小儿豉翘清热颗粒治疗小儿急性上呼吸道感染的疗效及安全性研究

目的观察小儿豉翘清热颗粒治疗小儿急性上呼吸道感染的疗效及安全性。方法采用随机、双盲双模拟、阳性平行对照、多中心临床研究方法,将2016年9月-2017年9月就诊的小儿急性上呼吸道感染患儿300例作为研究对象,分为试验组(157例)和对照组(143例),对照组给予小儿氨酚黄那敏颗粒治疗,试验组给予小儿豉翘清热颗粒治疗,每日3次,疗程均为3d。比较两组患儿的临床治疗效果、完全退热率、退热起效率及中医症候积分,比较两组不良事件及不良反应发生率。结果全分析集(FAS)分析人群:试验组治疗有效率为83.44%高于对照组的64.34%,差异有统计学意义(P0.05);试验组患儿用药72h完全退热率为67.52%高于对照组的44.26%,差异有统计学意义(P0.05);试验组治疗3d中医症候积分高于对照组,差异有统计学意义(P0.05);安全性数据集(SS)分析人群:实验过程中无1例出现严重不良事件,试验组5例出现不良反应,对照组1例出现不良反应,两组比较差异无统计学意义。结论小儿豉翘清热颗粒治疗小儿急性上呼吸道感染可缩短病程,具有较高的临床疗效和安全性。     

小儿豉翘清热颗粒治疗急性支气管炎伴发热的疗效

目的:探讨小儿豉翘清热颗粒治疗小儿急性支气管炎伴发热的临床疗效。对小儿豉翘清热颗粒治疗小儿急性支气管炎(风热咳嗽)的临床有效性作出进一步评价。方法:急性支气管炎146例随机分为两组。对照组予常规抗炎,止咳祛痰等治疗;治疗组常规治疗基础上,给予小儿豉翘清热颗粒口服。观察发热、咳嗽、肺部体征消失时间,比较疗效,同时观察副反应。结果:治疗组的退热时间,咳嗽消退时间均较对照组缩短,有显著性差异(p<0.01),治疗组总有效率97.22%,对照组85%(p<0.05)。结论:小儿豉翘清热颗粒更利于急性支气管炎伴发热患儿的恢复。     

小儿豉翘清热颗粒改善急性上呼吸道感染患儿临床症状研究

目的 探索小儿豉翘清热颗粒改善急性上呼吸道感染患儿临床症状的效果.方法 将160例小儿急性上呼吸道感染患者随机分为治疗组和对照两组,治疗组以小儿豉翘清热颗粒治疗4天,对照组给予利巴韦林颗粒治疗4天.观察临床疗效.结果 使用小儿豉翘清热颗粒的治疗组的临床效果要优于使用利巴韦林颗粒的对照组.结论小儿豉翘清热颗粒改善小儿急性上呼吸道感染临床症状的效果显著,值得在临床上推广使用.     

两种药物联合治疗儿童流感的疗效观察

目的观察磷酸奥司他韦颗粒联用小儿豉翘清热颗粒治疗儿童流感的疗效。方法选择高唐县人民医院2016年12月-2017年12月收治的流感患儿82例,随机分为观察组和对照组各41例。对照组给予磷酸奥司他韦颗粒口服,观察组联合给予小儿豉翘清热颗粒治疗。观察并比较两组Hb、WBC水平,症状消失时间,有效率及不良反应发生情况。结果治疗后两组Hb水平、不良反应发生率差异无统计学意义(P0.05)。治疗后观察组WBC改善情况,咳嗽、发热、喷嚏、鼻塞症状消失时间及有效率明显优于对照组,差异有统计学意义(P0.05)。结论采用磷酸奥司他韦颗粒联合小儿豉翘清热颗粒治疗儿童流感,可提高治疗有效率。     

小儿柴桂退热颗粒和小儿豉翘清热颗粒治疗急性上呼吸道感染的疗效比较

目的比较小儿柴桂退热颗粒和小儿豉翘清热颗粒治疗急性上呼吸道感染的疗效。方法选取2017年10月-2019年10月绍兴市中心医院收治的156例急性上呼吸道感染患儿为研究对象,根据随机数字表分为对照组和观察组,每组78例。对照组在常规治疗基础上给予小儿豉翘清热颗粒口服治疗,观察组在常规治疗基础上给予小儿柴桂退热颗粒口服治疗。比较两组临床症状消失时间、中医症候积分、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平及临床疗效。结果观察组治疗后患儿发热消失时间、咽喉红肿消失时间、鼻塞消失时间分别为(1.53±0.51)d、(2.86±0.72)d及(2.72±0.89)d,均明显短于对照组的(1.72±0.48)d、(3.21±0.87)d及(3.13±1.03)d,差异均有统计学意义(t=2.396 0,P=0.017 8;t=2.737 2,P=0.006 9;t=2.660 1,P=0.008 6)。治疗后,观察组患儿中医症候积分为(1.84±1.07)分,明显低于对照组的(2.23±1.23)分,差异有统计学意义(t=2.112 8,P=0.036 2)。治疗后,观察组患儿血清TNF-α和IL-6水平分别为(126.28±6.76)pg/ml和(31.26±7.07)pg/ml,显著低于对照组的(128.89±7.18)pg/ml和(33.78±6.15)pg/ml,差异均有统计学意义(t=2.337 5,P=0.020 7;t=2.375 1,P=0.018 8)。观察组治疗有效率为97.44%,对照组治疗有效率为92.31%,观察组有效率略高于对照组,但差异无统计学意义(χ~2=4.978 3,P=0.176 8)。对照组不良反应发生率为5.13%,观察组不良反应发生率为7.69%,两组患儿不良反应发生率比较差异无统计学意义(χ~2=0.427 0,P=0.513 0)。结论小儿柴桂退热颗粒和小儿豉翘清热颗粒辅助治疗小儿急性上呼吸道感染的临床疗效相当,安全性均较高,小儿柴桂退热颗粒更有助于快速缓解临床症状,抑制炎症反应,降低血清TNF-α、IL-6水平,调节患儿免疫功能。     

小儿豉翘清热颗粒辅助治疗疱疹性咽峡炎患儿的效果

目的 探讨小儿豉翘清热颗粒辅助治疗疱疹性咽峡炎患儿的效果。方法 选择2018年1月至2021年1月我院收治的疱疹性咽峡炎患儿116例,随机分为两组各58例。对照组采用利巴韦林注射液治疗,观察组在此基础上采用小儿豉翘清热颗粒辅助治疗,两组均治疗1周。对比两组的临床症状缓解时间、临床疗效及不良反应发生情况。结果 观察组临床症状缓解时间及住院时间均短于对照组（P <0.05）。观察组治疗总有效率为94.83%,高于对照组的82.76%(P <0.05)。两组的不良反应发生率比较（3.45%vs. 8.62%）,差异无统计学意义（P>0.05）。结论 小儿豉翘清热颗粒辅助治疗疱疹性咽峡炎患儿的效果显著,可缩短患儿症状缓解时间与住院时间,且不会增加不良反应。     

豉翘清热颗粒联合芬母口腔抗菌喷剂治疗疱疹性咽峡炎研究

目的探讨豉翘清热颗粒联合芬母口腔抗菌喷剂治疗小儿疱疹性咽峡炎中的治疗效果。方法选取2015年6月至2016年8月浙江中医药大学附属第二医院儿科感染门诊就诊的疱疹性咽峡炎患儿116例,随机分为观察组和对照组,两组患儿均予豉翘清热颗粒治疗,观察组联合芬母口腔抗菌喷剂,对照组联合口腔炎喷雾剂,观察患儿各项康复指标。结果与对照组比较,观察组体温恢复时间、疱疹愈合时间及CRP恢复正常时间均有缩短,差异有统计学意义(P0.01)。观察组药物总有效率(94.83%)高于对照组(82.76%),差异有统计学意义(Z=-3.837,P0.05)。观察组不良反应总体发生率(6.89%)低于对照组(36.21%),差异有统计学意义(χ2=14.736,P=0.000)。结论豉翘清热颗粒联合芬母口腔抗菌喷剂治疗小儿疱疹性咽峡炎疗效较好,可缩短病程,患儿服药依从性高,不良反应发生率低。     

甲基强的松龙短程冲击疗法辅以丙种球蛋白治疗小儿病毒性脑炎的疗效及安全性观察

目的观察甲基强的松龙短程冲击疗法辅以丙种球蛋白治疗小儿病毒性脑炎的临床疗效及安全性。方法选择我院2012年1月至2016年6月间收治的64例小儿病毒性脑炎患儿,随机分为治疗组与对照组各32例。在常规综合治疗的基础上,对照组给予地塞米松治疗,治疗组给予甲基强的松龙短程冲击疗法及丙种球蛋白治疗,比较两组患儿的临床疗效及症状(抽搐、脑膜刺激征、发热、意识障碍)缓解时间。结果治疗组的总有效率为93.8%,明显高于对照组的75.0%,差异具有统计学意义(P<0.05)。治疗组的临床症状缓解时间均显著短于对照组,差异具有统计学意义(P<0.05)。结论甲基强的松龙短程冲击疗法辅以丙种球蛋白治疗小儿病毒性脑炎,可显著改善患儿症状,疗效明显,安全性高。     

小儿柴桂退热颗粒辅助治疗小儿急性上呼吸道感染的效果观察

目的探讨在常规治疗基础上应用小儿柴桂退热颗粒治疗小儿急性上呼吸道感染(AURI)的临床疗效,并评估对患儿临床症状或体征、炎症反应及免疫功能的改善作用。方法选择AURI患儿184例,根据入院编号按照单双数随机分为对照组和研究组,每组92例,对照组患儿给予常规治疗。研究组患儿在常规基础上应用小儿柴桂退热颗粒进行治疗。评估两组患者临床疗效、主要症状或体征消失时间、主要证候评分,并检测两组患者治疗前后超敏C反应蛋白(hs-CRP)及相关免疫学指标。结果研究组患儿总有效率为高于对照组(P0.05);研究组患者发热消失时间、咳嗽咽痛消失时间、流涕、鼻塞消失时间、腹泻、纳少消失时间和平均治疗时间均低于对照组(P0.05);两组患儿治疗后发热、鼻塞、咳嗽、纳少评分均低于治疗前,两组患儿治疗后CD4~+/CD8~+均高于治疗前(P0.05);研究组患儿治疗后主要证候总积分低于对照组,差异有统计学意义(P0.05);研究组患儿治疗后血清hs-CRP低于对照组,差异有统计学意义(P0.05);研究组患儿治疗后血清CD4~+高于对照组,研究组CD8~+低于对照组(均P0.05)。结论小儿柴桂退热颗粒具有发汗解表、清里退热的功效,常规治疗基础上应用小儿柴桂退热颗粒治疗AURI患儿,能够显著改善患儿临床症状或体征,缩短治疗时间,临床疗效显著,且患儿炎症反应及免疫功能得到显著改善。     

炎琥宁治疗小儿上呼吸道感染的疗效观察

目的 观察炎琥宁治疗小儿上呼吸道感染的临床疗效.方法 将122例上呼吸道感染患儿按照随机数字表法分为两组,每组61例.观察组给予炎琥宁静脉滴注,对照组给予利巴韦林静脉滴注,观察两组患儿的临床疗效.结果 观察组总有效率为98.4％(60/61),明显高于对照组的85.2％(52/61),差异有统计学意义(P＜0.05).观察组退热时间,咳嗽、流涕好转时间,咽部充血消失时间,白细胞计数恢复正常时间均明显短于对照组,差异有统计学意义(P＜0.05).两组不良反应情况比较差异无统计学意义(P＞0.05).结论 炎琥宁用于治疗小儿上呼吸道感染的疗效显著,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.     

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.