Repeatability and validity of an upper limb and neck discomfort questionnaire: the utility of the standardized Nordic questionnaire

The repeatability and validity of a questionnaire for upper limb and neck complaints were assessed in a population of 105 hospital outpatients with a range of upper limb and neck disorders (including cervical spondylosis, adhesive capsulitis, lateral epicondylitis, carpal tunnel syndrome and Raynaud's phenomenon). Subjects were asked to complete a modified Nordic-style upper limb and neck discomfort questionnaire on two occasions closely spaced in time. The repeatability of their responses was assessed by calculating a kappa coefficient (kappa), and the sensitivity and specificity of component items in the questionnaire were determined for specific diagnostic categories of upper limb and neck disorder. Symptom reports for pain in the upper limb and neck, pain interfering with physical activities, neurological symptoms and blanching were all found to be highly repeatable (kappa = 0.63-0.90). A number of regional pain reports proved to be very sensitive in relation to specific upper limb disorders, but, with the exception of reported finger blanching in patients with Raynaud's phenomenon, none proved to have a good specificity (range = 0.33-0.38). We conclude that a modified Nordic-style questionnaire is repeatable and sensitive, and is likely to have a high utility in screening and surveillance. However a complementary examination schedule of adequate specificity and repeatability is essential to establish a clinical diagnosis.     

临床分离菌的耐药性测定与分析

目的：分析本地区临床分离菌耐药趋势，为合理选择抗生素提供参考。方法：用Kirbv-Bauer琼脂扩散法测定285株革兰阴性菌和133株革兰阳性菌对18种抗菌药物的敏感性，计算各菌种对不同抗生素的耐药率。结果：多数革兰阴性菌对第三代头孢菌素耐药率明显增加。74株金黄色葡萄球菌中甲氧西林耐药的金黄色葡萄球菌检出率为28．4％；所有金葡菌对万古霉素均敏感，耐万古霉素的肠球菌检出率为3．4％。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶阳性率分别是34．0％和29．7％。结论：本地区常见致病茵耐药情况较严重，提示用药前的药敏试验是非常必要。     

1999至2001年广州地区临床常见肠杆菌科细菌耐药性监测结果分析

目的 了解临床分离常见肠杆菌科细菌的耐药性。方法 统一采用纸片扩散法进行实验，以美国NCCLS文件为判断标准，每次监测均有质控数据。结果 共有11家广州市三级甲等医院实验室参加耐药性监测，三年共统计临床常见肠杆菌科细菌3147株。结论 对肠杆菌科细菌，亚胺培南的耐药率最低，可考虑为临床首选药物，阿米卡星、头孢他啶耐药率相对较低，可选择用药。庆大霉素的耐药率有逐年下降的趋势，将来可能成为临床一线药。而磺胺甲噁唑／甲氧苄啶、四环素、萘啶酸等耐药率相对较高，应慎用。氨节西林的耐药率很高，应避免使用。     

288例老年呼吸道感染患者病原菌分布特性及药敏分析

目的: 了解老年呼吸道感染患者病原菌的分布特点及药敏特性.方法: 对288例老年呼吸道感染患者痰样本(NCCLS法)进行细菌培养,K-B纸片法进行药敏测定.结果: 患者痰中共检出病原菌400株,细菌280株,其中G-杆菌147株,占36.75%, G 球菌133株,占33.25%.肺炎克雷伯菌及铜绿假单胞菌最敏感药的是头孢他啶,敏感率均为40%以上,肺炎链球菌和金黄色葡萄球菌最敏感药的是万古霉素;检出真菌120株,占30%,以白色念珠菌为主.结论: 进行病原菌跟踪监测及时的药敏试验,对及时控制老年呼吸道感染,是不可缺少的重要环节.     

Tamoxifen and the female genital tract

Ugwumadu AHN, Carmichael P, Neven P. Tamoxifen and the female genital tract. Int J Gynecol Cancer 1998; 8 : 6–15.
Tamoxifen was originally developed by Imperial Chemical Industries (England) (ICI) in 1966 as an anti-estrogenic contraceptive. Ironically, it found a role in the treatment of anovulatory infertility, but its most important application to date is in adjuvant hormonotherapy for breast cancer. Tamoxifen has a complex and poorly understood mix of estrogenic and anti-estrogenic properties with variable and contrasting effects on hormone-sensitive target tissues, such as the endometrium. This article reviews the gynecologic lesions associated with tamoxifen therapy and discusses the merits and acceptability of endometrial surveillance tests and the role of progestogens.     

黑龙江省医疗机构突发事件监测能力的影响因素分析

采用定性与定量相结合的方法对黑龙江省部分医疗机构突发公共卫生事件监测情况调查研究.结果显示:现阶段影响医院应急预警信息收集与上报能力的主要因素为:人员、资金、政策支持、培训演练;其中影响人员信息收集与上报能力的因素为:预案知晓情况、传染病的知晓情况、传染病报告时限的了解情况、医院类别.     

2001~2004年合肥市麻疹监测系统数据分析

目的评价合肥市麻疹监测系统数据,为控制和消除麻疹提供依据。方法对2001~2004年合肥市确诊的539例麻疹病例进行流行病学分析,并用ELISA(酶联免疫吸附试验)法检测血清麻疹IgM抗体和风疹IgM抗体。结果2001~2004年平均发病率为3.01/10万,2004年较2001年发病下降了43.6%,发病人群主要为中、小学生,<15岁儿童占总病例数的63.1%。结论应进一步对薄弱地区、薄弱人群进行MV的加强免疫活动,控制麻疹爆发;在有条件的地区对1~14岁儿童开展麻疹-腮腺炎-风疹联合疫苗使用,同时注意<1岁和20岁以上人群发病逐渐增长的趋势。     

深圳市麻疹监测及其控制策略评价

为了解深圳市控制麻疹的进展,以进一步控制麻疹疫情,对麻疹的发病资料进行流行病学分析,并结合麻疹疫苗常规接种和强化免疫情况对麻疹发病率的影响进行分析.结果显示,2000～2003年麻疹年平均发病率(10.21/10万)比1996～1999年(5.95/10万)上升了71.6%,2002年麻疹发病率在近几年中是最低.全市六个区均有病例发生,龙岗区、宝安区和南山区发病率较高.流行模式主要为散发.3～7月为麻疹高发季节,1～5岁和20～29岁为麻疹高发病年龄组.男女性别比为1.12:1.对麻疹免疫史分析表明,10.25%的麻疹病例未接种麻疹疫苗(MV),47.49% 的病例无免疫史,42.25%免疫史不详.建议采用以下控制麻疹策略,维持高水平麻疹接种率,加强免疫年龄提前到1.5～2岁,在外来青工中开展麻疹疫苗接种工作,进一步加强麻疹监测工作,充分利用麻疹监测系统,及时制定免疫方案以控制麻疹疫情.