bowel decontamination".     

氟康唑预防留置导尿管病人的尿路真菌感染

目的：研究氟康唑对重症监护室（ Ｉ Ｃ Ｕ） 病人尿路真菌感染的预防作用。方法：留置导尿的颅脑外伤和脑血管意外病人１３０ 例分为３ 组：对照组（４２例） ,不给抗真菌药物;氟康唑５０ ｍ ｇ 组（４９ 例） ,用氟康唑５０ ｍｇ ,ｑｄ , 始于置管后（２ ．８ ±１ ．２） ｄ ; 氟康唑１００ ｍｇ 组（３９ 例） ,用１００ ｍ ｇ ,ｑｄ , 始于置管后（２ ．７ ±１ ．３） ｄ 。氟康唑均由胃管注入或口服。每周作１ 次尿真菌培养等检查。结果：对照组ｗ ｋ １ ,２ ,３ 尿路真菌感染率分别为６２ ％ ,８３ ％ 和８５ ％ ;氟康唑５０ ｍｇ 组分别为４３ ％ ,３５ ％ 和１４ ％ 。１００ ｍｇ 组分别为３６ ％ ,２９ ％ 和２２ ％ 。２ 用药组ｗｋ ２ , ３ 的感染率显著降低（ Ｐ＜ ０ ．０１） 。结论：氟康唑（５０ ｍ ｇ 或１００ ｍｇ ,ｑｄ） 能安全有效地预防 Ｉ Ｃ Ｕ 病人尿路真菌感染。     

Fungal surveillance of an open haematology ward

Air sampling and surveillance cultures for fungi were performed in a Scottish general haematology ward over a five-month period in 1997. The mean total fungal count from the air sampling appeared to be correlated with the number of patients colonized by Aspergillus. The most commonly isolated species were Aspergillus versicolor, A. fumigatus and A. niger. Rooms with portable air filtration units had significantly lower total fungal counts than the others. Swabs were taken from 70 patients (mean age 62 years); 114 of the 563 cultures (20.2%) were positive. The most commonly isolated species were A. fumigatus, Candida albicans, C. glabrata and C. parapsilosis. Samples taken from the tongue and perineum showed colonization more often than those taken from the nostrils. Almost half the patients (48.6%) were colonized on, or within seven days of, admission; 11.4% became colonized whilst on the unit. One patient developed fatal aspergillosis. We conclude that colonization or high air-borne spore concentrations are not necessarily predictive of fungal infection but may prompt early treatment or more aggressive prophylaxis of potentially fatal invasive infections.     

Incidence of endomycoses in the autopsy material of the Berlin Charité Hospital

From 1970 to 1993, a total of 93 endomf1p4es confirmed by post-mortem examination was diagnosed in the autopsy material of the Berlin Charité, a large hospital with an average of 1,500 hospital beds and maximum medical care. These comprised 51 candidoses (54.8%), 24 aspergilloses (36.6%), five cryptococcoses (5.4%), one zygomycosis, 1 trichosporosis and one coccidioidomycoses. This corresponded to 0.7% of the 13,375 decreased persons autopsied during this period. The frequency of autopsy was 85.3%. In 3,770 cases (2,418 adults and 1,352 children), brain dissection was performed. An adequate clinical putative diagnosis was made in only six out of 28 patients (18 adults, 10 children) with histologically confirmed cerebral mycosis [11 candidoses (39.3%), 10 aspergilloses (35.7%), five cryptococcoses (17.9%), one trichosporosis and one coccidioidomycosis]. About 80% of the mycoses of the CNS thus remained undetected while the patients were alive. Against the background of the continuing reduction in the frequency of autopsy in the Federal Republic of Germany, the observations made in the present paper underscore the demand for improved efficiency of mycological in-vivo diagnoses in the hospital and laboratory.     

中国医学真菌学的发展

医学真菌学是真菌学的一门分支学科,它包括了与医学相关的致病真菌与真菌病的研究.随着医学科学的发展,医学真菌学受到了全世界的广泛重视.我国医学真菌学近年来取得了比较大的发展和进步,本文对我国医学真菌学的发展作一介绍.     

中药外治浅部真菌病用药规律分析

目的:基于中医传承辅助系统(V2.5)分析中药外用治疗浅部真菌病的组方用药规律,为临床新方研究提供依据。方法:检索1978-2018年中国期刊网全文数据库(CNKI)中有关中药外用治疗浅部真菌病的随机对照试验(randomized controlled trial,RCT)研究并选出符合纳入标准的文献,将文献中的方剂整理并录入,通过系统数据分析功能进行用药规律分析。结果:经筛选后共纳入文献63篇,包含中药方剂63首,演化出新治疗处方4首。结论:中药外治浅部真菌病多选用清热燥湿药和攻毒杀虫止痒药,方剂功效主要为清热燥湿、杀虫止痒、祛风解毒,药性多寒温并用,药味多甘苦辛同用;得到的新处方治疗效果有待临床进一步验证。