浙江省2003～2004年甲副伤寒菌株质粒图谱分析

目的：探讨浙江省2003、2004年不同地区分离的甲型副伤寒菌株质粒基因定位及与致病性的关系。方法：利用快速小量质粒提取技术及电泳图谱方法，对浙江省2003、2004年暴发点病人和住院病人分离的部分甲型副伤寒菌株进行质粒图谱分析并做药敏试验。结果：分析发现选择的78株菌株中，78株(100％)对红霉素(ETM)耐药，77株(98．72％)对利福平(RFP)、链霉素(SM)及头孢拉定(CV)耐药，76株(97．44％)对羧苄青霉素(CAR)及磺胺(SD)耐药，64株(82．05％)对强力霉素(DC)耐药；大多数菌株带有一20kb大小质粒，所有菌株均带有2．2kh大小的质粒。结论：甲型副伤寒菌对ETM、RFP、CAR、CV、SM、SD、DC耐药，并认为具有多重耐药性是浙江省甲型副伤寒发病率持续高发的主要原因。     

Pulmonary lymphangioleiomyomatosis: correlation of ventilation-perfusion scintigraphy, chest radiography, and CT with pulmonary function tests

PURPOSE: To determine the findings on ventilation-perfusion (V-P) scintigrams, computed tomographic (CT) scans, and chest radiographs and correlate them with pulmonary function test results in patients with lymphangioleiomyomatosis. MATERIALS AND METHODS: V-P scintigraphy, chest radiography, conventional and thin-section CT, and pulmonary function tests were performed in 39 patients. The images were graded on a scale of 0 (normal) to 3 (severely abnormal). RESULTS: Imaging abnormalities were found on 92% of ventilation scintigrams, 92% of perfusion scintigrams, 79% of chest radiographs, 100% of CT scans, and 100% of thin-section CT scans. On ventilation scintigrams, 28 (72%) patients demonstrated a speckling pattern. On CT scans, all patients had pulmonary cysts. Univariate analysis showed that extent of disease on chest radiographs and CT scans, cyst size, V-P abnormalities, and degree of speckling were inversely correlated with forced expiratory volume in one second (FEV(1)), diffusing capacity of lung for carbon monoxide, and the ratio of FEV(1) to forced vital capacity (FVC) (P <.01) but not with FVC and total lung capacity. Larger cyst size correlated with extent of disease at CT, but not significantly (P =.056). CONCLUSION: Scintigraphic and radiologic abnormalities are seen in a majority of patients with lymphangioleiomyomatosis. On ventilation scintigrams, a frequently seen speckling pattern may be related to accumulation of radionuclide in pulmonary cysts-a hallmark of the disease at CT. Findings with each imaging modality correlate with certain pulmonary functions.     

Lymphangioleiomyomatosis: abdominopelvic CT and US findings

PURPOSE: To describe the abdominal computed tomographic (CT) and ultrasonographic (US) findings in patients with thoracic lymphangioleiomyomatosis (LAM) and to relate the prevalence of the findings to the severity of pulmonary disease. MATERIALS AND METHODS: Eighty patients with LAM underwent chest and abdominopelvic CT and abdominopelvic US. The images were reviewed prospectively by one radiologist, and the abdominal findings were recorded and correlated with the severity of pulmonary disease at thin-section CT. RESULTS: Sixty-one (76%) of 80 patients had positive abdominal findings. The most common abdominal findings included renal angiomyolipoma (AML) in 43 patients (54%), enlarged abdominal lymph nodes in 31 (39%), and lymphangiomyoma in 13 (16%). Less common findings included ascites in eight (10%), dilatation of the thoracic duct in seven (9%), and hepatic AML in three (4%). A significant correlation (P =.02) was observed between enlarged abdominal lymph nodes and increased severity of lung disease. CONCLUSION: There are characteristic abdominal findings in patients with LAM that, in conjunction with the classic thin-section CT finding of pulmonary cysts, are useful in establishing this diagnosis.     

工业工程在医院信息系统中的应用

医院信息系统是医院管理现代化的必备条件.文章从工业工程的角度对医院信息系统进行了研究.在总结当前医院信息建设情况的基础上,对医院信息系统进行了分析,指出了医院信息系统普遍存在的问题.提出了如何使用工业工程方法来解决这些问题,帮助医院提高服务效率.     

知识管理与医院图书馆的发展

知识管理既涵盖对信息资料的管理，又包括对人力资源的管理，是管理理论和方法应用于知识型组织和知识型员工管理的创新与升华。本文分析了网络环境下医院图书馆面临的环境，指出知识经济的发展是图书馆实施知识管理的源动力，信息技术的发展为实施知识管理提供了技术支持，图书馆的范式演变是实施知识管理的要求，从而阐明了实施知识管理的必要性、可行性。医院图书馆引入知识管理，不仅有助于拓宽理论研究的新视角和新领域，更有助于在图书馆实际工作中树立新理念和方法，提高图书馆的学科专业地位，提升图书馆的组织效能。在其基础上对其实施策略进行探讨，提出了要以人为本，重视人力资源的开发，并深入知识单元，加强信息资源的开发整合，积极主动开展个性化服务，更新管理体制，构建开放式知识共享机制。     

Measuring ADHD behaviors in children with symptomatic accommodative dysfunction or convergence insufficiency: a preliminary study.

BACKGROUND: Accommodative dysfunction and convergence insufficiency (CI) are common pediatric vision problems that have been associated with an increase in frequency and severity of vision-specific symptoms that affect children when doing schoolwork. However, the relationship between accommodative dysfunction and CI and other learning problems, such as attention deficit hyperactivity disorder (ADHD), are not well understood. The purpose of this study was to evaluate the frequency of ADHD behaviors in school-aged children with symptomatic accommodative dysfunction or CI. METHODS: Children 8 to 15 years of age with symptomatic accommodative dysfunction or CI were recruited from the teaching clinic at the Southern California College of Optometry. Children with learning disabilities or ADHD were excluded. One parent of each child completed the Conners Parent Rating Scale-Revised Short Form (CPRS-R:S). The children's scores on the CPRS-R:S were compared with the normative sample. RESULTS: Twenty-four children (9 boys and 15 girls) participated in the study with a mean age of 10.93 years (SD = 1.75). On the CPRS-R:S, cognitive problem/inattention, hyperactivity, and ADHD index were significantly different from normative values (p < or = .001 for all tests). CONCLUSIONS: The results from this preliminary study suggest that school-aged children with symptomatic accommodative dysfunction or CI have a higher frequency of behaviors related to school performance and attention as measured by the CPRS-R:S.     

长寿老干部135例的视力及眼部情况

目的:调查长寿老人的视力状况及眼部情况,分析其影响因素。方法:对长寿老人135例采用Snellen国际标准视力表进行视力检测,并以裂隙灯、眼底镜及非接触眼压计常规检查外眼、眼前节、眼底及眼压。对疑似病例采取相应的辅助检查。对53例能合作验光检查的老人进行屈光矫正。资料统计采用SPSS1.0软件包进行均数统计和t检验。结果:除外4例老年性痴呆患者,131例262眼中<0.01的22眼,其余240眼≥0.01,右眼视力为0.01～1.0(0.46±0.50);左眼0.03～1.0(0.49±0.50)。两眼平均视力无显著性差异(P>0.05)。盲和低视力的发生率分别为5.9%和10.3%。53例验光者视力不变的10例(18.9%),43例(81.1%)视力提高1～5(平均3)行,自身对照t检验差异极显著(P<0.01)。所有老人均表现有眼睑下垂、角膜类脂环、眼底动脉硬化、老花眼等老年性眼部变化。平均每位老人患有2.4(2～7)种眼病和7.6(3～11)种全身主要脏器病变。对视力产生最普遍影响的因素是屈光不正,诸多眼病中白内障发病居首位,而影响视力最严重的眼病主要是黄斑病变和各种原因所致的视神经萎缩等。结论:长寿老人的增龄性视力减退更显著,盲和低视力的发生率更高。其原因既有衰老退化因素,又有与老年人常见眼病和屈光不正的影响。     

外伤性歪鼻畸形的综合整复疗法

目的探索一种安全、简便、有效的整复歪鼻畸形的方法.方法采用鼻前庭入路,鼻骨复位、鼻中隔偏曲矫正、隆鼻术相结合的综合治疗手段矫正歪鼻畸形.结果2002年11月至2004年4月我院整型外科共收治外伤性歪鼻畸形38例,治愈32例,好转6例.随访1～18个月,外形满意、鼻腔通气功能改善,未发生明显并发症.结论鼻骨外伤畸形多因伤后早期未及时有效处理,经手术切开复位、同时鼻整形,消除了引起畸形的原因,可取得较满意的效果.     

Trochlear nerve palsy in Sjögren's syndrome

Sj?gren's syndrome (SS) is a systemic lymphoproliferative, autoimmune disease, which is characterized by dryness of the eyes, mouth, and other mucous membranes. The nervous system may be affected in up to 20% of the cases of primary or secondary SS. We present a case of a 54-year-old woman with trochlear nerve palsy complicating Sj?gren's syndrome secondary to rheumatoid arthritis. We suggest that all patients with multiple cranial neuropathies, especially when associated with rheumatoid arthritis, should be carefully examined for the possible presence of secondary SS.     

溺水的乌鸦

关于第一次，她坦率地说过程已经不记得，唯一的印象是：男人本来刚强如炬的小弟弟一下软成了烂泥，萎缩而疲惫地吊在两腿之间，像一只溺水的乌鸦。[编者按]