Impact evaluation of HIV/AIDS education in rural Henan province of China

Nowadays, there is a trend of HIV prevalence transmitting from high-risk group to average-risk group in China. Rural China is the weak link of HIV prevention, and rural areas of Henan province which is one of the most high-risk regions in China have more than 60% of the AIDS patients in the province. Thus, improving the HIV awareness and implementing health education become the top-priority of HIV/AIDS control and prevention. A multistage sampling was designed to draw 1129 people living with HIV/AIDS （PLWHAs） and 1168 non-PLWHAs in 4 prevalence counties of Henan province. A health promoting and social-psychological support model was constructed to improve the health knowledge of participants. Chi-square tests and unconditional logistic regression were performed to determine the intervention effect and influencing factors. All groups had misunderstandings towards the basic medical knowledge and the AIDS transmission mode. Before the intervention, 59.3% of the HIV/AIDS patients and 74.6% of the healthy people had negative attitudes towards the disease. There was statistically significant difference in the improvement of knowledge, attitude and action with regards to HIV prevention before and after intervention （P〈0.05）. PLWHAs who were males （OR=l.731） and had higher education level （OR=1.910） were found to have better HIV/AIDS health knowledge, whereas older PLWHAs （OR=0.961） were less likely to have better HIV/AIDS health knowledge. However, the intervention effect was associated with the expertise of doctors and supervisors, the content and methods of education, and participants＇ education level. It was concluded that health education of HIV/AIDS which positively influences the awareness and attitude of HIV prevention is popular in rural areas, therefore, a systematic and long-term program of HIV control and prevention is urgently needed in rural areas.     

Unmet Needs for Reproductive Health Knowledge among Unmarried Migrant Youth

Objective To explore the deep reason for the lack of reproductive knowledge among migrant youth.
Methods Qualitative research method was used with in-depth interview as the major approach to collect data.
Results The results showed that lack of formal sexual education and the special social status were deep reason for their knowledge lack. Very few of them had received sex education in school. Before falling in love and beginning to date, most girls and some boys have no interest in sexual related knowledge. The knowledge they have usually come first from peer communication and are full of mistakes. As growing up, mass media, like TV and magazines begin to be their major knowledge sources. But many get the information from TV dramas, novels or advertisements, and few from formal educational programs. Working long hours each day, with little leisure time and living isolated in cities, migrant people rarely benefit from the ongoing education activities in cities.
Conclusion Special sexual and reproductive health education program are needed urgently among unmarried migrant youth, particularly female.     

A Cross—sectional Study of Health—related Behaviors in Rural Easten China

Objective This study examined the status of health-related behaviors among rural residents and the factors influencing the practice of such behaviors. Methods One thousand and ninety subjects aged 15 years or over in a rural community, Anhui Province, China were surveyed. A questionnaire was used to collect information on the health knowledge, attitude and behavior of the subjects. Information on health behavior included smoking, drinking, dietary habits, regular exercises, sleeping pattern and oral health behavior. Results The prevalence of smoking and drinking in the male subjects was 46.5% and 46.9%, respectively. There was a positive significant association between smoking and drinking. Only 8.3% of all subjects ate three regular meals a day regularly. Among subjects who ate two meals a day, 89.7% did not have breakfast. Only 1.7% of subjects took part in regular exercise. About 85% of subjects slept 6 to 8 h per day. Only 38.4 % of the respondents had the habit of hand washing before eating and after using the lavatory. 79.3% of the subjects brushed their teeth every day, and among them, only 10.6 percent brushed their teeth twice a day.Further analyses showed that 64.8% of subjects had 3-5 items of positive health behaviors out of 8 items and only 16.9% had six or more items. Logistical regression analyses suggested that better health behavior was affected by sex, age, years of education, income and health knowledge.Conclusion The status of health behaviors among rural residents was generally poor. It is thus urgent to reinforce health education in rural communities in China.     

AIDS—related Knowledge,Condom Usage Among Medical Postgraduates

Objective To investigate the knowledge about safety/unsafty of sexual acts relating to HIV transmission, levels of embarrassment related to condom and condom usage among medical postgraduates. Methods From August to December, 1998, a self-administered anonymous questionnaire was given to 271 new medical postgraduates from two medical colleges of Beijing and Hebei Province. Results There was a hazy understanding of the protective function of condom from AIDS among medical postgraduates. Only 14.4% medical postgraduates persisted in using condom, and 27.94% had never or almost never used it. The levels of embarrassment about condom were high. The median score was 3.55+0.98. Whether to use condom was related with the attitudes to condom, but not to AIDS. Conclusion There was some misunderstanding about condom and inconsistent condom usage in medical postgraduates. So it is essential to strengthen the sexual health education among them.     

Differences and determinants in access to essential public health services in China: a case study with hypertension people and under-sixes as target population

Background Since 2009, health reform had launched in China and essential public health services were provided for all residents to ensure service equity and accessibility, and to achieve sustained population-wide health improvement. This study aimed to investigate the differences and determinants among populations with different characteristics access to essential public health services in China, especially hypertension people and children aged 0-6 years. Methods A cross-sectional study with socio-demographic data analysis was undertaken to estimate distribution characteristics of receiving essential public health services of hypertension patients and children. Regular follow-ups and effective blood pressure control reflected the effective management for hypertension patients, and for children, public services provided were vaccination on schedule and regular physical check-up. Logistic regression was used to determine the predictors for effective management. Results A total of 1 505 hypertension patients and 749 children were involved; 39.14% of hypertension participants could control their blood pressure in the normal range, and the rate in urban areas （43.61%） was higher than that in rural （31.88%）. And 34.68% of them could receive more than 4 times follow-ups by the medical technician. Of 754 children, 79.84% could receive the periodic physical examination and 98.40% had vaccinated regularly. Children living in rural areas were more likely to have regular check-ups （83.96%） and regular vaccination （nearly 99%）. Overall, geographic location and education level were the determinants of people access to essential public health services. Conclusions Implementation of the health reform since 2009 has headed China＇s public health system in the right direction and promoted the improvement of public health system development. Our study highlights the growing needs for more public health services in China, and China＇s public health system needs to be greatly improved in terms of its quality and accessibility.     

麻醉医学专业临床教学的实践与探索

本文从师资队伍建设、教学管理制度完善、"三基"培训、实习考核、医疗安全教育、医德教育、实习生业余活动七个方面,探讨了如何做好麻醉医学专业实习生的临床教学工作.

Abstract：

Clinical education is the key step for cultivating students' basic knowledge, fundamental skills, and clinical thinking, and fulfilling the changing from medical students to clinicians who would be licensed. This article discussed how to improve clinical education of the anesthesiology interne from the following seven aspects: constructing teachers team, perfecting management system, emphasizing training of fundamental theory, knowledge and skills, clinical examination, education of medical insurance, education of medical ethics, and enriching extracurricular activities of interne.     

Demand for and Accessibility to Reproductive Health Service of Urban Floating Population

Summary： The demand for knowledge of productive health and the current status of productive health services provided by relevant governmental institutions were qualitatively and quantitatively studied. The study identified the key factors that influenced the demand for the productive health services and results of the services. It also discussed the effective approaches to control, planning and sustainable development of the reproductive health services for the floating populations.     

Analysis on health information extracted from an urban professional population in Beijing

Background  The assembled data from a population could provide information on health trends within the population. The aim of this research was to extract and know basic health information from an urban professional population in Beijing.

Methods  Data analysis was carried out in a population who underwent a routine medical check-up and aged >20 years, including 30 058 individuals. General information, data from physical examinations and blood samples were collected in the same method. The health status was separated into three groups by the criteria generated in this study, i.e., people with common chronic diseases, people in a sub-clinic situation, and healthy people. The proportion of both common diseases suffered and health risk distribution of different age groups were also analyzed.

Results  The proportion of people with common chronic diseases, in the sub-clinic group and in the healthy group was 28.6%, 67.8% and 3.6% respectively. There were significant differences in the health situation in different age groups. Hypertension was on the top of list of self-reported diseases. The proportion of chronic diseases increased significantly in people after 35 years of age. Meanwhile, the proportion of sub-clinic conditions was decreasing at the same rate. The complex risk factors to health in this population were metabolic disturbances (61.3%), risk for tumor (2.7%), abnormal results of morphological examination (8.2%) and abnormal results of lab tests of serum (27.8%).

Conclusions  Health information could be extracted from a complex data set from the heath check-ups of the general population. The information should be applied to support prevention and control chronic diseases as well as for directing intervention for patients with risk factors for disease.

     

Improving Demand-oriented Quality Care in Family Planning-A Review of Practice and Experience in Family Planning Programme of Qianjiang, Hubei

With the mainstreaming being the demand from the people at reproductive age, we systematically analyzed the ideas and ways to implement quality care (QC) in family planning (FP) in Qianjiang, including advocating the conception of quality care, caro, ing out health education and counseling, strengthening capacity building of service system and reforming measurement of the evaluation and other aspects. The demand-oriented QC in FP has met personalized and verified demands from people of reproductive age satisfactorily, and kept the fertility rate at a lower level while uplifting satisfaction of the public. The demand-oriented QC in FP in Qianjiang county proved to be a successful and great worth practice.     

Epidemiology and prevention of hepatitis B virus in China

Hepatitis B virus （HBV） infection is prevalent in China. Approximately 600 million people have ever been infected by HBV. About 130 million are HBV chronic carders and 30 million HB patients. Among them, 50% of HBV carriers are caused by carrier mothers to born infants. Around 300 000 people died of liver disease including liver cirrhosis and primary hepatocellular carcinoma each year and 50% of them died of primary hepatocellular carcinoma. HBV infection is not only the health problem but also becoming a social problem. HBV chronic carriers and patients have endured the great pressure from disease burden and social discrimination. According to the report of the national screening program of HBV released by the ministry of health in 2008, China has taken many effective measures to control the HBV infection, including vaccine immunization program, strengthening the management of blood sources and blood productions, prevention of nosocomial HBV infection, strengthening health education on HBV infection and safe injection techniques. The implementation of HB vaccine immunization program, which China officially introduced into the national immunization program since 1992, has dramatically reduced the incidence of HBV infection among infants and children. Integrated with other interventions, the rate of HBV infection decreased gradually. According to the survey of the national screening program of HBV in 2006, compared with the incidence of HBV in 1992, the incidence rate of HBsAg positive has decreased 26.36%, the number of children who have ever been infected by HBV decreased 80 million since 1992. However some problems are still existing. The solutions of low rate of vaccination in rural areas and migration population, lacking of practical measures on management of hepatitis B patients, the occurrence of health care acquired HBV infection, and low rate of vaccination among high risk groups have also been recommended.     

雌激素对缺氧/复氧神经元高迁移率族蛋白B1及核因子-κB表达的影响

目的 探讨雌激素对缺氧/复氧诱导新生大鼠皮质神经元损伤的保护作用及其机制.方法 将培养7 d的大鼠皮质神经元随机分为三组,A组为正常对照组,B组采用缺氧/复氧(H/R),C组采用雌激素(17βE2)预处理加H/R处理,各组在H/R后0、1、3、6、12、24 h各时间点,以TUNEL法比较各组凋亡细胞,免疫组化方法比较各组高迁移率族蛋白B1(HMGB1)、核因子-κB(NF-κB)表达.结果 ①B组凋亡神经元明显多于正常对照组(H/R后3～24 h),C组凋亡细胞数目显著少于B组,三组比较差异有统计学意义.②B组HMGB1、NF-κB的表达较正常对照组明显增加,C组HMGB1、NF-κB表达较B组明显减少.结论 雌激素可使H/R后神经元HMGB1、NF-κB表达降低,抑制神经元凋亡,提高其存活率,这可能是其脑保护作用的机制之一. Abstract： Objective To explore the protective effects of estrogen on injured neurons induced by H/R and the mechanisms of that. Methods The cortical neurons cultured for 7 days were randomly divided into group A (normal control group), group B (H/R alone), group C (pretreatment with Estrogen -17βE2 and H/R). Then the apoptotic neurons were count by TUNEL, and the expression of HMGB1,NF- κB was observed by immunocytochemical technique, on each time point after reoxygenation 0,1,3,6,12,24 h of each group. Results ①The number of apoptotic neurons in group B was more than that in control group after H/R 3-24 h, and was less in group C than in group B. ②Compared with group A, the expression of HMGB1 and NF-κB was higher in group B,and was lower in group C than in group B. Conclusions Estrogen could decrease the expression of HMGB1 and NF-κB to inhibit neuronal apoptosis after H/R, which may be one of the mechanisms in which estrogen exerts its neuro-protective effect.     

不同药物配方在分娩镇痛中的临床观察

目的 探讨产妇在分娩时镇痛时麻醉药物的选择.方法 选择我院2007年5月至2009年4月期间单胎初产妇150例随机分为三组,分别使用0.75%罗哌卡因20 ml+芬太尼0.2 mg+生理盐水至100 ml;0.75%罗哌卡因20 ml+曲马多200 mg+生理盐水至100 ml;0.75%罗哌卡因20 ml+曲马多200 mg+氟哌利多50 mg+生理盐水至100 ml,观察各组的疼痛评分、镇静评分及副作用.结果 使用芬太尼的患者镇痛、镇静效果明显优于其他的药物配伍,并且不良反应轻.结论 芬太尼在分娩镇痛中具有镇痛、镇静效果好,不良反应少,用药少的优势. Abstract： Objective To explore the choice of narcotic drugs required for analgesia in childbirth in maternal. Methods Random selection in our hospital from May 2007 to April 2009 during the period 150 cases of singleton pregnancies were divided into three groups of primipara.The use of 0.75% ropivacaine 20 ml+fentanyl 0.2 mg+saline to the 100 ml; 0.75% ropivacaine 20 ml+tramadol 200 mg+saline to the 100 ml; 0.75% ropivacaine 20 ml+tramadol 200 mg+droperidol 50 mg+physical salt to 100 ml. Observed in each group the pain score, sedation score and side effects. Results Patients using the fentanyl analgesic, sedative effect is superior to other drug compatibility, and side effects of light. Conclusions Fentanyl labor analgesia with analgesic, sedative effect is good, fewer adverse reactions, medication less advantage.     

半月板桶柄状撕裂的MRI诊断与关节镜下分类的相关研究

目的 探讨MRI对半月板桶柄状撕裂的诊断与关节镜下分类的比较研究.方法 分析63例患者65个经关节镜检查证实为半月板桶柄状撕裂的术前MRI的特征性表现,并将5种MRI征象(双后交叉韧带征、半月板翻转征、空领结征、碎块内移征和外周残半月板征)与关节镜下Dandy分型进行比较.结果 MRI桶柄状撕裂诊断符合率89.2%.碎块内移征和空领结征阳性率最高,分别为84.6%和81.5%;双后交叉韧带征(双PCL征)、半月板翻转征(双前角征)、外周残半月板征不如上二者普遍(阳性率分别为43%、21.5%、29.3%).未发现外侧半月板双PCL征;内侧半月板交锁Ⅰ型和Ⅱ型及外侧半月板半长全宽型、全长半宽型与MRI碎块内移征和空领结征有相关性;2例为半月板撕裂Ⅲ级信号,5例为假阴性.结论 5种MRI征象中最少2种(碎块内移征和空领结征阳性率最高)以上出现应高度怀疑为桶柄状撕裂. Abstract： Objective To evaluate the arthroscopic findings of meniscal bucket handle tears and to correlate them with the proposed MR imaging signs of meniscal bucket handle tears suggested in the literature. Methods Sixty-three patients who had a diagnosis of bucket handle tear in arthroscopy were included in our study.Meniscal tears were evaluated in arthroscopy according to Dandy's classification.The MRIs were retrospectively analyzed regarding the following findings:absence of bow tie sign,presence of double posterior cruciate ligament(PCL), fragment within the intercondylar region,flipped meniscus sign, abnormal circumferential meniscus sign. Sensitivity were evaluated for the presence of each individual sign. Results Locked types Ⅰand Ⅱfragment of medial meniscus and half-length,whole-width and whole length-half-width fragement of lateral meniscus in arthroscopy were correlated with fragement within the intercondylar notch and absent bow tie signs in MRI.We didn't find the double PCL sign in any of the patients with a lateral meniscal bucket handle tear.The most common signs in MR imagings of meniscal bucket handle tears were the fragement in the notch sign and the absent bow tie sign.They were observed with frequency of 84.6% and 81.5% respectively.The presence of double posterior cruciate ligament, flipped meniscus sign, abnormal circumferential meniscus sign were less common(43%,21.5% and 29.2%,respectively). Conclusions The presence of at least two of the five MRI signs should be regarded as highly suggestive for bucket handle tears of menisci.     

叶酸联合塞来昔布对食管癌的化学预防作用

目的 探讨选择性环氧合酶-2(COX-2)抑制剂塞来昔布联合叶酸预防食管癌的有效性.方法 将84例食管上皮轻、中重度不典型增生患者随机分为叶酸组(28例)、塞来昔布联合叶酸组(28例)以及安慰剂组(28例),连续服用12个月后,再行胃镜及病理复查.终点指标定义为食管上皮不典型增生的组织学分级有严重程度的改变,记录其逆转、稳定、进展变化,比较各治疗组疗效.结果 塞来昔布联合叶酸组的不典型增生的好转率为60.7%(17/28),显著高于对照组(P＜0.05).叶酸组对食管上皮各级不典型增生并未有显著影响.结论 塞来昔布和叶酸联合应用可能降低食管癌发病的危险,尚需进一步扩大样本量的研究. Abstract： Objective To determine the validity of celecoxib combined with folate for the prevention of esophageal carcinoma.Methods Eighty four subjects completed the trial. Subjects had histologically confirmed mild or moderate esophageal dysplasia at baseline. And they were randomly divided into three groups: folate group,celecoxib plus folate group and control group.Esophagogastroduodenoscopy was performed before and after a 12-month intervention. Per-subject change (regression, stable or progression) in the worst dysplasia grade was defined as the primary end point. Results were compared by agent group.Results The relative reverse rate of celecoxib plus folate group was 60.7%(17/28), significantly higher than that in placebo group (P＜0.05). Folate alone did not influence changes in dysplasia grade by baseline histology subgroup(P＞0.05).Conclusions Celecoxib and folate have better effects than celecoxib alone in the chemoprevention of esophageal carcinoma for high risk subjects. Further trials with larger numbers are needed to confirm these results.     

410例膝关节外伤MRI诊断分析

目的 探讨MRI对膝关节外伤的诊断价值.方法 回顾性分析410例膝关节外伤的MRI表现,其中72例行CT检查,380例同时拍摄X线平片,比较3种方法对膝关节外伤的诊断价值.结果 MRI、CT及X线对膝关节外伤的阳性检出率分别为99.02%(406/410)、70.83%(51/72)、30.00%(114/380).MRI表现分别为骨挫伤伴或不伴骨折、关节腔积液、半月板损伤、韧带损伤、关节周围软组织损伤.MRI阳性检出率明显高于CT组及X线组,组间比较差异有统计学意义(P<0.05).结论 MRI对膝关节外伤具有独特而重要的诊断价值,而且无创伤、无辐射,能够最大限度弥补X线及CT检查的不足,可作为膝关节外伤的常规检查手段. Abstract： Objective To investigate the diagnostic value of MRI imaging on detecting knee joint injury. Methods MRI manifestations of knee joint injury in 410 cases were analyzed retrospectively. Of all patients, 72 cases underwent CT scan,380 cases underwent X-ray examinations and to compare the diagnostic value of the three methods in detecting knee joint injury. Results The positive rates of MRI, CT, X-ray in detecting knee joint injury were 99.02%(406/410), 71.83%(51/71), 30.00%(114/380) respectively. Knee joint injury manifested as bone contusion or bone contusion accompanied with bone fracture, joint effusion, meniscus injury, ligament injury, para-articular soft tissue injuries with MRI. The positive rate was significantly higher than that of CT and X-ray, the difference was statistical significance. Conclusions MRI not only play a peculiar and important role in the diagnosis of the knee joint injury with non-invasion or radiation, but also can largely make up for the disadvantage of CT and X-ray,and could be used routinely.     

高血压病患者颈动脉粥样硬化与血尿酸及载脂蛋白水平的相关性

目的 通过对高血压病患者颈动脉超声多普勒检查和血尿酸及载脂蛋白水平的测定,探讨血尿酸及载脂蛋白与颈动脉硬化程度的关系.方法 测定100例高血压病患者血尿酸及载脂蛋白水平,用超声多普勒检测颈动脉粥样硬化程度.结果 颈动脉粥样硬化程度与血尿酸及载脂蛋白水平有关.结论 血尿酸及载脂蛋白水平与颈动脉粥样硬化的程度具有相关性,血尿酸及载脂蛋白B水平升高、载脂蛋白A水平降低是动脉粥样硬化的危险因素. Abstract： Objective To evaluate the correlation among the level of serum uric acid, apolipoproteins and the degree of carotid artery atherosclerosis in patients with hypertension. Methods The serum uric acid, apolipoproteins in 100 patients with hypertension were detected, and the degree of carotid artery atherosclerosis was determined by ultrasonic Doppler examination. Results The serum uric acid,apolipoproteins had the positive correlation to the degree of carotid artery atherosclemsis. Conclusions The concentrations of serum uric acid, apolipoproteins have positive relationship to the degree of carotid artery atherosclerosis. Increase of level of serum uric acid and ApoB, reduce of level of ApoA are risk factors for carotid artery atherosclerosis.     

四种抗体联合检测在SLE患者中的诊断价值

目的 探讨抗双链DNA(dsDNA)抗体、抗Smith(Sm)抗体、抗核小体抗体(AnuA)、抗组蛋白抗体联合检测在系统性红斑狼疮(SLE)患者中的诊断价值.方法 抗dsDNA抗体、抗Sm抗体、AnuA、抗组蛋白抗体均采用欧蒙斑点法测定98例SLE患者(分为活动期和稳定期)、90例其他结缔组织病患者及40例健康人血清中的四种自身抗体.结果 98例SLE患者中抗dsDNA抗体、抗Sm抗体、AnuA、抗组蛋白抗体阳性率分别为45.9%、 29.6%、 57.1%、33.6%,特异性分别为100%、99.2%、98.5%、89.2%;抗dsDNA抗体和AnuA在活动期SLE中的敏感性与稳定期相比差异有统计学意义(P<0.05);抗dsDNA抗体和AnuA以及四种抗体联合检测时阳性率分别为70.4%和79.6%,明显高于其中任何单项检测的阳性率,且明显高于疾病对照组,差异有统计学意义(P<0.05).结论 所检测的四种抗体在SLE中都具有很高的特异性和敏感性,其中抗dsDNA抗体和AnuA对活动期SLE具有很好的诊断价值,抗体的联合检测可较大程度提高SLE检测阳性率,四种抗体有明显的互补作用,尤其抗dsDNA抗体和AnuA的联合检测具有很好的组合价值. Abstract： Objective To investigate the diagnostic significance of combined detection of anti-double stranded DNA antibody(anti-dsDNA),anti-Smith antibody(anti-Sm)and antinuclesome antibody(AnuA) and anti-histone antibody in systemic lupus erythematosus(SLE),and evaluate the significance of combined detection of these autoantibodies in the diagnosis of SLE. Methods Ninety-eight cases of SLE patients who were divided into active and stable stage group and 90 disease controls and 40 healthy people were detected with Euro immunoblot assay.Results In the assays mentioned above. The serum positive rates of anti-dsDNA,anti-Sm, AnuA and anti-histone antibody were 45.9%,29.6%,57.1% and 33.1% in SLE, and the specificities were 100%,99.2%,98.5% and 89.2% respectively in patients with SLE.The positive rates of anti-dsDNA and AnuA in active SLE group were 57.5%,65.1%,which was apparently higher than that in the stable stage group;The sensibility of combined detection of anti-dsDNA and AnuA was 70.4%, four autoantibodies combined detection in SLE was 79.6%, which was apparently higher than any single autoantibodies, the difference had statistical significance. Conclusions These four autoantibodies have very high sensibility and specificity respectively, combined detection of four autoantibodies can markedly raise the relevance ratio in SLE, while their specificity didn't have a visual reduction. Especially, the sensibility of combined detection of anti-dsDNA and AnuA can markedly increased in active SLE patients. This compose can raise effectively the diagnosis of active SLE.So the detections of the four antibodies are complementary for the diagnosis of SLE.     

低浓度5-氟尿嘧啶与糖皮质激素联合激光治疗瘢痕疙瘩的疗效

目的 观察低浓度5-氟尿嘧啶(5-Fu)与糖皮质激素局部注射联合激光治疗瘢痕疙瘩的疗效及安全性.方法 瘢痕疙瘩70例,102处病灶,平均病史8.6年,平均治疗时间为10.29个月.70例瘢痕疙瘩患者108处病灶进行单纯瘢痕内注射,0.6 ml 5-Fu与5 ml曲安奈德、1 ml 2%利多卡因混合后局部注射于瘢痕全层注射,每2～4周1次,瘢痕完全萎缩后逐渐降低药物浓度并延长注射间歇期.另一组70例瘢痕疙瘩患者102处病灶将三联药物局部注射半个月后Nd:YAG激光照射,每2～4周1次.结果 在治疗6个月以上的患者中,5-氟尿嘧啶与糖皮质激素联合激光治疗瘢痕疙瘩的总有效率为97.06%,其中完全缓解者占45.10%,极大缓解者占49.02%,部分缓解者占2.94%,未缓解者为2.94%.结论 低浓度5-氟尿嘧啶与糖皮质激素局部注射联合激光治疗瘢痕疙瘩的疗效显著. Abstract： Objective To monitor the therapeutic action and security of 5-Fu and steroid injected associate with laser to keloid. Methods One hundred and two keloid focuses of 70 patients have the average 8.6 years history and the average therapy period of 10.29 months. Among them,70 patients with total 108 keloid were treated merely with intralesional injection of a mixture of 0.6 ml 5-Fu,5 ml corticosteroid and 1 ml 2% lidocaine once per 2-4 weeks. The other 70 patients with total 102 keloid around sternal area were treated with the mixture once per 2-4 weeks. And they were irradiated with apulsed Nd:YAG laser(wavelength 1064 nm)at 35-140 energy density levels after 15 days. After keloid became flattened,drug concentration was decreased with prolonged intermission of drug injection. Results The total therapy efficacy of 5-Fu associate with steroid to keloid was 97.06%. Of them, the complete remission percentage was 45.10%,the large remission percentage was 49.02%,part remission percentage was 2.94%,and the inefficacy percentage was 2.94%. Conclusions It is more effective that the combination therapy to keloid of low concentration 5-Fu,steroid and Nd:YAG laser.     

腹膜透析患者饮食成分与大动脉僵硬度的关系

目的 探讨持续性非卧床腹膜透析(CAPD)患者饮食营养成分与大动脉僵硬度的关系.方法 选取同一中心92例饮食状况稳定的CAPD患者为研究对象.采用自动脉搏波速度分析仪测定脉搏波速度(PWV),由专业的营养师计算患者饮食组成部分,与PWV进行相关和多元回归分析,筛选出大动脉僵硬度的影响因素.结果 Pearson分析发现PWV与尼克酸 (r=-0.148,P<0.05)、维生素C(r=-0.125,P<0.05)、维生素E(r=-0.181,P<0.05)、碳水化合物(r=-0.181,P<0.05)、能量(r=-0.147,P<0.05)、蛋白质(r=-0.154,P<0.05)相关.多元回归分析结果显示,饮食中维生素E(β=-0.163,P=0.022)及碳水化合物(β=-0.284,P=0.025)是PWV的独立相关因素,二者一起决定了PWV变化的5%.结论 腹膜透析患者饮食维生素E、碳水化合物与PWV密切相关.维生素E、碳水化合物是腹膜透析患者大动脉僵硬度的独立影响因素. Abstract： Objective To investigate the association between dietary nutritive composition and pulse wave velocity (PWV)in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods CAPD patients (n=92) of stable dietary habits in one single center were included.Carotid-femoral PWV was measured with a validated automatic device and was used as an index of large arterial stiffness.Dietary nutritive composition of these patients were calculated by a professional nutritionist. Pearson's correlation and multiple regression analysis were performed to identify the relationship between nutritive composition and PWV.Results PWV was closely associated with nicotinic acid (r=-0.148,P<0.05),vitamin C(r=-0.125,P<0.05),vitamin E (r=-0.181,P<0.05),carbohydrates (r=-0.181,P<0.05),energy (r=-0.147,P<0.05),protein(r=-0.154,P<0.05), respectively.Multiple regression analysis showed that PWV was independently determined by vitamin E (β=-0.163,P=0.022)and Carbohydrates (β=-0.284,P=0.025).They accounted for 5% of the total variance.Conclusions Dietary vitamin E and carbohydrates is closely associated with PWV in CAPD patients.Dietary vitamin E and carbohydrates are independent influential factors for PWV in CAPD patients.Suggesting that the relationship may help to explain the possible protective effect of vitamin E and carbohydrates on cardiovascular risk and mortality through alleviating atherosclerosis in CAPD patients.     

超声引导下酒精硬化治疗肝、肾囊肿的并发症及处理方法

目的 探讨超声引导下酒精硬化治疗肝、肾囊肿所发生的并发症及处理方法.方法 回顾性分析近年所施行的肝、肾囊肿介入性酒精硬化治疗患者202例(均以无水酒精为治疗药物),其中出现并发症23例,包括出血、酒精不耐受、注入无水乙醇后无法顺利抽出、术中出现明显疼痛、操作过程中针尖脱出等.结果 22例均经对症处理,成功治疗,1例因针尖脱出,未行酒精硬化治疗,仅抽出囊液.结论 超声引导下酒精硬化治疗肝、肾囊肿是普遍采用的有效方法,但可发生少数并发症,如经早期发现并正确处理均能予以治愈. Abstract： Objective To explore the causes and treatment of the complications of alcohol sclerotherapy for hepatic and renal cysts with ultrasound-guided. Methods In recent 4 years, 202 cases of hepatic and renal cysts were treated by alcohol sclerotherapy with ultrasound-guided,among which complications were found in 23 cases by retrospective analysis. Results 22 cases were treated successfully. In 1 case, the needle was falling off from the cyst cavity, the liquid of cyst was drained out. Conclusions Alcohol sclerotherapy is a generally applied and efficient method for hepatic and renal cysts. But a few complications might occur due to different factors, which could be treated successfully if you found them early.