精神心理、社会环境因素与妊高征关系的研究进展

随着生物医学模式向生物—心理—社会医学模式的转变 ,心理社会因素与妊高征的关系愈来愈受到医学界的普遍关注和重视。该文对精神心理因素、社会环境因素与妊高征发生、发展的关系及其原因作一综述。     

麻城市农村某社区O～6岁儿童意外伤害流行状况及影响因素研究

目的 探讨农村地区0-6岁儿童意外伤害流行病学特征及影响因素，为开展伤害预防干预提供依据。方法 以问卷方式调查湖北省麻城市宋埠镇1998年所有发生意外伤害的0—6岁儿童，采用1：1配对病例对照研究的方法探索危险因素。结果 该地区0—6岁儿童意外伤害发生率为3．56％，男女比例为2．67：1。跌伤、烧烫伤和动物咬伤是最常见类型。13．63％的受伤儿童需住院治疗，因伤害致残疾者占1．82％。意外伤害医疗资用支出占家庭年总收入的3．94％。农村儿童意外伤害的影响因素为儿童的照顾者、家庭社会经济状况及儿童性格行为特点等。结论 意外伤害严重影响着农村地区0-6岁儿童的健康，给家庭和社会造成经济损失。预防重点是培训村级医师，开展健康教育，尤其需要提高儿童家长的安全知识水平。     

生物素－链霉亲和素系统在检测HBeAg中的比较

应用链霉亲和素和生物素系统发展成的酶连接免疫吸附测定（ＥＬＩＳＡ）改良法检测ＨＢｅＡｇ，取得较满意效果。标记链霉亲和素－辣根过氧化物酶（ＳＡ－ＨＲＰ）时，两者的重量比以（０．５～０．８）：１为佳，浓度以７μｇ／ｍｌ为最理想；ＳＡ－ＨＲＰ的反应时间以３０ｍｉｎ为适宜。本改良法与生物素亲和素ＥＬＩＳＡ（ＢＡ）法、普通ＥＬＩＳＡ法检测ＨＢｅＡｇ的灵敏度比较，其相对灵敏度高于后二者；用Ａｂｂｏｔｔ试剂作为标准，检测ＨＢｅＡｇ１００人份，其阳性率高于ＢＡ法和普通ＥＬＩＳＡ法。提示链霉亲和素ＥＩ，ＩＳＡ（ＢＳＡ）法可提高方法的特异性及灵敏度。     

李辅仁治疗老年脑部疾患的经验

治疗脑出血,急症抢救期先以安宫牛黄丸之类芳香开窍醒脑,并予以止血,待神志清醒,血压稳定后,再施以补气活血、化瘀通络、平肝潜阳之法,脑血栓亦先开窍醒脑,后用自拟安脑化瘀汤以安脑通络、活血化瘀治之;老年性痴呆则以滋补肝肾、填精健脑为主,佐平肝活血、醒脑开窍为辅,药用自拟醒脑复聪汤;蛛网膜下腔出血以清脑醒神、镇痉熄风为治,药用自拟清脑熄风汤。     

血清睾酮与妊高征发病相关性研究

目的:测定妊高征患者血清睾酮水平并探讨其临床意义。方法:采用放射免疫分析法测定妊高征患者30例、正常孕妇20例血清及其新生儿脐血睾酮水平。结果:妊高征患者血清睾酮水平(0.153±0.078nmol/L)明显高于正常孕妇组(0.023±0.015nmol/L),有显著性差异(P<0.001)。妊高征组脐血睾酮水平(0.052±0.041nmol/L)低于正常孕妇组(0.119±0.059nmol/L),有显著性差异(P<0.05),两组睾酮水平与新生儿性别无关(P>0.05)。结论:孕妇血清睾酮在妊高征的病理生理中起调节或加强作用。     

小剂量阿斯匹林辅助促排卵过程中对子宫血流及内膜厚度的影响

目的　探讨小剂量阿斯匹林在促排卵过程中对子宫血流及内膜厚度的影响及其作用机理。方法　采用前瞻性随机双盲的方法 ,对不明原因的不孕妇女在克罗米酚 (CC)促排卵治疗同时 ,自月经第 1～ 2 0d连续服用小剂量阿斯匹林 ,75mg/d。 结果　试验组子宫动脉血流阻力指数 (RI)明显低于对照组 (P <0 0 1) ,子宫内膜厚度明显较对照组厚 (P <0 0 5 )。结论　小剂量阿斯匹林可增加子宫血流供应 ,从而改善促排卵治疗时CC所致的子宫内膜发育不良     

变形链球菌表面蛋白和葡糖基转移酶基因疫苗对唾液变形链球菌和牙菌斑的影响

目的　了解变形链球菌表面蛋白和葡糖基转移酶基因疫苗单独及联合免疫对定菌鼠唾液变链菌和牙面菌斑的影响。方法　 2 8d龄 Wistar大鼠 3 6只 ,随机分为 pc DNA3 - pac组、pc DNA3 - gtf B组、pc DNA3 - pac联合pc DNA 3 - gtf B组、变形链球菌灭活全菌组、pc DNA3空载体组和 PBS液组 ,进行三次双侧颌下腺腺周注射免疫 ,建立定菌鼠模型 ,作诱龋实验 3个月。唾液变链菌计数和菌斑计分。结果　唾液变链菌菌落计数和牙面菌斑计分在 pc D-NA3与 PBS组最高 ,其次为单基因疫苗免疫组 ,联合基因疫苗和灭活全菌细胞免疫组最低 ,各组间有显著性差异 ( P<0 .0 5 )。结论　 pc DNA3 - gtf B和 pc DNA3 - pac具有明显的免疫抑菌作用 ,联合基因疫苗免疫优于单基因疫苗     

Uncomplicated amebic liver abscess: prospective evaluation of percutaneous therapeutic aspiration.

The performance of therapeutic aspiration in the treatment of amebic liver abscess, advocated and practiced in many centers, is controversial. Previously, this practice has been evaluated in retrospective analyses. To test the potential benefit of therapeutic aspiration, the authors undertook a prospective randomized trial in 57 patients admitted for suspected amebic liver abscess during a 15-month period. Sixteen patients were excluded from the trial. The remaining 41 patients were randomly included in one of two study groups to receive amebicidal therapy alone or amebicidal therapy coupled with image-guided percutaneous therapeutic aspiration. All patients in the trial recovered. No statistically significant benefit was demonstrated in the aspiration group for the two objective parameters evaluated: length of hospitalization and duration of time to becoming afebrile. Subjective improvement in symptoms after aspiration was greater in the aspiration group at a marginally statistically significant level. These data do not support the adjunctive performance of percutaneous therapeutic aspiration in the treatment of uncomplicated amebic liver abscess. Amebicidals alone were equally efficacious in treating the group studied.     

二期后房型人工晶体植入术

本文报道对16只(16例)后囊膜完整的无晶体眼进行后房型人工晶体二期植入术的结果.术前的平均未矫正视力为0.06,术后半年,平均未矫正视力为0.53未矫正视力≥0.5的达62.50%,矫正视力≥0.5的占93.37%,≥1.0的占81.25%.术前角膜中央内皮细胞密度平均2646个/mm~2,术后半年为1824个/mm~2,除一例外,其余可恢复立体视.无一例发生持续性角膜水肿和葡萄膜炎等严重并发症.结果表明,只要掌握适应症和手术技术,在后囊膜完整的无晶体眼作二期后房型人工晶体植入是安全有效的方法.本文对手术的适应症、手术方式和技术进行了探讨.     

Prognostic factors in clinical trials

Summary Prognostic factors define the study population, help formulate the study objectives, and influence the treatment strategies. They must be accounted for in the study analysis to obtain valid estimates of the treatment differences and to evaluate results across studies. The causal relationship between a prognostic factor and the study endpoint can only be established through prospective randomized study designs. Potential factors discovered through retrospective analysis must be verified to establish their validity. Using such factors prematurely to select patient population and treatment strategy for a new study will not establish the validity of the potentially important factor.Supported by NCI 5 PO1 CA53996-15 and NCI 5 U10 CA38926-08.