含锌炉甘石洗剂联合酮康唑治疗肛周湿疹42例疗效观察及护理

目的探讨42例肛周湿疹患者用含锌炉甘石洗剂联合酮康唑治疗的疗效观察及护理方法。方法采用含锌炉甘石洗剂联合酮康唑药物治疗肛周湿疹患者42例,糠酸莫米松软膏治疗肛周湿疹患者40例,辅以严格规范的护理方法和制度。结果含锌炉甘石洗剂联合酮康唑药物治疗肛周湿疹患者治愈率高,疗效好。结论含锌炉甘石洗剂与酮康唑联合治疗肛周溃烂与糠酸莫米松软膏相比,创面愈合时间短,显效快,适合于治疗肛周湿疹。     

The vaginal ring and transdermal patch: new methods of contraception

The most common method of reversible contraception used worldwide is the intrauterine device. However, in the Asia-Pacific the combined oral contraceptive pill and condoms, methods of contraception that require a high degree of day-to-day user compliance, are more popular. The combined vaginal ring and transdermal patch have been developed to overcome the need for daily compliance associated with combined pill use. They have the added advantages of non-oral delivery, thus avoiding gastro-intestinal interference with absorption, and in addition there is no hepatic first-pass effect. Both have been available internationally for some years and offer an alternative to the combined pill. This article reviews and summarises published data on these new methods.     

头颈部血管病变的影像学诊断方法

介绍了头颈部动脉病变的主要影像学诊断方法,阐述了各种方法的优缺点,并分析了各种方法综合利用的意义,指出了多排螺旋CT血管成像在头颈部血管性疾病的诊断方面有望取代数字减影血管造影,为术前评估及手术术式的选择提供可靠的影像学保障。     

应用多种综合评价方法对医疗质量组合评价

目的对医院10年的医疗质量进行组合评价。方法分别应用功效系数法、TOPSIS法、灰色关联度法评价医疗质量，同时将此3种方法进行组合评价。结果一致性检验：相关系数形=0．9731，组合评价得分2005年（20．3428），2004年（18．6811），……。结论组合评价较单一评价方法更全面、客观，10年医疗质量取得较大进步。     

Changing high school students' attitudes toward disabled people

The modification of social stereotypes is a difficult challenge and has traditionally been attempted by means of individual methods such as the provision of factual information. In the study reported here, three different methods of influencing attitudes were combined in an effort to modify high school students' attitudes toward the disabled. Results suggest that combining methods has potential for success.     

宫、腹腔镜联合检查在女性不孕症中应用122例分析

目的探讨宫、腹腔镜联合检查在女性不孕症中的临床应用价值。方法对122例女性不孕患者行宫、腹腔镜联合检查结果进行回顾性分析。结果宫、腹腔镜联合检查对不孕症诊断有很高的阳性率,明显优于宫、腹腔镜单独应用。结论宫、腹腔镜联合检查在女性不孕症中有实用价值,是目前诊治女性不孕症的最佳方法之一。     

不同细胞学检测方法在宫颈癌筛查中的价值

目的:比较计算机辅助细胞学检测(computer-assisted cytological test,CCT)、液基细胞学检查(liquid-basedcytological test,LCT)、LCT联合二代杂交捕获系统(hybrid captureⅡ,HC2)HPV DNA检测在宫颈癌筛查中的灵敏度和特异度。方法:CCT检测的全部病例与LCT检测的部分病例为回顾性病例。HPV DNA检测选用HC2法,剩余标本继续做LCT检测。结果:HC2 HPV DNA结合LCT检查的敏感性显著高于CCT及LCT两种检查方法检查的敏感性(P<0.05)。CCT检测宫颈癌的特异性是88.14%,LCT的特异性是93.78%,LCT联合HC2 HPV DNA检测的特异性是100.00%。三者特异性比较差异均具有统计学意义(P<0.05)。结论:CCT和LCT是目前有效的宫颈癌筛查手段。HC2 HPV DNA检查结合LCT是筛查宫颈癌及癌前病变最好的方法,其阴性预测值几乎达到100%。     

含锌炉甘石洗剂联合酮康唑治疗肛周湿疹42例疗效观察及护理

目的探讨42例肛周湿疹患者用含锌炉甘石洗剂联合酮康唑治疗的疗效观察及护理方法。方法采用含锌炉甘石洗剂联合酮康唑药物治疗肛周湿疹患者42例,糠酸莫米松软膏治疗肛周湿疹患者40例,辅以严格规范的护理方法和制度。结果含锌炉甘石洗剂联合酮康唑药物治疗肛周湿疹患者治愈率高,疗效好。结论含锌炉甘石洗剂与酮康唑联合治疗肛周溃烂与糠酸莫米松软膏相比,创面愈合时间短,显效快,适合于治疗肛周湿疹。     

妇科腹腔镜手术不同麻醉方法效果分析

目的:探讨妇科腹腔镜手术采用不同麻醉方法后患者的麻醉效果及安全性。方法:对广州市妇女儿童医疗中心妇婴院区2006年1月~2008年12月150例不同麻醉方法的妇科腹腔镜患者麻醉效果进行回顾性分析。结果:全麻复合硬膜外麻醉组患者的血流动力学指标最平稳。结论:全麻复合硬膜外麻醉安全性高,苏醒快,具有良好的麻醉效果。     

不同方式终止14～24周妊娠的效果探讨

目的:探讨不同方法终止14~24周妊娠的临床效果。方法:将117例妊娠14~24周妇女随机分为3组,A组采用米非司酮联合米索前列醇引产(40例);B组采用米非司酮联合羊膜腔内依沙吖啶注射引产(39例);C组采用羊膜腔内依沙吖啶注射引产(38例),比较3组引产效果。结果:A组与B组、C组相比,宫缩发动时间及产程短,清宫率低,镇痛药使用率低,出血量少,差异均有统计学意义(P<0.05);B组与C组相比,宫缩发动时间及产程短,清宫率低,差异有均统计学意义(P<0.05)。引产成功率3组间差异无统计学意义(P>0.05)。结论:米非司酮联合米索前列醇引产简单、安全、高效,引产后不需常规清宫,优于米非司酮联合依沙吖啶引产和传统依沙吖啶引产,而米非司酮联合依沙吖啶引产优于传统依沙吖啶引产。     

几种生物活性物质体外抗氧化能力评价技术的研究

目的研究生物活性物质体外抗氧化能力评价方法,应用体外理化环境下建立起来的评价方法对受试物进行初步抗氧化能力评估。方法联合应用2,2’-连氮-双-(3-乙基苯并噻唑-6-磺酸)二铵盐(ABTS)法与铁离子还原/抗氧化能力测定法(FRAP)法用于生物活性物质体外抗氧化能力研究,在ABTS法中,使用紫外可见分光光度计734nm波长下测定以槲皮素、姜黄素、DL-α-生育酚和原花青素等为代表的生物活性物质;在FRAP法中,运用酶标仪,595nm波长处测定同样受试物的抗氧化能力。结果ABTS法:槲皮素和姜黄素的抗氧化活性TEAC值分别约为2.02和0.50;而1gDL-α-生育酚、原花青素清除自由基的能力相当于2.06mmol、2.897mmol的Trolox清除自由基的能力;FRAP法:抗氧化活性以1.0mmol/L FeSO4为参考标准,槲皮素、姜黄素和Trolox摩尔当量约为5.73、1.18和2.09;而DL-α-生育酚和原花青素抗氧化活性分别是207.7mg、156.36mg。结论ABTS法与FRAP法联合应用,操作简便、结果可靠,尤其适宜作为生物活性物质体外抗氧化能力的评价方法。     

Knowledge about contraceptives in a population 15 years or older in a southern Brazilian city

In Brazil, prevalence of contraceptive use is high, but incorrect and inappropriate use is frequent, suggesting limited knowledge about methods. This study thus evaluated the knowledge about the most widely used contraceptive methods, measured through a score (0-10) and related factors. A population-based cross-sectional study was performed, with 3,542 subjects ages 15 or older, residing in the urban area of Pelotas, Rio Grande do Sul State. The mean overall knowledge score was 4.65 (sd = 2.07): 5.02 (sd = 2.10) for women and 4.18 (sd = 1.92) for men. Lower age, higher schooling, a report of unwanted pregnancy, and any lifetime use of contraceptive methods (exclusive or combined) were associated with higher knowledge scores among men, while for women, the determinants of higher knowledge were higher age, living with a partner, higher schooling, higher socioeconomic status, not reporting a religion, and any lifetime use of contraceptive methods (exclusive or combined). Despite high prevalence of any lifetime contraceptive use (75.3%), knowledge is still limited about the most widely used methods, as well as about the menstrual cycle and fertile period.     

Comparison of multilocus enzyme electrophoresis (MEE), ribotyping, restriction enzyme analysis (REA) and phage typing for typing of Listeria monocytogenes.

The discriminatory power of four methods for typing of Listeria monocytogenes was compared. The four methods were multilocus enzyme electrophoresis (MEE), ribotyping, restriction enzyme analysis (REA), and a newly developed Danish phage typing system. Ninety-nine human clinical, food and slaughterhouse isolates of Listeria monocytogenes were typed by each method. The most discriminatory single typing method was phage typing with an overall discriminatory index (DI) of 0.88 followed by REA, MEE and ribotyping with DI-values at 0.87, 0.83 and 0.79 respectively. Considering strains from each of the two predominant O-serotypes alone, serotype 1 was best discriminated by the molecular typing methods, in particular REA, which showed a DI of 0.92. The serotype 4 strains were best discriminated by phage typing (DI = 0.78). If two or more typing methods were combined, the combination of REA and MEE were found to be the most discriminatory combination. The DI values were 0.96, 0.74 and 0.90 for serotype 1, 4, and both combined, respectively. Phage typing is a rapid and inexpensive typing method but not as reproducible as the molecular typing methods. It is the most suitable method for mass screening. In situations where results are required to be highly reliable, i.e. when studying the relationships between only a few strains, a single or a combination of molecular typing methods should be used, preferable MEE and REA.     

内镜联合显微手术治疗大型颅鼻沟通瘤

目的：探讨内镜联合显微手术治疗大型颅鼻沟通瘤的微创治疗方法。方法：对9例大型颅鼻沟通瘤患者在扩大额下入路显微手术切除颅内肿瘤的基础上,联合应用神经内镜经前颅窝颅骨缺损或经鼻切除肿瘤的颅外部分,其中7例经鼻行肿瘤切除,并重建颅底。结果：所有肿瘤均全切除,无手术死亡和新增神经功能缺损、脑膜脑膨出、颅内感染等并发症。结论：内镜联合显微手术治疗大型颅鼻沟通瘤创伤小,对深部能提供良好的照明及视野,安全有效。     

时间驱动作业成本法与RBRVS结合用于医院项目成本核算的研究

将时间驱动作业成本法和以资源为基础的相对价值系数（RBRVS）两种方法结合,用于医院医学影像科项目成本核算研究,探索提高医院成本管理效能的新方法。时间驱动作业成本法与RBRVS结合应用,在计算医疗服务项目成本时具有明显优势,适宜在医疗机构开展。但与此同时,也应考虑其适用性与注意事项,以及两种方法的适当并行。     

Meta-analysis combining parallel and cross-over clinical trials. II: Binary outcomes

We examine different methods to pool binary outcomes used both in parallel and cross-over trials. Odds ratio (OR) estimators obtained from joint conditional probabilities in cross-over trials, such as the Mantel-Haenszel and Peto methods, are compared to an OR estimator using marginal results of cross-over trials. When there is correlation between the outcomes in the two cross-over periods, joint conditional ORs differ from marginal ORs and cannot be combined with OR estimates from parallel trials. The marginal OR estimate is independent of the between-period correlation and it includes a correction for cross-over correlation in the variance estimate. As its computation is similar in cross-over and parallel trials, it is the method of choice to pool results from parallel and cross-over trials in a combined design meta-analysis.     

Adjusting for health status in non-linear models of health care disparities

This article compared conceptual and empirical strengths of alternative methods for estimating racial disparities using non-linear models of health care access. Three methods were presented (propensity score, rank and replace, and a combined method) that adjust for health status while allowing SES variables to mediate the relationship between race and access to care. Applying these methods to a nationally representative sample of blacks and non-Hispanic whites surveyed in the 2003 and 2004 Medical Expenditure Panel Surveys (MEPS), we assessed the concordance of each of these methods with the Institute of Medicine (IOM) definition of racial disparities, and empirically compared the methods’ predicted disparity estimates, the variance of the estimates, and the sensitivity of the estimates to limitations of available data. The rank and replace and combined methods (but not the propensity score method) are concordant with the IOM definition of racial disparities in that each creates a comparison group with the appropriate marginal distributions of health status and SES variables. Predicted disparities and prediction variances were similar for the rank and replace and combined methods, but the rank and replace method was sensitive to limitations on SES information. For all methods, limiting health status information significantly reduced estimates of disparities compared to a more comprehensive dataset. We conclude that the two IOM-concordant methods were similar enough that either could be considered in disparity predictions. In datasets with limited SES information, the combined method is the better choice.

Combined hormonal contraception

This article discusses the different combined hormonal contraception methods. Combined methods, delivering both estrogen and a progestin simultaneously, are among the most effective, widely used hormonal contraceptive options. They also have the best noncontraceptive benefit profile for young women of all hormonal contraceptive options. Oral contraceptive pills (OCPs) are described as the standard combined hormonal method and are discussed in detail. Newer combined hormonal contraceptive delivery systems, the transdermal patch, vaginal ring, and injectable form, are compared with OCPs in terms of pharmacology, efficacy, and adverse events. Advantages and disadvantages of all methods are emphasized, with particular attention to adolescent development and acceptability.     

艾滋病合并巨细胞病毒性视网膜炎的临床研究

目的探讨艾滋病合并巨细胞病毒性视网膜炎的病变特点、诊断方法及治疗原则。方法对38例（60眼）AIDS合并CMVR患者的临床资料进行回顾性分析,包括诊断标准、临床表现、治疗方法及疗效。结果发病1周内、1～2周、2～4周、〉4周患者的治疗有效率分别为100％、94．4％、76．9％、64．o％,不同发病时间的治疗有效率相比较,差异有统计学意义（P〈0．05）。结论早期诊断并采取有效抗病毒治疗措施,有助于防止AIDS合并CMVR导致的不可逆性视力障碍及其他眼部并发症。     

A new measure of the effective number of tests,a practical tool for comparing families of non‐independent significance tests

p‐Values from tests of significance can be combined using the ?idák correction (or the closely related Bonferroni correction) or Fisher's method, but both these methods require that the p‐values combined be independent when all null hypotheses tested are true. In this paper adjustments to these methods are proposed, using a new eigenvalue‐based measure of the effective number of independent tests to which the actual tests performed are equivalent, and are compared with adjustments proposed by previous authors. The adjusted methods are evaluated using a sample of 726 Alzheimer's disease (AD) cases and 707 group‐matched controls, genotyped at 84,975 single‐nucleotide polymorphism loci in 2,000 randomly chosen genes. The tests for genetic association with AD at loci within each gene are combined. The number of loci tested per gene varies from 2 to 994. The adjusted combined p‐values agree well with the significance of the combined p‐values determined empirically by random permutation of the data (?idák correction: r=0.990; Fisher's method: r=0.994). This indicates that the combined p‐values can be used to assess the relative strength of evidence for association of these genes with AD. The adjustment proposed here is a refinement of that of Nyholt ([2004] Am. J. Hum. Genet. 74:765–769), giving improved agreement with the results of random permutation. The improvement obtained is similar to that given by the refinement proposed by Li and Ji ([2005] Heredity 95:221–227). It is concluded that the concept of an effective number of tests is a valid approximation that allows p‐values to be combined in a highly informative way. Genet. Epidemiol. 33:559–568, 2009. © 2009 Wiley‐Liss, Inc.