Low eradication rate of Helicobacter pylori with triple 7-14 days and quadriple therapy in Turkey

AIM:The eradication rate of Helicobacter pylori (H pylon) shows variation among countries and regimens of treatment.We aimed to study the eradication rates of different regimens in our region and some factors affecting the rate of eradication.METHODS:One hundred and sixty-four Hpylori positivepatients (68 males, 96 females; mean age:48±12 years)with duodenal or gastric ulcer without a smoking history were included in the study. The patients were divided into three groups according to the treatment regimens. Omeprazole 20mg, clarithromycin 500mg, amoxicillin 1g were given twice daily for 1 week (Group I) and 2 weeks (Group Ⅱ).Patients in Group Ⅲ received bismuth subsitrate 300mg,tetracyline 500 mg and metronidazole 500mg four times daily in addition to Omeprazole 20mg twice daily.Two biopsies each before and after treatment were obtained from antrum and corpus, and histopathologically evaluated.Eradication was assumed to be successful if no Hpylorus was detected from four biopsy specimens taken after treatment. The effects of factors like age, sex, Hpyloridensity on antrum and corpus before treatment, the total Hpylori density, and the inflammation scores on the rate of Hpylori eradication were evaluated.RESULTS:The overall eradication rate was 42%. The rates in groups Ⅱ and Ⅲ were statistically higher than that in group I (P<0.05). The rates of eradication were 24.5%,40.7% and 61.5% in groups Ⅰ, Ⅱ and Ⅲ, respectively. The eradication rate was negatively related to either corpus Hpylori density or total Hpyloridensity (P<0.05).The median age was older in the group in which the eradication failed in comparison to that with successful eradication (55yr vs 39yr, P<0.001). No correlation between sex and Hpylori eradication was found.CONCLUSION: Our rates of eradication were significantly lower when compared to those reported in literature.We believe that advanced age and high Hpyloridensity are negative predictive factors for the rate of Hpylorieradication.     

最有损您健康的八种鞋

通常人们认为布鞋柔软、轻便、舒适，老年人尤为喜欢穿着，但是布鞋因为鞋底太软，石子等极容易扎破鞋底，尤其是有神经病变的老年糖尿病患者，对疼痛的感觉很弱，一旦扎破了脚都无法察觉，严重的会引起足部溃疡。因此．老年糖尿病患者应尽量在医生的指导下穿特制的鞋，最好是硬底、软垫、宽头的鞋，不要穿布鞋。     

Mucocele of the appendix： An unusual cause of lower abdominal pain in a patient with ulcerative colitis-. A case report and review of literature

The authors report the case of a 60-year-old male patient. In November 2001 he developed intestinal symptoms of bloody diarrhea and abdominal pain. Colononoscopy and biopsy established the diagnosis of ulcerative colitis (proctosigmoiditis). The disease activity was moderate at the beginning. No significant laboratory alterations were found (including CEA, CA19-9), and mesalazine was started orally. He was in remission until November 2003, when he was admitted to our Outpatient Clinic for upper and right lower abdominal pain and bloody diarrhea. Colonoscopy found proctosigmoiditis with a moderate activity, gastroscopy revealed chronic gastritis, laboratory data was normal. Treatment was amended with mesalazine clysma and methylprednisolone (16 mg) orally. Symptoms ameliorated; however, right lower abdominal pain persisted. US and CT examinat'on demonstrated a pericecal cystic mass (11 cm×3.5 cm). At first pericecal abscess was suspected, as the previous US examination (6 mo earlier) had revealed normal findings. Fine needie aspiration was performed. Cytology confirmed the diagnosis of mucocele. The patientunderwent partial cecum resection and extirpation of the mucocele. He recovered well and the final histology revealed a cystadenoma of the appendix. Follow up was started. The pati雗t is now free of symptoms. Although primary adenocarcinoma of the appendix is uncommon, the authors emphasize that preoperative diagnosis of an underlying malignancy in a mucocele is important for pati雗t management; however, it is difficult on imaging studies.     

31卷4期疑难病案

<正>患者27岁,因发现宫腔内占位1+年,月经周期延长3月于2014年10月13日入院。2013年9月6日曾因"阴道流血1+月,扪及下腹包块半月"至我院,妇科B超检查提示:子宫大小140 mm×99 mm×83 mm,宫内见大小约79 mm×43 mm异常回声,内以无回声为主,其间有大小不等的蜂窝状无回声。彩色多普勒血流成像(CDFI)检查示其内见血流信号,RI 0.55。     

局部晚期/复发性直肠癌患者根治性全盆腔脏器切除术的疗效

目的 分析局部晚期/复发性直肠癌患者应用根治性全盆腔脏器切除术治疗的方法和效果.方法 采用回顾性分析方法,收集1994年6月至2012年6月收治的88例局部晚期/复发性直肠癌患者作为研究对象,其中实验组58例应用根治性全盆腔脏器切除术治疗,对照组30例行姑息性手术治疗,比较两组患者的临床治疗效果.结果 实验组患者术后肾功能衰竭、性功能障碍等并发症发生率分别为3.45％和44.83％,均低于对照组(16.67％和70.00％),差异均有统计学意义(P均＜0.05).实验组与对照组术后2年生存率(96.55％ vs16.67％)、5年生存率(53.45％ vs0)比较,差异均有统计学意义(P均＜0.01).结论 局部晚期/复发性直肠癌患者应用根治性全盆腔脏器切除术临床效果较好,患者术后并发症发生率较低,能延长患者生存时间.     

腹腔镜治疗小儿腹股沟斜疝42例分析

小儿腹股沟斜疝是小儿普外科常见病之一,传统治疗方法为开放性疝囊高位结扎术,其复发率及并发症相对较多。随着医学技术的飞速发展,腹腔镜下治疗小儿腹股沟斜疝已经逐渐取代传统治疗方法,其具有切口小、损伤少、复发率低、恢复快等诸多优点。故本研究回顾性分析了42例行腹腔镜下内环口缝扎术的复发性斜疝患儿资料,现总结报道如下。1资料与方法1.1一般资料本组病例为2010年1月至2014年3月     

经皮透光负压旋切术治疗下肢静脉性溃疡的护理干预

目的：探讨经皮负压透光旋切术治疗下肢静脉性溃疡患者的护理方法。方法条件性选择下肢静脉性溃疡行经皮透光负压旋切术患者210例,按住院单双号分为治疗组160例和对照组50例。其中,治疗组：住院时由护士发放症状自评量表(SCL-90)进行评估,根据结果再由责任护士进行护理前后汉密顿焦虑量表(HAMA)、自评抑郁量表(SDS)的测量,提出护理诊断,实施护理措施。对照组按照常规护理方法进行疾病护理。观察患者平均住院日、出院后随访患者溃疡复发率。结果经过护理干预,治疗组的焦虑程度、抑郁情况均降低,战胜疾病的信心提高;平均住院日减少,出院后随访患者的溃疡复发率少。结论有效的护理干预可以提高患者战胜疾病的信心,积极主动配合治疗,提高机体抵抗力,促进疾病恢复,缩短病程。     

门静脉高压症复发性上消化道出血的精准外科治疗

目的探讨应用精准外科的理念,个体化选择最适合的手术方式,改善门静脉高压症复发性上消化道出血的治疗效果。方法回顾性分析2008年4月至2013年7月采用精准外科技术个体化治疗66例门静脉高压症复发性上消化道出血患者的临床资料。结果术后胃镜检查40例静脉曲张完全消失,19例基本消失,7例为轻度曲张。伴有门脉高压性胃病(PHG)的41例术后胃黏膜病变均明显改善。术后1年内再出血率6.1%(4/66)。术后肝性脑病发生率7.6%,1年、3年及5年生存率分别为97.0%(64/66)、93.3%(42/45)、85.7%(18/21)。结论应用精准外科技术采用个体化的术式治疗门静脉高压症复发性上消化道出血,可减少术后并发症的发生率,改善近远期疗效。     

高龄胃十二指肠溃疡穿孔患者术后并发症观察与护理

目的总结高龄胃十二指肠溃疡穿孔患者术后并发症情况及其护理措施。方法对接受手术治疗的50例高龄胃十二指肠溃疡穿孔患者,严密观察术后并发症情况并给予针对性护理措施。结果 50例患者术后4例心功能不全、3例出血、3例肺部感染。经及时治疗和针对性护理后,均获痊愈,住院时间(10.5±2.6)d。结论高龄胃十二指肠溃疡穿孔患者术后极易发生出血、心功能不全、感染性休克、肺部感染等并发症。加强术后病情观察、做好并发症护理等措施可促进患者早日恢复。     

护理干预对下肢静脉溃疡患者治疗效果及依从性的影响

下肢静脉溃疡是血管外科较常见疾病,是下肢静脉功能不全导致的皮肤代谢紊乱。由于缺乏有效的治疗措施,溃疡迁延难愈,已成为外科较为棘手的问题[1]。研究发现,57%~67%的下肢静脉溃疡患者没有得到系统、规范的治疗和护理[2]。我院伤口护理中心自2011年1月对下肢静脉溃疡患者进行护理干预,效果满意。现报告如下。