中耳炎

中耳炎是儿童的高发病.中耳炎的病因病理是多因素的,包含免疫反应、咽鼓管功能障碍、细菌和病毒的感染、遗传以及环境因素等.早期的观察适用于大多数中耳炎儿童;对于被确诊为急性中耳炎的两岁以内的患儿,建议使用抗生素.手术方法的选择取决于合并症、儿童的生长发育状况以及对自发性渗出液的预期估计.推荐的手术方法有鼓室置管术、腺样体刮除术等.然而,到目前还没有理想的治疗方法,需要探索新的、基于现代中耳炎的病因病理理论的有创意性的治疗方法.     

丹参酮治疗高血压肾病的临床研究

目的:探讨丹参酮对高血压肾病的治疗作用。方法:选择符合高血压肾病入选标准的慢性肾病(CKD)Ⅰ~Ⅲ期患者60例,基础治疗全部用氯沙坦,随机分为丹参酮组、基础治疗对照组,治疗用药2周,检测并比较各组血压、肾功能、24 h尿蛋白定量、尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)等的变化。结果:2组治疗前、后血压变化无明显差异;丹参酮组治疗2周时血肌酐(SCr)水平较基线下降[(162.2±10.1)μmol/L比(134.0±7.1)μmol/L],与对照组治疗2周时[(151.8±8.3)μmol/L]比较差异有统计学意义(P<0.05),但治疗后组间比较无明显差异。与基线相比,丹参酮组尿NAG下降有明显差异,氯沙坦组无明显下降趋势。结论:在氯沙坦降低蛋白尿的基础上,丹参酮还具有保护肾小管功能及延缓肾功能进展的作用,且安全性好,是高血压肾病治疗的可选药物之一。     

The quality of preventive health care delivered to adults: results from a cross-sectional study in Southern Italy

Background  

It is assumed that providing clinical preventive services to patients can identify or detect early important causes of adult mortality. The aim of this study was to quantify access to preventive services in Southern Italy and to assess whether and how the provision of preventive care was influenced by any specific characteristics of patients.     

浙江省一起由免疫接种空白导致的流动人口麻疹暴发

目的 为核实浙江省某村1名麻疹确诊患儿家长报告同村有多名发热、出疹病例,并调查暴发原因.方法 疑似病例定义为2010年6月1日至8月3日,该村及其所在街道和周围邻村居民中出现发热伴出疹症状者;确诊病例为疑似病例中血清麻疹IgM抗体阳性者.在全村范围开展逐户搜索,通过中国疾病预防控制信息系统搜索该村所在街道及相邻村的麻疹报告病例.对全村8月龄至14岁流动儿童开展回顾性队列研究.结果 该村共发现19例麻疹病例(17例确诊和2例疑似),均为流动人口,罹患率以1～2岁组为最高(13%).首发病例6月4日抵该村后发病,在非法私人诊所就医,但未向卫生部门报告疫情,卫生部门通过患儿家长报告识别暴发时,疫情已持续1个月.315名8月龄至14岁流动儿童中,麻疹疫苗接种率为81%.无麻疹疫苗接种史的61名流动儿童中,16名有明确病例接触史者发病风险(88%,14/16)高于45名无病例接触史者(4.4%,2/45)(Fisher精确概率法,RR=20,95%CI:5.7～94).结论 该村流动儿童麻疹疫苗接种率低,非法私人诊所不按规定对病例进行报告、隔离和医疗诊治,是导致此次疫情暴发的主要原因.     

An example of "leveling extraction" for repair of the 21st tooth supraposition

A supercomplect retained tooth, situated under the 21st tooth, was removed in order to eliminate the supraposition (vestibular position) of the 21st tooth under conditions of lack of place in the dental arch. The 14th tooth on the contralateral side of the jaw was removed in order to maintain the symmetry and order of the anterior part of the maxillary dental arch and for creating place for the 21st tooth. Further transposition of the 13th tooth to the place previously occupied by 14th tooth, 11th tooth instead of 12th tooth, and establishment of the 21st tooth into correct position in the dental arch were carried out using orthodontic devices.