Medical English | Day29
2014/12/10 医学生

     panacea

     [,p?n?'si?]

     n. 灵丹妙药；万能药

     词根pan-表示全部

     pandemic 流行性疾病

     pansexual 泛性论的

     词组Panacea Park 城市

     Polypurpose Panacea 万灵秘药

     Panacea Shield 万灵护盾

     a panacea 四海皆准 ; 包医百病

     例句However, much like automation itself, it is not a panacea.

     然而，就如同自动化本身一样，它不是万能的。

     www.ibm.com

     Question肖锋翻译和整理

     You are caring for a hemodynamically unstable pediatric patient with SVT. 2 attempts at cardioversion are not successful. What is your next step? SCD is a natural death due to cardiac causes, heralded by abrupt LOC and occurring within 1 hour of symptom onset. It may occur in patients with previously documented CAD or may be an initial event.

     你在处理一个血流动力学不稳定的儿童SVT患者。2次电复律都不成功。你的下一步计划是什么？ SCD是由于心脏原因导致的自然死亡，突发的神智丧失是其标志并通常在症状出现后1小时内发生。它可能在已有CAD患者中发生，也可能是最初的发现(Mayo Clin Proc, epub, 10/31/14)。

    

     AnswerIf a second shock is unsuccessful or the tachycardia recurs quickly, consider amiodarone or procainamide before a third shock.

     如果第二次复律失败或心动过速很快复发，在第三次复律前可考虑用胺碘酮或普鲁卡因胺(Circulation.2010;122:S876-S908)。

     HIV, hepatitis B virus, and hepatitis C virus co-infection in patients in the China National Free Antiretroviral Treatment Program, 2010-12: a retrospective observational cohort study.

     中国免费抗病毒治疗项目2010-2012中HIV、乙肝病毒和丙肝病毒共同感染：一项回顾性、观察性队列研究

     Fujie Zhang ,Hao Zhu ,Yasong Wu ,Zhihui Dou ,Yao Zhang ,Nora Kleinman

     Lancet Infect Dis

     2014-10-07

     索引：Lancet Infect Dis 2014 Oct;

     中文摘要来源：徐贝翻译

     BACKGROUND

     Hepatitis-related liver diseases are a leading cause of mortality and morbidity among people with HIV/AIDS taking combination antiretroviral therapy. We assessed the effect of hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection on HIV outcomes in patients in China.

     METHODS

     We did a nationwide retrospective observational cohort study with data from the China National Free Antiretroviral Treatment Program from 2010-11. Patients older than 18 years starting standard antiretroviral therapy for HIV who had tested positive for HBV and HCV were followed up to Dec 31, 2012. We used Kaplan-Meier analysis and Cox proportional hazard models to evaluate survival, and logistic regression models to estimate virological failure, immunological response, and retention in care.

     FINDINGS

     33?861 patients with HIV met eligibility criteria. 2958 (8·7%) participants had HBV co-infection, 6149 (18·2%) had HCV co-infection, and 1114 (3·3%) had triple infection. All-cause mortality was higher in participants with triple infection (adjusted hazard ratio 1·90, 95% CI 1·53-2·37) and HCV co-infection (1·46, 1·25-1·70) than in those with HIV only, but not in those with HBV co-infection (1·06, 0·89-1·26). People with triple infection were also more likely to have virological failure (adjusted odds ratio [OR] 1·26, 95% CI 1·02-1·56) than were those with HIV only, whereas the difference was not significant for those with HBV co-infection (0·93, 0·80-1·10) or HCV co-infection (1·10, 0·97-1·26). No co-infection was significantly associated with a difference in CD4 cell count after 1 year of treatment. Loss to follow-up was more common among participants with triple infection (OR 1·37, 95% CI 1·16-1·62) and HCV co-infection (1·30, 1·17-1·45), but not HBV co-infection (0·93, 0·82-1·05), than among those with HIV only.

     INTERPRETATION

     Screening for viral hepatitis is important in individuals diagnosed as HIV positive. Effective management for viral hepatitis should be integrated into HIV treatment programmes. Long-term data are needed about the effect of hepatitis co-infection on HIV disease progression.

     背景

     肝炎相关肝病是HIV/AIDS患者接受联合抗病毒治疗后死亡或患病的首要原因之一。本研究评估了乙肝病毒(HBV)和丙肝病毒(HCV)共同感染对中国HIV感染患者预后的影响。

     方法

     使用中国国家免费抗病毒治疗项目2010-2011年之间的数据进行全国范围的回顾性、观察性队列研究。研究纳入的患者为年龄大于等于18岁、接受HIV标准抗病毒治疗、HBV或HCV检测阳性的患者，对这些患者随访至2012年12月31日。本研究使用Kaplan-Meier分析和Cox比例风险模型评估患者的生存率，使用Logistic回归模型估算病毒学失败、免疫应答和治疗维持情况。

     结果

     33861例HIV感染者符合入选标准。其中2958例(8.7%)参与者合并HBV感染，6149例(18.2%)合并HCV感染，1114例(3.3%)有三重感染。三重感染组(校正危险比1.90，95%CI 1.53-2.37)和HCV合并感染组(1.46，1.25-1.70)的全因死亡率高于仅HIV感染组，但HBV合并感染组(1.06，0.89-1.26)与仅HIV感染组相比无显著差异。三重感染组的患者中病毒学失败风险也高于仅HIV组(校正比值比[OR]1.26，95%CI 1.02-1.56)，但HBV合并感染组(0.93，0.80-1.10)或HCV合并感染组(1.10，0.97-1.26)无此显著差异。任一合并感染组治疗1年后CD4细胞计数与仅HIV感染组无显著差异。三重感染组(OR 1.37，95%CI 1.16-1.62)和HCV合并感染组(1.30，1.17-1.45)的失访率较高，但HBV合并感染组的失访率(0.93，0.82-1.05)不高于仅HIV感染组。

     结论

     病毒性肝炎筛查对HIV阳性患者有重要意义。HIV治疗计划中应纳入病毒性肝炎的有效治疗。关于肝炎合并感染对HIV疾病转归的意义，仍需长期研究数据以确认。

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