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1含左氧氟沙星三联疗法联合益生菌根除幽门螺杆菌的补救治疗显示文摘背景:近年来,细菌耐药性的出现导致幽门螺杆菌(Hp)根除率逐渐降低,首次根除失败后,再次根除失败的可能性较大,因此补救治疗方案的选择尤为重要。目的:探讨含左氧氟沙星三联疗法联合益生菌根除Hp的补救治疗疗效。方法:192例经标准三联疗法根除Hp失败的患者随机分为四组,A组:兰索拉唑片30 mg+阿莫西林胶囊1 000 mg+左氧氟沙星片200 mg,bid,疗程14 d;B组:A组治疗方案基础上加用枸橼酸铋钾片600 mg,bid,疗程14 d;C组:双歧杆菌乳杆菌三联活菌片2 000 mg,tid,服用14 d后给予A组治疗方案,疗程14 d;D组:A组治疗方案基础上加用双歧杆菌乳杆菌三联活菌片2 000 mg,tid,疗程14 d。疗程结束4周后复查^(13)C-尿素呼气试验评估根除疗效。治疗期间记录患者不良反应发生情况。结果:177例(92.2%)患者按方案完成治疗,A、B、C、D组治疗完成率分别为87.5%(42/48)、83.3%(40/48)、97.9%(47/48)和100%,C、D组显著高于A、B组(P<0.05)。A、B、C、D组按意向治疗(ITT)根除率分别为60.4%、68.8%、81.3%和83.3%,C、D组显著高于A组(χ~2=5.042,P=0.045;χ~2=6.235,P=0.013);按方案(PP)根除率分别为69.0%、82.5%、83.0%和83.3%,组间差异无统计学意义(P>0.05)。不良反应包括便秘、味觉异常、腹胀、厌食等。A、B、C、D组的不良反应发生率分别为79.2%、95.8%、29.2%和22.9%,C、D组显著低于A、B组(P<0.05)。结论:含左氧氟沙星三联疗法联合双歧杆菌乳杆菌三联活菌可显著降低传统三联和四联根除疗法的胃肠道不良反应,提高患者依从性,从而提高根除Hp补救治疗的疗效。彭卫斌 容海鹰 沙卫红 聂玉强 朱雅丽 张明 2016胃肠病学2016,21,4:12
2Trends and predictions for gastric cancer mortality in Brazil显示文摘AIM: To analyze the effect of age-period and birth cohort on gastric cancer mortality, in Brazil and across its five geographic regions, by sex, in the population over 20 years of age, as well as make projections for the period 2010-2029.METHODS: An ecological study is presented herein,which distributed gastric cancer-related deaths in Brazil and its geographic regions. The effects of ageperiod and birth cohort were calculated by the Poisson regression model and projections were made with the age-period-cohort model in the statistical program R. RESULTS: Progressive reduction of mortality rates was observed in the 1980's, and then higher and lower mortality rates were verified in the 2000's, for both sexes, in Brazil and for the South, Southeast and Midwest regions. A progressive decrease in mortality rates was observed for the Northeast(both sexes) and North(men only) regions within the period 1995-1999, followed by rising rates. CONCLUSION: Regional differences were demonstrated in the mortality rates for gastric cancer in Brazil, and the least developed regions of the country will present increases in projected mortality rates.Angela Carolina Brandao de Souza Giusti Pétala Tuani Candido de Oliveira Salvador Juliano dos Santos Karina Cardoso Meira Amanda Rodrigues Camacho Raphael Mendonca Guimaraes Dyego LB Souza 2016World Journal of Gastroenterology2016,22,28:0
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