脑梗死OCSP分型和预后

目的了解脑梗死患者OCSP临床分型的构成及不同亚型与预后及复发的关系。方法采用回顾性队列研究,登记2002年1月~2005年6月第四军医大学西京医院神经内科确诊的617例脑梗死患者,按照OCSP标准分型并进行随访,分析各亚型与预后及复发的关系。结果OCSP各亚型构成比分变为:TACI占7.3%,PACI23.3%,POCI6.0%,LACI63.4%,分型与预后明显相关,TACI的预后最差,POCI和LACI预后相对较好,PACI次之,卒中复发与分型无明显相关。结论OCSP分型作为一种脑梗死临床分型方法,可以为脑梗死的预后判断提供参考依据。     

Association analysis of genes in the renin‐angiotensin system with subclinical cardiovascular disease in families with Type 2 diabetes mellitus: The Diabetes Heart Study

Aims Cardiovascular disease (CVD) is a major complication of Type 2 diabetes mellitus. The renin‐angiotensin system (RAS) and nitric oxide production are both important regulators of vascular function and blood pressure. Genes encoding proteins involved in these pathways are candidates for a contribution to CVD in diabetic patients. We have investigated variants of the angiotensinogen (AGT), angiotensin converting enzyme (ACE), angiotensin type 1 receptor (AT1R) and endothelial nitric oxide synthase (NOS3) genes for association with subclinical measures of CVD in families with Type 2 diabetes mellitus (T2DM). Methods Atherosclerosis was measured by carotid intima‐media thickness and calcification of the carotid and coronary arteries in 620 European Americans and 117 African Americans in the Diabetes Heart Study. Because of the role of these systems in blood pressure regulation, blood pressure was also investigated. Results Compelling evidence of association was not detected with any of the SNPs with any outcome measures after adjustments for covariates despite sufficient power to detect relatively small differences in traits for specific genotype combinations. Conclusions Genetic variation of the RAS and NOS3 genes do not appear to strongly influence subclinical cardiovascular disease or blood pressure in this diabetic population.     

成人护理专科教育护理学基础课堂教学设计的探讨

本文以“健康与疾病”为例，介绍了成人护理专科的护理学基础课堂教学设计。主要包括学生的情况分析、授课计划的制定、教学方法的选择、课程内容的优化、教学媒体和教学案例的运用等。同时，提出了调动学生的学习积极性、学生终身学习意识教育及医德教育等问题，从而使学生既能真正获得有用知识，又尽可能地通过考试取得学历文凭。     

Periodontal conditions in insulin-dependent diabetes mellitus.

In the present investigation, the frequency and severity of periodontal disease was assessed in a group of 71 patients with a mean duration of 16.5 years of insulin-dependent diabetes mellitus (IDD). The diabetics, aged 17-63 years, were under treatment at the diabetic outpatient clinic of the III Department of Medicine, University Central Hospital of Helsinki and at two clinics of the Helsinki Health Centre. Based upon their long-term medical records, 44 individuals were assessed to have a poorly controlled insulin-dependent diabetes mellitus (PIDD). At baseline of the present study, the PIDD group had a mean blood glucose level of 11.8 mmol/l and a mean glycosylated hemoglobin (HBA1) level of 10.7%. 27 subjects were classified as having a controlled insulin-dependent diabetes mellitus (CIDD). For each individual, site-specific recordings were made for the plaque index, gingival index, pocket depth, loss of attachment, bleeding after probing, gingival recession and radiographic loss of alveolar bone. Under similar plaque conditions, adult subjects with a long-term PIDD were found to have lost more approximal attachment and bone than subjects with a CIDD (P = 0.046, P = 0.019). These differences were not equally obvious when the subjects were classified according to the history of medical complications, such as retinopathies, neuropathies and nephropathies.     

腓骨支撑术在粉碎性胫腓骨折中的应用研究

目的：研究腓骨支撑术在粉碎性胫腓骨折中的应用价值。方法：回顾性分析1986年以来我院收治的粉碎性胫腓骨折55例临床资料。结果：全部病例均骨性愈合，总优良率95％。结论：腓骨支撑术在治疗粉碎性胫腓骨折中，损伤小，方法简单，易于操作，疗效好。     

肘关节后脱位并尺骨冠状突骨折9例临床疗效分析

目的 探讨肘关节后脱位并尺骨冠状突骨折的治疗方法。方法 总结2000年3月～2003年5月9例肘关节后脱位合并尺骨冠状突骨折患者的治疗经验，根据骨折类型分别采用内外侧入路对8例患者进行手术治疗，术后配合早期功能锻炼。结果 所有患者随访8～24个月，根据HSS评分标准，优5例（55.6%)，良2例（22.2%)，一般2例（22.2%)，优良率77.8%，无严重肘关节并发症发生。结论 选择恰当的手术入路和早期功能锻炼是提高该类骨折效果的关键。     

Association between age and clinical characteristics of renal cell carcinoma in adult patients

AIM: To study the association between age and clinical characteristics of renal cell carcinoma in adult patients. METHODS: Three hundred and ten patients with renal cell carcinoma were classified into three groups: or=60 years group. The clinical characteristics of the three groups were compared to define the association. RESULTS: The male/female ratio was 1.3/1, 2.0/1, 3.3/1 in the three groups, respectively, and a significant difference appeared when comparing the or=60 years group (P=0.010). The respective percentage of incidental renal cell carcinoma was 27.9%, 43.2%, 31.2%, and it was significantly higher in the 41-59 years group than the >or=60 years group (P=0.047). The incidence of poorly differentiated renal cell carcinoma decreased with age increasing (11.6% vs 5.2% vs 2.7%), and there was significant difference between the or=60 years group (P=0.038). In the 相似文献   

双侧内囊前肢毁损术治疗难治性强迫症疗效及随访研究

目的　对难治性强迫症进行双侧内囊前肢毁损术治疗 ,评定手术疗效并进行 2年随访 ,以进一步探索脑外科手术对难治性强迫症的疗效 ,并探讨手术治疗的良好适应症。方法　对 2 8例难治性强迫症患者进行双侧内囊前肢毁损术治疗 ,并分别在手术前、手术后二周、手术后三月、手术后六月、手术后一年、手术后二年进行Y BOCS、HAMA、HAMD量表评定及术后疗效评定。结果　 (1)强迫症患者手术后各期Y BOCS评分、HAMA评分与手术前比较均下降 ,有极显著差异 (P <0 .0 0 1) ;(2 )手术后各期Y BOCS的强迫思维评分均有明显下降 (P <0 .0 0 1) ,强迫行为在手术后 1年和 2年 ,与手术前比较无明显改变 (P >0 .0 5 ) ;(3)手术后 2年的总有效率为 5 3.5 % ,明显低于手术后 3月的总有效率 (P <0 .0 1)。结论　采用双侧内囊毁损术有相当的治疗效果 ,对于难治性强迫症患者可作为一种补充治疗手段 ;手术治疗对强迫行为的长期疗效较差 ,以严重的强迫思维为主的难治性强迫症患者为手术更好的适应症。     

龟羚帕安丸治疗血管性帕金森综合征疗效观察

目的 :观察龟羚帕安丸治疗血管性帕金森综合征 ( VP)临床疗效。方法 :治疗组 5 4例给予龟羚帕安丸和脉络宁注射液 ,对照组 36例单给脉络宁注射液 ,分别观察其综合疗效及改良UPDRS评分比较。结果 :治疗组总改善率 83.3% ,明显高于对照组的 5 8.3% ,P<0 .0 1。治疗组改良 UPDRS积分减少 ,明显优于对照组 ,P<0 .0 1。结论 :龟羚帕安丸治疗 VP确有一定疗效。     

复方胰岛素凝胶剂促进大鼠皮肤溃疡愈合的初步研究

目的:研究复方胰岛素凝胶剂对大鼠皮肤溃疡的促愈合作用,并探讨其可能的作用机制。方法:18只Wistar大鼠背部各制备4个皮肤溃疡模型,共复制溃疡72个,随机将溃疡分为复方胰岛素凝胶治疗组(A组)、凝胶基质对照组(B组)、空白对照组(C组)。以治疗后不同时间点各组溃疡面积、溃疡愈合速度及组织病理学检查评价修复效果。结果:在伤后头10天内,A组溃疡缩小最明显,愈合速度明显快于B组、C组。伤后14天,A组溃疡基本愈合,皮肤结构完整、上皮化较厚;而B、C组溃疡仍未完全愈合,皮肤结构不完整、上皮化较薄。结论:局部应用复方胰岛素凝胶剂对大鼠皮肤溃疡有促愈合作用。