RELIABILITY AND VALIDITY OF THE SPANISH VERSION OF THEGMS–AGECAT PACKAGE FOR THE ASSESSMENT OF DEMENTIA AND COGNITIVE DISTURBANCES

This report confirms the reliability and validity of the Geriatric Mental State–Automated Geriatric Examination for Computer Assisted Taxonomy (GMS–AGECAT) package in a Spanish elderly population. No changes in the original English version are considered necessary. A representative sample (N=1080) of the elderly (65+ years) community in Zaragoza, Spain, stratified by age and sex was assessed. A two-phase screening was designed: phase I (lay interviewers): Spanish versions of GMS–AGECAT and Mini-Mental (MMSE); phase II (psychiatrists,N=324): the same instruments and History and Aetiology Schedule (HAS). Diagnosis: DSM-III-R criteria. Stringent test–retest reliability coefficients were calculated by comparing lay interviewers’ (phase I) vs psychiatrists’ (phase II) ratings. DSM-III-R psychiatric diagnoses in phase II were the gold standards for the validity study. Test–retest reliability coefficients of the cognitive sections of GMS were: case/no case distinction, mean kappa=0.71; dementia/no dementia distinction, mean kappa=0.80. GMS validity coefficients: detection of cases, sensitivity=98.4%; specificity=76.5%. Test–retest reliability coefficients of AGECAT: case/no case distinction, mean kappa=0.59; organic syndrome, dementia, mean kappa=0.68. Validity coefficients of AGECAT (psychiatrists’ outputs): case/no case distinction, sensitivity=90.6%; specificity=89.3%; dementia/no dementia distinction, sensitivity=86.4%; specificity=94.3%.     

妇科腹腔镜手术的临床进展

妇科腹腔镜手术近年来发展迅速,有损伤小、术后痛苦少、住院时间短、机体恢复快、美容效果好、医疗负担轻等优点。在妇科恶性肿瘤的诊治上,相对传统开腹手术,腹腔镜有自己独特的优势。随着手术器械设备的更新,医生经验的积累和技能的成熟,术中保护措施的研发,腹腔镜手术的并发症明显减少,安全性大大提高,临床运用范围愈加广泛。如今在传统腹腔镜手术的基础上又开发了微型腹腔镜手术,无气腹腹腔镜手术,机器人手术等新的手术方式。其各具特点,各有临床发展的潜力。就妇科腹腔镜手术近年来临床实践探索的新进展做综述。     

持续气道内正压对阻塞性睡眠呼吸暂停低通气综合征患者动脉硬化早期表现的影响

背景和目的：阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与心血管不良事件相关，其中包括心肌梗死和卒中。动脉硬化是导致这些心血管事件的主要机制。最近的横断面研究结果显示，没有合并症的OSAHS患者也存在动脉硬化的早期表现。因此，本研究观察了持续气道内正压（CPAP）治疗对动脉硬化的影响。为了验证OSAHS直接参与动脉硬化的假说，本研究只纳入没有合并症的重度OSAHS患者。方法：在为期2年的时间内对400例男性重度OSAHS患者进行了筛选，其中376例因合并高血压、     

Neurotrophins: Peripherally and centrally acting modulators of tactile stimulus-induced inflammatory pain hypersensitivity

Brain-derived neurotrophic factor (BDNF) is expressed in nociceptive sensory neurons and transported anterogradely to the dorsal horn of the spinal cord where it is located in dense core vesicles in C-fiber terminals. Peripheral inflammation substantially up-regulates BDNF mRNA and protein in the dorsal root ganglion (DRG) in a nerve growth factor-dependent fashion and results in novel expression of BDNF by DRG neurons with myelinated axons. C-fiber electrical activity also increases BDNF expression in the DRG, and both inflammation and activity increase full-length TrkB receptor levels in the dorsal horn. Sequestration of endogenous BDNF/neurotrophin 4 by intraspinal TrkB-Fc fusion protein administration does not, in noninflamed animals, change basal pain sensitivity nor the mechanical hypersensitivity induced by peripheral capsaicin administration, a measure of C fiber-mediated central sensitization. TrkB-Fc administration also does not modify basal inflammatory pain hypersensitivity, but does block the progressive hypersensitivity elicited by low-intensity tactile stimulation of inflamed tissue. BDNF, by virtue of its nerve growth factor regulation in sensory neurons including novel expression in A fibers, has a role as a central modulator of tactile stimulus-induced inflammatory pain hypersensitivity.     

THE EFFECT OF PREVIOUS ANTIBIOTIC THERAPY ON THE BACTERIOLOGY OF THE TONSILS IN CHILDREN

The bacteriology of the tonsillar surface and core in 30 children undergoing tonsillectomy was studied. Antibiotics taken in the six months before surgery were recorded. Haemophilus influenzae and Staphylococcus aureus were the commonest isolates; Streptococcus pyogenes was relatively rare. Eight children had received no antibiotics, the others had been prescribed 65 different courses of 13 different types. No relationship between the various antibiotic regimens prescribed and tonsillar bacteriology could be demonstrated, and it would appear that the tonsillar bacteriology at the time of tonsillectomy is not altered by antibiotics prescribed in the previous six months.     

血府逐瘀汤合五味消毒饮治疗糖尿病周围神经炎临床观察

目的观察血府逐瘀汤合五味消毒饮治疗糖尿病周围神经炎的临床疗效及其对神经传导速度的影响。方法将68例糖尿病周围神经炎患者随机分为2组。对照组36例给予盐酸丁咯地尔注射液治疗,治疗组32例子血府逐瘀汤合五味消毒饮治疗。2组均14日为1个疗程,2个疗程后分另q进行疗效判定和监测血糖。测定右正中运动神经、右尺运动神经、左腓运动神经和右胫运动神经传导速度。结果治疗组总有效率为87．5％,对照组总有效率为83．1％,2组比较无显著性差异（P〉0．05）。2组治疗前后血糖比较无显著性差异（P〉0．05）。治疗组治疗后神经传导速度均明显增快,与对照组比较有显著性差异（P〈0．01）。结论血府退瘀汤合五味消毒饮治疗糖尿病周围神经炎有显著疗效。     

μ阿片受体基因多态性对腰椎手术患者痛觉敏感性的影响

目的 探讨μ 阿片受体基因多态性对腰椎手术患者痛觉敏感性的影响,为指导个体化镇痛提供理论依据.方法 选择2018-08～2019-12新疆维吾尔自治区人民医院全麻下行腰椎手术患者218例.根据OPRM1 A118G基因型将其分为野生型纯合子组(AA组,85例)、突变型纯合子组(AG组,104例)和突变型杂合子组(GG组...