引入PDCA循环规范医疗废物管理

目的采用PDCA循环法,规范医院医疗废物管理。方法通过计划、实施、检查、处理4个阶段具体实施。结果医疗废物要达到规范化管理,建立有效的组织管理体系,制定切实可行的规章制度是重要保证;加强培训与宣传教育,提高全员管理意识是重要环节;完善医疗废物处置过程中的配套设施是重要基础;制定管理质量标准认真督促检查考核是重要手段。结论PDCA循环法是加强完善医疗废物管理的一种科学的管理方式。     

氨气敏电极法快速测定血氨

本文介绍使用氨气敏电极,采用标准曲线法简便、快速、准确测定血氨的方法。取空腹血1ml,用1M HClO_4沉淀蛋白,以0.1M NH_4Cl—0.6MNa_2SO_4作内充液,碱化后的上清液可在2～3min内测试完毕。40例正常成人血氨的测定结果:■=31.4μmol/L N;S=6.4μmol/L N;■±2S(正常值范围)为18.6～44.2μmol/L N。10份血样的平均回收率为100.4％。该法用血少、简便、快速;结果较稳定、准确,适用于临床检验。     

The relationship between jaw deformity and scoliosis

Objectives To analyze the relationship between lateral displacement of the mandible and scoliosis. Methods From April 2002 through July 2003, we examined posteroanterior cephalometric radiographs and chest X-rays from 85 patients with jaw deformities and a control group of 20 patients with no jaw deformities. To measure the lateral shift of the mandible, we drew a horizontal baseline (X axis) on the cephalogram connecting the intersection of the external margins of the orbits and the most lateral points of the greater wings of the sphenoid. A vertical baseline (Y axis) was then marked perpendicular to the X axis, intersecting the ethmoid crista galli. Then, we measured the lateral displacement of the mandibular mentum from the Y axis. Displacement to the right was designated positive; that to the left was designated negative. Cobb's method was used to measure scoliosis curves on chest X-rays; the direction of the curve was designated similarly. Results Of the 85 patients with jaw deformity, 23 (27.1%) had a Cobb angle exceeding 10°. None of the control group had scoliosis exceeding 10°. No correlation was found between the direction of mandibular displacement and the direction of scoliosis. Conclusion This study suggests a relationship between jaw deformities and scoliosis, as scoliosis was found in 27.1% of the patients with a main complaint of jaw deformity.     

Rates of alcohol consumption and risk status among Australian university students vary by assessment questions

Introduction and Aims. Different self‐report methods tend to produce different estimates of alcohol consumption. The present study compares differences in rates and risk levels based on responses to a modified version of the Daily Drinking Questionnaire (m‐DDQ) and quantity‐frequency (QF) questions. Design and Methods. The sample comprised 2082 university students, 61% of whom were female and 39% male with a mean age of 23.5 years. An email containing an online link to a brief six‐question survey was emailed to students enrolled in participating faculties at the University of Wollongong, Australia. Current drinkers completed m‐DDQ and QF questions about alcohol consumption. Results. QF methods identified significantly lower estimates of consumption (Mean = 9.15, SD = 12.51) compared with m‐DDQ (Mean = 13.06, SD = 14.07). Allocation to risk categories based on the Australian Alcohol Guidelines were conducted for both the m‐DDQ and QF methods. Almost twice as many students were found to be drinking at levels considered risky using the m‐DDQ method compared with QF. In addition, the relative rank order of participants varied significantly between the two methods. Discussion and Conclusions. The m‐DDQ method identified higher rates of drinking and categorised almost twice as many individuals into risky categories of drinking compared with QF. Such variations have major implications for identification of risk groups in health promotion or prevention programs.[Utpala‐Kumar R, Deane FP. Rates of alcohol consumption and risk status among Australian university students vary by assessment questions. Drug Alcohol Rev 2009]     

股骨干粉碎性骨折的治疗

近年来随着交通运输业的发展,由于高能伤所导致创伤骨科中骨折粉碎程度愈来愈重,甚至使骨骼失去完整形态,尤其在股骨干部位,治疗极其困难,开放复位损伤大且达不到满意的固定,疗效不佳。我们最大限度地使用外固定器,很好地解决了这一难题,同样适用于肱骨和胫骨骨折。1临床资料本组12例,均为男性,年龄18~40岁,平均31.3岁。左侧5例,右侧7例。其中交通事故伤8例,高处坠落伤3例,摔伤1例。闭合伤10例,开放伤2例。骨折均为粉碎性,无软组织及血管神经损伤。2治疗方法患者麻醉后仰卧于骨科牵引手术床上,注意使患肢靠外,消毒铺巾后,保持下肢中立位轻度…     

羊耳菊水提取物体外抑菌活性研究

目的 探讨羊耳菊不同器官水提取物的体外抑菌活性.方法 以金黄色葡萄球菌、铜绿假单胞菌、白色念珠菌等10种微生物为试验菌株,采用药敏纸片扩散法、试管二倍稀释法,对羊耳菊水提取物进行抑菌试验.结果 羊耳菊全株各器官都具有较强的抑菌作用,其中根对10种供试菌种都有抑制作用,抑制范围最广;茎对9种供试菌种有抑制作用,叶对8种供试菌种有抑制作用.羊耳菊各器官对金黄色葡萄球菌与铜绿假单胞菌的抑制作用最强.羊耳菊根、茎、叶对金黄色葡萄球菌的MIC值分别为15.63,62.5,62.5 mg/ml,而其抑菌圈直径分别为14.3,13.8,13.5 mm;羊耳菊根,茎,叶对铜绿假单胞菌的MIC值分别为15.63,31.25,62.5 mg/ml,其抑菌圈直径分别为15.8,15.5,14.0 mm.结论 羊耳菊水提取物体外试验证实了该民间药物具有抗菌活性,也表明了羊耳菊是一种有开发潜力的新抗菌药物资源.     

高龄股骨转子间骨折两种治疗方法的临床观察

目的:探讨手术治疗高龄股骨转子间骨折的安全性、合理性。方法:股骨转子间骨折患者65例,其中采用动力髋螺钉(DHS)治疗32例,男14例,女18例;年龄65~79岁,平均(70.6±2.3)岁;EvansⅠ型2例,Ⅱ型7例,Ⅲ型15例,Ⅳ型8例。采用单边外固定支架治疗33例,男14例,女19例;年龄68~90岁,平均(74.2±3.8)岁;EvansⅠ型3例,Ⅱ型15例,Ⅲ型11例,Ⅳ型1例,Ⅴ型3例。临床观察包括术中出血量、手术时间、骨折愈合时间、术后并发症及髋部运动功能等。结果:所有病例均获随访,时间1~34个月,平均19个月。两组手术时间、术中出血量、术后并发症发生率差异有统计学意义(P<0.05)。平均愈合时间DHS组为(13.0±2.7)周,外固定支架组为(12.3±3.0)周,差异无统计学意义。Sanders髋关节功能评价:DHS组优19例,良6例,可3例,差2例;外固定支架组优12例,良8例,可8例,差5例。两组优良率差异有统计学意义(P<0.05)。结论:围手术期外固定支架组较DHS组安全简便,术后疗效DHS组优于外固定支架组。     

包含颈外静脉的颈阔肌肌皮瓣修复口腔癌切除后缺损

目的探讨将颈外静脉包含在颈阔肌肌皮瓣内修复口腔癌切除后缺损的手术方法。方法先形成蒂在颌缘下包含颈外静脉的颈阔肌肌皮瓣，待口腔肿瘤切除后，将肌皮瓣经口底隧道引入口腔修复缺损。结果临床应用17例，肌皮瓣均无血运障碍，100％存活，其中有2例发生口面痿，经换药后痿口完全闭合。结论将颈外静脉包含在颈阔肌肌皮瓣内有助于肌皮瓣血循环的改善和存活率的提高。     

有限内固定结合外固定支架治疗胫骨远端骨折

目的探讨有限内固定结合Hybrid外固定支架治疗胫骨远端骨折的疗效。方法从2003年1月～2005年7月,使用Hybird外固定支架治疗胫骨远端骨折21例,按AO分类:A1型4例;A2型5例;A3型4例;C1型2例;C2型3例;C3型3例,其中开放性骨折8例,手术采用有限切开,骨片钉固定,Hybrid外固定支架不跨踝关节固定。结果术后21例均获随访,平均随访时间12.3个月,骨折平均愈合时间7.6个月。功能评定采用Bone的踝关节活动度进行评价,优良率达76%。结论Hybrid外固定支架设计合理并能维持骨干的轴线,骨片钉能很好的固定骨折块,同时避免了软组织的并发症,可使踝关节早期活动,防止踝关节僵硬,因而是治疗胫骨远端骨折有效的方法之一。     

Fat and water separation in balanced steady-state free precession using the Dixon method.

In this work the feasibility of separating fat and water signals using the balanced steady-state free precession (SSFP) technique is demonstrated. The technique is based on the observation (Scheffler and Hennig, Magnetic Resonance in Medicine 2003;49:395-397) that at the nominal values of TE = TR/2 in SSFP imaging, phase coherence can be achieved at essentially only two orientations (0 degrees and 180 degrees ) relative to the RF pulses in the rotating frame, under the assumption of TR < T2, and independently of the SSFP angle. This property allows in-phase and out-of-phase SSFP images to be obtained by proper choices of the center frequency offset, and thus allows the Dixon subtraction method to be utilized for effective fat-water separation. The TR and frequency offset for optimal fat-water separation are derived from theories. Experimental results from healthy subjects, using a 3.0 Tesla system, show that nearly complete fat suppression can be accomplished.