Comparison of two low-dose one-week triple therapy regimens with and without metronidazole for cure of H. pylori infection.

BACKGROUND: One-week triple therapy consisting of omeprazole 20 mg b.d., clarithromycin 250 mg b.d. and tinidazole 500 mg b.d. is an effective therapy for H. pylori infection with a cure rate of 93%. We therefore compared two similar 1-week regimens consisting of a lansoprazole, clarithromycin and either metronidazole or tetracycline in a prospective study. METHODS: Two cohorts, each of 60 patients suffering from H. pylori infection associated with peptic ulcer disease or ulcer-like dyspepsia, were treated for 1 week with either lansoprazole 30 mg b.d., clarithromycin 250 mg b.d. and either metronidazole 400 mg b.d. (cohort A, n = 60) or tetracycline 300 mg b.d. (cohort B, n = 60). Four weeks after treatment, cure of H. pylori infection was evaluated by endoscopy using rapid urease testing together with histology. RESULTS: In cohort A, 55 patients out of 60 showed cure of H. pylori infection (92%); the treatment was well tolerated, but three patients suffered from side-effects. In cohort B, which was free of metronidazole, 50 out of 60 patients showed cure of H. pylori infection (83%); two patients reported side-effects. The differences between the two cohorts were not statistically significant. CONCLUSION: Triple therapy for 1 week with lansoprazole as the antisecretory agent seems to be as effective as is reported for omeprazole-based regimens.     

Esophageal carcinoma: CT findings

Preoperative CT scans of 33 patients with esophageal cancer were reviewed to assess staging accuracy and define the role of CT in patients being considered for transhiatal blunt esophagectomy. Surgical and pathological verification was obtained in all cases. Only 13 tumors were staged correctly according to the TNM classification. In addition, CT was not useful in assessing resectability because of its low accuracy in evaluating aortic invasion and the fact that few patients had tracheobronchial or aortic invasion or hepatic metastases at presentation.     

Metabolic consequences of intrauterine growth retardation

This review focuses on intrauterine growth retardation (IUGR) occurring spontaneously and without a defined infective, toxic or genetic cause. Such fetal growth retardation is generally thought to be a consequence of inadequate provision of nutritional substrates across the placenta.     

Image-guided pleural biopsies: indications, technique, and results in 23 patients

Twenty-six pleural biopsies were performed on 23 patients over a 3-year period. Twenty-three biopsies were performed guided with ultrasound; one, with computed tomography; and two, with fluoroscopy. Indications for an image-guided pleural biopsy were (a) pleural masses or thickening that were either not seen on chest radiographs or seen only on one view and (b) small or loculated pleural effusions of unknown cause with no mass seen. If only pleural fluid was present, reverse bevel needles were used for biopsy (n = 15). If a discrete pleural mass or thickening was seen with cross-sectional imaging, standard (16-20 gauge) biopsy needles were used (n = 11). In the 23 patients, biopsy results were true positive in ten (nine with malignancy, one with tuberculous pleurisy), true negative in ten (confirmed either at subsequent thoracotomy or clinical follow-up), and false negative in three. Complications were few, with a significant pneumothorax occurring in two patients (8.7%). Image-guided biopsy of small pleural lesions and small pleural effusions can be performed by the radiologist who understands the special needles and techniques involved.     

滇黄芩中新黄酮成分的结构研究

从唇形科植物滇黄芩Scutellaria amoena C.H.Wright的根中分得八种黄酮类成分(Ⅰ～Ⅷ)。经理化常数测定、光谱分析和化学反应证明,Ⅰ和Ⅱ为新化合物,其结构分别为(2S)-2′,5,6′-三羟基-7-甲氧基双氢黄酮-2′-O-β-D-葡萄吡喃糖甙(Ⅰ)和(2 R,3 R)-2′,3,5,7-四羟基双氢黄酮(Ⅱ);其余六种为已知化合物,分别鉴定为(2S)-5,7,8-三羟基双氢黄酮(Ⅲ)、(2S)-2′,5,6′,7-四羟基双氢黄酮(Ⅳ)、(2 R,3 R)-2′,3,5,6′,7-五羟基双氢黄酮(Ⅴ)、2′,5,6′,7-四羟基黄酮(Ⅵ)、去甲汉黄芩素(Ⅶ)和千层纸甲素(Ⅷ),此六种化合物均为首次从该植物中得到。     

电脑终端视疲劳原因及防治

0引言 操作电脑终端(video display terminal, VDT)过久有时会头昏、头胀、颈和腰背酸痛、四肢酸麻、食欲减退、便秘和视疲劳,称为VDT综合征(video display terminal syndrome,VDTS)[1]. 因操作电脑而引起的视疲劳(眼干、胀、酸、痛、视力下降)在学校日益增多.现将70例电脑终端操作者出现的视疲劳眼部表现分析如下.     

Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study

BACKGROUND: The earliest determinants of obesity may operate during intrauterine life, and gestational weight gain may influence the intrauterine environment in a way that may affect the risk of overweight in the offspring. OBJECTIVE: The purpose of this study was to examine the association of gestational weight gain with offspring overweight. DESIGN: This was a retrospective cohort study of 10,226 participants from the Collaborative Perinatal Project (1959-1972). Anthropometric and sociodemographic variables were assessed during gestation, at birth, and at age 7 y. The association between gestational weight gain and offspring overweight at 7 y was examined after adjustment for important confounding factors. RESULTS: The odds of overweight in offspring at age 7 y increased by 3% for every 1 kg of gestational weight gain (adjusted odds ratio: 1.03; 95% CI: 1.02, 1.05). When gestational weight gain was examined using Institute of Medicine guidelines, the odds of overweight was 48% greater for children of mothers who gained more than the weight gain recommendations than for children of mothers who met the weight gain guidelines (adjusted OR: 1.48; 95% CI: 1.06, 2.06). The association remained significant after additional adjustment for birth weight. The association between gestational weight gain and overweight in the offspring was strongest for women who were underweight before pregnancy (P for interaction < 0.01). CONCLUSION: Helping pregnant women to meet the recommended weight gain during pregnancy may be an important and novel strategy for preventing pediatric obesity.