Ergebnisse der strukturierten Konsensuskonferenz „Bild gebende Verfahren in der Unfallchirurgie“ und Methodik zur Messung der Akzeptanz unter Tagungsteilnehmern

Existing knowledge and present experience relating to the indications for imaging techniques in trauma surgery were summarised, screened and considered in different ways by representatives of various professional scientific bodies, with the aim of finding what procedures should be implemented as the primary examination techniques after a careful clinical examination when particular posttraumatic situations affecting the knee, foot, ankle, or hand were found. In the course of an interdisciplinary consensus conference the evidence-based recommendations prepared by a panel were discussed and modified, giving rise to statements on the suitability of the given imaging techniques in 28 different clinical situations immediately after a clinical examination, based on scientific evidence and medical consensus. The degree of consensus was measured and carefully documented. These statements were transformed into decision algorithms and presented to doctors working in accident and emergency medicine during a conference on trauma surgery, with the aim of.measuring the acceptance of the statements among those attending the trauma surgery meeting. The remarks made by the participants during the discussion and the results of the acceptance measurements clearly show the need for further discussion among experts.     

以市场需求为导向探索"宽口径大基础后分流"医学教育模式

在分析了我国医学教育现状的基础上 ,结合浙江省社会经济发展和医学教育的实际 ,提出医学教育必须以市场需求为导向 ,积极探索“宽口径、大基础、后分流”医学教育新模式 ,并从理论的高度 ,结合本校创办卫生管理专业的初步实践经验 ,分析了这种医学教育模式的特点和优点     

莪术油治疗毛细支气管炎60例疗效观察

目的　评价莪术油治疗毛细支气管炎的疗效。方法　毛细支气管炎患儿 110例 ,随机分为治疗组 6 0例和对照组 5 0例 ,6d为 1疗程 ,比较两组治愈率 ,临床指标对比观察 (咳喘 ,肺部罗音消失时间 ,住院时间 )。结果　总治愈率治疗组 96 .7% ,对照组 80 % ,两组比较有显著性差异 (P <0 .0 5 )。结论　莪术油治疗毛细支气管炎疗效满意。     

医源性腓总神经伤分析

目的：总结40a来收治的48例医源性腓总神经损伤的临床资料，探讨其损伤机制和特点。方法：通过随访，依据其损伤原因和机制分类统计。结果：牵拉压迫伤33例，占69％；手术切割伤12例，占25％。导致腓总神经损伤的原因中以石膏压迫为最多，占37％，牵伸性损伤占31％。结论：骨科医师必须具备丰富的解剖知识和责任心，重在预防，一旦发生损伤，应早期诊断，采用有效的方法及时治疗。     

尿毒症患者血透中血液动力学监测

目的：观察尿毒症患者血透过程中血液动力学改变，方法：尿毒症患者20例，均在透析放血前，放血后，30min,60min,120min,180min，回血前，回因后测定血压，脉搏，中心静脉压，平均直接动脉压，结果：透析过程中血压，脉搏以及直接平均动脉压较稳定，中心静脉压放血前较正常为高，且高于血透过程中其它时间段（P＜0．05），结论：血透过程中血液动力学稳定，且中心静脉压的变化有利于心功能的改善。     

高脂血症患者C—反应蛋白含量的变化及氟伐他汀对它的影响

OBJECTIVE: To observe the changes of C-reactive protein (CRP) level and its relationship with blood lipids, and the effects of fluvastatin on CRP and the lipids in patients with hyperlipidemia. METHODS: Serum levels of cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C) and lipoprotein(a)[Lp(a)] were measured by enzyme assay, and plasma CRP level by immunonephelometry before and after fluvastatin treatment (20 mg/d for 4 weeks) in patients with hyperlipidemia. RESULTS: CRP levels were above normal in 90.3% hyperlipidemia cases in spite of the various accompanying diseases. Fluvastatin treatment significantly reduced TC (-7.49%), TG (-14.32%), LDL (-13.88%), VLDL (-18.48%) and TC/HDL(-13.50%) levels (P<0.01), and also brought down Lp(a) concentration (-13.81%). CRP levels was very effectively reduced after the treatment (-15.92%, P<0.001). No association between basal CRP levels and basal lipids and Lp(a) concentrations was observed. Positive correlation of CRP, however, was observed after fluvastatin treatment with TC/HDL (r=0.62, P=0.041) and Lp(a) (r=0.320, P=0.011), while inverse relations were noted between CRP and HDL (r=-0.288, P=0.023). CONCLUSION: CRP levels increases markedly in patients with hyperlipidemia, a fact that is independent of the accompanying diseases. In addition to modulating blood lipid levels, fluvastatin also reduces CRP level, the latter possibly serving as an independent predictive factor for atherosclerotic cardiovascular diseases and also as an indicator for estimating the effectiveness of the treatment.     

重组人酸性成纤维细胞生长因子促进创伤愈合的研究

目的：研究重组人酸性成纤维细胞生长因子（rh-aFGF)对兔创伤的促愈合作用。方法：采用兔背部刀割伤模型，将rh-aFGF溶液隔日一次滴注于创面，用创面照像、透明膜描记称量法记录伤后第4、8、12、16天创面面积，用注水法测量伤腔容积，伤后第8、16天取创面组织，观察创面的病理学变化，包括肉芽组织生长与再上皮化情况。结果：rh-aFGF可明显加速兔皮肤创伤的愈合，使创面面积明显缩小（P＜0．05），使伤腔容积明显减少（P＜0．05）。组织学检查：rh-aFGF组创面伤后8天成纤维细胞生长活跃、数量多，其毛细血管胚芽与成纤维细胞数量显著多于对照组；伤后16天，创面收缩与再上皮化明显，新生上皮向创面中心爬行较快。结论：rh-aFGF对兔背部刀伤创面有明显的促修复作用。     

血气分析仪标准溶液定值器的研制

血气分析仪标准溶液定值器是基于Poiseuille定律研制。二氧化碳气体和空气中的氧气在仪器气体混合单元中充分、均匀混合成一定比例的气体，再和标准物质溶液混合，配制出血气分析仪检定用标准溶液。     

Posttraumatische Belastungsstörung

Current activities in the case management of patients with post-traumatic stress disorders are reported. In 2002 a project was initiated by accident insurance associations. The aim is to detect accident victims with stress disorder at an early stage and to avoid medical mismanagement.