放大胃镜在胃病中的应用

放大内镜由于具有变焦放大的功能，可以在消化道检查中清晰显示胃肠黏膜的腺管开口、微细血管等微细结构的变化，结合黏膜色素染色，可以比较准确地反映病变组织的病理学背景，更容易地在镜下区分不同性质的病变，提高了早期癌的镜下检出率。使得镜下诊断出现了新的标准，使内镜诊断提高到了一个新的水平，是医学发展的又一次革命性进步。     

关节镜治疗膝关节骨性关节炎

目的我科自2002—2004年对21例膝关节骨性关节炎进行关节镜检查及镜下清理术。方法按顺序镜检，切除增生的滑膜，修整退变碎裂的半月板，切除剥脱软骨并修整关节面，摘除游离体。结果21例均得到随访12—30个月，平均15个月；术后评估优15例、良4例、可2例，优良率90．5％。结论关节镜对骨性关节炎的诊断更全面准确，关节清理术具有疗效可靠、创伤小、并发症少、康复快和可重复等优点。     

自体髂骨移植修复颌骨缺损的护理

总结了88例采用自体髂骨移植修复颌骨缺损的病人的护理,包括术前心理、口腔护理、皮肤准备及术后呼吸道护理、伤口护理、口腔护理、饮食护理、功能锻炼等.     

医护人员职业紧张反应与应变能力分析

目的 探讨医务人员职业紧张反应和应变能力的状况。方法应用职业紧张量表(OSI-R)，对北京市某三级医院随机调查门诊及病房医护人员共299名，应用SPSS10．0进行统计分析。结果回收合格调查表272份。男女医生之间除了心理紧张反应得分女性高于男性之外，其余各项均无差异；门诊医护人员比病房医护人员的个人紧张反应强烈，个人应变能力差；随年龄的增长人际关系缓和、业务技术紧张反应较弱，但自我修养能力减弱；受教育程度越高，个人应变能力越低。结论医务人员的工作地点、年龄、受教育程度等与职业紧张有很大关系，应该加强对紧张反应强烈的医务人员的防护。     

手部烧伤后重度虎口挛缩虎口重建术

自１９８９年２月～１９９５年３月，对２３例手部烧伤后重度虎口挛缩行瘢痕切除及虎口开大后，选用带旋髂浅血管蒂的腹股沟皮瓣移植重建虎口，术后均取得了满意效果。虎口挛缩的程度为０°～２５°。虎口开大后达８０°～９０°。虎口区瘢痕切除后皮肤缺损最小８ｃｍ×５ｃｍ，最大１２ｃｍ×６ｃｍ，平均１０ｃｍ×５ｃｍ。皮瓣切取面积最小１４ｃｍ×７ｃｍ，最大１８ｃｍ×８ｃｍ，平均１６ｃｍ×７ｃｍ。术后皮瓣断蒂时间为２～３周，２３例皮瓣均完全成活。对重度虎口挛缩应用带旋髂浅血管蒂的腹股沟皮瓣移植重建虎口是一种简单易行、成功率高的方法。因其具有供区部位隐蔽，皮肤质量好，不损伤肢体重要血管及可早期断蒂等优点，极易被患者接受。     

15例老年人肺炎误诊分析

老年人由于免疫功能低下,各种器官系统相应发生老化,发生炎症时表现不明显,导致肺炎症状及体征不典型,以致误诊。现收集近年来被误诊为其他疾患的老年人肺炎15例分析如下。     

DNA content and morphological parameters in synovial sarcoma and synovioma.

By using image analysis technique with 6 normal synovial tissue specimens as controls,nuclear DNA content and morphological parameters in specimens from 51 synovial sarcomas and 15 synovioma were examined quantitatively.The DNA content in synovial sarcoma and synovioma was significantly different (P<0.01), and that of synovioma and normal synovial tissue was also different (P<0.05).Morphological parameters including nuclear areas and perimeters differed significantly among the above three groups(P<0.01).There was no correlation between the DNA content of synovial sarcoma and its histologic type (P>0.05), but the DNA content greatly differed between its higher and lower differentiated grade in each type (P<0.01). The DNA content in synoviai sarcoma IIA stage, according to Enneking's staging system, was lower than that in ⅡB, ⅢA and ⅢB (P<0.05).The 5-year survival rate of synovial sarcoma with diploid/nearly diploid (D/ND) pattern was higher than that of aneuploid (AN) pattern (P=0.028). The study suggests that analysis of the DNA content and morphological parameters of tumor cells is helpful in the diagnosis and pathologic grading of synovial sarcoma.It also provides a guide to clinical operation and estimation of the prognosis. Although synovioma is usually a well-differentiated and benign lesion,this investigation also suggested that increased DNA content may be an indication of poor prognosis for this neoplasm.