下呼吸道感染66例治疗分析

目的探讨下呼吸道感染的有效治疗方法。方法采用阿奇霉素联合山茛菪碱对66例下呼吸道感染患者进行治疗观察，疗程5～7d。结果治疗7天后，患者主要症状明显改善，痊愈44例、显效13例、进步7例，总有效率97．0％，治疗中不良反应轻微。结论阿奇霉素联合山茛菪碱的疗效确切，不良反应轻微，是下呼吸道感染的有效治疗方法。     

头孢曲松联合阿奇霉素治疗小儿急性下呼吸道感染疗效观察

目的 观察头孢曲松联合阿奇霉素治疗小儿急性下呼吸道感染的临床效果.方法 研究对象为2009年6月-2011年10月在儿科住院的96例患儿,随机分为治疗组与对照组,两组采用止咳、平喘、雾化吸入、支持等对症处理的基础上,治疗组48例以头孢曲松50～80mg/kg,加入0.9％氯化钠注射液或5％葡萄糖注射液50～100ml,静脉滴注,每日1次,疗程5～7d,1～2 h后再用阿奇霉素10mg/kg,加入5％葡萄糖中,浓度为1 mg/ml,静脉滴注,疗程5d;对照组48例以头孢曲松50～80 mg/kg,加入0.9％氯化钠注射液或5％葡萄糖注射液50～100ml,静脉滴注,每日1次,疗程5～7 d,分别观察、记录患儿症状(咳嗽、喘息)、肺部啰音消失时间、体温恢复时间、平均住院时间及不良反应.结果 头孢曲松联合阿奇霉素治疗组患者咳嗽消失时间、喘息消失时间、体温恢复正常时间、平均住院时间与头孢曲松对照组比较差异有统计学意义(t值分别为1.786、2.107、2.080、1.812,P＜0.05),肺部啰音消失时间比较差异有统计学意义(t=2.443,P＜0.01);头孢曲松联合阿奇霉素治疗组总有效率为89.58％,头孢曲松对照组总有效率为72.92％,头孢曲松联合阿奇霉素治疗组总有效率高于头孢曲松对照组,两组差异有统计学意义(x2 =4.37,P＜0.05);头孢曲松联合阿奇霉素治疗组与头孢曲松对照组不良反应比较差异无统计学意义.结论 头孢曲松联合阿奇霉素治疗小儿急性下呼吸道感染,具有杀菌作用强、疗效好,临床症状、体征消失快、住院时间缩短、使用次数少,使用1次/d,维持时间长,不良反应不明显,使用安全、简便、易于小儿及家长接受,值得注意的是,抗菌药物应用前应做痰细菌培养,根据药敏试验选择抗菌药物,以免产生细菌耐药.     

阿奇霉素联合清开灵注射液治疗肺部感染疗效观察

目的 探讨阿奇霉素联合清开灵注射液治疗肺部感染的疗效.方法 观察组74例,给予阿奇霉素与清开灵注射液联合治疗;对照组60例,给予青霉素和病毒唑等药物常规治疗.结果 总有效率观察组100％、对照组85％,两组比较,差异具有统计学意义(P＜0.01).结论 阿奇霉素联合清开灵注射液治疗肺部感染疗效确切,且安全、方便、副作用小,值得在基层医疗机构推广应用.     

红霉素与阿奇霉素序贯应用治疗小儿支原体肺炎疗效探讨

目的 探讨红霉素与阿奇霉素序贯应用在小儿支原体肺炎中的治疗效果.方法 78例支原体肺炎患儿随机分为观察组（n=39）与对照组（n=39）,对照组给予红霉素治疗,观察组给予红霉素与阿奇霉素序贯治疗,对比两组起效时间、治疗效果及不良反应.结果 观察组热退时间、咳嗽好转时间、罗音消失时间及住院时间均显著短于对照组（P＜0.05或P＜0.01）;观察组痊愈率为76.9％（30/39）,总有效率为97.4（38/39）,均显著高于对照组的48.7％（19/39）与76.9％（30/39）（P＜0.05或P＜0.01）;两组不良反应发生率比较均无统计学差异（P＞0.05）.结论 红霉素与阿奇霉素序贯应用治疗小儿支原体肺炎疗效可靠,且不良反应较少,值得推广.     

痰热清注射液治疗毛细支气管炎临床观察

目的观察痰热清注射液治疗毛细支气管炎的临床疗效和在小儿应用的安全性.方法将124例毛细支气管炎随机分为二组,治疗组60例和对照组64例,对照组采用综合治疗,治疗组在综合治疗的基础上加用痰热清注射液.结果治疗组在咳嗽、气喘、肺部罗音消失时间及住院天数均小于对照组,差异有显著性(P＜0.01).结论痰热清注射液治疗毛细支气管炎有显著疗效,而且安全.     

红霉素与阿奇霉素两种序贯疗法治疗小儿肺炎支原体肺炎临床疗效分析

目的观察红霉素静滴序贯疗法和阿奇霉素序贯疗法在小儿肺炎支原体肺炎治疗中的疗效.方法将89例肺炎支原体肺炎患儿随机分成两组,治疗组45例,应用红霉素静滴同时口服阿奇霉素,而后改阿奇霉素口服序贯治疗;对照组44例,先用阿奇霉素静滴,以后改为口服阿奇霉素序贯治疗.结果治疗组在促进炎症消散,加速患儿症状、体征消失,缩短住院时间,明显优于对照组,差异均有统计学意义(P＜0.05).结论红霉素静滴序贯疗法治疗小儿肺炎支原体肺炎效果显著,疗程短,不良反应少,值得临床推广.     

痰热清注射液佐治小儿肺炎支原体肺炎疗效观察

目的观察红霉素/阿奇霉素联合痰热清注射液治疗小儿肺炎支原体肺炎的临床疗效。方法将196例肺炎支原体肺炎患儿随机分为观察组98例和对照组98例,两组均使用红霉素和阿奇霉素粉针剂序贯治疗,观察组在此基础上加用痰热清注射液静脉滴注治疗,观察两组临床退热时间、咳嗽明显好转时间、平均住院时间、肺部阴影消失时间及副反应。结果观察组在退热时间、咳嗽明显好转时间、肺部阴影消失时间均短于对照组,差异有统计学意义（p〈0.05）,且未发现不良反应。结论红霉素/阿奇霉素联合痰热清注射液治疗小儿肺炎支原体肺炎有较好疗效。     

阿奇霉素联合头孢曲松钠治疗儿童难治性肺炎支原体肺炎的临床应用价值

目的 探讨阿奇霉素联合头孢曲松钠治疗儿童难治性肺炎支原体肺炎的临床应用价值.方法 将2011年12月至2012年12月期间本院收诊的73例难治性肺炎支原体肺炎患儿随机分成两组,对照组35例,观察组38例;对照组采用阿奇霉素治疗,观察组则采用阿奇霉素联合头孢曲松钠治疗.比较两组间的疗效、症状改善时间差异及住院时间,随访6个月统计病情反复例数.结果 治疗1个疗程后,观察组总有效率为94.74％,显著高于对照组的71.43％,P＜0.05.观察组患儿咳嗽消失时间、退热时间、肺部啰音消失时间、住院时间等显著短于对照组（P ＜0.05）;随访6个月,观察组病情反复率为18.42％,显著低于对照组的40.00％,P＜0.05.结论 阿奇霉素联合头孢曲松钠治疗儿童难治性肺炎支原体肺炎疗效好,能有效缩短症状改善时间和住院时间并降低病情反复率,具有较高的临床应用价值.     

儿童支原体肺炎80例临床分析

探讨儿童肺炎支原体肺炎的最佳治疗方案。80例肺炎支原体肺炎的儿童随机分为阿奇霉素治疗组(A)和红霉素治疗组B组各40例观察咳嗽、体温变化、肺部罗音变化及影像学变化,结果有2种方案。治疗儿童支原体肺炎均有效,但A组咳嗽消失时间、体温下降时间方面优于B组(p<0.01),在肺部罗音消失时间及肺部影像学恢复时间优于B组。结论:阿奇霉素治疗支原体肺炎疗效优于红霉素序贯治疗,患儿依从性好,毒副作用小。     

对比分析阿奇霉素序贯疗法、常规治疗社区获得性肺炎的价值

目的:对比阿奇霉素序贯疗法与常规治疗对社区获得性肺炎的治疗效果。方法:经过对本院2016年2月～2017年2月收治的100例社区获得性肺炎患者临床资料展开回顾分析,随机分为两组各50例,对照组选择阿奇霉素静滴疗法,观察组选择阿奇霉素序贯疗法,对比两组肺部啰音消失时间、体温水平复常时间、用药治疗时间以及治疗总有效率。结果:观察组肺部啰音消失时间、体温水平复常时间、用药治疗时间均短于对照组,两组相比差异显著,P0.05;观察组(96.0%)高于对照组(84.0%),两组相比差异显著,P0.05。结论:对于社区获得性肺炎患者而言,与阿奇霉素静滴疗法相比,选择阿奇霉素序贯疗法可以显著地缩短肺部啰音消失时间、体温水平复常时间、用药治疗时间,有效地提升了治疗效果,值得在临床应用中加以推广。     

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.