Seven-year survey of infective endocarditis at Keio University Hospital

To determine the recent clinical features of infective endocarditis (IE), the author evaluated data on 19 cases of 16 patients with IE who were treated at Keio University Hospital between April 1, 1987 and March 31, 1994. There were 13 men and 3 women aged 24 to 65 years (mean 43.4 years). Echocardiography revealed the presence of valve vegetation in 12 patients. Viridans streptococci were the most common pathogen, and were identified in seven cases. Two cases of native valve endocarditis (NVE) due toStreptococcus agalactiae and three cases due to group D streptococci (two of which were identified asEnterococcus faecalis) were encountered. One of two cases infected wthS. agalactiae had no underlying diseases. NVE due to viridans streptococci,S. agalactiae, and group D streptococcus was successfully treated with penicillin G or ampicillin combined with gentamicin. One case of NVE due to methicillin-resistantStaphylococcus aureus improved following treatment with a combination of cefmetazole and fosfomycin. Five patients underwent valve replacement surgery following antimicrobial therapy. One of these patients developed later endocarditis on the prosthetic valve. Three patients developed recurrent NVE. All but one of the 16 patients survived; the single death was due to a cerebral infarction. Based on these results, the author believes that currently available antibiotics are efficacious against IE.     

我院2007年314例药品不良反应报告分析

目的:探讨我院药品不良反应(ADR)发生的特点与一般规律。方法:对我院ADR监测中心2007年收集到的有效报告314例进行统计、分析。结果:314例ADR报告中,涉及药品13类178种,共338例/次。主要为抗感染药(38种,128例/次)和中药制剂(20种,51例/次)。ADR累及的器官或系统中皮肤及其附件损害最多(134例/次),消化道损害居第2位(56例/次)。转归较好,仅1例死亡。结论:加强合理用药监测,可避免和减少ADR的发生。     

弥漫实变型肺泡癌与感染性实变的鉴别分析

目的分析弥漫实变型肺泡癌（DCBAC）的临床及影像表现,探讨与感染性实变的鉴别诊断。方法分析1例经病理确诊为DCBAC的临床及影像资料,结合文献复习。结果DCBAC的临床及影像表现与感染性实变极其相似。掌握CT的重要征象,结合癌胚抗原检测及治疗中的变化,是诊断DCBAC的重要依据。结论对DCBAC临床及影像表现深入细致分析,提高本病与感染性实变鉴别诊断正确率。     

感染性心内膜炎26例临床分析

目的：提高对感染性心骨膜炎的诊治水平。方法：回顾性分析２６例感染性心骨膜炎的临床表现形式与治疗的关系。结果：发热为常见及起始症状，贫血，脾大，肝大，心脏杂音改变，周围动态栓塞，脑血管意外。血培养阳性率５７．６％，经胸超声心动图发现赘生物７３．１％。结论：（１）心脏结核异常是感染性心骨膜炎的主要基础病因；（２）先天性心脏病，室间隔缺损（ＶＳＤ）合并主动脉瓣关闭不全，风湿性心脏病有二尖瓣脱垂和联合病变     

Role of probiotics in inflammatory bowel disease and intestinal infections

Bacteria are present throughout the GI tract but their pattern and concentrations vary greatly. Probiotics are living microorganisms that belong to the normal intestinal flora and are important to the health and well-being of the host. The concept of probiotic therapy is still controversial; there are many data from in vitro and animal studies, however, to date the beneficial effects of probiotics in humans have mostly been demonstrated under poorly defined experimental conditions. Several experimental and clinical observations suggest a role for the intestinal microflora in inflammatory bowel disease (IBD) pathogenesis and there is increasing evidence supporting the potential therapeutic role for probiotics in the treatment of IBD. The use of probiotics to treat GI infections has produced contrasting results; their efficacy in the prevention or treatment of infective diarrhoea was evaluated in a large number of studies; however, the most convincing evidence of their benefit concerns rotavirus infection in children. Future research needs to focus on obtaining more precise information on the composition of the enteric microflora and the mechanisms of action of probiotics.     

吸毒者文身流行病学调查

目的 :了解吸毒人群中文身的情况。方法 :使用自拟的《文身情况调查表》对武汉市公安局强制戒毒所的戒毒者进行文身情况问卷调查。结果 :共收回有效问卷 76 6份 ,发现有文身者 2 89例 ,占 37.7% ,其中男 2 32例 ,占80 .3% ,女 5 7例 ,占 19.7% ;文身的主要原因是“好奇、好玩”(42 .6 % )、“无聊”(2 2 .2 % )和“情爱”(2 1.8% )。文身者中有孤独感的占 5 0 .2 % ,独立人格的 2 4 .2 % ,厌倦人生的 2 3.5 %。文身者中 2 18例 (75 .4 % )有违法犯罪行为 ,显著高于非文身者 (40 .2 % ,P <0 .0 1) ;使用没有经过消毒的文身针具者占 70 .6 % (197 2 89)。结论 :吸毒者中的文身比例高 ,文身原因多样化 ,病态人格多 ,犯罪比率大 ,易感染传染性疾病