REDUCED BINOCULAR DEPTH INVERSION IN PATIENTS WITH ALCOHOLISM

Binocular depth inversion represents an illusion of visual perception,serving to invert the perception of implausible hollow objects,e.g. a hollow face into a normal face. Such inversion occursfrequently, especially when objects with a higher degree offamiliarity (e.g. photographs of faces) are displayed. Cognitivefactors are assumed to override the binocular disparity cuesof stereopsis. The hypothesis was tested that during mild andmoderate alcohol withdrawal, and severe and mild alcohol intoxication,the central nervous system is unable to correct implausibleperceptual hypotheses. Measurements of binocular depth inversionin perception of three-dimensional objects were performed in10 patients with severe alcohol intoxication, in 10 subjectswith mild alcohol intoxication, in nine patients with moderatealcohol withdrawal treated with carbamazepine, in 10 patientswith moderate alcohol withdrawal without any pharmacologicaltreatment, in 11 patients with mild alcohol withdrawal and in10 healthy volunteers. The binocular depth inversion scoreswere highly elevated in the severely intoxicated patients groupand in the group with moderate withdrawal symptoms without carbamazepinetreatment, in comparison to the healthy volunteers. The datademonstrate a strong impairment of binocular depth inversionin moderate alcohol withdrawal and during severe alcohol intoxication.This supports the view that these states may be accompaniedby a disorganization of the interaction between sensory inputand top-down component. The effects of carbamazepine are discussed.     

CARBOHYDRATE-DEFICIENT TRANSFERRIN AS A SCREENING MARKER FOR DRINKING IN A GENERAL HOSPITAL POPULATION

We investigated the usefulness of the laboratory marker of alcoholconsumption carbohydrate-deficient transferrin (CDT) in 101consecutively admitted patients in a surgical and internal medicalward of a hospital in a rural wine-growing area. Four majoraspects were considered: the influence of liver disease, themethod of expression of CDT values (relative % vs absolute units/1),level and pattern of alcohol consumption and comparison with     

医用三氧治疗急性病毒性脑炎的临床观察

目的 探讨医用三氧治疗急性病毒性脑炎的临床疗效.方法 将50例急性病毒性脑炎患者随机分为医用三氧治疗组和对照组,治疗组在常规药物治疗基础上进行医用三氧治疗,对照组为常规药物治疗,两组病人治疗前和治疗3周后进行症状所需恢复时间、采用Glasgow-Pittsburgh昏迷评分表进行神经功能缺损评分.结果 两组治疗后3周与治疗前比较神经功能评分均有明显改善,治疗组的神经功能缺损评分为（32.2±4.3）,对照组为（26.4±3.1）,治疗组的症状恢复所需时间为7天,对照组为11天;治疗组总有效率96%,对照组总有效率76%.结论 医用三氧能明显提高急性病毒性脑炎患者的疗效.     

THE RELIABILITY OF ALCOHOLISM HISTORY IN PATIENTS WITH ALCOHOL-RELATED CIRRHOSIS

Alcoholic liver disease is considered an indication for livertransplantation when a candidate is felt to have a high likelihoodof abstinence following transplantation. Historical variablessuch as duration of sobriety, duration and quantity of drinking,and treatment history are commonly used to estimate alcoholismprognosis, yet their reliability and validity in patients withalcoholic cirrhosis has received limited study. Fifty subjects(9 women and 41 men) with alcoholic cirrhosis underwent an alcoholismhistory interview. Each subject had a collateral source (usuallya spouse) who was interviewed by a second interviewer blindto the subject's alcoholism history. The two histories werecompared for duration of abstinence in months and estimatedalcoholism relapse risk was calculated using the High-risk AlcoholismRelapse scale (HRAR). Duration of sobriety correlated highlybetween subject and collateral source (Spearman r=0.96, P=0.0001)as did HRAR total score (Spearman r=0.72, P=0.0001). Categoricalassignments also showed high correlations with duration of sobriety(k=0.97) and HRAR category (k=0.63). When disagreements werepresent, collateral sources tended to underestimate severityof alcoholism. We conclude that patients with alcoholic liverdisease provide a reliable history for alcoholism variableswhen compared with a collateral source, and that, when disagreementsare present, subjects tend to report a more acute or severealcohol problem. The results support the clinical use of patienthistory information in making decisions about medical interventionsfor alcoholic liver disease.     

ALCOHOL-RELATED DISEASES IN GENERAL HOSPITAL PATIENTS

To determine the prevalence and spectrum of alcohol-relateddiseases in a general hospital inpatient population, data of1288 patients newly admitted to a city general hospital, whohad been examined with regards to alcoholism, were surveyed.The sample consisted of 625 medical and 663 surgical patientsaged 18–64 years. In 21% (29.3% of the men and 9.4% ofthe women), inpatient treatment was due to an alcohol-relateddisorder. The highest occurrence was found in the 35–55-year-olds.Frequently diagnosed disorders in alcohol-dependent patientsincluded delirium tremens (12.8%), seizures (11.4%), head injuries(9.4%) and cirrhosis of the liver (8.1%), whereas alcohol abusershad often been injured. Excluding patients with alcohol-relateddiseases decreases the proportion of men in the sample by 6.2%.The prevalence of physically-damaged alcoholic patients in generalhospitals suggests that preventative measures, such as consultationservices, could be applied efficiently in this setting.     

普外科疾病合并糖尿病患者的护理

目的探讨普外科疾病合并糖尿病患者的护理。方法分析总结78例普外科疾病合并糖尿病患者的护理。主要包括术前做好心理护理,认真完善术前检查,根据病情应用有效的降糖药物控制血糖。术后严格掌握和调控好血糖,密切观察病情变化,落实好基础护理,采取正确有效的预防和控制感染措施。结果本组并发肺部感染2例,切口裂开3例,其余均治愈出院,取得了满意的效果。     

探讨病房猝死患者的医疗风险管理

[目的]通过对我院2006年的131例医疗纠纷案例中,猝死的发生率、赔偿率、尸检率与赔偿的关系等问题进行回顾性分析,探讨病房猝死患者医疗风险管理的重要性.[方法]对回顾性分析资料进行归类统计.[结果]死亡患者医疗纠纷发生率为2.5%,猝死患者医疗纠纷发生率为30.8%.[结论]医院管理者有必要更关注病房猝死患者的医疗风险管理、医疗行为管理及医疗风险预警与医疗纠纷处理管理.     

我国医学生全科医学规范化教育调查研究

[目的]探讨我国医学生全科医学规范化教育的途径及措施. [方法]采用现况调查,应用分层整群问卷进行调查研究. [结果]虽然接受全科医学教育率分别为52.5%和36.8%,全科医学教育途径各异,但是两者认知相似(P>0.05),所确定的全科医学教育目标及内容基本一致,现场教学法和讲授法应该作为医学生全科医学教育的主要教学方法,应该适当增加全科医学实习时间,对全科医学教育师资要求较高. [结论]全科医学教育与培训工作有待进一步提高.     

HEALTH-RELATED ASPECTS OF LIFESTYLE IN GENERAL HOSPITAL PATIENTS

Health-related aspects of lifestyle were surveyed in a random sample of adult inpatients from a general hospital in Sydney. The results were compared with the results of the National Heart Foundation of Australia 1980 Risk Factor Prevalence Study. The results suggest that the lifestyle of male hospital patients in this sample was similar to that of males in the community; the most prevalent lifestyle risk factors being smoking, obesity and heavy alcohol consumption. The lifestyle of female patients was different from that of females in the community; high risk lifestyles were more prevalent in the hospital group. The difference was most pronounced in women under the age of 40, in whom smoking, obesity, heavy alcohol consumption and frequent use of analgesics were 2–3 times more common in hospital patients than in the community sample. Hospitals need to consider more closely the specific health promotion and educational needs of their own patient populations.     

术后搬运和护送全麻患者的护理体会

术后搬运和护送全麻患者是手术室整体护理的组成部分，但大多数医院的手术室是综合性的手术室，由于手术多、人手少等原因，并没有不严格的去执行，而是将此项工作交给护士去完成。其实此期间患者尚处于或浅或深的麻醉状态，未完全苏醒，不能自主保持呼吸道通畅，气管导管尚未拔除，病情尚不稳定。我院从2003年1月开始，全麻术后患者均由护士亲自参与搬运并护送至麻醉恢复室，取得满意效果，现介绍如下。     

广西652例HIV感染者结核筛查结果分析

[目的]提高TB/HIV双重感染患者发现率,及时治疗,防止传播和蔓延。[方法]对某院2007年1月～2008年7月门诊及住院的652例HIV感染者进行结核病筛查,患者来自广西45个市、县。[结果]652例HIV感染者中筛查出结核病患者186例,结核的发病率为28.52%;CD4+T淋巴细胞计数﹥200/mm3时结核的发病率15.7%,其中肺外结核及肺结核并肺外结核占27.3%;CD4+T淋巴细胞计数0～100/mm3结核的发病率为36.5%,其中肺外结核及肺结核并肺外结核占54.8%;78例有结核诊断直接依据,其中10例大便涂片找到抗酸杆菌。[结论]随着CD4+T淋巴细胞计数的下降结核的发病率显著增加,且尤以肺外结核多见,大便可作为晚期艾滋病患者筛查结核的样本来源之一。     

THE VALIDITY OF THE MICHIGAN ALCOHOLISM SCREENING TEST (MAST)

This review examines the validity of the Michigan AlcoholismScreening Test (MAST) as a screening instrument for alcoholproblems. Studies that compare the MAST-questionnaire with otherdefined diagnostic criteria of alcohol problems were retrievedthrough MEDLINE and a cross- bibliographic check. A total of20 validity studies were included. The studies varied considerablyregarding the prevalence of alcohol problems, the diagnosticcriteria, and the examined patient categories. The MAST comparedwith other diagnostic criteria of alcohol problems gave validitymeasures with the following span: predictive positive value(PVpos) 0.24–0.96, predictive negative value (PVneg) 0.78–     

提高临床医学本科生普通外科实习质量方法的探讨

普通外科实习是医学生从课堂走进临床的必经阶段,本文针对临床医学本科生普通外科实习带教中出现的问题,分析探讨普外科实习办法,强调实习生综合素质培养,达到提高普通外科实习质量、培养优秀外科人才的目的。     

FOLACIN DEFICIENCY IN ALCOHOLISM

The relationships between folacin deficiency, serum B₁₂levels, cirrhosis, and macrocytic anemia were studied in a large group of alcoholic patients. While anemia and cirrhosis occurred with fair frequency, folacin deficiency of some degree occurred in over 90 per cent.     

高端医疗服务患者满意度调查分析

目的通过实际调查,探明高端医疗服务在实施过程中取得的实效和存在的问题,提出相应的对策建议。方法围绕医院医生的诊疗过程、护士的护理过程和患者的就医流程,设计患者满意度调查问卷,对广东省某医院高端医疗服务病区住院患者进行问卷调查。结果患者对高端医疗服务的总体评价满意度较高,患者最不满意的是关于供餐服务与食品质量,其次是检查费、药费等收费解释,房间及公共区域保洁,检查、治疗安排程序,办理登记、出入院手续。结论高端医疗服务在实施过程中取得了一定的成效,但是后勤保障工作、保洁工作以及护理水平有待提高。进一步提高医疗服务质量意识;加强与患者的沟通,开展人性化服务,发挥医院管理层职能,进而推动高端医疗服务的发展。     

医疗事故处理中医务人员合法权益的保护

2002年4月1日《最高人民法院关于民事诉讼证据的若干规定》的施行,关于“举证责任倒置”的规定对医疗机构及医务人员产生了重要影响;而2002年9月1日《医疗事故处理条例》（以下简称《条例》及其配套文件的施行,则更是将全社会关注的目光集中到了患者的权利及其保护,对此,包括卫生行政部门和医疗行业在内的全社会都给予了高度的评价。但是,作为一名临床护理工作者和卫生法学专业的本科毕业生（第二专业）,通过冷静的研究发现,当我们的立法机构和社会在对患者的权利呼吁并付诸实践的时候,却忽视了医患法律关系中当事人之一的医务人员的权利及其保护,这是我们立法和制度设计中的重大缺陷。