探讨恶性青光眼的危险因素与防治方法

目的：研究分析恶性青光眼临床中的临床防治,改善患者的青光眼治疗效果。方法对188例原发性闭角型青光眼合并小梁切除患者,其中16例(16眼)恶性青光眼患者作为观察组,172例(226眼)未发生恶性青光眼患者作为对照组。探讨恶性青光眼的危险因素与防治方法。结果观察组患者的平均年龄(55.6±2.6)岁小于对照组患者的平均年龄(64.3±4.6)岁,差异具有统计学意义(P<0.01)。观察组患者的眼压(33.2±2.3)mm Hg(1 mm Hg=0.133 kPa)高于对照组(24.6±1.9)mm Hg;术后观察组的眼轴长度(22.7±2.2)mm、前房深度(1.9±0.6)mm小于对照组眼轴长度(26.3±4.6)mm、前房深度(2.3±1.1)mm,差异具有统计学意义(P<0.01)。结论临床中青光眼会因为术前眼高压、短眼轴、慢性类型等因素而存在较大的危险,应该要对这些危险因素积极的预防。     

恶性血液病肺部真菌感染的危险因素及耐药研究

目的 探讨临床恶性血液病合并肺部真菌感染发生的危险因素,并对5种药物进行耐药性实验.方法 选取我院2006年3月至2009年12月收治的恶性血液病患者进行肺部真菌感染检测,真菌阳性发生的相关危险因素,检测真菌耐药性.结果 150例待检样本中检出46例真菌感染,曲霉菌14株(9.3%)、白色念珠菌23株(15.3%)、热...     

恶性青光眼的诊治

恶性青光眼又称为睫状环阻滞性青光眼（ ciliary block glaucoma ）是一种少见而严重的特殊类型闭角青光眼,它可以造成一眼或双眼失明,早在100多年前, VonGoaefe首先报告恶性青光眼病例,被认为是一种继发性青光眼。通常在抗青光眼手术后,前房变浅,眼压升高,用一般抗青光眼治疗方法无效。如处理不当往往失明,故称恶性青光眼,也可发生在其它眼科手术之后。     

总结恶性青光眼诊断及治疗中注意的问题

随着现代人工作压力的不断增大,其生活和饮食缺乏规律性,从而导致每年患青光眼的人数不断增加。同时,由于人们对青光眼这一疾病早期症状的认识不足,也导致就医的不及时,一旦错过治疗的最佳时间,往往会造成青光眼的恶化。本文将系统详细地阐述青光眼的定义概念,以及治疗方法和治疗时应引起注意的问题。     

恶性青光眼的临床观察及护理

目的探讨恶性青光眼的护理要点并评价其效果。方法回顾性总结2001～2007年本院经治的14例（14只眼）恶性青光眼的治疗及护理方法。结果14例经过药物、激光治疗，眼压平均控制在（15．1±3．5）mmHg，全部前房深度恢复且稳定，视力保持，无严重并发症。结论恶性青光眼患者的治疗和护理都比较棘手，针对其特点，采取相应的措施，仍可挽救视功能。     

青光眼滤过术中并发恶性青光眼的临床观察

目的:探讨青光眼手术中并发恶性青光眼的原因预防及处理方法.方法:对接受小梁切除术及准分子激光非穿透小梁切除术治疗184例(204 眼)中6 例术中发生恶性青光眼的原因进行临床分析.结果:术中并发恶性青光眼6 例中,小梁切除术5例(83.34%),准分子激光非穿透小梁切除术1例(16.66%).无晶体眼1 例(16.66...     

慢性闭角型青光眼(恶性青光眼)临床分析及护理

目的探讨慢性闭角型青光眼的临床症状和护理方法。方法回顾性分析博罗县人民医院2009年1月至2010年1月的90例慢性闭角型青光眼(恶性青光眼)的患者的临床资料,归纳患者的临床症状,并对临床护理方法进行归纳和总结。结果慢性闭角型青光眼发病隐匿,误诊漏诊概率大,临床多采用手术治疗,给予患者充分的心理干预,严密观察患者病情,做好围手术期的护理时帮助患者更好恢复健康的重要方法。结论慢性闭角型青光眼的确诊困难,确诊好需要采用多种联合手术,并给予患者优质的护理服务,以促进患者康复。     

恶性青光眼的临床诊断及治疗分析

目的探讨恶性青光眼患者的临床特征及治疗方法。方法选取我院2009年2月至2011年5月收治的30例恶性青光眼患者的临床资料进行总结分析。结果 30例患者中慢性闭角型青光眼22例,急性闭角型青光眼8例,均经玻璃体抽水囊或前部玻璃体切割术后前房得到改善,经针对性治疗,患者眼压均得到控制。结论恶性青光眼患者临床情况复杂多变,需要根据患者的具体情况进行针对性的治疗分析,以免延误病情,减少对患者的视力的影响。     

崇明农村高血压危险因素分析及防治对策

目的：探讨崇明地区农村居民高血压患病情况,主要危险因素及防治对策。方法：采用健康体检、问卷调查对崇明县新河镇5个行政村18岁以上居民8520人进行高血压患病情况、主要危险因素及合并症调查。结果：高血压患病率为21．6％;高血压合并冠心病,脑血管病和糖尿病的发生率分别为35．16％、21．09％和8．59％。结论：崇明地区农村居民高血压患病率较高,主要危险因素为吸烟、饮酒、高脂高盐饮食、活动少及家族史。开展健康教育,完善个人健康档案,提高防病意识,对降低高血压的患病率,减少并发症具有重要作用。     

Clinical risk factors for neuroleptic malignant syndrome

Pharmacological risk factors for neuroleptic malignant syndrome (NMS) are better defined than clinical risk factors. We examined the psychopathological status preceding the onset of NMS in 20 patients. We evaluated four key psychiatric symptoms (psychomotor agitation, catatonia, disorganization and confusion) and grouped them into definite clinical syndromes. Six patients presented with an acute and severe catatonic syndrome, with all the four key psychiatric symptoms. Twelve patients presented with an acute and severe disorganized psychotic episode, with two or three key psychiatric symptoms, but not catatonia. Our study suggests that a clinical syndrome of acute disorganization, in addition to acute catatonia, is a potential clinical risk factor for NMS. The two syndromes, which can occur in the context of different mental disorders, are related to each other as both implicate alteration in behavioural monitoring, and were, in our experience, unresponsive to neuroleptics. In conclusion, we hypothesize that the recognition of these two syndromes should reduce NMS occurrence. We recommend a judicious use of neuroleptics not only in patients with acute catatonia, but also in patients with acute disorganization.     

小儿高热惊厥危险因素及护理对策研究

目的：分析总结76例小儿高热惊厥的发病因素及护理对策。方法：密切观察病情变化情况下，给予规范的护理对策。结果：引起小儿高热惊厥最常见的原发病是上呼吸道感染，其次是肺炎和菌痢；发病以婴幼儿多见；主要护理措施包括控制惊厥、保持呼吸道通畅、吸氧、高热护理、安全护理、心理护理等。结论：严密观察病情变化，及时有效的护理是小儿高热惊厥急救的重要环节。     

Studies of risk factors and preventive care for neuroleptic malignant syndrome]

Neuroleptic malignant syndrome (NMS) is a life-threatening complication of anti-psychotic treatment and can occur any time during the course of treatment. Since NMS can occur in any subject treated with anti-psychotic drugs, causing senously adverse side effects, prevention of NMS is one of the most important issues in clinical psychiatry. Although therapeutic guidelines for NMS have been proposed and gradually put in place, the pathogenesis has not been fully elucidated. Prevention of NMS consists of three approaches: removal of pathogenetic factors, understanding of initial symptoms and consideration of the administration of preventive drugs. Risk factors for NMS are inherited factors, individual factors and environmental factors. The overlapping of these factors might lead to fulminant NMS. These risk factors such as environmental factors are enumerated in DSM-IV. We meta-analyzed the case-control studies of the risk factors for NMS, because the evaluation of each risk factor has not been studied yet. The results were as follows: mental retardation, psychiatric manifestations such as agitation and excitement as individual factors. High dosage administration, rapid increase and parenteral administration of antipsychotic drugs are the drug factors. It is hopeful to give preventive care, such as precautionary measurement of autonomic dysfunction, and treatment to these groups at high risk for NMS.     

胃癌根治术后胆囊结石形成的相关高危因素分析及对策

目的探讨胃癌根治术后胆囊结石形成的相关高危因素及对策。方法选取 2014年 6月至 2018年 6月南阳医学高等专科学校第一附属医院收治的胃癌根治术术后病人 162例,将复诊发现术后合并胆囊结石的 22例病人作为观察组,其余 140例作为对照组,对两组病人相关因素进行单因素非条件和多因素非条件的 Logistic回归分析。结果单因素分析结果显示性别(χ2＝4.372,P＝0.037)、十二指肠旷置(χ2＝6.831,P＝0.009)、手术方式(χ2＝6.202,P＝0.128)、淋巴结清扫数目(t＝8.4312,P＜0.001)、十二组淋巴结清扫(χ2＝4.047,P＝0.044)、切除范围(χ2＝7.236,P＝0.007)与胆囊结石形成具有相关性,差异有统计学意义(P＜0.05);多因素非条件的 Logistic回归分析显示手术方式(OR＝3.49,P＝0.001)、十二指肠旷置(OR＝2.06,P＝0.009)、淋巴结清扫数目(OR＝1.50,P＝0.025)、十二组淋巴结清扫(OR＝1.84,P＝0.018)、切除范围(OR＝3.36,P＝0.007)是胃癌根治术后胆囊结石形成的独立危险因素。结论胃癌根治术后胆囊结石形成可能是多种因素共同作用的结果,对相关危险因素积极进行干预,可最大限度降低胃癌根治术后胆囊结石的发生率。     

The eCHECKUP TO GO for High School: Impact on risk factors and protective behavioral strategies for alcohol use

The eCHECKUP TO GO is identified as a highly effective, low-cost individually-focused alcohol intervention by the NIAAA CollegeAIM guide. The research on the eCHECKUP TO GO for High School is less consistent, suggesting that the program content, originally designed for college students, may need modification for this age group. This randomized controlled study examined the effectiveness of the eCHECKUP TO GO for High School on shifting risk and protective factors for alcohol use targeted by the program at a 4–6 week follow-up. Female high school students in the intervention group reported a reduction in perceptions of peer drinking, beliefs about alcohol, and positive alcohol expectancies, compared to students in the control group. There were no group differences in risk factors for males or in protective behavioral strategies for either males or females. Results indicate the eCHECKUP TO GO for High School may be more effective for females and that program content targeting protective behavioral strategies may need modification for this age group.     

Corticosteroids and glaucoma risk

Corticosteroids (glucocorticoids), used frequently as potent anti-inflammatory agents, increase the risk of glaucoma by raising the intraocular pressure (IOP) when administered exogenously (topically, periocularly or systemically) and in certain conditions of increased endogenous production (e.g. Cushing's syndrome). Approximately 18 to 36% of the general population are corticosteroid responders. This response is increased to 46 to 92% in patients with primary open-angle glaucoma (POAG). Patients over 40 years of age and with certain systemic diseases (e.g. diabetes mellitus, high myopia) as well as relatives of patients with POAG are more vulnerable to corticosteroid-induced glaucoma. The association of corticosteroid-induced ocular hypertension in other conditions which are considered as risk factors for glaucoma (racial origins, hypertension, migraine, vasospasm) is likely but not fully established. The proposed mechanism of corticosteroid-induced glaucoma includes morphological and functional changes in the trabecular meshwork system and is similar to the pathogenesis of POAG. Trabecular cells exposed to corticosteroids in vitro show endoreplication of nuclei, an increase in cell size and excessive production of an approximately 56kD glycoprotein, identified as myocilin and transcribed by the GLC1A gene. Induction of ocular hypertension after corticosteroid administration depends on the specific drug, the dose, the frequency of administration and the corticosteroid responsiveness of the patient. The risk of corticosteroid-induced glaucoma can be minimised with judicious use of corticosteroids, as well as education of patients and medical practitioners. New treatment modalities include modified steroids and nonsteroidal anti-inflammatory agents that will have less effect on the elevation of IOP.     

整形外科手术室医院感染的危险因素与对策分析

目的：探讨整形外科手术室医院感染的影响因素,为预防感染提供依据。方法：对整形外科进行手术患者进行调查,回顾性分析手术感染患者临床资料,包括合并基础疾病、切口暴露时间、手术部位及围手术期用药等。结果：调查患者例中感染6例发现手术室的具体环境手术过程及患者基础疾病是发生感染的危险因素。结论：在整形外科手术全过程中严格控制感染危险因素的发生,可明显降低手术感染的可能性。     

Heavy episodic drinking in early adolescence: gender-specific risk and protective factors

This longitudinal study examined possible gender differences regarding risk and protective factors for heavy episodic drinking among 1,222 seventh-grade students (aged 13) in the City of Stockholm, Sweden, with follow-up 2 years later. Logistic regression analyses showed that several factors predicted heavy episodic drinking. The strongest predictors for boys' heavy episodic drinking in the ninth grade were heavy episodic drinking (odds ratio [OR] = 5.30) and smoking in the seventh grade (OR = 5.80). Drinking peers (OR = 2.47) and smoking (OR = 2.44) in the seventh grade showed the strongest association for girls. Furthermore, high parental monitoring and having a secure attachment to parents may have a protective effect when risk factors are present. Our results lend support to prevention initiatives to strengthen the parent-child relation and focus on adolescents' ability to resist peer pressure and of limiting parental provision of alcohol. The study's limitations are noted.     

Growing-up with a substance-dependent parent: development of subjective risk and protective factors

A qualitative phenomenological study of high-risk adolescents, who are children of substance-dependent parents, explored the presence of subjective risk and protective factors. Nineteen adolescents were interviewed, all of whom had a father or both parents either actively dependent on psychoactive substances or recovering from substance dependence. The participants were assigned to one of two groups, based on the degree to which they maintained normative lives or had misused substances themselves. It was found that certain perceptions of the participants, concerning themselves and their parents, served as either subjective risk or protective factors, respectively. Implications for the treatment of this population are outlined.     

Binge drinking among adolescents in Russia: Prevalence,risk and protective factors

Despite evidence that alcohol misuse has been having an increasingly detrimental effect on adolescent wellbeing in Russia in recent years this phenomenon has been little researched. Using data from 2112 children from the Arkhangelsk Social and Health Assessment (SAHA) 2003, this study examined which factors acted as ‘risk’ or ‘protective’ factors for adolescent binge drinking within three domains we termed the ‘family environment’, the ‘alcohol environment’ and ‘deviant behaviour’. The results showed that in the presence of comparatively moderate levels of binge drinking among both boys and girls, being able to access alcohol easily, being unaware of the risks of binge drinking and having peers who consumed alcohol increased the risk of adolescent binge drinking — as did playing truant, smoking and marijuana use, while parental warmth was protective against binge drinking for girls. Our finding that risk and protective factors occur across domains suggests that any interventions targeted against adolescent binge drinking may need to simultaneously focus on risk behaviours in different domains, while at the same time, broader social policy should act to limit the availability of alcohol to adolescents in Russia more generally.