Risk factors for mental disorder hospitalization after the Persian Gulf War: U.S. Armed Forces, June 1, 1991-September 30, 1993

Effects of Persian Gulf War (August 2, 1990–July 31, 1991) and Gulf War occupation on post-War hospitalization risk were evaluated through Cox proportional hazards modeling. Active-duty men (n = 1,775,236) and women (n = 209,760) in the Army, Air Force, Navy, and Marine Corps had 30,539 initial postwar hospitalizations for mental disorders between June 1, 1991 and September 30, 1993. Principal diagnoses in the Defense Manpower Data Center hospitalization database were grouped into 10 categories of ICD-9-CM codes. Gulf War service was associated with significantly greater risk for acute reactions to stress and lower risk for personality disorders and adjustment reactions among men. Personnel who served in ground war support occupations (men and women) were at greater risk for postwar drug-related disorders. Men who served in ground war combat occupations were at higher risk for alcohol-related disorders. Longitudinal studies of health, hospitalization, and exposure beginning at recruitment, are needed to better understand how exposure to combat affects the mental health of military personnel.     

我国农村地区实施大病统筹合作医疗或医疗保险方案的技术缺陷

在我国中等发达及上农村地区,大病统筹合作医疗或医疗保险以其可缓解农村居民的就医经济风险而受到欢迎,但是在方案的拟订过程中尚存在一些明显的技术缺陷,比如,“大病”的技术定义、农村居民就医经济风险分析、风险临界线界定、保险经付比测算和保险费率厘定等,这些技术的缺乏,已严重影响农村合作医疗或医疗保险的推广和实施效果。     

The diluting effect of medical work groups on feedback efficacy in changing physician's practice

Feedback intervention has been advocated as a successful method to modify the way that physicians practice medicine. However, most studies concerned with modifying physician profiles have focused on interns and residents. The results presented here concern regular staff and therefore provide a better basis for generalization. Over a 2.5-year period, we analyzed the use of clinical resoucces by physicians practicing in four medical specialties in two hospitals. Hierarchical multiple regression models were used to control case mix in order to identify the specific effects attributable to feedback. The information failed to modify the physicians' practice profiles. Our results suggest that this failure is related to the organization of inpatient medical practice as a group effort. This mode of practice has a negative effect on feedback efficacy. First, it weakens one of the main feedback mechanisms, that is personal identification with the data. Second, it probably generates mutual adjustment among physicians, thus eliminating practice variations at the source.     

Metallurgical evaluation of the compatibility of surgical clips with their appliers

Summary Five aneurysm clips and their respective appliers (Heifetz, Vari-Angle, McFadden, Scoville, and Yaargil) were tested for the production of small metal shards that could provoke a foreign body reaction or increase the risk of a stresscorrosion failure. Pivot and Vari-Angle-McFadden clips produced numerous large shards, the Scoville clip produced a few fine shards, and the Yaargil and Heifetz clips produced none. Metal shard production due to cold metal transfer is attributed to the abrasive mechanical interaction between clips and appliers made from metals with different degrees of hardness.     

反复流产患者的中医护理对策

目的 :探讨结合现代护理观为指导的具有中医特色的整体护理模式。方法 :运用中医基础理论知识 ,针对引起反复流产患者的病因 ,将患者主要分为内分泌异常型、免疫异常型、生殖道异常型、感染型、全身性疾病影响型、染色体异常型施以护理。结果 :依据不同证型 ,有的放矢的实施护理 ,使患者明确了引起反复流产的根本原因、治疗措施、注意事项、预防保健方法 ,消除了紧张、恐惧、焦虑等心理障碍 ,树立了再次妊娠的信心 ,提高了妊娠成功率     

若干疾病中医证的流行病学研究进展

以流行病学在病证结合的中医“证”研究中的应用为线索，光盘检索和手工查阅了1997—2002年的期刊文献，对若干疾病运用流行病学方法进行的大样本(100例以上)的中医证型临床研究结果作一个回顾和小结，从流行病学和统计学的角度分析科研和论文中存在的问题，提出改进方法和展望。     

中药结合中医经络诊断仪诊治神经性头痛157例

目的 探讨中医经络诊断仪与中医学的辨证施治相结合治疗神经性头痛。方法 用中医经络诊断仪对157例神经性头痛患者进行检测，区分虚实，然后结合中医辨证分型进行中药治疗，1个疗程后再用中医经络诊断仪复查，比较两次检查结果，再结合临床观察疗效。结果 实证平均总有效率达88．5％，虚证平均总有效率达90．8％。结论 中医经络诊断仪为中医学的辨证施治提供了一种量化的手段。     

慢性阻塞性肺病患者生存质量与中医证候的关系研究

探讨慢性阻塞性肺病(COPD)中医证候与患者生存质量的关系及其规律.采用生存质量综合评定问卷-74(GQOLI-74)对114例COPD不同中医证候患者的生存质量进行评价研究.结果不同中医证候COPD患者的QOL均明显受损,瘀血证、肺肾气虚证对COPD患者QOL的影响有统计学意义(P＜0.05);血瘀证患者QOL变化主要体现在工作与学习、运动与感觉、负性情感、进食、人际交往和性功能等方面.提示COPD证候与患者QOL存在着一定关系.     

末治脾肾,能起沉疴--单纯中药治疗乙肝相关性肝癌1例

探讨中药审因论治对乙肝相关性肝癌的治疗作用。应用调补脾肾、搜邪泄浊法 ,对一例乙肝相关性肝癌患者进行单纯中药治疗。结果 :经过 12个月治疗 ,AFP由最高 10 0 0 0 μg/L降至正常 (<2 0 μg/L) ,AFP异质体同步转阴 ,B超、MRI显示肝部实质性肿块消散 ,肝功能好转。提示本治法对肝癌具有较好的治疗作用。     

Outbreak of nosocomialAcinetobacter baumannii bacteremia in a high risk ward

Acinetobacter baumannii is emerging as a major cause of nosocomial infections particularly in high risk patients. Being resistant to adverse environmental conditions, it can stay for prolonged periods in the hospital environment. We report an outbreak in the medical oncology ward where nine patients suspected of bacteraemia were blood culture positive forA. baumannii from the two samples each, one collected through the i.v. cannula and another through the peripheral venous puncture. The bacteria was also isolated from the environmental sources from the various samples collected. The biotype, antibiogram, cellular protein profiles on SDS-PAGE and the restriction enzyme analysis patterns of the patient isolates and the environmental isolates were similar. This points to the environment as a source of infection. With reinforcement of proper barrier nursing and use of disposable heparine ampoules it was possible to control the outbreak.