驻地不同海拔高度西藏边防军人SCL-90评定结果分析

目的了解不同海拔高度西藏边防军人心理健康状况,为官兵心理健康教育及心理疏导提供科学依据。方法整群随机抽取不同海拔高度1550名高原边防军人,采用心理《症状自评量表》（SCL-90）进行心理健康测评。结果西藏边防军人在躯体化、抑郁、焦虑、敌对、恐怖、精神病性、睡眠饮食等7个因子均高于中国军人常模（P〈0.01或P〈0.05）,但人际敏感与中国军人常模相比降低明显（P〈0.05）;随海拔高度的升高,驻守海拔3500~4300米边防军人在躯体化、敌对、睡眠饮食、人际敏感、抑郁、焦虑、恐怖7个因子均高于驻守海拔3000~3500米边防军人（P〈0.01或P〈0.05）。结论高原对官兵心理健康有影响,且海拔越高其影响作用越明显。     

参芪扶正注射液联合化疗治疗恶性肿瘤的临床研究

目的比较参芪扶正注射液联合化疗与单纯化疗治疗恶性肿瘤的临床疗效及不良反应。方法入选的62例患者随机分为两组,观察组32例,采用参芪扶正联合化疗,平均化疗5.7周期。对照组30例,单纯化疗,平均化疗5.6周期。结果观察组完全缓解（CR）3例,部分缓解（PR）12例,稳定（NC）11例,进展（PD）6例,总有效率46.9%。对照组CR 1例,PR 9例,NC 11例,PD 9例,总有效率33.3%。治疗组与对照组比较,治疗组T细胞亚群CD3、CD4和CD4/CD8比值明显升高,差异有显著性（P〈0.01）。治疗组生活质量较对照组明显改善。结论参芪扶正注射液联合化疗治疗恶性肿瘤可以减轻化疗的不良反应,使患者化疗依从性更好,增强机体的免疫功能,改善患者生活质量。     

早期肠内营养及其输注方式对大鼠重症急性胰腺炎病理和肠道功能的影响

目的:观察早期肠内营养及其不同输注方式对重症急性胰腺炎的影响。方法:采用胰管逆行注射建立大鼠重症急性胰腺炎(SAP)模型,假手术组用生理盐水,SAP组随机分为持续、间隙和未行肠内营养3个亚组(每组12只),假手术组同样分为3个亚组(每组8只)。各组于48 h后启动肠内营养,72 h后再次麻醉大鼠,收集组织及血液标本;检测指标包括肠道转运系数、血淀粉酶、器官细菌移位率、血清细胞因子TNF-α、胰腺病理评分及血浆D-乳酸等。结果:①、SAP后48h进行肠内营养并未加重胰腺炎;肠内营养组与未行肠内营养组在血淀粉酶、胰腺病理评分方面,差异无统计学意义(P>0.05);然而早期肠内营养可以促进肠蠕动,减少肠道细菌移位率,两组间在肠道转运系数、脏器细菌移位率及血清TNF-α水平方面,差异有统计学意义(P<0.05)。②、SAP行肠内营养的两种方式间,各项指标比较无显著差异。结论:SAP大鼠在早期行肠内营养是可行的,其可保持肠道生理的完整性、减少了脏器细菌移位率,但未改善预后;持续和间隙二种肠内营养输注方式间无显著差异。     

高分辨率CT与三维重建技术在鼻外伤诊断中的价值

目的：探讨高分辨率CT和三维重建技术对鼻部外伤的临床应用价值。方法：对79例鼻部单纯或复合骨折患者行高分辨率CT检查,鼻区靶扫描,厚度1mm,骨算法重建成像,部分行三维重建。结果：79例病例,发现鼻骨和相邻结构骨折72例,双侧鼻骨骨折21例,单侧鼻骨骨折8例,鼻骨骨折合并上颌骨额突骨折20例,鼻中隔骨折12例,鼻颌缝分离2例,并对14例普通扫描难于确诊者行三维重建。结论：高分辨率CT和三维重建技术能细致、清晰地显示鼻部的骨质结构,对单纯或复合骨折观察全面且准确是重要的检查方法。     

MEBO纱条脓腔引流治疗肛旁脓肿

目的：观察湿润烧伤膏（MEBO）油纱条引流肛旁脓肿的临床效果。方法：28例肛旁脓肿棱形放射状切口切开术后行MEBO油纱条填塞脓腔治疗,合并肛门瘘管者同时实行挂线治疗。结果：78．57％患者经3－4次换药治疗愈合。结论：MEBO纱条引流治疗肛旁脓肿效果显著。     

湿润烧伤膏纱条肛周脓肿引流治疗的临床体会

目的：观察自制湿润烧伤膏（MEBO）纱条引流肛周脓肿的临床疗效。方法：自制湿润烧伤膏纱条,高压消毒,经肛周脓肿切口填塞脓腔,隔日换药。结果：90％以上的病例经2－5次换药引流后愈合。结论：肛周脓肿经湿润烧伤膏纱条换药后,可缩短病程,减少工作量,治疗效果显著。     

Influence of steep gradient supporting walls in rock climbing: biomechanical analysis

This study analyses the reaction forces and variations of rock climbing in vertical and overhanging positions. Subjects voluntarily released their right foot and regained equilibrium. In the overhanging position the quadrupedal state was characterised by a significant involvement of the arms to prevent fall. Moreover, the horizontal forces applied to the holds were less important, which suggests that equilibrium was easier to maintain than in the vertical position. The tripedal state was characterised by less extensive contralateral supporting force transfer on the remaining holds in the overhanging position, which reinforces safety.     

Personality factors, stoicism and motivation in subjects under hypoxic stress in extreme environments

Previous studies on the physiological and psychological adaptation of subjects to survival conditions involving high-altitude hypoxia (>6,500 m) have shown that personality factors are important in this adaptation. We, therefore, proposed personality traits assessments in two groups of subjects engaged in sporting activities under extreme hypoxic environmental conditions: a group of mountaineers at high altitudes (>5,500 m) and a group of free-lung divers at great depths (<30-60 m). These subjects were compared with two control groups: a group of subjects practicing no sport and another one practicing various competitive athletic activities involving speed constraints. The personality traits assessed concerned mainly the subjects' attitudes and their propensities to act out their feelings and fantasies; they were assessed using projective procedures, the Hand Test and Clark's Situational Pain Questionnaire based on the Sensory Decision Theory. Subjects trained in mountaineering and free-lung diving under extreme environmental conditions displayed a high degree of stoicism. These individuals shared some personality traits with other sportsmen, particularly aggressive tendencies and introversion although not to an extent which interfered with normal interpersonal relationships. However, at least when practicing these extreme sports, the subjects did retreat from society. One of our questions concerns the grounds for this social withdrawal, that is, whether it derives from a inner compulsion founded on personality factors or if it is merely an artifact of our perceptions of the subjects, created by the confluence of the individualistic nature of these sports and the extreme environments in which they are performed.     

99Tcm-PPM及99Tcm-MIBI肺显像诊断原发性肺癌

目的 探讨99Tcm－培普利欧霉素（PPM）及99Tcm-甲氧基异丁基异腈（MIBI）肺显像诊断原发性肺癌的临床价值。方法 对28例临床诊断肺肿瘤患者进行99Tcm-PPM ey 99T0-MIBI肺肿瘤显像并进行比较。结果 肺癌与良性病变对99T -PPMey 99T-MIBI观的摄取差异有显著性（P＜0．01）,以肺癌晚期显像摄取比值（T／NT,X－S）作为判断良恶性阈值,99Tcm-PPM及99Tcm-MIBI对肺癌诊断的灵敏度,准确性分别为90％,89．3％,和80％,82．1％,两者结合显像阳性率为95％,病灶对放射性药物的摄取与肿瘤大小无明显相关（P＞0．05）,结论 99Tcm-PPM ey 99T-MIBI肺显像对肺癌的诊断,鉴别诊断有一定的临床价值。两者联合应用可提高肺癌的阳性检出率,单独使用99Tcm-PPM优于99Tcm-MIBI。     

Shockwave therapy under ultrasonographic guidance in rotator cuff calcific tendinitis

OBJECTIVES: This is the first efficacy evaluation in patients with rotator cuff calcific tendinitis treated with shockwave therapy delivered using a dedicated extracorporeal lithotripter and ultrasonographic guidance. PATIENTS AND METHODS: Thirty-two patients with rotator cuff calcific tendinitis received shockwave therapy delivered using a lithotripter specifically designed for the musculoskeletal system (DORNIER EPOS ULTRA), under ultrasonography guidance (which is not part of the conventional procedure). The cumulative dose per patient was 1300 mJ/mm2 divided in two or three sessions. Three, six, 12, and 24 weeks after treatment, the patients were evaluated using a visual analog scale for pain, the ASES self-questionnaire, Constant's score, and plain radiographs. RESULTS: Improvements in the pain and self-questionnaire scores were noted in 36.6% of patients after 12 weeks and 55.1% after 24 weeks. Plain radiographs were changed in 26.6% of patients after 12 weeks (with complete clearance of the calcific deposits in 6.6%) and in 24.1% of patients after 24 weeks (complete clearance in 17.2%). CONCLUSION: These results seem less favorable than those reported with dedicated lithotripters and computed tomography guidance.