交锁髓内钉治疗股骨干骨折远端骨折锁钉操作总结

目前国产股骨带锁髓内钉为治疗股骨干骨折的首选,往往由于远端锁钉操作困难,而困扰骨科同行,如何解决此问题,自2001年1月-2005年2月总结了63例,报告如下。1临床资料本组中男48例,女15例;年龄18~65岁,平均35岁。车祸伤32例,重物砸压伤20例,高处坠落伤7例,摔伤4例。股骨中上段骨折42例,中段21例。横断形骨折39例,短斜形骨折14例,粉碎性10例。合并胫腓骨骨折16例,合并髋臼骨折2例。63例均为新鲜骨折,伤后至就诊时间1h~7d。2治疗方法本组63例采用国产带远端瞄准器股骨交锁髓定钉器械。腰硬膜外联合麻醉完成后,患者仰卧位于手术台上,患侧臀部垫高…     

汶川地震陇南灾区伤情调查与分析

目的：调查分析汶川地震甘肃陇南伤情情况，进一步讨论如何采取措施应对突发灾害。方法：采用问卷调查、访谈等方法，对甘肃陇南地震受灾人口进行抽样调查，重点对伤员伤情、致伤原因、救治方法进行统计学分析。结果：在此次地震伤抽样调查中共有1652例，死亡16例，四肢骨折患者750例，占45．4％，精神、神经方面40例，占2．4％。通过有组织的及时救助伤员，减少了并发症的发生，降低了死亡率。结论：加强地震伤的预防与救治，从而有效地减少致死率和致残率。     

创伤性膝关节脱位失稳性的检查与治疗

目的：探讨创伤性膝关节脱位失稳性的检查方法、手术时机与治疗方法。方法：本组63例创伤性膝关节脱位，男48例，女15例；年龄16-75岁，平均36．6岁。鲜新膝关节脱位40例，陈旧膝关节脱位23例。按Wascher膝关节脱位分型标准：KD—Ⅰ型1例，KD—Ⅱ型13例，KD-Ⅲ型17例，KD—Ⅳ型18例，KD—Ⅴ型14例。结合物理与影像学检查评判患膝稳定性。单纯开放手术治疗53例，单纯关节镜治疗4例，关节镜加开放手术治疗4例，截肢1例，全膝关节置换1例。结果：膝MRI阳性率100％（39／39），膝应力位X线检查阳性率100％（19／19），膝关节镜阳性率93．3％（14／15）。按Lysholm膝关节评分标准：治疗前陈旧伤组平均（37．17±5．33）分，新鲜伤组平均（37．41±5．38）分；治疗后陈旧伤组平均（67．33±14．72）分，新鲜伤组平均（82．45±12．13）分（Z=-3．061，P=0．002）。结论：膝关节应力位X线检查、MR及关节镜检查对评判创伤性膝关节脱位的稳定性有积极意义，失稳性创伤膝关节脱住手术治疗的关键是早期，鲜新伤以修复为主，陈旧伤以重建为主。     

腹腔镜行消化性溃疡急性穿孔修补手术的临床研究

目的 探讨腹腔镜治疗消化性溃疡急性穿孔的临床价值。方法对腹腔镜手术组（腔镜组）53例和开腹手术组（开腹组）54例患者的手术时间、术中出血量、肠鸣音恢复时间、住院时间、使用镇痛剂例数、住院费用、术后切口及腹腔感染例数等指标进行比较。结果 腔镜组术中出血量、术后肠鸣音恢复时间、住院时间、使用镇痛剂等指标均显著小于开腹组（P〈0．05）。结论 腹腔镜治疗消化性溃疡急性穿孔具有侵袭性小、腹腔干扰小、术后痛苦小、肠功能恢复快、住院时间短等优点，且不增加住院费用，可取代传统开腹修补术。     

茶叶中微量锰的新催化光度法测定

利用于氨三乙酸存在下，锰（Ⅱ）对高碘酸钾氧化二甲苯蓝ＦＦ的催化效应，建立了一个新的测定微量锰的动力学分光光度法。该法检出限为６×１０￣（－２）ｎｇ·ｍｌ￣（－１），线性范围为０．２～８．０ｎｇ·２．５ｍｌ￣（－１），常见离子基本不干扰测定。用于直接测定健齿茶和茉莉花茶中的锰含量，结果发现，锰含量分别为２２１４μｇ·ｇ￣（－１）及６４８μｇ·ｇ￣（－１）。此法简便易行，灵敏度高。     

Voices of the Afflicted

Over the past 10 years, I have been privileged to conduct educational forums for audiences containing many recovering alcoholics or otherwise chemically dependent persons. In these forums about the addictive diseases and their treatment and research possibilities, significant interaction with the audience members occurs. During these interactions, certain anecdotal phenomena seem to predominate. The repetitive nature of these reports suggests the need for systematic investigation. As with editorial comments in major medical journals, observed phenomena and unanswered questions from those afflicted can be valuable in the generation of testable hypotheses. Perhaps the ideas presented herein will be useful in the development of future research on alcohol abuse and alcohol dependence.     

Rehabilitation: the Cinderella of neurological research? A bibliometric study

Rehabilitation is under-represented in the neurological literature on disabling diseases. A Medline search was conducted to retrieve the articles published between January 1991 and June 1994 under the main headings of Stroke, Parkinson's disease, Multiple sclerosis, Brain injury, Ataxia and Dementia. These were then combined with the sub-heading Rehabilitation. The former search yielded 27724 articles, the latter 1272 (4.6%). In 1992, the Journal of Citation Reports (JCR) assigned to Journals publishing rehabilitation papers an average Impact Factor (IF) of 0.7–2.8 (median 1.8): that is, 31–90% (depending on the various main headings, median 68%) of the average IF given to Journals publishing non-rehabilitation papers. In the present study, the weight of the literature was defined as the product of the number of articles multiplied by the IF of the corresponding Journal (IF=0 for non-JCR Journals). Across the various neurologic conditions, the weight of the Rehab literature was 0.1–7% (median 2%) of the weight of the non-Rehab literature. The results suggest that neurology is still reluctant to face the disability challenge.

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Sommario La riabilitazione è scarsamente rappresentata nella letteratura neurologica sulle patologie che causano disabilità. Gli Autori hanno interrogato la banca-dati Medline nella ricerca degli articoli pubblicati fra il Gennaio 1991 ed il Giugno 1994 sotto le parole-chiave Stroke, Parkinson's disease, Multiple Sclerosis, Brain injury, Ataxia e Dementia. È stato poi eseguito un incrocio con la parola-chiave secondaria Riabilitazione.La prima ricerca ha prodotto 27724 articoli mentre la seconda ne ha prodotti 1272 (4.6%). Nel 1992 il Journal of Citation Reports (JCR) ha attribuito alle Riviste che hanno pubblicato articoli con tema riabilitativo un Impact Factor (IF) medio di 0.7–2.8 (mediana 1.8), pari al 31–90% (a seconda della parola-chiave principale: mediana delle percentuali 68%) dell'IF medio attribuito alle Riviste che hanno pubblicato soltanto articoli su temi non riabilitativi. In questo studio è stato definito come peso della letteratura il prodotto del numero di articoli per l'IF delle rispettive Riviste (IF=0 per le Riviste non censite dal JCR). A seconda delle diverse patologie neurologiche, il peso della letteratura riabilitativa variava fra 0.1 e 7% (mediana 2%) del peso della letteratura non riabilitativa.I risultati suggeriscono che la Neurologia sia ancora riluttante ad affrontare la sfida che le pone la disabilità.

     

House officers in general medicine: their perception of educational value of rotation components

Summary: As curriculum planners in general medicine residency training programmes we were concerned about house officers' anecdotal reports that hospital work requirements often overshadow individual learning goals. After each of five rotations, we asked residents to identify the educational 'usefulness' of certain rotation components which can be included in three categories; team members, work-related activities and educational events. Of 165 surveys distributed, 127 (77%) were returned. Data were analysed by residency year and by all years combined. The mean overall perception of learning was 3.9 out of a possible 5 points suggesting that residents do find some learning value. Results suggest that different residency years vary as to the significance of specific educational components. The importance of faculty/resident relationships to residents' perceptions of learning value was highlighted in particular.     

CT对眼球异物的诊断及定位

本文比较了11例眼球异物CT与X线影像，并经手术摘出异物证实，CT眼球异物检出及定位准确性均优于X线，尤其对球壁异物的定位，而且能显示断层眼球壁轮廓，具有直观效果，CT异物影像比异物明显扩大，应警惕CT伪影可能使球壁异物定位发生误差，CT目前尚不能完全取代眼球异物常规X线检查。