两种试剂盒快速检测疟原虫的比较

目的寻找更适合基层和贫困疟区的敏感、特异、快速、廉价的检测疟原虫的方法，比较两种恶性疟金标免疫层析试剂盒的敏感性和特异性。方法采用ACON试剂盒和Paracheck试剂盒对镜检确认的134例疟疾病人血样进行平行检验。结果ACON试剂盒和Paracheck试剂盒分别检测恶性疟84例，阳性均为84例，符合率均为100％；检测间日疟30例，均为阴性，特异性均为100％；检测恶性疟和间日疟混合感染20例，阳性分别为19例，18例，敏感性分别为95％和90％。结论ACON试剂盒胶体金法具有与Paracheck试剂盒ICT法相同的敏感性和特异性，具有操作快速、简便、直观的特点，并且价格便宜，更适合在基层和疟疾贫困地区推广应用。     

艾康恶性疟/间日疟免疫层析检测试剂盒效果评价

目的 评价艾康恶性疟／间日疟（P．f／P．v）胶体金免疫层析检测试剂盒诊断疟疾效果。方法 以镜检法为金标准。采用盲法实验室测试疟痰阳性和阴性血样。结果 共测试331例血样，其中疟痰血样121倒。对疟疾的灵敏性和特异性分别为92．56％和98．57％，与镜检符合率为96．38％；其中恶性疟的灵敏性和特异性分别为1130．00％和98．57％，重复性为100．00％；对间日疟的灵敏性和特异性分别为86．96％和100．00％，恶性疟和间日疟之间无交叉反应。结论 艾康P．f．／P．v肢体金免疫层析检测试剂盒诊断疟痰具有快速、简便、准确、直观以及不需要特殊仪器优点，能同时诊断单纯恶性疟和单纯间日疟，但不能鉴别诊断混合感染。     

快速免疫色谱测试法诊断疟原虫现场效果评价

目的 评价快速免疫色谱测试法（ICT）在我省基层门诊诊断疟疾的适用性。方法 每一发热病人同时用镜检和ICT两种方法检验,并将RCT检验结果与镜检结果进行比较。结果 ICT双虫卡诊断间日疟的敏感度为60.27%,特异度为84.15%;ICT双虫卡诊断恶性疟的敏感度为88.89%。特异度为99.35%。结论 ICT法较镜检法诊断恶性疟更为快速,简便,但对间日疟诊断ICT法不如镜检法准确。     

BinaxNOW 疟原虫检测试剂卡临床应用效果观察

目的评价美国Inverness medical professional diagnostics公司生产的疟原虫检测试剂卡的临床应用效果。方法以镜检方法作为金标准比较BinaxNOW疟原虫检测试剂卡临床应用效果。结果 400份样本用镜检方法和BinaxNOW疟原虫检测试剂卡诊断,镜检法检出阳性138份,其中恶性疟77份、间日疟61份;疟原虫检测试剂卡检出阳性139例,其中恶性疟71份,间日疟68份。试剂卡检测疟疾的敏感度为98.55%,特异度为98.85%,检测恶性疟的灵敏度为87.01%、特异度为98.76%,检测间日疟的敏感度为93.44%、特异度为96.76%。存在交叉反应。结论BinaxNOW疟原虫检测试剂卡诊断疟疾敏感性与特异性高,操作简单,结果显示直观、快速,适合边远疟区无镜检能力的个体、乡村医生开展疟疾筛查。     

BinaxNOW(R)疟原虫检测试剂卡临床应用效果观察

目的 评价美国Inverness medical professional diagnostics公司生产的疟原虫检测试剂卡的临床应用效果.方法 以镜检方法作为金标准比较BinaxNOV 疟原虫检测试剂卡临床应用效果.结果 400份样本用镜检方法和BinaxNOW 疟原虫检测试剂卡诊断,镜检法检出阳性138份.其中恶性疟77份、间日疟61份;疟原虫检测试剂卡捡出阳性139例,其中恶性疟71份,间日疟68份.试剂卡检测疟疾的敏感度为98.55%,特异度为98.85%,检测恶性疟的灵敏度为87.01%、特异度为98.76%,检测间日疟的敏感度为93.44%、特异度为96.76%.存在交叉反应.结论 BinaxNOW 疟原虫检测试剂卡诊断疟疾敏感性与特异性高,操作简单,结果显示直观、快速,适合边远疟区无镜检能力的个体、乡村医生开展疟疾筛查.     

多重巢式聚合酶链反应在疟疾混合感染检测与分型中的应用

目的:应用能够同时检测恶性疟(P.falciparum)、间日疟(P.vivax)、卵形疟(P.ovale)、三日疟(P.malarie)及其混合感染的多重巢式PCR方法,对疑似疟疾混合感染样本进行检测,评价其在疟原虫混合感染及分型中的应用价值,旨在为疟疾流行病学调查、疟疾混合感染的确诊提供一种快速高效、特异性强、灵敏度高的实验室诊断方法,为传统的镜检法提供有效的补充。方法:根据恶性疟原虫、间日疟原虫、卵形疟原虫和三日疟原虫的18SSU rRNA基因序列设计5对引物(1对通用引物、4对特异性引物),以等比例混合的4种疟原虫核酸为模板,建立疟疾多重巢式PCR检测方法,并应用该法对28份疑似疟疾混合感染样本进行检测及测序验证,将其结果与镜检法比较。结果:28份疑似混合感染样本中混合感染样品数为6例,其中恶性疟和间日疟混合感染样品5例,恶性疟和卵形疟混合感染样品1例。结论:本研究建立的多重巢式PCR检测方法能够同时用于恶性疟、间日疟、卵形疟、三日疟及其混合感染样本的检测,在疟疾混合感染的确诊与分型上较镜检法有明显的优势和更高的应用价值。     

艾康疟原虫检测试剂盒现场应用效果观察

目的评价国产艾康疟原虫(pf/pv)检测试剂盒现场应用效果。方法以镜检方法作为金标准比较艾康疟原虫检测试剂盒现场应用效果。结果336例样本均用镜检方法和艾康疟原虫试剂盒诊断,镜检阳性155例,阴性181例;试剂盒诊断阳性156例,阴性180例,试剂盒诊断疟疾的灵敏度为99.4%,特异度为98.9%。试剂盒诊断间日疟的灵敏度为98.8%、特异度为100.0%;试剂盒诊断恶性疟的灵敏度为100.0%、特异性为99.3%。未发现交叉反应。结论艾康试剂盒诊断疟原虫敏感性与特异性均高,且一次能测出单纯恶性疟或单纯间日疟的感染,操作简单,结果显示直观、快速,在常温下保存稳定,适合疟疾流行区的基层单位使用。     

应用双重PCR检测海南疟区发热病人的效果

目的 评价双重PCR检测疟区发热病人的效果。方法 对疟区求诊发热病人，手指取血分别制作厚薄血膜片和滤纸血斑作为检测血样。参照献用恶性疟原虫PF1－2和间日疟原虫PV3－5为特异性引物，同在一个反应体系常规进行PCR，扩增片段分别为206bp和431bp。同时镜检厚血膜作对照。结果 该反应体系最低可检出原虫血症为1个恶性疟原虫／μl血和10个间日疟原虫／μl血的感染；检测132例疟区发热病人血样的阳性率为65．1％，而镜检法为64．4％，且有1例漏诊和3例误诊，两法符合率为97％。结论 双重PCR用于疟区发热病人检测，较镜检敏感、特异，适合我国恶性疟与间日疟混合流行区的疟疾诊断，还可用于血检质量的监控。     

高疟乡镇卫生院镜检疟原虫情况的调查

本文1998年7月对元江和新平的高疟乡镇卫生院血检疟原虫情况进行了调查,血检疟原虫阳性率、符合率、漏检率和误检率依次为9.79％、57.58％、3.86％及4.15％,卫生院与市防疫站血检疟疾阳性率间差异无显著性意义,但是对恶性疟的漏检率较高。提示:更新镜检设备,加强镜检人员的技能培训,结合镜检使用新的诊断技术,减少漏检和误检,提高对恶性疟的检出率。     

深圳市2008年“三热”病人疟疾疫情监测分析

目的了解深圳市2008年“三热”病人疟疾血检状况,分析其监测的效果。方法对医院监测点临床诊断为疟疾、疑似疟疾或不明原因发热的“三热”病人采血作疟原虫检查;收集2008年疟疾血检监测数据,以描述流行病学的方法分析其特点;对各镜检点阴性和阳性的血膜片进行抽检,计算血膜片的合格率及复核符合率。结果全市共血检9788人次,发现阳性病例39例,血检阳性率为0．40％,其中间日疟28例,恶性疟11例,血栓阳性病例占总报告病例数的82．98％（39147）。血检阳性病例以输入性为主,占总阳性病例数的74．4％（29／39）,其中恶性疟病例均为本市前往非洲、东南亚等疟疾高发地区从事商务的归国人员;病例的地区分布按发病数由高到低依次为罗湖18例、宝安11例、龙岗5例、南山3例和福田区2例,盐田区无阳性病例;病例时间分布呈现6、7、8月和11、12、1月的2个高发期。抽查6个区15个镜检点514张血片,血片制作和染色的平均合格率分别为86．19％和89．88％,对其中的213张阴性片及12张阳性片进行复检,符合率为100％。结论“三热”病人血检监测是及时发现传染源的重要手段,须进一步巩固和加强;疟疾病例分布特征的阐明为我市科学防治疟疾提供了决策依据。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.