外伤性延迟性脾破裂的诊断和治疗（附21例报告）

目的探讨外伤性延迟性脾破裂的发病规律、临床特点、诊断和治疗方法。方法结合国内外资料及本组病例进行回顾性分析。结果明确诊断16例，误诊为肝破裂2例，宫外孕破裂2例，脾肿瘤1例。21例均手术治疗，行脾切除14例，其中保留副脾2例；脾切除加自体脾组织网膜内移植术3例；脾缝合修补术3例；脾部分切除术1例。死亡1例，原因有就诊晚、失血性休克。结论本病由于腹腔内出血与受伤时间间隔长，容易误诊。诊断除依靠病史、临床表现外，应及时进行腹腔穿刺、B超及CT检查。治疗以脾切除为主，可根据病情、脾破裂的程度以及是否有合并伤等情况采取保脾手术。     

SNAP-II predicts mortality among infants with congenital diaphragmatic hernia.

OBJECTIVE: Outcomes analysis in congenital diaphragmatic hernia (CDH) requires a validated risk-adjustment tool. The purpose of this study was to use the Canadian Neonatal Network (CNN) database to validate the Score for Neonatal Acute Physiology, Version II (SNAP-II) for prediction of mortality among CDH infants admitted to a neonatal intensive care unit (NICU), and to compare this to the predictive equation recently developed by the Congenital Diaphragmatic Hernia Study Group (CDHSG). STUDY DESIGN: Infants with CDH in the CNN database were identified. Bivariate and multivariable logistic regression models were used to identify risk factors predictive of mortality. Model predictive performance and calibration were assessed using the area under the receiver operator characteristic curve and the technique of Hosmer-Lemeshow, respectively, and compared with the CDHSG predictive equation. RESULTS: There were 88 patients with CDH among 19,507 admissions to CNN hospitals. The mortality rate among CDH patients surviving to NICU admission was 17%, and 12.5% received extracorporeal membrane oxygenation therapy. Gestational age and admission SNAP-II score predicted mortality. Model predictive performance and calibration were optimized with these variables combined. The CDHSG equation was equally predictive of mortality, but was only marginally calibrated. CONCLUSIONS: SNAP-II is highly predictive of mortality among patients with CDH, and can be used to risk-adjust these patients.     

固定剂量复合剂在省结核病防治规划中应用的研究

目的 研究固定剂量复合剂在省结核病防治规划中应用的可行性.方法 将初治涂阳肺结核病人按登记序号单双分入研究组和对照组.用对照研究方法对两组的完成治疗率、治疗效果、治疗依从性和不良反应等情况进行分析.结果 研究组和对照组在性别、年龄、体重、完成治疗率、督导管理方式和治疗依从性等方面差异无显著性（P值均＞0.05）.研究组的2、3个月未痰菌阴转率和治愈率分别为87.0%、93.5%和93.5%,对照组的2、3个月未痰菌阴转率和治愈率分别为89.4%、93.5%和87.0%,两组间的疗效差异无显著性（P值均＞0.05）.除因链霉素引起的耳鸣（精确概率法P=0.024）外,两组其他不良反应症状出现的比例都无显著性差异（P值均＞0.05）.结论 在结核病防治规划中推广应用固定剂量复合剂是可行的.     

自增强可吸收内固定治疗儿童肘部骨折

目的评价自增强可吸收内固定治疗儿童肘部骨折的可行性和有效性。方法2002年7月-2003年12月，25例儿童肘部骨折应用自增强可吸收内固定螺钉或棒固定，对其手术方法、骨折愈合、功能恢复进行回顾性分析总结。结果平均随访时间18个月（10-24个月）。所有骨折均于4周内达到临床愈合。1例肱骨髁上骨折因可吸收棒穿于皮下引起疼痛，妨碍关节活动，于术后6周拔除，恢复良好。1例肱骨内上髁骨折予可吸收螺钉固定，为保持骨折复位稳定，术后伸肘位石膏固定3周致关节僵硬，经CPM被动活动锻炼后肘关节活动基本恢复正常。其余病例在最后一次随访时，均关节活动良好，无畸形发生，也未见局部无菌性反应。结论自增强可吸收内固定治疗儿童肘部骨折可靠有效，近期随访效果满意，术后可早期进行功能锻炼。     

补肾益气逐浊法治疗ABO溶血致习惯性流产的临床研究

目的观察补肾益气逐浊法治疗ABO溶血所致习惯性流产的临床疗效。方法将152例患者随机分为两组，治疗组98例，用补肾益气逐浊法，选用黄芪、菟丝子及蚕砂颗粒剂口服；对照组54例，口服胸腺肽肠溶胶囊等。结果在降低血清抗体效价方面，治疗组总有效率为95．9％，对照组为51．9％；在妊娠疗效方面，治疗组总有效率为95．9％，对照组为42．1％。治疗组疗效明显优于对照组（P〈0．01）。结论补肾益气浊法治疗ABO溶血所致的习惯性流产疗效显著。     

The Application of Topical Anesthesia Combined with Subconjunctival Anesthesia for Glaucoma Surgery

Purpose: To evaluate the feasibility, reliability and analgesia effect of topical anesthesia combined with subconjunctival anesthesia in anti-glaucomatous surgery.Methods: Two hundred and four cases (357 eyes) underwent anti-glaucomatous surgeries under topical anesthesia with 0.5％ Alcaine eye drops combined with subconjunctival anesthesia with 2％ Lidocaine. The analgesic effect was analysed with visual analogue pain scale.Results: Among all of 357 eyes, 62 eyes underwent peripheral iridectomy, 67 eyes underwent simple trabeculectomy, 167 eyes underwent compound brabeculectomy and 12 eyes nonpenetrating trabecular surgery. The effects of anesthesia were as follows: 304 eyes (85.2％) were painless (Grade Ⅰ), 50 eyes (14.0％) were slight painful (Grade Ⅱ), and 3 eyes (0.8％) were more painful (Grade Ⅲ) during surgery. And no severe complications were observed in all the cases during surgery and postoperatively. Amaurosis fugax was not observed in the glaucoma patients at the late stage with narrow vi     

温针灸结合手法治疗椎动脉型颈椎病32例观察

目的：观察大椎穴温针灸结合手法治疗椎动脉型颈椎病的疗效。方法：治疗组32例采用大椎穴温针灸结合手法治疗，对照组30例用电针夹脊穴治疗。每周治疗6次，12天为一疗程。治疗2个疗程后观察疗效。结果：治疗组总有效率93．75％，对照组80．00％，两组比较有显著性差异（P〈0．05）。结论：大椎穴温针灸结合手法治疗椎动脉型颈椎病疗效明显。