双重钢丝荷包环扎配合中药治疗髌骨粉碎性骨折

目的　探讨双重钢丝荷包环扎治疗髌骨粉碎性骨折的优势和可行性。方法　运用双重钢丝荷包环扎配合中药治疗髌骨粉碎性骨折 1 5例。结果　 1 5例患者中得到随访 1 2例 ,其中优 7例 ,良 4例 ,可 1例 ,优良率为 92 %。结论　运用双重钢丝荷包环扎治疗髌骨粉碎性骨折具有操作简便 ,内固定可靠等优点 ,同时配合中药治疗能促进骨折愈合疗效更好     

腰椎管侧隐窝狭窄症的再认识

作者对１５３例下腰痛手术治疗在术前进行过ＣＴＭ检查的患者作了影像学及临床分析,按形态不同,侧隐窝可分为五种类型：（１）三角型：即整个椎管呈倒三角形,其侧隐窝完开放;（２）猫耳型：因后关节和椎体后缘轻度增生,形成底宽顶尖的侧隐窝,整个椎管如同猫头,侧隐窝头为猫耳,基本开放;（３）牛角型：因关节突向椎体方向过度增生使侧隐窝呈横向伸开的带状,中央椎管不窄,横断面形如牛头,侧隐窝为牛角,严重者侧隐窝近于闭     

PBL与CTM在中医内科教学中联合应用初探

医学教育的目标是培养合格的临床医师,中医内科学是一门临床学科,具有较强的实践性,PBL（以问题为基础的教学法）与CTM（案例教学法）在中医内科教学中的联合应用,可以深化理论知识,加强对疾病的认识,达到提高学生综合学习能力的目的,从而为社会培养优秀的复合型人才.     

中药对大负荷游泳运动大鼠睾酮水平的影响

目的:探究中药(益气养阴补肾方剂)对大负荷运动训练导致的低血睾酮的作用。方法:40只雄性SD大鼠被随机分为安静对照组、训练对照组、训练+睾酮组与训练+中药组。训练大鼠进行为期6周的递增负荷游泳训练;中药通过灌胃方式补充,丙酸睾酮通过腹腔注射补充。动物宰杀后,分别取血清、睾丸与垂体检测睾酮与促性腺激素FSH、LH。结果:训练补充中药大鼠血清与睾丸组织的睾酮水平,以及血清和垂体LH水平均显著高于训练对照组大鼠的水平(P<0.05);训练对照组大鼠血清与睾丸组织的睾酮水平以及血清LH水平显著低于安静对照组大鼠的相应水平(P<0.05);训练补充丙酸睾酮组大鼠血清睾酮水平显著高于训练补充中药与安静对照组大鼠的水平(P<0.05),但其睾丸组织睾酮水平以及血清LH水平均显著低于训练补充中药与安静对照组大鼠的相应水平(P<0.05)。结论:中药可明显改善运动训练导致的大鼠低血睾酮水平,其机制可能是益气养阴补肾方剂通过提高血清LH水平刺激睾丸间质细胞进而增加了睾丸组织中睾酮的合成与分泌。     

Evaluation of the COBAS® AmpliPrep/COBAS® TaqMan® HCV Test,v2.0 and comparison to assays used in routine clinical practice in an international multicenter clinical trial: The ExPECT study

BackgroundThe COBAS^® AmpliPrep^®/COBAS^® TaqMan^® HCV Test, v2.0 (CAP/CTM2) is used for HCV RNA viral load monitoring.ObjectivesThe performance of the CAP/CTM2 was compared to other widely used tests, including a manual version of the assay (the COBAS^® TaqMan^® HCV Test, v2.0 for use with the High Pure System, HPS/CTM2) predominantly used during phase III clinical trials for the new direct acting antiviral therapies.Study designLow HCV RNA level comparisons were performed across tests (Abbott Realtime HCV Test, ART; COBAS^® AmpliPrep^®/COBAS^® TaqMan^® HCV Test, v1.0, CAP/CTM1; CAP/CTM2; and HPS/CTM2) using dilutions of the 2nd HCV WHO International Standard. Additionally, the clinical performance of the CAP/CTM2 was evaluated with 421 leftover HCV RNA-positive routine clinical samples.ResultsAll quantifiable WHO dilutions were within ±0.3 log₁₀ IU/mL of the expected results across tests and the analytical sensitivity resulted in a limit of detection of 12 IU/mL (95% confidence interval, 10, 15). When clinical samples were tested the results for 87% (367 of 421) of all sample comparisons were within ±0.5 log₁₀ IU/mL. When low viral load results (25–3500 IU/mL) were compared, values obtained by the ART assay were significantly lower (p < 0.0001) than those obtained with the CAP/CTM2.ConclusionsThe new CAP/CTM2 showed good accuracy with comparable sensitivity to comparator assays. The new kit is well-suited for use in the routine diagnostic laboratory, especially for accurate monitoring of patients receiving triple therapy or interferone-free regimens.     

Aptima HIV-1 Quant Dx—A fully automated assay for both diagnosis and quantification of HIV-1

BackgroundSeparate assays are available for diagnosis and viral load (VL) monitoring of HIV-1. Studies have shown that using a single test for both confirmatory diagnosis and VL increases linkage to care.ObjectiveTo validate a single assay for both diagnosis and VL monitoring of HIV-1 on the fully automated Panther platform.Study designValidate the assay by assessing specificity, sensitivity, subtype detection, seroconversion, reproducibility and linearity. Also assess diagnostic agreement with the Procleix^® Ultrio Elite™ discriminatory assay (Procleix), and agreement of VL results (method comparison) with Ampliprep/COBAS TaqMan HIV-1 version 2.0 (CAP/CTM), using clinical samples.ResultsThe assay was specific (100%) and sensitive with a 95% limit of detection of 12 copies/mL with the 3rd WHO standards. Aptima detected HIV in seroconversion panels 6 and 11 days before p24 antigen and antibody tests, respectively. Diagnostic agreement with Procleix, was 100%. Regression analysis showed good agreement of VL results between Aptima and CAP/CTM with a slope of 1.02, intercept of 0.07, and correlation coefficient (R²) of 0.97. Aptima was more sensitive than CAP/CTM. Equivalent quantification was seen on testing clinical samples and isolates belonging to HIV group M, N, O and P and commercially available subtype panels. Assay results were linear (R² 0.9994) with standard deviation of <0.17 log copies across assay range.ConclusionsThe good specificity, sensitivity, precision, subtype performance and clinical agreement with other assays demonstrated by Aptima combined with the complete automation provided by the Panther platform makes Aptima a good candidate for both VL monitoring and diagnosis of HIV-1.     

浅谈中医院的现代化建设

建设现代化综合性中医院既是国家“九五”期间“弘扬工程”的重要内容，又是摆在从事中医院管理者面前的一项艰巨任务。要达到这一目标，中医院建设必须：①坚持办院方向，正确处理中医特色与现代化的关系。②加强专科专病建设，形成特色。③重视人才培养，抓科学研究。④加强制度建设，重视信息管理。⑤加强医德医风建设，树立良好形象。⑥重视建筑和环境美化，配备精良诊疗设备。     

CT及CT脊髓造影对椎管内肿瘤诊断价值的探讨

目的 探讨CTM(CT脊髓造影)和CT检查对椎管内肿瘤的诊断价值。方法 回顾性分析经手术病理证实并经CTM(CT脊髓造影)和CT检查诊断的肿瘤35例。结果 CTM、CT诊断髓内肿瘤10例(占28．6％)，髓外硬膜内肿瘤15例(占42．9％)，硬膜外肿瘤8例(占22．9％)，硬膜内外肿瘤2例(占5．7％)。结论 该方法能反映肿瘤各自特征，准确的反映椎管内各种肿瘤的位置和性质。     

脊髓造影与CTM联合应用诊断腰椎间盘突出症46例报告

本文报告手术证实的46例腰椎间盘突出症术前经正位、侧位的中立、过伸、过屈位脊髓造影符合率为87%,CTM的符合率为97.7%,而两者联合应用则诊断准确率可提高到100%.     

Evaluation of COBAS AmpliPrep/COBAS TaqMan CMV Test for use in hematopoietic stem cell transplant recipients

Introduction: Cytomegalovirus (CMV) is a common opportunistic infection that contributes to poor outcomes in hematopoietic stem cell transplant (HSCT) recipients. Prevention of CMV end-organ disease in allogeneic HSCT recipients is commonly achieved by preemptive antiviral therapy of asymptomatic CMV reactivation that is detected by serial nucleic acid testing (NAT). However, there was no standardized CMV NAT until the development of the World Health Organization (WHO) International Standard.

Areas covered: This article provides a comprehensive review on COBAS AmpliPrep/TaqMan (CAP/CTM) CMV assay (Roche) and emphasizes the limitations in the clinical use of CMV NAT in HSCT recipients.

Expert commentary: The CAP/CTM CMV Test is the first US FDA approved commercial quantitative NAT for CMV viral load monitoring of plasma samples in solid organ transplant and HSCT recipients. The CAP/CTM assay has wide linear range of DNA quantification and demonstrates colinearity to the WHO International Standard. Studies of CAP/CTM CMV assay in HSCT recipients are still limited, but are now being reported to define viral thresholds for diagnosis, surveillance and monitoring. Results from these early studies in HSCT recipients suggest that, while the WHO IS has improved the inter-laboratory result variances, there are still important factors that continue to contribute to assay variability. This lack of harmony among NAT highlights the need for further standardization.