Efficacy and tolerability of pantoprazole 40 mg versus 80 mg in patients with reflux oesophagitis.

BACKGROUND: Pantoprazole is a substituted benzimidazole which is a potent inhibitor of gastric acid secretion by its action upon H+, K+- ATPase. METHODS: Pantoprazole 40 mg and 80 mg were compared in a randomized double-blind study in 192 out-patients with stage II or III (Savary-Miller classification) reflux oesophagitis. Patients received either pantoprazole 40 mg (n = 97) or pantoprazole 80 mg (n = 95), once daily before breakfast for 4 weeks. Treatment was extended for a further 4 weeks if the oesophagitis had not healed. RESULTS: After 4 weeks complete healing of the reflux oesophagitis was seen in 78% of protocol-correct patients given pantoprazole 40 mg daily (n = 86), and in 72% in the 80 mg (n = 87) group. The cumulative healing rates after 8 weeks were 95 and 94%, respectively (P > 0.05, Cochran-Mantel- Haenszel), and time until healing of oesophagitis comparable in both groups. Differences between doses were also not significant in an intention-to-treat analysis. Both dosing schedules were well tolerated and the patients experienced remarkable symptom relief. No adverse event or changes in laboratory values of clinical significance could definitely be ascribed to the trial medication. CONCLUSION: The 40 mg pantoprazole dosage is comparable to 80 mg in reflux oesophagitis, both in efficacy and tolerability.     

农村乙型肝炎疫苗接种率及影响因素调查

为了解农村地区乙型肝炎 (乙肝 )疫苗免疫效果及影响因素 ,提出相应措施提高乙肝疫苗的保护效果。在南江、旺苍两县 ,采用多阶段随机整群抽样方法 ,抽取 5 2 7名 2 0 0 0年出生儿童及其 4 99名母亲 ,采血检测血清乙肝病毒表面抗原 (HBsAg)。结果显示 :儿童乙肝疫苗免疫接种率和全程免疫接种率分别为 99 0 5 %、95 4 5 % ;首针及时接种率和全程及时接种率分别为 6 8 39%、6 1 6 9%。住院分娩和在家分娩儿童首针及时接种率分别为 83 5 9%、5 6 90 % ,两者的差异有非常显著的统计学意义 (P <0 0 1)。≥第 2胎儿童的首针及时接种率非常明显的低于第 1胎儿童 (χ2 =34 1178,P <0 0 1)。被调查儿童母亲的HBsAg阳性率为 6 6 1% ;儿童HBsAg阳性率为 1 5 2 % ,7例均为阳性母亲所生儿童。由此可见 ,在农村推广乙肝疫苗免疫接种将大大降低HBsAg阳性率。在经济欠发达的边远地区和山区农村 ,对孕妇进行HBsAg筛查 ,重点对HBsAg阳性产妇的新生儿及时接种乙肝疫苗 ,将会取得事半功倍的效果     

发挥科研优势 促进学科发展

<正> 暨南大学医学院第一附属医院,又名广州华侨医院,经过20年的发展已成为一所集医、教、研为一体的大型三级甲等医院。医院的科研发展始终坚持"以学科建设为基础,人才培养是关键"的科研办院思路,从建院初期以调入人才为主到目前的以人才引进为辅、培养人才为主,20年来培养了一批中青年学术带头人,形成了一批技术力量强大的学科群。从建院初期仅有眼科学、内科学(血液病专业)2个硕士学位授与点发展到现在拥有眼科学、内科学、妇产科学3个博士学位、14个硕士学位授权点,1998年还被国家教委批准为临床医学专业学位授与点的试点单位。在各类学术期刊上发表文章3089篇,主编及参与编写171部专著,承担各级科研课题695项,获国家科技进步奖1项,省部级成果奖25项,厅局级科技进步奖69项,获专利9项。医院在培育科研优势的同时更注意发挥学科优势促进学科的发展。     

Therapeutic potential of fish oil in the treatment of ulcerative colitis

In a pilot study six patients with active ulcerative colitis and six healthy controls were given fish oil (MaxEPA) containing 3-4 g of eicosapentaenoic acid daily for a period of 12 weeks. There was a significant improvement in the patients' symptoms and histological appearance of the rectal mucosa by the end of the treatment period. There was significant fall in neutrophil chemiluminescence during treatment in patients, whereas no change was observed in the control group. Neutrophil leukotriene B4 levels fell significantly during treatment. Serum from patients receiving fish oil was significantly less chemotactic for neutrophils compared with control serum. Eicosapentaenoic acid inhibited neutrophil chemotaxis and chemiluminescence in vitro. The omega-3 fatty acids, which occur naturally in fish oils, may exert a beneficial effect by decreasing the production of inflammatory mediators.     

Cutaneous calcinosis in erythromelanosis follicularis faciei et colli

A case of erythromelanosis follicularis faciei et colli is described which showed deposition of calcium in the lesional skin on the face.     

Recombinant activated factor VII in treatment of bleeding complications following hematopoietic stem cell transplantation

BACKGROUND: Bleeding is a common complication following hematopoietic stem cell transplantation (HSCT) and standard hemostatic treatment is often ineffective. We conducted a multicentre, randomized trial of the efficacy and safety of activated recombinant factor VII (rFVIIa, NovoSeven) in the treatment of bleeding following HSCT. METHODS: 100 patients with moderate or severe bleeding (52 gastrointestinal; 26 hemorrhagic cystitis; seven pulmonary; one cerebral; 14 other) were included from days +2 to +180 post-transplant (97 allogeneic; three autologous) to receive seven doses of rFVIIa (40, 80 or 160 microg kg(-1)) or placebo every 6 h. The primary efficacy endpoint was the change in bleeding score between the first administration and 38 h. RESULTS: No significant effect of increasing rFVIIa dose was observed on the primary endpoint. A post hoc analysis comparing each rFVIIa dose with placebo showed that 80 microg kg(-1) rFVIIa improved the bleeding score at the 38 h time point (81% vs. 57%, P = 0.021). This effect was not seen at 160 microg kg(-1). There were no differences in transfusion requirements across dose groups. There was no trend in the type or number of severe adverse events observed. Six thromboembolic events were observed in the active treatment groups: three during, and three following the 96-h observation period. CONCLUSIONS: Despite no overall effect of rFVIIa treatment on primary endpoint, post hoc analysis showed an improvement in the control of bleeding for 80 microg kg(-1) rFVIIa vs. standard hemostatic treatment. The heterogeneity of the population may have contributed to the lack of an increasing effect with increased dose. Further trials should focus upon identifying the patient populations that may benefit from treatment with rFVIIa.     

连续硬脊膜外麻醉应用于女性尿漏手术的体会——附85例报告

本文分析了连续硬膜外麻醉术用于女性尿漏手术85例的情况。提出术前、术中应注意的问题及其某些处理方法。并认为此种麻醉术用于女性尿漏手术,不失为是一种安全、可靠、易于掌握的麻醉方法。