新生儿缺氧缺血性脑病的发生原因及护理

阐述了新生儿缺氧缺血性脑病的病因及临床诊断依据 ,重点综述了新生儿缺氧缺血性脑病的护理。     

Are There Identifiable Risk Factors and Causes Associated with Unplanned Readmissions Following Total Knee Arthroplasty?

We conducted a retrospective review of 3218 primary total knee arthroplasties (TKA) performed over two years at an urban academic hospital network using clinical and administrative data. Increased length of stay (LOS) was associated with readmission (P < 0.001). Readmission was not associated with age (P = 0.100), gender (P = 0.608), body mass index (P = 0.329), or staged bilateral procedures (P = 0.420). The most common readmitting diagnoses were post-operative infection (22.5%), hematoma (10.1%), pulmonary embolus (7.9%) and deep vein thrombosis (5.6%). Of readmissions, 53.9% were for surgical reasons and 46.1% were for medical reasons. Certain interventions described in previous literature may be more successful in minimizing unplanned readmissions by focusing on patients with extended LOS, elevated infection risk and low socioeconomic status.     

Combat-related upper extremity injuries: Surgical management specificities on the theatres of operations

This review presents the current surgical management of combat-related upper extremity injuries during the acute phase. The strategy consists of saving the life, saving the limb and retaining function. Surgical tactics are based on damage control orthopaedics techniques of haemorrhage control, wound debridement, and temporary bone stabilization prior to evacuation out of the combat zone. Features of the definitive management of local casualties in battlefield medical facilities are also discussed. In this situation, reconstructive procedures have to take into account the limited resources and operational constraints.     

满洲里市2013全年全人群死亡病例监测结果分析

目的回顾性分析内蒙古满洲里市居民2013年死亡原因,掌握主要死因与人群分布特征,为政府卫生决策和疾病预防控制提供科学依据。结果 2013年满洲里市居民死亡1 168例,死亡率为694/10万。从≥30岁年龄组开始死亡率随年龄增加而升高,65岁上升趋势明显加剧。结论循环系统疾病、肿瘤、呼吸系统疾病、疾病和死亡的外因、消化系统疾病是满洲里市居民死亡的五大主要影响因素。可见以循环系统疾病、肿瘤等疾病为代表的慢性非传染性疾病严重威胁着满洲里市居民的生命健康。慢性病的防治工作应从早期、一级预防抓起,长期坚持[1]。     

4例外伤性小肠破裂CT漏诊原因分析

目的 熟悉小肠破裂CT征象以提高综合分析能力.方法 回顾性分析经手术证实4例外伤性小肠破裂患者的CT图像.结果 原因分析4例患者均出现大网膜、系膜改变,以及腹盆腔积液.腹腔微量积气2例.肠壁增厚2例.结论 充分认识外伤性小肠破裂的CT征象有助于提高诊断的准确率并减少漏诊,为临床及时救治提供重要的影像学依据.     

超声体检发现血脂正常者患脂肪肝原因分析

目的 对体检发现血脂正常但确诊为脂肪肝患者的患病原因做出统计分析.方法 对2012年01月至2014年1月来我门诊体检发现的150例血脂正常的脂肪肝患者和150例血脂正常的非脂肪肝患者的临床资料进行回顾性分析,对临床表现为血脂正常但患脂肪肝的原因进行回归统计分析.结果 血脂正常的脂肪肝患者和血脂正常的非脂肪肝患者在肥胖情况、高血糖情况、嗜酒情况三方面差异显著,具有统计学意义（P＜0.05）.在肝炎情况、服用肝损伤药物病史情况存在差异,但是差异减小,不具有统计学意义（P＞0.05）.结论 即使血脂正常也具有患脂肪肝的概率,血脂正常者患脂肪肝的主要原因为过度肥胖、高血糖以及嗜酒.     

住院患者退药现象分析及改进方法

目的了解患者退药的具体原因,有针对性地实行应对措施,以减少退药现象。方法采用回顾性研究方法,对医院2013年7月25日至8月10日收治的495例住院患者退药单的退药情况进行统计及分析。结果日平均退药率为2.20%,退药原因为出院（43.64%）,调整用药（17.98%）,医生原因（10.91%）,手术原因（9.90%）;退药较多的科室为普外科、妇产科、骨科、中医科,分别占10.30%,8.89%,8.08%,8.08%;退药种类中营养及补液类药物最多（28.31%）,其次为抗感染药物（20.48%）。结论退药现象由医院信息管理系统、医生、患者等多方面因素造成,只有医患共同努力,医院提高信息技术水平,才能减少退药情况的发生,提高医疗服务质量。     

中医对慢性咳嗽的六经辨证认识

慢性咳嗽为临床常见病,按传统分为外感咳嗽与内伤咳嗽,当前临床治疗常用脏腑辨证,而六经辨证治疗咳嗽也有特色。本文论述了六经辨证在论治咳嗽的应用,阐释太阳病、少阳病、阳明病、太阴病、少阴病以及厥阴病六经病咳嗽的临床症状特点、与他经合病规律以及依据六经辨证指导下经方在治疗咳嗽中的应用。     

Endoscopic ultrasound elastography for small solid pancreatic lesions with or without main pancreatic duct dilatation

Background/Objectives: Endoscopic ultrasound elastography (EUS-EG) is useful for diagnosis of small solid pancreatic lesions (SPLs), particularly in excluding pancreatic cancer (PC), but its dependence on main pancreatic duct dilatation (MPDD) has not been examined. We aimed to investigate EUS-EG for diagnosis of small SPLs with and without MPDD.MethodsPatients with pathologically diagnosed SPLs of ≤20 mm were included and retrospectively analyzed. Using the blue:green ratio, an EUS-EG image was classified as blue-dominant, equivalent, or green-dominant. Using multiple EUS-EG images per patient, a lesion with a greater number of blue-dominant than green-dominant images was classified as stiff, and the others as soft. EUS-EG images in random order were judged by three raters. Considering stiff SPLs as PC, diagnostic performance of EUS-EG was examined for SPLs with and without MPDD.ResultsOf 126 cases analyzed, 65 (52%) were diagnosed as PC, and 63 (50%) had MPDD. A total of 1077 EUS-EG images were examined (kappa coefficient = 0.783). Lesions were classified as stiff in 91 cases and soft in 35 (kappa coefficient = 0.932). The ratio of stiff to soft lesions was significantly higher in PC than in non-PC (62:3 vs. 29:32, P < 0.001). The sensitivity, specificity, and negative predictive value of a stiff lesion with vs. without MPDD for diagnosis of PC were 94%, 23%, and 50% vs. 100%, 60%, and 100%, respectively.ConclusionsUsing the EUS-EG stiffness classification for small SPLs, PC can be excluded with high confidence and concordance for a soft lesion without MPDD.