荷斯坦牛乳房诸性状与305d产奶量的相关

对淮南地区荷斯坦牛体型线性性状与产奶量进行了相关分析,结果显示:荷斯坦牛后乳房高度与乳牛产奶量成强正相关(P<0.01)后乳房宽度与产奶量呈中等强度正相关(P<0.05),乳房深度与产奶量则呈显著负相关(P<0.05),乳静脉长度与产奶量呈显著正相关(P<0.05),而乳头长度与乳头直径在4胎前均与产奶量呈显著负相关(P<0.05),4胎后则呈弱负相关(P<0.05);后乳房高度、后乳房宽度及乳静脉长度是直接影响产奶量的重要性状。     

115例急诊死亡病例分析

目的了解急诊死亡的病因构成和救治状况，为制定预防措施提供依据。方法对我院2005年全年死亡病例进行回顾性分析，对以上患者的性别、年龄、发病情况、病因、抢救地点、抢救时间、抢救措施等资料进行整理。结果平均死亡年龄为68．4岁，以70—80岁年龄段最多。死亡原因依次为脑血管病、呼吸系统疾病、猝死、心脏病、恶性肿瘤等，慢性病及心脑血管病占70％；院内猝死占7．8％；诊断不清者占15．7％。与家属提出不复苏指令的相关因素为年龄增大、救治时间延长．猝死是家属不放弃抢救的重要因素。结论慢性病及心脑血管疾病占急诊死亡病例的绝大部分；应采取措施积极预防院内猝死的发生；应重视急诊疑难病。     

Infections in patients with systemic lupus erythematosus

Infection is a major contributor to morbidity and mortality in patients with systemic lupus erythematosus (SLE). In most clinical series, infection ranks first or second as the most common cause of death in SLE patients worldwide, including Hong Kong. In this article, the spectrum of infections and their protean manifestations in lupus patients will be reviewed with emphasis on clinical data from Hong Kong and other Asian countries. A high index of suspicion and dedicated work‐up to identify the causative pathogens is pivotal to the early diagnosis and effective management of infective complications in patients with SLE.     

Validation study of a portable monitoring device for identifying OSA in a symptomatic patient population

Background and objective: Obstructive sleep apnoea syndrome (OSAS) is a common disorder associated with early atherosclerosis, diabetes mellitus, ischaemic heart disease and cerebrovascular disease. The gold standard for confirming OSAS is based on an attended overnight polysomnography (PSG) in a sleep laboratory; however lack of health‐care resources creates long waiting times for patient access to this diagnostic test. This study evaluated the ability of a portable sleep‐monitoring device to identify patients in Hong Kong with suspected OSAS. Methods: Patients with symptoms of OSAS were invited to use the ARES (apnoea risk evaluation system) concurrently with an attended inpatient PSG. Several sets of AHI were generated by the ARES provider based on different oxygen desaturation criteria and surrogate parameters of arousal. The results were compared against PSG to determine the optimal sensitivity and specificity. Results: There were 141 patients who completed the study successfully. Results of AHI from the ARES study were presented in the order of different scoring criteria––4% oxygen desaturation alone, obstructive events with 3% oxygen desaturation and obstructive events with 1% desaturation plus surrogate arousal criteria. The sensitivity was 0.84 (95% confidence interval (CI): 0.77–0.90), 0.89 (95% CI: 0.89–0.94) and 0.97 (95% CI: 0.94–0.99), respectively. The specificity was 1, 1 and 0.63 (95% CI: 0.55–0.71), respectively. The receiver operating curve had an area of 0.96, 0.97 and 0.98, respectively. The kappa coefficient varied from 0.24 to 0.55 for agreement of severity between PSG and ARES. The likelihood ratio positive and the likelihood ratio negative were 2.61, infinity, infinity and 0.16, 0.11, 0.05, respectively, in the order of oxygen desaturation described earlier. Conclusions: The ARES device has reasonable sensitivity and specificity for diagnosing severe OSAS in symptomatic Chinese patients. There is moderate agreement between ARES and PSG in the diagnosis of severe disease, but less agreement in patients with mild/moderate disease.     

成人严重骨性Ⅲ类错(牙合)畸形手术前后的正畸治疗

目的：研究成人严重骨性Ⅲ类错耠畸形在正颌外科治疗的术前与术后正畸的特点及难点。方法：成人严重骨性Ⅲ类错胎病例35例，对该类畸形的临床特点、正颌手术前后正畸治疗方法和注意事项进行分析研究。结果：术前正畸治疗必须完成个别牙齿错位的调整，纠正牙弓形态与宽度的不调和牙齿代偿的去除：术后正畸的主要目的是牙弓内残留间隙的关闭和咬合关系的进一步精细调整。结论：只有完善的术前、术后正畸治疗与正颌外科手术相互配合，才能较好地完成成人严重骨性Ⅲ类错胎的临床治疗。     

高压灭菌器对口腔医疗器械灭菌效果的实验研究

目的：评价高压灭菌器对口腔诊室常用医疗器械的消毒效果。方法：随机选取患者使用过的高速手机、洁牙手柄各20件，使用Tuttnauer-2540MK高压灭菌器对高速手机、洁牙手柄进行消毒，然后进行细菌采样，观察48d小时细菌计数。采用ELISA法对HB-sAg阳性血清处理过的器械进行消毒后检测，判断标准：S／N≥12．1为阳性．反之为阴性。结果：Tuttnauer-2540MK高压灭菌器对细菌及HBsAg的消杀效果良好，经消毒15分钟后，高速手机组有9份样本细菌杀灭率为100％，1份为99．84％。洁牙手柄组有8份标本细菌杀灭率为100％，1份为99．89％。20件被HBsAg阳性血清污染的器械，消毒后S／N值均小于2．1，全部阴性。结论：Tuttnauer-2540MK高压灭菌器灭菌所需时间短较，可使各种结构复杂的口腔医疗器机均达到并灭活HBsAg的要求。     

踝臂指数评价肾功能不全患者下肢外周动脉病的研究

目的通过测量踝臂指数（ankle—brachial index，ABI）评价我国肾功能不全患者下肢外周动脉病（Pe—ripher alarterial disease．PAD）的发病情况，并对肾功能不全和PAD的共同危险因素进行评价。方法按照肌酐清除率．将2005年1月至2006年6月于北京、上海、石家庄、青岛等十几家医院住院及门诊就诊期间的6108例患者为研究对象分为两组，以肌酐清除率〈60ml·min^-1·1．73m^-2作为肾功能不全组，以肌酐清除率〉60ml·min^-1·1．73m^-2作为肾功能正常组，分别进行踝臂指数测量，以ABI≤0．9作为PAD的诊断标准，并进行资料收集和统计学处理。结果与非PAD组相比，PAD组患者肌酐清除率较低、年龄较大、男性发病率较高、糖尿病、冠心病、高血压、有吸烟史者的发病率较高，总胆固醇值较高，而在身高、体重、体重指数、收缩压、舒张压等方面无统计学意义。结论在肾功能不全患者中，PAD有非常高的发病率；ABI与肌酐清除率呈负相关，即随着肌酐清除率的下降，PAD的发病率逐渐增加。     

持续救护模式在危重新生儿救治中的应用

目的探讨持续救护模式在危重新生儿救治中的应用及成效。方法对NICU收冶的1207例危重新生儿实施持续救护模式，包括院前转运采用STABLE模式．住院期问运用新生儿个体化发育支持性护理模式（NIDCAP）和出院后给予定期随访、早期干预模式。结果采用持续救护模式后．危重新生儿转运成功率为100％，治愈率为96．5％，病死率3．5％。体重〈1000g早产儿的救治存活率为88．5%。出院随访130例，早期发现脑瘫2例。神经发育迟缓4例,者通过积极干预后，明显好转。结论持续救护模式对危重新生儿的救护安全、有效。     

含抗生素骨水泥假体在人工关节术后感染中的应用

目的回顾分析含抗生素骨水泥假体(PROSTALAC)治疗人工关节置换术后感染的疗效.方法对16例髋和膝关节置换术后感染的病例采用PROSTALAC方法,进行二期翻修治疗并进行随访.结果16例髋和膝关节置换术后感染中,有14例于治疗后接受二期全髋或全膝关节翻修术,经平均46月的随访,感染无复发,成功率达87.5%.术后Harris髋关节评分平均达82.9分,膝关节评分平均达90.5分.结论在PROSTALAC基础上进行的二期全髋和全膝关节翻修手术能成功地治疗人工关节术后感染,并且保持术后关节的功能.