儿童疾病单病种质量管理体系的研究

在总结分析武汉地区儿童疾病结构用度春诊疗规律的基础上,运用现代医院全面质量管理的理论,建立了以儿科常见病、多发 为主,兼纳部分专科疾病的２４个儿童疾病单病种质量控制标准及规范的组织管理和考核评价第统。形成以增强病种质量控制能力为核心的儿童疾病单病种质量管理体系。该管理体系运用后,医院医疗质量管理水平和社会、经济效益得到了同步提高,并了医务人员的医疗行为,使医院步入优质、低砂和高效的运营轨道。     

Orbital infarction and melting in a patient with systemic lupus erythematosus

OBJECTIVE: To present a patient with systemic lupus erythematosus who developed infarction and melting of the orbit secondary to her systemic disease. DESIGN: A case report. PARTICIPANT: A 61-year-old white woman with a 5-year history of systemic lupus erythematosus. METHODS: The patient presented with left orbital pain, limitation of extraocular movements, and a fistula from the ethmoid sinus to the upper eyelid. A detailed examination with computerized tomography, ultrasound, and a comprehensive medical evaluation with laboratory testing was performed. Histopathologic analysis with special stains of the orbital tissues was also performed. RESULTS: Histopathologic examination of the biopsy specimens revealed the features of an inflammatory process involving the orbit, similar to a panniculitis. These include a lymphocytic reaction with a predominance of plasma cells, vasculitis with occlusion, and thickening of the vessel walls, necrosis, and hyalinization of fat. CONCLUSION: This is a unique case in which infarction and melting of the entire orbital structures occurred in the presence of systemic lupus erythematosus. The underlying disease process is a lupus-related panniculitis. The authors stress that this is a very rare entity and that other diseases should be ruled out before entertaining this diagnosis.     

Retrograde intubation dacryocystorhinostomy for proximal and midcanalicular obstruction

Objective

Retrograde intubation of canaliculi during dacryocystorhinostomy can restore canalicular patency in cases otherwise managed with bypass tubes. The surgical technique and success for this procedure are discussed.

Differential diagnosis of anterior segment cysts by ultrasound biomicroscopy

BACKGROUND: To describe the ultrasound biomicroscopic (UBM) features of anterior segment cysts. DESIGN: A retrospective case series. PARTICIPANTS: One hundred eighteen eyes with anterior segment cysts examined by UBM at The New York Eye and Ear Infirmary between August 1992 and November 1997 were included in this study. INTERVENTION: The authors reviewed demographic and diagnostic data from the medical record including ocular and medical history, age, race, gender, and intraocular pressure. Ultrasound data concerning the type, number, position, and acoustic characteristics of cysts were recorded. The authors then correlated the written, clinical, and UBM characteristics. RESULTS: One hundred eyes (92.6%) had neuroepithelial cysts. Ninety (83.3%) of these had primary neuroepithelial cysts, 10 (9.3%) had cysts associated with uveitis, 7 (6.5%) had implantation cysts, and 1 (0.9%) had a cavitated ciliary body tumor. Neuroepithelial cysts typically were round or ovoid, thin-walled, and echolucent. Of the 90 eyes with primary neuroepithelial cysts, 56 (62.2%) had 3 or fewer cysts; multiple cysts (>3 per eye) were found in 34 eyes (37.8%). The multiple cysts occupied more than 180 degrees in 12 patients (13.3%). Primary neuroepithelial cysts were located at the iridociliary junction (74.2%), pars plicata (14.0%), pars plana (6.8%), and iris (5.0%). Implantation cysts (seven eyes) tended to have thicker walls and two contained a copious, echogenic material. CONCLUSION: The UBM results provide important information regarding location and extent of anterior segment cystic lesions. Ultrasound characteristics may help differentiate between neuroepithelial, implantation, and neoplastic cysts.     

Neutropenia, fever, and infection

With the advances in the management of various neoplastic diseases and subsequent improvement in "disease-free" states, complications of therapy--particularly, infectious complications--have evolved as stumbling blocks to survival. Among neutropenic (absolute neutrophil count below 1,000/mm3) patients with cancer, infection is the major autopsy-determined cause of death. With expected "cure rates" of childhood leukemia approaching 60 to 70 percent, it seems unreasonable to lose such patients to an infectious cause of death, yet this, indeed, happens. The purpose of this review is to (1) define the magnitude of the problem; (2) describe the various agents responsible for infections in neutropenic patients; (3) attempt to more sharply define degrees of neutropenia and mechanical defenses; and (4) consider various approaches to studying and treating these infections.     

鼻咽癌放射治疗后听力的变化

目的 探讨鼻咽癌患者放疗前后听力的变化。方法 对63例鼻咽癌患者放疗前后采用纯音测听检测听觉功能。结果 鼻咽癌初次放疗对内耳感音功能无明显影响，对中耳传音功能有明显的改善作用。结论 鼻咽癌所致听力下降通过放疗可使听力得以不同程度的恢复。     

关于综合能力培养的几个问题

围绕学科建设和成才，指出成才、成功的几个宏观条件及其相互关系；要形成正确的世界观与价值取向；要不断提高人们的素质与思想境界，这与学术水平的提高是相辅相成的；要按照学习—实践—思考—提高的过程提高学术水平；重点学科建设的新思路：学科研究方向是学科发展的根本，学科带头人是学科发展的关键，学科关键的实验设备是学科发展的保障。     

Can Young People with Autism Refer to Knowledge States? Evidence from Their Understanding of "Know" and "Guess"

A number of studies have reported that most individuals with autism have difficulty in attributing mental states. The primary aim of the present study was to compare the ability of children with autism to refer to knowledge states with that of mainstream school children and children with Down's syndrome. The second aim was to investigate the role of verbal mental age in referring to knowledge states. The third aim was to compare the ease with which the children referred to their own mental state and to that of others. The results suggest that some individuals with autism are able to attribute knowledge to themselves and others but that they need to have higher verbal skills than is necessary in normal individuals. The level of language skill predicted the performance of the individuals with autism, but not that of the children in the other groups. There was no good evidence that referring to one's own mental states was easier than referring to another person's, a finding which supports representational theory rather than the simulationist position.     

38所综合医院病种质量管理调查分析

搜集整理吉林省 38所二、三级综合医院为期一年的 31个病种3.4万份病例的信息资料,对其治疗转归、平均住院日和平均住院费用进行了统计分析,为制定病种质量控制标准和深入广泛开展病种质量管理提供了可靠依据。     

从药品的特殊属性谈医药企业的服务营销

目的 :探讨我国医药企业在市场竞争日益激烈的现状下的服务营销策略选择。方法 :分析处方药品和非处方药品的服务特性 ,并介绍药品市场营销的新观念———服务营销的发展及应用。结果与结论 :医药企业的服务营销应针对处方药品走服务的差异化、有形化、规范化道路 ;针对非处方药品走服务的标准化、技巧化、品牌化道路。