海岛地区婴幼儿呼吸道感染的病原学研究

目的 探讨海岛地区婴幼儿急性呼吸道感染的病毒病原.方法 采取211例急性呼吸道感染患儿的痰液做病毒检测.结果 病毒感染35例,其中呼吸道合胞病毒(RSV)感染20例(9.5%),流感病毒感染6例(2.8%),腺病毒9例(4-3%),副流感病毒Ⅲ型4例(1.9%),副流感病毒Ⅰ、Ⅱ型各2例(1%).结论 RSV感染仍是海岛婴幼儿急性呼吸道病毒感染最常见的病原,病毒病原的诊断可为临床诊断和治疗提供可靠的依据.     

两种快速检测呼吸道合胞病毒抗原的方法比较

呼吸道合胞病毒（respiratory syncytial virus，RSV）是引起婴幼儿急性下呼吸道感染最主要的病毒病原。血清学证据显示，几乎所有2岁以下的儿童均感染过RSV。RSV是引发毛细支气管炎的主要病原。可引起婴幼儿尤其是新生儿较高的死亡率。随着抗RSV特异性药物研究的迅速发展，临床迫切需要一种快速、敏感的RSV早期诊断方法，     

人感染新型布尼亚病毒病误诊为肾综合征出血热一例

目的 探讨人感染新型布尼亚病毒病的临床特征及流行病学特点,以提高诊治水平.方法 结合我院收治的1例误诊为肾综合征出血热的人感染新型布尼亚病毒病的临床资料,并分别从临床特征、流行病学特点及实验室检查等方面进行对比分析.结果 本例因高热、乏力、腰痛、全身不适5d,于外院疑诊肾综合征出血热转入我院,根据临床表现及实验室检查考虑蜱虫叮咬所致发热伴血小板减少综合征,并将蜱虫送至省疾病控制中心检测.因病情加重,家属放弃治疗患者死亡,后根据检测结果回报确诊为人感染新型布尼亚病毒病.结论 临床应提高对人感染新型布尼亚病毒病的认识,对有明确流行病学史、发热伴血白细胞和血小板同时减少者应考虑本病可能,及时行病原学检测,以及早诊断并治疗.     

非甲非乙型肝炎和丙型肝炎病毒抗体

本文作者报道了对70年代输血传播病毒研究组(TTVS)贮藏的血清标本检测丙型肝炎病毒抗体(抗-HVC)的情况.标本来自1974年至1979年输血的和医院未输血患者的血清,诊断和病程相同(对照病例).血清标本每隔2-3周收集1次,共6个月,随访至少10个月.诊断肝炎需至少1次血清丙氨酸氨基转移酶(ALT)活性大于90U/L以及3至17天后第二次复查大于45U/L.NANB型肝炎诊断的根据是无急性甲型肝炎病毒、乙型肝炎病毒(HBV)感染和任何非病毒病原血清学改变的证据.HCV抗体(抗-HCV)检测用重组多肽病毒抗原和人过氧化物歧化酶.用放射标记第2抗体测定反应活性.所有标本均以编码进行.结果表明,5名住院对照者在外科手术治疗后     

十五种常见病毒病的ELISA诊断方法

为适应临床特异性诊断常见病毒病的需要，建立了用ELISA法检测15种常见病毒病特异性抗体的方法用于常规诊断。15种病毒病包括麻疹、风疹，科萨奇B组病毒引起的病毒性心肌炎，癌疹病毒Ⅰ型病毒引起的疱疹性脑膜炎，巨细胞病毒引起的先天性畸形，乳儿肝炎，脊髓灰质炎，     

弥散性血管内凝血及其前期的诊断

弥散性血管内凝血(disseminated intravascular coagulation,DIC)的诊断主要依据原发病种类、临床表现及实验检查结果.由于DIC多系危急、重症,临床表现较为复杂,目前的实验检查又多缺乏特异性.为能在较短时间内排除其他病症,确定诊断,以便及时治疗,临床上需有较为明确、严格和科学的诊断标准,从而为临床医师在诊疗工作中提供参考依据.     

尿胰蛋白酶原-2对诊断急性胰腺炎的应用价值

目的探讨免疫层析法测尿胰蛋白酶原-2在急性胰腺炎诊断中的临床意义.方法收集347例急腹症患者血清和尿液标本,分别测定尿胰蛋白酶原-2和血、尿淀粉酶(AMY)活性,并将结果进行比较.结果尿胰蛋白酶原-2检测对急性胰腺炎诊断的敏感性、特异性分别为89.3%和90.3%,血AMY为80.2%和81.9%,尿AMY为74.8%和77.8%.尿胰蛋白酶原-2的敏感性和特异性均显著高于血、尿AMY检测.结论试纸法快速检测尿胰蛋白酶原-2诊断急性胰腺炎具有较高的特异性和敏感性,是筛选急性胰腺炎简便而快速的方法.     

甲状腺活检标本201例回顾性分析

目的:了解结节性甲状腺肿与甲状腺腺瘤的病理鉴别诊断要,最及恶变情况.方法:选择原病理诊断为结节性甲状腺肿和甲状腺腺瘤201例的病理切片资料再次复检,时两种病变的病理特点、癌前病变进行分析和研究.结果:201例中原诊断为结节性甲状腺肿37例(18.4%),甲状腺腺瘤164例(81.6%),复检后诊断为结节性甲状腺肿164例(81.6%),甲状腺腺瘤37例(18.4%);原诊断为甲状腺腺瘤癌变2例,现诊断1例;原诊断为结节性甲状腺肿伴癌变3例,现诊断4例;结节性甲状腺肿伴非典型增生2例维持原诊断.结论:既往时结节性甲状腺肿及甲状腺腺瘤的病理诊断把握不准.结节性甲状腺肿及甲状腺腺瘤均可发生癌变,尤其前者发生癌变的可能性更大,提示临床应对伴有非典型增生的结节性甲状腺肿者加强随访.     

寨卡病毒病的流行情况(2016年6月2日最新报告)

1 核心信息 (1)寨卡病毒病是一种主要由伊蚊叮咬传播的病毒性疾病. (2)寨卡病毒病患者可出现轻微发热、皮疹、结膜炎、肌肉和关节疼痛、身体不适或头痛,症状通常持续2～7d. (3)已经证明寨卡病毒病与小头畸形和格林-巴利综合征有关,其他神经系统并发症还需要调查.     

尿胰蛋白酶原-2在筛查急性胰腺炎临床应用中的评价

目的评价尿胰蛋白酶原-2试纸条在筛查急性胰腺炎中的临床价值.方法收集50例急腹症患者的血清和尿液,按最终诊断分为急性胰腺炎组(22例)和非急性胰腺炎组(28例),分别检测尿胰蛋白酶原-2,血淀粉酶和尿淀粉酶,并将结果进行比较.结果尿胰蛋白酶原-2诊断急性胰腺炎的敏感性、特异性分别为96%、86%;血淀粉酶为73%、82%;尿淀粉酶为82%、86%.结论尿胰蛋白酶原-2的敏感性和阴性预期值均高于血、尿淀粉酶,可以作为急性胰腺炎诊断的筛选指标.     

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.     

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.     

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.     

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.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.