中医治疗慢性盆腔炎

从祖国医学对该病的认识及临床症状在古医案中的记载,以及现代医学理论入手,分析肾虚气滞血瘀导致的妇女盆腔慢性炎症的病因、病机,并对中医治疗此类病症的作用机理及疗效优势进行探讨,以期提高广大妇女的生活质量。     

Gonorrheal Infection,Pelvic Inflammatory Disease and Spinal Disability

Gonorrheal infection is an important sexually transmitted disease. Neisseria gonorrhoeae is responsible for about one-third to one-half of cases of acute pelvic inflammatory disease (PID). Spinal osteochondrosis is an important complication of chronic gonococcal PID. Rehabilitative intervention plays an important role for coping with this condition. In addition to gonococcal PID, congenital gonorrhea and gonococcal prostatitis are the other two important conditions that relate to spinal disability.     

Lyme Disease in Maine: a Comparison of NEDSS Surveillance Data and Maine Health Data Organization Hospital Discharge data

Background

Lyme disease is the most commonly reported vector borne disease in the United States and is a major public health concern in Maine. Maine Center for Disease Control and Prevention (Maine CDC) monitors Lyme disease through a passive surveillance system. In order to validate the Lyme disease surveillance system, Maine CDC was interested in comparing trends with a secondary data source. Specifically, Maine CDC was interested in comparing trends by age group, gender, geography, and timelines. Also, because hospitalization due to Lyme disease is rare, this analysis provided an opportunity to look at the diagnosis codes used for Lyme disease visits. The purpose of this paper is to compare the data acquired through surveillance to a secondary data source in order to evaluate the completeness of the data and verify trends.

Methods

Surveillance data was extracted from Maine’s NEDSS Base System for the years 2008 – 2011. Only confirmed and probable cases were included in data analysis. The Maine Health Data Organization (MHDO) collects information on all hospital inpatient and outpatient data visits and was used for this comparison. MHDO inpatient and outpatient hospital encounters with a diagnosis of 08881 in any diagnosis field were extracted from the full dataset from 2008 – 2011.

Results

Surveillance data showed the 5-14 year old age group had the highest rates of Lyme disease while outpatient data showed adults over the age of 45 to have the highest rates. Outpatient data showed a higher percentage of females with Lyme disease visits. Geographic trends did not match well between surveillance data and MHDO data which may be due to the hospital being used as proxy for the patient address. Timeliness trends were consistent between all sources, with the majority of Lyme disease occurring in the summer months of June, July and August. The majority of outpatient visits had Lyme disease listed as their primary diagnosis while the majority of inpatient visits had Lyme disease as a secondary or lower diagnosis.

Conclusions

There were several limitations to this study including incomplete data, and the inability to differentiate between new and old Lyme diagnoses. There is reasonably good similarity in the trends of these two systems helping validate the usefulness of Maine’s Lyme disease surveillance system. Many of the discrepancies warrant further investigation, and may lead to future opportunities for education or improvement in Lyme disease surveillance.     

慢性盆腔炎人性化护理分析

目的：分析盆腔炎患者在人性化护理下的临床康复效果。方法：将178例盆腔炎患者随机分为对照组和试验组,其中对照组88例,试验组90例,分别对两组患者实施中西医结合治疗,试验组实施人性化护理,对照组行常规护理。结果：试验组总有效率和痊愈率明显高于对照组,半年复发率低于对照组,比较差异有统计学意义（P〈0.05）。结论：慢性盆腔炎患者在人性化的护理方式下,有着明显的临床康复效果,患者生活质量提高显著,值得大力推广。     

慢性盆腔炎临床治疗分析

目的?分析中西药联合应用治疗慢性盆腔炎(CPID)的临床效果.方法?该院105例CPID患者分为3组.结果?中西组的总有效率、复发率和受孕率均优于中药组和西药组(P<0.05).结论?中西药联合治疗CPID有效.     

宫内节育器与生殖道感染及盆腔炎

本研究调查带有尾丝及无尾丝两种宫内节育器的两组妇女生殖道感染及盆腔炎的发生情况。结果显示有尾丝及无尾丝两组妇女在年龄、孕产次、宫腔深度等方面均无显著差异。无尾丝组停用率高于有尾丝组（Ｐ〈０．０５）。两组妇女在生殖道感染发生情况及发生时间方面均无显著差异（Ｐ〉０．０５）。有尾丝组３例、无尾丝组２例发生盆腔炎。提示尾丝的存在并不增加生列道感染及盆腔炎的发生。     

A Systematic Evaluation of Data Streams for Global Disease Surveillance

Objective

The overall objective of this project is to provide a robust evaluation of data streams that can be leveraged from existing and developing national and international disease surveillance systems, to create a global disease monitoring system and provide decision makers with timely information to prepare for and mitigate the spread of disease.

Introduction

Living in a closely connected and highly mobile world presents many new mechanisms for rapid disease spread and in recent years, global disease surveillance has become a high priority. In addition, much like the contribution of non-traditional medicine to curing diseases, non-traditional data streams are being considered of value in disease surveillance. Los Alamos National Laboratory (LANL) has been funded by the Defense Threat Reduction Agency to determine the relevance of data streams for an integrated global biosurveillance system through the use of defined metrics and methodologies. Specifically, this project entails the evaluation of data streams either currently in use in surveillance systems or new data streams having the potential to enable early disease detection. An overview of this project will be presented, together with results of data stream evaluation. This project will help gain an understanding of data streams relevant to early warning/monitoring of disease outbreaks.

Methods

Three specific aims were identified to address the overall goal of determining the relevance of data streams for global disease surveillance. First, identify data streams as well as define metrics for the evaluation. Second, evaluate data streams using two different methodologies, decision analysis modeling using a support tool called Logical Decisions® that assigns utility scores to data streams based on weighted metrics and assigned values specific to data stream categories; and a Surveillance Window concept developed at LANL that assigns a window or windows of time specific to a disease within which information coming from various data streams can be determined to have utility. This would obtain a ranked list of useful data streams. Additionally, evaluate data integration algorithms useful for a global disease surveillance system through a review of scientific literature. Finally, validate the top-ranked data streams by application of specific historical outbreaks to determine whether the data streams are capable of providing early warning or detection of the particular disease before it became a large outbreak.

Results

Seventeen categories of data streams were identified that ranged from traditional ones such as clinic/healthcare provider and laboratory records to newly emerging sources of information such as social media and internet search queries. The Logical Decisions® based evaluation of data streams identified 5 data streams that consistently showed utility regardless of the goal of biosurveillance. However, different data streams varied in rank, given different biosurveillance goals, and there is no one top ranked data stream. Surveillance window based evaluation of data streams during disease outbreaks identified data streams that had high utility for early detection and early warning regardless of disease, while others were more disease and operations specific. Additionally, we have built a searchable biosurveillance resource directory that houses information on global disease surveillance systems.

Conclusions

LANL has developed a robust evaluation framework to determine the relevance of various traditional and non-traditional data streams in integrated global disease surveillance. Through the use of defined surveillance goals, metrics and data stream categories, not only have we identified data streams currently in use that have high utility, but also new data streams that could be exploited for the early warning/monitoring of disease outbreaks. Our robust evaluation framework facilitates the identification of a defensible set of options for decision makers to use to prepare for and mitigate the spread of disease.     

慢性盆腔炎家庭护理研究进展

慢性盆腔炎是妇科常见病,多由急性盆腔炎治疗不彻底或患者体质较差、病程迁延所致,常反复发作。由于病程长、恢复慢以及经济方面等因素,家庭护理在盆腔炎的彻底治愈中发挥日益重要的作用。     

Evaluating Syndromic Data for Surveillance of Non-infectious Disease

Objective

To evaluate several non-infectious disease related syndromes that are based on chief complaint (cc) emergency department (ED) syndromic surveillance (SS) data by comparing these with the New York Statewide Planning and Research Cooperative System (SPARCS) clinical diagnosis data. In particular, this work compares SS and SPARCS data for total ED visits and visits associated with three non-infectious disease syndromes, namely asthma, oral health and hypothermia.

Introduction

Syndromic surveillance data has predominantly been used for surveillance of infectious disease and for broad symptom types that could be associated with bioterrorism. There has been a growing interest to expand the uses of syndromic data beyond infectious disease. Because many of these conditions are specific and can be swiftly diagnosed (as opposed to infectious agents that require a lab test for confirmation) there could be added value in using the ICD9 ED discharge diagnosis field collected by SS. However, SS discharge diagnosis data is not complete or as timely as chief complaint data. Therefore, for the time being SS chief complaint data is relied on for non-infectious disease surveillance.SPARCS data are based on clinical diagnoses and include information on final diagnosis, providing a means for comparing the chief complaint (from SS) to a diagnosis code (from SPARCS), for evaluating how well the syndrome is captured by SS and for assessing if it would be advantageous to get SS ED diagnosis codes in a more timely and complete manner.

Methods

Syndromes previously developed by the DOHMH were used for this work. Syndrome definitions are based on querying the cc field in SS data for terms associated with asthma, oral health and hypothermia. The asthma syndrome consists of search terms for ‘ASTHMA’, ‘WHEEZING’ and ‘COPD’. The oral health syndrome uses (‘TOOTH’ or ‘GUM’) and (‘ACHE’, ‘HURT’) and excludes visits resulting from trauma (e.g., ‘INJURY’, ‘ACCIDENT’). The hypothermia syndrome is limited to search for the word ‘HYPOTHERMIA’. For the purpose of comparison of the SS data with SPARCS data for the three syndromes, the following ICD9 diagnosis codes were considered in SPARCS: 493 for asthma, 521–523, 525, 528–529 for oral health and 991 for hypothermia.SS and SPARCS data for 2007 were used for this work as this was the most recent and complete SPARCS ED dataset that was available. Overall city-wide daily counts and hospital-level annual counts for total ED, asthma-, oral health- and hypothermia-related visits were computed for SS ED data and SPARCS ED data. A comparison of daily and hospital trends for SS and SPARCS for total and syndrome-related counts were conducted using correlation coefficients.

Results

There is a high correlation between total ED SS and SPARCS daily counts (r=0.98, p-value<0.001). On average, SPARCS daily counts are higher by approximately 75 visits (range: −674, 591) per day. Correlations between SS and SPARCS daily counts for asthma, oral health and hypothermia were 0.96 (p-value<0.001), 0.66 (p-value<0.001) and 0.45 (p-value<0.001), respectively. Correlations between SS and SPARCS hospital-level annual counts for asthma, oral health and hypothermia were 0.89 (p<0.001), 0.87 (p<0.001) and 0.07 (p=0.61). In 2007, less than 8% of individual SS records had a discharge diagnosis, and this was found to vary between hospitals (0–69%); therefore, a comparison between SS discharge diagnosis and SPARCS diagnosis data was not possible.

Conclusions

Overall, syndromic surveillance data was found to be a useful data source for public health surveillance of non-infectious disease. Total ED visits were found to be comparable between SS and SPARCS. While direct comparison of counts for syndromes is not possible, the daily syndrome counts between SS and SPARCS correlated well. However, the strength of correlation varied depending on the syndrome, with a better correlation for syndromes with larger volume of visits to the ED (e.g., asthma) and with more commonly used terms in the cc search (e.g., ‘tooth ache’) compared to syndromes with very specific search terms (e.g., ‘hypothermia’).In certain instances, it is hypothesized that SS discharge diagnosis would provide more reliable and representative estimates than cc for tracking non-infectious disease. Future work will consider a period with more complete SS ED discharge diagnosis data for further comparisons and to test the hypothesis that more complete and timely SS ED discharge diagnosis data could improve surveillance efforts.     

女性盆腔炎病原菌分布与耐药性分析

目的 了解引起女性盆腔炎感染的病原菌分布及耐药情况,为临床正确诊断、合理应用抗菌药物提供科学依据.方法 对分离的348株病原菌用K-B法进行药敏试验,对革兰阴性菌采用ESBLs确认试验检测ESBLs,头孢西丁三维试验检测AmpC酶.结果分离的348株病原菌中,革兰阴性菌215株,占61.78%,主要为大肠埃希菌、肺炎克雷伯菌、褪色沙雷菌;革兰阳性菌127株,占36.49%,以凝固酶阴性葡萄球菌、金黄色葡萄球菌居前2位,革兰阴性杆菌ESBLs、AmpC酶总检出率分别为38.1%、34.9%,单产ESBLs、单产AmpC、同产ESBLs+高产AmpC酶、ESBLs+诱导AmpC酶菌株依次占13.02%、9.77%、13.95%、11.16%,革兰阳性菌除对万古霉素、替考拉宁、喹奴普汀/达福普汀、利福平的耐药率较低外,其余抗菌药物的耐药率均>48.00%,革兰阴性菌对亚胺培南、美罗培南、头孢吡肟的耐药率分别为5.58%、3.72%、26.00%,产酶株较非产酶株具有较高的耐药率(P<0.05).结论 女性盆腔感染以凝固酶阴性葡萄球菌、金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、褪色沙雷菌为主,万古霉素、替考拉宁对革兰阳性菌,亚胺培南、美罗培南、头孢吡肟对革兰阴性菌具有良好的抗菌活性.     

温针配合抗生素治疗对盆腔炎致慢性盆腔痛转归影响的临床研究

目的：探讨温针配合抗生素治疗盆腔炎所致慢性盆腔疼痛转归的影响。方法：101例盆腔炎患者随机分成两组,温针组予以温针配合抗生素治疗,对照组单纯予以抗生素治疗,于第2、4、8、24周观察疗效及盆腔痛症状积分变化。结果：总有效率温针组93.75%,对照组73.58%;半年内复发率温针组8.3%,对照组37.7%,两组比较差异有统计学意义（P〈0.01）。结论：温针配合抗生素治疗盆腔炎取得较好疗效,减轻腹痛症状,减少慢性盆腔痛发生率。     

我国人群的主要卫生问题——全国疾病监测死亡资料分析

利用全国疾病监测系统的5年死因监测资料,使用标化死亡率、潜在减寿年数(YPLL)和失能调整的损失健康生命年(DALY),对我国人群的主要卫生问题进行了分析。由于人口的老龄化,感染性疾病死亡下降而导致慢性病相对重要性的上升,以及某些危险因素上升,致使肺癌等疾病呈上升趋势,从而我国的疾病模式不同于50年代的模式,呈现出这样的特点:虽然感染性疾病有所下降,构成比降低,但并未得到根本控制。同时,慢性病、意外伤害所导致的卫生问题上升,形成双重挑战。     

旋磁光子热疗仪辅助治疗慢性盆腔炎临床分析

目的 观察旋磁光子热疗仪辅助治疗慢性盆腔炎患者的临床症状和体征.方法 对照组60例给予抗生素治疗,观察组60例给予抗生素并用体外旋磁光子热疗仪,治疗结束进行疗效对比.结果 观察组疗效明显优于对照组(P<0.01).结论 抗生素辅助旋磁光子热疗仪治疗慢性盆腔炎临床效果显著,费用低廉,是治疗该病有效的方法之一,值得临床推广应用.     

非淋菌性尿道炎合并盆腔感染药物治疗效果对比研究

目的探讨临床上对非淋菌性尿道(宫颈)炎合并盆腔感染有效的治疗方法。方法将妇产科及性病科门诊确诊的非淋菌性尿道(宫颈)炎合并盆腔感染201例病人随机分为2组,治疗组采用头孢曲松纳加阿奇霉素治疗,对照组采用头孢曲松纳加口服美满霉素治疗。结果治疗组治愈率为80.95%,总有效率为97.14%;对照组治愈率为58.33%,总有效率为69.79%。两者的,临床治愈率及有效率有显著性的差异(P<0.005)。结论头孢曲松纳加阿奇霉素静脉给药治疗非淋菌性尿道(宫颈)炎合并盆腔感染取得良好的治疗效果,较头孢曲松纳加美满霉素效果有显著性提高。     

A nutrient analysis of students' diets in the State of Hawaii

As part of a comprehensive nutrition education needs assessment, we collected, by a modified 24-hour recall method, data on the nutritional quality of diets of a representative sample of 890 students in the state of Hawaii. In general, the nutritional quality of diets decreased as the students got older. Large proportions of students reported daily intake of less than two-thirds of the Recommended Dietary Allowances for iron, calcium, vitamin A, thiamin, and vitamin C. We also found high intakes of sodium, cholesterol, and saturated fatty acids and relatively high energy contribution from snacks and high-sugar foods. These data document the need for nutrition education for the school children in Hawaii and provide important baseline food selection information for designing a nutrition education program for the specific target audience.     

中西药灌肠联合理疗治疗慢性盆腔炎60例疗效分析

目的探讨中药红藤汤＋西药灌肠配合理疗治疗慢性盆腔炎的临床疗效。方法回顾性分析我院妇科自2006年2月-2008年9月门诊及住院诊治的慢性盆腔炎患者120例的治疗经过。将120例患者随机分为2组,治疗纽于月经干净3天后开始中药红藤汤＋西药（庆大霉素针、地塞米松针、糜蛋白酶针和2％利多卡因针）保留灌肠,并配合热磁贴下腹部,10天为1个疗程：对照组于经期采用头孢哌酮钠针3．0g加入0．9％生理盐水250ml＋0．5％甲硝唑注射液100mI静滴,每日2次,7日为1个疗程,两组均为每月1个疗程,连用3个月。结果治疗纽60例,治愈45例,显效11例,有效3例,无效1例,总有效率为98．3％。与对照组比较,经统计学处理,差异有显著性（P〈0．05）。结论中药红藤汤＋西药灌肠联合理疗治疗慢性盆腔炎,疗效较好,治愈率高,又无副作用,患者乐于接受,值得推广。     

中西医结合治疗盆腔炎性疾病后遗症临床观察

目的观察中西医结合治疗方法对盆腔炎性疾病后遗症的疗效。方法盆腔炎性疾病后遗症患者180例,随机分为治疗组和对照组各90例,治疗组采用药物加物理治疗方法,对照组采用单纯药物治疗方法,比较两组患者治疗后的临床效果。结果治疗组的总有效率明显高于对照组,两组比较差异有统计学意义（P〈0．05）。结论中西医结合治疗盆腔炎性疾病后遗症效果稳定,不良反应少,值得临床推广。