武汉地区健康老年人血气生理正常值的探讨

本文对武汉地区健康老年人(60岁以上)81人和老年前期(45～59岁)75人进行了动脉血气检测,以探讨健康老年人血气及酸碱之正常参考值。其结果:pH 7.44±0.03,PaCO_2 4.77±0.65kPa,PaO_2 10.89±1.03kPa,HCO_3-24.08±3.02mmol/L,BE 0.75±2.77mmol/L,TCO_2 25.25±3.15 mmol/L,SaO_2 0.96±0.01,老年人与老年前期相比较,差别不明显(P>0.05)。     

老年骨髓炎患者的围术期护理

目的探讨老年骨髓炎患者围术期护理的体会及经验。方法对32例老年骨髓炎患者围术期护理经验进行分析和总结。结果全组32例患者通过手术治疗及合理护理措施均得到治愈，无褥疮、肺部及泌尿系感染等并发症发生。结论老年骨髓炎患者体质差，合并症多，护理需认真、细致，并且根据术前、术中、术后按不同病情制订个案护理计划，预防并发症，能有效地提高手术成功率。     

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。     

Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept

Background and Purpose . Patients with multiple sclerosis (MS) tend to have movement difficulties, and the effect of physiotherapy for this group of patients has been subjected to limited systematic research. In the present study physiotherapy based on the Bobath concept, applied to MS patients with balance and gait problems, was evaluated. The ability of different functional tests to demonstrate change was evaluated. Method . A single‐subject experimental study design with ABAA phases was used, and two patients with relapsing–remitting MS in stable phase were treated. Tests were performed 12 times, three at each phase: A (at baseline); B (during treatment); A (immediately after treatment); and A (after two months). The key feature of treatment was facilitation of postural activity and selective control of movement. Several performance and self‐report measures and interviews were used. Results . After intervention, improved balance was shown by the Berg Balance Scale (BBS) in both patients, and improved quality of gait was indicated by the Rivermead Visual Gait Assessment (RVGA). The patients also reported improved balance and gait function in the interviews and scored their condition as ‘much improved’. Gait parameters, recorded by an electronic walkway, changed, but differently in the two patients. Among the physical performance tests the BBS and the RVGA demonstrated the highest change, while no or minimal change was demonstrated by the Rivermead Mobility Index (RMI) and Ratings of Perceived Exertion (RPE). Conclusion . The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept, but this should be further evaluated in larger controlled trials of patients with MS. Copyright © 2006 John Wiley & Sons, Ltd.     

Augmentation technique with semitendinosus and gracilis tendons in chronic partial lesions of the ACL: clinical and arthrometric analysis

Most of the techniques described in the literature for the repair of chronic partial ACL tears, don’t spare the intact portion of the ligament. The aim of this study was to perform a prospective analysis of the results of augmentation surgery using gracilis and semitendinosus tendons to treat partial sub-acute lesions of the ACL. This technique involves an “over the top” femoral passage, which enables salvage and strengthening of the intact portion of the ACL. The study included 47 patients treated consecutively at our institute from 1993 to 1998, with a mean injury-surgery interval of 18 weeks (range 12–36). The patients were followed up by clinical and instrumental assessment criteria at 3 months, 1 and 5 years after surgery. Clinical assessment was performed using the IKDC form. Subjective and functional parameters were assessed by the Tegner activity scale. Instrumental evaluation was done using the KT-2000 instrument: the 30-pound passive test and the manual maximum displacement test were performed. We obtained good or excellent results in 95.7% of cases. No recurrences in ligamentous laxity were observed. We believe that the described technique has the advantage of being compatible with ACL anatomy, and enables very rapid functional recovery.     

采用改良McBride与Greer手术治疗严重(足母)外翻

目的探讨采用改良McBride与Greer手术(第1跖骨截骨术)治疗严重足母外翻的临床效果。方法采用改良McBride与Greer手术治疗严重足母外翻19例(32足)。术后根据足母外翻矫正情况进行评价。结果随访19例,时间为1.5个月~6年,所有患者术后外形明显改善,复发1足。结论采用改良McBride与Greer手术治疗严重足母外翻是一种安全、有效的治疗方法。     

辽宁满族和汉族指纹白线正常值分析

本文报告了辽宁满族和汉族人指纹白线的调查结果。满族和汉族人的指纹白线出现率分别是7.14％和31.73％。满族人的指纹白线出现率低于汉族、维吾尔族、德国人、波兰人和美国白人。作者注意到满族人的指纹白线不存在左右手间和性别间的差异,而汉族人性别间差异显著。十指均有白线频率为1.91％(满族)和10.5％(汉族)。十指均有白线的白线平均数满族为39.3±6.6,汉族为35.5±10.6。五指中指纹白线出现率从高到低的顺序在满族为Ⅰ、Ⅳ、Ⅲ、Ⅱ、Ⅴ,在汉族为Ⅳ、Ⅲ、Ⅱ、Ⅰ、Ⅴ。存在民族间的差异。     

Primary aspergillosis of the sphenoid sinus with pituitary invasion – a rare differential diagnosis of sellar lesions

Summary Aspergillosis belongs to the group of mycotic diseases of paranasal sinuses. The invasive forms, and particularly the fulminant forms, are potentially fatal. Isolated aspergillosis of the sphenoid sinus or the clivus is a difficult diagnosis, since the often misleading clinical manifestations of this rare disease develop late. These patients become apparent by neurological signs such as cavernous sinus syndrome, pseudotumor of the pituitary or the orbit. Diagnosis is often made intra-operatively or on histological examination. We report a case of invasive aspergillosis uniquely involving the sellar area revealed by clinical features suggesting a pseudotumor of the pituitary. Although such lesions are almost always seen in immune suppressed subjects, in our case, the patient was immune competent and had no past history of sinusitis. The question of whether, and when to perform limited or extensive surgery remains an issue for discussion, owing to the rarity of this disease honed by lack of experience. It depends on several factors: the kind of disease, the immunity, the subtype of invasive fungal sinusitis and the degree of tissue invasion.     

积极开展客户管理 努力提高健康体检客户满意度

健康体检有利润高、风险小的特征，具有非常好的市场前景。广州新海医院积极进行市场营销，开展客户管理，正确区分客户类型，建立客户资料数据库，合理确定客户组合，整合医院人力资源、业务流程及专业技术，对不同需求和消费层次的客户，采取不同的服务和管理策略，提供个性化、人性化的优质服务，主动搜集客户意见，认真处理客户投诉，不断改进医院健康体检工作方法，完善客户管理工作机制，使客户满意度不断提高，产生了良好的经营业绩，提高了医院的市场竞争力和品牌形象。