改良Reid阴道镜评分对宫颈上皮内瘤变的诊断价值——附119例报告

目的:探讨改良Reid阴道镜评分对诊断宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的价值.方法:对119例阴疲乏检查或宫颈细胞学检查异常者行阴道镜检查,应用改良Reid阴道镜评分进行诊断,并以活组织病理检查(活检)结果为标准进行对照.结果:阴道镜诊断与组织病理学结果对照,完全符合率为24%(29/119),包括相差1个级别在内的诊断符合率70%(83/119).结论:改良Reid阴道镜评分法与组织病理学有较高的诊断符合率,对依断CIN有较高的应用价值.     

电针对脑卒中患者软瘫肢体肌张力及运动功能的影响

Objective To investigate the effects of electro-acupuncture on muscular tension and motor function in the flaccid,paralytic limbs of stroke survivors.Methods Seventy-two stroke survivors with flaccid,paralytic limbs were divided randomly into a control group and an electro-acupuncture group.Both grourps received routine therapy and rehabilitation training,but the electro-acupuncture group was also treated with electro-acupuncture.Muscular tension and motor function in the flaccid,paralytic limbs in both groups were evaluated by modified Ashworth scale (MAS)and Fugl-Meyer scores before treatment and at the end of 4 weeks.Results After treatment,in 24 patients of the electro-acupuncture group and 10 patients of the control group muscular tension had increased 1-2 grades.The effectiveness rate(68.57%)in the electro-acupuncture group wag higher significantly than that(27.03%)in the control group(P＜0.01).Fugl-Meyer scores in the electro-acupuncture group were significantlv higher than those in the control group(P＜0.01).Conclusion Electro-acupuncture supplementing traditional rehabilitation improves muscle tension in flaccid,paralytic limbs and promotes the recovery of motor flunction after stroke.     

个体化护理对妊娠期糖尿病及妊娠结局的影响

妊娠期糖尿病(gestational diabetes mellitus,GDM)发病率为1.7％ ～16.7％[1].GDM自身不仅是妊娠期常见的并发症之一,而且可明显增加妊娠高血压综合征(pregnancy induced hypertension syndrome,PIHS)、巨大儿、胎儿宫内窒息、羊水过多、剖宫产和产后糖尿病的发生率,严重危害着母婴的健康.GDM的发病机制目前尚未明确,但有研究认为饮食习惯与GDM的关系十分密切[2].因此,根据孕妇的自身状况合理制定个体化的饮食结构来控制血糖已成为临床研究的热点问题,本研究在合理制定个体化饮食结构的同时进行运动护理干预并血糖监测,观察GDM患者的治疗效果.     

椎板切开复位术在成人椎管内肿瘤术中的应用

目的 评价椎板切开复位术在成人椎管内肿瘤切除术中的应用价值及术后椎管的稳定性变化.方法 经后正中入路行椎管内肿瘤切除72例,术中分开椎旁肌,取下相应病变节段椎板、棘突.在显微镜下切除椎管内肿瘤后,将取下的椎板用钛片-钛钉固定复位,将椎旁肌解剖复位.分析此术式对椎管内肿瘤的显露与切除效果,评价术后患者的神经功能.结果 72例病人中髓内室管膜瘤18例,血管网织细胞瘤6例,髓外硬膜下神经鞘瘤22例,脊膜瘤21例,先天性肿瘤5例.椎板切开复位节段2～6节段(平均3.8节段),肿瘤全切68例,全切率94.4%.共27例病人获得随访,随访率37.5%,术后随访时间6个月到2.5年(平均11个月).所有随访病例均在术后7 d到2.5年间检查MRI、X线片.结论 椎板切开对椎管内肿瘤的暴露及切除效果满意,可减少椎板切除术后脊柱畸形的发生,对脊柱的稳定件影响较小.     

癌症患者的镇痛疗法

癌症疼痛是一个普遍的世界性问题。有效的止痛治疗，尤其对于晚期癌症患者是世界卫生组织癌症综合规划中四项重点之一。我国是世界上最大的发展中国家，由于多种原因很多癌症患者在确诊时已属晚期。因此，癌症止痛及姑息治疗在我国具有更为重要的意义。     

电针对脑卒中患者软瘫肢体肌张力及运动功能的影响

Objective To investigate the effects of electro-acupuncture on muscular tension and motor function in the flaccid,paralytic limbs of stroke survivors.Methods Seventy-two stroke survivors with flaccid,paralytic limbs were divided randomly into a control group and an electro-acupuncture group.Both grourps received routine therapy and rehabilitation training,but the electro-acupuncture group was also treated with electro-acupuncture.Muscular tension and motor function in the flaccid,paralytic limbs in both groups were evaluated by modified Ashworth scale (MAS)and Fugl-Meyer scores before treatment and at the end of 4 weeks.Results After treatment,in 24 patients of the electro-acupuncture group and 10 patients of the control group muscular tension had increased 1-2 grades.The effectiveness rate(68.57%)in the electro-acupuncture group wag higher significantly than that(27.03%)in the control group(P＜0.01).Fugl-Meyer scores in the electro-acupuncture group were significantlv higher than those in the control group(P＜0.01).Conclusion Electro-acupuncture supplementing traditional rehabilitation improves muscle tension in flaccid,paralytic limbs and promotes the recovery of motor flunction after stroke.     

宝鸡市工矿企业职业中毒、意外伤亡分析及预防对策

宝鸡市工矿企业职业中毒、意外伤亡分析及预防对策宝鸡市卫生防疫站（７２１００１）雷宏智，杨海峰本文分析了１９８９～１９９１年宝鸡市工矿企业职业中毒、意外伤亡情况，并提出几点预防措施。１调查结果与分析１．１职业中毒、意外伤亡月份特点３年职业中毒及伤亡人数...     

血栓闭塞性脉管炎患者“瘀血”状态的研究

我们对血栓闭塞性脉管炎(TAO)患者测定了血小板功能及血液流变学等方面指标。现报道如下。     

黄芪甲苷拮抗马兜铃酸Ⅰ所致的急性肾小管损伤

 目的：观察黄芪甲苷对马兜铃酸Ⅰ所致的急性肾小管损伤的影响。方法：（1）体外实验：四甲基偶氮唑盐（MTT）法观察黄芪甲苷对马兜铃酸Ⅰ所致人近曲小管上皮细胞（HK-2）存活率降低的拮抗作用;（2）动物体内实验：马兜铃酸Ⅰ腹腔注射6 d建立昆明小鼠急性肾损伤模型,同时用50 mg·kg^-1·d^-1黄芪甲苷灌胃进行干预治疗。7 d后检测尿蛋白、尿γ-谷氨酰转移酶（γ-GT）、血清肌酐（SCr）、血尿素氮（BUN）水平的变化和肾脏组织形态学变化。结果：（1）黄芪甲苷能增加马兜铃酸Ⅰ处理的HK-2细胞存活率,并呈剂量依赖趋势;（2）黄芪甲苷干预组小鼠尿蛋白、尿γ-GT、SCr、和BUN的水平均低于马兜铃酸肾损伤组;近曲小管坏死和裸基底膜面积也较马兜铃酸肾损伤组明显改善。结论：黄芪甲苷可以拮抗马兜铃酸Ⅰ诱导的急性肾小管损伤。