高渗盐水联合沙丁胺醇雾化吸入治疗毛细支气管炎的疗效

目的:探讨高渗盐水(3.6%)联合沙丁胺醇雾化吸入治疗小儿毛细支气管炎的疗效。方法:选取2011年4月～2012年7月毛细支气管炎患儿96例,随机分为治疗组和对照组各48例,两组均采用相对的综合性治疗及一般的对症处理,在此基础上,对照组给予生理盐水联合沙丁胺醇雾化吸入,治疗组给予3.6%高渗盐水联合沙丁胺醇雾化吸入,评估两组临床治疗效果。结果:治疗组治愈率95.8%、对照组治愈率75.0%,与对照组比较,治疗组咳嗽消失时间、喘憋消失时间、心率恢复正常时间、肺部体征消失时间均优于对照组(P<0.05),两组疗效差异有统计学意义(P<0.05)。结论:在综合治疗基础上应用3.6%高渗盐水联合沙丁胺醇雾化吸入治疗小儿毛细支气管炎疗效肯定,既安全、有效,同时治疗费用低,可成为毛细支气管炎新的治疗方法,值得临床推广应用。     

足量布地奈德与氨溴索联合雾化吸入治疗毛细支气管炎疗效观察

目的 观察足量布地奈德与盐酸氨溴索联合通过氧气驱动雾化吸入治疗毛细支气管炎的疗效.方法 将102例诊断为毛细支气管炎患儿随机分为两组,对照组50例给予吸氧、化痰止咳、解痉平喘、抗感染等常规治疗,观察组52例在常规治疗的基础上,给予足量布地奈德和盐酸氨溴索氧气驱动雾化吸入治疗,观察两组患儿临床主要症状、体征消失时间、住院天数、疗效及不良反应.结果 观察组与对照组总有效率分别为92.3%与64.0%,疗效差异有统计学意义（P〈0.01） 观察组喘憋缓解时间、哮鸣音消失时间、湿啰音吸收时间、咳嗽消失时间、住院时间均明显短于对照组（P〈0.01） 两组患儿均无明显不良反应发生.结论 足量布地奈德与盐酸氨溴索联合雾化吸入治疗毛细支气管炎疗效显著.     

雾化吸入高渗盐水治疗小儿毛细支气管炎的临床观察

目的：对比3％高渗盐水雾化吸入及异丙托溴铵联合布地奈德、沙丁胺醇雾化吸入治疗小儿毛细支气管炎的临床疗效。方法120例毛细支气管炎患儿,随机分为对照组及治疗组,两组均给予对症综合治疗,治疗组应用3％高渗盐水雾化吸入治疗,对照组应用异丙托溴铵、布地奈德及沙丁胺醇联合雾化吸入治疗。观察比较两组患儿用药后临床症状缓解、肺部体征消失时间、住院天数、住院花费以及临床疗效。结果治疗后两组患儿临床症状及体征均有不同程度改善;治疗组在咳嗽、喘息、呼吸困难缓解时间方面短于对照组,差异均无统计学意义（t值分别为－1．263、－0．294、－0．605,均P＞0．05）,在肺部哮鸣音消失时间以及住院天数、住院花费也短于对照组,差异均具有统计学意义（t值分别为－4．368、－2．77、－4．913,均P＜0．05）,两组的治疗有效率无明显差异（χ2＝0．319,P＞0．05）。结论3％高渗盐水雾化吸入治疗小儿毛细支气管炎可明显改善临床症状,并能缩短住院日,减少住院治疗总费用。     

沙丁胺醇联合氨溴索雾化吸入佐治毛细支气管炎疗效观察

目的观察沙丁胺醇联合氨溴索雾化吸入治疗毛细支气管炎的疗效。方法将80例毛细支气管炎患儿随机分为治疗组（40例）及对照组（40例）,治疗组在综合治疗基础上加用沙丁胺醇及氨溴索雾化吸入,对照组加用α-糜蛋白酶及地塞米松雾化吸入。结果治疗组与对照组患儿喘憋、哮鸣音、湿罗音持续时间及住院时间比较差异有统计学意义（t分别为2．163、2．283、2．024、2．023,P〈0．05）,显效率及总有效率治疗组分别为72．5％和97．5％,对照组分别为55．0％和82．5％,差异均无统计学意义。结论沙丁胺醇联合氨溴索雾化吸入治疗毛细支气管炎疗效显著。     

高渗盐水联合特布他林雾化吸入佐治毛细支气管炎观察

目的：观察高渗盐水联合特布他林治疗毛细支气管炎临床疗效。方法：79例患儿随机分为两组,观察组40例,对照组39例,两组患儿均给予相同的综合治疗,在此基础上,观察组予3％高渗盐水3ml联合特布他林雾化液lml,对照组予0．9％氯化钠3ml联合特布他林雾化液lml,氧驱雾化吸入,每8h1次,观察两组患儿喘憋缓解、肺部哮呜音消失时间、肺部湿哆音消失时间及住院天数。结果：观察组在喘憋缓解、肺部哮呜音消失时间、肺部湿哆音消失时间及住院天数均少于对照组,两组比较差异有统计学意义。结论：3％高渗盐水联合特布他林雾化吸入较0．9％氯化钠联合特布他林雾化吸入疗效好,可明显缩短喘憋缓解、肺部哮呜音消失时间、肺部湿哆音消失时间及住院天数。     

万托林溶液雾化吸入治疗小儿毛细支气管炎疗效观察

目的观察万托林溶液雾化吸入缓解毛细支气管炎患儿喘憋、咳嗽、呼吸困难疗效。方法将80例临床诊断为毛细支气管炎的患儿随机分为对照组和治疗组。结果万托林吸入组喘憋、咳嗽、呼吸困难消失时间、住院天数均较对照组减少。结论万托林溶液雾化吸入是治疗小儿毛细支气管炎的有效方法。     

高浓度病毒唑雾化吸入治疗毛细支气管炎疗效观察

目的通过使用高浓度病毒唑雾化吸入治疗毛细支气管炎,了解高浓度病毒唑雾化吸入治疗毛细支气管炎是否较常规浓度病毒唑雾化吸入治疗毛细支气管炎更有效。方法将84毛细支气管炎患儿分成治疗组和对照组,治疗组用50mg/m1病毒唑雾化吸入,对照组用10mg/m1病毒唑雾化吸入,每次治疗均30`分钟。结果治疗组平均喘憋缓解时间为3.01±1.23天,住院天数6.50±1.26天;对照组平均喘憋消失时间为4.48±1.41,住院天数为9.01±1.33天。结论高浓度病毒唑雾化吸入治疗较常规剂量病毒唑雾化吸入治疗毛细支气管炎可明显缩短其喘憋时间和病程。     

布地奈德混悬液联合肾上腺素雾化吸人治疗毛细支气管炎的疗效分析

目的探讨布地奈德混悬液联合肾上腺素雾化吸入治疗毛细支气管炎的疗效及安全性。方法将128例毛细支气管炎患儿随机分为两组,均采用综合治疗,治疗组在常规抗感染、对瘫治疗的基础上予布地奈德混悬液与肾上腺素雾化吸入,疗程5～7d,对照组在常规抗感染、对症治疗的基础上,单用布地奈德混悬液雾化吸入,疗程7d。观察两组患儿症状、体征消失的时间、住院时间,并进行临床疗效分析。结果治疗组咳嗽、喘、憋症状缓解,呼吸困难好转,哮呜音、湿哕音消失时间,住院时间明显缩短,与对照组比较差异有统计学意义（P≤0．05）。结论布地奈德混悬液联合肾上腺素雾化吸入治疗毛细支气管炎,对急性期症状缓解优势明显,可缩短病程,减少住院时间,疗效肯定．使用安全。     

复方异丙托溴铵联合布地奈德雾化吸入治疗小儿毛细支气管炎疗效观察

目的探讨复方异丙托溴铵（可必特）联合布地奈德（普米克令舒）雾化吸入治疗小儿毛细支气管炎的疗效。方法将96例毛细支气管炎患儿随机分为3组，均采用综合治疗，观察组加用可必特联合普米克令舒雾化吸入，对照1组加用沙丁胺醇（万托林）雾化吸入，对照2组静脉使用氨茶碱，对各组治疗症状、体征、持续时间、病情治愈好转率进行比较。结果观察组在治愈率、气促缓解、哮鸣音及肺部湿啰音消失、咳嗽消失时间方面明显优于对照1、2组（P〈0．05或〈0．01）。结论雾化吸入可必特联合普米克令舒治疗小儿毛细支气管炎疗效好，方便，安全。     

普米克令舒和万托林联合雾化吸入治疗毛细支气管炎的疗效观察

目的探讨普米克令舒和万托林联合雾化吸入治疗毛细支气管炎的疗效。方法将162例毛细支气管炎患儿随机分为两组,两组均采用相同的综合性基础治疗,治疗组加用普米克令舒、万托林联合雾化吸入。对治疗前后症状、体征、持续时间进行对比。结果治疗组在缓解喘憋、缩短咳嗽时间、哮呜音和湿哕音消退时间均优于对照组（P〈0．01）。结论普米克令舒、万托林联合雾化吸入治疗毛细支气管炎有明显疗效,且安全、方便,可作为治疗毛细支气管炎的主要药物。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.