Xpert MTB/RIF试验快速诊断结核病的研究进展

<正>结核病是由结核分枝杆菌(Mycobacterium tuberculosis,MTB)感染引起的慢性传染病,仍然是全世界公共卫生面临的重大威胁。据世界卫生组织统计~([1-2]),我国2014年的新发肺结核人数位居全球第三位,是22个全球结核病高负担国家之一。目前肺结核的诊断主要依靠痰涂片抗酸染色,但由于痰涂片对标本的含菌量要求高,导致其诊断结核病的敏感度较低。诊断结核病的金标准是MTB培     

2004～2010年安徽铜陵市钉螺分布动态

目的 分析铜陵市2004～2010 年不同流行类型和流行程度钉螺分布特点及变化规律,为采取因地制宜、分类指导的防治策略与措施提供依据.方法 采取回顾性调查方法,收集2004～2010 年螺点卡报表和血吸虫病防治工作报表资料,分析不同年份钉螺面积、感染性钉螺面积和钉螺感染率的变化趋势,比较流行类型和程度不同的地区上述指标的年间变化.结果 2004～2010 年期间传播未控制、传播控制地区钉螺面积总体呈下降趋势;钉螺感染率由0.267%下降到0.003%,下降了98.88%(χ2=173.05,P<0.01).其中感染性钉螺面积江洲湖滩和山丘地区分别由129.89hm2、0.56hm2 下降到2hm2和0,分别下降了98.46%和100%.结论 铜陵市钉螺面积和感染性钉螺面积总体呈下降趋势,加强江洲湖滩地区螺情控制仍然是现阶段的主要目标和任务.同时应进一步加大以传染源控制为主的综合防治力度,有效控制感染性钉螺.     

The circRNA–miRNA–mRNA regulatory network in systemic lupus erythematosus

Clinical Rheumatology - Systemic lupus erythematosus (SLE) was an autoimmune disease with a large variety of clinical manifestations and involving many organs. Its exact etiology was unclear, and...     

新加坡护理学习见闻

2011年12月作者参加由新加坡淡马锡基金会出资援助为期12d的护理培训。此次培训的项目包括教学方法、护理管理方法等,旨在帮助护理教育工作者和领导者认识、发展和提高以护理学员为中心的教育。1新加坡在临床带教的教学方法与护理管理方面的优势1.1教材制定新加坡的护理教材由卫生部、学校和医院合作     

Findings from the Adjuvant Colon Cancer End Points (ACCENT) Collaborative Group: the Power of Pooled Individual Patient Data from Multiple Clinical Trials

Randomized clinical trials (RCTs) are relied upon for determining the standard of care and changes to the standard of care in oncology. Through data sharing, the pooled individual patient data (IPD) from these trials can provide high-quality sources and enriched power for analyses beyond the original goals of each trial. To address important scientific questions in early-stage colon cancer, the Adjuvant Colon Cancer End Points (ACCENT) Collaborative Group has continuously integrated IPD from large adjuvant colon cancer RCTs conducted worldwide. Through June 2016, IPD from over 40,000 patients from 27 major trials (1977 to 2009) have been assembled. Over the past 20 years, a variety of clinical questions have been investigated and addressed by ACCENT collaborations. Many of the findings have provided additional understanding of treatment mechanisms, suggested changes or reinforced quality patient care, and informed and improved the design for the current and next generation of RCTs. We review these significant contributions from the ACCENT collaboration.     

Acquired MET D1228N Mutations Mediate Crizotinib Resistance in Lung Adenocarcinoma with ROS1 Fusion: A Case Report

Patients with non‐small cell lung cancer (NSCLC) containing ROS1 fusions can have a marked response to the ROS1‐targeted tyrosine kinase inhibitors (TKIs), such as crizotinib. Common resistance mechanisms of ROS1‐fusion targeted therapy are acquired mutations in ROS1. Along with the use of next‐generation sequencing in the clinical management of patients with NSCLC during sequential targeted therapy, many mechanisms of acquired resistance have been discovered in patients with activated tyrosine kinase receptors. Besides acquired resistance mutations, bypass mechanisms of resistance to epidermal growth factor receptor (EGFR)‐TKI treatment are common in patients with EGFR mutations. Here we describe a patient with metastatic lung adenocarcinoma with CD74‐ROS1 fusion who initially responded to crizotinib and then developed resistance by the acquired mutation of D1228N in the MET kinase domain, which showed short‐term disease control for cabozantinib.Key Points

• The D1228N point mutation of MET is an acquired mutation for crizotinib resistance.
• The patient obtained short‐term clinical benefit from cabozantinib therapy after resistance to crizotinib.
• The clinical use of next‐generation sequencing could maximize the benefits of precision medicine in patients with cancer.

     

变频式桡动脉穿刺示教器在急诊护理教学中的应用

目的探讨提升急诊科进修护士桡动脉穿刺技术水平的有效方法。方法将64名进修护士按照入科时间分为对照组34名,实验组33名。在统一理论教学后,对照组采用互动方式互相触摸桡动脉并讲解穿刺方法。实验组采用变频式桡动脉穿刺示教器进行穿刺练习。结果实验组进修护士动脉穿刺成功率显著高于对照组,穿刺并发症发生率及患者疼痛程度显著低于对照组(P0.05,P0.01)。结论采用变频式桡动脉穿刺示教器进行教学,可使进修护士多次进行模拟穿刺练习,提高其桡动脉穿刺水平。     

Iodine-125 brachytherapy alone for advanced primary parotid gland carcinoma

This study aimed to evaluate the efficacy of iodine-125 (¹²⁵I) brachytherapy alone for the treatment of advanced parotid gland carcinoma and to identify predictors of tumour control and patient survival. Primary parotid gland carcinoma patients (n = 23) treated with ¹²⁵I brachytherapy alone between 1 October 2005 and 31 July 2013 at Peking University Stomatology Hospital were enrolled in this retrospective study. All had clinical stage IV disease. The prescribed dose was 60–160 Gy. The local control rate, survival rate, and predictors of the prognosis were evaluated. Adverse events related to treatment were also noted. The average follow-up time was 29 months (range 9–74 months). Among the 23 patients, six had local failure and 11 died during the follow-up period. The 1-, 3-, and 5-year overall survival rates were 87.0%, 55.4%, and 47.5%, respectively. The 1-, 3-, and 5-year progression-free survival rates were 73.9%, 47.0%, and 39.2%, respectively. The 1-, 3-, and 5-year local control rates were 82.1%, 73.9%, and 73.9%, respectively. Age and distant metastasis were independent predictors of survival, while the preoperative duration of the disease was an independent predictor of local control. The use of ¹²⁵I seed brachytherapy alone for the treatment of primary parotid gland carcinoma can provide good short-term results without causing any severe side effects.