阻塞性睡眠呼吸暂停低通气综合征120例临床分析

目的总结120例阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床资料,以期提高对OSAHS的诊治水平。方法回顾性分析北京朝阳医院120例OSAHS患者的诊治资料。结果患者就诊多是经他人提醒或是由初诊医师发现其有与睡眠紊乱有关的主诉,提示有睡眠呼吸暂停或夜间低氧血症的可能。较常见的临床症状是习惯性打鼾且鼾声不规律,27%的患者有睡眠时憋醒史。59%患者体质量指数〔体质量(kg)/身高2(m2)〕>25,Epworth嗜睡程度问卷评分为4.7±2.3。多导睡眠监测示中重度患者占70%。81.7%的患者可接受无创正压通气治疗,且经治疗后血氧饱和度均有不同程度的提高。结论多数患者在来睡眠实验室就诊以前,对睡眠紊乱情况缺乏认识。对前来就诊的患者,要进行认真的病史询问和细致的查体,并进行多导睡眠监测,以帮助诊断。无创正压通气治疗可以有效改善患者的睡眠和纠正缺氧。     

中医专业七年制学生临床实习存在问题及对策

通过对中医专业七年制学生临床实习状况调研分析,发现临床教学中存在运用和实践中医知识的机会不多、学生专业知识功底不扎实、临床医生带教积极性不高等问题;提倡应坚持不懈地突出中医特色,积极培养学生中医临床思维,加强中医示范教学病房建设和师资队伍建设。     

创新人才培养模式加强临床医学本科生培养与管理

论述了温州医学院附属第一医院以办“社会化住院医师轮训班”为契机,创建新型人才培养模式,加强对临床医学本科毕业生的培养与管理的具体做法;总结了医院通过做好毕业后医学教育工作,在提高临床医学本科毕业生的业务素质、职业道德水平、参与市场竞争能力,以及通过二次分配提高基层的医疗服务水平等方面取得的成效。     

肿瘤医院技术人员在职培训需求分析

为了解北京肿瘤院技术人员在职培训的现状及需求,特对技术人员进行了问卷调查。将调查结果进行统计,并对不同学历、不同工龄、不同职称、不同聘用形式和不同所属系统的技术人员希望达到的培训目的、得到的培训内容、影响培训的因素、培训采取的方式等进行X2检验和统计学分析。结果显示,医院技术人员的培训工作存在很多问题,并针对此种情况提出培训工作的有效途径和方式。     

传染性单核细胞增多症临床与病原学分析

传染性单核细胞增多症(infectious m ononucleo-sis,IM)是主要由EB病毒感染所致的全身性疾病之一,还可有多种其他病原引起,如巨细胞病毒(C M V)、鼠弓形虫(Toxoplasm a gondli)、腺病毒(A D V)、人类免疫缺陷病毒(H IV)、支原体(M P)等。现将我科收集的102例具IM表现的患儿临床特征、病原学等资料及治疗结果报告如下。1资料与方法1.1一般资料2003年2月至2004年10月,在我院住院诊断为IM的患儿102例,其中男72例,女30例,男∶女=2.4∶1;年龄最小为37d,最大12岁,～1岁组26例(25.5%),～3岁组42例(41.2%),～6岁组19例(18.6%),～12岁组15例(…     

新生儿心律失常42例临床分析

随着新生儿心血管监护的加强,新生儿心律失常的发现逐渐增多,新生儿心律失常有自身特点,治疗及转归与年长儿不尽相同。现将我院2003年11月～2005年11月收治的新生儿心律失常42例临床特点分析如下。1资料与方法1.1一般资料本组患儿42例,其中男29例,女13例;足月儿33例,早产儿6例,     

儿童肾上腺脑白质营养不良11例

目的探讨儿童肾上腺脑白质营养不良(ALD)的临床特点、影像学特点及治疗。方法回顾总结11例儿童ALD临床及影像学资料,结合文献进行分析。结果患者均为男性,起病年龄5~12岁,临床表现均有不同程度智力下降、视力减退、四肢活动障碍、构音困难、语言减少,部分患者有抽搐、听力下降、色素沉着。1例患儿血浆极长链脂肪酸(VLCFA)异常增高。影像学特点:1.蝶形病灶,在双侧三角区周围呈现对称的、大片状、局限于脑白质的蝶形病灶。2.花边样强化条带将蝶形病灶分隔成较大片中央和外周区,两个区域的信号强度与密度不同。3.整个胼胝体压部信号异常。4.MRI优于CT能显示视觉、听觉传导通路上病灶。内科治疗无效。结论ALD临床特点为智力下降、视力减退、四肢活动障碍、语言障碍为主。CT、MRI有特征性改变。VLCFA检测是诊断本病的特异方法。骨髓移植、基因治疗是治疗本病的方法。     

Train the trainers!

With the introduction of training programmes and logbooks for basic postgraduate training and subspecialty training, the European Board and College of Obstetrics and Gynaecology has given impulses to harmonise training in obstetrics and gynecology in the European Union. Current changes in the practice of medicine, among which the European Working Time Directive, numbers of surgical procedures decreasing, more demanding patients and a change in work ethos, challenge both trainers and trainees to optimise postgraduate training. For training to be effective and efficient, it is necessary to clearly define learning goals and outcomes and to create a stimulating educational environment. This requires trainers who (a) have knowledge of adult learning and educational theory and (b) will act as facilitators of the learning process of postgraduate trainees. Most of the doctors involved in postgraduate training have not had any formal formation to be a trainer. Teacher professionalisation offers the medical professional a framework to increase efficiency as a trainer. In this article, an introduction to educational practice for the medical professional is given. Several aspects of adult learning, such as the learning cycle, appraisal and assessment, and giving feedback, are discussed.     

儿童急性肾功能不全临床分析

目的探讨儿童急性肾功能不全的病因、治疗和预后。方法回顾2002~2005年本院34例儿童急性肾功能不全住院患儿的临床资料,对其发病原因、临床表现、治疗和预后行归纳分析,并作进一步探讨。结果急性肾功能不全34例中男19例,女15例;起病年龄16.0 d~15.5岁。因急性肾功能发病占35.3%。药物引起占29.4%。药物致儿童急性肾功能不全死亡率为20%,转为慢性肾功能不全为30%。结论原发性肾小球疾病是儿童急性肾功能不全的最常见原因,药物致儿童急性肾功能不全预后差,应及早干预原发性肾小球疾病防止慢性化,充分重视肾毒性药物的临床应用。     

The Effects of Social Interactive Training on Early Social Communicative Skills of Children with Autism

Growing attention has been directed at the relation between early social communicative skills of children with autism and subsequent development of these children's social and communicative functioning. We reviewed 16 empirical studies that investigated the effects of social interactive interventions designed to increase early social communicative skills of young children with autism by increasing their role as initiator of social interactions. To identify factors relating to treatment effectiveness, we analyzed studies in relation to participant characteristics, settings, target behaviors, training methods, and results. To determine durability of treatment, we analyzed generalization effects across persons, settings, stimuli, and time. Increases were found for social and affective behaviors, nonverbal and verbal communication, eye contact, joint attention, and imitative play. Limited generalization or maintenance of target behaviors was reported. Findings are discussed in relation to critical variables that may relate to treatment effectiveness in future research and practice efforts.