重庆市城市居民1991～2000年死亡损失生命年分析

目的：研究重庆市城市居民20世纪90年代疾病所致早死的生命损失。方法：用死亡损失生命年YLLs为测量单位，计算不同性别、不同社区的死因别标化YLLs率，及分析1991～2000年死因别标化YLLs率的变化趋势。结果：非传染性疾病标化YLLs率为42.58‰，占全死因的82.76%，其中，恶性肿瘤标化YLLs率为12.80‰，占30.06%，脑血管疾病标化YLLs率 6.62‰，占15.55%，呼吸系统疾病标化YLLs率5.77‰，占13.55%，心脏病标化YLLs率4.38‰，占10.29%；意外死亡标化YLLs率为7.59‰，占全死因的14.75%；传染病、妇科及围产期疾病标化YLLs率为1.28‰，仅占2.49%。在社区之间，死因别标化YLLs率存在明显差异。结核病和精神病标化YLLs率曾出现上升趋势。结论：非传染性疾病已成为该城市居民的主要疾病负担，结核病防治不能放松，精神卫生工作急待开展。     

妇女叶酸增补中需要关注的问题

妇女围孕期增补叶酸能够有效预防神经管缺陷等疾病的发生。随着对叶酸研究的不断深入，叶酸补充中出现了诸多问题。本文简要综述了叶酸在服用方式以及基础和临床研究中出现的值得讨论、已经引起关注和需要进一步研究探讨的问题，并提出了深入研究叶酸可能的发展趋势。     

Primary aspergillosis of the sphenoid sinus with pituitary invasion – a rare differential diagnosis of sellar lesions

Summary Aspergillosis belongs to the group of mycotic diseases of paranasal sinuses. The invasive forms, and particularly the fulminant forms, are potentially fatal. Isolated aspergillosis of the sphenoid sinus or the clivus is a difficult diagnosis, since the often misleading clinical manifestations of this rare disease develop late. These patients become apparent by neurological signs such as cavernous sinus syndrome, pseudotumor of the pituitary or the orbit. Diagnosis is often made intra-operatively or on histological examination. We report a case of invasive aspergillosis uniquely involving the sellar area revealed by clinical features suggesting a pseudotumor of the pituitary. Although such lesions are almost always seen in immune suppressed subjects, in our case, the patient was immune competent and had no past history of sinusitis. The question of whether, and when to perform limited or extensive surgery remains an issue for discussion, owing to the rarity of this disease honed by lack of experience. It depends on several factors: the kind of disease, the immunity, the subtype of invasive fungal sinusitis and the degree of tissue invasion.     

不同采血针对新生儿足跟采血成功率的影响

目的：探讨不同采血针在新生儿疾病筛查采血中的采血效果。方法：采用三种采血针分别对2126例（A组）、1786例（B组）、1471例（C组）新生儿进行足跟采血，比较其采血成功率。结果：A、B、C三组之间差异有统计学意义（P〈0．01）。结论：采用7号一次性注射针头采血（C组）可明显提高采血成功率。     

小儿输尿管开口异位的诊断和治疗(附22例报告)

目的 提高小儿输尿管开口异位的诊治效果。方法 总结22例输尿管开口异位患儿临床资料。男1例，女21例。年龄1个月～12岁，平均4岁。单侧17例，双侧5例。21例女童中，有正常分次排尿伴异常漏尿18例，完全持续性漏尿3例；1例男童有上尿路梗阻及泌尿系感染。异位开口于阴道14例、尿道4例、前庭3例、膀胱颈1例。结果 手术治疗20例，其中肾切除者11例、半肾切除者7例，术后漏尿症状消失，3例合并输尿管残端综合征；1例双输尿管膀胱再植术后仍有尿失禁；1例直肠化膀胱术无漏尿症状。结论 明确诊断，选择合理手术是小儿异位输尿管口治疗成功的关键。     

Periodontal conditions among the middle-aged and the elderly in Hong Kong

Abstract The aim of this study was to describe the periodontal conditions in 372 35–44-yr-old and 537 noninstitutionalized 65–74-yr-old Hong Kong Chinese who were examined clinically for loss of attachment, recession, probing depth, calculus, and bleeding after probing. Community Periodontal Index (CPI) data and treatment need indications were compiled from index teeth or their substitutes. The prevalence of loss of attachment varied considerably in both cohorts according to the definition of the threshold (≥6, ≥9, and ≥12 mm, respectively). The mean numbers of teeth with loss of attachment at the ≥6-mm threshold and at higher thresholds were small. In both age cohorts, about one-fifth of subjects had probing depths ≥6-mm, while al the ≥9-mm threshold only 2–3% were so affected. Although recession was an important component of loss of attachment in the younger cohort, in the older cohort the prevalence and extent of recession were greater than for probing depths at thresholds ≥4 mm. All subjects had one or more teeth with calculus, bleeding, or both, most teeth being so affected. Eighty-four of the 537 65–74-yr-old subjects were excluded either because of edentulousness or because extractions indicated for the remaining teeth would have rendered the subjects edentulous. The distribution of subjects according to their highest CPI score was remarkably similar for the two cohorts. No subjects in either age group were assessed as “healthy” (CPI code 0) or had “bleeding only” (code 1) as their highest score. While most subjects scored CPI code 2 or 3 us their highest score, only 17% of the younger and 15% of the older cohort scored Community Periodontal Index of Treatment Needs (CPITN) code 4. Differences in the mean number of sextants affected by CPI codes between the two cohorts were mainly due to a greater number of excluded sextants in the older cohort. CPI findings for 35–44-yr-olds differed little from those reported in 1984.     

浅谈对传染科护士素质的要求与体会

根据笔者在传染科病房工作中的体会,从六个方面针对传染科工作的特殊性和存在的共性分别阐述了传染科护士在工作中如何高标准、严要求自己,如何对病人做到到位的护理,旨在提高传染科病房的整体护理质量,从而把更多的实惠让利于患者。     

Comparative effects of plateletderived growth factor-BB and insulin-like growth factor-I, individually and in combination, on periodontal regeneration in Macaca fascicularis

Platelet-derived growth factor (PDGF) and insulin-like growth factor I (IGF-I) in combination have previously been shown to enhance periodontal regeneration. The objective of this study was to further characterize the biological effects of this combination of growth factors in non-human primates and compare the effects to those of each growth factor individually. Ligature-induced periodontitis was initiated in 10 cynomolgus monkeys. After periodontal lesions were established, surgery was performed, and either a methylcellulose gel vehicle or vehicle containing 10 μg each of either PDGF-BB, IGF-I or both PDGF-BB and IGF-I was applied to exposed root surfaces. Biopsies were taken 4 and 12 wk after treatment and the extent of periodontal regeneration was assessed by histomorphometry. At both 4 and 12 wk vehicle-treated lesions generally revealed minimal osseous defect fill (ODF) (8.5±2.1% and 14.5±5.7%, respectively) and new attachment (NA) (34.1±5.2% and 26.6±10.5%, respectively). IGF-I treatment did not significantly alter healing compared to vehicle in any parameter at both 4 and 12 wk. PDGFBB-treated sites exhibited significant (p<0.05) regeneration of NA (69.6±12.0%) at 12 wk; trends for PDGF-BB treatment effect were also observed in other parameters at 4 and 12 wk. although these increases were not statistically significant. Treatment with PDGF-BB/IGF-I resulted in 21.6±5.1 % and 42.5±8.3% ODF at 4 and 12 wk, respectively, and 64.1±7.7% and 74.6±7.4% NA at 4 and 12 wk, respectively (all significantly greater than vehicle, p<0.05). The results from this study demonstrated that: 1) IGF-1 alone at the dose tested did not significantly alter periodontal wound healing; 2) PDGF-BB alone significantly stimulated NA, with trends of effect on other parameters; and 3) the PDGF-BB/IGF-I combination resulted in significant increases in NA and ODF above vehicle at both 4 and 12 wk.