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71.
Zhongjie Li Shengjie Lai Honglong Zhang Liping Wang Dinglun Zhou Jizeng Liu Yajia Lan Jiaqi Ma Hongjie Yu David L Buckeridge Chakrarat Pittayawonganan Archie CA Clements Wenbiao Hu Weizhong Yang 《Bulletin of the World Health Organization》2014,92(9):656-663
Objective
To evaluate the performance of China’s infectious disease automated alert and response system in the detection of outbreaks of hand, foot and mouth (HFM) disease.Methods
We estimated size, duration and delay in reporting HFM disease outbreaks from cases notified between 1 May 2008 and 30 April 2010 and between 1 May 2010 and 30 April 2012, before and after automatic alert and response included HFM disease. Sensitivity, specificity and timeliness of detection of aberrations in the incidence of HFM disease outbreaks were estimated by comparing automated detections to observations of public health staff.Findings
The alert and response system recorded 106 005 aberrations in the incidence of HFM disease between 1 May 2010 and 30 April 2012 – a mean of 5.6 aberrations per 100 days in each county that reported HFM disease. The response system had a sensitivity of 92.7% and a specificity of 95.0%. The mean delay between the reporting of the first case of an outbreak and detection of that outbreak by the response system was 2.1 days. Between the first and second study periods, the mean size of an HFM disease outbreak decreased from 19.4 to 15.8 cases and the mean interval between the onset and initial reporting of such an outbreak to the public health emergency reporting system decreased from 10.0 to 9.1 days.Conclusion
The automated alert and response system shows good sensitivity in the detection of HFM disease outbreaks and appears to be relatively rapid. Continued use of this system should allow more effective prevention and limitation of such outbreaks in China. 相似文献72.
由于治疗方法的进步,近80%的儿童和青少年癌症患者能够长期生存。在美国,约有270000例儿童癌症的幸存者,即每640名20至39岁成年人中就有一名幸存者。大量的幸存者有利于儿童癌症治疗后长期健康结果的研究。现在可以明确的是,化疗和放疗所致的儿童各器官系统损害在临床上可能潜伏多年。为了全面了解治疗儿童癌症而继发的健康问题,重要的是衡量三项长期结果:健康状况、死亡率和患病率。这三项中,关于前两项已有相当好的研究报道。在一项对20227例癌症5年生存者的回顾性分析中,Mertens等发现以下原因导致的超额死亡率具有统计学意义:继发癌症(… 相似文献
73.
目的:探讨腹腔镜技术在外科和妇科疾病治疗中联合应用的临床价值。
方法:总结近7年来施行腹腔镜联合手术治疗妇、外科疾病229例的临床资料,其中腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合输卵管造口术5例,LC联合卵巢囊肿剥除术28例,LC联合子宫肌瘤剔除术25例,LC联合子宫次全切除术39例,LC联合子宫全切除术26例,LC联合子宫内膜异位症手术6例;腹腔镜阑尾切除术(laparoscopicappendectomy,LA)联合输卵管手术38例,LA联合卵巢囊肿切除术32例,LA联合子宫全切除术或子宫次全切除术24例,腹腔镜肝囊肿开窗引流术联合卵巢囊肿切除术6例。
结果:229例妇、外科联合腹腔镜手术均获成功,无中转开腹手术。手术时间40~220 min,平均120 min;住院1~6 d,平均3.4 d。仅1例术后10 d阴道残端出血非手术疗法治愈。175例随访3~24个(平均19.5)月,1例术后2个月发现阴道残端息肉,经手术切除治愈。
结论:严格掌握联合手术指征,充分术前准备,多科室良好配合,腹腔镜联合手术能够有效地同时处理外科和妇科并存疾病,在基层医院具有良好的应用前景。 相似文献
方法:总结近7年来施行腹腔镜联合手术治疗妇、外科疾病229例的临床资料,其中腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合输卵管造口术5例,LC联合卵巢囊肿剥除术28例,LC联合子宫肌瘤剔除术25例,LC联合子宫次全切除术39例,LC联合子宫全切除术26例,LC联合子宫内膜异位症手术6例;腹腔镜阑尾切除术(laparoscopicappendectomy,LA)联合输卵管手术38例,LA联合卵巢囊肿切除术32例,LA联合子宫全切除术或子宫次全切除术24例,腹腔镜肝囊肿开窗引流术联合卵巢囊肿切除术6例。
结果:229例妇、外科联合腹腔镜手术均获成功,无中转开腹手术。手术时间40~220 min,平均120 min;住院1~6 d,平均3.4 d。仅1例术后10 d阴道残端出血非手术疗法治愈。175例随访3~24个(平均19.5)月,1例术后2个月发现阴道残端息肉,经手术切除治愈。
结论:严格掌握联合手术指征,充分术前准备,多科室良好配合,腹腔镜联合手术能够有效地同时处理外科和妇科并存疾病,在基层医院具有良好的应用前景。 相似文献
74.
75.
76.
目的探讨经关节入路微创钢板固定(MIPPO)技术治疗股骨远端C型骨折的临床疗效。方法2002年4月~2005年2月,应用MIPPO技术治疗股骨远端C型骨折14例,按AO/ASIF分类:C1型3例,C2型6例,C3型5例。先行关节内骨折切开复位、松质骨螺钉固定,再行髁上部分骨折间接复位、经关节内切口插入髁支撑钢板或LISS钢板桥接固定骨折。结果12例患者获得10~32个月(平均18.4个月)随访,骨折均获愈合,愈合时间10周~12个月,平均4.6个月。按Kolmert和Wulff的评价标准:优4例,良5例,可2例,差1例,优良率为75%。结论应用MIPPO技术治疗股骨远端C型骨折实现了微创操作,具有创伤小、软组织干扰少、骨折愈合快等优点,疗效满意。 相似文献
77.
Muthu Veeraputhiran Jerry Ware Judith Dent Joshua Bornhorst Ginell Post Michele Cottler‐Fox Gina Pesek John Theus Mayumi Nakagawa 《Transfusion》2011,51(5):1030-1036
BACKGROUND: Washed or volume‐reduced platelets (PLTs) are occasionally requested for patients with a history of allergic or anaphylactic transfusion reactions. However, conclusive data are not available as to which method is more suitable. STUDY DESIGN AND METHODS: A direct comparison of saline‐washed and volume‐reduced PLTs was performed by splitting 11 units of 6‐day‐old apheresis PLT units. PLT activation, aggregation, plasma protein, and PLT count were determined before and after each procedure. To assess whether washing using neutral, calcium‐free Ringer's acetate (NRA) would better preserve PLT function, 8 additional units of apheresis PLTs were split and were washed in saline or NRA. RESULTS: Saline washing resulted in significantly increased number of activated, P‐selectin–expressing PLTs compared to volume reduction (24.2% vs. 10.3%, p = 0.001). Aggregation was also significantly reduced (?40.6% vs. ?0.8%, p = 0.004). Plasma protein removal was significantly better for saline‐washed than volume‐reduced PLTs (96% vs. 51.1%, p < 0.001). PLT recovery was not significantly different for saline‐washed versus volume‐reduced PLTs (70.5% vs. 80.7%, p = 0.079). There was no difference between washing in saline or NRA with regard to PLT activation and loss of aggregation. CONCLUSIONS: PLT washing with saline or NRA significantly increases PLT activation and decreases PLT aggregability. On the other hand, volume reduction does not adequately remove plasma proteins. Therefore, PLT washing should be reserved for patients with a history of severe allergic or anaphylactic transfusion reactions. We suggest that fresher PLTs be selected to improve the functionality of washed PLTs. 相似文献
78.
C Badenas J To-Figueras JD Phillips CA Warby C Muñoz and C Herrero 《Clinical genetics》2009,75(4):346-353
Porphyria cutanea tarda (PCT) arises from decreased hepatic activity of uroporphyrinogen decarboxylase (UROD). Both genetic and environmental factors interplay in the precipitation of clinically overt PCT, but these factors may vary between different geographic areas. Decreased activity of UROD in erythrocytes was used to identify patients with UROD mutations among a group of 130 Spanish PCT patients. Nineteen patients (14.6%) were found to harbor a mutation in the UROD gene. Eight mutations were novel: M1I, 5del10, A22V, D79N, F84I, Q116X, T141I and Y182C. Five others were previously described: F46L, V134Q, R142Q, P150L and E218G. The new missense mutations and P150L were expressed in Escherichia coli. D79N and P150L resulted in proteins that were localized to inclusion bodies. The other mutations produced recombinant proteins that were purified and showed reduced activity (range: 2.3–73.2% of wild type). These single amino acid changes were predicted to produce complex structural alterations and/or reduced stability of the enzyme. Screening of relatives of the probands showed that 37.5% of mutation carriers demonstrated increased urinary porphyrins. This study emphasizes the role of UROD mutations as a strong risk factor for PCT even in areas where environmental factors (hepatitis C virus) have been shown to be highly associated with the disease. 相似文献
79.
目的观察变应性鼻炎(AR)脱敏治疗的效果,探讨影响变应性鼻炎脱敏治疗效果的相关因素。方法对185例AR患者通过皮肤试验,选择敏感变应原浸液,按递增剂量进行常规皮下脱敏治疗。根据患者治疗前后的症状和体征得分情况,分为显效、有效和无效。选择性别、年龄、病程、病情、伴慢性鼻窦炎、伴哮喘、脱敏治疗时间、皮试反应等8个影响变应性鼻炎脱敏治疗效果的可能因素进行多元回归分析,筛查影响脱敏治疗效果的因素。结果总有效率74.6%,其中显效22.9%,有效51.7%。影响脱敏治疗效果的主要因素是治疗时间,即时间越长,效果越好(P〈0.01);其次是年龄因素,年龄越小,效果越好(P〈0.05);伴慢性鼻窦炎和伴哮喘也可能影响脱敏治疗效果(P值分别为0.072和0.069)。结论变应性鼻炎脱敏治疗是有效的,脱敏治疗时间越长、年龄越小,效果越好。 相似文献
80.
Effects of sleep deprivation on neural cardiovascular control may have important clinical implications. We tested the hypothesis that sleep deprivation increases heart rate, blood pressure, and sympathetic activity and potentiates their responses to stressful stimuli. We studied 8 healthy subjects (aged 40+/-5 years, 6 men and 2 women). Blood pressure, heart rate, forearm vascular resistance, and muscle sympathetic nerve activity were measured at rest and during 4 stressors (sustained handgrip, maximal forearm ischemia, mental stress, and cold pressor test). Measurements were obtained twice, once after normal sleep and once after a night of sleep deprivation. All measurements were obtained in a blinded, randomized manner. In comparison with normal sleep, sleep deprivation resulted in an increase in blood pressure (normal sleep versus sleep deprivation=82+/-8 versus 86+/-7 mm Hg, mean+/-SEM, P=0.012) and a decrease in muscle sympathetic nerve activity (normal sleep versus sleep deprivation=28+/-6 versus 22+/-6 bursts/min, P=0.017). Heart rate, forearm vascular resistance, and plasma catecholamines were not significantly changed by sleep deprivation, nor did sleep deprivation affect autonomic and hemodynamic responses to stressful stimuli. Sleep deprivation results in increased resting blood pressure, decreased muscle sympathetic nerve activity, and no change in heart rate. Thus, the pressor response to sleep deprivation is not mediated by muscle sympathetic vasoconstriction or tachycardia. 相似文献