退变性腰椎管狭窄症手术治疗的探讨

目的：探讨退变性腰椎管狭窄症的手术治疗。方法：对９４例６０岁以上患者进行分型和手术治疗。结果：将本病分为Ⅰ型（侧隐窝狭窄型）;Ⅱ型（中央管狭窄型）;Ⅲ型（混合型）。对Ⅰ型手术方式采用单侧或双侧椎板开窗,扩大神经根管或（和）摘除髓核;对Ⅱ型行半椎板或全椎板切除术;对Ⅲ型行全椎板切除术。结论：通过术后疗效观察和３年随访,根据分型的不同选择不同的手术方式,可达到较好的临床疗效     

Effects of air pollution on respiratory health of adults in three Chinese cities

The authors examined potential associations between air-pollution exposures and respiratory symptoms and illnesses of 4,108 adults who resided in 4 districts of 3 large, distinct Chinese cities. Data on respiratory health outcomes and relevant risk factors for parents and children were obtained via standardized questionnaires in the winter of 1988. (The effects in children were described previously.) The yearly averages of ambient levels of total suspended particles in the 4 districts for the years 1985-1988 differed greatly. The authors constructed logistic-regression models to assess the respiratory health parameters of parents of the children. The results revealed significant and strong effects, by district, on prevalence rates of cough, phlegm, persistent cough and phlegm, and wheeze for both the mothers and the fathers. In addition, the odds ratios increased as ambient total suspended particle concentration increased across the 3 urban districts. Other local within-city risk factors, however, may have confounded the total suspended particles-effects association, especially for asthma prevalence. Findings for adults were similar to those found for their children. A strong adverse effect of active tobacco smoking on the fathers' respiratory health was observed. The children appeared to be more strongly affected by passive smoking exposure received in their homes than their mothers.     

A claims data approach to defining an episode of care.

OBJECTIVE: To utilize health services research techniques in developing an episode of care using an administrative data set. This method is demonstrated for an episodic clinical condition, migraine. DATA SOURCES: Medicaid administrative data set of 3,372 patients with a diagnosis of migraine (ICD-9-CM 346.0, 346.1) in the state of Pennsylvania between May 1990 and March 1992. STUDY DESIGN: The duration of a migraine episode was measured by assessing the magnitude of resource utilization and the proportion of patients with charges in the period after the index migraine as compared to the period before the index migraine. A confidence interval (CI) was developed around each measure using bootstrap techniques. DATA COLLECTION METHODS: All charge data were extracted daily for a 113-day observation period surrounding each index migraine in order to observe the duration of impact of a migraine diagnosis on resource utilization. PRINCIPAL FINDINGS: The lower limits of both the 95% and 99% CIs for the difference in charges are greater than 0 for three weeks. The lower limits of both CIs for the difference in the proportion of patients with charges are above 0 for six weeks. CONCLUSIONS: Our analysis demonstrates that a health services research framework can be used to define an episode of care for a chronic disease category such as migraine. This method can be used to evaluate episodes of care for clinical studies of limited or episodic conditions and to complement clinical expertise in developing time horizons for clinical trials.     

全髋关节置换术后早期脱位发生原因探讨

目的：探讨全髋关节置换术后早期脱位发生原因,以指导预防和治疗。方法：统计１０１例患者的１１３侧全髋置换术临床资料,对其中发生早期脱位的７例患者进行治疗及随访观察。结果：脱位主要由术后搬动及康复锻炼不适当引起,保守治疗效果良好。结论：髋关节周围的组织完整是全髋关节术后稳定的主要因素之一     

慢性肾功能衰竭中医证型标准化研究探讨

本文对２次全国性慢性肾衰中医辨证分型标准进行了分析和总结,并按现行慢性肾衰辨证分型方案对４４４例患者进行证候学研究,列出了慢性肾衰中出现率高且具有鉴别诊断价值的症状及体征,并发现慢性肾衰尿毒症患者其气血阴阳虚损的积分值明显高于其它各期,提出现行方案的不足之处及有待改进的探讨意见     

慢性低浓度二硫化碳接触作业工人血脂的变化

对某化纤厂99名长期接触低浓度二硫化碳（CS2）作业工人和28名同厂非CS2作业工人的血脂进行流行病学横断面调查。结果发现：除接触组脂蛋白（a）［Lp（a）］浓度明显高于对照组外,其它血脂指标差别均无统计学意义;进一步通过多元逐步回归分析发现,长期低浓度CS2接触对Lp（a）的影响最大,二者呈正相关（r＝0．43,P＜0．01）。提示Lp（a）可能在CS2致脂质代谢障碍毒作用机制中起着重要作用。     

新生儿血镉浓度的性别差异

金属镉对生物体造成的危害早已被人们所认识。１９５５年日本富山神通川下游出现的“痛痛病”即是与人们食入含镉量过高的食物有关。据该地流行病学调查,患者多为４０岁以上的妇女［１,２］,说明女性对镉的危害性较为敏感。本文取长沙地区的新生儿脐血及母血进行血镉的...     

单导管射频消融治疗频发房颤的预激综合征

采用单导管射频消融法治疗１２ 例预激综合征（ Ｗ Ｐ Ｗ） 。１２ 例中８ 例有反复快速性房颤史,３ 例须用同步直流电复律,１ 例伴有晕厥。旁路分别为左侧８ 条,右后间隔２ 条,右后侧及右前间隔各１ 条,右侧者有１ 例并存１ 条左侧隐匿旁路。全部旁路一次消融成功。术中未诱发房颤。随访５ ～１７ 月未见复发。     

Bone age and linear skeletal growth of children with cerebral palsy

The aim of this study was to compare the linear growth of children with cerebral palsy (CP) with that of children without CP. The segmental lengths (humerus, ulna, femur, tibia, and spine), recumbent length, body weight, and bone age of 62 children with CP (age range 2.25 to 14 years, mean 7.13 years) were measured and compared with 68 children without CP (age range 1.50 to 12.67 years, mean 6.73 years). The results show that bone-age delay is common in children with CP (68% with a delay of more than 1 year). The linear growth of children with CP is similar to that of children without CP when bone age is used instead of chronological age. There is a strong correlation between segmental lengths and body height. Hence, this study favours using segmental lengths for estimating height in children with CP and using the comparison group as a reference for this purpose. Nutritional and non-nutritional factors on bone-age delay are discussed.     

联合内分泌治疗对前列腺和睾丸的影响

目的 探讨抑那通和缓退瘤联合治疗对正常前列腺,增生的前列腺（ＢＰＨ）和前列腺癌以及睾丸的作用。方法 对１６例接受联合内分泌治疗至少３个月且有治疗前后病理资料的前列腺癌患者的标本进行了系统的病理学检查。对内分泌治疗后的睾丸标本与同龄未接受治疗的进行对照研究。结果 １４例内分泌治疗后的前列腺标本２例未见残存癌灶,９例对治疗有明显的反应;３例对治疗反应差,治疗并未降低前列腺癌的病理分期。３例内分泌治疗后