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find Keyword "曲霉菌" 14 results
  • Effects of Aspergillus fumigatus spores on airway inflammation and airway responsiveness on asthmatic rat model

    Objective To explore the effects of Aspergillus fumigatus(A. fumigatus) spores on airway inflammation and responsiveness in asthmatic rats.Methods Seventy male Wistar rats were randomly divided into Ⅰ and Ⅱ groups(n=35 in each group),then Group Ⅰ and Group Ⅱ were subdivided into a normal control group(n=5),an asthma group(n=10),a spores-treated control group(n=10),and a spores-treated asthma group(n=10).The rats were sensitized to ovalbumin(OVA) and challenged with aerosol OVA to establish the asthma model.The effects of A. fumigatus spores on asthmatic rats before and after OVA aerosol challenging were investigated in Group Ⅰ and Group Ⅱ,respectively.The parameters associated with bronchial epithelial damage were observed by total protein concentration in BALF measured by BCA method.Total and differential cell counts in BALF were also counted.The airway resistance and airway responsiveness were calculated by transpulmonary pressure and gas flow rate.Results In Group Ⅰ,the total protein in BALF in the asthma group treated with A. fumigatus spores before OVA challenging(Group CA) was increased remarkably compared to the asthma group(Group A1)[(1.125±0.254)μg/mL vs(0.825±0.173)μg/mL,Plt;0.01].The nonspecific airway resistances induced by different concentration of acetylcholine in Group CA [(0.997±0.196)cm H2O•mL-1•s-1,(1.123±0.142)cm H2O•mL-1•s-1,(1.130±0.197)cm H2O•mL-1•s-1]were increased significantly compared to Group A1 [(0.655±0.089)cm H2O•mL-1•s-1,(0.687±0.048)cm H2O•mL-1•s-1,(0.821±0.043)cm H2O•mL-1•s-1](all Plt;0.05).In Group Ⅱ,however,the above parameters in the asthma group treated with A. fumigatus spores after OVA challenging(Group AC) were not dramatically increased compared with the asthma group(Group A2)(all Pgt;0.05).The differences in the total and differential cell counts in BALF in Group CA were not remarkable compared to other subgroups in Group Ⅰ(all Pgt;0.05).But the BALF neutrophil count in Group AC was increased obviously compared to Group A2 [(2.488±0.420)×106 vs (0.936±0.459)×106,Plt;0.05].Conclusion These data indicate that exposure to A. fumigatus spores before challenging causes aggravated epithelial damage and increased airway resistance in an asthma rat model.

    Release date:2016-08-30 11:35 Export PDF Favorites Scan
  • 侵袭性肺曲霉菌感染诊治进展

    随着社会老龄化, 抗肿瘤药物、免疫抑制剂和器官移植等治疗的广泛开展, 在危重患者中广谱抗生素药物的长期应用, 与之伴随的是真菌感染发生的逐年增多, 其中侵袭性曲霉菌感染因其感染隐匿, 难以诊治和高死亡率等特点被临床医生所重视。按我国医院感染监控网分析, 医院真菌感染率从1993 ~1996 年的13. 9% 上升至1998 ~1999 年的17. 1% 、1999 ~2000 年的24. 4% 。侵袭曲霉菌病特别是肺部曲霉菌感染多发生在有严重基础疾病的患者,预后差, 病死率达50% ~100% [ 1 ] 。本文回顾相关研究文献中关于侵袭性肺曲霉菌诊治进展, 高危人群, 目前诊断检测技术的临床价值, 抗曲霉菌药物特点和治疗现状。

    Release date:2016-08-30 11:56 Export PDF Favorites Scan
  • 联合检测半乳甘露聚糖和(1→3)-β-D葡聚糖在诊治侵袭性曲霉菌感染中的研究进展

    近年随着广谱抗生素和免疫抑制剂的使用,侵袭性真菌感染(invasive fungal disease,IFD)的发病率逐年上升。其中侵袭性曲霉病(invasive aspergillosis,IA)在IFD中比例逐年增高。侵袭性曲霉菌感染在血液科和重症加强治疗病房(ICU)最为常见,其次为呼吸内科、感染科和免疫科,IA为免疫功能低下患者致死率高的主要原因,造血干细胞移植(HSCT)患者中IA的发病率为2%~26%,在血液病和造血干细胞移植患者中IA死亡率高达70.0%~90.0%。造成死亡率高的主要原因是在病程早期不能对IA进行可靠诊断,往往使患者延误治疗而死亡。因此,选择正确、合适的早期诊断方法对疾病的预后具有决定性意义。传统的诊断方法如影像学、真菌直接镜检、培养及组织病理学检查的敏感性不高,检出率低,难以用于早期诊断。因此,新的诊断方法对IA的治疗至关重要。血清学诊断方法是应用免疫和生化方法检测血清或其他体液中的真菌细胞壁和胞质成分,分为抗原和抗体检查两类。但由于IFD多继发于严重免疫受损患者,往往缺乏可检测到的抗体,或者抗体的产生变化较大,因此以检测真菌抗原为主。目前半乳甘露聚糖(GM)和(1→3)-β-D葡聚糖(BG)成为真菌检查中非常重要的两个抗原。

    Release date:2016-08-30 11:58 Export PDF Favorites Scan
  • Diagnosis and Surgical Treatment of Pulmonary Tuberculosis Complicated by Aspergillus Infection

    Objective To investigate diagnosis and treatment strategies of patients with pulmonary tuberculosis (TB) complicated by Aspergillus infection. Methods Clinical data of 38 patients with pulmonary TB complicated by Aspergillus infection who underwent surgical treatment from January 2008 to December 2010 in Chengdu Infectious Disease Hospital were retrospectively analyzed. There were 23 male patients and 15 female patients with their average age of 37.8 (23-59) years. Preoperatively,all the patients received regular anti-TB treatment for more than 2 weeks,and patients with definite Aspergillus infection received anti-Aspergillus therapy for more than 3 days with consultation of infectious disease physicians. After above treatment,26 patients underwent lobectomy,1 patient underwent right pneumonectomy,and 11 patients underwent left pneumonectomy. All the patients were followed up at the outpatient department after discharge. They were evaluated every 2 weeks in the first 3 months,every 1 month after 3 months,and every 6 months after 1 year. During follow-up,they received acid-fast bacillus smear and sputum culture to check Aspergillus,as well as CT chest scan. Results All the patients successfully received surgical resection of the pulmonary lesion without perioperative death or severe complication. Postoperative pathology examination confirmed pulmonary TB with Aspergillosis infection in all the 38 patients,whose basic diseases included TB cavity in 17 patients,TB-destroyed lung in 12 patients,and post-TB bronchiectasis in 9 patients. All the patients were followed up after discharge for 1.5-4.5 years. During follow-up,they received regular anti-TB therapy for adequate duration in addition to antifungal medications such as voriconazole. None of the 38 patients had recurrence of Aspergillus infection or pulmonary TB. One patient had hemoptysis which was controlled after proper treatment during follow-up. Conclusion Missed diagnosis rate of pulmonary TB complicated by Aspergillus infection is high. Surgical resection of the pulmonary lesion and postoperative medication treatment are the most effective treatment strategies for patients with pulmonary TB complicated by Aspergillus infection.

    Release date:2016-08-30 05:46 Export PDF Favorites Scan
  • 肺曲霉菌病的外科治疗

    目的探讨肺曲霉菌病的临床特点与外科治疗原则。方法回顾分析32例肺曲霉菌病患者的临床资料和手术治疗结果,手术施行采用标准后外侧切口肺叶切除术6例,楔形切除术3例,胸腔镜或胸腔镜辅助改良后外侧微创小切口楔形切除术15例,肺叶切除术6例,肺段切除术2例。结果21例无肺原发疾病,11例有肺原发疾病。痰菌检查阳性率为13.3%(2/15),术前诊断符合率为28.1%(9/32);术后并发症发生率为15.6%(5/32),其中切口皮下积液、肺膨胀不良各2例,气胸1例;随访32例,随访10~160个月,无咯血或血痰、肺曲霉菌病复发或播散。结论肺曲霉菌病多数无肺原发疾病和症状,无论有否症状均应手术治疗,而微创外科手术治疗并发症少且较轻,是首选的治疗方法。

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • Clinicopathologic study on fungal necrcotizing retinochoroiditis

    Objective To investigate the clinical manifestation and histopathologic changes of the fungal necrotizing retinochoroiditis. Methods Collecting 7 cases of fungal retinochoroiditis with severe immunodepression and loss of visual acuity.Seven removed eyeballs were stained with HE,PAS and silver methenamine,and observed by light microscopy,and in addition,2 of them examined by electron microscopy.Also fungal cultures of blood and affected tissues were performed. Results The chief clinical macnifestation included ciliary injection of conjunctiva,opaque aqueous fluid and vitreous and diffuse hemorrhage and greyt white opacity with retinal detachment in severe cases.Pathologic changes included hemorrhage in the retina,chorioretinal tissue necrosis,hyphae in the blood vessels,affected tissue and vitreous.Fungal culture of blood was positive in three cases.Culture of affected tissues was positive in all cases. Conclusions Eedogenous fungal infection of choroid and retina may be due to the severe immunodepression of the sufferers and usually causes chorioretinal tissue destruction and blind. (Chin J Ocul Fundus Dis, 1999, 15: 235-237)

    Release date:2016-09-02 06:07 Export PDF Favorites Scan
  • Detection of Invasive Aspergillosis by Serum Galactomannan Test: A Systematic Review

    Objective To assess the quality of current domestic literature about enzyme-linked immunosorbent assay (ELISA) for invasive aspergillosis diagnosis by detecting Aspergillus galactomannan (GM) antigen, and to analyze the sources of bias and variability, as well as the diagnostic ability of different thresholds. Methods Both computer-based online search and manual retrieval were employed to identify relevant articles. The statistical information and quality of science were assessed and classified. The data were analyzed using Meta Disc 1.4 software. The best cutoff value for defining a positive test result was selected by summarizing the following statistical indicators as sensitivity, specificity, likelihood ratio (LR) and summary receiver operating characteristic curve (SROC curve), and by calculating the area under the curve (AUC) as well. Results A total of 20 studies among 2658 literatures were included in accordance with the inclusion criteria, and were divided into different groups based on different cutoff values. Though heterogeneity tests showed no threshold effect, and there were other reasons of heterogeneity. So the data were analyzed by random effects model. The results showed that, compared with other groups, the one with cutoff value set at 0.7 (AUC=0.9456, Q= 0.884 6) showed the best accuracy in diagnosing. Conclusion ELISA detection of Aspergillus GM antigen with cutoff value set at 0.7 has important significance in the early diagnosis of invasive aspergillosis, and it can be conducive to reduce mortality in patients at high risk for Aspergillus infection.

    Release date:2016-09-07 11:07 Export PDF Favorites Scan
  • 长期服用糖皮质激素及免疫抑制剂致肺曲霉菌感染一例

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
  • 狼疮性肾炎合并肺部多重真菌感染一例

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  • Completely Video-assisted Thoracopic Surgery for Pulmonary Aspergilloma: A Case Control Study

    ObjectiveTo discuss the possibility and safety of video-assisted thoracoscope surgery for pulmonary aspergilloma. MethodsWe retrospectively analyzed the clinical data of 39 patients with pulmonary aspergilloma in Beijing Chaoyang Hospital between June 2009 and May 2014. The patients were divided into two groups according to their operation method including a conventional thoracotomy surgery group (open group, n=11) and a video-assisted thoracoscope pneumonectomy group (VATS group, n=28). There were 8 male patients and 3 female patients with age of 29-64 (50.7±9.7) years in the open group. There were 13 male patients and 15 female patients with age of 20-75 (55.4±15.3) years in the VATS group. We compared clinical effectiveness between the two groups. ResultsThe operations of all patients were performed successfully. There were statistical differences between the two groups in the average length of operative time (P=0.001), the loss of intraoperative blood (P=0.005), and the score of pain (P=0.001). There was no statistical difference in lead flow of postoperative chest (P>0.05) and the time of hospitalization (P>0.05). ConclusionVideo-assisted thoracoscope surgery in the treatment of pulmonary aspergilloma could be feasible, safe, and effective based on our study. It is worth of clinical application and popularization.

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