Medical English | Day30
2014/12/11 医学生

     supernumerary

     [,su?p?'nju?m(?)r(?)r?; ,sju?-]

     n. 定额以外的人；临时雇员；小配角

     adj. 多余的；后备的；临时雇用的

     词根super-表示超过，在…上

     superficial 表面的，肤浅的

     supernormal 非凡的

     词组supernumerary breast 副乳

     supernumerary digit 多指

     supernumerary bud 附芽

     supernumerary crossveins 加横脉

     例句To our knowledge, this is the first report of supernumerary breast tissue on the foot.

     据我们所知，这是第一个被报道在脚底长出副乳组织的案例。

     article.yeeyan.org

     Question肖锋 翻译和整理

     Which class of antibiotics is the only oral antimicrobials recommended for the outpatient empirical treatment of acute uncomplicated pyelonephritis in women?

     那一类抗生素是唯一的院外治疗急性没有合并症急性肾盂肾炎的口服抗菌药物？

     AnswerFluoroquinolones are the only oral antimicrobials recommended for the outpatient empirical treatment of acute uncomplicated pyelonephritis.

     氟喹诺酮类抗生素是唯一的院外治疗急性没有合并症急性肾盂肾炎的口服抗菌药物(NEJM, 2012; 366:1028)。

     Pulse oximetry with clinical assessment to screen for congenital heart disease in neonates in China: a prospective study.

     经皮血氧饱和度检测结合临床评估筛查新生儿先天性心脏病：中国的一项前瞻性研究

     Qu-Ming Zhao ,Xiao-Jing Ma ,Xiao-Ling Ge ,Fang Liu ,Wei-Li Yan ,Lin Wu

     柳叶刀杂志(Lancet)

     2014-04-22

     索引：Lancet.2014 Apr 22;

     中文摘要来源：柳叶刀中文版

     BACKGROUND

     Several pioneering studies have provided evidence for the introduction of universal pulse oximetry screening for critical congenital heart disease. However, whether the benefits of screening reported in studies from high-income countries would translate with similar success to low-income countries is unknown. We assessed the feasibility and reliability of pulse oximetry plus clinical assessment for detection of major congenital heart disease, especially critical congenital heart disease, in China.

     METHODS

     We did a pilot study at three hospitals in Shanghai to assess the accuracy of pulse oximetry plus clinical assessment for detection of congenital heart disease. We made a data collection plan before recruitment. We then undertook a large, prospective, and multicentre screening study in which we screened all consecutive newborn babies (aged 6-72 h) born at 18 hospitals in China between Aug 1, 2011, and Nov 30, 2012. Newborn babies with positive screen results (either an abnormal pulse oximetry or abnormal clinical assessment) were referred for echocardiography within 24 h of screening. We identified false-negative results by clinical follow-up and parents' feedback. We calculated sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios for pulse oximetry alone, and in combination with clinical assessment, for detection of major and critical congenital heart disease.

     FINDINGS

     In the pilot study, 6785 consecutive newborn babies were screened; 46 of 49 (94%) cases of asymptomatic major congenital heart disease and eight of eight (100%) cases of asymptomatic critical disease were detected by pulse oximetry and clinical assessment. In the prospective multicentre study, we screened 122?738 consecutive newborn babies (120?707 asymptomatic and 2031 symptomatic), and detected congenital heart disease in 1071 (157 critical and 330 major). In asymptomatic newborn babies, the sensitivity of pulse oximetry plus clinical assessment was 93·2% (95% CI 87·9-96·2) for critical congenital heart disease and 90·2% (86·4-93·0) for major disease. The addition of pulse oximetry to clinical assessment improved sensitivity for detection of critical congenital heart disease from 77·4% (95% CI 70·0-83·4) to 93·2% (87·9-96·2). The false-positive rate for detection of critical disease was 2·7% (3298 of 120?392) for clinical assessment alone and 0·3% (394 of 120?561) for pulse oximetry alone.

     INTERPRETATION

     Pulse oximetry plus clinical assessment is feasible and reliable for the detection of major congenital heart disease in newborn babies in China. This simple and accurate combined method should be used in maternity hospitals to screen for congenital heart disease.

     背 景 以前的一些研究已经为应用经皮血氧饱和度检测(POX)筛查危重先天性心脏病(先心病)提供了可靠性依据。然而，在发展中国家POX筛查先心病能否获得和发达国家相同的优势仍不明确。本研究中，作者旨在评价在中国开展POX结合临床评估筛查重症(包括严重和危重)先心病的可行性与可靠性。

     方 法 研究者首先在上海市3家医院开展了一项先导研究，评价POX结合临床评估检出先心病的准确性。在此基础上我们制定了数据收集计划，开展了一项大型、前瞻性、多中心筛查研究，在全国18家医院2011年8月1日至2012年11月30日出生的所有新生儿(出生后6～72 h)均被纳入。筛查阳性(POX阳性或临床评估指标阳性)的新生儿在24 h内完成心脏超声诊断。假阴性结果通过临床随访和家长反馈获得。此外，还分别计算了单纯POX筛查和POX结合临床评估筛查的灵敏度、特异度、阳性/阴性预测值、阳性/阴性似然比。

     结 果 在先导研究中，采用POX和临床评估筛查了6785名新生儿，检出了46/49例(94%)无症状先心病和8/8例(100%)有症状先心病。在前瞻性多中心研究中，我们筛查了122 738名新生儿(120 707例无症状，2031例有症状)，检出了1071例先心病患儿(包括157例危重和330例重症先心病)。在无症状的新生儿中，POX结合临床评估筛查危重先心病和重症先心病的灵敏度分别为93.2%(95%CI 87.9～96.2)和90.2%(95%CI 86.4～93.0)。POX与临床评估结合可显著提高危重先心病的检出率[从77.4%(95%CI 70.0～83.4)提高至 93.2%(95%CI 87.9～96.2)]。单纯临床评估与单纯POX筛查危重先心病的假阳性率分别为2.7%(3298/120 392例)和0.3%(394/120 561例)。

     结 论 在中国，采用POX结合临床评估筛查新生儿重症先心病可行且可靠，这种简便精确的联合方案应该用于妇幼保健院对新生儿先心病的筛查。

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