肝硬化治疗前后肝血流动力学及肝纤维化指标的变化

目的：观察不同方法治疗肝硬化前后肝血流动力学及肝纤维化指标的变化。方法：140例患用彩色多普勒和放免法分组比较治疗前后肝流动力学和的血清肝纤维化指标的变化。结果：疾病组肝血流动力学和纤维化指标均高于对照组，治疗后较治疗前下降；治疗后各组患的症状、体症较治疗前均有不同程度好转；肝硬化治疗后显效率25％、有效率50％、总有效率75％、无效率25％。结论：肝硬化程度与肝流动力学和血清肝纤维化指标的变化有关。联合治疗的效果更好。     

不稳定髌骨外移度测量方法的探讨

目的 :探讨髌骨外移的影像学分度测量方法 ,为临床精确测量及治疗提供依据。方法 :本研究利用CR成像技术对已确诊为髌骨外移的 30例病人进行髌骨外移的分度测量 ,主要测量髌骨最大横径中点到股骨内、外髁顶点连线的内侧缘垂线的距离 ,以此距离与髌骨最大横径长度作比较 ,将髌骨外移分为四度。结果 :本组 30例病例经CR测量 ,15例为髌骨Ⅰ度外移 ,8例为髌骨Ⅱ度外移 ,5例为髌骨Ⅲ度外移 ,2例为髌骨Ⅳ度外移 ,即髌骨完全性脱位。各组病例与其不同的临床症状吻合。结论 :①CR成像技术对髌骨的外移进行了准确的测量。②髌骨的外移分度测量 ,为髌骨外移的影像学诊断提供了一种准确、直观的测量方法 ,为临床治疗方法的选择提供了科学依据。     

医院管理干部360度考核测评的做法和体会

目的通过计算机网络完成年度干部360度全方位测评考核,摆脱手工操作的繁琐,达到考评数据的科学性、真实性、直观性、保密性,为干部的管理及领导层任免干部提供可靠的决策依据。方法应用计算机网络采用人机对话的形式,由测评人对被测评人的考评试卷内容进行逐一回答,通过计算机汇总,统计出每位被测评人的全方位测评成绩。结果连续三年对医院60余名管理干部360度考核测评,从上级、同级、下级、自评四个层面来看,上级和同级分数打分较低,下级和自评打分较高,敬业精神和思想品德方面打分稍高,总成绩90分以上达到优秀的占7·83%,80分以上良好的占54·68%,60分以上及格占34·37%,不及格3·12%。结论测评结果比较客观公正地反映了干部的业绩。     

医用洁净送风天花的气流均匀性和抗干扰性实验研究

通过在模型I级手术中对医用洁净送风天花的实验，对应用阻漏层理论的医用洁净送风天花的送风均匀性和抗干扰能力进行了研究。实验结果说明医用洁净送风天花具有良好的气流均匀性和抗干扰能力。     

基层医院病区责任护士工作现状调查与分析

目的 明确基层医院整体护理模式病房责任护士工作定位,真正做到以患者为中心,促进整体护理持续发展.方法 对内外科6个不同专科12名责任护士每日实施护理项目时间及患者需求、满意度作跟踪调查.结果 病历书写、治疗、基础护理、专科护理、新患者处置、其他等项目分别占每日工时构成比26.6%、24.3%、15.2%、12.3%、9.7%、11.9%;外科责任护士基础护理时间明显多于内科,P＜0.05,其余护理项目实施时间内外科比较,差异无统计学意义(P＞0.05).患者对与治疗相关的需求总体满意度较高,而与生活护理、健康宣教相关的护理项目总体满意度较低.结论 责任护士工作现状影响整体护理发展,让责任护士用更多的时间"贴近临床、贴近患者"是深化护理改革的关键.     

Cytogenetic evaluation of 20 sporadic breast cancer patients and their first degree relatives

Many genetic abnormalities disclosed even in somatic cells like peripheral blood lymphocytes may mark footprint(s) of malignancy(ies). The present cytogenetic study on peripheral blood lymphocytes of sporadic breast cancer patients (n = 20) and their first degree relatives (n = 39) reports abnormalities of chromosomes 16, 5, 12, and 17 respectively in 17.59%, 8.33%, 6.48%, and 5.57% cells of patients and 15.83%, 8.33%, 7.5%, and 5% cells of their first degree relatives. These common chromosomal abnormalities pave the way to assume why first degree relatives of sporadic breast cancer patients are at increased risk of developing the same or other malignancies.     

Stapled haemorrhoidopexy in fourth degree haemorrhoidal prolapse: is it worthwhile?

INTRODUCTION: Ten years after the introduction of stapled haemorrhoidopexy few studies have stratified patients by degree of haemorrhoidal disease when analysing results. Objective The aim of this study was prospectively to evaluate 116 patients who underwent stapled anopexy conducted by the same surgeon for III or IV degree haemorrhoidal prolapse. MATERIALS AND METHODS: One hundred and sixteen consecutive patients affected by symptomatic haemorrhoids of III or IV degree underwent stapled anopexy using the technique described by Longo in the period January 2001 to October 2003. Mean follow-up was 28.1 months. Fischer's exact test was used for statistical analysis. Results, in terms of morbidity and recurrence rates, were stratified according to degree of haemorrhoidal disease. RESULTS: There was no statistically significant difference between the results for third degree compared with fourth degree prolapse although there was a trend towards increased incidence of postoperative bleeding and recurrence. CONCLUSION: Third degree haemorrhoidal prolapse remains the best indication for stapled haemorrhoidopexy. This procedure may also be indicated in fourth degree haemorrhoidal prolapse. Patients with fourth degree haemorrhoids may be subjected to this procedure following adequate discussion of the outcome.     

在职申请医学硕士学位论文的选题

通过对同等学力在职申请医学硕士学位人员学位论文选题的调查,提出了同等学力人员在职申请医学硕士学位的学位论文选题应紧密结合自身专业特点,充分考虑所在单位及培养单位的实验技术条件,使所选课题既具有较高的理论意义和实用价值,又能在规定的时间内完成。     

Analysis of results related to the percent free prostate specific antigen among men without prostate diseases in Xi’an area

To measure the percent of free prostate specific antigen （fPSA） among men without prostate diseases in Xi＇an area, and to study the relationship of percent fPSA with age and pathological grade, clinical stage of prostate cancer （PCa） with percent fPSA, and to analyze the difference between the data in China and the.overseas data to determine appropriate reference range for Chinese male. Methods： A total of 713 participants were enrolled into the study, with PSA, fPSA in serum measured and the percent fPSA calculated. Out of 713 cases, 679 without prostate diseases were divided into 5 groups by age, and then the relationships of PSA, fPSA and percent fPSA with age were studied, respectively. The relationship of pathological grade and clinical stage with percent fPSA of the 34 participants with PCa was also studied. With the help of the related data of men without prostate disease, the appropriate reference range for Chinese male was established. Results： The increases in PSA or fPSA were correlated with age, while there was no significant correlation between age and percent fPSA. The percent fPSA was also correlated with pathological grade and clinical stage of PCa. The percent fPSA of men without prostate disease in Xi＇an area was significandy lower than that in the related overseas data. The reference range of percent fPSA for Chinese male was≥ 15%. Conclusion： Percent fPSA might be more useful than PSA in the detection of prostate cancer. As the percent fPSA is decreased, the pathological grade is decreased, and the clinical stage is increased, the malignant degree is increased. The reference range of ≥15% is more appropriate for Chinese male.     

住院患者满意度调查对护理服务质量的影响

目的探讨以患者需求为导向，提高住院患者满意度，对护理服务质量持续改进的作用。方法采用住院患者满意度调查表，对2005～2006住院患者每季度调查1次，并将调查结果进行分析、讨论、改进，两年度进行比较。结果找出与患者需要的差距，采取转变护理服务理念、增强服务意识、狠抓业务培训、强化健康教育等一系列有效改进措施，从而使患者的平均满意度由2005年的95．7％上升到2006年98％。结论通过对患者满意度调查、分析，发挥满意度调查作为护理服务工作的导向作用，并可为管理者提供决策参考，有效促进护理服务质量的持续改进。