艾司西酞普兰与氟西汀治疗抑郁症的临床疗效对比

目的探讨艾司西酞普兰与氟西汀治疗抑郁症的临床疗效。方法本研究按照随机数字表法将60例患者随机分为研究组和对照组各30例,其中研究组患者采用艾司西酞普兰治疗,而对照组则采用氟西汀治疗,比较两组患者的临床疗效、HAMD评分及不良反应。结果研究组患者治疗2w后即起效,且HAMD评分明显低于对照组,且差异具有统计学意义(P0.05)。研究组的总有效率明显高于对照组,且差异具有统计学意义(P0.05)。研究组的不良反应发生率(36.67%)与对照组(40.00%)比较无明显差异(P0.05)。结论艾司西酞普兰在治疗抑郁症方面,与氟西汀相比临床疗效佳,起效快,安全性好,值得临床推广使用。     

真两性畸形妊娠足月产病例报告并文献复习

目的探讨真两性畸形的发病机制、临床特点及诊治措施。方法对我院收治的真两性畸形妊娠足月产1例的临床资料进行回顾分析,并复习相关文献。结果患者孕38+4周临产,妇科检查发现外生殖器呈两性畸形,剖宫产娩出一正常男活婴,术中发现右侧卵巢有睾丸样组织,行卵睾切除,术后病理检查提示真两性畸形。染色体核型:46XX。术后6 d痊愈出院。结论临床上对真两性畸形应及时、正确诊断,并进行性别确认,早期手术治疗。     

奥氮平治疗50例老年痴呆患者精神行为症状临床分析

目的探讨奥氮平治疗老年痴呆患者的疗效。方法将98例老年痴呆症患者分为两组,研究组50例给予奥氮平治疗,对照组48例给予利培酮治疗。结果研究组总有效率为94.00%,不良反应发生率为12.00%,对照组总有效率为68.75%,不良反应发生率为33.33%,研究组研究组总有效率较高,不良反应发生率较低,治疗后PANSS量表评分下降更明显,两组差异有统计学意义(P0.05)。结论奥氮平治疗老年痴呆患者精神行为症状,可取得较好的疗效,PANSS量表评分下降明显。     

Rural and Small Town Breast Cancer Survivors’ Preferences for Physical Activity

Background

Recent data suggests that only 35 % of rural and small town breast cancer survivors are achieving physical activity (PA) guidelines after treatment.

Purpose

The purpose of this study was to determine preferences for PA counseling and programming and barriers to program participation in a sample of rural and small town breast cancer survivors.

Methods

Survivors (n?=?524) residing in rural and small town areas of Alberta, Canada completed a mailed self-report survey that assessed demographic variables, PA, and PA counseling and programming preferences.

Results

Seventy-eight percent of survivors indicated they would have possibly (i.e., yes or maybe) been interested in being counseled about PA at the time of diagnosis, while 70 % would possibly be interested in being counseled about PA at this current time. Overall, 85 % felt they would possibly be able to participate in a PA program. Receiving chemotherapy was negatively associated with wanting to receive PA counseling (odds ratio [OR]?=?0.58; 95 % confidence interval [CI], 0.39 to 0.86), PA program interest (OR?=?0.43; 95 % CI, 0.28 to 0.67), and PA program ability (OR?=?0.44; 95 % CI, 0.26 to 0.75). Preferred activities involved walking (51 %), flexibility and related activities (e.g., yoga, stretching) (36 %), and strength training (27 %).

Conclusions

Rural and small town survivors appear to be interested in and able to participate in PA counseling and programs. PA initiatives targeted to the preferences of breast cancer survivors living in nonurban areas may be more likely to facilitate and maintain PA behavior.     

应用锥形束CT分析上颌前牙区龈乳头形态的初步研究

目的 探索上颌前牙区龈乳头充满牙间接触点根方楔形间隙时(以下简称龈乳头充满)的特点及相关因素.方法 选择牙龈健康的北京大学口腔医学院在读学生15人,共纳入62个龈乳头,进行印模技术结合造影间接牙龈显影的锥形束CT拍摄后测量骨嵴顶处的龈乳头高度及厚度,临床测量龈乳头宽度,应用SPSS16.0统计软件分析其相互关系.结果 自然人群中上颌前牙区健康牙龈乳头充满时骨嵴顶处的龈乳头高度为(3.67 ±0.51) mm(均＜5 mm);龈乳头厚度为(8.38±0.75) mm;龈乳头宽度为(4.35±1.03) mm.中切牙与侧切牙间骨嵴顶处龈乳头厚度为(7.97±0.56) mm,与中切牙间及侧切牙与尖牙间的龈乳头厚度差异均有统计学意义(P＜0.05).龈乳头充满时骨嵴顶处的龈乳头高度与厚度呈中度正相关(r=0.433,P＜0.001).结论 应用锥形束CT拍摄能获得龈乳头的清晰影像并可测量其相关指标,牙龈健康的自然人群上颌前牙区龈乳头充满时骨嵴顶处龈乳头高度均＜5 mm;骨嵴顶处龈乳头高度、厚度、宽度两两相关.     

Long-term effectiveness of a prefabricated oral appliance for myofascial pain

The long-term effectiveness of a prefabricated oral appliance (R) was compared with a stabilisation appliance (S) in patients with myofascial pain. Sixty-five patients diagnosed with myofascial pain at two centres for Stomatognathic Physiology in Sweden and Finland were included in a randomised controlled trial using Research Diagnostic Criteria for Temporomandibular Disorders, with history questionnaires and clinical examinations performed by blinded examiners at baseline and at 6- and 12-month follow-ups. Patients were randomly assigned either to the R or the S group. Treatment outcome was measured according to IMMPACT for four chronic pain outcome domains: pain intensity, overall improvement, physical functioning and emotional functioning. Physical functioning was classified for Graded Chronic Pain severities and assessed by the Jaw Functional Limitation scale. Emotional functioning composed of scores of non-specific physical symptoms and depression. There were no differences between groups at baseline. At both follow-ups, all outcome domains showed significant within-group improvement, without significant differences between groups. At 12 months, 72% of all patients reported a 30% reduction in worst pain and 63% of the patients a 50% reduction in worst pain. Overall improvement 'better' to 'symptom-free' was observed in 81% in the R and 64% in the S group at the 12-month follow-up. Graded Chronic Pain, Functional Limitation of the Jaw, non-specific physical symptoms and depression showed statistically significant reduction at 12-month follow-up. Results support the hypothesis that the effectiveness of the prefabricated appliance is similar to that of the stabilisation appliance in the long-term when treating patients with myofascial pain.     

牙周探诊法判断牙龈生物型的初步研究

目的 检验牙周探诊法判断牙龈生物型的准确性.方法 选择牙龈健康、20～30岁之间的青年14人(男6人,女8人),共66颗上颌前牙.通过判断牙周探针在探入的牙龈组织内轮廓是否清晰定性判断上颌前牙牙龈生物型;使用锥形束CT测量上颌前牙唇侧中央釉质牙骨质界处牙龈厚度,并分析其相互关系.结果 牙周探诊法判断牙龈生物型的方法具有良好的一致性(一致率为80％,Kappa=0.699)和可重复性(一致率为88％,Kappa=0.815);牙周探诊法定性判断牙龈生物型与锥形束CT定量测量牙龈厚度的结果一致,薄型、中间型、厚型3种牙龈的平均厚度分别为(1.02±0.20)、(1.28 ±0.25)和(1.46±0.25) mm,三者间差异有统计学意义(P =0.001).结论 牙周探诊法判断牙龈生物型是一种简便、相对客观、适用于临床的检查方法.     

糖尿病学组在非内分泌科糖尿病护理中的应用

目的探讨糖尿病学组在非内分泌科糖尿病护理中的运用效果。方法在院内成立糖尿病学组。对非内分泌科护理人员开展系统的糖尿病知识及糖尿病专科技能培训．组织糖尿病专项护理质量检查,制订糖尿病相关护理流程,开展糖尿病护理会诊,开设糖尿病教育门诊,组建糖尿病护理微信及QQ群。最后对组内成员理论知识及操作技能进行评测,并与成立前作比较分析;总分为100分,评价非内分泌科病区糖尿病专项护理质量检测的得分情况,做比较分析。结果培训前学组成员理论知识、胰岛素笔注射操作、血糖仪操作及胰岛素泵操作达标率分别为23．68％、21．05％、39．47％和6．58％,而培训后,除了理论知识达标率为94．74％外,其他均为100．00％．差异有高度统计学意义（P＜0．01）;培训前非内分泌科病区糖尿病专项护理质量检测得分为（65．00±10．23）分,培训后为（95．00±6．18）分,培训前后比较差异显著,差异有高度统计学意义（P＜0．01）;完成院内疑难糖尿病护理会诊28次、糖尿病教育门诊接诊788人次,规范了5项糖尿病护理流程,微信及QQ群共有成员321人。学组成员共同完善了糖尿病的会诊流程。结论糖尿病学组对非内分泌专科护理人员实施的糖尿病知识与护理技能培训可以有效提高对糖尿病患者的护理质量。