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1988年美国进出口贸易一览表

世界经济与政治论坛 1990年第1期 48-50页

作者：徐冬青

二期翻修再植入前未获取关节液时持续感染的诊断

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二期翻修再植入前未获取关节液时持续感染的诊断

作者：江桥南开大学

学位级别：硕士

第一部分:血清指标变化趋势诊断再植入前持续感染目的:在二期翻修手术中,适当的再植入时机是治疗成功的关键之一。2018年国际骨骼感染会议共识认为,血清标志物正常化的变化趋势有助于确定适当的再植入术时间。然而,以往的研究却发现相... 详细信息

第一部分:血清指标变化趋势诊断再植入前持续感染目的:在二期翻修手术中,适当的再植入时机是治疗成功的关键之一。2018年国际骨骼感染会议共识认为,血清标志物正常化的变化趋势有助于确定适当的再植入术时间。然而,以往的研究却发现相反的结果,有报道称血清标志物的正常化并不能预测感染控制。我们希望研究:四种常见血清标志物（血沉率（ESR）、c反应蛋白（CRP）、白细胞介素-6（IL-6）和纤维蛋白原）的绝对值变化和百分比变化是否能预测持续感染?方法:我们对2014年1月至2018年1月接受二期翻修治疗的141例患者进行了回顾性研究。血清指标的变化趋势通过百分比变化（使用再植入术前血清标志物绝对值除以占位器植入术前血清标志物绝对值）和绝对值变化（使用占位器植入术前血清标志物绝对值减去再植入术前血清标志物绝对值）来评估。治疗成功的定义是根据基于Delphi的共识标准,至少随访1年,并使用受试者工作特征曲线（ROC）来检查血清标志物变化预测感染的有效性。结果:22例（15.60%）为持续性感染。再感染和非再感染患者血清标志物的绝对值变化或百分比变化均无显著差异。当预测持续感染时,曲线下面积（AUC）表明血清标志物的百分比变化和绝对值变化都是较差的指标。当预测持续感染时,CRP绝对值变化的AUC为0.533,IL-6为0.504,ESR为0.508,纤维蛋白原为0.586。AUC显示CRP（0.464）、IL-6（0.534）、ESR（0.527）、纤维蛋白原（0.586）百分比变化百也是预测持续感染的较差指标。结论:我们已经表明,血清标志物的绝对值变化和百分比变化都不足以帮助持续感染诊断。因此,合理的再植入时机不能仅仅考虑血清标志物的下降趋势,而必须结合多种临床检查综合考虑。第二部分:2018新定义诊断再植入前持续感染目的:在缺乏关节液指标时,对于因假体周围感染而接受二期翻修手术的病人,研究在再植入前判断持续感染与否的诊断方法,研究了:（1）缺乏关节液时,2018年假体周围感染诊断的新标准对于再植入前持续感染的诊断价值;（2）缺乏关节液时,2013年肌肉骨骼感染协会（Musculoskeletal Infection Society,MSIS）标准对于再植入前持续感染的诊断价值;（3）比较两种不同标准在诊断再植入前持续感染的效果差异。方法:我们回顾性地收集了从2014年1月到2018年12月因假体周围感染在我院关节病区接受二期置换翻修的患者共150人。详细收集了病人的各项实验指标,包括:患者的人口统计学特征,占位器植入及假体再植入时的血清学标记物、冰冻病理检查结果、微生物培养结果及术中所见。在没有关节液的情况下,参照以往文献及专家共识,建立了2018年新标准及2013年MSIS标准对于持续感染的诊断模型。分别用两种方法定义再植入前持续性感染:标准1.狭义标准:因2018年新标准及MSIS标准关于感染定义的主要标准相同,将此作为狭义标准;标准2.广义标准:符合狭义标准定义的感染和/或再植入术后出现的再感染。在2018年新标准中,感染组和非感染组的患者均按照标准进行评分,以总分诊断感染。分别比较两种不同感染定义标准下,两种不同诊断方法的灵敏度、特异度、阳性预告值、阴性预告值。使用受者工作特征曲线（Receiver Operating Characteristic Curve,ROC）计算2018年新标准总得分的最佳阈值,并分别计算两种标准诊断感染的曲线下面积（area under curves,AUC）。结果:根据ROC计算的约登指数,在2018新标准中,在标准1和标准2中的综合得分最佳阈值均为4。当使用标准1诊断持续感染时,2018年新标准的敏感度和特异性为86.96%（95%置信区间[confidence interval,CI]67.83-95.51）,84.25%（95%CI 77.83--90.67）,AUC为0.871;MSIS标准诊断的敏感度和特异度为47.83%（95%CI 25.74-69.91）,93.70%（95%CI88.06-96.77）,AUC为0.708。在标准2中,2018年新标准的敏感度和特异性为78.57%（95%CI 58.54-90.97）,85.25%（95%CI 77.42-90.79）,AUC为0.835;MSIS标准诊断的敏感度和特异度为39.29%（95%CI 22.12-59.27）,93.44%（95%CI 87.08-96.92）,AUC为0.664。在两种定义标准中,2018年新定义的诊断价值均显著高于MSIS[标准1,（P=0.004）;标准2（P=0.0002）]。结论:对于因假体周围感染行二期翻修手术的病人,当缺乏关节液时,2018年新标准对于诊断再植入前持续感染具有较高的敏感性和特

关键词：二期翻修绝对值变化百分比变化血清指标假体周围感染 2018年新标准持续感染 MSIS标准

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韩国经济展望

理论学习与探索 1994年第2期 64-66页

作者：黄福平

韩国经济展望ＥｈｕｎｓＧｉＢａｅｋ文黄福平译１．经济增长１９９２年，韩国经济增长率为４．７％，是自１９８０年以来经济增长最慢的一年．１９９１年下半年，韩国政府采取稳定政策以冷却过热的国内需求，使得目前的赤字有所下降。... 详细信息

韩国经济展望ＥｈｕｎｓＧｉＢａｅｋ文黄福平译１．经济增长１９９２年，韩国经济增长率为４．７％，是自１９８０年以来经济增长最慢的一年．１９９１年下半年，韩国政府采取稳定政策以冷却过热的国内需求，使得目前的赤字有所下降。季度国民生产总值表１：消费增长率情...

关键词：经济展望消费增长率经济发展速度国家统计局存货调整贸易平衡百分比变化经济预测计划委员会经济衰退

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重组活化因子Ⅶ在急性颅内出血中的应用

世界核心医学期刊文摘（神经病学分册） 2005年第8期1卷 3-4页

作者： Mayer S.A. Brun N.C. Begtrup K. 郭俊 Neurological Institute Box 39 710 W. 168th St. New York NY 10032 United States Dr.

BACKGROUND: Intracerebral hemorrhage is the least treatable form of stroke and is associated with high *** patients who undergo computed tomograph y (CT) within three hours after the onset of intracerebral hemorrhage, one third have an increase in the volume of the hematoma related to subsequent bleeding. We sought to determine whether recombinant activated factor VII (rFVIIa) can red uce hematoma growth after intracerebral hemorrhage. METHODS: We randomly assigne d 399 patients with intracerebral hemorrhage diagnosed by CT within three hours after onset to receive placebo (96 patients) or 40 μg of rFVIIa per kilogram of body weight (108 patients), 80 μg per kilogram (92 patients), or 160 μg per k ilogram (103 patients) within one hour after the baseline scan. The primary outc ome measure was the percent change in the volume of the intracerebral hemorrhage at 24 hours. Clinical outcomes were assessed at 90 days. RESULTS: Hematoma volu me increased more in the placebo group than in the rFVIIa groups. The mean incre ase was 29 percent in the placebo group, as compared with 16 percent, 14 percent , and 11 percent in the groups given 40 μg, 80 μg, and 160 μg of rFVIIa per k ilogram, respectively (P=0.01 for the comparison of the three rFVIIa groups with the placebo group). Growth in the volume of intracerebral hemorrhage was reduce d by 3.3 ml, 4.5 ml, and 5.8 ml in the three treatment groups, as compared with that in the placebo group (P=0.01). Sixty-nine percent of placebo-treated pati ents died or were severely disabled (as defined by a modified Rankin Scale score of 4 to 6), as compared with 55 percent, 49 percent, and 54 percent of the pati ents who were given 40, 80, and 160 μg of rFVIIa, respectively (P=0.004 for the comparison of the three rFVIIa groups with the placebo group). Mortality at 90 days was 29 percent for patients who received placebo, as compared with 18 perce nt in the three rFVIIa groups combined (P=0.02). Serious thromboembolic advers

关键词：急性颅内出血活化因子血肿体积血栓形成性继发出血计算机断层扫描安慰剂百分比变化行基失能

英夫利昔单抗显著提高重症银屑病患者生活质量:双盲安慰剂对照试验

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世界核心医学期刊文摘（皮肤病学分册） 2005年第8期1卷 21-22页

作者： Feldman S.R. Gordon K.B. Bala M. A.B. Gottlieb 李政霄 Dr.University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School 51 French Street New Brunswick NJ 08901- 0019 United States

Background: Psoriasis is a chronic disease that significantly diminishes the health- related quality of life (HRQOL). Infliximab is a chimeric, tumour necrosis factor α monoclonal antibody that has been shown to improve the signs and symptoms of plaque psoriasis. Objectives: The objective of this study was to evaluate the effect of infliximab induction therapy on the HRQOL of patients with severe plaque psoriasis. Methods: In this double- blind, placebo- controlled trial, 249 patients were randomly assigned to receive intravenous infusions of 3 or 5 mg kg- 1 of infliximab or placebo and were treated at weeks 0, 2 and 6. Patients completed the Dermatology Life Quality Index (DLQI) at baseline and week 10. Results: Infliximab induction therapy resulted in a substantial improvement in HRQOL. At week 10, patients in the infliximab 3- and 5- mg kg- 1 groups showed a median percentage improvement in DLQI scores of 84.0% and 91.0% , respectively, compared with 0% in the placebo group (P < 0.001). The median decrease from baseline in DLQI score at week 10 was 8.0 and 10.0 for the 3 and 5 mg kg- 1 infliximab groups, respectively, compared with 0 in the placebogroup(P < 0.001). Thirty- three per cent and 40% of patientsinthe 3 and 5 mgkg- 1 infliximab groups, respectively, had a DLQI score of 0 at week 10, compared with 2% in the placebo group (P < 0.001). There was a strong correlation between the percentage change from baseline at week 10 in Psoriasis Area and Severity Index (PASI) scores and the percentage change in DLQI scores during the same period (Spearman’ s correlation, 0.61, P < 0.001). When the infliximab and placebo treatment groups were combined, patients with at least 75% improvement in PASI scores between baseline and week 10 had a greater mean improvement in DLQI scores (81% ) than those with 50- 75% improvement in PASI during the same period (60% ). Conclusions: Infliximab induction therapy resulted in significant improvement in HRQOL in patients with severe

关键词：银屑病生活质量安慰剂对照 PASI 诱导治疗静脉输注肿瘤坏死因子α 嵌合体单克隆抗体百分比变化

从美国避孕套销售量的增长看艾滋病的教育和宣传作用

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中国健康教育 1991年第5期7卷 33-35页

作者：约翰.S.莫兰哈兰.R.詹尼斯托马斯.A.皮特曼凯瑟琳.M.斯张庆贺

从一份全国药店的抽样数据表明,避孕套从1986年度的24亿只上升到1988年度的29.9亿只。自1987年外科学总干事的一篇关于艾滋病的报告发表后,出现了最大的销售增长。含有杀精剂的胶乳避孕套销售量上升了116％,其他种类的避孕套销量很少发... 详细信息

从一份全国药店的抽样数据表明,避孕套从1986年度的24亿只上升到1988年度的29.9亿只。自1987年外科学总干事的一篇关于艾滋病的报告发表后,出现了最大的销售增长。含有杀精剂的胶乳避孕套销售量上升了116％,其他种类的避孕套销量很少发生变化。这些数据提示:美国人正在使用更多和可能更有效的避孕套,以做为对艾滋病教育的反应。

关键词：抽样数据性伙伴性伴侣吸烟与健康城市居民避孕套避孕未婚妇女百分比变化宣传作用年轻男性

对比每天1次与每天3次妥布霉素治疗肺囊性纤维化(TOPIC研究):一项随机对照研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第7期1卷 7-8页

作者： Smyth A. Tan K.H.- V. Hyman- Taylor P. 王志宇 Department of Paediatrics Nottingham City Hospital Nottingham NG5 1PB United Kingdom Dr

Background: Intravenous tobramycin (three- times daily)is widely used for pu lmonary exacerbations in patients with cystic fibrosis who have chronic Pseudomo nas aeruginosa infection. We undertook a double- blind, randomized controlled t rial to assess the safety and efficacy of once versus three- times daily tobram ycin in these patients. Methods: 244 patients from 21 cystic- fibrosis centres in the UK were randomly assigned to once or three- times daily tobramycin (with ceftazidime) for 14 days. Treatment was given as 30- min infusions of tobramyc in in 0.9% saline. Primary outcome measure was change in forced expiratory vol ume in 1s (FEV1), over the 14 days of treatment, expressed as a percentage of th e predicted normal value for age, sex, and height. We also measured the change i n FEV1 expressed as a percentage of baseline. Secondary outcomes included change in serum creatinine. The study was powered for equivalence,and primary analysis was per protocol. Findings:219 patients (107 once daily, 112 three- times dail y) completed the study per protocol. None was lost to follow- up, although 20 d iscontinued intervention. Of 122 patients assigned to once daily treatment, thre e did not receive the study regimen. The mean change in FEV1 (% predicted) over 14 days was similar on the two regimens (10.4% [once daily] vs 10.0% [three - times daily]; adjusted mean difference 0.4% [95% CI - 3.3 to 4.1]). Mean % change in FEV1 from baseline was also similar in both treatments (21.9% v s 22.1% ; - 0.1% [- 8.0 to 7.9]). There was no significant difference in % change in creatinine from baseline (- 1.5% [once daily] vs 1.7% [three- times daily]). However, in children, once daily treatment was significantly less nephrotoxic than was thrice daily (mean % change in creatine - 4.5% [once daily] vs 3.7% [thrice daily]; adjusted mean difference - 8.0% , 95% CI - 15.7 to - 0.4). No patients developed hearing loss during the study, although two reported acute dizziness and were wit

关键词：囊性纤维化 TOPIC 百分比变化头孢他定绿脓假单胞菌诊疗中心基线水平静脉滴注预测值肾毒性

早期青光眼和高眼压症患者视盘边缘闪光诱发反应降低

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世界核心医学期刊文摘（眼科学分册） 2005年第2期1卷 36-37页

作者： Riva C.E. Salgarello T. Logean E. 齐翔云 Inst. de Recherche en Oph talmologie 64 Avenue Grand Champsec 1950 Sion Switzerland

PURPOSE. To determine in patients with ocular hypertension (OHT) or early glau coma (EOAG) the change in blood flow measured at the neuroretinal rim of the opt ic disc in response to a 15-Hz diffuse green luminance flicker, a stimulus that activates predominantly the ganglion cell magnocellular pathway. METHODS. Thirt een patients with EOAG, 29 with OHT, and 16 age-matched control subjects, all w ith excellent fixation, were examined. Blood flow (Fonh) at the neuroretinal rim of the optic disc was continuously monitored by laser Doppler flowmetry before and during exposure to a 15-Hz, 30°field green luminance flicker. The response of Fonh to this stimulus (RFonh)-was expressed as percentage change in Fonh be tween baseline and the last 20 seconds of flicker. Two to three temporal sites o f the disc were tested, and the highest RFonh was considered for further analysi s. RF onh results in patients were correlated with morphologic (cup-to-disc ar ea ratio, cup shape neuroretinal rim area) and functional (perimetric mean devia tion and pattern electroretinogram amplitude) clinical parameters. RESULTS. In t he patients with OHT or EOAG, Fonh and RFonh were both reduced compared with the ir respective values in the control group. Both quantities decreased significant ly with neuroretinal rim area when the patients’data were pooled. No significan t correlation was found between Fonh or RFonh and the other morphometric and fun ctional parameters. The group averaged time course of RFonh was not significantl y different from that in the normal subjects. CONCLUSIONS. Luminance flicker-ev oked RF onh is abnormally reduced in patients with OHT or EOAG, indicating an im pairment of neurally mediated vasoactivity. The data suggest that PERG-derived neural activity and flicker-evoked RFonh can be independently altered early in the disease process.

关键词：高眼压症视网膜神经图形视网膜电图边缘区视杯神经节细胞眼科检查血流量百分比变化神经活性

在美学习的中国学生持续强劲增长中国是美国学生的亚洲首选目的地

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留学 2015年第23期 24-25页