改良Weissmen手术治疗严重骨盆倾斜

目的：脊髓灰质炎后遗严重骨盆倾斜，内收侧多伴有肢体短缩，持重功能丧失。传统手术，分期进行，周期长，疗效差。本研究的目的是探讨周期短，操作简单，疗效好的新术式。方法：采用改良Ｗｅｉｓｍｅｎ手术，即外展侧软组织松解加股骨转子下内收短缩截骨，内收侧利用对侧切取骨块做髂骨延长术。本组共２１例，术前１７例扶单拐，４例扶双拐。结果：术后平均随访３．８年，１３例完全弃拐，５例短距离步行弃拐，３例扶单拐。结论：该术式具有一次矫正多种畸形的优点，缩短了治疗周期，提高了疗效，无术后严重并发症。     

Survey of village informants—An alternate method to estimate paralytic poliomyelitis prevalence in rural area

Lameness surveys were conducted among children of 0–14 year age group in 60 villages of a Community Development Block of district Ambala in Haryana State. The methods used were: village informants survey and house-to-house survey. Village informants were village chief, school teachers, primary health care workers, traditional birth attendants and several prominent persons from each street/neighbourhood of the village. These informants located lame children in their locality. Subsequently, a house-to-house search for identification of lame children was made in all the 60 sampled villages. Physicians later on, examined the lame children to diagnose paralytic poliomyelitis. Estimate of the prevalence rate of lower extremity paralytic poliomyelitis in 0–14 year age group was found to be 7.9/1000 in village informants survey. This did not differ significantly from the rate of 8.8/1000 revealed by house-to-house survey in the same community (p>0.05). Time required to complete village informants survey was almost one third and costs were also about half as compared to house-to-house survey. Therefore, village informants based lameness survey is a rapid and economical alternative for the estimation of poliomyelitis prevalence in rural communities.     

中国2004年急性弛缓性麻痹病例监测系统运转情况分析

目的了解中国2004年急性弛缓性麻痹(AFP)病例监测系统运转状况。方法描述流行病学方法分析个案数据。结果2004年AFP病例监测系统共报告5 620例,其中AFP病例5 285例,非AFP病例335例。AFP病例中,经实验室标本检测和专家诊断小组诊断,5 266例被排除脊髓灰质炎(脊灰),19例为临床符合脊灰病例。2004年AFP病例监测系统及时发现了疫苗衍生脊灰病毒(VDPV)的循环,未发现本土或输入脊灰野病毒病例。结论AFP病例监测系统各项指标均达到世界卫生组织和卫生部的要求,保持了无脊灰状态。     

The fight against poliomyelitis through the history: past,present and hopes for the future. Albert Sabin's missing Nobel and his “gift to all the world's children”

Polio, or poliomyelitis, is a disabling and life-threatening disease caused by three poliovirus (PV) serotypes. The virus spreads from person to person and can infect a person’s spinal cord, causing paralysis. In 1988, when the WHO registered 350,000 cases of poliomyelitis in the world and 70,000 which occurred in Africa alone, global poliomyelitis eradication was proposed by the World Health Organization to its member States. On 25 August 2020, while the world was waging war against the Coronavirus pandemic, a historic milestone was reached: Africa was officially declared polio-free.It is an important result obtained thanks to an intensive large-scale vaccination campaign.The road was far from smooth, nevertheless, according to the WHO, a great effort needs to be made in order to facilitate access to vaccination and to promote its implementation in those countries where coverage is low and vaccine hesitancy is high because the risk of the spread of poliomyelitis is still relevant. Eradication of the virus in Africa provides us with an excellent opportunity to commemorate the many scientists who contributed to achieving this epoch-making goal: first of all, Jonas Salk, who developed a killed-virus vaccine in 1952, and, especially, Albert Sabin, who in 1961 launched programs of mass immunisation with his oral vaccine against poliomyelitis.     

Aspects of Vitamin A

Musgrave Park Hospital in 1942 was the site of an Anglo-American Vitamin A caper. A threatened court-martial was pre-empted. Subsequently the Queen''s lecturer in Anatomy, JW Millen, who was the other lecturer to the first editor of this journal, RH Hunter, did much distinguished work. The neurological effects of Vitamin A were elucidated. Further work on cerebrospinal fluid (CSF), placenta, thalidomide and poliomyelitis led to the pre-eminence in applied anatomy and teratology of now Reader James Wilson Millen and Professors JD Boyd and WJ Hamilton, all Queen''s Medical School graduates. Training of RH Hunter, JH Biggart and JD Boyd at Johns Hopkins University profoundly influenced these seminal discoveries. The Garretts, a family of Lisburn, County Down origin, saved Johns Hopkins Hospital and Medical School from financial disaster. The Garretts founded a commercial and mercantile empire that took control of the Baltimore and Ohio (B and O) Railroad and enabled the Garretts to dictate that women should be admitted to the Hopkins Medical School and Hospital on exactly the same terms as men. All women and men should already be university honours graduates. Winston S Churchill on his progress up and down the B and O main line in March 1946, recounted to President Harry S Truman and Harry Hopkins his mother''s tales of the Garrett boys'' adventures.     

内蒙古自治区2009年急性弛缓性麻痹病例监测系统运转情况分析

目的为提高内蒙古自治区急性弛缓性麻痹(AFP)病例监测系统工作质量,继续保持无脊髓灰质炎(脊灰,下同)状态。方法对2009年内蒙古AFP病例监测系统报告的病例进行流行病学分析,对监测系统运转情况进行评价。结果 2009年内蒙古自治区AFP病例监测系统共报告病例60例,分布在11个盟(市,下同)的33个旗(县、区,下同)中占全自治区总旗数的32.7%(33/101)。15岁儿童非脊髓灰质炎(脊灰)AFP病例报告发病率为1.24/10万,报告后48h内调查率96.7%,合格粪便标本采集率为88.3%,粪便标本7d内及时送检率98.3%,随访表75d及时送达率为91.8%。结论内蒙古自治区AFP病例监测系统各项指标均达到世界卫生组织(WHO)和卫生部的要求,但个别地区监测质量下降,监测工作发展不平衡,应继续加强培训和主动监测工作,进一步提高监测质量,防止脊灰的死灰复燃。     

闽东地区急性弛缓性麻痹病例监测系统建立的应用研究

[目的]评价闽东地区AFP监测系统的工作质量和应用性。[方法]利用EpiInfo软件对全区AFP监测系统上报数据进行分析。[结果]监测系统的敏感性，及时性和完整性逐年提高。15岁以下儿童非脊灰AFP病例报告发病率、合格粪便采集率等各项监测指标连续多年达到WHO和卫生部消灭脊灰的证实要求。[结论]AFP监测系统的建立和应用，在查明闽东地区脊灰发病状况、制定免疫策略，指导消灭脊灰工作中发挥了重要作用，并为无脊灰的证实提供可靠的科学依据。     

Zinc supplementation fails to increase the immunogenicity of oral poliovirus vaccine: A randomized controlled trial

BackgroundPolio eradication remains a challenge in Pakistan and the causes for the failure to eradicate poliomyelitis are complex. Undernutrition and micronutrient deficiencies, especially zinc deficiency, are major public health problems in Pakistan and could potentially affect the response to enteric vaccines, including oral poliovirus vaccine (OPV).ObjectiveTo assess the impact of zinc supplementation among infants on immune response to oral poliovirus vaccine (OPV).MethodsA double-blind, randomized placebo-controlled trial was conducted in newborns (aged 0–14 days). Subjects were assigned to either receive 10 mg of zinc or placebo supplementation daily for 18 weeks. Both groups received OPV doses at birth, at 6 weeks, 10 weeks and 14 weeks. Data was collected on prior immunization status, diarrheal episodes, breastfeeding practices and anthropometric measurements at recruitment and at 6 and 18 weeks. Blood samples were similarly collected to determine the antibody response to OPV and for micronutrient analysis. Logistic regression was used to determine the relationship between seroconversion and zinc status.ResultsOverall, 404 subjects were recruited. At recruitment, seropositivity was already high for poliovirus (PV) serotype 1 (zinc: 91.1%; control: 90.5%) and PV2 (90.0%; 92.7%), with lower estimates for PV3 (70.0%; 64.8%). By week 18, the proportion of subjects with measured zinc levels in the normal range (i.e. ≥60 μg/dL) was significantly greater in the intervention group compared to the control group (71.9%; 27.4%; p < 0.001). No significant difference in seroconversion was demonstrated between the groups for PV1, PV2, or PV3.ConclusionsThere was no effect of zinc supplementation on OPV immunogenicity. These conclusions were confirmed when restricting the analysis to those with measured higher zinc levels.     

Arnold Netter (1855–1936) and infectious pathology of the nervous system

Arnold Netter (1855–1936) was a paediatrician who clinically applied the progress that his Pasteurian contemporaries had made possible through their bacteriological discoveries. From a neurological point of view, he brought looking for Kernig's sign into mainstream use to confirm the clinical diagnosis of meningitis and made diagnostic lumbar puncture systematic. He was one of the first to cure meningococcal and pneumococcal meningitis, long before the era of antibiotics, using subtractive lumbar puncture and intraspinal serotherapy. Netter's attentive vigilance enabled him to recognise, from its onset, the first poliomyelitis epidemic of the 20th century which took place in the summer of 1909. He described the clinical and epidemiological characteristics, identifying the viral rather than microbial origin.Netter detected the first cases of encephalitis lethargica in Paris in 1918. The disease had been described by Constantin von Economo (1876–1931) in Vienna the previous year. Netter spent fifteen years studying this new disease, which caused a pandemic a century ago. He filled in the clinical picture and used his understanding of cerebrospinal fluid and pathological anatomy to enhance knowledge and improve treatment of this neurological pathology.     

Describiendo el síndrome pospolio

IntroductionPatients presenting sequelae of poliomyelitis may present new symptoms, known as post-polio syndrome (PPS).ObjectiveTo identify the clinical and functional profile and epidemiological characteristics of patients presenting PPS.Patients and methodsWe performed a retrospective study of 400 patients with poliomyelitis attended at the Institut Guttmann outpatient clinic, of whom 310 were diagnosed with PPS. We describe patients’ epidemiological, clinical, and electromyographic variables and analyse the relationships between age of poliomyelitis onset and severity of the disease, and between sex, age of PPS onset, and the frequency of symptoms.ResultsPPS was more frequent in women (57.7%). The mean age at symptom onset was 52.4 years, and was earlier in women. Age at primary infection > 2 years was not related to greater poliomyelitis severity.The frequency of symptoms was: pain in 85% of patients, loss of strength in 40%, fatigue in 65.5%, tiredness in 57.8%, cold intolerance in 20.2%, dysphagia in 11.7%, cognitive complaints in 9%, and depressive symptoms in 31.5%. Fatigue, tiredness, depression, and cognitive complaints were significantly more frequent in women.Fifty-nine percent of patients presented electromyographic findings suggestive of PPS.ConclusionsWhile the symptoms observed in our sample are similar to those reported in the literature, the frequencies observed are not. We believe that patients’ clinical profile may be very diverse, giving more weight to such objective parameters as worsening of symptoms or appearance of weakness; analysis of biomarkers may bring us closer to an accurate diagnosis.