男性尿道分泌物前列腺液及精液的支原体培养分析

目的对男性尿道分泌物、前列腺液和精液作支原体培养分析，提高支原体的阳性检出率，为临床早期诊治提供帮助。方法所有病例分为非淋菌性尿道炎组（NGU）、前列腺炎组、附睾炎组和不育组，分别取尿道分泌物、前列腺液和精液进行支原体培养。结果NGU组或前列腺炎组，用前列腺液或精液作支原体培养，其支原体阳性检出率比用尿道分泌物明显要低，其中前列腺炎组前列腺液中基本检不到人型支原体（Mh）；附睾炎组和不育组患者用精液作支原体培养，其支原体阳性检出率比用尿道分泌物略高，前列腺液比较低。结论疑是支原体引起的NGU或前列腺炎，用尿道分泌物作支原体培养，其支原体阳性检出率最高；疑是支原体引起的附睾炎或不育，用尿道分泌物和精液同时进行支原体培养，其支原体阳性检出率最高。     

解脲支原体感染与男性不育症患者关系的探讨

目的了解解脲支原体感染与不育症患者精液质量的状况。方法检测251例男性不育症患者（不育症组）与40例有正常生育能力的男性（健康对照组）的精液质量及支原体感染状况并进行对比分析。结果不育症组解脲支原体感染率为35．6％，明显高于健康对照组的12．5％差异有统计学意义（P〈0．01）；不育症组患者的精子密度、精子存活率、a级和b级精子活力均明显低于健康对照组，而液化时间、精子畸形率、白细胞数／高倍视野均高于对照组，差异有统计学意义（P〈0．01）。结论解脲支原体感染可以引起精液质量下降，导致男性不育症。     

抗精子抗体与解脲支原体感染对精子运动参数的影响

目的探讨解脲支原体（UU）、抗精子抗体对精子运动参数的影响。方法培养法检测精液UU感染，采用间接血凝法检测精浆抗精子抗体，采用精子自动分析系统分析精子运动参数。结果UU阳性组精子运动参数精子曲线速度、直线速度、平均路径速度均显著低于UU阴性组（P〈0．001）；UU阳性组精子运动参数平均移动角度、鞭打频率均显著高于UU阴性组（P〈0．05）。抗精子抗体阳性组精子曲线速度、直线速度、平均路径速度、前向性和摆动性均低于抗精子抗体阴性组（P〈0．001或P〈0．05）。UU阳性与UU阴性组比较，精浆抗精子抗体阳性率差异有显著性（P〈0．001）。结论精液UU感染和精浆抗精子抗体均可影响精子运动。     

精液微生物感染对精子质量的影响及其检测意义

[目的]研究精液微生物感染对精子质量的影响及精液微生物检测在男性不育症诊断中的意义。[方法]对620例不育患者和50例正常生育者进行精液细菌培养、解尿支原体培养、过氧化物酶染色等检测微生物感染；精液常规、精浆抗精子抗体、尾部肿胀实验、精子形态学分析检测精子质量。[结果]620例不育男性精液中531例感染微生物，总感染率为85．6％，解脲支原体48．8％，革兰阴性菌36．7％，革兰阳性菌35．8％，其他2．5％。正常生育组总感染率24．5％，解脲支原体20．1％，革兰阴性菌15．1％，革兰阳性菌11．3％，其他1．02％；精液质量包括精液常规、精子形态学、尾部肿胀实验、抗精子抗体等检测结果实验组与对照组比较均有明显差异。[结论]男性不育患者精液微生物感染率明显升高且影响精子质量，针对男性不育患者进行精液微生物检测对指导临床诊断治疗具有重要意义。     

解脲支原体感染与精液常规及精浆生化指标的比较与分析

解脲支原体(Ureaplasm urealytic,UU)感染能够影响精子质量,是导致男性不育的重要原因之一。精浆的生化检查能反映附属腺体的分泌、代谢功能和病理改变。本文就解脲支原体感染与精液常规及精浆的生化指标进行探讨,为临床男性不育症的诊断和疗效观察提供较客观的依据。     

性病门诊女性尿道和宫颈解脲支原体感染的同步检测分析

目的 比较分析性病门诊女性尿道和宫颈解脲支原体（UU）感染的发病情况，探讨同步检测解脲支原体感染的意义。方法 采用聚合酶链反应PCR荧光检测法，严格按试剂盒操作程序操作。结果 性病组（STD组）共检出解脲支原体阳性病例291例，其中142例为尿道和宫颈合并感染UU，单纯尿道感染UU为71例，STD组总的尿道UU阳性率为34．02％；单纯宫颈感染UU为78例，STD组总的尿宫颈UU阳性率为35．14％；尿道对照组UU阳性率为15．15％；宫颈对照组UU阳性率为18．06％。用χ^2检验，差异均有显著性。结论 性病门诊女性尿道和宫颈UU感染的发生率均明显高于普通泌尿及妇科门诊女性患者，其中尿道和宫颈合并感染UU的比例相当高，提示应同时取尿道和宫颈标本检测。     

不育症精液与炎症尿道生殖道支原体检出及药敏的区别

目的观察不育症精液与炎症尿道生殖道支原体检出及药敏的区别;方法采用解脲支原体(UU)和人型支原体(MH)培养鉴定计数药敏一体化法对312例不育症精液及348例前尿道生殖道炎患者局部分泌物进行支原体培养鉴定、计数,并作9种抗生素药物敏感性测定。结果女性生殖道支原体阳性率高于精液支原体阳性率及男性前尿道支原体阳性率(P<0.01),精液分离的支原体药物高敏率高于男性前尿道及女性生殖道分泌物分离的支原体(P<0.01),男性前尿道和女性生殖道分泌物分离的支原体药物高敏率和抗药率无显著差别;女性生殖道分泌物分离的支原体抗药率高于精液和男性前尿道分离的支原体(P<0.01),而精液与男性前尿道分泌物分离的支原体抗药率无显著差别。结论不育症精液支原体有较高阳性率,但低于女性生殖道。精液支原体抗菌谱与前尿道生殖道支原体抗菌谱有相似之处,药物敏感性高于前尿道生殖道支原体。     

男性不育精液支原体感染检测的分析

目的探讨解脲支原体（UU）、人型支原体（MH）与抗精子抗体（As-Ab）、精液常规参数和男性不育的关系。方法对146例男性不育患者进行UU、MH培养和抗精于抗体检测、精于质量分析仪检测精液常规。结果146例不育男性精液中UU感染率为19．17％，MH感染率为25．34％，As-Ab检测阳性率为12．33％，其中UU、MH感染者及非感染者As-Ab阳性率分别为21．43％、8．1】％、11．11％。UU感染与非感染组比较有显著性差异（P〈0．01），MH感染组与非感染组比较无显著性差异（P〉0．05），精液功能参数检测结果显示UU阳性者精液量、精于密度、存活率、STR与非感染组有显著性差异（P〈0．01），表现为精于活力减弱、密度减少、存活力降低、STR降低。MH阳性者精液量、精于密度与非感染组有显著性差异（P〈0．01）。其它精液功能参数与阴性感染者无显著性差异。结论UU感染可能与As-Ab的产生有关，可能影响精于的数量、精液的功能和质量。MH感染可能与影响精液量、精于密度有关。     

用荧光PCR检测泌尿生殖道解脲脲原体和沙眼衣原体

目的：调查非淋茵性泌尿生殖道感染患者中解脲脲原体（UU）和沙眼衣原体（CT）感染。方法：共检测219例患者,男性患者取尿道分泌物或前列腺液,女性患者取宫颈分泌物,用荧光PCR法检测UU和CT的DNA,并对结果进行统计、分析。结果：UU阳性率50．2％（110／219）,CT阳性率15．3％（30／196）。结论：UU和CT是非淋茵性泌尿生殖道感染的主要原因。     

解脲支原体感染与精液白细胞及精子密度关系探讨

目的探讨解脲支原体,精液白细胞与精子密度的关系。方法对275例男性不育患者精液样本进行分析,解脲支原体采用培养法进行检测,白细胞采用联苯胺染色方法进行检测,精子密度检测采用计算机辅助系统进行分析。结果UU阳性率为31．64％,白细胞阳性率为22．55％。UU阳性组精子密度显著低于UU阴性组（P〈0．05）,白细胞异常组精子密度显著低于白细胞正常组（P〈0．05）,UU阳性组白细胞异常例数与UU阴性组相比,有显著性差异（P〈0．05）,UU阳性自细胞异常组精子密度显著低于其对应的白细胞正常组及UU阴性组（P〈0．001）,而UU阴性白细胞异常组精子密度与其对应的正常组无显著性差异（P〉0．05）。结论UU感染、白细胞、精子密度关系密切,UU感染可通过引起白细胞异常,进而使ROS水平增高,使精子密度下降。     

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.     

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.     

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.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

Prospects for the control of neglected tropical diseases by mass drug administration

The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In spite of this and other striking successes, mass drug administration programs are faced with major challenges resulting from suboptimal coverage and lack of efficacy. At current suboptimal coverage rates, programs may need prolongation for an extended period, increasing costs and undermining sustainability. Community participation through health education and information appears to be crucial to improve coverage and to achieve sustainability. Implementation of complementary measures, such as vector control, improved hygiene and environmental sanitation, are important to further control transmission and to prevent re-emergence of the infection and, again, may only be achieved effectively through community-based initiatives. To reduce costs and to relieve pressure on the health system, combining neglected tropical disease programs in areas where diseases coexist and integration with existing control programs for malaria, tuberculosis and HIV/AIDS is advocated. The risk of developing drug resistance is of particular concern in view of the lack of alternative drugs, and reduced treatment efficacy due to emerging resistance is evident for the soil-transmitted helminths and onchocerciasis. Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.