Epidemiological considerations following long-term surveillance of invasive group A streptococcal disease in The Netherlands, 1992–2003

A nationwide laboratory-based surveillance system for invasive group A streptococcal (GAS) infections was conducted in The Netherlands from March 1992 until December 2003. Until 1996, all isolates submitted were evaluated clinically and demographically. During this period there was a transition from passive to active surveillance for some of the participating laboratories, corresponding to a national coverage of 50%. During active surveillance, participating laboratories submitted twice as many isolates from invasive GAS disease, whereas the relative submission of isolates representing very severe manifestations (toxic shock-like syndrome, fatality) did not increase. From 1997 onwards, invasiveness was defined solely on the basis of source of isolation (without clinical evaluation). During the period of microbiological and clinical evaluation, microbiological evaluation alone was found to be specific (> 99%), but had limited sensitivity (66%). Estimation of the true rate of invasive GAS disease should be based on an active surveillance system with inclusion of both microbiological and clinical data.     

胆道癌ERCP诊断(附49例分析)

本文报道用ERCP诊断胆管癌24例、胆囊癌6例、壶腹癌19例、共49例,都经手术或病理证实,诊断符合率为85.7％。 文章描述了胆道癌ERCP的X线表现。依造影所见把胆管癌分为阻塞型、狭窄型和息肉型。狭窄型又分闭塞型、环型及弥漫型三个亚型。胆管癌以阻塞型和闭塞型狭窄多见。胆囊癌表现为胆囊内基底宽广固定不变的充盈缺损。壶腹癌为壶腹部边缘不整的占位病变,可阻塞胆管或胰管或同时阻塞胰胆管。肝内胆管的软藤状改变是胆道恶性肿瘤的特征性表现。     

416例甲状腺肿瘤临床病理分析

目的了解本地区甲状腺肿瘤的发病情况，探讨甲状腺肿瘤的诊断与鉴别诊断6方法对416例甲状腺肿瘤病理资料进行回顾性分析。结果甲状腺肿瘤以良性多见，良恶性之比为8．2：1。各类型肿瘤均以女性明显多于男性，男女之比为1：5．4，好发年龄为21～50岁，肿瘤发生于甲状腺右侧多见。结论本组甲状腺肿瘤的发生率、好发年龄、性别差异、良恶之比与文献报道基本一致。乳头状腺瘤与乳头状癌的鉴别有一定难度，对可疑标本要多处取材，连续切片，仔细观察，找出其特征，提高诊断的准确性。     

老年性痴呆的病理特征与防治对策

老年痴呆症的发生与AB以及Tau蛋白的错误折叠密切相关，是蛋白质折叠相关的疾病，早期诊断是预防老年痴呆症的首要任务，而综合治疗是人类对抗老年痴呆症的必然举措。     

胎盘早剥的超声诊断

目的:探讨超声对胎盘早剥的诊断价值。方法:对过去16年间我院收治的19例经手术或阴道分娩证实的胎盘早剥患者的声像图与产后结果对照。结果:B超对Ⅰ度胎盘早剥(剥离面积<1/3)的诊断符合率为37.50%,对Ⅱ度(剥离面积1/3左右)、Ⅲ度胎盘剥离(剥离面积>1/2)的诊断符合率为88.89%。结论:超声对中重型胎盘早剥的诊断符合率较轻型患者为高。     

Time to REST: epidemiology and burden

Restless legs syndrome (RLS) is a neurological disorder characterized by a compelling urge to move, accompanied by disturbing sensations within the legs. It is now recognized that RLS is a common condition that has a substantial impact on sleep, daily activities and quality of life. Recent data from the REST (RLS Epidemiology, Symptoms, and Treatment) general population study show that symptoms of RLS are present in approximately 7% of the general population, and that 2–3% experience moderate or severe symptoms at least twice a week. Amongst this RLS cohort, approximately 88% reported sensory disturbances and 76% reported sleep-related symptoms. These symptoms had a marked effect on everyday life, with up to 50% of the RLS cohort reporting disruption of everyday activities or personal relationships. Sleep disturbances in turn lead to impaired daytime functioning. RLS is associated with a significant impairment of quality of life, comparable with that seen in chronic medical conditions such as diabetes or depression. Given the significant burden of morbidity associated with RLS, there is a strong case for treatment in patients with troublesome symptoms.     

关节镜辅助下微创经皮螺钉内固定治疗胫骨平台骨折

目的:探讨关节镜辅助下微创经皮螺钉内固定治疗胫骨平台骨折的可行性及疗效。方法:自2001年1月-2005年1月,应用膝关节镜检查及监测下经皮螺钉内固定治疗胫骨平台骨折27例,按照Schatzker分类法:Ⅰ型9例,Ⅱ型8例,Ⅲ型5例,Ⅳ型5例。所有病例均行经皮骨折有限显露复位,适当植骨,应用1~3枚松质骨拉力螺钉内固定,术后配合CPM功能锻炼。结果:本组随访6~24个月,平均15个月。骨折临床愈合时间3~4个月,平均3·5个月。无畸形愈合、感染、螺钉断裂。按Sanders膝关节功能评分法评定结果:优12例,良11例,中3例,差1例,优良率85·2%。结论:关节镜辅助经皮螺钉内固定是治疗胫骨平台骨折的有效方法之一,其对膝关节创伤小,可达解剖复位,固定可靠,患肢功能恢复好,并发症少。     

孕妇血清AFP、uE3和β-hCG水平与严重胎儿缺陷的关系

①目的 探讨孕中期血清甲胎球蛋白（AFP），游离雌三醇（uF3)和β绒毛膜促性腺激素（β-HCG）水平与严重胎儿缺陷的关系。②方法 用ELISA方法对832例16-21周妊娠妇女血清AFP、UE3和β-hCG进行检测，以筛查阳性病人。③结果 14例胎儿被确诊为异常，其中唐氏综征2例，无脑儿3例，脊柱裂3例，唇腭裂1例，腹裂肠外翻1例，孕中期自然流产2例，死胎1例，葡萄胎1例，总检出率为1.68%，假阳性15例，占被检人数的1.80%。④结论 以上3种生化指标联合检测可作为产前诊断严重胎儿缺陷的有效方法。     

磁共振成像对肺癌的诊断价值

目的：探讨磁共振成像对术前肺部恶性、良性肿瘤诊断的准确性。方法：回顾性分析了104例肺部肿瘤磁共振成像术前检查与术后病理检查的结果。结果：磁共振成像对术前肺部恶性、良性肿瘤的诊断准确率分别为70％和30％，术后病理检查对肺部恶性、良性肿瘤的诊断准确率分别为83％和17％。结论：磁共振成像对肺部恶性和良性肿瘤具有一定的诊断价值。