黄褐斑病人皮损区皮肤菌群的研究

首次应用定位、定量和定性方法对５１例黄褐斑病人皮损区菌群进行微生态学的研究,并将结果与１０４例健康人面部菌群及经治后１０例病人菌群进行比较,结果表明黄褐斑病皮损区过路菌改变明显,象产色素的微球菌及革兰氏阴性杆菌数量增加（５×１０￣３／ｃｍ２）,分离率高（１７－３９％）,与健康人相比（５×１０￣２／ｃｍ￣２及１～３％）差异显著（Ｐ＜０．０５或Ｐ＜０．０１）。经治后黄褐斑病人常住厌氧菌增加（从６８,５２％到１００％,Ｐ＜０．０５）,使用皮肤微生态制剂调整菌群,有利于恢复微生态平衡     

反复呼吸道感染患者的微生态学分析

冬季是呼吸道反复感染的多发季节。我们对反复发生呼吸道感染病人口咽粘膜菌群的定植进行了分析。结果表明,正常组需氧菌群密度为４．１１３５±０．０８８４,厌氧菌群密度为４．４１０１±０．３５８６１;患者需氧菌群密度为４．５２９０±０．００８６,厌氧菌群密度为４．８７１８±０．３４２４。反复呼吸道感染患者需氧菌和厌氧菌的含量均不于正常对照组（Ｐ＜０．０５）。１８例病人分离出两种以上需氧菌,奈瑟氏菌和肺炎链球菌检出率较高,分别为３８．７％和２２．６％;厌氧菌以韦荣氏球菌和消化链球菌为多见,检出率分别为３２．２％和５８．１％。有７例病人分离出白色念珠菌。４例病人分离出绿脓杆菌,明显表现出微生态失调。药敏结果表明,不同菌株对抗生素均有一定的耐药性存在。     

痤疮皮损区皮肤菌群的研究

本研究对皮肤常见病─—痤疮４０例病人皮损区的皮肤菌群进行了探讨,并以１０４例健康人面部皮肤菌群及８２例治愈后病人原皮损区菌群分析作为对照,结果痤疮病人皮损区中痤疮丙酸杆菌活菌数为４．５５±０．７３（ＣＦＵ以Ｌｏｇ／ｃｍ２计）。分离率为１００％,表皮葡萄球菌数为４．１９±０．７０（１００％）,微球菌数为２．７１±０．６９（６２．５％）,杆菌数为３．０９±０．６４（９０％）,需氧的革兰氏阴性杆菌数为３．３１±０．７６（３５％）,产色素微球菌数为３．０５±０．８２（４５％）,痤疮病人皮肤的皮损区内常住菌和过路菌都较健康人明显增加,差异显著（Ｐ＜０．０５或Ｐ＜０．０１）。而经皮肤微生态制剂治疗后痤疮病皮肤菌群与健康人几乎无差异（Ｐ＞０．０５）,说明皮肤微生态制剂具有调整皮肤菌群恢复微生态平衡,提高定植抗力的生理作用,故能较有效的治疗痤疮。     

腹腔镜腹膜阴道成形术术后人工阴道微生态分析CSCD

目的了解腹腔镜腹膜阴道成形术后患者人工阴道的微生态状况,探讨腹腔镜腹膜阴道成形术后阴道微生态评价的临床意义。方法选取54例性腹腔镜腹膜阴道成形术术后回访的患者,取阴道分泌物进行微生态评价,同时检查患者的人工阴道物理功能及阴道壁组织活检。结果腹腔镜腹膜阴道成形术术后患者的人工阴道具有正常阴道的组织学特点,物理功能良好。54例患者中阴道菌群密集度为Ⅱ-Ⅲ级者48例,占88.9%;菌群多样性为Ⅱ-Ⅲ级者39例,占72.2%;优势菌为革兰阳性大杆菌者15例,占27.8%;pH≤4.5者31例,占57.4%。无病原菌感染。术后时间≥2年的23例患者阴道微生态正常者占14例（60.9%）,异常者占9例（39.1%）。术后时间〈2年的31例患者中阴道微生态正常者11例（35.5%）,异常者20例（64.5%）。菌群异常主要包括：菌群抑制（包括未见到任何细菌）、革兰阳性短杆菌（12.3%）、革兰阳性球菌（31.5%）、革兰阴性短杆菌（9.6%）。结论 （1）先天性无阴道的患者在阴道成形术后不同程度存在菌群失调表现。表现为pH值升高,阴道内菌群多样性欠佳,正常优势菌群存在比例低。（2）手术后时间是影响腹膜阴道成形术后阴道微生态的重要因素,随着术后时间的延长,人工阴道阴道微生态正常的比例逐渐增加。（3）评价腹腔镜腹膜阴道成形术后阴道微生态环境的状况,对预防与治疗术后人工阴道感染、促进人工阴道的健康发展具有重要意义。     

生态调节剂防治抗生素相关性腹泻

本文了生态调节剂防治抗生素相关性腹泻的效果并调查抗生素对肠菌群的影响。结果表明,预防组ＡＡＤ的发生率明显低于对照组,预防组肠道菌群失调较轻而对照组肠道菌群明显失调,应用生态调节剂治疗ＡＡＤ有效率为８０．３％,治疗后ＡＡＤ病人肠道菌失调 明显好转。提示生态调节剂能维护肠道微生态平衡减少ＡＡＤ的发生。     

腹腔镜腹膜阴道成形术术后人工阴道微生态分析

目的了解腹腔镜腹膜阴道成形术后患者人工阴道的微生态状况,探讨腹腔镜腹膜阴道成形术后阴道微生态评价的临床意义。方法选取54例性腹腔镜腹膜阴道成形术术后回访的患者,取阴道分泌物进行微生态评价,同时检查患者的人工阴道物理功能及阴道壁组织活检。结果腹腔镜腹膜阴道成形术术后患者的人工阴道具有正常阴道的组织学特点,物理功能良好。54例患者中阴道菌群密集度为Ⅱ~Ⅲ级者48例,占88.9%;菌群多样性为Ⅱ~Ⅲ级者39例,占72.2%;优势菌为革兰阳性大杆菌者15例,占27.8%;pH≤4.5者31例,占57.4%。无病原菌感染。术后时间≥2年的23例患者阴道微生态正常者占14例(60.9%),异常者占9例(39.1%)。术后时间2年的31例患者中阴道微生态正常者11例(35.5%),异常者20例(64.5%)。菌群异常主要包括:菌群抑制(包括未见到任何细菌)、革兰阳性短杆菌(12.3%)、革兰阳性球菌(31.5%)、革兰阴性短杆菌(9.6%)。结论 (1)先天性无阴道的患者在阴道成形术后不同程度存在菌群失调表现。表现为pH值升高,阴道内菌群多样性欠佳,正常优势菌群存在比例低。(2)手术后时间是影响腹膜阴道成形术后阴道微生态的重要因素,随着术后时间的延长,人工阴道阴道微生态正常的比例逐渐增加。(3)评价腹腔镜腹膜阴道成形术后阴道微生态环境的状况,对预防与治疗术后人工阴道感染、促进人工阴道的健康发展具有重要意义。     

16057例中国北京地区健康妇女阴道菌群的结果分析

目的初步了解中国健康女性阴道菌群的情况。方法选取中国北京地区健康体检妇女16 057例,采集阴道分泌物,进行显微镜检。结果 (1)菌群正常者占75.7%。菌群密集度范围多在++~+++,占99.2%;菌群多样性多在+~++,占81.2%;优势菌均为革兰阳性大杆菌,占100.0%。(2)在健康妇女中仍存在24.3%异常菌群,依次为菌群失调、菌群增殖过度和菌群抑制。结论健康女性阴道菌群表现为多样性,阴道微生态评价有助于筛查无症状的阴道微生态失衡女性,并对临床评价阴道感染时的阴道微生态状况有一定的指导作用。     

赫哲族和汉族健康人群肠道细菌群落分析

目的 对汉族和赫哲族健康人群肠道菌群进行研究,探讨遗传背景和饮食习惯对肠道菌群多样性以及组成的影响.方法 以佳木斯市区20例健康汉族人群、佳木斯街津口赫哲族聚居地的20例健康赫哲族志愿者及20例健康汉族人群粪便样本为研究对象,应用基于16S rDNA V3-V4可变区的高通量测序技术测定肠道菌群多样性以及核心菌群的组成...     

复方双歧杆菌制剂治疗成人腹泻疗效观察

复方双歧杆菌制剂(胶囊,成分:两歧双岐杆菌、嗜酸乳酸杆菌、粪链球菌)是由中国预防医学科学院流行病学微生物学研究所研制的。根据正常菌群具有调节肠道菌群作用,拮抗多种肠道病原菌的理论,我们以此药对20例急性腹泻的志愿者进行治疗,并检测了治疗前后肠菌群的变化,现将结果报告如下:一、病例选择:本组病例均为1989年6月～10月我院肠道门诊患者。年龄16～62岁,平均31岁。其中男性11例,女性9例,共20例。     

地衣芽孢杆菌活菌制剂对几种肠道需氧菌群的影响

我院研制的地衣芽孢杆菌活菌制剂在治疗肠道疾病方面显示了良好的效果。我们对24例急性肠炎病人和20例健康人分为两组,进行了服药前后的菌群动态观察。结果肠炎组在治疗后检查显示了肠道葡萄球菌和酵母样菌减少,肠杆菌、肠球菌无变化,健康组服药前后肠杆菌、肠球菌、葡萄球菌、酵母样菌均无明显变化。肠炎组和健康组在服药后     

Etanercept in the Treatment of Intestinal Behcet’s Disease

Behcet’s disease (BD) accompanied by intestinal involvement is called intestinal BD. Although recent studies have attained positive feedback with the administration of anti-TNF-α agents in patients with BD, only a few reports on the study of etanercept in intestinal BD have been found. In this study, 35 cases of intestinal BD were treated with conventional therapy (prednisone or methotrexate) for a minimum period of 3 months (group 1). Another 19 patients who failed to respond to conventional therapy were then treated with etanercept (25 mg twice a week for 3 months). During each subsequent relapse, the patients were given the same treatment. The main outcome measures were the four criteria for diagnosis of BD (buccal ulcers, genital ulcers, ocular lesions, and skin lesions), the manifestation of intestinal involvement (abdominal symptoms, double-balloon enteroscopy), laboratory examinations of the acute phase reactants (erythrocyte sedimentation rate) and C-reactive protein, and relapses. As a result of the administered therapy, the healing rate of buccal and genital ulcers, the remission rate of ocular lesions, skin lesions, and abdominal symptoms, the healing rate of intestinal ulcers, and the recovery rate of ESR and CRP were significantly higher in group 2 than those of group 1. The relapse rate in the etanercept therapy was reduced significantly when compared with conventional therapy group. In conclusion, etanercept treatment, in contrast to the conventional therapy, can result in better curative effect and less adverse reactions in intestinal BD.     

三联疗法抗幽门螺杆菌感染对儿童肠道菌群状态的影响

目的　探讨抗幽门螺杆菌治疗对儿童肠道菌群状态的影响。方法　分别称取18例幽门螺杆菌感染儿童治疗前后新鲜粪便1.0 g,对肠道菌群中最有代表性的3种需氧菌(肠杆菌、肠球菌和酵母菌)和4种厌氧菌(双歧杆菌、乳杆菌、类杆菌和产气荚膜梭菌) ,分别进行需氧和厌氧培养,菌落计数,同时计算B/ E值来代表定植抗力。结果　抗Hp治疗后,双歧杆菌、乳杆菌和类杆菌较治疗前明显降低( P<0 .0 5 ) ,B/ E值明显下降( P<0 .0 1) ,肠杆菌数量明显增加( P<0 .0 5 ) ,酵母菌的检出率明显增加( P<0 .0 5 )。结论　三联疗法抗Hp治疗对儿童肠道菌群产生明显的影响,因此在治疗Hp感染时须考虑到大量抗生素治疗后可能对患儿产生的副作用及潜在的危险     

急性肠系膜缺血性疾病36例治疗体会

摘要 目的：探讨急性肠系膜缺血(acute mesenteric ischemia,AMI)的诊断和治疗方法。方法：回顾性收集并分析36 例AMI患者的临床资料,均术前行MDT讨论,血管外科及胃肠外科联合手术治疗。所有治疗病例均行手术探查。其中3例病人术中使用荧光内镜判断肠道血供。统计诊治过程中腹部CT、白细胞计数、D-二聚体相关数据,应用SPSS软件分析其与肠道坏死的相关性。结果：腹部CT特异表现、白细胞计数升高与肠道坏死有相关性关系。治疗病例有11例行肠切除、 8例为外院行手术治疗后,在我院行术后康复治疗。术后8例发生短肠综合证。1例病人自动出院。1例死亡。1例病人术后出现肠道坏死、肠瘘,3个月后行肠瘘切除术,术后恢复良好。5例病人术后6个月行造口还纳。荧光内镜判断肠道血供及生机效果良好。结论：AMI 病情凶险,提高对疾病的认识,早期诊断,尽早重建小肠血运是提高疗效、改善预后的关键。多学科讨论后精准治疗,可提高治疗效果。术前腹部CTA对AMI的诊断及判断肠道坏死有重要意义。术中使用吲哚箐绿荧光显影剂、配合荧光导航内镜,判断肠道缺血范围,值得进一步探讨。临时性肠道双造瘘有利于及时发现肠管血运恢复情况,远端造瘘可早期进行肠内营养,值得推广。     

Long-Term Alteration of Intestinal Microbiota in Patients with Ulcerative Colitis by Antibiotic Combination Therapy

Previous work has demonstrated that intestinal bacteria, such as Fusobacterium varium (F. varium), contribute to the clinical activity in ulcerative colitis (UC); thus, an antibiotic combination therapy (amoxicillin, tetracycline, and metronidazole (ATM)) against F. varium can induce and maintain UC remission. Therefore, we investigated whether ATM therapy induces a long-term alteration of intestinal microbiota in patients with UC. Patients with UC were enrolled in a multicenter, randomized, double-blind, placebo-controlled study. Biopsy samples at the beginning of the trial and again at 3 months after treatment completion were randomly obtained from 20 patients. The terminal restriction fragment length polymorphism (T-RFLP) in mucosa-associated bacterial components was examined to assess the alteration of the intestinal microbiota. Profile changes of T-RFLP in mucosa-associated bacterial components were found in 10 of 12 patients in the treatment group and in none of 8 in the placebo group. Dice similarity coefficients using the unweighted pair group method with arithmetic averages (Dice-UPGMA) confirmed that the similarity of mucosal microbiota from the descending colon was significantly decreased after the ATM therapy, and this change was maintained for at least 3 months. Moreover, at 3 months after treatment completion, the F. varium/β-actin ratio, examined by real-time PCR using nested PCR products from biopsy samples, was reduced less than 40% in 8 of 12 treated patients, which was higher, but not significantly, than in 4 of 8 patients in the placebo group. Together, these results suggest that ATM therapy induces long-term alterations in the intestinal microbiota of patients with UC, which may be associated, at least in part, with clinical effects of the therapy.     

Efficacy of Clostridium butyricum preparation concomitantly with Helicobacter pylori eradication therapy in relation to changes in the intestinal microbiota

Antibiotic associated diarrhea due to human intestinal microbiota abnormalities is a side effect of H. pylori eradication therapy. We examined intestinal microbiota changes during H. pylori eradication therapy and the preventive effect of CBM588 as a probiotic agent. Nineteen patients with gastro-duodenal ulcer were randomly divided into three groups: group A (without probiotics), group B (with regular doses of CBM588) and group C (with double doses of CBM588). The incidence of diarrhea and soft stools during H. pylori eradication therapy was 43% in group A and 14% in group B, while none of the patients in group C reported diarrhea or soft stools. Both bacterial counts and detection rates of bifidobacteria and/or obligate anaerobe were decreased by eradication therapy. However, bacterial counts of obligate anaerobes in group C were significantly higher than in group A ( P  < 0.05). Additionally, during eradication therapy C. difficile toxin A was detected in both group A and group B but not in group C.
In conclusion, these results indicate that H. pylori eradication therapy induces antibiotic associated diarrhea due to abnormalities in intestinal microbiota and/or C. difficile . However, these side effects might be prevented by probiotics.     

双气囊小肠镜在小肠出血中的应用价值

目的:观察双气囊小肠镜在小肠出血中的病变检出率、病因诊断率、耐受性和安全性,并探讨双气囊小肠镜对小肠出血的内镜下治疗情况.方法:对2006年3月至2009年11月烟台毓璜顶医院消化内科收治的可疑小肠出血患者102例行双气囊小肠镜检查,首选进镜方式分为经口或经肛2种,首选方式检查后未发现病灶者,日后改换进镜方式再行检查.对活动性出血病灶行内镜下止血治疗,小肠息内行息肉切除.结果:双气囊小肠镜的病变检出率为94.12%(96/102),病因诊断率为84.31%(86/102).其中35例检查时见病变活动性出血,行内镜下止血治疗,33倒止血成功,内镜止血成功率为94.30%(33/35);在耐受性方面.双气囊小肠镜的耐受性依次为:全麻下经肛进镜、全麻下经口进镜、非麻醉经肛进镜、非麻醉经口进镜.所有患者均未发生严重并发症.结论:双气囊小肠镜对小肠出血具有较高的病变检出率和病因诊断率,并且可行内镜下止血治疗,是一项安全、有效的临床诊疗方法.     

微生态制剂治疗肝硬化肠功能紊乱患者的临床观察

目的探讨微生态制剂治疗肝硬化肠功能紊乱患者的疗效。方法选择80例肝硬化肠功能紊乱患者,随机分成治疗组和对照组。治疗组:常规保肝治疗加金双歧(4粒/次,2次/d);对照组:常规保肝治疗。疗程均为4周。结果治疗组和对照组相比,腹胀、腹泻、腹部不适症状明显改善,血氨水平降低,血浆内毒素水平下降,2组相比差异有显著性(P<0.05)。结论微生态制剂对于改善肝硬化患者临床症状有肯定的价值,并可降低血氨及血浆内毒素水平,有利于肝功能的改善。     

Rifaximin antibiotic treatment for restless legs syndrome: a double-blind,placebo-controlled study

Sleep and Biological Rhythms - The purpose was to evaluate rifaximin antibiotic therapy for restless legs syndrome (RLS) patients who have small intestinal bacterial overgrowth (SIBO). Patients...     

肠疗与贝飞达合用治疗急性黄疸型肝炎的研究

目的 对90例急性黄疸型肝炎患者分别测定应用肠疗和贝飞达治疗前、后肠道菌群数量和红细胞粘附率、红细胞CR1分子数量及临床疗效评价指标,并进行比较。方法 将患者随机分成常规治疗、常规治疗加肠疗、常规治疗加肠疗与贝飞达3个治疗组（各30例）。分析患者治疗前后血液生化指标和肠道菌群数量及红细胞粘附率、红细胞CR1分子数量,并观察临床症状的改善情况。结果 急性黄疸型肝炎患者存在肠道菌群失调,红细胞粘附肿瘤功能及红细胞CR1分子数量明显下降（P〈0．01）;应用微生态调节剂组患者的肝功能恢复程度及临床症状的改善好于常规治疗组和常规治疗加肠疗组,差异有显著性（P〈0．01）。结论 结肠治疗机治疗联合微生态调节剂贝飞达可以有效改善急性黄疸型肝炎患者肠道菌群失调,提高患者红细胞粘附率及红细胞CR1分子数量,提高临床治疗有效率。     

Changes in endogenous microflora among febrile granulocytopenic patients receiving empiric antibiotic therapy: implications for fungal superinfection.

The ecologic effect of empiric systemic antibiotic therapy on the endogenous microflora was evaluated in 83 febrile granulocytopenic patients with cancer who were randomly allocated to receive moxalactam plus ticarcillin (45 patients) or tobramycin plus ticarcillin (38 patients) for suspected infection. Serial surveillance cultures of the nasal passages, oropharynx and feces performed twice a week showed that patients who received the former regimen had higher elimination rates and significantly lower acquisition rates (p = 0.027) for aerobic gram-negative bacilli than did patients who received the latter regimen. However, therapy with moxalactam plus ticarcillin also resulted in significantly higher acquisition rates for yeasts (p = 0.004). This was associated with a significantly higher fungal superinfection rate among these patients than among those who received tobramycin plus ticarcillin (40% v. 16%) (p less than 0.05). Moxalactam plus ticarcillin therapy created a greater microbial ecologic vacuum by the elimination of intestinal anaerobes, which, in turn, permitted fungal colonization and an increased risk of superinfection. Our results support the recommendation that an antipseudomonal penicillin plus an aminoglycoside be selected as empiric therapy for suspected infection in febrile granulocytopenic patients with cancer. Such a regimen would spare the anaerobic intestinal microflora, thereby reducing the risk of fungal colonization and infection.