病历书写缺陷更正方式探讨

目前病历书写缺陷的更正方式有3种：（1）在错误的字迹上划双线;（2）在计算机上删除原有记录,重新书写。计算机系统上保留或不留原有痕迹;（3）放弃原有纸质记录,重新抄写。这几种方式或存在页面不洁问题,甚至有的还存在法律纠纷的隐患。理想的办法是：针对病历书写的缺陷或错误,书写更正说明。说明原有的问题是什么,正确的内容是什么,这种方式即保持病历页面的整洁,又不会造成原有记录的丢失,更重要的是不易引发因更正病案书写缺陷而带来的纠纷。     

Prevalence of familial hypercholesterolemia in premature coronary artery disease patients admitted to a tertiary care hospital in North India

AimsThe prevalence of premature coronary artery disease (CAD) in India is two to three times more than other ethnic groups. Untreated heterozygous familial hypercholesterolemia (FH) is one of the important causes for premature CAD. As the age advances, these patients without treatment have 100 times increased risk of cardiovascular (CV) mortality resulting from myocardial infarction (MI). Recent evidence suggests that one in 250 individuals may be affected by FH (nearly 40 million people globally). It is indicated that the true global prevalence of FH is underestimated. The true prevalence of FH in India remains unknown.MethodsA total of 635 patients with premature CAD were assessed for FH using the Dutch Lipid Clinical Network (DLCN) criteria. Based on scores, patients were diagnosed as definite, probable, possible, or no FH. Other CV risk factors known to cause CAD such as smoking, diabetes mellitus, and hypertension were also recorded.ResultsOf total 635 patients, 25 (4%) were diagnosed as definite, 70 (11%) as probable, 238 (37%) as possible, and 302 (48%) without FH, suggesting the prevalence of potential (definite + probable) FH of about 15% in the North Indian population. FH is more common in younger patients, and they have lesser incidence of common CV risk factors such as diabetes, hypertension, and smoking than the younger MI patients without FH (26.32% vs.42.59%; 17.89% vs.29.44%; 22.11% vs.40.74%).ConclusionFH prevalence is high among patients with premature CAD admitted to a cardiac unit. To detect patients with FH, routine screening with simple criteria such as family history of premature CAD combined with hypercholesterolemia, and a DLCN criteria score >5 may be effectively used.     

基于M68H08系列MCU的血糖测试样片校正系统的设计与实现

研究并没计了基于M68H08系列MCU的血糖测试样片校正系统，该校正系统采用酶电极法和非线性校正技术检测血糖，这不仅方便厂家进行样片校正，而且为用户提供验证样片修正值的手段。     

对微菌落既定公式计数偏差的修正及其应用

本文试用对大肠杆菌菌液的不同浓度,进行系列微菌落计数分析。发现采用既定公式:DMSCC/ml=FWF×计数的总细菌数,计数后偏差较大。若用该数据进行常规平板倾注法和微菌落-酶联免疫吸附法(MC-ELISA)相关性比较,得R~2=-0.056。而用修正公式:DMSCC/ml=FWF×计数的总细菌数×1/菌液稀释倍数,得两法相关系数r=0.99936,经相关系数检验,P<0.01,说明修正正确。     

儿童血压测定中袖带所致误差及校正方法的探讨

用不同宽度袖带测定一组儿童血压,证实了袖带宽度可明显影响血压测得值的精确度,并由此推导出不适宜袖带测压值的校正公式。在另两组儿童血压测定中检验了该校正公式的有效性及可行性。血压校正公式的提出,使实施美国心脏学会建议的臂中点周径百分之四十为适宜袖宽的标准成为可能。血压校正公式应用简便,可在儿童医疗预防、卫生保健、特别是各种血压调查、科研协作中发挥积极作用。     

Correction of myopia and astigmatism using laser in situ keratomileusis

Patients and methods: In order to better define the potential advantages and risks of laser in situ keratomileusis (LASIK), we designed a prospective study including 73 eyes. Results: After 6 months, 62 eyes were examined. Myopia was corrected from –6.10 ± 3.12 (mean ± standard deviation) to + 0.04 ± 0.66 D, with 54 eyes (87.1 %) being within ± 1.00 D of emmetropia. Astigmatism was corrected from –1.07 ± 1.02 to –0.32 ± 0.89 D. Uncorrected visual acuity was 0.5 or better in 59 eyes (95.2 %) and 1.0 or better in 27 eyes (43.5 %) 6 months postoperatively. More than one line in best-corrected visual acuity was lost by 6 eyes (9.7 %), with most of these eyes being highly myopic. There was no change or a gain in lines in best corrected visual acuity in 42 eyes (66.1 %). Intraoperative complications arose in two eyes (2.7 %); in one eye, visual acuity was temporarily decreased. More treatments were performed in 7 eyes (9.6 %). Postoperatively, no haze, scars or central islands were detected. Patient satisfaction after LASIK was high: 97.3 % were pleased or very pleased with the result. Conclusions: In conclusion, LASIK is effective in the correction of myopia and myopic astigmatism. Although complications more frequently occurred in the correction of higher refractive errors, LASIK seems to be relatively safe compared with other refractive methods.      

The Beneficial Effect of Low Initial Dose and Gradual Increase of Erythropoietin Treatment in Hemodialysis Patients

Abstract: It is well known that the effects of human re-combinant erythropoietin (rHuEPO) are dose-dependent. However, when higher doses of rHuEPO are used, the frequency of the side effects also increases. The aim of our study was to analyze the hematologic parameters and blood pressure response in hemodialysis patients treated with low initial and gradually increased rHuEPO. Sixteen regular hemodialysis patients were treated with 3 times 20 U/kg/week of rHuEPO subcutaneously during the first month. Every fourth week the dose was increased by 3 times 20 U/kg/week if the hematocrit did not rise by 2%. If the elevation was 2% or more, the dose of the rHuEPO was not changed. Blood count and blood pressure were checked every week. The antihypertensive treatment was also reviewed weekly. The hematocrit increased significantly from the second week, and 11 patients achieved the target level (30%) between Weeks 8 and 24. Two patients reached the 30% hematocrit level between Weeks 2 and 8, and another 2 patients reached the target level between Weeks 25 and 28. There was 1 nonresponder. The average rHuEPO dose needed to achieve the target hematocrit was 56.3 U/kg/week. We did not observe significant changes in the mean arterial or diastolic blood pressure. It was necessary to increase the doses of anti-hypertensive drugs, namely nifedipine and captopril, to control blood pressure. Encephalopathy occurred in none of the cases. The low initial dose and the gradual increase of rHuEPO treatment were beneficial to the hemodialysis patients. Although the target hematocrit took longer to achieve, high blood pressure and encephalopathy were prevented by close monitoring and administration of suitable antihypertensive treatment.     

游离下鼻甲粘膜瓣修复鼻中隔术中穿孔

为２１７ 例鼻中隔偏曲患者行鼻中隔偏曲矫正术,９ 例术中出现鼻中隔粘骨膜对位性穿孔,经及时用游离下鼻甲粘膜瓣修复,其修复要点是（１）继续分离中隔穿孔周围粘骨膜,去除穿孔周围的偏曲骨质,以完成中隔矫正术,并扩大放置鼻甲粘膜瓣的空间;（２）取下鼻甲粘膜瓣较正常的部分,要略大于中隔穿孔的大创孔面积,光滑粘膜面可修整使之较为粗糙,以利粘膜瓣生长。８ 例修复成功,仅１ 例发生术后中隔穿孔。     

“L”型硅胶支架矫治单侧唇裂继发鼻畸形

目的 为了更好地修复单侧唇裂鼻畸形中鼻尖、鼻翼，鼻小柱的低平，塌陷，偏斜等畸形。方法 我们在纠正错位软骨的基础上，利用“L”型硅橡胶鼻模支架对单侧唇裂鼻病人进行了鼻尖部的加固和塑形。结果 自1996～2000年8月，选择性地治疗唇裂鼻病人20例，年龄16～21岁，经过3个月至4年的随访，获得满意的效果。结论 利用“L”型支架及软骨复位纠正单侧唇型鼻畸形的效果。明显优于单纯软骨复位的方法，简便易学，支架价廉，易修整，且可同时纠正鼻梁部的发育不良。     

小腿外伤后足趾屈曲畸形发生与疗效的相关因素分析

目的 统计不同小腿外伤致足趾屈曲畸形的发生率,探讨不同手术方式和手术时机对疗效的影响,及外伤后肌肉MRI表现与畸形发生的关系. 方法 1990年1月至2006年12月,采集小腿外伤病例1922例,502例患者于外伤后7～10 d行MRI检查.并发足趾屈曲畸形39例,男28例,女11例;年龄20～48岁,平均30.8岁.分别于畸形发生后3个月、3～6个月和6～18个月采用肌腱粘连松解及松解+肌腱延长两种方式矫正畸形.采用美国足与踝关节协会足趾关节功能评分法对矫正效果进行评定. 结果 39例全部得到随访,随访时间6～72个月(平均22个月),其中优18例,良15例,可4例,差2例,优良率84.62%.17例单纯行肌腱粘连松解术,复发2例;22例行松解+肌腱延长术,复发4例.畸形于6个月内矫正27例,复发5例,复发率18.52%;6个月以上矫正12例,复发1例,复发率8.33%.结论 本组小腿外伤后足趾屈曲畸形的发生率为2.03%,不同结构损伤,其发生率不同,以腓骨骨折最高,为3.38%.手术以单纯行肌腱粘连松解复发率为低.手术时机对预后有显著性影响,矫正手术宜在畸形发生后6个月以上进行.外伤后小腿<足母>长屈肌、趾长屈肌MRI信号的异常变化对足趾屈曲畸形发生的判断有一定的临床意义.