新生儿及婴儿完全型肺静脉异位引流的外科治疗

目的　回顾性探讨新生儿及婴儿完全型肺静脉异位引流 (TAPVC)的早期外科手术效果。方法　 2 0 0 1年 3月～ 2 0 0 3年 4月 ,共收治 8kg以下完全型肺静脉异位引流患儿 13例 ,男 11例 ,女 2例。体重 (3.5～ 8)kg ,平均体重 (5 .0 3± 1.15 )kg。年龄 2 0d～ 11个月 ,平均年龄 (3.73± 3.30 )个月。心上型 6例 (4 6 .15 % 6 /13) ,心内型 4例 (30 .77% 4 /13) ,心下型 2例 (15 .38% 2 /13) ,混合型 1例 (7.6 9% 1/13)。所有患儿均在全麻低温体外循环下行矫治术。结果　术后早期死亡 2例(15 .38% ) ,均为心上型 ,2例心下型全部存活 ,随访 9例 ,时间为 2个月～ 2年 ,心功能均良好。结论　完全型肺静脉异位引流早期矫治效果良好 ,心下型肺静脉异位引流一旦确诊应急诊手术 ,不增加手术死亡率。     

Vertebral artery dissection: warning symptoms, clinical features and prognosis in 26 patients

BACKGROUND AND OBJECTIVES: Internal carotid artery dissection has been extensively studied and well-described. Although there has been a recent increase in the number of reported cases of vertebral artery (VA) dissection, the clinical variety of presentation and the early warning symptoms have not been well-described before. Our objectives in this study include: (1) To determine the early symptoms and warning signs which may help the clinician in the early identification and treatment of patients with VA dissection. (2) To explore the variety of clinical presentation of VA dissection and its relation to prognosis. DESIGN AND SETTING: Retrospective analysis of hospital records in a tertiary academic centre for the period 1989-1999. RESULTS: Twenty-six patients were identified (13 men and 13 women). The mean age was 48. Possible precipitating factors were identified in 14 patients (53%). Sporting activity and chiropractic manipulations were the most common (15% and 11% respectively). Headache and/or neck pain was the prominent feature in 88% of patients and was a warning sign in 53%, preceding onset of stroke by up to 14 days. The most common clinical features included vertigo (57%), unilateral facial paresthesia (46%), cerebellar signs (33%), lateral medullary signs (26%) and visual field defects (15%). Bilateral VA dissection presented in six patients (24%). The most common region of dissection was the C1-C2 level (16 arteries, 51%). Intracranial VA dissection was found in eight arteries (25%). The majority of patients (83%) had favorable outcome. Poor prognosis was associated with (1) bilateral dissection; (2) intracranial VA dissection accompanied by subarachnoid hemorrhage. Only two patients reported stroke recurrence. CONCLUSIONS: Our findings show that VA dissection affects mainly middle age persons and involves both sexes equally. Headache and/or neck pain followed by vertigo or unilateral facial paresthesia is an important warning sign that may precede onset of stroke by several days. Although the majority of patients will have excellent prognosis, this was less likely in patients presenting with subarachnoid hemorrhage or bilateral VA dissection. Recurrence rate was low.     

2005年吉林省农村生活饮用水监测县水质分级评价

目的掌握吉林省农村生活饮用水基本状况，并为农村改水工作提供科学的依据。方法依据“农村实施《生活饮用水卫生标准》准则”，对2005年吉林省农村生活饮用水监测县的枯水期和丰水期水质分别进行分级评价。结果100个监测水点中，枯水期安全饮用水监测点数34个，非安全饮用水监测点数66个；丰水期安全饮水的监测点数66个，非安全饮用水监测点是34个。结论细菌总数和大肠菌群这两项微生物学指标是影响本省农村饮水水质的重要因素。必须进行适当净化和消毒处理，加强对饮水水源的卫生防护，以保障农村居民的身体健康。     

Cochlear implant outcomes and quality of life in the elderly: Manchester experience over 13 years1

Objectives: To objectively evaluate the clinical and functional outcomes of cochlear implantation in an elderly population. Design: Retrospective comparative study. Setting: Neurotology unit at Manchester Royal Infirmary, a supraregional tertiary referral centre in collaboration with Adult Cochlear Implant Programme at The University of Manchester. Participants: All cochlear implant procedures (38) undertaken on post‐lingually deafened elderly patients (age range at the time of implantation 65–80 years, n = 34) in the period from 1989 to 2002. Main outcome measures: Medical and surgical outcomes. Audiological performance outcomes for isolated words, words in sentences in quiet and noise. Functional outcome measures used are self‐reported measures of the social, psychological and emotional aspects of quality of life, and the differences between expectations for functional outcomes and the realization of functional outcomes. They included expectation profiles, Glasgow Benefit inventory (GBI) and Glasgow Health Status Inventory Questionnaire (GHSI). Results: There was statistically significant improvement post‐implantation of both open and closed set test scores (P < 0.01). Eighty‐two percentage of patients were completely satisfied with their cochlear implants. Patients judged that implantation restored half the loss of quality of life that they had experienced as a result of severe‐profound deafness with a highly significant (P < 0.001) improvement in overall quality of life after implantation. The commonest post‐operative observation was transient mild pyrexia. Conclusions: The age of a cochlear implant candidate should not be a factor in the candidacy decision‐making process. The quality of life of our elderly recipients was significantly improved after cochlear implant.     

The prevalence, classification and treatment of mental disorders among attenders of native faith healers in rural Pakistan

  Background: Although native faith healers are found in all parts of Pakistan, where they practice in harmony with the cultural value system, their practice is poorly understood. This study investigated the prevalence, classification and treatment of mental disorders among attenders at faith healers. Method: The work of faith healers with 139 attenders was observed and recorded. The mental status of attenders was assessed using a two-stage design: screening using the General Health Questionnaire followed by diagnostic interview using the Psychiatric Assessment Schedule. Results: The classification used by faith healers is based on the mystic cause of disorders: saya (27%), jinn possession (16%) or churail (14%). Sixty-one percent of attenders were given a research diagnosis of mental disorder: major depressive episode (24%), generalized anxiety disorder (15%) or epilepsy (9%). There was little agreement between the faith healers' classification and DSM-IIIR diagnosis. Faith healers use powerful techniques of suggestion and cultural psychotherapeutic procedures. Conclusions: Faith healers are a major source of care for people with mental health problems in Pakistan, particularly for women and those with little education. Further research should assess methods of collaboration that will permit people with mental health problems to access effective and culturally appropriate treatment. Accepted: 9 June 2000     

临床试验数据采集与报告文件设计制作的技术规程

临床试验数据采集与报告文件的设计和制作对保证试验数据的质量与完整性至关重要。参照临床试验数据管理规范 (GCP)并结合具体实践经验制订本规程。设计规程包括与方案设计同步、文件格式、问题和提示、冗余数据、数据记录指南、标准化、版本管理与培训 ;印制规程包括审批、印制说明书以及厂商选择。     

正态分布定量指标统计分析报表的SAS宏程序

为规范临床试验数据管理，简化程序并减少数据统计分析过程中的错误来源，我们编制了一些特定的SAS宏程序，可以直接输出临床试验正态分布的定量指标统计分析报表。     

右美托咪定靶控输注在冠状动脉搭桥术中的作用

【摘要】 目的 研究右美托咪定靶控输注在冠状动脉搭桥术 (CABG) 中的作用。方法 纳入2015年1 月~2017年10月于我院行CABG治疗的94例冠心病患者,数字法随机分为观察组与对照组,每组各47例。两组均采用常规气管插管全麻,观察组在此基础上进行右美托咪定靶控输注,对照组输注等量生理盐水。将麻醉诱导前、麻醉后、插管前、插管后及插管后5min设为T0、T1、T2、T3、T4,比较各时间点两组动脉舒张压（DBP）、收缩压（SBP）、平均动脉压（MAP）、心率（HR）、HR与SBP乘积（RPP）以及手术时间、拔管时间、苏醒时间。结果 两组T0、T1、T2 HR、RPP比较差异均无统计学意义（P＞005）,T3、T4观察组HR低于对照组,差异具有统计学意义（P＜005）; 两组T0、T1、T2DBP、SBP、MAP比较差异均无统计学意义（P＞005）,T3、T4观察组DBP、SBP、MAP均低于对照组,差异具有统计学意义（P＜005）;两组手术时间比较差异无统计学意义（P＞005）;观察组苏醒时间、拔管时间低于对照组,差异具有统计学意义（P＜005）。结论 冠心病冠状动脉搭桥术治疗运用右美托咪定靶控输注能够降低插管后血压与心率,即减轻气管插管时心血管反应及心肌耗氧。     

下肢深静脉血栓形成置管溶栓的护理

【】目的：探讨下肢深静脉血栓形成置管溶栓的治疗效果及护理。方法：回顾分析245例混合型下肢深静脉血栓形成置管溶栓治疗效果及护理的临床资料。结果：本组245例患者中,治愈219例,显效26例,有效100%。结论：置管溶栓治疗是治疗下肢深静脉血栓形成的重要手段,做好术前术后护理,可降低下肢深静脉血栓形成后遗症的发生。     

Reprocessed Materials Used in Rotationally Moulded Sandwich Structures for Enhancing Environmental Sustainability: Low-Velocity Impact and Flexure-after-Impact Responses

In the rotational moulding industry, non-used, scrap, and waste purge materials have tremendous potential to be reprocessed and applied in skin-foam-skin sandwich structures to replace and reduce the use of virgin polymers. This approach not only encourages the re-use of these waste materials but also significantly contributes to reduce environmental impacts associated with the use of virgin polymers in this sector. The demand of rotationally moulded sandwich structures is rapidly increasing in automotive, marine, and storage tanks, where investigating their impact and after-impact responses are crucial. Hence, this study investigated the low-velocity impact (LVI) and flexure-after-impact (FAI) responses of rotationally moulded sandwich structures manufactured using reprocessed materials. Results obtained from LVI induced damage at two different incident energy levels (15 J, 30 J), and the residual flexural strength of impacted structures evaluated by three-points bending tests were compared with non-reprocessed sandwich structures (virgin materials). The impact damage progression mechanism was characterized using the X-ray micro-computer-tomography technique. Reprocessed sandwiches demonstrated 91% and 66% post-impact residual strength at 15 J and 30 J respectively, while for non-reprocessed sandwiches, these values were calculated as 93% and 88%. Although reprocessed sandwich structures showed a lower performance over non-reprocessed sandwiches, they have a strong potential to be used in sandwich structures for various applications.