高原与平原地区世居汉族人群胃黏膜XOD活力比较

目的探讨高原地区世居汉族人群慢性胃炎患者胃组织内黄嘌呤氧化酶(XOD)水平及其意义。方法检测平原地区与高原地区世居汉族人群慢性胃炎胃组织内XOD活力。结果平原地区世居汉族人群胃黏膜组织中的XOD活力显著高于高原地区世居汉族人群。结论XOD并未参与高原地区慢性胃炎发生过程,甚至可能起到保护作用。平原地区人群XOD显著高于高原缺氧地区,原因不明。     

3年间昆明地区消化系疾病住院病种分析

目的了解昆明地区近3 a消化系疾病住院病种变化的特点和规律,分析原因,为昆明地区消化系疾病临床工作、预防保健及合理配置卫生资源提供依据.方法对昆明市卫生局人才中心提供的政府办医院出院病人疾病转归情况统计报表消化系疾病部分进行分析,并结合调查昆明地区5家规模最大的＂三甲医院＂消化系疾病住院病种详细统计资料,了解2007年至2009年昆明地区消化系疾病出院病人病种变化.采用ICD10进行疾病分类,了解2007年至2009年昆明市消化系疾病住院病人占所有病种出院病人的结构比,掌握近3a按ICD10分类主码排位前7位的消化系疾病病种变化规律.结果昆明市2007年政府办医院消化系疾病住院病例数为46 572例,占所有住院病例病种的19.3%,居第二位,排位前7位的病种为胆囊结石及胆囊炎、肝炎后肝硬变、胃及十二指肠溃疡、慢性浅表性胃炎、急性胰腺炎、结肠息肉、结肠预激综合症;2008年为59 050例,占16.9%,居第二位.排位前7位的病种与2007年相同,仅结肠息肉排位在急性胰腺炎之前;2009年为65 889例,占12.1%,居第三位.排位前7位的病种前4种与2007年相同,第五位为结肠预激综合征,第六位为结肠息肉,急性胰腺炎排至第七位.县区级医院消化系疾病住院结构比高于省市级医院.结论消化系疾病在2007年至2009年是昆明地区的常见多发病,但住院病种结构比有逐年下降趋势.县区级消化系疾病住院结构比较高,提示城郊及农村地带消化系疾病发生率较城市多.在消化系疾病出院病人中,最多见的病种为胆结石及胆囊炎,说明昆明地区为结石高发地区;而肝炎后肝硬化仍是本地区主要消化系疾病;消化性溃疡、慢性胃炎在3 a中住院结构比较稳定,但绝对数有逐年下降趋势;结肠息肉及结肠预激综合症结构比有逐年上升趋势,提示潜在肿瘤及功能性疾病的发病有所增加.本次调查分析获取了昆明地区消化系疾病谱现状及变化趋势,为消化系疾病卫生防御及医疗资源配置提供了依据.     

乌鲁木齐市某医院自治区级医保住院病人现状调查分析

目的 通过比较乌鲁木齐市某医院2006-2008年自治区级医保住院病人的相关信息,了解自治区级医保的运行现况及发展趋势并据此提出可行性建议.方法 将所有研究对象的数据用Excel2003建立数据库,对医保住院病人的人次构成、费用构成、医疗费用进行分析并进行恰当的统计学描述.结果 (1)自治区级医保住院病人均次费用介于省属、部属住院病人均次费用之间;(2)退离休组的统筹费用及统筹比例3年期间均高于在职组;(3)哈萨克族与维吾尔族区医保住院病人均次费用及统筹比例较其他族别高.结论 自治区级医保为进一步建立健全全区多层次医疗保障体系,完善我区基本医疗保险制度以及减轻参保职工住院费用压力等方面都发挥了重要作用,但仍然存在不足.     

硫酸镁和生理盐水湿热敷在静脉补钾中的应用

目的:观察硫酸镁和生理盐水联合湿热敷防治静脉补钾致静脉炎和减轻疼痛的效果。方法:将62例因妊娠剧吐需长期静脉补钾的孕妇分为观察组(31例)和对照组(31例)观察组采用硫酸镁和生理盐水联合湿敷,对照组采用常规护理心理干预。结果:观察组总有效率高于对照组(P<0.05)。结论:硫酸镁和生理盐水联合湿敷可有效防治静脉炎及减轻静脉补钾所致的疼痛。     

Bipolar versus Monopolar Transurethral Resection of the Prostate: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Context

Incorporation of bipolar technology in transurethral resection (TUR) of the prostate (TURP) potentially offers advantages over monopolar TURP (M-TURP).

Objective

To evaluate the evidence by a meta-analysis, based on randomized controlled trials (RCTs) comparing bipolar TURP (B-TURP) with M-TURP for benign prostatic obstruction. Primary end points included efficacy (maximum flow rate [Q_max], International Prostate Symptom Score) and safety (adverse events). Secondary end points included operation time and duration of irrigation, catheterization, and hospitalization.

Evidence acquisition

Based on a detailed, unrestricted strategy, the literature was searched up to February 19, 2009, using Medline, Embase, Science Citation Index, and the Cochrane Library to detect all relevant RCTs. Methodological quality assessment of the trials was based on the Dutch Cochrane Collaboration checklist. Meta-analysis was performed using Review Manager 5.0.

Evidence synthesis

Sixteen RCTs (1406 patients) were included. Overall trial quality was low (eg, allocation concealment and blinding of outcome assessors were poorly reported). No clinically relevant differences in short-term (12-mo) efficacy were detected (Q_max: weighted mean difference [WMD]: 0.72 ml/s; 95% confidence interval [CI], 0.08–1.35; p = 0.03). Data on follow-up of >12 mo are scarce for B-TURP, precluding long-term efficacy evaluation. Treating 50 patients (95% CI, 33–111) and 20 patients (95% CI, 10–100) with B-TURP results in one fewer case of TUR syndrome (risk difference [RD]: 2.0%; 95% CI, 0.9–3.0%; p = 0.01) and one fewer case of clot retention (RD: 5.0%; 95% CI, 1.0–10%; p = 0.03), respectively. Operation times, transfusion rates, retention rates after catheter removal, and urethral complications did not differ significantly. Irrigation and catheterization duration was significantly longer with M-TURP (WMD: 8.75 h; 95% CI, 6.8–10.7 and WMD: 21.77 h; 95% CI, 19.22–24.32; p < 0.00001, respectively). Inferences for hospitalization duration could not be made. PlasmaKinetic TURP showed an improved safety profile. Data on TUR in saline (TURis) are not yet mature to permit safe conclusions.

Conclusions

No clinically relevant differences in short-term efficacy exist between the two techniques, but B-TURP is preferable due to a more favorable safety profile (lower TUR syndrome and clot retention rates) and shorter irrigation and catheterization duration. Well-designed multicentric/international RCTs with long-term follow-up and cost analysis are still needed.     

Biochemical and histological assessment of Alkali therapy during high animal protein intake in the rat

The Westernized diet is acidogenic due to the high content of sulfur-containing amino acids and relative deficiency of potassium organic anions. Chronic acid loads result in hypercalciuria and negative calcium balance often associated with loss of bone mineral. Alkali therapy tends to reverse the hypercalciuria but little is known regarding its effect on bone as assessed by bone histomorphometry. The present study utilized dynamic bone histomorphometry to evaluate the effects of alkali therapy on acid-induced changes in bone turnover. Serum and urine analyses and bone histomorphometry were assessed in adult rats after 2 months of either a low casein (LC) or high casein (HC) diet supplemented with either potassium chloride (KCl) or potassium citrate (KCit). Compared to animals on LC-KCl diet, HC-KCl diet delivered a substantial acid load as shown by significant increases in urinary sulfate, ammonium, and net acid excretion, and a lower urinary pH and citrate excretion without detectable changes in serum parameters. The acid load also resulted in hypercalciuria. Dynamic and static bone histomorphometry disclosed a significant reduction in cancellous bone volume and trabecular number associated with a 2.5-fold increase in eroded and a 3.5-fold increase in osteoclastic surfaces. There was also a near 2-fold increase in bone formation rate in rats on the HC-KCl diet. When animals on the HC diet were given KCit instead of KCl, all of the aforementioned changes in urine biochemistry and bone turnover were significantly attenuated or entirely prevented. These findings underscore the deleterious effects of high animal protein intake in promoting hypercalciuria and increasing bone turnover. Co-administration of potassium alkali attenuates or prevents these changes. In this animal model of high dietary animal protein intake, the major skeletal effect of alkali therapy is to reduce bone resorption, with little or no effect on bone formation.     

An ethnobotanical survey of mosquito repellent plants in uMkhanyakude district, KwaZulu-Natal province, South Africa

Ethnopharmacological relevance

The aim of the study was to document plants traditionally used to repel mosquitoes in the uMkhanyakude district, KwaZulu-Natal, South Africa. The specific objectives of the study were to: (1) identify plant species and their parts being used; (2) determine the condition of plant material used and the method of application.

Materials and methods

Data was collected from 60 respondents in five villages in the district using standardised and pre-tested questionnaires.

Results

Thirteen plant species are used in the study area to repel mosquitoes. These species belong to 11 genera from 9 families. Meliaceae and Anacardiaceae were the most represented families with two species each. The most frequently recorded species were Lippia javanica (91.67%), followed by Aloe ferox (11.67%), Sclerocarya birrea (5%), Melia azedarach (3%), Balanite maughamii (3%) and Mangifera indica (3%). Leaves were the most (38%) common plant part used. The majority (82%) of the plant parts were used in a dry state. Burning of plant materials to make smoke was the most (92%) common method of application. Nine plant species, namely: A. ferox, Calausena anista, Croton menyharthii, S. birrea, B. maughamii, Olax dissitiflora, Trichilia emetic, M. indica, and Atalaya alata are documented for the first time as mosquito repellents.

Conclusion

This documentation provides the basis for further studies in developing new, effective, safe and affordable plant-derived mosquito repellents especially for Africa where malaria is highly prevalent. The study also plays a part in documenting and conserving traditional knowledge of mosquito repellent plants for future use.     

Documentation and quantitative analysis of the local knowledge on medicinal plants among traditional Siddha healers in Virudhunagar district of Tamil Nadu, India

Ethnopharmacological relevance

India has a population with high degree of medical pluralism. Siddha system of Indian traditional medicine is practiced dominantly by the people in Tamil Nadu. The traditionally trained Siddha healers still play an important role in the rural health care. Their knowledge is comparatively more vulnerable than the documented traditional knowledge. Thus, the present study was aimed to document and quantitatively analyze the local knowledge of the traditional Siddha healers in Virudhunagar district of Tamil Nadu, India.

Materials and methods

The results presented in this paper are the outcome of series of interviews conducted between January and August, 2010 consisting of 196 field days. After getting prior informed consent, interviews were conducted and successive free-listing was used in the interviews in order to make informants cite the medicinal plants that they have used. By this way 96 healers were interviewed and their data were quantitatively analyzed using various indices such as Informant Consensus Factor (F_ic), Fidelity Level (FL), Informant Agreement on Remedies (IAR) and Cultural Importance Index (CII).

Results

This study recorded the ethno-medicinal usage of 227 species which were used to prepare 611 formulations for the treatment of 36 illness categories. The knowledge holders had the experience of minimum 20 years. There was unevenness in male-female ratio. Regarding the medicinal plants, easily available plants were holding significantly high number of citations, IAR and CII values. Nine illness categories had a high F_ic value, compared to others. Species with high citations in these groups were Moringa oleifera (aphrodisiacs), Acalypha indica (dermatological ailments), Dodonaea viscosa (musculo-skeletal disorders), Solanum trilobatum (pulmonary ailments), Phyllanthus amarus (jaundice), Piper nigrum (adjuvant) Allium cepa (hemorrhoids), Azadirachta indica (antiseptic) and Tribulus terrestris (urinary ailments).

Conclusion

Quantitative analysis of the data had revealed that the easily available species hold a high consensus and cultural importance. Future biomedical studies using the medicinal plants enumerated in this study, particularly those with high number of citations and high F_ic values might yield some novel prototypes. Such studies will also be useful to assess the efficacy and safety of these herbal treatments to take decisions on the health care of rural India.     

北京市海淀区奥运相关餐饮业食源性致病菌监测结果分析

目的掌握北京市海淀区奥运相关餐饮业卫生状况,为卫生行政部门制定相应监督、监测方案提供依据。方法2007年对海淀区110家奥运相关餐饮单位卫生状况进行监测,依据GB 14934-94等国标方法检测,统计用卡方检验。结果海淀区餐饮业抽检样品合格率为79.25%,高于北京市平均水平（72.53%）,差异有统计学意义（χ^2=28.57,P〈0.05）。海淀区几种样品中,凉拌菜、鲜榨果汁果盘、爆炒炝拌菜及熟肉合格率较低,分别为66.01%、57.45%、67.31%、72.64%。153件凉拌菜中48件检出大肠菌群,1件检出致病性大肠杆菌,13件检出变形杆菌。106件熟肉样品中,27件检出致病性大肠杆菌,1件检出亚硝酸盐,8件检出变形杆菌。海淀区奥运场馆餐饮业抽检合格率为76.30%,低于北京市奥运场馆平均水平（96.23%）,差异有统计学意义（χ^2=10.20,P〈0.05）。海淀区奥运场馆、签约宾馆周边餐饮业中抽检合格率为75.48%,明显高于北京市平均水平（67.20%）。海淀区集中配送营养餐企业抽检合格率100.00%。海淀区量化分级A、B级单位餐饮抽检合格率为85.40%,主要问题是大肠菌群超标。结论海淀区餐饮业总体卫生情况好于北京市的平均水平,但是凉拌菜等几种食品的卫生状况有待提高,宾馆、场馆周边餐饮企业总体水平需要加强。     

新鲜羊膜与生物羊膜移植治疗早期眼烧伤的临床观察

目的 观察新鲜羊膜与生物羊膜移植术治疗早期眼烧伤的临床效果.方法 收集2006年1月～2007年3月于本院眼科诊治的眼表烧伤病例19例(19只眼),分为两组新鲜移植治疗组和生物羊膜移植治疗组,术后随访3～18个月.结果 19眼术后移植片全部存活,角膜上皮愈合良好,未发现无排斥反应和继发感染,未见新生血管形成及睑球粘连,视力较术前均有不同程度提高.结论 新鲜羊膜与生物羊膜均可重建眼表,治疗眼表烧伤,二者对于眼表烧伤重建效果间无显著性差异.