Brighton合作组关于Guillain-Barré综合征的诊断定义和资料收集规范

Guillain-Barr啨综合征(GBS)和Miller Fisher综合征(MFS)的诊断标准随着临床研究的深入在不断演变。2011年1月,《疫苗》杂志发表了国际疫苗安全性监测Brighton合作组关于GBS/MFS的诊断定义和研究资料收集规范。此文献中未采用"诊断标准"而采用"诊断定义"是因为其主要目的为评价疫苗安全性而制定,而非用于神经科的GBS/     

What Factors Affect Posterior Dislocation Distance in THA?

Background

Dislocation remains common after total hip arthroplasty. Efforts have been made to identify and minimize risk factors. One such factor, jump distance, or the distance the femoral head must travel before dislocating, has been poorly characterized with respect to three-dimensional kinematics.

Questions/purposes

We therefore determined: (1) the three-dimensional stability of four different component designs; (2) whether the degree of abduction and anteversion affects the stability; (3) whether pelvic inclination angles affected stability; and (4) which combination of these three factors had the greatest stability.

Methods

We created a positionable three-dimensional model of a THA. Acetabular components were modeled in various abduction and anteversion angles and in two different pelvic inclinations which simulate standing and chair-rising activities.

Results

The posterior horizontal dislocation distance increased as inclination angle and femoral head size increased. The 48-mm resurfacing typically had lower jump distances and was at risk of posterior edge loading at 30° inclination. The highest jump distance for all positions and activities occurred with the dual-mobility bearing.

Conclusion

These findings suggest that monoblock cups require extremely accurate positioning for low dislocation risk and that pelvic orientation may increase dislocation risks.

Clinical Relevance

As a result of the dual-mobility designs having the greatest resistance to dislocation, these cups may be appropriate for patients who are at risk for dislocation in difficult primary situations and in revision hip arthroplasty procedures in which proper component orientation may be less likely to be achieved.     

腺病毒载体介导的PML生长抑制因子对前列腺癌细胞生长和致瘤能力的抑制效果

为探讨用腺病毒载体携带ＰＭＬ（ＰｒｏｍｙｅｌｏｃｙｔｉｃＬｅｕｋｅｍｉａ）基因作为前列腺癌基因治疗的可能性，应用重组人携带ＰＭＬ基因腺病毒（ＡｄＰＭＬ）感染培养的前列腺癌细胞，观察表达ＰＭＬ蛋白的癌细胞与对照组癌细胞的体外生长和裸鼠体内致瘤能力变化，对荷瘤裸鼠瘤体周围注射ＡｄＰＭＬ，观察治疗组和对照组肿瘤生长的变化。结果显示，感染ＡｄＰＭＬ的前列腺癌细胞体外生长和裸鼠体内致瘤能力明显下降，荷瘤裸鼠瘤体周围注射ＡｄＰＭＬ后肿瘤生长速度明显减慢。证实了ＰＭＬ是一种生长抑制因子，提示其可能被应用于前列腺癌的基因治疗研究     

Neuropsychiatric symptoms in older people with and without cognitive impairment

Neuropsychiatric symptoms (NPS) are non-cognitive disturbances such as depression. Rates of NPS have been shown to increase as cognitive ability declines and may be useful in predicting transition from mild cognitive impairment (MCI) to dementia. This community-based study reports the association between NPS and cognitive decline over two years. Participants included 873 community dwelling adults aged 70-90 years enrolled in the Sydney Memory and Ageing Study. NPS were assessed by the Neuropsychiatric Inventory (NPI). Cognitive impairment was defined by diagnosis (MCI or incident dementia) or neuropsychological test performance across five cognitive domains. Cognitive decline was defined by progression to dementia or worse neuropsychological performance. Total NPS at baseline did not differ between those without cognitive impairment (26.2%) and those with MCI (28.8%), but agitation and apathy were associated with MCI. Only baseline depression was associated with dementia at follow-up. Total NPS at baseline was cross-sectionally associated with cognitive impairment in executive function, attention, and global cognition, but did not predict cognitive decline. Depression, anxiety, agitation, anxiety, and apathy were all associated with impairment in at least one cognitive domain, but only anxiety and agitation were significantly associated with cognitive decline. Sensitivity analyses applied more stringent criteria for NPS and cognitive impairment in MCI but did not alter interpretation of results from the main analysis. Overall rates of NPS at baseline were not associated with MCI, dementia, or cognitive decline over two years. Additional follow-up is needed to further examine this association over a longer time course.     

A Critical Review of Mental Health Court Liaison Services in Australia: A first national survey

Mental health Court Liaison Services have emerged in Australia as a key part of the response to the over-representation of people with mental illness in the criminal justice system. These specialist services aim to intervene early in the criminal justice process by identifying mentally ill individuals at the post-charge, pre-sentence stage, providing timely advice to courts and linkage with treatment providers. To date there has been no systematic comparison of the various models of court liaison in each of the Australian jurisdictions, and little is known about their effectiveness. This article presents the findings of the first national survey of Court Liaison Services. In the absence of clear national guidelines, services have formed independently of each other, shaped by the jurisdictional legislation and health services. While services were found to have similar aims, variation exists in their human resources, clinical processes, geographic coverage, and their ability to provide equitable access.