Drug use frequency among street-recruited heroin and cocaine users in harlem and the bronx before and after September 11, 2001

We determined if illicit drug use frequency changes after a disaster by comparing drug use frequency in two street-recruited samples of heroin and cocaine users, ages 15–40 years. The users were interviewed between July 11 and November 11 and divided into before- and after-September 11th groups for analysis. The before and after groups were similar in the mean number of days of drug use per month (sniff cocaine 6.8 days vs. 9.4 days, respectively, P=.17; snorted heroin 13.9 vs. 14.0, respectively, P=.96; smoked crack 16.9 vs. 15.6, respectively, P=.96; and smoked marijuana 17.5 vs. 15.3, respectively, P=.36) and in the proportion of daily users: sniffed cocaine 10% versus 17%, respectively (P=.28); snorted heroin 47% versus 40%, respectively (P=.91); smoked crack 33% versus 37%, respectively (P=.68); and smoked marijuana 47% versus 40%, respectively (P=.41). Among street-recruited heroin and cocaine users in Harlem and the Bronx, the frequency of drug use did not increase following the events of September 11, 2001. Dr. Factor is from the Division of Prevention Research and Analytic Methods in the Epidemiology Program Office at the Centers for Disease Control and Prevention and is assigned to     

北京地区某医院神经内科住院医疗绩效分析

目的通过对比2012年与2011年研究医院神经内科DRG相关指标,评价其住院医疗绩效改进。方法以BJ-DRG分组方式,运用病例组合指数（CMI）、时间效率指数、费用效率指数等指标对神经内科的出院病例进行分析。结果研究医院神经内科CMI值由2011年1.10降至2012年1.06,时间效率指数由1.02改善至0.94,费用效率指数由1.52改善至1.31。结论该医院神经内科CMI变化与北京地区相关病种构成变化有关,时间与费用资源消耗进一步改善。     

低场磁共振DWI技术与常规MRI扫描对超急性脑梗死的诊断灵敏度的比较

目的 探讨低场磁共振弥散加权成像(DWI)技术与常规MRI扫描对超急性脑梗死的诊断价值差异。 方法 选择2014年4月至2015年3月期间收治的临床疑诊为脑缺血病例78例, 分别采用低场磁共振DWI技术与常规MRI扫描技术进行检查, 评价两种检查技术对超急性脑梗死的诊断灵敏度。 结果 低场磁共振DWI诊断超急性脑梗死的灵敏度为100.00%(72/72), 而常规MRI扫描的诊断灵敏度仅为5.56%(4/72), 可见采用低场磁共振DWI技术的诊断灵敏度显著高于常规MRI扫描技术。 结论 低场磁共振DWI技术应用于超急性脑梗死的诊断中, 可有效提高其诊断灵敏度, 其效果显著优于常规MRI扫描, 值得在临床上推广使用。     

Period and birth-cohort effects on age of first phencyclidine (PCP) use among drug users in New York City, 1960 to 2000

PURPOSE: The aim of the study is to determine period and birth-cohort effects in the early initiation of phencyclidine (PCP) use in drug users in New York City (NYC). METHODS: We analyzed data collected from two surveys of street-recruited drug users in NYC. We used survival analysis and proportional hazards modeling to assess period and birth-cohort effects on risk for early initiation of PCP use. RESULTS: Of 787 participants, 292 (37.1%) had used PCP by the age of 23 years. Before 1987, there was a greater risk for initiation of PCP use through the age of 23 years (hazard ratio [HR] = 34.77; 95% confidence interval [CI], 21.45-56.36). Proportional hazards modeling showed that those born in the 1971 to 1975 birth cohort compared with those born in 1976 to 1980 had a lower risk for initiation of PCP use through age 23 years (HR = 0.58; 95% CI, 0.37-0.91). Other significant predictors of PCP use by age 23 included white race and having been in a juvenile detention center. CONCLUSIONS: There are period and birth-cohort differences in the likelihood of early initiation of PCP use. Changes in drug culture and social norms may influence the likelihood of initiation of PCP use. This may have implications for interventions aimed at slowing the nationwide increase in use of PCP.     

急诊应用多个腹部管状皮瓣治疗多指毁损伤

目的观察急诊应用多个腹部管状皮瓣治疗多指毁损伤的疗效。方法 2006年5月～2010年12月我院急诊收治5例15指手指毁损伤的患者,均应用游离植骨及多个腹部管状皮瓣治疗,观察手术效果及术后处理情况。结果所有皮瓣均成活,术后随访4～6个月。皮瓣感觉恢复：S0级3例,S3级2例。手功能评定：优1例,良3例,差1例。结论应用游离植骨及多个腹部管状皮瓣治疗多指毁损伤对供区损伤小、操作简单、伤指功能恢复较满意。     

Retinal Vascular Caliber and Age-related Macular Degeneration in an Indian Population from Singapore

Purpose: To examine the association between retinal vascular caliber and early age-related macular degeneration (AMD) in an Indian population.

Methods: A total of 3112 Indian participants aged ≥40 years from the population-based Singapore Indian Eye Study who had data available on retinal vascular caliber measurements and AMD status were included. Retinal arteriolar and venular calibers were measured from digital photographs using computer-assisted software according to a standardized protocol. Images of the macular region were graded according to the modified Wisconsin age-related maculopathy grading system. Right eyes were selected for analyses. Binary logistic regression models were used to assess the association, adjusting for age, sex, systolic blood pressure, total cholesterol, random blood glucose, body mass index, and the companion retinal vascular caliber.

Results: A total of 107 participants (3.4%) were diagnosed with early AMD. Neither arteriolar nor venular caliber was related to AMD. For early AMD, the age-, sex-, and companion retinal vascular caliber-adjusted odds ratio (OR) per standard deviation (SD) decrease in arteriolar caliber was 0.95 (95% CI 0.84–1.31; p?=?0.671), and per SD increase in venular caliber was OR: 0.96 (95% CI: 0.77–1.20); p?=?0.714. No trend was found after categorizing retinal vascular calibers into quartiles. Multivariate adjustment and stratified analyses did not alter these results.

Conclusion: Retinal vascular calibers were not related to early AMD among Indian participants. These findings differ from those of several previous studies performed in Caucasian and Asian populations.     

全麻气管插管患者术后咽喉疼痛预防最佳证据总结

目的 总结全麻气管插管患者术后咽喉疼痛预防的最佳证据,为预防术后咽喉疼痛提供循证依据.方法 运用循证护理的方法,检索相关数据库建库至2020年8月针对围手术期咽喉疼痛预防的临床决策、推荐实践、最佳实践信息册、指南、证据总结、系统评价、专家共识.结果 共纳入18篇文献,从咽喉疼痛评估、插管策略、预防药物、套囊管理、拔管管理方面总结20条最佳证据.结论 临床医护人员可通过最佳证据的临床转化及应用来减少全麻气管插管患者术后咽喉疼痛发生率和严重程度,促进患者康复.     

苏黄止咳胶囊对于慢性阻塞性肺疾病急性加重期患者的临床疗效

目的:探讨苏黄止咳胶囊治疗慢性阻塞性肺病急性加重期的临床疗效。方法:选取2014年9月至2015年9月河南大学附属郑州市第一人民医院收治的老年慢阻肺急性加重期患者90例为研究对象,随机分为观察组和对照组,各45例。对照组患者给予常规治疗,观察组患者在常规治疗的基础上,每天口服苏黄止咳胶囊,1.35 g/次,3次/d,8周为1个疗程。在疗程结束后,进行12个月以上的随访观察。结果:随访期间,观察组与对照组比较,复发次数和复发率明显降低(P0.01);观察组的FVC、FEV1、FEV1/FVC、MVV均明显升高,RV、RV/TLC均明显降低,与治疗前和对照组比较,差异均有统计学意义(P0.05);观察组的血清免疫球蛋白IgG、IgA、IgM水平,以及CD3~+、CD4~+、CD4~+/CD8~+水平均明显升高,与治疗前和对照组比较,差异均有统计学意义(P0.05);另外,观察组的生命质量评估表得分明显降低,6 min步行距离明显提高,与治疗前和对照组比较,差异均有统计学意义(P0.05)。结论:苏黄止咳胶囊口服可以提高慢性阻塞性肺病患者的肺功能,免疫功能,生命质量,减少慢性阻塞性肺病的复发再入院次数和复发率。