剖宫产同时行子宫肌瘤剔除术122例临床分析

目的 探讨剖宫产术同时行子宫肌瘤剔除术的效果及安全性.方法 对观察组122例妊娠并子宫肌瘤者在剖宫产术同时行肌瘤剔除术,对对照组122例妊娠无子宫肌瘤者行单纯剖宫产术,观察两组手术时间、术中出血量、术后住院时间、恶露干净时间等.结果 两组相关指标比较均无统计学意义.结论 剖宫产术中同时行子宫肌瘤剔除术切实可行,但应加强围术期处理并酌情选择剖宫产手术指征.     

剖宫产同时行子宫肌瘤剔除术71例分析

目的:探讨剖宫产同时行子宫肌瘤剔除术的安全性及可行性。方法:选择2004年5月~2007年5月剖宫产同时行子宫肌瘤剔除术的71例为研究组,同时选择同期单纯剖宫产术71例为对照组,对两组各项临床指标进行比较分析。结果:两组的手术时间、术中出血量、产后出血量、产褥病率及术后住院天数差异无统计学意义(P>0.05)。结论:剖宫产术中同时行子宫肌瘤剔除术是安全可行的。     

妊娠合并子宫肌瘤在剖宫产术中处理的探讨

目的:探讨妊娠合并子宫肌瘤在剖宫产术中同时行肌瘤剔除术的可行性。方法:选取妊娠合并子宫肌瘤52例为观察组,同期因其它原因行单纯剖宫产60例为对照组进行回顾性分析。对两组平均术中出血量,产后感染率,产后出血率,住院天数与低体重儿进行比较。结果:平均术中出血量,产后感染率,产后出血率,住院天数两组比较无统计学意义(P<0.05),低体重儿两组比较差异有统计学意义(P>0.05)。结论:妊娠合并子宫肌瘤在选择合适的病例与正确的手术方式的前提下,剖宫产同时行肌瘤剔除术是安全可行的。     

剖宫产术中行子宫肌瘤剔除术210例临床分析

目的:探讨剖宫产术中行子宫肌瘤剔除术的可行性。方法:回顾性分析210例剖宫产术中行子宫肌瘤剔除术(观察组)与无任何合并症的单纯剖宫产200例(对照组)行比较,比较观察组、对照组术中出血量、手术时间、住院天数、产后出血量、输血量及产褥感染发生率,并比较上述各指标之间差异有无显著性。结果:小型肌瘤组与单纯剖宫产组在相应指标比较,差异无显著性(均P>0.05)。结论:剖宫产术中发现子宫肌瘤同时行剔除术绝大多数是安全可行的;对部位特殊的子宫肌瘤及大型子宫肌瘤的处理则须谨慎,应根据手术医生经验、抢救条件等而定。     

剖宫产术同时行子宫肌瘤剔除术69例临床分析

目的 分析妊娠合并子宫肌瘤患者剖宫产术同时行子宫肌瘤剔除术的可行性及安全性.方法 回顾性分析69例剖宫产术同时行子宫肌瘤剔除术(观察组)和70例单纯行剖宫产术(对照组)患者的手术时间、术中出血量、手术前后血红蛋白差值、住院时间、恶露持续时间及产褥病发生情况.结果 观察组手术时间较对照组明显延长[(65.78±8.16)min比(40.54±5.69) min,P＜0.01],但两组术中出血量、手术前后血红蛋白差值、住院时间、恶露持续时间、产褥病发生率比较差异均无统计学意义(P＞0.05).结论 选择合适的妊娠合并子宫肌瘤患者在剖宫产术同时行子宫肌瘤剔除术是安全可行的.     

剖宫产同时行子宫肌瘤切除术420例分析

目的:探讨剖宫产同时行子宫肌瘤切除术是否可导致产时和产后短期内发病率的增加。方法:电脑检索本院1999年1月～2004年12月病历资料,妊娠合并子宫肌瘤孕妇在剖宫产的同时行子宫肌瘤切除术共有420例,单纯行剖宫产的有335例,比较两组手术前、后的血色素改变、手术时间、产后住院时间、产后发热率和出血率。结果:肌瘤切除组出血率高于单纯剖宫产组(P<0.01),但在产后发热率、手术时间和产后住院时间方面两组比较无显著差异。结论:恰当选择病例并由有经验的手术医生进行手术,剖宫产同时行子宫肌瘤切除术是一种安全的手术方法。     

对妊娠合并子宫肌瘤在剖宫产术中处理的分析

目的 探讨妊娠合并子宫肌瘤在剖宫产术中同时行肌瘤剔除术的可行性、安全性和处理方法.方法 随机选取2000～2006年收治妊娠合并子宫肌瘤220例,其中168例于剖宫产中行子宫肌瘤剔除术为Ⅰ组,52例剖宫产中未行子宫肌瘤剔除术为Ⅱ组和同期行单纯子宫下段剖腹产220例为对照组的临床资料进行回顾性分析.对剖宫产术中平均失血量、平均手术时间、术后产后出血情况、术后产褥感染率、住院天数及胎儿出生体重进行比较.结果 平均术中失血量、平均手术时间Ⅰ组与其他两组比较差异均有统计学意义(P＜0.05),术后产后出血率Ⅱ组与其他两组比较差异均有统计学意义(P＜0.05),术后产褥感染率及住院天数三组比较差异无统计学意义(P＞0.05).Ⅰ、Ⅱ组和对照组分娩的胎儿出生体重比较差异有统计学意义(P＜0.05).结论 妊娠合并子宫肌瘤在选择合适病例及正确术式的前提下,在剖宫产同时行肌瘤剔除术是安全可行的.     

剖宫产术中子宫肌瘤剔除56例分析

目的探索妊娠合并子宫肌瘤时行剖宫产术同时行子宫肌瘤剔除术的手术指征,并分析其临床可行性意义及手术的安全性。方法选取我院妇产科从2013年8月~2014年7月期间收治入院的妊娠合并子宫肌瘤行剖宫产术中子宫肌瘤剔除者56例为观察组,同时随机抽取同一时间段行单纯子宫下段剖宫产术无子宫肌瘤合并症的产妇56例为对照组,观察并分析两组产妇手术前后中的四项基本生命体征、相关实验室检查结果、术中出血量、手术时间及术后的临床表现有无差异。结果术中及术后两组产妇的出血发生率分别为观察组12.33%,对照组11.21%,两组差异无统计学意义(P0 05);两组产妇的催产素使用量、手术前后发热率及血红蛋白值、红细胞压积、术后恶露持续时间、肛门通气及住院时间相比,差异无统计学意义(P0 05);观察组剖宫术同时行子宫肌瘤剔除术时间比对照组长,两组手术时间对比,差异有统计学意义(P0.05);子宫肌瘤分为单发和多发、浆膜下和肌壁间,不同部位、大小不同的子宫肌瘤剔除后,术中出血量差异有统计学意义(P0.05)。所有产妇伤口愈合良好,均无产后并发症发生。结论当子宫肌瘤≤5cm时,行剖宫产手术并子宫肌瘤剔除术,不仅可以减轻患者再次手术的医疗费用及手术的痛苦,而且该手术方案安全可行,并没有因合并子宫肌瘤剔除术而增加手术风险。但当子宫肌瘤位于子宫下段且直径5cm时,手术风险较大,不推荐临床行剖宫产合并子宫肌瘤剔除术。     

剖宫产同时行子宫肌瘤剔除98例临床分析

目的:观察剖宫产同时行子宫肌瘤剔除术对产妇术中及术后的影响。方法:对2009年6月～2011年12月剖宫产同时行子宫肌瘤剔除产妇临床资料进行回顾性分析,随机分为对照组和观察组各98例进行观察。对照组单纯行剖宫产术,观察组剖宫产同时行子宫肌瘤剔除术。结果:两组患者均顺利完成剖宫产术。观察组术中见单发肌瘤67例,多发肌瘤31例。观察组在术中出血量、术后排气时间、恶露干净时间、住院时间与对照组相比较差异无统计学意义(P>0.05),观察组手术时间与对照组相比较长,差异具有统计学意义(P<0.05)。结论:剖宫产同时行子宫肌瘤剔除术是安全可行的。     

妊娠合并子宫肌瘤的诊断与治疗

目的:观察妊娠合并子宫肌瘤患者的肌瘤发生部位和肌瘤数量,比较不同妊娠情况的结局以及术中和术后的不同情况,为临床上妊娠合并子宫肌瘤患者的诊断和治疗提供一定的参考.方法:选择我院产科2014年8月-2016年9月收治住院的确诊妊娠合并子宫肌瘤的患者68例,统计分析患者的子宫肌瘤分类情况,按子宫肌瘤大小分为直径≥5cm和＜5cm组,比较两组对手术时间、术中出血量和住院时间的影响;比较单纯行剖宫产组和剖宫产术后剔除子宫肌瘤组的手术时间,术中出血量、术后出血率和住院时间等.结果:子宫肌瘤＜ 5cm组的手术时间和住院时间明显少于肌瘤≥5cm组,术中出血量和术后出血率明显小于肌瘤≥5cm组(P＜0.05),差异具有统计学意义;单纯行剖宫产组和剖宫产术中子宫肌瘤剔除组在术中出血量、术后出血率和住院时间上差异无统计学意义(P＞0.05),仅在手术时间上子宫肌瘤剔除组比单纯剖宫产组手术时间长(P＜0.05).结论:对子宫肌瘤＜ 5cm的妊娠合并子宫肌瘤患者剖宫产术中切除子宫肌瘤的方法是安全可行的,与单纯行剖宫产手术差别不大,熟悉妊娠合并子宫肌瘤的诊断及处理方法对妊娠妇女的安全具有重要的意义.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.