地衣芽胞杆菌对肠道致病菌的体内拮抗作用研究

目的:探讨地衣芽胞杆菌C01在模型小鼠体内对大肠杆菌、沙门氏菌抑制作用以及对乳杆菌等有益菌的促进作用。方法:用地衣芽胞杆菌C01灌胃肠道感染模型小鼠,采用体外活菌培养,分析粪便菌群数量的变化。结果:C01灌胃治疗组(EPEC C01)中乳杆菌的数量显著高于EPEC灌胃模型组(EPEC N)(P<0.01),肠杆菌数量下降极显著(P<0.01),而(EPEC N)组肠杆菌数显著高于正常对照组(NS)(P<0.05);肠炎沙门氏菌处理后C01灌胃治疗组(SL C01)和处理后肠炎沙门氏模型组(SL N)比较,乳杆菌、肠球菌和总厌氧菌的变化不明显,但肠杆菌数量下降极显著(P<0.01);形态病理学观察结果显示,C01芽胞杆菌灌胃治疗组肠粘膜病变明显减轻,肠粘膜及绒毛高度明显增加,绒毛轻度水肿,绒毛排列整齐、致密。结论:地衣芽胞杆菌C01在体内对肠炎沙门氏菌和致病性大肠杆菌有较强的抑制作用,能促进乳杆菌等生理性有益菌的增殖,可保护肠粘膜结构的完整性免受病原菌的侵袭。     

中西医结合治疗血栓闭塞性脉管炎33例

血栓闭塞性脉管炎 (TAO )系一种非动脉硬化性、阶段性炎症、阻塞性周围血管疾病之一 ,其病因现代医学尚未明确 ,中医辨证多属热毒血瘀范畴。我科从 2 0 0 1年 8月～ 2 0 0 2年 9月对 33例TAO患者进行中西医结合治疗 ,取得满意的疗效。1　临床资料本组 33例中 ,男 2 8例 ,女 5例     

外伤性白内障术后二期人工晶状体植入术

目的 探讨外伤性白内障术后二期植入后房型人工晶状体的时机和手术方式。方法 对34例(34只眼)外伤性白内障术后无晶状体眼根据不同情况采用直接睫状沟植入法或缝线固定法进行二期植入后房型人工晶状体，观察两组患者的术后反应和治疗效果。结果 直接睫状沟植入法14只眼(41．2％)，缝线固定法20只眼(58．8％)，31只眼(91．2％)视力达到0．1以上，21只眼(61．76％)视力达0．3以上，28只眼(82．4％)术后矫正视力等于或高于术前最佳矫正视力。结论 选取合适的时机和方式二期植入人工晶状体，有助于减少术后并发症，提高视功能的恢复。     

医院感染及漏报率统计分析

目的　了解我院医院感染发生及漏报率。方法　将我院 2 0 0 3年 1～ 12月出院的所有病例进行回顾性调查。结果　医院感染率 7.3 2 %、漏报率 14 .93 %,均符合国家卫生部要求。结论　做好医院感染监测工作 ,严格执行各项工作制度 ,掌握医院感染与手术并发症的鉴别诊断 ,提高医院感染诊断的准确率     

主班工作制在泌尿科临床工作中的应用

2006年10月开始上主班，通过近2个月的主班工作及与前两任主班的共同经验交流，探讨泌尿科主班工作制在临床工作中的应用，现介绍如下。     

A comparative study of etanercept plus methotrexate and methotrexate alone in Taiwanese patients with active rheumatoid arthritis: a 12-week, double-blind, randomized, placebo-controlled study.

BACKGROUND AND PURPOSE: Etanercept (Enbrel), a recombinant tumor necrosis factor receptor fusion protein, has been shown to be effective in the treatment of patients with rheumatoid arthritis (RA). The purpose of this study was to compare the efficacy and safety of etanercept in combination with methotrexate (MTX) and MTX alone in Taiwanese patients with active RA. METHODS: In this double-blind study, 58 patients with active RA who were maintained on MTX therapy at a stable dose of 12.5 to 20 mg per week for 4 weeks were randomized to receive either etanercept 25 mg (n = 29) or placebo (n = 29) by subcutaneous injection twice weekly over a period of 12 weeks. The primary endpoint was the reduction of tender and swollen joint counts by 20% (ACR 20), 50% (ACR 50), and 70% (ACR 70) as determined by the American College of Rheumatology criteria at the 12th week. RESULTS: The addition of etanercept to MTX resulted in a greater reduction in the number of tender (7.00 vs 2.45, p = 0.012) and swollen joints (8.55 vs 3.86, p = 0.017), and in serum levels of C-reactive protein (1.26 mg/dL vs 0.45 mg/dL, p = 0.014) compared to MTX alone after 12 weeks of therapy. In addition, the global assessment of disease activity by both physicians and patients, duration of morning stiffness, pain visual analog scale score, and Health Assessment Questionnaire were all improved by etanercept plus MTX therapy. Results for the overall improvement in disease activity assessed by ACR 20 (90% vs 34%), ACR 50 (66% vs 10%) and ACR 70 (24% vs 0%) all favored the etanercept plus MTX group. However, the adverse events were comparable between the 2 treatment groups. CONCLUSION: Etanercept in combination with MTX was well tolerated and provided significantly more clinical benefit than MTX alone in Taiwanese patients with active RA.     

Demand feeding for healthy premature newborns: a randomized crossover study.

BACKGROUND AND PURPOSE: In hospitals, preterm infants are routinely fed specified amounts of formula on a fixed schedule. This results in the baby's intake volume being regular and easily confirmed, but does not consider the individual baby's needs. The purpose of this study was to compare the effects of demand feeding and fixed schedule feeding for healthy premature newborn babies. METHODS: A 2-feeding-type, 2-period crossover study design was employed, in which each period consisted of 2 days, the first of which was a washout period, comprising a self-comparison protocol designed to identify any differences in the feeding characteristics of premature infants on demand or scheduled bottle-feeding. Eleven preterm infants were included. The sample size was monitored during the observation period by power calculation. The mean weight at study entry was 1897.27 +/- 175.94 g and the mean postconceptional age was 35.34 +/- 1.54 weeks. RESULTS: Compared with scheduled feeding, demand feeding was associated with a longer daily mean interval (4.17 vs 3.02 hours; p = 0.00), greater volume per feed for demand feeding (67.28 vs 51.11; p = 0.00), greater feeding speed (5.73 vs 4.51 mL/min; p = 0.00), but a similar daily total duration of feeding. There was no significant difference in the daily total feeding volume. CONCLUSIONS: Demand feeding provides superior volume per feed, and feeding speed and shortens the duration of feeding compared to feeding on a routine schedule. It is suitable and feasible for healthy premature newborns.     

Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial.

Patients with depression have been extensively reported to be associated with the abnormality of omega-3 polyunsaturated fatty acids (PUFAs), including significantly low eicosapentaenoic acid and docosahexaenoic acid in cell tissue contents (red blood cell membrane, plasma, etc.) and dietary intake. However, more evidence is needed to support its relation. In this study, we conducted an 8-week, double-blind, placebo-controlled trial, comparing omega-3 PUFAs (6.6 g/day) [corrected] with placebo, on the top of the usual treatment, in 28 patients with major depressive disorder. Patients in the omega-3 PUFA group had a significantly decreased score on the 21-item Hamilton Rating Scale for Depression than those in the placebo group (P < 0.001). From the preliminary findings in this study, omega-3 PUFAs could improve the short-term course of illness and were well tolerated in patients with major depressive disorder.