阴道镜检查在阴道上皮内瘤变中的应用

目的:探讨电子阴道镜检查在阴道病变中的临床应用价值。方法:对2007年8月～2010年8月在吉林市妇产医院妇科门诊就诊的宫颈上皮内瘤变、阴道上皮内瘤变或宫颈癌术后31例患者行阴道细胞学涂片检查,结果异常者15例行电子阴道镜检查,在可疑病变区取活检送病理检查。16例细胞学检查为正常或鳞状上皮非典型增生者给予阴道用药治疗1～3个疗程,3个月后复查宫颈阴道涂片,2例细胞学仍异常,行阴道镜下活检送病理检查,余14例细胞学阴性者定期复查细胞学。结果:15例涂片异常者中检出阴道上皮内瘤变9例,原位癌2例,余4例避免活检。阴道镜检查准确率达73.33%,与病理学诊断符合率达81.82%。结论:阴道镜对阴道上皮内瘤变的诊断至关重要,活检定位准确,避免不必要的活检。     

宫腔镜对绝经后子宫出血的诊治价值

目的:探讨宫腔镜技术对绝经后子宫出血的临床应用价值。方法:对2009年8月～2011年8月在吉林市妇产医院就诊的125例绝经后子宫出血的患者给予宫腔镜检查,行取环术或活检、宫腔镜电切,并送病理检查。结果:未取出节育环12例,三苯氧胺或激素替代后患者5例;萎缩性子宫内膜43例,子宫内膜增生26例,子宫内膜息肉24例,黏膜下子宫肌瘤8例,子宫内膜癌6例,低度恶性子宫内膜间质肉瘤1例,病理符合率分别为90.7%、76.9%、83.3%、100.0%、100.0%、0.0%。结论:宫腔镜对绝经后子宫出血的诊治无可替代,病理符合率高。     

Factors Influencing Utilization of ASHA Services under NRHM in Relation to Maternal Health in Rural Lucknow

Background:

Under National Rural Health Mission (NRHM), ASHA (accredited social health activist) has been identified as an effective link to address the poor utilization of maternal and child health (MCH) services by rural pregnant women.

Objective:

To study the factors influencing utilization of ASHA services in relation to maternal health.

Study Design:

Cross-sectional.

Setting

Primary Health Centre (PHC), Sarojininagar, Lucknow and its rural field area.

Study Period:

September 2007 to August 2008.

Study Unit:

RDW (recently delivered women) were considered as those who delivered a live newborn at PHC Sarojininagar, within a week of interview and belonged to villages within the confines of the PHC being served by ASHA.

Materials and Methods:

350 RDW were interviewed at their bedside, by a preformed and pretested schedule and then were followed-up after six weeks.

Results:

Utilization of ASHA services for early registration was significantly associated with age and religion of RDW. Young, educated and socio-economic class III RDW utilized ASHA services the maximum for early registration. Utilization of ASHA services for adequate ANC or antenatal care (100 iron and folic acid tablets, 2 tetanus toxoid injection and ≥3 antenatal visits) was also inversely associated with age of RDW. Young, Hindu, scheduled caste, middle school pass, Class III RDW and those with birth order one had high odds for utilization of ASHA services for adequate ANC. With regard to postnatal check-up, again young RDW with birth order one, Hindu RDW in reference to Muslim and RDW in socio-economic class III had higher likelihood for utilization of ASHA services. Caste-wise scheduled caste (SC) and other backward caste (OBC) RDW had higher odds for utilization of ASHA services. Educated RDW and those with educated husband had higher odds for utilization of ASHA services for postnatal check-up.

Conclusion:

Young, educated RDW with low parity, educated husband and belonging to higher socio-economic class had higher odds of utilization of ASHA services.     

Oral squamous cell carcinoma: overview of current understanding of aetiopathogenesis and clinical implications

MEDLINE contains well over 14 000 papers revealed by a search using keywords 'oral squamous cell cancer' or 'oral squamous cell carcinoma', over 27 000 using 'oral carcinoma' and over 48 000 using the keywords 'oral cancer'. It is difficult to see how clinicians could keep abreast of such a subject. This paper attempts to help by providing an overview of the aetiopathogenesis of oral squamous cell carcinoma (OSCC), discussing changes in epidemiology and increasing awareness of the wide range of risk factors, emphasising the genetic background to cancer susceptibility and the genetic changes associated with progression to OSCC and highlighting clinical implications.     

清代四部温病著作防治温疫方药规律研究

文章对清代四部温病学著作雷丰的《时病论》、陈耕道的《疫痧草》、熊立品的《治疫全书》、王士雄的《霍乱论》防治温疫的药物进行了整理统计及分析,总结了其防治温疫的用药规律及治疗特色。研究认为四部著作中选方数量、用药味数、用药频率等方面虽略有差异,但其防治温疫的医学思想具有共同的特点,即立足祛邪、重视扶正、气运变化与温疫发生相关。研究结果能为临床治疗及预防温疫类传染病提供重要参考资料。     

“红丝带关爱中心”在艾滋病患者护理服务中的作用

目的探讨"红丝带关爱中心"在艾滋病患者护理服务中的作用。方法为患者建立健康电子档案,实施网络和电话健康咨询、心理咨询、行为干预、健康教育及法律援助等服务。结果提高了患者的满意度(P0.01),减少了艾滋病的传播(P0.01)。结论 "红丝带关爱中心"在艾滋病护理服务中深化了优质护理服务,减少了艾滋病的传播。