破坏性心境失调障碍的诊断与治疗的思考

概述：美国精神障碍诊断与统计分册第5版新增一个诊断类别为破坏性心境失调障碍,但是临床实践中对此认识仍然较为有限。因此,本文就该诊断类别的由来、诊断要点、治疗以及对临床实践的启示作一介绍,供临床参考。     

抬眉切眉联合眶脂去除术的手术方式与效果

为了改善上睑皮肤松弛、眉下垂及眼角鱼尾纹的状况或文眉后的并发症,抬眉切眉术成为修复这些缺陷的方案之一,同时对部分求美者上睑臃肿进行了处理。作者自2004年1月至2011年6月,对220例求美者施行抬眉切眉术,其中50例抬眉切眉联合眶脂去除手术,取得较满意效果。现报道如下。     

颅内埋藏电极脑电图监测在顽固性癫癎中的定位价值（1例报道并文献复习）

本院于2012年5月对1例顽固性癫癎患者行颅内埋藏电极术并行视频脑电图监测,定位后行手术治疗,取得了较满意的效果,现具体报告如下。     

盐城市大丰区家庭医生开展签约服务 实现多方共赢

目的：通过对大丰区家庭医生签约服务现状、主要做法、推进措施进行调查分析，总结经验，向全国农村地区推广。方法：访谈法、现场调查。结果：家庭医生签约服务切实可行，医改落地、成效明显、赢得民心、政府满意。结论：在政府主导下，家庭医生签约服务是解决村医工作待遇和农民健康服务需求之间矛盾的很好方式。     

鼻用激素联合抗白三烯药物治疗儿童阻塞性睡眠呼吸暂停低通气综合征

目的探讨鼻用激素联合抗白三烯药物治疗儿童阻塞性睡眠呼吸暂停低通气综合征的治疗效果。方法选取2013年6月‐2015年12月在该科就诊行多导睡眠监测并确诊儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的儿童40例,治疗前后对40例患儿进行儿童OSAHS疾病特异性生活质量调查(OSA-18)以及血清C反应蛋白(CRP)检查,并给予患者鼻用激素联合抗白三烯药物(内舒拿+顺尔宁)治疗8周,治疗后半年后复查多导睡眠监测(PSG)检查、OSA-18及血清C反应蛋白检查。结果 (1)患者治疗后呼吸暂停低通气指数(AHI)、血氧饱和指数明显改善,治疗前后比较差异有统计学意义。(2)治疗后OSA-18评分降低,治疗前后比较差异有统计学意义。(3)治疗后血清C反应蛋白较治疗前降低,治疗前后比较差异有统计学意义。结论鼻用激素联合抗白三烯药物治疗对儿童OSAHS的保守治疗有效,能明显改善患儿的缺氧情况及呼吸暂停指数,并能改善患儿的生活质量,减少不必要的手术治疗。     

67例开放性手外伤患者术后感染的原因分析及护理对策

手外伤是外科常见的急性损伤疾病,如伤口污染严重,大量微生物侵入感染部位导致创面愈合缓慢,可严重影响患者手部功能,甚者会危及生命.本研究分析了2015年1月-12月三峡大学仁和医院开放性手外伤术后感染的原因,并提出相应的护理对策,现报告如下.     

A Multicentre Comparative Clinical Study of Three Types of IUD（Eight：Year Follow up）

The Stainless steel ring(SSR), VCu200 and TCu220C were in randomized comparison for eight years in a cohort of 4,490 subjects covering 16 centres in 9 provinces and municipalities. The follow-up rate at the end of the eithth year was 90.33%. The cumulative continuation rates were 47.06 per 100 women at the end of the eighth year for SSR,54.05 for VCu200 and 61.14 for TCu220C. The cumulative pregnancy rates for VCu200 and TCu220C were 10.35 and 8.94 per 100 women respectively, significantly lower than 24.14 for SSR. There were significant differences in eight-year expulsion rates among SSR(21.69%), VCu200(13.05%) and TCu220C(7.48%). The removal for bleeding and/or pain was the lowest in SSR; and no significant differences were found between VCu200 and TCu200C. but the rate ws getting higher in VCu200 at the end of the eighth year than in TCu220C. The discontinued use of lUD for desire to become pregnant in rural area was extremely higher than in urban area. The risk of pregnancy and expulsion was in association with the types of lUD in this study, age at insertion, previous use of IUD and pregnancy frequency prior to insertion. The risk of pregnancy and expulsion for VCu200 and TCu220C was significantly lower than that for SSR. Failure risks were associated with age at insertion, the types of IUD in this study and pregnancy frequency prior to insertion, and failure risk in SSR was still higher than in VCu200 and TCu220C at the end of the eighth year. The study revealed that TCu220C was of good long-term safe ty, efficacy, and acceptability.     

500例腹泻患者病原性弧菌调查

本文报导了海口港地区500例腹泻患者病原性弧菌调查结果。共检出各种病原性弧菌75株,检出率为15％。其中主要为副溶血性弧菌、溶藻弧菌、OI群霍乱弧菌,分别占检出总数的46.7％,22.7％及21.3％。还托出了非OI群霍乱弧菌、河弧菌等。作者就本项调查对开展腹泻疾病监测工作的重要意义提出了讨论。     

大网膜移植修复头皮肿瘤切除后缺损

头皮恶性肿瘤的基本治疗方法是外科手术切除。对广泛头皮损害并已向深部侵犯的病例切除后的重建,是一个十分重要的问题。现将经治的病例报道如下。 病例介绍 例1男,51岁。因左顶部头皮外伤后溃疡不愈合8年,明显扩大半年,于1983