浙江省宁波市手足口病经济负担调查研究

目的 评估宁波市手足口病经济负担。 方法 选取国家疾病监测信息报告管理系统中2011年宁波市报告的手足口病例,进行问卷调查和病历回顾,收集病例就医过程、相关费用和医疗保险等信息,估算手足口病例经济负担。 结果 共调查手足口病轻症病例106例,重症病例58例,死亡病例6例。2011年宁波市手足口病总体经济负担为3635.1万元,其中直接经济负担2181.2万元,间接经济损失1453.9万元。轻症、重症、死亡病例直接费用的中位数分别为1581、7419和21 533元,直接医疗费用的中位数分别为1431、6977和17 224元。参加至少一种医疗保险的病例占32.9%,医疗保险可为轻症、重症病例分别减轻38.2%和29.1%的直接医疗费用。 结论 手足口病给患者和社会均造成了较重的经济负担。提高医疗保险覆盖率、减少轻症病例住院比例将有助于减轻患者经济负担;控制和降低发病率,才能有效减轻手足口病对社会的经济负担。     

Arthrocentesis followed by intra-articular autologous blood injection for the treatment of recurrent temporomandibular joint dislocation

Temporomandibular joint (TMJ) dislocation is an excessive forward movement of the condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. This study was conducted to assess autologous blood injection to the TMJ for the treatment of chronic recurrent TMJ dislocation. Fifteen patients with bilateral chronic recurrent condylar dislocation were included in the study. Bilateral TMJ arthrocentesis was performed on each patient, followed by the injection of 2 ml of autologous blood into the superior joint compartment and 1 ml onto the outer surface of the joint capsule. Preoperative and postoperative assessment included a thorough history and physical examination to determine the maximal mouth opening, presence of pain and sounds, frequency of luxation, recurrence rate, and presence of facial nerve paralysis. Eighty percent of the subjects (12 patients) had a successful outcome with no further episodes of dislocation and required no further treatment at their 1-year follow-up, whereas three patients had recurrent dislocation as early as 2 weeks after treatment. Autologous blood injection is a safe, simple, and cost-effective treatment for chronic recurrent TMJ dislocation.     

瘘管切除合并内口结扎治疗肛瘘临床疗效分析(附74例报告)

目的观察瘘管切除合并内口结扎治疗肛瘘的临床疗效。方法选择74例内口在肛管齿线附近的肛瘘患者,采用将瘘管完全剥离切除,内口盲端结扎的方法手术的临床资料作回顾性分析。结果 74例患者全部一次性治愈,住院时间为12~23d,完全愈合时间为22~47d。痊愈后肛门外观无缺损、移位等改变,生理功能正常。3例患者早期有少许黏液泄漏,8~10周后症状消失,肛门无失禁。结论采用瘘管切除合并内口结扎的手术方法治疗肛瘘彻底,治愈率高,疗效确切,无肛瘘再次复发。     

更昔洛韦治疗小儿手足口合并病毒性脑炎122例疗效观察

目的：探讨更昔洛韦治疗小儿手足口合并病毒性脑炎的临床疗效。方法：122例患儿按入院顺序随机分为研究组和对照组，各61例，所有患儿均根据临床不良反应给予对症的物理降温、水电解质平衡纠正、补液、抗病毒治疗、脑神经营养等，研究组在此基础上加用更昔洛韦。结果：经治疗研究组患儿总有效率明显高于对照组，数据经统计学比较具有显著差异(P<0.05)。患儿退热时间比较两组间数据无显著差异(P>0.05)，研究组疱疹消退时间、神经体征缓解时间和平均住院时间均明显短于对照组，数据经统计学比较具有极显著差异(P<0.01)。结论：更昔洛韦不仅可达到更好的治疗效果，还有助于提高治疗效率、加快改善患儿的临床不良反应，适合于手足口病合并病毒性脑炎的临床治疗。     

New Applications of Photolabile Nitrobenzyl Groups in Polymers

This article describes progress in the author's laboratory in two new areas of photoresponsive polymers: (1) photochemical control of electrostatics, and (2) conjugated materials with photocleavable pendants. In both cases, incorporation of o‐nitrobenzyl esters (NBEs) imparts this photoreactivity. NBE‐derivatized, ring‐opening metathesis polymerization (ROMP)‐derived polycations form positive photoresist layer‐by‐layer (LbL) films that dissolve in base upon irradiation. NBE‐derivatized conjugated oligomers show photoactivated fluorescence, whereas NBE‐substituted polythiophenes are negative photoresists due to photolysis of solubilizing alkyl chains.     

手足口病患儿临床护理路径应用效果的评估

目的 评估临床护理路径(CNP)在儿科手足口病(HFMD)患儿护理中的应用效果。方法 2018年9月—2019 年 9月,选择4 个月～5 岁确诊为HFMD的230例患儿为研究对象,将其随机分为对照组和观察组,各组115例,2组患儿在临床治疗和对症处理的基础上,对照组患儿给予常规护理,观察组则采用CNP护理,观察指标包括症状改善及住院时间、焦虑水平、依从性、监护人HFMD知识掌握率与健康行为率、临床有效率、护理满意度等;采用t检验、χ2检验对观察指标进行统计分析。结果 观察组体温恢复(2.98±0.46)d、皮疹消退(3.82±0.54)d、溃疡愈合(4.69±0.72)d和住院时间(4.85±0.87)d,均显著短于对照组的(3.41±0.51)d、(4.90±0.46)d、(5.06±0.81)d、(5.52±0.99)d (P＜0.05);观察组焦虑水平(48.61±6.15)分,明显低于对照组的(55.53±6.59)分(t=8.233,P＜0.05),而依从性却显著高于对照组(χ2=7.495,P＜0.05);知识掌握率及健康行为率,观察组较对照组获得明显改善(P＜0.05);治疗有效率和护理满意率,观察组高于对照组(95.62% VS 86.09%,93.91% VS 80.87%,P＜0.05)。结论 在儿童手足口病护理中,采用CNP模式,可行有效,值得借鉴和推广应用。     

Comparison between burning mouth syndrome patients with and without psychological problems

The purpose of this study was to compare clinical and socio-demographic characteristics between burning mouth syndrome (BMS) patients with and without psychological problems. Of 644 patients with symptoms of oral burning, 224 with primary BMS were selected on the basis of laboratory testing, medical history, and psychometric tests: 39 with psychological problems (age 62.5 ± 11.5 years) and 185 without psychological problems (age 58.4 ± 11.4 years). Comprehensive clinical and socio-demographic characteristics, including psychological profiles and salivary flow rates, were compared between the two groups. No significant difference in sex ratio, duration and diurnal pattern of symptoms, unstimulated whole saliva flow rate, or marital status was found between the groups. The patients with psychological problems had a significantly higher mean age, reduced stimulated whole saliva flow rate, and lower level of education than those without psychological problems. The patients with psychological problems also displayed higher rates and greater severity of various types of BMS-related symptom in most parts of the oral mucosa, higher rates of stress-related symptoms, and greater difficulties in daily activities. The severity of taste disturbance was the factor most significantly correlated with the level of psychometry. In conclusion, psychological problems in BMS patients are associated with an aggravation of BMS symptoms.