腹腔镜手术治疗中重度内膜异位症的术后用药

目的　探讨中重度内膜异位症腹腔镜手术治疗后 ,加用内分泌治疗的必要性以及副作用。方法　 1 9位患者术后不用药 (A组 )、 1 9例加用人工合成孕激素治疗 (B组 ) ,1 8例促性腺激素释放激素激动剂(GnRH -a)治疗 (C组 ) ,比较三组患者术后复发、妊娠结局及用药副作用情况。结果　A组 1 5 8%复发 ,B组2 6 3%复发 ,C组 1 7 0 %复发 ,三组差异无显著性 (P >0 0 5 )。三组不孕患者妊娠情况差异无显著性 (P >0 0 5 )。B组 7例患者未完全闭经 ,C组全部闭经 ,B组及C组闭经时间分别为 (4 4 0± 2 3 7)d及 (4 0 0± 1 3 6 )d ,复潮时间分别为 (4 8 7± 2 6 6 )d及 (5 8 1± 1 7 4 )d ,两组间差异无显著性 (P >0 0 5 ) ,但B组患者闭经及复潮的发生更加不确定。B组患者以高雄激素症状为主 ,5例患者服药后声音变低钝 ,C组患者以低雌激素所至围绝经期征候为主 ,均于停药后恢复。结论　对于有生育要求的患者 ,手术者若能彻底地清除盆腔内膜异位病灶 ,术后可不用药。 6～ 1 2个月后未妊娠者 ,考虑用药及助孕治疗。孕激素类药物使用前应充分交代该药的副作用 ,特别注意特殊职业的患者     

Endogenous urinary steroids in premenopausal women with uterine leiomyomas.

OBJECTIVES: To study the effect of endogenous steroids on the presence of uterine leiomyomas. METHODS: Urine samples of 27 premenopausal women with leiomyomas and 25 age-matched healthy premenopausal women were collected. The concentration of estrogens and androgens in the urine samples of the two groups were determined using a gas chromatography mass spectrometer and the two groups were compared. To study metabolic changes in patients indirectly, the concentration ratios of precursor metabolite to product metabolite of the two groups were also compared. RESULTS: Urinary concentrations of 17beta-estradiol, 5-androstene-3beta, 16beta, 17beta, triol, 11-keto-ethiocholanolone, 11beta-hydroxy-androsterone, 11beta-hydroxy-etiocholanolone, THS, THA, THE, alpha-cortol and beta-cortol were significantly higher in patients than in controls. The concentration ratios of 17beta-estradiol/estrone and 11/beta-hydroxy-ethiocholanolone/11beta-hydroxy-androsterone increased in patients. CONCLUSIONS: The presence of uterine leiomyomas correlates with an increase in urinary concentrations of estrogens and androgens, and it appears to be caused by a decrease in patients' metabolism of steroids.     

注射用苄星青霉素的局部用药安全性评价

目的评价国产注射用苄星青霉素的局部用药安全性。方法采用过敏试验、肌肉刺激试验考察注射用苄星青霉素的局部安全性。结果注射用苄星青霉素过敏反应与进口对照品相同,肌肉刺激试验符合要求。结论国产注射用苄星青霉素在该实验条件下是安全的。     

控制乳腺癌住院费用的探讨

目的:通过对315份乳腺癌病例的住院费用进行分析,阐述实行乳腺癌单病种最高限价控制中遇到的主要问题及解决途径。方法:利用EXCEL数字处理系统从年龄、平均住院日和治疗方式3个方面对乳腺癌住院费用进行分析。结果:乳腺癌住院费用主要和治疗方式有关,3种治疗方式人均医疗费用差别很大。结论:控制乳腺癌的住院费用,可采用缩短住院日、控制抗生素药物的使用和对化疗用药进行规范等方法进行控制。     

手术治疗中晚期胃癌126例报告

目的研究分析胃癌围手术期处理及并发症预防。方法本组126例,男84例,女42例,年龄34岁￣79岁,平均64岁,术前行特殊准备,纠正贫血、低蛋白血症,进行CRIS分级及FEV1测定。选择时机行胃空肠Roux-en-Y吻合手术治疗。结果临床治愈123人,死亡3人,并发症:切口感染8例,切口裂开6例,心肌梗死1例,十二指肠残端瘘1例,吻合口瘘2例,肺炎1例,并发症发生率15.0(%19/126)。结论①术前充分纠正贫血、低蛋白血症、水电解质紊乱,对心肺疾病者行CRIS分级评定和FEV1测定是保证手术成功的要点。②手术原则上行根治性切除,减少瘤负荷,以Roux-en-Y术式为佳。③术后输入端充分减压,输出端适时肠内营养,并严格心肺功能监测,合理应用抗生素,可望降低死亡率。     

计划生育服务机构医疗废弃物处理的调查研究

目的调查由计划生育技术操作而产生的医疗废弃物是否得到正确处理。方法采用随机抽样方法抽取本省45个县(市)级以下乡镇计划生育服务站(所)工作人员,以问卷调查的形式对调查内容进行统计学分析。结果使用过的医疗废弃物6%~60%回收,6%~33%丢弃,6%~73%烧毁,6%~93%填埋。结论应加强对计划生育技术服务人员对医疗废弃物处理管理等相关知识及操作方法的培训,严格按照规定对医疗废物进行处理。     

The design of a cervical vertebra titanium plate-interbody fusion cage

Objective： To study the biomechanical feature of a newly designed cervical vertebra internal fixation device and its clinical applications. Methods： Some functional spinal units were fixed respectively with titanium plate, fusion cage and new device designed by ourselves, then a controlled biomechanical study including flexion, extension, torsion and lateral bending was performed and the results were analyzed. Results： As to the mechanical performance, fusion cage showed poor performance in extension test and so did the titanium plate in the distortion test. However, the new device showed good performance in every test. Conclusion： Both simple titanium plate fixation and simple fusion cage fixation have biomechanical defaults, but they are complementary. The titanium plate-interbody fusion cage avoids the defaults and has specific advantages.     

Age transition of tuberculosis patients in Taiwan, 1957-2001.

BACKGROUND: The incidence of tuberculosis (TB) has been falling in many developed countries; however, there is a trend of an increasing proportion of TB among the elderly. The aim of this study was to evaluate the age transition of patients with TB in Taiwan from 1957 to 2001. METHODS: Data on the number of TB cases and patient age were collected from the National Tuberculosis Registry for three different 5-year periods: 1957-1961, 1977-1981, and 1997-2001. The distribution of TB cases in these three different periods was analyzed. RESULTS: The age distributions of TB patients were different among the 1957-61 (n = 26,000), 1977-81 (n = 31,363) and 1997-2001 (n = 71,447) groups. During the 1957-61 period, the most common age group was 25-44 years (50.9%). During 1977-81, the most common age group was 45-64 years (44.9%). In 1997-2001, the most common age group had shifted to people aged 65 years or older (43.7%). For the whole period from 1957 to 2001, after adjusting for age shifts in the general population, the proportion of TB patients had significantly increased in persons 65 years or older, slightly increased in persons aged 0-14 years, and decreased in the 15-24, 25-44, and 45-64-year-old age groups. For the period 1977-2001, age-specific registered case rates increased with age. CONCLUSION: The age of TB patients in Taiwan showed a rising trend from 1957 to 2001. A high index of suspicion and prompt investigation of elderly patients with signs and symptoms characteristic of TB may allow earlier diagnosis and treatment.     

宫颈癌术前放射治疗

手术和放疗是子宫颈癌主要治疗手段。局部晚期即预后不良型巨块状宫颈癌及淋巴结转移是影响可手术治疗宫颈癌预后的主要因素。目前,有许多研究认为,术前放疗可以减少肿瘤局部复发,提高存活率。1腔内为主的术前放疗对于ⅠB2期和ⅡA期宫颈癌,肿瘤直径>4cm,具有手术指征的患者,术前应以腔内放疗为主,用以缩小肿瘤,减小肿瘤体积,利于子宫旁及阴道旁的切除,获得切除边缘最宽的无瘤边缘,同时降低肿瘤细胞活性及术中播散,减少局部复发,提高存活率。中国医学科学院肿瘤医院长期以来对ⅠB2期和ⅡA期宫颈癌,肿瘤直径≥4cm,通常给予术前腔内放疗,肿瘤…     

从我院药品盘点工作的改进浅析医院药品的管理

运用医院电脑信息系统的盘点程序来进行药品盘点工作,使盘点准确率大大提高,为药剂科完成实时库存的管理打下了扎实的基础