山东省济南市历城区健康人群水痘-带状疱疹病毒抗体水平调查

目的 了解山东省济南市历城区健康人群水痘-带状疱疹病毒（VZV）抗体水平,掌握水痘易感人群,为今后水痘预防控制提供参考依据。方法 采用酶联免疫吸附试验（ELISA）检测血清中VZV-IgG抗体。结果 共调查547人,年龄最小17月龄,最大的85岁,平均年龄（22.9420.20）岁,VZV-IgG抗体阳性率为64.53%（353/547）。1～、4～、7～、10～、15～、20～、30～、40～、50岁及以上各年龄组抗体阳性率分别为26.74%、29.69%、59.78%、50.00%、73.68%、71.11%、95.16%、91.18%和97.18%,不同年龄组之间抗体阳性率差异有统计学意义（2=173.33,P0.05）,有随着年龄增加而升高的趋势。14岁及以下儿童水痘疫苗接种率为43.62%。2006-2013年,济南市历城区14岁及以下人群水痘年平均报告发病率较高,为322.82/10万,以后随着年龄增加而降低,与VZV-IgG抗体水平调查结果相符。水痘病例中,70.27%为14岁及以下人群,27.50%为15～29岁人群。结论 14岁及以下儿童为济南市历城区水痘的易感人群,今后应提高该人群水痘疫苗的接种率,以形成有效的免疫屏障,达到预防水痘的目的。同时,15岁及以上人群水痘发病有增加趋势,应引起重视。     

浙江省温州市儿童肺炎支原体流行特征分析

目的 分析浙江省温州市儿童肺炎支原体感染趋势及流行特征。 方法 采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测20 385例疑似肺炎支原体感染患儿血清肺炎支原体IgM抗体,并对结果进行回顾性分析。以每半个月为肺炎支原体流行监测的一个监测时间点,从2007年1月开始连续监测至2012年7月,通过肺炎支原体IgM抗体阳性率变化来分析肺炎支原体感染趋势及流行特征。 结果 2007年1月至2012年7月期间温州市儿童肺炎支原体感染分别在2007年1月上半月(阳性率55.17%)、2009年10月下半月(阳性率54.10%)出现高峰,在2007年12月下半月(阳性率12.24%)、2011年8月下半月(阳性率10.70%)出现低谷;2009年、2010年度内的大多数监测时间点其阳性率高于30%,特别是从2009年4月至2010年8月阳性率持续维持在30%以上;而2008、2011、2012年度内仅有若干个不连续的监测时间点其阳性率高于30%。2007年1月至2012年7月肺炎支原体IgM抗体总阳性率为28.82%;男、女性患儿阳性率分别为25.56%和34.33%,差异有统计学意义(χ2=178.39,Pχ2=390.93,P结论 血清肺炎支原体IgM抗体检测可作为肺炎支原体感染及流行监测指标;肺炎支原体IgM抗体阳性率超过50%或连续3个监测时间点阳性率超过30%可提示肺炎支原体暴发流行;温州地区在2007年初及2009-2010年曾暴发流行过肺炎支原体,预计在2013年或2014年将有可能再次暴发。     

2013-2015年广东省深圳市福田区3~18岁健康人群水痘-带状疱疹病毒抗体水平调查

目的 了解深圳市福田区3～18岁在校学生水痘抗体水平,探讨能否在1～12岁儿童中补充接种一剂次水痘疫苗。 方法 2013-2015年每年采集辖区幼儿园、小学、中学在校学生血清,用VZV-IgG 抗体试剂盒(ELISA)检测水痘抗体。 结果 共检测3044名学生,水痘抗体阳性率为62.81%,抗体几何平均浓度(GMC)为(668.45187.29)mIU/ml。6～岁组学生抗体阳性率(42.25%)和GMC(155.1766.25 mIU/ml)最低;接种疫苗后6~8年的学生抗体阳性率(47.20%)和GMC(227.6185.61 mIU/ml)最低;接种疫苗比不接种疫苗抗体阳性率和抗体水平均高,且差异有统计学意义(2=48.240,P=0.000;t=10.830, P=0.020);2006-2014年福田区水痘发病率为10.74/10万～53.51/10万,72.45%的病例为3～18岁在校学生。2010-2014年福田区共发生53起水痘暴发疫情,89.36%发生在小学1～4年级。 结论 接种一剂次疫苗后水痘抗体阳性率和抗体水平呈现先下降后上升趋势,6～岁组和在接种疫苗6年后的学生抗体阳性率和抗体水平最低,建议在做第二剂次水痘疫苗安全性研究的情况下将目前1～12岁儿童水痘疫苗改为两剂次接种。     

山东地区0～12岁儿童人巨细胞病毒抗体阳性特征分析

目的分析山东地区0~12岁儿童人巨细胞病毒抗体的阳性特征。方法收集2014年1月至2016年12月在山东大学附属省立医院门诊就诊和住院的儿童患者1 429例。用化学发光方法检测血清人巨细胞病毒IgG和IgM抗体。用SPSS21.0软件进行统计分析。结果巨细胞病毒IgG抗体和IgM抗体阳性率分别为89.36%和16.59%,男性巨细胞病毒IgG抗体阳性率为88.04%,明显低于女性的91.32%(P0.05)。男性巨细胞病毒IgM抗体阳性率为14.07%,明显低于女性的20.31%(P0.05)。巨细胞病毒IgG抗体阳性率以6~12个月年龄组最低(73.68%),0~6个月年龄组最高(92.73%);巨细胞病毒IgM抗体阳性率以4~12岁年龄组最低(10.26%),1~3岁年龄组最高(21.57%)。巨细胞病毒IgM抗体阳性率冬季最高为22.92%,秋季阳性率最低为11.11%,四个季节之间阳性率差异有统计学意义(P0.05)。共检出4种巨细胞病毒抗体项目组合模式,以巨细胞病毒IgG抗体阳性、巨细胞病毒IgM抗体双阴性模式最多见,占73.27%。结论山东地区0~12岁儿童人巨细胞病毒抗体的阳性率存在性别、年龄和季节差异,应加强对儿童人巨细胞病毒感染的防控。     

面神经炎与抗水痘-带状疱疹病毒抗体的相关性探讨

目的　通过比较面神经炎患者与正常对照之间的抗水痘 带状疱疹病毒抗体滴度的差异以及面神经炎患者在不同疾病阶段的抗水痘 带状疱疹病毒抗体滴度变化 ,探讨抗水痘 带状疱疹病毒抗体与面神经炎之间的关联。方法　用酶标记葡萄球菌A蛋白 (SPA)染色法对 11例面神经炎患者及 2 6例正常人血清中抗水痘 带状疱疹病毒 (VZV)抗体进行检测 ,还对其中 6名患者进行了发病早期及 2周后的血清抗VZV抗体检测。结果　面神经炎患者组的抗VZV抗体滴度显著高于对照组 (P <0 .0 5 ) ;在 6例患者的不同疾病阶段测得的抗体滴度中 ,3例患者在发病 2周后抗体滴度比发病初期增加 4倍以上 ,1例增加 2倍 ,2例无改变。结论　抗VZV抗体滴度与面神经炎的发病相关 ,提示VZV感染可能是面神经炎的致病因素之一。     

2019年三门峡地区麻疹风疹疑似病例血清学指标检测分析

目的分析2019年三门峡地区麻疹风疹疑似病例血清学指标检测结果,以了解麻疹风疹的流行特点。方法选取2019年我院196例麻疹风疹疑似病例,统计麻疹免疫球蛋白M(IgM)抗体、风疹IgM抗体阳性结果,并分析不同性别、年龄以及月份的麻疹IgM抗体、风疹IgM抗体阳性率。结果 196例疑似麻疹风疹病例中,共有71例检出麻疹IgM抗体或风疹IgM抗体阳性,检出率为36.22%。麻疹IgM抗体阳性患者42例,其中男性患者26例,占比61.90%,女性患者16例,占比38.10%;风疹IgM抗体阳性患者29例,其中男性患者17例,占比58.62%,女性患者12例,占比41.38%;1岁、20～40岁以及40岁人群的麻疹、风疹IgM抗体阳性率较高;5月、8月以及12月的麻疹IgM抗体阳性率较高,4月、7月以及12月的风疹IgM抗体阳性率较高。结论疑似麻疹风疹病例的麻疹IgM抗体、风疹IgM抗体阳性率较高,男性IgM抗体阳性率高于女性,多发于0～1岁婴儿和20岁以上的成年人,4～5月、7～8月以及12月是麻疹风疹发病的高峰时期,应加以重视。     

抗SSA60000抗体和抗SSA52000抗体检测在系统性红斑狼疮和原发性干燥综合征诊断中的应用

目的:探讨抗SSA60000抗体和抗SSA52000抗体的检测在系统性红斑狼疮(SLE)和原发性干燥综合征(pSS)诊断中的应用.方法:收集血清抗SSA抗体阳性的SLE患者78例和pSS患者36例,采用线性免疫分析法检测抗SSA60000抗体和抗SSA52000抗体.结果:SLE患者双抗体均阳性38例,单独抗SSA60000阳性33例,单独抗SSA52000阳性7例;pSS患者双抗体均阳性32例,单独抗SSA60000阳性0例,单独抗SSA52000阳性4例.抗SSA60000阳性率在SLE及pSS间差异无统计学意义(x2=0.000 3,P=0.96);pSS患者抗SSA52000阳性率高于SLE患者(x2=19.43,P=0.000 0);SLE患者单独抗SSA60000阳性率高于pSS患者x2=19.43,P=0.000 0);单独抗SSA52000阳性率在SLE患者及pSS患者间差异无统计学意义(x2=0.000 3,P＞0.05).结论:抗SSA60000抗体和抗SSA52000抗体联合检测可用于辨别SLE和pSS,单独抗SSA60000抗体阳性主要见SLE,可排除pSS;抗SSA52000阳性率在pSS患者高于SLE患者,但单独抗SSA52000阳性不能排除SLE.     

2010至2015年南通地区人群戊型肝炎病毒感染的血清流行病学调查

目的：探讨2010至2015年南通市人群戊肝病毒（hepatitis E virus, HEV）的感染状况及流行特点,为戊型病毒性肝炎（简称戊肝）防治提供依据。方法：选择南通大学附属医院2010年1月1日至2015年12月31日收诊并作HEV血清学检测的病例6 772例。采用酶联免疫吸附试验（ELISA）诊断试剂盒检测血清抗HEV抗体（IgM、IgG）。对不同年度、年龄、性别人群的HEV感染率进行统计分析,并对戊肝发病率进行分析。结果：6年间,6 772例受测试者抗HEV抗体（IgM/IgG）总阳性率为3.35%（227例）;2010至2015年各年度人群血清HEV抗体阳性率分别为6.92%、1.74%、3.53%、0.90%、3.50%、2.13%。20岁以下、20～29岁、30～39岁、40～49岁和50～59岁年龄段人群血清HEV抗体阳性率随年龄增加而升高（P=0.001）;59岁以后各年龄段人群血清HEV抗体阳性率逐步下降。男性抗HEV抗体阳性率明显高于女性（P=0.001）。227例血清抗HEV抗体阳性者中,显性感染率为72.25%;其中,急性黄疸型肝炎发病率显著高于急性无黄疸型肝炎发病率（P=0.001）。HEV感染者中,HBV-HEV重叠感染率为21.15%,HCV-HEV重叠感染率为0.88%;HAV-HEV重叠感染率为0.44%。HBV-HEV重叠感染的戊肝组患者血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素水平与单纯戊肝组患者差异无统计学意义,凝血酶原活动度、血清白蛋白水平均低于单纯戊肝组（P<0.01）。结论：2010年南通市人群HEV感染率为6.92%,此后5年HEV感染率维持在较低水平（0.90%～3.53%）。男性较女性更易感染HEV;40～59岁人群具有相对较高的HEV感染风险,应引起高度重视。HEV感染后,多数表现为急性黄疸型肝炎;慢性HBV感染重叠HEV感染可致肝损伤加重。     

2010-2013年甘肃省白银市流感样病例监测哨点医院数据分析

目的 分析甘肃省白银市2010-2013年国家哨点医院流感样病例(ILI)监测结果,掌握本地区流行性感冒的流行趋势及病毒株变化特点,为制定防控措施提供依据. 方法 收集哨点医院ILI就诊数、门急诊病例总数,采集ILI咽拭子进行核酸检测,使用Excel 2003和SPSS 19.0统计软件分析ILI分年度、诊室、年龄段分布及ILI核酸检测情况. 结果 4年ILI就诊百分比(ILI%)比较差异有统计学意义(2=193.678,P=0.000),ILI%最高的年份为2013年,为1.58%,最高的月份是12月,最低在8月,就诊比例最高诊室是儿内科急诊,占5.21%,年龄分布主要集中在15岁以下儿童,占65.03%;4年核酸检测阳性率比较差异有统计学意义(2=154.680,P=0.000),阳性率最高的是2012年,为26.37%;甲型H1N1型流感病毒构成比逐年上升(2趋势=58.773,P=0.000);分月核酸检测阳性率比较差异有统计学意义(2=646.743,P=0.000),阳性率最高的是11月,为50.39%;5个年龄组核酸检测阳性率比较差异有统计学意义(2=143.568,P=0.000),阳性率最高的是15~24岁组,为36.04%. 结论 白银市流感发病呈冬春季高峰且冬季流感来临较早,儿童和青少年是防控重点人群,甲型H1N1型流感近4年病毒活性逐年上升.     

吴家堡镇2004年度水痘疫情流行分析

水痘是一种由水痘-带状疱疹病毒引起的严重影响儿童健康的急性传染病。该病主要经呼吸道和直接接触传播，以1—5岁儿童在冬春季节好发，主要临床症状有发热→斑丘疹→疱疹→脓疱→结痂→脱痂的演变过程。由于体内高效价抗体不能清除，潜伏的病毒在多年后可发生带状疱疹。自2004年吴家堡镇开展接种水痘疫苗以来，水痘发病率大幅度下降。为进一步加强吴家堡镇水痘防治工作，制订有效的防治对策，控制以至消除水痘，对吴家堡镇2004年度水痘疫情作分析如下。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."