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Periodontal bio‐repositories, which allow banking of clinically validated human data and biological samples, provide an opportunity to derive biomarkers for periodontal diagnosis, prognosis and therapeutic activities which are expected to improve patient management. This article presents the establishing of the Malaysian Periodontal Database and Biobank System (MPDBS) which was initiated in 2011 with the aim to facilitate periodontal research. Partnerships were established with collaborating centres. Policies on specimen access, authorship and acknowledgement policies were agreed upon by all participating centres before the initiation of the periodontal biobank. Ethical approval for the collection of samples and data were obtained from institutional ethics review boards. A broad‐based approach for informed consent was used, which covered areas related to quality of life impacts, genetics and molecular aspects of periodontal disease. Sample collection and processing was performed using a standardized protocol. Biobanking resources such as equipment and freezers were shared with the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). In the development of the MPDBS, challenges that were previously faced by the MOCDTBS were considered. Future challenges in terms of ethical and legal issues will be faced when international collaborations necessitate the transportation of specimens across borders.  相似文献   
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Isolated patellofemoral arthritis is an increasingly recognized entity, and is usually associated with previous patellofemoral dysplasia or instability. Patellofemoral arthroplasty (PFA) has evolved significantly in recent years, both in terms of implant design and importantly in the understanding of appropriate patient selection. This review outlines the indications and investigations for PFA, provides a brief history of the development of contemporary implants, and presents the clinical outcomes for the prostheses most commonly used in the UK. In addition, it provides a detailed surgical technique for implantation of an onlay implant, with tips on how to optimize patellofemoral biomechanics and thus achieve a consistently good outcome.  相似文献   
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Rationale

The gold standard for detection of axillary sentinel lymph nodes uses injection of a radioisotope (99Tc Nanocoll). As an alternative to this method, a magnetometer detecting the superparamagnetic tracer Sienna+® can be applied for detection of sentinel lymph nodes.The goal of this study was to determine whether interpretation of breast MRI is impaired by Sienna+® tracer residues in the operated breast and axillary lymph nodes after a sentinel procedure using this tracer.

Patients and methods

34 patients who received the Sienna+® tracer for marking the sentinel node were invited to undergo a follow-up breast MRI. Native MR images were obtained from breast and axilla. The breast MRIs were evaluated by two independent breast radiologists for Sienna+® tracer related artefacts and for the degree of impairment of the MR imaging.

Results

24 of the 34 invited patients took part in this study. The mean time since injection of Sienna+® was 42 months (40.6–45.4 months). Two patients had bilateral surgery with injections in both breasts, leading to a total of 26 separate cases. One case had to be excluded due to breathing artefacts. In 10 cases (40%), impaired imaging was found. In three cases (12%), the MRI scan reading was impossible due to Sienna+® tracer residues, the other 12 cases (48%) showed no restriction.In the subgroup of patients treated with breast conserving surgery, tracer residue artefacts were found in 13 of 17 patients (76.5%).

Conclusion

To our knowledge, in this study for the first time MR feasibility after Sienna injection was investigated. Sienna+® impaired breast MRI after a mean follow-up time of 42 months in half of the cases. Further research is needed to investigate time and field-strength dependency of tracer detectability as well as the diagnostic impact of these artifacts on contrast-enhanced imaging in a clinical setting.  相似文献   
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Objective: Young people with asthma often lack engagement in self-management. Smartphone apps offer an attractive, immediate method for obtaining asthma information and self-management support. In this research we developed an evidence-based asthma app tailored to young peoples needs, created using a participatory design approach to optimize user engagement. This paper describes the participatory design process. Methods: This multi-phased research included concept generation and ideation of app design by young people with asthma, and development of asthma information by the research team. Clinical review was sought regarding safety and accuracy of app content. Participants suggestions for improvement and any problems with the app were logged throughout. Our young co-designers were invited back to test a high fidelity prototype app using a “think aloud” process and completed a usability questionnaire. Results: Twenty asthma patients aged 15-24 years contributed to the initial app design. Three respiratory specialists and two pharmacists suggested minor corrections to clinical terminology in the app which were all incorporated. Nine co-designers acted as expert reviewers of the prototype app, of whom eight completed a usability questionnaire. Median usability scores (maximum score 6) indicated high satisfaction with app content, usefulness and ease of use [median item score 5.3 (range 4.7-6.0)]. All feedback was incorporated to create an updated prototype app. Conclusions: A clinically sound asthma app has been developed which is considered highly acceptable to the young co-designers. A six-week test of the engagement, acceptability, and usefulness of the app in young people not involved in the participatory design will follow.  相似文献   
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目的探讨血清降钙素原检测(PCT)在儿科呼吸道感染中的诊断价值,为临床合理用药提供依据。方法将80例呼吸道感染患儿分为细菌感染组和病毒感染组,每组40例,测定所有患儿的血清PCT水平,PCT检测阳性患儿给予抗生素治疗。结果细菌感染组PCT检测阳性率高于病毒感染组(x^2=45.112,P〈0.05);细菌感染组PCT检测值高于病毒感染组(t=22.641,P〈0.05);38例PCT检测阳性患儿抗生素治疗有效率为86.8%。结论血清PCT是儿科早期判断呼吸道细菌感染的敏感指标,并为儿科医生早期应用抗生素提供依据。  相似文献   
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