An analytical framework of physician productivity and variation in utilization.

The utilization of medical services by patients is an important determinant of doctor productivity, but this factor does not appear to have been given much attention in previous studies. In order to answer the question of why is there a wide variation in doctor output at low level medical facilities in China, an analytical framework of doctor productivity and utilization is developed. The simulation model is used to produce data that can be analyzed by such a framework. Great uncertainty about patient flows is one reason for the average lower and varying doctor productivity in lower level health facilities. Until uncertainty can be reduced, more flexibility is needed at the lower level to cope with changing utilization patterns and patient characteristics. The management by doctors of non-patient care activities (preventive programmes, medical research, teaching, and administration) is crucial to any approach to using doctor resources more effectively and efficiently.     

植物神经癫痫52例脑电图分析

报道52倒6个类型植物神经癫痫,重点分析了脑电图的变化,脑电图异常率100％,69.4％的病例出现两侧阵发性4～7Hzθ节律及6和14Hz阳性棘波,提示中线深部有功能紊乱,亦支持丘脑及脑干部有病变。此外蝶骨电极能提高脑电图对本病的阳性诊断率,值得采用。本文证明脑电图对植物神经性癫痫与非癫痫的鉴别诊断,具有肯定的价值。     

Analysis thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis in the lower extremities

Objective:To explore the effect of thrombolysis with anticoagulation treatment forearly stage of deep vein thrombosis of lower extremity.Methods:The clinical data of 10 patients at the early stage of deep vein thrombosis(DVT)in the lower extremuites treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively.Results:The thrombolytic effect was significant.After treatment,the deep veins were recanalized without regurgitation in 75.3% of the patients.The total effective rate was 100%.Only three patients had hemorrhagic complication,but none of the patients died.Conclusion:Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.     

Clinical assessment and management of depression.

Major depressive disorder is a psychiatric disorder that encompasses a broad range of emotional, psychological, behavioral, and physical symptoms (Fava et al., 2004). The nurse in the hospital, office, school, or community setting can provide the essential elements of effective care for depression, including early detection by screening, medication teaching, depression education, teaching coping skills, and appropriate use of specialists and resources. Utilizing the nursing process, the nurse can provide comprehensive care to improve the depressed patient's physical and psychological well-being.     

WR-2721对γ线照射小鼠胃排空的防护作用

小鼠经γ线1200rad照射后胃排空受到明显抑制,如照前15min腹腔注射WR-2721 5mg或10mg对照后3天胃排空的抑制有明显改善。虽然WR-2721药物本身对胃排空具有一定的抑制作用,但经过24～48h后则可表现出对胃排空有一定程度的改善效应,这可能与该药减轻急性放射损伤的过程有关。     

高脂血症患者血小板体积及有关参数的研究

本文报道242例高脂血症患者血小板(PLT)、平均血小板数(MPLT)及平均血小板体积(MPV)等参数的测定结果,其中高胆固醇并高甘油三酯患者,PLT、MPLT及巨大血小板比例(Macro-PLT)高于正常,MPV正常;而单纯高胆固醇或高甘油三酯患者,上述指标与正常人无显著性差异。提示高胆固醇并高甘油三酯患者,存在血小板生成动力学异常,其血小板的破坏增加,生成率加速、但处于一种高水平的动态平衡之中。这可能是高脂血症出现高凝状态的原因之一。同时表明此类患者使用抗血小板疗法具有一定的合理性和必要性。     

新疆出血热病毒与流行性出血热病毒的生物学特性比较

本文通过免疫荧光(IF)和电镜(EM)技术对新疆出血热(XHF)及流行性出血热(EHF)病毒的生物学特性在Vero E_6及LLC-MK_2两株传代细胞上进行了比较。两种病毒感染两株细胞后免疫荧光染色有两种不同的荧光形态特征,两种病毒对细胞的敏感性明显不同,XHF病毒在LLC-MK_2细胞上感染后6～8天可出现明显的细胞病变,而EHF病毒感染此细胞后则不引起病变。电镜观察到两种病毒在LLC-MK_2细胞中都能形成与布尼病毒相似的形态特征。     

γ线照后大鼠胃组织乙酰胆碱含量胆碱酯酶活性及平滑肌对乙酰胆碱反应性的变化

本文以大鼠为实验对象,观察了γ线8Gy照后胃组织内乙酰胆碱含量、胆碱酯酶活性及平滑肌对乙酰胆碱反应性的变化。结果表明,照后1/24～l天胃组织内乙酰胆碱含量明显下降,3天趋向正常,5天基本恢复至照前水平。胃组织的胆碱酯酶活性在照后l/24～5天基本无改变。在同一剂量照后1h,胃窦平滑肌对乙酰胆碱的反应与照前近似,l天后开始减弱,3天后明显下降,与正常相比有非常显著差异。     

Differences in aerodynamic characteristics of new and dysfunctional Provox®2 voice prostheses in vivo

Tracheoesophageal voice prostheses need to be replaced due to increased airflow resistance or retrograde leakage of fluid into the trachea as a consequence of biofilm formation. Previous in vitro studies show a change of aerodynamic features of biofilm covered voice prostheses after removal of the prostheses out of the patient. To assess these changes in an in situ situation, aerodynamic characteristics were measured within 45 patients at the beginning and at the end of the wearing process of the Provox 2 voice prosthesis. As a consequence, the influence of biofilm formation on aerodynamic characteristics can be evaluated. In the majority of cases, leakage through the prosthesis was the reason for replacement. No differences were found in the total flow, volume range and intratracheal pressure (ITP) of the voice prostheses measured. The airflow resistance of biofilm covered prostheses was significantly reduced compared to new clean prostheses. However, no correlation was found between the extent of biofilm and the different aerodynamic features measured. Biofilm formation on the Provox 2 is responsible for both reduction in airflow resistance and leakage through the prosthesis by deterioration of the silicone rubber material.