目的系统评价蛛网膜下腔不成比例扩大的脑积水(disproportionately enlarged subarachnoid space hydrocephalus,DESH)征对特发性正常压力脑积水(idiopathic normal pressure hydrocephalus,iNPH)手术预后的诊断价值。材料与方法计算机...目的系统评价蛛网膜下腔不成比例扩大的脑积水(disproportionately enlarged subarachnoid space hydrocephalus,DESH)征对特发性正常压力脑积水(idiopathic normal pressure hydrocephalus,iNPH)手术预后的诊断价值。材料与方法计算机检索WanFang Data、CNKI、PubMed、The Cochrane Library、Web of Science和EMbase数据库,搜集DESH征诊断iNPH手术预后的诊断性试验,文献检索时限均从建库至2020年5月。由两名研究者按照纳入与排除标准进行独立筛选文献、提取资料并采用QUADAS-2工具评价纳入研究的偏倚风险后,使用Meta-Disc 1.4软件进行Meta分析。结果共纳入5个研究,包括333例患者。Meta分析结果显示:DESH征诊断iNPH的合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比和绘制汇总受试者工作特征(summary receiver operating characteristics,SROC)曲线并计算曲线下面积分别为60%[95%CI(0.54,0.67)]、66%[95%CI(0.56,0.76)],1.87[95%CI(1.13,3.10)]、0.45[95%CI(0.23,0.88)]、4.91[95%CI(1.45,16.68)]和0.75。结论本研究系统评价DESH征对iNPH手术预后的诊断价值,尽管其仅具有中等诊断价值,但仍有比较重要的临床意义,因纳入研究较少,仍需开展更多研究予以证实,同时提醒临床工作者应重视影像学尤其是核磁共振检查在iNPH诊断中的意义。展开更多
<strong>Background:</strong> Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in...<strong>Background:</strong> Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in mild to moderate COVID-19 pa-tients. As it is highly contagious, health care workers including physicians are high risk of being infected in hospital care. <strong>Case Report:</strong> A 37 years old Bangladeshi physician working in a paediatric unit of a medical college hos-pital with multiple co-morbidities, hypertension, diagnosed axial spondy-loarthropathy (ankylosing spondylitis) taking disease modifying anti rheu-matic drugs— DMARDs (Salfasalazine) from 2016 till now, chronic persis-tent bronchial asthma on medication developed sore throat, increasing breathlessness and cough admitted to his own hospital on 22 April, 2020. He had a history of contact with a relapse nephrotic syndrome (glomerulone-phritis) patient admitted with severe respiratory distress later confirmed as COVID-19 following RT PCR test on 14 April, 2020. After 3 days of contact with the patient, the physician also developed the symptoms mentioned above. The RT PCR test result of the physician came positive on 18 April, 2020. The physician primarily taken only azithromycin 500 mg once daily along with other regular drugs. On 5, 12 and 18 May, 2020, his sample was taken for re-test and came positive subsequently. After that he started Iver-mectin (0.15 mg/kg) once daily for 3 days and doxycycline 100 mg BD for 7 days. He gave samples again on 27 and 29 May, 2020 which were came nega-tive after 39 days. On full recovery he was discharged from hospital on day 40. We choose the patient because presence of co-morbidities may be asso-ciated with delayed viral clearance and physicians with co-morbidities working in a hospital have high risk of being infected.展开更多
This paper examines the formation of the self in the context of emigration and the Indian individual in the Anglo-American space, in the novels: Fasting, Feasting by Anita Desai, The Inheritance of Loss by Kiran Desai...This paper examines the formation of the self in the context of emigration and the Indian individual in the Anglo-American space, in the novels: Fasting, Feasting by Anita Desai, The Inheritance of Loss by Kiran Desai, and The Namesake by Jhumpa Lahiri. The analysis focuses on exploring the way in which the hyphenated self is constructed under the influences of dialogical negotiation of desh and pardesh in the context of racism, global-local (glocal) specificity, becoming authenic under the presure of home memory, diaspora ethnicity and mimicry. Is reterritorialization and acculturation successful for the hybrid self? The answers is to be found by the characters of the novels and shown in instances of self expression and integration. Arun, the Indian guy, from Anita Desai’s novel left India for studying in America. During the summer, he is accommodated to an American family. The clash between the two cultures, traditions, and customs is felt as a huge breakage, which leads to desintegration and alienation. Biju and Harish-Harry from Kiran Desai’s novel go to America for a better living, and they succeeed in finding a job at a bakery. The impact of racism is higher in the lower strata of the society, thus their chances to integration are lost;Biju decides to return home, while Harish-Harry ends in a hyphenated self and a dissatisfied living. In The Namesake, Ashoke and Ashima, the Indian emigrants husband and wife, experience a different reshaping of identity. Ashoke works as a university assistant, while Ashima is a housewife. For him, America is a space for affirmation and self-verification, while for his wife, the space becomes a ghetto where she feels lonely and marginalised. Therefore, in the formation of the self there are many coordinates which should be taken into consideration and above this, their impact over the immigrant is different from case to case depending on many factors.展开更多
文摘<strong>Background:</strong> Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in mild to moderate COVID-19 pa-tients. As it is highly contagious, health care workers including physicians are high risk of being infected in hospital care. <strong>Case Report:</strong> A 37 years old Bangladeshi physician working in a paediatric unit of a medical college hos-pital with multiple co-morbidities, hypertension, diagnosed axial spondy-loarthropathy (ankylosing spondylitis) taking disease modifying anti rheu-matic drugs— DMARDs (Salfasalazine) from 2016 till now, chronic persis-tent bronchial asthma on medication developed sore throat, increasing breathlessness and cough admitted to his own hospital on 22 April, 2020. He had a history of contact with a relapse nephrotic syndrome (glomerulone-phritis) patient admitted with severe respiratory distress later confirmed as COVID-19 following RT PCR test on 14 April, 2020. After 3 days of contact with the patient, the physician also developed the symptoms mentioned above. The RT PCR test result of the physician came positive on 18 April, 2020. The physician primarily taken only azithromycin 500 mg once daily along with other regular drugs. On 5, 12 and 18 May, 2020, his sample was taken for re-test and came positive subsequently. After that he started Iver-mectin (0.15 mg/kg) once daily for 3 days and doxycycline 100 mg BD for 7 days. He gave samples again on 27 and 29 May, 2020 which were came nega-tive after 39 days. On full recovery he was discharged from hospital on day 40. We choose the patient because presence of co-morbidities may be asso-ciated with delayed viral clearance and physicians with co-morbidities working in a hospital have high risk of being infected.
文摘This paper examines the formation of the self in the context of emigration and the Indian individual in the Anglo-American space, in the novels: Fasting, Feasting by Anita Desai, The Inheritance of Loss by Kiran Desai, and The Namesake by Jhumpa Lahiri. The analysis focuses on exploring the way in which the hyphenated self is constructed under the influences of dialogical negotiation of desh and pardesh in the context of racism, global-local (glocal) specificity, becoming authenic under the presure of home memory, diaspora ethnicity and mimicry. Is reterritorialization and acculturation successful for the hybrid self? The answers is to be found by the characters of the novels and shown in instances of self expression and integration. Arun, the Indian guy, from Anita Desai’s novel left India for studying in America. During the summer, he is accommodated to an American family. The clash between the two cultures, traditions, and customs is felt as a huge breakage, which leads to desintegration and alienation. Biju and Harish-Harry from Kiran Desai’s novel go to America for a better living, and they succeeed in finding a job at a bakery. The impact of racism is higher in the lower strata of the society, thus their chances to integration are lost;Biju decides to return home, while Harish-Harry ends in a hyphenated self and a dissatisfied living. In The Namesake, Ashoke and Ashima, the Indian emigrants husband and wife, experience a different reshaping of identity. Ashoke works as a university assistant, while Ashima is a housewife. For him, America is a space for affirmation and self-verification, while for his wife, the space becomes a ghetto where she feels lonely and marginalised. Therefore, in the formation of the self there are many coordinates which should be taken into consideration and above this, their impact over the immigrant is different from case to case depending on many factors.
