无张力疝修补术在基层医院腹外疝的应用——附102例体会

目的总结在基层医院无张力疝修补术治疗腹外疝的经验。方法采用意大利Herniamesh公司的单纤聚丙烯丝网片(疝补片)87例及美国Bard公司的锥型疝环充填物和补片治疗15例腹外疝的手术方法、时间、术后患者疼痛、住院时间、复发率进行回顾性分析。结果 102例手术过程顺利,手术时间30～90min,术后皮下轻度积液1例,阴囊血肿积液2例,腹股沟区轻微疼痛及腹股沟区不适感14例,在住院期间或出院后经相应的处理3～34d均治愈,无尿潴留,住院时间7～9d。随访3个月～1年无复发,无感染,无疼痛等情况。结论无张力疝修补方式更加符合人体解剖结构,操作简单、效果好、恢复快、安全可靠,无复发是腹外疝的最理想疝修补术。     

无张力疝修补术在基层医院腹外疝的应用——附102例体会

目的总结在基层医院无张力疝修补术治疗腹外疝的经验。方法采用意大利Hemiamesh公司的单纤聚丙烯丝网片（疝补片）87例及美国Bard公司的锥型疝环充填物和补片治疗15倒腹外疝的手术方法．时间，术后患者疼痛、住院时间．复发率进行回顾性分析。结果102例手术过程顺利，手术时间30-90min，术后皮下轻度积液1倒，阴囊血肿积液2例，腹股沟区轻微疼痛及腹股沟区不适感14例，在住院期间或出院后经相应的处理3-34d均治愈，无尿潴留，住院时间7-9d。随访3个月～1年无复发，无感染，无疼痛等情况。结论无张力疝修补方式更加符合人体解剖结构，操作简单，效果好，恢复快、安全可靠，无复发是腹外疝的最理想疝修补术。     

120例腹外疝老年患者无张力修补术的疗效分析

目的探讨无张力疝修补治疗老年腹外疝的疗效。方法回顾性分析2004年1月~2008年12月我院收治的120例腹外疝老年患者的临床特点和无张力平片修补术的治疗效果。结果所有患者均治愈出院。术后并发尿潴留5例,伤口红肿9例。随访1~5年无复发病例。结论老年腹外疝患者行无张力疝修补可以获得良好的治疗效果。     

临床观察治疗腹外疝的临床方法及效果

目的研究治疗腹外疝的方法及临床效果。方法将我院2007年6月至2010年1月收治的患者选择84例腹外疝患者作为试验组,另选一般资料无显著性差异的84例患者作为对照组,对照组应用传统修补手术,试验组应用疝环充填式无张力疝修补术。结果 2组患者均顺利完成手术,和对照组相比,试验组在术后并发症、手术时间、半年复发率等指标方面均显著优于对照组(P<0.05)。结论对腹外疝采用环充填式无张力疝修补术,能显著减少患者手术痛苦,促进患者更快的恢复,是值得临床考虑的手术治疗方案。     

无张力疝修补术治疗腹股沟疝116例的报告

目的：总结无张力疝修补术治疗腹殷沟疝的临床经验。方法：对116例腹肢沟疝行无张力疝修补术治疗情况进行回顾性分析。结果：与传统疝修补手术相比,具有方法简便、手术指征广、术后疼痛轻、恢复快、并发症少和复发率低的优点。结论：这是一项更符合人体解剖结构和疝的病理生理的手术方法,具有传统方法无法比拟的优势。尤其适于在基层医院推广。     

无张力疝修补术治疗老年腹外疝60例

目的探讨无张力疝修补术治疗老年腹外疝的疗效。方法对60例老年腹外疝患者采用无张力疝修补术治疗。结果手术时间45~70 min,术后7 h下床,切口疼痛时间平均28 h。阴囊上方积液1例,疝复发1例。结论无张力疝修补术并发症少、复发率低,术后患者无明显不适,可作为老年人疝修补术的首选术式。     

老年腹外疝修补术病人的护理要点分析

目的:分析老年腹外疝修补术病人的护理要点.方法:本次研究选取的研究对象为2014年3月~2015年4月期间在我院进行治疗的老年腹外疝患者,将70例患者简单随机分为2组,35例老年腹外疝患者为一组.其中,一组患者实施常规护理(对照组),另一组采用围手术期护理(观察组).对比两组老年腹外疝患者的术后离床活动情况.结果:观察组老年腹外疝患者的术后离床活动情况优于对照组(P<0.05).结论:对进行修补术的老年腹外疝患者使用围手术期护理,可有效的缩短了患者离床活动时间,有利于减少并发症的发生,预后效果好.     

应用补片修补腹壁巨大切口疝35例临床分析

目的 总结补片修补腹壁巨大切口疝治疗的临床经验.方法 回顾性分析35例腹壁巨大切口疝患者的临床资料,其中23例采取腹膜前腹直肌后鞘下置入术,3例采取腹直肌前鞘上补片置入术,9例置于腹膜下补片置入术,随访1～36个月.结果 患者均痊愈出院,无严重并发症,4例复发,经再次修补后治愈.结论 应用补片修补腹壁巨大切口疝效果良好,选择合理的手术方式及围手术期处理方案可减少术后并发症的发生.     

改进无张力疝修补手术治疗腹外疝的临床观察

目的：探讨改进无张力疝修补手术治疗腹外疝的临床疗效。方法：选择我院收治的48例腹外疝患者,将其平均分为观察组和对照组,两组患者各24例。观察组予以改进无张力疝修补手术治疗,对照组予以常规修补术治疗。观察和统计两组患者的围手术期观察指标及术后并发症发生情况。结果：观察组患者的围手术期观察指标明显优于对照组患者（P〈0.05）;观察组患者术后并发症发生率明显低于对照组患者（P〈0.05）。结论：改进无张力疝修补手术应用于腹外疝临床治疗中的效果显著,有效预防和降低了并发症的发生,值得推广。     

102例中老年腹股沟疝手术方式治疗效果评价

目的:比较中老年腹股沟疝不同手术方式疗效,探讨基层医院适宜手术方法。方法:随机选取2008年1月至2013年12月我院住院手术治疗腹股沟疝病例。年龄35岁至73岁,平均53.6±8.9岁。男性85例,女性17例。腹股沟斜疝81例,腹股沟直疝21例,单侧93例,双侧9例,滑疝3例,传统术式组51例,无张力术式组51例。通过两组术式统计学分析,无张力修补组在住院时间、麻醉时间、手术时间、术后恢复、疝复发优于传统术式组(P0.05),医用费用高于传统手术组。结果:无张力修补术优于传统手术修补术式,适用于基层医院开展。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.