2001年与2004年抗菌药物应用情况比较

目的　了解抗菌药物应用的基本情况。方法　将 2 0 0 1年 3月 14 3 0例住院患者病历与 2 0 0 4年 3月的 2 0 66例住院患者病历进行回顾性调查和对比分析。结果　 2 0 0 1年的 14 3 0例中有 948(66 3 % )例 ,和 2 0 0 4年的 2 0 66例有 10 60例 (5 1.3 % ) ,应用了抗菌药物。结论　定期检查考评 ,严格掌握用药指征 ,是加强抗菌药物应用管理的关键。     

临沂地区三十年丝虫病防治与研究

班氏丝虫病分布于临沂地区的13个县市,淡色库蚊为主要传播媒介,据开始防治前的1957年调查,微阳率15.03％;经60年代部分县的防治,70年代大面积的普查普治和重点病区的全民服药以及食用“海盐”防治,至1983年微阳率已降至0.16％。通过1984～1986三年的横纵向监测,微阳率处较低水平,未见回升趋势,蚊媒自然感染率已接近于0;在抽查10岁以下的15974名儿童中未有新感染,显示我区丝虫病传播已基本阻断。     

575名新疆汉族青年学生手长、掌长与身高的关系

目的：研究新疆汉族青年手长、掌长与身高的关系，为人类学、法医学提供参考，同时为中国人体质调查积累资料。方法：应用Ｈｒｄｌｉｃａｓ标准和我国普遍采用的方法测量了５７５名（男２７０名，女３０５名）１８～２４岁汉族青年学生的手长、掌长和身高，并将原始数据进行医学统计学处理。结果：按年龄组和性别组计算出各组手长、掌长和身高的均值，身高与手长、掌长的比值。并提出由手长、掌长推算身高的简单公式（身高＝手长×比值，身高＝掌长×比值）和回归方程（身高＝回归系数×手长＋截距，身高＝回归系数×掌长＋截距）。结论：手长、掌长和身高各组性差有显著性（Ｐ＜０．０１）；由手长、掌长推算身高的简单公式和回归方程成立（Ｐ＜０．０５）。     

Evaluation of Hemoperitoneum Using a Single- vs Multiple-view Ultrasonographic Examination

Objective: To compare the sensitivities, specificities, and accuracies between a single-view ultrasonography (US) technique and a multiple-view technique for identifying hemoperitoneum in multiple-trauma patients.
Methods: Data from a prior prospective study of US for trauma diagnosis at a level I trauma center were retrospectively analyzed. A convenience sample of adult patients (≥ 18 years of age) who had presented with major blunt or penetrating torso trauma and had undergone rapid trauma US examinations to detect hemoperitoneum were reviewed. The US interpretations by emergency physicians had been recorded prior to obtaining other diagnostic tests. Five views were evaluated, including the right intercostal oblique view examining Morison's pouch. Evidence of free intraperitoneal fluid by exploratory laparotomy, CT, or diagnostic peritoneal lavage (DPL) was used as the criterion standard.
Results: Of the 245 patients entered into the study, 37 had free intraperitoneal fluid, confirmed by CT, DPL, or exploratory laparotomy. With the multiple-view technique, US was 87% (95% CI = 71%, 96%) sensitive, 100% (95% CI = 97%, 100%) specific, and 98% (95% CI = 95%, 100%) accurate. The single-view technique, evaluating only Morison's pouch, was 51% (95% CI = 34%, 68%) sensitive, 100% (95% CI = 98%, 100%) specific, and 93% (95%. CI = 89%, 96%) accurate.
Conclusions: An initial trauma US examination using a multiple-view technique is more sensitive than that using a single-view technique for detecting hemoperitoneum in trauma patients.     

氨甲喋呤配伍中药治疗未破裂型输卵管妊娠(附86例报告)

目的：探讨用氨甲喋呤（Methotraxate,MTX)配伍中药治疗条件适宜的输卵管妊娠的可行性及疗效。方法：对MTX配伍中治疗的输卵管妊娠86例临床资料进行分析。结果：82例治疗成功，成功率为95．35％，其中，治疗1个疗程69例，2个疗程13例，随访16例妊娠，1例2年后对侧输卵管妊娠，4例治疗失败者改手术治疗，病理见不同程度的滋养细胞溶解，绒毛坏死，出血，结论：使用MTX配伍中药治疗输卵管异位妊娠，方法简便易行，安全有效，副作用少，特别适合于基层医院。     

How do clinicians learn to request permission for autopsies?

A postal survey of 434 clinicians at four local hospitals was undertaken in order to identify the methods by which clinicians learn how to request permission for hospital autopsies and to assess the preferred techniques and timing of relevant communication skills training. The majority of 128 responding clinicians had learnt through personal experience with some assistance from senior colleagues and peers. Few clinicians appeared to have learnt through formal training. The preferred methods for the provision of communication skills training were training in small groups (such as seminars or tutorials) and observation of clinicians at work. The most desirable time for the provision of this training was considered to be between the beginning of the final undergraduate year and the end of the pre-registration house officer year. The communication skills training provided within medical education is in need of improvement. More emphasis should be given to clinical-task- or situation-specific applications such as requesting permission for autopsies.     

基础医学教师课堂教学质量评价

为了了解本科教师的教学质量和教学效果 ,教学专家和学生评价了 14 7位基础医学教师。结果显示 ,讲师以上职称教师的教学质量明显好于初级职称教师 (P<0 .0 5 ) ,高级职称教师教学的科学性、艺术性和思想性明显好于讲师和助教 (P<0 .0 5 )。文章还对教学中存在的问题和对策进行了讨论。     

Why do long-distance runners not have more bone? A vital biomechanical explanation and an estrogen effect

Inanimate structures cannot detect and repair their fatigue damage or microdamage, so to minimize it they need more structural material and strength. Living bone handles this matter differently. Bone modeling drifts adapt bone architecture and strength to the loads on bones in ways that tend to keep strains from exceeding a “modeling threshold” range. Strains (or equivalent features) above that threshold switch mechanically controlled modeling ON. Where strains stay below that threshold, this modeling goes OFF. Repeatedly loading-deloading a bone causes microdamage in it, and basic multicellular unit (BMU)-based bone remodeling normally repairs it. Where strains stay below an operational “microdamage threshold,” remodeling can repair whatever microdamage happens for as long as it happens. Strains above that threshold can cause too much microdamage to repair completely and lead to fatigue fractures of trabeculae or whole bones. The modeling threshold normally lies comforably below the microdamage threshold. Since modeling normally adjusts bone architecture to keep strains from exceeding the modeling threshold, this keeps strains below the microdamage threshold, too, and voluntary activities do not cause more microdamage than remodeling can repair. Therefore, long-distance runners do not need more bone mass and strength than nonrunners of comparable age, sex, and body size.