Reliability and validity of nociception coma scale-revised (NCS-R) in patients with disorders of consciousness / 中华行为医学与脑科学杂志

Objective To assess the pain of patients with disorders of consciousness(DOC) and e-valuate the reliability and validity of Chinese version of Nociception Coma Scale- revised ( NCS-R). Meth-ods Sixty-two patients with disorders of consciousness were assessed by NCS-R and the internal reliability, inter-rater reliability,test-retest reliability and concurrent validity was analyzed. Results Cronbach's alpha (α) of internal reliability was 0. 611, test-retest reliability for the NCS-R total scores by spearman was 0. 884. For the subscales,the reliability for the motor,verbal and facial subscale scores by Cronbach's kappa were 0. 856,0. 870 and 0. 856 respectively. Inter-rater reliability for the NCS-R total scores by spearman was 0. 662. For the subscales,the reliability for the motor,verbal and facial subscale scores by Cronbach's kappa were 0. 962,0. 867 and 0. 671 respectively. The spearman coefficient of concurrent validity was 0. 560 (all P<0. 01). Conclusion The NCS-R is a good valid scale and available for Chinese clinician and researchers to assess the pain of DOC patients.

The value of detection pre-S1 antigen in patients with chronicity type B hepatitis (CHB) / 中国基层医药

Objective To evaluate the value of pre-S1 Ag in combined detection of hepatitis B virus. Methods 288 patients' serums with chronicity type B hepatitis (CHB)were collected when they had been detected with HBV-DNA,HBVM or ALT/AST,and then ELISA assay were applied to detect pre-S1Ag. Results A total of 288 patients ,including 175 males and 113 females( their meso-age is 36.89 years old) were recruited into this study. 161 patients were pre-S1 Ag positive(68.4%), 197 patients' HBV DNA contents exceeded 5.0E + 2 copy/ml(55.9%) ,71patients were H BeAg positive (24.6%), 186 patients were HBeAg negative (64.58%). The rate of 64 patients' ALT and AST exceeded 0. 84, and their' ALT exceeded 40 u/ml ( 22. 2% ). 60 patients' AST exceeded 50 u/ml (20. 8% ). These patients were divided into pre-S1 Ag positive group and pre-S1 Ag group. In pre-S1 Ag positive group, 124 patients' HBV DNA contents exceeded 5.0E + 2 copy/ml( 62.9% ), 118 patients were HBeAg negative (59.8%). When HBV DNA content was less than 5.0E+2 copy/ml,pre-S1 Ag positive rate was 35.2% and pre-S1 Ag negative rate was 63.6%. when HBV DNA content was less than 5.0E + 3 copy/ml, pre-S1 Ag positive rate was 56.9% and pre-S1 Ag negative rate was 81.7%. When HBV DNA content exceeded 5.0E + 5 copy/ml but less than 5.0E + 8 copy/ml ,pre-S1 Ag positive rate was 33% and pre-S1 Ag negative rate was 14.3% ,so two groups had significant difference. Conclusion Pre-S1 Ag positive and HBeAg negative in the CHB patients serums signify virus replication,and it can help us decide prognosis.

Long-term efficacy of replanlation vesus prosthetic replacement for complex severed lower legs / 中华全科医师杂志

Objective To explore indications for replantation and amputation of complex severed lower legs. Methods Fifteen lower legs in 25 cases with complex severed lower limbs were replanted including four finally amputated again, and other 10 legs were amputated directly after trauma. Those with successful replantation were repaired with microsurgical technology and limb lengthening procedure for complications such as soft tissue defect, bone defect and limb shortening. The amputated cases were fitted with prosthetic limb after wound healing. Results All cases were followed-up for three to 10 years (6.4 years in average), and 11 lower legs were survived in 15 replanted cases and other four were finally amputated and fitted with prosthetic replacement. The limbs of those with successfully replantation shortened to varied extent, and one can be categorized as grade Ⅰ, four as grade Ⅱ, four as grade Ⅲ and two as grade Ⅳ, according to Chen's classification of function evaluation for replanted limbs. Appearance of prosthetic limbs in 14 cases had no significant difference from the normal, and 12 of them could walk with load and two had slight claudication. Those with prosthetic limbs were more satisfactory than those with replantation of the limbs. Conclusion Replantation for complex severed lower legs should be comprehensively considered based on mangled extremity severity score (MESS), their local condition and function prognosis.

The epidemic characters and tendency of HIV/AIDS of Sinkiang / 中华检验医学杂志

Objective To study the epidemic characters and tendency of HIV/AIDS (Human immunodeficiency virus/ Acquired immunodeficiency syndrome) from serologic check results.Methods 36 021 specimens of suspected clinical cases and routine cases before surgery in Xinjiang Urumqi Uiger Municipal People's Hospital were detected from 2001—2004. At first, these cases werescreened by ELISA(Enzyme-linked immunoadsordent assay) , then ascertained by desease-control center and AIDS surveillance systems through WB , HIV RNA were estimated by the application of RT-PCR , CD cell were counted with flow cytometry.Result Prevalence figures have risen sharply from 1999—2001 and increased steadily since 2002 , the positive rates of anti-HIV were 0.714%(259 cases) . 38 percents cases were female (97/259), female ratio had the increasing trend and 3 cases were found as intrauterine infection . 80% cases were adolescent(16 year old to 35 year old) , 85.6% cases were Uiger minority , 94% and 67.7% cases were drug abuse through vein and non-occupation respectively.83.3% and 8.69% cases were found in north and south of Xinjiang respectively.The positive rates of virus nucleic acid were 50% , in which 76%(19/25) were 104~105 cop/ml. CD4,CD8,CD4/CD8 were all abnormal,CD4/CD8 ratio decreased to 96%,The number of CD4 cells was remarkably reduced 56%; while CD8 cells was significantly rised 60%;Inpatients increased gradually. Among them , 80% cases were dead due to infection , 16.7% surgical cases were fracture spontaneously.Conclusion The serologic detection of anti- HIV , HIV RNA , CD cell counts had confirmed AIDS episode later ; The progress was more rapidly;infectious rate of female was increased and followed intrauterine infection in Xinjiang.The numbers of episode and death were in growth stage , antivirus therapy were imperative.