仁术健胃颗粒逆转胃癌前期病变的临床研究

目的观察仁术健胃颗粒对胃癌前病变的逆转作用。方法将１２０例符合诊断标准的胃癌前期病变患者,随机分为仁术健胃颗粒治疗组８０例和胃复春对照组４０例进行临床疗效观察。结果①综合疗效：治疗组总有效率为９１．２５％,对照组为７５．００％,经统计学处理,差异有显著性（Ｐ〈０．０５）;②治疗组胃镜及对萎缩、肠化、异型增生的疗效分别为７１．２５％、７７．５０％、７９．４９％、８８．４６％,对照组为５２．５０％、６     

树立新观念 搞好高校教材工作改革

社会主义市场经济必然要求高校教材走向市场。教材管理者、学校领导和师生都必须树立新观念。坚持社会效益首位前提下的双重效益观念是搞好主校教材工作改革的关键     

肾小球轻微病变型肾病综合征并发特发性急性肾衰临床分析

目的 :探讨肾小球轻微病变 NS并发 IARF的病理特征、治疗效果及预后。方法 :回顾性分析 12例肾小球轻微病变 NS并发 IARF患者的临床特征、病理结果、治疗及预后情况。结果 :本组 12例病理示肾小球病变轻微 ,肾小管间质病变较广泛。 10例肾功能恢复正常、2例好转 ,肾衰恢复或好转的平均时间为 2 2 .4± 15.3d;8例 NS缓解 ,时间为 4 0 .5± 2 0 .7d。结论 :肾小球轻微病变 NS并发 IARF可能为肾小管间质的亚致死性损伤所致 ,兼顾 PNS和 ARF两个环节的治疗 ,预后良好。     

生前与死后伤的区别——用免疫组化法检测损伤组织中的免疫球蛋白G

目的 :研究损伤组织中的免疫球蛋白 G(Ig G)的分布以区别生前与死后伤。方法 :卵白素—生物素过氧化物酶复合物技术 (ABC法 ) ,直接用辣根过氧化物酶标记单一特异性抗体 (直接法 )检测人体生前与死后损伤皮肤组织中的 Ig G。结果 :生前损伤标本均阳性 ,死后损伤标本均阴性。应用本方法可以检测极短时间 (<1 0 min)内死亡的生前伤。钝器伤 Ig G阳性反应分布范围比锐器伤广。结论 :应用 ABC法、直接法的免疫组化技术检测人体损伤皮肤组织中的 Ig G比较简便 ,该方法适用基层推广应用。     

益气养阴活血法治疗糖尿病性周围神经病变

临床筛选了糖尿病性周围神经病变患者 57例 ,对比观察益气养阴活血法结合西药治疗与单纯西药治疗的疗效。结果 :益气养阴活血法结合降糖药治疗糖尿病性周围神经病变的总有效率及显效率均较后者明显升高。能明显改善其神经传导速度 ,减少自发电位、增加多项电位等。提示 :养阴活血法具有促进周围神经侧支再生修复的功能。     

Dyadic reciprocal associations between self-efficacy and planning predict sedentary behaviour

Objectives

There are two alternative hypotheses regarding bidirectional associations between self-efficacy and planning in predicting health behaviour change: self-efficacy may establish planning (cultivation hypothesis) or planning may enable the formation of self-efficacy (enabling hypothesis). This study investigates the order in which these two social cognitions are linked in adult–adult dyads in the context of sedentary behaviours (SB).

Design

A longitudinal study with 4 measurement points, spanning 8 months.

Methods

A total of 320 dyads (age: 18–90 years) were enrolled. Dyads included a focus person (who received the recommendation to reduce SB and intended to change their SB), and their partners, who were willing to support the focus persons and intended to reduce their own SB as well. Data were collected at Time 1 (T1), Time 2 (1 week later, T2), Time 3 (T3, 2 months after T1) and Time 4 (T4, 8 months after T1). SB was measured with accelerometers at (T1 and T4). Mediation models with individual and dyadic reciprocal effects were tested with path analyses.

Results

Only one indirect effect was found: A higher level of partners' SB reduction-specific self-efficacy at T2 was related to the focus person's more frequent planning to reduce SB at T3, which, in turn, predicted lower SB time among partners at T4.

Conclusions

The findings provide partial support for the cultivation model (self-efficacy prompting planning) and for dyadic reciprocal associations in the context of SB time reduction among adult dyads.     

Change in process: bringing about change in health care through action research

• ? A 2-year action-research project aiming to facilitate the management of change was carried out in a district general hospital.
• ? Hospital managers and senior ward nurses had very different views concerning the source of challenges and problems within the hospital organization.
• ? A case-study of nurses' experience of change at ward level was produced as part of the diagnostic phase of the action research.
• ? The results of the case-study indicated that general managers and professionals had different agendas for change hut that there is common ground between them.

     

Changes of nursing organization in a surgical department: effects on work satisfaction and quality of care

• ? The aim of the study was to evaluate the effects of an organizational change programme in a surgical department in Sweden (the introduction of modular nursing) on the nursing staffs perception of job satisfaction and quality of care, and to identify factors which promote or hinder this organizational change.
• ? Planning and implementation of the change programme took about 1 year and comprised structural changes and staff training.
• ? Assessments of job satisfaction and quality of care were made immediately before, and 1 year after, implementation of the change programme. Data were collected from the staff of two wards.
• ? Virtually no statistically significant changes were found when looking at the department as a whole. However, considerable differences were noted between the two wards, particularly in the following areas: relationships with colleagues, identification and commitment, and perceived quality of care.
• ? The quality of the interpersonal relationships, and the leadership of the wards' head nurses, appeared to be crucial determinants of the outcome.

     

6岁以下小儿头面部烧伤后体积变化的研究

为探讨小儿头面部烧伤后体积的变化,我们从1991年5月～1997年12月用陈壁教授提出热量计算小儿头面部体积的方法,对30例渡过休克期而生命体征平稳的6岁以下合并头面部重度烧伤的患儿在烧伤后48小时及5天～7天分别出量计算头面部体积,得出每1％头面部烧伤创面每kg体重烧伤后48小时内体积增加6.05±1.08cm3.明显高于目前习用输液公式伤后48小时每kg体重量1％烧伤面积2.7～3ml.为了准确计算此类病人休克期液体丢失量,建议分别计算头面部和其他部位创面伤后丢失量,从而指导临床治疗,提高救治水平.     

An Unexpected Change in DXA Calibration not Detected by Routine Quality Control Checks

Since its commercial introduction a decade ago, the technique of dual-energy X-ray absorptiometry (DXA) has been widely recognized as a useful and sensitive method of measuring changes in bone mineral density (BMD) at selected sites in the skeleton such as the spine and proximal femur. Because of their high precision and stable calibration, DXA scanners are frequently used in clinical trials to evaluate new treatments for osteoporosis. Quality assurance procedures based on regular scanning of phantoms are widely adopted in such trials, and continuity of the phantom BMD measurements is generally believed to ensure continuity in the in-vivo calibration. We report a change in calibration of a DXA scanner that occurred during a clinical trial where the calibration shift was different for the spine and femur sites and was not predicted or explained by the standard quality control procedures using phantoms. However, we show that provided patients enrolled in studies are thoroughly randomized and the statistical analysis is confined to the differences between the treated and control groups, then the effects of such calibration shifts on conclusions regarding the efficacy of treatment are considerably smaller than the random statistical errors. Received: 12 February 1998 / Accepted: 20 May 1998