Promotion strategies for environmentally friendly packaging: a stochastic differential game perspective.

With the evolution of the e-commerce and express delivery industry, the consumption of packaging materials is increasing rapidly. Many members of society encourage using environmentally friendly packaging. However, due to the attitude-behavior gap, i.e., expressing concerns about environmental issues does not necessarily lead to green consumption, promoting the use of green packaging remains a challenge. This paper considers a stochastic differential game between green packaging manufacturers and e-commerce platforms. The optimal promotion strategies are derived for scenarios involving cooperation as well as non-cooperation. In addition, a welfare allocation mechanism for attaining stable cooperation is also discussed under the bargaining model. Numerical simulations and a sensitivity analysis were conducted to demonstrate the results. This paper finds that the cooperation between manufacturers and platforms can expand the actual market demand and promote the consumption of green packaging. The proposed model provides an effective tool for manufacturers and platforms to devise optimal strategies for promoting the use of green packaging.

On the diagnosis and treatment of cutaneous and soft tissue tumours misdiagnosed as scars: Lessons from four cases.

Some types of skin and soft tissue tumours may be misdiagnosed as scars because of the scar-like manifestation or the history of injury. It is generally believed that injuries will activate wound healing, ultimately ending in fibrosis. Because of the tumour-promoting properties of both the microenvironment of the wound and the wound-healing process that may go awry, there is a likelihood that injuries may trigger tumour growth. From 2012 to 2016, we treated four patients who underwent unsuccessful treatments because of the misdiagnosis of scars or keloids. Upon the pathological diagnoses of skin and soft tissue tumours in the four cases, extended resection of the tumours was performed. Recurrence was not observed up to the last follow up. Since then, soft tissue tumours have much greater visibility and are considered during diagnosis if a wound is presented with the atypical appearance of scar after injuries. Under these circumstances, biopsy should be conducted.

[Therapeutic outcomes and influence factors of maximal orbital decompression in the treatment of severe dysthyroid optic neuropathy].

Objective: To evaluate the effectiveness of maximal orbital decompression in treatment for severe dysthyroid optic neuropathy (DON) of thyroid associated ophthalmopathy (TAO) and predictive factors of this therapy. Methods: The group consisted of 21 patients (30 eyes) with DON. The diagnosis was based on the following criteria: Deterioration of best corrected visual acuity (VA≤0.1), enlargement of extraocular muscles and sign of apical crowding in CT imaging, loss of colour vision. EXCLUSION CRITERIA: VA of DON>0.1 or other diseases with visual function damage. Maximal 3-wall orbital decompression was undergone. Clinical outcomes were recorded and assessed including pre- and postoperative VA, age, clinical activity score (CAS), thyroid hormonal status and duration of DON. The pre- and postoperative VA were compared by Wlicoxon signed rank analysis. The relationships between the change of VA and age(<50 years vs ≥50 years), thyroid hormonal status(hyperthyroidism vs hypothyroidism), CAS(<3 vs ≥3), duration (<3 months vs ≥3 months), pre-VA(<0.01 vs ≥0.01) were made statistically by Mann-Whitney U-test, rank correlation analysis,and Logistic regression analysis. Results: Thirty eyes of 21 patients (11 male, 10 female) were included in this study. Hyperthyroidism was recorded in 13 cases, the other 8 cases with hypothyroidism. The average age at the time of diagnosis was 52.9 years (range, 33.0-71.0 years). The median of the duration of DON was 4.5 months (range, 1.0-12.0 months). Twenty-eight eyes (28/30, 93%) showed improvement of visual acuity after surgery (Z=-4.62, P=0.000). There was positive correlation between pre- and postoperative VA(r=0.38, P<0.05 ). Patients with VA of 0.01 or better had better postoperative VA than those with poorer VA (0.10 vs 0.50, Z=-2.09, P=0.037). There was negative correlation between the duration and degree of improvement of postoperative VA (r=-0.44, P<0.05). Other factors such as age, thyroid hormonal status, CAS were not statistical factors for postoperative VA (Z=-1.83--0.97, P>0.05 ) and improvement of postoperative VA (Z=-1.80--0.82, P>0.05). Conclusions: Maximal orbital decompression is safe and effective for management of visual damage in severe DON in this small sample study. Preoperative VA and duration of DON were important predictive factors for surgical outcome. Earlier diagnosis and treatment are possibly useful for improvement of prognosis of DON but large sample data are needed.(Chin J Ophthalmol, 2017, 53:416-423).

[The importance for improving the cure rate of lacrimal gland benign pleomorphic adenoma].

The pleomorphic adenoma was the most common epithelial tumor of the lacrimal gland. The 2 major factors determining the prognosis of pleophormic adenoma of lacrimal gland were likelihood of recurrence and evidence of malignant transformation. Management of the recurrent pleomorphic adenoma was difficult. Moreover, the malignant transformation was danger for life. The reason for orbital recurrent involved many factors, but the main reasons may be related to correct preoperative judgment of the nature of the tumor, taking the appropriate surgical approach and operative techniques. Long-term follow-up was available for the patient. It could help doctors detect recurrence of tumor earlier and treat it timely. (Chin J Ophthalmol, 2016, 52: 241-243).

Emergency stent-graft implantation for iatrogenic peripheral arterial rupture.

PURPOSE: We evaluated the experience with and efficacy of stent-grafting for iatrogenic peripheral arterial ruptures. MATERIALS AND METHODS: From 2005 to 2009 we performed stent-grafting on four male patients (age 38-67 years) with iatrogenic peripheral arterial ruptures. In patient 1, grointissue necrosis followed a subcutaneous injection and led to femoral arterial rupture. Pseudoaneurysms ruptured in patients 2 and 3 who were undergoing femoral arteriotomy. Patient 1 experienced a ruptured carotid artery during neck surgery. Shock occurred in three of the four patients. Four patients underwent self-expanding stent-grafting (8 mm×60 mm or 8 mm×80 mm) under local anaesthesia. RESULTS: Haemorrhages were controlled in all patients. No procedure-related complications occurred. Patient 1 died of lung metastases 13 months after stent-grafting. Follow-up examinations showed that the stent-graft remained patent in patients 1, 2 and 4, whereas stent occlusion occurred after 15 months in patient 3; in this case, a pseudoaneurysm proximal to the stent was identified, and although repeat stent-grafting successfully stopped the bleeding, the patient died of multiple organ failure 1 week later. CONCLUSIONS: Emergency stent-grafting is a technically feasible and therapeutically effective modality for treating high-risk patients who experience iatrogenic peripheral arterial ruptures. The efficient treatment of hypotension and early endovascular intervention will improve the prognosis.

Mental health risks in the local workforce engaged in disaster relief and reconstruction.

To build a sustainable workforce for long-term disaster relief and reconstruction, more effort must be made to promote local relief workers' mental health. We conducted 25 semistructured interviews with local relief officials 10 months after the 2008 earthquake in China to investigate the stress and coping experiences in their personal lives as survivors. We conducted thematic analysis of interview transcripts. Traumatic bereavement and grief, housing and financial difficulties, and work-family conflict were the three main sources of stress in the respondents' personal lives. The coping themes were finding meaning and purpose in life through relief work, colleagues' support and understanding, suppression or avoidance of grief, appreciation for life, hardiness, optimism, letting nature take its course, and making up for loss. We suggest that relief work has a double-edged-sword effect on workers' coping abilities. We discuss the implications of this effect for work-life balance measures and trauma and grief counseling services.

[Development and challenges of tobacco epidemic surveillance in China].

Tobacco use is the leading preventable risk factor causing the global burden of disease and one of China's most significant public health issues. Continuous and dynamic tobacco monitoring can provide critical index data for developing tobacco control strategies and measures and evaluating the impact of tobacco control. The WHO has incorporated monitoring programs into the crucial content of tobacco control and put forward relevant compliance requirements in the Framework Convention on Tobacco Control (FCTC). The Chinese government has actively promoted tobacco control significantly since the entry into force of the FCTC in China and continuously strengthened tobacco monitoring. In 2021, China's tobacco monitoring was honored to have reached the highest level required by the WHO. This study introduces the sampling design of tobacco surveys, monitoring content, the definition of key indicators and data weighting based on a complex sampling design, analyzing the challenges facing in the current setting, and provides a reference for the understanding and utilization of the data, the comparison of the results, and the future development of tobacco monitoring. The surveys involved in this study will focus on the specialized epidemiological surveys of tobacco for adults and adolescents carried out nationwide.

[Analysis of exposure to tobacco advertisement and promotion among Chinese adults aged 15 years and above, 2010 and 2018].

Objective: To investigate the exposure to tobacco advertisements and promotions among Chinese adults aged 15 and above, identify the publicity channels and forms of tobacco advertising and promotion in 2010 and 2018, and implicate further tobacco control measures in China. Methods: A multistage, stratified, randomized cluster sampling design was used in 2010 and 2018 China Adult Tobacco Survey, with national representativeness. 13 354 and 19 376 permanent residents were selected in the 2010 and 2018 surveys. SAS 9.4 software was applied for data analysis, and all the data were weighted based on a complex sampling design. Rao Scott χ2 test was used for group comparison of a single factor. Results: In 2010 and 2018, 19.61% and 18.14% of the survey respondents did see tobacco advertising and promotion. From 2010 to 2018, there was no significant change in the situation of tobacco advertisements and promotions. Among those who had gone to a cigarette shop, the proportion of seeing tobacco advertisements increased from 29.28% in 2010 to 43.28% in 2018. Among those who had seen tobacco advertisements on TV, the rate fell from 50.93% in 2010 to 28.58% in 2018. Among those who had gone to movie theaters, the proportion of seeing tobacco advertisements increased from 2.17% in 2010 to 9.89% in 2018. Among those who had used the Internet, the proportion of seeing tobacco advertisements online rose from 19.20% in 2010 to 42.30% in 2018. In terms of tobacco promotion, the percentages of people who had seen tobacco promotions, cigarette price discounts, cigarette discount coupons, gifts, and other preferential activities in various places in the past 30 days were 4.99% vs. 9.30%, 0.78% vs. 4.09%, 0.04% vs. 0.33% and 0.98% vs. 3.33% in 2010 and 2018, respectively (P<0.001). Conclusions: Tobacco advertising and promotion are still prevalent in China, with no significant change in 2010 and 2018. Tobacco advertising and promotion have been with the constant changes and development of media platforms. It is necessary to improve the implementation of relevant policies, comprehensively ban tobacco advertisements and promotions, and strengthen the supervision of ads and promotions.

[Smoking relapse rate and influencing factors in smokers aged 15 years and above in China].

Objective: To describe the relapse status of smokers aged ≥15 years in China, and investigate the main factors influencing their relapse behavior. Methods: The data of this study cames from the 2018 China Adult Tobacco Survey, covering 400 committees or villages in 200 districts or counties in 31 provinces (autonomous regions and municipalities) of China. The relevant data of smoking and relapsing in residents aged ≥15 years were collected by face-to-face interview. Software SAS 9.4 was used to clean and analyze the data, and logistic regression model was used to analyze the influencing factors for relapse rate. Results: A total of 19 376 questionnaires were completed, with a response rate of 91.50%. In 2018, 66.05% of smokers aged ≥15 years in China had smoking relapse, in whom 66.59% were males and 55.79% were females. In all age groups, the age group 15-24 years had the highest smoking relapse rate (82.63%). Multivariate analysis showed that the younger age 15-24 years (OR=4.618,95%CI:1.981-10.763), e-cigarette use (OR=9.782,95%CI:3.139-30.490), and tobacco advertising, promotion and sponsorship in the past 30 days (OR=1.710,95%CI:1.291-2.265) were associated with higher smoking relapse rate. Compared with people who were allowed smoking at home or those without smoking limit, the smoking relapse rate in people who were not allowed to smoke at home (OR=0.562, 95%CI: 0.439-0.719) or those with smoking limit (OR=0.487, 95%CI: 0.366-0.647) was lower. Conclusion: The smoking relapse rate in Chinese smokers is high, especially in young people. It is suggested to conduct targeted intervention based on the results of this study to reduce the smoking relapse rate and help achieve the smoking control goal in Healthy China 2030.

[Studies on efficacy of a bioabsorbable steroid-eluting sinus stent in the frontal sinus opening of chronic rhinosinusitis with nasal polyps].

Objective: To assess the efficacy of a bioabsorbable steroid-eluting sinus stent in improving surgical outcomes when placed in the frontal sinus ostium (FSO) following full endoscopic sinus surgery (ESS) in patients with whole group chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Patients with whole group CRSwNP who had similar lesions on bilateral sinus between September 2019 and March 2020 in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Changhai Hospital were chosen. Patients with CRSwNP who underwent extended ESS were randomly assigned to receive a steroid-eluting sinus stent in one FSO whereas the contralateral side received surgery alone. Endoscopic evaluations recorded at 30, 90 days postoperative were graded by an independent assessment panel to assess the need for interventions in the FSO. Semi-quantitative data with CT and endoscopic score were performed by rank sum test. The need for postoperative intervention and the patency rate of FSO were analyzed using the McNemar test. Results: Thirty-one patients with whole group CRSwNP met all eligible criteria, including 17 males and 14 females, with the age of (44.5±11.8) years(x¯±s). Stents were successfully placed in one FSO of all patients. At 30 days post-ESS, the assessment panel reported that steroid-eluting stents reduced the need for postoperative interventions by 41.0% (χ2=5.314,P=0.021), the need for oral steroid interventions by 40.0% (χ2=4.133,P=0.042) and the need for surgical interventions by 74.8% (χ2=4.292,P=0.038) compared to control sinuses with no stents. Clinical surgeons also reported greater diameter of FSO compared to control sinuses at 30 days post-ESS (74.2% vs 48.4%, χ2=4.351, P=0.037). These results at 90 days post-ESS were consistent with those at 30 days post-ESS. Conclusion: Bioabsorbable steroid-eluting sinus stents in the FSO can reduce polyp formation, adhesion, and the need for postoperative interventions in FSO of CRSwNP patients and improve the early postoperative outcomes.

[Implementation of Beijing Tobacco Control Regulation in restaurants in Dongcheng and Chaoyang districts of Beijing, 2018].

Objective: To evaluate the implementation effect of the Beijing Tobacco Control Regulation. Methods: An observational study was conducted in a multi-stage randomly selected sample of 93 restaurants in Dongcheng and Chaoyang districts, Beijing. Undercover visits to the restaurants were paid by investigators at lunch or dinner time. The incidence of smoking behavior and the posters of no-smoking signs were observed, waiters were interviewed about awareness of the regulation, and comparisons with the baseline data of 6 months before and 1 month after regulation implementation were made. Results: The pasting rate of no-smoking signs was 76.3%. The awareness of the regulation in the waiters surveyed was high. The incidence rate of smoking in restaurants (29.0%) was lower than that before the regulation implementation (36.7%), but it was significantly higher than that one month after regulation implementation (14.8%). No active interventions from the restaurant staff were observed when smoking occurred. The incidence of smoking in restaurants within commercial buildings (3.3%) was significantly lower than that in non-commercial buildings (41.3%), the difference was significant (P<0.05). Conclusions: The effect of the regulation weakened 3 years after implementation compared with that in 1 month after the implementation. The enforcement degree of the regulation was conflicted with pasting rate of no-smoking signs and the regulation awareness level in waiters in restaurants in Dongcheng and Chaoyang districts.

Efficacy of a quadruple therapy regimen for Helicobacter pylori eradication after partial gastrectomy.

We aimed to evaluate the effectiveness and safety of bismuth-containing quadruple therapy plus postural change after dosing for Helicobacter pylori eradication in gastrectomized patients. We compared 76 gastric stump patients with H. pylori infection (GS group) with 50 non-gastrectomized H. pylori-positive patients who met the treatment indication (controls). The GS group was divided into GS group 1 and GS group 2. All groups were administered bismuth potassium citrate (220 mg), esomeprazole (20 mg), amoxicillin (1.0 g), and furazolidone (100 mg) twice daily for 14 days. GS group 1 maintained a left lateral horizontal position for 30 min after dosing. H. pylori was detected using rapid urease testing and histologic examination of gastric mucosa before and 3 months after therapy. Mucosal histologic manifestations were evaluated using visual analog scales of the updated Sydney System. GS group 1 had a higher prevalence of eradication than the GS group 2 (intention-to-treat [ITT]: P=0.025; per-protocol [PP]: P=0.030), and the control group had a similar prevalence. GS group 2 had a lower prevalence of eradication than controls (ITT: P=0.006; PP: P=0.626). Scores for chronic inflammation and activity declined significantly (P<0.001) 3 months after treatment, whereas those for atrophy and intestinal metaplasia showed no significant change. Prevalence of adverse reactions was similar among groups during therapy (P=0.939). A bismuth-containing quadruple therapy regimen plus postural change after dosing appears to be a relatively safe, effective, economical, and practical method for H. pylori eradication in gastrectomized patients.

A smoking cessation intervention among tuberculosis patients in rural China.

OBJECTIVE: To assess the integration of a smoking cessation intervention into routine tuberculosis (TB) services. METHOD: Consecutive TB patients registered from 1 March to 31 August 2010 were enrolled in an intervention for self-reported smoking to promote tobacco cessation during treatment for TB. Information on the harmful health effects of tobacco smoke and smoking and TB were provided to TB patients who self-reported as current smokers. Smoking status was reassessed at every follow-up visit during anti-tuberculosis treatment with reinforced health messages and advice to quit. RESULTS: Of 800 TB patients enrolled, 572 (71.5%) were male and 244 (30.5%) were current smokers. Females were more likely to be non-smokers (100% vs. 35.8%, P < 0.001). Of the 244 current smokers, 144 (59.0%) started smoking at <20 years, 197 (80.7%) consumed ⩾20 cigarettes per day, 211 (86.5%) had perceived smoking dependence and 199 (81.6%) had made no attempt to quit before the diagnosis of TB. Of the 244 current smokers, 234 (95.9%) were willing to quit, and 156 (66.7%) reported abstinence at month 6. Challenges to implementing smoking cessation intervention were identified. CONCLUSION: The majority of current smokers among TB patients were willing to quit and remained abstinent at the end of anti-tuberculosis treatment. This intervention should be scaled up nationwide.

Objectif : Evaluer la possibilité d'intégrer une intervention d'arrêt du tabac dans les services de routine de la tuberculose (TB).Méthode : Les patients tuberculeux consécutifs inscrits entre le 1e mars et le 31 août 2010 ont été enrôlés dans une intervention visant à promouvoir l'arrêt du tabac chez ceux qui disaient fumer pendant le traitement de leur TB. Des informations sur les effets sanitaires dangereux de la fumée de tabac et sur le fait de fumer en étant tuberculeux ont été fournies aux patients qui se sont dit fumeurs actuels. Le statut en matière de tabac a été réévalué à chaque visite de suivi pendant le traitement antituberculeux avec des messages sanitaires renforcés et des conseils visant à l'arrêt.Résultats : Sur 800 patients TB enrôlés, 572 (71,5%) étaient des hommes et 244 (30,5%) étaient des fumeurs actuels. Les femmes étaient plus souvent non fumeuses (100% contre 35,8% ; P < 0,001). Des 244 fumeurs actuels, 144 (59,0%) avaient commencé à fumer avant 20 ans, 197 (80,7%) consommaient ⩾20 cigarettes par jour, 211 (86,5%) étaient conscients de leur dépendance au tabac et 199 (81,6%) n'avaient jamais essayé d'arrêter avant le diagnostic de TB. Des 244 fumeurs actuels, 234 (95,9%) voulaient arrêter et 156 (66,7%) ont déclaré être toujours abstinents à 6 mois. Les défis à la mise en œuvre d'une intervention d'arrêt du tabac ont été identifiés.Conclusion : La majorité des fumeurs actuels parmi les patients TB voulaient arrêter et sont restés abstinents à la fin du traitement antituberculeux. Cette intervention devrait être étendue au pays tout entier.

Objetivo: Evaluar la utilidad de la integración de las intervenciones de promoción del abandono del tabaquismo en los servicios ordinarios de atención de la tuberculosis (TB).Métodos: Se inscribieron de manera consecutiva los pacientes con diagnóstico de TB y tabaquismo actual del 1° de marzo al 31 de agosto del 2010 en una intervención cuyo objeto era a promover el abandono del hábito tabáquico durante el tratamiento antituberculoso. Se suministró información acerca de los efectos deletéreos del humo del tabaco sobre la salud y de la asociación del tabaquismo y la TB a los pacientes que autorrefirieron un tabaquismo actual. En cada consulta de seguimiento durante el tratamiento se evaluó de nuevo la situación frente al tabaco, se reforzaron los mensajes sobre la salud y se reiteró el consejo de abandonar el hábito.Resultados: De los 800 pacientes con TB inscritos, 572 fueron de sexo masculino (71,5%) y 244 eran fumadores actuales (30,5%). Las mujeres fueron con mayor frecuencia no fumadoras (100% contra 35,8%; P < 0,001). De los 244 fumadores actuales, 144 habían comenzado a fumar antes de los 20 años de edad (59,0%), 197 consumían ⩾20 cigarrillos por día (80,7%), 211 habían percibido la dependencia al tabaquismo (86,5%) y 199 nunca habían intentado abandonar el hábito antes del diagnóstico de TB (81,6%). De los 244 fumadores actuales, 234 estaban dispuestos a abandonar el tabaco (95,9%) y 156 notificaron abstinencia al sexto mes (66,7%). Se pusieron de manifiesto obstáculos a la aplicación de la intervención en favor del abandono del tabaquismo.Conclusión: En su mayoría, los fumadores actuales entre los pacientes con diagnóstico reciente de TB estaban dispuestos a abandonar el tabaquismo y cumplieron con la abstinencia hasta el final del tratamiento antituberculoso. Se debería ampliar la aplicación de esta intervención a escala nacional.

Two-year weight-loss maintenance in primary care-based Diabetes Prevention Program lifestyle interventions.

OBJECTIVE: To investigate whether the effects on weight loss and cardiometabolic risk factor reduction of two technology-mediated lifestyle interventions for 15 months in a primary care-based translation trial sustained at 24 months (that is, 9 months after the end of intervention). DESIGN: This study analyzed data from an extended follow-up of participants in the original 'E-LITE' (Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care)-randomized controlled trial, which demonstrated the effectiveness of two adapted Diabetes Prevention Program (DPP) lifestyle interventions compared with usual primary care. SUBJECTS: E-LITE randomized 241 overweight or obese participants with pre-diabetes and/or metabolic syndrome to receive usual care alone (n=81) or usual care plus a coach-led (n=79) or self-directed intervention (n=81). The interventions provided coach-led group behavioral weight-loss treatment or a take-home, self-directed DVD using the same 12-week curriculum, followed by 12 additional months of technology-mediated coach contact and self-monitoring support. Participants received no further intervention after month 15. A blinded assessor conducted 24-month visits by following the measurement protocols of the original trial. Measurements include weight and cardiometabolic risk factors (waist circumference, fasting plasma glucose, resting blood pressure, triglycerides, high- and low-density lipoprotein cholesterol, total cholesterol and triglyceride to high-density lipoprotein cholesterol ratio). RESULTS: At month 24, mean±s.e. changes in body mass index (trial primary outcome) and weight (kg) from baseline were -1.9±0.3 (P=0.001) and -5.4±0.9 (P<0.001) in the coach-led intervention, and -1.6±0.3 (P=0.03) and -4.5±0.9 (P=0.001) in the self-directed intervention, compared with -0.9±0.3 and 2.4±0.9 in the usual care group. In addition, both interventions led to a greater percentage of participants maintaining 7% weight loss and sustained improvements in waist circumference and fasting plasma glucose levels than usual care. CONCLUSION: This study shows sustained benefits of the two primary care-based, technology-mediated DPP lifestyle interventions. The findings warrant replication in long-term studies involving diverse populations.

Efficacy of electrical stimulation for spinal fusion: a meta-analysis of fusion rate.

BACKGROUND CONTEXT: Many clinical studies have demonstrated the effectiveness of electrical stimulation as an adjunct to spinal arthrodesis. However, there is a paucity of comparative data among different electrical stimulation techniques. PURPOSE: To compare the efficacy of three electrical stimulation methods for spinal fusion based on the literature review. SAMPLE: Twenty-one articles, meeting all the inclusion criteria, were selected. A total of 1,381 patients were evaluated. STUDY DESIGN: Systematic literature review and meta-analysis. OUTCOME MEASURES: Fusion rates were determined using radiography or computed tomography. METHODS: A systematic literature review was conducted on spinal fusion surgeries with the aid of electrical stimulation devices. Only studies applying radiography or computed tomography for fusion assessment were included. Study groups were divided based on electrical stimulation types and were further grouped by other patient characteristics. Pooled estimates and 95% confidence intervals (CIs) were calculated by random-effects meta-analysis. RESULTS: The pooled fusion rate for all studies was 85% (95% CI, 79-90). There were 14 direct current, 1 capacitive coupling (CC), and 10 inductive coupling studies in our analysis, with combined fusion rate of 85% (95% CI, 76-91), 90% (95% CI, 83-95), and 85% (95% CI, 74-93), respectively. There were no statistically significant differences among the three electrical stimulation methods. Further subgroup analysis suggested that age, sex, smoking status, surgery type, fusion levels, fusion column, implant use, and graft type did not significantly influence the fusion rate. CONCLUSIONS: The three types of electrical stimulation devices had similar clinical efficacy in promoting bone growth for spinal fusion. The results for CC stimulation should be applied with caution as only one relevant study was identified.

Efficacy of a quadruple therapy regimen for Helicobacter pylori eradication after partial gastrectomy

We aimed to evaluate the effectiveness and safety of bismuth-containing quadruple therapy plus postural change after dosing for Helicobacter pylori eradication in gastrectomized patients. We compared 76 gastric stump patients with H. pylori infection (GS group) with 50 non-gastrectomized H. pylori-positive patients who met the treatment indication (controls). The GS group was divided into GS group 1 and GS group 2. All groups were administered bismuth potassium citrate (220 mg), esomeprazole (20 mg), amoxicillin (1.0 g), and furazolidone (100 mg) twice daily for 14 days. GS group 1 maintained a left lateral horizontal position for 30 min after dosing. H. pylori was detected using rapid urease testing and histologic examination of gastric mucosa before and 3 months after therapy. Mucosal histologic manifestations were evaluated using visual analog scales of the updated Sydney System. GS group 1 had a higher prevalence of eradication than the GS group 2 (intention-to-treat [ITT]: P=0.025; per-protocol [PP]: P=0.030), and the control group had a similar prevalence. GS group 2 had a lower prevalence of eradication than controls (ITT: P=0.006; PP: P=0.626). Scores for chronic inflammation and activity declined significantly (P<0.001) 3 months after treatment, whereas those for atrophy and intestinal metaplasia showed no significant change. Prevalence of adverse reactions was similar among groups during therapy (P=0.939). A bismuth-containing quadruple therapy regimen plus postural change after dosing appears to be a relatively safe, effective, economical, and practical method for H. pylori eradication in gastrectomized patients.

Cryptosporidium.

This review discusses characteristics of the genus Cryptosporidium and addresses the pathogenesis, reservoirs, public health significance and current applications for the detection and typing of this important pathogen. By increasing knowledge in key areas of Cryptosporidium research such as aetiology, epidemiology, transmission and host interactions, the numbers of cases of human cryptosporidiosis should be reduced.

Zoonotic protozoa in the marine environment: a threat to aquatic mammals and public health.

This collection of abstracts provides an account of four presentations at the 19th International Conference of the World Association for the Advancement of Veterinary Parasitology (WAAVP)(held in New Orleans, LA, USA from 10­14 August 2003) in a symposium session on zoonotic protozoan parasites found in the marine environment and chaired by Ronald Fayer and David Lindsay.The focus was on three genera of parasites of veterinary and public health concern­Toxoplasma,Giardia, and Cryptosporidium with emphasis on their epidemiology in the marine environment.