醋酸曲安缩松注射液的一阶导数分光光度测定

采用一阶导数分光光度法测定醋酸曲安缩松注射液的含量，平均回收率为９９．８２％，ＲＳＤ为０．３９％。方法简便快速，结果满意。     

腹部多脏器损伤的救治

报告了腹部多脏器损伤１５８例的救治情况。致伤因素中交通事故和高空坠落伤占６７．０％，抢救存活１３２例，存活率８３．５％；死亡２６例，病死率１６．５％。作者分析了病死率与致伤暴力强、现场急救延误、就诊时间及受伤的脏器数的密切关系。作者认为院前救护、院内正确诊断、及时治疗、果断手术是抢救成功的重要环节；术中应仔细探查、止血，术后应注意防治多脏器衰竭的发生。     

胰岛素泵治疗与2型糖尿病第一时相分泌的研究进展

随着对糖尿病机理研究的深入，发现胰岛β细胞第一时相分泌，对糖尿病的发生、发展有重要影响，新诊断2型糖尿病患者早期予胰岛素泵治疗，模拟生理性胰岛素分泌方式，可改善第一时相分泌，促进胰岛β细胞功能的修复，利于糖尿病的治疗及预后。     

分级诊疗背景下多病共存患者就医机构选择行为及其影响因素研究

背景 近年来,国内针对多病共存患者在分级诊疗背景下就医机构选择行为的研究较少,研究多病共存患者的就医机构选择行为有重要的现实意义。目的 以分级诊疗为视角,分析多病共存患者就医机构选择行为及其影响因素,为进一步落实分级诊疗制度和合理配置医疗资源提供研究参考。方法 采用随机抽样法,选取2019-06-01至2020-01-01在上海市杨浦区中心医院医疗联合体（上海市杨浦区中心医院和上海市杨浦区定海、延吉、长白社区卫生服务中心）就诊的多病共存患者为研究对象。采用自设问卷对其进行调查,收集多病共存患者的一般资料,了解其对分级诊疗政策的认知情况及实际遵守情况、在不同疾病控制状况下至社区卫生服务中心首诊的意愿,以及其选择就诊医疗机构时考虑的因素等。采用二分类Logistic回归分析多病共存患者此次因病就医是否选择至社区卫生服务中心首诊的影响因素。结果 共发放1 100份问卷,回收有效问卷1 072份,有效问卷回收率为97.45%。1 072例多病共存患者中,老年（≥60岁）多病共存患者占85.07%(912/1 072)。624例（58.21%）患者表示知晓分级诊疗制度;940例（87.69%）患...     

Orthofix-微型外固定器治疗Bennett骨折31例

目的分析应用Orthofix-微型器治疗第一掌骨基底部Bennett骨折的临床疗效。方法收集2009年1月~2013年1月我院31例采用Orthofix-微型器治疗的第一掌骨基底部Bennett骨折患者。记录患者年龄、性别等基线资料,以及术后上肢臂、肩、手功能调查量表(Disabilities of the arm,shoulder and hand,DASH)评分,随访终末期采用指总关节活动度(Total action movement,TAM)评分。结果随访6~24个月,平均14.4月,手术时间为18~40分钟,平均29.1分钟,术中出血量10~30m L,平均14.5m L。术后3月、术后6月及终末期DASH评分之间比较,差异均有统计学意义(0.05)。随访终末期,其中26例解剖复位,5例骨折对线良好,TAM评分优22例,良7例,差2例。随访期间未发生桡神经浅支损伤、钉道感染等并发症。结论 Orthofix-微型外固定器治疗Bennett骨折操作简单、疗效满意。     

A new physical assay method for tobacco mosaic virus using a radioactive virus recovery standard and the first derivative of the ultraviolet absorption spectrum

A new physical assay method for tobacco mosaic virus is described which incorporates two improvements on previous procedures. Losses of up to 75% of virus during extraction are corrected by adding a trace of radioactive virus to leaf samples before homogenization, and determining percentage recovery of radioactivity in final virus preparations. Estimation of virus concentration in partially purified preparations is from the first derivative (dA/d lambda) of the ultraviolet absorption spectrum, using a pronounced signal from the tryptophan fine-structure absorption band at 285-293 nm. This method is highly insensitive to ultraviolet-absorbing contaminants, which cause errors and increase variation between replicates, when estimation of virus concentration is by normal measurement of ultraviolet absorption (A260). The method can be applied to at least some other viruses.     

Does Low FEV1 in Addition to Fixed Ratio and/or Lower Limit of Normal of FEV1/FVC Improve Prediction of Mortality in COPD? The NHANES-III-linked-mortality Cohort

Purpose

There is presently an ongoing debate on the relative merits of suggested criteria for spirometric airway obstruction. This study tests the null hypothesis that no superiority exists with the use of fixed ratio (FR) of forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) < 0.7 versus less than lower limit predicted (LLN) criteria with or without FEV1 <80% predicted in regards to future mortality.

"军字1号"工程使用前后病案首页质量对照统计分析

为探讨“军字1号”工程使用前后的病案首页质量变化,本文通过作者所在医院近八年病案首页的质量调查统计,对“军字1号”工程使用前后的病案首页质量作了详细的对照分析比较,为进一步加强“军字1号”工程中的病案首页质量管理提供经验。     

Fluid compartments of the embryonic environment

The exocoelomic cavity was probably the last remaining physiological body fluid cavity to be explored in the human embryo. Its unique anatomical position has enabled us to study the protein metabolism of the early placenta and secondary yolk sac and to explore materno-embryonic transfer pathways. The exocoelomic cavity forms inside the extraembryonic mesoderm alongside the placental chorionic plate and is now believed to be an important transfer interface and a reservoir of nutrients for the embryo. Maternal or placental proteins filtered in the extraembryonic coelomic cavity are probably absorbed by the secondary yolk sac which is directly connected with the primitive digestive system throughout embryonic development. Protein electrophoresis has shown that the coelomic fluid results from an ultrafiltrate of maternal serum with the addition of specific placental and secondary yolk sac bioproducts demonstrating that the exocoelomic cavity is a physiological liquid extension of the early placenta. The selective sampling of fluid from the exocoelomic cavity has also offered a novel approach to the study of drug and toxin transfer across the early human placenta and as a unique tool to explore embryonic physiology in vivo. Further investigation should include a comparison between the coelomic fluid values of a molecule and its quantifiable presence in decidual, placental and fetal tissues.     

Fetal heart rate and umbilico-placental Doppler flow velocity waveforms in early pregnancies with a chromosomal abnormality and/or an increased nuchal translucency thickness

Fetal heart rate, umbilical artery pulsatility index, end-diastolicflow,nuchal translucency thickness and placental thickness were recordedin 250 women with a viable singleton pregnancy undergoing chorionicvillous sampling for fetal karyotyping at 11–14 weeksof gestation. The fetal karyotype was normal in 210 cases andabnormal in 40, including 21 with trisomy 21, 13 with trisomy18, three with triploidy, two with monosomy X and one with trisomy13. A total of 52 fetuses with a normal karyotype had a nuchaltranslucency 3 mm and were considered separately. There wasa stable and significant increase in the mean fetal heart ratein trisomy 21 pregnancies compared to controls. No significantdifference was found for the other variables between the groups.In chromosomally normal fetuses with an increased nuchal thickness,the development of fetal heart rate and compliance of the umbilico-placentalcirculation were within the normal ranges. Some fetuses withtrisomy 18 or triploidy had an increased resistance to bloodflow in the umbilical artery, which was probably due to abnormalplacental development.