上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

对《医疗事故处理条例》的几点认识--学习《医疗事故处理条例》的一点体会

国务院颁布的《医疗事故处理条例》（以下简称《条例》）在吸收、总结原《医疗事故处理办法》（以下简称《办法》）实施十几年以来正反两方面经验教训的基础上，对《办法》作了许多重大的修改：《条例》扩大了医疗事故的主体与范围，提出了防范医疗事故的一些重要措施，授权医学会独立担纲医疗事故技术鉴定工作，赋予了患者更多的权利，规定医疗事故民事责任争议可以“私了”，制定了更为规范的医疗事故的赔偿制度等。《条例》作出的这些新规定必将使医疗事故得以更加科学、客观、公正、公平、合理的解决。认真学习、把握《条例》的这些新规定，很好地透视《条例》的立法宗旨与原则，必将极大地提高学习、宣传《条例》的主动性与积极性，更好地推进《条例》的贯彻执行工作。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Problem of methodology of evaluation of the quality of public health

The basic general methodological assessments of public health quality are considered. An analogy is drawn with quality assessment in industry, approaches to the development of multi-aspect and multi-parameter assessment of public health quality are substantiated. A term of "qualimetry " of public health is suggested.     

早产儿视网膜病变的筛查策略探讨

目的:根据早产儿出生体重和出生胎龄为指标,探讨早产儿视网膜病变的临床筛查标准和初次筛查时间。方法:收集2008年2月～2011年2月厦门市妇幼保健院NICU病区1 148例早产儿,使用双目间接眼底镜进行眼底检查,收集相关临床资料进行统计分析。结果:出生体重≤1 000 g、1 001～1 250 g、1 251～1 500 g、1 501～1 750 g、1 751～2 000 g、>2 000 g各组间阈值ROP发生率比较有统计学差异(χ2=201.54,P<0.001),其OR值为1.00、0.45、0.24、0.07、0.02、0.003,出生体重﹥1 500 g时阈值ROP发病率显著降低;ROC曲线示在出生体重为1 532.5g面积最大;出生胎龄﹤28周、28～30周、30～32周、32～34周、≥34周各组间阈值ROP发生率差异有统计学意义(χ2=213.14,P<0.001),其OR值为1.00、0.68、0.29、0.07、0.02,出生胎龄>32周时阈值ROP发病率明显降低;ROC曲线显示在出生胎龄32.07周面积最大;出现阈值ROP时的矫正胎龄﹤35周的8例早产儿,出生后周龄均在4～6周。结论:出生体重≤1 500 g和出生胎龄≤32周是ROP筛查指标;初次筛查时间在矫正胎龄≥35w或出生后4～6周。     

大学生社会交往心理调查表的结构效度分析

目的对大学生社会交往心理调查表的结构效度进行分析，为进一步评价和完善大学生社会交往心理调查表提供科学依据。方法对自行设计的大学生社会交往心理调查表，采用探索性因子分析法进行量表结构效度评价。结果探索性因子分析显示，大学生社会交往心理调查表的因子组成和重要性依次为大学生社交活动（包括社交心理和社交行为）、负性生活事件、志愿兴趣等（前3个因子累计贡献率为91．75％），大多数指标的载荷系数与某个因子内涵相匹配。结论本次研究自行设计的大学生社会交往心理调查表整体结构是合理可行的。     

Occupation of father at time of birth of children dying of malignant diseases

Occupation of father at time of birth was ascertained for a series of 386 children who died of malignant disease before age 5 during the years 1965-70 in the province of Quebec and a control group of 772 children whose birth registration immediately preceded and followed that of each case in the official files. The comparison of cases with controls showed a significant excess of fathers in hydrocarbon-related occupations among the cases with relative odds of 2·1. These occupations included, in particular, motor-vehicle mechanics, machinists, miners, and painters. On the other hand, cases and controls did not differ with regard to place of residence of parents or mean paternal age. The possible role of father's occupation in the risk of malignant disease of his offspring seems to deserve further investigation.     

急性胃十二指肠穿孔手术治疗临床分析

目的分析总结急性胃十二指肠穿孔手术治疗体会。方法随机选取2006年9月—2011年9月在该院就诊的60例胃十二指穿孔患者,对其临床资料进行回顾性分析。结果在60例患者中,胃溃疡穿孔患者14例(23.3%),十二指肠溃疡穿孔患者46例(76.7%)。其中青年患者居多,但呈下降趋势,然而老年患者则呈上升趋势。服用非甾体类抗炎药物(NSAIDS)与老年患者的发病具有密切关系(P<0.05)。60例患者中10例实行保守治疗,1例因中毒性休克死亡,并发症3例;30例采用单纯穿孔缝合术,无一例死亡,并发症1例;10例采用穿孔缝合术+高选择性迷走神经切除,无一例死亡,并发症1例;10例采用胃大部切除术,1例死亡,并发症2例。单纯穿孔缝合术产生的并发症少于保守治疗和胃大部切除术的并发症(P<0.05),并且其术后的复发率与穿孔缝合术+高选择性迷走神经切除差异无统计学意义(P>0.05)。结论单纯穿孔缝合术手术操作简单、便捷,麻醉时间较短,创伤较轻并且术后恢复快,值得临床手术治疗借鉴使用。     

Assessment of frequency of consumption of selected sources of dietary fibre by students

The study deals with the evaluation of the frequency of food products consumption that are a source of dietary fiber in the diet of students. Survey was conducted in May 2010 among 96 second-year students of 'Food Processing Technology and Human Nutrition' at the University of Rzeszow. The Block's questionnaire was used to assess the frequency of consumption of selected sources of dietary fiber. In order to determine the frequency of consumption of fruits, fruit juices, salads, potatoes, legumes, white bread, dark bread and other cereal products the 5-degree scale with verbal terms (less than once per week--0 points, roughly once a week--1 point, 2-3 times per week - 2 points, 4-6 times per week--3 points, every day--4 points) was used. It was found that none of the examined persons, both women and men, had a sufficient consumption of fiber in the diet. The main source of dietary fiber in the diet of the examined students were white and dark bread and potatoes. A small percentage of the examined persons consume fruits and vegetables in their daily diet.     

Choice of the limits of allowable random errors of measurement of the basic indices of respiration

Modern methods for the evaluation of principal respiration indexes were analysed to formulate the demands for methodological characteristics of the devices used in lung functional diagnosis. As a result the extent of measurement random errors of main respiration indexes, which guarantee the prescribed level of right diagnosis probability are established.     

心肌致密化不全的研究进展

心肌致密化不全是一种特殊类型的罕见先天性心肌病,是胚胎生长过程中心内膜心肌发育缺陷所造成的,早期诊断和早期治疗有助于改善患者预后。着重介绍该病的病因,发病机制,临床表现,诊断,治疗和预后的研究现状,旨在临床诊断及治疗提供客观依据。     

491例高血压患者心电图分析

本文报告了沈阳口岸1991—1993年出国人员中491例高血压患者心电图检查结果。异常心电图为330例，检出率高达67.2%，种类归为4类18种，以左室高电压，ST—T改变两种为主要表现，异常心电图检出率随年龄增大，血压升高而增加．通过对高血压人群中异常心电图与年龄及血压的的关系的分析，为在口岸开展非传染性疾病的监测，旅行健康咨询提供了科学依据。     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

Scientific bases of a concept of promotion of health of children and adolescents

The paper outlines theoretical concepts on society-state-individual to reduce mortality, morbidity, and disability among children and adolescents and to increase physical and social fitness at the stage of human maturation. On implementation of the concepts, the author proposed to follow the following principles: 1) their governmental nature and priority of preventive measures; 2) the structurization of measures by levels (federal, regional); 3) the optimization of resources and financing; 4) interdisciplinary integration and intersectoral cooperation.     

Effects of type of dietary fat on indices of immune status of rabbits

We have compared the effects of dietary saturated and unsaturated fats of the n-6 and n-3 types on the immune status of male New Zealand white rabbits. Four groups of rabbits (n = 8) were fed purified diets containing one of the following fats (7.6% w/w, 23 kcal%) for 5 mo, hydrogenated soybean oil (HSO); safflower oil (SFO); linseed oil (LSO); or menhaden oil (MHO). In vitro proliferation of peripheral blood lymphocytes (PBL) cultured with T-cell mitogens was significantly higher in the LSO group than in the other three groups, and that in the HSO group was higher than in the MHO and SFO groups which were not different from each other. Proliferation of PBL in response to B-cell mitogens was significantly higher in the LSO group than in the SFO and MHO groups. In vitro proliferation of splenocytes (SPC) from the LSO group was higher than that from the other three groups only when SPC were cultured with T-cell mitogens. Serum antibody levels against bovine serum albumin were significantly higher in the LSO group than in the SFO group after second and third immunizations. Spleen weights, number of SPC or PBL, and delayed-type hypersensitivity were not different among the four dietary groups. Our data show that linseed oil diet enhanced several indices of immune status in rabbits.     

137例地中海贫血出生相关因素分析

目的:揭示地中海贫血患儿出生相关因素,提出干预措施,为进一步制定地贫预防控制总体规划提供决策参考。方法:对近3年137例地贫儿(45例重型β-地贫、29例中间型β-地贫、32例中间型α-地贫和31例巴氏胎儿水肿综合征)出生相关因素进行调查研究。结果:地贫儿出生相关社会心理因素顺位依次为:基因携带者不知情(70.07%)、经济困难(21.17%)、心理因素(5.11%)、其它(3.65%)。基因携带者对自身情况不知情是本组地贫儿主要出生相关因素,与其它出生相关因素有显著差异(P<0.05)。结论:基因携带者自身的认识与重视是预防控制工作的一个重要组成部分,地贫高发区人群携带者(轻型β-地贫、α-地贫特征和静止型携带者)的检出及系统管理是预防控制工作的关键环节,应进一步应用生物、社会及心理的医学模式搞好地贫预防控制工作。