多发性结节性腱黄瘤1例

患者,女,66岁,主因双跟腱、双膝及右手肿物30余年入院.查体:双跟腱、双髌骨下缘、右中指掌指关节背侧分别有10 cm×3cm ×7 cm、10 cm×3 cm×8 cm、7cm×6 cm ×2 cm、7 cm ×6 cm×2 cm、3 cm×2 cm×2 cm肿物,质地中等,无压痛,无关节积液,不能移动,无关节功能障碍.     

商洛半夏块茎不同种植密度的对比试验研究

目的:考查商洛半夏块茎不同种植密度对增产的影响.方法:采用株行距3cm×20cm,6cm×20cm,9cm×20cm,12cm×20cm,15cm×20cm5种种植密度与8cm×15cm作对照,以半夏鲜产量和粒数、粒重为指标,计算增产百分率.结果:半夏种植过密、过稀均达不到增产的目的.株行距9cm×20cm增产效果显著.平均增产33.46%.结论:适当密植,对商洛半夏生产有较高的应用价值.     

多电极射频肿瘤治疗的体外实验研究

目的　了解射频消融灶大小与功率及时间的关系、超声与大体病理测值的关系、消融灶与周围组织的关系。方法　新鲜牛肝 3只和牛肾 2只 ,消融灶分两组 :距肝表面 1cm和 4cm ;同时将肾脏置于肝表面 ,用不同的功率和时间实验。结果　 10min时 ,2 0W ,40W ,6 0W ,80W的消融灶病理测值分别为 4.1cm ,3.8cm ,3.0cm ,3.3cm ,超声测值分别为 4.5cm ,4.0cm ,4.5cm ,4.0cm。 2 0min时 ,消融灶病理测值分别为 3.0cm ,4.1cm ,2 .8cm ,3.5cm ,超声测值分别为 4.3cm ,4.2cm ,3.4cm ,3.8cm。 30min时 ,消融灶病理测值分别为 3.5cm ,2 .9cm ,3.5cm ,3.4cm ,超声测值分别为 4.5cm ,4.0cm ,3.6cm ,4.1cm。超声和大体解剖测值相比 ,P <0 .0 1。消融灶和周围组织间有0 .3～ 0 .5cm的浅红色移行区。结论　射频消融灶的大小不随功率和时间的增加而增加 ,超声比大体病理测值大 ,两者差别有极显著性意义。消融病灶和周围组织间有移行区。浅表面的消融病灶对临近组织有损伤作用     

卵巢交界性Brenner瘤1例及文献复习

1病例资料 患者,女,39岁,以下腹部疼痛伴恶心、呕吐8 h为主诉入院,B超示：右侧附件区囊实性包块,约8.0 cm×8.0 cm×7.5 cm,左侧附件区实性包块,约2.0 cm×1.0 cm×1.0 cm。遂行术中探查,并送检右侧附件及左侧卵巢赘生物病理检查。 大体检查：右侧卵巢,囊性肿块10.0 cm×8.0 cm×4.5 cm,一端附输卵管5.0 cm×0.8 cm,切开肿块,囊内见淡黄色液体,囊里大部分光滑,局灶乳头状突起,范围约3.0 cm×2.0 cm,最厚处1.5 cm,质地软;另送检左侧卵巢,不成形组织2.5 cm×1.0 cm×1.0 cm,表面光滑,质硬。     

一例海绵状血管瘤压迫肠系膜上动脉致死案例的临床与病理学特点分析

海绵状血管瘤为一种血管发育畸形,可发生于肾。肝脏体积28 cm×18 cm×5.5 cm,表面灰黄色,切面无异常。肺门及支气管旁淋巴结肿大,最大直径0.6 cm,左肺体积29 cm×12.5 cm×3 cm。右肺体积27 cm×17 cm×4 cm。切面见末端支气管扩张,指压有     

彩色多普勒超声诊断成人多囊肾伴多囊肝、多囊胰1例

患者,女性,40岁,主因血尿3 d就诊.父亲患有多囊肾,健在.超声表现,双肾位置正常,体积明显增大,外形失常,呈较密集的大小不等的液性暗区,右肾范围约19.0 cm×11.0 cm×10.6 cm,其内液性暗区大者约10.0 cm×8.3 cm;左肾范围约21.2 cm×11.7 cm×10.9 cm,其内液性暗区大者约8.1 cm×7.1 cm.肝脏体积明显增大,右肝斜径约15.3 cm,被膜不光滑,肝内呈较密集的大小不等的液性暗区,大者约5.0 cm×3.8 cm.     

16层螺旋CT扫描野的设置与儿童头部图像质量关系的临床研究

目的探讨16层螺旋CT扫描野大小与儿童头部图像质量之间关系。方法分别采用18cm×18cm、25cm×25cm扫描野对分辨率模体进行扫描,测量出各扫描野其空间分辨率;对40例儿童分别采用18cm×18cm、25cm×25cm扫描野进行头部扫描,采用双盲法对图像质量进行比较。结果不同的扫描野其图像空间分辨率不同,18cm×18cm扫描野的图像空间分辨率最高;扫描野为18cm×18cm时,儿童头部的图像明显比扫描野为25cm×25cm的图像清晰（P〈0.05）。结论16层螺旋CT儿童头部常用的扫描野范围内,当扫描野为18cm×18cm时,其头部图像的空间分辨率最佳。     

多电极射频肿瘤治疗的体外实验研究

目的：了解射频消融灶大小与功率及时间的关系、超声与大体病理测值的关系,消融灶与周围组织的关系。方法：新鲜牛肝3只和牛肾2只,消融灶分两组,距肝表面1cm和4cm;同时将肾脏置于肝表面,用不同的功率和时间实验。结果：10min时,20W,40W,60W,80W的消融灶病理测值分别为4．1cm,3．8cm,3．0cm,3．3cm,超声测值分别为4．5cm,4．0cm,4．5cm,4．0cm。20min时,消融灶病理测值分别为3．0cm,4．1cm,2．8cm,3．5cm,超声测值分别为4．3cm,4．2cm,3．4cm,3．8cm。30min时,消融灶病理测值分别为3．5cm,2．9cm,3．5cm,3．4cm,超声测值分别为4．5cm,4．0cm,3．6cm,4．1cm。超声和大体解剖测值相比,P＜0．01。消融灶和周围组织间有0．3－0．5cm的浅红色移行区。结论：射频消融灶的大小不随功率和时间的增加而增加,超声比大体病理测值大,两者差别有极显著性意义。消融病灶和周围组织间有移行区。浅表面的消融病灶对临近组织有损伤作用。     

超声诊断胎儿多发畸形合并脐膨出l例

病人,女,27岁,孕24周。2011年1月17日产前超声检查：胎儿双顶径4.5 cm,头围18.4 cm,下颌骨长1.7 cm,左侧股骨长3.8 cm,左侧肱骨长3.5 cm,左侧桡骨长2.4cm,左侧尺骨长3.5 cm;右侧股骨长4.0 cm,右侧肱骨长3.3 cm,右侧桡骨长3.2 cm,右侧尺骨未探及;     

超声诊断胎儿短肢畸形合并多指(趾)畸形1例

1临床资料孕妇,27岁,G4P3,孕33 5周,超声所见:双顶径9.05cm,相当于孕36 5周,头围31.2cm,相当于孕34 6周,胸围24.5cm,腹围28.6cm,相当于孕32 4周,股骨长3.81cm,相当于孕22 1周,胫骨长3.75cm,腓骨长3.75cm;肱骨长3.9cm,尺骨长4.2cm,桡骨长4.0cm;胎儿足长6.4cm。胎儿颅骨光环完整,     

农村居民家庭对便携式药包的需求调查

目的了解中国农村居民对便携式药包的需求,为科学设计适合农村居民使用的便携式药包提供依据。方法采用单纯随机抽样与整群抽样相结合的方法,对中国9个省451户农村居民对便携式药包的需求进行了调查与分析。结果农村居民对便携式药包的需求率为80.7%。364户需求者期望便携式药包能储存的主要药品:感冒药为88.7%、创可贴为71.2%、清凉油为50.8%、风油精为47.0%、高血压用药为29.4%、碘酊为25.8%;期望能储存的主要器械:体温计为77.5%、棉签为68.4%、血压计为27.5%、注射器为12.1%;期望其大小为:长(25.17±9.16)cm,宽(17.97±8.16)cm,高(15.74±8.92)cm。期望其主要的功能特点:适用占65.9%、安全占57.4%、轻便占53.8%、经济占48.6%、防水占39.3%、简单占38.2%;期望其价格主要为5～15元,占48.0%;对材质需求主要倾向于硬材料的占86.0%,并把塑料作为原材料的首选。结论农村居民对便携式药包的需求率较高,便携式药包的开发必须尊重市场需求,只有充分满足多数农村居民的需求,才能保证便携式药包推广使用,减少不合理用药行为的发生,进而保障居民健康。     

Diabetes and cardiovascular disease. The Framingham study.

Based on 20 years of surveillance of the Framingham cohort relating subsequent cardiovascular events to prior evidence of diabetes, a twofold to threefold increased risk of clinical atherosclerotic disease was reported. The relative impact was greatest for intermittent claudication (IC) and congestive heart failure (CHF) and least for coronary heart disease (CHD), which was, nevertheless, on an absolute scale the chief sequela. The relative impact was substantially greater for women than for men. For each of the cardiovascular diseases (CVD), morbidity and mortality were higher for diabetic women than for nondiabetic men. After adjustment for other associated risk factors, the relative impact of diabetes on CHD, IC, or stroke incidence was the same for women as for men; for CVD death and CHF, it was greater for women. Cardiovascular mortality was actually about as great for diabetic women as for diabetic men.     

医养结合视角下初级养老护理员胜任力模型的构建

目的：构建初级养老护理员胜任力模型,为初级养老护理员的选拔、考核和培训提供参考。方法：运用 文献回顾法建立初级养老护理员胜任力初级模型;运用Delphi法对20名专家进行2轮函询,对初级模型各级指标进行 修改与完善,并运用层次分析法和专家排序法确定各级指标权重。结果：两轮函询问卷的有效回收率分别为87%和 100%;专家权威系数为0.70~0.93,平均权威系数为0.80;最终确立的初级养老护理员胜任力模型包含4个一级指标、 11个二级指标、37个三级指标。结论：所构建的初级养老护理员胜任力模型结果可靠,可作为初级养老护理员选 拔、考核和培训的参考标准。     

156株肺炎支原体对14种抗生素的药敏分析

目的 了解肺炎支原体对临床常见14种抗生素的敏感情况及其特点,用于说明肺炎支原体药敏检测在临床的意义.方法 用商品化试剂盒考察临床收集并确认的156株肺炎支原体菌株对14种抗生素的药敏情况.结果 14种抗生素的敏感率分别是:依托红霉素(58.3%)、美满霉素(94.2%)、强力霉素(92.3%)、红霉素(54.5%)、阿奇霉素(71.2%)、交沙霉素(76 9%)、乙酰螺旋霉素(70.5%)、克林霉素(74.3%)、克拉霉素(68.6%)、罗红霉素(64.1%)、环丙沙星(60.9%)、莫西沙星(87.8%)、左氧氟沙星(82.7%)、加替沙星(86.5%).结论 肺炎支原体在临床耐药情况日趋严重,药敏检测对有效快速治疗意义重大.     

Birth weight among women of different ethnic groups

Differences in mean birth weight and low birth weight (less than 2.5 kg) are analyzed among Asians, blacks, Hispanics, and whites who were enrolled in the Northern California Kaiser-Permanente Birth Defects Study, a prospective study of 29,415 pregnancy outcomes. Large differences in birth weight among babies of different ethnic groups persist after controlling for the joint effects of maternal smoking and alcohol use during pregnancy, sex of child, parity, length of prenatal care, and maternal weight-for-height percentile. Compared with whites, the relative mean differences in birth weight are estimated as -246 g for blacks, -210 g for Asians, -105 g for Hispanics, and -140 g for others. The low-birth-weight rates and crude odds ratios are 7.70% (2.17) for blacks; 5.57% (1.57) for Asians; 5.52% (1.55) for others; 4.00% (1.13) for Hispanics; and 3.55% (1.00) for whites. After controlling for the effects of 22 factors, the odds ratios for a low-birth-weight infant are 2.41 for blacks, 1.37 for Asians, 1.93 for others, and 1.25 for Hispanics. It is concluded that factors currently used to control for ethnic differences in birth weight are insufficient to explain the observed differences.     

The Significance of Spermatozoa in Victims of Sexual Offences

Factual information for the use of the doctor called upon to give evidence in court after examining the victim of an alleged sexual attack is considered on the basis of an extensive review of the literature and of years of experience by the staff of the Attorney-General's Laboratory for Ontario. This experience emphasizes the need for immediate examination of fluid from the vaginal pool for motility of the spermatozoa and the need for a later examination for delayed bruising of the victim. Motile spermatozoa are found in the vagina for one-half to six hours, with an average time of three hours. Non-motile forms usually are found for seven to 12 hours, but exceptionally for 18 to 24 hours. Data relative to the survival of spermatozoa under various conditions are tabulated.     

北京市某综合医院开展预约挂号服务实践的探讨

通过实名制预约挂号和预约挂号优先的原则,开展多种形式预约挂号服务,可提高复诊预约率、预约挂号率以及预约专科号比例,各种预约挂号方式均占有一定比例。可见,医患双方是预约挂号的主体,医院的社会知名度和信誉度是预约挂号的保障,信息化建设是预约挂号的技术支柱,多种预约挂号方式功能互补。     

乡镇全科医生继续医学教育需求的调查与分析

目的了解乡镇卫生院全科医生对继续医学教育的需求。方法采用自行设计的问卷调查表对随机抽取的桂林市乡镇全科医生进行调查。结果在参加继续医学教育的乡镇卫生院全科医生中,69.05%为了提高业务水平,45.23%为了提高理论水平,24.60%为了获得学历或证书,15.87%为了完成任务,2.38%为了晋升职称;培训形式多样,选择脱产学习者占50.00%,进修学习者占33.33%,专题培训者占20.00%,函授学习者占13.49%,继续学分教育者占11.90%,学术会议者占4.76%,自学网络培训者占3.97%。结论建立合理的继续医学教育机制,采取多种培训形式开展继续教育,有利于提高乡镇全科医生的职业素质。     

博泰软膏对海训部队常见皮肤病的疗效观察

目的观察博泰软膏治疗常见皮肤病的疗效。方法单用博泰软膏治疗,将药物涂于患处,每日2次,疗程4周。结果治疗总有效率分别为湿疹96%,湿疹样皮炎100%,接触性皮炎97%,毛囊炎92%,手、足癣96%,体、股癣97%。结论博泰软膏在治疗常见皮肤病方面有良好的疗效。     

南京医科大学七年制临床医学专业人才培养效果评价

通过对毕业生及其培养或用人单位的问卷调查,本文分析了南京医科大学七年制临床医学专业人才培养的成效,以及江苏省医疗卫生事业发展对高层次医学人才的需求.结果 显示,临床实践能力和科研创新能力是医疗卫生事业发展所需要的高层次医学人才的重要能力;在三级甲等医院工作,具有硕士/博士学位、在专业技术岗位的被调查者更加看重医学生的科研创新能力;而在"1年通识教育、4年医学专业教育(含1年临床课程及见习、1年临床通科实习)、2年二级学科轮转"模式下培养的七年制临床医学专业毕业生的临床实践能力较强,但是科研创新能力不足,且学业负担偏重.因此,应当加强对七年制临床医学专业学生科研创新能力的培养和临床实践能力的通科训练.

Abstract：

An evaluation of 7-year medical education program in Nanjing Medical University was performed via questionnaire survey to the graduates and the staff of hospitals in which the graduates work,and the demand for advanced quality of medical graduates in the field of medical health care in Jiangsu Province is further analyzed. The results showed that the capacity for clinical practice and the capacity for research and innovation are the most important, which can meet the demands of health service development for high-level medical talents. The staff working in advanced hospitals, possessing master or doctor degree,or working as medical experts put more emphasis on the ability of the graduates to do innovative scientific research. Through the completed procedure of the 7-year program includes college general education for 1 year, medical education for 4 years ( containing senior clinical clerkship for 1 year and internship for 1 year) and alternation for medical and surgery subspecialties for 2 years, the graduates showed higher ability to do clinical practice, but not showed the growth of capacity for research and innovation. The most staff investigated proposed an enhancement in training for the capacity for innovative research and general clinical practice.