牛源性人结核疫源追踪辨析

结核病是一种人畜共患传染病,牛和人是最常见的感染者。牛型分枝杆菌引起的人类结核病,其传染源可以来源于患者,也可以来源于患牛。通过辨析结核病菌感染及诊断防治中的各种复杂因素,对同型不同物种来源的分枝杆菌进行鉴别,以追踪结核病的传染源,从源头上防治结核病。     

我国医院感染管理存在问题及对策

医院感染是影响医疗质量的临床难题。控制医院感染,仅仅通过专职管理人员是不够的,应充分发挥国家政策导向作用,通过宏观调控与微观干预相结合的方法,促使医院真正重视医院感染,变“要我控制医院感染”为“我要控制医院感染”,使医务人员变“被动接受感染控制”为“主动参与感染控制”,促使医院感染控制工作不断深化。     

Clinical Differences Exist Between Patients Fulfilling the 1988 and 1994 Case Definitions of Chronic Fatigue Syndrome

Despite the existence of 2 different case definitions for chronic fatigue syndrome, little data exist to evaluate how each performs. We evaluated the symptom patterns of patients fulfilling either the more demanding 1988 or the less demanding 1994 case definitions of Chronic Fatigue Syndrome over an 11-year period from 1991 to 2001. Factor analysis identified 3 factors: muscular–skeletal, viral, and sleep:memory symptom factors accounting for significant variation in the data. Further discriminant analysis showed that the first 2 factors and a self-reported measure of decrease in activity alone gave 91% accuracy in the placement of patients into their respective case definitions. This analysis did indicate that both case definitions were capturing the same broad group of patients. However, the patients in the 1994 group do not endorse infectious-type symptoms as often or to the same degree of severity as those in the 1988 group. This may mean that infection as a cause of CFS is more likely in patients fulfilling the earlier, more demanding case definition.     

Psychosocial correlates of emotional distress and risk behavior in african-american women at risk for hiv infection

We examined a model of stress and coping in 749 African-American women at risk for HIV infection. Women in the sample were either homeless, intravenous drug users (IVDUs) sexual partners of IVDUs, or prostitutes. A model was hypothesized based on stress and coping theory and research. Antecedents studied were personal resources, specifically self-esteem and available support. Mediators were threat appraisal and coping efforts. Outcomes studied were emotional distress and HIV risk behaviors. Structural equation modeling techniques were used to test hypothesized pathways between these variables. Forty-five percent of the variance in emotional distress in these women was explained by the model with self-esteem and avoidant coping the strongest predictors. Ten percent of the variance in risk behavior was explained by the model with emotional distress the strongest predictor. Direct and indirect pathways predicting risk behavior and distress are discussed. Implications of results for intervention and theory building are considered.     

Mental health correlates of HIV risk behaviour and STIs/HIV infection among university students from 22 low,middle and high income countries

The aim of this study was to determine mental health correlates of HIV risk behaviour and self-reported STIs/HIV infection among university students in 22 low, middle and high income countries. Data on mental health and HIV risk were collected from 16 567 undergraduate university students (mean age 20.9, SD = 2.9) from 23 universities in 22 countries across Asia, Africa and the Americas. Results indicate that overall 16.8% of the students had two or more sexual partners in the past 12 months, and among the sexually active, 73.7% had inconsistently used a condom in the past three months with their primary sexual partner, 3.2% had ever been diagnosed with a sexually transmitted infection (STI) and 0.6% had been diagnosed with HIV. In multivariate logistic regression poorer mental health and child abuse (physical and sexual) were associated with HIV risk behaviour, and child abuse (physical and sexual) was associated with STI and HIV positive diagnoses.     

大转子延长截骨在THR术后感染一期翻修中的临床应用

评价大转子延长截骨并行单纯钢丝捆扎在人工髋关节置换（THR）术后感染一期翻修中的作用及对翻修假体的影响.选取2010年10月~2013年10月期间30例髋关节置换术后假体感染性松动并行一期翻修术的患者,随访时间（34.8＆#177;13.2）月,对患者手术时间、截骨长度和愈合时间、术前术后Harris评分及术后感染控制情况进行统计.30例患者髋关节术后评分明显高于术前,手术时间为（132.4＆#177;23.6）min,经大转子截骨长度为（11.4＆#177;2.6）cm,截骨愈合时间（3.8＆#177;1.3）个月.术后感染未见复发.因此THR术后感染的一期翻修术中应用大转子延长截骨方法能缩短手术时间,髋关节功能较术前明显改善.     

锁定加压钢板联合自体骨治疗非感染性股骨骨不连的疗效观察

观察锁定加压钢板联合植骨对非感染性股骨骨不连的临床疗效.回顾性分析2010年~2012年收治的31例非感染性股骨骨不连患者的临床资料.结果29例愈合,2例未完全愈合,本组愈合时间6个月~14个月,平均愈合时间6.9个月;术后均无感染、下肢成角、缩短畸形等并发症,手术前后髋、膝关节功能评分差异具有统计学意义（P＜0.05）.锁定加压钢板联合自体骨治疗非感染性股骨骨不连可获得牢固连接,并发症少,是临床治疗股骨骨不连的有效方法之一.     

维生素D在危重病治疗中的价值

近年来随着研究的深入,发现维生素D除了调节钙磷代谢外,对先天性免疫、适应性免疫亦具有调节作用,其不仅能降低重症加强治疗病房（ICU）内多器官衰竭的病死率,还能预测疾病的严重程度及预后,在危重患者中具有广阔的应用前景,可作为ICU的一种辅助治疗手段。     

Cognitive and motor deficits in older adults with HIV infection: Comparison with normal ageing and Parkinson’s disease

Despite the life-extending success of antiretroviral pharmacotherapy in HIV infection (HIV), the prevalence of mild cognitive impairment in HIV remains high. Near-normal life expectancy invokes an emerging role for age–infection interaction and a potential synergy between immunosenescence and HIV-related health factors, increasing risk of cognitive and motor impairment associated with degradation in corticostriatal circuits. These neural systems are also compromised in Parkinson’s disease (PD), which could help model the cognitive deficit pattern in HIV. This cross-sectional study examined three groups, age 45–79 years: 42 HIV, 41 PD, and 37 control (CTRL) participants, tested at Stanford University Medical School and SRI International. Neuropsychological tests assessed executive function (EF), information processing speed (IPS), episodic memory (MEM), visuospatial processing (VSP), and upper motor (MOT) speed and dexterity. The HIV and PD deficit profiles were similar for EF, MEM, and VSP. Although only the PD group was impaired on MOT compared with CTRL, MOT scores were related to cognitive scores in HIV but not PD. Performance was not related to depressive symptoms, socioeconomic status, or CD4⁺ T-cell counts. The overlap of HIV-PD cognitive deficits implicates frontostriatal disruption in both conditions. The motor-cognitive score relation in HIV provides further support for the hypothesis that these processes share similar underlying mechanisms in HIV infection possibly expressed with or exacerbated by ageing.