复发性外阴阴道念珠菌病的致病菌种鉴定及药敏分析

目的:探究复发性外阴阴道念珠菌病致病菌的菌种分布及耐药情况,指导临床治疗。方法:收集210例念珠菌性外阴阴道炎患者阴道分泌物标本,其中复发性外阴阴道念珠菌病(RVVC)组76例,外阴阴道念珠菌病(VVC)组134例。运用科玛嘉显色培养基法进行菌种鉴定和药物敏感试验。结果:在210例病例中,RVVC组中白色念珠菌54株(71.05%),光滑念珠菌15株(19.74%),热带念珠菌4株(5.26%),克柔念珠菌2株(2.63%),近平滑念珠菌1株(1.32%)。非白色念珠菌中以光滑念珠菌为主,在RVVC组中的比例明显高于VVC组,有显著性差异(P<0.05)。药敏试验显示,RVVC的念珠菌株中仅8株对7种药物全部敏感,23株敏感药物<5种,其中1株仅对制霉菌素敏感;对药物的敏感率为制霉菌素(97.37%)>克霉唑(60.52%)>酮康唑(51.32%)>伊曲康唑(36.84%)>咪康唑(35.53%)>氟康唑(23.68%)>特比奈芬(10.53%)。结论:白色念珠菌仍是RVVC的主要致病菌,非白色念珠菌比例在RVVC组中显著高于VVC组,其中以光滑念珠菌为主。念珠菌对制霉菌素敏感率最高,对唑类药物耐药性有增加趋势。     

复发性外阴阴道念珠菌病的致病菌种鉴定及药敏分析

目的：探究复发性外阴阴道念珠菌病致病菌的菌种分布及耐药情况,指导临床治疗。方法：收集210例念珠菌性外阴阴道炎患者阴道分泌物标本,其中复发性外阴阴道念珠菌病（RVVC）组76例,外阴阴道念珠菌病（VVC）组134例。运用科玛嘉显色培养基法进行菌种鉴定和药物敏感试验。结果：在210例病例中,RVVC组中白色念珠菌54株（71.05%）,光滑念珠菌15株（19.74%）,热带念珠菌4株（5.26%）,克柔念珠菌2株（2.63%）,近平滑念珠菌1株（1.32%）。非白色念珠菌中以光滑念珠菌为主,在RVVC组中的比例明显高于VVC组,有显著性差异（P〈0.05）。药敏试验显示,RVVC的念珠菌株中仅8株对7种药物全部敏感,23株敏感药物〈5种,其中1株仅对制霉菌素敏感;对药物的敏感率为制霉菌素（97.37%）〉克霉唑（60.52%）〉酮康唑（51.32%）〉伊曲康唑（36.84%）〉咪康唑（35.53%）〉氟康唑（23.68%）〉特比奈芬（10.53%）。结论：白色念珠菌仍是RVVC的主要致病菌,非白色念珠菌比例在RVVC组中显著高于VVC组,其中以光滑念珠菌为主。念珠菌对制霉菌素敏感率最高,对唑类药物耐药性有增加趋势。     

复发性外阴阴道念珠菌病与女性生殖支原体感染的关系

外阴阴道念珠菌病（Vulvovaginal candidiasis,VVC）是常见妇科疾病,病原体主要为白念珠菌,易出现反复发作情况。若经过治疗,临床症状和体征消失,真菌学检查为阴性后症状重现,真菌学检查又呈阳性,则属复发。1a内4次复发则称为复发性外阴阴道念珠菌病（Recurrence vulvovaginal candidiasis,RVVC）。     

344对性伴侣生殖器念珠菌感染的菌型分析

<正>生殖器念珠菌病包括外阴阴道念珠菌病和念珠菌性包皮龟头炎。念珠菌是条件致病性真菌,一般健康妇女阴道可携带而无临床症状,孕妇带菌者     

67例阴道念珠菌病临床分析及药敏试验

为了解女性性病高危人群中阴道念珠菌病的发病情况和菌群特征,笔者对性病门诊中67例阴道念珠菌病进行性病检查和化验,并对分离到的念珠菌进行菌种鉴定和体外药敏试验,现报告如下。     

可宝净治疗外阴阴道念珠菌病的临床研究

目的探讨可宝净治疗外阴阴道念珠菌病（VVC）的疗效。方法将2004年5月-2005年4月在朝阳市二医院确诊为VVC的患者分为2组。单纯使用达克宁栓者（A组）60例,单纯使用可宝净者（B组）70例进行对照。对2组的临床症状及真菌学检查结果进行分析讨论。结果停药7—10d时与停药28-35d时,A、B两组患者的疗效差异无显著性（P〉0.05）。但A组治愈后3个月复发人数为5例,B组复发人数为0例（P〈0.05）,差异有显著性。结论单纯使用可宝净与单纯使用抗真菌药物,均能够达到满意的治疗VVC的疗效。但可宝净治疗念珠菌病的复发率低。     

外阴阴道念珠菌病的病原学研究进展

念珠菌感染为阴道感染的第二大原因,仅次于细菌性阴道炎。估计75％的育龄妇女至少患有一次念珠菌性阴道炎,40％－50％患者有再次发作的经历,而5％的妇女有反复发作的外阴阴道念珠菌病,严重影响着育龄妇女的身心健康。本文主要综述了近几年来国内外有关外阴阴道念珠菌病和复发性外阴阴道念珠菌病病原学方面的研究进展。     

念珠菌病的临床研究进展

念珠菌病是由念珠菌属的某些种群引起的条件致病真菌感染,是人类真菌感染性疾病中最多见的疾病。临床上分为浅部皮肤黏膜念珠菌病和深部念珠菌病（亦称系统性念珠菌病）。近年来深部念珠菌病的发病率有上升趋势,该病涉及临床各科室,危害性大,病死率高,是临床研究的热点。现复习近年国内外文献,就其致病念珠菌的动态流行病学、分子流行病学以及该病的实验室诊断进展及防治现状加以简要的介绍。     

外阴阴道念珠菌病的诊治

外阴、阴道念珠菌病是妇女发生外阴、阴道不适的原因之一,严重时影响生活质量,甚至产生心理后遗症。其病原体分为白念珠菌和非白念珠菌两大类,以白念珠菌居多,但近年来非白念珠菌感染所占比率有所上升。诊断主要依靠临床症状、体征和实验室检查。真菌培养是诊断的金标准。单纯性外阴阴道念珠菌病的治疗简单,唑类是常用药。症状严重时可加大药量、口服和局部联合用药,易复发者行6个月的巩固治疗。常用治疗方法对HIV感染患者同样有效。妊娠期外阴阴道念珠菌病患者应避免口服药,唑类药物为局部常用药如硝酸布康唑。糖尿病患者光滑念珠菌感染较多,对硼酸治疗比较敏感。     

生殖道念珠菌病病原真菌的调查及药敏试验

目的了解本地区生殖道念珠菌病病原真菌构成及其体外药敏试验情况。方法采用科玛嘉念珠菌显色培养基和YBC鉴定卡对患者1164份生殖道标本的致病真菌进行分离和鉴定,并用ROSCO纸片扩散法检测分离菌株对制霉菌素、酮康唑、氟康唑、伊曲康唑、咪康唑和特比萘芬的药敏情况。结果共分离9种295株念珠菌,其中自念珠菌为85．76％,近平滑念珠菌为7．46％,光滑念珠菌为3．39％,其他念珠菌为3．39％。295株念珠菌对制霉菌素、酮康唑、氟康唑、伊曲康唑、咪康唑和特比萘芬的敏感性分别为99．66％、97．29％、89．83％、72．22％、46．44％和36．61％。结论本地区生殖道念珠菌病患者致病菌分布以白念珠菌为主,体外药敏显示制霉菌素、酮康唑和氟康唑有较好的敏感性。     

Chimpanzee genital swelling and its role in the pattern of sociosexual behavior

Behavioral observations were made on thirteen female and seven male adult group-living chimpanzees (Pan troglodytes). The behavioral data were analyzed as a function of the day of the females' menstrual cycles to explore the possible interrelationship between genital swelling and sociosexual behavior of female chimpanzees. Copulatory behavior was confined almost entirely to the period of genital swelling and the occurrence of male-to-female genital inspection (both female- and male-initiated) was negatively correlated with the days from swelling onset, i.e., as the presumed day of ovulation approached, genital inspection decreased, while copulatory behavior increased. In addition, more females groomed their male cagemates during the luteal phase than in the follicular phase of their cycles, whereas male-to-female grooming was positively correlated with the progress of the cycle, with peaks during the time of swelling onset and menstruation. The profile of sociosexual behavior observed throughout the menstrual cycle suggested that, although chimpanzees exhibit an extended period of sexual receptivity and genital swelling, the presumed fertile period is not concealed. The role of genital swelling in chimpanzees is discussed in relation to the possible hormonal effect on female sexuality and the evolution of chimpanzee mating strategies. © 1992 Wiley-Liss, Inc.     

3D genital shape complexity in female marine mammals

Comparisons of 3D shapes have recently been applied to diverse anatomical structures using landmarking techniques. However, discerning evolutionary patterns can be challenging for structures lacking homologous landmarks. We used alpha shape analyses to quantify vaginal shape complexity in 40 marine mammal specimens including cetaceans, pinnipeds, and sirenians. We explored phylogenetic signal and the potential roles of natural and sexual selection on vaginal shape evolution. Complexity scores were consistent with qualitative observations. Cetaceans had a broad range of alpha complexities, while pinnipeds were comparatively simple and sirenians were complex. Intraspecific variation was found. Three‐dimensional surface heat maps revealed that shape complexity was driven by invaginations and protrusions of the vaginal wall. Phylogenetic signal was weak and metrics of natural selection (relative neonate size) and sexual selection (relative testes size, sexual size dimorphism, and penis morphology) did not explain vaginal complexity patterns. Additional metrics, such as penile shape complexity, may yield interesting insights into marine mammal genital coevolution. We advocate for the use of alpha shapes to discern patterns of evolution that would otherwise not be possible in 3D anatomical structures lacking homologous landmarks.     

Geographic variation in genital morphology of Ciulfina praying mantids

Geographic variation in morphological traits is widespread and important to our current understanding of evolutionary processes. Although male genitalia are perhaps the most divergent morphological traits in animals, geographic variation in genital traits has received little attention and the mechanism driving such variation is unclear. The species isolation hypothesis of genital evolution makes explicit predictions about geographic variation in genitalia predicting patterns of genital divergence that reflect the risk of mating with related but incompatible species. The sexual selection and pleiotropy hypotheses, however, predict general levels of geographic variation that reflect divergent sexual selection pressures or genetic drift. To test these predictions, we investigated geographic variation in genital morphology in the praying mantid genus Ciulfina (Mantodea: Liturgusidae) using elliptic Fourier analysis. We found significant levels of geographic variation in the genital morphology of four Ciulfina species irrespective of the relative proximity of different populations to contact zones with other species. These results reject the species isolation hypothesis, and instead support either the sexual selection or pleiotropy hypotheses to explain patterns of genital evolution in this genus.     

Selection on an antagonistic behavioral trait can drive rapid genital coevolution in the burying beetle,Nicrophorus vespilloides

Male and female genital morphology varies widely across many taxa, and even among populations. Disentangling potential sources of selection on genital morphology is problematic because each sex is predicted to respond to adaptations in the other due to reproductive conflicts of interest. To test how variation in this sexual conflict trait relates to variation in genital morphology we used our previously developed artificial selection lines for high and low repeated mating rates. We selected for high and low repeated mating rates using monogamous pairings to eliminate contemporaneous female choice and male–male competition. Male and female genital shape responded rapidly to selection on repeated mating rate. High and low mating rate lines diverged from control lines after only 10 generations of selection. We also detected significant patterns of male and female genital shape coevolution among selection regimes. We argue that because our selection lines differ in sexual conflict, these results support the hypothesis that sexually antagonistic coevolution can drive the rapid divergence of genital morphology. The greatest divergence in morphology corresponded with lines in which the resolution of sexual conflict over mating rate was biased in favor of male interests.     

Influence of body and genital morphology on relative male fertilization success in oriental beetle

Although the frequently large variance in relative male fertilizationsuccess when females are mated by more than 1 male has beenappreciated for some time, the factors that influence relativepaternity are still poorly understood. Recently, experimentalevidence that morphology of male genitalia influences fertilizationsuccess has been documented in 2 water striders, a dung beetle,and a leaf beetle. We explored the role of male genital morphologyin postcopulatory sexual selection in the oriental beetle. Wemated females to 2 males in succession and assessed relativepaternity by the sterile male technique. Morphology of the malegenitalia was found to strongly influence relative paternitybut only for the first male to mate. Male body size influencedrelative fertilization success as well, but again, only forthe first male; surprisingly, smaller males achieved higherpaternity when mating first. We also found suggestive evidencethat copula duration of both the first and second male to mateinfluenced paternity. Other factors, including female size anddegree of asymmetry of hind tibiae length of males had no effecton relative fertilization success. Our results for the orientalbeetle are novel among sperm precedence studies for 2 reasons:1) traits of the first male appear to be more important in influencingpaternity than those of the second, and 2) smaller, not larger,males achieved greater relative paternity. Our results alsocontribute to the growing body of empirical evidence in supportof the hypothesis that male genitalia evolve by postcopulatorysexual selection.     

No evidence for external genital morphology affecting cryptic female choice and reproductive isolation in Drosophila

Genitalia are one of the most rapidly diverging morphological features in animals. The evolution of genital morphology is proposed to be driven by sexual selection via cryptic female choice, whereby a female selectively uptakes and uses a particular male's sperm on the basis of male genital morphology. The resulting shifts in genital morphology within a species can lead to divergence in genitalia between species, and consequently to reproductive isolation and speciation. Although this conceptual framework is supported by correlative data, there is little direct empirical evidence. Here, we used a microdissection laser to alter the morphology of the external male genitalia in Drosophila, a widely used genetic model for both genital shape and cryptic female choice. We evaluate the effect of precision alterations to lobe morphology on both interspecific and intraspecific mating, and demonstrate experimentally that the male genital lobes do not affect copulation duration or cryptic female choice, contrary to long‐standing assumptions regarding the role of the lobes in this model system. Rather, we demonstrate that the lobes are essential for copulation to occur. Moreover, slight alterations to the lobes significantly reduced copulatory success only in competitive environments, identifying precopulatory sexual selection as a potential contributing force behind genital diversification.     

Condition dependence of male and female genital structures in the seed beetle Callosobruchus maculatus (Coleoptera: Bruchidae)

Theory predicts that costly secondary sexual traits will evolve heightened condition dependence, and many studies have reported strong condition dependence of signal and weapon traits in a variety of species. However, although genital structures often play key roles in intersexual interactions and appear to be subject to sexual or sexually antagonistic selection, few studies have examined the condition dependence of genital structures, especially in both sexes simultaneously. We investigated the responses of male and female genital structures to manipulation of larval diet quality (new versus once‐used mung beans) in the bruchid seed beetle Callosobruchus maculatus. We quantified effects on mean relative size and static allometry of the male aedeagus, aedeagal spines, flap and paramere and the female reproductive tract and bursal spines. None of the male traits showed a significant effect of diet quality. In females, we found that longer bursal spines (relative to body size) were expressed on low‐quality diet. Although the function of bursal spines is poorly understood, we suggest that greater bursal spine length in low‐condition females may represent a sexually antagonistic adaptation. Overall, we found no evidence that genital traits in C. maculatus are expressed to a greater extent when nutrients are more abundant. This suggests that, even though some genital traits appear to function as secondary sexual traits, genital traits do not exhibit heightened condition dependence in this species. We discuss possible reasons for this finding.     

A non-sperm transferring genital trait under sexual selection: an experimental approach

Male genitalia are among the fastest evolving morphological characters, and at a general level sexual selection seems to be involved. But experimental determination of the functions of many remarkable genitalic elaborations is very rare. Here we present the first study to address experimentally the adaptive function of a male genital structure that is not involved in sperm transfer. Females of the orb-weaving spider Argiope bruennichi are sexually cannibalistic and polyandrous. The male increases his paternity by obstructing the female's insemination duct with a fragment of his complex genitalia (embolus tip). We manipulated males by detaching another species-specific structure, the median apophysis spur, and found that the spur promotes breakage of the embolus tip inside the female duct, but does not affect the probability and duration of copulation. These data are novel in that they suggest that a genitalic structure which does not transfer sperm nevertheless evolved in the context of sperm competition.     

Intra-specific variation in the morphology and the benefit of large genital sclerites of males in the adzuki bean beetle (Callosobruchus chinensis)

Rapid evolution has led to a large diversity in the sizes and morphology of male genitals across taxa, but the mechanisms driving this evolution remain controversial. In this study, we investigated the function of male genital sclerites in the adzuki bean beetle (Callosobruchus chinensis) and compared the length and morphology of genital sclerites between two populations that vary in their degree of polyandry. We found that the length of male genital sclerites was negatively correlated with copulation duration but positively correlated with the speed of matings with multiple females. Additionally, we found that the average length and number of genital sclerite spines of males from the more polyandrous population were larger than those from the less polyandrous population. We suggest that the genital sclerite of male adzuki bean beetles evolved by sexual selection, and a larger genital sclerite has a selective advantage because it allows for rapid copulations with multiple females.