目的 分析轮状病毒性腹泻患儿心肌受损情况和所伴随生化检验指标改变。 方法 2008年7月－2010年7月收治腹泻患儿80例，年龄6～27个月，平均12.9个月。其中有50例为轮状病毒腹泻（A组），30例为非轮状病毒性腹泻（B组）。A组患儿均符合轮状病毒腹泻诊断标准，有心肌损伤的异常指标但达不到心肌炎诊断标准者诊断为心肌损害。B组患儿有水样腹泻，但症状较轻，病程较短，轮状病毒抗原检测阴性。用全自动生化分析仪测定血清谷草转氨酶、乳酸脱氢酶、肌酸磷酸激酶和肌酸磷酸激酶同工酶，免疫亲和层析法测定血清肌钙蛋白值，并进行心电图检查。 结果 A组50例轮状病毒性腹泻患儿中，44例（88.0%）存在心肌损害，其血清谷草转氨酶（74.32 ± 13.77）U/L、肌酸磷酸激酶（52.01 ± 10.37）U/L、肌酸磷酸激酶同工酶（273.43 ± 27.55）U/L均升高，且明显高于B组[（24.98 ± 7.03）、（17.11 ± 6.52）、（151.46 ± 16.52）U/L]，差异有统计学意义(P＜0.05)。两组患儿的乳酸脱氢酶变化差异无统计学意义(P＞0.05)。 结论 轮状病毒性腹泻患儿往往伴有心肌损害及相应的血液生化检测指标改变；以肌酸磷酸激酶同工酶作为近期心肌损害的诊断指标更为特异和敏感。
ObjectiveTo systematically evaluate the efficacy of probiotics in preventing antibiotic-associated diarrhea (AAD) in aged people. MethodsPubMed, Web of Science, the Cochrane Database of Systematic Reviews, the Cochrane Controlled Trials Register, CNKI, VIP, and WANFANG electronic databases were searched for studies published, and references of included studies and reviews were screened from database inception to April 2014. Only randomized, controlled trials involving patients older than 65 years were included. Furthermore, only the trials which combined antibiotic administration and probiotic therapy for the prevention of AAD and Jadad score >3 were extracted. ResultsA total of eight articles containing 3 680 subjects (1 843 in the probiotic group, 1 837 people in the control group) met the inclusion criteria. Meta-analysis showed that there was no significant difference in the risk of antibiotic-associated diarrhea (AAD) between probiotics and control groups[RR=0.76, 95%CI (0.51, 1.13), P=0.17]. Further subgroup analysis found that compared with the control group, saccharomyces[RR=1.24, 95%CI (0.70, 2.19), P=0.46], lactobacillus[RR=0.59, 95%CI (0.31, 1.13), P=0.11], multi-probiotics combination[RR=0.58, 95%CI (0.24, 1.41), P=0.23] in the probiotics group were not significantly different. ConclusionThere is no evidence to support that probiotics can reduce the risk of AAD among aged people administrated with antibiotics therapy.
Acute diarrhea has a high incidence in children. Pediatric tuina has been widely used in children with acute diarrhea in China. However, there is no guideline on the treatment of tuina for children with acute diarrhea. This guideline was developed following evidence-based principles and the World Health Organization handbook for guideline development. The linked systematic review was conducted following the Cochrane handbook. The quality of evidence and the strength of recommendations were evaluated using the GRADE approach. The reporting followed the RIGHT statement. Seven clinical questions (2 foreground questions and 5 background questions) were identified by literature review and expert consensus. Based on the linked systematic review and through comprehensive consideration of the balance of benefit and harm, quality of evidence, patient preferences, and other resources, we formulated the recommendations using Delphi expert consensus. We suggested combination of a weak recommendation for tuina with Western medicine usual care to treat children with acute diarrhea. This guideline can be used by clinicians and nurses in the department of traditional Chinese medicine pediatrics, and department of pediatric tuina, and can also be used as a reference for relevant clinicians of Western medicine and is also applicable to all institutions that practice tuina treatment.
Objective To analyze the clinical features and outcomes of pregnant women with acute diarrhea. Methods We collected the clinical data of 133 pregnant women with acute diarrhea (group A) admitted into Tangshan Maternal and Child Health Hospital and Kailuan General Hospital between June 2009 and June 2015. Another 100 acute diarrhea patients without pregnancy (group B) and 100 pregnant women without acute diarrhea (group C) were regarded as controls. All the patients’ medical history, symptoms and signs, laboratory examination results, diagnosis and treatment, termination of pregnancy and pregnancy outcomes were retrospectively analyzed. Results The average age of group A patients was (29.72±5.19) years old, and 83.46% of them came to hospital within 24 hours. There were significant differences in vomiting, abdominal pain, white blood cells, neutrophils, C-reactive protein, white blood cells in the feces, fibrinogen, prothrombin time, activated partial prothrombin time, thrombin time and the recovery time of the laboratory indicators between group A and group B (P<0.05). The neonatal weight of group A was lower than that of group C, and the difference was statistically significant (P<0.05). Regression analysis showed that hemoglobin and albumin had significant influence on acute diarrhea during pregnancy (P<0.05). Conclusion Pregnancy with acute diarrhea is a kind of severe obstetric complication, which may lead to adverse pregnancy.