早产儿两种不同灌肠方法效果的比较

目的对早产儿两种不同灌肠方法的效果进行比较。方法将240例需要灌肠的早产儿随机分成两组,观察组115例予以生理盐水2.5ml加开塞露2.5ml肛门内注入,对照组125例予以温生理盐水30ml进行回流式灌肠,比较两组患儿在灌肠后排便效果、肠黏膜损伤情况、灌肠耗时等方面的差异。结果观察组患儿灌肠后的排便效果优于对照组(P0.05),肠黏膜损伤的发生明显低于对照组(P0.05),灌肠耗时也明显短于对照组(P0.05)。结论对早产儿行开塞露加生理盐水对半稀释后肛门内注入的灌肠方法效果好,损伤小,值得临床推广。     

不同方法治疗输卵管妊娠的疗效对比

目的 探讨腹腔镜保守手术治疗输卵管妊娠的临床疗效及预后.方法 275例输卵管妊娠患者分别采用腹腔镜保守手术、开腹保守手术及药物保守治疗,对比观察3组治疗的临床疗效、输卵管复通率、受孕率及 再次宫外孕几率.结果 腹腔镜保守治疗组与开腹手术组及药物保守治疗组比较效果最好,输卵管通畅率及宫内妊娠率最高,再次宫外妊娠发生率最低,差异有显著性(P＜0.05).结论 腹腔镜保守手术治疗输卵管妊娠不仅疗效肯定,而且提高了宫内妊娠率,降低了再次异位妊娠率,成为有生育要求的患者的首选治疗方法.     

Influencing prescribing in primary care: a comparison of two different prescribing feedback methods

This study evaluated two different methods of providing practice-based, antibiotic prescribing feedback to general practitioners (GPs). The impact of face-to-face Prescribing discussion visits led by a pharmaceutical prescribing adviser were compared to the provision of practice specific prescribing analysis workbooks. Sixty-six practices within one Family Health Services Authority were randomly stratified into one of two groups (Group 1: visits: Group 2: workbooks). The 23 practices who did not wish to participate were used as a self selected control group (Group 3). Twelve months after the start of the programme, visits were extended to Group 2 and Group 3. Prescribing patterns were evaluated using five prescribing indicators, before and at 12 and 24 months after the start of the programme. Analysis of practice prescribing patterns at 12 months demonstrated that the desired changes in the selected five indicators were greater in Group 1 than Group 2 or Group 3; changes were statistically significant for indicators 5, 4 and 2 in each group, respectively. After 24 months all groups demonstrated significant changes in five indicators. Face-to-face visits proved the most successful of the two methods to influence GP prescribing, although the workbook promoted more change than that seen in the control group.     

Iontophoresis versus subcutaneous injection: a comparison of two methods of local anesthesia delivery in children

The relative efficacy of local lidocaine anesthesia administered by subcutaneous injection and by iontophoresis was studied in 13 pediatric renal dialysis patients (ages 11-19 years: mean age 15.8 years). Each patient served as his own control at 3 assessment periods. Each type of anesthetic delivery method was administered to either of 2 fistula sites. Patients used visual analogue scales to rate pain, anxiety, and satisfaction for each method. Behavioral observations were made by an observer and a nurse. Paired sample t tests were used to compare the 2 drug delivery methods for patient, observer, and nurse ratings across assessment periods. There were no significant differences between methods for ratings of anxiety before or during the procedure. The injection of lidocaine was rated as more painful by the observer and nurse (with a trend for patients) than the use of iontophoresis. But, the patients and nurse rated the injection method as more effective. Iontophoresis was never rated as superior to the injection method, even after turning over control of drug delivery by iontophoresis to the patient (sessions 2 and 3). Patients were more satisfied with iontophoresis at session 2 when they took over control, but lost enthusiasm by session 3. Three subjects withdrew from the study due to cutaneous burns and prolonged anesthesia delivery time with iontophoresis. Iontophoresis appears to be effective in reducing the pain of dialysis needle insertion but requires further investigation before it can be considered a viable alternative to subcutaneous injection.     

Head trauma: comparison of infection rates for different methods of intracranial pressure monitoring

This article describes a study comparing the rates of infection for three different methods of intracranial pressure (ICP) monitoring. Case summaries of infected patients are presented. Maintenance of sterile technique by medical and nursing staff caring for the monitoring system is emphasized.     

Bronchial allergen challenge: comparison between two different methods of provocation

Bronchial allergen challenge was performed twice in ten well-defined stable asthmatic patients. On each provocation day the allergen was administered either by a standard method at tidal volume breathing or by a dosimeter method. Ten-fold increasing concentrations of allergen were administered with an interval of 10 min. Total amount of allergen of 9, 90, 900, 9000 and 90,000 SQ units using the standard method, whereas the corresponding amount by the dosimeter method was 0.5, 5, 50, 500, and 5000 SQ units. The bronchial response was determined by forced expiratory volume in the first second (FEV1) and by total resistance to breathing (Rt) measured by an opening interrupter method. The provocation was stopped when a decrease of at least 20% of the post-saline FEV1 and a 40% increase in post-saline Rt was observed. A PC20-FEV1 and a PC40-Rt was calculated by interpolation on the log dose-response curve. The late reaction was recorded and defined as a 20% reduction in peak expiratory flow (PEF) occurring during the 24-hr period after challenge. The comparability of PC20-FEV1 and PC40-Rt obtained with the standard method and with the dosimeter was high, r = 0.89 and r = 0.88. Furthermore, no significant difference was found by comparing delta FEV1 and delta Rt during provocation by either method as well as the occurrence and magnitude of the late reaction. We conclude that there exists a high comparability of the bronchial response to an allergen challenge performed either by a standard method at tidal volume breathing by continuous inhalation of the allergen aerosol or by a dosimeter method of inhalation despite the difference in the total allergen doses inhaled.     

不同麻醉方法用于婴幼儿腹部手术的对比研究

目的探讨施行婴幼儿腹部手术安全、有效、实用的麻醉方法。方法选择年龄3 d至3周岁行腹部手术患儿60例,随机分为两组,Ⅰ组采用骶管阻滞加浅全麻,Ⅱ组采用气管插管或喉罩静脉全麻。观察并记录两组患儿麻醉前、手术探查、手术结束各时点的心率(HR)、收缩压(SBP)数据变化,计算两组患儿丙泊酚、氯胺酮平均用量、苏醒时间以及苏醒质量。结果Ⅱ组患儿在手术探查时HR明显增快,血压(BP)升高,与Ⅰ组比较差异显著(P<0.01);组内比较,两组患儿在手术探查时HR均有所增快,但Ⅱ组增快更为明显(P<0.01),Ⅰ组增快较缓和(P<0.05),Ⅰ组在手术探查时BP无明显变化,Ⅱ组在手术探查时BP明显升高(P<0.01)。Ⅱ组患儿丙泊酚、氯胺酮用量明显多于Ⅰ组,苏醒时间也较Ⅰ组明显延长(P<0.01)。结论婴幼儿施行腹部手术,采用骶管阻滞联合浅全麻是较为理想、实用的麻醉方法。     

抗-HIV不同检测方法的结果比较

目的探讨不同检测方法、不同检测试剂对献血者人类免疫缺陷病毒抗体（抗-HIV）检测结果的影响。方法采用不同试剂使用酶联免疫吸附试验（ELISA）对献血者血浆标本进行抗-HIV分析,呈反应性血浆标本采用免疫学蛋白印迹法进行确证分析。结果ELISA再次检测抗-HIV阳性率显著低于初次检测阳性率,差异有统计学意义（P〈0．01）,确证试验阳性率显著低于初次检测和再次检测的阳性率,差异有统计学意义（P〈0．01）。结论采用不同试剂检测抗-HIV对于保证血液安全是非常必要的。     

Creamatocrit procedure versus triglyceride analysis: a comparison of methods for the determination of human milk fat in epidemiological studies.

A comparison is made of triglyceride analysis and the creamatocrit procedure to determine their usefulness as methods for measuring the fat content of human milk. Triglyceride analysis is shown to be the more precise technique but, for use in the field, the creamatocrit method has the advantage of simplicity.     

不同麻醉方法下经皮肾镜下取石术的效果比较

目的比较椎管内麻醉与全身麻醉用于经皮肾镜下取石术患者的安全性和临床效果。方法 100例行经皮肾镜取石的肾结石患者随机分为观察组和对照组,每组50例。观察组给予椎管内麻醉,对照组给予全身麻醉。比较2组患者手术结果、术后并发症、术后24 h需要镇痛药物剂量及临床效果。结果 2组患者手术时间、住院时间、术前GFR、术后GFR、结石排空率、并发症发生率无显著差异(P0.05)。2组术后镇痛药物剂量有显著差异(P0.01)。结论椎管内麻醉与全身麻醉的手术结果及并发症发生率相似。     

Transdermal nitroglycerin systems: methods for comparison

A number of transdermal nitroglycerin delivery systems are able to maintain a constant plasma level of nitroglycerin for up to 24 hours, even though the drug's elimination half-life is only a few minutes. Unfortunately, wide variations in plasma drug levels reported in studies of transdermal delivery systems can make plasma level comparisons between products inappropriate and misleading. Other measures of clinical performance include adhesive properties and patient preference. In one adhesion study, Minitran demonstrated superior adhesive properties when compared with Transderm-Nitro, Nitro-Dur II, and a medical reference tape. In patient preference studies involving several hundred patients with angina pectoris, patients consistently selected Minitran over Transderm-Nitro or Nitro-Dur II, citing patch size, shape, ease of application, comfort, better patch adhesion, and reduced instances of skin irritation.     

Extrathoracic versus transthoracic methods of surgical correction of stenoses and occlusions of the aortic arch branches: a comparison

125 reconstructions performed during the years 1968 to 1988 were analysed retrospectively. 81 surgical procedures were extrathoracic (64.8%) and 44 transthoracic (35.2%). The symptoms of the aortic arch branch lesions included subclavian steal syndrome in 67 (53.6%), transient cerebral ischemia in 16 (12.8%), residua of cerebral infarction in 5 (4.0%), monocular ischemic attacks in 16 (12.8%) and ischemic arm symptoms in 27 (21.6%) patients. Surgical repair was achieved by subclavian-carotid transposition in 44 (35.2%), carotid-subclavian bypass in 23 (18.4%), carotid-subclavian transposition in 2 (1.6%), endarterectomy of the subclavian artery in 5 (4.0%), carotid-carotid bypass in 3 (2.4%), subclavian-subclavian bypass in 4 (3.2%), aorto-subclavian bypass in 9 (7.2%), endarterectomy of the left subclavian artery in 18 (14.4%) and reconstruction of the innominate artery in 17 (13.6%) patients. 124 patients had complete remission of symptoms or at least showed marked improvement postoperatively. The overall patency rate of the extra- and transthoracic procedures in 85% at an average follow-up of 115 months. The patency rate in the extrathoracic group is 82% and not significantly lower than in the transthoracic group with a patency rate of 89%.     

Screening for slight albuminuria: a comparison of selected commercially available methods

Slight albuminuria predicts clinically significant nephropathy in patients with insulin-dependent diabetes mellitus (IDDM) and early death in patients with non-insulin-dependent diabetes mellitus (NIDDM). This study compares four commercially available methods for measuring low concentrations of urinary albumin. We tested random spot urine specimens from 50 nondiabetic volunteers and 100 diabetic patients. This specimen was chosen to simplify collection in an outpatient setting. Two screening methods were evaluated for their ability to detect urinary albumin in the range of 15 to 200 mg/L. Sensitivity and specificity were 100% and 54.7%, respectively, for the Ames Micro-Bumintest; and 95.5% and 91.5%, respectively, for the Sclavo Albumin Screen. The high number of false-positive results made the Micro-Bumintest unacceptable. The Albumin Screen yielded fewer false-positive results, but also produced some false-negatives. Two quantitative methods, a radioimmunoassay (RIA) and a turbidimetric assay (the SPQ Microalbumin), yielded results that agreed well with each other.     

In vivo total antioxidant capacity: comparison of two different analytical methods.

Several methods to assess the total antioxidant capacity (TAC) are available. However, the final value of measured TAC in the sample depends on the procedure used in every specific assay. This makes crucial the comparison of different analytical methods. The aim of our study was to evaluate analytical characteristics and laboratory reliability of two different assays: the ferric-reducing ability (FRAP) assay and a new spectrophotometric test (OXY-adsorbent test, Diacron, Italy). Unselected outpatients referred to the Institute of Clinical Physiology were studied (n = 187, 58 females, 129 males, mean age: 65 +/- 13 years). All blood samples were maintained on ice, centrifuged within 15 minutes after blood collection and then stored at -80 degrees C until performance of assay procedures. OXY assay: The lower limit of sensitivity was 6 micromol HClO/ml. The assay was found to be linear up to 440 micromol HClO/ml (r = -0.99, p < 0.001). Absorbance was linear over a wide concentration range with solutions containing uric acid in purified form (0-1000 micromol/l, r = -0.996, p < 0.001), serum (r = -0.99, p < 0.01) or plasma serially diluted (r = -0.99, p < 0.01). Mean value in plasma samples accounted for 366.2 +/- 7.2 micromol HClO/ml. Mean OXY value in females (353.4 +/- 13.2 micromol HClO/ml) was not different from that detected in males (372 +/- 8.6 micromol HClO/ml). A significant difference was observed between subjects without and with hypertension in serum OXY levels (344.8 +/- 9.9 and 383.2 +/- 10 micromol HClO/ml, p < 0.01, respectively). FRAP assay: The lower limit of sensitivity was 15 micromol/l. Linearity was observed up to 1000 micromol/l (r = 0.998, p < 0.001). Absorbance was linear over a wide concentration range with solutions containing uric acid in purified form (0-1000 micromol/l, r = 0.997, p < 0.001), serum (r = 0.99, p < 0.01) or plasma serially diluted (r = 0.99, p < 0.01). FRAP mean value in plasma samples, evaluated in 102 patients, accounted for 514.1 +/- 19.1 micromol/l. Mean FRAP in females (469 +/- 22.5 micromol/l) was not different from that detected in males (535 +/- 25.6 micromol/l). FRAP vs. OXY: A significant direct relationship was observed when comparing FRAP with OXY levels in the whole population (r = 0.22, p < 0.05). Neither of the methods are expensive and they are speedy and simple to perform. Values are reproducible and linearly correlated to the concentration of antioxidants present in the samples. For this reason, these methods may be considered practicable indicators of total antioxidant capacity, for routinely potential use in every laboratory and useful in all the studies concerning the evaluation of oxidative stress.     

Manual cleaning of endoscopes: a comparison study of syringe versus suction methods using the endo-suction cleaning system.

The manual syringe method of cleaning endoscopes involves numerous problems, including cross-infection, contamination, wasted time, and employee safety issues. This article describes the development of an alternative system by a nurse entrepreneur for endoscopic cleaning using a suction method. Scientific findings gathered over four years are presented supporting the efficacy and usefulness of this system, the Endo-Suction Cleaning System, also known as the PSK System.