Eradication of 'ooHelicobacter pylori'ox : an objective assessment of current therapies

The purpose of the present review was to determine objectively the optimal treatment for the eradication of H. pylori amongst the currently used regimens. A comprehensive literature search provided a data-base relating to the following treatments: dual therapy with an anti-secretory drug plus either amoxycillin or clarithromycin; standard triple therapy, with or without additional anti-secretory drugs; proton pump inhibitor triple therapy; and H₂-receptor antagonist triple therapy. Emphasis was placed on intention-to-treat analyses of eradication rates using all of the available evidence. The criteria used to select the optimal treatment were efficacy (eradication rates), frequency of side-effects, simplicity of the regimen (number of tablets per day and duration of treatment) and cost. The analysis showed that proton pump inhibitor triple therapy (that is, a proton pump inhibitor plus any two of amoxycillin, clarithromycin or a nitroimidazole) was the preferred treatment for the eradication of H. pylori . In particular, the 1-week, low-dose regimen with omeprazole plus clarithromycin plus tinidazole produced the highest eradication rates (>90%) with the lowest frequency of side-effects and at only modest cost.     

Efficacy of an air-cleaning device equipped with a high efficiency particulate air filter in house dust mite respiratory allergy

The efficacy of an air-cleaning device equipped with a high efficiency particulate air (HEPA) filter (without further avoidance measures) was studied in patients allergic to house dust mite. The effects of the air-cleaner on indoor Dermatophagoides sp. levels, symptom score and bronchial hyperresponsiveness in nine mite-allergic patients were assessed using a cross-over controlled study. No significant effect was demonstrated on indoor Dermatophagoides sp. levels when comparing the period of air-cleaner activity (2 months) with the control period (2 months). The Dermatophagoides sp. levels in the houses studied were lower than the risk level for asthmatic attacks, making it difficult to assess any effect on asthma; however, neither bronchial hyperresponsiveness nor rhinitis symptom score were changed by air-cleaner activity. During the trial period, however the mean level of Dermatophagoides sp. allergen in the houses changed spontaneously from 4.4 micrograms/g (mean level in the first 2 trial months) to 1.75 micrograms/g of dust (second 2 months) (P less than 0.05). Owing to this change, the mean rhinitis symptom score also decreased (P less than 0.05), even if no significant correlation was demonstrated (r = 0.4 P = 0.089). HEPA filter air-cleaners appear insufficient as substitutes for standard avoidance measures in mite allergic patients.     

内皮素鞘内注射后的脊髓形态学观察

对18只大鼠进行内皮素脊髓鞘内注射,观察及记录大鼠后肢功能状态,并将18只大鼠分为3个不同的时间处死,进行病理形态学观察。结果表明:3组均表现缺血缺氧病理改变。2及4h实验组病变重于30min实验组。脊髓下胸段、腰段病变重于颈段及骶尾段。同时发现,大鼠后肢的功能状态与其脊髓相应的病理形态学变化不呈正比。     

根除幽门螺杆菌疗效与细胞色素氧化酶P450 2C19基因多态性的关系

目的 比较雷贝拉唑与奥美拉唑三联疗法根除幽门螺杆菌（Hp）的疗效与细胞色素氧化酶P4502 C19（CYP 2C19）基因多态性的关系。方法 采用随机、对照研究方法，将169例因消化不良症状接受常规胃镜检查确诊为慢性胃炎且Hp阳性的连续患者分人两组：雷贝拉唑三联疗法组（RAC组85例）和奥美拉唑三联疗法组（OAC组84例）。Hp诊断依靠组织病理学检查并参考快速尿素酶试验、血清Hp抗体检测结果。RAC组、OAC组均给予三联治疗：RAC组：雷贝拉唑10mg，OAC组：奥美拉唑20mg，两组均联用羟氨苄青霉素1000mg和克拉霉素500mg，全部药物每日2次，疗程7d。采用聚合酶链式反应结合限制性内切酶技术（PCR-RFLP），进行CYP 2C19基因型分析，治疗结束后第28天用^14C尿素呼气实验检测Hp根除疗效。结果 160例完成治疗方案，RAC组及OAC组的Hp根除率按PP分析及ITT分析均无统计学差异（P〉0．05）。根据CYP 2C19基因型分析，160例中，弱代谢型（PM）、中间代谢型（IM）及强代谢型（EM）的Hp根除率分别为95．5%（21／22）、85．9％（73／85）和67．9％（36／53）。PM型及IM型的Hp根除率均显著高于EM型（P〈0．05），而PM型与IM型间差异无统计学意义（P〉0．05）。RAC组中，各基因型的Hp根除率差异无统计学意义（P〉0．05）。OAC组中。IM型与EM型间（P〈0．01）及EM型与PM型间（P〈0．05）差异均有统计学意义。结论 雷贝拉唑与奥美拉唑两种三联疗法均能有效根除Hp。总疗效差异无统计学意义。雷贝拉唑三联疗法疗效较稳定，个体间差异小。PM型及IM型的Hp根除率均较EM型为高。     

Geste antagonistes in idiopathic lower cranial dystonia.

Geste antagonistes, or sensory tricks, are well described in focal dystonia affecting the neck, hand, and face. Improvement in dystonic movements is typically maintained while the trick is performed, but disappears when the geste ends. We investigated the phenomenological features of geste antagoniste maneuvers in 19 patients with idiopathic lower cranial dystonia who were prospectively evaluated over a period of 6 years. Of the 19, 10 were men, mean age of onset was 49.8 years, and the most commonly involved lower cranial area was the jaw (10 patients). In most patients, dystonia was task-specific. Taking advantage of the improvement with a sensory geste, we manufactured oral appliances that mimicked the geste in 8 patients, and 3 continue to use it.     

滤网式脑保护装置下颈动脉狭窄支架置入术的临床研究

目的探讨颈动脉支架置入术中滤网式脑保护装置的有效性及安全性。方法19例颈动脉狭窄患者在滤网脑保护装置下使用自膨胀支架行颈动脉支架置入术。观察脑栓塞的发生和所回收的过滤网。术后短期随访。结果19例滤网式脑保护装置下颈动脉支架置入术均成功实施,回收的过滤伞中8个发现组织碎片,无手术死亡及症状性脑梗塞并发症。临床短期随访无脑缺血发生。结论脑保护装置下支架置入术治疗颈动脉狭窄是安全和有效的。     

人工心肺机血液泵监测系统的研制

为避免人工心肺机血液泵转速失控现像的发生，特研制人工心肺机监测系统，通过对血泵转速的实时监测，判断系统是否正常，自动进行相应的处理，提高现有系统的安全性。