48家医院自身抗体检测的质控总结

目的了解我国自身抗体的检测现状，提高现有的检测水平。方法通过发函的方式确定48家医院为参与单位，质控项目包括抗核抗体、抗dsDNA抗体、抗可提取性核抗原(ENA)抗体、抗线粒体抗体和抗平滑肌抗体。标本发放和结果分析采用双盲操作，质控标本共计11份。结果抗核抗体、抗dsDNA抗体、抗ENA抗体、抗线粒体抗体和抗平滑肌抗体正确率分别是47％、70％、46％、95％和40％。结论总体情况不容乐观，试剂盒质量参差不齐，检测人员水平不一，应从选择好的方法和提高认识水平方面着手改善国内现状。     

Allogeneic stem cell transplantation in second rather than first complete remission in selected patients with good-risk acute myeloid leukemia

Through two consecutive trials, a policy that considered allogeneic stem cell transplantation (SCT) from a sibling donor in second rather than first complete remission (CR) in selected younger patients with acute myeloid leukemia (AML) with t(8;21)/inv(16) (core binding factor (CBF) group) or a normal karyotype (NN group) was followed by Acute Leukemia French Association (ALFA) centers. The outcome of 92 of these patients in first relapse (32 CBF, 60 NN) was reviewed with the aim of validating this strategy. The presence of an FLT3 internal tandem duplication (ITD) was retrospectively assessed in 50 patients. A total of 61 patients (66%) reached a second CR. Donor availability was an independent prognostic factor for survival in the whole patient population as well as in the CBF subset, but not in NN patients, further supporting this strategy for CBF-AMLs. In NN patients, FLT3-ITD was the main bad-prognosis factor for second CR achievement and survival, leading to consider SCT earlier, at least in FLT3-ITD patients with a donor.     

中华医学会第八次全国心血管病学术会议纪要

中华医学会第八次全国心血管病学术会议于2004年10月28日-10月31日在沈阳召开。来自全国各地的代表1400多人参加了大会，收到论1300多篇。开幕式上颁发了我国第一批心血管病学分会专科会员证书。会议采取专题报告和论交流的方式对当前心血管病学界的热点问题和有争议的问题进行了交流和讨论，评选了优秀论和优秀壁报取得了圆满成功。现就会议的主要研讨内容总结如下。     

Diagnosis and treatment of acromegaly complications

The Pituitary Society in conjunction with the European Neuroendocrine Association held a consensus workshop to develop guidelines for diagnosis and treatment of the co-morbid complications of acromegaly. Fifty nine pituitary specialists (endocrinologists, neurosurgeons and cardiologists) assessed the current published literature on acromegaly complications in light of recent advances in maintaining tight therapeutic control of GH hypersecretion. The impact of elevated GH levels on cardiovascular disease, hypertension, diabetes, sleep apnea, colon polyps, bone disease, reproductive disorders, and neuropsychologic complications were considered. Guidelines are proposed for effective management of these complications in the context of overall acromegaly control. When appropriate, requirements for prospective evidence-based studies and surveillance database development are enunciated. Effective management of co-morbid acromegaly complications will lead to improved morbidity and mortality in acromegaly.     

Screening, diagnosis and management of early syphilis in genitourinary medicine clinics in the UK

New diagnoses of syphilis in the UK increased eight-fold between 1997 and 2002. This study, conducted in 2002, demonstrated that 31% of clinics were not confident of their expertise to obtain an adequate specimen for dark ground microscopy (DGM), and 35% were not confident of their expertise to detect treponemes on DGM. In all, 64% of clinics had observed adherence problems in HIV-positive patients treated with parenteral regimens, as against 42% with oral regimens. Also, 51% of clinics waited more than a week for the results of initial serological tests for syphilis, and 88% of clinics waited more than a week for confirmatory test results. Other concerns include the failure to perform syphilis serology consistently whenever HIV-positive patients were at risk, and the widespread use of doxycycline as a therapy for syphilis in HIV-positive patients despite concerns that this is not known to be fully treponemicidal in cerebrospinal fluid.     

抗结核药物引起的副作用综合报告

目的了解各种抗结核药物引起的副作用并掌握一般处理原则。方法直接或间接证明６２例中由抗结核药物引起的副作用，观察并分析各种副作用分布情况、出现时间及表现形式。结果过敏反应频度占副作用的首位，共３７例，占６０％；严重副反应绝大多数由利福霉素类引起；副作用出现时间多为服药后２个月以内；药物服用过量易导致副反应发生；多种药物可同时或相继产生严重副作用。结论一旦发生严重药物副作用，必须立即停药，及时治疗，否则后果严重；利福霉素类药停药后再服，有可能加重过敏反应程度，故要详细询问既往用药情况，对有肝炎史、酗酒史、药物过敏史和年老体弱者用药过程中要严密观察；对多种药物过敏者，无论反应轻重，以快停药、早脱敏为原则；必须确定过敏原时，要使用常量的１／１０以下，并制定应急处理措施，严重过敏者不应进行重复验证     

严重急性呼吸综合征冠状病毒2疫情期间儿童肾脏病房感染防控思维导图

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的疫情已经持续了近2个月,现处于疫情胶着的状态。因儿童SARSCoV-2感染症状不典型,慢性肾脏疾病(CKD)患儿是高危感染人群,儿童肾脏专科病房的管理在复工、返校压力下,面临疫情防控的新挑战,国家临床研究中心肾脏病房、重庆市医学会儿科专委会肾脏学组,为进一步做好肾脏专科病房的疫情防控工作,结合目前疫情和相关防控建议,推荐SARS-CoV-2疫情期间儿童肾脏病房感染防控思维导图,以供儿童肾脏专科病房参考。