培菲康作为辅助剂治疗肝硬化自发性腹膜炎临床研究

 目的探讨培菲康作为辅助剂治疗肝硬化自发性腹膜炎的临床治疗作用。方法将89例肝硬化并发自发性腹膜炎的 患者随机分为治疗组(45例)和对照组(44例)。对照组在保肝、利尿、补充白蛋白等基础上加用杭菌素进行治疗,7d为1疗程，共2个疗程。治疗组在对照组治疗基础上加用培菲康胶囊420mg,tid,疗程同对照组。疗程结束后观察两组临床症状、体征、腹水常规及培养和肝功能的变化情况。结果治疗组的总有效率为93.3%，而对照组为68.2%(P<0.01)治疗组在腹痛、腹部压痛、腹泻消失方面与对照组比较差异有显著性(P<0.05)，而在发热、腹水常规及培养检查方面与对照组比较差异亦有显著性(P<0.01),肝功能改善方面存在差异。结论培菲康作为辅助剂在治疗肝硬化自发性腹膜炎的临床治疗中有恢复肠道正常菌群，增强免疫，降低内毒素血症的作用，具有一定治疗作用。     

参苓白术颗粒预防老年抗生素相关性肠道菌群失调的RCT研究

目的:观察参苓白术颗粒对住院老年人抗生素相关性肠道菌群失调的防治作用。方法:选择2012年5月~2014年5月住院老年重症肺炎患者100例,随机分配至对照组(单用美罗培南)和研究组(美罗培南+参苓白术颗粒),疗程14 d,治疗结束后判定疗效和菌群失调发生的情况。结果:美罗培南对老年重症肺炎患者有效果良好,对照组与研究组的有效率分别为68%和74%(P0.05);研究组患者肠道菌群失调的发生率、肠道二重感染的发生率显著低于对照组(P0.05)。结论:参苓白术颗粒用于预防住院老年患者抗生素相关性肠道菌群失调的发生疗效显著,可用于临床推广。     

Candida and dysbacteriosis: A cytologic,population‐based study of 100,605 asymptomatic women concerning cervical carcinogenesis

BACKGROUND.

The objective of this study was to investigate whether the presence of vaginal Candida or dysbacteriosis predisposes women to an increased susceptibility for (pre)neoplasia over time.

METHODS.

A retrospective, longitudinal, cohort study was performed and was conducted in a population of 100,605 women, each of whom had 2 smears taken over a period of 12 years as part of the Dutch Cervical Screening Program. From these women, a cohort of 1439 women with Candida and a cohort of 5302 women with dysbacteriosis were selected as 2 separate study groups. The control cohort consisted of women who had completely normal cervical smears (n = 87,903 women). These groups were followed retrospectively over time. The odds ratios (OR) for squamous abnormalities in the follow‐up smear for the women in these 3 cohorts were established.

RESULTS.

The dysbacteriotic cohort was significantly more likely to have low‐grade squamous intraepithelial lesions (LSIL) and high‐grade squamous intraepithelial lesions (HSIL+) in their follow‐up smear (OR, 1.85; 95% confidence interval [95% CI], 1.28–2.67 and OR, 2.00; 95% CI, 1.31–3.05, respectively) compared with women in the control group. In contrast, the Candida cohort had no significantly increased or decreased risk of developing SIL. The equivocal diagnosis ‘atypical squamous cells of undetermined significance’ was rendered significantly more often in the follow‐up smear of both study cohorts (Candida cohort: OR, 1.42; 95% CI, 1.03–1.95; dysbacteriotic cohort: OR, 1.44; 95% CI, 1.22–1.71).

CONCLUSIONS.

The results from this study indicated that the presence of Candida vaginalis was not associated with an increased risk for SIL over time. In contrast, women with dysbacteriosis had a significantly increased risk of developing (pre)neoplastic changes. These findings should be taken into account in further research concerning predisposing factors for cervical carcinogenesis. Cancer (Cancer Cytopathol) 2007. © 2007 American Cancer Society.     

Pathogenetic Role of Dysbacteriosis in the Development of Complications of Type 1 Diabetes Mellitus in Children

A relationship between enteric microbiocenosis and severity of type 1 diabetes mellitus was detected. Microbiological analysis showed II-IV degree dysbacteriosis in all diabetic children. Long-term therapy with probiotics aimed at eradication of opportunistic microflora resulted in recovery of microbiocenosis, which was paralleled by improvement of the clinical status, regression of complications in children who were ill for a long time, and prevention of complications in children with newly detected diabetes. These results indicate the leading role of chronic enteric toxic infectious process in the development of complications of type 1 diabetes. The significance of infection in the pathogenesis of other noninfectious diseases in man is discussed.     

61例抗生素相关性腹泻患者失调菌群耐药性分析

目的 了解抗生素的使用对患者肠道菌群的影响,以及失调菌群的耐药性.方法 采用粪便细菌培养进行分析,同时对相应患者通过查病历了解其抗生素使用情况.结果 2010年5月至2011年12月共发现相关患者61例,主要发病人群为老年人、婴幼儿以及重症患者.61例相关腹泻患者大便培养,培养出念珠菌24例,肠球菌22例,奇异变形杆菌8例,葡萄球菌5例,铜绿假单胞菌2例.其中白色念珠菌对各种抗真菌药保持较好的敏感性,而非白色念珠菌耐药性明显高于白色念珠菌.粪肠球菌和类粪肠球菌对利奈唑胺、呋喃妥因和万古霉素耐药性较低,通过比较可知粪肠球菌和类粪肠球菌对呋喃妥因、利奈唑胺、利福平、青霉素G、万古霉素的耐药率比较差异无统计学意义(P>0.05),而两者对链霉素2000、莫昔沙星、庆大霉素、左旋氧氟沙星耐药率比较差异有统计学意义(P<0.05).结论 对特殊患者进行粪便培养检查是实验室诊断抗生素相关性腹泻较好的方法,可以给临床提供实验依据,防止抗生素的滥用.     

Dysbacteriosis and squamous (pre)neoplasia of immigrants and Dutch women as established in population-based cervical screening

We examined the statistical relationships between dysbacteriosis and (pre)neoplasia related to age and ethnicity from the cervical screening of almost half a million smears. Data from 445,080 smears were coded according to KOPAC (the Dutch national cervical smear coding system) with nine grades. Prevalence per 100,000 smears and relative risks (RR) were calculated for dysbacteriosis and for squamous abnormalities. Patients were stratified by their probable country of origin. Dutch women had an RR of 0.92 for dysbacteriosis. Surinamese women had the highest RR for dysbacteriosis (RR = 2.36) and Moroccan women had the lowest (RR = 1.00). The same trends were seen for the risks of squamous abnormalities. The data for Turkish women follow the patterns of those for Surinamese women. The RR of dysbacteriosis is highest at 50 yr (1.28) and lowest at 35 yr (0.86). When dysbacteriotic and non-dysbacteriotic smears were compared, dysbacteriosis was observed more frequently in smears with squamous abnormalities (4.1% vs. 2.2%). Dysbacteriosis may warrant more intensive cytological surveillance and changes in lifestyle.     

Gardnerella vaginalis and Lactobacillus sp in liquid-based cervical samples in healthy and disturbed vaginal flora using cultivation-independent methods

Our objective was to determine the morphotype of the adherent bacteria in liquid-based cytology (LBC) in smears with healthy and disturbed vaginal flora. And to use PCR technology on the same fixed cell sample to establish DNA patterns of the 16S RNA genes of the bacteria in the sample. Thirty samples were randomly selected from a large group of cervical cell samples suspended in a commercial coagulant fixative "(BoonFix)." PCR was used to amplify DNA of five bacterial species: Lactobacillus acidophilus, Lactobacillus crispatus, Lactobacillus jensenii, Gardnerella vaginalis, and Mycoplasma hominis. The LBC slides were then analyzed by light microscopy to estimate bacterial adhesion. DNA of lactobacilli was detected in all cell samples. Seventeen smears showed colonization with Gardnerella vaginalis (range 2.6 x 10(2)-3.0 x 10(5) bacteria/mul BoonFix sample). Two cases were identified as dysbacteriotic with high DNA values for Gardnerella vaginalis and low values for Lactobacillus crispatus. The sample with the highest concentration for Gardnerella vaginalis showed an unequivocal Gardnerella infection. This study indicates that the adherence pattern of a disturbed flora in liquid-based cervical samples can be identified unequivocally, and that these samples are suitable for quantitative PCR analysis. This cultivation independent method reveals a strong inverse relationship between Gardnerella vaginalis and Lactobacillus crispatus in dysbacteriosis and unequivocal Gardnerella infection.     

联合应用思连康及整肠生治疗肠道菌群失调的临床研究

目的观察联合应用思连康及整肠生治疗肠道菌群失调的疗效。方法选取门诊符合入选条件的患者80例,随机平均分成2组:A思连康组;B思连康+整肠生组。入组患者分别于治疗后半个月复查肠道菌群并进行症状评分,对于各组治疗前后的评分进行统计学处理。结果思连康+整肠生组进行治疗后,患者的症状及肠道菌群有显著改善,与对照药物组相比,疗效差异有统计学意义。结论联合应用思连康及整肠生治疗肠道菌群失调的疗效优于单用思连康。     

刘力教授治疗溃疡性结肠炎病例经验介绍

刘力教授是国家中医药管理局重点学科——陕西中医学院附属医院脾胃病学科学术带头人,对溃疡性结肠炎有独到的见解和丰富的临床经验,本文主要从论溃疡与肠道菌群失调有关、大便性状判断病性特征、便稀与排便不畅相兼、审时度势把握病势寒热转化等4个方面对其临床经验进行介绍。     

Bacterial Vaginosis and Cervical Intraepithelial Neoplasia: Is there an Association or is Co-Existence Incidental?

Objectives: To determine associations, if any, of bacterial vaginosis with cervical pre-neoplastic lesions and evaluate any effects of sub-categorization of smears with bacterial vaginosis. Methods: All cervico-vaginal smears reported as positive for bacterial vaginosis over a five-year period were reviewed and sub-categorized into ‘type I (dysbacteriosis)’ and ‘type II (pure Gardenerella infection)’ smears by two cytopathologists (PS, SG). The proportion of smears with healthy flora and pre-neoplastic lesions was compared with those having bacterial vaginosis in conjunction with such changes. In addition, a comparison was also attempted between the frequencies of pre-neoplastic lesions with the two categories of bacterial vaginosis smears. Results: Bacterial vaginosis was diagnosed in 28.6% (7017 of the 24,565) of the 24,565 smears received in the Institute during the study period. Of these 7,017 smears with bacterial vaginosis, 53% (3717) were categorized as type I and 42.7% (3000) as type II by both cytopathologists. Pre-neoplastic lesions were detected in 10.2% of smears with bacterial vaginosis compared to 5.7% of those with healthy flora (P<0.0001). Of the sub-categories of bacterial vaginosis, the risk of detecting precancerous lesion was higher for type II smears (P<0.001). Conclusion: Sub-categorization of bacterial vaginosis, as performed in the Dutch coding system, may be worthwhile due to the strikingly different risk of associated preneoplasia.