新入园幼儿的皮质醇变化与上呼吸道感染的关系：气质的作用

采用酶联免疫吸附法分析唾液皮质醇和日志记录上呼吸道感染(upper respiratory tract infection; URI)的方法, 考察新入园的59名幼儿皮质醇变化与两个月期间患URI次数、持续时间的关系, 同时检测了幼儿气质在其中的作用。结果发现, 新入园幼儿在国庆小长假后的第一周内, 其皮质醇变化的整体趋势表现为下午的皮质醇水平比上午的皮质醇水平高; 上、下午皮质醇水平的变化幅度与其患URI次数显著负相关, 注意分散度与患URI次数呈显著正相关, 幼儿的自我控制能力与其患URI的平均持续时间显著负相关; 趋避性能够调节上、下午皮质醇水平变化幅度与URI的平均持续时间的关系。研究表明, 幼儿面对新入园这一急性压力事件时, 皮质醇水平的暂时性升高对免疫系统产生了一定的刺激作用来抵抗URI。幼儿气质的认知、情绪的或注意的不同过程与URI以及对皮质醇变化水平与URI关系的作用机制有所不同。     

艾滋病防治中几个问题

HIV感染/艾滋病是一类新发的传染病,呈现全球大流行趋势,我国艾滋病流行经历了3个阶段,目前正处于HIV感染高速发展期,在地域范围、人群特点、传播途径等方面有了新变化,亟需从全社会各个层面上积极协作,有效地遏制疫情的蔓延。     

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.     

Diagnosis and treatment of respiratory tract infections in primary health care by the nurse versus the physician: Efficacy and patient attitudes

Abstract

Five district physicians and one registered nurse were compared regarding their effectiveness in diagnosing and treating acute upper respiratory tract infections in patients (n=186) at a Swedish community health centre. Attitudes and views of the patient, or of the accompanying adult when the patient was a child, regarding the consultation itself, as well as more general aspects of health care were investigated (n=99) using a questionnaire. The questionnaire included 42 propositions of a “fuzzy” type to be judged on a 100-point truth-value scale, 18 of them concerning the consultation and 24 the more general aspects. No differences between the physicians and the nurse were found in their efficacy of diagosis and treatment. Subjects' overall attitudes were found to be positive toward both the physicians and the nurse. Results of multivariate analyses of variance performed for the consultation and general aspects of health care items separately and concerning type of persons providing health care (physician/nurse), treatment (antibiotics/no antibiotics) and patient age (child/adult), revealed overall differences in questionnaire response as regards patient age in relation to the consultation items.