弹性绷带在乳腺癌术后应用的效果观察

目的　观察弹性绷带在乳腺癌术后应用效果。方法　 4 8例乳腺癌根治术后应用弹性绷带包扎为实验组 ,4 5例用普通宽绷带包扎为对照组。然后 ,对两组患者术后并发症进行观察。结果　实验组患者的并发症明显低于对照组 ,两组比较有显著性差异 ,P <0 .0 5。结论　应用弹性绷带包扎 ,能明显减少并发症的发生 ,促进切口愈合 ,使患者术后术侧上肢功能锻炼可以提早进行。     

早期干预对高危儿在婴儿早期发育的影响

目的：探讨早期干预对高危儿在婴儿早期发育的影响。方法：采用自行设计的一套早期干预方法通过指导家长对实验组实施，分别在3个月、6个月时进行格体生长和行为发育的评估，另设对照组进行比较。结果：实验组和对照组在体重、身长、头围方面均无统计学差异，但实验组的5个能区行为发育商均值都高于对照组，除3个月的语言能区外，其余均有统计学差异。结论：早期干预在婴儿早期就能促进高危儿的行为发育，但对促进高危儿的体格生长无明显效果。     

儿童原发性腹膜后恶性肿瘤的诊断与治疗

分析原发性腹膜后恶性肿瘤１２例。８３％以腹块和腹痛为主要症状，体征中腹块占９１．５％，以恶性淋巴瘤居首位占６１％。全组完全切除率为５８％，行脏器联合切除占２５％。完全切除加放疗、化疗３年存活率为２８．５％，部分切除及活检未给其它治疗者５例预后差，均１年内死亡，差别显著。     

性服务工作者性病和艾滋病的干预研究

目的 了解性工作者的性病/艾滋病知识、态度、信念、行为等现状,积极探索对该人群进行预防性病、艾滋病及行为干预的有效办法,为今后在更大范围的高危人群中进行干预提供科学依据.方法 成立专职高危干预队伍,设计借鉴其他地区经验,深入目标人群进行系列外展服务,利用干预前后封闭式调查问卷评价干预效果.结果 发放干预前后问卷各522份,收回前后有效问卷387份.通过外展服务,娱乐场所从业人员对性病史滋病预防知识知晓率明显提高,对安全套及安全性行为预防性病艾滋病的传播的信念和态度有明显转变.结论 对娱乐场所从业人群开展系列专业外展服务可以提高该人群的防病意识,提升对性病史滋痛的知晓率,是高危人群干预的有效方法.     

先天性胆总管囊肿23例的术式及疗效分析

目的：探讨先天性胆总管囊肿的术式及疗效。方法：回顾分析手术治疗先天性胆总管囊肿23例，其中Roux-Y囊肿-空肠吻合8例；囊肿切除，Roux-Y肝总管-空肠吻合15例。结果：20例获得随访，Roux-Y囊肿-空肠吻合随访6例，仅2例无症状，另4例反复发作腹痛，发热或黄疸，其中1例再手术，囊肿切除，Roux-Y肝总管-空肠吻合随访14例。仅1例有腹痛，余13例无症状，结论：Roux-Y肝总管-空肠吻合是治疗先天性胆总管囊肿的首选术式。     

彩超对肾移植术后并发肝脏恶性肿瘤的监测

目的　探讨彩超在肾移植术后并发肝脏恶性肿瘤监测中的应用价值。　方法　应用 Acuson12 8XP彩色多普勒超声诊断仪 ,对在我院行异体肾移植手术的终末期尿毒症患者 12 0 0例进行规律随访。　结果　发现 17例恶性肿瘤 ,其中肝癌 7例 ,占 4 1.17%。 5例肿块单发 ,2例多发 ;肿块最大 10 cm× 10 cm,最小 2 .3cm× 2 .1cm。其中 6例手术病理证实 ,1例肝活检证实。　结论　对移植肾术后患者 ,首选彩超随访肝脏变化 ,能早期发现肿瘤 ,为临床选择治疗方案提供时机 ,并提高换肾后发生恶性肿瘤患者的存活率     

Postoperative convalescence after inguinal hernia surgery: Prospective randomized multicenter study of laparoscopic versus Shouldice inguinal hernia repair in 1042 patients

Interest in inguinal hernia surgery has increased significantly with the introduction of new operating techniques during the past decade. This multicenter study compared short-term results in patients treated by the laparoscopic transabdominal preperitoneal patch technique (TAPP; n=518) and the Shouldice technique (n=524). We evaluated demographics, operative data, complications, hospital stay, postoperative pain, use of analgesics, functional status, sick leave, and complaints up to 3 months postoperatively. The median operating time was shorter in the Shouldice group (55 vs. 65 min), but there were no significant differences in complication rates, and major complications were rare. The hospital stay was 1 day or less in over 98% of cases in both groups, but more operations were performed on outpatient basis in the Shouldice group. In the TAPP group postoperative pain and analgesic consumption were less, postoperative functional status was better, and sick leave was shorter (10 vs. 14 days). These results show that the two methods are equally safe and have few major complications. The TAPP operation is associated with less postoperative pain, better postoperative functional status, and shorter sick leave, but at the price of a longer operating time. Electronic Publication     

胆道镜应用对肝胆胰术式选择的影响

目的 探讨分析胆道镜检查在肝胆胰疾患术式选择中的价值。方法 回顾分析1994～2004年收集术中或联合术后应用胆道镜治疗肝胆胰疾患2276例临床资料，进行分析及总结。结果 1966例肝胆管胆石患者胆道残留结石率从34．5％降至9．6％；82例术中胆道镜发现合并胆管狭窄，其中45例肝胆管膜状狭窄者在胆道镜指导下实施了有效扩张治疗；胆总管下段梗阻患者中224例肿瘤依据形态学检查，结合术中扪诊及活检组织学检查得到确诊，并采取了相应的手术方式。结论 胆道镜的应用有利于肝胆胰疾患术式的选择，可使一些较为复杂的胆道手术变得简单易行；对术前未能确诊的病变可以达到明确诊断并指导选择合理的术式。     

The 5-Step family intervention in primary care: II. The views of primary healthcare professionals

Background: This is the second of two papers using qualitative methods from a study of an intervention for family members affected by close relatives' substance misuse problems.

Participants: 168 primary healthcare professionals (PHCPs: GPs, practice nurses and health visitors) working in general practices in two areas of England, and who took part in the study.

Data sources: Recruitment and post-session forms completed by PHCPs; telephone interviews with each PHCP 12 weeks after recruitment of a family member; interviews with PHCPs at the end of the study.

Results: At the end of the project PHCPs were overwhelmingly positive about the family member intervention and about primary care as the appropriate site. Difficulties were encountered, however, in identifying and engaging affected family members, who were often excluded on grounds of the complexity of their problems or the level of their distress. Shortage of PHCP time and other practice-related factors added to the difficulty. Active work by a PHCP was often necessary in order to make the link between presenting symptoms of physical or mental ill-health and the existence of a family substance misuse problem. When family members were identified and recruited, PHCPs were usually positive about what was achieved. Nearly all were in favour of an approach that combined giving a self-help manual with some follow-up contact with a family member as needed.

Conclusions: Taken in conjunction with statistical outcome findings of significant reductions in symptoms and changes in ways of coping, plus qualitative analysis of the views of family members, the present results encourage the view that a flexible form of this intervention should be developed for use in primary healthcare, and that further work should build on existing strengths and attempt to overcome weaknesses identified.