复杂性先天性心脏病8例报告

先天性心脏病（CHD）是胎儿期心脏及大血管发育异常而致的先天畸形,是小儿最常见的心脏病,其发病率高达4．05—12．3％（其中未包括出生前即死亡的胎儿）,我国每年出生10-15万患有先天性心脏病患儿,发生率占活产婴儿的0．7-0．8％,严重和复杂的先天性心脏病不经治疗30％在生后1周死亡。25％死于1个月内。     

Radiology report turnaround: expectations and solutions

The ultimate work product of a radiology department is a finalized radiology report. Radiology stakeholders are now demanding faster report turnaround times (RTAT) and anything that delays delivery of the finalized report will undermine the value of a radiology department. Traditional reporting methods are inherently inefficient and the desire to deliver fast RTAT will always be challenged. It is only through the adoption of an integrated radiology information system (RIS)/picture archiving and communication system (PACS) and voice recognition (VR) system that RTAT can consistently meet stakeholder expectations. VR systems also offer the opportunity to create standardized, higher quality reports.     

宫颈细胞学与活检组织病理诊断对比分析

目的以宫颈活检组织病理学诊断为标准，对液基薄层细胞学检查宫颈癌及癌前病变的准确性进行评价，以提高和规范液基薄层细胞学检查的诊断水平。方法收集2006年5月到2007年12月期间在妇科门诊及住院就诊患者12，300例中288例宫颈脱落细胞学检查异常结果病例，采用新柏氏（Thinprep Cytology Test，TCT）操作系统提供的取样器取材，专用的液基保存液瓶保存标本，Thin-prep2000制片仪制片，巴氏染色。TCT筛查出ASCUS以上患者，均在阴道镜下行多点活检以作组织病理学检查。结果宫颈鳞状细胞癌诊断符合率为100％，高度病变符合率为93．1％，低度病变符合率为86．5％。结论液基薄层细胞学诊断宫颈癌及癌前病变（Cervical intraepithelial Lesion，CIN）具有较高的准确性，为宫颈病变的进一步诊断和治疗提供有效依据。     

Eating ourselves to death (and despair): The contribution of adiposity and inflammation to depression

Obesity and related metabolic conditions are of epidemic proportions in most of the world, affecting both adults and children. The accumulation of lipids in the body in the form of white adipose tissue in the abdomen is now known to activate innate immune mechanisms. Lipid accumulation causes adipocytes to directly secrete the cytokines interleukin (IL) 6 and tumor necrosis factor α (TNFα), but also monocyte chemoattractant protein 1 (MCP-1), which results in the accumulation of leukocytes in fat tissue. This sets up a chronic inflammatory state which is known to mediate the association between obesity and conditions such as cardiovascular disease, type 2 diabetes, and cancer. There is also a substantial literature linking inflammation with risk for depression. This includes the observations that: (1) people with inflammatory diseases such as multiple sclerosis, cardiovascular disease, and psoriasis have elevated rates of depression; (2) many people administered inflammatory cytokines such as interferon α develop depression that is indistinguishable from depression in non-medically ill populations; (3) a significant proportion of depressed persons show upregulation of inflammatory factors such as IL-6, C-reactive protein, and TNFα; (4) inflammatory cytokines can interact with virtually every pathophysiologic domain relevant to depression, including neurotransmitter metabolism, neuroendocrine function, and synaptic plasticity. While many factors may contribute to the association between inflammatory mediators and depression, we hypothesize that increased adiposity may be one causal pathway. Mediational analysis suggests a bi-directional association between adiposity and depression, with inflammation possibly playing an intermediary role.     

The World Report on Disability as a blueprint for international,national, and local aphasia services

Abstract

This commentary aims to extend the debate of the lead article authors () by translating the nine recommendations of the World Report on Disability into a plan of action for the aphasia community. Solutions for the advancement of aphasia science and services are presented at international (macro), national (meso), and local (micro) levels. Implications for speech-language pathologists and aphasia service delivery are discussed. An overarching call to action is the need for speech-language pathologists to support a strong and vibrant aphasia community at all levels, so that the voices of people with aphasia can be heard.     

第四届慢性乙型肝炎抗病毒治疗难点和热点学术会议纪要

由中华医学会肝病学分会病毒性肝炎学组及中华肝脏病杂志编辑委员会主办,中南大学湘雅医院、重庆医科大学病毒性肝炎研究所和重庆医科大学附属第二医院协办的第四届慢性乙型肝炎抗病毒治疗难点和热点学术会议于2012年11月16-18日在湖南浏阳召开.庄辉院士,中华医学会肝病学分会前任主任委员贾继东教授,主任委员魏来教授,候任主任委员段钟平教授,副主任委员任红教授、徐小元教授、陆伦根教授、窦晓光教授,中华医学会感染病学分会候任主任委员侯金林教授,以及来自全国各地的435名代表参加了会议.会议邀请贾继东、魏来、侯金林、徐小元、万谟彬、黄祖瑚、窦晓光、张欣欣、陆伦根9位教授分别从不同角度对慢性乙型肝炎治疗中的难点和热点作了专题报告,并与参会代表进行了热烈的讨论.