Systemic Nickel Allergy after Internal Fixation of a Bunionectomy

Allergic reactions to implanted metals have been estimated to occur in 1% to 5% of orthopedic cases. Stainless steel screws, which contain 14% nickel, are commonly used for internal fixation in an array of podiatric procedures. We present a rare case of a systemic allergic reaction to nickel secondary to stainless steel screw fixation in a bunionectomy procedure.     

Sampling methods for the study of pneumococcal carriage: A systematic review

Streptococcus pneumoniae is an important pathogen worldwide. Accurate sampling of S. pneumoniae carriage is central to surveillance studies before and following conjugate vaccination programmes to combat pneumococcal disease. Any bias introduced during sampling will affect downstream recovery and typing. Many variables exist for the method of collection and initial processing, which can make inter-laboratory or international comparisons of data complex. In February 2003, a World Health Organisation working group published a standard method for the detection of pneumococcal carriage for vaccine trials to reduce or eliminate variability. We sought to describe the variables associated with the sampling of S. pneumoniae from collection to storage in the context of the methods recommended by the WHO and those used in pneumococcal carriage studies since its publication. A search of published literature in the online PubMed database was performed on the 1st June 2012, to identify published studies that collected pneumococcal carriage isolates, conducted after the publication of the WHO standard method. After undertaking a systematic analysis of the literature, we show that a number of differences in pneumococcal sampling protocol continue to exist between studies since the WHO publication. The majority of studies sample from the nasopharynx, but the choice of swab and swab transport media is more variable between studies. At present there is insufficient experimental data that supports the optimal sensitivity of any standard method. This may have contributed to incomplete adoption of the primary stages of the WHO detection protocol, alongside pragmatic or logistical issues associated with study design. Consequently studies may not provide a true estimate of pneumococcal carriage. Optimal sampling of carriage could lead to improvements in downstream analysis and the evaluation of pneumococcal vaccine impact and extrapolation to pneumococcal disease control therefore further in depth comparisons would be of value.     

护患情境会话

抑郁病人的护理 交流 护士:既然医生没告诉你病看不好了,就表明你的病是有希望治好的.你的各项检查报告显示你的不适感并非由器质性疾病引起,而是抑郁症的一种典型临床表现.像你这样的抑郁症我们遇到的不少,他们都痊愈出院了.你要对自己有信心,医生、护士会帮助你战胜病魔的. 病人:可是,我身体不好,不能工作,也不能照顾家人,反而拖累他们,要他们一天到晚陪着我,照顾我,觉得自己真是没用,还不如死了算了.     

KIinefeIter综合征的诊断：新型甲基化特异性实时定量PCR

本文研究目的为设计一种基于额外X染色体（X-ch）检测的分子检测方法用于Klinefelter综合征的诊断。从26名47，XXY男性，2名46，XY／47，XXY男性，22名46，XY男性和15名46，XX的女性的外周血标本中提取DNA，并进行脱氨基处理。甲基化特异性的定量多聚酶链反应（MS-qpPCR）以非甲基化和甲基化的X染色体非活化特异性转录基因（XIST-U和XIST-M）拷贝为模板。X染色体二倍体通过XIST基因甲基化状态来判定。46，XY／47，XXY男性的嵌合程度通过核型分析和原位荧光杂交（FISH）的结果比较来判定。数据分析应用Roche LightCycler software v．3．5.3，包括通过拟合点分析和溶解曲线分析决定交叉点（CPs）。所有对照组女性和Ks患者均检测到X染色体二倍体，而对照组男性只表达XIST-M。XIST-U和IXIST-M的交叉点范围分别是（29．5-32．5，SD0．8）和（29-31，SD0．6）。嵌合度的检测极限为1％。根据2名47，XXY/46，XY患者的XIST-U／）（IST-M比值分析，计算出的嵌合率（1．8％和17．8％）与FISH结果（2．3％和15％）相当。从DNA脱氨基到最终数据分析的间隔小于9小时。本文得出结论：MS-qpPCR是一种敏感、特异及快速的X染色体二体检测方法，可以用于KS的筛查和诊断，甚至在低嵌合水平的47，XXY／46，XY患者也适用。     

注射用两性霉素B治疗艾滋病/HIV感染合并深部真菌感染的不良反应及防护

目的:为临床合理应用注射用两性霉素B(AMB)治疗人类免疫缺陷病毒(HIV)感染或艾滋病(AIDS)合并深部真菌感染提供参考。方法:收集某院2010年1月至2012年2月期间住院治疗的3 202例HIV/AIDS患者的临床资料,分析其中使用AMB治疗深部真菌感染患者的不良反应(ADR)发生及防护。结果:HIV/AIDS合并深部真菌感染患者948例,感染率为29.61%;899例使用AMB,其中18例出现ADR,发生率为2.00%。AMB静脉滴注的ADR主要表现为发热、腹泻、瘙痒、肝功能异常及血液系统毒性。及时停药或减量,同时对症治疗,可有效地减少、减轻药物的ADR。结论:AMB虽ADR多见,但其疗效确切,是治疗HIV/AIDS合并深部真菌感染比较安全、有效、经济的选择。只要合理用药,严密监测用药后患者病情进展,尽早发现ADR,及时采取有效措施,并将心理护理贯穿治疗始终,就能保证患者治疗的顺利进行。     

human NF-κB miRNA干扰载体的构建

目的:设计并构建针对胰腺癌基因治疗中最关键的靶基因人细胞核因子κB(human NF-κB)的miRNA干扰载体。方法:根据靶基因设计并合成miRNA oligo(引物设计软件),将oligo退火成双链,然后用载体构建试剂盒进行重组克隆,将双链的miRNA oligo插入到miRNA表达载体中,构建miRNA质粒,转化入感受态细胞DH5α,从转化平板分别挑取克隆,用载体通用引物进行菌落PCR筛选,筛选得到的阳性克隆进行测序,以验证重组克隆中插入片段序列是否与设计的oligo序列一致。结果:经过比对,重组克隆中插入片段序列与设计的oligo序列完全一致。结论:成功构建了针对靶基因human NF-κB的miRNA干扰载体,为进一步研究奠定了基础。     

肾上腺素大腿前外侧肌内注射抢救 严重过敏反应的临床效果观察

〔摘 要〕 目的：探讨肾上腺素大腿前外侧肌内注射抢救严重过敏反应的临床效果。方法：选择 2018 年 1 月至 2022 年 7 月东莞市长安医院收治的 60 例 Ⅱ ~ Ⅳ 级的严重过敏反应者，按照不同的使用肾上腺素给药方法，分为两组， 各 30 例。观察组针对 Ⅱ ~ Ⅳ 过敏反应患者，使用肾上腺素原液大腿中 1/3 前外侧深部肌内注射，针对 Ⅳ 级严重过 敏反应者，联合肾上腺素（1:10000）静脉注射。对照组针对 Ⅱ ~ Ⅳ 级过敏反应者，使用肾上腺素原液皮下注射，针 对 Ⅳ 级严重过敏反应者均予序贯肾上腺素（1:10000）静脉注射，比较干预前后两组患者生命体征变化情况，循环稳 定时间及肾上腺素总用量，以及干预期间不良反应情况。结果：干预后，两组患者心率、呼吸频率均低于干预前，平 均动脉压均高于干预前，且观察组患者心率、呼吸频率均低于对照组，平均动脉压高于对照组，差异具有统计学意义 （P ＜ 0.05）；观察组患者循环稳定时间短于对照组，肾上腺素总用量少于对照组，差异具有统计学意义（P ＜ 0.05）； 观察组患者不良反应发生率低于对照组，差异具有统计学意义（P ＜ 0.05）。结论：对于不同级别严重过敏反应者， 使用大腿中 1/3 前外侧深部肌内注射联合静脉注射肾上腺素（1:10000）的治疗效果均较好，且不良反应少。     

腹腔镜下卵巢囊肿剥除术的疗效观察及安全性分析

目的:探讨腹腔镜下卵巢囊肿剥除术的疗效观察及安全性。方法:以2017年1月~2018年12月期间108例卵巢囊肿的患者为研究对象,按照患者入院治疗的先后顺序,将其分为观察组与对照组各54例,对照组实施传统开腹手术,观察组实施腹腔镜卵巢囊肿剥除术,观察两组患者的临床指标及不良反应率。结果:观察组患者手术用时及肛门首次排气时间明显短于对照组,术中出血量明显少于对照组(P<0.05);观察组5.56%的不良反应率明显低于对照组20.37%的不良反应率(P<0.05)。结论:针对卵巢囊肿患者,行腹腔镜下卵巢囊肿剥除术能缩短手术用时及肛门首次排气时间,减少术中出血量,使得不良反应发生率得以减少,对患者预后有着积极的作用。     

The histopathologic spectrum of decorative tattoo complications

Tattooing for ornamental purposes is an ancient practice that remains popular in modern times. Tattoos are encountered by the dermatopathologist either as incidental findings on skin biopsies or because of complications specific to the tattoo. A range of neoplasms and inflammatory conditions are seen in association with tattoos, many of which may be attributed to hypersensitivity to tattoo inks. The composition of tattoo inks is highly variable, and inks can contain numerous potentially allergenic or carcinogenic compounds. Infections with bacterial, viral and fungal species can occur after tattooing, sometimes after substantial delay. Atypical mycobacterial infections in particular are increasingly reported; special stains for mycobacteria should be performed and cultures recommended particularly when dense, mixed or granulomatous infiltrates are present.