青海省啮齿动物种类与地理分布

目的了解青海省啮齿动物的种类与地理分布。方法现场采集标本并鉴定。结果在青海省发现44种啮齿动物。结论小家鼠、褐家鼠、草兔在青海省分布广泛，灰旱獭与喜马拉雅旱獭在全省大部分地区均有分布。     

64层螺旋CT后处理技术在骶骨骨折诊断中的应用

骶骨骨折是一种高能量暴力造成的创伤,虽然占不到所有脊柱骨折的1％,约占骨盆骨折的20％～30％[1],但其22％～60％合并有神经损伤[2],作为骨盆环的重要组成部分,骶骨骨折可能对骨盆的稳定性产生损害,及时诊断和治疗对骨盆和神经功能的恢复具有重要的意义.笔者回顾性分析25例骶骨骨折患者的64层CT三维影像和临床资料,探讨64层CT后处理技术对骶骨骨折诊断价值.     

医用电子直线加速器辐射防护验收

目的通过对医用电子直线加速器辐射防护验收,观察其是否达到有关辐射防护法规标准要求,从而保护患者和公众的安全。方法按照国家和军队相关标准法规规定的医用电子直线加速器验收程序、方法对某医院实施验收。结果检查项目:对控制台显示、安全联锁系统、防护设施、剂量测量系统、操作规程与管理规定、防护监测与健康管理、安全操作要求等检查项目进行现场检查,均符合相关规定要求;检测项目:①防护设施,治疗室门外辐射水平3.6～5.53μSv/h,控制室辐射水平0.4～4.3μSv/h,治疗室墙外辐射水平4.4～5.5μSv/h(照射主防护墙时)和0.1μSv/h(其他照射情况);②监测系统示值校准的相对偏差均小于±3%,X射线能量在6、10和15MV时分别测量10次重复性均不超过0.7%,X射线能量在6、10和15MV均满足线性的最大偏差不超过±2%。③辐射质与厂家给出的结果的偏差不超过±3%,辐射野的均整度测量结果为1.04(6MV),辐射野的对称性测量结果为1.02(6MV),透过限束装置X射线漏射线吸收剂量与有用线束中心轴最大吸收剂量之比为0.02%,透过限束装置X射线最大漏射线和平均漏射线吸收剂量分别占最大吸收剂量的0.0012%和0.000 63%;④机架旋转中心偏差、准直器旋转中心偏差和治疗床旋转中心偏差均小于1mm。结论通过对该医院医用电子直线加速器技术性能、防护性能、治疗室防护设施、放射防护监测、放射防护管理等方面的全面验收,均达到相关标准要求,可以开展放射治疗工作。     

甘肃麦积山区媒介及宿主动物中莱姆病螺旋体检测及基因型别研究

目的 了解甘肃麦积山景区蜱及野鼠体内莱姆病螺旋体感染及其基因分型情况。方法 采用布旗法采集蜱标本,采用夹夜法捕捉野鼠。经种类鉴定后,提取病原体DNA,应用巢式PCR扩增鼠中莱姆病螺旋体5S-23S rRNA间隔区片段,对阳性产物进行限制性片段长度多态性(RFLP)分析。结果 共检测4个蜱种1 273只蜱标本,其中若蜱1 126只,成蜱147只,若蜱分组进行处理和检测,共分为67组,其中13组检测到莱姆病螺旋体DNA片段;成蜱15只检测阳性。检测4个鼠种42只野鼠,其中10只检测阳性,不同鼠种阳性率存在差别(χ²=16.93, P=0.00),4个鼠种中以大林姬鼠的阳性率为最高,达到33.33%。基因分型分析结果显示蜱及野鼠标本中莱姆病螺旋体为B. garinii 及B. afzelii基因型,其中B. garinii基因型占78.95%。结论 麦积山景区存在莱姆病螺旋体,并至少有B. garinii 及B. afzelii两种基因型。     

电视胸腔镜治疗创伤性浮动胸壁

目的：旨在明确电视胸腔镜在创伤性浮动胸壁治疗中的作用。方法：１９９５年１月至１９９６年７月，共开展了１２例创伤性浮动胸壁电视胸腔镜手术，行浮动胸壁人工胸壁钢丝悬吊外固定术。结果：浮动胸壁应用胸腔镜处理均达到恢复快、胸廓外形及功能较好的效果，无并发症发生。结论：电视胸腔镜手术治疗创伤性浮动胸壁是一种安全、有效、微创的方法。     

内镜治疗非扩张性肝外胆管结石68例

目的 探讨非扩张性肝外胆管结石的病因、诊断,分析内窥镜下十二指肠乳头切开术（endo-scopic　sphincterotomy,EST）的治疗效果。方法 对1993-2001年治疗的68例患者进行回顾性分析。界定非扩张性肝外胆管结石的概念,对该类患者采取EST+网篮取石治疗,术后进一步通过腹腔镜胆囊切除术或开腹胆囊切除术治疗。结果 非扩张性肝外胆管结石多为继发性胆总管结石,多数直径≤0.5cm,少数为原发性胆总管结石,常合并十二指肠乳头肌狭窄或十二指肠乳头旁想室。结论 逆行性胰胆管造影（enda-scopic　retrograde cholangiopancreatography,ERCP）检查对非扩张性肝外胆管结石诊断阳性率高,EST治疗非扩张性肝外胆管结石疗效显著。     

北京口岸地区蚊虫监测报告

目的掌握北京口岸蚊虫的种类和季节消长,为蚊虫控制提供依据。方法成虫密度监测采用灯诱法和人帐诱法,幼虫密度监测采用勺捞法。结果共捕获成蚊14270只,经鉴定为4属6种,分别为中华按蚊、淡色库蚊、三带喙库蚊、白纹伊蚊、刺扰伊蚊和骚扰阿蚊;共捕获蚊幼虫114条,为淡色库蚊和凶小库蚊。淡色库蚊为北京口岸的优势蚊种,活动高峰为9月。结论北京口岸蚊虫控制宜采用综合治理策略。     

中耳炎颅内外继发感染的MSCT诊断

目的:探讨化脓性中耳炎继发颅内外感染的MSCT表现,以提高其诊断水平.材料和方法:回顾性分析继发颅内外感染的急慢性化脓性中耳炎61例的CT表现.结果:61例中耳炎继发颅内外感染,硬脑膜炎10例、硬膜外脓肿5例、硬膜下脓肿6例、脑脓肿9例、耳周围脓肿28例和颈部脓肿3例,其CT表现与其他病因引起的颅内外感染相似.结论:CT可清楚地显示并诊断中耳乳突炎及其颅内外的扩散和继发感染的情况,为临床准确及时诊治提供重要依据.     

青海省祁连县牦牛和山羊的莱姆病螺旋体和Q热柯克斯体血清抗体调查

为了解我国青海省祁连县家畜中莱姆病螺旋体及Q热柯克斯体的自然感染及复合感染状况,收集该地牦牛和山羊的血样标本,采用间接免疫荧光法分别检测血清莱姆病螺旋体及Q热柯克斯体抗体.共收集了200份血样,山羊及牦牛各100份,两种家畜均为当地的主要家畜.结果显示,牦牛血清中有11份为莱姆病螺旋体抗体阳性,23份为Q热柯克斯体抗体阳性 山羊血清中有17份为莱姆病螺旋体抗体阳性,27份为Q热柯克斯体抗体阳性 3只山羊和7头牦牛血清为双抗体阳性.结果提示该地区为莱姆病和Q热的自然疫源地,牦牛和山羊可能隐性感染了Q热柯克斯体和（或）莱姆病螺旋体.     

内镜乳头球囊扩张术治疗非扩张性肝外胆管结石的疗效分析

Objective To investigate the efficacy of endoscopic papillary balloon dilation (EPBD) and endoscopic sphincterotomy (EST) in the treatment of non-dilated extrahepatic biliary stones. Methods The clinical data of 317 patients with non-dilated extrahepatic biliary stones who were admitted to the Taiyuan Iron and Steel Corporation Hospital from January 1999 to April 2008 were retrospectively analyzed. Of all patients, 119 received EPBD treatment, and the remaining 198 received EST treatment. Sixty-two patients treated by EPBD (EPBD group) and 62 by EST (EST group) were selected to conduct the matched-pair analysis. In the EPBD group, a cylindrical balloon was inserted under the guidance of a guidewire after the conclusive diagnosis by endoscopic retrograde cholangiopancreatography. After the dilation, stones were extracted by a stone basket or a balloon, and then conventional endoscopic nasobiliary drainage was carried out. In the EST group, stones were extracted by a stone basket or a balloon under the monitor of the digital subtraction radiography after incision of the duodenal papilla. The efficacy of the two methods was compared using the chi-square test. Results The stonefree rate in one session was 92% (57/62) in the EPBD group and 94% (58/62) in the EST group, with no significant difference between the two groups ( χ 2 = 0.222, P > 0.05 ). The number of patients who were complicated with hyperamylasemia and pancreatitis was slightly greater, and the number of patients who were complicated with duodenal perforation was smaller in the EPBD group than those in the EST group, while there was no significant difference between the two groups ( χ 2 = 0. 286, 1. 000, 2.000, P > 0.05 ). The numbers of patients who were complicated with duodenal papilla bleeding or biliary infection in the EPBD group were significantly smaller thanthose in the EST group ( χ 2 = 4. 000, 7. 000, P < 0.05 ). All patients were followed up for 24 months. The recurrence rate of bile duct stone and the incidence of biliary infection in the EPBD group were significantly lower than those in the EST group at the end of 6, 12 and 24 months (χ2 =4. 000, 5. 000, 6.000; 6.000, 8.000,11. 000, P < 0.05 ). Conclusions Combined application of EPBD and ENBD has the advantages of minor trauma and quick recovery of patients. It can preserve the function of duodenal papilla, so it is the first choice for treating non-dilated extrahepatic biliary stones.