Cilazapril对高血压病患者左心舒张功能、细胞内钙和血管张素Ⅱ关系的影响

对26例原发性高血压（EHT）患者口服血管紧张素转换酶抑制剂（ACEI）Cilazapril2.5～5mg每日1次，治疗8周，观察治疗前后血压、左室舒张功能、淋巴细胞胞荣游离钙浓度［Ca2＋］、血浆血管紧张素Ⅱ浓度［AT1］的变化、结果提示：治疗后在血压降低的同时，［Ca2＋］i［AT1］显著降低，心脏舒张功能有显著改善，包括：舒张早期峰值流速（E）上升，心房收缩期的峰值流速（A）下降，E／A比值增高，舒张早期减速度（DC）上升，左室重量指数（LVMI）下降等，［Ca2＋］i、［AT1］的下降幅度分别与E／A、DC的改善幅度呈正相关，间接证明：ACEICilazapril可能通过减少AT1对心肌组织的影响及纠正心肌细胞钙超负荷状态这两种机理使心脏舒张功能改善。     

Altitude-dependent Bartonella quintana genotype C in head lice, Ethiopia

To determine the presence of Bartonella quintana in head and body lice from persons in different locations in Ethiopia, we used molecular methods. B. quintana was found in 19 (7%) genotype C head lice and in 76 (18%) genotype A body lice. B. quintana in head lice was positively linked to altitude (p = 0.014).     

1213所医疗机构助产技术应用现状的调查研究

目的 了解国内医疗机构助产技术的应用现状,为助产教育、培训及政策的制订提供依据。方法 2017年12月—2018年11月,采用自行设计的“中国助产技术开展情况调查表”,对全国22个省份的1 213所医疗机构进行调查。 结果 共调查672所（55.4%）三级医院、541所（44.6%）二级医院。三级医疗机构使用的助产技术中,自由体位、心理保健、全面支持、非药物镇痛、导乐陪伴分娩等助产技术的应用率高于二级医疗机构,差异具有统计学意义（均P<0.05）;二级医疗机构使用的助产技术中,剃除阴毛、经肛门评估宫口、强迫体位分娩、常规人工破膜、增加腹压等助产技术的应用率高于三级医疗机构,差异具有统计学意义（均P<0.05）。按医疗机构类型分,综合医院使用的助产技术中,自由体位分娩、导乐陪伴分娩和助产士门诊的应用率低于专科医院和妇幼保健院,差异具有统计学意义（均P<0.05）;剃除阴毛、第二产程用手扩张阴道、强迫体位分娩等助产技术的应用率高于专科医院和妇幼保健院,差异具有统计学意义（均P<0.05）。 结论 国内医疗机构中明显有益的助产适宜技术应用情况较好,但不同级别医院的助产技术应用不均衡,建议制订适合国内的助产适宜技术实施标准和规范,提高助产服务质量,更好地保障母婴安全。     

加服米非司酮预防药物流产后蜕膜残留的临床疗效比较

目的 探究妇女加服不同剂量的米非司酮预防药物流产后蜕膜残留的临床疗效.方法 选取2016年1月至10月期间,我院收治的共1200例要求药物流产终止妊娠的妇女,随机将其分为对照组、A组、B组和C组,每组各300例.各组妇女药流后均予复方益母片5 d及头孢拉定3 d,同时A组妇女于排胚后第1 d早晚各加服米非司酮25 mg(共50 mg),B组妇女于排胚后第1~3 d早晚各加服米非司酮25 mg(共150 mg),C组妇女于排胚后第1~5 d早晚各加服米非司酮25 mg(共250 mg),对照组不服用.比较各组妇女行药流后蜕膜残留情况以及不良反应.结果 A组、B组和C组的总有效率明显要比对照组更好(P<0.05),同时,B组的总有效率与C组相当,均更优于A组(P<0.05),各组妇女均未出现不良反应.结论 行药流妇女可于排胚后第1~3 d早晚各加服米非司酮25 mg(共150 mg)能够有效减少药流后蜕膜残留,避免不良反应的发生,安全性较好.     

导乐陪伴分娩开展现状的调查

目的 调查导乐陪伴分娩开展现状并分析未开展的原因,为今后开展助产适宜技术培训及制定相关政策提供参考依据。方法 2017年12月—2018年11月采用自行设计的“助产士人力资源及适宜技术应用现况”调查表,对全国22个省、直辖市、自治区,共1 213所二级及以上的助产医疗机构的导乐陪伴分娩开展现状进行调查。结果 1 213所医院中,开展导乐陪伴分娩的医院有679所（56.0%）,其中410所（60.4%）在孕妇宫口开至3 cm时开始进行导乐陪伴,523所（77.0%）将导乐陪伴持续至第四产程,393所（57.9%）的医院员工主要是利用上班时间完成导乐陪伴,606所（89.2%）由助产士来完成导乐陪伴,433所（63.8%）有导乐仪器;未开展导乐陪伴分娩的主要原因是人员不够、空间不足和不能收费。结论 导乐陪伴分娩技术还未得到广泛普及,开展状况参差不齐,应在人力资源、空间和经济上对开展导乐陪伴分娩提供支持。     

Caregiver-reported antiretroviral therapy non-adherence during the first week and after a month of treatment initiation among children diagnosed with HIV in Ethiopia

To achieve optimal virologic suppression for children undergoing antiretroviral therapy (ART), adherence must be excellent. This is defined as taking more than 95% of their prescribed doses. To our knowledge, no study in Ethiopia has evaluated the level of treatment adherence at the beginning of the child’s treatment. Our aim was therefore to evaluate caregiver-reported ART non-adherence among children and any predictors for this during the early course of treatment. We conducted a prospective cohort study of 306 children with HIV in eight health facilities in Ethiopia who were registered at ART clinics between 20 December 2014 and 20 April 2015. The adherence rate reported by caregivers during the first week and after a month of treatment initiation was 92.8% and 93.8%, respectively. Our findings highlight important predictors of non-adherence. Children whose caregivers were not undergoing HIV treatment and care themselves were less likely to be non-adherent during the first week of treatment (aOR?=?0.17, 95% CI: 0.04, 0.71) and the children whose caregivers did not use a medication reminder after one month of treatment initiation (aOR?=?5.21, 95% CI: 2.23, 12.16) were more likely to miss the prescribed dose. Moreover, after one month of the treatment initiation, those receiving protease inhibitor (LPV/r) or ABC-based treatment regimens were more likely to be non-adherent (aOR?=?12.32, 95% CI: 3.25, 46.67). To promote treatment adherence during ART initiation in children, particular emphasis needs to be placed on a baseline treatment regimen and ways to issue reminders about the child’s medication to both the health care system and caregivers. Further, large scale studies using a combination of adherence measuring methods upon treatment initiation are needed to better define the magnitude and predictors of ART non-adherence in resource-limited settings.     

中医药对提高非小细胞肺癌中位生存期的作用研究

【目的】观察中医药在提高Ⅲ、Ⅳ期非小细胞肺癌生存期中的作用,探讨晚期非小细胞肺癌(NSCLC)的治疗方案。【方法】采用前瞻性、多中心、随机、对照的临床研究方法,将符合标准的病例按1：1：1比例分成中医组、中西医组以及西医组,临床试验在6家医院进行,纳入研究的合格病例294例,其中中医组99例,中西医组103例,西医组92例。用Kaplan—Meier法分析主要终点指标中位生存期及中位疾病进展时间。【结果】中医组、中西医组、西医组中位生存期分别为292d、355d、236d,1年累积生存率分别为45．38％、48．86％、42．17％(组间比较,P=0．4508)。中位疾病进展时间3组分别为187d、239d、180d,1年累积疾病无进展率分别为33．22％、37．44％、28．28％(组间比较,P=0．2890)。【结论】由于样本量的原因,组间比较未出现显著性差异,但就总体趋向来看,中医药治疗可使Ⅲ、Ⅳ期NSCLC的中位生存期达到近10个月,与化疗联合应用可进一步提高生存期至近12个月,是一种有效的治疗方案。     

Phase I trial of metronomic oral vinorelbine in patients with advanced cancer

Background  

Antitubulin agents exhibit antiangiogenic effects in vitro and in vivo. We evaluated the safety and feasibility of administering a metronomic schedule of oral vinorelbine designed to optimize its antiangiogenic effects.     

Microbial flora and food borne pathogens on minced meat and their susceptibility to antimicrobial agents

Background

Food-borne pathogens are the leading cause of illness and death in developing countries. Changes in eating habits, mass catering, unsafe food storage conditions and poor hygiene practices are major contributing factors to food associated illnesses. In Ethiopia, the widespread habit of raw beef consumption is potential cause for food borne illnesses. The present study aimed at investigating the microbial quality of meat available in common retail shops, restaurants and abattoir of Jimma City and determining susceptibility pattern of bacterial isolates.

Method

A total of 165 samples from food establishments, butcher shops and a slaughter houses were processed and analyzed for the presence of indicator bacterial and potential food pathogens using standards methods. Antimicrobial susceptibility test was performed for Salmonella, Shigella and Staphylococcus aureus isolates using Kirby-Bauer disk diffusion method.

Results

A total of 165 samples were collected from twenty four hotels and five butchers and an abattoir. Various food borne pathogens were isolated in 13 (43.3%) and indicator organisms in 29 (96.7%) out of the thirty food establishments (hotels, butchery and abattoir). Overall, ten different bacterial species were isolated which included, proteus spp 89 (53.9%), E. coli 44 (26.6%), Providencia spp 23 (13.9%) Citrobacter spp 15(9%), Pseudomonas spp 9 (5.5%), Klebsiella spp 2 (1.2%), Enterobacter spp 2 (1.2%), Salmonella spp 2(1.2%), and Shigella species 1 (0.6%). Out of the 44 E. coli isolates 37 (84%) were thermo tolerant E. coli and out of the gram positive organisms identified 20 (12.1%) were Staphylococcus aureus isolates. From the two Salmonella isolates one was susceptible against all 12 tested antimicrobials, while the other to all the 11 except cephalexin. Shigella dysentery was resistant only to co-trimoxazole and tetracycline. Out of the 20 S. aureus isolates, 90% showed resistance to oxacillin, 85% to ampicillin, 65% to erythromycin, 60% to amoxicillin, 35% to streptomycin, and 20% to vancomycin and all isolates were sensitive to co-trimoxazole (100%). In this study, 90% (18/20) of the S. aureus isolates were Methicillin Resistant Staphylococcus aureus.

Conclusion

In this study high percentage of indicator organisms as well as food borne pathogens were identified, which shows unhygienic condition of handling and processing in the food establishments. Our data also confirmed the presence of resistant food pathogens; particularly Staphylococcus aureus isolates which are Methicillin Resistant Staphylococcus aureus and multidrug resistant that emphasizes close follow up in the utilization of antibiotics. Therefore, meat handlers and sellers should be educated on the adverse effect of lack of proper personal, environmental hygiene and sanitation. In addition, consumers should be made aware of the risk of consuming raw and inadequately cooked meat.     

Preparation and characterization of pure phase CdMnTe nanopowders by a hydrothermal route

In this paper, CdMnTe nanopowders with uniform shapes were prepared through a facile hydrothermal route using 3-mercaptopropionic acid (MPA) as the stabilizer and modifier. The effects of different experimental conditions including Cd-to-MPA ratio, pH value and reaction temperature on the phase composition and formation mechanism of as-prepared nanopowders were studied. XRD results indicated as-prepared CdMnTe nanopowders were pure phase and had cubic sphalerite structure with high crystallinity. SEM and Rietveld refinement clearly showed that the powders were about 10–100 nm in size. In PL measurement, there was a strong luminescence peak in the infrared region 1.717–1.826 eV. Compared with the CdMnTe single crystal, a blue shift of about 0.109 eV indicated a wider band gap. In UV-vis spectra, the absorption peak of the sample blue shifted with the decrease of crystal size, which indicated an obvious quantum confinement effect (QCE) in nanopowders. The optimal conditions for the preparation of CdMnTe nanopowders are 180 °C for 24 h with the molar ratio 1 : 1 of Cd : MPA at pH 13. In particular, the growth kinetics and possible formation mechanism of the nanopowders were proposed.

CdMnTe high-quality and pure phase nanopowders, with diameters of 20 nm to 100 nm, were synthesized by a hydrothermal route using mercapto propionic acid as the stabilizer. A CdMnTe single crystal was produced by melting method and flash sintering using CdMnTe nanopowder.