56例重症药疹临床回顾性研究

目的探讨重症药疹的致病药物,临床特征及疗效相关因素.方法回顾性研究56例重症药疹患者临床资料,并与同期住院148例非重症药疹患者进行比较.结果56例重症药疹患者糖皮质激素治疗剂量相当于强的松量(1.81±0.98)mg/(kg@d),治愈率为82.7%.致敏药物,黏膜损害、并发症发生率,糖皮质激素治疗剂量及治愈率与非重症药疹患者相比有明显差异(P＜0.01).结论重症药疹致病药物最常见的是解热镇痛药,其黏膜损害、并发症发生率高,早期足量使用糖皮质激素治疗可以取得较好疗效.     

Health and social service use among old people in the last 2 years of life

This study focuses on differences in health and social service use in the last 2 years of life among Finnish people aged 70–79, 80–89, and 90 or older and on the variation in service use in the various municipalities. The data set, derived from multiple national registers, consists of 75,578 people who died in 1998–2001. The services included hospitals and long-term-care facilities, use of regular home care, and prescribed medicines. General hospital and public long-term care were the services most commonly used: general hospitals for younger age groups and public long-term care for older groups. The number of inpatient days in hospital was lower with increasing age, but older age groups used long-term care more frequently. Men had more hospital inpatient days than women, but women used more long-term care. The number of hospital inpatient days increased rapidly in the last months of life, almost doubling in the final month. Days in public long-term care increased regularly in the last 2 years of life. Variation in both hospital and long-term care by municipality was remarkable. The results indicate that, among people aged 70 years and older, age is a major determinant of care in the last 2 years of life. The variation in the use of care by municipality and the differences between men and women deserve more detailed analysis in future.     

对广东患者抑郁体验的定性研究——医学人类学对精神病学视角的丰富

目的目前,对中国人抑郁体验的现象学理解很大程度上依赖于西方教科书和国际诊断系统中的描述。而临床经验告诉我们,不同地区、不同文化对情绪痛苦的表达有着各自的特点;但中国在这方面还缺乏研究。为此,我们采用民俗学方法对广州地区就诊人群的抑郁体验进行了研究。方法在广州市精神卫生中心门诊,采用定额取样招募40例有抑郁情绪的患者;问及的合适的病人共43人,只有3人不同意参加。采用开放式深入民俗学访谈了解患者的抑郁体验,即让患者用他们自己的话来讲述患病经历。对访谈进行录音,转录为文字并译成英文。对中英文记录分别进行了内容分析。结果除了西方教科书和诊断系统中描述的抑郁症状外,还发现了六个情感体验的类别:本地情感语汇、具身的情绪体验、隐含的忧伤、难以言状的痛苦、情绪不良造成的人际不和谐,以及专注于失眠。结论精神病学教科书和诊断系统中的描述未能涵盖中国抑郁患者对抑郁症状的全部体验。需要进一步研究抑郁体验与生活事件的关联及其在不同文化下的表现方式,这样才能作出与文化相适应的有效诊断。     

Association between age and clinical characteristics of renal cell carcinoma in adult patients

AIM: To study the association between age and clinical characteristics of renal cell carcinoma in adult patients. METHODS: Three hundred and ten patients with renal cell carcinoma were classified into three groups: or=60 years group. The clinical characteristics of the three groups were compared to define the association. RESULTS: The male/female ratio was 1.3/1, 2.0/1, 3.3/1 in the three groups, respectively, and a significant difference appeared when comparing the or=60 years group (P=0.010). The respective percentage of incidental renal cell carcinoma was 27.9%, 43.2%, 31.2%, and it was significantly higher in the 41-59 years group than the >or=60 years group (P=0.047). The incidence of poorly differentiated renal cell carcinoma decreased with age increasing (11.6% vs 5.2% vs 2.7%), and there was significant difference between the or=60 years group (P=0.038). In the 相似文献   

双侧内囊前肢毁损术治疗难治性强迫症疗效及随访研究

目的　对难治性强迫症进行双侧内囊前肢毁损术治疗 ,评定手术疗效并进行 2年随访 ,以进一步探索脑外科手术对难治性强迫症的疗效 ,并探讨手术治疗的良好适应症。方法　对 2 8例难治性强迫症患者进行双侧内囊前肢毁损术治疗 ,并分别在手术前、手术后二周、手术后三月、手术后六月、手术后一年、手术后二年进行Y BOCS、HAMA、HAMD量表评定及术后疗效评定。结果　 (1)强迫症患者手术后各期Y BOCS评分、HAMA评分与手术前比较均下降 ,有极显著差异 (P <0 .0 0 1) ;(2 )手术后各期Y BOCS的强迫思维评分均有明显下降 (P <0 .0 0 1) ,强迫行为在手术后 1年和 2年 ,与手术前比较无明显改变 (P >0 .0 5 ) ;(3)手术后 2年的总有效率为 5 3.5 % ,明显低于手术后 3月的总有效率 (P <0 .0 1)。结论　采用双侧内囊毁损术有相当的治疗效果 ,对于难治性强迫症患者可作为一种补充治疗手段 ;手术治疗对强迫行为的长期疗效较差 ,以严重的强迫思维为主的难治性强迫症患者为手术更好的适应症。     

龟羚帕安丸治疗血管性帕金森综合征疗效观察

目的 :观察龟羚帕安丸治疗血管性帕金森综合征 ( VP)临床疗效。方法 :治疗组 5 4例给予龟羚帕安丸和脉络宁注射液 ,对照组 36例单给脉络宁注射液 ,分别观察其综合疗效及改良UPDRS评分比较。结果 :治疗组总改善率 83.3% ,明显高于对照组的 5 8.3% ,P<0 .0 1。治疗组改良 UPDRS积分减少 ,明显优于对照组 ,P<0 .0 1。结论 :龟羚帕安丸治疗 VP确有一定疗效。     

复方胰岛素凝胶剂促进大鼠皮肤溃疡愈合的初步研究

目的:研究复方胰岛素凝胶剂对大鼠皮肤溃疡的促愈合作用,并探讨其可能的作用机制。方法:18只Wistar大鼠背部各制备4个皮肤溃疡模型,共复制溃疡72个,随机将溃疡分为复方胰岛素凝胶治疗组(A组)、凝胶基质对照组(B组)、空白对照组(C组)。以治疗后不同时间点各组溃疡面积、溃疡愈合速度及组织病理学检查评价修复效果。结果:在伤后头10天内,A组溃疡缩小最明显,愈合速度明显快于B组、C组。伤后14天,A组溃疡基本愈合,皮肤结构完整、上皮化较厚;而B、C组溃疡仍未完全愈合,皮肤结构不完整、上皮化较薄。结论:局部应用复方胰岛素凝胶剂对大鼠皮肤溃疡有促愈合作用。     

多层螺旋CTA:不同重建方法在主动脉瘤腔内隔绝术后的应用评价

目的：探讨多层螺旋CT血管造影不同重建方法在主动脉瘤腔内隔绝术后的临床应用价值。材料与方法：46例主动脉瘤腔内隔绝术后行多层螺旋CT血管造影，采用准直2.5mm，层厚3.0mm，螺距为6，重建方法为容积显示技术（volume rendering，VR）、表面阴影遮盖显示(shade surface display，SSD)及最大密度投影法（maximum intensity projection，MIP），并对三种方法进行比较。结果：46例中有1例术后内支架出现局限性断裂，VR及MIP均清晰显示了内支架的变化，SSD未能显示。1例内支架展开不良，三种重建方法均明确显示；6例术后出现渗漏，VR清晰显示渗漏的部位、形态及内漏量，MIP、SSD仅显示其中的5例，三者中以VR显示最佳。在显示支架内血流情况及瘤周血栓方面，VR能明确支架内有无血栓形成及腔内隔绝术后的转归变化，VR显示1例术后支架内血栓形成SSD及MIP未能显示。结论：多层螺旋CT能在较短时间内进行大范围的扫描，有利于主动脉病变的检查；VR图像优于SSD及MIP，能为术后内支架情况提供更多更准确的信息，VR技术应作为主动脉瘤内支架术后的首选三维重建方法。     

心理干预对错[牙合]畸形治疗中合作行为及结果的影响

目的：观察心理干预对错[牙合]畸形患者正畸治疗中合作行为及结果的影响。方法：对门诊口腔科60例青少年[牙合]畸形患者随机分为干预组和对照组各30例。两组均由从事正畸工作5年以上的主治医师采用标准方丝弓技术进行矫正治疗，干预组同时实施心理干预等心理治疗。将两组治疗中的合作行为和结果进行比较分析。结果：心理干预组自律性、主动性、自觉性、矫治时间、满意度等均明显优于对照组，差异有显著性（P〈0．01）。结论：心理干预对青少年正畸患者治疗中合作行为和结果有明显影响，通过心理干预能提高矫治的效果，保证治疗的顺利完成。     

Diet and premenopausal bilateral breast cancer: A case-control study

We investigated associations between diet and premenopausal bilateral breast cancer in a familial matched case-control study. We studied 140 cases from population-based registries in Los Angeles County (California) and Connecticut, and from the major hospitals in the southern parts of the Province of Quebec. Unaffected sisters of the cases served as matched controls (222 total). Dietary intake were assessed with a food frequency questionnaire. Total fat, monounsaturated fat, polyunsaturated fat, oleic acid, and linoleic acid intake was inversely associated with premenopausal bilateral breast cancer risk. Consumption of carbohydrates (and sweetened beverages) was associated with an increased risk. We observed no associations for dietary fiber, antioxidants, or major food groupings, but we did observe inverse associations for intake of low fat dairy products and tofu. These findings suggest that monounsaturated and polyunsaturated fats, as well as soy foods, might reduce the risk of premenopausal bilateral breast cancer.