Screening for Down's syndrome in the North East Thames region

The suggested strategies for a screening programme for Down's syndrome by maternal serum alpha fetoprotein concentration were examined and tested on the experience of the North East Thames Regional. Screening by maternal serum alpha fetoprotein concentration may be used to identify pregnancies at increased risk, but this is useful only in women aged over 32 whose collective risk is greater than one in 200. The absolute probability of carrying babies with Down's syndrome for individuals in this high risk group can then be calculated and used to decide whether further diagnosis by amniocentesis is desired.     

Human leptospirosis in New South Wales, 1975-1985

From July 1975 to June 1985, 14,630 sera from patients in New South Wales were tested for serological evidence of leptospirosis. Among these, 361 sera contained evidence of past infections and 150 of these 361 specimens had evidence of recent or current infections. Serologically-diagnosed cases of leptospirosis were distributed mainly in the central and eastern parts of the State. Pomona, hardjo and icterohaemorrhagiae were the most common serovars to be detected; male abattoir workers and farmers were the most common occupational groups that were infected. An increase in seropositive cases occurred from 1981, largely due to hardjo and to a lesser extent pomona infections among farmers. Clinical histories indicated that most cases presented as pyrexias of unknown origin or as febrile illnesses; however, four patients were reported to have presented with renal failure; three patients were reported to have presented with meningitis; and 10 patients were jaundiced at presentation.     

Seasonal variation and time trends in childhood asthma in England and Wales 1975-81

In England and Wales hospital admissions for childhood asthma almost trebled over the period 1975-81. This may have reflected a true increase in the incidence of acute asthma, a swing from primary to hospital care, or both. The trend was not due to a change in diagnostic fashion. Monthly admissions showed a pronounced seasonal variation with fewest admissions in winter, rising in spring and early summer to peak in the autumn. A deep admission trough was present in August. The monthly admission profile was very similar throughout England and Wales, suggesting that major "trigger" factors were responsible.     

西部地区鼠疫流行态势及防治对策

西部地区是我国重要的鼠疫自然疫源地,其面积大、分布广,一些历史疫区重新复燃,新的疫区又发现。近年来,鼠间鼠疫发生非常活跃,并常有波及人类事件的发生,给西部地区人民的生命财产及社会经济发展带来了严重挑战。本文综述相关文献,分析西部地区鼠疫流行的现状及特点,并提出相应的防治对策。     

Guillain-Barré syndrome in Western Australia, 1980-1985

A clinicoepidemiological study of 109 patients with Guillain-Barré syndrome who were admitted to the four major teaching hospitals in Perth between January 1, 1980 and December 31, 1985 was conducted through the Hospital Morbidity Data System. The annual incidence rate of Guillain-Barré syndrome was 1.35 cases per 100,000 population. The age-adjusted incidence rates were 1.49 cases per 100,000 men and 1.20 cases per 100,000 women. A minor peak in the sex-adjusted incidence rate was present in young adult life with a larger peak in later life. Twenty-two (20%) patients presented in the five-month period from July 1984 to November 1984 (P less than 0.05) but a common infectious agent or geographical area of residence was not discovered during this period. Immune function had been affected potentially before the onset of Guillain-Barré syndrome in 12 (11%) patients, which raises further speculation as to the role of immunological mechanisms in the pathogenesis of Guillain-Barré syndrome. In order to enhance our understanding of this disorder, it is recommended that an assessment of immune function be considered in cases of Guillain-Barré syndrome and also chronic inflammatory demyelinating polyneuropathy.     

孕中期Down's综合征的筛查和诊断

目的探讨建立完善孕中期筛查胎儿Down's综合征的方法,增加其检出率,减少有创性产前诊断的盲目性.方法应用酶联免疫吸附法(ELISA)测定2124例孕中期(14～20周)妇女血清甲胎蛋白(AFP)及β绒毛膜促性腺激素(β-HCG)浓度;应用优生胜算软件综合评价妊娠Down's综合征胎儿的风险度;应用羊水细胞培养方法明确诊断.结果孕14～20周孕妇血清AFP浓度随孕周的增加而增加,β-HCG浓度随孕周的增加而迅速降低.168例(7.91%)为Down's综合征高危妊娠,诊断Down's综合征3例,检出率100%,筛查假阳性率7.77%.结论孕中期应用ELISA法联合筛查Down's综合征切实可行.应注意孕周的核对以及筛查截断值的确定,制定良好的筛查策略.     

Down's syndrome. Recent trends in the United States

The crude incidence of Down's syndrome (DS) in the United States is currently about 1/1,000 births. Reduction in the proportion of births to women 35 years and older can account for a halving of the estimated percentage of DS births to this age group and a drop in the estimated crude incidence of DS from 1.33/1,000 births in 1960 to 0.99/1,000 births in 1978. Epidemiologic studies suggest that among women 35 years and older, the risk of having a child with DS has not changed. With the present distribution of maternal ages, prenatal diagnosis among women 35 years and older can result in no more than a 20% decrease in the crude incidence of DS. With continued use of prenatal diagnosis among older gravidas, upward of 80% of DS births will occur to younger mothers.     

唐氏综合征产前筛查的研究进展

唐氏综合征（DOwn＇s syndrome,Ds）是一种最常见的常染色体遗传病之一,是先天性智力低下最常见的遗传类型。10％～15％的智力低下儿童罹患该病。该疾病影响个体智能发育和体格发育,是致残和致死的严重出生缺陷,至今尚无有效的治疗方法。凶此,对该疾病进行产前筛查,再对受检者中高风险者进行产前诊断,让妊娠DS患儿的孕妇终止妊娠,才能达到优生目的。本文就DS产前筛查的最新研究进展作一综述。     

中国西部远程医学教育发展思考

文章在分析中国西部自然条件差、教育医疗基础薄弱的现状后,指出开展远程教育是解决这种现状的一项有效措施。同时,文章还就远程教育的开展方式以及如何积极发展和规范管理等问题提出了建议。     

Cholelithiasis in the western region of Saudi Arabia

This is a prospective study of 454 patients with cholelithiasis treated surgically in the University Hospital at Jeddah admitted to surgical department of K.A.U.H. from 1979 until the end of 1987. Biliary surgery constituted 4.7% of all major operations reviewed in our Hospital. The disease affected females 4.5 times more than males. Right hypochondrial pain was present in 74.2% of cases, biliary colic in 60% and obstructive jaundice occurred in 14.09% of patients. The clinical diagnosis of cholelithiasis was confirmed by radiological examinations by laboratory, oral and I.V. Cholangiogram, and Ultrasound. These included liver function tests. All cases had cholecystectomy. This was carried out electively in 95.34% of patients, and as an emergency in only 4.63% of cases. Exploration of the CBD was performed in 14.09% of patients. Choledochoduodenostomy in 0.44% and sphincterotomy. Sphincteroplasty in another 0.44% of cases. There was no operative mortality, and post op complications occurred in 14.53% of patients.     

早孕PAPP-A联合唐氏综合征三联筛查方案在胎儿唐氏综合征和开放性神经管缺陷筛查中的应用

目的 探讨早孕期孕妇血清妊娠血浆相关蛋白A(PAPP-A)联合唐氏综合征三联筛查方案在胎儿唐氏综合征和开放性神经管缺陷筛查中的应用效果.方法 回顾性分析2019年5月至2020年12月期间在渭南市妇幼保健院产科进行早孕期PAPP-A、孕中期唐氏综合征三联筛查的400例孕妇的检查情况.同时分析随访后出生为缺陷儿的孕妇检查...     

江西省中北部地区孕中期唐氏综合征筛查血清标志物中位数的构建

目的：建立江西省中北部地区孕中期唐氏综合征(Down’s syndrome,DS)产前筛查血清学标志物中位数数据 库。方法：采用时间分辨免疫荧光法对57 548例孕15~20+6周孕妇进行甲胎蛋白(AFP)、游离绒毛膜促性腺激素(β-hCG) 和游离雌三醇(uE3)血清学三联筛查,应用LifeCycle 4.0软件进行风险评估。使用SAS 9.2软件进行模型筛选,构建江西 省中北部地区孕中期DS筛查人群中位数拟合方程,采用新构建的中位数系统重新评估人群患DS风险,并评估其适用 性。结果：江西省中北部地区中位数与内置中位数分布不同,差异有统计学意义(Z=2.201,P=0.028),经模型筛选, 三联指标中位数与孕龄的关系采用加权回归模型拟合,三联指标中位数倍数(MoM值)与体重的关系采用倒数模型, 拟合效果好;新构建的中位数系统较内置系统检出率由62.75%提高到72.55%,假阳性率由5.84%降低至4.94%。结论： 新构建的江西省中北部地区孕中期中位数系统适用于本地区筛查,各地区应建立自己的血清标志物中位数系统以提 高筛查效率。     

腰骶部骨筋膜室综合征

目的：探讨腰骶部骨筋膜室综合征与慢性腰痛的关系。方法：对27例腰骶部骨筋膜室综合征患者临床的诊断及治疗。结果：以脱水为主的早期综合治疗,可以明显缓解腰骶部骨筋膜室综合征的疼痛,减少腰肌劳损发病率。结论：对腰骶部骨筋膜室综合征的认识及早期治疗。对预防或减少慢性腰肌劳损所致的慢性腰痛具有重要意义。     

孕中期唐氏综合征筛查的临床意义

目的：探讨游离β-人绒毛膜促性腺激素（β-HCG）、甲胎蛋白（AFP）、游离雌三醇（uE3）三联筛查法在孕中期唐氏综合征筛查中的作用。方法：采用时间分辨荧光法检测孕妇外周血三个血清学指标,通过计算机软件分析孕妇唐氏综合征风险率。高风险孕妇在知情同意的原则下实行羊水穿刺进行产前诊断。结果：4116例唐氏筛查标本中检出高风险216例,阳性率为5.25%,经羊水产前诊断为唐氏儿6例,唐氏儿发生率为0.17%,假阳性率为5.11%,假阴性为0.026%。结论：孕妇实行唐氏三联法血清学筛查是预防唐氏儿出生的有效方法,能显著降低唐氏儿的出生率。