头孢哌酮/舒巴坦治疗耐药菌与二重感染患者的疗效评价

目的研究应用头孢哌酮/舒巴坦治疗耐药菌及二重感染患者进行的临床效果。方法回顾性分析2012年9月-2013年9月应用头孢哌酮/舒巴坦进行治疗的294例耐药菌感染患者及二重感染患者临床资料,采用SPSS 19.0软件进行统计处理。结果共培养出336株病原菌,革兰阴性菌267株占79.46%,革兰阳性菌69株占20.54%;革兰阴性菌对头孢哌酮/舒巴坦敏感率达79.78%;革兰阳性菌对头孢哌酮/舒巴坦敏感率达82.61%;127例二重感染患者培养出病原菌201株,均为革兰阴性菌,其对头孢哌酮/舒巴坦敏感率达80.10%。结论应用头孢哌酮/舒巴坦对耐药菌及二重感染患者进行治疗,效果显著。     

梅毒螺旋体优势表位抗原嵌合表达构建双抗原夹心法的研究

目的用基因工程方法表达嵌合的梅毒螺旋体优势表位抗原,建立检测血清梅毒抗体的双抗原夹心酶联免疫方法(double antigen sandwich enzyme-linked immunosorbent assay,DAS-EIA)。方法通过计算机软件分析选择梅毒螺旋体优势抗原表位,用聚合酶链式反应(PCR)扩增优势表位基因,构建了梅毒螺旋体多优势表位嵌合抗原(rTpN15-TpN17-TpN47)表达载体,转化宿主菌BL21(DE3)进行表达,亲和层析柱法纯化获得高纯度融合抗原,并用其建立检测梅毒抗体的DAS-EIA。结果表达的优势表位嵌合抗原具有很好的抗原性。用其建立的嵌合抗原DAS-EIA检测确诊的50份阳性和30份阴性血,阳性检出率和阴性检出率都是100%。结论嵌合抗原DAS-EIA法具有比间接EIA和重组单抗原DAS-EIA更高的灵敏度和检出正确率,其检测水平已经达到国外TPHA的水平。该方法的建立为临床检测梅毒开辟了新的方法。     

Membranes for Therapeutic Apheresis

Abstract: Kuraray has developed many kinds of apheresis devices, such as plasma separators, plasma fractionators, and apheresis monitors. In this article, apheresis membranes, especially double filtration plasmapheresis (DFPP) and plasma fractionators used in DFPP are introduced. DFPP is both clinically and cost effective apheresis therapy, and it has been used widely for the treatment of many kinds of diseases. Several types of plasma separators with various pore sizes are available. It is important to select the proper plasma separator with suitable pore size, determined by the size of the pathogenic substances to be removed. The Evaflux 5A ethylene‐vinyl alcohol copolymer plasma fractionator efficiently separates low‐density lipoprotein from high‐density lipoprotein. DFPP with the Evaflux 5A is effective for the treatment of familiar hyperlipidemia.     

Linear lesions for treating the recurrence of persistent atrial tachyarrhythmia after cryoballoon ablation of atrial fibrillation

Overall, 133 patients underwent 170 procedures for the treatment of persistent ATa following an index cryoballoon pulmonary vein isolation (n = 715). After all the procedures, > 90% of the patients had a roof line, a mitral isthmus and/or septal line, and a cavotricuspid isthmus line. Ninety-two patients (69.2%) were in sinus rhythm after a median of 36 months since the index cryoballoon PVI. ATa: atrial tachyarrhythmia; cryo: cryoballoon; CTI: cavotricuspid isthmus; LSPV: left superior pulmonary vein; LIPV: left inferior pulmonary vein; PVI: pulmonary vein isolation; RF: radiofrequency; RSPV: right superior pulmonary vein; RIPV: right inferior pulmonary vein.

     

右室双出口超声和右心室造影与手术结果对比分析

对15例经手术证实的右室双出口患者术前超声检查和右心室造影诊断与手术病理结果进行对比分析，超声诊断准确率86．7％（13／15），右心室造影诊断准确率91．7％（11／12）。经统计学分析，两者无显著性差异（P＞0．05）。认为：超声心动图检查与右心定造影结合可在术前诊断右室双出口及合并畸形。     

Plasma Exchange Versus Double Filtration Plasmapheresis in the Treatment of Guillain‐Barré Syndrome

Abstract: Previous studies have shown that both plasma exchange (PE) and double filtration plasmapheresis (DFPP) are effective treatments in Guillain‐Barré syndrome (GBS). Whether PE and DFPP have similar effects in GBS is not clear. This report compares the therapeutic effectiveness of PE and DFPP in GBS patients treated in 3 major hospitals in northern Taiwan. A total of 102 patients were included in this survey, including 39 with PE (hereafter PE group) and 63 with DFPP (hereafter DFPP group). Both groups showed significant improvement of disability scores after treatment. However, time to onset of effect was shorter (5.6 ± 3.5 versus 7 ± 3.4 days, p < 0.05), and changes of disability scores were more prominent (1.3 ± 0.8 versus 0.8 ± 0.8, p < 0.05) in the PE group than the DFPP group. Mortality and outcome after 6 months were not different between the 2 groups. In conclusion, both PE and DFPP are effective treatments in GBS. PE was superior to DFPP in short‐term effectiveness. The long‐term effectiveness was not different.     

批质量保证二次抽样法在抗疟药治疗恶性疟疗效监测中的适用性研究

目的　探索批质量保证二次抽样法 (DLQAS)在抗疟药对恶性疟疗效监测中应用的可能性。　方法　在现场按WHO推荐的 2 8d体内法氯喹疗效评估方案收集病例 ,给予氯喹治疗 ,判定治疗失败与否 ,比较传统的流行病学方法与DLQAS法对疗效判定的结果 ,评估和比较对样本量的需求。　结果　传统方法调查到治疗失败率为 40 .7% ,DLQAS法第一阶段和第二阶段调查到治疗失败率均大于WHO推荐换用药物治疗失败率上限 2 5 % ;DLQAS法的样本量比传统的流行病学横断面抽样方法少。　结论　DLQAS的现场调查治疗失败判定结果同传统流行病学方法 ,且样本量小、快速 ,适用于对抗疟药治疗恶性疟疗效监测的现场评估。     

Prevalence of double diabetes in youth onset diabetes patients from east Delhi and neighboring NCR region

Background

It is being increasingly reported that some of the youth onset diabetes patients cannot be classified clearly as type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) based on usual criteria and the term double diabetes (DD) coined for these cases.

In vitro investigations on retention force behavior of conventional and modern double crown systems

ObjectiveThis study aimed to investigate the effects of long-term use on the retention force and wear behavior of double crown systems.MethodsBased on a common double crown design sixty pairs of telescopic crowns were fabricated and divided into six groups, each consisting ten samples: “Gold standard” cast gold alloy primary and secondary crown (GG) and cast non-precious alloy (NN), computer-aided design (CAD)/computer-aided manufacturing (CAM)-milled zirconia primary crown and galvanoformed secondary crown (ZG), CAD/CAM-milled non-precious alloy primary and secondary crown (CC NN), CAD/CAM-milled zirconia primary crown and non-precious alloy secondary crown (CC ZN) and CAD/CAM-milled zirconia primary crown and polyetheretherketone (PEEK) secondary crown (CC ZP). In the constant presence of artificial saliva, all samples were subjected to 10,000 joining-separation cycles at a velocity of 120 mm/min. Wear was analyzed by reflected light microscopy and confocal microscopy before and after artificial aging.ResultsRetention force losses were observed in each group after long-term use, with significant losses in the groups ZG and CC ZP (p_ZG = 0.01, p_{CC ZP} = 0.049). During artificial aging, no significant differences in pull-off force were recorded for groups GG, NN and CC ZN. Regarding wear, merely the Y-TZP primary crowns of the CC ZP group displayed no surface changes.SignificanceAll tested production methods and material combinations seem to be suitable for clinical practice. CAD/CAM technology allows similarly predictable results to be achieved as the gold standard. Confocal microscopy is recommended for surface examinations of double crowns.