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喘鸣是婴幼儿时期呼吸道疾病中最常见的症状,病因很多,并非所有的喘鸣均由哮喘引起。气管、支气管炎及气管、支气管软骨软弱、异物、血管畸形,胸内肿瘤以及支气管淋巴结核等,均可引起喘鸣。分析天津市儿童医院收治的以喘鸣为主要症状的3岁以下婴幼儿196例,其主要病因见表1。表1天津市儿童医院收治的196例以喘鸣为主要症状的婴幼儿喘鸣病因病因例数大气道阻塞气管、支气管异物21气管、支气管淋巴结核51先天性气管、支气管、肺发育畸形12支气管软骨软化3纵隔囊肿和(或)肿瘤19血管畸形1中叶综合征5小气道阻塞毛细支气管炎30以喘息为表型的婴幼…     

浅谈建立新型师生关系

1 建立新型师生关系是实施素质教育的需要 传统教学中，教师是知识的载体，是教学活动的主宰。学生是教师知识传授的对象。课堂上，教师站在讲台上严肃认真地讲解。学生规规矩矩地坐在座位上专心听讲。教师讲的知识点，学生掌握了，就达到教学目的了。教师对学生最为关注的是其学习成绩。学生对教师则敬而远之，甚至关系紧张，很难向教师敞开心扉、畅所欲言。素质教育的核心就是创新教育。而这种师生关系严重阻碍了学生个性的发展和创新意识的培养。     

整脐，做零缺点女生

去年，我到中东旅游时，在下榻的酒店看到阿拉伯美女大跳肚皮舞以及脐部佩戴的脐环，不禁感叹原来肚脐也可以让女性如此性感。     

How does fast track affect quality of care in the emergency department?

STUDY OBJECTIVES: Use of fast track has been shown to improve the emergency department flow of less urgent patients. It has been speculated, however, that this could negatively affect the care of urgent patients. The objective of this study was to determine whether a dedicated fast track for less urgent patients [Canadian Triage and Acuity scale category 4/5 (CTAS 4/5)] affected (1) the time to assessment for urgent patients (CTAS 3), (2) the length of stay for less urgent patients (CTAS 4 and 5), and (3) the left-without-being-seen rate. METHODS: In June 2003, fast track was opened in our emergency department from 13:00 to 19:00 h. A before-after intervention comparison analysis was completed for 1 week in Aug 2002 and the same week in Aug 2003. Data collected included (1) time to assessment of CTAS 3 patients, (2) the length of stay for CTAS 4/5 patients, and (3) percentage of patients who left without being seen. RESULTS: A total of 368 patients were reviewed for 2002 and 380 patients were reviewed for 2003. Median time to assessment of CTAS 3 patients presenting from 13:00 to 19:00 h was reduced from 66 min (Interquartile range: 40, 94 min) in 2002 to 60 min (IQR: 38, 108 min) after fast track was open in 2003 (P = 0.95). Median length of stay of CTAS 4 and 5 patients was reduced from 170 min (IQR: 111, 256 min) to 110 min (IQR: 69, 185 min) (P < 0.001). The overall left-without-being-seen rate decreased from 5% (20/368) to 2% (9/380). CONCLUSION: A dedicated fast track for CTAS 4/5 patients can reduce the length of stay and the left-without-being-seen rate with no impact on CTAS 3 patients seen in the main emergency department.     

Point mutation in exon 4 of presenilin-1 gene and early-onset familial Alzheimer disease

INTRODUCTION Alzheimer disease can be classified into familial Alzheimer disease (FAD) and sporadic Alzheimer disease (SAD)[1]. Among FAD, ear- ly-onset FAD(EOFAD) is a familialform in which the onset ofsymptoms occurs before the age of 60 to 65 years, an…