西咪替丁联合利巴韦林治疗婴幼儿轮状病毒肠炎临床效果研究

目的 探讨西咪替丁联合利巴韦林治疗婴幼儿轮状病毒肠炎的临床效果.方法 将124例轮状病毒肠炎婴幼儿采用机械抽样法随机分为试验组和对照组,每组62例,两组均给予综合治疗,对照组加用利巴韦林静脉滴注[10～ 15mg/(kg·d)],试验组在对照组基础上加用西咪替丁静脉滴注[10～ 15mg/(kg·d)],观察比较两组的疗效.结果 试验组显效率为79.0％(49/62),总有效率为96.8％(60/62),显著高于对照组的54.8％(34/62)和75.8％(47/62),差异有统计学意义(x2=7.142、9.816,P＜0.01).试验组见效时间为(1.3±0.7)d,也显著快于对照组的(2.4±1.3)d,差异有统计学意义(t=2.815,P＜ 0.05).治疗期间,两组均未见明显不良反应.结论 在综合治疗的基础上,给予西咪替丁联合利巴韦林,可以在保证安全性的同时显著提高临床效果,从而为改善患儿预后奠定良好基础,值得临床进一步研究.     

西咪替丁联合锌硒宝治疗轮状病毒性肠炎临床观察

目的 探讨西咪替丁联合锌硒宝对婴幼儿轮状病毒性肠炎的治疗效果.方法 将婴幼儿轮状病毒性肠炎80例随机分为治疗组和对照组,两组均常规使用抗病毒、补液等治疗,治疗组用西咪替丁(10-15mg/kg.d)静脉滴注、锌硒宝(1片,tid)口服,对照组单用西咪替丁(10-15mg/kg.d)静脉滴注.结果 治疗组、对照组总有效率分别为92.5％,75％.治疗组与对照组总有效率比较,有显著性差异(P＜0.05).结论 西咪替丁联合锌硒宝治疗婴幼儿轮状病毒性肠炎疗效显著.     

山莨菪碱联合消旋卡多曲、蒙脱石散治疗婴幼儿急性水样腹泻的疗效观察

目的 观察山莨菪碱联合消旋卡多曲、蒙脱石散治疗婴幼儿急性水样腹泻的临床疗效。方法 将92例急性水样腹泻患儿按随机数字表法分为两组，观察组46例采用山莨菪碱联合消旋卡多曲、蒙脱石散治疗，对照组46例仅采用蒙脱石散治疗，比较两组的临床疗效、止泻时间、退热时间和总疗程时间。结果 观察组总有效率为89.1％(41/46)，明显高于对照组的73.9％(34/46)，差异有统计学意义(P＜0.05)。观察组的止泻时间、退热时间和总疗程时间分别为(2.33±0.43)、( 1.82±0.39)和(4.23±0.75)d，而对照组分别为(3.76±0.61)、(2.54±0.53)和(5.58±0.89)d，两组比较差异有统计学意义(P＜0.05)。两组均未见严重不良反应。结论 山莨菪碱联合消旋卡多曲、蒙脱石散治疗婴幼儿急性水样腹泻，能够明显提高临床疗效，缩短患儿止泻时间、退热时间和总疗程时间，值得临床推广应用。     

蒙脱石散保留灌肠辅助治疗小儿轮状病毒肠炎疗效观察

目的 评价蒙脱石散(思密达)保留灌肠辅助治疗小儿轮状病毒性肠炎的疗效.方法 选择适应症患儿101例,随机分为实验组51例及对照组50例;实验组在常规治疗基础上辅助蒙脱石散保留灌肠,对照组常规治疗.结果 实验组与对照组在平均退热时间、大便成形时间、大便次数、腹泻天数等方面均有显著差异(P＜0.01).结论 蒙脱石散保留灌肠治疗小儿轮状病毒性肠炎效果显著.     

消旋卡多曲联合蒙脱石散治疗婴幼儿轮状病毒肠炎疗效观察

目的探讨蒙脱石散与消旋卡多曲联合治疗婴幼儿轮状病毒肠炎的疗效。方法将60例轮状病毒肠炎患儿随机分为治疗组和对照组,每组30例,均给予蒙脱石散对症治疗,治疗组加用消旋卡多曲,比较两组疗效。结果治疗组和对照组的总有效率分别为92.4%和73.3%,平均止泻时间分别为(48.92±3.02)h和(100.23±3.16)h,差异有统计学意义(P<0.01)。结论蒙脱石散与消旋卡多曲联合治疗婴幼儿轮状病毒肠炎疗效好,可以在临床中推广应用。     

葡萄糖酸锌联合喂养对小儿轮状病毒肠炎的疗效观察

目的 观察葡萄糖酸锌联合喂养对小儿轮状病毒肠炎的疗效,以缩短腹泻的病程.方法 将105例轮状病毒肠炎患儿按住院号单双号随机分为观察组52例和对照组53例,对照组采用常规治疗方法(补液、纠正水电解质酸碱平衡、微生态制剂)和腹泻一般喂养宣教,观察组在此基础上增加葡萄糖酸锌进行联合喂养,比较两组治疗后总有效率;纠正脱水时间、治愈时间.结果 观察组总有效率94.2％;对照组总有效率81.1％,两组总有效率比较差异有统计学意义(P＜0.05).观察组纠正脱水时间(2.40±0.32)d,治愈时间(5.40±0.65)d;对照组纠正脱水时间(2.75±1.15)d,治愈时间(5.85±1.20)d,两组比较,差异有统计学意义(P＜0.05).结论 葡萄糖酸锌联合喂养能较早纠正脱水,缩短腹泻病程,提高小儿轮状病毒肠炎的治疗效果.     

消旋卡多曲治疗婴幼儿轮状病毒性肠炎的疗效观察

目的 观察消旋卡多曲治疗婴幼儿轮状病毒性肠炎的疗效.方法将78例婴幼儿轮状病毒性肠炎患儿随机分为治疗组(40例)和对照组(38例),对照组予蒙脱石散(思密达)口服,治疗组在对照组治疗基础上,加用消旋卡多曲治疗,疗程均为3 d,观察两组疗效.结果治疗组和对照组的总有效率分别为85.0%(34/40)和63.2%(24/38),两组比较差异有统计学意义(P<0.05).结论消旋卡多曲治疗婴幼儿轮状病毒性肠炎可较快缓解病情,缩短病程.     

消旋卡多曲联合蒙脱石散治疗小儿轮状病毒肠炎的临床研究

目的:观察消旋卡多曲联合蒙脱石散治疗小儿轮状病毒肠炎的临床疗效。方法:将86例轮状病毒肠炎患儿随机分为两组,对照组43例采用蒙脱石散治疗,观察组43例采用消旋卡多曲联合蒙脱石散治疗,比较观察两组的临床疗效、退热、止泻时间和总疗程。结果:观察组的总有效率明显高于对照组(P<0.05)。观察组的平均退热时间、平均止泻时间和总疗程时间均明显短于对照组(P<0.05)。两组在治疗过程中均未发生明显不良反应。结论:消旋卡多曲联合蒙脱石散对小儿轮状病毒肠炎进行治疗,能够明显提高临床疗效,加快患儿退热和止泻,缩短病程,且不良反应少,是一种安全、有效的治疗方案。     

不同剂量蒙脱石散治疗儿童轮状病毒肠炎的疗效及对炎症因子的影响研究

目的探讨不同剂量的蒙脱石散治疗儿童轮状病毒肠炎的临床疗效及对炎症因子血清C反应蛋白(CRP)的影响。方法选择2017年1月-2019年1月共80例儿童轮状病毒肠炎患儿,按随机数字表分为对照组40例及观察组40例,两组在相同的常规综合治疗基础上,观察组采用大剂量(0. 3～0. 4 g·kg~(-1)·次~(-1))的蒙脱石治疗,3次/d,起始量0. 3 g·kg~(-1)·次~(-1),服药后每24 h评估疗效,根据疗效调整剂量,若无效,改为0. 4 g·kg~(-1)·次~(-1),若显效,根据大便次数和性状,次数较前次评估多和/或性状较前次评估稀的,维持前药量,次数较前次评估少且较前次评估成形的情况,减0. 1 g/kg直至治愈停药。若治愈,停药。对照组采用小剂量(厂家推荐剂量,约0. 1～0. 2 g·kg~(-1)·次~(-1)):1岁为3 g/d,1～2岁为3～6 g/d,2岁为6～9 g/d,均分3次口服。治疗72 h后,比较两组患儿的呕吐消失时间、腹痛消失时间、止泻时间及住院时间,比较两组的疗效,比较治疗前后炎症因子血清CRP的浓度。结果观察组在呕吐消失时间、腹痛消失时间、止泻时间及住院时间均明显短于对照组,差异有统计学意义(P0. 05),观察组治疗总有效率为95. 0%,明显高于对照组的75. 0%,差异有统计学意义(P0. 05)。两组患儿治疗后血清CRP水平均能降低,但观察组患儿的血清CRP水平显著低于对照组,差异有统计学意义(P0. 05)。结论不同剂量的蒙脱石散治疗儿童轮状病毒肠炎的临床疗效不同,大剂量的蒙脱石散剂疗效更好,在临床症状改善时间、住院时间及降低血清CRP水平方面显著优于小剂量,不良反应少而轻微,为临床更好的使用蒙脱石治疗腹泻病提供参考。     

消旋卡多曲颗粒联合蒙脱石散治疗婴幼儿轮状病毒肠炎的疗效分析

目的观察消旋卡多曲颗粒联合蒙脱石散治疗婴幼儿轮状病毒肠炎的临床疗效。方法 2009年3月～2010年3月,120例轮状病毒肠炎患儿随机分为两组,观察组60例给予消旋卡多曲颗粒联合蒙脱石散治疗,对照组60例仅采用蒙脱石散治疗,对比观察两组的临床疗效以临床指标的变化。结果观察组的总有效率为86.7%,明显高于对照组的71.7%(P﹤0.05);并且,观察组的止吐时间、脱水纠正时间、大便次数正常时间和大便性状正常时间均明显短于对照组(P﹤0.05)。结论消旋卡多曲颗粒联合蒙脱石散对婴幼儿轮状病毒肠炎进行治疗,能够明显提高临床疗效,安全性高,值得临床推广应用。     

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.     

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.     

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.     

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.