不孕症从肝论治60例

近年来，笔者从肝论治不孕症患者60例，取得了较好疗效，现总结如下。     

以CT和MRI颅底骨成像计算鼻咽癌肿瘤靶体积及邻近危及器官照射剂量的对比研究

目的 比较CT与MRI颅底骨成像差异对鼻咽癌肿瘤靶体积及邻近危及器官照射剂量的影响。方法 从101例鼻咽癌中选出MRI与CT颅底骨成像差异病例26例,分别根据MRI与CT成像信息应用ARTP-TOP 3D-TPS系统制定三维适形计划,比较两计划中GTV_MR和GTV_CT,及邻近危及器官的平均剂量和D₅平均剂量。结果 GTV_MR为(47.0±16.3)cm³,GTV_CT为(31.6±10.0)cm³,差异有统计学意义(Z＝4.462,P＜0.01);MRI计划中的脑干、垂体、左右颞叶和左右眼球的平均剂量大于CT计划中相应器官的平均剂量(P＜0.05);两个计划中脊髓平均剂量比较差异无统计学意义;MRI计划中的脑干、脊髓、垂体、左右颞叶、左右眼球的D₅平均剂量均大于CT计划中相应器官的D₅平均剂量(P＜0.05)。结论 根据MRI制定的三维适形计划,肿瘤靶区的剂量覆盖较CT好,但是邻近危及器官组织的照射剂量相对CT的较高。     

我院41例烧伤病人创面分泌物检出的细菌及其药敏性分析

对我院1999年～2001年以来41例烧伤病人创面分泌物检出的细菌和药敏试验进行了整理分析，结果如下。     

卵巢原发性绒癌2例

例1 患者12岁，因在外院做2次手术后病情恶化于2001年9月10日入院。患者1月前因发现下腹部肿物在外院行“右侧卵巢肿瘤”切除术，术后又出现血腹症并尿妊娠试验阳性，以“异位妊娠”行第2次手术。查体：一般情况极差，重度贫血貌，恶病质，全身浅表淋巴结未触及肿大。心肺无异常，下腹见一长约8cm纵形疤痕，压痛，无反跳痛，无移动性浊音。外阴发育正常，处女膜完整。     

上颌双侧磨牙形态异常1例

正常上颌第一、第二磨牙有独特的外形特征 ,尤其上颌第一磨牙 ,其牙冠外形和牙根数目都比较恒定。然而 ,笔者最近发现 1例 ,患者的上颌双侧第一磨牙、左侧第二磨牙牙冠及牙合面形态与常见的同名牙有明显差异 ,且牙根数目均为4个。笔者观察其牙冠牙合面形态与牙根数目可能有相关     

从预防医院感染谈护理管理的重要性

随着医学科学的发展和医学模式的转变，医院感染在医院管理中占据了重要地位，医院感染护理管理构成了医院管理系统的重要组成部分。医院感染率的高低是衡量医院医疗质量的重要标志，加强医院护理管理是预防医院感染的关键措施。     

闭塞性血栓性脉管炎1例

患者男,28岁.双足发冷,阵发性发白、发绀8个月,双小腿肌肉疼痛6个月,表面无红肿,未予重视.4个月前,患者右足第2趾末端出现红肿、化脓,形成溃疡伴痒痛,以夜间疼痛剧烈,在当地医院按照"甲沟炎"诊治,无明显好转.     

1例严重电伤的术后护理

随着社会的发展，电能的应用日益广泛，因此电损伤的发生率亦随之增加。由于生活中，家用电器而造成的自然灾害，生产工作中意外事故的发生等，都具有很强的突发性，使受伤者心理震撼大，对蒙难时的惨境记忆深刻，承受着躯体和心理上的创伤与痛苦，严重影响着患者的身心健康。2003年8月12日，我科收治1例严重高压电击伤患者，经及时救治及精心护理而获得成功，未发生任何护理并发症。现将护理工作报告如下。     

基层医院感染性疾病科平战结合训练应对突发事件

笔者所在医院是一所集医疗、科研、教学、预防、康复为一体的二级甲等综合性基层医院,是政府指定诊疗突发公共卫生事件病员的定点医疗机构,医院感染性疾病科承担具体的防治工作.     

广东省梅县重点人群碘营养状况调查分析

Objective To estimate the present salt iodine content and iodine nutrition need of high risk population of iodine deficiency disorder in Meixian County. Methods Each primary school was selected from urban and rural areas(Xiyang Town, 20 kilometers away from Meixian County), the goiter rate of 8 to 10 year-old students was examined and urinary iodine and household salt iodine was sampled. Twenty to 40 year-old women of childbearing age nearby schools around the urban and villages around Xiyang Town were selected to collect their urine and salt samples. At urban hospitals and rural health centers, 0 to 2 year-old infant urine samples were collected, Thyroid gland was palpated and urinary iodine was determined by iodine in urine by As3+-Ce4+catalytic spectrophotometry, salt iodine was determined by direct titration. Results The goiter rates of 8 to 10 year-old students were 1.5 % (3/200), 1.0% (1/100) for the urban area and 2.0% (2/100) for rural area. Median of urinary iodine in 8 to 10 year-old students, infants, women of childbearing age averaged at 237.1 μg/L and 280.1, 234.7,187.6 μg/L respectively, with each being 287.4,245.0,205.5 μg/L in urban area and 278.9,228.5,176.4 μg/L in rural area. Women of childbearing age had a higher percentage of urinary iodine < 50.0 μg/L than students,students had a higher percentage than infants, each being 7.5%(15/200), 4.5%(9/200), 4.0%(4/100). The ration of urinary iodine > 300.0 μg/L was more in infants than in students, that in students was more than that in women of childbearing age, each being 33.0% (33/100), 30.0% (60/200),22.5% (45/200). The median of salt iodine was 27.2 mg/kg. The coverage of iodized salt was 100.0%(400/400). Ninty-seven percent(194/200) and 96.0% (192/200) of qualified iodized salt were consumed in urban area and in rural area. Conclusions The amount of iodine added to salt meets the requirement in the 3 kinds population risk of iodine deficiency disorder. But a higher iodine status has been found out in students and infants. It is reasonable to decrease the present salt iodine content.