双歧杆菌三联活菌治疗飞行员慢性腹泻的效果观察

目的观察双歧杆菌三联活菌治疗空军飞行员慢性腹泻的临床效果。方法将慢性腹泻空军飞行员75例随机分为试验组(40例)和对照组(35例)。试验组予双歧杆菌三联活菌肠溶胶囊(4周)加蒙脱石散治疗(3~14 d),对照组予左氧氟沙星片(2周)加蒙脱石散治疗(3~14 d),疗程结束比较两组治疗效果,对治疗显效者1年后随访并统计比较复发率。结果治疗结束后显效率和总有效率试验组分别为82.5%、97.5%,对照组分别为42.9%、65.7%,两组比较差异均有统计学意义(P0.01)。治疗显效者1年后随访复发率试验组为24.2%,对照组为86.7%,两组比较差异亦有统计学意义(P0.01)。结论双歧杆菌三联活菌治疗空军飞行员慢性腹泻效果满意且复发率较低。     

A comparative study of a nerve block therapy with and without a deeply inserted acupotomy applied to hyeopcheok points for lumbosacral radiculopathy: Safety,effectiveness, cost-effectiveness (a randomized controlled,two-arm,parallel study,pilot study,assessor-blind)

Introduction:The prevalence of lumbosacral radiculopathy is estimated to be approximately 3% to 5% in patient populations. Lumbosacral radiculopathy is largely caused by a complex interaction between biomechanical and biochemical factors. Nerve block therapy (NBT) mainly treats lumbosacral radiculopathy by improving the biochemical factors, whereas acupotomy mainly focuses on improving the biomechanical factors. Therefore, it is thought that synergistic effects may be obtained for the treatment of lumbosacral radiculopathy when both NBT and acupotomy are combined. However, no study in China and Korea, where acupotomy is majorly provided, has reported the effects of such a combination treatment. Therefore, this study aimed to evaluate the safety, effectiveness, and cost-effectiveness of the concurrent use of a deeply inserted acupotomy and NBT for the treatment of lumbosacral radiculopathy.Methods/design:This is an open-label, parallel, assessor-blinded, randomized controlled trial, which will include 50 patients with lumbosacral radiculopathy. After patients voluntarily agree to participate in the study, they will be screened, and will undergo necessary examinations and tests according to the protocol. Those who satisfy the selection criteria will be randomly assigned to either the NBT + acupotomy or NBT groups in a 1:1 ratio. Both groups will undergo 2 NBTs once every 2 weeks from 1 week after the screening test. The treatment group will receive additional acupotomy twice a week for 4 weeks. The primary endpoint is the Oswestry Disability Index, whereas the secondary endpoints are the Numeral Rating Scale, European Quality of Life 5-dimension, McGill pain Questionnaire, Roland-Morris Disability Questionnaire, safety assessment, and economic feasibility evaluation. The measurements will be made at 0, 2, 4, and 8 weeks.Ethics and dissemination:This trial has received complete ethical approval from the Ethics Committee of Catholic Kwandong University International St. Mary''s Hospital (IS20OISE0085). We intend to submit the results of the trial to a peer-reviewed journal and/or conferences.     

Clinical features and management of haemophilic pseudotumours: a single US centre experience over a 30‐year period

Given the rarity of haemophilic pseudotumours, consensus on management is lacking. We describe the clinical features and management of haemophilic pseudotumours by retrospectively reviewing the medical records of haemophilia patients with a diagnosis of pseudotumour seen at our Hemophilia Center from 1981 to 2011. We recorded the following data: type and severity of haemophilia, documented aetiological antecedent, localization of the pseudotumour, presenting symptoms, management and outcome. We identified 12 pseudotumours in 11 patients over a 30‐year period. Six patients had known inhibitors or a history of inhibitor. An aetiological antecedent leading to the development of pseudotumour was reported in nine cases. Localization of the pseudotumour was confined to soft tissue (n = 3) and bone (n = 8). Six of the 12 pseudotumours (50%) were not diagnosed at the time of initial presentation, with a delay ranging from 6 weeks to 6 years. In eight cases, surgical intervention (surgical drainage, n = 2; excision, n = 4; limb amputation, n = 2) was the initial treatment choice, with complete resolution in six cases. Conservative management with close monitoring occurred in three cases, with one case subsequently requiring surgical resection. We conclude that haemophilic pseudotumours still occur sporadically, and the diagnosis is frequently delayed. Surgical intervention is generally a safe and effective treatment, although conservative management may be appropriate in selected cases.     

Intuitive design guidelines for fast spin echo imaging with variable flip angle echo trains.

We present a simple and intuitive means for determining the flip angles (FAs) required for smooth transitions between static pseudo steady states (SPSSs) in fast spin echo (FSE) imaging with variable FA (VFA) echo trains. We demonstrate the effectiveness of single and multiple transition pulses to successfully vary refocusing FAs while retaining high signal levels. The graphical interpretation presented here is consistent with previous analytical techniques and permits accurate signal-intensity predictions along the echo train.     

阻塞性睡眠呼吸暂停低通气综合征对飞行员认知功能的影响

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对飞行员认知功能的影响.方法 对13名经多导睡眠图(PSG)确诊的中重度OSAHS患者及10名正常体检健康飞行员进行Epworth嗜睡程度问卷(ESS)评分,以及进行闪光融合频率、多项反应时、空间位置记忆广度、注意力集中能力、警戒性等认知功能测试,并对OSAHS组进行ESS评分、睡眠呼吸紊乱指数(AHI)、最低血氧饱和度与各项认知功能测试结果间进行相关性分析.结果 OSAHS组ESS评分明显高于对照组(P＜0.01),闪光融合频率、空间位置记忆广度分值、注意力集中能力时间明显低于对照组(P＜0.05或P＜0.01),对黄、绿色的选择反应时明显慢于对照组(P＜0.05),对红色的选择反应时与对照组相比无显著差异.OSAHS组警戒性作业总错误率明显高于对照组(P＜0.01).OSAHS组ESS评分与警戒性作业的总错误率呈显著正相关(r=0.789 0,＜0.01).结论 中重度OSAHS患者有不同程度的认知功能减退,可能损害飞行操作能力,造成飞行安全隐患.临床未进行有效治疗的患者应暂时或永久取消飞行资格.     

10例EDTA依赖性假性血小板减少症血小板检测的动态分析

目的探讨EDTA依赖性假性血小板减少症(EDP)形成的原因及其血小板计数方法。方法选取EDP患者10例,采集2份样本,1份EDTA-K2抗凝,1份枸橼酸钠抗凝。EDTA抗凝血分别于0、15、30、60、120min上机检测。枸橼酸钠抗凝血在15min内检测。同时手工计数血小板。结果 EDTA抗凝血0min检测的血小板结果与手工计数及枸橼酸钠抗凝法的结果相比,差异均无统计学意义(P>0.05),15～120min的血小板计数与手工计数相比差异有统计学意义(P<0.05)。枸橼酸钠抗凝血计数与手工计数的结果亦无明显差别(P>0.05)。结论对EDP的动态分析支持EDTA依赖的血小板聚集是抗原抗体介导的免疫反应。确认EDP患者用EDTA抗凝采血后应立即检测,也可用枸橼酸钠抗凝检测或手工计数。     

空军航空兵场站卫勤信息管理系统的研制

目的：为了推动空军航空兵场站的卫勤保障信息化建设。方法：结合空军航空兵场站的保障特点及要求，设计了集飞行人员健康信息、场站卫勤保障、飞行人员生理心理检测为一体的综合数据库。结果：为空军各级卫生单位实时传递卫勤保障信息、动态掌握飞行人员健康状况提供自动化和智能化手段。结论：该系统的成功运用，有效提高了航空兵场站卫勤保障效率，对提高部队战斗力起到了积极的作用。     

浙江省新型农村合作医疗试点地区农村居民意向评价

目的:从农村居民意向角度评价新型农村合作医疗。方法:从筹资水平、满意程度、未参合农村居民的意愿和已参合农村居民(以下简称参合农民)续保情况4个方面评价2个试点县(秀洲区、开化县)和1个对照县 (常山县)3地的新型农村合作医疗实施情况。结果:(1)98．8％的农村居民能够承受目前的筹资水平,其中秀洲区为 99．0％,开化县为99．3％,常山县为98．8％;(2)对新型农村合作医疗不满意、持否定态度的农村居民比例仅为2．8％, 其中秀洲区和开化县皆为1．8％,对照县常山县略高,为5．1％;(3)40．5％的参合农民认为新型农村合作医疗能解决倾家荡产问题,其中秀州区为39．2％,开化县为39．3％,常山县为43．0％;(4)未参合农村居民期望新型农村合作医疗报销要方便,其中秀洲区未参合农村居民更为强调方案解决因病致贫的效果:(5)大部分新型农村合作医疗参合农民表达了续保意愿,明确表示不续保的比例仅为3．0％,其中秀洲区为1．5％,开化县为1．8％,常山县为5．7％。结论: (1)秀洲区、开化县农村居民对新型农村合作医疗有较高评价,常山县次之;(2)新型农村合作医疗有必要增加筹资,而且增加筹资是可行的。