前列舒乐胶囊联合加替沙星治疗慢性非细菌性前列腺炎89例疗效观察

<正>慢性前列腺炎(CP)的发生率为成年男性的5%～8%,是男性泌尿外科最常见的疾病之一。慢性非细菌性前列腺炎则占CP的95%左右[1]。本站自2006年10月～2007年8月对89例慢性非细菌性前列腺炎采用前列舒乐胶囊联合加替沙星治疗,取得比较满意的效果。现报告如下。     

前列腺内注射川参通治疗慢性非细菌性前列腺炎/慢性骨盆疼痛综合征

目的探讨经会阴部注射川参通治疗慢性非细菌性前列腺炎/慢性骨盆疼痛综合征(CAP/CPPS)的有效性和安全性。方法将70例诊断为慢性非细菌性前列腺炎/慢性骨盆疼痛综合征的患者分为2组。治疗组50例,运用川参通注射液4 m l、利多卡因注射液2 m l,经会阴注射至前列腺,1次/d,共8次;对照组20例,予安慰剂治疗8次。采用美国国立卫生研究所(NIH)制定的前列腺炎症状评分(CPSI)标准判定疗效。结果观察45 d,治疗组痊愈27例(54%),显效11例(22%),有效9例(18%)。无效3例(6%)。对照组无痊愈病例(0%),显效3例(15%),有效5例(25%),无效12例(60%)。治疗组痊愈率、显效率及有效率显著高于对照组(P≤0.05)。川参通治疗前后,CPSI评分、排尿症状评分、生活质量评分及总分均有显著改善。结论经会阴注射川参通治疗慢性非细菌性前列腺炎/慢性骨盆疼痛综合征有效、安全。     

美舒郁联合中药治疗慢性无菌性前列腺炎/慢性盆腔疼痛综合征的疗效观察

慢性非细菌性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)是常见的泌尿生殖系统疾病,其发病率占前列腺炎的90%～95%[1]。中医临床分型,CP/CPPS多见于病程较长、疾病反复迁延难愈的患者。其病理基础为瘀血内阻,主要表现为会阴、小腹、睾丸、腰骶、尿道等部位的刺痛或胀痛[2]。由于CP/CPPS病因复杂、疗效不佳、病程迁延,多数患者伴有不同程度的焦虑抑郁情绪,如悲观失望、失眠、疑病及自杀情绪等,这不仅影响患者对治疗的依从性,而且导致治疗的复杂化。近年多有学者将抗抑郁药用于CP/CPPS的治疗报道,笔者尝试将现代医学的抗抑郁治疗与传统…     

生物反馈联合药物治疗慢性前列腺炎的临床研究

目的 探讨生物反馈联合药物治疗慢性前列腺炎的临床疗效.方法 将145例慢性前列腺炎患者根据美国国立卫生院(NIH)前列腺炎分型标准分型后,随机分为治疗组和对照组.治疗组(85例)均接受生物反馈治疗20次,每次20 min,同时给予常规药物治疗;对照组(60例)仅给予常规药物治疗.以NIH慢性前列腺炎症状评分(NIH-CPSI)和前列腺按摩液(EPS)中白细胞计数为疗效评价指标.结果 治疗组NIH-CPSI总分治疗前后分别为(26.65±6.32)、(10.34±5.07)分,平均降低16.31分,症状程度评分治疗前后分别为(19.76±4.77)、(7.25±3.38)分,平均降低12.51分;对照组NIH-CPSI总分治疗前后分别为(25.57±6.11)、(15.45±5.76)分,平均降低10.12分,症状程度评分治疗前后分别为(18.23±4.65)、(10.56±4.21)分平均降低7.67分.治疗组NIH-CPSI总分与症状程度评分的下降幅度均比对照组更明显(P＜0.01).治疗组总有效率90.6%(77/85),总显效率67.1%(57/85),对照组总有效率66.7%(40/60),总显效率45.0%(27/60),两组比较差异均有统计学意义(P＜0.05或＜0.01).结论 生物反馈联合药物治疗慢性细菌性前列腺炎及非细菌性前列腺炎(慢性盆腔疼痛综合征)安全、有效,患者的依从性好.     

慢性前列腺炎的病原菌及其耐药性研究

目的 了解慢性前列腺炎(CP)病原菌感染及其对常用抗菌药物的耐药性,对CP的诊断和治疗提供科学依据.方法 对143例CP患者的前列腺液进行常规病原菌培养和药物敏感性试验.结果 82例病原菌培养阳性,阳性率57.34%,共分离出病原菌85株,其中革兰阳性球菌73株,占85.9%,革兰阴性杆菌12株,占14.1%;革兰阳性球菌中以凝固酶阴性葡萄球菌(CNS)为主(60.0%),其次为金黄色葡萄球菌(12.9%)、肠球菌属(11.8%);CNS对常用的β-内酰胺类、喹诺酮类,红霉素、四环素类抗菌药物耐药率较高,对万古霉素、利福平、复方新诺明、庆大霉素较敏感.结论 慢性前列腺炎的病原菌感染以CNS为主,对CNS引起的CP,首选利福平、复方新诺明、庆大霉素;选择敏感且对前列腺组织渗透性强的药物是慢性前列腺炎抗菌治疗的关键.     

盐酸坦索罗辛联合微波治疗慢性前列腺炎/慢性骨盆疼痛综合征的疗效观察

目的 观察盐酸坦索罗辛联合微波治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的疗效及安全性.方法 将102例Ⅲ型CP/CPPS患者根据门诊病历号的奇偶数分为治疗组和对照组,每组51例.对照组单纯口服盐酸坦索罗辛0.2 mg,每晚睡前口服,首次加倍,疗程30d;治疗组在对照组基础上加用直肠微波治疗,隔日1次,15次为1个疗程.结果 治疗组与对照组有效率分别为72.55%(37/51)与50.98%(26/51),两组比较差异有统计学意义(P＜0.05).全部病例中15例口服药物初期有不同程度的头痛、头晕、心慌、恶心等不适,药物减半后症状消失.结论 盐酸坦索罗辛联合微波治疗Ⅲ型CP/CPPS疗效显著.     

诊患者慢性前列腺炎/慢性骨盆疼痛综合征危险因素分析

[目的]调查门诊慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)患者的生活方式、个体疾病既往史以及精神心理等因素与CP/CPPS的关系. [方法]采用以医院为基础的病例对照研究方法,病例为2005年8月～2007年7月到临床泌尿外科门诊就诊并被确诊为CP/CPPS的612名男性患者,年龄为20～57岁;对照为同期入院,年龄相同的非CP/CPPS的612名门诊患者所组成.采用<美国国立卫生研究院慢性前列腺炎症状评分指数> (NIH-CPSI)评价患者对生活质量(QOL)的影响.应用多元Logistic模型计算出CP/CPPS与研究因素的比值比(DR)及其相对应的95%可信区间(CI). [结果]QOL 9～12分的397名患者中,324名为20～39岁,占81.61%.调整了年龄因素后.经多因素Logistic回归分析的结果表明:尿道炎、频繁手淫、无节制性生活、泌尿系外伤、固定体位、焦虑心理、长时间憋尿与CP发病有关联. [结论]大多数CP/CPPS患者生活质量受影响较大;随着年龄增长,患病人数逐渐减少.影响慢性前列腺炎发生的危险因素分别为尿道炎、无节制性生活、频繁手淫、泌尿外伤、固定体位(尤其是坐位/骑跨位)、焦虑心理和长时间憋尿.     

慢性前列腺炎综合征病人心理因素分析

目的了解抑郁和焦虑等心理因素在慢性前列腺炎综合征病人中的发生率及与慢性前列腺炎综合征病人治疗效果的相关性。方法应用抑郁自评量表(SDS)及焦虑自评量表(SAS)[1,2]随机对135例慢性非细菌性前列腺炎/慢性盆腔疼痛综合征(CPPS)患者进行调查,另以随机抽查的40例年龄相仿的慢性疼痛的门诊病人作为对照。将CPPS病人分成两组:A组,SDS>50或SAS>50;B组,SDS和SAS<50。用舍尼通口服进行对比治疗,并对治疗效果进行比较。结果135例CPPS患者发生抑郁81例(60%),焦虑67例(49.6%)。对照组40例门诊患者发生抑郁11例(27.5%),焦虑8例(20%)。两组相比差别有显著性意义(P=0.03,P=0.01)。有抑郁或焦虑的病人舍尼通治疗后症状改善情况分别为显效15.9%,有效25.5%,无效58.5%。无抑郁和焦虑的CPPS病人分别为26.8%,39.0%,34.1%。两组相比差别有显著性意义(P<0.05)。结论慢性前列腺炎综合征病人明显具有心理因素,主要表现为抑郁和焦虑.对治疗效果有一定影响,可考虑合并抗抑郁及抗焦虑药物。     

前列腺炎与良性前列腺增生相关性

前列腺炎是泌尿外科临床常见的疾病．1995年美国国立卫生研究所建议对前列腺炎进行更准确的重新分类：Ⅰ型为急性细菌性前列腺炎,Ⅱ型为慢性细菌性前列腺炎,Ⅲ型为慢性非细菌性前列腺炎或慢性盆腔疼痛综合征（chronic prostatitis／chronic pelvic pain syndrome,CP／CPPS）,包括炎症型（ⅢA,为慢性无菌性前列腺炎）和非炎症型（ⅢB,为前列腺痛）。     

老年患者慢性细菌性前列腺炎的病原菌及耐药性分析

目的 了解老年患者慢性细菌性前列腺炎的病原菌分布及其耐药性,为临床医师疾病诊断及治疗提供试验依据.方法 采集老年慢性前列腺炎患者的前列腺液进行细菌培养和体外药敏试验,并进行统计分析.结果 211例老年慢性前列腺炎患者的前列腺液中共检出病原菌131株,其中革兰阳性菌111株,占84.7%;革兰阴性菌20株,占15.3%;耐甲氧西林葡萄球菌占葡萄球菌属总数的40.9%.结论 老年慢性细菌性前列腺炎的病原菌对常用抗菌药物已产生了耐药性,应加强病原菌耐药性检测,提高临床治愈率.     

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.