中药内服配合灌肠治疗慢性前列腺炎40例

目的:观察中药内服配合保留灌肠治疗慢性前列腺炎的临床疗效。方法:将80例慢性前列腺炎患者随机分为治疗组和对照组各40例,对照组单纯以西医治疗,治疗组在对照组的基础上加用中药内服配合保留灌肠治疗。结果:对照组有效率为82.5%,治疗组有效率为92.5%,两组有效率比较,差异有显著性(P0.05)。结论:中药内服配合灌肠治疗慢性前列腺炎疗效显著,无不良反应发生。     

椎体间纤维性融合重建兔脊柱稳定性的初步探索

目的:研究椎体间纤维性融合后脊柱节段的稳定性,探讨椎体间纤维性融合在治疗脊柱节段失稳中的可行性。方法:将18只6月龄新西兰白兔随机分为两组,均摘除L4/5椎间盘髓核,A组在椎间植入环状聚乳酸-聚羟基乙酸(poly L-lactic-co-glycolic-acid,PLGA)可吸收支架;B组单纯髓核摘除。于术前、术后4周、12周行X线检查,运用Image J软件测量椎间盘高度指数(DHI)并计算其百分数(%DHI),分别于术后4周、8周、12周处死3只动物,行组织病理及免疫组化观察。结果:1只动物死亡,17只实验动物术后存活至预期时间,未补充实验动物。12周时,侧位X线片示两组椎间高度较术前均有下降,两组椎间高度的差异有统计学意义(P<0.05),A、B两组屈伸活动度与术前相比差异均无统计学意义(P>0.05)。X线片显示A组手术节段椎体无明显移位及反向成角,B组1只兔子出现前屈位腰椎后凸曲度增加,手术节段椎间隙变窄并邻近软骨终板钙化。细胞组织学观察:术后4周时A组见新生血管及纤维组织生成,有少量类软骨细胞出现,未观察到PLGA支架结构;B组见较多纤维细胞生成。术后8周时,A组出现软骨细胞,纤维组织排列不规则,并见少量的胶原纤维及成纤维细胞;B组纤维组织进一步增生,形成瘢痕样组织。术后12周时,A组大量的胶原纤维、软骨组织交互长入,排列杂乱无序,此时的胶原纤维较8周时增多;B组仍为纤维细胞和瘢痕组织,且Ⅰ型胶原表达高于Ⅱ型胶原。结论:椎体间植入PLGA并利用其与椎体骨髓血的诱导成骨作用短期内可以形成椎间纤维融合;短期内观察椎间纤维融合能够维持一定的脊柱节段稳定性并保留部分生理活动功能,但中远期效果有待进一步观察。     

改良胆胰转流术对Goto-Kakizaki大鼠血糖的影响

目的 观察改良胆胰转流术对非肥胖性2型糖尿病模型鼠(GK大鼠)的降糖作用.方法将16只GK大鼠随机分为A、B组,分别对A组行改良胆胰转流术,对B组行假手术.检测术前1周及术后第1、8周两组大鼠体质量、空腹血糖、随机血糖、糖耐量.结果 术后早期A组大鼠体质量由术前的(373.100±9.859)g降至(343.260±12.399)g,与B组比较,差异有统计学意义.术后第8周A组大鼠随机血糖降至( 10.500±1.509) mmol/L,明显低于B组的(19.480±1.281) mmol/L,A组大鼠糖耐量明显优于B组.结论 改良胆胰转流术能改善GK大鼠糖耐量,胆胰液在外科手术治疗2型糖尿病的机制中可能起重要作用.     

Implementation of effective alcohol control strategies is needed at large sports and entertainment events

Objective: To assess the implementation and effectiveness of strategies and actions to eliminate and/or reduce alcohol‐related problems at large sports and entertainment events in New Zealand. Methods: We conducted site visits and monitoring observations at venues before, during and after a variety of large events between March 2009 and November 2010. Thirteen events were attended at nine different venues. Events included rugby, rugby league and cricket matches, motor racing, rowing, horse racing, an outdoor music festival, and food and wine festivals. Results: Most large events appeared to pass with few or no alcohol‐related problems. The exceptions were one of the horse‐race meetings, a rugby league match and one food and wine festival. Common contexts at events where alcohol‐related problems were seen included: inadequate alcohol control and management by security staff; the ability to purchase four alcoholic drinks (rather than two) at a time; inexperienced bar staff untrained in responsible alcohol service; no or little promotion of low and non‐alcoholic drinks; and a lack of monitoring and enforcement of the law on intoxication. Conclusions: An important approach to prevent and reduce alcohol‐related problems at large spots and entertainment events is the use of specific alcohol‐control strategies. The management of alcohol consumption is a major part of event management that must be planned with harm‐minimisation strategies well in advance of the event itself. Implications: If strategies and actions are not properly implemented to manage the sale and supply of alcohol at large events, there is significant risk of alcohol‐related problems and harm resulting from them.     

Korero te kai o te Rangatira: Nutritional wellbeing of Māori at the pinnacle of life

Aim: To provide a succinct overview of the historical food eating patterns of Māori, the indigenous population of New Zealand, by examining the dietary practices of older Māori, and the significance of these practices for their health and wellbeing. Method: A historical review of food sources that provided pre‐colonisation eating patterns of Māori was developed. Full engagement of older Māori was sought in the design and implementation of a longitudinal study of ageing ‘Life and Living to Advanced Age: A Cohort study in New Zealand’, (LILACS NZ) referred to in the present review. A cross‐sectional pilot study, which included older Māori aged 75 to 79 years, provided detail of traditional foods currently utilised in Northland and the Bay of Plenty regions. For the main study, local Māori providers conducted the research processes and the longitudinal cohort study (LILACS NZ) was implemented. Nutritional assessment included nutrition screening at baseline and detailed assessment using the repeated multiple pass, 24‐hour recall method for each participant in a 12‐month follow up. Results: A wide range of foods were utilised prior to European contact. Similar traditional food was used in Northland and Bay of Plenty regions and these traditional foods were found to be valued and frequently used by older Māori. Those able to access important traditional foods on a regular basis had a significantly better nutrition status. Those who had less regard for the importance of traditional foods to practise their culture tended to be at higher nutrition risk. Screening identified over half of older Māori to be at high nutrition risk. Most participants viewed traditional foods to be very important and were able to eat these on a regular basis. Conclusion: Research shows the impact of colonisation resulted in displacement of traditional foods from the diets of older Māori and this has been accompanied by higher nutrition risk. Food is an important cultural activity for Māori and Māori elders need to be supported to increase their consumption of traditional foods. Further investigations will examine the dietary patterns and nutrient intake of older Māori in relation to health and wellbeing.     

浅谈新媒体时代如何正确处理医院危机事件

医院已经成为普通市民和媒体的重点关注对象。与此同时,近些年各种医院危机事件层出不穷。新媒体改变了传统媒体的传播方式,并对事件的发生、发展、结束有着重要的影响。本文重点论述新媒体时代信息传播方式的新变化以及正确处理方法在医院危机事件中的实践与应用,进一步讨论在新媒体时代中如何正确处理医院危机事件。     

广东梅州新农合与医疗机构业务收入的相关研究

目的研究新农合与医疗机构业务收入的相关性并提出建议。方法对梅州市7年来新农合与医疗机构业务收入数据及有关官方网站发布的信息进行统计学分析。结果 2010年新农合参合数为345.78万人,达到农村常住人口全覆盖,占全市常住人口的81.55%,全市农村居民医疗费用占医疗机构业务收入的52.76%;参合人数、筹资总额、人均筹资、补偿总额、受益人次、住院费用、住院人次、门诊人次与医疗机构业务收入高度相关,p<0.01。结论新农合是全民医保的参保主体,是医疗机构业务收入的基础,完善新农合管理和进一步规范医疗机构的医疗行为是全民医保成功与保证医疗机构业务收入良性循环的关键。     

中国医疗改革的问题与对策

今年7月在北京、深圳两地开始实行的药品"零加成"措施引起了人们的广泛关注。这次以"总量控制、结构调整"为目标的医疗改革措施是解决药品、耗材等重要价格问题的有效实践,但距离解决公立医院投入不足、医生培养模式有待改善等国内医疗环境存在的根本性问题还有差距。笔者认为建立政府主导的多元卫生体制、加强药品流通环节的监督工作、重新定位和思考医生的筛选模式,才能从根本上促进医疗改革的进一步发展,为我国人民的生命健康提供有效的保障。