行为干预对糖尿病患者健康相关行为的研究

目的观察行为干预对糖尿病(diabetesmellitus,DM)患者健康行为的影响。方法将本科收治172例DM患者作为目标人群进行健康教育,建立目标人群管理档案,进行目标人群健康行为干预,比较教育前后相关行为的改变。结果DM患者10项健康行为和10项危险健康行为有明显改观,统计学检验干预前后差异显著P<0.01。结论通过行为干预,有效的使DM患者完全遵从医嘱合理用药,完全依从健康行为,从而减少危险行为的发生。     

慢性非特异性溃疡性结肠炎中医研究述评

本文通过对古典医籍及近１０年文献有关慢性非特异性溃疡性结肠炎的资料分析，认为本病的证候特点与中医病名“休息痢”相符，病机归纳为脾虚为发病之本，湿热为致病之标，血瘀为局部病理变化，治疗方面得出了健脾益气化湿、活血化瘀解毒、托疮祛腐生肌等方法是治疗本病之关键的结论，提出分期治疗本病的思想，认为提高近期治愈率、降低复发率及做好癌前监测是今后研究的努力方向。     

幼年型强直性脊柱炎5例诊治分析

幼年型强直性脊柱炎（Juvenile ankylosing spondylitis）不同于成人型强直性脊柱炎的脊柱椎间盘、纤维环韧带骨化融合和骶髂关节破坏,而主要表现为髋膝等外周大关节不对称性破坏所致的反复发作性肿痛,而腰背部及骶髂关节痛不明显。     

医源性胆管损伤的诊治体会

目的探讨手术中胆管损伤后即时手术和再次手术处理的方法。方法回顾性分析1984年5月-2003年11月经作者手术或参与手术21例的临床资料。结果术中即时发现并处理6例。其中，成功4例，术后狭窄再次手术治愈1例，处理结果不满意1例。术后处理15例，均择期行胆肠吻合治愈。结论术中处理结果与损伤程度和胆管横径大小密切相关。术后因各种原因导致胆管狭窄者应行胆管空肠吻合术。     

儿童幽门螺杆菌感染的诊断和治疗

幽门螺杆菌（H．pylori）感染主要发生在儿童期，儿童期许多消化系统疾病，如慢性胃炎、消化性溃疡等与H．pylori感染密切相关，并可能与成年后胃癌的发生相关。H．pylori感染还可导致儿童缺铁性贫血。H．pylori感染主要经“口-口”或“粪-口”以及“胃-口”途径从人到人传播，社会经济因素对H．pylori感染的影响是主要的。胃镜活检胃黏膜细菌学检查是诊断H．pylori现症感染的“金标准”，粪抗原的测定和^13C-尿素呼气试验可用于诊断和评价疗效。质子泵抑制剂（PPI）加两种抗生素的三联疗法是目前最佳治疗方案，抗生素耐药的不断增加给治疗带来了困难．儿童H．pylori感染对大环内酯类药物的耐药高于成人。     

Does the Child Behavior Checklist juvenile bipolar disorder phenotype identify bipolar disorder?

BACKGROUND: A profile of Child Behavior Checklist(CBCL) T-scores>or=70 on the attention problems, aggression, and anxious/depressed subscales has been proposed to identify juvenile bipolar disorder(JBD). We tested this hypothesis in a population-based sample. METHODS: Data for this analysis come from a birth-records-based twin sample having semi-structured interview and CBCL data (N=1,346). We compared prevalence of DSM-IV psychiatric disorders and suicidal behaviors in CBCL-JBD and non-CBCL-JBD subjects. Twin modeling assessed genetic and environmental contributions to CBCL-JBD. Associations with DRD4 and DAT1 were examined using chi-square tests. RESULTS: The prevalence of CBCL-JBD was 2.5%. No subjects with CBCL-JBD met criteria for bipolar or other mood disorders. CBCL-JBD subjects had more oppositional defiant disorder (ODD), conduct disorder(CD), and attention deficit hyperactivity disorder(ADHD). The CBCL-JBD profile was uncommon in these disorders. CBCL-JBD subjects more frequently endorsed suicidal behaviors. The CBCL-JBD profile was heritable and associated with the number of DAT1 9-repeat 3' untranslated region alleles. CONCLUSIONS: The CBCL-JBD phenotype does not correspond with a semi-structured interview assessment of JBD. ADHD, CD, and ODD are common in children with CBCL-JBD but do not account for the profile. Increased suicidal behaviors indicate substantial impairment in CBCL-JBD subjects.     

Differences between conduct disordered and normal control children in their tendencies to escalate or neutralize conflicts when interacting with normal peers

The behavior of conduct disordered (CD) children was compared with normal control (NC) children in interaction with normal peers. Dyads consisting of a) a CD child and a normal peer and b) an NC child and the same normal peer as in a) were observed. CD boys were less able than NC boys to neutralize incipient conflicts. Hitherto most behavioral studies of CD boys have concentrated on their tendency to escalate conflicts but have paid very little attention to their difficulty in neutralizing conflicts.     

Applications of magnetic resonance spectroscopy to diagnosis and monitoring of mitochondrial disease

Magnetic resonance spectroscopy (MRS) can now be performed on routine high-field clinical magnetic resonance imaging systems. Over the last decade it has provided several useful insights into the pathophysiology of mitochondrial disorders. More recently, the feasibility of applications to clinical diagnosis and monitoring have been demonstrated. Exciting new work suggests that carefully supervised physical conditioning in conjunction with sodium dichloroacetate administration can markedly enhance both biochemical measures of aerobic metabolism and functional performance of patients with mitochondrial myopathies.

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Sommario La risonanza magnetica spettroscopica (MRS) può oggi essere effettuata di routine in apparecchi clinici di risonanza magnetica. Nell'ultima decade essa ha fornito importanti informazioni nella patofisiologia dei disordini mitocondriali. Più recentemente sono state dimostrate le sue possibilità di applicazione nella diagnosi clinica e nel monitoraggio di pazienti neurologici. Nuovi ed interessanti studi suggeriscono che un allenamento attentamente supervisionato in congiunzione con trattamento con dicloroacetato è capace di migliorare i parametri biochimici e la performance di pazienti con miopatie mitocondriali.

     

抗磷脂抗体对妊娠的影响

自身免疫性疾病或免疫功能异常影响妊娠，在自身免疫疾病中，抗磷脂综合征（antiphospholipid syndrome APS）占了一定比例。本文就抗磷脂抗体的性质进行详细阐述。血栓形成是APS的主要病理基础和突出临床表现，随着研究深入，APA对早孕期滋养细胞的影响越来越受到重视，而APA导致不良妊娠结局的作用机制，目前仍有争论。本文还介绍了APS最新的治疗进展，为今后的APS发病机制研究及临床治疗带来更多的启示。