住院医师规范化培训之“333”制管理模式运行与思考

调查本院103名“333”制人员,主要是临床类研究生和住院医师的“333”制活动出勤情况,结合我院以往住院医师规范化培训的相关情况,对取得的经验进行总结,探讨规范化管理“333”制人员的方法和最佳运行机制。     

10例原发性气管肿瘤的外科诊断及手术治疗

目的总结外科手术治疗原发性气管肿瘤的临床经验。方法回顾分析本院1993年10月～2010年1月收治的10例气管肿瘤的诊断和治疗经验。结果本组鳞癌3例,腺癌3例,腺鳞癌1例,良性肿瘤3例;临床治愈9例,术后3d死亡1例。本组3例鳞癌患者分别于手术后3年和8个月复发死亡;3例腺癌,1例术后1年出现肺转移,另2例存活10个月。结论手术切除是治疗气管肿瘤最有效的方法：（1）纤维支气管镜检查与多排CT增强三维成像对确定气管肿瘤范围有互补作用;（2）充分的术前呼吸道准备,是术中安全、术后顺利康复的保障;（3）手术者和麻醉医师密切配合,选择视野较宽的纤维支气管镜引导气管插管是麻醉安全的重要保障。     

运动训练中服用“高效强力饮”对心血管功能的效应

本文研究了一种中药水剂——高效强力饮对44名中长跑和游泳运动员运动能力的影响。测试结果表明:服药组与对照组相比,心搏量、射血分数和△D%均有明显增高;而运动后血乳酸水平,平均动脉压和总外周阻力均明显下降。这些都表明服药组有氧代谢能力方面有改善。     

子宫内膜癌磁共振成像诊断和分期

回顾性分析子宫内膜癌的磁共振（MRI）表现和手术病理结果，探讨MRI诊断和分期的价值。材料和方法：18例子宫内膜癌诊断和分期均经手术和病理检查。术前MRI检查采取冠状面和矢状面的T1WI和T2WI成像，双盲法MRI阅片，子宫内膜癌MRI分期基本按FIGO分期原则。结果：病灶区在T1WI像上为等信号（不伴出血），T2WI呈现5种表现。MRI分期准确率达83．8％，分辨工期的准确率达90．9％。结论：子宫内膜癌MRI表现多样化，有44．4％病例表现不典型。MRI对子宫内膜癌（尤其对占多数的Ⅰ期病例）的分期具有很高的价值。     

Clinical usefulness of breast-specific gamma imaging as an adjunct modality to mammography for diagnosis of breast cancer: a systemic review and meta-analysis

Purpose

The purpose of this study was to assess the diagnostic performance of breast-specific gamma imaging (BSGI) as an adjunct modality to mammography for detecting breast cancer.

Methods

Comprehensive searches of MEDLINE (1984 to August 2012) and EMBASE (1994 to August 2012) were performed. A summary receiver operating characteristic curve (SROC) was constructed to summarize the overall test performance of BSGI. The sensitivities for detecting subcentimetre cancer and ductal carcinoma in situ (DCIS) were pooled. The potential of BSGI to complement mammography was also evaluated by identifying mammography-occult breast cancer.

Results

Analysis of the studies revealed that the overall validity estimates of BSGI in detecting breast cancer were as follows: sensitivity 95 % (95 % CI 93–96 %), specificity 80 % (95 % CI 78–82 %), positive likelihood ratio 4.63 (95 % CI 3.13–6.85), negative likelihood ratio 0.08 (95 % CI 0.05–0.14), and diagnostic odds ratio 56.67 (95 % CI 26.68–120.34). The area under the SROC was 0.9552 and the Q* point was 0.8977. The pooled sensitivities for detecting subcentimetre cancer and DCIS were 84 % (95 % CI 80–88 %) and 88 % (95 % CI 81–92 %), respectively. Among patients with normal mammography, 4 % were diagnosed with breast cancer by BSGI, and among those with mammography suggestive of malignancy or new biopsy-proven breast cancer, 6 % were diagnosed with additional cancers in the breast by BSGI.

Conclusion

BSGI had a high diagnostic performance as an excellent adjunct modality to mammography for detecting breast cancer. The ability to identify subcentimetre cancer and DCIS was also high.     

多时点动态观测原发性痛经寒凝血瘀证患者的脉图参数变化

目的 分析原发性痛经寒凝血瘀证患者脉图参数的动态变化及其与疼痛程度的相关性.方法 以原发性痛经寒凝血瘀证患者为原发性痛经组,健康者为对照组.在痛经典型发作时予以电针治疗,形成4个观测时点(T0:经前7～10 d,T1:经期痛经典型发作时,T2:针刺镇痛治疗30 min结束即刻,T3:针刺镇痛治疗结束后30 min).运...     

冠心病患者白细胞介素-6基因-174G/C的多态性研究

目的　探讨白细胞介素 -6基因多态性是否与冠心病患者有关联。方法　应用聚合酶链反应限制性片断长度多态性技术对湖北地区汉族 112例冠心病患者及 183例正常对照组者白细胞介素 6基因 174G/C位点进行研究。结果　发现冠心病组与正常对照组白细胞介素 6基因 174位点均以GG型为主 ,其频率分别为 0 991和 0 989。 174位点等位基因频率在两组中无显著差异 (P >0 0 5 )。结论　提示白细胞介素 6基因 174G/C位点多态性与中国人冠心病无关联     

Effect of conventional medical treatment plus Qigong exercise on type 2 diabetes mellitus in Chinese patients: A Meta-analysis

OBJECTIVE

To systematically evaluate the effect of conventional medical treatment plus Qigong exercise on type 2 diabetes mellitus (T2DM) in Chinese patients.

康复治疗学专业创新型人才培养的探索与实践

针对新建的康复治疗学专业本科教育,为了培养创新型康复治疗高级人才,首都医科大学康复医学院通过开设一系列科研训练课程、开展毕业设计和学术交流等教学实践活动,构建了创新型人才培养的教学体系,收到了良好的教学效果。