非职业因素与血铅水平的岭回归分析

调查１３３名城市居民的血铅水平。通过ＲｉｄｇｅＲｅｇｒｅｓｓｉｏｎ程序分析非职业因素对血铅水平的影响。结果表明，汽车尾气是影响城市居民的血铅水平的主要因素。     

试述餐饮业和集体用餐配送单位卫生规范的制定与施行

我国首部《餐饮业和集体用餐配送单位卫生规范》于2005年6月27日由卫生部发布,并于同年10月1日起施行。该规范规定了餐饮业人员、建筑、设施、设备、工用具等的设置和卫生管理、加工操作等方面应达到的标准或要求,适用于有固定加工场所的餐饮业经营者,也适用于单位和学校的集体食堂和集体供餐企业。本文是作者对该规范的研制说明和实施建议与讨论。     

Decoding glaucoma module premium edition

Background:Traditional methods for neuroretinal rim width measurement in spectral domain optical coherence tomography (SD-OCT) employs the Bruch‘s membrane opening (BMO) as the anatomical border of the rim, referenced to a BMO horizontal reference plane, termed as “Bruch’s Membrane Opening-Horizontal Rim Width” (BMO-HRW). BMO-HRW is defined as the distance between BMO and internal limiting membrane (ILM) on the horizontal plane. In contrast, the Spectralis OCT (Heidelberg Engineering, Germany) employs a new parameter called “Bruch’s Membrane Opening–Minimum Rim Width” (BMO-MRW) with Glaucoma Module Premium Edition (GMPE). GMPE provides a novel objective method of optic nerve head (ONH) analysis using BMO, but the neuroretinal rim assessment is performed from the BMO to the nearest point on the ILM, rather than on the horizontal reference plane. It is the BMO-MRW and is defined as the minimum distance between the BMO and ILM in the ONH.Purpose:In this video, anatomy of the ONH and GMPE is decoded from a neophyte user’s point of view, as to why BMO-MRW is more important than the traditional BMO-HRW for glaucoma evaluation.Synopsis:The GMPE concepts are depicted in a novel dynamic (Clinical vs OCT Vs Histology) screenplay, detailing the below focal points with 2D & 3D animations: True Margin of ONH, Bruch’s Membrane (BM), Histology Vs OCT, BMO, Bruch’s Membrane Opening-Minimum Rim Width, Bruch’s Membrane Opening-Minimum Rim Width Versus Bruch’s Membrane Opening-Horizontal Rim Width, Alpha, Beta, Gamma Zone of ONH in OCT, Anatomic Positioning System, Impact of Fovea Bruch’s Membrane Opening Centre Axis.Highlights:This video also highlights, how with the advent of Anatomic Positioning System, scans were able to align relative to the individual’s Fovea-to-BMO-center (FoBMOC) axis at every follow-up, for accurately detecting changes, as small as 1 micron in BMO-MRW, thus creating a new world in diagnosing glaucoma and detecting glaucomatous progression with precision.Video link: https://youtu.be/6RqF5guAziw     

乳腺钼靶X线摄影及乳腺微小钙化灶定位活检在触诊阴性乳腺疾病诊治中的临床意义

目的探讨乳腺钼靶X线摄影及乳腺微小钙化灶定位活检与临床触诊阴性乳腺疾病的关系。方法2003年11月～2007年7月临床触诊阴性,仅因乳腺钼靶X线片中发现微小钙化灶而入住我院62例(70侧),患者行钙化灶定位切除经病理检查,行鉴别诊断。结果62例(70侧)中发现乳腺癌16例(16侧、占22.9%),乳腺良性疾病46例(54侧、占77.1%)。其中术后病理证实早期乳腺癌10例,占62.5%。结论外科、影像科、病理科的合作下行乳腺微小钙化灶定位活检在触诊阴性乳腺疾病诊治过程中有重要临床意义。尤其提高了无肿块乳腺癌早诊率,此方法简单易行便于推广。     

髂筋膜间隙阻滞对股骨粗隆间骨折患者体位改变的镇痛效应

目的 探讨术前髂筋膜间隙阻滞对股骨粗隆间骨折手术患者体位改变的镇痛效应.方法 选择80例股骨粗隆间骨折行择期手术治疗的患者,美国麻醉医师协会麻醉风险评分(ASA)Ⅰ～Ⅱ级,随机分为髂筋膜间隙阻滞组(F组)和静脉注射地佐辛组(D组),每组40例.于入室前60 min,F组以0.4％罗哌卡因30 ml行髂筋膜间隙阻滞,D组以地佐辛注射液5 mg静脉注射.记录第1次过床(T1)、第2次过床(T2)、麻醉体位摆放(T3)时间点被动活动的视觉模拟评分(VAS)和局麻药毒性反应情况.结果 F组T1、T2、T3的VAS评分分别为(4.5±1.4)分、(3.8±1.2)分、(3.9±0.7)分,明显低于D组各时间点VAS评分[(7.9±1.2)分、(7.5±0.8)分、(7.0±1.1)分,P均＜0.05].F组无局麻药中毒发生;D组在静脉注射地佐辛60 min内,恶心3例(7.5％),头晕2例(5.0％).结论 髂筋膜间隙阻滞可以安全有效地用于股骨粗隆间骨折手术患者的转运及椎管内麻醉前体位的摆放.     

A Complex Negotiation: Women's Experiences of Naming and Not Naming Premenstrual Distress in Couple Relationships

ABSTRACT

Recent research has demonstrated the importance of family relationships in women's experience of premenstrual changes, their construction of these changes as “PMS.” However, the discursive process by which women take up the subject position of “PMS” sufferer through the explicit naming of “PMS” to an intimate partner has received little research attention. Drawing on 60 individual interviews with Australian women, conducted between 2004 and 2006, we examined accounts of naming “PMS” in intimate relationships, women's explanations for naming or not naming, their experiences of their partner naming them as premenstrual. The analysis process identified an overarching theme of naming “PMS,” which was made up of three themes: naming to explain; “PMS” becoming the only explanation for distress; “PMS” as not a legitimate explanation for distress. The findings suggest that clinicians need to be aware of women's complex, often ambivalent, experiences of naming “PMS” within their relationships, when working with women, couples, seeking treatment or support for premenstrual distress.     

现状与未来：论我国综合性大学医学教育

在不同历史阶段,我国综合性大学医学教育经历了不同的发展模式。文章简要回顾了我国综合性大学医学教育的基本办学现状;结合我国高等教育事业的总体改革与发展思路,厘清综合性大学医学教育的办学定位和人才培养模式;重点分析和论述了综合性大学医学教育的人才培养目标以及基于此目标的预期教学效果。     

Randomized,double-blind,placebo-controlled,safety and immunogenicity study of 4 formulations of Anthrax Vaccine Adsorbed plus CPG 7909 (AV7909) in healthy adult volunteers

A new anthrax vaccine that could accelerate the immune response and possibly reduce the number of injections needed for protection would be desirable in a post-exposure setting.