快通道麻醉在ASAⅡ～Ⅲ级老年患者麻醉中的应用

目的探讨瑞芬太尼联合丙泊酚双通道靶控输注全凭静脉麻醉与静吸复合全麻在ASAⅡ～Ⅲ级老年患者全身麻醉中的应用。方法择期手术50例,年龄62～89岁,ASAⅡ～Ⅲ级,手术时间1～3h。随机分为2组,瑞芬太尼-丙泊酚靶控输注组（TCⅠ组）和静吸复合全麻组（Ⅰ组）,每组25例。分别采用全凭静脉和静吸复合维持麻醉,观察术毕停药后患者自主呼吸恢复的时间、睁眼时间、拔管时间、离开手术间的时间,并观察术后是否有恶心、呕吐、呼吸抑制、术后躁动、肌肉僵直等不良反应。结果TCI组患者较Ⅰ组术毕停药后自主呼吸恢复的时间、睁眼时间、拔管时间、离开手术间的时间均早,并且术后不良反应低。结论与静吸复合全麻相比,在ASAⅡ～Ⅲ级老年患者全身麻醉中应用瑞芬太尼联合丙泊酚双通道靶控输注全凭静脉麻醉,患者血流动力学更平稳,术后苏醒快,不良反应少,麻醉效果及安全性好,值得推广。     

北京市某区102例3～5岁儿童健康体检结果分析

目的:了解北京市某区入园儿童的生长发育和健康状况。方法:2007年9月1～5日,采用随机整群抽样的方法,抽取北京市某区某镇1所幼儿园入园的全部儿童进行体格检查。结果:在102例受检儿童中,消瘦率、肥胖率、低体重率、超重率分别为1.0%、2.9%、1.0%和1.9%,患龋率为18.63%、贫血患病率为5.88%(均属于轻度贫血)。结论:北京市某区儿童生长发育状况良好,但患龋率和贫血率较高,应加强口腔保健,合理膳食以纠正贫血。     

米非司酮和米索前列醇配伍羊膜腔内注射利凡诺终止14～28周中期妊娠的临床分析

目的探讨临床上应用米非司酮配伍米索前列醇和羊膜腔内注射利凡诺在终止14～28周妊娠的应用分析。方法选取120例自愿要求终止妊娠的14～28周妊娠妇女,分为3组,A组单纯行羊膜腔内注射利凡诺100mg;B组口服米非司酮2d后阴道后穹隆放置米索前列醇200～600μg;C组口服米非司酮1d后行羊膜腔内注射利凡诺100mg配伍米索前列醇阴道给药。记录用药时间、宫缩发动时间、胎儿胎盘免出时间以及术中术后出血多少等。结果 3组流产率比较有显著差异性(P<0.05);术后3组在子宫出血,胎盘胎膜残留以及患者的痛苦等方面差异有显著性(P<0.05)。结论对于终止14～28周妊娠口服米非司酮1d后行羊膜腔内注射利凡诺100mg配伍米索前列醇阴道给药流产率高,用时短,术中术后出血少,胎盘胎膜残留少等优势,克服了这一孕期单纯用一种方式流产率低,需要再次穿刺,增加感染机会,以及孕14～16周这一时段对个种方式及药物的敏感度低等困难。非常值得临床上推广和应用。     

The experience of being disabled and obese

Purpose. This qualitative study was designed to explore the experiences of disabled and severely obese people living in the community. The challenges that their size and disabilities posed within their homes and in accessing community facilities were explored, with particular reference to the provision and use of assistive technologies.

Methods. The study comprised in-depth interviews with a sample of six severely obese, disabled people using a grounded theory approach.

Results. Three key themes emerged: the experience of daily life; accessing services; and responses to challenges. The study participants found that their home and community environments were seldom adequate for their size. Difficulties were identified in relation to accessing and using NHS services and negative attitudes and treatment from staff. Assessments and quality of assistive devices and housing adaptations received were criticised by some. Participants identified a range of responses to these challenges.

Conclusion. The challenges that obesity bring are compounded by disability, including the need for higher levels of care and the higher costs of assistive devices for this client group. The study suggests there may be a need for training for professionals who work with obese, disabled people to ensure their needs are met in appropriate and cost-effective ways.     

《上海市民体质简易测评指南(20~69岁)》的研制

本指南研制目的是为了推广体质测评研究网络化,更好地为有不同层次需求的市民提供体质测评服务,以服务大众健康事业。研究采用文献复习和专家论证的方法,筛选并确立了体质简易测试评价指标体系,并通过与现行国民体质监测方案同步监测,与同国际先进水平相当的高精度的体质测评方案比较研究,推出便于推广普及并可由市民在线点击的上海市民体质简易测试评价方案。     

顺铂节拍化疗联合放疗治疗Ⅱ～Ⅳ期鼻咽癌的临床效果观察

目的 探讨顺铂节拍化疗联合放疗治疗Ⅱ～Ⅳ期鼻咽癌的临床效果.方法 选取70例Ⅱ～Ⅳ期鼻咽癌患者作为研究对象.按照治疗方法不同将患者分为实验组38例和对照组32例.观察患者不良反应发生情况、颈部淋巴结、鼻咽部原发灶疗效、NK细胞活性、T细胞亚群变化情况.结果 实验组恶心呕吐、咽(食)管毒性发生率低于对照组(P＜0.05).2组患者颈部淋巴结、鼻咽部原发灶疗效比较,差异无统计学意义(P＞0.05).实验组治疗后NK细胞活性显著高于对照组(P＞0.05).实验组治疗后CD3、CD4、CD4/CD8水平高于治疗前和对照组(P＞0.05),对照组治疗后CD3、CD4、CD4/CD8水平低于治疗前(P＜0.05).结论 顺铂节拍化疗联合放疗治疗Ⅱ～Ⅳ期鼻咽癌的临床效果较好,不良反应发生较少,颈部淋巴结、鼻咽部原发灶疗效较好,NK细胞活性、T细胞亚群恢复较好.     

N～2·9-二乙酰基鸟嘌呤检测方法的研究

目的建立合适的检测N～2·9-二乙酰基鸟嘌呤的方法。方法通过UPLC和HPLC法检测，在使用不同种类溶剂溶解的样品和不同流动相的情况下，比较分别进样后得到的图谱，从而找到合适的溶剂及流动相。结果N～2·9-二乙酰基鸟嘌呤以乙腈为溶剂进行检测时，未出现分解产物2-乙酰基鸟嘌呤的色谱峰。结论N～2·9-二乙酰基鸟嘌呤溶解在乙腈中不会发生分解现象，通过UPLC和HPLC法可以有效的进行检测。     

米非司酮配伍米索前列醇用于孕10～13周终止妊娠25例临床分析

目的探讨米非司酮配伍米索前列醇用于10～13周终止妊娠的有效性及安全性。方法选择25例年龄在18～35岁的健康妊娠妇女,口服米非司酮150mg,分2d服用,于第3天顿服米索前列醇600ug,观察疗效。结果 96%服药有效,1例失败给予钳刮。结论要严格掌握用药的适应证,孕周的严格把握是决定成功的主要因素,明显降低了手术时间,减少了并发症的发生。     

Temporal and Spatial Epidemiological Analysis of Peste Des Petits Ruminants Outbreaks from the Past 25 Years in Sheep and Goats and Its Control in India

This study was aimed to understand the temporal and spatial epidemiology of peste des petits ruminants (PPR) in India using national surveillance data available in the National Animal Diseases Referral Expert System (NADRES) along with its control plan undertaken. On analysis of the outbreaks/cases reports in sheep and goats in NADRES database from 1995 to 2019, it was observed that PPR features among the top ten diseases and stands first among viral diseases, and among reported deaths, PPR accounts for 36% of mortality in sheep and goats. PPR outbreaks occur round the year in all the seasons but are encountered most frequently during the lean period especially, in the winter season (January to February) in different regions/zones. The reported outbreaks have been progressively declined in most of the states in India due to the implementation of a mass vaccination strategic program since 2011. On state-wise analysis, the PPR risk-areas showed wide variations with different levels of endemicity. Andhra Pradesh, West Bengal, and Karnataka were the top three outbreaks reported states during 1995–2010, whereas Jharkhand and West Bengal states reported more outbreaks during 2011–2015 and 2016–2019 periods. The temporal and spatial distribution of PPR in India provides valuable information on the hotspot areas/zones to take appropriate policy decisions towards its prevention and control in different regions/zones of India. The study also identifies when and where intensive surveillance and vaccination along with biosecurity measures need to be implemented for the control and eradication of the disease from India in consonance with the PPR Global Control and Eradication Strategy.     

RPH联合外痔切除术治疗Ⅱ～Ⅳ期混合痔临床观察

目的对照观察RPH联合外痔切除术治疗Ⅱ～Ⅳ期混合痔的临床疗效。方法将118例Ⅱ～Ⅳ混合痔患者随机分为对照组和治疗组各59例,治疗组采用RPH和联合外痔切除术,对照组采用传统外剥切内扎术,观察两组治愈率、手术时间、术后疼痛评分、创面愈合时间、术后并发症等情况。结果疼痛评分、创面愈合时间、治愈率治疗组优于对照组;差异有统计学意义(P<0.05),但两组在手术时间、并发症方面差异无统计学意义(P>0.05)。结论 RPH联合外痔切除术较传统外切内扎术具有痛苦小、愈合时间短、治愈率高等优点,值得临床推广。