股二头肌腱囊肿压迫腓总神经一例

股二头肌腱囊肿压迫腓总神经一例马伟，孙涛，吴觉民患者男，４０岁，农民。因右窝发现肿块伴右足下垂１年，于１９９５年６月３０日入院。１年前病人发现右窝有－２ｃｍ×２ｃｍ肿块，无疼痛，病人反复按摩肿块，未见缩小，渐渐出现有足无力并下垂。入院时检查：跛行步态...     

久泄治验两则

一患,男,30岁。腹泻2年。西医结肠镜检查诊断:慢性结肠炎。便溏如水,日数行,面黄体倦,辨作脾虚泻。方用参苓白术散,不愈;渐见形寒恶风,腹中冷痛,改投四神丸,仍不愈。详查症形,述少腹处冷凝作痛,形若碗大,喜熨     

刘氏湿热清治疗温病湿热证的临床疗效观察及部分作用机理研究

本文观察了刘氏湿热清对25例温病湿热证的疗效,并设西药治疗作对照组,对两组患者的血液分析、血浆内毒素含量、红细胞免疫粘附功能等指标也进行了同步观察。结果表明:治疗组25例患者,治愈20例(80％)、显效2例(8％)、有效2例(8％)、无效1例(4％);对照组18例患者治愈13例(72.2％)、显效1例(5.6％)、有效2例(11.1％),无效2例(11.1％),两组疗效相当(P>0.05)。治疗后,湿热清组血浆内毒素含量比西药组明显降低(P<0.01),红细胞C_3b受体花环率明显升高,红细胞免疫复合物花环率明显下降(P<0.01)。上述结果提示刘氏温热清对温病湿热证有良好的治疗作用,其机理可能与其降低血浆内毒素水平,增强机体免疫功能有关。     

VVI起搏心电图中早搏特殊表现形式31例分析

目的分析31例VVI起搏心电图中早搏的特殊表现形式。方法回顾性分析31例植入VVI起搏器合并早搏特殊表现形式患者的心电图,并根据心律失常的类型进行分类。结果VVI起搏-房性早搏（PAS）二联律8例;VVI起搏-室性早搏（PVS）二联律18例;起搏-PVS-夺获三联律2例;VVI起搏与PVS形成显性、隐匿性二、三联律各1例;VVI起搏PVS折返径路内的双径路传导1例。结论正常窦性心律时的早搏的特殊反应方式均可在起搏心电图中出现,但隐匿性二、三联律及PVS折返径路内双径路传导十分罕见。早搏的反应方式必须受到起搏器的节律、类型及起搏器反应方式的影响。     

VVI起搏心电图中的室性融合波群

室性融合波群是心脏内同时存在两个独立的节律先后或几乎同时激动心室的不同部位,并完成整个心室除极,形成相互融合的QRS波群。植入起搏器的患者心腔内至少同时存在自身和起搏两个节律点,当两者频率相近时,则可能同时或先后激动引起心室除极,使心室除极波的形态既不同于单纯自身心律,也不同于单纯起搏节律,而形成了介于自身心律与起搏节律之间的第3种心室波,称为室性融合波群,当两个节律点频率非常接近时还可形成一系列连续的形态、电压各不相同的室性融合波群。VVI起搏器患者的心电图中室性融合波群更为常见,现分述如下。     

细辛脑注射液致不良反应文献回顾与原因分析

目的通过对近5年细辛脑注射液致不良反应报告的回顾性研究,探讨该药品产生不良反应的类型、规律及趋势。方法检索CNKI、维普期刊数据库与Google、百度等搜索引擎,统计细辛脑注射液致不良反应病例报告。结果共发现细辛脑注射液致不良反应报告128例,其中全身过敏样反应66例（过敏性休克34例）,消化系统损害27例,皮肤及其附件损害26例,其他不良反应9例,儿童患者发生不良反应的比例占87.5%。制剂处方中的吐温-80是导致其过敏性不良反应的主要原因。结论细辛脑注射液致不良反应引起高度重视,须尽快开展该药品的安全性研究工作。     

上海宝山地区60例慢性咳嗽患者生活质量评估

目的评估上海宝山地区慢性咳嗽患者的生活质量。方法选择2010年12月至2012年12月门诊慢性咳嗽患者60例,对照组为60例健康志愿者。慢性咳嗽组完成简明36项健康问卷（shortform-36healthsurvey,SF-36）、莱塞斯特咳嗽量表（Leicestercoughquestionnaire,LCQ）、对照组完成sF-36评估;48例慢性咳嗽患者经治疗后,再次完成了sF-36、LCQ量表。结果慢性咳嗽患者sF-36总得分低于健康对照组（P〈0．001）,其中以情感问题导致的角色受限（role—limitationsduetoemotionalproblems,RE）、总体健康（generalHealth,GH）和躯体健康问题导致的角色受限（role—limitationsduetophysicalhealth,RP）三个方面最突出。特异性治疗后,慢性咳嗽患者LCQ总分、生理领域、心理领域、社会领域得分较治疗前升高（P均〈0．01）。结论慢性咳嗽患者生活质量下降,特异性治疗后,患者生活质量明显改善。     

北京市男男性行为者安全套使用社会规范与无保护性肛交关系的研究

Objective To understand the prevalence of and factors associated with unprotected anal intercourse(UAI)among men who have sex with men(MSM)in Beijing.Methods Five hundred MSM were recruited for a survey using Respondent Driven Sampling (RDS)method, from September to October in 2009. A computer-assisted, interviewer-administered questionnaire was used to gather information including demographics, sexual behaviors and condom use social norms(a scaled number). Variables were evaluated by using RDSAT and SAS software.Results Mean age of the participants was 30.6 years, with 96.0% of them as Han ethnicity and68.5% having had at least high school or higher education level. 72.8% of them were unmarried, with 61.7% of them identified themselves as homosexual, 61.2% had ＞ 1 male partners in the past six months, and the prevalence of UAI was 42.0%. Significant bivariate predictors of UAI would include condom use social norms score, role for anal sex with male sex partner, number of male sexual partners in the past 6 months and amount of alcohol consumed. In multivariable analysis, UAI was associated with a higher condom use social norms score(AOR= 1.2, 95%CI: 1.1-1.3), receptive anal intercourse(AOR=2.0, 95%CI: 1.3-3.2)and drinking alcohol more than 3 times per month in the past 12 months(AOR=1.6, 95%CI: 1.1-2.5). Conclusion The prevalence of UAI was high in the MSM community in Beijing, suggesting that efforts should be targeting on how to make the condom use a social norm and being promoted.     

北京市男男性行为者安全套使用社会规范与无保护性肛交关系的研究

目的 了解北京市男男性行为者(MSM)无保护性肛交发生情况及其与社区安全套使用社会规范的关系.方法 2009年9-10月采用应答驱动抽样方法(RDS)在北京市MSM中开展调查,问卷采用计算机辅助调查员访谈式,内容包括人口学、性行为学特征及安全套使用社会规范,使用RDSAT和SAS进行统计学分析.结果 500名MSM平均年龄30.6岁,96.0%为汉族,高中及以上文化程度者占68.5%,72.8%未婚.61.2%最近6个月男性性伴数量＞1;42.0%的调查对象最近一次发生过无保护性肛交.多因素统计分析表明,差异有统计学意义的变量包括安全套使用社会规范计分低(AOR=1.2,95%CI:1.1-1.3),肛交中非主动角色(AOR=2.0,95%CI:1.3-3.2)和近12个月饮酒次数＞3次/月(AOR=1.6.95%CI:1.1-2.5).MSM社区安全套使用社会规范量表内部一致性检验克朗巴赫系数为0.93.结论 北京市MSM无保护性肛交行为发生率较高,应充分发挥MSM社区内社会规范的作用,减少无保护性肛交行为的发生.

Abstract：

Objective To understand the prevalence of and factors associated with unprotected anal intercourse(UAI)among men who have sex with men(MSM)in Beijing.Methods Five hundred MSM were recruited for a survey using Respondent Driven Sampling (RDS)method, from September to October in 2009. A computer-assisted, interviewer-administered questionnaire was used to gather information including demographics, sexual behaviors and condom use social norms(a scaled number). Variables were evaluated by using RDSAT and SAS software.Results Mean age of the participants was 30.6 years, with 96.0% of them as Han ethnicity and68.5% having had at least high school or higher education level. 72.8% of them were unmarried, with 61.7% of them identified themselves as homosexual, 61.2% had ＞ 1 male partners in the past six months, and the prevalence of UAI was 42.0%. Significant bivariate predictors of UAI would include condom use social norms score, role for anal sex with male sex partner, number of male sexual partners in the past 6 months and amount of alcohol consumed. In multivariable analysis, UAI was associated with a higher condom use social norms score(AOR= 1.2, 95%CI: 1.1-1.3), receptive anal intercourse(AOR=2.0, 95%CI: 1.3-3.2)and drinking alcohol more than 3 times per month in the past 12 months(AOR=1.6, 95%CI: 1.1-2.5). Conclusion The prevalence of UAI was high in the MSM community in Beijing, suggesting that efforts should be targeting on how to make the condom use a social norm and being promoted.     

植入起搏器死亡心电图3例分析

植入人工心脏起搏器患者的心电图是由患者自身心律与起搏心律共同构成。起搏脉冲发放后心肌能否应激取决于心脏自身状况,如心肌已失去应激能力,丧失收缩功能时,起搏器虽有脉冲发放,但不能激动心肌,因而心脏不能产生收缩。植入起搏器患者在临终时,由于心脏已失去应激和收缩功能,