141例小儿感染性腹泻临床特征及流行病学分析

目的:探讨儿童感染性腹泻(Infectious diarrhea,ID)的临床特征及病原菌学流行病特点,为临床防治提供理论依据。方法:回顾性分析我院2010年2月至2014年2月收治并确诊的141例感染性腹泻患儿的粪便培养结果,观察并总结患者体内大肠埃希菌、痢疾杆菌、肺炎克雷伯菌病毒等常见致病细菌的分布情况。结果:儿童感染性腹泻四季均可发病,夏季发病率最高,春季最低;年龄为1月~3岁的患儿感染性腹泻细菌及病毒感染比例显著高于其他两组(P0.05);141例患儿中,细菌阳性23例(16.3%),病毒培养阳性94例(66.7%)。各种病毒感染与患儿性别无关(P0.05)。结论:小儿感染性腹泻四季均较常见,病毒感染比例高于细菌感染比例,应根据病原菌分布情况积极采取预防与控制措施。     

口服补液盐治疗儿童急性腹泻轻中度脱水的疗效研究

目的:观察口服补液盐治疗儿童急性腹泻轻中度脱水的临床疗效。方法:选取我院儿科收治的63例急性腹泻伴轻中度脱水症状患儿,采取随机数表法分为两组,其中对照组32例患儿予标准口服补液盐,而治疗组31例患儿予补液盐溶液。对比治疗前后两组患儿血浆内Na+、K+、Cl-离子水平,临床症状恢复时间及改善情况。结果:治疗后,两组患儿的电解质水平均有所改善,治疗组患儿Na+、K+及Cl-水平均优于对照组,差异有统计学意义(P0.05);治疗组患儿口渴、头晕、乏力及腹痛症状的恢复时间均较对照组明显缩短,差异有统计学意义(P0.05)。治疗组临床总有效率明显优于对照组,差异具有统计学意义(P0.05)。结论:口服补液盐能明显改善儿童急性腹泻而致的轻中度脱水症状,减少静脉输液对患儿造成的负面影响,值得在临床上进行推广。     

人星状病毒研究进展

人星状病毒是引起婴幼儿病毒性腹泻的重要病原之一,本文回顾了其分子生物学特征、型别、所致疾病特征、致病机制、流行病学特征及检测方法等方面的文献,指出人星状病毒目前存在多种型别,尤其是近年来发现了多种新型的星状病毒,主要的流行型别是血清型1型,不仅引起肠道内感染,还可以引起其他系统疾病,所致疾病特征和其他腹泻相关病毒相似,但是其致病机制的研究尚不清楚,对于几种新发现的星状病毒,其与疾病的相关性研究较少,且未建立完善的实验室检测方法,还需要进一步的研究。     

中药复方对抗生素相关性腹泻微生态药理的研究进展

抗生素相关性腹泻指应用抗生素后继发腹泻,为一种严重的药源性腹泻病,具传染性和普遍性,对人们的健康危害严重,中药复方在该病的治疗中疗效显著且具更合理的治疗理念。基于目前中药复方对AAD的微生态药理学尚无综合报道,本文综述了研究领域的最新进展,并结合本人正开展的工作对未来的研究进行了展望。     

320例腹泻患者病原菌分离及流行病学分析

目的了解广州市2009年至2010年肠道门诊就诊的细菌性腹泻患者病原谱的分布情况,为制定针对重点人群肠道传染病防治策略提供依据。方法收集2009年5月至2010年5月暨南大学附属第一医院腹泻患者的粪便标本,使用卡-布运送培养基,增菌培养后,采用生化反应和氧化酶试验进行菌株鉴定,并用梅里埃API生化板条进行验证,用病原菌诊断血清进行细菌分型。结果从320份粪便标本中分离到38株菌株,其中沙门菌15株,产毒大肠埃希菌12株,致病大肠埃希菌6株,志贺菌2株,出血性大肠埃希菌、霍乱弧菌、气单胞菌各1株。0—20岁年龄段高发,以1岁以内婴幼儿为主;7—10月为发病高峰期。结论来该院肠道门诊就诊的细菌性腹泻患者,其病原体以沙门菌为主,其次为产毒大肠埃希菌。因此．广州地区细菌件腹泻的预防．廊右针对件的面向雷占人群和重占病厢莴．     

凝结芽孢杆菌活菌片预防小儿肺炎继发性腹泻疗效观察

目的观察和评价凝结芽孢杆菌活菌片（商品名：爽舒宝）与抗菌药联用预防小儿肺炎继发性腹泻的临床疗效。方法将164例肺炎患儿随机分为预防组和对照组,预防组84例,对照组80例,两组均给予抗菌药及对症支持治疗。其中预防组在治疗的同时序贯（间隔2～3h）应用凝结芽孢杆菌活菌片,出现腹泻继续服用;对照组单用抗菌药,出现腹泻用凝结芽孢杆菌活菌片治疗。对两组继发性腹泻的发生率、腹泻持续天数、肺炎治疗的总疗程、腹痛和肠鸣音异常等症状和体征进行统计分析。结果预防组继发腹泻10例,发生率11．9％,对照组继发腹泻41例,发生率51．3％,两组相比差异具有统计学意义（P〈0．01）;预防组腹泻持续时间和治疗疗程显著短于对照组（P〈0．05）;预防组患儿腹痛、肠鸣音异常和脱水等症状和体征发生率均少于对照组（P〈0．05）。结论凝结芽孢杆菌活菌片与抗菌药序贯应用治疗肺炎,能显著降低继发性腹泻的发生率,缩短疗程,值得临床推广。     

Biochemical tracers reveal intra-specific differences in the food webs utilized by individual seabirds

Food web structure regulates the pathways and flow rates of energy, nutrients, and contaminants to top predators. Ecologically and physiologically meaningful biochemical tracers provide a means to characterize and quantify these transfers within food webs. In this study, changes in the ratios of stable N isotopes (e.g., δ¹⁵N), fatty acids (FA), and persistent contaminants were used to trace food web pathways utilized by herring gulls (Larus argentatus) breeding along the shores of the St Lawrence River, Canada. Egg δ¹⁵N values varied significantly among years and were used as an indicator of gull trophic position. Temporal trends in egg δ¹⁵N values were related to egg FA profiles. In years when egg δ¹⁵N values were greater, egg FA patterns reflected the consumption of more aquatic prey. Egg δ¹⁵N values were also correlated with annual estimates of prey fish abundance. These results indicated that temporal changes in aquatic prey availability were reflected in the gull diet (as inferred from ecological tracer profiles in gull eggs). Analysis of individual eggs within years confirmed that birds consuming more aquatic prey occupied higher trophic positions. Furthermore, increases in trophic position were associated with increased concentrations of most persistent organic contaminants in eggs. However, levels of highly brominated polybrominated diphenyl ether congeners, e.g, 2,2′,3,3′,4,4′,5,5′,6,6′-decabromoDE (BDE-209), showed a negative relationship with trophic position. These contrasting findings reflected differences among contaminant groups/homologs in terms of their predominant routes of transfer, i.e., aquatic versus terrestrial food webs. High trophic level omnivores, e.g., herring gulls, are common in food webs. By characterizing ecological tracer profiles in such species we can better understand spatial, temporal, and individual differences in pathways of contaminant, energy, and nutrient flow.     

An overview of atypical enteropathogenic Escherichia coli

The enteropathogenic Escherichia coli (EPEC) pathotype is currently divided into two groups, typical EPEC (tEPEC) and atypical EPEC (aEPEC). The property that distinguishes these two groups is the presence of the EPEC adherence factor plasmid, which is only found in tEPEC. aEPEC strains are emerging enteropathogens that have been detected worldwide. Herein, we review the serotypes, virulence properties, genetic relationships, epidemiology, reservoir and diagnosis of aEPEC, including those strains not belonging to the classical EPEC serogroups (nonclassical EPEC serogroups). The large variety of serotypes and genetic virulence properties of aEPEC strains from nonclassical EPEC serogroups makes it difficult to determine which strains are truly pathogenic.     

表面表达猪流行性腹泻病毒核蛋白蛋白的重组干酪乳杆菌诱导产生的免疫应答

为探讨表达猪流行性腹泻病毒(PEDV)核蛋白(N)基因的重组干酪乳杆菌口服免疫小鼠后诱导特异性免疫应答,本研究制备表达流行性腹泻病毒核蛋白的重组干酪乳杆菌,应用Western blotting、间接免疫荧光和全细胞ELISA鉴定目的蛋白的表达。然后用该重组干酪乳杆菌口服免疫BALB/c小鼠,分别测定了免疫后不同时间血清中特异性IgG、粪便中特异性的sIgA水平以及血清的中和活性;并测定免疫小鼠脾淋巴细胞增殖情况和细胞因子水平。结果显示,目的蛋白表达在细胞表面,可被阳性血清所识别。免疫小鼠后,可分别在血清中和粪便中检测到较高水平特异性IgG、sIgA(P<0.01),但血清并没有中和活性;淋巴细胞增殖试验和细胞因子测定结果显示,免疫组可产生明显的细胞免疫应答。结果表明,该重组干酪乳杆菌表达系统可诱导小鼠产生黏膜免疫应答和系统免疫应答,具有作为口服疫苗潜在的应用价值。