Childhood Desmoplastic Fibroblastoma (Collagenous Fibroma) with a 12-Year Follow-up

We report the first case of a childhood desmoplastic fibroblastoma (collagenous fibroma). The tumor was located in subcutaneous tissue of the left buttock in a 5-year-old boy. No recurrence has been observed after 12 years, the longest follow-up available. Received September 19, 1997; accepted January 5, 1998.     

Long-Term Outcome of the GORE EXCLUDER AAA Endoprosthesis for Treatment of Infrarenal Aortic Aneurysms

Purpose

To evaluate long-term outcome of GORE EXCLUDER AAA Endoprosthesis (W.L. Gore & Associates, Inc, Flagstaff, Arizona) for elective treatment of infrarenal aortic aneurysms and to evaluate performance of different generations of the device.

Pocket-sized spirometer for monitoring bronchial challenge procedures

SUMMARY. Diagnosis of occupational asthma is verified by inhalation challenge testing when frequent monitoring of peak expiratory flow (PEF) or forced expiratory volume in 1 s (FEVj) is needed. FEV₁ measurements also allow frequent monitoring of changes in small airways. For the follow-up of lung function of suspected occupational asthma, a reliable, personal and mobile device is needed. We studied the accuracy of a pocket-sized spirometer, Micro Plus Spirometer (MP), compared with our former combination of two devices, i.e. the values of forced expiratory volume in 1 s (FEV₁) with those measured with the Vitalograph bellow spirometer (V); and the peak expiratory flow (PEF) values with the values obtained with a Wright PEF meter (W). In healthy control subjects, the values of FEVj obtained with Micro Plus correspond well to those obtained using a bellow spirometer (r= 0–97) and the mean difference (MP-V) was -0–06 1 irrespective of the mean FE V₁ value. W gives smaller PEF values than the MP; the mean difference in PEF (MP-W) was 44 1 min^-1, but the values increased linearly with increasing flow. The poor relation between PEF values might be based on the low reliability of the Wright device. In patient follow-up, the FEVj values measured with MP and V showed a good correlation (r= 0–99). The PEF values in patients increase linearly measured with W vs. MP with increasing flow values. In conclusion, we found the pocket-sized spirometer a handy and useful device for monitoring bronchial challenge procedures in patients with suspected occupational asthma. The number of exhalations during the challenge test follow-up is lessened when FEV₁ and peak expiratory flow (PEF) can be measured simultaneously.     

弹簧圈栓塞颅内动脉瘤的远期MRA随访研究

目的:探讨磁共振血管成像(MRA)在颅内动脉瘤弹簧圈栓塞后远期随访的可行性。方法:应用3D时间飞跃法MRA(3D TOF-MRA)对38例患者用弹簧圈栓塞3年以上的38个颅内动脉瘤进行扫描,并同期进行数字减影血管造影(DSA)检查。以DSA结果为标准,对MRA图像显示的动脉瘤的残留及载瘤动脉通畅情况进行分析。结果:38个动脉瘤中,DSA证实稳定33个,复发5个,载瘤动脉通畅36例,闭塞2例;MRA发现动脉瘤稳定32个,复发6个,载瘤动脉通畅34例,闭塞4例。MRA判断动脉瘤残留的敏感度、特异度分别为84.6%、92.0%;判断动脉瘤复发的敏感度、特异度分别为80.0%、93.0%;判断载瘤动脉是否通畅的敏感度、特异度分别为94.4%、100%。结论:3D TOF MRA是长期随访栓塞后颅内动脉瘤的有效、可靠的方法,但需进一步积累经验。     

预见性护理在类风湿关节炎门诊随访患者中应用的效果观察

目的：探讨预见性护理在类风湿关节炎（RA）门诊随访患者中的作用.方法：将110例RA门诊随访患者随机分为对照组50例和观察组60例,对照组接受常规护理,观察组接受心理、药物不良反应、关节功能锻炼、日常生活保健四项预见性护理,分别于随访3、6个月后比较2组患者疗效的负性因素差异及RA病情缓解情况.结果：观察组随访6个月的负性因素均少于对照组（P〈0.05~P〈0.01）;随访3、6个月,观察组心理抑郁状况、类风湿关节炎疾病活动性评分改善均明显优于对照组（P〈0.01）.结论：预见性护理降低了RA患者负性因素影响,保证了治疗顺利进行,提高了治疗质量.     

骨关节炎软骨细胞凋亡率的实验研究

目的检测和分析髋关节骨关节炎中软骨损伤轻重部位的软骨细胞凋亡率。方法关节软骨组织切片分别进行HE染色，番红O-固绿染色，Mankin评分评价软骨损伤程度，TUNEL方法检测软骨细胞凋亡率。结果关节软骨损伤重的部位的Mankin评分值及软骨细胞凋亡率均高于软骨损伤轻的部位。结论软骨细胞凋亡率与骨关节炎软骨损伤程度相一致，说明细胞凋亡可能是骨关节炎软骨损伤的机制之一。     

慢病管理在临床科研中的作用

随着慢性疾病发病率、致死率增高,造成社会经济负担巨大,慢病管理已成了全球关注的焦点。传统门诊急性诊疗模式不太适应慢性病的特点,为慢病科研的开展造成了困难。而慢病管理属于防治慢性疾病的一种新模式,为患者提供全面的管理,保证患者依从性,以达到促进健康、延缓进程、减少并发症、延长寿命、提高生活质量等目的,同时对临床科研的开展,促进科研成果的临床转化有良好的促进作用,或许将成为未来诊疗慢性病的新模式。     

急诊静脉溶栓治疗急性脑梗死临床观察

目的：了解急诊溶栓治疗急性脑梗死患者的院内延迟时间及不同治疗时间的治疗效果。探讨缩短病人院内延迟时间的方法及溶栓治疗的有效时间窗，方法：将80例急性脑梗死患者随机分为两组，每组40例，急诊溶栓组经CT或MRI确诊后立即应用尿激酶静脉溶栓治疗，住院溶栓组则在住院后进行。结果：急诊溶栓组病人来诊至溶栓治疗开始的平均时间为58min，发病6h内接受溶栓治疗者19例（47．5％），住院溶栓组来诊至溶栓治疗开始的平均时间为120min，发病6h内接受溶栓治疗者12例（30％），两组治疗前后神经功能缺损积分比较有显著性差异，组间比较亦有显著性差异（P＜0．05），发病6－48h内溶栓仍有效，结论：急诊尿激酶静脉溶栓治疗急性脑梗死可缩短院内延迟时间，减轻神经功能缺损程度。     

糖尿病护理门诊患者失随访影响原因的研究

目的:调查糖尿病护理门诊患者失随访原因。方法:自某三级甲等医院护理门诊系统中筛选6个月未按时随访的203例患者为研究对象,电话调查患者对随访的主观认识和未按时随访的原因。同时抽取规律随访患者91例作为对照,电话询问对随访的主观认识。分析患者客观资料,与失随访与否作相关性回归分析。结果:患者对随访的主观态度(OR=60.67)、患者独自随访能力(OR=0.05)、随访路程耗时(OR=1.03)、并发症严重程度(OR=0.26)与失随访存在相关性,具有统计学意义。结论:具有失随访特征的患者对于护理门诊随访耐受性较差,应针对该人群探讨新的方式。