46例Wernicke脑病的临床、影像学、治疗及预后

目的 探讨Wernicke脑病的病因、临床表现特点、MRI表现及预后.方法 对46例Wernicke脑病患者的病因、发病机制、临床表现、头颅MRI特点和预后进行了回顾性分析.结果 Wernicke脑病病因多与维生素B1缺乏有关,慢性酒精中毒仍是其主要病因(本组占56.5%),临床经典三联征少见,易漏诊、误诊,主要临床表...     

护理人员311例接种甲型H1N1流感疫苗免疫效果分析

目的了解内蒙古大兴安岭地区医院中的护理人员接种甲型H1N1流感疫苗的免疫效果。方法选用随机采样的方法,对311名接种者的特异性抗体进行调查分析,采用酶联免疫吸附试验（ELISA）法半定量测定人血清中H1N1IgG含量。结果接种甲型H1N1流感疫苗后93d内的抗体的阳转率为86.17%。所产生的特异性抗体在各年龄段之间比较,差异没有统计学意义（P〉0.05）;免疫60d内的阳转率在92.98%以上,免疫80～93d的阳转率已经降至80%以下,差异有统计学意义（P〈0.01）。结论内蒙古大兴安岭地区医院中的护理人员接种甲型H1N1流感疫苗工作取得了非常好的免疫效果。     

505名医务人员接种甲型H1N1流行性感冒疫苗3个月内的免疫效果分析

Objective To investigate the immunization effect of influenza A/H1N1 vaccine in health care workers (HCW) in Inner Mongolia Greater Khingan Mountains area. Methods Five hundred and five HCW who received A/H1N1 influenza vaccination (immunized group) and 129 staffs who didn't receive the vaccination (unimmunized group) were randomly sampled for semiquantitative testing of serum H1N1 antibody (IgG) levels by enzyme-linked immunosorbent assay (ELISA).Results were analyzed and stratified by age, sex, occupation and the time interval between the time of vaccination and serum sample collection. The antibody positive rates of the two groups were compared by x2test. Results There were 401 (79. 4%) HCW whose H1N1 antibody were positive and 50 (9.9%) whose antibody were weak positive among 505 immunized HCW. While among 129 unimmunized HCW, there were 59 (45.7%) whose antibody were positive and 15 (11.6%) whose antibody were weak positive. The seroconversion rates of specific antibody were not significantly different among the different age groups after receiving A/H1N1 influenza vaccine (P＞ 0.05).However, there were statistical differences of the seroconversion rates among different sex groups (men 95.7% vs women 87.4% in immunized group, x2=6.40, P＜0.05; and men 73.3% vs women 52.5% in unimmunized group, x2 =4.07, P＜0.05) and different occupation groups (doctor 86.0% vs nurse 94.5% in immunized group, x2 = 9. 16, P＜0.01; and doctor 43. 8% vs nurse 75.0% in unimmunized group, x2=12.61, P＜0.01 ). The seroconversion rate was 81.5% after 80 to 89 days of vaccination, which was significantly lower than those after 30 to 39, 50 to 59 days and 60 to 69 days of vaccination, which was 100.0%, 94.7% and 93.6%, respectively (x2 =3.96, P ＜0.05; x2=7.15, P ＜0. 01; x2 = 9. 98, P＜0. 01). Conclusions A/H1N1 influenza vaccination can induce effective immune response in HCW in Greater Khingan Mountains area of Inner Mongolia. However,the level of specific antibody significantly reduces after 80 to 89 days of vaccination.     

超声生物显微镜测量慢性原发性闭角型青光眼进展期手术前后眼前节结构的比较

目的：客观评价慢性原发性闭角型青光眼（chronic primary angle closure glaucoma,CPACG）进展期小梁切除加虹膜根部切除术前后眼前节结构变化,探讨眼压变化机制。方法：以18例CPACG为研究对象,应用超声生物显微镜（ultrasound biomicroscopic,UBM）,于降眼压前及手术后第7 d分别进行眼前节结构定量测定,对测量结果进行统计学分析。结果：反映瞳孔阻滞的参数前房深度和虹膜晶状体接触距离,手术前后变化差异有显著性（P＆lt;0.05）;反映眼前节结构拥挤状况的参数小梁睫状体距离和巩膜睫状体夹角,手术前后变化差异无显著性（P＆gt;0.05）;反映房水循环状况的参数睫状突厚度和房角开放距离500,手术前后变化差异无显著性（P＆gt;0.05）。结论：小梁切除加虹膜根部切除术后,没有根本改变CPACG眼前节结构整体前移所致的拥挤状况。手术后眼压的变化仍然依赖滤过泡的功能状态。     

自制灌注器

1．制作方法：取1只1ml一次性注射器，支除活塞，保留空筒部分。另取1只口号注射针，去除针梗，保留针栓部分。用牙托粉将针柱与注射器空简尾部粘连即可。（图1）2使用方法：（回）在白内障囊外摘出除术截囊时，将自制灌注器乳头部接于截囊针，针检部接于带有灌注液的一次性输液器，调整好灌注液的水流即可进行。（2）在挽核时，将自制灌注器乳头部接于灌注式晶体圈，针栓部仍接于输液器，调好灌注液的水流即可进行。（3）在注吸皮质时，将自制灌注器乳头部接于注吸针头，针检部接于输液器，调整好灌注液的水流即可进行。3．优点：应用该自…     

505名医务人员接种甲型H1N1流行性感冒疫苗3个月内的免疫效果分析

目的 了解内蒙古大兴安岭地区医务人员接种甲型H1N1流行性感冒(流感)疫苗的免疫效果.方法 采用单纯随机抽样方法,通过ELISA法对505名接种和129名未接种H1N1流感疫苗的健康医务人员半定量测定血清H1N1流感IgG.按年龄、性别、职业和从接种到不同采样时间检测结果进行分组分析.率的比较行x2检验.结果 505名医务人员接种甲型H1N1流感疫苗后,401人特异性抗体阳性,占79.4%;弱阳性50人,占9.9%.129名未接种组中特异性抗体阳性59人,占45.7%;弱阳性15人,占11.6%.两组各年龄分层比较差异无统计学意义(P＞0.05).接种组男性抗体阳转率为95.7%,女性为87.4%(x2=6.40,P＜0.05);未接种组男性抗体阳转率为73.3%,女性为52.5%(x2=4.07,P＜0.05).接种组护士和医生的阳转率分别为86.0%和94.5%(x2=9.16,P＜0.01),未接种组分别为43.8%和75.0%(x2=12.61,P＜0.01).从接种到不同采样时间特异性抗体检测结果比较,接种第80～89天阳转率为81.5%,与接种第30～39、50～59、60～69天的阳转率分别为100.0%、94.7%和93.6%比较,差异有统计学意义(x2=3.96,P＜0.05;x2=7.15,P＜0.01;x2=9.98,P＜0.01).结论 内蒙古大兴安岭地区医务人员甲型H1N1流感疫苗接种有良好免疫效果.免疫后第80～89天免疫水平较前有显著下降.

Abstract：

Objective To investigate the immunization effect of influenza A/H1N1 vaccine in health care workers (HCW) in Inner Mongolia Greater Khingan Mountains area. Methods Five hundred and five HCW who received A/H1N1 influenza vaccination (immunized group) and 129 staffs who didn't receive the vaccination (unimmunized group) were randomly sampled for semiquantitative testing of serum H1N1 antibody (IgG) levels by enzyme-linked immunosorbent assay (ELISA).Results were analyzed and stratified by age, sex, occupation and the time interval between the time of vaccination and serum sample collection. The antibody positive rates of the two groups were compared by x2test. Results There were 401 (79. 4%) HCW whose H1N1 antibody were positive and 50 (9.9%) whose antibody were weak positive among 505 immunized HCW. While among 129 unimmunized HCW, there were 59 (45.7%) whose antibody were positive and 15 (11.6%) whose antibody were weak positive. The seroconversion rates of specific antibody were not significantly different among the different age groups after receiving A/H1N1 influenza vaccine (P＞ 0.05).However, there were statistical differences of the seroconversion rates among different sex groups (men 95.7% vs women 87.4% in immunized group, x2=6.40, P＜0.05; and men 73.3% vs women 52.5% in unimmunized group, x2 =4.07, P＜0.05) and different occupation groups (doctor 86.0% vs nurse 94.5% in immunized group, x2 = 9. 16, P＜0.01; and doctor 43. 8% vs nurse 75.0% in unimmunized group, x2=12.61, P＜0.01 ). The seroconversion rate was 81.5% after 80 to 89 days of vaccination, which was significantly lower than those after 30 to 39, 50 to 59 days and 60 to 69 days of vaccination, which was 100.0%, 94.7% and 93.6%, respectively (x2 =3.96, P ＜0.05; x2=7.15, P ＜0. 01; x2 = 9. 98, P＜0. 01). Conclusions A/H1N1 influenza vaccination can induce effective immune response in HCW in Greater Khingan Mountains area of Inner Mongolia. However,the level of specific antibody significantly reduces after 80 to 89 days of vaccination.     

球旁注射妥布霉素加地塞米松诱发视网膜中央动静脉栓塞

孙XX 男72岁因双眼间断胀痛伴头痛视物不清3年，于2006年11月就诊我院。既往有高血压病史。手术前检查诊断为双眼闭角型青光眼。入院血压160／95mmHg，完善相关检查、治疗，待眼压下降及各项检查正常行双眼小梁切除术，手术顺利。术毕给予球旁注射妥布霉素0．5u加地塞米松2．5mg时患者血压突然升高180／100mmHg。同时伴有眼压升高使右眼虹膜向切口外涌出嵌顿在小梁切口巩膜瓣下，立即给予20％甘露醇250ml快速静点，舌下含心痛定10mg，血压平稳150／80mmHg，眼压逐渐缓解。检查切口排除驱逐洼脉络膜上腔出血。打开结膜恢复嵌顿的虹膜，加固巩膜瓣双眼包扎。次日换药时右眼视力黑朦。前房形成，滤过形成良好，瞳孔中度扩大，光反射消失。眼底检查：后极部网膜及视乳头苍白水肿，视盘边界不清，中央动静脉变细，     

新生儿泪囊炎治疗体会

新生儿泪囊炎是小儿常见的眼病,患儿出生后有溢泪现象,压泪囊可有黏液或脓性分泌物自泪点溢出。如治疗不当可引起急性泪囊炎、泪囊瘘、角膜感染等后果。收集我科1997年10月～2006年10月门诊新生儿泪囊炎患儿60例,在冲洗出其泪囊内脓液后泪道探通术,效果满意,现报道如下。     

扎兰屯地区眼外伤统计分析

为了解本地区眼外伤情况 ,我科从 1995年 6月开始 ,在完成眼外伤住院病例的同时 ,填写由马志中医师设计的眼外伤病例登记表[1] ,截止 1999年 12月 ,共收集完整病例 2 62例。其中手术病例 2 3 1例占 88 17% ,非手术病例 3 1例占 11 83 % ,有随访登记的病例 5 8例占 2 2 14 %。现统计分析如下 :临床资料1 一般情况 :本组 2 62例眼外伤占同期眼科住院患者 12 3 5例的 2 1 2 1% ,高于丁莹报告的 16 10 % [2 ] ,低于裴舒然的 3 3 .73 % [3 ] ,与石浔的 2 2 2 6% [4] 相似。患者中男 2 10例占 80 15 % ,女5 2例占 19 85 %。年龄分布[5] :0～ 5…     

内蒙古牙克石林区人工晶状体植入术现状分析

目的:分析牙克石地区人工晶状体植入术的手术质量、复明效果及影响复明效果的相关因素,并探讨提高该地区白内障手术质量和手术率(cataract surgical rate,CSR)的有效方法。方法:对184例203眼现代白内障囊外摘除术联合后房型人工晶状体植入术(ECCE+IOL)患者进行回顾性分析,包括一般临床资料,术后3mo的随访资料,手术方法,术后视力,屈光状态,眼科耗材及手术后并发症。结果:5a间共完成各类白内障手术249例,CSR值为118。其中人工晶状体植入术184例203眼,农民82例(44.6%),城市居民102例(55.4%),出院时96.1%脱盲,73.9%脱残,验光结果,平均球面镜屈光度数为2.15±0.59D,散光度数2.70±1.04D。术后3mo有随访记录的99例109眼(53.8%),农民21例(21.2%),城市居民78例(78.8%),95.4%脱盲,79.8%脱残,验光结果,平均球面镜屈光度数2.09±0.54D,散光度数2.04±0.96D。术后角膜水肿,皮质残留,前房积血,虹膜睫状体炎,角巩膜缘切口漏水,玻璃体积血共114眼(56.2%),术前没有检查到的眼后节病变26眼(12.8%),平均每眼手术费用1500元。结论:对经济相对落后地区的基层医院眼科医生进行正规化培训,推广价格低、效果好的新术式,增加必要的眼科设备投入,降低手术成本,同时积极向农民宣传白内障的防治知识,是提高该地区白内障手术质量和CSR值的有效途径。