宝宝频呛奶 家长这样做

正张女士诞下爱子达达,膝下儿女双全,终于凑成了一"好"字。仗着有养育女儿的经验,在达达的喂养上,张女士便没有太多的忌讳,夜里困得厉害,就躺着给达达喂奶;达达吃奶的时候,自己充溢的奶水会像一条直线喷出来,达达常常吞咽不及,被奶水呛到,她不但不因儿子频频呛奶而担心,反为"粮食"充足而欣喜;平时用奶瓶给达达喂水时,尽管奶嘴口倒过来放已经可以流出小水柱,她仍认     

SRY和maspin基因对胎儿游离DNA的检测效率

目的:探讨应用非性别依赖的表观遗传学标记代替SRY基因检测孕妇血浆中胎儿游离DNA的可行性。方法:分别以SRY基因和不同甲基化状态的maspin基因序列为标记对孕妇和非妊娠女性血浆中的游离DNA进行PCR和甲基化PCR检测,并对结果进行统计学分析。结果:孕男胎孕妇血浆DNA标本中SRY基因的检出率为93.9%。u-maspin(maspin基因的非甲基化序列)仅在妊娠组中被检测出,检出率88.3%。两检出率间的差异不具有统计学意义。m-maspin(maspin基因的甲基化序列)在妊娠组和非妊娠组中的检出率无差异。结论:u-maspin基因可作为非性别依赖的胎儿DNA特异性标志物,相对于以SRY基因作为标志物有助于扩大非创伤性产前诊断的临床应用范围。     

脆骨-蓝巩膜-耳聋综合征合并高度近视一例

患者,男,39岁,双耳听力下降2个月,于2012年8月26同就诊于我院耳鼻喉科,因双眼发蓝请眼科会诊。患者既往有多发轻微外伤后骨折病史,分别于5、7、15、16、19岁发生有锁骨骨折、右上臂骨折、有肘关节骨折、右前臂桡骨骨折、左下腿股骨骨折,均经对症治疗后痊愈,未留有肢体功能障碍,无其他病史及耳毒件药物使用史。查体：一般状态良好,步态正常,身材矮小（身高155 cm）,毛发稀疏．、眼科检查：右眼视力0.2,左眼0.25．有眼矫正视力0.4,左眼0.4;外眼正常+双眼结膜无充血,巩膜区成淡蓝色,角膜透剧J,无角膜后色素,双眼前房等深,无前房闪辉,瞳孔网,直径3 mm,直接、问接对光反射(+),品状休透叫,眼底弛双眼视盘色淡红界清,C/D约为0.3,A/V约为2/3,视网膜呈豹纹状,未见视网膜裂孔及脱离区,黄斑区未见出血及渗出,无黄斑中心凹反射。验光：右眼-15.00-0.50x91,左眼-9.00-0.50x91。B超：双眼玻璃体混浊、A超测眼轴艮：右眼29.3 mm,左眼28.5 mm。耳科检查：双耳鼓膜完整：纯音听阈测试示双耳骨气导听力曲线均呈下坡型,骨导阈值左耳5-40 dB/HL．右耳阈佰10-40 dB/HL.气导阈值35-75 cIB/HL,右耳阈值30-80 dB/HL;C;elle试验双耳均为阴性：声导抗测试示双耳鼓窒压图均为A型;鼓窒压左耳0 dapa,右耳30 dapa;声顺值左耳0.29 ml,右耳0.25 ml;橙骨肌声反射舣耳均未引出;,耳科检查示耳聋为混合性听力减退,以传导性为主（镫骨固定）。辅助检查：腕关节及膝关节X线片示骨质密度降低,骨皮质变薄。诊断为脆骨一蓝巩膜一耳聋综合征合并双眼高度近视。予以配镜治疗,以提高视力。     

水银体温计测量腋窝体温放置时间的研究及其Meta分析

目的 比较腋窝测量体温时水银体温计放置5 min与10 min所得体温值有无差别.方法 用方便抽样的方法抽取右江民族医学院附属医院住院患者365例,用同一支体温计连续测量同侧腋窝温度5 min与10 min,对测量结果进行比较.检索各数据库,获取相关研究数据,用Meta分析的方法对纳入研究的6篇文献进行分析.结果 在α=0.05水准上,用配对t检验对测量腋温5 min与10 min所得体温值进行检验,差异显著;Meta分析的结果也证明两者差异显著.用365例受试者的体温数据做出的Bland-Altman图显示,2种测量时间所得体温值的差异在临床上不可接受.结论 用水银体温计测腋温时体温计放置时间应持续10 min更为科学.     

小儿外科危重创伤患者院际转运的临床研究CSCD

Objective To review the clinical data of critical pediatric surgical trauma patients transported from hospital to hospital and provide suggestions for safe and effective transport. Methods Clinical data were retrospectively reviewed for 232 critically injured children actively transported between hospitals from January 2015 to January 2022 analyzed. According to whether or not pediatric trauma score (PTS) was ⩾ 8,they were assigned into two groups of non-serious injury ( PTS > 8 , n = 108 ) and serious injury ( PTS < 8, n = 124 ) . General profiles, causes and sites of trauma, treatment during transport and adverse events of two groups were compared and treatment and outcomes of children with different causes of trauma examined. Results There were 160 boys (69.0%) and 72 girls (31.0%) with an average age of 54 months. The age group of (3 -6) years was the largest number of children ( n = 96,41.3% ) . The median transport distance was 72 km and the total transport time (2.68 ±1.06) hour. Gender (boy/girl:76/32 vs. 84/40) ,age[ <1 year/I -3 years (including 3 years) /3 - 6 years / > 6 years; 11/20/42/35 vs. 13/26/54/31 ] , transport distance (0 - 100 km/ 100 - 200 km/ >200 km) ;62/30/16 vs. 66/41/27) had no statistical significance (P >0.05). However,statistical significance (P <0.05) existed in transit time (2 h;40/45/23 vs. 22/64/38). In terms of causes, collision injury was the most common; as for site, craniocerebral injury was the most common. In terms of causes (collision/height fall/traffic accident/others ;77/12/10/9 vs. 12/52/43/17) and site (craniocerebral injury/limb fracture/multiple injuries/other; 34/38/11/25 vs. 38/26/39/21) ,the differences were statistically significant (P <0.001). No serious adverse events such as respiratory & cardiac arrest occurred during transport. Both groups were treated en route ( mechanical ventilation/sedative analgesics/vasoactive agents/ fluid resuscitation; (3/6/2Z2 vs. 14/16/6/6) and adverse events (airway catheter withdrawal/retention needle withdrawal/cyanosis/cardiac & respiratory arrest; no significant difference between 1/1/1/0 and 3/2/2/0) (P >0.05). After hospitalization;223 children (96.1% ) were operated and 9 (3.9%) received non-surgical treatment. The inter-group difference in composition ratio of surgical treatment was statistically significant ( P < 0.001). Outcome ;221 cases improved/cured (95. 3% ) ,6 disabled/sequelae (2.6%) and 5 (2.2%) died. The inter-group difference in outcome composition ratio was statistically significant (P<0.001). Conclusion Equipped with professional transport team and transport equipment, accurate assessment and communication of condition before transport, close monitoring of the changes of condition during transport and timely treatment after transport, children may undergo timely and effective surgery and receive optimal interventions. Thus it is feasible to improve the safety and prognosis of inter-hospital transport of critically injured children. © 2023, Science and Technology Association of Hunan Province. All rights reserved.     

北京市2013年流动人口自报患病及就诊行为分析

目的分析北京市流动人口自报患病情况及就诊行为特点。方法利用国家卫生计生委2013年流动人口动态监测数据中的北京市数据,该数据采用PPS抽样方法抽取了北京市各区县流动人口总计8 000人,利用《流动人口动态监测调查问卷(A)(2013年)》,采取自填与访谈相结合的方式进行调查。结果调查对象自报2周患病率为2.5%,近一年曾患病的比例为9.4%,近一年内患病的人群中未就诊的比例为37.1%。对近一年患病后就诊选择的logistic分析发现,女性、年龄增加、在婚状态更有可能选择就诊;受教育程度在初中及以下的人群是大专及以上的人群未就诊风险比的2倍(95%CI 1.10-3.61);拥有本地医保的人群未就诊比是无本地医保人群的约2/3(OR=0.67,95%CI0.45-0.99)。结论北京市流动人口自报患病率相对较低,但患病后未就诊比例较高,是否拥有本地医保是影响患病就诊的重要因素之一,需要继续努力扩大流动人口医疗保障的覆盖水平,促进流动人口健康。     

两种后房型人工晶体植入术临床观察

白内障的治疗,手术仍是目前唯一有效的治疗方法。术后须配戴高度凸透镜或角膜接触镜。采用植入人工晶体,以达到恢复有用视力的目的效果较好。我们自1983.3——1987.3施行白内障囊外摘除术同时行一期国产后房型人工晶体植入30眼,经过四年临床观察效果较好,现报告如下:对象及方法四年来白内障住院患者自愿接受人工晶体植入术者,男16人,女13人,年龄最小8岁,最大82岁,老年性白内障25眼,外伤性白内障2眼,并发性白内障2眼,先天性白内障1眼。     

外科病人夜间病情观察及护理体会

外科病人夜间病情观察及护理体会附院外科黄金神，赵小平对病人病情进行全面细致的观察，是临床护理工作的一项重要任务。在观察中可通过病情的微小变化，全面掌握病人的情况，为诊断治疗、护理及预防等工作提供依据。然而对病情观察必须是连续性，不能因夜班值班护士少而...     

波姆光治疗皮肤湿疹100例观察

湿疹是病因不肯定的过敏性炎症 ,是一种常见病多发病 ,呈多种形态 ,发无定位 ,有红斑、糜烂、鳞屑、皲裂等不同表现 ,有病情反复发作、迁延不愈的特点 ,影响患者的日常生活。目前治疗方法较多 ,但效果均欠佳 ,近 2年我科运用波姆光治疗湿疹取得了显著疗效 ,将观察结果介绍如下。1　一般资料本组患者 1 0 0例 ,其中男 6 5例 ,女 35例 ;年龄最大 6 2岁 ,最小 5岁 ;面部湿疹 1 0例 ,躯干湿疹 2 5例 ,乳房湿疹 8例 ,四肢湿疹 37例 ,会阴湿疹 1 0例 ,皲裂湿疹 8例 ,钱币湿疹 2例 ;病程长者 3年 ,短者 2ｄ。2　治疗方法1 0 0例患者均采用直接照射…