324例可疑医疗器械不良事件报告分析

目的 对324例可疑医疗器械不良事件报告进行分析，评价报告可利用性，探索安全使用医疗器械监测手段及医疗器械不良事件监测模式。方法 采用描述性分析的方法进行分析。结果 医疗器械不良事件监测工作为安全有效使用医疗器械提供了有意义的启示，医疗器械不良事件监测模式初步形成。结论 加强医疗器械不良事件监测工作是确保安全使用医疗器械的有力手段。     

Detection of alcohol problems in primary care outpatients under different conditions

Outpatients from two primary care clinics in a county hospital were screened for alcohol problems under three conditions. The objective was to determine whether patients would report more drinking and alcohol-related problems if self-report information was gathered in a research setting and/or if patients knew that their doctors would not be informed about their self-reports. The data indicate that patients' self-reports of alcohol consumption or problems were not affected by their knowledge that doctors would know their responses, and that interviews conducted in medical settings did not corrupt self-report data.     

The use of a simple functional appliance as an adjunct to fixed appliance orthodontic treatment

Three clinical case studies are presented to demonstrate the use of a simple functional appliance in orthodontic situations not covered by traditionally-accepted dental and skeletal indications. In each case, the appliance was used to reduce the severity of the malocclusion, before a routine fixed-appliance detailing phase.     

Progress we can be proud of: U.S. trends in assisted reproduction over the first 20 years

OBJECTIVE: Documentation of the significant progress of assisted reproductive technology (ART) therapy in the United States. DESIGN: Tabulation of data from the annual published reports of ART activity in the United States for the years 1985 through 1999. SETTING: ART centers in the United States that report their results to the Centers for Disease Control and Prevention (CDC) via the Society for Assisted Reproductive Technology (SART). PATIENT(S): The annual reports included 647,208 cycles of treatment. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The number of clinics and cycles, and the rates of pregnancy, delivery, miscarriage, and multiple pregnancy were examined. Practice trends were also examined. RESULT(S): The number of clinics and cycles has grown steadily. The 155,661 clinical pregnancies led to 128,608 births and 177,745 babies born. The advent of intracytoplasmic sperm injection (ICSI) and the fall of GIFT and zygote intrafallopian transfer (ZIFT) are noted. Pregnancy rates have risen steadily in all therapies, and the number of deliveries of triplets or more has declined dramatically in the most recent reporting years. CONCLUSION(S): Over the years, ART therapies have steadily become more effective, with notable reductions in multiple pregnancies, the ability to avoid laparoscopy (for egg retrieval and in some cases tubal transfers), and effective therapy for serious sperm, egg, and uterine problems, none of which was true in the early years. This has occurred owing to the dedication and ingenuity of practitioners, and, notably, without federal regulation of clinical practice.     

Parent-proxy and child self-reported health-related quality of life: using qualitative methods to explain the discordance

Background Although parent-proxy reports of health-related quality of life (HRQOL) are only moderately correlated with child reported HRQOL, it remains unknown why these scores differ. The aim of this study was to use a qualitative methodology to examine why parents and children report different levels of HRQOL. Method The sample consisted of 15 parent–child pairs. A think-aloud technique was used where parents and children were given a generic HRQOL instrument (KIDSCREEN) and instructed to share their thoughts with the interviewer. Qualitative analyses were conducted to assess whether parents and children base their answer on different experiences or reasoning, have different response styles, or interpret the items differently. Results There was discordance between parents and children, in terms of rating scale and in terms of the reasoning for their answer. Children tended to have different response styles to parents, where for example, children tended to provide extreme scores (highest or lowest score) and base their response on one single example, more than parents. Parents and children interpreted the meaning of the items very similarly. Discussion This study provides evidence to suggest that discordance among parent-child pairs on KIDSCREEN scores may be as a result of different reasoning and different response styles, rather than interpretation of items. These findings have important implications when parent-proxy reported HRQOL is used to guide clinical/treatment decisions.     

双侧大脑前动脉闭塞一例

正患者男性,70岁,农民,主因突发性意识不清11h,于2016年6月25日入院。患者入院前11h于田间劳作时突然出现意识障碍,跌倒,无四肢抽搐、双眼上翻、大小便失禁等,呼之不应,急诊入当地医院,头部MRI显示双侧额顶叶梗死,予抗血小板聚集和营养神经等治疗(具体方案不详),临床症状无     

经脐单孔腹腔镜胆囊切除术的应用(附40例报告)

目的:探讨经脐单切口腹腔镜胆囊切除术的可行性及应用价值。方法:回顾分析40例胆囊结石及胆囊息肉样病变患者行经脐单切口腹腔镜胆囊切除术的临床资料。结果:手术时间30~60m in,平均42m in;术中出血10~15m l,平均11m l。无并发症发生。术后随访1~3个月,患者均无腹痛、发热及黄疸。脐部瘢痕隐蔽、不明显。结论:经脐单切口腹腔镜胆囊切除术治疗胆囊良性疾病安全有效,且更具微创性,美容效果更佳。     

A mandibular block technique useful in ''gaggers''

Three patients with severe gagging problems requiring mandibular molar extractions and who could not tolerate conventional block injections were successfully given closed-mouth mandibular block injections without provoking any retching. This technique permits patients to concentrate on clenching their teeth during the injection. This displacement activity, combined with the reduction in tactile sensation following anaesthesia, helps to prevent gagging.