学生驱虫对人群感染率的影响

目的在肠道线虫病有效控制地区,开展学生目标化疗,观察人群感染率变化。方法在校学生中每年1次化疗驱虫,粪检用改良加藤氏厚涂片法;蛲虫用透明胶纸肛拭法,另设对照组。结果通过连续4年的学生目标化疗,肠道线虫感染率:村民从2001年1．23%下降到2005年0．33%,每年以28．03%的速度下降;外来流动人口以14．05%的速度下降;对照组每年以13．23%的速度回升。儿童蛲虫感染率:城区和集镇每年以44．16%的速度下降;农村呈成倍回升态势。结论在肠道线虫低感染区,开展学生目标化疗,既可以巩固防治成果,又可以继续降低人群感染率。     

胸腺肽α1用于化疗所致神经毒性的疗效观察

目的观察胸腺肽α1对神经系统的保护作用。方法 32例化疗中出现2~3级神经毒性的患者,继续用原方案化疗,同时加用胸腺肽α1,化疗前4天1.6 mg/d,化疗后1.6 mg隔日1次共2周。治疗期间每周进行神经系统毒性反应评价。结果 18例患者(56.3%)神经系统毒性下降1~2级,其中下降1级8例(25%),下降2级10例(31.3%)。结论胸腺肽α1可减轻化疗所致神经毒性作用。     

结核病控制项目组合药物利用与经济学评价

目的:评价韶关市结核病控制项目组合药物利用情况及其经济学效果。方法:以限定日剂量(DDD)和药物利用指数(DUI)作为评价合理用药的指标,分析韶关市区1993年～2003年结核病控制项目化疗药物利用情况,并对结核病控制项目化疗方案B与常规化疗方案A进行成本-效果比较。结果:除B4 外,其它组合药物DUI≤1。B方案治愈率(E1)为96. 5 % ,有效率(E2)为98. 8 % ;A方案E1、E2 分别为65. 7 %和79 .5 %。B方案的治疗成本-效果比低于A方案,按治愈率计算的成本-效果比(C/E1)分别为8 59、25. 31 ,按有效率计算的成本-效果比(C/E2)分别为8 39、20. 92。结论:韶关市区结核病控制项目组合药物利用比较合理,经济学效果较好。     

后程加速超分割放疗联合化疗治疗食管癌的疗效分析

目的评价后程加速超分割联合紫杉醇加顺铂治疗食管癌的疗效。方法 60例食管癌患者随机分为后程加速超分割放疗联合紫杉醇加顺铂化疗组(放化疗组)和单纯后程加速超分割放疗组(放疗组)。两组均进行后程加速超分割放疗:前4周常规分割2.0Gy/次,1次/天,5天/周,照射至40Gy,20次后于第5、6周避脊髓1.4Gy/次,2次/天,5天/周,总剂量68Gy分40次6周完成。两次放射时间相隔≥6h。放化疗组在放疗同时行紫杉醇加顺铂联合静脉化疗:紫杉醇175mg/m2,顺铂75mg/m2,静脉输注,3周为1个周期,共完成2个周期。观察两组总有效率、1年和3年生存率及不良反应。结果后程加速超分割放疗的总有效率为56.7%,1年和3年生存率分别为63.3%,16.7%,与目前大多数的临床报道一致。后程加速超分割放疗再联合紫杉醇加顺铂同步化疗的总有效率为80%,1年和3年生存率分别为76.7%,36.7%,明显优于放疗组(P<0.05)。结论食管癌后程加速超分割联合紫杉醇加顺铂治疗能提高食管癌的治疗效果,患者对后程加速超分割联合紫杉醇加顺铂的耐受性可。     

Ⅲ期乳腺癌术前超选择性动脉灌注化疗的临床应用

目的　评价术前超选择性动脉灌注化疗对Ⅲ期乳腺癌的临床疗效。方法　将 84例Ⅲ期乳腺癌患者随机分为两组 ,每组 4 2例。一组行术前超选择性动脉化疗 ,另一组行全身性静脉化疗 ,全部用ACF方案 ,化疗后再进行手术。评估术后疗效。结果　动脉灌注化疗组的平均疗程 10d ,病灶缓解率为 92 % ,组织学出现明显变化的为 95 % ,并发症发生率为 2 3 8% ,5年生存率为 6 9% ,明显优于全身化疗组 (P <0 0 1)。结论　超选择性动脉灌注化疗作为晚期乳腺癌的术前辅助治疗具有效果好、疗程短、能改变癌细胞的组织形态、降低肿瘤分期、提高生存率等优点     

中晚期食管癌三维适形放射治疗协同化疗的疗效分析

目的对比研究食管癌常规放射治疗后后程三维适形放疗与在此基础上协同化疗的疗效、不良反应。方法将食管鳞癌60例随机分至两个组:①单纯放射治疗组前2/3疗程常规设野放疗40Gy,后1/3疗程改为CT模拟定位三维计划系统设野适形放射治疗,4Gy/次,隔日1次,每周3次,共20～24Gy;总剂量为60～64Gy,全疗程38～42d。②协同化疗组在上述放射治疗的同时加用化疗药紫杉醇60mg/m2,静脉滴注第1、8天,顺铂20mg/m2,静滴第1～5天,21d为1个周期,共2个周期,放疗结束后再行紫杉醇175mg/m2,静脉滴注第1天,顺铂20mg/m2,静滴第1～5天,21d为1个周期,共2个周期。结果随访1～36个月,单纯放射治疗组和协同化疗组的有效率(CR+PR)分别为71.4%、81.3%,协同化疗组高于单纯放射治疗组(χ2=1.330,P>0.05);两组比较放射性食管炎发生率差异无统计学意义,两组比较放射性肺炎差异无统计学意义。协同化疗组的骨髓抑制和胃肠反应明显高于单纯放射治疗组,两组比较差异有统计学意义;单纯放射治疗组和协同化疗组的1、2年生存率分别为67.9%、46.4%和78.1%、53.3%,协同化疗组高于单纯放射治疗组;1、2年局部控制率分别为62%、40%和72%、62.4%,协同化疗组高于单纯放射治疗组。结论常规放射治疗后后程加三维适形放射治疗协同化疗可以提高局部控制率和生存率,但骨髓抑制和胃肠反应毒性增加。     

某县麻风病防治效果的分析

目的探析麻栗坡县麻风病的防治效果。方法回顾性分析我县1960年²013年麻风病患者资料,根据患病率、新发现率、疫村个数、畸残率等指标评价防治效果和现状,提出整改措施。结果我县麻风病累计患者198例,除外迁及死亡38例,治愈150例,现症患者10例;2013年患病数为10例,较1971年73例下降86.3%;2013年患病率为0.36/万,较1967年4.31/万下降91.6%;2013年疫村共计7个,较1971年56个疫村下降87.5%;2013年新发现病例1例,新发现率为0.36/10万,比1966年下降98.7%;新发现患者平均延迟期在2年左右,且新发现患者均未发生Ⅱ级畸残;治愈患者中有40例患者残留不同程度的眼、手、足畸残,2006年2013年麻风病患者资料,根据患病率、新发现率、疫村个数、畸残率等指标评价防治效果和现状,提出整改措施。结果我县麻风病累计患者198例,除外迁及死亡38例,治愈150例,现症患者10例;2013年患病数为10例,较1971年73例下降86.3%;2013年患病率为0.36/万,较1967年4.31/万下降91.6%;2013年疫村共计7个,较1971年56个疫村下降87.5%;2013年新发现病例1例,新发现率为0.36/10万,比1966年下降98.7%;新发现患者平均延迟期在2年左右,且新发现患者均未发生Ⅱ级畸残;治愈患者中有40例患者残留不同程度的眼、手、足畸残,2006年²013年期间,为10例畸残患者进行了免费康复手术。结论我县麻风病防治效果显著,患病率、新发现率、疫村个数及畸残率等均得到控制,但仍未彻底消灭该疾病,应根据现状提出有效地整改措施进一步防控麻风病。     

广州市海珠区1993～2001年新发涂阳肺结核病例队列分析

目的 通过对海珠区1993～2001年1417例新发涂阳肺结核病人的转归进行队列分析，以评价本地区传染病的控制效果。方法 以1993～2001年本区新登记涂阳病例为该年队列分析的对象，分析登记满一年时转归。初治、复治涂阳病例分别采用2H3R3Z3S3（E3）／4H3R3，2H3R3Z3S3E3／6H3R3E3方案，实施全程督导化疗。结果 九年平均治愈率为92．0％，仍阳性率2．5％。结论 严格执行DOTS的技术规范是控制肺结核传染的主要措施。DOTS是控制传染源的最佳措施。     

手术加皮下埋藏腹腔化疗泵联合化疗治疗晚期胃癌的疗效观察

目的对晚期胃癌患者行手术及术中皮下埋藏腹腔化疗泵联合治疗,并对其疗效进行评价,以期对治疗提供帮助。方法对江苏省金坛市人民医院2004年4月至2007年4月收治的晚期胃癌患者中72例行手术及术中皮下埋藏腹腔化疗泵,术后采用MFP方案联合化疗。MMC8mg/m2,静脉注射,每4周1次;5-FU2.0g和DDP80mg腹腔灌注,每2周1次;平均4周为1个疗程,总疗程6～12个。结果Ⅲ期患者总有效率为77.8%;3年生存率50.0%;5年生存率25.0%。结论彻底手术加腹腔泵灌注化疗及静脉化疗是治疗晚期胃癌的有效途径,可提高患者的生活质量和生存率。     

晚期胃肠癌FAM与EVP方案交替化疗（附150例对比分析）

目的 探讨晚期胃肠癌应用FAM与EVP方案交替化疗疗效。方法 将150例住院确诊的晚期胃肠癌患者，随机分为治疗组和对照组Ⅰ和对照组Ⅱ，各组均50例，治疗组先用FAM方案：5-氟尿嘧啶（5-FU）500mg/m^2静滴每周1次；阿霉素（ADM）30mg/m^2静推，第1、28天；丝裂霉素（MMC）8mg/m^2第1天静推，间歇4-6周后应用EVP方案化疗；足叶乙甙（VP-16）100mg/次，第1、2、3天静滴；长春新碱（VCR）2mg/次第1天静推，顺氯氨铂（PDD）30mg/m^2第1、2、3天静滴，并加水化；间歇4周重复FAM与EVP方案交替化疗，共6个疗程，对照组Ⅰ应用单一FAM方案，对照组Ⅱ应用单一EVP方案化疗，剂量及用法同上，各化疗6个疗程，结果 三组均无CR病例。治疗组中PR12例占24%，SD20例占40%，PR SD为64%，对照组ⅠPR7例占14%，SD14例占28%《PR SD为42%，对照组ⅡPR7例占14%，SD15例占30%，PR SD为44%，生存期；治疗组生存7-12个月25例占50%，13-18个月8例占16%，对照组Ⅰ：生存7-12个月15例占30%，生存13-18个月6例占12%，对照组Ⅱ生存7-12个月11例占22%，生存13-18个月5例占10%。结论 通过三组疗效对比分析，提示FAM与EVP方案交替化疗晚期胃肠癌，是简便、安全、有效的治疗方法。     

Albendazole in the treatment of intestinal helminthiasis in children

A single dose of 2% albendazole suspension (400 mg in 20 ml) was administered to 77 patients (42 males and 35 females), ages ranging between 2 to 12 years, with helminthic infections. Ascariasis was the most prevalent infection. Patients were followed-up for 3 weeks. The results showed that albendazole was highly effective against Ascaris lumbricoides, Ancylostoma duodenale and Enterobius vermicularis. Significant improvement was also observed in patients having infections due to Trichuris trichiura. Albendazole was well tolerated and did not produce any significant side-effects. Single dose albendazole appears to be appropriate for mass chemotherapy to control intestinal nematode infections in highly infected communities.     

Efficacy of alebendazole and mebendazole in the treatment of Ascaris and Trichuris infections

This study was conducted to evaluate the efficacy of 100 mg mebendazole administered twice a day for three consecutive days and a single dose of 400 mg albendazole for the treatment of single or mixed Ascaris lumbricoides and Trichuris trichiura infections. Both drugs were found to be highly effective against Ascaris lumbricoides infection, with cure rate of over 96% and egg reduction of over 99.8%. However, the efficacy of the two drugs against Trichuris trichiura infection was low. Mebendazole appeared to be more effective against Trichuris trichiura in that it exhibited a cure rate of 34.7% and egg reduction of 92.3% as opposed to albendazole, which exhibited a cure rate and egg reduction rate of 13.9% and 63.4%, respectively. The two drugs appeared to have little effect on Schistosoma mansoni infection. More complaints were reported by individuals treated with albendazole than with mebendazole. In conclusion, mebendazole appears to be safer and more effective for the treatment of single or mixed infections with Trichuris trichiura and Ascaris lumbricoides as compared to albendazole.     

Efficacy of mebendazole and albendazole for Ascaris lumbricoides and hookworm infections in an area with long time exposure for antihelminthes, Northwest Ethiopia

OBJECTIVE: The efficacy of mebendazole and albendazole in the treatment of Ascaris lumbricoides and hookworm infections was evaluated in school children in an area with long time exposure for broad spectrum anthelminthic drugs. RESULTS: Mebendazole exhibited cure rates of 90.6% and 83.5%; egg reduction rates of 96.7% and 94.2% against Ascaris lumbricoides and hookworm infections respectively. Albendazole showed a cure rate of 83.9% and egg reduction rate of 96.3% against Ascaris lumbricoides and a cure rate of 84.2% and egg reduction rate of 95% against hookworm infection. Albendazole appeared to be more effective against hookworm infection (egg reduction rate of 95% versus 94.2%, p = 0.04). CONCLUSIONS: Mebendazole and albendazole showed reduced efficacy against Ascaris lumbricoides and hookworm infections at the recommended doses. This may be a sign for emergence of drug resistance in this region. Care in routine use of the anthelminthes and continuous drug efficacy surveillance is recommended.     

Comparative prevalences of some common intestinal helminth infections in different altitudinal regions in Ethiopia

Infection prevalences of Ascaris lumbricoides, Trichuris trichiura and the hookworms in school children in several communities of three altitudinal regions in Ethiopia have been analyzed. The prevalence of A. lumbricoides infection was 29% in the highlands, 35% in the temperate areas and 38% in the lowlands. The prevalence of hookworm infection was highest in the lowlands (24%) followed by the temperate (15%) and highland (7%) areas and the difference was significant (p < 0.0001). T. trichiura infection exhibited similar prevalences in all altitudinal regions (13% on the average). The prevalence of infection due to Ascaris lumbricoides and Trichuris trichiura was significantly correlated (rs = 0.55, p < 0.001) in the lowlands hinting the closely related distribution and co-occurrence of these parasites. The prevalence of infection due to the hookworms and T. trichiura in the temperate areas showed some pattern of association (rs = 0.29). A similar pattern has also been noted between the prevalence of infection due to A. lumbricoides and T. trichiura in the highland areas (rs = 0.48). The co-occurrence of A. lumbricoides and T. trichiura infections in the lowlands and in the highlands suggest that a concurrent intervention against infection due to these two parasites using the same control methods would be advantageous.     

Human helminthiasis in Wondo Genet, southern Ethiopia, with emphasis on geohelminthiasis

A parasitological survey was made in 1999 and 2002 to determine the magnitude of geohelminthiasis (soil-transmitted helminthiasis) and generate reference baseline helminthological data for Wondo Genet area, southern Ethiopia. Stool specimens were collected using Kato technique from 3167 schoolchildren, 92 schoolteachers, and 1160 residents of two Peasant Associations (PAs) and microscopically examined. The prevalence of infection for Ascaris lumbricoides and Trichuris trichiura among schoolchildren was 83.4% and 86.4%, respectively, and the respective intensity of infection was 7343 eggs per gram of stool (EPG) and 461 EPG. The prevalence of infection for Ascaris lumbricoides, Trichuris trichiura, and Schistosoma mansoni among schoolteachers was 33.7%, 35.9% and 17.4%, respectively, with the respective intensity of 1089 EPG, 194 EPG and 89 EPG. Similarly, the prevalence of infection among the residents of Shesha Kekele and Wondo Wosha Peasant Associations for Ascaris lumbricoides, Trichuris trichiura, and Schistosoma mansoni was 77%, 88% and 30%, respectively, with the respective intensity of 4673 EPG, 452 EPG and 125 EPG. Both the prevalence and intensity of infection were low among the schoolteachers possibly due to a better personal hygiene. The most prevalent soil-transmitted helminth in the area was Trichuris trichiura. Other rare helminths encountered were Taenia species, hookworms, Enterobius vermicularis and Hymenolepis nana, all occurring in less than 4% prevalence of infection. The heavy helminth burden among the schoolchildren calls for immediate intervention to reduce morbidity and transmission of helminthiasis in Wondo Genet.     

Pharmacotherapy of ascariasis

Ascaris lumbricoides, the most frequent human intestinal nematode, is the causative agent of ascariasis, with an estimated worldwide prevalence of over one billion people, especially in moist tropical and subtropical regions, but also in cooler climates. Although characterised with low morbidity and mortality rates, the global prevalence of ascariasis still results in approximately 20,000 deaths annually, primarily as a consequence of intestinal obstruction. In humans, transmission usually occurs by hand-to-mouth route by way of contaminated agricultural products and food, or from dirty hands. Three phases of ascariasis may be present, namely, the pulmonary, intestinal and the complications stage. Although generally asymptomatic, heavy infestation may cause serious pulmonary disease, or partial or complete obstruction of biliary or intestinal tracts. Anthelminthic chemotherapy is required to eradicate the parasites and prevent potentially serious complications. Mebendazole, albendazole and pyrantel pamoate are the most widely used agents to treat ascariasis. Preventive chemotherapy delivered to communities in endemic regions may serve as an affordable and cost-effective strategy to reduce the prevalence and morbidity in endemic regions. Under unusual circumstances, Ascaris suum, the cause of helminthic infection in pigs, may also cause disease in humans.     

Pharmacotherapy of ascariasis

Ascaris lumbricoides, the most frequent human intestinal nematode, is the causative agent of ascariasis, with an estimated worldwide prevalence of over one billion people, especially in moist tropical and subtropical regions, but also in cooler climates. Although characterised with low morbidity and mortality rates, the global prevalence of ascariasis still results in approximately 20,000 deaths annually, primarily as a consequence of intestinal obstruction. In humans, transmission usually occurs by hand-to-mouth route by way of contaminated agricultural products and food, or from dirty hands. Three phases of ascariasis may be present, namely, the pulmonary, intestinal and the complications stage. Although generally asymptomatic, heavy infestation may cause serious pulmonary disease, or partial or complete obstruction of biliary or intestinal tracts. Anthelminthic chemotherapy is required to eradicate the parasites and prevent potentially serious complications. Mebendazole, albendazole and pyrantel pamoate are the most widely used agents to treat ascariasis. Preventive chemotherapy delivered to communities in endemic regions may serve as an affordable and cost-effective strategy to reduce the prevalence and morbidity in endemic regions. Under unusual circumstances, Ascaris suum, the cause of helminthic infection in pigs, may also cause disease in humans.     

广东省梅州市结核病控制项目(2001-2012年)效果分析与评价

目的 分析和评价我市2001年至2012年结核病控制项目效果,进一步改进和提高防治工作质量,为今后结核病的管理和治疗提供科学依据.方法 从结核病信息管理系统中导出梅州市全市2001年至2012年结核病患者发现、登记、治疗、管理和转归的相关信息,对全市辖区内确诊登记并治疗管理的肺结核患者资料进行综合分析、管理评价和化疗效果分析.结果 2001年至2012年全市发现并登记活动性肺结核病人37701例,其中新涂阳肺结核病人21132例,复治涂阳3338例,涂阴肺结核病人13231例,每年均超额完成新涂阳肺结核病人的发现任务,完成广东省结核病控制项目办公室下达我市发现新涂阳肺结核病人任务的109.3％,已治愈了21731例涂阳肺结核患者,治愈率96.01％.结论 梅州市在2001至2012年结核病控制项目实施期间,发现和治愈了大批活动性肺结核病人,有效控制了传染源,遏制了结核病在我市的流行.     

Hookworm infection among the Melka Sedi banana plantation residents, middle Awash Valley, Ethiopia.

A study of intestinal parasites was done among the people who lived within the banana plantation zone of the Melka Sedi Agricultural Enterprise, Awash Valley, Ethiopia in April 1987. The methods of parasite detection were the Ritchie formal ether and the charcoal culture method for hookworm larvae species identification. From the total 633 population, 311 were examined at random of whom 60.8% were positive for one or more intestinal parasites. Eight parasites were encountered, Ascaris lumbricoides in 1.3%, Trichuris trichiura in 6.4%, Strongyloides stercoralis in 3.9%, hookworm in 53.1%, Taenia sp. in 3.5%, Schistosoma mansoni in 1.9%, Entamoeba histolytica in 0.6% and Hymenolepis sp. in 0.6%. Prevalence of hookworm infection was significantly higher than that of any of the other parasites (p less than 0.001). In the hookworm infected individuals there were more males than females, and the 25 to 34 year age group had significantly higher infection rates (p less than 0.05). The majority of those with hookworm were banana plantation workers. This communication emphasizes the basic guidelines for control and prevention of hookworm and other related faecal/soil-borne infections in this and similar agricultural settings.     

生脉注射液结合姑息化疗治疗耐药性晚期结肠癌临床分析

目的 观察分析耐药性晚期结肠癌患者采取生脉注射液结合姑息化疗的疗效。方法 70例因耐药性结肠癌接受化疗的患者,采用随机数字表法分为参照组和研究组,每组35例。参照组患者进行姑息化疗,研究组患者在参照组基础上给予生脉注射液治疗。对比两组患者干预前后外周血淋巴细胞膜P-糖蛋白(P-gp)含量;P-gp转阴率;临床疗效。结果 干预前,两组患者的外周血淋巴细胞膜P-gp含量对比,差异无统计学意义(P>0.05);干预后,研究组患者的外周血淋巴细胞膜P-gp含量(4.16±1.57)%显著低于参照组的(6.59±2.14)%,差异具有统计学意义(P<0.05)。研究组患者的P-gp转阴率为31.43%,明显优于参照组的5.71%,差异具有统计学意义(P<0.05)。研究组患者的中位生存期(11.09±5.73)个月和1年生存率34.29%均明显优于参照组的(5.27±2.61)个月和8.57%,差异均具有统计学意义(P<0.05)。结论 应用生脉注射液结合姑息化疗,对耐药性晚期结肠癌患者的耐药性具有逆转作用,可有效提高患者生存率,值得临床推广。