Prevalence of non-healed and healed chronic leg ulcers in an elderly rural population

Background. A lesbian woman will have to choose whether to disclose or not in every new encounter, including when consulting her general practitioner (GP). She may fear a negative reaction in the doctor, based on knowledge of marginalization and prejudice of homosexuals throughout history. Objectives. To explore patients’ experiences concerning disclosure of their lesbian orientation to general practitioners (GPs), focusing on why they find it important, and what GPs can do to promote disclosure. Methods. One group interview was conducted, audiotaped, and transcribed verbatim. Qualitative analysis was conducted by systematic text condensation inspired by Giorgi's phenomenological approach. Six women aged 28–59 years, who self-identified as lesbian, were recruited through a web-based, publicly accessible network for research on homosexuality. Main outcome measures. Accounts of experiences where the patient thought that information of a lesbian sexual orientation was of importance in the consultation with a GP. Results. Disclosure can imply information of medical relevance, explain circumstances, and generate a feeling of being seen as one's true self. The intentional use of common consultation techniques may facilitate disclosure. Conclusion. Lesbian patients may want to disclose their sexual orientation to the general practitioner but they experience certain barriers. These can be overcome when the GP provides an open and permissive context. GPs can benefit from knowledge concerning sexual orientation in their work with lesbian patients.     

Improved diagnosis of melioidosis using a 2-dimensional immunoarray

Melioidosis is caused by the Gram negative bacterium Burkholderia pseudomallei. The gold standard for diagnosis is culture, which requires at least 3–4 days obtaining a result, hindering successful treatment of acute disease. The existing indirect haemagglutination assay (IHA) has several disadvantages, in that approximately half of patients later confirmed culture positive are not diagnosed at presentation and a subset of patients are persistently seronegative. We have developed 2 serological assays, an enzyme-linked immunosorbent assay (ELISA), and a 2-dimensional immunoarray (2DIA), capable of detecting antibodies in patient sera from a greater proportion of IHA-negative patient subsets. The 2DIA format can distinguish between different LPS serotypes. Currently, the 2DIA has a sensitivity and specificity of 100% and 87.1%, respectively, with 100% of culture-positive, IHA-negative samples detected. The ELISA has a sensitivity and specificity of 86.2% and 93.5%, respectively, detecting 67% of culture-positive, IHA-negative samples. The ELISA and 2DIA tests described here are more rapid and reliable for serological testing compared to the existing IHA.     

经络辨证的数据挖掘与探讨

目的 分析国内建国以来发表的经络辨证相关性研究文献报道及发展趋势，为本领域科研人员提供参考。方法 以中国知网资源总库源数据库为资料来源，从文献计量学角度对建国以来国内期刊收录的经络辨证的文献进行分析，从发表年度、文献来源、文献类型、作者、作者单位、基金资助、高频关键词等方面进行统计，初步研究与分析本领域的科研状况。结果 截止到2018年11月21日，共检索到相关文献890篇。文献数量在2004年以前增长平缓，从2004年以后增长较快；发表文献5篇以上期刊单位有20家，其中最多的发表了57篇；发表3篇以上的作者共有33人，其中王居易发表论文数量最多（25篇）；发表文献5篇以上的单位共36所，其中北京中医药大学发表了59篇，数量最多；文献以临床研究为主，占66.52%；受各级科研基金资助文献50篇，占5.62%，其中国家自然基金资助文献有37篇；文献被引用频次57.08%，总体偏高。结论 经络辨证相关研究近20年来不断受到关注，呈多样化发展趋势，研究质量也不断提高；侧重临床应用的研究，学科应用稍显集中，经络辨证用于诊断方面理论内涵方面研究不足，有待形成系统而深入的辨证体系。采用经络辨证能够指导循经用药或者采用相应治法，以提高临床疗效；将经络辨证与脏腑辨证有机结合起来，能够帮助准确辨证，减少误诊、漏诊。