香港的中医药发展

从制定管理制度和标准、设立良好的教育及培训系统、设立优质中医药诊疗中心、促进科研和创新、推动产业发展、未来工作方向6个方面全面论述了香港的中医药发展。     

香港医院的手术核对工作透视

手术室核对制度作为手术室核心制度之一,是医疗安全制度的一个重要组成部分。笔者在香港公立医院手术室为期10个月的实践中,对香港医院手术室的患者核对工作有了深入的了解和体会; 同时也了解到世界卫生组织正在为规范手术核对进行一系列的改革尝试。本文介绍并分析了香港手术室患者核对方法、手腕带的使用、如何执行和记录,希望可以为改革和完善手术室的核对制度和规范核对流程提供参考。     

Awareness and knowledge of hepatitis B infection and prevention and the use of hepatitis B vaccination in the Hong Kong adult Chinese population

Background  Hepatitis B virus (HBV) infection remains a global public health problem and it is an important cause of acute, chronic and fulminant hepatitis, liver cirrhosis and hepatocellular carcinoma. The prevalence of HBV infection in Hong Kong over the past decade remained unchanged at 10%, despite the implementation of universal neonatal and availability of adult vaccination. We suspect that the current state of affairs is attributable to inadequate awareness and knowledge of HBV transmission and prevention in the general population, resulting in a low rate of uptake of HBV vaccination by the lay public. Therefore, we have embarked in this study to evaluate the awareness and knowledge on HBV infection in our local Chinese population, their attitude on the prevention of horizontal transmission of HBV, and the use of HBV vaccination, especially in those who were born before the era of universal neonatal vaccination.

Methods  The factors associated with HBV screening, vaccination uptake, and knowledge were examined in a face-to-face questionnaire survey on a group of adult Chinese in Hong Kong.

Results  Within this group, 14% was considered to have good knowledge for HBV infection, and 26% had HBV vaccination. Age, occupation, having children, and family monthly income, are independent factors associated with vaccination.

Conclusion  This study suggests insufficient public awareness of HBV infection in the Hong Kong Adult Chinese population.

     

SARS在香港的流行病学调查与防治

目的 总结香港特区严重急性呼吸系统综合征(SARS)流行病学的调查结果与防治经验。方法 回顾SARS疫症在香港的爆发经过,收集有关资料,进行流行病学分析;介绍政府从公共卫生角度采取的一系列防疫的行政措施。结果 根据流行病学调查,该病潜伏期一般为2～7d,亦可长达十多日。SARS病毒的主要传播途径是经飞沫传播,即接触到患者分泌物的飞沫或污染的传病媒介。感染者多为医护人员及与患者有紧密接触者。采取控制疫情的措施包括：第一、控制传染源,做到早发现、早诊断、早报告、早隔离和早治疗。第二、切断传播途径。第三、保护易感人群。第四、公布疫情资料。同时也配合其他措施,包括出入境检疫措施、与病人接触者的隔离措施、学校停课等,使得香港的SARS疫情日趋稳定。结论 防治传染病要制定宏观统筹的策略,进行有效的监察,发现疫情时应采取快速果断的防疫措施。     

香港理工大学《功能解剖》授课模式的启示

通过介绍香港理工大学知名教授进行《功能解剖》教学时的授课模式和授课特点,并归纳其带来的教学启示,从而增加对香港理工大学《功能解剖》授课模式的了解,为高校以后开展《功能解剖》教学提供参考。     

A prospective epidemiological study on tinea pedis and onychomycosis in Hong Kong

Ｔｈｅｐｒｅｖａｌｅｎｃｅｒａｔｅｓｏｆｔｉｎｅａｐｅｄｉｓａｎｄｏｎｙｃｈｏｍｙｃｏｓｉｓａｒｅｄｅｔｅｒｍｉｎｅｄｂｙａｇｅ ,ｐｒｅｄｉｓｐｏｓｉｎｇｆａｃｔｏｒ,ｓｏｃｉａｌｃｌａｓｓ ,ｏｃｃｕｐａｔｉｏｎ ,ｃｌｉｍａｔｅ ,ｌｉｖｉｎｇｅｎｖｉｒｏｎｍｅｎｔａｎｄｆｒｅｑｕｅｎｃｙｏｆｔｒａｖｅｌ 1　Ｉｎｓｐｉｔｅｏｆｉｍｐｒｏｖｅｄｐｅｒｓｏｎａｌｈｙｇｉｅｎｅａｎｄｌｉｖｉｎｇｅｎｖｉｒｏｎｍｅｎｔ,ｔｉｎｅａｐｅｄｉｓａｎｄｏｎｙｃｈｏｍｙｃｏｓｉｓｃｏｎｔｉｎｕｅｔｏｓｐｒｅａｄａ…     

新时期来自港台的新词语及其社会心理透视

本文对源于港台的新词语———方言词、外来词、新造词进行结构方式的归并 ,归并为缩略词、派生词、类化语词 ,然后进行社会心理的分析 ,作者认为上述新词语在汉语中得以广泛运用 ,主要是因为模仿心理、商业社会文化心理、求新尚简心理等因素所致     

Features of Ciguatera Fish Poisoning Cases in Hong Kong 2004-2007

Ohjective To review the clinical features and laboratory investigations of ciguatera patients in Hong Kong between 2004 and 2007 in order to show the timely sampling of implicated fish from ciguatera victims and application of validated mouse bioassay for confirming suspected clinical cases of ciguatera. Methods Diagnosis of the ciguatera victims was based on history of coral fish consumption and clinical presentations stated in official guidelines for clinical diagnosis of ciguatera fish poisoning in Hong Kong. Food remnants of coral fish samples were collected swiftly from ciguatera victims between 2004 and 2007 for ciguatoxins （CTXs） analysis. Results Major clinical symptoms in ciguatera patients included gastrointestinal and neurological effects including limb numbness and diarrhoea, which developed at 0.5 to 15 hours after consumption of fish. In most cases, neurological symptoms were more common than gastrointestinal symptoms. A broad range of attack rate （10%-100%） was observed in each ciguatera outbreak. Validated mouse bioassay on ether extracts of the food remnant samples confirmed that all were CTXs-positive （〈0.5 - 4.3 MU/20 mg ether extract） and directly linked to the corresponding ciguatera cases. Conclusion Consistency between clinical and laboratory analysis for ciguatera poisoning illustrates the application of laboratory mouse bioassay in a timely fashion for confirming ciguatera poisoning cases and implementing effective public health measures. With further improvement in laboratory techniques, features of ciguatera fish poisoning cases can be better defined, Further studies are needed to determine the risk of each class of CTXs （Pacific-, Indian- and Caribbean-CTXs） in Hong Kong.     

脑梗死继发癫痫30例临床分析

[目的]探讨脑梗死继发癫痫的临床特点及发病机制。[方法]针对352例脑梗死病例中继发性癫痫患者的临床资料进行回顾性分析。[结果]脑梗死继发癫痫发作共30例,发生率为8.5%。癫痫发作的类型以部分性发作最多见,共21例(占70%)。继发癫痫的梗死部位,脑叶梗死26例,基底节区3例,丘脑1例。早发性癫痫11例,迟发性癫痫19例。系统抗癫痫治疗24例癫痫发作停止。[结论]脑叶梗死较易合并癫痫发作,抗癫痫药物对脑梗死继发癫痫治疗大多有效。     

20世纪香港中医药发展特点

香港的多数居民为华人,长期以来一直信赖和依靠中医.20世纪百年间,香港中医药界合理利用港英政府的相关法规,为其生存争取了空间;在积极参与内地“废止中医案”抗争的同时,又与内地合作开办中医教育,加上部分内地中医赴港定居,使得香港中医药界保持着活力;出于公共卫生的考虑,港英政府允许并协助建立华人医院并应用中医药,从而首创了香港的中医医院,并对中西医合作进行了探索;受社会各团体的资助,香港中医医院注重慈善服务,使其拥有了深厚的群众根基.这些都为香港回归祖国后中医药的发展以及相关政策的实施奠定了基础.     

Outcome of severely injured trauma patients at a designated trauma centre in the Hong Kong Special Administrative Region

Background The Hong Kong Special Administrative Region （HKSAR） of the People＇s Republic of China （PRC） has seen significant changes in its trauma service over the last ten years including the implementation of a regional trauma system. The author＇s institution is one of the five trauma centres designated in 2003. This article reports our initial clinical experience. Methods A prospective single-centre trauma registry from January 2004 to December 2008 was reviewed. The primary clinical outcome measure was hospital mortality. The Trauma and Injury Severity Score （TRISS） methodology was used for bench-marking with the North America Major Trauma Outcome Study （MTOS） database. Results There were 1451 patients. The majority （83.9%） suffered from blunt injury. The overall mortality rate was 7.8%. Severe injury, defined as the Injury Severity Score 〉15, occurred in 22.5% of patients, and was associated with a mortality rate of 31.6%. A trend of progressive improvement was noted. The M-statistic was 0.99, indicating comparable case-mix with the MTOS. The Z- and W-statistics of each individual year revealed fewer, but not significantly so, number of survivors than expected. Conclusions Trauma centre designation was feasible in the HKSAR and was associated with a gradual improvement in patient care. Trauma system implementation may be considered in regions equipped with the necessary socio-economic and organizational set-up.     

600例香港人群亚健康状态的流行病学调查

目的 了解香港地区亚健康的发生率、临床症状分布等情况,为香港地区亚健康的防治提供依据.方法 首先采用现场调查的方式,让受调查者现场填写亚健康状态调查问卷,然后根据被调查者填写的内容,结合查体结果,参考中华中医药学会亚健康专业委员会制定的《亚健康中医临床指南》,判断受调查者的亚健康状态,并统计分析香港地区人群亚健康状态的发生率、一般情况、临床症状等.结果 亚健康现患率为68.4％.女性发病率高于男性(x2=7.899,P＜0.01);年龄在70岁以上者亚健康状态现患率最低,30～50岁者亚健康发生率最高,健康人群比例亦依次递减,疾病人群比例却依次递增(x2=303.939,P＜0.01).亚健康临床症状复杂多样.结论 香港地区人群健康状况不容乐观,应采取各种干预措施加以改善.     

Doubling over ten years of central obesity in Hong Kong Chinese working men

Obesity is now an epidemic in most parts of the world. In this cross sectional study, we report the most recent data on obesity in Hong Kong Chinese working population and compare the changes over 10 years. Methods Between July 2000 and March 2002, 5882 adult subjects from the working class in Hong Kong were recruited （2716 men （46.2%） and 3166 women （53.8%））. They were randomly selected using computer generated codes according to the distribution of occupational groups. Results of this study were compared with the data collected from a prevalence survey for cardiovascular risk factors in a Hong Kong Chinese working population conducted in 1990 （1513 subjects, 910 men （60.1%） and 603 women （39.9%））. Results Standardized percentages of overweight, obesity, and central obesity, in Hong Kong Chinese working population were 59.7%, 35.0%, 26.7% in men and 32.0%, 21.7%, 26.7% in women. Compared to the data collected in 1990, the percentage of obesity increased by 5% in men and reduced by 6% in women. The percentage of central obesity doubled in men （from 12.2% to 26.7%） but remained stable in women. Conclusions There is a doubling of the percentage of central obesity in Hong Kong Chinese working men over previous decade. Education and proper lifestyle modification program to tackle this social health issue are urgently indicated.     

Perioperative anaphylaxis and investigations: a local study in Hong Kong

INTRODUCTIONData on local intraoperative anaphylaxis in Hong Kong is scarce, with few reviews available. We aimed to study the characteristics, presentations and workup results of cases referred to a local allergy clinic.METHODSA retrospective review was performed of patient referrals and workup results for suspected intraoperative anaphylaxis at Queen Mary Hospital drug allergy clinic in 2012–2016.RESULTSTryptase was checked in only 81.7% (49/60) of the cases, most of which showed elevation (71.4%, 35/49). Among the 59 patients who received a workup, 47 (79.7%) showed positive findings, with a particularly high yield in the tryptase-positive subgroup (88.6%, 31/35). Among the 54 patients who consented to skin tests (the most sensitive investigation), 43 (79.6%) cases were positive. Overall, neuromuscular blockers were the commonest cause (25.0%, 15/60) of intraoperative anaphylaxis, while antibiotics ranked second (23.3%, 14/60). The timing of reactions was an important indication of potential allergens. For example, the majority of the neuromuscular blocker allergies occurred during the induction phase, while all gelofusine allergic events were in the maintenance phase of anaesthesia. 13 (21.7%) out of 60 cases received subsequent general anaesthesia procedures, with no recurrence of allergic reactions.CONCLUSIONProper workup after an intraoperative anaphylactic event has a fairly good chance of identifying the causative allergen. These results are useful for patient management and the planning of subsequent anaesthetic procedures.     

香港中文大学与中山大学医学教育课程教学的比较

以香港中文大学和中山大学为代表,分别从理论课、实验课授课情况以及临床教学开展情况对粤港医学教育课程教学进行比较,发现两校的课程结构各有优势与不足,应互相借鉴以共同提高。而重视早期接触临床和实践教学,为医学生成为合格的临床医生奠定坚实基础则是两校的共同点。     

香港地区针灸戒烟受试者的依从性影响因素分析

目的探讨香港地区针灸戒烟受试者的依从性影响因素。方法选择2010年8月到2015年6月参加中国中医科学院针灸研究所与香港博爱医院联合开展的"中医针灸戒烟先导研究"的受试者,比较脱落人群与未脱落人群的人口学、吸烟背景、戒烟意愿等资料的差异。以8周和52周是否脱落作为因变量,使用二项分类Logistic回归分析法筛选出针灸戒烟的依从性影响因素。结果共纳入受试者4 480例,8周、26周和52周的依从率分别为68.86%、58.24%和49.51%。纳入的受试者以男性为主(62.25%),年龄(43.50±12.04)岁,文化程度以中学为主(62.46)%;烟龄(25.09±11.61)年,每日吸烟数(17.68±7.90)根,法氏烟草依赖评估量表(FTND)指数(5.35±2.29)分,大多数(81.12%)曾经戒过烟,80.96%的受试者因担心自身健康戒烟;总针灸次数(5.40±3.25)次。Logistic回归分析结果表明,影响针灸戒烟8周受试者依从性的因素有FTND(OR=1.048,95%CI 1.007~1.092);是否因他人劝说戒烟(OR=0.795,95%CI 0.708~0.892);选择中医针灸原因(OR=1.101,95%CI 1.031~1.176);总针灸次数(OR=1.346,95%CI 1.290~1.404)和是否首月完成6次治疗(OR=2.975,95%CI 2.424~3.652)。影响针灸戒烟52周受试者依从性的因素有性别(OR=1.406,95%CI 1.207~1.637);总针灸次数(OR=1.134,95%CI 1.097~1.173)和是否首月完成6次治疗(OR=5.128,95%CI 4.242~6.220)。结论香港地区针灸戒烟受试者依从性较好,其中高质量的针灸治疗是提高受试者依从性的最重要因素。     

自发性脑出血后继发癫痫的临床研究

目的：对自发性脑出血后继发癫痫的发作特点及治疗方法进行探讨。方法：选取我院2010年1月～2015年1月收治的自发性脑出血后继发癫痫患者158例作为研究对象,对患者颅内出血部位与继发性癫痫的发作类型、发作时间之间的相关性、治疗方法等临床资料进行回顾性分析。结果：158例脑出血继发癫痫患者中脑叶出血91例,其中58例为强直阵挛发作,33例为部分性发作,非脑叶出血67例,53例为部分性发作,14例为强直阵挛发作。脑叶出血中强直阵挛发作占63.7%,非脑叶出血强直阵挛发作占20.9%,两者比较有差异。另91例脑叶出血继发癫痫患者中早发型癫痫为58例,67例非脑叶出血继发癫痫的患者中早发型仅16例,两相比较有差异。对158例脑出血继发癫痫患者,均采用常规一线抗癫痫药物治疗,排除最终12例死亡患者,133例患者均无再发癫痫,有效率达91.1%。结论：脑出血继发癫痫患者,脑叶出血多早发型,发作类型以强直阵挛发作常见,非脑叶出血多迟发型,发作类型以部分性发作常见。脑出血继发癫痫通过常规一线抗癫痫药物治疗有效。     

1978～2008年香港食物中毒事件分析

目的了解香港1978-2008年食物中毒的状况与特征,为有效预防和控制提供科学依据。方法收集整理香港1978～2008年食物中毒事件相关资料进行统计分析。结果香港1978～2008年共发生食物中毒12 228起,中毒人数51 996人,死亡7人。31年来年均发生394起事件、中毒1 677人,月均发生33起、中毒140人。食物中毒事件发生最多的年份是2006年（1 095起）,最少的是1990年（96起）。近5年（2004～2008年）年均发生食物中毒826起,中毒3082人。1997～2008年食物中毒事件多发于每年6月～9月;细菌性食物中毒占78.0%;高风险食物主要有烧烤类、寿司与刺身、蚝、海鲜等。结论从香港食物中毒发生情况来看,微生物类食物中毒居首位。须加强对市售即时食物的监测以及对食品的卫生监管。     

病毒性脑炎继发癫痫患者临床特点分析

目的探讨病毒性脑炎继发性癫痫患者的临床特点,以提高对该病的认识。方法回顾性分析46例病毒性脑炎继发癫痫患者的临床资料。结果 46例病毒性脑炎继发癫痫患者中37例出现影像学异常,异常率为80%。癫痫发作类型:全身性强直-阵挛发作19例(41.3%)、单纯部分性发作6例(13.04%)、复杂部分性发作7例(15.22%)、部分性发作继发全面性8例(17.39%)、持续状态6例(13.04%)。脑电图表现:呈边缘脑电图4例(8.7%)、轻度异常8例(17.39%)、中度异常20例(43.48%)、重度异常14例(30.43%)、首次脑电图检测出现癫痫波(尖波、棘波、棘-慢波综合)14例(30.43%)。结论病毒性脑炎易继发癫痫,病毒性脑炎患者应积极行影像及EEG检查。     

新形势下港澳台学生教育管理的思考

分析当前港澳台学生教育管理中存在的问题,提出提高认识,加强管理,完善分工协作管理制度,适当微调教学要求,以提高教育质量的思路。