Extracorporeal shock wave lithotripsy in the management of pediatric urolithiasis

The main objective of this paper was to evaluate the efficacy and safety of the management of pediatric urolithiasis by extracorporeal shock wave lithotripsy (ESWL). Between November 1988 and July 2000, 165 renal stones, 53 ureteral stones, and 5 bladder stones were treated in 126 pediatric patients using Siemens Lithostar lithotriptor. The ESWL treatments ranging from 1 to 7 were needed per patient (mean: 2.1). One ESWL session was performed for 49.6% of stones, two for 24.6%, three for 13.0 %, four for 5.6% and > 4 for 8.2%. The success rate for renal stone units (asymptomatic fragments less than 4 mm) was 88.2%, stone-free rate was 49.0%. The stone-free rate for ureteral stone units was 87.5%, but was 75% for bladder stones. The overall results of ESWL treatment in 126 children was satisfactory: the success rate was 90.5%, stone-free rate was 51.6%, residual fragments > 4 mm were 9.5%. General anesthesia was required in 65 children (136 treatments) under the age of 10, and only in 18 children (40 treatments) in the age 11–14. Auxiliary procedures, such as double J stent and percutaneous nephrostomy (PCN) were used in 19 and 7 patients, respectively. Perirenal hematoma in one patient and hematomas in enteric wall in another one patient were the only major complications managed conservatively without consequences. Low energy lithotripsy with the Siemens Lithostar in our series of pediatric patients was safe and relatively effective.     

Comparing the effectiveness of different types of supported housing for patients with chronic schizophrenia

This longitudinal study assessed the effectiveness of different types of supported housing recently established for patients with chronic schizophrenia in the East German region of Dresden. Survey data covering a 2-year period are reported for five patient subgroups (n=244) living in a psychiatric nursing home, in social therapeutic hostels, in sheltered community residential care, at home with family and alone in their own homes. Psychopathological symptoms, social disabilities, subjective quality of life, and normative individual needs for care were the relevant outcome domains assessed. For all subgroups, changes in the outcome parameters were rather small, from a clinical perspective, demonstrating deterioration, particularly for the older and more severely disabled group living in the nursing home. Results from linear variance analytical statistical models showed that group assignment played a significant role only for the baseline-controlled development of social disabilities and subjective quality of life. Contrasts between the groups outlined the disadvantage of homes and hostels in terms of subjective quality of life and the advantage of maintaining integration in family life in terms of social disabilities. These results support health policy decisions that would invest more deliberately in forms of supported housing that endeavour to improve patients’ autonomous functioning in their own flats, as well as providing assistance to families taking care of patients with chronic schizophrenia.

The effectiveness of human impact assessment in the Finnish Healthy Cities Network

OBJECTIVES: To develop a framework for analysing the effectiveness of prospective assessment and to apply the framework to human impact assessments (HuIA) carried out in the Finnish Healthy Cities Network. METHODS: The framework was formed by synthesizing and developing the themes that emerged from the published literature on effectiveness. The research material consists of interviews with people who participated in the assessment process in the municipalities (19 interviews). The research material also included assessment documents, proceedings of working meetings, municipal policy documents, background material and project reports produced in the municipalities studied. The research datasets were examined by content analysis. RESULTS: HuIA increased the decision-makers' awareness of effects and functioned as a tool for empowerment. The latter was apparent, for instance, in the social welfare and healthcare sector, finding a role for itself in decisively co-ordinating interdisciplinary work and actively seeking to alleviate identified negative effects. The assessment process also opened up the planning process, committed various actors to the decision, helped select the right alternative and promoted social learning. CONCLUSIONS: From the viewpoint of preparation and decision-making, the effectiveness of a HuIA increases when assessment becomes a recurring process and an integral part of an organization's activities. Integration of an assessment into permanent structures or activities, such as drawing up programmes or preparing strategies, helps the results of the assessment to be seen more clearly. From the viewpoint of decision-making, it is also important to strengthen the decision-makers' expertise in prospective assessment. When the effectiveness of HuIA is looked at in a new way (i.e. from the viewpoint of goal achievement, decision-making or learning), a more comprehensive interpretation can be given.     

苏州市健康城市示范路健康促进活动效果评价

目的了解苏州市实施"健康城市示范路健康促进活动"后,居民健康相关行为的形成及改变情况,为制定健康教育综合干预策略提供依据。方法以苏州市示范路上的33个单位、10个社区,共计2043人作为调查对象;使用统一问卷,采取分层随机整群抽样的方法,于2006年和2007年进行了两次调查。结果两次调查的结果显示:在血压测量次数、锻炼、饮用牛奶和过马路等方面存在差异。结论健康促进活动对促进居民健康知识的提高和健康行为习惯的养成是有效的。     

痰热清注射液联合抗生素治疗慢性支气管炎急性发作期的临床观察

目的：评价痰热清注射液治疗慢性支气管炎急性发作期的有效性。方法：观察我科住院病人共60例，随机分为治疗组32例和对照组28例，治疗组应用痰热清注射液联合头孢哌酮钠，对照组单用头孢哌酮钠，10天后观察患者的基本症状、体征变化和综合疗效。结果：治疗组的总有效率显著优于对照组。结论：痰热清注射液是治疗慢性支气管炎急性发作期的有效药物，具有临床应用价值。     

3种包装材料的灭菌效果及成本效益研究

目的探讨不同包装材料的灭菌、阻菌效果及成本构成。方法将棉布类、纸塑包装、医用皱纹纸类包装随机分为3组,研究其灭菌、阻菌效果及成本构成。结果纸塑包装、医用皱纹纸类包装的灭菌及阻菌效果均优于棉布类包装;与棉布类包装相比较,纸塑包装成本降低27%,皱纹纸包装成本降低50%。结论纸塑包装和医用皱纹纸包装具有良好的灭菌和阻菌效果,其包装成本明显低于棉布类包装,值得推广应用。     

中小学生家长预防儿童意外伤害健康教育效果评价

目的 探索有效预防儿童意外伤害的干预措施。方法 在通州区选择两所小学、两所中学的1157名学生及家长为研究对象，其中1所小学、1所中学的588名学生及家长为干预组，另两所中小学校的569名学生及家长为对照组。对干预组的学生及其家长进行交通安全知识、自救急救、生活常识等3个方面健康教育，对照组不采取任何干预措施。干预期1年，并在于预前、后分别进行问卷调查，最后对于预效果进行评价。结果 干预后干预组学生家长的意外伤害相关知识知晓率显著高于对照组（P〈0．05），在将锐利物品、药品、热水等合理放置的行为改变上显著好于对照组（P〈0．05）。结论 对中小学生及其家长进行预防意外伤害的健康教育，能指导学生和家长形成健康相关行为，能有效预防儿童意外伤害的发生。     

银杏达莫注射液治疗急性脑梗死有效性的Meta分析

目的应用Meta分析方法,进一步了解银杏达莫注射液治疗急性脑梗死的临床疗效.方法应用Meta分析对21篇文献研究银杏达莫注射液治疗急性脑梗死的有效性进行同质性检验及合并效应的估计.结果同质性检验x2=9.546,自由度为20,P＞0.05.合并效应量的估计OR合并=4.040,OR合并95%可信区间为3.228～5.056.OR合并的检验x2=148.892,P＜0.001. 21项研究中,均未见明显不良反应出现.结论银杏达莫注射液治疗急性脑梗死的疗效显著优于目前常用药物,且无明显不良反应.     

泪囊冲洗促进化脓性角膜炎治疗分析

目的探讨化脓性角膜炎行泪囊冲洗辅助治疗的效果。方法将本院收治的104例病人随机平分为治疗组与对照组,对照组采用常规方法治疗,治疗组在常规治疗的基础上加用泪囊冲洗辅助治疗。结果应用泪囊冲洗的治疗组的治疗总有效率为96.2%,而对照组只有71.2%,两组总有效率比较有极显著差异(P<0.01)。结论泪囊冲洗联合常规药物治疗能控制的化脓性角膜溃疡,效果良好。     

四川省癫痫防治管理及苯巴比妥治疗效果评价

目的将癫痫病患者的治疗、管理纳入四川省现有初级卫生保健网,控制癫痫病患者发病。方法由经过培训的乡镇卫生院医生对已确定或怀疑为惊厥型癫痫的患者先用筛查诊断表初筛,填表后由县级医院神经科医生对所有初筛患者进行复查,符合条件者列为入组病例,用苯巴比妥药物进行为期1年的规范化治疗、随访和管理。结果治疗的药物剂量范围在30-240mg/d之间,86.8%集中在60-150mg/d,治疗有效率达61.2%。结论在四川农村推广苯巴比妥治疗癫痫,并进行规范化防治管理是可行的。