阿齐霉素辅助治疗非淋菌性宫颈炎39例临床观察

目的:探讨阿齐霉素辅助治疗非淋菌性宫颈炎的临床疗效和安全性。方法:选取非淋菌性宫颈炎患者78例,随机均分为对照组和观察组,每组各30例。对照组给予多西环素治疗,观察组给予多西环素联合阿齐霉素治疗,比较两组患者治疗总有效率和不良反应发生率。结果:观察组治疗总有效率为94.9%,显著高于对照组的82.1%(P0.05);两组患者不良反应发生率比较无显著差异(P0.05)。结论:阿齐霉素联合多西环素治疗非淋菌性宫颈炎疗效确切,安全性高,较单纯用药效果好,值得临床推广使用。     

小剂量强力霉素联合甲硝唑凝胶治疗酒渣鼻疗效观察

目的观察小剂量强力霉素联合甲硝唑凝胶治疗酒渣鼻的临床疗效和安全性。方法将入选的90例酒渣鼻患者随机分成3组,各30例,治疗组口服强力霉素20mg,同时外搽0.75%甲硝唑凝胶,均2次/d;对照1组仅口服强力霉素,对照2组仅外用0.75%甲硝唑凝胶,用法同治疗组,均4周为1个疗程,共治疗3个疗程。每个疗程结束后分别观察疗效。结果治疗组有效率(96.55%)明显优于对照1组(75.00%)和对照2组(76.67%),差异均有统计学意义(P均<0.05),而对照1组有效率和对照2组比较差异无统计学意义(P>0.05)。治疗组不良反应发生率为10.34%、对照2组为13.33%,该两组均表现为用药局部皮肤轻度干燥,对照1组未见不良反应。结论小剂量强力霉素联合甲硝唑凝胶外搽治疗酒渣鼻疗效肯定,安全性好。     

多西环素联合双唑泰栓治疗宫颈支原体感染55例效果观察

目的探讨多西环素联合双唑泰栓治疗宫颈支原体感染的效果。方法将宫颈支原体感染110例随机分成两组,对照组55例口服多西环素治疗,观察组55例口服多西环素联合外用双唑泰栓。治疗结束后7～10 d进行宫颈拭子支原体培养,阳性者间隔两周再次复查,根据培养结果,结合症状、体征判断疗效,并比较两组转阴率和不良反应发生情况。结果观察组总有效率和支原体培养转阴率（92.73%,81.82%）均高于对照组（69.09%,30.91%）,差异有统计学意义（P〈0.05）。两组不良反应发生率比较差异无统计学意义（P〉0.05）。结论多西环素联合双唑泰栓能提高对宫颈支原体感染的治疗效果。     

Serum MMP-8, -9 and TIMP-1 in sepsis: High serum levels of MMP-8 and TIMP-1 are associated with fatal outcome in a multicentre, prospective cohort study. Hypothetical impact of tetracyclines

Recent evidence suggests that matrix metalloproteinases (MMPs) and their endogenous inhibitors are involved in the pathogenesis of sepsis. We studied serum levels of MMP-8, MMP-9 and TIMP-1 (tissue inhibitor of matrix metalloproteinase-1) in a multicentre, prospective cohort study of patients with sepsis treated in Intensive Care Units (ICUs). We analyzed serum samples taken on ICU admission from 248 critically ill sepsis patients. MMP-8, -9 and TIMP-1 serum levels were analyzed by enzyme-linked immunosorbent assays. Serum MMP-8, MMP-9 and TIMP-1 levels were significantly higher in patients with severe sepsis than in healthy controls. Serum MMP-8 levels among non-survivors (n = 33) were significantly (p = 0.006) higher than among survivors (n = 215). Serum TIMP-1 but not MMP-9 levels were significantly higher among non-survivors than survivors (p < 0.0001, p = 0.079, respectively). Systemic MMP-8 is upregulated in sepsis suggesting that MMP-8 may contribute to the host response during sepsis. High serum MMP-8 and TIMP-1 levels at ICU admission were seen among patients with fatal outcome. With this background, clinical studies examining the ability of MMP-inhibitors (such as the non-antimicrobial properties of tetracyclines) to diminish the MMP-mediated inflammatory response are needed to develop novel therapies in order to improve the outcome of sepsis.     

Doxycycline protects against pilocarpine-induced convulsions in rats, through its antioxidant effect and modulation of brain amino acids

This work evaluated doxycycline (2nd generation tetracycline) protection against pilocarpine-induced convulsions in rats. The animals were treated with doxycycline (Dox: 10 to100 mg/kg, i.p., 7 days), 30 min before the pilocarpine injection (P: 300 mg/kg, i.p.) and observed for cholinergic signs, latencies to the first convulsion and death. Amino acid concentrations, lipid peroxidation and nitrite levels in temporal cortices were determined as well as the radical scavenging activity. Doxycycline increased latencies to the first convulsion and death as compared to the untreated P300 group. It also decreased glutamate and aspartate, increased GABA, blocked nitrite formation, reduced TBARS contents and showed a radical scavenging activity. Finally, doxycycline decreased the number of degenerating neurons (evaluated by fluoro-jade staining) and increased the number of viable neurons (assessed by cresyl violet staining) as compared do the P300 group. The antioxidant effect associated with decreased levels of excitatory and increased levels of inhibitory amino acids could explain the neuroprotective effect of doxycycline.     

克拉霉素与阿奇霉素、多西环素治疗生殖道衣原体感染的疗效比较

目的:探讨克拉霉素与阿奇霉素、多西环素治疗生殖道衣原体感染的临床疗效差异。方法:对从2012年2月到2013年5月我院收治的174例生殖道衣原体感染患者的临床资料进行回顾性分析,根据治疗方法分为克拉霉素组(Ⅰ组)、阿奇霉素组(Ⅱ组)和多西环素组(Ⅲ组)各58例。比较三组患者临床疗效和不良反应发生情况。结果:Ⅰ、Ⅱ、Ⅲ组治疗结束后临床有效率和病原体清除率分别为93.10%、74.14%、68.97%,三组临床疗效比较差异具有统计学意义(P0.05)。Ⅰ组有2例患者产生不良反应,毒副反应发生率为3.45%,Ⅱ、Ⅲ组毒副反应发生率分别为8.62%、10.34%,Ⅰ组同Ⅲ组毒副反应发生率比较差异具有统计学意义(P0.05);三组患者发生毒副反应后及时处理患者情况均有好转。结论:克拉霉素较阿奇霉素和多西环素在治疗生殖道衣原体感染上临床疗效显著,清除病原体效果明显,安全性高,值得临床推广。     

丙戊酸钠与多西环素治疗脊髓炎大鼠的行为学评分及对小胶质细胞、单核细胞及中性粒细胞水平的差异比较分析

目的 分析丙戊酸钠与多西环素治疗脊髓炎大鼠的行为学评分及对小胶质细胞、单核细胞及中性粒细胞水平的差异.方法 构建致敏抗原诱导敏感实验动物诱发T细胞介导的反应性脊髓炎模型,并将大鼠分为模型组、丙戊酸钠组、多西环素组及空白对照组;模型组及空白对照组采用0.9％氯化钠注射液干预,丙戊酸钠组及多西环素组分别采用丙戊酸钠和多西环...     

Low efficacy of levofloxacin-doxycycline-based third-line triple therapy for Helicobacter pylori eradication in Italy

AIM: To evaluate a levofloxacin-doxycycline-based triple therapy with or without a susceptibility culture test in non-responders to Helicobacter pylori (H. pylori) eradication.METHODS: A total of 142 (99 women, 43 men; mean 53.0 ± 12.7 years) non-responders to more than two H. pylori eradication therapies underwent susceptibility culture tests or were treated with a seven-day triple therapy consisting of esomeprazole, 20 mg b.i.d., levofloxacin, 500 mg b.i.d., and doxycycline, 100 mg b.i.d., randomly associated with (n = 71) or without (n = 71) Lactobacillus casei DG. H. pylori status was checked in all patients at enrollment and at least 8 wk after the end of therapy. Compliance and tolerability of regimens were also assessed.RESULTS: H. pylori eradication was achieved in < 50% of patients [per prototol (PP) = 49%; intention to treat (ITT) = 46%]. Eradication rate was higher in patients administered probiotics than in those without (PP = 55% vs 43%; ITT = 54% vs 40%). Estimated primary resistance to levofloxacin was 18% and multiple resistance was 31%. Therapy was well tolerated, and side effects were generally mild, with only one patient experiencing severe effects.CONCLUSION: Third-line levofloxacin-doxycycline triple therapy had a low H. pylori eradication efficacy, though the success and tolerability of this treatment may be enhanced with probiotics.     

Severe Plasmodium vivax cerebral malaria complicated by hemophagocytic lymphohistiocytosis treated with artesunate and doxycycline

Malaria-related hemophagocytic lymphohistiocytosis is a rare, potentially fatal, hyperinflammatory disease entity which can be challenging to diagnose and treat. It is usually associated with Plasmodium falciparum infection. It is less frequently associated with Plasmodium vivax. Here we report an unusual case of a 23-year-old healthy Nigerian man who presented with fever, microangiopathic hemolytic anemia, acute renal failure, and confusion, and was diagnosed as having cerebral malaria-related hemophagocytic lymphohistiocytosis caused by P. vivax infection. He was successfully treated with intravenous artesunate and doxycycline with dramatic clinical improvement.     

Documento de consenso español para el algoritmo de tratamiento de la rosácea

Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea.