HIV, HCV, and HBV co-infections in a rural area of Shanxi province with a history of commercial blood donation

Background:Unhygienic blood collection in the early 1990s led to blood‐borne infections in Central China.This study aimed to estimate human immunodeficiency virus (HIV) co‐infection with hepatitis C and B viruses (HCV and HBV) and their risk factors in a rural area of Shanxi Province with a history of commercial blood donation.Methods:A cross‐sectional study was conducted in 2004.All adult residents in the target area were invited to participate in the study.Face‐to‐face interviews were completed and blood ...     

Mass Spectrometry Biotyper System Identifies Enteric Bacterial Pathogens Directly from Colonies Grown on Selective Stool Culture Media

We evaluated the performance and cost-effectiveness of a matrix-assisted laser desorption ionization time-of-flight mass spectrometry-based Biotyper system for the routine identification of common enteric bacterial pathogens seen in middle Tennessee from suspicious colonies grown on selective stool culture media. A total of 304 suspicious colonies were selected and further identified from 605 stool specimens. The suspicious colonies were analyzed by the Biotyper system, and the results were compared to those from routine phenotypic methods, which identified 22 Salmonella species, 39 Shigella species, 3 enterohemorrhagic Escherichia coli (EHEC) isolates, 2 Yersinia enterocolitica isolates, 2 Campylobacter species, and 236 gastrointestinal normal flora isolates. The Biotyper system correctly identified the Salmonella species, Yersinia enterocolitica, and Campylobacter species but failed to distinguish the Shigella species and EHEC isolates from E. coli. Among the 236 normal flora isolates, 233 (98.7%) and 228 (96.6%) agreed at the genus and species levels, respectively, between the phenotypic and Biotyper methods. Organism identification scores were insignificantly different between colonies directly from selective media and subsequently from pure subculture. The entire Biotyper identification procedure, from smear preparation to final result reporting, can be completed within 30 min. The Biotyper system provides a rapid and simple screening tool for identifying many, but not all, suspicious colonies grown on selective media within 24 h after inoculation, which shortens test turnaround time by 2 to 3 days.Infectious diarrhea continues to be a worldwide problem and accounts for more than 2 million deaths annually (6, 25, 38). For example, in the United States, it is estimated that there are between 211 and 375 million episodes of acute diarrhea each year, and such episodes are responsible for more than 900,000 hospitalizations and 6,000 deaths annually (18, 21). Stool specimens from patients with acute diarrheal illnesses, particularly with systemic illness, fever, or bloody stools, are routinely cultured for enteric bacterial pathogens. In addition to Salmonella, Shigella, and enterohemorrhagic Escherichia coli (EHEC), the list of potential enteric bacterial pathogens has been expanded to include microorganisms such as Campylobacter jejuni, Aeromonas hydrophila, Yersinia enterocolitica, and Vibrio species.Bacterial stool cultures remain the mainstay laboratory diagnostic method for the evaluation of diarrheal illnesses. Moreover, providing a rapid, accurate, and specific identification of enteric bacterial pathogens is considered essential for directing the antimicrobial therapy of diarrheal illnesses (4, 32, 38). Selective agars are used to facilitate the isolation of suspicious enteric bacterial pathogens. Pure cultures obtained subsequently then allow the microorganisms to be more fully characterized and identified by morphological and biochemical characteristics. These conventional methods, however, are time-consuming and labor-intensive, and they require experienced clinical microbiologists. A number of different types of selective media have been developed to enhance the recovery of enteric pathogens from stool samples. Unfortunately, these media have been shown to have poor specificity and produce numerous false-positive colonies (11, 16, 33). The identification and confirmation of suspicious colonies is highly nonspecific, and it places a heavy burden on the laboratory in terms of biochemical and serological testing (11, 16, 34). Multiplex PCR-based molecular methods have the potential to provide rapid results, but the detection and identification of a panel of pathogens has been difficult and costly (15, 17, 24, 31).In recent years, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has emerged as a new technology for species identification. The analyte molecules embedded within the saturated matrix on the target plate are irradiated by a laser of special wavelength and intensity, inducing desorption and ionization; the charged analytes then are accelerated by an electric field in a flight tube to a detector, where they are captured. The separation of various molecules depends on the time of flight, which is reversely proportional to the mass of molecules. After detection signals are processed and interpreted into the mass spectra, the characteristic mass peaks are used to characterize and eventually identify the microorganisms. By measuring the exact sizes of peptides and small proteins, which are assumed to be characteristic for each bacterial species, it is possible to determine the species within a few minutes of when the analysis is started with whole cells, cell lysates, or crude bacterial extracts (8, 14, 22, 26, 27, 36).A MALDI-TOF MS-based Biotyper system (Bruker Daltonics, Germany) has been developed for the rapid identification and characterization of microorganisms based on the characterization of biomarker molecules, which are mostly mass signals of ribosomal protein with house-keeping functions in a comparatively more efficient manner (1, 7, 23, 30, 37). In this preliminary study, we explored the application of the Biotyper system for the routine identification of common enteric bacterial pathogens seen in middle Tennessee directly from suspicious colonies grown on selective stool culture media.(This study was presented in part at the 110th American Society for Microbiology Annual Meeting, San Diego, CA, 23 to 27 May 2010.)     

深圳市中小学生伤害流行特征及其疾病负担调查

目的了解中小学生伤害的流行特征及造成的社会及经济损失.方法采用分层整群抽样的方法,调查深圳特区内外2个市区6所中小学校2181名学生2000年伤害发生情况.结果年伤害发生率为15.59%,男生高于女生(P＜0.01),中学生高于小学生(P＜0.01),发生率随年龄增长而上升,高中为高发年龄段.居前三位的伤害为跌伤、交通伤、碰撞伤,其主要发生原因为运动、骑车及玩耍.校外或校内受伤机会远多于家中,分别为43.52%、37.37%和19.11%.结论开展以学校为主体的综合干预措施对降低中小学生伤害的发生非常重要.     

心房颤动对脑动脉血流的影响

目的 :观察心房颤动 (AF)对脑动脉血流的影响。方法 :选择 14例心功能代偿期AF患者作观察组 (AF组 ) ,18例同龄健康体检者作对照组。采用经颅多普勒检测仪 (TCD)以脑动脉平均血流速度 (Vm)及搏动指数 (PI)为观察指标。结果 :AF组脑动脉血流速度快慢不一 ,各动脉血管的Vm均较对照组降低 ,P <0 .0 5或 0 .0 1。AF组大脑中动脉 (MCA)、大脑前动脉 (ACA)的最大心搏平均血流速度 (MaxVm)及心室率控制在 6 0～ 10 0次 /min内时MCA的Vm与对照组比较无统计学差异 ,P >0 .0 5 ,但MCA、ACA的最小心搏平均流速 (MinVm)及心室率低于 6 0次/min时MCA的Vm较对照组显著降低 ,P <0 .0 1;AF组基底动脉 (BA)、椎动脉 (VA)及大脑后动脉 (PCA)的MaxVm、Vm、MinVm及任何心室率范围BA的Vm均较对照组Vm显著降低 ,P <0 .0 5或 0 .0 1。AF组与对照组的PI值比较无统计学意义 ,P >0 .0 5。结论 :AF对脑底动脉血流均有不同程度的影响 ,表现为Vm降低 ,供血减少。AF心室率低于 6 0次 /min对脑血流影响严重 ;AF对椎基底动脉系统的血流影响较颈内动脉系统严重。     

六味地黄丸对帕金森患者自主神经功能的影响

目的：评估六味地黄丸对已接受多巴胺替代治疗的帕金森病患者多个系统自主神经症状的影响。方法：128侧应用多巴胺替代治疗的原发性PD患者，随机分为两组，对照组63例单用多巴胺替代治疗，六味地黄丸组65例在多巴胺替代治疗基础上合用六味地黄丸。治疗6个月后，两组进行SCOPA—AUT量表评估。结果：六味地黄丸组在泌尿系统、体温调节功能、性功能三方面症状SCOPA—AUT评分和总分上显著低于对照组（P〈0．05），而在消化系统、心血管系统和瞳孔调节功能方面评分与对照组相比未见显著性差异。在各系统症状发生率方面，六味地黄丸组有增加腹胀、减少大便失禁的趋势，但与对照组比较无显著性差异（P〉0．05）。六味地黄丸可显著降低患者夜间盗汗和畏热的发生率，减少夜尿、尿失禁、尿频，还能明显减少性功能障碍，与对照组比较均有显著性差异（P〈0．05）。六味地黄丸对心血管系统和瞳孔调节系统症状发生率未见明显影响（P〉0．05）。结论：帕金森病患者显示出明显的多系统自主神经症状。本研究证实六味地黄丸可在泌尿系统、体温调节和性功能等多方面改善帕金森病自主神经症状。     

愈胃舒胆颗粒对胃动力低下大鼠血液及组织中胃泌素、胃运素含量的影响

临床及实验研究表明,组织及血液中的脑肠肽含量与胃肠动力障碍发生密切相关。愈胃舒胆颗粒通过提高胃动力低下大鼠血液及胃窦组织中的脑肠肽胃泌素、胃运素含量从而达到提高大鼠胃肠动力的效果。     

全凭静脉麻醉妇科腹腔镜手术患者保持自主呼吸的可行性

目的分析全凭静脉麻醉下妇科腹腔镜手术患者保持自主呼吸的可行性和安全性。方法206例患者用芬太尼、氯胺酮和丙泊酚靶控输注并维持麻醉深度为听觉诱发电位（AAI）20～30，气腹压力≤12mmHg，头低位25℃。在全凭静脉麻醉下维持自主呼吸完成手术。记录患者麻醉前（Tn），静脉全麻后AAI降至20以下（T1），气腹后3min（T2），T体位后3min（T3），气腹后30min（T4），术毕后10min（B）时的HR、SBP、DBP、Rf及PETCO2。结果血流动力学的变化，T1、T2及T3的HR与T0相比显著加快（P〈0．05），T4、T5的测得值与佝相比差异无显著性。气腹前后及手术全过程SBP、DBP平稳，与麻醉前差异无显著性（P〉0．05）。Rf及PETCO2的变化，气腹全程至术毕（T2～T5）Rf均加快，与T0相比差异有显著性（P〈0．05），T2、T3及T4的PETCO2与T0相比明显上升（P〈0．05），术毕后10min接近气腹前水平。结论在气腹压力≤12mmHg、CO2流量为3L／min、麻醉深度为AAI20～30时，可以有效维持妇科腹腔镜患者的自主呼吸。     

健康干预对妊娠期糖尿病的围产结局

目的探讨健康干预对妊娠糖尿病的围产结局。方法选择已确诊的妊娠期糖尿病患者123例分为干预组和对照组，干预组采取一系列妊娠期健康促进干预措施，对照组不进行特殊干预。结果对照组围生病率明显高于干预组，妊高征（x^2=30．5525，P=0．00005）、巨大儿（x^2=5．3953，P=0．0202）、新生儿窒息（x^2=5．6267，P=0．0177）、胎儿窘迫（x^2=12．8041，P=0：0003）、早产（x^2=40．1748，P=0．0000）、羊水过多（x^2=4．6313，P=0．0314），其差异均有显著性意义。结论妊娠期糖尿病严重威胁着母儿健康，尽早对孕期糖尿病患者进行健康干预，可有效降低母婴并发症。     

中药序贯治疗对NSTAMI患者左心室收缩非同步性影响的研究

目的:研究中药序贯治疗对NSTAMI患者左心室收缩非同步性的改善作用。方法:将入选NSTAMI患者60例随机分为治疗组、对照组各30例。对照组予常规西医治疗,治疗组在对照组治疗基础上,采用中药序贯治疗,先予活血祛瘀之血栓通注射液,而后改用温阳益气之参附针,疗程均为7d,共14d。检测血栓相关指标、心电图及超声检测左心室收缩不同步指数和心功能指标进行评价。结果:治疗组血栓相关指标下降明显优于对照组(P0.05),心电图NST及ΣST改善优于对照组(P0.05),心功能Tei指数、LVEF好转优于对照组(P0.05),左室收缩不同步指数SDI-Tv与SDI-Tmv下降优于对照组(P0.05)。SDI与Tei指数和LVEF呈显著相关性(P0.05),SDI与E/A无相关性(P0.05)。结论:中药序贯治疗能促进NSTAMI的心肌再灌注,有效改善心室收缩不同步运动和心脏功能,无严重不良反应。     

两类留置针在OGTT采血过程中的比较

静脉留置针应用于临床，既减少了病人痛苦也方便医务人员的工作。由于市场上留置针有多种型号产品，我们选用了两种类型留置针用于作ＯＧＴＴ试验静脉抽血，观察它们对溶血的影响，结果发现德国ＢＲＡＵＮＵ－ＬＥ套管式留置针溶血例数（占１６．７％）比美国产Ｂ－Ｄ软管式留置针（占２．８６％）高很多（Ｐ〈０．０１），且溶血程度也较深。这给我们更好地选择留置针提供了参考。