还原型谷胱甘肽、生长抑素联合治疗重症急性胰腺炎(SAP)的临床疗效观察

目的探讨重症急性胰腺炎(SAP)应用还原型谷胱甘肽联合生长抑素治疗的临床疗效。方法选择2018年2月-2020年2月收治的SAP患者80例随机分为两组各40例,对照组用生长抑素治疗,观察组则加用还原型谷胱甘肽治疗。比较两组症状缓解时间,以及治疗前后肝功能指标。结果两组体温恢复正常时间差异无统计学意义(P>0.05),但观察组腹胀缓解时间、腹痛缓解时间、胃肠道功能恢复时间、脂肪酶恢复正常时间、淀粉酶恢复正常时间较对照组低(P<0.05);治疗前两组ALT、AST、TB、γ-GT差异无统计学意义(P>0.05),治疗后观察组上述指标水平明显低于对照组(P<0.05);治疗前两组白介素-8(IL-8)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)指标并无差异(P>0.05),治疗后观察组上述指标改善优于对照组(P<0.05)。结论SAP应用还原型谷胱甘肽联合生长抑素治疗,可促进症状更快缓解,同时更好地改善肝功能指标,更可以改善炎性因子水平,值得应用。     

生长抑素与泮托拉唑钠治疗重症急性胰腺炎的临床效果观察

目的:探讨生长抑素与泮托拉唑钠治疗重症急性胰腺炎的临床效果。方法:选取我院2015年12月至2017年12月收治的76例重症急性胰腺炎患者临床资料,按不同治疗方式分为研究组(n=40)与对照组(n=36)。对照组予以生长抑素单独治疗,研究组予以生长抑素与泮托拉唑钠联合治疗,比较两组的临床疗效。结果:研究组各项临床症状改善所花费时间为:血清淀粉酶恢复时间,肠蠕动恢复时间,呼吸机撤离时间和腹痛消失时间均显著优于对照组(P 0.05);且研究组的不良反应总发生率为7.50%,显著低于对照组(P 0.05)。结论:生长抑素与泮托拉唑钠联合治疗重症急性胰腺炎可有效改善患者临床症状,临床疗效安全可靠。     

生长抑素治疗急性胰腺炎效果探讨

目的:探讨生长抑素治疗急性胰腺炎临床应用效果.方法:对照组急性胰腺炎患者给予临床常规治疗,研究组在常规治疗基础上加用生长抑素.两组急性胰腺炎患者均连续治疗14d,记录其临床疗效.结果:两组急性胰腺炎患者均顺利完成上述相应治疗,研究组治疗总有效率(90.00%)显著高于对照组(70.00%),数据对比差异显著(P<0.05).结论:对急性胰腺炎患者给予常规治疗联合生长抑素可显著提高其临床疗效,有利于保障患者生活质量、生命安全.     

联合检验血清淀粉酶、脂肪酶及C-反应蛋白对急性胰腺炎临床诊断的意义

目的分析联合检验血清淀粉酶、脂肪酶及C-反应蛋白对急性胰腺炎临床诊断的意义。方法选取本院2018年5月到2019年5月期间收集的66例急性胰腺炎患者作为对照组,同期66例健康体检患者作为观察组。所有患者均通过血清淀粉酶、脂肪酶及C-反应蛋白联合检验,对比两组患者的检验结果。结果观察组患者的血清淀粉酶、血清脂肪酶以及C-反应蛋白均低于对照组,两组患者的差异比较P0.05,具有统计学分析意义。结论联合检验血清淀粉酶、脂肪酶及C-反应蛋白对急性胰腺炎进行诊断,能够提高诊断的准确性,从而提高临床疗效。     

血清脂肪酶、淀粉酶联合D-二聚体诊断急性胰腺炎的临床价值

目的研究血清脂肪酶、淀粉酶联合D-二聚体诊断急性胰腺炎的临床价值。方法选择2021年10月至2022年10月我院收治的80例急性胰腺炎患者,根据患者疾病严重程度分为轻症组与重症组各40例。另选择同期于我院体检的健康者40例作为对照组。检测并比较三组的血清脂肪酶、淀粉酶及D-二聚体水平,分析其对疾病的诊断价值。结果三组的血清脂肪酶、淀粉酶及D-二聚体水平比较差异有统计学意义(P<0.05)。重症组血清脂肪酶、淀粉酶及D-二聚体水平高于轻症组,轻症组血清脂肪酶、淀粉酶及D-二聚体水平高于对照组(P<0.05)。血清脂肪酶、淀粉酶及D-二聚体联合诊断急性胰腺炎的灵敏度、特异度、准确度均高于单一指标检测,特异度、准确度均高于两项指标联合检测(P<0.05)。结论血清脂肪酶、淀粉酶联合D-二聚体有助于急性胰腺炎的准确诊断,值得临床应用推广。     

促肝细胞生长素联合还原型谷胱甘肽治疗肝衰竭患者的疗效观察

目的探讨促肝细胞生长素联合还原型谷胱甘肽治疗肝衰竭患者的临床疗效。方法选取2019年1月至2021年1月我院收治的68例肝衰竭患者,随机分为研究组(n=34)与对照组(n=34)。对照组采用促肝细胞生长素静脉滴注治疗,研究组在对照组基础上采用还原型谷胱甘肽静脉滴注治疗。对比两组患者的凝血功能、肝功能、临床疗效及复发率。结果治疗前,两组的凝血功能和肝功能指标比较差异无统计学意义(P>0.05);治疗后,研究组的凝血功能和肝功能指标明显优于对照组(P<0.05)。研究组总有效率97.06%,明显高于对照组的79.41%(P<0.05)。随访6个月,研究组复发率为2.94%,明显低于对照组的17.65%(P<0.05)。结论促肝细胞生长素联合还原型谷胱甘肽治疗肝衰竭患者的临床疗效显著,可有效改善患者的肝脏功能,复发率低,药物安全性高,值得临床推广。     

还原型谷胱甘肽联合复方甘草酸苷治疗药物性肝病的临床疗效

目的探讨采用还原型谷胱甘肽联合复方甘草酸苷治疗药物性肝病的临床效果。方法选取我院收治的药物性肝病患者80例,随机平均分成两组。对照组采用益肝灵进行治疗,研究组在对照组的治疗基础上加用还原型谷胱甘肽联合复方甘草酸苷治疗。治疗结束后对两组患者的治疗效果与肝功能情况进行比较分析。结果研究组治疗后的总有效率明显高于对照组,差异具有统计学意义(P<0.05)。两组治疗后的ALT、AST、TBIL等指标均显著降低,其中研究组的指标在治疗后显著低于对照组,差异均存在统计学意义(P<0.05)。结论采用还原型谷胱甘肽联合复方甘草酸苷治疗药物性肝病疗效显著,可有效促进患者肝功能的改善,值得推广。     

淀粉酶与脂肪酶联合检测在急性胰腺炎患者诊断中的应用价值

目的:探讨淀粉酶与脂肪酶联合检测在急性胰腺炎诊断中的价值。方法:选取我院2017年5月至2019年5月收治的80例急性胰腺炎患者,其中轻度急性胰腺炎60例,重度急性胰腺炎20例。选择同期健康体检者80例作为对照组。对3组对象均进行血清脂肪酶(LPS)与淀粉酶(AMY)水平检测,并进行对照比较。同时对AMY,LPS单独与联合检测准确度,灵敏度和特异度进行比较。结果:(P0.05)重度急性胰腺炎组AMY,,LPS显著高于轻度急性胰腺炎组与对照组;轻度急性胰腺炎组AMY,LPS显著高于对照组。血清AMY、LPS单独检测的准确度、灵敏度以及特异度均显著低于联合检测,对急性胰腺炎诊断的价值(P0.05)。结论:LPS与AMY联合检测,能够有效提高诊断急性胰腺炎的准确度、特异度及灵敏度,及早诊断病情,尽快进行治疗控制病情,减轻患者痛苦。     

前列地尔在急性胰腺炎治疗中的疗效观察

目的 观察前列地尔对急性胰腺炎(SAP)的疗效.方法 125例SAP患者随机分为对照组和治疗组:对照组在常规治疗的基础上泵入生长抑素针,治疗组在常规治疗基础上静脉泵入生长抑素与静脉注射前列地尔.分别统计两组的治疗有效率,临床症状的缓解时间以及治疗第5天生化指标的改变.结果 治疗组在临床症状消失的时间,降低血淀粉酶、脂肪酶、WBC及CRP方面均优于对照组.结论 联合使用生长抑素及前列地尔较单独使用生长抑素效果要好,值得在临床上广泛推广.     

还原型谷胱甘肽治疗慢性病毒性肝炎合并酒精肝损伤的临床疗效观察

目的探讨还原型谷胱甘肽治疗慢性病毒性肝炎合并酒精肝损伤的临床疗效。方法将我院55例慢性病毒性肝炎合并酒精肝损伤患者随机分成两组,对照组(27例)实施常规治疗,研究组(28例)在对照组基础上给予还原型谷胱甘肽治疗,对两组的疗效、肝功能复常情况进行比较。结果研究组治疗总有效率为96.4%,明显高于对照组的70.4%,差异具有统计学意义(P<0.05)。研究组治疗后的慢性活动性肝炎(CAH)、急性黄疽型肝炎(AIH)、肝炎后肝硬变(LC)及慢性重型肝炎(CSH)复常率均明显高于对照组,复常时间显著短于对照组,差异具有统计学意义(P<0.05)。结论还原型谷胱甘肽在治疗慢性病毒性肝炎合并酒精肝损伤中疗效显著,明显缩短了肝功能复常时间,有利于改善患者的症状,促进肝功能恢复,值得推广。     

Best Interests,the Power of the Medical Profession,and the Power of the Judiciary

This paper is a response to a paper by John Coggon ‘Best Interests, Public Interest, and the Power of the Medical Profession'. It argues that certain legal judgements in relation to best interests seek to change and curtail the role of the medical profession in this arena while simultaneously extending the jurisdiction of the courts. It also argues that we must guard against replacing one professional standard, that of the medical profession, with another, that of the judiciary in this area.

Benzene in the environment: an assessment of the potential risks to the health of the population

OBJECTIVES—Benzene has long been recognised as a carcinogen and recent concern has centred on the effects of continuous exposure to low concentrations of benzene both occupationally and environmentally. This paper presents an overview of the current knowledge about human exposure to benzene in the United Kingdom population based on recently published data, summarises the known human health effects, and uses this information to provide a risk evaluation for sections of the general United Kingdom population.
METHOD—Given the minor contribution that non-inhalation sources make to the overall daily intake of benzene to humans, only exposure from inhalation has been considered when estimating the daily exposure of the general population to benzene. Exposure of adults, children, and infants to benzene has been estimated for different exposure scenarios with time-activity patterns and inhalation and absorption rates in conjunction with measured benzene concentrations for a range of relevant microenvironments. Exposures during refuelling and driving, as well as the contribution of active and passive tobacco smoke, have been considered as part of the characterisation of risk of the general population.
RESULTS—Infants (<1 years old), the average child (11 years old), and non-occupationally exposed adults, receive average daily doses in the range of 15-26, 29-50, and 75-522 µg of benzene, respectively, which correspond to average ranges to benzene in air of 3.40-5.76 µg/m³, 3.37-5.67 µg/m³, and 3.7-41 µg/m³ for infants, children, and adults, respectively. Infants and children exposed to environmental tobacco smoke have concentrations of exposure to benzene comparable with those of an adult passive smoker. This is a significant source of exposure as a 1995 United Kingdom survey has shown that 47% of children aged 2-15 years live in households where at least one person smokes. The consequence of exposure to benzene in infants is more significant than for children or adults owing to their lower body weight, resulting in a higher daily intake for infants compared with children or non-smoking adults. A worst case scenario for exposure to benzene in the general population is that of an urban smoker who works adjacent to a busy road for 8 hours/day—for example, a maintenance worker—who can receive a mean daily exposure of about 820 µg (equal to an estimated exposure of 41 µg/m³). The major health risk associated with low concentrations of exposure to benzene has been shown to be leukaemia, in particular acute non-lymphocytic leukaemia. The lowest concentration of exposure at which an increased incidence of acute non-lymphocytic leukaemia among occupationally exposed workers has been reliably detected, has been estimated to be in the range of 32-80 mg/m³. Although some studies have suggested that effects may occur at lower concentrations, clear estimates of risk have not been determined, partly because of the inadequacy of exposure data and the few cases.
CONCLUSIONS—Overall the evidence from human studies suggests that any risk of leukaemia at concentrations of exposure in the general population of 3.7-42 µg/m³—that is at concentrations three orders of magnitude less than the occupational lowest observed effect level—is likely to be exceedingly small and probably not detectable with current methods. This is also likely to be true for infants and children who may be exposed continuously to concentrations of 3.4-5.7 µg/m³. As yet there is no evidence to suggest that continuous exposures to these environmental concentrations of benzene manifest as any other adverse health effect.


Keywords: risk assessment; benzene; environment     

Lipidomics Technologies at the End of the First Decade and the Beginning of the Next

The lipidome is composed of all of the biomolecules defined as lipids, which encompass compounds of amazing structural diversity and complexity. It has been ∼1 decade since the study of “lipidomics” was begun in earnest, and the technologies and tools for data analysis have advanced considerably over this period. This workshop summarized the scope of the lipidome and technologies for its analysis, lipidomics databases and other online tools, and examples of the application of lipidomics to nutritional research. The slides from the workshop, online lipidomics tools, and databases are available at http://www.lipidmaps.org.     

From the end of the world to the top of the world

I've been on the road a bit this summer. Because of the kind generosity of my London broker, Lloyd and Partners, Ltd., I've been allowed the unique opportunity to have an insider's view of the London market. I observed an interesting renewal situation and sat with underwriters in their boxes amid the hallowed (at least to us insurance geeks) trappings of Lloyd's. I spent several lovely days in Hanover with my long‐time lead reinsurer, Hanover Re, while trying desperately to keep up with my own work back home. It's been stimulating and thought‐provoking, and I know I won't ever view the purchase of insurance in the same way.     

Evaluation of the effectiveness of the notification process in the area of health products

In Brazil, health products are subject to health technology and are marketed only after they are registered by regulated companies. It is important to monitor the performance of these products in the market during the post-marketing phase, in an effort to prevent, intervene, and act in response to complaints and adverse events.Objectives: Evaluate and perform a functional benchmarking to identify best practices in health technology monitoring of health product companies, and determine critical points regarding the execution of health technology assessment programs.Methods: The sampling of the target population was non-probabilistic and the investigation was conducted with the collection of different kinds of information related to technical complaint (TC) and adverse event (AE) procedures performed by companies that register health products.Results: A pilot study was performed. After the preparation of a questionnaire, it was applied in a functional benchmarking in 22 medium/large companies that follow-up with consumers of health products.Conclusions: The questionnaire developed throughout the study proved to be a useful tool for the diagnosis of the degree of implementation of health products monitoring procedures. Company “A” appeared to be meeting what Brazilian legislation requires as a standard procedure for health technology monitoring.     

Examination of the effect of agitation on the potency of the Ebola Zaire vaccine rVSVΔG-ZEBOV-GP

The Ebolavirus vaccine (rVSVΔG-ZEBOV-GP) is stored at −80 to −60 °C and should be kept frozen for transport. Due to significant logistical challenges, frozen transport is not feasible for some remote locations. To determine if local distribution at 2–8 °C is a potential option for these locations, a study was conducted to evaluate the impact of agitation on the thawed vaccine. After up to 7 days of constant agitation, no impact on vaccine potency was evident for the agitated vaccine versus the corresponding vaccine kept stationary at 2–8 °C. In conclusion, in-country transport of the Ebolavirus vaccine, rVSVΔG-ZEBOV-GP, at 2–8 °C appears to be a feasible option for those remote locations where significant logistical challenges prohibit transporting the vaccine at −80 to −60 °C.     

The Content of Minerals in the PCOS Group and the Correlation with the Parameters of Metabolism

Polycystic ovary syndrome (PCOS) is a common disease in women of childbearing age. It is characterized by excessive androgen production, ovulation disorders, and developing metabolic syndrome. The aim of the study was to check whether selected minerals were related to the pathophysiological mechanisms of PCOS. The concentrations of minerals were determined using an inductively coupled atomic plasma-emission spectrometer (ICP-AES Jobin Yvon JY-24). Blood samples from PCOS and control women were collected, processed, and digested with a microwave system in women with PCOS with and without insulin resistance and in the control group. It was found: zinc (Zn)-10.14 ± 2.11, 9.89 ± 1.44 and 10.30 ± 1.67; nickel (Ni) 0.001 ± 0.0009, 0.001 ± 0.0006 and 0.002 ± 0.00001; iron (Fe) 868.0 ± 155.8, 835.3 ± 156.4 and 833.0 ± 94.6; manganese (Mn) 0.017 ± 0.006, 0.017 ± 0.008 and 0.020 ± 0.009; copper (Cu) 0.714 ± 0.129, 0.713 ± 0.114 and 0.761 ± 0.146; magnesium (Mg) 48.4 ± 8.3, 50.0 ± 8.4 and 45.3 ± 10.7; sodium (Na) 374.3 ± 84.3, 396.3 ± 66.6 and 367.9 ± 88.9; potassium (K) 2541.8 ± 330.9, 2409.6 ± 347.1 and 2336.9 ± 211.4 (µg/g). Some micronutrient deficiencies may have a negative effect on the lipid profile in PCOS patients (Ni, Na). Further studies are needed to better understand dependencies.     

A study of the microbial content of the domestic kitchen

A total of 46 houses were sampled, 13 of these being sampled over a wide range of sites (76 sites in total), and the remaining 33 being sampled at potential ‘key’ sites for cross contamination. Highest counts (i.e. > 450 cfu's per area sampled) were associated with two main types of site, viz. wet areas around the sink (surface, plughole, draining board, washing up bowl) and cloths used for wiping surfaces and/or drying equipment (dish washing cloths and sponges, tea towels). Gram‐negative rods were predominant in the sink area whereas Gram‐positive cocci were predominant in cloths. Results of the study showed Enterobacter cloacae to be isolated from 52.2% of the 46 kitchens examined, with other Enterobacter spp. at 26.1%. Other enterobacteria isolated included Klebsiella pneumoniae (23.9%) and Escherichia coli (19.6%). The most common pseudomonad was Pseudomonas aeruginosa at 15.2%. Bacillus subtilis was isolated from 56.5% of the domestic kitchens sampled, and all of the kitchens were found to have Staphylococcus spp. (100%) and Micrococcus spp. (100%) present in several of the sites sampled. Food poisoning bacteria were seldom detected in the kitchens examined, although individual isolates of Listeria monocytogenes, Yersinia enterocolitica and Bacillus cereus were recorded.