广西边远少数民族学生体型及体质量指数3年追踪**

背景: 前期研究表明广西18~22岁少数民族学生体质量偏轻。 目的：拟进一步了解广西2645名少数民族学生体型及体质健康状况，寻找影响的关联因子。 设计、时间及地点：追踪调查，于2004-12/2007-12在广西民族大学完成。 对象：广西民族大学2003/2005三次体质健康测试的全体学生2 645人。男1 337人，女1308人，年龄为18~20岁，共15个民族。 方法：根据2003年教育部、体育总局《学生体质健康标准（试行方案）》和实施方法分为形态指标、技能指标和身体素质指标3大类。对2 645名少数民族身体机能与体质量指数变化的跟踪调查。 主要观察指标：身高、体质量、肺活量、立定跳远、坐位体前屈、体质量指数。 结果：①广西民族大学2003级学生大学3年期间男生身高、体质量增长率比全国同期多2.45%，身体形态发育正处于高峰期，女生成偏瘦型体型，身体形态发育情况总体欠佳。②男女学生在刚入校时肺活量机能较差，远远低于同期全国平均水平。3年后男生肺活量增长率为11.55%、女生肺活量增长率为27.72%，分别高于全国同期肺活量增长率。③坐位体前屈机能高于同期全国平均水平，男生呈逐年上升趋势，同期全国男性呈下降趋势；同期全国乡村女生均呈逐年上升趋势。④立定跳远机能提高较大，3年后增长率为18.15%，明显高于全国同期立定跳远增长率水平的2.61%。女生立定跳远机能总体不如全国同期水平。⑤体质量指数总体与同期全国乡村男女学生体质量指数比较稍低一些(P < 0.01)。 结论：2 645名少数民族学生发育正处于高峰期；肺活量机能不及全国同期平均水平。男女体质量指数分布有所不同，体质量偏轻者女生多于男生，表明学生营养状况总体欠佳。     

Intussusception in Taiwanese children: analysis of incidence, length of hospitalization and hospital costs in different age groups.

BACKGROUND AND PURPOSE: This study investigated the characteristics of intussusception in Taiwanese children of different age groups, including the incidence, length of hospitalization and hospital costs. METHODS: Children with a diagnosis of intussusception who were hospitalized from 1999 through 2001 were identified from a nationwide health insurance claims database. The incidence of intussusception was calculated by age, gender, and season. Length of hospitalization and hospital costs were also analyzed. RESULTS: A total of 6988 cases of intussusception were identified in Taiwan from 1999 to 2001. Among them, 4859 cases occurred in children below 15 years of age. The average incidence among children below age 15 years was 34.5 per 100,000, with a peak incidence of 118.8 per 100,000 observed among children younger than 24 months old. The highest incidence of intussusception in Taiwanese children occurred between 12 and 24 months of age. According to the data for patients below 15 years of age hospitalized for intussusception in year 2000, males were more likely to be affected than females (61.3% vs 38.7%). Intussusception-related hospitalizations were rare in infants in the first few months of life, increased in those 6 to 12 months old, and peaked among children 1 to 3 years old. Among the 952 patients with intussusception admitted to hospitals in 2000, 297 (31.2%) received surgery, incurring higher median medical costs (New Taiwan Dollars [NT dollars] 42,265 or US dollars 1234) and longer median hospital stay (6.2 days) than the 655 patients who did not require surgery (NT dollars 6290 or US dollars 185 for hospitalization of 2.4 days). CONCLUSIONS: The study found that the incidence of intussusception peaked in the second year of life in Taiwanese children. There was also a male predominance and lack of seasonal variation in incidence.     

Acute pancreatitis combined with acute Budd-Chiari syndrome as the initial manifestation of small cell lung cancer.

Tumor metastasis to the pancreas is a rare but recognized cause of acute pancreatitis. Autopsy series have reported a 24-40% of pancreatic involvement in small cell lung cancer. However, only a very few cases of tumor-induced acute pancreatitis have been described. Budd-Chiari syndrome complicating lung cancer is a rarely reported condition. We report a 68-year-old woman with extensive small cell lung cancer with the unusual initial presentation of both acute pancreatitis and acute Budd-Chiari syndrome. This patient suffered from progressive epigastralgia for 3 weeks. Severe epigastralgia with radiation to back and progressive jaundice developed 2 days prior to admission. After admission, the liver enlarged rapidly and the ascites increased markedly. Chest roentgenogram showed a mass lesion over the left lower lung field. Poorly differentiated carcinoma cells were found in ascites and bone marrow. The patient died on the ninth day of hospitalization before chemotherapy was initiated. Prompt diagnosis of extensive-stage small cell lung cancer may allow early chemotherapy treatment which favorably influences recovery when the pancreatitis is mild. Although prolonged survival might have been expected had this patient recovered from pancreatitis and received chemotherapy, diagnosis was delayed due to difficulty in immunohistochemical diagnosis of the tumor and the unusual clinical presentation. The use of stains employing antibodies against neurofilament and neuron-specific enolase cell antigens is important for early diagnosis of poorly differentiated metastatic tumor cells.     

Matched-unrelated-donor bone marrow transplantation for children with leukemia.

BACKGROUND AND PURPOSE: This report describes the results of matched-unrelated-donor transplant for leukemia or myelodysplasia in the first 23 recipient children at a single medical center in Taiwan. METHODS: Between August 1994 and February 2003, 23 consecutive children with leukemia or myelodysplasia underwent matched-unrelated-donor bone marrow transplantation (BMT). The preparative regimen consisted of fractionated total body irradiation and cyclophosphamide in 6 patients; busulfan in combination with etoposide and cyclophosphamide in 4 patients who received cranial irradiation before transplantation; and busulfan and cyclophosphamide in 13 patients. RESULTS: Engraftment was achieved in 91.3% of cases. Acute graft-versus-host disease (GVHD) occurred in 18 of 21 patients who engrafted (85.7%). Event-free survival for all patients was 24.46 +/- 9.24%. The 12 children with standard-risk disease had better event-free survival than the 11 children with high-risk disease (46.88 +/- 15.03% vs 0%, p < or = 0.001). CONCLUSIONS: The major obstacles to successful matched-unrelated-donor BMT are acute GVHD, relapse and infection. Early transplantation and patient selection, prophylactic and therapeutic maneuvers for GVHD, as well as appropriate donor selection and virus prophylaxis may improve the results.     

介绍一种针头拔出器

临床工作中，医务人员在分离注射器、输液器针头时，常用止血钳、纱布或直接用手分离，这些方法易被针头刺伤。在许多医院使用自动针头毁形器。现介绍一种低成本、易制作及安装的简易针头拔出器。     

Performance and comparison of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease formulae in estimating glomerular filtration rate in a Chinese Type 2 diabetic population.

AIMS: Our aim was to assess performances of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease (MDRD) formulae in estimating glomerular filtration rate (GFR) in Chinese diabetic populations and their association with vascular risks. METHODS: A total of 1009 patients with Type 2 diabetes were categorized into low estimated GFR groups (GFR < 60 ml/min/1.73 m(2)) and control groups by the two equations. The performances of these formulae were assessed at different stages of kidney function. Carotid artery intima-media thickness (IMT) and the prevalence of diabetic retinopathy or albuminuria were compared among the groups. The ability of these formulae to identify established vascular risk markers using sensitivity, specificity, positive and negative predictive values were also compared. RESULTS: The prevalence of low estimated GFR was 32.7% with the Cockcroft-Gault formula and 5.2% with the MDRD formula, respectively. In low estimated GFR subjects by the MDRD formula, IMT was significantly thicker than those by the Cockcroft-Gault formula (1.2 mm vs. 1.0 mm; P < 0.05), with a higher prevalence of albuminuria (78.4 vs. 52.8%, P < 0.05) and diabetic retinopathy (46.5 vs. 30.5%; P < 0.05). The Cockcroft-Gault formula gave a specificity of 71.7% and a sensitivity of 37.0%, and the MDRD formula gave a specificity of 96.6% and a sensitivity of 7.9% in estimating low GFR relevant for established vascular risks. CONCLUSIONS: These formulae performed differently in Chinese diabetic populations. The simplified MDRD formula is minimally superior to the Cockcroft-Gault formula for its high specificity and positive predictive values in estimating low GFR relevant for vascular risks.     

Pathologic findings after recession and resection of extraocular muscles in rabbits

A study on the pathologic findings after recession and resection of extraocular muscles in rabbits was performed. Fibrosis of the extraocular muscles increased with time, which showed no difference between the recessed and resected muscles. Inflammation and foreign body reaction decreased with time, which showed no difference between the recessed and resected muscles. Adhesions of extraocular muscles to the sclera were observed from one month after the operation. The resected muscles showed milder adhesion to the sclera than the recessed ones. The operated extraocular muscles showed atrophies at one month, which showed no difference between the recessed and resected muscles. According to our results, when reoperation is needed, fibrosis of the extraocular muscles after recession and resection should be considered when making a decision on the amount of muscle to be recessed and resected.     

放疗科病人医院感染原因分析与控制

医院感染是指病人在入院时不存在,也不处于潜伏期,而是在医院内发生的感染,也包括在医院里获得治疗,出院后发病的病人感染[1].癌症病人是一个特殊的群体,是医院感染的易感和高危人群,由于疾病本身引起消瘦无力、营养不良、甚至恶病质,免疫力低下、再加上接受放射线治疗后引起骨髓功能抑制、消化道功能障碍、皮肤反应及其他副反应等危险因素,医院感染发生率高,因此放疗科的医院感染控制是非常重要的工作.本文通过对我院放疗科病房2003年8月-2004年4月住院病人137例中发生医院感染病例12例进行分析,总结出一些控制医院感染的方法,现将其介绍如下.……