骨科术后急性时相蛋白变化规律的研究

目的 为了了解骨科不同类型手术后急性时相蛋白的变化规律,增加术后护理观察指标。方法 对40例骨科术后病人根据手术方式分为3组,并分别于手术后第2、7、10、14天进行急性进相蛋白检查。结果 软组织术后仅CRP轻度增高,且在7天内恢复正常;部分涉及骨骼组与骨关节手术组术后除CER外,其余急性时相蛋白均增高,2天达最高峰,但在10～14天内恢复正常,而术后感染病人有3项急性时相蛋白增高,呈现双峰特征,且持续至21天后才基本恢复正常。结论 术后急性时相蛋白检查是一种判断感染的有价值的观察指标,应用急性时相蛋白判断术后感染应依骨科不同类型的手术而有不同标准。     

孟氏骨折脱位(儿童)愈合后畸形的早期手术矫治探讨

Objective To stody the clinic effect of treating the Deformation after Monteggia fracture healing with the orthopedic operation in nonage. Methods All expose the fracture of the ulna and the disloca-tion of the radial head through the Boyd incision. 17 cases of thedeformation were treated with two method, the one is cut off and extend ulna with bone graft, reduce humeroradial joint, theother is cut off and deeurtate radius and reest humeroradial joint, then re-establish annular ligament and fixed humeroradial joint with Kirschner wire temporarily,forearm is external fixation with plaster slab on crooked elbow I00° neutral position. Results The follow-up period for 13 to 27 months, 17 cases were all obtained the head of radius resetting fundamentally. The elbow-joint is stabilization and painless obviously and the functional rehabilitation is well fairly. Conclusion The orthopedic operation is favourable for the acromegalic normal development in nonage, that the head of radius is resetted, the ulna malformation is corrected, the normal article combination is recovered. Even though bone and joint is deformation,it can obtained occasion to renew molding in growth period. It is more valuable for active re-shaping than wait-and-see expecting for this reason.     

孟氏骨折脱位(儿童)愈合后畸形的早期手术矫治探讨

Objective To stody the clinic effect of treating the Deformation after Monteggia fracture healing with the orthopedic operation in nonage. Methods All expose the fracture of the ulna and the disloca-tion of the radial head through the Boyd incision. 17 cases of thedeformation were treated with two method, the one is cut off and extend ulna with bone graft, reduce humeroradial joint, theother is cut off and deeurtate radius and reest humeroradial joint, then re-establish annular ligament and fixed humeroradial joint with Kirschner wire temporarily,forearm is external fixation with plaster slab on crooked elbow I00° neutral position. Results The follow-up period for 13 to 27 months, 17 cases were all obtained the head of radius resetting fundamentally. The elbow-joint is stabilization and painless obviously and the functional rehabilitation is well fairly. Conclusion The orthopedic operation is favourable for the acromegalic normal development in nonage, that the head of radius is resetted, the ulna malformation is corrected, the normal article combination is recovered. Even though bone and joint is deformation,it can obtained occasion to renew molding in growth period. It is more valuable for active re-shaping than wait-and-see expecting for this reason.     

注射用依诺沙星与利巴韦林注射液的配伍稳定性考察

目的考察注射用依诺沙星与利巴韦林注射液配伍的稳定性。方法模拟临床将注射用依诺沙星与利巴韦林注射液在5％葡萄糖中混合，于25℃、37℃放置，在0、1、2、4、6h对混合液进行外观观察、测定pH值、扫描紫外吸收光谱及测定依诺沙星和利巴韦林的含量。结果在0-6h内，溶液外观、pH值和紫外吸收光谱基本不变，依诺沙星和利巴韦林的含量在25℃时有所下降，在37℃时基本不变。结论注射用依诺沙星与利巴韦林注射液在5％葡萄糖中可以配伍使用。     

2010～2011年绵阳市流感样病例哨点监测结果分析

目的了解2010—2011年绵阳市流感流行状况,为制定预防控制策略提供依据。方法收集绵阳市2010～2011年流感样病例（ILI）监测资料、流感病毒病原学监测结果以及暴发疫情信息进行分析。结果2010年共上报ILI12100例,ILI就诊比（ILI％）为2．72％。2011年报告ILI 8364例,ILI％为1．83％,较2010年减少32．47％。两个年度中,ILI就诊比例的时间分布均呈“双峰”型增高。病例以0岁～最多,占46．24％。发热门诊的ILI％最高,为88．56％。共采集788份ILI病例标本,核酸检测阳性标本共34份,阳性率为4．31％,包括甲型HIN1流感病毒5份（0．63％）,A型未分型流感病毒8份（1．02％）,季节性H3型流感病毒1份（o．13％）,B型流感病毒20份（2．54％）。两年中未发生流感暴发疫情。结论2010～2011年绵阳市流感发病相对稳定,未发生较大规模的暴发流行。哨点医院ILI报告质量有待提高,流感监测网络实验室应积极准备开展流感病毒分离工作,加强对各型流感病毒的监测,以预防、控制流感的流行。     

不同类别骨科手术患者围术期睡眠质量的比较分析

目的:探讨不同类别骨科手术患者围术期睡眠质量的比较分析.方法:选取2018年6月至2019年6月期间湖北省谷城县人民医院骨科收治的骨科手术患者288例作为研究对象,其中关节手术78例,颈椎病74例,上肢或下肢骨折70例,腰椎间盘疾病66例.使用AIS阿森斯失眠治疗评价表和PSQI匹兹堡睡眠质量评分系统检测患者睡眠质量....     

Recurrent 'Migrainelike' Episodes in Patients With HIV Disease

Recurrent transient neurological deficits have been described in human immunodeficiency virus (HIV)-infected subjects, but their frequency, pathogenesis, and outcome are still unsettled.
We describe 10 HIV-infected patients with transient neurological deficits (0.8% of all patients followed in ourdepartment during the last decade). All patients were in the advanced stage of immunological disease. None of theclinical or special investigations performed outside of the attacks indicated an underlying structural lesion of the centralnervous system. In 80% of these patients, anticardiolipin antibodies were present. The final outcome was unrelated tothese transient neurological deficits which, per se, had a benign course.
We discuss the possible etiopathogenetic mechanisms of such episodes and suggest that they may be "migrainelike"events, possibly related to transient functional circulatory abnormalities secondary to an immunologicalantiphospholipid antibody-dependent mechanism.     

吸毒人群与HIV感染相关的高危行为分析

目的 了解深圳市某地吸毒人群与HIV感染相关的高危行为。方法 对某地戒毒所1516名戒毒人员进行血清HIV抗体检测，并对76例HIV阳性者进行问卷调查。结果 HIV抗体检出率5．01％，戒毒人群中15～35岁占93．67％；HIV感染者中，15～35岁占96．05％，静脉注射吸毒者高达98．68％，共用注射器者占静脉吸毒者的80．26％。结论 某地吸毒人群中存在引起HIV流行的高危行为，需尽快开展有效的干预措施；建议在流动人口中开展艾滋病预防教育活动；同时还应对在校学生开展预防吸毒的教育。     

Beyond the end of exceptionalism: integrating HIV testing into routine medical care and HIV prevention

In September 2006, the US CDC issued new guidelines for HIV testing. These guidelines were designed not only to simplify and expand HIV testing but also to integrate testing into routine medical care in the USA. The nationwide implementation of these guidelines is currently facing several political and legal barriers. In this article, we examine the origins of current patient-driven and risk-based HIV testing in the USA and highlight shortcomings of this strategy. We then demonstrate how the changing HIV epidemic in the USA requires routine HIV screening at all points of contact in the medical system in order to control the HIV epidemic and how novel testing strategies could increase the yield of testing in these settings.     

HIV感染者/AIDS患者的自我效能及其相关因素

目的探讨HIV感染者/AIDS患者自我效能现状,分析其相关因素,以期为制定有针对性的干预对策提供科学依据。方法便利抽样法选取2011年7月至2012年12月首次到玉林市红十字会医院就医的HIV感染者/AIDS患者182例为研究对象。采用自行设计的基本资料调查表和HIV感染者/AIDS患者疾病管理自我效能感量表对其进行调查和分析。结果有112例(61.54%)HIV感染者/AIDS患者表现为低水平自我效能,60例(32.97%)患者表现为中等水平自我效能,仅有10例(5.49%)患者表现为高水平自我效能。HIV感染者/AIDS患者总体自我效能得分为(160.51±30.52)分,得分指标为46.59%。HIV感染者/AIDS不同患者性别、婚姻及家庭月收入的自我效能水平的差异均无统计学意义(均P0.05);而不同年龄、文化程度、感染方式、病程及目前工作状态不同患者的自我效能水平差异均有统计学意义(均P0.01)。结论 HIV感染者/AIDS患者自我效能普遍处于较低水平,亟待提高;同时,应对年老、文化程度较低、有吸毒或性乱史者和失业或无固定工作等特殊群体实施有针对性的干预对策,有效提高其自我效能水平,从而提高其生活质量。     

孟氏骨折脱位（儿童）愈合后畸形的早期手术矫治探讨

目的探讨早期手术矫形治疗儿童孟氏骨折愈合后畸形的临床效果。方法本组17例,全部采用肘后外侧切口。方法一：切断尺骨并作相应延长及植骨,使肱桡关节复位;方法二：切断桡骨,复位肱桡关节后作相应短缩。重建环状韧带,并用克氏针暂时固定肱桡关节,石膏托外固定前臂于屈肘100。中立位。结果随访13—27个月,本组17例均基本获得桡骨头复位,肘关节稳定而无明显疼痛。功能恢复情况较为良好,大致接近于肢体的正常活动范围。结论对儿童孟氏骨折后畸形早期采取积极的矫形治疗措施,使桡骨头复位,矫正尺骨畸形,恢复正常的关节组合,对患儿的正常发育是有利的。即使骨与关节已有变形,在成长期也可获得重新塑型的机会。因此积极矫形较等待观望的态度更有价值。     

急性等容性血液稀释在骨科手术中的应用分析

目的探讨大型骨科手术中行急性等容性血液稀释自体输血对术后患者恢复的影响。方法70例择期骨科手术患者于术前行血液稀释,每例采血10 ml/kg,输入同量血定安和3倍的平衡液,测患者血液稀释前后、术后1 d、术后1 w的循环指标、Hb、Hct、PLT及凝血功能指标。结果血液稀释前后、术后1 d、术后1 w患者的HR、MAP、CO、CI、SVR、凝血功能指标无显著差异,血液稀释后、术后1 d患者的Hb、Hct、PLT较稀释前明显降低(P<0.05),但术后1 w较稀释前无显著差异。结论在骨科大型手术中,应用急性等容性血液稀释自体输血,可以明显改善术后血液功能的恢复,维持术中及术后循环功能和凝血功能的稳定。     

Latency to initiation of antiretroviral therapy in people living with HIV in Japan

Rapid initiation of antiretroviral therapy (ART) in HIV infection is recommended because it increases care retention rate and reduces the time to viral suppression. In Japan, although ART initiation is delayed, there is little information on the latency to ART initiation (time from HIV diagnosis to ART initiation). The present study was designed to obtain information on the latency to ART initiation in individuals with 1) acute or recent HIV infection (ARH), and with 2) advanced HIV diseases. Questionnaires were sent to 379 regional AIDS facilities requesting information on the people living with HIV (PLWH) who visited their facilities during 2020. Among 1098 new PLWH visitors, 706 were treatment-naïve patients, including 111 (15.7%) with ARH and 304 (43.1%) with advanced HIV diseases. Among those with ARH, only 8.2% received rapid ART initiation (latency to ART <2 weeks) and the time from diagnosis to virological suppression was longer than 14 weeks in 40.4%. Among those with advanced HIV diseases, 36.2% received late ART initiation (latency to ART ≧6 weeks). Our data showed that only a small proportion of PLWH with ARH in Japan received rapid ART. Furthermore, in PLWH with advanced HIV diseases in Japan, current latency to ART seems too long, though the timing of ART commencement should be tailored according to the presence/lack of opportunistic infections and accessibility to medical care. Further investigation is required to identify barriers to rapid ART initiation in Japan.     

广州地区HIV感染者的临床和流行特征分析

目的：了解人类免疫缺陷病毒(HIV)感染者中HIV感染途径、HIV／HBV及HIV／HCV合并感染情况和机会性感染的发生率及类型。方法：检测HIV感染者／获得性免疫缺陷综合征(AIDS)患者HBV、HCV感染标志，确定HIV／HBV、HIV／HCV合并感染情况，了解其HIV感染途径，对是否存在机会性感染情况进行临床和实验室指标的综合诊断。结果：55例HIV感染者中静脉吸毒、性接触、输血或血制品及垂直传播分别占40％、36．4％、20．0％及3．6％。HIV／HBV、HIV／HCV合并感染率分别为16．4％和41．8％，两者比较有显著差异。机会性感染发生率为85．5％，感染类型由高至低依次为：肺炎、口腔毛状黏膜白斑(OHL)、口腔真菌感染、各种感染性腹泻、各种结核病、败血症、疱疹病毒感染。结论：广州地区HIV感染途径由高到低的顺序为：静脉吸毒传播、性传播、输血或血制品传播、母婴传播，其中以静脉吸毒和性接触方式感染为主。广州地区存在HIV／HBV、HIV／HCV合并感染情况，尤其是HIV／HCV合并感染率情况较严重；来医院住院治疗的HIV感染者绝大部分为已发生机会性感染的AIDS患者。     

贵港市献血者感染HIV流行态势调查分析

目的 调查分析贵港市无偿献血者HIV感染的流行态势,为无偿献血宣传、招募、健康征询和筛查提供依据.方法 对2005～2013年贵港市268 218人次的无偿献血者标本,用2种不同厂家的ELISA法试剂同时检测抗-HIV,最终检测结果为有反应性者送贵港市疾病控制中心实验室进行WB确认,对WB确认阳性者进行调查分析.结果 2005～2013年贵港市无偿献血者抗-HIV确认阳性有134例,占5.0/万.性别、年龄、学历、职业、传播途径比较差异均有统计学意义(P＜0.05),首次献血者高于≥2次献血者,男性高于女性,年龄18～30岁组高于其他年龄组,文化程度低者高于文化程度高者,服务行业人员及农民高于其他职业,性传播者高于其他途径传播者.结论 建立对献血者招募、宣传机制,让献血者形成良好的生活方式,远离高危行为,以确保再次献血的安全性.     

Asymptomatic Atherosclerosis in HIV-positive Patients: A Case-control Ultrasound Study

Atherosclerosis has been reported in some HIV-positive subjects without any known risk factor. The purpose of the present study was to investigate cervical arteries, abdominal aorta and femoral arteries by B-mode ultrasonography and doppler in 30 HIV-positive subjects matched to 18 controls for sex, age, tobacco consumption and arterial hypertension. Although no haemodynamically or clinically relevant lesions were found, plaques occurred more often in patients than in controls (11 patients, 36.7% vs. 2, 11.1%; P = 0.05). Compared to the HIV-positive patients without plaques, those with plaques had a tendency to have decreased lower HDL cholesterol, higher tobacco consumption and lower CD4-cell count (77±85/mm³ vs. 220 ± 202/mm³). The patients with plaques (but not those without plaques) had lower HDL cholesterol than controls (P = 0.03).

Asymptomatic atherosclerosis seems to be more frequent in HIV-positive patients and is associated to lower HDL cholesterol.