合理情绪疗法对广泛性焦虑障碍药物治疗效果的影响

目的:探讨并研究合理情绪疗法对广泛性焦虑障碍药物治疗效果影响。方法:选取我院自2013年6月-2014年4月我院心理咨询门诊的广泛性焦虑障碍患者120例,随机分为两组,每组60例,治疗期8周。对照组采用药物进行治疗,试验组在对照组的基础上同时进行合理情绪疗法治疗。结果:试验组采用药物治疗联合合理情绪疗法明显优于对照组,在对于患者治疗前后的SAS、HAMA评分中进行比较,发现试验组治疗后较治疗前SAS、HAMA分明显降低(t=6.6496,8.9374;P0.05),具有统计学意义。结论:合理情绪疗法在对广泛性焦虑障碍患者的治疗中,能够有效提高患者的生活质量,减少患者的不良情绪。     

313例尿培养病原菌分布及耐药性分析

目的分析313例清洁中段尿培养菌株构成及耐药性分析,为医师合理规范使用抗生素提供依据。方法对医院2012年6月~2013年5月住院泌尿系感染患者尿培养分离出的313株病原菌用法国梅里埃公司VITEK 2 COMPACT全自动微生物鉴定药敏检测系统仪进行鉴定和药敏试验。结果共培养1804份中段尿标本,分离出313例病原微生物,阳性率17.35%。其中革兰阴性杆菌、革兰阳性球菌、真菌、革兰阳性杆菌分别占65.50%、19.81%、7.35%、7.35%。大肠埃希菌仍是泌尿系感染的主要致病菌,其次为肺炎克雷伯杆菌、阴沟肠杆菌、铜绿假单胞菌、奇异变形菌;其中产超广谱β-内酰胺酶(ESBLs)大肠埃希菌占大肠埃希菌41.94%;而在革兰阳性菌中以肠球菌属为主。检出耐亚胺培南的肺炎克雷伯菌1株,耐碳青霉烯类阴沟肠杆菌2株,耐万古霉素屎肠球菌1例。结论泌尿系感染常见病原菌仍为大肠埃希菌,临床应根据尿培养及药敏试验结果有针对性筛选敏感药物进行治疗。     

Effectiveness of Reinduction and/or Dose Escalation of Ustekinumab in Crohn’s Disease: A Systematic Review and Meta-analysis

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Follow up on atopy and the gastrointestinal tract – a review of a common association 2018

Introduction: Primary atopic disorders can be classified as heritable genetic disorders presenting with deregulated pathogenic allergic effector responses irrespective of sensitization. In the last decade, there are parallel rises in the burden of atopic and gastrointestinal (GI) diseases.

Areas covered: There is increasing recognition of an association between atopy and GI disease through immune dysregulation, the microbiome and shared genetic pathways. Since the first article on atopy and the GI tract in 2014 in this journal, many more studies have shed light on the shared pathways in these diseases, particularly in the field of eosinophilic GI disease, functional GI disorders, and inflammatory bowel disease.

Expert opinion: Understanding the links with common mechanisms in atopy and GI diseases that may lead to better targeting of treatment through manipulation of immune mechanisms, the microbiome, genetics, food allergens and specific GI diseases such as inflammatory bowel disease, functional GI disorders.     

老年人下呼吸道嗜麦芽窄食单胞菌感染的临床分析

目的 探讨老年人下呼吸道嗜麦芽窄食单胞菌感染的危险因素及该菌对常用抗生素的敏感性。方法 分析40例老年下呼吸道嗜麦芽窄食单胞菌感染患者的临床资料，用K-B法测定该菌的体外药物敏感性。结果 全部患者均有基础疾病，其中慢性阻塞性肺疾病(COPD)20例(50．0％)，混合感染17例(42．5％)。均有抗生素应用史，70．0％的患者机体免疫功能低下，30．0％的患者曾有侵袭性治疗，平均住院时间达41．7d。临床症状及X线表现符合下呼吸道感染。药敏试验提示该菌呈现多重耐药，复方磺胺甲噁唑、环丙沙星、左氧氟沙星、阿米卡星、庆大霉素及氧氟沙星为较敏感抗生素。结论 老年下呼吸道嗜麦芽窄食单胞菌感染多发生于患有各种基础疾病、免疫功能低下及长期应用抗菌药物者，细菌耐药现象严重，诊断及治疗应根据病原学检查及药物敏感试验。     

Effects of Ethanol on Intestinal Absorption of Drugs.

The effect of chronic alcohol intake on the intestinal absorption of seven compounds belonging to a homologous series (ciprofloxacin derivatives) was evaluated using an in situ rat gut technique that measures the intrinsic absorption rates of the compounds both in control and chronic alcohol-fed rats. For chronic alcohol treatment, the animals were fed a liquid diet containing ethanol (36% of calories), whereas an isocaloric diet was given to the pair-fed control animals. The biophysical absorption model, relating the intestinal absorption rate constants and partition indexes of the tested compounds, was then established either for control or alcohol-fed animals. Differences were analyzed and tentatively interpreted on the basis of general diffusion principles. Results revealed that, in chronic alcohol-fed animals, hydrophilic homologs are absorbed at a significantly faster rate than in control ones, whereas lipophilic homologs do not change their absorption rate relative to controls. Results demonstrate that the bulk polarity of the microvillous lipoidal membrane is enhanced by chronic ethanol intake, whereas basic features of the aqueous boundary layer are not altered. These observations suggest that the physicochemical properties of the compounds are an important factor in explaining the influence of chronic alcohol intake on passive intestinal absorption of xenobiotics. The possible practical implications of our results are discussed from a speculative viewpoint     

Sleep problems in early childhood and early onset of alcohol and other drug use in adolescence

BACKGROUND: No prospective studies exist on the relationship between sleep problems early in life and subsequent alcohol use. Stimulated by the adult literature linking sleep problems to the subsequent onset of alcohol use disorders in some adults, we examined whether sleep problems in early childhood predicted the onset of alcohol and other drug use in adolescence and whether such a relationship was mediated by other known predictors of this relationship, namely, attention problems, anxiety/depression, and aggression in late childhood. METHODS: This study is part of an ongoing longitudinal study of the development of risk for alcohol and other substance use disorders. Study participants were 257 boys from a community-recruited sample of high-risk families. RESULTS: Mothers' ratings of their children's sleep problems at ages 3 to 5 years significantly predicted an early onset of any use of alcohol, marijuana, and illicit drugs, as well as an early onset of occasional or regular use of cigarettes by age 12 to 14. Additionally, although sleep problems in early childhood also predicted attention problems and anxiety/depression in later childhood, these problems did not mediate the relationship between sleep problems and onset of alcohol and other drug use. CONCLUSIONS: This is, to our knowledge, the first study that prospectively examines the relationship between sleep problems and early onset of alcohol use, a marker of increased risk for later alcohol problems and alcohol use disorders. Moreover, early childhood sleep problems seem to be a robust marker for use of drugs other than alcohol. Implications for the prevention of early alcohol and other drug use are discussed.     

The association between erythromycin monotherapy for Mycobacterium avium complex lung disease and cross-resistance to clarithromycin: A retrospective case-series study

Long-term, low-dose erythromycin monotherapy, based on the anti-inflammatory effects of macrolides, has been reported to have the potential to suppress the exacerbation of Mycobacterium avium complex (MAC) lung disease with less toxicity. It remains unclear whether erythromycin monotherapy induces cross-resistance to clarithromycin, a key drug for MAC. To clarify this point, we conducted a retrospective, single-center, case-series study on patients with MAC lung disease who underwent erythromycin monotherapy for at least 6 months. Drug susceptibility tests, before and after erythromycin treatment initiation, were analyzed. Thirty-three patients were included in our study. All 33 patients showed susceptibility to clarithromycin for MAC both before and after erythromycin monotherapy. There was no significant difference in clarithromycin minimum inhibitory concentrations between before and after erythromycin treatment (median difference = 0 μg/ml; P = .313, Wilcoxon's signed-rank test). We conclude that erythromycin monotherapy for MAC lung disease may not induce cross-resistance to clarithromycin.     

超声联合微泡辅助卡铂抑制A549细胞活性的适宜剂量研究

目的 探讨超声辅助卡铂抑制体外A549细胞活性的适宜卡铂剂量及超声能量参数。方法 96孔板接种A549细胞,加入浓度梯度0-400>μg/ml的卡铂培养24小时后,每孔加入 10μlCCK8 溶液,孵育 1.5 小时,酶标仪测定在450nm处的吸光度值,计算细胞抑制率,应用Graphpad Prism 5软件的“药物剂量-效应模型”计算卡铂24小时IC50。设置空白组、US组、USMB组、CBP组、CBP+US组、CBP+USMB组,卡铂浓度为50 μg/ml,声强梯度范围为0.2-2.2W/cm2,频率1MHz,占空比10%,辐照时间1分钟,培养24小时,CCK8法测细胞存活率,应用SPSS24.0分析存活率差异,筛选有效剂量。光学倒置显微镜观察各组细胞形态学变化。结果 卡铂24小时IC50为65.72μg/ml。抑制A549细胞活性的强弱排序为CBP+USMB组>CBP+US组>CBP组>USMB组>US组,CBP+USMB组与其余4组之间差异有统计学意义(P<0.001),CBP(50μg/ml)+USMB(0.2-1.0W/cm2)5组之间差异无统计学意义(P>0.05)。处理组均可见细胞形态不规则、贴壁性降低,以CBP+USMB组为著。结论 卡铂50μg/ml、声强0.6W/cm2为24小时联合疗法适宜剂量。超声联合微泡可以与卡铂协同抑制A549细胞活性,成为肿瘤联合疗法的新策略。