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Severe scrub typhus infection: Clinical features, diagnostic challenges and management

World j.urnal of Critical Care Medicine 2015年第3期4卷 244-250页

作者： j.hn Victor Peter Thomas I Sudarsan j.hn anthony j.Prakash George M Varghese Medical Intensive Care Unit Christian Medical College Department of Microbiology Christian Medical College Department of Infectious Diseases Christian Medical College

Scrub typhus infection is an important cause of acute undifferentiated fever in South East Asia. The clinical picture is characterized by sudden onset fever with chills and non-specific symptoms that include headache, myalgia, sweating and vomiting. The presence of an eschar, in about half the patients with proven scrub typhus infection and usually seen in the axilla, groin or inguinal region, is characteristic of scrub typhus. Common laboratory findings are elevated liver transaminases, thrombocytopenia and leukocytosis. About a third of patients admitted to hospital with scrub typhus infection have evidence of organ dysfunction that may include respiratory failure, circulatory shock, mild renal or hepatic dysfunction, central nervous system involvement or hematological abnormalities. Since the symptoms and signs are non-specific and resemble other tropical infections like malaria, enteric fever, dengue or leptospirosis, appropriate laboratory tests are necessary to confirm diagnosis. Serological assays are the mainstay of diagnosis as they are easy to perform; the reference test is the indirect immunofluorescence assay(IFA) for the detection of Ig M antibodies. However in clinical practice, the enzyme-linked immuno-sorbent assay is done due to the ease of performing this test and a good sensitivity and sensitivity when compared with the IFA. Paired samples, obtained at least two weeks apart, demonstrating a ≥ 4 fold rise in titre, is necessary for confirmation of serologic diagnosis. The mainstay of treatment is the tetracycline group of antibiotics or chloramphenicol although macrolides are used alternatively. In mild cases, recovery is complete. In severe cases with multi-organ failure, mortality may be as high as 24%.

关键词： Rickettsia Diagnosis Management Outcome Multi-organ failure

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An international survey of classification and treatment choices for group D retinoblastoma

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International j.urnal of Ophthalmology(English edition) 2017年第6期10卷 961-967页

作者： Christina Scelfo j.smine H Francis Vikas Khetan Thomas j.nkins Brian Marr David H Abramson Carol L Shields j.cob Pe’er Francis Munier j.sse Berry j.William Harbour Andrey Yarovoy Evandro Lucena Timothy G Murray Pooj. Bhagia Evelyn Paysse Samuray Tuncer Guillermo L Chantada Annette C Moll Tatiana Ushakova David A Plager Islamov Ziyovuddin Carlos A Leal Miguel A Materin Xun-Da j. j.se W Cursino Rodrigo Polania Hayyam Kiratli Charlotta All-Ericsson Rej.n Kebudi Santosh G Honavar Vicktoria Vishnevskia-Dai Sidnel Epelman anthony B Daniels j.anie D Ling Fousseyni Traore Marco A Ramirez-Ortiz Ophthalmic Oncology Service Department of Surgery Memorial Sloan Kettering Cancer Center New York 10065 USA Department of Ophthalmology Weill-Cornell Medical Center New York 10065 USA Department of Vitreoretinal and Ocular Oncology Sankara Nathralaya Chennai 600066 India Ocular Ontology Service Wills Eye Hospital Thomas Jefferson University Pennsylvania 19107 USA Hadassah - Hebrew University Medical Center Jerusalem 91120 Israel j.les-Gonin Eye Hospital Lausanne 1004 Switzerland USC Roski Eye Institute Children＇s Hospital of Los Angeles California 90033 USA Ocular Oncology Service Bascom Palmer Eye Institute University of Miami Miller School of Medicine Florida 33136 USA Ocular Oncology Department S.N. Fyodorov Eye Microsurgery Federal State Institution Moscow 127486 Russia Department of Ocular Oncology Instituto Nacional de Cancer Rio de Janeiro 1122 Brazil Murray Ocular Oncology and Retina Miami Children＇s Hospital Florida 33143 USA St. j.seph＇s Children＇s Hospital New Jersey 07504 USA Department of Ophthalmology Baylor College of Medicine Texas 77030 USA Department of Ophthalmology Ocular Oncology Istanbul Medical Faculty Istanbul University Istanbul 34452 Turkey Oncology Department Hospital JP Garrahan Buenos Aires 1245 Argentina Department of Ophthalmology VU University Medical Center Amsterdam 1081 the Netherlands Department of Head and Neck Tumors Science Research Institute of Pediatric Oncology and Hematology N.N. Blokhin Russian Cancer Research Center Moscow 115478 Russia Pediatric Ophthalmology and Adult Strabismus Riley Hospital for Children Indiana University Medical Center Indiana 46202 USA National Oncology Center of Uzbekistan Tashkent 110508 Uzbekistan nstituto Nacional de Pediatria Coyoacan 04530 Mexico Department of Ophthalmology and Visual Science Smilow Cancer Hospital at Yale New Haven CT 06520 USA Xin Hua Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200092 China Department of Ophthalmology Santa Casa Mi

AIM： To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region. METHODS： An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism. RESULTS： The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children＇s Hospital of Los Angeles （CHLA） version, 33% used the Children＇s Oncology Group （COG） version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were： Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were： Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center （P〈0.0001）. CONCLUSION： Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic r

关键词： retinoblastoma oncology retina enucleation chemotherapy intra-arterial chemotherapy ophthalmic arterychemosurgery cancer

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探讨智能医疗设备需求迅速崛起的原因

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世界电子元器件 2011年第10期 38-38页

作者： anthony j.Kalaij.kis Molex公司

医疗设备设计工程师一直面对开发病患护理的先进电子设备的挑战,在过去的十年左右,我们看到医疗设备市场出现了显著的进步,从易于使用的血压和血糖水平家庭监控装置,到医院手术室里使用的综合诊断成像设备、尖端机器人技术和激光外科设... 详细信息

医疗设备设计工程师一直面对开发病患护理的先进电子设备的挑战,在过去的十年左右,我们看到医疗设备市场出现了显著的进步,从易于使用的血压和血糖水平家庭监控装置,到医院手术室里使用的综合诊断成像设备、尖端机器人技术和激光外科设备都纷纷面世。医疗行业的一个重大发展趋势是逐渐采用与消费电子和通信行业相同的电子设计策略和组件,因而推动了这两个行业在最近几年实现快速增长。

关键词：医疗设备设备需求原因智能电子设备通信行业设计工程师医院手术室

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南卡罗莱纳大学代勒摩尔商学院裁员后如何提升效率

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董事会 2009年第8期 98-98页

作者： anthony j.Nyberg

如果你的公司近期通过裁员缩小了规模，那么现在你所领导的正是那些经历裁员后的“幸存者”，但是在这种公司环境下，运气好并不与业绩佳挂钩，实际上你可能会面临严重的员工机能障碍。根据我们的研究，在以下几方面采取措施可以有效减... 详细信息

如果你的公司近期通过裁员缩小了规模，那么现在你所领导的正是那些经历裁员后的“幸存者”，但是在这种公司环境下，运气好并不与业绩佳挂钩，实际上你可能会面临严重的员工机能障碍。根据我们的研究，在以下几方面采取措施可以有效减少这种机能障碍带来的消极影响：

关键词：裁员商学院效率摩尔大学公司环境幸存者机能

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Medial ulnar collateral ligament reconstruction of the elbow in maj.r league baseball players:Where do we stand?

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World j.urnal of Orthopedics 2016年第6期7卷 355-360页

作者： Brandon j.Erickson Bernard R Bach j. Charles A Bush-j.seph Nikhil N Verma anthony A Romeo Midwest Ortho-paedics at Rush Rush University Medical Center

The ulnar collateral ligament(UCL) is a vital structure to the overhead athlete,especially the baseball *** reasons not completely understood,UCL inj.rieshave become increasingly more common in maj.r league baseball(MLB) pitchers over the past 10 *** reconstruction(UCLR) is the current gold standard of treatment for these inj.ries in MLB pitchers who wish to return to sport(RTS) at a high level and who have failed a course of non-operative *** following UCLR in MLB pitchers have been encouraging,with multiple RTS rates now cited at greater than 80%.Unfortunately,with the rising number of UCLR,there has also been a spike in the number of revision UCLR in MLB *** to primary UCLR,the etiology of the increase in revision UCLR,aside from an increase in the number of pitchers who have undergone a primary UCLR,remains *** current literature has attempted to address several questions including those surrounding surgical technique(method of exposure,graft choice,management of the ulnar nerve,concomitant elbow arthroscopy,etc.),post-operative rehabilitation strategies,and timing of RTS following *** some questions have been answered,many remain *** literature surrounding UCLR in MLB pitchers will be reviewed,and future directions regarding this inj.ry in these high level athletes will be discussed.

关键词： Ulnar collateral ligament Ulnar collateral ligament reconstruction Tommy j.hn Maj.r league baseball Pitcher Baseball

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合理检查脓毒症的生物标记物检查

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英国医学杂志中文版 2015年第5期18卷 295-297页

作者： anthony S McLean professor of intensive care medicine Benj.min Tang associate professor of inteasive care medicine Stephen j.Huang associate professor and principal research fellow, intensive care reedicine 熊号峰 Department of Intensive Care Medicine University of Sydney Sydney NSW. Australia Nepean Hospital Sydney NSW Australia 首都医科大学附属北京地坛医院危重症病房

一名65岁男性，因嗜睡、发热和寒战就诊。体格检查：血压120／50mmHg，轻微心动过速（心率105次／分），发热（38．7℃），无其他异常。尿液混浊，尿液常规检查显示白血球和硝酸盐阳性。近期无旅行史，无泌尿系统症状，无药物过敏（包... 详细信息

一名65岁男性，因嗜睡、发热和寒战就诊。体格检查：血压120／50mmHg，轻微心动过速（心率105次／分），发热（38．7℃），无其他异常。尿液混浊，尿液常规检查显示白血球和硝酸盐阳性。近期无旅行史，无泌尿系统症状，无药物过敏（包括抗菌素过敏）。系统回顾无相关发现（例如肝脏或者肾脏疾病）。

关键词： Rational 生物标志物测试调查败血症

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应用数字图象处理技术对颜面审美观的研究

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口腔正畸学 2000年第3期7卷 107-110页

作者： anthony L.Maganzini 曾应魁 j.sh Z.Epstein Luis j.Alvarez 邹冰爽曾祥龙美国新泽西大学牙科学院正畸科台湾中山医学院牙医系美国纽约大学牙科学院正畸科

目的　本研究使用可调式数字图象模型比较美国正畸医师与中国普通人对颜面的审美观是否一致。对标准比较法和配对比较法这两种容貌美学评判方法的有效性也进行了比较。方法　由一张正常中国成人的头颅侧位片经处理产生四幅不同的数字图... 详细信息

目的　本研究使用可调式数字图象模型比较美国正畸医师与中国普通人对颜面的审美观是否一致。对标准比较法和配对比较法这两种容貌美学评判方法的有效性也进行了比较。方法　由一张正常中国成人的头颅侧位片经处理产生四幅不同的数字图象构成一个系列。这些图象的骨骼或牙齿与正常值相差 2倍标准差 ,软组织侧貌图象则经相应软件处理产生。结果　一系列非参数检验证实数字变形模型的有效性 ,且配对比较法优于普通的标准比较法。专业和非专业人士都认为和谐或“正常”型最具吸引力 ,其次是“直面”或双颌后缩的男性中国人、“前部发育不足”或上颌后缩的女性中国人。研究发现牙齿后缩而骨骼型协调的男性与上颌后缩而余无异常的女性同“双牙弓前突”的正常型具有同样的吸引力。结论　本研究有利于中外正畸医师在治疗中国患者时有所依据 ,以达到医患均满意的治疗效果。

关键词：颜面正常上颌医师正畸男性骨骼牙齿女性头颅侧位片

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社区获得性肺炎的非典型病原体及治疗

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中国实用乡村医生杂志 2005年第12期12卷 52-53页

作者： Kristopher P.Thibodeau anthony j.Viera Naval Hospital j.cksonville j.cksonvilleFlorida 《中国实用乡村医生杂志》编辑部康素明 USNR Naval Hospital j.cksonville JacksonvilleFlorida USNR Naval Hospital j.cksonville JacksonvilleFloridaLCDRMC 《中国实用乡村医生杂志》编辑部

每年社区获得性肺炎影响大约450万美国成年人.患社区获得性肺炎的住院患者的病死率每年不同,最高可达35%.肺炎链球菌可导致70%的社区获得性肺炎的病例,而非典型病原体导致30%～40%的病例.尽管我们已经获知有关非典型病原体导致感染的特... 详细信息

每年社区获得性肺炎影响大约450万美国成年人.患社区获得性肺炎的住院患者的病死率每年不同,最高可达35%.肺炎链球菌可导致70%的社区获得性肺炎的病例,而非典型病原体导致30%～40%的病例.尽管我们已经获知有关非典型病原体导致感染的特征,但是在临床、放射学、检验学基础上确定某种特定的病原体非常困难.确定病原体通常是回顾性的.

关键词：肺炎社区获得性非典型病原体治疗

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Erratum to: Vapors in the ambient-A complication in tribological studies or an engineering solution of tribological problems?

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Friction 2015年第4期3卷 353-353页

作者： Ala ALAZIZI anthony j.BARTHEL Nicholas D.SURDYKA j.awei LUO Seong H.KIM Department of Chemical Engineering and Materials Research Institute Pennsylvania State UniversityUniversity ParkPA 16802USA

Erratum to Friction 3(2):85-114(2015)DOI 10.1007/s40544-015-0083-5 The original version of this article contained the incorrect caption of Fig.7 on page 93,instead of Fig.7 Line profiles of the wear tracks on different glasses under different humidity conditions:(a)soda-lime silicate glass;(b)fused quartz;(c)BF33;(d)AF45;(e)sodium alumino-silicate;(f)K-exchanged alumino-silicate.(a)and(b)are reproduced with permission from Ref.[110].Copyright j.hn Wiley and Sons,2013.(c)and(d)are reproduced with permission from Ref.[124].Copyright j.hn Wiley and Sons,2014.(e)and(f)are reproduced with permission from Ref.[125].Copyright Springer,2014.

关键词： Friction wear silicate

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Enzymatic Hydrolysis of Fish Frames Using Pilot Plant Scale Systems

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Food and Nutrition Sciences（食品与营养科学） 2011年第6期

作者： Aristotelis T. Himonides anthony K. D. Taylor Anne j. Morris

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