799例住院患者死亡病例回顾性分析

目的了解住院患者死因及威胁人类生命的主要原因,降低病死率,提高医疗质量。方法收集我院2003年～2005年住院病例799例,对其死因、性别、年龄、职业、发病时间、入院时间、抢救措施等进行回顾性分析。结果死亡病例中,以老年人为主,男性多于女性,恶性肿瘤成为住院患者死亡的首位原因,寒冷季节是死亡高峰期,多数患者来院时发病已超过1周,一半患者在入院一周内死亡,抢救过程中气管插管和电除颤是重要措施。结论重视各种因素对死亡病例的影响,加强新理论、新知识的提高,对提高医疗质量有重要作用。     

病案室自动化系统中数据库资源的优化与合理应用

目前,病案室自动化系统已成为病案室工作模式,数据库的资源十分充实;本文从数据库资源建设、开发、合理使用中提出注意要点,以便更好的利用病案的内在信息,为医教研、现代医院管理服务。     

IGF-I及IGF-I受体与视网膜新生血管的研究

本文介绍了IGF-I及IGF-I受体的结构特征、生物功能、及影响因素,以及它们对视网膜新生血管的影响。     

Vitapex糊剂在儿童年轻恒牙根尖诱导成形术中的应用

目的探讨Vitapex糊剂和氢氧化钙糊剂用于儿童年轻恒牙根尖诱导成形术的治疗效果。方法对85例儿童,98颗牙根尖发育未完成,牙髓病变已波及根髓、牙髓已坏死或并发根尖周炎的年轻恒牙分为2组,分别用Vitapex糊剂和氢氧化钙糊剂进行根尖诱导成形术,观察其根尖发育情况。结果Vitapex糊剂组总有效率为91.84%。氢氧化钙组总有效率为77.55%。2者疗效在统计学比较存在显著性。结论Vitapex糊剂作为一种根尖诱导成形剂具有良好的治疗效果。值得在临床推广应用。     

红霉素对哮喘豚鼠嗜酸性粒细胞凋亡的影响

目的探讨红霉素对哮喘豚鼠嗜酸性粒细胞凋亡的影响。方法用卵白蛋白致敏复制哮喘豚鼠模型,分为哮喘组、地塞米松治疗组,及小、中、大剂量红霉素组6组。检测各组豚鼠支气管肺泡灌洗液(BALF)中白细胞总数、嗜酸性粒细胞(EOS)总数、EOS百分数,分离纯化BALF的EOS,用吖啶橙/溴乙啶(AO/EB)荧光染色法检测EOS凋亡率。结果①豚鼠BALF白细胞总数、EOS总数及EOS百分数哮喘组均明显高于正常对照组,各红霉素组与哮喘组相比均有所降低,但小剂量红霉素组与之相比差异无显著性;②豚鼠BALF中EOS凋亡率哮喘组明显低于正常对照组,各红霉素组均高于哮喘组,但小剂量红霉素组与之相比差异无显著性;③EOS凋亡率与BALFEOS总数及EOS百分数呈显著负相关。结论红霉素具有一定的抗气道非特异性炎症作用,可以诱导EOS凋亡,这可能是其抗哮喘炎症作用的主要机制之一。     

儿童胃电图与胃镜对照观察136例

目的比较分析胃电图和胃镜对于儿童胃病诊断的一致性,探讨胃电图在儿童胃病检查中的临床诊断价值。方法136例因消化道症状住院或就诊的人同时经胃镜及胃电图检查的患儿进行比较,按胃镜诊断结果,观察胃电图与胃镜诊断的符合率,对比分析胃电图的主频、振幅和节律变化,探讨变化规律。结果与胃镜诊断相比,胃电图对慢性浅表性胃炎的诊断符合率高达95.8%,对器质性胃部疾病的诊断符合率不到40%。结论虽然胃镜仍为一种不可替代的检查手段,但胃电图对于儿童胃部功能性疾病的诊断却有着重要意义,可作为初筛的一种重要手段。     

婴幼儿哮喘的危险因素

目的寻找婴幼儿喘息、儿童哮喘的危险及保护因素。方法1个月~3岁肺炎患儿82例、毛细支气管炎65例、婴幼儿哮喘76例,107例正常儿童作为对照。采用向家长书面问卷调查方法询问各组婴儿既往病史、家族及个人过敏史、怀孕出生及婴幼儿喂养情况、生活条件等。结果父母任何一方有喘息史、父母任何一方有其他过敏史、父母任何一方吸烟、湿疹等个人过敏史任何一种、父(母)亲有哮喘史及过敏史、兄弟姐妹有哮喘史及过敏史、个人有过敏性鼻炎、个人有药物过敏、母妊娠期间早孕反应重、母亲是素食者、母亲文化程度低是婴幼儿哮喘的危险因素;而自然分娩、婴幼儿期补充VitD和钙剂、生后冬季户外活动时间长、每天平均睡眠时间长、住所有上下水设备是婴幼儿哮喘的保护因素。结论个人过敏史和家族过敏史为婴幼儿哮喘的主要危险因素。     

LASEK对角膜内皮细胞的影响

目的:评价准分子激光上皮瓣下角膜磨镶术(LASEK)对中央角膜内皮细胞的影响。方法:选择无配戴接触镜史的-6.00￣-19.00D[(-9.56±3.44)D]高度近视患者49例(90只眼)进行LASEK治疗,按照角膜切削面距离角膜内皮层厚度分为两组,组1:35眼为275￣300μm,组2:55眼为300μm以上,各组患眼于术前和术后1、4、12周观察和分析中央角膜内皮的细胞密度(CCD)、变异系数和六角型细胞百分比。结果:LASEK手术前后角膜内皮细胞密度,变异系数差异均无显著性意义(P>0.05),上述两项指标的变化与切削深度不存在统计学的相关性;LASEK术后六角型细胞百分比显著下降(P<0.05),其下降程度与角膜切削深度呈现显著正相关(P<0.001);上述三项指标的变化与切削面距离内皮层厚度不存在统计学的相关性。结论:LASEK术后早期对中央部角膜内皮细胞产生可观察到的影响,表现为细胞形态的改变,其对角膜内皮细胞的远期影响有待进一步的观察。     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.