国际间合作遏制青光眼:2008年3月6日第一届"世界青光眼日"

众所周知,青光眼是全球第二位可治疗的致盲性眼病.作为不可逆盲的重要原因,其防治已成为重要的公共卫生问题,其在世界各国致盲眼病的排名不断攀升[1].尽管在发展中国家及发达国家,白内障和年龄相关性黄斑变性分别是首位的致盲原因,但在发达国家有一半的青光眼患者不知道自己患有青光眼[2],发展中国家中则有超过90%的青光眼患者对自己的疾病一无所知,甚至从未听说过青光眼.尽管对青光眼危险因素的理解有所进步,但对这一状况的改善并不明显.青光眼尽管可以发生于任何年龄,但在老年人更常见,其患病率随着年龄增长而增加.预计到2020年,全世界将有7960万人患有青光眼,其中1120万人最终可能发展为双眼盲[1].     

A simple monthly means chart system for monitoring sperm concentration

A simple, robust monthly means chart system for monitoring sperm concentration was developed and used in our andrology laboratory. The system relied on the central limit theorem to allow estimation of chart limits without resorting to data transformation procedures. Once the chart was drawn up, the arithmetic mean of sperm concentration was determined monthly and plotted. Monthly means which fell outside 2 SE from the baseline mean were investigated. Initial experience with this chart system suggests that it provides a simple and useful quality assurance method which should be applicable to other semen variables such as motility and sperm morphology.      

Radiologic evaluation of mass casualty victims: lessons from the Gander, Newfoundland, accident

This study describes the use of radiologic methods in the identification of 256 bodies after the crash of an airliner in Gander, Newfoundland. Two hundred thirty-one (90%) of the victims were identified positively with dental and/or fingerprint comparisons. Radiologic data confirmed identification in 29 of these victims. Seventeen bodies without dental or fingerprint identification were presumptively identified with a variety of data, which included radiologic characteristics in four cases. Eight bodies were identified with an exclusion matrix. Radiologic input was critical in two of these. The procedures described provide practical information for radiologists in a mass casualty disaster investigation.     

Which AO/OTA 31-A2 pertrochanteric fractures can be treated with a dynamic hip screw without developing a lateral wall fracture? A CT-based study

Purpose

To determine whether radiographic measurements derived from standard computed tomography (CT) evaluation can be used to predict likelihood of a peri-operative lateral femoral wall fracture in AO/OTA 31-A2 pertrochanteric fractures treated with a dynamic hip screw (DHS).

Methods

Fifty-one patients with AO/OTA 31-A2 classified pertrochanteric fractures were evaluated using a pre-operative CT scan of the pelvis with both hips. Dimensions of the lateral wall were calculated for each patient using four parameters: (1) height of the lateral wall above the vastus ridge; (2) circumference of the lateral wall 2 cm below the vastus ridge at an angle of 135°; this circumference was further divided into an anterior, lateral and posterior component; (3) cortical thickness at the centre of the lateral component of the lateral wall; and (4) cortical index. All patients were treated with a 135° DHS. Postoperative radiographs were assessed for lateral femoral wall fracture.

Results

Patients with a lateral wall fracture (17/51) had a smaller circumference (4.47 cm vs 5.44 cm p value?<0.001) as well as a lower height of the lateral femoral wall (1.37 cm vs 2.21 p value?<?0.001). Analysis of the three components of the circumference revealed a significant difference for the anterior component only and not for the lateral and posterior components. There was no statistical difference in the cortical thickness or cortical index in the two groups. The cutoff values for height of the lateral wall and anterior component were calculated using ROC curves and found to be 1.68 cm (AUC 0.918) and 2.10 cm (AUC 0.851) respectively.

Conclusion

AO/OTA 31-A2 pertrochanteric fractures with a lateral wall height of > 1.68 cm and an anterior component of > 2.10 cm in circumference are not likely to sustain a lateral wall fracture when treated with a DHS.

     

Science review: Searching for gene candidates in acute lung injury

Acute lung injury (ALI) is a complex and devastating illness, often occurring within the setting of sepsis, and carries an annual mortality rate of 30–50%. Although the genetic basis of ALI has not been fully established, an increasing body of evidence suggests that genetic predisposition contributes to disease susceptibility and severity. Significant difficulty exists, however, in defining the exact nature of these genetic factors, including large phenotypic variance, incomplete penetrance, complex gene–environment interactions, and strong potential for locus heterogeneity. We utilized the candidate gene approach and an ortholog gene database to provide relevant gene ontologies and insights into the genetic basis of ALI. We employed a Medline search of selected basic and clinical studies in the English literature and studies sponsored by the HopGene National Institutes of Health sponsored Program in Genomic Applications. Extensive gene expression profiling studies in animal models of ALI (rat, murine, canine), as well as in humans, were performed to identify potential candidate genes . We identified a number of candidate genes for ALI, with blood coagulation and inflammation gene ontologies being the most highly represented. The candidate gene approach coupled with extensive gene profiling and novel bioinformatics approaches is a valuable way to identify genes that are involved in ALI.     

Hepatitis B and C in doctors and dentists in Nigeria

We surveyed a random sample (n = 75) of doctors and dentists at University College Hospital, Ibadan, Nigeria. They were offered anonymous testing for hepatitis B surface antigen (HBsAg), hepatitis Be antigen (HBeAG), antibodies to hepatitis B core antigen (anti-HBc) and to hepatitis C virus (anti-HCV), by enzyme immunoassay. The results suggest a high prevalence of hepatitis B virus (HBV) with a high potential of transmissibility, as well as a high prevalence of HCV infection. The majority of the doctors and dentists use universal precaution for protection against viral hepatitis on < 50% of the occasions when they carry out procedures on their patients. Infection with HBV was associated with type of specialty (surgeons, dentists) and lack of HBV vaccination (p < 0.05). After logistic regression, these factors were independently associated with HBV infection (p < 0.05). Sixty (80%) had not received prior HBV vaccination. Unvaccinated personnel were more likely to be surgeons, dentists, < 37 years of age, and have fewer years of professional activity (p < 0.05). After logistic regression, only fewer years of professional activity remained independently associated with lack of vaccination (p < 0.05). To reduce the occupational exposure of HBV, universal precautions must be rigorously adhered to when the doctors and dentists carry out procedures on their patients, and all health-care workers should be vaccinated with HBV vaccine and the HCV vaccine, when it becomes available.      

Reduction of human immunodeficiency virus-infected cells from donor blood by leukocyte filtration

Several filters for leukocyte removal were evaluated in terms of their ability to reduce the cell-associated human immunodeficiency virus (HIV) load in units of blood either inoculated in vitro with lymphocytes from a chronically infected cell line or collected directly from seropositive donors. Filtration of the experimentally inoculated units of blood resulted in a 5.9 log 10 mean reduction (95% confidence interval:7.4-4.5) of tissue culture infectious units (TCIU) as assayed by end-point titration using the coculture assay. Filtration of the units of blood from anti-HIV positive donors lowered the infectivity by over 2 logs, as detected by the coculture and polymerase chain reaction (PCR) techniques. However, residual cell-associated virus was detected in the majority of experiments. Clinical studies are warranted to determine if leukocyte filtration of blood will reduce the risk of transfusion transmitted viral infections.