Guidelines for laboratory testing and result reporting of antibody to hepatitis C virus. Centers for Disease Control and Prevention.

Testing for the presence of antibody to hepatitis C virus (anti-HCV) is recommended for initially identifying persons with hepatitis C virus (HCV) infection (CDC. Recommendations for prevention and control of hepatitis C virus [HCV] infection and HCV-related chronic disease. MMWR 1998;47[No. RR-19] :1-33). Testing for anti-HCV should include use of an antibody screening assay, and for screening test-positive results, a more specific supplemental assay. Verifying the presence of anti-HCV minimizes unnecessary medical visits and psychological harm for persons who test falsely positive by screening assays and ensures that counseling, medical referral, and evaluation are targeted for patients serologically confirmed as having been infected with HCV. However, substantial variation in reflex supplemental testing practices exists among laboratories, and an anti-HCV-positive laboratory report does not uniformly represent a confirmed positive result. These guidelines expand recommendations for anti-HCV testing to include an option for reflex supplemental testing based on screening-test-positive signal-to-cut-off (s/co) ratios. Use of s/co ratios minimizes the amount of supplemental testing that needs to be performed while improving the reliability of reported test results. These guidelines were developed on the basis of available knowledge of CDC staff in consultation with representatives from the Food and Drug Administration and public health, hospital, and independent laboratories. Adoption of these guidelines by all public and private laboratories that perform in vitro diagnostic anti-HCV testing will improve the accuracy and utility of reported anti-HCV test results for counseling and medical evaluation of patients by health-care professionals and for surveillance by public health departments.     

猴免疫缺陷病毒(SIV)慢性感染猴模型的建立

目的：在先前已建立了模拟人艾滋病感染者和患者的猴免疫缺陷病毒（ＳＩＶ）急性感染猴和中、晚期猴艾滋病（ＳＡＩＤＳ）模型的基础上,再摸索建立ＳＩＶ慢性感染猴模型,以期为抗区滋病药物的体内药效学介研究提供更合适的动物模型。方法：用ＳＩＶｍａｃ２５１感染恒河猴１７只,追踪观察其临床表现,体征变化,病程进展,血浆和全血病毒症规律,淋巴细胞亚群ＣＤ４的动态等。结果：临床体征有特征性,病程较长,１年内死亡２只（     

Ifosfamide, carboplatin, and etoposide with midcycle vincristine versus standard chemotherapy in patients with small-cell lung cancer and good performance status: clinical and quality-of-life results of the British Medical Research Council multicenter randomized LU21 trial.

PURPOSE: Ifosfamide, carboplatin, etoposide, and vincristine, alone and in combination, are highly active against small-cell lung cancer (SCLC). This trial was designed to investigate whether survival could be improved by a regimen of all four drugs (ICE-V) compared with standard chemotherapy in patients with SCLC and good performance status, and to assess the patients' quality of life (QL). PATIENTS AND METHODS: Patients were randomly assigned to receive six cycles of either ICE-V at 4-week intervals without dose reduction or standard chemotherapy administered according to local practice. The recommended standard control regimens were cyclophosphamide, doxorubicin, and etoposide; and cisplatin and etoposide. RESULTS: A total of 402 patients were randomly assigned, and 350 (87%) patients have died. Overall survival was longer in the ICE-V group (hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P = .0049), median survival was 15.6 months in the ICE-V group and 11.6 months in the control group, and 2-year survival rates were 20% and 11%, respectively. There was no evidence that the relative survival benefit for ICE-V was less in extensive-stage than in limited-stage patients. An increased rate of septicemia was reported in the ICE-V group (15% v 7% in the control group), but this did not result in an increase in reported treatment-related deaths (four patients [2%] in both groups). The findings on QL were broadly similar in both groups, with some benefit in favor of ICE-V. CONCLUSION: Compared with standard chemotherapy, the ICE-V regimen improves overall survival without QL penalties, despite an increased but manageable level of toxicity.     

Histopathologic diagnosis of multifactorial alopecia

Establishing a definitive diagnosis for any form of alopecia can be challenging. Adding to the diagnostic complexity is the fact that many patients have more than one form of alopecia contributing to their hair loss. We conducted a review of 1360 consecutive scalp biopsy specimens submitted for the evaluation of scalp hair loss over a 16‐month period, demonstrating that 12.5% of cases had a combination of diagnoses (multifactorial alopecia) accounting for their hair loss. An approach to the histopathologic diagnosis of multifactorial alopecia, particularly multiple forms of alopecia found in a single biopsy, is here presented.     

Successful management of lung adenocarcinoma with ALK/EGFR co-alterations and PD-L1 over-expression by bevacizumab combined with chemotherapy

Angiogenesis - Anaplastic lymphoma kinase (ALK)/epidermal growth factor receptor (EGFR) co-alterations in adenocarcinomas are rare and no therapeutic consensus is reached. The potentially negative...     

机器人在口腔医学中的应用进展

随着工业机器人技术的发展,机器人已进入医学领域,为众多医疗应用开发新型机器人,已成为全球机器人领域重要的研究方向。在口腔医学中,机器人已经应用于修复、正畸、种植、牙体牙髓以及口腔外科等领域中。本文主要从以上5个方面介绍了机器人在口腔医学中的应用进展。     

艾灸结合中药熏蒸干预对慢性腰肌劳损患者疼痛及腰背功能恢复的影响

目的探究艾灸结合中药熏蒸干预对慢性腰肌劳损患者疼痛及腰背功能恢复的影响.方法选取某院2016年7月至2018年5月诊治的慢性腰肌劳损患者90例,采用随机数表法分为两组,各45例.对照组给予功能康复锻炼干预,观察组在对照组基础上采用艾灸联合中药熏蒸,对比两组临床疗效、治疗前后疼痛评分及腰背功能恢复情况.结果观察组治疗总有效率91.11%,高于对照组的66.67%,差异有统计学意义(P<0.05);观察组治疗后视觉模拟评分法(VAS)评分低于对照组,背肌力高于对照组,腰肌耐力时间长于对照组,差异有统计学意义(P<0.05).结论艾灸结合中药熏蒸干预可有效改善慢性腰肌劳损患者的临床症状,降低其腰痛评分,利于促进腰背功能的恢复,改善预后.