高尿酸血症的治疗及微生态方面治疗的相关进展

近年,高尿酸血症(Hyperuricemin)发病率快速增加,发病年龄年轻化趋势愈加明显,临床表现更为严重,还有部分患者因高尿酸血症症状严重,并用药物多,以致不能耐受现有治疗,病情得不到有效控制,最终发展成为难治性痛风。因此,     

Multidrug-resistant tuberculosis treatment outcomes in Karakalpakstan, Uzbekistan: treatment complexity and XDR-TB among treatment failures

Background

A pilot programme to treat multidrug-resistant TB (MDR-TB) was implemented in Karakalpakstan, Uzbekistan in 2003. This region has particularly high levels of MDR-TB, with 13% and 40% among new and previously treated cases, respectively.

Methodology

This study describes the treatment process and outcomes for the first cohort of patients enrolled in the programme, between October 2003 and January 2005. Confirmed MDR-TB cases were treated with an individualised, second-line drug regimen based on drug susceptibility test results, while suspected MDR-TB cases were treated with a standardised regimen pending susceptibility results.

Principal Findings

Of 108 MDR-TB patients, 87 were started on treatment during the study period. Of these, 33 (38%) were infected with strains resistant to at least one second-line drug at baseline, but none had initial ofloxacin resistance. Treatment was successful for 54 (62%) patients, with 13 (15%) dying during treatment, 12 (14%) defaulting and 8 (8%) failing treatment. Poor clinical condition and baseline second-line resistance contributed to treatment failure or death. Treatment regimens were changed in 71 (82%) patients due to severe adverse events or drug resistance. Adverse events were most commonly attributed to cycloserine, ethionamide and p-aminosalicylic acid. Extensively drug resistant TB (XDR-TB) was found among 4 of the 6 patients who failed treatment and were still alive in November 2006.

Conclusions

While acceptable treatment success was achieved, the complexity of treatment and the development of XDR-TB among treatment failures are important issues to be addressed when considering scaling up MDR-TB treatment.     

Feasibility of using constructed wetland treatment for molasses wastewater treatment

The surface flow constructed wetland (SFCW) with Cyperus involucratus, Typha augustifolia and Thalia dealbata J. Fraser was applied to treat anaerobic treated-molasses wastewater (An-MWW) under the organic loading rates (OLRs) of 612, 696, 806, 929 and 1,213 kg BOD(5)ha(-1)day(-1). The results showed that both removal efficiency and plant growth rate were increased with the decrease of organic loading rate (OLR). All tested-plant species could not grow under OLR of higher than 696 kg BOD(5)mg l(-1) (p>0.05). Also, the plant-biomass of the systems was reduced by 10.4%, 26.5%, and 64.7% of initial plant-biomass under the OLR of 806, 929 and 1,213 kg BOD(5)ha(-1)day(-1), respectively. However, all tested-plant species showed the same pattern on the plant-biomass production yield and removal efficiency. The highest SS, BOD, COD, total phosphorus, NH(4)(+), NO(3)(-) and molasses pigments (MP) removal efficiencies of 90-93%, 88-89%, 67%, 70-76%, 77-82%, 94-95% and 72-77%, respectively were detected under the OLR of 612 kg BOD(5)ha(-1)day.     

Insulinoma--diagnosis and treatment

Insulinomas are the most common functioning endocrine tumors of pancreas. Approximately 10% are multiple, less than 10% can be malignant and 5-10% associated with the MEN-1 syndrome. Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism. The aim of this lecture is to present the up-to-date information concerning the prevalence, diagnosis and treatment of insulinoma.