经前综合征患者月经周期中血清Ca~(2+) Mg~(2+)水平变化的研究

测定经前综合征（ＰＭＳ）患者月经各时期血Ｃａ２＋、Ｍｇ２＋水平,探讨其在ＰＭＳ发生发展中的作用。结果发现ＰＭＳ妇女各期Ｅ２、Ｐ变化与正常妇女无显著差异,卵泡期有较高的Ｍｇ２＋水平,黄体期明显降低,同时Ｃａ２＋／Ｍｇ２＋比值增高（Ｐ＜０．０５）,而正常妇女各期Ｍｇ２＋水平与Ｃａ２＋／Ｍｇ２＋比值无显著差异。提示黄体期血Ｍｇ２＋水平降低和Ｃａ２＋／Ｍｇ２＋比值升高可能与ＰＭＳ症状有关,有助于ＰＭＳ的诊断和治疗     

非医疗产业的质量评价

在日本，由于第二产业（即制造业）具有优秀的质量评价机构，因而其制造的优质产品（汽车、电视机等）获得了全世界的好评。１９９３年第５期《病院》杂志刊发了日本东海大学师冈孝次教授的文章，对制造业的ＴＱＣ和ＴＰＭ管理方法以及戴明奖和ＰＭ奖进行了介绍。同时就ＴＱＣ和ＴＰＭ在医疗机构的应用进行了探讨。     

非医疗产业的质量评价

在日本，由于第二产业（即制造业）具有优秀的质量评价机构，因而其制造的优质产品（汽车、电视机等）获得了全世界的好评。１９９３年第５期《病院》杂志刊发了日本东海大学师冈孝次教授的文章，对制造业的ＴＱＣ和ＴＰＭ管理方法以及戴明奖和ＰＭ奖进行了介绍。同时就ＴＱＣ和ＴＰＭ在医疗机构的应用进行了探讨。     

胫骨平台骨折术后的持续被动功能活动治疗的护理

胫骨平台骨折属于关节内骨折 ,常导致关节失稳、疼痛和功能障碍。因此重建平整的关节面 ,维持关节稳定 ,力求合理的应力分布和保证关节功能的恢复是治疗的目的。膝关节持续被动功能活动 (ＣｏｎｔｉｎｕｏｕｓＰａｓｓｉｖｅＭｏｖｅｍｅｎｔ,ＣＰＭ )可预防膝关节再黏连 ,促进软骨再生 ,为膝关节功能的恢复提供了有利的条件[1] 。 1997年 8月起我院行外伤性胫骨平台骨折手术 93例 ,其中 48例术后应用ＣＰＭ治疗 ,同时治疗期间做好心理、疼痛、引流管及皮肤等各方面的护理 ,使ＣＰＭ治疗取得了良好的效果 ,在护理方面也积累了一些经验。现报…     

车间空气中多次甲基多苯基多异氰酸酯卫生标准的制定研究

ＰＭＰＰＩ分子式中含多个－ＮＣＯ基团,对眼、皮肤等有轻微刺激和潜在致敏作用。小鼠经口ＬＤ５０为７２６６．１ｍｇ／ｋｇ,表明ＰＭＰＰＩ属低毒化合物。２小时吸入染毒小鼠ＬＣ５０大于１２６．９ｍｇ／ｍ＾３,大鼠ＬＣ５０大于５７．２ｍｇ／ｍ＾３。亚慢性吸入染毒实验表明４．４９ｍｇ／ｍ＾３可视为无可见作用浓度。Ａｍｅｓ、ＵＤＳ试验和小鼠骨髓微核试验表明ＰＭＰＰＩ在很高剂量时有一定致突变性。安全系数拟取１０。     

氧自由基在冻伤发病中的作用

冻伤包括冻结和融化两个损伤阶段，类似于缺血再灌流损伤。冻融损伤可能直接或间接地激活中性粒细胞（ＰＭＮ）或（和）血管内皮细胞（ＶＥＣ），促进ＰＭＮ－ＶＥＣ粘附，进而活化黄嘌呤氧化酶生成氧自由基造成ＶＥＣ损伤。因此，阻断氧自由基生成的和作用的不同环节的药物均可减轻冻融损伤。临床治疗应在复温前或复温开始时联合用药，以提高疗效     

工频磁场抑制细胞缝隙连接通讯功能的机制探讨

目的　研究工频磁场抑制细胞缝隙连接通讯（ ＧＪＩＣ） 功能的可能作用机制。方法　中国仓鼠肺成纤维（ ＣＨＬ） 细胞受０ ．８ ｍ Ｔ５０ Ｈｚ 脉冲磁场作用２３ 小时后,加入不同浓度的蛋白激酶Ｃ（ ＰＫＣ）抑制剂———斯特罗斯孢啉（ Ｓｔａｕｒｏｓｐｏｒｉｎｅ,ＳＴＳ） 或十六酰基肉毒硷（ ＰａｌｍｉｔｏｙｌＤＬｃａｒｎｉｔｉａ ,ＰＭＣ） 共同作用１ 小时,中止作用后,用微注射方法检测ＧＪＩＣ 功能。结果　５０ Ｈｚ 脉冲磁场对ＧＪＩＣ 的抑制作用能被ＳＴＳ或ＰＭＣ 所拮抗,拮抗程度与 ＳＴＳ 或ＰＭＣ 的浓度有关,当ＳＴＳ、ＰＭＣ 分别达到１０ ｎｍｏｌ／ Ｌ、１０μｍｏｌ／ Ｌ 时,ＧＪＩＣ 功能恢复至（８ ．７１ ±１ ．０７） 个、（９ ．００ ±１ ．０７） 个,接近于辐照前水平（１０ ．０１ ±２ ．０１） 个。结论　工频磁场抑制ＧＪＩＣ 与ＰＫＣ 激活有关。     

肥大细胞对肺成纤维细胞生长的影响

应用光镜、电镜、细胞生长曲线和同位素技术等方法。研究了大鼠腹腔肥大细胞及ＰＭＣ上清对培养的同源肺成纤维细胞生长的影响。结果表明，实验组ＩＦｂ呈复层生长，＾３Ｈ－ＴｄＲ掺入量和细胞密度均明显大于对照组。提示ＰＭＣ释放的活性介质可能含有促进ＬＦｂ增生的因子。     

中草药添加剂对卷烟主流烟雾颗粒物诱变性的影响

本文运用ＲＭ２０／ＣＳ自动吸烟机收集样品卷烟主流烟雾颗粒物（简称ＴＰＭ），以ＳＯＳ／ｕｍｕ试验、小鼠骨髓嗜多染红细胞（ＰＣＥ）微核试验、及小鼠睾丸染色体畸变试验测定了中草药添加剂黄芪、桔梗对卷烟ＴＰＭ含量及诱变性的影响，结果表明：黄芪可降低ＴＰＭ的含量约３．７３ｍｇ／支，并且可降低ＴＰＭ的诱变性，桔梗可使ＴＰＭ含量上升１．０ｍｇ／支，但对ＴＰＭ的诱变性无任何影响。     

单核细胞株在矽肺体外研究中的应用

目的 探索具有肺泡巨噬细胞特性的人血单核细胞株（ＴＨＰ－１细胞）在矽肺发生机制体外研究中的应和。方法 观察二氧化硅（ＳｉＯ２）刺激ＴＨＰ－１细胞或佛波酯（ＰＭＡ）诱导分化的ＴＨＰ－１细胞培养上清液对成纤维细胞（ＣＨＬ）增殖和核仁组成区相关的嗜银蛋白（Ａｇ－ＮＯＲｓ）形成,肺泡上皮细胞（ＣＣＬ－６４）迁移以及大鼠矽肺样病变发生的影响。同时对ＰＭＡ诱导分化的ＴＨＰ－１细胞受ＳｉＯ２刺激的化学发光进行研     

CPM配合中药薰洗对髋膝关节置换术后功能康复的临床观察

目的探讨髋膝关节置换术后采用CPM配合中药薰洗以促进关节功能恢复的作用效果。方法回顾分折CPM配合中药薰洗进行髋膝关节置换术后康复治疗50例,以同期常规康复治疗30例作对照,分别按照Harris评分标准和HSS膝关节评分标准进行功能评定。结果经过长期随防,髋膝关节置换术后采用CPM配合中药薰洗进行康复治疗后功能评定有较高的优良率。结论CPM配合中药薰洗可有效促进髋膝关节置换术后关节功能恢复,提高患者生活质量。     

骨创伤治疗仪与CPM机联合预防术后膝关节僵硬疗效观察

目的:探讨下肢持续被动活动机(CPM)与骨创伤治疗仪早期联合使用对预防下肢骨折术后膝关节僵硬的疗效.方法:选取50例下肢骨折术后患者随机分为治疗组25例和对照组25例,治疗组施行下肢CPM机与骨创伤治疗仪联合治疗;对照组仅使用CPM机治疗.结果:治疗组2周内膝关节活动度与膝关节屈伸功能得到明显的改善,关节活动度明显优于对照组(P<0.05).结论:早期联合使用CPM机与骨创伤治疗仪能预防膝关节僵硬,减轻关节疼痛、肿胀,有利于关节活动度的改善,是创伤小、适应性广、安全有效的治疗手段.     

下肢CPM训练器的研制

基于CPM理论，研制出适用于膝，髋，踝关节功能锻炼的下肢CPM训练器，介绍了该机的基本结构。主要功能，工作原理及临床机理和作用，具体给出了该机的主要技术参数和控制系统的设计方法。     

锁定钢板内固定并植骨治疗复杂胫骨平台骨折的疗效分析

目的：探讨锁定钢板内固定并植骨对于临床复杂胫骨平台骨折的治疗效果。方法：选取2008年2月-2013年2月本院收治的58例复杂性胫骨平台骨折患者作为研究对象,其中38例采用锁定钢板稳定固定并植骨治疗的患者作为观察组,20例采用传统钢板固定治疗的患者作为对照组。术后根据骨折类型及手术固定情况,早期结合CPM机、膝关节外固定支架行膝关节功能锻炼。术后平均随访15.4个月。比较两组治疗后关节功能恢复情况及术后出现关节面下沉并发症的发生率。结果：观察组手术后膝关节评分优良率为86．8％,明显高于对照组的70．0％,且观察组患者术后没有出现关节面下沉等并发症,而对照组此类并发症的发生率明显高于观察组,差异均有统计学意义（P〈0．05）。结论：锁定钢板内固定并植骨治疗复杂胫骨平台骨折较传统的内固定治疗效果明显,其治愈率高,患者膝关节功能恢复好,致残率低,值得临床推广使用。     

Regulatory control of Chinese Proprietary Medicines in Singapore

In Singapore, there has been a growing public interest in traditional Chinese medicine (TCM), which plays an important role in the healthcare system. With effect from 1 September 1999, the control on Chinese Proprietary Medicines (CPM) was implemented in three phases over a span of 3 years. Under the CPM regulatory framework, CPM importers, wholesalers, manufacturers and re-packers must be licensed and CPM products assessed and listed by the health authority before they are allowed for sale. Product assessment is based on the criteria of safety and quality which include limits of toxic heavy metals and microbial contents. During the 3-year CPM listing exercise, irregularities were detected, including intrinsic toxicity, adulteration, substitution, contamination, misidentification, non-traditional and/or inappropriate usage, incorrect preparation, inappropriate labelling, exaggerated claims and/or advertising. The full implementation of CPM control by September 2001 saw the listing of 7943 CPM products and brought about an improvement in the quality and safety of CPM in Singapore as well as the removal of sub-standard, fake/imitation and adulterated products. The standards of practices by local CPM dealers have also been raised. These improvements have, in turn, increased the level of public confidence in CPM products in Singapore.     

Matland关节松动术治疗创伤术后伸直型膝关节功能障碍的临床疗效观察

目的观察Matland关节松动术治疗创伤术后伸直型膝关节功能障碍的临床疗效。方法共收集63例患者,随机分为两组,其中治疗组38例,对照组25例,两组患者均用TCP局部照射后,治疗组应用Matland关节松动术,对照组应用CPM机,分别于治疗前、治疗后1个月及治疗后3个月进行患膝关节屈曲活动范围测定。做比较分析。结果两组膝关节ROM治疗后较治疗前均有改善,差异有统计学意义(P<0.001);两组膝关节ROM改善情况,治疗1个月后,差异有统计学意义(P<0.05),治疗组优于对照组;治疗3个月后,差异有显著统计学意义(P<0.001),治疗组明显优于对照组。     

AN UNUSUAL CASE OF CENTRAL PONTINE MYELINOLYSIS

Central pontine myelinolysis (CPM) is a rare complication ofalcoholism. There have been recent reports that hyponatremiaand its rapid correction are of aetiological significance inthe development of CPM. We describe the case of a 47-year-oldalcoholic who developed CPM and subsequently recovered. Alcoholicand psychiatric patients are at risk for CPM and cliniciansneed to have a high index of suspicion to diagnose this condition.     

全膝关节置换术后系统康复的疗效观察

目的探讨分析全膝关节置换术后系统康复的临床疗效。方法回顾性分析行单侧人工全膝关节置换术的骨关节炎患者82例,并分成两组。观察组(41例)在置换术后进行系统康复训练,对照组(41例)进行持续被动训练机(CPM)的康复训练,比较两组患者的术后膝关节功能恢复状况。结果观察组在术后1周、3周、6周HSS评分均高于对照组,并且术后6周实验组的有效率高于对照组,P<0.05。结论 TKA后系统康复有助于患者恢复,提高临床疗效,值得在临床上推广。     

Impact of a clinical preventive medicine curriculum for primary care faculty: results of a dissemination model.

BACKGROUND. This study was designed to test a dissemination model for providing clinical preventive medicine (CPM) training to general internal medicine faculty across the United States. METHODS. The model incorporated direct instruction of a few faculty as seminar facilitators who, in turn, taught a CPM curriculum to their faculty colleagues, who then could teach it to housestaff and students. The CPM curriculum consisted of six seminars that focused primarily on the risk factors for chronic diseases and on behavior change methods for modifying smoking, diet, and exercise. RESULTS. Faculty who participated in the seminars had significant pre- to post-test increase in knowledge and reported self-efficacy to implement CPM strategies with patients, as well as changes in CPM clinical practices. These faculty, in turn, successfully disseminated CPM information to their housestaff, who also had increases in self-efficacy and changed clinical practices regarding CPM topics. CONCLUSIONS. The successful implementation of the dissemination model attests to its viability as a mechanism for disseminating CPM curricula and increasing the emphasis on CMP issues in both clinical teaching and clinical encounters with patients.     

Compartment syndrome--current trends in Scottish practice

The results are reported of a postal survey into current trends in the management of compartment syndrome and the use of compartment pressure monitoring (CPM) within Scottish trauma units. The majority of consultants in the study felt that all patients, especially the obtunded, with suspected compartment syndrome should be diagnosed using a combination of clinical review and CPM. 73% had CPM devices available representing an increase of 27% compared with previously published UK data. 43% improvised a device using a standard CVP/Arterial-line, transducer and monitor. Marked variation in threshold pressure was noted with the majority recommending perfusion pressure (PP) of diastolic blood pressure (DBP)--intracompartmental pressure (ICP) < 30 mmHg for intervention. We have found no published evidence to suggest that CPM in itself is harmful. Although a marked variation in intervention threshold exists in the literature, we would support a perfusion pressure of < 30 mmHg as being a safe, familiar and conservative intervention threshold, particularly when used in conjunction with clinical assessment.