2000年广西麻疹疑似病例血清学监测分析

目的了解麻疹的血清流行病学特征 ,探讨麻疹与风疹之间的血清学鉴别诊断。方法采用酶联免疫吸附法对714例RFIs的血清标本进行麻疹IgM和风疹IgM抗体检测 ,对204例麻疹IgM抗体阳性的血清标本进行麻疹IgG抗体检测。结果麻疹IgM阳性率为45.7 % ,风疹IgM抗体阳性率为27.5%。在出疹后4～14天采集的血清标本其麻疹IgM和风疹IgM抗体阳性检出率最高。麻疹IgM阳性数以1～14岁为主 ,1～6岁最高 (44.5% ) ,风疹IgM阳性数是7～14岁为最高 (73.5% ) ;麻疹IgG检出<1:200为76例 (27.7 % ) ,1:200为59例 (21.5% ) ,1:800为17例(6.2 %) ,1:3200为25例(9.1 %) ,≥1:12800为27例(9.8 %)。结论采血时间与检出率密切相关 ;采集血清标本要注意质量和采集时间 ;麻疹患者与风疹患者有一定的年龄差距 ,风疹是最主要的需要与麻疹相鉴别的RFIs,未经实验室诊断极易发生误诊 ;应提高麻疹实验室诊断的及时性、准确性和敏感性 ,建议有条件的地区开展麻疹抗体血清学检测     

接种麻疹疫苗后发热出疹性病例的流行病学调查

目的 调查接种麻疹疫苗(MV)后发热出疹性疾病(RFIs)的发病情况。方法 对山东省1999～2002年通过麻疹监测专报系统报告的150例接种MV后RFIs病例进行流行病学调查和分析。结果 接种MV后RFIs多呈散发状态,且相互之间无流行病学联系;以MV投入量进行估算,报告发生率为0.14/10 000ml～0.25/10 000ml,年均报告发生率为0.20/10 000ml,且各年份发生率之间差异有统计学意义(X~2=10.13,P<0.05);88.67％的病例发热在38.5℃以上,75.33％的病例接种MV后4～11天出疹(中位数为8天),皮疹较为典型;出疹顺序基本与野病毒引起的麻疹病例一致;68.67％的病例为首次接种MV,其中8～12月龄组占94.17％;风疹IgM均为阴性,麻疹IgM阳性率为45.65％。结论 接种MV可引起RFIs,主要原因是疫苗接种后的过敏反应和减毒活疫苗引起的疫苗相关病例,其发生率与疫苗接种剂次有关;RFIs病例是否与接种麻疹疫苗有因果关系,今后应从病毒的基因型上加以鉴别。     

Validation of the fear of COVID-19 scale in South Africa: Three complementary analyses

Fear is the most common response to disease outbreaks. Persistent and prolonged fear can elevate the levels of psychological distress and aggravate preexisting mental health problems. Therefore, prompted by the central role of fear in psychological responses to COVID-19, the Fear of COVID-19 Scale was developed, which is the only instrument that can assess emotional fear reactions in relation to the current pandemic. In this study, we extend research on the psychometric properties of this instrument by adopting three complementary approaches: classical test theory, Rasch analysis, and Mokken analysis. Combining these methods allows for a more nuanced overview of the psychometric properties of the instrument. The sample comprised South African teachers (n = 355) who completed the Fear of COVID-19 Scale. All three approaches confirmed the reliability and the construct, convergent, and concurrent validity of the scale as used with South African teachers. In addition, all three approaches confirmed that the scale is sufficiently homogenous to be considered unidimensional.     

利伐沙班致皮疹文献病例分析

目的:探究利伐沙班导致皮疹的特点,为患者安全用药提供参考。方法:检索国内外数据库,获得利伐沙班致皮疹的病例报道文献,对病例的患者年龄、性别、既往病史,利伐沙班使用目的、使用剂量、联合用药,药品不良反应(ADR)出现时间、临床表现、处理、预后等信息,以及ADR关联性评价结果进行统计分析。结果:共检索获得16篇文献(16例患者)。ADR患者男女比例为1∶1,>60岁老年患者11例(68. 7%)。16例患者中14例的利伐沙班给药剂量符合药品说明书规定,12例患者联用了其他药物;5例(31. 3%)患者用药后第3天出现皮疹,3例(18. 8%)在用药10 d时出现。16例均出现全身多处散在红斑,其中8例明确诊断为伴嗜酸粒细胞增多及系统症状的药疹综合征、特发性血小板减少性紫癜、白细胞破碎性血管炎、血清病和神经性水肿;患者经治疗后症状改善。5例患者关联性评价为"很可能有关",11例为"可能有关"。结论:临床工作中要关注利伐沙班导致的皮疹,长期服药患者仍应引起重视。     

Rash Impulsiveness and Reward Sensitivity as predictors of treatment outcome in male substance dependent patients

Recent theories hypothesize that the impulsivity observed in addictive behaviors is a two-factor construct, consisting of Rash Impulsiveness and Reward Sensitivity. There is some evidence for this distinction, but it is unknown what the clinical relevance of this distinction is. The present study examines the predictive value of the two-factor model regarding drop-out from treatment and relapse into substance use in a clinical population of male substance dependent patients. Both behavioral and self-report measures of Rash Impulsiveness and Reward Sensitivity were measured during treatment while substance use relapse was measured after 90 days. Results indicate that treatment drop-out could be predicted by a behavioral index of Reward Sensitivity (Card Playing Task); self-reported Rash Impulsiveness only approached significance as predictor drop-out. In contrast, relapse could not be predicted in the present study. These findings might have implications for the early identification and treatment of patients at risk of treatment drop-out.     

皮肌炎／多发性肌炎127例临床分析

目的 探讨DM/PM的临床表现，主要诊断要点和疗效。方法 分析了127例住院病例资料。结果 初发症状以皮损（52.8％）和皮损肌炎同发（31.5％）多见，而仅有肌炎占14.9％。皮损以眼睑及眶周浮肿性紫红色斑（85.2％），Gottron丘疹（58.3％），甲周红斑（43.5％）和皮肤异色病样改变（43.5％）多见，胆炎以四肢近端（82.3％）和吞咽肌群（44.9％）多见。此外可见血清肌浆酶和24h尿肌酸排出量增加，肌电图异常，少数合并恶性肿瘤及心肌受累。皮质激素治疗有效，与MTX合用能提高疗效。结论 眼睑及眶周浮肿紫红色斑，四肢近端肌无力，肌痛，肌力减退及24h尿肌酸排出量增加为主要诊断要点。皮质激素治疗有效，合用MTX能提高疗效。     

小儿36例复发及慢性过敏性紫癜临床分析

目的分析小儿复发及慢性过敏性紫癜的临床特点及预后。方法回顾性分析皮疹复发及慢性组、肾炎复发及慢性组及普通对照组过敏性紫癜患儿的临床特点,并比较3组患儿紫癜性肾炎的临床分型及预后。结果3组患儿持续性皮疹、严重腹痛、肾炎的症状与体征发生率比较差异均有统计学意义（P〈0.05）;3组患儿紫癜性肾炎临床类型的构成及预后分级比较,差异均无统计学意义（P〉0.05）。结论对于年龄超过9岁、严重腹痛、持续性皮疹、肾炎者,转为复发及慢性过敏性紫癜的可能性较大,应积极寻找诱因,多方面综合治疗,以防止病情进一步加重。     

喜炎平注射液治疗小儿手足口病的疗效观察

目的探讨喜炎平注射液在小儿手足口病治疗中的临床疗效。方法选择2009年5月～2011年5月在我院治疗的手足121病患儿45例,随机分为研究组22例和对照组23例。研究组在常规治疗基础上加用喜炎平注射液治疗,在常规治疗基础上采用利巴韦林注射液治疗。观察两组的临床效果。结果研究组的总有效率显著高于对照组,体温恢复正常时间、皮疹消退时间均早于对照组（P均〈0．05））;肝功能恢复率、肌钙蛋白转阴率优于对照组。但差异无统计学意义（P〉0．05）;肠道病毒转阴率达到了100％。结论喜炎平注射液用于治疗手足VI病,具有疗效确切、副作用少等优点。     

Polyarthritis, rash and lymphadenopathy: Case reports of two patients with angioimmunoblastic lymphadenopathy presenting to a rheumatology clinic

Two patients presented with a symmetrical inflammatory polyarthropathy. Both patients fulfilled the diagnostic criteria for angioimmunoblastic lymphadenopathy. We present the two case histories and review the current literature. Although an uncommon disease, the diagnosis of angioimmunoblastic lymphadenopathy should be considered in a patient presenting with polyarthritis and skin rash.