Development and evaluation of a breast cancer prevention decision aid for higher-risk women

Objective To develop and evaluate the effectiveness of a breast cancer prevention decision aid for women aged 50 and older at higher risk of breast cancer. Design Pre‐test–post‐test study using decision aid alone and in combination with counselling. Setting Breast Cancer Risk Assessment Clinic. Participants Twenty‐seven women aged 50–69 with 1.66% or higher 5‐year risk of breast cancer. Intervention Self‐administered breast cancer prevention decision aid. Main outcome measures Acceptability; decisional conflict; knowledge; realistic expectations; choice predisposition; intention to improve life‐style practices; psychological distress; and satisfaction with preparation for consultation. Results The decision aid alone, or in combination with counselling, decreased some dimensions of decisional conflict, increased knowledge (P < 0.01), and created more realistic expectations (P < 0.01). The aid in combination with counselling, significantly reduced decisional conflict (P < 0.01) and psychological distress (P < 0.02), helped the uncertain become certain (P < 0.02), and increased intentions to adopt healthier life‐style practices (P < 0.03). Women rated the aid as acceptable, and both women and practitioners were satisfied with the effect it had on the counselling session. Conclusion The decision aid shows promise as a useful decision support tool. Further research should compare the effect of the decision aid in combination with counselling to counselling alone.     

温针灸为主治疗前列腺增生症疗效观察

笔者于1998年2月～1999年12月应用温针灸为主治疗前列腺增生症51例,效果理想.现报道如下. 1临床资料 1.1病例选择全部98例观察病例均来自男科门诊.按随机法分为治疗组和对照组.其中治疗组51例,年龄最小49岁,最大72岁,平均56.3岁;病程最短2年,最长5年,平均4.1年.对照组47例,年龄最小48岁,最大71岁,平均57.1岁;病程最短3年,最长7年,平均5.0年.两组具有可比性.     

六草二苓汤治疗急性黄疸型病毒性肝炎的临床研究

目的 对六草二苓汤治疗急性黄疸型病毒性肝炎的疗效进行对比临床研究,并探讨其作用机制。方法采用六草二苓汤的治疗组治疗急性黄疸型病毒性肝炎72例,并与使用肝泰乐、益肝灵、甘草甜素片的67例对照组作对比研究。结果 治疗组总有效率为93.1％,对照组总有效率为76.1％。在治疗后显效率、显效者复发率二方面,治疗组明显优于对照组(P<0.01)。在治疗前后主要症状体征变化、治疗前后肝功能变化、治疗后肝功能复常天数三方面,治疗组优于对照组(P<0.05)。结论 六草二苓汤治疗急性黄疸型病毒性肝炎,在较快地消除主要症状体征、消退黄疸、恢复肝功能、减少复发率方面有较好的疗效。     

211例下肢长骨骨折带锁髓内钉固定的临床评价

目的 对211例下肢长骨骨折带锁髓内钉内固定治疗的临床结果进行评价。方法 用不扩髓带锁髓内钉为主要固定方法，对211例股骨、胫骨骨折进行手术复位内固定治疗，术后进行包括CPM在内的有序功能锻炼。结果 获得随访189例，时间4～26个月，平均9个月。全组病例获得骨性愈合，无骨不连发生，骨折延迟愈合7例，膝关节功能受限4例。按Johner-wruch标准：优158例，良22例，中9例，优良率95．2％。结论 带锁髓内钉是治疗下肢长骨骨折较好的方法，其适应证较以往有进一步的拓展，术中骨折复位与保存骨折块血供并重的理念是正确的。     

CRRT治疗老年顽固性心力衰竭的疗效观察

顽固性心力衰竭(CHF)是临床常见而又难治的心脏疾病,其病死率一直居高不下,虽然国内外许多学者采用了多种综合性措施,如主动脉内气囊反搏、植入心脏起搏器等,然而其预后仍较差。近几年来国外学者采用血滤或血透的方法矫治顽固性CHF取得了一些进展。由于研究结果差异较大,已成为     

糖尿病肾病临床研究述评

本文从中医病名、病因病机、诊断标准、临床分期、疗效评定、辨证论治、临床科研七个方面对糖尿病肾病的研究进行了述评。指出：糖尿病肾病的中医病名、诊断、分期及疗效评定标准亟待统一；立足于临床实际，参考现代医学有关认识，应用ＤＭＥ方法，开展糖尿病肾病临床和实验研究，深入探讨其病因病机和证治规律，在中医基本理论指导下，大胆创新，是提高临床疗效的关键；分期辨证论治较为符合疾病的发展规律，便于寻找防治糖尿病肾病的有效方法。     

KS—2A型特效癌症治疗仪治疗宫颈病变905例分析

对我院1992年1月到1994年6月间应用KS—2A型特效癌症治疗仪治疗宫颈病变905例进行疗效分析,总的一次治愈率为97%,治疗宫颈糜烂858例,有效率100%,一次治愈率为97.4%,与冷冻治疗相比差异有显著性(P<0.001).治疗宫颈腺体囊肿34例,治愈率为84.5%.提示:与其它治疗方法相比,KS仅治疗具有治愈率高,副作用少,愈合时问短,操作简单,患者无痛苦等特点,具有推广和普及的价值.     

活性金属单环165的临床研究

不锈钢环型节育器(金单环)在中国广为应用。为提高金单环的避孕效果,进行了金单环支撑力与脱落关系的研究,对200,165,135g不同支撑力进行比较性研究筛选出较为合理的支撑力为165g,其外形和金单环相似,分大、中、小三种型号,大号外径22mm,中号21mm,小号为20mm。外层为不锈钢丝螺旋簧,在螺旋环内相间置入纯铜丝(200mm2)和消炎痛硅橡胶各二段(消炎痛总含量5mg左右,现已改为10mg)。于1988年10月～1989年6月全国南北方7省市11所医院共放置1000例,经3年定期随访,12,24,36个月继续存放率各为92.5,88.99及85.94/100妇女年,36月累积带器妊娠率仅1.61/100妇女,脱落率比原金单环明显降低近40％,因症取出率为3.12。于放置前后进行月经血量测量24例,放置后3、6月各增加24.4％和27.4％。行子宫内膜“含铜含药组”和“有铜无药”组对照检查各11例,含药组炎症细胞略少。作宫颈粘液中铜离子含量测定,以6月内含量较高,6月后趋向平稳。消炎痛释放测定,1月内释放较快,一年后残留20％左右。经1249例临床观察,活性金单环165是一种不需特殊培训易于推广的、安全、经济并能长期放置的IUD。     

环丙沙星治疗急性细菌性痢疾29例临床疗效观察

食源性急性菌例２９例中２８例大便培养为弗氏２ａ志贺氏菌。经２天吡哌酸加ＴＭＰ短程快速治疗，２９例无一例治愈。依据药敏试验改用环丙沙星治疗，其中１１例感染严重者先予静脉点滴，每１２小时２００ｍｇ，１￣２天，症状好转即改口服，每１２小时２５０ｍｇ。另１８例口服，疗程均为４天。用药后，平均退热时间１．３２天，大便次数恢复正常时间平均２．１０天，大便常规正常时间平均２．８６天，２８例大便培养阳性者，平均阴     

Osteogenesis imperfecta: A clinical study of the first ten years of life

Summary One hundred twenty-seven children with osteogenesis imperfecta (O.I.) were studied during the first 10 years of life. According to Sillence, 40 patients were assigned to type I, 39 to type III, and 48 to type IV O.I. Centiles for height, weight, and the annual number of fractures could be established for the different types of O.I. The development of the skeletal changes could be documented for the different forms of the disease. At birth, the skeletal changes were significantly more severe in type III than in type IV patients. During the first 10 years of life the number of fractures, extent of skeletal deformities, and growth retardation did not differ between types III and IV. Only fracture nonunion, dentinogenesis imperfecta, and congenital cardiac malformations were more frequent in type III than in type IV. Papillary calcifications of the kidney and kidney stones were diagnosed in 4 type III and 2 type IV patients. Hemihypertrophy of the body developed, in 2 type I patients. Although types III and IV patients suffered from severe short stature, serum insulin-like growth factor (IGF) I was in the normal range.