中西医联合治疗单纯疱疹性角膜炎的疗效观察

目的 :探讨单纯疱疹性角膜炎是中西医联合用药的治疗方法。方法 :本组 10 0例 ( 10 6只眼 )单纯疱疹性角膜炎患者应用抗病毒药物联合清热解毒中药的疗效观察。结果 :本组病例治疗后总有效率 82 .0 8%。结论 :中西医联合治疗措施是我们对单纯疱疹性角膜炎治疗的一项新的探讨。     

子宫颈癌226例临床病理分析

目的：探讨宫颈癌的临床、病理特点、诊治方法及预后因素。方法：收集1996年1月至2001年1月226例宫颈癌患者进行回顾性分析。结果：平均患病年龄为48．18岁。130例患者为阴道流血，70例为阴道流液，25例下腹疼痛，l例精神减退、贫血、浮肿。病理分期：Ⅰ期病例数为169例(75％)；Ⅱ期病例数为3l例(13．72％)；Ⅲ期病例数为23例(10．18％)；Ⅳ期病例数为3例(1．1％)。比较2l例宫颈鳞癌与宫颈腺癌的转移，显示后者的腹主动脉旁淋巴结转移、肾上腺转移、子宫转移、胸水形成明显高于前者。结论：重视宫颈癌发病相关因素及临床症状，争取早期诊断，严格手术病理分期，选择适当治疗方案。     

多站点综合性毕业考试的改革与实践

我校改革临床医学专业毕业考试模式与方法，在临床实习过程中组织多站点综合性考试，采用闭卷笔试方法考核临床理论知识，占70％；采用实践操作与现场口试方法考核临床技能及相关知识，占20％；采用开卷笔试方法考核医疗文书书写，占10％。实践证明，此项改革能促进医学生端正实习态度，调动实习的积极性与主动性，引导医学生在实习中重视理论学习与临床实践的密切结合，促进临床教学质量的提高。     

Scientific quality of clinical research an analysis of 40 research projects in pharmacology/pharmacotherapy

Objective: The scientific quality of research is an important ethical issue. To clarify the quality of research projects in pharmacotherapy/pharmacology, 40 randomly selected research projects in pharmacotherapy/pharmacology submitted to a research ethics committee were reviewed. Results: Eight of the projects would not have contributed new knowledge nor were they necessary as controls for the results of previous research. Fifteen of the research protocols were of good quality, 15 could be used after revisions, and 10 were unfit for use. Eleven of the research projects were not finished 5 years after they were started. A written report was produced from 26 of the projects. Nine were of good quality and could be accepted for publication in a medical journal, 10 of the reports were in need of revision before publication, and 7 should not be accepted for publication. Conclusion: Research in this field ought to be improved, and ways to improve the standard of clinical trials in pharmacotherapy are dicussed. Received: 1 April 1996 / Accepted in revised form: 28 June 1996     

32例青年食管癌临床病理分析

目的：探讨青年食管癌患者的临床病理特点。方法：以病例对照方式对32例青年食管癌临床病理特点进行分析，选用同期50岁以上食管癌病例40例为对照组。结果：青年食管癌患者与老年者相比，病理分化程度低，恶性度高，早期诊断率低，生存期短。结论：青年食管癌症状隐匿，诊断率低，预后差。     

因症就诊检出早期大肠癌的临床及病理学特征

目的探讨在就诊的肛肠病人中如何提高早期大肠癌的检出率。方法在１１家医院推广对肛肠病人的四项检查程序——直肠指检，乙结镜检查，大便隐血试验，和Ｘ线气钡灌肠造影。结果在４８２１例有肛肠症状的病人中，检出大肠癌１８８例，检出率为３．９％，其中１８０例有术后病理诊断。４７／１８０例（２６．１％）属早期癌（ＤｕｋｅｓｓｔａｇｅＡ）。４１／４７例由上述四项检查作出初步诊断。初发症状为：（１）便血（２６例，持续１５．２±９．４周后就诊，肿瘤平均直径２．５８ｃｍ）；（２）大便习惯改变（９例，３３．４±１９．７周，３．３９ｃｍ）；（３）腹痛腹块（１０例，１９．２±１１．２周，５．０ｃｍ）；（４）贫血（２例，１７．２±９．９周，４．７５ｃｍ）。８／１２例的Ａ０和Ａ１期病例属便血组，并多位于直肠。４１／４７例以高、中分化腺癌为主，其中１５例伴有腺瘤癌变。术前曾作活检的２７例中，１２例未检出癌变细胞。结论四项检查对检出早期大肠癌是有效的，便血是提示早期癌最有价值的症状，加强大肠癌防治宣教，采用瘤灶多点或全瘤活检技术，高度重视大肠腺瘤和不典型增生等癌前病变，将有助于提高早期大肠癌的检出率     

Critical care nurses, ethical decision-making and stress

Considerable attention has focused on describing ethical issues that critical care nurses face in their practice; however, less attention has been directed at describing the process of ethical decision-making. Systematic research linking aspects of ethical-decision making and stress is lacking. This cross-sectional study examines the relationship between selected aspects of ethical decision-making, stress and selected nurse characteristics. Sixty-one critical care nurses completed the Nurse's Ethical Decision Making—ICU Questionnaire and the Health Professions Stress Inventory. Findings revealed that nurses who selected the patient advocacy model had significantly higher nurse autonomy scores, that perceived anxiety had a negative association with nurse autonomy, and that workplace restrictions and stress were related.     

应把防治医患纠纷作为临床医德教育的重要内容

不断强化医务人员的服务意识是消除医患纠纷的首要条件,认真培养敬业精神是避免医患纠纷的根本途径;提高道德境界是避免医患纠纷的决定因素.     

Pneumatosis cystoides intestinii

Zusammenfassung Die Pneumatosis cystoides intestinii (PCI), das Auftreten submuköser oder subseröser, gasgefüllter Zysten in der Wand des Gastrointestinaltrakts, tritt als seltene Erkrankung ohne eindeutige Geschlechtspräferenz vorwiegend in der 3. bis 5. Lebensdekade auf. Atiopathogenetisch werden unterschiedliche Faktoren diskutiert, am wahrscheinlichsten ist eine bakterielle Ursache (Clostridium perfringens) in Verbindung mit einer minimalen Unterbrechung der Mukosaintegrität. Eine pathognomonische Symptomatik gibt es nicht, das klinische Bild reicht von asymptomatischen Zufallsbefunden bis zur Hämatochezie. Die Diagnose wird durch den Nachweis der Gaseinschlüsse mittels Abdomenübersichtsaufnahme und Kolonkontrasteinlauf gestellt. Als Behandlungsmethoden für symptomatische Patienten stehen Sauerstofftherapie, Antibiotikagabe (Metronidazol) und in schweren Fällen die Resektion des betroffenen Darmabschnitts zur Verfügung.

---

Pneumatosis cystoides intestinalis (PCI), a condition involving submucosal or subserosal gas-containing cysts of the wall of the gastrointestinal tract, is a rare entity. It is mostly diagnosed between the third and fifth decades of life without a clear sexual predominance. Different aetiopathogenetic factors are under discussion, the most probable being a bacteriologic cause (Clostridium perfringens) in combination with minimal leaks in mucosal barrier. There are no pathognomonic symptoms; the clinical picture ranges from incidental findings to haematochezia. Diagnosis is based on plain abdominal film and X-ray following barium enema. Methods of treatment in symptomatic cases are oxygen and antibiotic (metronidazole) therapies and, in severe cases, resection of the diseased part of the intestine.