超声波对胎儿畸形的筛查与诊断

目的探讨产前超声诊断先天性胎儿畸形的超声特征,提高胎儿畸形的超声检出率。方法采用LOGIQ200PRO、LOGIQ400PRO超声诊断仪,LOGIQ7PRO彩色超声诊断仪,对我院产前常规B超检查的孕妇进行筛查,对畸形胎儿确诊后引产或生产证实。结果90例畸形胎儿中,以神经系统畸形最多,依次为肢体畸形,泌尿系畸形,唇、腭裂,腹裂,胸腹联体,头颈淋巴水肿,胸、腹腔积液,骨髂发育不良,胎儿水肿综合征,胎儿颈部包块,心脏畸形等。结论超声检查是产前筛查与诊断畸形胎儿的重要诊断工具,是目前产科首选的影像检查方法,建议每位孕妇产前进行至少3次B超检查。     

Do the ABCS 135 short cognitive screen and its subtests discriminate between normal cognition,mild cognitive impairment and dementia?

BACKGROUND: Cognitive screening instruments are either too long for routine clinical use or not sensitive to distinguish mild cognitive impairment (MCI) from normal cognition (NC) or dementia. OBJECTIVE: To evaluate the sensitivity and specificity of the AB Cognitive Screen (ABCS) and its subtests with a view to improving its ability to differentiate between dementia, MCI and NC. The influence of age and education on sensitivity and specificity is also examined. DESIGN: Cross-sectional study. METHODS: Participants with dementia and MCI were recruited from those presenting to four specialty geriatric clinics in southern Ontario. Participants with NC were recruited from the family and friends of patients. A comprehensive geriatric assessment was done including ABCS, SMMSE and 15 point Geriatric Depression Scale. Analysis of variance and receiver operating characteristic (ROC) curves compared test scores. SMMSE scores were also analysed for comparison purposes. RESULTS: Three hundred and two participants had dementia, 166 had MCI and 174 had NC. ABCS total scores were significantly different between NC and MCI (mean difference 7.1, 1.8-12.5 CI, p = 0.000) while SMMSE scores were not (mean difference 0.5, -0.7-1.7, p < 0.628). Of individual ABCS subtests, verbal fluency and delayed recall were most sensitive to differences between NC and MCI. ROC curve analysis, which presents sensitivity and specificity, showed verbal fluency was better than delayed recall in distinguishing between NC and MCI, among participants 75 years of age or older. CONCLUSION: The AB Cognitive Screen (ABCS) can be administered in 3-5 min. The SMMSE and ABCS total and subtests significantly distinguished between dementia and MCI or NC. Verbal fluency and delayed recall were best at distinguishing between MCI and NC. The analysis illustrates how each subtest contributes to the sensitivity of the ABCS and suggests ways that sensitivity might be improved.     

President's Message

This article derives statistical models relating adolescents’ universal human values with their problem and pathological gambling. An adolescent's values are measured by the priority accorded to each value using the Schwartz Values Inventory, whereas problem or pathological gambling, if any, is indicated by his or her answers to the South Oaks Gambling Screen. Among other complex results, statistical analysis suggests that the value subtypes of “non-faith tradition,” “faith tradition,” and “macro-universalism” and the value type “stimulation” are associated with less problem and pathological gambling. Among other uses, such findings help identify high-risk adolescents.     

CHROM平板在沙门菌初筛中的应用

目的：用CHROM平板对上海口岸从业人群进行沙门菌初筛。方法：采用cHROM平板进行沙门菌初筛，可疑菌落做血清凝集、肠道综合发酵管生化、VITEK生化鉴定、血清分型。结果：CHROM平板的灵敏度为100％，本中心用CHROM平板初筛，比前两年用SS平板初筛沙门菌检出率高12.2倍。结论：采用CHROM平板初筛，能快速、灵敏、简便、准确地提高沙门菌检出率，该平板尤其适用于食物中毒中沙门菌的快速筛查。     

先天性甲状腺功能减低症的新生儿筛查及临床分析

目的:总结分析深圳市5年来开展先天性甲状腺功能减低症(CH)新生儿筛查和诊断治疗情况。方法:建立深圳市所有产科医院的筛查网络,以非选择性新生儿为对象,在出生72h后采足跟血,检测滤纸标本中促甲状腺激素(TSH)含量,筛查阳性者,以静脉血血清标本复查TSH,T3、T4确诊。结果:5年共筛查213085人,其中确诊为CH61例,发病率为0.286‰。早期诊断治疗及随访,患儿的智能和体格发育无明显异常。结论:新生儿疾病筛查是CH早期诊断的有效措施之一,采取早期诊断和治疗能有效地防止患儿的智力和体格发育低下。     

婚检人群地中海贫血筛查与产前诊断

目的减少本地区中重症α和β地中海贫血儿的出生率,提高出生人口素质.方法取在本院婚检的5810对育龄男女进行地中海贫血血液学筛查,初筛阳性者进行基因诊断,对有生中重症地贫儿风险的配偶,于妊娠中期进行胎儿产前诊断.结果 5810对婚检男女中,高风险者73对,占1.26%,对其中51例妊娠进行羊水产前诊断,检出重型β地贫7例,Hb Bart's水肿胎3例,HbH病3例,对重型地贫胎儿予终止妊娠.结论在高发区婚检人群进行地贫筛查,对预防重型地贫儿出生有积极的意义.     

视网膜检影法在弱视早期筛查中的应用

目的 探讨视网膜检影法在弱视早期筛查法中的应用。方法 用视网膜检影法对842例0～3岁就诊患儿进行屈光状态检查，并对屈光异常者进行散瞳检影。结果 屈光异常率为17．6％，散瞳检影符合率为93．4％。结论 视网膜检影法是对弱视进行早期筛查的一种准确客观、简便易行的方法。     

宫颈癌早期诊断4种方法的比较和意义

目的 通过比较4种常用方法，以期找到宫颈癌早期筛查的最佳方案。方法 2003年3～4月。选取华中科技大学同济医学院附属同济医院门诊阴道镜室接诊病例50例，以病理检查作为金标准，采用肉眼观测(辅以醋酸和碘试验)、阴道镜检查、液基细胞学检查(TCT)、HC-Ⅱ法HPV DNA检测等4种常用方法，对比其特异性、敏感性、准确性、约登指数及Kappa值。结果 4种检测方法敏感性、特异性、准确性、阳性预测值、阴性预测值、约登指数及Kappa值依次为：肉眼观测辅以醋酸和碘试验(33．33％、74．47％、72．00％、7．69％、94．59％、0．0780、0.0270)，阴道镜检查(33．33％、91．49％、88．00％、20．00％、95．56％、0．2482、0．1892)，液基细胞学检查(66．67％、97．87％、96．00％、66．67％、97．87％、0．8227、0．6454)，HCⅡ法HPV DNA(100％、85．11％、86．00％、30．00％、100．00％、0．8511、0．4067)。结论 肉眼观测辅以醋酸和碘试验诊断价值很低；液基细胞学检测和HC-Ⅱ法HPV DNA检测两者均为宫颈癌早期筛查的可选方法，两种方法联合应用阴性预测值高，阴道镜检测不适用于早期筛查。     

高通量药物筛选模型

介绍了可用于药物筛选的3种新的快速高通量筛选方法，包括基于反酵母双杂交的筛选系统；细胞平台伤的高通量筛选系统以及动物水平的筛选系统。并对其应用原理，应用情况和优缺点进行了阐述。