用多通道串联式压电生物传感仪快速检测临床病原菌

目的:通过本室研制的多通道串联式压电石英传感装置(MSPQC),快速检测病人血液及体液中致病菌。方法:将含血液标本的检测池放入MSPQC及BACTEC9120血培养仪检测,再转种血平板验证,比较两种仪器的检测结果。结果:培养时间为5天时,MSPQC的阳性检出率是18.92%(650例中123例阳性结果),而BACTEC9120的阳性检出率是19.38%(650例中126例阳性结果);MSPQC有2例假阳性和2例假阴性结果,BACTEC9120有3例假阳性和0例假阴性结果。结论:对于大多数革兰阳性菌和革兰阴性菌MSPQC的检出时间比BACTEC9120快。MSPQC有很好的临床应用前景。     

BACTEC MGIT^TM960全自动分枝杆菌培养鉴定／药敏仪基本原理及其应用

BACTEC MGIT^TM960全自动分枝杆菌培养鉴定／药敏仪，能大大缩短分枝杆菌的检测时间，该仪器自动化程度高，无放射性污染，可进行药敏学动态研究。     

The prevalence of scapular malalignment in elementally school aged baseball player and its association to shoulder disorder

Background

Various shoulder disorders have been reported to be associated with scapulothoracic joint dysfunction in adult overhead athletes. However, little is known about the prevalence of scapular malalignment and its relationship to shoulder injuries in skeletally immature baseball players.The purpose of the current study was to investigate the prevalence of scapular malalignment in elementary school-aged baseball players, as well as its association with shoulder disorder.

BACTEC MGIT 960仪在肺结核病诊断中的应用

[目的]探讨BACTEC MGIT 960仪在肺结核病诊断中的应用。[方法]应用BACTEC MGIT 960仪对肺结核病人的痰标本进行培养，并与BACTEC TB 460仪、改良罗氏培养法及涂片抗酸染色法进行对照。[结果]BACTEC MGIT 960仪阳性率为31．96％，与BACTEC TB 460仪的阳性率接近，比改良罗氏培养法及涂片抗酸染色法高。[结论]BACTEC MGIT 960仪能显著缩短（初代阳性平均分离时间为11．6d，比BACTEC TB 460仪快1．9d，比改良罗氏培养法快9．1d。）报告时间，且阳性检出率高。     

A Cost-Effectiveness Analysis of Organ Preservation Methods for Deceased Donor Kidneys at High Risk for Delayed Graft Function in Brazil

The clinical benefit of machine perfusion (MP) was recently assessed in a 1-year Brazilian multicenter prospective randomized trial, that showed that the use of MP was associated with a reduced incidence of delayed graft function (DGF) compared to static cold storage (SCS) in kidney transplant recipients (45% vs 61%). The objective of the present analysis is to consider the cost-effectiveness of MP relative to SCS based on clinical data from this Brazilian cohort. A decision tree model was constructed to simulate a population of 1000 kidney transplant recipients based on data derived from this Brazilian multicenter clinical trial. The model accounts for different health state utilities to estimate the cost-effectiveness of deceased donor kidney transplantation in Brazil comparing 2 kidney preservation methods: MP and SCS. The model accounts for 3 possible graft outcomes at 1 year post-transplantation: success (an immediate functioning kidney), failure (primary nonfunction requiring a return to dialysis), or DGF 1 year post-transplant. MP provided 612 total quality-adjusted life years (QALYs) (0.61 QALYs per patient) as compared to SCS (553 total QALYs, 0.55 QALYs per patient). MP was cost effective relative to SCS (US$22,117/QALY, R$70,606/QALY). The use of MP also resulted in more functioning grafts than SCS (821 vs 787), leading to a cost per functioning graft of US$38,033 (R$121,417). In conclusion, this analysis indicates that, despite the initial added cost associated with MP, the use of MP results in more functioning grafts (821 vs 787) and higher patient quality of life relative to SCS in Brazil.     

两种需氧血培养系统对模拟菌血症检测能力的比较

目的比较BACTEC PLUS树脂需氧瓶与BacT／Alert FA活性炭需氧瓶对模拟菌血症的检测能力。方法选择烧伤科常用的抗生素与细菌病原体，将菌液、抗生素、新鲜无菌血注入各培养瓶内，记录5d内阳性瓶的检出时间及二者对万古霉素的吸附能力，对2种具有不同吸附剂的血培养瓶的阳性检出率及平均检出时间进行比较。结果除替考拉宁组外，BACTEC PLUS树脂需氧瓶的细菌阳性检出率和平均检出时间均优于BacT／Alert FA活性炭需氧瓶，差异有统计学意义（P〈0．001）；替考拉宁组BacT／Alert FA活性炭需氧瓶的细菌阳性检出率和平均检出时间优于BACTEC PLUS树脂需氧瓶。结论在进行血培养时，应该尽可能在抗生素使用以前或F次使用抗生素以前采血。对已经应用抗生素的患者，应选择具有中和、吸附抗生素能力的培养系统。     

The organism

Three treponemes are pathogenic for man: T. carateum, T. pertenue, and T. pallidum. T. carateum is the causative agent of pinta; T. pertenue is the causative agent of yaws, and T. pallidum is responsible for two distinct diseases, endemic syphilis and venereal syphilis. Morphologically indistinguishable, even with electron microscopy, these organisms do show differences in the ease with which they can be inoculated into lower animals and in the response of the animals to the inoculations. The fact that the pathogenic treponemes produce four different human diseases that are not always mutually exclusive and vary considerably in immunologic profile is also evidence ipso facto that they differ in some way.¹ Nevertheless, the closeness of the interrelationship has recently been demonstrated clearly by Miao and Fieldsteel.² Using DNA-DNA saturation assays, these investigators were unable to show any genetic difference between strain of T. pallidum (Nichols and KKJ) and the Gauthier strain of T. pertenue. In their studies, single strand T. pertenue DNA reassociated in the presence of T. pallidum, DNA in exactly the same manner that single strand T. pertenue DNA reassociated with its own DNA counterpart, indicating DNA sequence homology of a very high order. These studies also furnish evidence both welcome and reassuring to those engaged in syphilis re search that the 65 years of continuous passage of the Nichols strain through rabbit testes has not produced detectable DNA sequence changes. The Nichols organism appears to differ in no wa y from the more recently isolated KKJ strain, which has undergone only eight such passages.     

Benign tertiary syphilis

Benign tertiary syphilis (BTS) includes all forms of symptomatic acquired syphilis occurring beyond the secondary and relapsing stages, with the exception of cardiovascular and neurosyphilis.^1–5 This group of manifestations is sometimes also called “late benign syphilis.” The characteristic lesion is the gumma, and generally speaking, the longer the interval between initial infection and lesion onset, the more destructive the manifestations will be.The incidence of BTS in untreated cases is set at 16.6% in the Gjestland revision of the Bruusgaard figures, but the incidence in the general population has been steadily falling in the past 50 years, and BTS in any form has become a rare disease. Experience at the Vanderbilt clinic, for example, showed a decline in the average number of cases per five-year period from 130 in 1940 to 17 in 1951.⁵ No doubt it is significantly lower now.With classically accepted exceptions—the ovary, for example, and the small intestine—BTS can affect virtually any anatomic site. The great majority of lesions are concentrated in the skin, mucous membranes, and bone, however; and the material presented in this section will deal principally with disease in those structures. The distribution of BTS by site in the series of 601 examples collected by Kampmeier6 is shown in Table 13-1.BTS lesions can appear as early as two years and as late as 35 years after the initial infection. The great majority of cases fall in the 2-to 7-year time period.