沈阳市961名老年干部牙健康状况调查

目的了解并分析沈阳市老年干部牙健康状况。方法按第二次全国口腔健康流行病学抽样调查标准,对沈阳市961名60岁以上的老年干部进行口腔健康调查,结果用SPSS软件处理。结果患龋率为67.12%,患龋者的龋均随着年龄的增长而逐渐增高(P<0.05),龋齿全部充填率为33.18%。缺牙率为80.65%,人均失牙7.38颗,人均保留牙的数目与年龄呈负相关(P<0.01)。无牙牙合率为10.20%,无牙牙合与牙列缺损的修复率分别为98.98%和36.04%。牙周健康状况与年龄呈负相关(P<0.01)。结论牙列缺失及缺损是老年人常见的口腔疾患,龋病和牙周病是其主要原因。加强老年人的口腔保健意识,是提高口腔疾病治疗成功率的重要环节,进而增进老年人的全身健康。     

手法整复塑形夹板固定配合跟骨牵引治疗胫骨平台骨折

胫骨平台骨折为临床常见的关节内骨折，多见于高能量创伤，治疗较棘手，并发症多。从1995-2002年，我们采用手法整复超膝关节塑形夹板固定配合跟骨牵引治疗胫骨平台骨折69例，术后辅以积极的功能锻炼，获得较满意的疗效，现总结如下。     

Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan.

This article presents the revision process, major innovations, and clinimetric testing program for the Movement Disorder Society (MDS)-sponsored revision of the Unified Parkinson's Disease Rating Scale (UPDRS), known as the MDS-UPDRS. The UPDRS is the most widely used scale for the clinical study of Parkinson's disease (PD). The MDS previously organized a critique of the UPDRS, which cited many strengths, but recommended revision of the scale to accommodate new advances and to resolve problematic areas. An MDS-UPDRS committee prepared the revision using the recommendations of the published critique of the scale. Subcommittees developed new material that was reviewed by the entire committee. A 1-day face-to-face committee meeting was organized to resolve areas of debate and to arrive at a working draft ready for clinimetric testing. The MDS-UPDRS retains the UPDRS structure of four parts with a total summed score, but the parts have been modified to provide a section that integrates nonmotor elements of PD: I, Nonmotor Experiences of Daily Living; II, Motor Experiences of Daily Living; III, Motor Examination; and IV, Motor Complications. All items have five response options with uniform anchors of 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe. Several questions in Part I and all of Part II are written as a patient/caregiver questionnaire, so that the total rater time should remain approximately 30 minutes. Detailed instructions for testing and data acquisition accompany the MDS-UPDRS in order to increase uniform usage. Multiple language editions are planned. A three-part clinimetric program will provide testing of reliability, validity, and responsiveness to interventions. Although the MDS-UPDRS will not be published until it has successfully passed clinimetric testing, explanation of the process, key changes, and clinimetric programs allow clinicians and researchers to understand and participate in the revision process.     

手法治疗非牵拉力致桡骨小头半脱位22例

自2005年6月-2006年3月,急诊收治小儿桡骨小头半脱位126例,其中22例为非牵拉力致桡骨小头半脱位,采用手法治疗疗效满意,现报告如下。1临床资料本组22例,男14例,女8例;年龄6个月～8岁,其中1～4岁17例;左侧12例,右侧10例。受伤原因:跌伤15例,压伤5例,甩手伤1例,其他1例。伤后至治     

Integrated home monitoring predicts lead failure in a pacemaker dependent 4-year-old girl.

A 4-year-old girl with post-surgical complete atrioventricular block received an epicardial dual chamber pacemaker system. During further growth intermittent exit block occurred, first misinterpreted as neurological seizures. The epicardial lead was replaced using a transvenous approach, and a pacemaker with an integrated home monitoring facility was implanted. After her discharge, a rise in the pacing threshold automatically initiated an event message. On the basis of this information, the patient was called in and imminent dislodgement of the ventricular lead was diagnosed by x-ray. The lead was repositioned and was found stable over 1-year follow-up.     

Late Reconstruction of a Traumatic Trapeziometacarpal Dislocation with a Semi-constrained Prosthesis: A Case Report

Abstract Traumatic dislocation of the trapeziometacarpal joint is rare. A stable reduction should be accomplished as soon as possible, usually with K-wiring. In this case of persistent instability a semi-constrained prosthesis was applied successfully.     

Case report: Concordant traumatic brainstem contusion delayed diagnosis in a young man with Wilson's disease

Wilson's disease is a hereditary autosomal recessive disorder of copper metabolism. The corresponding gene locus has been localized on the long arm of chromosome 13. Three different clinical variants of the disease can be distinguished: hepato-cerebral, abdominal/hepatic, and central nervous type. The heterogeneity of symptoms can cause problems in differential diagnosis, especially when another concordant disorder can also explain the pathogenesis of symptoms. The case report of a young man who suffered from brainstem contusion demonstrates the possibilities of misinterpretation because presenting symptoms could be attributed either to traumatic brain injury followed by adjustment disorder or Wilson's disease. Clinical signs included leftsided hemiparesis, bilateral gaze direction nystagmus, marked dysarthria with consecutive pervasive mutism, choreo-athetoid movements, spasmodic torticollis and diplopia dependent on gaze direction. Slit lamp examination showed Kayser-Fleischer's corneal ring. EEG- and computer assisted tomography investigations revealed non-specific findings. The patient was treated with D-Penicillamine. Alternative treatment with oral zinc preparations is discussed.

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Zusammenfassung Beim Morbus Wilson handelt es sich um eine autosomal rezessiv vererbte Störung des Kupferstoffwechsels. Der Genort konnte auf dem langen Arm des Chromosoms 13 lokalisiert werden. Klinisch können aufgrund ihrer Symptomatik drei Verlaufsformen (hepato-zerebraler, abdominalhepatischer und zerebraler Typ) unterschieden werden. Die Vielfalt der Symptome kann differentialdiagnostische Schwierigkeiten bereiten. Das Beispiel eines jungen Mannes mit einer traumatischen Hirnstammkontusion zeigt, wie die Diagnose der hepato-lentikulären Erkrankung dadurch erschwert wurde, daß die Pathogenese der Symptome durch die Hirnstammkontusion und darauf folgende Anpassungsstörungen erklärt worden war. Die Symptomatik bestand aus linksseitiger Hemiparese, lateralem Blickrichtungsnystagmus, Dysarthrie mit nachfolgendem universalem Mutismus, choreo-athetodischen Bewegungsstörungen, Torticollis spasmoidicus und blickrichtungsabhängigem Auftreten von Doppelbildern. Bei der Spaltlampenuntersuchung stellte sich der Kayser-Fleischer Ring dar. EEG- und computertomographische Untersuchungen erbrachten nur unspezifische Befunde. Die Behandlung erfolgte mit D-Penicillamin. Die alternative Behandlung mit oraler Gabe von Zinksalzen wird diskutiert.

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Résumé La maladie de Wilson est une affection héréditaire autosomale recessive concernant le métabolisme cuivré. Le locus du gène a été situé sur le bras long du chromosome 13. Du point de vue clinique on distingue trois formes symptomatologiques: le type hepato-cérébral, hepato-abdominal et cérébral. La diversité des signes cliniques peut poser des problèmes de diagnostic différentiel, car d'autres affections peuvent se présenter avec cette même Symptomatologie. Nous rapportons ici l'exemple d'un homme jeune, porteur d'une maladie de Wilson et victime d'une contusion traumatique du tronc cérébral, dont les signes cliniques ainsi que les troubles du comportement pouvaient été autant rapportés à la contusion du tronc cérébral qu'à l'affection métabolique.La Symptomatologie comprenait une hemiparesie gauche, un nystagmus lateralisé, une dysarthrie avec mutisme secondaire universel, des mouvements choréo-athétosiques, un torticolis spasmodique et une diplopie dépendante de la direction du regard. L'examen à la lampe à fente permettait à mettre en evidence un anneau de Kayser Fleischer. L'EEG et le scanner cérébral ne montraient pas d'anomalies specifique.Le traitement a consisté en l'administration de D-Penicillamine. Traitment alternative avec les sels de zinc est discuté.

     

某部队急性腹泻病监测报告 Ⅰ.流行病学部分

１９９１年６月～１９９２年５月在驻粤某部队进行了急性腹泻病的主动监测。年发病率为０．６４～１．０次／人／年。发病率与相对湿度（Ｘ２）、气温（Ｘ３），特别是雨量（Ｘ１）的关系经多元回归分析表明呈正相关。ｙ＝１．９８＋０．０２ｘ１＋０．０２ｘ２＋０．０７ｘ３，ｒ＝０．８７２７，Ｐ＜０．０１。病例－对照研究结果提示，饭前、便后不洗手等生活习惯用腹泻发病有密切关系。２６．３％的患者有淋雨、腹部受凉或感冒等     

某幼儿园1991～2005年儿童传染病发病趋势分析

[目的]了解幼儿园儿童传染病发病情况和流行趋势,为制定传染病防治策略提供依据.[方法]统计幼儿园内每年发病儿童人数与当年9月份在园儿童人数相比得出当年各种传染病发病率,对传染病进行特征性分析,用统计软件SPSS11.0作u检验.[结果]幼儿园是儿童传染病易感者集中的场所,1年12个月均有传染病发生.9种常见传染病中,腮腺炎、水痘、手足口病的发病率居顺构前3位.与计划免疫相关的“病”未见发病.乙肝自1994年以来未有检出.手足口病自2000年首次发病,发病率居近4年来各种传染病发病率之首.[结论]有必要将流腮疫苗和水痘疫苗纳入计划管理.重视对手足口病的监测,将手足口病纳入幼儿园常见传染病的管理之中.