重质石油中含氮化合物的形态及分布分析Ⅱ．含氦杂环化合物的定性方法

探索了色谱保留值与质谱信息相结合的定性分析方法。用ＳＥ－５４柱代替ＳＥ－５２柱，选用六个多环芳烃化合物作为标准计算保留指数，从而改善了Ｍ．Ｌ．Ｌｅｅ保留指数的应用条件和范围；用文献值转换扩充了Ｌｅｅ的含氮杂环化合物保留指数表，并利用保留时间与沸点的关系作定性佐证。应用该法鉴定了重质石油样品子组分及萘油中的４６个含氮杂环化合物及其异构体，为质谱在异构体鉴定以及缺乏标样所产生的困难提供了可信、简便的定性鉴定方法。     

Evaluation by dental students of a communication skills course using professional role-players in a UK school of dentistry

This paper reports student (n = 180) feedback on the role-play teaching methodology used in behavioural sciences teaching at The School of Dentistry in Birmingham (UK). The feedback received on this well-established (since 1995) educational programme was collected via questionnaire (100% response rate), requiring Likert scale and free text responses. Generally students reported that they had enjoyed and valued the session. Over two-thirds (69.7%) of students rated the role-players as 'very real' and over three-quarters (78.9%) rated their feedback as 'very fair'. The data collected from this study will inform future curriculum development. Student feedback was very positive and demonstrated that the cohort (86% of all students studying in years 1, 2 and 3) found the use of professional role-players involved in behavioural sciences teaching to be both acceptable and valuable.     

Developing a Peer Review Process for Web-based Curricula

The World Wide Web creates new challenges and opportunities for medical educators. Prominent among these are the lack of consistent standards by which to evaluate web-based educational tools. We present the instrument that was used to review web-based innovations in medical education submissions to the 2003 Society of General Internal Medicine (SGIM) national meeting, and discuss the process used by the SGIM web-based clinical curriculum interest group to develop the instrument. The 5 highest-ranked submissions are summarized with commentary from the reviewers.     

惠州市结核病控制项目实施效果评价

目的 总结我市结核病控制项目实施效果和经验。方法 根据全市各县(区)上报的结核病报表和有关总结材料进行分析。结果 在项目实施期间发现涂阳病人7522例，治愈了7303例，涂阳病人登记率从1993年的8．2／10万提高到2001年的39．4／10万，初、复治涂阳病人治愈率从1992年的80．0％和81．8％提高到2001年的98．9％和96．2％。结论 我市结核病控制项目实施效果显，项目所取得的成功经验和技术策略对今后结核病控制可持续发展有着重要的指导作用。     

Clinical and Physical Evaluation of the Infertile Male: Testicular Measurement or Orchidometry/Klinische und physikalische Bewertung des infertilen Mannes: Hodenmessung oder Orchidometrie

Summary: For the quantitative determination of the testicular size or volume, two groups of apparatus are available: on the one hand, model testes, which are extremely valuable in longitudinal and cross-sectional studies during the period of pubescence, and on the other hand, measuring devices, with which the testicular dimensions can be specified. The latter instruments are helpful chiefly during the adolescent years and the diagnosis of problems surrounding fertility. The testicular volume can be calculated subsequently from the specific testicular measurements. The formula, for computing the volume of an ellipsoid, seems to be the most suitable for this purpose. Appliances also have been developed, which allow the largest (longitudinal) dimension (in mm) and the testicular volume (in cm3) to be read off simultaneously. A tonometer can be useful to quantitatively estimate the testicular consistency, which is a parameter of the testicular integrity at the level of tubular function (spermatozoa production).     

Zero-Order Release Formulation of Oxprenolol Hydrochloride with Swelling and Erosion Control

Zero-order release of oxprenolol hydrochloride was obtained by controlling the swelling and erosion of the matrix. This formulation involves only mixing of drug, hydroxypropylmethylcellulose (HPMC), and sodium carboxymethylcellulose (Na CMC) at the ratio of 1:0.4:1.6, respectively, and compressing the mixture directly into tablets. The in vitro release pattern from this optimized matrix tablet was reproducible. Accelerated stability studies revealed that the optimized formulation remains stable for an approximately 2-year shelf life. This sustained-release (SR) tablet was evaluated in dogs, and for comparison a conventional (CV) formulation was also given at the same dose level. Plasma oxprenolol levels were monitored by a sensitive and specific high-performance liquid chromatographic (HPLC) method. Significant differences in the pharmacokinetic parameters, i.e., lower C _max, higher values of t _max, MRT, AUC, and plasma concentration at 24 hr, and nearly constant plasma levels over 12 hr, indicated that the SR matrix tablet is superior to the CV rapid-releasing formulation. The in vitro release parameters and in vivo pharmacokinetics correlated well.     

病案质量问题与改进

病案作为记录医疗活动过程的重要载体,包含着各类丰富的信息。医疗服务质量评价有很多内容是通过病案实现的。作者分析了包括"三级医师查房"在内的20余项在病案中反映的医疗服务质量项目,指出影响质量判断的常见因素,并提出解决的对策与措施。     

用秩和比法对我院的10个公示病种医疗质量进行综合评价

目的对我院2005年度公示的10个病种进行医疗质量综合评价。方法采用秩和比法(RSR)进行统计分析。结果我院的10个公示病种被划分成4个医疗质量等级:老年性白内障、小儿支气管肺炎2个病种质量为优,急性阑尾炎、腹股沟疝(单侧)、子宫平滑肌瘤、剖宫产4个病种质量为良,胃大切、脑梗塞、急性心肌梗塞3个病种质量为中,脑出血1个病种质量为差。结论通过对综合指数秩和比(RSR)的计算并根据其值分级归档,反映出所研究病种之间存在着医疗质量高低的差异。控制和降低本院临床常见病种的医药费用,进行医疗全程连续性控制,为患者提供经济有效的医疗服务。     

肱骨髁间骨折的手术治疗及疗效评价

目的 探讨肱骨髁间骨折的手术方式并评价疗效。方法 1998年1月～2004年12月共手术治疗肱骨髁间骨折28例，进行随访分析。结果 28例中26例获随访，时间6个月～4年7个月，其中22例获2年以上随访。疗效评价参照casse‰。评分系统，优良率为65％。结论 骨折类型及手术方式直接影响预后。关节良好的复位和牢固的固定，以及术后早期积极的功能锻炼是得到良好疗效的保证。     

Retrospective review of the preoperative biliary and gastrointestinal evaluation for gastric bypass surgery

BACKGROUND: The purpose of this study was to analyze the frequency and results of preoperative biliary and gastrointestinal (GI) evaluation of patients undergoing Roux-en-Y gastric bypass (RYGB). METHODS: Retrospective review of the preoperative evaluation of 144 consecutive RYGB patients. RESULTS: Cholecystectomy had already been performed in 43 (30%) patients; 22% of those patients with an intact gallbladder had cholelithiasis. Ten patients (7%) had an upper GI x-ray (UGI), and 94 patients (65%) had an esophagogastroduodenoscopy (EGD). Abnormalities were found in 40% of the UGIs and 84% of the EGDs. A total of 96 patients (67%) were tested for Helicobacter pylori; 11% were positive. Twenty-one patients (15%) underwent preoperative colonoscopy; 48% were abnormal, but most of the abnormalities were not clinically significant. Three patients had barium enema x-ray, which was normal in all cases. CONCLUSIONS: The preoperative biliary and GI evaluation of bariatric surgery patients should include a routine ultrasound of the gallbladder. Routine preoperative EGD will detect a significant number of abnormalities that should be treated, but should rarely alter the bariatric surgical procedure or result in denial of bariatric surgery. Many abnormalities will be asymptomatic. Patients should be routinely screened for H. pylori and, if positive, treated before bariatric surgery. Lower GI evaluation should be performed selectively based on the patient's symptoms, physical findings, and guidelines for colorectal cancer and polyp screening.