青少年特发性脊柱侧弯症患者椎旁肌表面肌电信号频域指标变化规律

目的采用表面肌电图（sEMG）检测技术对青少年特发性脊柱侧弯症（AIS）患者脊柱旁椎旁肌肌电活动频域指标变化规律进行初步探讨。方法AIS患者25例,男7例,女18例,年龄11～21岁;所有患者均执行BST实验、抬物实验,采用芬兰ME6000型表面肌电仪记录患者凸、凹侧椎旁肌表面肌电信号频域指标中位频率（MF）、平均功率频率（MPF）、过零点率（ZCR）。结果AIS患者顶椎区凸、凹侧MF、MPF、ZCR波形曲线波幅较其他测试部位低平、数值降低,MF斜率（MFslope）、MPF斜率（MPFs-lope）、ZCR斜率（ZCRslope）随运动负荷时间的延长均呈线性递减。结论AIS患者脊柱旁顶椎区椎旁肌耐力较差,容易疲劳,表面肌电图可用作评定AIS脊柱旁凸、凹侧肌电活动差别的客观指标之一,具有较好的临床应用价值。     

青少年特发性脊柱侧弯症患者椎旁肌表面肌电信号时域指标变化规律

目的:采用表面肌电图（sEMG）检测技术对青少年特发性脊柱侧弯症(AIS)患者脊柱旁凸、凹侧椎旁肌肌电活动时域指标变化规律进行初步探讨。方法:AIS患者25例,男7例,女18例,年龄11—21岁;正常对照组少年14例,男4例,女10例,年龄12—19岁;两组受试者均执行BST实验、抬物实验,采用ME6000型表面肌电仪记录受试者双侧椎旁肌表面肌电信号时域指标平均肌电值（AEMG）、频谱面积（SPA）。结果: AIS患者脊柱旁顶椎区凸、凹侧椎旁肌AEMG(凸侧106.76±47.73μV/s, 凹侧67.93±26.11μV/s,P<0.01),SPA（凸侧11.01±8.81 m2,凹侧4.38±3.14m2,P<0.01）,差异具有显著性意义;正常对照组椎旁肌左、右侧表面肌电值差异无显著性意义。结论: AIS患者脊柱旁顶椎区凸、凹侧椎旁肌肌电活动不对称,表面肌电图可用作评定AIS脊柱旁凸、凹侧肌电活动差别的客观检查之一,具有较好的临床应用价值。     

青少年特发性脊柱侧弯症患者椎旁肌表面肌电信号测试方法选择与比较

目的采用多种方法对青少年特发性脊柱侧弯症(AIS)患者椎旁肌表面肌电活动进行检测,筛选可用于评价椎旁肌功能的检测方法。 方法共选取AIS患者25例,所有入选患者均给予BST、抬物动作及半桥动作检测,采用芬兰ME6000型表面肌电仪记录患者凸、凹侧椎旁肌表面肌电信号指标,包括平均肌电值（AEMG）及频谱面积（SPA）等,分析各检测方法所得结果间有无差异。 结果本研究AIS患者经上述3种方法检测后,发现各检测手段所获凸侧及凹侧AEMG、SPA数据间差异均无统计学意义(P&rt;0.05)。 结论BST、抬物动作及半桥动作试验均可作为检测AIS患者椎旁肌表面肌电活动的有效方法。     

特发性脊柱侧凸患者椎旁肌结蛋白和波形蛋白的特征表达

目的:研究表明,结蛋白和波形蛋白可反映肌肉损伤再生的情况,同时结蛋白可反应肌力的大小。比较特发性和先天性脊柱侧凸患者顶椎处凹凸两侧椎旁肌形态和结蛋白及波行蛋白的表达,探讨椎旁肌在特发性脊柱侧凸发生发展中的作用。方法:①选择2005-07/2006-11间南方医科大学南方医院脊柱骨病科收治的部分特发性脊柱侧凸患者12例,Cobb角平均73.8°;先天性脊柱侧凸患者5例,Cobb角平均36.0°;腰椎间盘突出症患者2例和胸腰椎管内占位性病变患者3例作为正常对照。所有患者年龄均在10～20岁。②对脊柱侧凸患者顶椎凹凸两侧及正常对照组患者椎旁肌进行活检,术前均签署知情同意书。③采用光镜和电镜下观察椎旁肌的形态改变;SP法分别对光镜切片的结蛋白和波行蛋白进行免疫组织化学染色,在光镜下观察蛋白表达;应用图像分析系统测量结蛋白免疫组织化学染色后反应椎旁肌蛋白表达强弱的吸光度(A)。结果:22例患者全部进入结果分析。①椎旁肌组织形态:特发性脊柱侧凸患者椎旁肌在光镜及电镜下均有病变,凹侧椎旁肌病变较重,凸侧椎旁肌相对正常。②结蛋白免疫组织化学的阳性表达:结蛋白在各组椎旁肌中均有不同程度的表达,组间比较差别显著(P<0.01)。特发性脊柱侧凸及先天性脊柱侧凸患者椎旁肌在顶椎凸侧比正常组结蛋白表达稍强(0.2727±0.0478,0.2768±0.0372,0.2429±0.0272,P<0.05),特发性脊柱侧凸及先天性脊柱侧凸患者椎旁肌在顶椎凹侧相对于正常组表达减弱(0.1898±0.0258,0.1869±0.0306,0.2429±0.0272,P<0.05)。③波行蛋白免疫组织化学的阳性表达:各组间椎旁肌肌纤维内均无波形蛋白表达。特发性脊柱侧凸与先天性脊柱侧凸患者同侧椎旁肌两组间在形态和结蛋白及波行蛋白表达无明显差别(P>0.05)。结论:特发性脊柱侧凸患者椎旁肌内波形蛋白表达均为阴性,提示椎旁肌不存在再生现象。与先天性脊柱侧凸类似,特发性脊柱侧凸患者椎旁肌结蛋白表达凸侧增强及凹侧减弱为继发性改变。     

青少年特发性脊柱侧弯症患者凸凹侧椎旁肌平均肌电比值与Cobb角度相关度的分析研究

目的：对青少年特发性脊柱侧弯症（AIS）患者凸凹侧椎旁肌表面肌电比值与相应的Cobb角度进行相关关系分析研究。方法：AIS患者25例，男7例，女18例，年龄11—21岁；所有患者均执行BST实验，采用芬兰ME6000型表面肌电仪记录患者凸、凹侧椎旁肌表面肌电信号时域指标平均肌电值（AEMG），计算凸凹侧AEMG比值，并与相应Cobb角度进行相关分析。结果：AEMG比值与Cobb角度之间的相关系数为0．534，（P〈0．01），有显著性意义。结论：AIS患者AEMG比值与Cobb角呈正相关,表明Cobb角度越大，凸凹侧的肌力差异越大，失衡越明显。     

特发性脊柱侧凸椎旁肌组织Bcl-2蛋白表达及细胞凋亡的研究

背景特发性脊柱侧凸的病因学尚不十分清楚,已有几位学者发现在特发性脊柱侧凸的产生与进展中椎旁肌肉可能是重要的致病因素之一,因此,椎旁肌在脊柱侧凸中作用已经成为研究热点.目的本研究通过比较脊柱侧凸患者胸弯顶点处凸侧、凹侧椎旁肌的Bcl-2,Caspase-3及bcl-x表达的差异,以从分子生物学角度探讨椎旁肌在脊柱侧凸中的可能的作用机制.设计随机对照研究.地点和对象在北京协和医院骨科完成.对照组为胸腰椎爆裂骨折患者2例.研究组为胸椎侧凸畸形患者10例,男2例,女8例;年龄12-17岁(平均14.3岁).平均Cobb角57.7°(范围45°～85°).干预手术中,于T6～T11椎体水平的侧弯顶椎水平取双侧椎旁肌部分组织甲醛固定,行苏木精-伊红(HE)染色;其余组织冰冻,进行免疫组织化学及Western印迹杂交.主要观察指标①脊柱侧凸凸侧、凹侧椎旁肌组织中Bcl-2的表达.②椎旁肌组织肌纤维形态.③椎旁肌肌细胞的凋亡情况.结果脊柱侧凸患者凸侧肌肉组织Bcl-2蛋白的表达量降低.脊柱侧凸患者及正常对照椎旁肌肉组织均存在个别细胞的凋亡,二者无明显差异.凸侧肌纤维比其凹侧及正常对照的肌纤维明显变细.结论神经-肌肉异常所致的椎旁肌的不对称有可能是特发性脊柱侧凸发生发展的一个重要因素,而这种不对称很可能与Bcl-2表达不对称相关.     

特发性脊柱侧凸椎旁肌组织Bcl-2蛋白表达及细胞凋亡的研究

背景：特发性脊柱侧凸的病因学尚不十分清楚，已有几位学者发现在特发性脊柱侧凸的产生与进展中椎旁肌肉可能是重要的致病因素之一，因此，椎旁肌在脊柱侧凸中作用已经成为研究热点。目的：本研究通过比较脊柱侧凸患者胸弯顶点处凸侧、凹侧椎旁肌的Bcl-2，Caspase-3及bcl-x表达的差异，以从分子生物学角度探讨椎旁肌在脊柱侧凸中的可能的作用机制。设计：随机对照研究。地点和对象：在北京协和医院骨科完成。对照组为胸腰椎爆裂骨折患者2例。研究组为胸椎侧凸畸形患者10例，男2例，女8例；年龄12-17岁(平均14．3岁)。平均Cobb角57．7&;#176;(范围450&;#176;-850&;#176;)。干预：手术中，于T6-T11椎体水平的侧弯顶椎水平取双侧椎旁肌部分组织甲醛固定，行苏木精-伊红(HE)染色；其余组织冰冻，进行免疫组织化学及Western印迹杂交。主要观察指标：①脊柱侧凸凸侧、凹侧椎旁肌组织中Bcl-2的表达。②椎旁肌组织肌纤维形态。③椎旁肌肌细胞的凋亡情况。结果：脊柱侧凸患者凸侧肌肉组织Bcl-2蛋白的表达量降低。脊柱侧凸患者及正常对照椎旁肌肉组织均存在个别细胞的凋亡，二者无明显差异。凸侧肌纤维比其凹侧及正常对照的肌纤维明显变细。结论：神经-肌肉异常所致的椎旁肌的不对称有可能是特发性脊柱侧凸发生发展的一个重要因素，而这种不对称很可能与Bcl-2表达不对称相关。     

单节段腰椎间盘突出继发腰椎侧凸患者间盘摘除后椎旁肌的表面肌电分析

背景：先天性及特发性脊柱侧凸患者椎旁肌肌电图改变已被广泛研究,而对腰椎间盘突出继发腰椎侧凸患者椎旁肌肌力肌电图的研究较少。目的：通过应用表面肌电图技术分析腰椎间盘突出继发腰椎侧凸患者两侧椎旁肌的肌电活动,评估两侧肌力,揭示腰椎侧凸的特殊临床特点并探讨其产生的机制。方法：回顾性分析2012年7月至2014年7月收治的单节段腰椎间盘突出继发腰椎侧凸的成人患者26例,均行腰椎侧路椎间孔镜下间盘摘除。治疗前后摄站立位全脊柱正侧位片,测量腰椎侧凸Cobb角及躯干偏移距离,行表面肌电图检查,测量两侧椎旁肌大力收缩募集电位值,评估腰椎间盘突出水平两侧椎旁肌肌力。结果与结论：治疗后所有患者腰椎侧凸明显减少,脊柱冠状面平衡恢复。患者治疗前腰椎侧凸Cobb角为（11.81±3.50）°,治疗后为（2.65±3.10）°,腰椎侧凸明显减少,平均差值为（9.15±2.84）°,差异有显著性意义（P〈0.05）。治疗前躯干偏移距离为（5.92±3.20）cm,治疗后为（0.32±0.26）cm,平均差值为（5.59±3.08）cm,差异有显著性意义（P〈0.05）。治疗后疼痛明显缓解（P〈0.05）。治疗前Oswestry功能障碍指数平均为78%,治疗后平均为4%。突出节段水平治疗前凹侧屈曲时凹侧大力收缩募集电位为（0.21±0.12）m V,治疗后为（0.88±0.26）m V,平均差值为（0.59±0.27）m V;治疗前凸侧屈曲时凸侧大力收缩募集电位为（0.29±0.12）m V,治疗后为（0.88±0.25）m V,平均差值为（0.67±0.27）m V,差异均有显著性意义（P〈0.05）;治疗后两侧大力收缩募集电位平均差值为（0.003±0.020）m V,差异无显著性意义（P〉0.05）。随访至少1年,所有患者均无并发症发生,无腰椎间盘突出复发。以上结果说明腰椎间盘突出症引起的腰椎侧凸为代偿性侧凸,早期行腰椎侧路椎间孔镜下间盘摘除可以纠正腰椎侧凸。椎旁肌肌?     

特发性脊柱侧凸椎旁肌组织中神经型及诱导型一氧化氮合酶表达的研究

背景特发性脊柱侧凸病因不清楚,目前关于其病因及发病机制存在诸多争论.椎旁肌在脊柱侧凸中作用已经成为研究热点.目的比较特发性脊柱侧凸胸椎椎旁肌肉中神经型一氧化氮合酶和诱导型一氧化氮合酶表达与定位.设计以诊断为依据设立对照的实验研究.地点与对象北京协和医院骨科收治胸椎侧凸畸形患者10例,其中男8例,女2例;平均年龄14岁.胸腰椎爆裂骨折患者2例做对照.干预手术中,于T6～T11椎体水平的侧弯顶椎水平取双侧椎旁肌,部分组织甲醛固定,行苏木精-伊红(HE)染色;其余组织冰冻,进行免疫组织化学及Western印迹杂交.主要观察指标脊柱侧凸患者及正常椎旁肌组织中神经型一氧化氮合酶和诱导型一氧化氮合酶的表达情况.?结果脊柱侧凸患者脊柱凸侧椎旁肌组织与凹侧椎旁肌组织和正常对照相比,神经型一氧化氮合酶的表达明显下调,诱导型一氧化氮合酶的表达也有所下调,但诱导型一氧化氮合酶表达总量较低.Western印迹检测得到同样的结果.结论脊柱侧凸患者双侧椎旁肌神经型一氧化氮合酶蛋白表达不均衡,可能与特发性脊柱侧凸发生存在密切关系,诱导型一氧化氮合酶可能在特发性脊柱侧凸的发生中不发挥作用.     

特发性脊柱侧凸椎旁肌组织中神经型及诱导型一氧化氮合酶表达的研究

背景：特发性脊柱侧凸病因不清楚，目前关于其病因及发病机制存在诸多争论。椎旁肌在脊柱侧凸中作用已经成为研究热点。目的：比较特发性脊柱侧凸胸椎椎旁肌肉中神经型一氧化氮合酶和诱导型一氧化氮合酶表达与定位。设计：以诊断为依据设立对照的实验研究。地点与对象：北京协和医院骨科收治胸椎侧凸畸形患者10例，其中男8例&;#183;女2例；平均年龄14岁。胸腰椎爆裂骨折患者2例做对照。干预：手术中，于T6～T11椎体水平的侧弯顶椎水平取双侧推旁肌，部分组织甲醛固定．行苏木精-伊红(HE)染色：其余组织冰冻．进行免疫组织化学及Western印迹杂交。主要观察指标：脊柱侧凸患者及正常椎旁肌组织中神经型一氧化氮合酶和诱导型一氧化氮合酶的表达情况。结果：脊柱侧凸息者脊柱凸侧椎旁肌组织与凹侧椎旁肌组织和正常对照相比，神经型一氧化氮合酶的表达明显下调，诱导型一氧化氮合酶的表达也有所下调．但诱导型一氧化氮合酶表达总量较低，Western印迹检测得到同样的结果。结论：脊柱侧凸患者双侧椎旁肌神经型一氧化氮合酶蛋白表达不均衡，可能与特发性脊柱侧凸发生存在密切关系．诱导型一氧化氮合酶可能在特发性脊柱侧凸的发生中不发挥作用。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.     

Molecular characterization of virulence and antimicrobial resistance profile of Shigella species isolated from children with moderate to severe diarrhea in northeastern Brazil

Molecular characterization of virulence and antimicrobial resistance profiles were determined for Shigella species isolated from children with diarrhea in Fortaleza, Brazil. Fecal specimens were collected along with socioeconomic and clinical data from children with moderate to severe diarrhea requiring emergency care. Shigella spp. were isolated by standard microbiological techniques, and we developed 4 multiplex polymerase chain reaction assays to detect 16 virulence-related genes (VRGs). Antimicrobial susceptibility tests were performed using disk diffusion assays. S. flexneri and S. sonnei were the predominant serogroups. S. flexneri was associated with low monthly incomes; more severe disease; higher number of VRGs; and presence of pic, set, and sepA genes. The SepA gene was associated with more intense abdominal pain. S. flexneri was correlated with resistance to ampicillin and chloramphenicol, whereas S. sonnei was associated with resistance to azithromycin. Strains harboring higher numbers of VRGs were associated with resistance to more antimicrobials. We highlight the correlation between presence of S. flexneri and sepA, and increased virulence and suggest a link to socioeconomic change in northeastern Brazil. Additionally, antimicrobial resistance was associated with serogroup specificity in Shigella spp. and increased bacterial VRGs.     

护理干预对面部中重度寻常型痤疮的临床疗效影响分析

目的研究护理干预对面部中重度寻常型痤疮的临床疗效影响。方法选取本院在2014年4月~2016年7月诊治的136例面部中重度寻常型痤疮患者,随机分为研究组与对照组,每组68例;所有患者均依据其情况给予对应的治疗,其中对照组在治疗期间给予常规护理,研究组在对照组的基础上再给予综合性护理干预,比较两组的治疗效果及护理满意度情况等。结果患者在接受治疗和护理后,研究组中度与重度患者的治疗效果较对照组均明显提高(P0.05),研究组护理满意度较对照组明显增高(P0.05)。结论对面部中重度寻常型痤疮患者在其治疗期间给予综合性护理干预,具有良好的效果。