Neuroleptic malignant syndrome during low dosed neuroleptic medication in first-episode psychosis: a case report

 Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal side-effect of antipsychotic drug therapy, especially of dopamine receptor antagonists. As a dose relationship has been postulated, low dose neuroleptization would be expected to help to avoid this side-effect. In contrast, we report on a 21-year-old female following low dose fluphenazine treatment with 2.5 mg/day. The patient recovered from NMS after 3 days of dantrolene administration. Eventually, remission from psychotic symptoms was achieved with clozapine. At 8-month follow-up, psychopathology remained stable and there were no more signs of NMS. Received: 8 July 1998 / Final version: 6 November 1998     

西藏高原藏族患者用药依从性调查

目的 :了解西藏高原藏族患者用药依从性现状 ,探讨提高患者用药依从性的方法。方法 :采用问卷调查法 ,对188例藏族患者进行疾病种类、用药情况、依从性情况调查。结果 :用药依从性与疾病性质、患者文化程度、患者对疾病的认知程度有关。提高患者对疾病及其药物治疗的认知程度 ,强化医师与患者的沟通及加强用药指导不失为提高患者用药依从性的好方法。结论 :针对不同年龄患者 ,其用药咨询服务内容应有所区别     

药浴剂的研究和应用

药浴剂为综合性新剂型。药浴剂是医务工作者在患者的配合下共同配制的洗浴药水。药浴剂在给药范围上应用广泛；在用药途径上，属于外用药中的一种；在治疗方法上属于透皮疗法；在临床应用上，可以治疗或辅助治疗各学科的多种疾病。药浴剂治疗疾病的机理有二，其一是透过全身汗毛孔进入体内，其二是刺激各个穴位，通行十二经脉，透达全身，激活或调动体内各器官和组织的积极因素，以加强五脏六腑的功能，达到治疗疾病的目的。     

论医疗纠纷处理技巧与防范程序的建立

近年来,医院发生医疗纠纷的频率有上升态势,处理纠纷难度亦日益加大,是医院管理者经常面临的难题。依据多年从事医院医疗质量管理的实践经验和相关资料分析认为:医疗纠纷增多的现象不仅与医务人员的医疗技术、服务态度、管理人员素质、管理作风和医院对纠纷处理的方式有关,与公民的社会保健知识和法律意识的增强等因素亦有相关性。令人满意的医疗纠纷处理办法在于是否能从错综复杂的医疗纠纷中寻找其发生、发展和解决的规律,处理医疗纠纷重在把握好三个基本原则和运用技巧。此外,认为解决纠纷与防范纠纷具有同等的重要性,并对医疗缺陷防范程序的建立以及在现代医院管理中的意义进行了初步探讨。     

Diabetic nephropathy in children and adolescents: a critical review with particular reference to angiotensin-converting enzyme inhibitors

Clinical diabetic nephropathy is a well-recognized cause of increased morbidity and mortality in patients with type 1 diabetes. The finding that microalbuminuria predicts progression to overt nephropathy has allowed early diagnosis and preventive interventions. Several studies have demonstrated that treatment with angiotensin-converting enzyme (ACE) inhibitors slows down the rate of decline of the glomerular filtration rate in type 1 diabetes patients with established proteinuria. The renoprotective properties of the ACE inhibitor captopril extend beyond its antihypertensive effects. ACE inhibitors represent the most appropriate class of antihypertensive drugs for treating type 1 diabetes patients because of their efficacy and safety. When microalbuminuria is detected and confirmed in a diabetic child or adolescent, and if it persists despite 6-12 months of improved metabolic control, treatment with ACE inhibitors should be started, even if the child is normotensive. Careful follow-up of renal function is essential.     

Recommendations for medical management of hereditary breast and ovarian cancer: The French National Ad Hoc Committee

Background and purpose: Almost 10% of breast and ovarian cancers are familial, and the majority are linked to BRCA1 and BRCA2 germline mutations. Despite uncertainty about the management of female gene carriers, consensus guidelines have been established to assist practitioners and consultees in making health care decisions.Methodology: The Ad Hoc Committee was composed of 14 experts appointed by the French National Institute for Health and Medical Research, all of whom attended eleven workshops at which more than 3500 articles were systematically analyzed. Five additional experts critically analysed the first version of the report.Criteria and decision process: On a probability scale of the risk of developing breast or ovarian cancers, two thresholds were defined for use in determining whether an intervention would be worthwhile. The first is the threshold above which an intervention can be envisaged or recommended, and the second is the one below which an intervention can be ruled out; between the two, the decision has to be made on a case-by-case basis.Screening and preventive strategies analyzed: With respect to breast cancer: 1) hormonal interventions; 2) primary prevention (diet, family planning and chemoprevention); 3) screening (breast self-examination, clinician breast examination, tumor markers, imaging); 4) prophylactic mastectomy. With respect to ovarian cancer: 1) hormonal stimulation; 2) screening (clinical screening, ultrasound and tumor markers); 3) prophylactic oophorectomy.Main conclusions: For each strategy the following points were addressed: the information to be given to the consultee, the procedure and the indications. In addition, the committee's opinion about BRCA1 and BRCA2 mutation screening is that population-based, or even large-scale, implementation are not justified. Although no scientific evidence is available, the committee feels that specific management is indispensable and advocates the use of defined and evaluated procedures, and participation in clinical trials.     

某高校教职工健康状况调查

目的　了解我校教职工健康状况和疾病谱特征 ,为制定预防措施提供依据。方法　对 1 75 2名教职工健康检查数据进行统计分析。结果　我校教职工平均患病率为 88.30 % ,患病率随年龄增长而上升。高脂血症患病率最高 ,占 4 5 .89%。结论　加强高校保健服务 ,开展针对教职工的健康教育 ,是今后高校卫生保健工作的重要内容     

羊膜加巩膜前部覆盖防治羟基磷灰石义眼座眶内植入暴露的临床分析

目的:探讨羊膜加前部巩膜覆盖对防治羟基磷灰石(HA)义眼座植入暴露的临床效果。方法:采用羊膜联合自体或异体巩膜为加固物对13例(13眼)行Ⅰ、Ⅱ期HA义眼座植入,随访12～20mo。结果:13例均获得了较好的疗效,未见其他并发症。结论:在行HA义眼座植入时采用羊膜联合前部自体或异体巩膜覆盖加固有利于结膜创口的愈合,预防创口裂开,减少义眼座暴露。     

阻断乙型肝炎病毒母婴传播对血清病毒转录体的影响

目的进一步探讨阻断乙型肝炎病毒（HBV）母婴垂直传播的效果，明确携带HBV孕妇干预治疗对保护婴儿抗-HBV感染的意义。探讨乙型肝炎病毒转录体（RNA）检测在母婴传播诊断中的意义。方法将91例HBsAg／HBeAg呈阳性孕妇分成两组。其中治疗组为61例，以乙肝免疫球蛋白（HBIG）与左旋咪唑涂布剂阻断治疗；对照组为30例。治疗组在孕26周起开始阻断治疗，自母亲及其婴儿血清和母亲乳汁中提取核酸，经PCR及RT—PCR分别扩增HBV DNA和RNA，Southern—blotting验证反应的特异性，取代表性产物克隆、测序，检测血清HBV DNA及全长型（IRNA）和顿挫性转录体（trRNA）。结果治疗组和对照组新生儿外周血HBV DNA、fRNA和trRNA的阳性率分别为3．3％，3．3％，47．5％和6．7％，13．3％。70．0％。治疗组的前二项指标明显低于对照组，差异有显著意义（P〈0．01），但trRNA差异无显著意义（P〉0．05）。结论携带HBV孕妇于孕晚期给予HBIG和左旋咪唑涂布剂阻断治疗后，婴儿HBV DNA和fRNA携带率明显降低。治疗组和对照组均有超过1／2的患儿携带trRNA。trRNA在HBV母婴垂直传播过程中有可能是一个出现更早期的可检测指标，有助于确定新生儿HBV感染的状态。     

足疗与保健服务质量评价模型研究

足疗保健行业的快速发展产生了服务质量问题，如何科学评价服务质量已成为重要课题。文章论述了已有服务质量评价模型的特点，探索了服务质量评价模型研究的方向，提出了足疗保健服务质量评价模型的建立步骤。