The child with recurrent respiratory infections: normal or not?

Respiratory infections (RI) are one of the major complaints in children and adolescents, and represent a demanding challenge for the pediatrician. It has been estimated that at least 6% of Italian children younger than 6 yr of age present recurrent respiratory infections (RRI). Children with RRI are not affected by severe alterations of the immune system. RRI represent essentially the consequence of an increased exposure to infectious agents during the first years of life, when immune functions are still largely immature. Several social and environmental factors, such as day-care attendance, family size, air pollution, parental smoking, and home dampness, represent important risk factors for airway diseases and may contribute in various degrees to determine the incidence of RRI. The main problem for the pediatrician is to discriminate normal children with high RI frequency related to an augmented exposure to environmental risk factors from children affected by other underlying pathological conditions (immunological or not), predisposing to infectious diseases. When RRI diagnosis has been formulated, removal of environmental risk factors (i.e. precocious day-care attendance, smoking in the household) must first be suggested.     

Minimizing macrovessel signal in cerebral perfusion imaging using independent component analysis.

The pronounced susceptibility effect of macrovessels in MR bolus-tracking studies induces spots of artificially high blood flow and volume in perfusion parameter images. These high-intensity regions impede the detection of perfusion changes and lead to elevated perfusion parameters in adjacent tissues. The purpose of this work was to explore postprocessing methods to reduce the influence of macrovessel signal in dynamic MRI. After data reduction was performed with the use of a principal component analysis (PCA), an independent component analysis (ICA) was applied to separate signal components of different compartments. Based on this decomposition, the dynamic time series were reconstructed with minimized contributions of macrovessel signal and noise. The influence of the temporal resolution and signal-to-noise ratio (SNR) of the source data were investigated by means of a simulation study. A region-of-interest (ROI)-based analysis of corrected and uncorrected in vivo data demonstrated that the influence of arteries and veins was reduced at least by 50%, while gray matter (GM) and white matter (WM) tissues were nearly unaffected by the correction process. Hemodynamic parameter images of the cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) were calculated from corrected and uncorrected scans. The corrected parameter images showed a clearly reduced macrovessel signal and an improved perceptibility of microvascular perfusion changes compared to the uncorrected ones.     

6种中药制剂治疗急性脑梗死的成本-效果分析

目的：运用药物经济学的方法对在我院应用的6种中药注射液进行成本-效果分析。方法：271例急性脑梗死患者依据药物治疗方案不同分为6组，即血塞通组、舒血宁组、苦碟子组、疏血通组、川芎嗪组、丹红组，分别观察疗效，并运用药物经济学的方法进行成本-效果分析。结果：疏血通组的成本为3 419.90元，总有效率最高（91.84%），6组间增量成本-效果最低。因此疏血通组是较为合理、经济的方案。     

武汉西马街社区成人健康相关危险因素调查

目的 探讨当地成人健康相关危险因素构成，尝试低费用下开展此类监测的方法。方法 依托教育系统对武汉市江岸区西马街地区成人进行随机抽样入户问卷调查。结果 人群吸烟率32．4％，男性吸烟率60．6％，中年人高于老年人，女性吸烟率5．9％；92．5％的人不愿意自己的孩子在将来成为烟民；人群饮洒率为26．5％，其中男性饮洒率51％，23．5％的饮酒者存在违意饮酒情节；33．3％的成人有体育锻炼习惯，其比例随文化程度的升高而升高；19％的人每周户外活动时间达不到1天1小时；35．6％的人存在体重过重问题，分解19．2％为超重，14．7％为肥胖，1．7％为Ⅱ度肥胖。人群自述（非现场测量）高血压患病率为11．1％，自述糖尿病患病率为2．8％，但自觉有糖尿病典型症状而从未检测血糖的比例达16％。结论 落实社区人群基础医学检查任务迫切，依托教育系统进行的成人健康相关危险因素监测方法足当前经济适用的监测方法。     

A review of incisional hernia repairs: preoperative weight loss and selective use of the mesh repair

At the Shouldice Clinic pre-operative weight loss is used prior to incisional hernia repairs. Mesh repair is selectively used, based on specific hernia characteristics. A series of 236 patients were reviewed and followed up for 36 months. Data were available on 188 patients (80%). There were 15 recurrences (8%). The number of obese patients was reduced from 67 (35.6%) to 25 (13.3%) through the weight loss program. The hernia diameter, gastrointestinal complications, and surgical site infection were significantly related to recurrence but not the type of repair, obesity, location, or previous recurrences. The risk factors of incisional hernias include size, intestinal complications and infections. A selective use has a comparable result to the exclusive use of mesh repair. Weight reduction has yet to be shown to affect the rate of recurrence, and further prospective studies are required.     

128例肾输尿管结石临床分析

目的为探讨肾输尿管结石的临床特点,以提出更好的防治措施。方法对原西南师范大学医院1997-2004年治疗的128例肾输尿管结石病例的临床资料进行统计分析。结果本组病例男女之比为2.05∶1,29岁以下发病103例,占80.5%。2001年起发病呈上升趋势,2003年最高。每年9-10月是发病高峰,占本组病例的31.2%。经体外震波碎石99例,3个月结石排净率为83%,与文献报道的基本一致。结论该校肾输尿管结石患者,男性多于女性,30岁以下居多。发病近年增加,体外震波碎石疗效好。     

甲状腺素治疗新生儿硬肿症疗效观察

目的 观察甲状腺素治疗新生儿硬肿症的疗效。方法 将63例随机分为甲状腺素治疗组(简称治疗组)32例,对照组31例,两组均给予综合治疗,治疗组加用甲状腺素片每天4～6mg/kg口服,疗程1周。结果 治疗组与对照组总有效率分别为87.5％、61.3％,有显著差异(P<0.05)。两组间复温时间分别为7.0±3.7h、16.5±11.2h,硬肿消退时间分别为4.1±1.9天、6.9±3.1天,住院时间分别为6.9±3.1天、9.8±4.6天,治疗组比对照组明显缩短,有显著差异(P<0.01)。结论 新生儿硬肿症使用甲状腺素治疗可明显提高治愈率,缩短病程,且使用方便,无副作用。     

颈动脉加压注射复方维脑路通合剂治疗脑梗死180例临床分析

本科自 2 0 0 0年 6月以来 ,采用颈动脉加压注射复方维脑路通合剂治疗脑梗死 180例 ,并与静脉给药组相比较 ,现总结如下。1　资料与方法1.1　临床资料　治疗组 180例 ,男 117例 ,女 6 3例 ,年龄 37岁～ 76岁 ,平均年龄 5 7.2 0岁。均为颈内动脉系统脑梗死。其中大面积脑梗死 4例 ,脑梗死 85例 ,腔隙性脑梗死 91例。大面积脑梗死组 4例 ,其梗死灶涉及 2个脑叶或以上 ,均无意识障碍及脑疝者 ,在发病 10d后即脑水肿高峰期后开始颈动脉加压注射。治疗组病例选择除下列禁忌 :①严重高血压病(血压≥ 2 6 .6 / 16kPa) ;②脑出血、出血性梗死 ;③严…     

传染病流行的社会因素及社会控制策略刍议

传染病与社会文化因素的关系密切。应重视社会因素对传染病的发生发展影响，从社会根源上探究其发病原理，包括经济因素、科学技术、文化、人口、卫生服务和其它社会因素。人类要有与传染病长期斗争的思想准备，并制定包括大卫生观和技术合作等相应的社会策略。     

妊高征患者胰岛素样生长因子水平及对胎儿生长发育的影响

目的：探讨妊娠高血压综合征(妊高征)患者血清胰岛素样生长因子(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)水平与疾病程度及新生儿出生体重之间的关系。方法：用放射免疫方法测定33例妊高征和32例正常血压妊娠妇女的血清IGF-1、IGFBP-3的水平。结果：重度妊高征组IGF-1显著低于正常组，IGFBP-3在各组间的水平浓度差异均无显著性，但IGF-1与IGFBP-3之间呈正相关。新生儿出生体重随妊高征严重程度的加剧而降低，各组间比较差异有显著性(F=5．453，P=0．002)。结论：妊高征患者的发病及严重程度与IGF-1有明显的关系，IGF-1与胎儿的发育及新生儿出生体重有明显的相关性。