从病情危重度与住院费用的关系看卫生服务的公平性

公平合理地分配卫生资源是制定卫生政策的重要医学伦理学原则之一。作者在对高血压患者危重度分级的基础上，通过分析患者危重度等级与住院费用的关系，揭示了住院患者的资源消耗量与实际医疗需求相脱节的现象，提示我国卫生资源分配的公平性有待进一步提高。     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

医院感染及漏报率统计分析

目的　了解我院医院感染发生及漏报率。方法　将我院 2 0 0 3年 1～ 12月出院的所有病例进行回顾性调查。结果　医院感染率 7.3 2 %、漏报率 14 .93 %,均符合国家卫生部要求。结论　做好医院感染监测工作 ,严格执行各项工作制度 ,掌握医院感染与手术并发症的鉴别诊断 ,提高医院感染诊断的准确率     

从医德价值理念的建立看医德教育

医德教育不仅是一种知识传授，更是一种信念培养，因此必须引导学习建立医德价值的理念。这是改进医德教育的关键。     

新生儿肠旋转不良的诊治分析

目的 分析新生儿期先天性肠旋转不良的临床特点及诊治方法。方法 回顾分析1996～2003年12例新生儿期先天性肠旋转不良，男10例，女2例，就诊时出生7～75d，平均45d，术前均经泛影葡胺口服及灌肠造影确诊后行Ladd术，附加阑尾切除术。结果本组1例术后并发粘连性肠梗阻二次手术行粘连松解术，其余11例无并发症，全部治愈出院。结论 本病的发病机制是由于并发急性肠扭转所致高位十二指肠的梗阻，主要临床特点是反复间断性胆汁性呕吐，口服和灌肠的消化道造影是诊断本病的最可靠依据。Ladd式手术是本病手术治疗的最佳选择，且效果满意。     

Polymorphism p53 codon-72 and invasive cervical cancer: a meta-analysis.

OBJECTIVES: Although some studies have reported that the arginine isoform on codon 72 of p53 increases the susceptibility to invasive cervical cancer, such data remain controversial. The objective of this study was to quantitatively summarize the evidence for such a relationship. METHODS: Our data sources consisted of a MEDLINE search of the literature published before December 2002, bibliography review, and expert consultation. Thirty-seven studies met the inclusion criteria. Information on sample size, study design, Hardy-Weinberg equilibrium, and method of genotype determination was abstracted by two reviewers using a standardized protocol. The overall odds ratio (OR) of the p53 gene on invasive cervical cancer was estimated using the Mantel-Haenzel method. RESULTS: The overall OR (95% confidence interval) for cervical cancer among those with the homozygous mutant (Arg/Arg) was 1.2 (1.1-1.3, P=0.001) compared with those with the heterozygous mutant (Arg/Pro). By a cellular type of cervical cancer, the overall OR among those with Arg/Arg was statistically significant in adenocarcinomas (1.7, 1.1-2.6, P=0.024), but not in squamous cell carcinomas (1.1, 0.9-1.2, P=0.960), compared with Pro/Pro. Compared with Arg/Pro, the OR among those with Arg/Arg was statistically significant in HPV types 16 (1,5, 1.2-2.0, P=0.002). CONCLUSIONS: Overall, the p53 gene was associated with increased risk for invasive cervical cancer. However, the risk varied by country, cellular, and HPV type.     

切开复位内固定治疗股骨髁间骨折

目的探讨股骨髁间骨折的切开复位内固定临床价值。方法自1995年7月～2001年12月,采用切开复位,普通钢板、95°角钢板、DCS或髁部支撑钢板等内固定治疗股骨髁间骨折32例。根据AO/ASIF分类,C1型13例,C2型10例,C3型9例。根据术前术后X线片及术后膝关节功能恢复情况评价内固定效果。结果27例获得随访,随访时间9个月～7年,根据Sanders评分标准,优14例,良9例,差4例。结论切开复位内固定是治疗股骨髁间骨折的理想选择。     

滇缅边境打洛镇6年的疟疾防治措施与效果

方法:1983—1985年在滇缅边境打洛镇采取DDT加DDVP全面滞留喷洒灭蚊,1986—1988年改用溴氰菊酯浸泡蚊帐灭蚊,并均辅以现症病人根治、重点人群保护和流动人口预防服药等综合性防治措施。结果:防治后全镇1983—1988年的年带虫发病率依次降为10.1‰、5.8‰、5.5‰、4.8‰、14.4‰和10.1‰。各年均明显较全面防治前1982年的29.0‰低。有效控制了疟疾流行。     

纤维支气管镜与间接喉钳手术治疗声带疾病

目的进一步研究声带小结与息肉的治疗手段。方法采用日本OlimpusBFp20型纤支镜和国产FF-99光电子内窥镜显示仪，配合间接万向喉钳治疗声带小结和息肉57例。结果治愈率92％，病人痛苦小。结论纤支镜配合间接喉钳手术治疗声带小结和息肉效果良好。     

奥明格健脑口服液改善小鼠记忆的作用

目的观察奥明格健脑口服液对改善小鼠记忆作用的影响。方法断乳小鼠，体重１２～１４ｇ，每组１４～１６只。把实验动物随机分为正常对照组、高剂量组、中剂量组和低剂量组，连续给样３０ｄ，进行跳台和水迷宫试验，以上试验按同样方法重复一次。结果两次小鼠实验表明，灌胃奥明格健脑口服液１ｍｏ后，跳台试验中受电击动物数和错误总数，各试验组均低于对照组，其中高剂量试验组显著低于对照组，而且潜伏期显著延长。水迷宫试验中，动物到达终点所需时间和错误总数，高中剂量组试验组均显著低于对照组。结论奥明格健脑口服液具有改善动物记忆的作用。