Epidemiology of sexually transmitted infections and human immunodeficiency virus in Europe

Sexually transmitted infections and HIV in Europe present considerable social and medical problems and are not always adequately controlled. The recent trends for sexually transmitted infections and HIV in Western and Eastern Europe are reviewed.     

Effect of breast-feeding on pain relief during infant immunization injections

Using a quasi-experimental design, this study was conducted in two maternal & child health centres in Jordan to examine the effects of breast-feeding on pain relief during neonatal immunization injections. Inclusion criteria were first year of age, breast-fed and no concurrent illness. Infants were divided into two groups (of 60 infants for each). One is intervention group: mothers were taken to a private room, seated and reclined on a comfortable chair with their infants awake in their arms, without cloth and with clean diapers. The mothers cradled their infants during breast-feeding to maintain full-body skin-to-skin contact during immunization injections. The other is control group: infants were observed during routine immunization in maternal & child health centres. Pain responses of infants during and after immunization were assessed by using Facial Pain Rating Scale and Neonatal/Infant Pain Scale (NIPS), before, during and after the procedure. Infants' heart rates and duration of crying for both groups were calculated. Findings revealed that the crying time was shorter in intervention (breast-fed) group than in the control group with a statistically significant difference in the duration of crying during and after immunization. We concluded that, breast-feeding and skin-to-skin contact significantly reduced crying in infants receiving immunization.     

FREDDY激光器的碎石效率的体外分析

背景和目的　双频双脉冲Nd :Yag(FREDDY)激光 (德国W .O .M .公司生产 )是一个短脉冲 ,双频率 ( 5 3 2nm和 10 64nm)的固体激光器。该激光器功率小 ,成本低 ,目前已在腔内碎石术中得到应用。我们设计了一个试验 ,以测试在不同能量和不同频率下的碎石效率。材料和方法　 40个预先称过重量的硫酸钙石头被分成 4组 ,在 5Hz和 10Hz情况下 ,分别碎石 2min和 4min。一个水下的试验装置包括一个支架和一个容器 ,使得石英玻璃光纤可以直接抵住石头 ,发射激光。光纤被剥离成直径为 2 80 μm的裸露光纤 ,以保证最佳的能量传输。碎石完成后 ,所有的残余颗粒都落在容器内 ,晾干 48小时后 ,再重新称重 ,根据重量缺失的百分比来测试碎石效果。结果　 5Hz时 ,碎石 2min的重量缺失为 2 4%;碎石 4min的重量缺失为 5 4%。 10Hz时 ,碎石 2min的情况与 5Hz时碎石 4min的结果相似 ,重量缺失为 5 1%;碎石 4min的重量缺失为 64 %,原先估计这么高的能量设置 ,重量缺失应该更大些。在高能量发射时 ,可以观察到光纤有损耗 ,这可能是导致碎石效率下降的原因。结论　FREDDY激光器在 5Hz时碎石 4min ,和在 10Hz时碎石 2min的效率是同等的 ,提示传输到结石的能量与碎石效率的相关性很好。而 10Hz、4min组的碎石效率比预期的略有下降 ,     

The active straight leg raising test and mobility of the pelvic joints

Objective signs to assess impairment in patients who are disabled by peripartum pelvic girdle pain hardly exist. The purpose of this study was to develop a clinical test to quantify and qualify disability in these patients. The study examined the relationship between impaired active straight leg raising (ASLR) and mobility of pelvic joints in patients with peripartum pelvic girdle pain, focusing on (1) the reduction of impairment of ASLR when the patient was wearing a pelvic belt, and (2) motions between the pubic bones measured by X-ray examination when the patient was standing on one leg, alternating left and right. Twenty-one non-pregnant patients with peripartum pelvic girdle pain in whom pain and impairment of ASLR were mainly located on one side were selected. ASLR was performed in the supine position, first without a pelvic belt and then with a belt. The influence of the belt on the ability to actively raise the leg was assessed by the patient. Mobility of the pelvic joints was radiographically visualized by means of the Chamberlain method. Assessment was blinded. Ability to perform ASLR was improved by a pelvic belt in 20 of the 21 patients (binomial two-tailed P = 0.0000). When the patient was standing on one leg, alternating the symptomatic side and the reference side, a significant difference between the two sides was observed with respect to the size of the radiographically visualized steps between the pubic bones (binomial two-tailed P = 0.01). The step at the symptomatic side was on average larger when the leg at that side was hanging down than when the patient was standing on the leg at that side. Impairment of ASLR correlates strongly with mobility of the pelvic joints in patients with peripartum pelvic girdle pain. The ASLR test could be a suitable instrument to quantify and qualify disability in diseases related to mobility of the pelvic joints. Further studies are needed to assess the relationship with clinical parameters, sensitivity, specificity and responsiveness in various categories of patients. In contrast with the opinion of Chamberlain, that a radiographically visualized step between the pubic bones is caused by cranial shift of the pubic bone at the side of the standing leg, it is concluded that the step is caused by caudal shift of the pubic bone at the side of the leg hanging down. The caudal shift is caused by an anterior rotation of the hip bone about a horizontal axis near the sacroiliac joint. Received: 7 November 1998 Revised: 6 July 1999 Accepted: 9 September 1999     

Cajal间质细胞研究进展

西班牙神经解剖学家Cajal首次在消化道肌肉层观察并描述了Cajal间质细胞的形态结构,发现他们在肠道内源性神经系统末梢发挥作用．后来人们进一步研究发现,他们是胃肠道起搏细胞,胃肠动力障碍性疾病与他们的分布和形态学异常有关．但在最近几年,人们在腺体、脉管系统、泌尿生殖系统中陆续鉴定出此类Cajal间质细胞,人们开始重视Caial间质细胞在胃肠道以外器官和组织中的作用,试图阐明他们的形态结构和生理功能．这些细胞在形态学上与胃肠道Cajal间质细胞十分相似,但也存在少量迥异之处,他们很可能属于Cajal间质细胞新的亚型．这些发现将会使人们对Cajal间质细胞产生新的认识,同时也对Cajal间质细胞重新分类有着重要影响．     

2，4－二氨基5－氟－6－取代苄氨基喹唑啉的合成及生物活性

本文报道２，４－二氨基－５－氟－６－取代苄氨基喹唑啉类化合物的合成及抗疟、抗肿瘤和抗菌活性，这类化合物的合成是由５－氟－２，４，６－三氨基喹唑啉（６ａ）与取代苯甲醛缩合成Ｓｃｈｉｆｆ碱，然后经还原、甲酰化、亚硝化或甲基化制得。５－氟－２，４，６－三氨基喹唑啉（６ａ）尚未见文献报道，由５－氟－２，４－二氨基喹唑啉（４）经硝化生成异构体５ａ和５ｂ分离得５ａ后再经还原制得。经对伯氏鼠疟原虫Ｐｌａｓｍｏｄｉｕｍｂｅｒｇｈｅｉ抑制性治疗筛选，有６个化合物Ｉ２，４．５，６和ＩＩ５，６以每日１ｍｇ·ｋｇ－１，给药４天，抑制率为１００％；体外抗肿瘤活性以Ｉ４最强，对Ｌ１２１０白血病细胞的ＩＣ５０为９．８６×１０－４μｇ·ｍｌ－１，优于氨甲蝶呤（ＭＴＸ）；经对１８种常见菌进行体外筛选，发现对肺炎双球菌Ｄｉｐｌｏｃｏｃｃｕｓｐｎｅｕｍｏｎｉａｅ活性较好。     

Extraperitoneal laparoscopic para-aortic lymphadenectomy for lymph node recurrence of fallopian tube carcinoma

The endoscopic retroperitoneal approach is a minimally invasive method for surgical staging of cervical cancer. A 57-year-old woman had an intraoperative diagnosis of carcinoma of the left fallopian tube and undergone a retroperitoneal pelvic and para-aortic lymphadenectomy with no peritonization during surgical staging. Small suspicious nodes in the serous membrane of the sigmoid colon and peritoneal washings were positive for malignancy. A total of 12 nodes were obtained, all of which were negative. She received six cycles of paclitaxel and platinum-based chemotherapy and showed a complete clinical response. Thirty-two months after surgery, the abdominal computed tomography scan showed a left para-aortic lymph node, 19 mm in diameter, which was successfully removed through an extraperitoneal laparoscopic approach. The extraperitoneal laparoscopic approach of the para-aortic region is a feasible procedure after previous transperitoneal lymphadenectomy and chemotherapy.