癫痫的外科治疗

本文报告40例癫痫病人采用手术治疗。30例作了CT检查、脑电图检查,6例作脑电地形图检查,对手术定位有较大帮助。术中用脑皮层电图监测,有效地提高了癲痫源灶的切除率,手术有效者34例(85.0%)。作者还应用了胼胝体切开术,从病灶切除的病理所见,癫痫的外科治疗应引起神经外科的重视。     

The dental caries status and dental treatment patterns of 12-year-old children in Hong Kong

A randomly selected sample of 662 12-year-old Hong Kong children, 529 of whom were Southern Chinese and 133 non-Chinese, was clinically examined for dental caries. The DMFT values were 2.76 and 1.66 for the Chinese and non-Chinese children, respectively. The D component for the Chinese children was 2.12, while for the non-Chinese children it was only 0.45. Approximately 24.0% of the Chinese children had attended the dentist because they were in pain. Only 3.8% of the Chinese children had sought orthodontic or preventive treatment, compared with 24.0% of the non-Chinese children. Although these findings indicate the caries experience to be well below the FDI/WHO global goal for the year 2000, there is a great need to increase the level of dental awareness among Chinese children.     

γ线照后大鼠胃组织乙酰胆碱含量胆碱酯酶活性及平滑肌对乙酰胆碱反应性的变化

本文以大鼠为实验对象,观察了γ线8Gy照后胃组织内乙酰胆碱含量、胆碱酯酶活性及平滑肌对乙酰胆碱反应性的变化。结果表明,照后1/24～l天胃组织内乙酰胆碱含量明显下降,3天趋向正常,5天基本恢复至照前水平。胃组织的胆碱酯酶活性在照后l/24～5天基本无改变。在同一剂量照后1h,胃窦平滑肌对乙酰胆碱的反应与照前近似,l天后开始减弱,3天后明显下降,与正常相比有非常显著差异。     

不同雾化吸入方式对婴幼儿支气管肺炎治疗效果的影响

分析病区库房物资管理中存在的问题，主要有管理意识缺乏，物资领取与临床需求脱节，医疗物资分配和使用不合理，物资的保管、维护不当。应对措施：加强医疗成本管理意识；物资领取时注意计划性和灵活性相结合；库房物资使用时注意原则性和节约性相结合；库房物资规范存放，做好各类固定资产的维护、保养管理；健全病区库房管理规章制度；树立科学发展观。     

国产奎硫平合并舒必利治疗难治性精神分裂症

目的:了解舒必利合并国产奎硫平(启维)治疗难治性精神分裂症的疗效和安全性。方法:26例符合CCMD-Ⅲ精神分裂症诊断标准且临床判断属于难治性病人,予舒必利合并奎硫平治疗,疗程8周,分别在治疗前及治疗后进行阳性与阴性症状量表(PANSS)和不良反应状量表(TESS)评定。结果:合并治疗8周后总有效率65.3%。PANSS阳性、阴性及一般精神病理评分于治疗前后均有显著差异(P<0.01)。TESS总分治疗前后无显著差异(P>0.05)。副反应主要为肌张力增高、失眠、体重增加、静坐不能。结论:对于舒必利治疗反应不佳的难治性精神分裂症病人合并奎硫平治疗仍可取得较好的临床效果,安全性较高,耐受性及依从性好,可作为临床治疗难治性病人的方法之一。     

癌痛从痰论治探讨

癌痛是晚期癌症患者的主要症状之一,属于中医痛证范畴。痰是产生癌痛的重要中医病机,消痰法是治疗癌痛的重要方法。     

婴幼儿癫痫的外科治疗

目的探讨婴幼儿癫痫外科的手术意义。方法从2002-2005年有12例婴幼儿因海绵状血管瘤(4例)、发育不良神经上皮肿瘤(DNTs)(2例)、Sturge.weber综合征(1例)、半侧巨脑病(2例)、外伤后脑膜脑疤痕(1例)、脑脓肿疤痕组织(1例)、脉络丛乳头瘤(1例);由分别位于额(2例)、颞(4例)、顶(2例)、枕(2例)与额顶及颞顶(各1例)病变所致均为灾难性癫痫。当年龄在9—32(平均21.5)个月龄时做了病变及致痫灶切除/功能性大脑半球切除。癫痫开始于出生后5～20 (平均11.8)个月,每天或每周发作多次,抗痫药物治疗无效。患儿做手术评估是6—22(平均12.8)个月。3例患儿有偏瘫,7例显示有缓慢发展的认知功能减低表现。MRI、PET及V-EEG都证实了病灶及致痛灶。结果手术后无死亡及新的神经症状缺失。8例解除了癫痫(EngelⅠ级);2例罕有发作(EngelⅡ级);2例有值得的(worthwhile)改善(EngelⅢ级),7例认知功能也有改善,3例偏瘫者2例有改善。结论灾难性癫痫婴幼儿仔细选择手术病例,外科可以减轻、解除癫痫的疾苦。     

Deliberate hypotension in orthopedic surgery reduces blood loss and transfusion requirements: A meta-analysis of randomized controlled trials

PURPOSE: To determine if deliberate hypotension decreases blood loss and transfusion requirements in patients undergoing orthopedic surgery, a systematic review of all randomized trials addressing this issue was undertaken. METHODS: Electronic databases, citations lists and review articles were searched for potential articles. Relevant articles met the following inclusion criteria: English language, humans undergoing orthopedic surgery, deliberate hypotension used by any method, intraoperative blood loss measured as an outcome, and the trial methodology being randomized and controlled. Four outcomes were analyzed, including estimated blood loss, blood transfused, surgery duration, and quality of the surgical field. For all analyses, the random-effects model was used. RESULTS: Seventeen articles met the inclusion criteria. The surgeries studied included total hip arthroplasty (seven), orthognathic surgery (eight), total knee arthroplasty (one) and spinal fusion (one). A total of 636 patients were randomized across all studies. For blood loss, the overall weighted mean difference favoured treatment, with a savings of about 287 mL of blood [95% confidence interval (CI): -447, -127]. The mean differences also showed a statistically significant benefit for deliberate hypotension in reducing transfusion requirements (-667 mL of blood transfused; 95% CI: -963, -370). Deliberate hypotension was not shown to reduce the duration of surgery (-1.9 min of surgery; 95% CI: -7.2, 3.5) or improve surgical conditions (surgical field quality rating -0.5; 95% CI: -1.1, 0.2). CONCLUSION: This review provides some support for the use of deliberate hypotension in reducing blood loss and transfusion requirements in orthopedic surgery, but these results are tempered by the small sample sizes and poor methodological quality of published studies.     

南海某岛礁作业人员睡眠状况与身心健康状况关系的研究

目的 研究南海某岛礁作业人员睡眠状况与身心健康状况的关系。方法 由经过统一培训的医务人员连续91d每日逐人逐项当面调查、记录。其中的“指数”指标，采用视觉模糊评分法。结果 随着在礁时阃的延长，作业人员睡眠状况明显变差，其主要影响因素依次为值勤（28．73％）、情绪（20．09％）、多梦（10．16％）、噪音（8．86％）和气候（7．73％）等。睡眠状况与身心健康状况明显相关，相关系数7=0．937～0．980，P＜0．01；睡眠指数对身心健康状况各指标均有明显影响（P＜0．01），睡眠时间主要影响体能指数、健康指数、工作质量指数、工作积极性指数、注意力指数及情绪指数等（P＜0．05～0．01），对食欲指数、记忆力指数影响则不明显。结论 在岛礁期间，影响作业人员睡眠的主要因素是值勤和情绪，睡眠状况明显影响身心健康状况。