感染性腹泻疫情中诺如病毒的分子流行病学分析

目的 研究感染性腹泻疫情中诺如病毒的分子流行病学特点.方法 对2008-2010年湖州地区的感染性腹泻疫情标本共119份进行诺如病毒核酸检测,并选取部分阳性扩增产物经序列测定分析诺如病毒的基因型.结果 119份感染性腹泻标本荧光定量PCR检测阳性50份,其中GⅠ型9份,GⅡ型35份,GⅠ和GⅡ混合感染6份.对12份PCR扩增阳性产物进行序列分析显示：5株GⅠ型诺如病毒毒株分属于GⅠ/2和GⅠ/3两种基因型;7株GⅡ型诺如病毒毒株中除1株属于新基因型GⅡb外,其余6株均属于GⅡ/4基因型.结论 诺如病毒是引起湖州地区感染性腹泻疫情最重要的病原菌之一,且湖州地区的诺如病毒存在很高的遗传多样性,同时也存在基因型别的差异.     

2007-2010年河北省卢龙县婴幼儿腹泻患者A组轮状病毒感染监测

目的 了解河北省婴幼儿腹泻患者轮状病毒的感染特点及基因型别的变迁情况.方法 2007 -2010年在河北卢龙县医院和卢龙县妇幼保健院收集5岁以下腹泻住院病例1643例的粪便标本,采用酶联免疫吸附试验( ELISA)检测轮状病毒抗原,阳性标本用多重反转录-聚合酶链反应(RT-PCR)进行基因分型.结果 1643例标本中8...     

广朴止泻液药效学研究

目的 观察广朴止泻液的主要药效. 方法 通过轮状病毒致树鼩腹泻实验、大肠埃希菌致乳兔腹泻实验、大黄致小鼠腹泻实验;小鼠肠推进、胃排空实验、免疫以及体外抑菌实验,观察广朴止泻液的止泻作用和对胃肠运动、免疫功能及抗菌作用的影响. 结果 广朴止泻液对大黄致小鼠脾虚、树鼩感染轮状病毒所致腹泻具有明显止泻作用,明显延长感染致病性大肠埃希菌乳兔的生存时间,抑制正常小鼠小肠推进及胃排空运动,促进小鼠腹腔巨噬细胞吞噬功能和特异性抗体形成,体外实验还提示该药具有较好的广谱抑菌作用. 结论 广朴止泻液具有止泻作用,机制可能是通过抑制胃肠道平滑肌而抑制腹泻.     

Knowledge and practices among rural mothers in Haryana about childhood diarrhea

Knowledge and practices of 108 rural mothers about childhood diarrhea, were determined by using pretested semi-structured interview schedules. The common causes of diarrhea reported were eruption of teeth (67.59%), eating of mud (51.85%), worm infestation (47.22%), change of climate (35.18%), poor personal hygiene (34.25%) and changes in diet (25.92%). Majority (83.33%) of mothers practiced food restriction during diarrhea. Seventy seven percent consulted their mother-in-laws in the first instance for treatment of diarrhea. The home remedies tried by mothers were, isabgol husk with curd (30.55%), ghee with tea (28.70%) water boiled with mint leaves (25.92%), local ghutti (22.22%) and unripe mango juice (16.66%). Majority of mothers (83.33%) believed that oral rehydration therapy alone, cannot treat diarrhea.     

Duodenocolic fistula in a child

Duodenocolic fistulae usually occur in adults and are mostly malignant in etiology. The present report describes the occurrence of a duodenocolic fistula of benign etiology in a 13-year-old boy who presented with chronic diarrhea and severe growth retardation.     

Relationship between the Pharmacokinetics of Irinotecan and Diarrhea during Combination Chemotherapy with Cisplatin

Two phase I trials of irinotecan (CPT-11) in combination with cisplatin were conducted. In both cases, the dose-limiting toxicities were leukopenia and/or diarrhea. During these trials the pharmacokinetics of CPT-11 and its active metabolite, 7-ethyl-10-hydroxycamptothecin (SN-38), were investigated to evaluate the relationship between pharmacokinetic parameters and diarrhea, since this is an unpredictable and severe toxicity of combination chemotherapy using CPT-11 and cisplatin. Twenty-three previously untreated patients with advanced lung cancer were evaluated in the pharmacokinetic study. Ten patients received CPT-11 at 80 or 90 mg/m² plus cisplatin at 60 mg/m². The other 13 patients received CPT-11 at 80 or 90 mg/m² plus cisplatin at 80 mg/m² with the granulocyte colony-stimulating factor support (2 μg/kg × 16 days). CPT-11 was given as a 90-min intravenous infusion on days 1, 8, and 15. Cisplatin was given on day 1. The pharmacokinetics of CPT-11 and SN-38 were analyzed on day 8 during the first course of treatment. The maximum tolerated dose of CPT-11 was 90 mg/m² in both phase I trials. The severity of diarrhea was best correlated with the peak plasma concentration of SN-38 among the pharmacokinetic parameters tested. In addition, patients with a plasma SN-38 level > 12.4 ng/ml at 1.75 h after the start of CPT-11 infusion had a higher incidence of Eastern Cooperative Oncology Group grade 3–4 diarrhea than those with a lower SN-38 level ( P =0.0003). Stepwise logistic regression analysis identified the SN-38 concentration as a significant contributor to the development of diarrhea ( P =0.0021). We conclude that there is a clear relationship between the SN-38 concentration and diarrhea during chemotherapy with CPT-11 plus cisplatin.     

Necrotizing enterocolitis beyond the neonatal period

Necrotizing enterocolitis (NEC) is usually considered to be a neonatal disease, and is rarely described beyond the newborn period. During the last 15 years, 19 infants from the Negev region, Israel, with NEC were beyond the neonatal age group (range=34–616 days, median-90 days). Of this group only 16% were born prematurely, and only 16% had perinatal or neonatal pathology. Diarrhea and dehydration preceding NEC were common as was malnutrition. Bacteremia was detected in 42%. The mortality rate was 90%. Malnutrition, supposedly contributed to the formation of NEC and to the high mortality rate among these infants.     

引起成人腹泻的新轮状病毒在原代人胚肾细胞上的培养和传代

目的 探讨用细胞培养系统在体外培养新轮状病毒（RV）。方法 含新RV的病人粪便标本经高浓度胰蛋白酶（100μg/ml)37℃作用1h,接种于原代人胚肾（PHEK）细胞,37℃吸附1h后,补加无血清含胰蛋白酶（100μg/ml）的DMEM,37℃转鼓培养3d,收获细胞培养液,冻融1次,作为下一代培养的接种物,培养传代。用聚丙烯酰胺凝胶电泳、免疫荧光（IF）、电镜（EM）、免疫电镜（IEM）等方法对细胞培养液进行病毒核酸、抗原及形态检查。结果 从10份粪便标本中培养分离到1株病毒,定名为J19。该病毒在PHEK细胞上稳定培养传代（28代）,其病毒核酸（dsRNA）电泳图型与初始用于接种细胞的粪便标本中的dsRNA电泳图形完全一致,而与A、B、C组RV dsRNA电泳图型明显不同。J19株感染的细胞与病人恢复期血清呈IF阳性反应,与成人腹泻轮状病毒（ADRTV）腹泻病人恢复期血清、兔抗A组RV和兔抗ADRV血清均为IF阻性;EM和IEM在该病毒的细胞培养液中观察到,在形态上与初始接种物中病毒一样的轮状病毒颗粒,而且可被新RV腹泻病人恢复期血清凝集,结论 成功地从含新RV的成人腹泻粪便标本上分离培养出1株轮状病毒－－J19,并能在细胞稳定传代。J19株不属于A、B、C组RV,而是一种新RV。关于新RV在细胞上培养传代,本文是第一次报告。