Acceptability of self-collected vaginal samples for HPV testing in an urban and rural population of Madagascar

ObjectiveTo evaluate the acceptability of self-collected vaginal samples for HPV testing in women living in rural and urban areas of Madagascar.ResultsA total of 300 women were recruited. Median age was 44.1 years (range 29–65 years) in the urban group and 40.9 years (range 29–65 years) in the rural group. Urban women had improved knowledge on HPV, cervical cancer and cervical cancer screening (p<0.05) as compared to rural women. Urban women lived closer to a health care center (P<0.05), had fewer different sexual partners (P<0.05) and later first sexual intercourse (p=0.07). Unlike urban women, most rural women were married (p<0.05).ConclusionAcceptability of self-sampling for HPV testing was similarly excellent in both groups despite their difference in terms of socio-demographic factors and knowledge about cervical cancer.     

唇腭裂新生儿听力检测

目的 分析唇腭裂新生儿瞬态声诱发耳声发射、鼓室图以及听性脑干反应(ABR)的特点,以探讨相关听力学检查对这类新生儿的临床应用价值.方法 采用瞬态声诱发耳声发射(transiently evoked otoacoustic emission,TEOAE)及鼓室图测试,对23例（46耳）唇腭裂新生儿进行新生儿听力筛查,初筛...     

40 Hz听性稳态反应预测大脑中动脉供血区梗死的恶性过程:回顾性病例系列研究

目的 探讨40 Hz听性稳态反应(40 Hz auditory steady-state response,40 Hz ASSR)对大脑中动脉供血区梗死患者恶性过程的预测价值.方法 收入神经重症监护病房(neuro-intensive care unite,NICU)的大脑中动脉供血区梗死患者入院后72 h内行40Hz ASSR以及脑干听觉诱发电位(brainstem auditory evoked potential,BAEP)检查,同时行美国国立卫生研究院卒中量表(Naional Institutes of Health Stroke Scale,NIHSS)评分.采用多变量logistic回归分析确定恶性过程的影响因素.对恶性过程相关指标进行接受者操作特征(receiver operating characteristic,ROC)曲线分析,明确40Hz ASSR对大脑中动脉供血区梗死恶性过程的预测价值.结果 共纳入104例大脑中动脉供血区梗死患者,其中恶性过程组59例,非恶性过程组45例,两组基线NIHSS评分[(17.25±7.23)分对(20.40±8.09)分;t=-2.055,P=0.043)、梗死体积[(105.85±73.37)mm3对( 179.15±144.38)mm3;t=-3.011,P=O.004]、白细胞计数[(10.26±3.14)×109/L对(13.45±5.42)×109/L;t=-3.336,P=0.001]、40 Hz ASSR(Z=-3.237,P =0.001)和短潜伏期体感诱发电位(Z=-3.130,P=0.002)分级存在显著差异.多变量logistic回归分析显示,40 Hz ASSR[优势比(odds ratio,OR)3.347,95％可信区间(confidence interval,CI)1.630～6.872,P=0.014]、梗死体积(OR 1.006,95％ CI 1.001 ～1.012,P=0.003)和白细胞计数(OR 1.277,95％CI 1.074～1.402,P=0.001)为大脑中动脉供血区梗死患者出现恶性过程的独立预测因素.40 Hz ASSR为3级时预测恶性过程的敏感性为39.5％,特异性为94.4％.结论 40 Hz ASSR对大脑中动脉供血区梗死患者的恶性过程具有重要的预测价值.     

卒中后失语患者的认知功能评估工具

语言是人类独有的复杂认知心理活动,语言障碍是支持语言行为认知过程的有效活动和相互作用的减退.卒中后失语患者的认知功能受到一定程度的影响.因此,准确识别这些认知损害有助于失语患者的治疗和康复.评估认知损害的严重程度往往需要借助认知功能评定量表.文章就适用于卒中后失语患者的认知功能评定量表进行了综述.     

急性低压低氧应激导致大鼠认知功能损伤研究

目的:探讨急性低压低氧暴露对大鼠大脑海马损伤、氧化应激以及对认知功能的影响。方法:36只大鼠随机分为3组:常压常氧组(对照组)、模拟海拔4000 m组(4 km组)、模拟海拔6000 m组(6 km组)。比较各组大鼠Morris水迷宫学习与记忆测试成绩、海马神经元凋亡、海马组织中GSH、MDA含量和CAT、SOD的活力。结果:与对照组比较,急性低压低氧组大鼠Morris水迷宫测试成绩明显降低(P<0.05);急性低压低氧组大鼠海马组织中GSH含量、SOD和CAT活力均明显降低(P<0.05),MDA含量明显增加(P<0.01);急性低压低氧组大鼠海马神经元凋亡率明显高于常氧饲养组(P<0.01),以上改变均随海拔升高而更为明显。结论:急性低压低氧应激导致大鼠氧化应激系统失衡,而氧化应激反应直接导致海马神经元的细胞凋亡,并最终导致大鼠学习与记忆等认知能力的下降。     

低压舱内大鼠游泳运动模型的建立

目的：大鼠在低压舱内进行游泳时,皮毛上会附着大量气泡,严重影响对大鼠运动能力的判断。本实验旨在建立低压舱内稳定可靠的大鼠游泳运动模型。方法：SD大鼠分平原组和高原组,每组大鼠又分为A、B、C、D四组。A组大鼠为对照组;B组大鼠在游泳用水中加入去污剂;C组大鼠实验前1天用脱毛剂脱去头部以下被毛;D组大鼠用实验前1天沸腾后自然冷却的水游泳。大鼠分别置于平原和5 000m低压舱内饲养,24h后各组在其饲养环境下进行负重2.5%体重的游泳运动。观察大鼠游泳运动情况,并记录游泳力竭时间。结果：在平原,往游泳用水中加入吐温20（B组）或去除大鼠被毛（C组）可减轻大鼠身上附着的气泡,而在低压舱中使用这两种方法无效。无论是在舱内还是在舱外,使用实验前1天沸腾后自然冷却的水（D组）可完全消除大鼠游泳时皮毛上附着的气泡。D组大鼠在平原力竭时间为（56±11）min,显著长于高原力竭时间（25±17）min。结论：通过实验前煮沸游泳用水,可消除大鼠在低压舱中游泳时皮毛上附着的气泡,建立稳定可靠的低压舱内大鼠游泳运动模型。     

急性低压低氧对小鼠学习记忆能力及海马组织一氧化氮和内皮素-1水平的影响

目的 探讨模拟高原急性低压低氧环境对小鼠学习记忆行为及脑组织含水量、海马组织一氧化氮（Nitric oxide,NO）和内皮素-1（Endothelin-1,ET-1）的影响.方法 将小鼠随机分为常压常氧组和低压低氧组（模拟海拔6000 m 8 h）,用Morrs水迷宫测定小鼠的空间学习记忆能力;用干湿质量法测定脑组织含水量的变化;用酶联免疫吸附法观察其海马组织NO和ET-1的变化.结果 与常压常氧组比较,低压低氧组小鼠寻找平台的潜伏期延长[常压常氧组：（26.39±8.44）s,低压低氧组：（44.60±7.80）s,P＜0.01],目标象限停留时间减少[常压常氧组：（22.98±6.14）s,低压低氧组：（19.78±2.74）s,P＜0.05],脑组织含水量增加（P＜0.05）,海马组织NO[常压常氧组：（2.37± 1.07） μmol/gProt,低压低氧组：（4.48±1.45）μmol/gProt,P＜0.01]和ET-1水平增高[常压常氧组：（38.87±6.17） ng/L,低压低氧组：（52.09±6.75） ng/L,P＜0.01].结论 急性低压低氧环境小鼠学习记忆能力下降,这可能与急性低压低氧所致的脑水肿、海马组织NO和ET-1水平增加有关.     

Quality of Liver and Kidney Function Tests among Public Medical Laboratories in Western Region of Amhara National Regional State of Ethiopia

Background

Medical laboratories play essential roles in measurements of substances in body fluids for the purpose of diagnosis, treatment, prevention, and for greater understanding of the disease process. Thus, data generated from have to be reliable for which strict quality control, management and assurance are maintained. The aim of this study is to assess the accuracy and precision of clinical chemistry laboratories in western region of Amhara national regional state of Ethiopia in testing liver and kidney functions.

Methods

Eight laboratories in hospitals and a Regional Health Research Laboratory Center participated in this study from February to March, 2011. Each participant was requested to measure six specimens for six chemistry tests from two control samples. Three hundred twenty four test results to be reported from all participant laboratories, if all measurements can be made, were designed to be collected and statistically evaluated.

Results

None of the study subject laboratories could deliver all the six tests for estimation of both liver and renal functions simultaneously during the study period. Only 213 values from the expected 324 values were reported and about 65 % of the 213 values reported fell outside of the allowable limits of errors for the chemistry tests of the control specimen used.

Conclusion

This study finding showed that there were lack of accuracy and precision in chemistry measurements. A regular survey on medical laboratories should be conducted questioning the accuracy and precision of their analyses in order to sustain improvements in the quality of services provided by participating laboratories for the benefit of patients. Laboratory Quality Management Systems appreciate the need for regular quality control and quality assessment schemes in medical laboratories.     

Controverse : les tests de provocation médicamenteux assurent toujours le diagnostic d’allergie médicamenteuse

The diagnosis of drug allergy is important because most suspected cases are not confirmed. Diagnosis is based on immediate or delayed skin test reactions, done in the absence of contraindications. In vitro laboratory tests have not yet replaced skin testing. Skin tests are not without risk, which accentuates the very important place of the clinical history, and also the need for precaution in skin testing, but in the large majority of cases they are the only means of confirming or rejecting the diagnosis of drug allergy.