江门市新会区水源水监测结果分析

目的了解江门市新会区水源水水质状况,为合理选择水源、水源保护和卫生监督管理等提供科学依据。方法对江门市新会区2008—2012年水源水的监测结果进行整理分析,按GB3838—2002《地表水环境质量标准》Ⅲ类标准进行分析评价。结果水源水中的铁、总氮、锰和粪大肠菌群的合格率较低;年度间合格率差异有统计学意义（χ^2=11．74,P〈0．05）;丰、枯和平水期水源水合格率差异无统计学意义（P〉0．05）;水库水合格率高于河水,两者差异有统计学意义（χ^2=23．01,P〈0．05）。结论江门市新会区镇级以上供水单位水源水主要受铁、总氮、锰和粪大肠菌群的污染,需采取措施加强对水源水的保护和对已经污染的水源的治理。     

Sonography-guided trigger point injections in abdominal myofascial pain syndrome

Even though chronic abdominal pain is 1 of the most common reasons for hospital visits, diagnostic testing is often time-consuming and treatment is inadequate. Abdominal myofascial pain syndrome (AMPS) is usually not included as a differential diagnosis, but it should be considered in cases of chronic abdominal pain. The purpose of this study was to investigate the clinical characteristics of AMPS and to assess the effect of sonography-guided trigger point injections (TPI).A total of 100 patients with AMPS from 2012 to 2018 were retrospectively evaluated for clinical characteristics and TPI effects. AMPS was diagnosed using Srinivasan and Greenbaum''s criteria, and the TPIs were performed at intervals of 2 to 4 weeks. The Visual Analog Scale (VAS) ratio was calculated by subtracting the final VAS from the initial VAS score and dividing it by the initial VAS score after injections, and the patients were divided into 4 groups: non-responders, mild, moderate, and good responders.The median duration of pain was 12 months, and the median number of hospital visits before TPI was 2. Of the 100 patients, 66 (66%) were categorized as good responders, 11 (11%) as moderate responders, 7 (6.9%) as mild responders, and 16 (15.7%) as non-responders. When the initial and final VAS scores were compared, the sonography-guided injections were found to be effective in alleviating pain (P < .001). Moreover, patients who received the injections 2 or more times tended to have more significant pain reduction than those who received a single injection (P < .001).Patients with AMPS suffer from long-term pain and undergo many hospital visits and diagnostic tests. TPI with lidocaine can be an effective and safe treatment for patients with chronic AMPS.     

TMS by double-cone coil prefrontal stimulation for medication resistant chronic depression: A case report

A double-cone coil with large angled windings has been developed to modulate deeper brain areas such as the anterior cingulate cortex (ACC). Abnormal resting state activity in the pregenual ACC (pgACC), dorsal ACC (dACC) and subgenual ACC (sgACC) has been observed in depression. A patient with medication resistant chronic depression received ten sessions of transcranial magnetic stimulation (TMS) (10 Hz, 2000 stimuli/session) using a double-cone coil placed over the supplementary motor area, targeting the anterior cingulate. Source localized EEG recordings were conducted pre- and post-TMS. The Beck Depression Inventory (BDI-II) improved by 27%, and the two subscales of the Hospital Anxiety Depression Scale (HADS), namely depression (40%) and anxiety (33%) improved as well. Along with the clinical improvement eletrophysiological resting state activity changed in the dACC and sgACC in this patient in comparison to a normative group. The results of this case report further support the involvement of pgACC, dACC and sgACC activity in the pathophysiology of depression and indicate that modulation of neural activity in this area by high frequency TMS with a double-cone coil might represent a new promising approach in the treatment of medication resistant chronic depression.     

强阿片类药物相关性便秘患者耳穴敏感点探测分析

目的探测强阿片类药物相关性便秘患者耳穴敏感点分布情况,为护理人员选穴干预提供参考。方法选择138例符合纳入与排除标准的患者,采用耳穴探测仪对患者左、右耳37个穴位进行探测。统计出现阳性反应的耳穴及数量,并对阳性率较高的耳穴进行组合,分析其分布规律。结果阳性率较高的前4种耳穴依次为:皮质下(63.8%)、脑干(60.0%)、腹(57.2%)、大肠(37.0%);对阳性率较高的前4种耳穴进行组合发现,以4个耳穴中任意选择3个组合或4个耳穴一起组合阳性率最高,达76.1%。结论皮质下、脑干、腹穴、大肠是强阿片类药物相关性便秘患者阳性反应点,可为今后干预阿片类便秘提供选穴处方。     

2013年我院住院患者来源分析

目的：通过分析住院患者来源情况,为医院管理决策提供依据。方法采用回顾性研究,对住院患者分布进行统计分析。结果2013年收治德阳市城区患者占62.24%,同比增长6.26%;收治郊县区患者占33.57%,增幅15.76%;其他地区患者占4.26%,增幅3.90%。结论医疗市场高度集中于城区,周边县市市场还需要拓展。     

Prevalence and sensitivity of trigger points in lumbo-pelvic-hip muscles in patients with patellofemoral pain syndrome

ObjectivesChanges in the activity of the lumbo-pelvic-hip muscles have been established as a major cause of patellofemoral pain syndrome (PFPS), a common orthopedic problem. The present study aimed to compare the prevalence and sensitivity of myofascial trigger points (MTrPs) in lumbo-pelvic-hip muscles in persons with and without PFPS.MethodsThirty women with PFPS and 30 healthy women 18–40 years old were recruited for this study. The prevalence of MTrPs was assessed by palpation, and pressure algometry was used to measure the pressure pain threshold. This study evaluated the areas where MTrPs are most commonly found in the lumbar muscles (internal oblique, erector spinae and quadratus lumborum), pelvic muscles (gluteus maximus, gluteus medius, gluteus minimus and piriformis), and hip muscles (hip adductor, quadriceps, hamstring, tensor fascia lata and sartorius). Independent t-tests were used to compare mean pressure pain thresholds between the two groups. Chi-squared tests were used to compare the prevalence of MTrPs.ResultsThe prevalence of MTrPs was significantly higher in most of the lumbo-pelvic-hip muscles in patients with PFPS compared to healthy persons. However, there were no significant differences between groups in the prevalence of MTrPs in the gluteus minimus or adductor muscles. The pressure pain threshold in lumbo-pelvic-hip muscles was lower in patients with PFPS compared to healthy participants.ConclusionIn patients with PFPS the prevalence of MTrPs in the lumbo-pelvic-hip region was higher, and the pressure pain threshold was lower, than in healthy people. Thus therapy to treat PFPS should target the lumbo-pelvic-hip muscles.     

音乐疗法联合针刺与耳穴按压在初产妇分娩中的应用

目的探讨音乐疗法联合针刺与耳穴按压在初产妇分娩中的效果。方法采用便利抽样法,选取2017年6—12月于浙江大学舟山医院产科分娩的初产妇90例为研究对象,按随机数字表法分为干预组和对照组各45例。对照组采用音乐疗法,收听患者自己喜欢的音乐,干预组在对照组基础上采用针刺与耳穴按压。比较两组产妇的疼痛数字评分(NRS)、宫口开3~10 cm的时间、新生儿阿普加评分及产后2 h出血量。结果在宫口开≥3 cm时,两组初产妇NRS评分比较差异无统计学意义(P>0.05);镇痛后30 min和宫口开全时,干预组的NRS评分均低于对照组,两组比较差异有统计学意义(P<0.05)。干预组患者宫口开3~10 cm的时间短于对照组,两组比较差异有统计学意义(P<0.05)。两组患者的新生儿阿普加评分、产后2 h出血量比较,差异无统计学意义(P>0.05)。结论在音乐疗法的基础上联合针刺与耳穴按压能减轻分娩疼痛,缩短宫口开全时间,且对母婴安全,效果优于单纯音乐疗法,值得推广应用。     

公共场所异味来源及消毒除味方法

目的 研究目前公共场所异味来源及消毒除味方法。方法 在中国知网、万方、PubMed、Web of Science、Science Direct数据库检索1995年1月—2021年7月国内外关于公共场所异味的相关性研究53篇，并对文献进行整理归纳与总结。结果 公共场所异味产生的来源有公共卫生用具、建筑及装修材料、家具及装饰类用品、集中空调系统、流动人群和周围工业污染等六大类。消毒除味的物理方法包括通风、电离、吸附、吸收、膜分离，化学方法包括光催化氧化、臭氧催化氧化和二氧化氯消毒和生物方法包括酶氧化、植物净化和生物过滤器。结论 公共场所异味来源多、消毒除味方法种类多，但不同方法的使用有一定限制，今后需要加强现有方法的优化、新方法的开发及这些方法的效果监测。     

气象对胃经五输阻抗值影响的初探

目的:观察数据中不同季节因素对人体胃经五输穴的阻抗值是否有显著影响,用以判断季节因素是否对人体胃脏有显著影响。方法:试用自行研制脏腑疾病诊断仪DM-Ⅰ,测试180例无胃病及其循行经脉病的健康人胃经五输体表阻抗值。结果:经过统计方法处理,发现α=0.05水平下,季节对各个穴位的测试值没有显著性差异(p>0.05)。结论:可以排除季节变化因素对胃输五经阻抗值测定的影响。