新疆奎屯市汉族 哈萨克族学生注意缺陷多动障碍发病情况调查

目的了解不同民族混居生活条件下汉族、哈萨克族学生注意缺陷多动障碍(ADHD)发病情况。方法采用流行病学调查随机整群抽样方法,应用Conners父母症状问卷和Conners教师评定量表,检测奎屯市两所汉族小学,两所汉族中学三年级至初二学生和两所哈萨克族小学,一所哈萨克族中学三年级至初二学生,共1244人,其中汉族923人,哈萨克族321人。结果汉族学生ADHD发病率13%,哈萨克族学生发病率10%,总发病率12.2%。汉族学生发病率略高于哈萨克族学生,但两者差异无显著性。男生发病率高于女生,两者之间差异有显著性(P<0.01)。汉族学生随年龄增加发病率减少,哈萨克族学生随年龄增加发病率增加。结论汉、哈族学生ADHD发病差异无显著性,提示发病无民族差异,各民族儿童均可发病。两民族儿童高峰发病年龄相差6岁,可能与其生活方式及早期干预有关。     

老年病房不同职称护士对预防肺部感染知识掌握情况调查

目的了解老年病区不同职称护理人员对预防肺部感染相关知识掌握情况,有针对性的加强薄弱环节,提高护理质量。方法采用自行设计的问卷调查表,对本院老年病房90名护理人员进行调查。结果主管护师在翻身、叩背、吸痰的基础知识及操作技能方面得分均大于雾化吸入有振动排痰仪得分。主管护师组得分显著高于护师组、护士组。结论需要加强雾化吸入、振动排痰仪相关知识的宣教及继续教育。     

COMPARISON OF FOUR METHODS FOR SPERM PREPARATION FOR IUI

We compared the pregnancy rates and sperm characteristics of semen prepared by the albumin, Percoll, Puresperm, and swim-up methods. Semen analysis was performed by a computer-assisted system (CASA). The overall pregnancy rate was 14% per patient and 11% per cycle. The albumin and Percoll methods had the highest pregnancy rates, up to 12% per cycle. We then compared each method with the albumin method. The swim-up technique yielded the highest percentage of motile sperm. The Percoll method yielded statistically significant changes in average path velocity and straight-line velocity, while the Puresperm method revealed the same statistical changes in total concentration and hyperactive motile sperm percentage. After adjusting for age, methods, and CASA estimates, only straight-line velocity was significantly correlated with pregnancy. Although the Percoll method was associated with the best pregnancy rate, this product has been withdrawn from the market because of toxic contamination. Puresperm had replaced it in our laboratory but showed an unsatisfactory pregnancy rate. The swim-up method is the best choice for IUI.     

舒康博敷贴缓解老年患者肌内注射部位硬结的效果

目的 探讨舒康博敷贴缓解注射部位硬结的疗效.方法 对40例患者肌内注射硬结进行处理,随机分为实验组和对照组各20例,实验组采用舒康博敷贴外敷,对照组采用50%硫酸镁湿热敷,比较两组疗效.结果 两组在有效率和患者满意率上差异均有统计学意义（P＜0.05或P＜0.01）.结论 舒康博敷贴对老年患者注射部位硬结疗效明显,满意率高,是舒康博敷贴在临床应用上的新发现.     

Factors associated with failure to identify the culprit artery by the electrocardiogram in inferior ST-elevation myocardial infarction

Background

Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored.

Methods

Patients with inferior preinfarction syndrome (n = 266) were included to the Danish Trial in Acute Myocardial Infarction-2 substudy. The culprit vessel was predicted by the ECG, and findings were correlated with angiography. Factors associated with false identification of the culprit artery by the ECG were examined.

Results

Electrocardiogram criteria for right coronary artery occlusion to predict coronary angiography findings had sensitivity, specificity, and positive and negative predictive values of 95%, 52%, 84%, and 81%. For left circumflex coronary artery occlusion, the corresponding values were 51%, 93%, 70%, and 85%, respectively. False ECG identification of the culprit artery was independently associated with left coronary dominance (P < .001; odds ratio [OR], 22.0; 95% confidence interval [CI], 7.2-67.0), multivessel disease (P = .035; OR, 2.2; 95% CI, 1.1-4.7), and absence of proximal occlusion pattern in the ECG (P = .003; OR, 4.0; 95% CI, 1.6-9.8).

Conclusions

Left coronary artery dominance, multivessel disease, and absence of ECG signs of proximal culprit lesion are associated with failure to predict the culprit artery of inferior myocardial infarction by the 12-lead ECG.     

经皮空心加压螺钉内固定治疗股骨颈骨折

目的：探讨经皮空心加压螺钉内固定治疗股骨颈骨折的方法及疗效。方法：对58例股骨颈骨折患者在C型臂监测下于牵引床上复位后采用经皮加压空心螺钉内固定。结果：58例随访6～24个月,骨折愈合51例,不愈合4例,股骨头坏死3例。结论：经皮空心加压螺钉内固定术治疗股骨颈骨折具有创伤小、方法简便、固定牢靠、可早期功能锻炼、并发症少的优点。     

Perforating plate-like osteoma cutis in a man with solitary morphoea profunda

Summary Solitary morphoea profunda is an unusual form of scleroderma. characterized by marked fibrosis, hyalinization of collagen fibres, and inflammatory cell infiltration in the deep dermal and subcutaneous layers. We describe a 58-year-old man showing solitary morphoea profunda. Plate-like osteoma cutis, with transepidermal elimination of bony material. within the morphoea profunda, was present.     

高龄髋部术后足踝运动方法对下肢静脉回流 影响的临床观察

目的：观察高龄髋关节置换术后足踝屈伸运动时不同的运动角度与持续时间对小腿肌群挤压深静脉增加血流速度的效果,探讨最佳的足踝屈伸运动角度与持续时间。方法：选择2009年10月至2010年8月收治的高龄髋部外伤行择期全髋或半髋关节置换术的患者17例。其中股骨颈骨折8例,股骨粗隆骨折9例;年龄80～96岁,平均87岁;男11例,女6例。用彩色超声多普勒检测患者术后第2天患侧股静脉在足踝屈伸不同角度与不同持续时间状态下的血流动力学指标（血流峰速度）,并进行统计学分析。结果：不同角度的血流峰速度与静息状态[（29.2±3.4）cm/s]比较,足踝跖屈30°背伸20°持续时间2秒/次[（38.1±6.2）cm/s]、3秒/次[（37.9±6.4）cm/s]及足踝跖屈45°背伸30°5个持续时间[持续时间1～5秒/次分别为（40.6±7.9）、（52.6±7.0）、（48.8±7.1）、（42.1±6.3）、（39.3±5.7）cm/s]差异有统计学意义（P〈0.01）;足踝跖屈30°背伸20°持续时间2秒/次与3秒/次比较无统计学意义（P〉0.05）;足踝跖屈45°背伸30°各持续时间与足踝跖屈30°背伸20°持续时间2秒/次比较：足踝跖屈45°背伸30°持续时间2、3秒/次时差异有统计学意义（P〈0.01）;持续时间为4秒/次也有统计学意义（P〈0.05）。结论：高龄髋外伤围手术期卧床期间足踝运动角度以跖屈45°背伸30°,运动持续时间以2秒/次和3秒/次最佳,可显著地增加股静脉血流速度。     

苯扎氯铵进行膀胱冲洗对导尿管相关下尿路感染的防治

目的：探讨使用苯扎氯铵溶液进行膀胱冲洗对长期留置尿管患者下尿路感染的防治效果：方法：30例需要留置尿管超过3d的患者,按住院号单双号分为对照组和观察组,分别采用0．02％呋喃西林溶液和0．0025％苯扎氯铵溶液进行膀胱冲洗,在不同时问点留取中段尿标本进行尿常规及细菌学检测。结果：膀胱冲洗后第5、9天对照组尿白细胞计数明显高于观察组,对照组尿液细菌培养的阳性率明显高于观察组（P〈0．01）。结论：用苯扎氯铵溶液进行膀胱冲洗,患者表现出较好的耐受性,能够有效预防和治疗与留置尿管相关的下尿路感染。