Comparison of one-day oral dosing with three bismuth compounds for the suppression of Helicobacter pylori assessed by the13C-urea breath test

Assessment of intragastric urease activity by the 13C-urea breath test was performed before and after one day of dosing with either De-Noltabs (tripotassium dicitrato bismuthate, one tablet 1 q.d.s.), Pepto-Bismol liquid (bismuth salicylate 30 ml q.d.s.), or Roter tablets (bismuth subnitrate, one tablet q.d.s.) in twelve Helicobacter pylori-positive patient volunteers. There was a significant decrease in the excess of 13CO2 after one day of dosing with each of the three bismuth compounds, but analysis of variance could detect no difference between the effects of the three compounds. Systemic absorption of bismuth following oral dosing with either Pepto-Bismol or Roter is minimal, yet both compounds have a suppressive effect on H. pylori similar to that of De-Noltab. This study suggests that the action of all three bismuth compounds is within the gastric lumen, and that systemic absorption of bismuth is not necessary for activity against H. pylori.     

脊柱黄韧带骨化的临床影像学研究和meta分析

目的 探讨黄韧带骨化(ossification ofligamentum flavum,OLF)的临床流行病学特征,评估OLF在普通人群中的发病率、形态和分布特点.进行相关OLF流行病学研究的meta分析.方法 对1736名中国南方人进行脊柱的临床影像学研究,分别进行MRI T2加权的矢状位成像,OLF定义为一椎管后方的低信号区,并在CT上证实.根据OLF累及的节段分为单一型、连续型和非连续型;根据矢状位T2加权像上OLF的形态学特征分为三角形、圆形和鸟喙形三种.检索Ovid Medline、PubMed、Embase和中国生物文献数据库(1980年1月至2010年1月),搜集全部有关OLF的流行病学研究.结果 共有66例志愿者发现有脊柱OLF,其中女52例,男14例.根据该研究新的分型,单一型45例(68.2%),连续型11例(16.7%),非连续型10例(15.2%);形态学上,92个OLF中,17个(18.5%)为三角形,75个(81.5%)为圆形骨化物.纳入研究的OLF流行病学研究共有4篇.结论 OLF在中国南方人群中的患病率约为3.8%(66/1736),发生率与年龄和性别相关;31.8%的多节段OLF和15.2%的非连续型OLF均提示全脊柱MR检查的必要性.     

Tobacco and the European common agricultural policy

The common agricultural policy of the European Community subsidizes tobacco production to the tune of 1300 million ecu a year (US$ 1500 million, UK£ 900 million). This amounts to 2 500 ecu ($3100, £1700) per minute, and is more in one year than the total amount spent on tobacco subsidies by the US in the last 50 years. The purpose of this policy was to maintain farmers' incomes and adapt community production to demand. Demand for the dark tobaccos which dominate EC production has fallen, while demand for light flue cured tobacco like Virginia has risen. A complex system of production subsidies and quotas was intended to discourage production of the dark tobaccos, for which there is virtually no market, and lead to more Virginia production. The policy has failed. Expenditure has spiralled out of control, production of unmarketable tobacco varieties has risen enormously, and the EC is the world's largest importer of raw tobacco. As a result tobacco is being bought by the community for intervention storage and surpluses of the dark high tar varieties are being ‘exported’ to eastern Europe and north Africa at giveaway prices. There has been no effective monitoring or control of this policy. This paper explains how this has happened and argues that, in view of the health risks attached to tobacco, these subsidies should be abolished.     

Rolling review: gastrointestinal malignancy

The chemotherapy of gastrointestinal malignancies remain mostly investigational, although several adjuvant protocols in colorectal cancer and anal cancer are beginning to be accepted as standards against which newer regimens are to be compared. Chemotherapy regimens are best understood and appreciated with a basic understanding of cancer biology, tumour cell kinetics, and drug toxicities. An appreciation of chemotherapy-induced toxicity and an awareness of their management will help the gastroenterologist be an active participant in the multidisciplinary team caring for the patient with gastrointestinal malignancies.     

Differences in attention control between ''clinic-observable'' and ''reported'' hyperactivity: a preliminary report

A series of attention tests were administered to two groups of hyperactive children and a control group of normal children. The first group of hyperactive children had both 'reported' hyperactivity (defined as having hyperactive behaviour reported at school and home) and 'clinic-observable' hyperactivity (defined as having hyperactive behaviour readily observable in a clinic interview). The second group had only 'reported' hyperactivity. The results of attention testing indicated that the children with both 'reported' and 'clinic-observable' hyperactivity had significant attentional difficulties in comparison with children with 'reported' hyperactivity as well as with the normal controls. On the other hand, the children with 'reported' hyperactivity had less evidence of attentional problems when compared to the normal children. Hence; the differentiation into 'reported' and 'clinic-observable' hyperactivity was of theoretical importance as clinic behaviour was a significant diagnostic marker in predicting performance in attention tests. The results of this study suggest the presence of different types of attention deficits in 'reported' and 'clinic-observable' hyperactivity respectively as well as heterogeneity in hyperactive children.     

Urinary mitochondrial DNA level as a biomarker of tissue injury in non-diabetic chronic kidney diseases

Background

Urinary mitochondrial DNA (mtDNA) fragment level has been proposed as a biomarker of chronic kidney disease (CKD). In this study, we determine the relation between urinary mtDNA level and rate of renal function deterioration in non-diabetic CKD.

Methods

We recruited 102 non-diabetic CKD patients (43 with kidney biopsy that showed non-specific nephrosclerosis). Urinary mtDNA level was measured and compared to baseline clinical and pathological parameters. The patients were followed 48.3?±?31.8?months for renal events (need of dialysis or over 30% reduction in estimated glomerular filtration rate [eGFR]).

Results

The median urinary mtDNA level was 1519.42 (inter-quartile range 511.81–3073.03) million copy/mmol creatinine. There were significant correlations between urinary mtDNA level and baseline eGFR (r?=?0.429, p?<?0.001), proteinuria (r?=?0.368, p?<?0.001), severity of glomerulosclerosis (r?=???0.537, p?<?0.001), and tubulointerstitial fibrosis (r?=???0.374, p?=?0.014). The overall rate of eGFR decline was ??2.18?±?5.94?ml/min/1.73m² per year. There was no significant correlation between the rate of eGFR decline and urinary mtDNA level. By univariate analysis, urinary mtDNA level predicts dialysis-free survival, but the result became insignificant after adjusting for clinical and histological confounding factors.

Conclusion

Urinary mtDNA levels have no significant association with the rate of renal function decline in non-diabetic CKD, although the levels correlate with baseline renal function, proteinuria, and the severity of histological damage. Urinary mtDNA level may be a surrogate marker of permanent renal damage in non-diabetic CKD.