社区健康教育干预促进鼻咽癌早期发现和防治的效果研究

目的　评价健康教育干预对鼻咽癌早发现和早治疗的效果。方法　在广州市天河区华乐社区的5 1 40 3名居民中开展为期 3年的社区健康教育干预。另选登峰社区 5 0 3 1 7名居民作为对照组 ,不采取任何干预措施。结果　干预后鼻咽癌患者初发鼻咽症状至确诊的持续时间缩短 ,居民鼻咽癌防治知识知晓率明显提高 (P <0 0 1 ) ,干预组的知晓率为 92 3 3± 6 3 8% ,明显高于对照组的 72 92± 1 7 64%。在华乐社区 5 1 40 3例有鼻咽症状的患者中检出鼻咽癌 1 96例 ,其中 ,5 3例为早期鼻咽癌 ,早诊率为 2 7 0 4% ,明显高于对照组的早诊率 9 2 1 %。结论　社区健康教育干预对鼻咽癌早发现和早治疗有积极的促进作用。     

重度窒息儿早期干预防治脑功能障碍的研究

本文排除了影响婴幼儿智能发育有关生物学及环境因素的差异,对60例重度窒息新生儿分为干预组和对照组(各30例)进行观察。结果显示干预组在1.5岁时MDI较对照组高12.6分,PDI高9.2分,2岁时分别高13.4分和9.8分。证明对重度窒息儿进行早期干预对防治脑功能障碍有显著效果。     

Dental arch changes after anterior open bite treatment in the mixed dentition produced by miniscrew-supported palatal crib vs conventional fixed palatal crib:: A randomized clinical trial

ObjectivesTo evaluate the dental arch changes produced by the miniscrew-supported palatal crib (MSPC) and the conventional fixed palatal crib (CFPC) after the treatment of patients with anterior open bite (AOB) attributed to the tongue-thrusting habit in the mixed dentition stage.Materials and MethodsA total of 26 children aged 8 to 11 years with an AOB were randomly distributed into two equal groups; the MSPC group was treated using a palatal crib supported by two miniscrews inserted paramedially, whereas the CFPC group was treated using a conventional fixed palatal crib soldered to bands. Digital models were obtained pretreatment and after a follow-up duration of 9 months.ResultsThe MSPC group included 12 participants (9 girls and 3 boys; mean age, 9.4 ± 0.75 years), and the CFPC group included 12 participants (10 girls and 2 boys; mean age, 9.0 ± 0.73 years). The amount of AOB closure was similar in both groups: 3.97 ± 1.44 mm in the MSPC group and 3.97 ± 0.89 mm in the CFPC group. There was significant mesial movement of the maxillary first molar in the CFPC (−1.42 ± 0.99 mm) compared with the MSPC group (−0.53 ± 0.32 mm).ConclusionsBoth appliances resulted in similar improvement in the amount of AOB closure. There was significantly more mesial movement of the maxillary first molars in the CFPC group compared with the MSPC group.     

术后早期炎性肠梗阻的药物治疗进展

术后早期炎性肠梗阻往往不需要手术,通过药物治疗能恢复胃肠动力。本文综述了14种类药物。这些药物可以单独使用,也可以几种药物联合。为术后早期炎性肠梗阻的治疗开拓了新的研究方向,提供了极具潜力的应用前景。     

浸润深度、瘤体直径和阻塞性肺炎或肺不张对支气管内浅表性肺癌的预后和分期的影响

研究背景：支气管内浅表性肺癌的外科病理学特征至今极少文献报道。这种肿瘤定义为肿瘤浸润局限于支气管内的肺癌,其预后和相对应的TNM分期尚未阐明。同样,当肿瘤阻塞引起肺炎或肺不张时,究竟分期归属应该是T1或者T2,至今没有相关研究。 材料和方法：回顾性分析1988至2007年我院收治的此类患者81例。 结果：本组患者的总5年生存率为85.6%;对于N0M0,N1M0和N2M0的患者,其5年生存率分别为89.3%,75.0%和60.0%。肿瘤直径为0.4-3.0厘米,14例患者存在阻塞性肺炎或肺不张;两者对5年生存率的影响没有统计学差异（P值分别为0.70和0.96）。肿瘤局限于粘膜13例,浸润至粘膜下12例,肌层20例,肌层外21例,软骨层15例。在所有N0M0病例中,累及上述5层结构的相对应的5年生存率分别为：前三层100%,第4和5层为84%和61.3%。 结论：支气管内浅表性肺癌的5年生存率高于通常意义的早期肺癌,应属于T1的较早亚期。它的分期不受阻塞性炎症或肺不张、肿瘤大小的影响。预后与淋巴结的转移情况和肿瘤的浸润深度密切相关。     

早发型重度子痫前期终止妊娠的时机选择及母婴结局的临床分析

摘要：目的：探讨早发型重度子痫前期终止妊娠的时机选择及母婴结局的关系。方法：回顾性分析132例早发型重度子痫前期患者的临床资料,按其妊娠时间分为A、B、C三组。A组：30 -32周(39例);B组：32+1-34周(50例);C组：34+1 -36周(43例)。比较三组的临床特点及母儿并发症。结果：A组孕妇并发症发生率...     

健康新生儿口腔正常微生物的早期定植研究

目的　观察新生儿口腔微生物的早期定植情况 ,确定健康新生儿口腔正常微生物群的组成以及新生儿口腔中的优势细菌。方法　对 2 2名健康新生儿口腔进行棉拭子取样 ,在需氧、兼性厌氧、厌氧条件下培养 ,培养均采用成品培养基和培养盒 ,培养结果作微生物的形态学及生化鉴定。结果　 90 .9%的刚出生健康新生儿口腔中无菌 ;4 5 .5 %的新生儿出生第 2天即可检出 Streptococcus salivarius(S.salivarius) ,2 7.3%可检出 Streptococ-cus mitis(S.mitis) ,到出生后第 2 8天这两种菌的检出率分别达 86 .4 %和 81.8% ;Candida albicans(C.albicans)在1月龄新生儿口腔中检出率为 2 2 .7% ;母乳喂养与人工喂养的新生儿口腔正常微生物群之间无明显差异 (P>0 .0 5 )。结论　在早期定植于健康新生儿口腔生态区的正常微生物中 ,S.salivarius和 S.mitis为其优势细菌 ,C.albi-cans为优势真菌。不同喂养方式对新生儿口腔优势菌群的组成和数量无明显影响。     

Surgical Complications and the Risk Factors of Laparoscopy-Assisted Distal Gastrectomy in Early Gastric Cancer

Background Information on surgical complications of laparoscopy-assisted distal gastrectomy (LADG) and their risk factors is limited in the literature despite increasing popularity of this procedure. This study was performed to identify the surgical complications and their associated risk factors of LADG in early gastric cancer. Methods LADG was performed in 347 gastric cancer patients from January 2002 to December 2006 at the Korean National Cancer Center by four surgeons with ample experience of open gastric surgery before LADG. LADG indications for cases of gastric cancer at our institution are preoperatively diagnosed cT1N0 or cT1N1, except in cases with an absolute indication for endoscopic resection. Lymph node dissection of more than D1 + β was performed in all patients. Intraoperative and postoperative complications were reviewed and their risk factors were retrospectively analyzed by prospective database information. Results Forty complications occurred in 34 patients (9.8%), but there was no mortality. Intraoperative complications occurred in nine patients (2.6%), and open conversion was performed in eight (2.3%) of these patients. Early and late postoperative complications occurred in 21 (6.1%) and 10 (2.9%) patients, respectively. The most serious complication was vascular injury resulting in bleeding or organ ischemia, which occurred in seven patients. Degree of lymph node dissection and surgical inexperience were found to be risk factors of surgical complication (P = .023, odds ratio 2.832, 95% confidence interval 1.155–6.946 vs. P = .028, odds ratio 2.975, 95% confidence interval 1.127–7.854). Conclusions Lymph node dissection during LADG should be performed cautiously to prevent surgical complications like vascular injuries, especially during the surgeon’s early learning period.     

感觉障碍与格林—巴利综合征(附48例分析)

本文报导以末梢型感觉异常为首发症状的格林—巴利(Guillain—Barre)综合征43例,其中单有主观感觉异常而无客观体征24例,以一侧上、下肢末梢型感觉异常为首发症状5例,而以单肢末梢型感觉异常为首发症状6例。由此我们认为:首发对称性、非对称性末梢型感觉障碍对格林—巴利综合征早期诊断应予以重视。