Rates and causes of emergency department revisits within 72 hours.

The purpose of this study was to determine the rates and causes of revisits to the emergency department (ED) of a 3,500-bed referral hospital, to identify areas for improvement, and to generate baseline data for the development of a computerized, automatic monthly audit system. We identified all patients returning within 72 hours of their initial ED visits, from 1 July 1995 to 30 June 1997, and monthly revisit rates were calculated. To determine the reasons for revisits, two independent reviewers examined the charts of revisit cases from 1 July 1996 to 30 June 1997. A one-in-three sampling method was used to select charts. A total of 485 revisit charts were reviewed. The monthly revisit rates ranged from 1.32% to 2.38%, with no particular seasonal or event-specific pattern. Most revisits were attributed to disease factors (79.0%). Those felt to be medical errors only accounted for 7.8% of the revisits but led to a higher hospital admission rate (73.7%) subsequently. By contrast, the overall hospital admission rates for revisit patients (36.5%) and all ED patients (36.2%) were similar. We suggest setting baseline monthly ED revisit rates at 2% for future computer-programmed audit filters. While this study indicates that most revisits are disease-related, further prospective studies are needed to evaluate the most common and serious causes of revisits to see if improvements can be made.     

近视眼黄斑区视网膜厚度的研究

目的 探讨近视眼黄斑区视网膜厚度的特点.方法 122例除视盘旁近视弧外无其他眼部异常的近视患者,等效球镜度数-1.50～-15.25 D(-6.18±2.61)D,每例随机选取1眼受检.所有受检眼行屈光检查和眼轴长度测定.将黄斑区分为9个区域,测定各区域视网膜厚度后,进行相关因素分析.结果 受检者黄斑中心凹视网膜厚度与年龄及眼轴长度均不相关.旁中心各区域视网膜厚度与年龄不相关,与眼轴长度呈负相关,鼻侧内圈除外;随眼轴增长,外圈视网膜厚度较内圈变薄明显.结论 随着近视眼眼轴长度增加,除黄斑中心凹视网膜厚度无变化外,旁中心视网膜厚度呈变薄趋势,且外圈变薄较内圈明显.     

Doripenem 的合成工艺研究

以（1R，5S，6S）-2-（二苯氧磷酰氧基）-6-[（R）-1-羟乙基]-1-甲基碳青霉-2-烯-3-羧酸-4’-硝基苯甲酯为原料，经缩合、二次脱保护即得目标化合物，经IR、^1H-NMR、MS等确证结构为doripenem，总收率达55％。本法为doripenem用于中试放大提供了依据。     

补肾活血方对ITP患儿P-选择素表达的影响及临床疗效观察

目的观察补肾活血方治疗儿童原发性血小板减少性紫癜（ITP）的疗效及探讨其治疗机理。方法将58例ITP患儿随机分为治疗组和对照组，治疗组给予补肾活血方煎剂，对照组给予强的松口服。2个疗程后统计2组的临床疗效和P-选择素表达的水平。结果治疗组总有效率为86．7％，对照组总有效率为67．9％，2组疗效比较差异有统计意义（P〈0．05）；治疗后治疗组P-选择素表达水平明显下降，与对照组比较差异有统计意义（P〈0．05）。结论补肾活血方对儿童ITP疗效明显，为临床治疗提供了新的思路。     

红金消结片的制备与质量控制

目的:研究红金消结片的制备及其质量控制方法.方法:鉴别采用薄层色谱法,用高效液相色谱法测定人参皂苷Rg1含量.色谱柱为Cmsmosil C18(200mm×4.6mm,5μm),乙腈-0.05%磷酸溶液(21:79)为流动相;检测波长为203nm,柱温为25℃.结果:红金消结片中人参皂苷Rg1在0.7～6.3μg呈良好线性关系,r=0.999 2.结论:红金消结片制备工艺简单,质量控制方法可靠,重现性好.