莫西沙星治疗慢性支气管炎细菌感染急性发作的临床疗效观察

目的:观察莫西沙星短疗程治疗慢性支气管炎细菌感染急性发作(ABECB)的临床疗效。方法:将74例ABECB患者随机分为两组,治疗组用莫西沙星400mg,po.qd,治疗5d;对照组用克拉霉素500mg,po.bid,治疗5d。观察临床指标、细菌学、临床疗效及安全性。结果:治疗组与对照组的有效率分别为91.9%和78.4%,细菌清除率为89.2%和75.7%,两组比较差异有显著性(P<0.05)。结论:莫西沙星在短疗程下治疗慢性支气管炎急性细菌加重的疗效显著,是一种广谱、安全的抗菌药物。

小儿幽门螺杆菌感染

幽门螺杆菌（helicobacter pylori,HP）感染是一种很常见的慢性细菌感染,它可导致慢性活动性胃炎、消化性溃疡,甚至胃癌等消化道疾病。近年来研究表明,许多胃肠外疾病与HP感染也有明显关系,50%的成人发生HP相关疾病都是在儿童期感染了HP而未得到及时根治所致;因此,深入研究小儿HP感染的流行病学特点、发病机制、诊断,并及时予以治疗非常重要。

重视幽门螺杆菌感染,根除有策略

幽门螺杆菌（HP）感染是人类最常见的慢性细菌感染．全世界约一半的人口都感染了HP，分布在不同地区及不同年龄人群。

抗精神病药物联合抗感染治疗精神分裂症的3例分析

精神分裂症是一组主要表现为思维障碍,认知、情感及行为不协调的重性精神病,患者难以独立生活。患病后严重影响社会功能,对患者自身及其家庭均造成严重影响,终生患病率为1%,复发率高。目前病因尚未明确,有神经生化假说,神经发育障碍假说,遗传假说及自身免疫障碍相关、社会心理因素影响等[1-2];也有学者研究发现精神分裂症患者海马、额叶皮层、扣带回和内嗅脑皮层有细胞结构紊乱;或认为与免疫系统和大脑的复杂交互作用密切相关[3];近几年有学者认为炎症因子如白介素、肿瘤坏死因子等与疾病的发生发展有关,并探讨了非甾体类抗炎药物在精神分裂症疗效方面的研究[4]。

加替沙星治疗慢性支气管炎细菌感染急性发作的疗效观察

目的观察加替沙星短疗程治疗慢性支气管炎细菌感染急性发作（ABECB）的临床疗效。方法将74例ABECB住院患者采用随机盲法对照试验分为两组，治疗组用加替沙星胶囊200mg，口服，每天3次，治疗5d；对照组用环丙沙星片250mg，口服，每天3次，治疗5d。观察临床指标、细菌学、临床疗效及安全性。结果治疗组与对照组的有效率分别为91．9％和78．4％，细菌清除率为89．2％和75．7％，两组比较差异有统计学意义（P〈0．05）。结论加替沙星对急性细菌感染有很好的临床疗效和微生物学效果，耐受性和安全性好，不失为抗敏感菌感染可选药物，在短疗程内治疗慢性支气管炎急性细菌感染加重的疗效显著，是一种广谱、安全的抗菌药物。

抗菌素将用于预防冠心病

医学研究表明．慢性细菌感染也是致冠心病的危险因素之一。据美国《医学论坛报》1998年11月5日报道，美国盐湖城犹他大学心导管实验室主任muhlestein提出，抗菌素总有一天可能成为心血管治疗的一部分。最近美国明尼苏达大学赫斯伯格教授．将人体和兔子身上的血小板分别与口腔链球菌结合时发现，试管中的口腔链球菌可使血小板凝固起来。

肝硬化并发自发性腹膜炎90例

自发性腹膜炎（SBP）是在非腹膜腔脏器穿孔和损伤情况下出现的腹膜急慢性细菌感染，其最常见的基础病变为失代偿期肝硬化。自发性腹膜炎的临床表现多不典型而易延误治疗，预后差、病死率高。本文对我院90例自发性腹膜炎患者的临床资料进行分析，旨在总结自发性腹膜炎的治疗方法，以早发现、早治疗，改善预后。

Gut flora and bacterial translocation in chronic liver disease

Increasing evidence suggests that derangement of gut flora is of substantial dinical relevance to patients with cirrhosis. Intestinal bacterial overgrowth and increased bacterial translocation of gut flora from the intestinal lumen, in particular, predispose to an increased potential for bacterial infection in this group. Recent studies suggest that, in addition to their role in the pathogenesis of overt infective episodes and the clinical consequences of sepsis, gut flora contributes to the pro-inflammatory state of cirrhosis even in the absence of overt infection. Furthermore, manipulation of gut flora to augment the intestinal content of lactic acid-type bacteria at the expense of other gut flora species with more pathogenic potential may favourably influence liver function in cirrhotic patients. Here we review current concepts of the various inter-relationships between gut flora, bacterial translocation, bacterial infection, pro-inflammatory cytokine production and liver function in this group.

Helicobacter pylori infection in the pharynx of patients with chronic pharyngitis detected with TDI-FP and modified Giemsa stain

AIM： To detect whether there is Helicobacter pylori （Hpylori） colonization in the pharynx mucous membrane of healthy people and whether chronic pharyngitis is related to Hpylori infection. METHODS： Fifty cases of chronic pharyngitis refractory over three months were prospectively studied from March 2004 to August 2004 in the otolaryngology outpatient department of the Second Hospital of Xi＇an Jiaotong University. Template-directed dye-terminator incorporated with fluorescence polarization detection （TDI-FP） and modified Giemsa stain were used to examine pharynx mucous membrane tissue for H pylori colonization in the patients with chronic pharyngitis and the healthy people as a control group. RESULTS： In the control group, no people were detected to have Hpylori in the pharynx. In contrast, in 50 cases with chronic pharyngitis, 19 （38.0%） cases were H pylori positive with a TDI-FP assay and 4 （8%） cases were TDI-FP positive with Giemsa staining in the pharynx. Sixteen of the 50 pharyngitis cases had stomach ailment history, 11 cases （68.8%） of these 16 patients were determined to be H pylori positive in the pharynx with the TDI-FP assay. 2,2 test showed that this infection rate was remarkably higher （P= 0.0007） than that in the cases without stomach ailment history. Giemsa staining showed that 3 cases （18.8%） of the patients with stomach ailment history were infected with H pylori in the pharynx, which was remarkably higher （P = 0.042） than that in the patients without stomach ailment history （1 case, which was 2.9%）. CONCLUSION： H pylori may not be detected in the pharynx of healthy people. Chronic pharyngitis may be related to H pylori infection. The infection rate with Hpylori in the pharynx is higher in patients with stomach ailment histories than in patients without stomach ailment histories, suggesting that chronic pharyngitis may be related to stomach ailment history.

H pylori are associated with chronic cholecystitis

AIM： To study whether H pylon are associated with chronic cholecystitis. METHODS： The subjects were divided into three groups： H pylori-infected cholecystitis group, H pylorinegative cholecystitis group and control group. Pathologic changes of the gallbladder were observed by optic and electronic microscopes and the levels of interleukin-1, 6 and 8 （IL-1, 6 and 8） were detected by radioimmunoassay. RESULTS： Histological evidence of chronic cholecystitis including degeneration, necrosis, inflammatory cell infiltration, were found in the region where H pylori colonized. Levels of IL-1, 6 and 8 in gallbladder mucosa homogenates were significantly higher in H py/oriinfected cholecystitis group than those in Hpylorinegative cholecystitis group and control group. CONCLUSION： H pylon infection may be related to cholecystitis.

联合抗生素治愈焦虑性障碍1例及其随访报道

本研究对1例焦虑性障碍并呼吸道、泌尿道及消化道隐性感染的患者给予抗焦虑药物联合抗生素治疗,取得了良好效果,启发作者对隐性感染与焦虑性障碍之间可能存在的因果关系进行了思考。

抗生素联合激素治疗3例免疫性脑炎患者的效果分析

目的:分析抗生素联合激素治疗免疫性脑炎的效果,为治疗免疫性脑炎提供新的参考。方法:选取2018年5月—2020年7月在广东医科大学附属医院住院的3例以精神行为异常及情绪变化为首发症状的抗N-甲基-D-天冬氨酸(NMDA)型免疫性脑炎患者,在使用抗生素抗细菌感染的同时给予激素治疗。该3例患者以精神症状为首发,存在咽喉、鼻窦等部位的感染,同时血液存在细菌感染的生物学指标。结果:随着抗生素、激素的应用,精神症状、意识状态、认知缺损等症状得到了快速改善。结论:当前被定义为抗NMDA型自身免疫性脑炎的发病可能与脑外躯体的慢性隐性细菌感染有关,在传统的大剂量激素治疗方案中,同时使用抗生素,当感染被有效治疗后,疾病的各方面症状也得以迅速缓解。本文作者体会到,抗感染联合激素治疗抗NMDA型免疫性脑炎的疗效显著,并认为,抗生素抗细菌感染治疗是该类疾病的病因学治疗。

吸入性抗生素治疗支气管扩张症的前景与局限性

非囊性纤维化支气管扩张症（支扩）是一种由多种原因引起的气道疾病.慢性细菌感染与疾病进展及反复急性加重相关,导致症状加重,肺功能和生活质量下降,也是病死率增加的原因之一[1-3].抗生素在治疗感染、急性加重和预防致病菌的慢性气道定植方面发挥了重要作用[4-7],但与慢阻肺及支气管哮喘相比,稳定期支扩的治疗未得到足够的重视[8].吸入性药物可在局部达到较高的浓度且毒性低,但可刺激气道,出现支气管痉挛等不良反应,因此,20世纪40年代后抗生素吸入治疗被否定[9-10].近期有关吸入抗生素治疗支扩的研究有了新的进展,但仍存在争议[11-23].

浙江苍南地区幽门螺杆菌流行趋势及耐药现状研究

幽门螺杆菌（Hpylori）感染是临床常见的慢性细菌感染，流行病学调查显示我国Hpylori感染率总体上仍然很高，成人感染率达40％--60％。随着治疗根除且pylori抗菌药物的广泛使用，临床上根除Hpylori的难度逐年增加。

左氧氟沙星注射液不良反应分析及合理应用

左氧氟沙星注射液系氧氟沙星的左旋体,属人工合成的第三代喹诺酮类药物,包括左氧氟沙星及其乳酸盐、甲磺酸、盐酸盐注射液。剂型包括粉针剂、小容量注射液、大容量注射液。该药主要作用机制为抵制细菌DNA旋转酶的活性,阻碍细菌DNA的复制。本品具有广谱抗菌作用;对各种急慢性细菌感染及难治感染有良效,适用于G-、G＋及卡它布兰菌等敏感菌引起的各种中重度感染。左氧氟沙星注射剂抗菌活性很强,该药对细胞组织穿透力强,生物利用度高,

Bacterial persistence

Although bacterial persistence was first observed in 1944,its underlying mechanism is just beginning to be understood and many fundamental questions remain.In this review,we summarize studies in order to chart the full map of bacterial persistence.Because persistence significantly contributes to disease recalcitrance,we also elucidate the probable relationships between bacterial persistence and prolonged chronic infections,with some comments on future research directions and therapeutic strategies.