甲硝唑联合过氧化氢冲洗宫腔治疗产褥感染39例疗效观察

目的：探讨针对产褥感染患者开展甲硝唑联合过氧化氢冲洗宫腔治疗的临床效果.方法：选取2012年2月-2014年1月我院妇产科收治的产褥感染患者78例,随机分为对照组与治疗组个39例,对照组患者采用产科常规抗感染治疗,治疗组患者增加甲硝唑与过氧化氢冲洗宫腔的联合治疗,比较两组患者的临床表现并开展讨论与分析.结果：治疗组产妇症状持续时间为（5.4±0.4）d,发热持续时间为（4.1±0.6）d,住院时间为（7.0±1.1）d,均显著好于对照组,具有统计学意义（P〈0.05）. 结论：针对产褥感染患者开展甲硝唑联合过氧化氢冲洗宫腔的治疗方式,能够直接作用于感染部位,迅速杀灭细菌缓解临床症状,具有良好的应用效果.     

甲硝唑联合过氧化氢冲洗宫腔对治疗产褥感染的临床疗效

目的:总结甲硝唑结合过氧化氢冲洗宫腔疗法对治疗产褥感染的临床疗效。方法:随机将126例产褥感染患者分成对照组56例和观察组70例,对照组采用常规的抗生素治疗,观察组在常规的抗生素治疗的基础上采用甲硝唑结合过氧化氢冲洗宫腔辅助治疗,统计两组的发热持续时间、症状好转时间、住院天数、临床疗效。结果:通过治疗,观察组在发热持续时间、症状好转时间、住院天数、临床有效率显著优于对照组(P0.05)。结论:甲硝唑结合过氧化氢冲洗宫腔辅助治疗产褥感染,临床效果明显优于常规抗生素治疗,临床上具有广泛使用和推广的价值。     

过氧化氢与甲硝唑冲洗宫腔辅助治疗产褥感染的临床体会

目的探讨过氧化氢与甲硝唑冲洗宫腔辅助治疗产褥感染的临床疗效。方法对郑州市第六人民医院在2010年10月-2013年1月收治的84例产褥感染患者随机分为观察组和对照组,对照组的患者给予常规的抗生素治疗,观察组患者在常规治疗基础上使用过氧化氢和甲硝唑冲洗宫腔进行辅助治疗。结果观察组患者经过治疗在发热持续的时间和症状持续的时间上明显低于对照组,差异具有统计学意义（P〈0.05）;两组患者都没有出现较为明显的不良反应。结论过氧化氢与甲硝唑冲洗宫腔辅助治疗产褥感染取得的临床疗效显著,值得在临床上广泛使用和推广。     

过氧化氢联合甲硝唑宫腔冲洗治疗产褥感染的效果

目的探讨过氧化氢联合甲硝唑宫腔冲洗护理对产褥感染的疗效。方法选取2016年7月-2018年6月于海口市第四人民医院接受治疗的92例产褥期感染妇女为研究对象,按照随机数表法将患者平均分为试验组与对照组,各46例,试验组采用过氧化氢联合甲硝唑进行宫腔冲洗,对照组采用常规方法进行宫腔冲洗。检测并比较两组患者的血清炎性因子水平,观察并比较两组患者的治疗效果。结果试验组患者的症状消失时间(5.36±1.12)d、发热消退时间(3.96±1.02)d以及住院时间(7.82±1.39)d低于对照组患者,差异均具有统计学意义(P<0.05)。试验组患者的白细胞介素-6(6.83±0.32)㎎/L、血清C-反应蛋白(2.79±0.42)㎎/L以及降钙素原(0.67±0.13)μg/L低于对照组患者,差异均具有统计学意义(P<0.05)。试验组患者抗凝血酶Ⅲ(79.64±0.45)%水平高于对照组患者,差异均具有统计学意义(P<0.05)。试验组患者总有效率为91.30%,高于对照组患者的71.74%,差异具有统计学意义(χ~2=5.024,P=0.025)。结论过氧化氢联合甲硝唑进行宫腔冲洗具有显著疗效,能够有效促进患者康复,减少住院时间,改善患者的临床症状,同时通过联合护理降低患者血清炎症因子水平,减少应激反应,降低感染率。     

左氧氟沙星联合替硝唑治疗盆腔炎的临床分析

目的对左氧氟沙星联合替硝唑治疗盆腔炎的临床效果进行研究分析。方法选取该院盆腔炎患者94例并将其分为治疗组（采用左氧氟沙星联合替硝唑治疗）和对照组（采用氧氟沙星联合甲硝唑治疗）,均为47例,对比两组患者出现不良反应发生率、临床症状消失时间和临床治疗总有效率。结果治疗组患者临床治疗总有效率高达93.62%、腹痛消失时间为（2.74±1.13）d、包块消失时间为（6.25±2.13）d、体温恢复正常时间为（4.11±0.58）d、白带恢复正常时间为（5.13±2.18）d、出现不良反应发生率仅为4.26%同对照组患者的76.60%、（4.22±1.62）d、（8.54±2.68）d、（6.53±1.15）d、（6.98±2.65）d和23.40%相比,P〈0.05。结论在治疗盆腔炎疾病临床上左氧氟沙星联合替硝唑临床效果显著,促使患者早日康复。     

五官超短波结合甲硝唑与过氧化氢配成液冲洗治疗颌面部多间隙感染疗效观察

目的 通过对两种不同方法治疗颌面部多间隙感染的治愈时间比较,探讨五官超短波结合甲硝唑与过氧化氢配成液冲洗治疗颌面部多间隙感染的临床价值.方法 40例颌面部多间隙感染患者按随机数字表法分为观察组和对照组,每组20例.观察组行甲硝唑与2％过氧化氢1∶1配成液冲洗结合五官超短波治疗,对照组行普通切开引流+2％过氧化氢局部冲洗治疗.比较两组疗效.结果 观察组住院时间为13.5 d,平均住院时间为6.75 d.对照组住院时间为18.8d,平均住院时间为9.40 d.观察组较对照组平均住院时间少2.65 d.结论 五官超短波结合甲硝唑与2％过氧化氢1∶1配成液冲洗治疗颌面部多间隙感染操作简便、疗效好、疗程短、费用少,值得推广.     

阿奇霉素联合奥硝唑应用于急性盆腔炎患者的临床疗效分析

目的 分析阿奇霉素联合奥硝唑治疗急性盆腔炎的临床疗效.方法 选择符合标准的急性盆腔炎患者128例,按随机数字表法分为治疗组和对照组,每组64例.对照组给予左氧氟沙星联合甲硝唑治疗,治疗组给予阿奇霉素联合奥硝唑治疗.7d为1个疗程,共治疗2个疗程.观察治疗前后患者盆腔包块的变化情况,并评价临床疗效以及不良反应发生情况.结果 治疗组总有效率显著高于对照组[93.75％（60/64）比82.81％（53/64）],差异有统计学意义（P＜0.05）.两组治疗后子宫或附件压痛、腹痛、盆腔积液、白带增多、附件包块等临床症状和体征均显著改善,且治疗组治疗后临床症状和体征改善情况优于对照组,差异有统计学意义（P＜0.05）.治疗组患者体温恢复正常时间、腹痛缓解时间、盆腔积液消失时间、附件包块吸收时间均显著短于对照组[（4.35±1.98）d比（5.31±1.67） d,（3.50±1.64）d比（5.19±1.36） d,（7.28±2.09）d比（9.34±1.81）d,（7.63±1.99）d比（9.28±1.72）d],差异有统计学意义（P＜0.05）.两组患者治疗过程中均未发生明显不良反应.结论 阿奇霉素联合奥硝唑对急性盆腔炎具有良好的临床疗效,且不良反应较少,有推广与应用的价值.     

两种缓释剂联合治疗急性智齿冠周炎的疗效观察

目的探讨观察急性智齿冠周炎患者应用甲硝唑棒与盐酸米诺环素软膏两种缓释剂联合治疗的临床疗效。方法选取我院收治的64例急性智齿冠周炎患者按照随机数字表法分为观察组（在常规局部冲洗后应用甲硝唑棒与盐酸米诺环素软膏两种缓释剂联合治疗）和对照组（常规局部冲洗后给予1%碘甘油治疗）,对比观察两组患者临床疗效及不良反应情况。结果观察组治愈23例,好转6例,无效3例,对照组治愈17例,好转10例,无效5例,观察组患者治疗总有效率（93.4%）明显高于对照组（84.4%）,差异对比具有统计学意义（P〈0.05）。结论急性智齿冠周炎患者应用甲硝唑棒与盐酸米诺环素软膏两种缓释剂联合治疗的临床疗效显著,可有效改善临床症状,且不良反应较少,是一种安全、有效的治疗方案,值得在临床上进一步推广、应用。     

中药熏洗联合甲硝唑在滴虫性阴道炎中的疗效研究

目的 为提高临床治疗效果,探索中药熏洗联合甲硝唑治疗滴虫性阴道炎的临床应用价值.方法 选择2011年1-6月妇产科门诊进行治疗的56例滴虫性阴道炎患者,机械抽样随机将其中36例分为观察组,采取中药熏洗联合甲硝唑治疗;余者分为对照组,采取甲硝唑治疗.结果 观察组控制率为100.0％,对照组控制率为80.0％;两组有效率差异无统计学意义,观察组痊愈率显著高于对照组(P＜0.05),而无效率显著低于对照组(P＜0.05);两组治疗费用差异无统计学意义,观察组症状缓解时间(5.2±1.4)d,痊愈时间(6.4±1.6)d,对照组的症状缓解时间(8.3±2.2)d,痊愈时间(10.4±1.8)d,两组症状缓解及痊愈时间差异有统计学意义(P＜0.05).结论 中药熏洗联合甲硝唑治疗滴虫性阴道炎,可显著提高治疗效果,缩短治疗周期,但并未增加治疗费用.     

吲哚布芬联合氯吡格雷治疗不稳定性心绞痛的临床观察

目的：研究吲哚布芬联合氯吡格雷在不稳定型心绞痛（UAP）治疗方面的效果。方法对本院收治的不稳定心绞痛（UAP）患者150例进行随机分组,分别为观察组与对照组,每组各75例。对照组,口服阿司匹林以及氯吡格雷;观察组,口服吲哚布芬以及氯吡格雷。治疗6周后,分析评价观察组和对照组两组的临床治疗效果。结果疗程结束后,两组患者心绞痛频率和持续时间均降低,观察组发作频率（3.1±1.1）次/d,持续时间（42.1±2.7）d,与对照组相比差异显著（P＜0.05）。观察组总有效率达94.6%,对照组达88%,观察组总有效率显著优于对照组（P＜0.05）。观察组仅有3例轻微出血症状,1例白细胞减少反应,不良反应发生率低于对照组,差异显著（P＜0.05）。结论联合运用吲哚布芬与氯吡格雷对不稳定性心绞痛治疗的治疗较好的临床效果,值得临床推广。     

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.     

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.