子宫肌瘤术式临床研究268例分析

目的通过临床资料分析，探讨子宫肌瘤的临床表现与几种手术治疗方式的和弊，以达到共同提高诊疗水平。方法选择2003年1月至2006年12月收入我院治疗的268例手术病人进行回顾性临床总结。结果子宫肌瘤无临床症状者71例，占26．49％，有相关症状者197例，占73．51％；手术方式：以腹全子宫切除术为主，占53％，其次为微创手术，经阴道子宫肌瘤摘除术等。结论目前子宫肌瘤的治疗方式仍以手术为主，但需根据年龄、生育要求、肌瘤大小及部位进行综合考虑，以选择相应的手术方式。微创手术是近年来发展的一门新兴外科技术，安全有效，值得推广应用。     

腹部创伤性疾病的救治体会

目的:探讨腹部创伤诊断、急救、手术等临床问题.方法:对258例住院经手术抢救的腹部创伤病例的临床资料作回顾性分析.结果:258例病人获救康复247例,占96%,死亡11例,占4%,死亡原因6例为肝脏严重破裂大出血,5例为腹内多脏器广泛损伤.结论:腹部创伤病人入院后首先建立输液途径,积极预防和纠正休克,尽快通过临床检查或辅助检查明确诊断,内脏损伤严重者果断手术探查处理.     

Online scheduling of pick-up and delivery tasks in hospitals

ObjectiveThe aim of this study was to develop an algorithm for scheduling pick-up and delivery tasks in hospitals. The number of jobs and the dynamic nature of the problem, in having jobs arriving over time, makes the use of information technology indispensable. An optimized scheduling for all types of transportation tasks occurring in a hospital accelerates medical procedures, and reduces the patient’s waiting time and costs.MethodsIn the design of the algorithm we use techniques from classical scheduling theory. In addition, due to some special properties and constraints, we model the problem using methods from graph theory. The resulting algorithm combines both approaches in a transparent manner.ConclusionsTo optimize the schedules, we define the average weighted flow time as an objective function that corresponds to a measure for the task throughput. An evaluation of the algorithm at the Natters State Hospital in Austria shows that it has a superior performance than the current scheduling mechanism.     

Self-Report of Psychological Function Among OEF/OIF Personnel Who Also Report Combat-Related Concussion

MMPI-2 RF profiles of 128 U.S. soldiers and veterans with history of concussion were examined. Participants evaluated in forensic (n?=?42) and clinical (n?=?43) settings showed significantly higher validity and clinical elevations relative to a research group (n?=?43). In the full sample, a multivariate GLM identified main effects for disability claim status and Axis I diagnosis across numerous MMPI-2 RF scales. Participants with co-morbid PTSD and concussion showed significant Restructured Clinical and Specific Problem scale elevations relative to those without Axis I diagnosis. Participants with PTSD and active disability claims were especially prone to elevate on FBS/FBS-r and RBS. Implications for neuropsychologists who routinely administer the MMPI-2/RF in the context of combat-related concussion are discussed.     

腹腔镜外科和妇科联合手术的临床应用

目的：探讨腹腔镜技术在外科和妇科疾病治疗中联合应用的临床价值。　
方法：总结近7年来施行腹腔镜联合手术治疗妇、外科疾病229例的临床资料,其中腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合输卵管造口术5例,LC联合卵巢囊肿剥除术28例,LC联合子宫肌瘤剔除术25例,LC联合子宫次全切除术39例,LC联合子宫全切除术26例,LC联合子宫内膜异位症手术6例;腹腔镜阑尾切除术(laparoscopicappendectomy,LA)联合输卵管手术38例,LA联合卵巢囊肿切除术32例,LA联合子宫全切除术或子宫次全切除术24例,腹腔镜肝囊肿开窗引流术联合卵巢囊肿切除术6例。
结果：229例妇、外科联合腹腔镜手术均获成功,无中转开腹手术。手术时间40~220 min,平均120 min;住院1~6 d,平均3.4 d。仅1例术后10 d阴道残端出血非手术疗法治愈。175例随访3~24个(平均19.5)月,1例术后2个月发现阴道残端息肉,经手术切除治愈。　
结论：严格掌握联合手术指征,充分术前准备,多科室良好配合,腹腔镜联合手术能够有效地同时处理外科和妇科并存疾病,在基层医院具有良好的应用前景。     

Cancellation of elective oral and maxillofacial operations

Our aim was to assess whether the Commission for Health Improvement Performance Indicator value of 0.5% of cancellations on the day of operation or less had been achieved. We reviewed 912 consecutive elective operations, both day case and inpatient over an 8-month period (January–August 2003). A total of 117 procedures (13%) were cancelled for non-clinical or logistical reasons, of which 39 (4%) were cancelled on the day of the operation. Only 3 of the 39 patients who wanted a new admission date within 28 days of cancellation could not be accommodated. The performance indicator value of 0.3% was below the target threshold. An additional 60 (7%) patients had their admissions cancelled the day before operation and 18 (2%) had their operations deferred for a day before they were cancelled. However, these patients have been specifically excluded from the performance indictor.     

两种术式治疗直肠前突疗效比较

目的通过经阴道修补直肠前突术和PPH术治疗直肠前突疗效比较,探讨两种术式治疗直肠前突方面的优缺点。方法对2004～2011年采用经阴道修补直肠前突术式(A组)和PPH术式(B组)治疗直肠前突各30例,在有效例数、手术时间、术中出血量、住院时间、住院费用、恢复工作时间、术后疗效等指标作对比分析。结果 PPH术式在手术时间、术中出血量、住院时间、恢复工作时间等方面优于经阴道修补直肠前突术式,两种术式有效率相近。结论 PPH术式治疗直肠前突是一种有效方法,手术简单,疗效好。     

The atlas of surgical operations: Elliott Carr Cutler and Robert Zollinger

The author of Zollinger's Atlas of Surgical Operations describes the development of the Atlas of Surgical Operations over the course of seven editions and 64 years.