The top 100 papers in dry eye – A bibliometric analysis

Purpose

Citation analysis represents one of the best currently available methods for quantifying the impact of articles. Bibliometric studies list the ‘‘best sellers’’ in a single field of interest. The purpose of the present study was to identify and analyze the most frequently cited papers in dry eye research that may be of high interest for researchers and clinicians.

A prospective study of high resolution ultrasound in brachial plexopathies – Correlation with electrophysiological measurements

ObjectivesTo evaluate the diagnostic role of ultrasound in brachial plexopathies.MethodsWe included 59 healthy subjects (HS) and 42 patients consecutively referred with clinical suspicion of brachial plexopathy from October 2015 to May 2016. Patients underwent routine electrodiagnostic testing (EDx) as reference standard and a blinded standardised ultrasound examination of the brachial plexus as index test with cross-sectional area (CSA) as the ultrasound parameter of choice.ResultsSeventeen patients were diagnosed by EDx with brachial plexopathy, ten with mononeuropathies, and ten had normal EDx. Five had a cervical radiculopathy. In 11 (64%) out of the 17 patients with EDx diagnosed plexopathy, we found at least one abnormal level on ultrasound. Six (60%) out of ten normal EDx patients had a normal ultrasound examination at all levels. Ultrasound identified the same abnormal level(s) as EDx in eight (73%) of the 11 patients who had both abnormal EDx and ultrasound results. Mean CSA was higher in the plexopathy group compared to HS at the level of the C6 root (p = .022), the middle trunk (p = .027), and the medial cord (p = .003).ConclusionUltrasound examination showed abnormalities in patients with brachial plexopathies in good agreement with EDx.SignificanceUltrasound may be an important supplement to electrodiagnostics in evaluating brachial plexopathies.     

Hepatitis C eradication: A long way to go

Hepatitis C virus (HCV) is a major global health problem with high morbidity and mortality. About 185 million people are living with HCV, of which 80% are living in low and middle income countries. With the development of new highly effective treatments for HCV, it is considered that the eradication of HCV may only be one step away. The major problem with new treatment options is its high price. The price of sofosbuvir-based treatment for one patient in the United States is US$85000-110000, while the actual production cost of a 12 wk direct-acting antiviral regimen is less than US$250. Another major hindrance in HCV eradication is the lack of quality management of blood transfusion screens. Due to the lack of HCV screening, 75% of people in the United States with HCV infection are unaware of their positive HCV status. The control of massive HCV pandemic will require a significant financial investment, political will, and support from medical, pharmaceutical, and civil organizations around the globe.     

Haemostatically active proteins in snake venoms

Snake venom proteins that affect the haemostatic system can cause (a) lowering of blood coagulability, (b) damage to blood vessels, resulting in bleeding, (c) secondary effects of bleeding, e.g. hypovolaemic shock and organ damage, and (d) thrombosis. These proteins may, or may not, be enzymes. We review the data on the most relevant haemostatically active proteinases, phospholipases A₂, l-amino acid oxidases and 5′-nucleotidases from snake venoms. We also survey the non-enzymatic effectors of haemostasis from snake venoms - disintegrins, C-type lectins and three-finger toxins. Medical applications have already been found for some of these snake venom proteins. We describe those that have already been approved as drugs to treat haemostatic disorders or are being used to diagnose such health problems. No clinical applications, however, currently exist for the majority of snake venom proteins acting on haemostasis. We conclude with the most promising potential uses in this respect.     

Seminar教学法在中医诊断教学中的应用

中医诊断是以中医理论为指导,通过对病人询问、检查来收集病情资料,实现对病人健康状况和病变本质的辨识,对所患病、证做出概括性判断,为进一步论治提供指导,因此,中医诊断学是一门系统学科。该学科包括了"三个基本,一大思维",即基本理论、基本知识、基本技能和辨证思维。三大基本内容繁多、理论抽象,学生在理解、记忆方面均难以达到较好的效果,而中医辨证思维需要逻辑思维、形象思维、灵感思维等多种思     

Diagnostic accuracy of ultrasonography vs. electromyography in carpal tunnel syndrome: a systematic review of literature

A plethora of research investigates sonography vs. electrodiagnostic testing (EDX) for diagnosis of carpal tunnel syndrome (CTS). Through database searches, hand searches and communication with authors, 582 abstracts published from 1999 to 2009 were identified. A comprehensive systematic review process resulted in inclusion of 23 studies. Significant methodologic discrepancies among the studies limited the ability to complete a meta-analysis to identify specific diagnostic thresholds. Instead, the data were reviewed to provide implications for clinical utility of sonography as a screening tool as a compliment to EDX and to suggest continued and future research. The largest cross-sectional area of the median nerve within the carpal tunnel region has high potential for clinical screening, especially in individuals with severe CTS. Identifying swelling of the nerve through comparative measurements, qualitative analysis and Doppler techniques all require further investigation. Screening protocols may be enhanced through exploration of sonography in patients with mild CTS and false-negative EDX.     

Engineered cell surface expression of membrane immunoglobulin as a means to identify monoclonal antibody-secreting hybridomas

Monoclonal antibodies (mAbs) have proven to be effective biological reagents in the form of therapeutic drugs and diagnostics for many pathologies, as well as valuable research tools. Existing methods for isolating mAb-producing hybridomas are tedious and time consuming. Herein we describe a novel system in which mAb-secreting hybridoma cells were induced to co-express significant amounts of the membrane form of the secreted immunoglobulin (Ig) on their surfaces and are efficiently recovered by fluorescent activated cell sorting (FACS). Fusion of a novel myeloma parent, SP2ab, expressing transgenic Igα and Igβ of the B-cell receptor complex (BCR) with spleen cells resulted in hybridomas demonstrating order of magnitude increases in BCR surface expression. Surface Ig levels correlated with transgenic Igα expression, and these cells also secreted normal levels of mAb. Hundreds of hybridoma lines producing mAbs specific for a variety of antigens were rapidly isolated as single cell-derived clones after FACS. Significant improvements using the Direct Selection of Hybridomas (DiSH) by FACS include reduced time and labor, improved capability of isolating positive hybridomas, and the ease of manipulating cloned cell lines relative to previously existing approaches that require Limiting Dilution Subcloning (LDS).     

How useful is rectal endosonography in the staging of rectal cancer?

It is essential in treating rectal cancer to have adequate preoperative imaging,as accurate staging can influence the management strategy,type of resection,and candidacy for neoadjuvant therapy.In the last twenty years,endorectal ultrasound(ERUS) has become the primary method for locoregional staging of rectal cancer.ERUS is the most accurate modality for assessing local depth of invasion of rectal carcinoma into the rectal wall layers(T stage) .Lower accuracy for T2 tumors is commonly reported,which could ...     

酷似免疫性脑炎的线粒体脑肌病伴乳酸酸中毒及卒中样发作综合征的诊断学特征

目的探讨酷似免疫性脑炎的线粒体脑肌病伴乳酸酸中毒及卒中样发作(MELAS)综合征的临床、神经电生理及影像学改变的诊断学特征,总结诊疗过程。 方法回顾性分析1例酷似免疫性脑炎的MELAS综合征的发病过程及临床资料,并复习相关文献。 结果患儿曾以发热、头痛、恶心、呕吐、视物模糊、眼球阵挛、步态不稳等相似症状分别于3,6个月前误诊为病毒性脑炎、免疫性脑炎两次住院,经治疗症状逐渐好转出院。现以相同症状加重并出现视物不清、行走困难再次入院。检查脑脊液常规及抗N-甲基-D-天冬氨酸受体(NMDA-R)抗体阴性,脑电图显示右侧枕部、后颞部大量散发－阵发性棘波/棘慢复合波、尖波/尖慢复合波,可波及右侧顶部;头颅磁共振(MRI)表现多样,可累及皮质和髓质,以灰质为主,表现为脑回明显肿胀,脑沟变窄、变浅,DWI呈弥散受限高信号,晚期脑组织可出现局部软化、脑萎缩改变,病灶可反复出现,基因检测A3243G位点突变,最终确诊为MELAS综合征。 结论临床症状酷似免疫性脑炎的患儿,遇有病情不稳、症状反复出现,应做进一步检查,排除或确诊是否为MELAS综合征。     

天津市医疗机构丙肝病例诊断及报告质量现况调查

目的 了解天津市医疗机构丙肝病例诊断与报告现状, 为提高丙肝疫情监测能力和医疗机构传染病报告管理水平提供科学依据。方法 以天津市二级及以上所有具有抗-HCV检测能力的79家医疗机构为研究对象,每家机构按30%的比例随机抽取抗-HCV检测阳性的住院病例共1 232例,通过查阅医疗机构门诊日志、病案室登记及实验室检测等方式对丙肝报告情况进行调查。结果 天津市被调查医疗机构仅27.85%的医院具有HCV RNA检测能力,抗-HCV阳性报告率为36.28%,HCV-RNA阳性报告率为62.13%,三级医院指标阳性报告率明显高于二级医院;丙肝误诊率为4.30%,临床诊断病例漏诊率为70.90%,三级医院误诊率及漏诊率均明显低于二级医院;报告病例诊断分类正确率为66.67%,急慢性分类正确率为99.50%,三级医院的报告病例诊断分类率和急慢性分类正确率均高于二级医院。结论 目前天津市医疗机构丙肝病例诊断和报告质量较低,医疗机构需提高丙肝病例报告质量,为政府丙肝防治卫生政策的制定提供科学依据。