Meniscal repair: Outcomes and clinical follow-up

A retrospective study of arthroscopic meniscal repair in 101 consecutive patients was conducted. Sixty-three patients constituted our study group. The arthroscopic technique used for meniscal repair was the inside-out method using malleable cannulas. Forty-five patients were available for clinical examination, with a mean follow-up of 27 months. Tegner and Lysholm scores were comparable to those previously reported for arthroscopic meniscal repair. The HSQ (similar to the SF-36) scores were equal to those from an age- and sex-matched normal population, indicating that individuals with repaired menisci do not have any residual negative effects on global health at mean 26.9 months' follow-up. The physical functioning subscale of the HSQ was found to be sensitive to patient perception of results. Complications included one case of restricted knee range of motion requiring arthroscopy and lysis of adhesions. Overall clinical results were 64% excellent, 27% good, and 9% failure. Age, sex, and length of the meniscal tear had no affect on clinical outcome.     

毛细玻管人体肿瘤干细胞集落形成检测

人癌干细胞集落形成测定常用双层琼脂平皿法。新法系采用园形玻璃毛细管法培养!可 以减少细胞用量及药物消耗。管内径为1.3mm,管长9.75cm,内盛15.000有核细胞/50μl,培养7～ 14天。50例肿瘤活检标本生长成功率为88％,并可供化疗药物敏感性试验用。这种微量化检测具有 独特的优点,便于推广应用。     

Evaluation by dental students of a communication skills course using professional role-players in a UK school of dentistry

This paper reports student (n = 180) feedback on the role-play teaching methodology used in behavioural sciences teaching at The School of Dentistry in Birmingham (UK). The feedback received on this well-established (since 1995) educational programme was collected via questionnaire (100% response rate), requiring Likert scale and free text responses. Generally students reported that they had enjoyed and valued the session. Over two-thirds (69.7%) of students rated the role-players as 'very real' and over three-quarters (78.9%) rated their feedback as 'very fair'. The data collected from this study will inform future curriculum development. Student feedback was very positive and demonstrated that the cohort (86% of all students studying in years 1, 2 and 3) found the use of professional role-players involved in behavioural sciences teaching to be both acceptable and valuable.     

急性胰腺炎病因和诊治十年变迁(附725例报道)

急性胰腺炎的病因和早期诊治一直是临床医师关注的问题。目的：探讨近十年来急性胰腺炎病因、诊断和治疗的变迁及其对预后和住院费用的影响，总结急性胰腺炎的治疗经验。方法：采用回顾性临床研究方法，将725例人选患者分为两组．1993年4月～1998年12月就诊的患者为第一组，1999年1月～2002年8月就诊的患者为第二组：分析两组患者病因、诊断指标、治疗方案、并发症、预后、住院费用方面的变化。结果：比较两组病因，两组患胆囊炎胆结石者分别占72．3％和75．8％，高脂血症者分别占25．3％和25．8％，酗酒者分别占10．6％和9．7％。血清淀粉酶水平高于正常上限3倍的总检出率为66．9％．CT诊断总阳性率为92．0％。第一组46．9％的患者应用生长抑素，31．1％的重症患者发生胰腺假性囊肿，2．2％发生胰腺脓肿，死亡率为15．6％。第二组72-3％的患者应用生长抑素，13．2％的重症患者发生胰腺假性囊肿，2．2％发生胰腺脓肿，死亡率为6．5％。第二组的住院费用与第一组相比呈下降趋势，但无显著差异。结论：胆道疾病仍为急性胰腺炎的主要病因，血清淀粉酶和CT是急性胰腺炎较常用和可靠的检查手段。通过早期足量应用胰酶抑制剂(尤其是生长抑素)、肠道去污和改善胰腺微循环，可改善急性胰腺炎的预后，降低并发症发生率、死亡率和住院费用。     

Developing a Peer Review Process for Web-based Curricula

The World Wide Web creates new challenges and opportunities for medical educators. Prominent among these are the lack of consistent standards by which to evaluate web-based educational tools. We present the instrument that was used to review web-based innovations in medical education submissions to the 2003 Society of General Internal Medicine (SGIM) national meeting, and discuss the process used by the SGIM web-based clinical curriculum interest group to develop the instrument. The 5 highest-ranked submissions are summarized with commentary from the reviewers.     

惠州市结核病控制项目实施效果评价

目的 总结我市结核病控制项目实施效果和经验。方法 根据全市各县(区)上报的结核病报表和有关总结材料进行分析。结果 在项目实施期间发现涂阳病人7522例，治愈了7303例，涂阳病人登记率从1993年的8．2／10万提高到2001年的39．4／10万，初、复治涂阳病人治愈率从1992年的80．0％和81．8％提高到2001年的98．9％和96．2％。结论 我市结核病控制项目实施效果显，项目所取得的成功经验和技术策略对今后结核病控制可持续发展有着重要的指导作用。     

Clinical and Physical Evaluation of the Infertile Male: Testicular Measurement or Orchidometry/Klinische und physikalische Bewertung des infertilen Mannes: Hodenmessung oder Orchidometrie

Summary: For the quantitative determination of the testicular size or volume, two groups of apparatus are available: on the one hand, model testes, which are extremely valuable in longitudinal and cross-sectional studies during the period of pubescence, and on the other hand, measuring devices, with which the testicular dimensions can be specified. The latter instruments are helpful chiefly during the adolescent years and the diagnosis of problems surrounding fertility. The testicular volume can be calculated subsequently from the specific testicular measurements. The formula, for computing the volume of an ellipsoid, seems to be the most suitable for this purpose. Appliances also have been developed, which allow the largest (longitudinal) dimension (in mm) and the testicular volume (in cm3) to be read off simultaneously. A tonometer can be useful to quantitatively estimate the testicular consistency, which is a parameter of the testicular integrity at the level of tubular function (spermatozoa production).     

Zero-Order Release Formulation of Oxprenolol Hydrochloride with Swelling and Erosion Control

Zero-order release of oxprenolol hydrochloride was obtained by controlling the swelling and erosion of the matrix. This formulation involves only mixing of drug, hydroxypropylmethylcellulose (HPMC), and sodium carboxymethylcellulose (Na CMC) at the ratio of 1:0.4:1.6, respectively, and compressing the mixture directly into tablets. The in vitro release pattern from this optimized matrix tablet was reproducible. Accelerated stability studies revealed that the optimized formulation remains stable for an approximately 2-year shelf life. This sustained-release (SR) tablet was evaluated in dogs, and for comparison a conventional (CV) formulation was also given at the same dose level. Plasma oxprenolol levels were monitored by a sensitive and specific high-performance liquid chromatographic (HPLC) method. Significant differences in the pharmacokinetic parameters, i.e., lower C _max, higher values of t _max, MRT, AUC, and plasma concentration at 24 hr, and nearly constant plasma levels over 12 hr, indicated that the SR matrix tablet is superior to the CV rapid-releasing formulation. The in vitro release parameters and in vivo pharmacokinetics correlated well.     

病案质量问题与改进

病案作为记录医疗活动过程的重要载体,包含着各类丰富的信息。医疗服务质量评价有很多内容是通过病案实现的。作者分析了包括"三级医师查房"在内的20余项在病案中反映的医疗服务质量项目,指出影响质量判断的常见因素,并提出解决的对策与措施。     

用秩和比法对我院的10个公示病种医疗质量进行综合评价

目的对我院2005年度公示的10个病种进行医疗质量综合评价。方法采用秩和比法(RSR)进行统计分析。结果我院的10个公示病种被划分成4个医疗质量等级:老年性白内障、小儿支气管肺炎2个病种质量为优,急性阑尾炎、腹股沟疝(单侧)、子宫平滑肌瘤、剖宫产4个病种质量为良,胃大切、脑梗塞、急性心肌梗塞3个病种质量为中,脑出血1个病种质量为差。结论通过对综合指数秩和比(RSR)的计算并根据其值分级归档,反映出所研究病种之间存在着医疗质量高低的差异。控制和降低本院临床常见病种的医药费用,进行医疗全程连续性控制,为患者提供经济有效的医疗服务。