虎栀合剂治疗婴儿肝炎综合征直肠给药效果观察

目的 研究虎栀合剂保留灌肠治疗婴儿肝炎综合征.方法 随机将62例婴肝患儿分成两组,用虎栀合剂保留灌肠并与口服虎栀合剂疗效组对照,观察虎栀合剂对婴肝缩肝、退黄、利疸、降酶的疗效.结果 两组疗效相似,无统计学意义(P>0.05).结论 对婴肝患儿,采用保留灌肠法能确保用药剂量的准确性、药物疗效的可靠性.     

舒适法保留灌肠治疗放射性直肠炎的效果分析

目的分析舒适法保留灌肠治疗放射性直肠炎的临床效果。方法把42例放射性直肠炎病人随机分为实验组与对照组。实验组22例采用舒适法保留灌肠;对照组20例采用传统法灌肠。结果实验组满意度为95.50%,保留时间(5.40±2.31)h,治愈显效率为90.91%;对照组满意度为60.00%,保留时间(3.70±2.14)h,治愈显效率为60.00%。2组比较有统计学意义(P<0.05)。结论舒适法保留灌肠提高了病人的满意度,延长了灌肠液的保留时间,治疗放射性直肠炎疗效肯定。     

活血通下法对子宫肌瘤介入术后疼痛的临床应用

目的：应用活血通下法的中医中药方法处理子宫肌瘤介入术后疼痛的疗效观察。方法：对行子宫肌瘤介入术后下腹疼痛的患者,用中药煎剂保留灌肠,观察疼痛缓解情况。结果：15例患者按VRS分级,Huskisson疼痛缓解的方法进行评定：轻微痛11例,完全缓解11例;中度痛3例,完全缓解2例,中度缓解1例;重度痛1例,完全缓解。结论：临床应用活血通下法的中医中药方法对缓解子宫肌瘤介入术后疼痛有明显效果。     

Optimizing Dual-Time and Serial Positron Emission Tomography and Single Photon Emission Computed Tomography Scans for Diagnoses and Therapy Monitoring

INTRODUCTION: A region's early and late tracer uptake activities, QE and QL, within a dual-time scan (i.e. using two frames) or in serial scans (as for monitoring therapeutic response), are popular quantitative diagnostic aids, especially in oncology. In this paper, maximum performance is sought from their joint use. METHODS: QL/QnE is introduced as a tumor marker with an empirical n. This generalizes traditional data weighting having n=1 for QL/QE, the retention index (RI), with its associated % difference. Using patient data, iterative guessing finds an optimal n that maximizes a measure of diagnostic performance: D=(difference of normal and abnormal marker means)/(their combined SD), which may be computed from values of QL/QnE, as well as of QL, QE, and RI each used alone. For 2-deoxy-2-[F-18]fluoro-D-glucose(FDG)-positron emission tomography (PET) dual-time protocols, another approach to optimization-selection of scan times-is investigated by simulations using the Sokolov model. RESULTS: A meta-analysis of 12 PET and single photon emission computed tomography (SPECT) studies with various tracers, cancers, and scan classes (dual-time or serial) finds ns from 0.5 to 1.1. The optimal D necessarily exceeds the best (or any) computed using QE, QL, or RI: negligibly to by as much as 0.6 (or 1.5). The increases in optimal receiver operating curve area (Az) over the best (or any) traditional marker range from negligible to 0.07 (or 0.4). QE alone usually has the lowest D and Az. Statistically significant performance improvement of QL/QnE over QE and QL is shown for most studies. Contrasting with an optimal n, another value n0 can also be found where D=0. Occasionally, n0 can be close to 1, and RI then will have a small D and poor performance. Simulation with kinetic modeling of FDG dual-time scans for liver and liver metastases demonstrates worst and best scan times. Indicated for these imaging protocols are QE at very early cellular transport associated times and QL rather late when phosphorylation/dephosphorylation dominate. Benefits from choosing optimal times in dual-time protocols, especially in combination with choosing optimal ns, can be significant. CONCLUSION: A protocol-dependent optimizing parameter n in an improved classification marker can easily be identified in a learning set of scans having normals and abnormals. Finding this parameter below 1.0 in most all studies suggests that a popularly used QL/QE may often overweight early activities. Additionally, QL/QE may sometimes be a poor marker choice and underestimate a protocol's diagnostic capability. Subsequent use of the proposed QL/QnE in settings similar to that of the learning set gives improved diagnostic performance over traditional approaches, although by widely varying amounts. Additionally, a method of seeking optimal scan times is demonstrated and suggests significant gains in dual-time protocol performances are possible.     

The association between naltrexone compliance and daily supervision

Most studies investigating the efficacy of naltrexone maintenance as a treatment for illicit heroin use have reported poor patient compliance in taking naltrexone. A number of studies have, however, reported better compliance when patients receive family therapy, or when patients resided in a supportive family environment. These studies suggest that patient outcomes on naltrexone maintenance may be better if there is ongoing family support to continue naltrexone use. The current study investigated 6-month outcome status in 300 illicit heroin users who commenced naltrexone maintenance in a community-based out-patient treatment programme. The study aimed to assess the relationship between vigilance of naltrexone supervision by salient others over the first 6 weeks of treatment and patient status at 6 months. Supervision of naltrexone at week 6 was a predictor of a patient's status at 6 months, with those receiving less supervision of 3-4 days more likely to have returned to heroin use or be assessed as 'heroin use undetermined'. In contrast, patients who still received naltrexone supervision for 6 or 7 days per week at week 6 were more likely to be taking naltrexone or were naltrexone- and heroin-free at 6 months. It is argued that since relapse to heroin use is a common occurrence, vigilant supervision of naltrexone dosing in a supportive environment may improve patient retention and reduce relapse. It is suggested that poor outcomes reported in many previous studies may reflect use of inadequate supportive frameworks that encourage naltrexone compliance.     

快套精密附件活动义齿的临床应用

目的介绍快套精密附件活动义齿的设计原理、制作方法、评价效果。方法对2例肯氏Ⅰ类、6例肯氏Ⅱ类牙列缺损制作10件快套精密附件共8付义齿，随访0．5—2．0年。结果8例使用快套精密附件活动义齿病例，戴入就位快速，固位良好，咀嚼功能好，美观舒适。结论快套精密附件活动义齿取戴方便，固位好，咀嚼功能好，快套精密附件内部的弹性钮扣能产生一定的缓冲作用，减少垂直向和侧向力对基牙的损伤。     

PKVP中保留膀胱颈完整性对中年前列腺增生患者的治疗效果及术后性功能的影响分析

目的:探讨中年前列腺增生患者经尿道前列腺等离子电切术(PKVP)中保留膀胱颈对手术效果及性功能的影响。方法:选取本院泌尿外科2012年4月至2014年3月行PKVP手术的107例良性前列腺增生患者进行回顾性分析,根据术中是否保留患者的膀胱颈分为保留组68例、非保留组49例,对比两组患者的围手术期指标、手术效果及术后性功能差异。结果:保留组患者的手术时间(59.9±8.2)min显著的长于非保留组的(56.8±8.7)min(P0.05);两组患者的手术出血量、膀胱冲洗时间、尿管留置时间、术后住院时间比较差异均无统计学意义(P0.05);术后复查,保留组患者的IPSS评分、QOL评分、膀胱顺应性、最大逼尿肌压力、Qmax、RUV均显著的优于非保留组,差异具有统计学意义(P0.05)。术后复查,保留组患者的勃起满意度、自慰或性交后患者达到高潮的满意度、射精满意度评分均显著的高于非保留组,差异具有统计学意义(P0.05)。结论:PKVP术中保留膀胱颈有利于患者术后排尿功能、性功能的恢复,手术效果及术后性功能效果优于手术中不保留膀胱颈。     

An exploratory, comparative study investigating attrition and retention of student midwives

Objective

to explore the retention and attrition of pre-registration midwifery students.

Design

an exploratory, comparative design that enabled the comparison of a 3-year and a 78-week midwifery programme. The methodology was designed into two main phases using both quantitative and qualitative methodology.

Setting

a university in the South West of England.

Participants

36 questionnaires were sent to students who had left the programmes during 2001–2003. A purposive sample of 16 student midwives formed two separate focus groups. The participants were selected from current 3-year and 78-week midwifery programmes.

Findings

midwifery attracts highly motivated students. In order for this motivation to continue through an emotional and demanding programme of study, their motivation needs to be nurtured and retained. The findings of this study clearly illustrate that in only a few cases can one over-riding reason be given for students withdrawing from midwifery programmes.

Implications for practice

there is often a complexity of ‘personal reasons’ and an accumulation of clinical and theoretical demands as to why students leave. Although there were realistic expectations of the programmes, the lived experiences of these expectations created anxiety and tension. It is therefore imperative that clinicians and academics work in harmony to plan and offer a programme of adequate mentorship and support for student midwives. This should also acknowledge the uniqueness of the different programmes that lead to qualification as a midwife.