序贯疗法与标准三联疗法治疗幽门螺杆菌的疗效分析

目的比较由奥美拉唑、阿莫西林．克拉霉素、替硝唑组成的10日序贯疗法与由奥美拉唑、克拉霉素和阿莫西林组成的标准三联疗法根除幽门螺杆菌的效果。方法94例H．pylor采用单盲法随机分成对照组与实验组,对照组采用标准三联疗法（奥美拉唑＋阿莫西林＋克拉霉素治疗7d）治疗,实验组采用序贯疗法（奥美拉唑＋阿莫西林治疗5d后继之以奥美拉唑＋克拉霉素＋替硝唑再治疗5d）治疗,停药4周后,复查胃镜,快速尿素酶实验与13C尿素呼气试验,比较2组LH．pylori根除率,溃疡愈合率及不良反应。结果序贯治疗组与标准三联治疗组H．pylori根除率按意向分析分别为93．0％-75．0％;按完成治疗分析分别为91．50与71．3％;H．pylori再现率分别为2．1%与14．9％,差异均具有统计学意义。2组溃疡愈合情况比较,较χ2=8．098,P-=0．044,序贯治疗组优于标准三联治疗组;2组不良反应无明显差异。结论10日序贯疗法治疗H．pylori感染疗效优于标准三联疗法,无明显副作用增加,是治疗H．pylori感染理想方案。     

10日序贯疗法根除幽门螺杆菌的疗效观察

目的观察由奥美拉唑联合阿莫西林、克拉霉素等组成的10日序贯疗法根除幽门螺杆菌(Hp)的疗效。方法将经胃镜检查确诊为有明显异常的慢性胃炎和胃十二指肠溃疡且Hp阳性的患者85例随机分组,治疗组(43例)方案为前5d奥美拉唑+克拉霉素,后5d奥美拉唑+阿莫西林+呋喃唑酮;对照组(42例)三联疗法为奥美拉唑+阿莫西林+克拉霉素,疗程7d。结果治疗组Hp根除率为90.7%,对照组Hp根除率为71.4%,两组比较差异有统计学意义(P<0.05)。结论以奥美拉唑、阿莫西林等组成的10日序贯疗法治疗成人Hp感染具有疗效高、耐受性和依从性好等优点。     

儿童幽门螺杆菌感染的临床治疗分析

目的 探讨序贯疗法以及两种三联疗法治疗儿童幽门螺杆菌(Hp)感染的临床疗效,寻找一种根除率高、不良反应少,更经济的幽门螺杆菌根除方法.方法 选择经Hp相关检查均符合Hp感染诊断标准的患儿129例,随机分为A组:10 d序贯疗法44例,B组:7 d三联疗法组43例和C组:14 d三联疗法组42例;A组前5d应用奥美拉唑+阿莫西林/克拉维酸钾,每日早晚2次口服;后5d应用奥美拉唑+克拉霉素+甲硝唑,每日早晚2次口服;B组予阿莫西林/克拉维酸、克拉霉素和奥美拉唑,每日早晚2次口服,疗程1周;C组予阿莫西林、克拉霉素和奥美拉唑,每日早晚2次口服,疗程2周.结果 A、B、C组Hp根除率分别为86.5％、79.1％和64.3％,A组与B组Hp根除率差异无统计学意义,A组与C组Hp根除率差异有统计学意义(P＜0.05);临床疗效比较差异无统计学意义;A组不良反应发生率与B组比较差异无统计学意义,与C组比较差异有统计学意义(P＜0.05).结论 10d序贯疗法和阿莫西林/克拉维酸、克拉霉素和奥美拉唑疗程1周的三联疗法,是治疗儿童HP感染简单、经济、有效的治疗方法,且前者不良反应更少,依从性更好.     

序贯疗法根除幽门螺杆菌感染的临床研究

目的 研究序贯疗法能否获得比标准三联疗法更高的幽门螺杆菌（Hp）感染根除率,以及比较两种方案之间发生副反应的差异.方法 将Hp阳性患者分成两组,治疗组采用先给予埃索美拉唑＋阿莫西林,2次/d,口服,共5 d,然后再继续予埃索美拉唑＋克拉霉素＋甲硝唑,2次/d,口服,共5 d序贯疗法;对照组采用标准三联疗法.疗程结束30 d后复查快速尿素酶试验,观察Hp根除率和不良反应.结果 治疗组Hp根除率为93.3%,对照组分别为73.3%,两组根除率比较差异有统计学意义（P〈0.05）;治疗组和对照组不良反应分别为3例和2例.结论 埃索美拉唑、阿莫西林、克拉霉素、甲硝唑组成的10天序贯疗法是一种疗效高、不良反应少的Hp根除方案,可作为治疗Hp感染的一种选择方案.     

序贯疗法与三联疗法治疗幽门螺杆菌感染的疗效比较

目的比较埃索美拉唑、阿莫西林、克拉霉素、替硝唑组成的10日序贯疗法与三联疗法根除幽门螺杆菌（Hp）的疗效。方法将本院经胃镜检查确诊为慢性胃炎或消化性溃疡且Hp阳性的患者80例随机分为两组,治疗组（40例）序贯疗法方案,对照组（40例）三联疗法方案。所有患者停药4周后复查^13C呼气试验,或胃黏膜快速尿素酶实验,判断Hp根除率。结果治疗组Hp根除率为95．0％,对照组为80．0％,两组比较差异具有统计学意义（χ^2=4．14,P〈0．05）,且序贯疗法并未增加患者的经济负担。两种方案不良方应的发生率差异无统计学意义（χ^2=0．04,P〉0．05）。结论10日序贯疗法治疗Hp感染明显优于7日三联疗法,是一种安全、经济、有效的方案。     

四联疗法治疗幽门螺旋杆菌感染84例疗效观察

目的探讨四联疗法治疗幽门螺旋杆菌感染的疗效。方法84例经胃镜检查确诊Hp阳性患者，随机分为治疗组42例，对照组42例。治疗组采用克拉霉素＋阿莫西林＋洛赛克＋铋剂治疗，对照组采用甲硝唑＋阿莫西林＋洛赛克＋铋剂治疗。结果治疗组Hp根除率（37／42）88．1％，对照组（26／42）61．9％。结论克拉霉素四联疗法是根除幽门螺旋杆菌的有效力‘法。     

序贯疗法与标准三联疗法治疗幽门螺杆菌的疗效分析

目的比较由奥美拉唑、阿莫西林、克拉霉素、替硝唑组成的10日序贯疗法与由奥美拉唑、克拉霉素和阿莫西林组成的标准三联疗法根除幽门螺杆菌的效果。方法 94例H.pylor采用单盲法随机分成对照组与实验组,对照组采用标准三联疗法(奥美拉唑+阿莫西林+克拉霉素治疗7d)治疗,实验组采用序贯疗法(奥美拉唑+阿莫西林治疗5d后继之以奥美拉唑+克拉霉素+替硝唑再治疗5d)治疗,停药4周后,复查胃镜、快速尿素酶实验与13C尿素呼气试验,比较2组H.pylori根除率,溃疡愈合率及不良反应。结果序贯治疗组与标准三联治疗组H.pylori根除率按意向分析分别为93.0%与75.0%;按完成治疗分析分别为91.5%与71.3%;H.pylori再现率分别为2.1%与14.9%,差异均具有统计学意义。2组溃疡愈合情况比较,较χ2=8.098,P=0.044,序贯治疗组优于标准三联治疗组;2组不良反应无明显差异。结论 10日序贯疗法治疗H.pylori感染疗效优于标准三联疗法,无明显副作用增加,是治疗H.pylori感染理想方案。     

序贯疗法和三联疗法根除幽门螺杆菌感染的疗效观察

目的比较10日序贯疗法和标准三联疗法根除幽门螺杆菌（H.pylori）感染的疗效。方法将门诊经胃镜检查确诊为消化性溃疡且H.pylori阳性的患者60例,随机分为两组。治疗组30例,用10日序贯疗法（雷贝拉唑＋阿莫西林治疗5d,继之以雷贝拉唑＋克拉霉素＋奥硝唑再治疗5d）;对照组30例,用三联疗法（雷贝拉唑＋克拉霉素＋甲硝唑治疗7天）。停药4周后复查胃镜、快速尿素酶实验与14C尿素呼气试验,评估H.pylori根除率及溃疡愈合率。结果治疗组H.pylori根除率为93.3%,对照组70.3%,两组比较具有统计学意义（χ2=4.32,P〈0.05）。两组溃疡愈合率相比无统计学意义。两种方案不良方应的发生率无明显统计学意义（χ2=0.05,P〉0.05）。结论序贯疗法治疗Hp感染优于三联疗法,其是一种安全、有效的治疗方案。     

序贯疗法根除幽门螺杆菌感染的临床研究

目的 比较埃索美拉唑、阿莫西林、克拉霉素、替硝唑组成的10 d序贯疗法与标准三联疗法根除幽门螺杆菌Hp的疗效和安全性. 方法 214例Hp患者,随机分成两组,治疗组(10 d序贯组):前5d给予埃索美拉唑(阿斯利康制药有限公司)20 mg+阿莫西林1.0g,2次/d口服,后5d,埃索美拉唑20 mg+克拉霉素0.5g+替硝唑0.5g,2次/d口服;对照组(7 d标准三联组):埃索美拉唑20 mg+阿莫西林1.0g+克托霉素0.5g,2次/d口服,疗程7 d.4周后复查胃镜及14C- UBT,观察溃疡愈合、Hp根除情况及不良反应. 结果 治疗组的Hp根除率、溃疡愈合率按治疗意向分析、完成随访病例分析均优于对照组,差异有统计学意义(P＜0.05).均无严重不良反应. 结论 序贯疗法具有溃疡愈合率及Hp根除率高的优点,不良反应相当,可作为Hp感染的一线治疗方案.     

三联短程疗法治疗幽门螺杆菌阳性十二指肠溃疡的临床研究

目的探讨奥美拉唑、阿莫西林和克拉霉素5d短程疗法对Hp相关性活动期十二指肠溃疡（DU）治疗效果。方法85例Hp阳性的活动期DU患者随机分成两组：A组（45例），奥美拉唑20mg、阿莫西林1．0g、克拉霉素0．5g，每日2次，饭前1h服用，共5d；B组（40例），奥美拉唑20mg、阿莫西林1．0g、甲硝唑400mg，每日2次，饭前1h服用，共2周。治疗前和疗程结束后5-6周及1年各做1次电子胃镜检查，并取活组织做快速尿素酶和Warthin—Starry银染色检查Hp。结果A、B两组Hp根除率分别为91．11％（41／45）、92．50％（37／40），P〉0．05；DU治愈率为88．89％（40／45）、90．00％（36／40），P〉0．05；副作用发生率为11．11％（5／45）、10．00％（4／40）。P〉0．05。Hp是否根除的治愈率分别为89．74％（70／78）、57．14％（4／7），P〈0．001；1年后DU复发率分别为10．26％（8／78）、42．86％（3／7），P〈0．05。结论奥美拉唑、阿莫西林和克拉霉素5d短程疗法治疗Hp相关性DU是一种短程、安全、高效、副作用小、依从性好的根除Hp方案。     

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.     

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.     

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.     

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.     

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.