合肥地区大学生功能性消化不良流行病学调查

目的调查合肥地区大学生功能性消化不良(FD)患病率、临床特征,探索影响FD的危险因素。方法采用问卷调查病例对照及多种精神量表调查收集FD的可疑危险因素。结果大学生FD患病率为8.3%,性别上无差异(P>0.05)。临床症状以上腹饱胀、早饱为多,临床分型以运动障碍型为多(65.9%),病情轻,病程短,就诊率低。FD伴HP感染率47.7%。大学生的FD发病与经济状况、生活习惯和生活方式无明显关系(P>0.05),而与家族史(有消化不良及消化性溃疡)明显相关(P=0.000及P=0.011)。社会心理状态调查显示大学生FD患者也是一类易焦虑的人群。不良生活事件、负性社会经历及消极应对方式对FD发生可能有一定影响。结论FD在大学生中较为常见,运动障碍型为多。心理社会及家族因素可能对大学生FD发生有一定影响。防治重点应是加强应对指导、心理疏导。     

小剂量红霉素治疗小儿腹部手术后动力性功能障碍

目的 探讨应用小剂量红霉素促进小儿腹部手术后胃肠道动力恢复的疗效.方法 将符合入选标准的开腹及胃肠手术后小儿随机分为治疗组40例,对照组40例.治疗组在给予常规对症处理、支持治疗基础上加用小剂量红霉素5mg/(kg·d),缓慢静脉滴注,1次/d,连用3-5天,观察其疗效.结果 治疗组术后不出现腹胀、呕吐、等症状,胃液引流量逐日减少及无胆汁粪渣,引出胃液清亮,食欲增加,术后72小时前肠鸣音恢复,有肛门排气排便,有效为率80.0%,高于对照组(P＜0.05),具有明显的治疗作用.结论 应用小剂量红霉素促进小儿腹部手术后胃肠道动力恢复安全有效,具有一定的临床价值.     

静滴阿奇霉素、白霉素、红霉素治疗小儿肺炎支原体急性期感染的疗效分析

目的：比较静滴阿奇霉素、白霉素与红霉素治疗小儿肺炎支原体（MP）感染的疗效及药物不良反应。方法：选择确诊为MP急性期感染的患儿146例,随机分为3组,分别静滴上述三种药物,对它们的临床疗效及药物不良反应进行评价。结果：上述三种药物的疗效无显著性差异（P〉0．05）,药物不良反应发生率红霉素为50％,与其它两组相比差异显著（P〈0．01）;白霉素与阿奇霉素组药物不良反应发生率低,两组问对比无显著性差异（P〉0．01）。结论：静滴阿奇霉素和白霉素疗效良好,药物不良反应少。可作为MP急性期感染的基础治疗药物,值得临床推广,其中白霉素为第一线抗生素,且价廉,可作为患儿MP急性期感染治疗的首选。     

红霉素、氨茶碱联合治疗小儿哮喘临床分析

目的:观察红霉素、氨茶碱治疗小儿哮喘的临床疗效,探讨其有效机制。方法:将232例哮喘合并感染患儿随机分为治疗组112例与对照组120例,均按哮喘合并感染常规治疗,治疗组择用红霉素、氨茶碱,对照组选用其他抗生素和支气管舒张剂。结果:治疗组患儿哮喘发作缓解时间较对照组明显缩短,疗效优于对照组,差异显著(P<0.01)。结论:红霉素和氨茶碱联合是治疗小儿哮喘既有效又经济的药物。     

Vonoprazan treatment improves gastrointestinal symptoms in patients with gastroesophageal reflux disease

The effects of vonoprazan, a new potassium-competitive acid blocker, on gastroesophageal reflux disease (GERD) symptom are not fully elucidated. The aim of this study is to determine the effect of vonoprazan on GERD and associated gastrointestinal symptoms. We retrospectively reviewed 88 Helicobacter pylori negative patients with GERD treated with vonoprazan 10 mg daily. Symptoms were evaluated using the Izumo scale, which reflects quality of life related to various abdominal symptoms. The rates of improvement and resolution of GERD symptoms were 86% (76/88) and 57% (50/88), respectively. Improvement and resolution in patients with erosive esophagitis was higher than in those with non-erosive reflux disease (91% vs 83%, p = 0.260 and 71% vs 47%, p = 0.025, respectively). We attempted to identify factors which predict the effects of vonoprazan. Multivariate analysis identified advanced age (≥60-year-old) (odds ratio [OR] 7.281, 95% confidence interval [CI] 2.056–25.776, p = 0.002), obesity (BMI ≥ 24) (OR 3.342, 95%CI 1.124–9.940, p = 0.030) and erosive esophagitis (OR 4.368, 95%CI 1.281–14.895, p = 0.018) as positive predictors of resolution of GERD symptoms. Alcohol use (OR 0.131, 95%CI 0.027–0.632, p = 0.011) and history of H. pylori eradication (OR 0.171, 95%CI 0.041–0.718, p = 0.015) were identified as negative predictors. Vonoprazan also improved epigastric pain (73%), postprandial distress (60%), constipation (58%) and diarrhea (52%) in patients with GERD. In conclusion, vonoprazan 10 mg daily is effective in improving GERD symptoms. Advanced age, obesity, erosive esophagitis, alcohol use and history of H. pylori eradication influence the resolution of GERD symptoms. Treatment with vonoprazan favorably affects gastrointestinal symptoms in patients with GERD.     

Implantación y evaluación de una prestación de gastroscopia precoz para pacientes con dispepsia y datos de alarma en Atención Primaria

Introduction

Dyspepsia is a common disorder in both Primary (PC) and Specialised Care (SC). Gastroscopy is recommended at the start of the study if there are warning signs, although it is not always available in PC.

Comparison of intravenous pantoprazole and ranitidine in patients with dyspepsia presented to the emergency department: a randomized,double blind,controlled trial

BACKGROUND: This study aimed to compare pantoprazole, a proton-pomp inhibitors (PPIs), and ranitidine, a H₂ receptor antagonists (H₂RA), in ceasing dyspeptic symptoms in the emergency department (ED).METHODS: This randomized, double-blinded study compared the effectiveness of 50 mg ranitidine (Ulcuran^®) and 40 mg pantoprazole (Pantpas^®), given in a 100 mL saline solution by an intravenous rapid infusion within 2-4 minutes in patients with dyspepsia presented to the ED. Pain intensity was measured at baseline, 30 and 60 minutes after the drug administration.RESULTS: A total of 72 patients were eligible for the study. Of these patients, 2 were excluded from the study because the initial visual analogue scale (VAS) scores were under 20 mm and 4 were excluded from the statistical analysis because of being diagnosed as having other causes of epigastric pain despite being allocated to one of the study groups. Thirty-three patients in the pantoprazole group and 33 patients in the ranitidine group were analyzed ultimately. The mean age of the patients was 36.6±15 years, and 26 (39.4%) patients were male. Both of the groups reduced pain effectively at 30 [27.6±28 (18 to 37) vs. 28.3±23 (20 to 37), respectively] and 60 minutes [39.6±39 (26 to 53) vs. 42.3±25 (33 to 51), respectively]. There were 13 (39.4%) patients in the pantoprazole group and 8 (24.2%) patients in the ranitidine group who required additional drug at the end of the study (P=0.186).CONCLUSION: Intravenous pantoprazole and ranitidine are not superior to each other in ceasing dyspeptic symptoms at 30 and 60 minutes in the ED.     

Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder

AIMTo study if anxiety, depression and experience of stress are associated with gastrointestinal (GI) symptoms in patients with bipolar disorder.METHODSA total of 136 patients with bipolar disorder (mean age 49.9 years; 61% women) and 136 controls from the general population (mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome (GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale (HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTSIn subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls (GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for “constipation” and “reflux”. Factors associated to GI symptoms in the patient group were female sex (adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score (adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores (29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls (25% vs 17%, P = 0.108).CONCLUSIONFemale patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects.     

贺氏火针治疗功能性消化不良脾胃虚寒证临床研究

目的:评价贺氏火针治疗功能性消化不良脾胃虚寒证患者的临床疗效。方法:选择2017年3月－2019年3月首都医科大学附属北京中医医院功能性消化不良脾胃虚寒证患者60例,在研究过程中自然形成2个队列,分别暴露在2种不同的干预措施中,其中对照组30例口服莫沙必利片,治疗组30例在对照组基础上结合火针点刺治疗。2组均治疗4周,...     

红霉素衍生物抑制活化T淋巴细胞核转录因子-κB表达的研究

目的 通过观察红霉素衍生物9（S）-羟基红霉素对活化T淋巴细胞核转录因子（NF）-κB表达的影响．探讨红霉素衍生物在RA治疗中的潜在意义。方法 事先加入不同剂量的红霉素或9（S）-羟基红霉素后，用肿瘤坏死因子（TNF）-α诱导活化T淋巴细胞NF—κB表达，体外培养1h后，利用反转录-聚合酶链反应（RT-PCR）方法观察上述化合物对NF—κB的mRNA表达影响，利用Western Blot方法观察上述化合物对NF-κB蛋白水平表达的影响。结果 红霉素和9（S）-羟基红霉素均可抑制活化T淋巴细胞NF—κB的mRNA和蛋白表达，并与剂量呈相关性，在100μg／ml时红霉素和9（S）-羟基红霉素使NF—κB mRNA的相对表达分别降低36％、45％（P〈0．01），使蛋白表达分别降低46％，56％（P〈0．01）。结论 红霉素及其衍生物的抗炎活性可能是通过对活化T淋巴细胞NF—κB信号途径的作用实现的。提示红霉素衍生物在类风湿关节炎治疗中具有潜在意义。