Low eradication rate of Helicobacter pylori with triple 7-14 days and quadriple therapy in Turkey

AIM:The eradication rate of Helicobacter pylori (H pylon) shows variation among countries and regimens of treatment.We aimed to study the eradication rates of different regimens in our region and some factors affecting the rate of eradication.METHODS:One hundred and sixty-four Hpylori positivepatients (68 males, 96 females; mean age:48±12 years)with duodenal or gastric ulcer without a smoking history were included in the study. The patients were divided into three groups according to the treatment regimens. Omeprazole 20mg, clarithromycin 500mg, amoxicillin 1g were given twice daily for 1 week (Group I) and 2 weeks (Group Ⅱ).Patients in Group Ⅲ received bismuth subsitrate 300mg,tetracyline 500 mg and metronidazole 500mg four times daily in addition to Omeprazole 20mg twice daily.Two biopsies each before and after treatment were obtained from antrum and corpus, and histopathologically evaluated.Eradication was assumed to be successful if no Hpylorus was detected from four biopsy specimens taken after treatment. The effects of factors like age, sex, Hpyloridensity on antrum and corpus before treatment, the total Hpylori density, and the inflammation scores on the rate of Hpylori eradication were evaluated.RESULTS:The overall eradication rate was 42%. The rates in groups Ⅱ and Ⅲ were statistically higher than that in group I (P<0.05). The rates of eradication were 24.5%,40.7% and 61.5% in groups Ⅰ, Ⅱ and Ⅲ, respectively. The eradication rate was negatively related to either corpus Hpylori density or total Hpyloridensity (P<0.05).The median age was older in the group in which the eradication failed in comparison to that with successful eradication (55yr vs 39yr, P<0.001). No correlation between sex and Hpylori eradication was found.CONCLUSION: Our rates of eradication were significantly lower when compared to those reported in literature.We believe that advanced age and high Hpyloridensity are negative predictive factors for the rate of Hpylorieradication.     

最有损您健康的八种鞋

通常人们认为布鞋柔软、轻便、舒适，老年人尤为喜欢穿着，但是布鞋因为鞋底太软，石子等极容易扎破鞋底，尤其是有神经病变的老年糖尿病患者，对疼痛的感觉很弱，一旦扎破了脚都无法察觉，严重的会引起足部溃疡。因此．老年糖尿病患者应尽量在医生的指导下穿特制的鞋，最好是硬底、软垫、宽头的鞋，不要穿布鞋。     

消化性溃疡患者临床护理体会

消化性溃疡主要指发生于胃和十二指肠的慢性溃疡，是一种多发病、常见病。溃疡的形成有各种因素，其中酸性胃液对黏膜的消化作用是溃疡形成的基本因素，因此得名。酸性胃液接触的任何部位，如食管下段、胃肠吻合术后吻合口、空肠以及具有异位胃黏膜的Meckel憩室。绝大多数的溃疡发生于十二指肠和胃，故又称胃、十二指肠溃疡。     

Mucocele of the appendix： An unusual cause of lower abdominal pain in a patient with ulcerative colitis-. A case report and review of literature

The authors report the case of a 60-year-old male patient. In November 2001 he developed intestinal symptoms of bloody diarrhea and abdominal pain. Colononoscopy and biopsy established the diagnosis of ulcerative colitis (proctosigmoiditis). The disease activity was moderate at the beginning. No significant laboratory alterations were found (including CEA, CA19-9), and mesalazine was started orally. He was in remission until November 2003, when he was admitted to our Outpatient Clinic for upper and right lower abdominal pain and bloody diarrhea. Colonoscopy found proctosigmoiditis with a moderate activity, gastroscopy revealed chronic gastritis, laboratory data was normal. Treatment was amended with mesalazine clysma and methylprednisolone (16 mg) orally. Symptoms ameliorated; however, right lower abdominal pain persisted. US and CT examinat'on demonstrated a pericecal cystic mass (11 cm×3.5 cm). At first pericecal abscess was suspected, as the previous US examination (6 mo earlier) had revealed normal findings. Fine needie aspiration was performed. Cytology confirmed the diagnosis of mucocele. The patientunderwent partial cecum resection and extirpation of the mucocele. He recovered well and the final histology revealed a cystadenoma of the appendix. Follow up was started. The pati雗t is now free of symptoms. Although primary adenocarcinoma of the appendix is uncommon, the authors emphasize that preoperative diagnosis of an underlying malignancy in a mucocele is important for pati雗t management; however, it is difficult on imaging studies.     

口腔黏膜病外周血淋巴细胞亚群的观察及分析

目的观察2种常见的口腔黏膜病——复发性阿佛他溃疡(RAU)和口腔扁平苔藓(OLP)患者外周血淋巴细胞亚群分类的变化,探讨其免疫学发病机制。方法用流式细胞术分析105例RAU患者、70例OLP患者和65名健康对照者的外周血淋巴细胞亚群(总T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞、CD4+/CD8+、NK细胞、B细胞),比较各指标的组间差异。结果与健康对照组相比,RAU组总T细胞和CD8+T细胞显著增加(P0.05、P0.01),CD4+T细胞、CD4+/CD8+比值和B细胞均显著减少(P0.01、P0.001、P0.05);而OLP组与健康对照组相比,CD8+T细胞显著降低(P0.05);RAU组的总T细胞和CD8+T细胞显著高于OLP组(P0.01、P0.001)),而CD4+T细胞、CD4+/CD8+比值和NK细胞均显著低于OLP组(P0.01、P0.001、P0.05)。结论 RAU和OLP患者多出现外周血淋巴细胞亚群百分率异常,细胞免疫功能紊乱,但二者的免疫状态存在差异,因此针对性的免疫干预将成为一项极具潜力的治疗措施。     

集束化护理在预防糖尿病足意外发生中的应用

目的：探讨集束化护理对预防糖尿病患者住院期间糖尿病足意外发生的效果。方法筛选2011年8月—2012年1月住院糖尿病患者126例为对照组,2013年8月—2014年1月住院糖尿病患者121例为观察组,对照组进行糖尿病足部预防健康教育指导,观察组进行预防糖尿病足意外发生的集束化护理与管理。比较两组患者住院期间糖尿病足意外事件发生情况、糖尿病足部护理知识和足部自我护理操作评分。结果住院期间观察组患者无一例糖尿病足意外事件发生,对照组发生率为22.22%;观察组患者糖尿病足部护理知识、足部自我护理操作得分分别为(35.39±3.09),(86.93±3.99)分,均高于对照组的(26.05±5.53),(60.04±10.95)分,差异有统计学意义(t值分别为52.87,61.54;P<0.01)。结论集束化护理能有效预防糖尿病足的意外发生,确保糖尿病患者住院期间的护理安全。     

糖尿病足危险因素的筛查及预防护理

目的:探讨糖尿病患者足部血管病变对糖尿病足的影响,及早采取预防护理措施,减少或预防糖尿病足的发生。方法:选取50例糖尿病患者,分为伴发糖尿病足组和单纯糖尿病组,分别进行糖尿病足危险因素筛查即ABI检查。结果:伴糖尿病足组患者ABI值与单纯糖尿病组患者相比显著降低(P<0.01)。结论:对糖尿病患者进行ABI筛查,能够判断其是否存在下肢动脉病变的可能,从而可及早采取预防护理措施,以预防或减少糖尿病足的发生。     

奥扎格雷联合特定电磁波治疗糖尿病足溃疡的疗效观察和护理

目的:探讨奥扎格雷联合特定电磁波治疗糖尿病足溃疡的临床疗效。方法:将66例糖尿病足溃疡患者随机等分为常规组和联合组。两组均在有效控制血糖、感染等常规治疗的基础上给予胰岛素合剂外用,联合组联合奥扎格雷注射液静脉注射+特定电磁波治疗,共治疗4周,观察两组患者治疗效果及溃疡愈合时间。结果:联合组治疗效果优于常规组(P0.05),糖尿病足溃疡愈合时间短于常规组(P0.05)。结论:奥扎格雷联合特定电磁波治疗能促进糖尿病足溃疡的愈合。     

系统健康教育在预防糖尿病足中的应用效果研究

目的：探讨系统健康教育在预防糖尿病足的应用效果。方法选择我院2012年6月至2014年6月接诊的108例糖尿病患者作为研究对象,将所有接诊患者按照随机数字表分为对照组患者54例,采用常规护理措施,观察组54例患者,采用系统健康教育,比较两组患者的护理效果。结果干预后,观察组患者糖尿病足发生率明显低于对照组患者,观察组患者的血糖各指标也较对照组患者出现了明显改善,组间差异具有统计学意义,而且观察组患者的生活质量各维度也较对照组患者出现了明显改善,组间差异具有统计学意义。结论系统健康教育在预防糖尿病足具有十分显著的效果,可有效降低糖尿病足的发生率,降低患者的血糖水平,并较大程度提高患者的生活质量各维度指标,延缓糖尿病的进一步发展,有利于患者的预后,值得临床应用。     

经皮透光负压旋切术治疗下肢静脉性溃疡的护理干预

目的：探讨经皮负压透光旋切术治疗下肢静脉性溃疡患者的护理方法。方法条件性选择下肢静脉性溃疡行经皮透光负压旋切术患者210例,按住院单双号分为治疗组160例和对照组50例。其中,治疗组：住院时由护士发放症状自评量表(SCL-90)进行评估,根据结果再由责任护士进行护理前后汉密顿焦虑量表(HAMA)、自评抑郁量表(SDS)的测量,提出护理诊断,实施护理措施。对照组按照常规护理方法进行疾病护理。观察患者平均住院日、出院后随访患者溃疡复发率。结果经过护理干预,治疗组的焦虑程度、抑郁情况均降低,战胜疾病的信心提高;平均住院日减少,出院后随访患者的溃疡复发率少。结论有效的护理干预可以提高患者战胜疾病的信心,积极主动配合治疗,提高机体抵抗力,促进疾病恢复,缩短病程。