玻璃体视网膜手术后早期低眼压和睫状体脱离的临床观察

目的 观察玻璃体视网膜手术后早期睫状体脱离的发生率及其自然病程，并分析其与手术后早期低眼压的关系。方法 利用超声生物显微镜检查(UBM)连续观察行玻璃体视网膜手术治疗的患者46例46只眼。按玻璃体视网膜手术后不同填充内容分组：气体填充组11例11只眼，硅油填充组8例8只眼，平衡盐溶液（BSS）填充组27例27只眼。按手术后眼压分组：眼压<10 mm Hg（1 mm Hg=0.133 kPa)组25例25只眼，≥10 mm Hg组21例21只眼。玻璃体视网膜手术后第3天行UBM确定有无睫状体脱离，手术后每天用非接触眼压计监测眼压，有睫状体脱离者每隔7 d复查1次，直至睫状体脱离复位，所有患者均随访观察14～35 d。结果 手术后睫状体脱离20例，占本组患者的43.5％。无睫状体脱离者26例，占本组患者的56.5%。玻璃体视网膜手术后气体填充组睫状体脱离发生率 27.3％，硅油填充组25.0％，而BSS填充组为55.6％。睫状体脱离者手术后平均眼压(6.47±4.49) mm Hg （1 mm Hg=0.133 kPa），无睫状体脱离者平均眼压(15.61±7.72) mm Hg，两者差异有统计学意义（t=8.031,P＜0.001）。手术后眼压<10 mm Hg组患者睫状体脱离发生率为68.0％，眼压≥10 mm Hg组患者睫状体脱离发生率为14.3％，两组差异有统计学意义(χ2＝15.60, P＜0.001)。玻璃体视网膜手术后早期睫状体脱离患者除1例因低眼压引起视盘水肿而需行气体填充外，其余患者均在手术后30 d内自行复位。结论 手术后早期睫状体脱离是玻璃体视网膜手术的常见并发症。玻璃体视网膜手术后行BSS填充患者手术后睫状体脱离的发生率高。绝大多数患者睫状体脱离能够在玻璃体视网膜手术后30 d内自行复位。     

小剂量异丙酚加喉上神经阻滞用于纤支镜检查

目的：观察异丙酚加喉上神经阻滞用于纤支镜检查期间，患对操作刺激反应、耐受程度以及对心血管反应和遗忘程度。方法：选40例拟诊肺癌患行ASAⅡ～Ⅲ纤支镜检查，喉上神经阻滞成功后推注0．5～1mg／kg异丙酚，患意识消失后，进行纤支镜操作。结果：所有病人都能耐受检查。术中收缩压、舒张压、心率、血氧饱和度等无明显影响，无恶心、呕吐等并发症，大大减轻了检查对病人带来的痛苦。结论：异丙酚加喉上神经阻滞用于纤支镜检查，对呼吸、循环影响小，能减轻病人痛苦，术后具有遗忘作用，值得推广。     

老年认知功能障碍与脑结构CT测量的相关性研究

目的探讨脑萎缩与老年认知功能障碍之间的相关性。方法对开滦集团公司1063名离退休职工进行健康查体,用简易精神状态量表(MMSE)评定认知功能,按分界值将本次研究对象分为认知功能障碍组和认知功能正常组,同时用CT线性测量脑的相关部位以诊断脑萎缩情况,并对各型脑萎缩与认知功能的相关系数及提示老年认知功能障碍的敏感度、特异度、准确度进行分析。结果1063名观察对象中符合入选标准并资料完整者共计511名,其中108名有认知功能障碍,髓质脑萎缩55名、皮质萎缩5名、混合型萎缩30名;认知功能正常者403名,髓质脑萎缩214名、皮质萎缩13名、混合型萎缩62名。认知功能障碍组脑萎缩的发病率高于认知功能正常组,差异具有统计学意义(P<0.005);2组间颞叶海马钩回间距(26.86mm±3.73mmvs25.95mm±3.80mm)及海马钩回间距/大脑左右径的比值(0.21±0.02vs0.20±0.02)差异具有统计学意义(P<0.05);海马钩回间距、皮质脑萎缩、混合型脑萎缩与认知功能障碍呈负相关(分别为r=-0.094,P=0.034,r=-0.156,P≈0.000,r=-0.147,P≈0.000),以海马钩回间距20mm提示老年认知功能障碍的敏感度最高(98.14%),混合型脑萎缩的特异度(84.86%)、准确度最高(72.80%)。结论CT测量相关脑结构,判断脑萎缩类型可以为老年认知功能障碍的诊断提供有价值的信息。     

Changing health status and health expectancies among older adults in China: Gender differences from 1992 to 2002

Numerous studies document improvements in health status and health expectancies among older adults over time. However, most evidence is from developed nations and gender differences in health trends are often inconsistent. It remains unknown whether changes in health in developing countries resemble Western trends or whether patterns of health improvement are unique to the country's epidemiologic transition and gender norms. Using two nationally representative samples of non-institutionalized adults in China aged 65 years and older, this study investigates gender differences in the improvements in disability, chronic disease prevalence, and self-rated health from 1992 to 2002. Results from multivariate logistic regression models show that all three indicators of health improved over the 10-year period, with the largest improvement in self-rated health. With the exception of disability, the health of women improved more than men. Using Sullivan's decomposition methods, we also show that active life expectancy, disease-free life expectancy, and healthy life expectancy increased over this decade and were patterned differently according to gender. Overall, the findings demonstrate that China experienced broad health improvements during its early stages of the epidemiologic transition and that these changes were not uniform by gender. We discuss the public health implications of the findings in the context of China's rapidly aging population.     

Characteristics of teenage mothers and predictors of breastfeeding initiation in the Michigan WIC Program in 1995. Women, Infants, and Children.

Although breast milk is recommended as the optimal source of infant nutrition, breastfeeding initiation is below recommended levels, especially among teenage mothers. Breastfeeding initiation rates among Michigan (US) teenage mothers (12-19 y) were compared by demographics and health behaviors. Multivariate analyses determined which factors were significant independent predictors of breastfeeding initiation among teenage mothers enrolled prenatally in the Michigan Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in 1995. Significant predictors independently associated with breastfeeding initiation were race/ethnicity, education, marital status, postpartum anemia status, parity, prenatal trimester of WIC enrollment, and smoking. The strongest predictor of breastfeeding initiation differed for white mothers (positive predictor: education beyond high school [OR = 3.13]) and black mothers (negative predictor: multiparous [OR = 0.25]). Initiation rates for this population of teenage mothers fall below the national average for mothers of all ages and the US Healthy People 2010 goals. Research is needed concerning how breastfeeding support and education can be improved to reach the US national health goals.     

单甲氧聚乙二醇化学修饰药物酶的研究进展

用单甲氧基聚乙二醉(1)化学修饰药物酶是生化药物研究开发的重要手段之一。本文综述了1化学修饰药物酶的一般方法及修饰后酶在生物和理化性质方面的变化，同时对1研究前景进行展望，并指出了尚待解决的问题。     

地震伤患者医院感染目标性监测

对某院收治的50名地震伤员进行医院感染目标性监测，有效地预防与控制医院感染的发生。通过分类安置伤员，专人目标监测，严格执行消毒隔离制度及手卫生、标准预防措施等，将医院感染发生率降至最低：仅1例重症挤压伤者发生医院感染，医院感染率为2．00％。     

Importance of an immunodominant surface-exposed loop on outer membrane protein P2 of nontypeable Haemophilus influenzae.

Nontypeable Haemophilus influenzae (NTHI) frequently causes recurrent infections of the respiratory tract in humans. Previous indirect evidence suggested that a strain-specific immune response occurs following infection and that this immune response is directed at an immunodominant epitope on the bacterial surface. To test this hypothesis, mice and rabbits were immunized with whole cells of a strain of NTHI and the antiserum was characterized to identify the antigens to which antibodies were directed. All animals made a prominent antibody response to the loop 5 region of the P2 molecule, which is the major outer membrane protein. Rabbit serum showed complement-dependent bactericidal activity. Adsorption of the immune serum with the loop 5 fusion peptide removed bactericidal activity and also abolished reactivity to P2 detected by an immunoblot assay, an enzyme-linked immunosorbent assay, and a radioimmunoprecipitation assay. These data indicate that immunization with whole cells of NTHI results in a prominent antibody response which is directed at epitopes on the loop 5 region of the P2 molecule. Thus, a strain-specific immune response to NTHI occurs as a result of the expression of an immunodominant epitope on the P2 molecule.     

牙源性脓肿标本中的产黑色素类杆菌群菌株分离鉴定

本文对４４例牙源性脓肿（尖周脓肿２４例，牙周脓肿１２例，冠周脓肿８例）脓液标本中的产黑色素类杆菌群菌株进行分离、培养、鉴定。其中３８例存在产黑菌群，以中间型类杆菌阳性率最高。牙龈类杆菌在牙周脓肿中检出率最高。２４例尖周脓肿可分离出６株牙髓类杆菌而其它两种牙源性脓肿则无牙髓类杆菌，推测该菌与牙髓尖周感染的病理过程有关。     

Identification of Leishmania donovani isolates from different kala-azar foci in China by kDNA hybridization.

kDNA sequence homology of Leishmania donovani isolates from three types of kala-azar foci in China were analyzed by using dot and Southern hybridization with biotin- and 32P-labelled probes. The results revealed kDNA sequence heterogeneity among Leishmania donovani isolates from the three kala-azar foci: sequence homology between isolates of hill and desert foci was higher than that between hill and plain foci isolates. The kDNA hybridization technique was also found to be specific and sensitive for direct identification of Leishmania in animal tissues. In a preliminary survey, kDNA hybridization of cutaneous tissue blots of 71 dogs from endemic regions showed a positive rate of 40.8%, and the rate of double positive cases (touch blot hybridization and bone marrow smear) reached 91.3%. The direct identification of Leishmania in tissues by kDNA hybridization seems to be a useful and convenient method for epidemiological study and clinical diagnosis, especially for species/strain characterization.