计算机辅助导航下手术治疗儿童股骨近端骨样骨瘤

目的探讨ISO-3D计算机辅助导航下开放手术切除儿童股骨近端骨样骨瘤的临床效果。方法回顾性分析33例临床诊断股骨近端骨样骨瘤患者,根据是否行导航下病灶切除术分为导航组(14例)和传统手术组(19例),比较两组病例术中情况及术后结果差异。结果两组患者在平均年龄及发病时间上差异无显著性。导航组平均手术时间122.5分钟,出血量89.3ml,无术后行石膏固定;传统手术组平均手术时间94分钟,出血量62.5ml,有8例术后行石膏固定。导航组手术时间较传统手术增加(P<0.01),两组病例术中出血量差异无显著性(P>0.05)。导航组14例仅1例未能明确诊断,其余均明确诊断骨样骨瘤。传统手术组有7例患者术后病理未见到肿瘤细胞而不能给予确诊,所有病例随访均未见复发。结论导航手术可有效治疗儿童股骨近端骨样骨瘤,较传统手术不增加术中出血量,手术时间延长差异有显著性,术后病理诊断阳性率明显增高,且减少术后石膏固定的使用。     

北京城乡居民人群中的吸烟问题：3000个家庭的流行病学研究

目的：了解９０年代初北京城乡居民吸烟状况及与吸烟有关的因素。方法：采用对３０００户计７０７７人的流行学调查。结果：显示北京市城乡居民的吸烟率为２２５８％，烟草依赖率为６４６％，几乎占吸烟人数的１／３。男性吸烟率为４１４６％，女性吸烟率为５３５％。农村地区吸烟率高于城市（２５９０％和１９７５％）。５０岁以上的女性吸烟率有上升的趋势。每日吸烟达２０支以上的重度吸烟者近于１／２。在对烟草价格选择上，以低廉价格为最多（８６３２％）。有１／３吸烟依赖者戒烟后出现渴求吸烟，焦虑、易怒、瞌睡、头痛及胃肠不适等症状。     

儿童胫骨结节骨骺骨折

Objective To discuss the characteristics, treatment method and prognosis of tibial tuberosity avulsion fracture in children. Methods From January 1995 to December 2007, there were 25 cases (23 boys and 2 girls). The age at injury ranged from 12 to 16 years(average 13.5 years). All cases were unilateral involved (10 of left, 15 of right). All of the injuries resulted from participation in athletic activities, 10 in basketball, 7 while jumping, and 8 in football game. According to the classification of Ogden, there were 1 type 1A, 4 type 1B, 5 type 2A, 7 type 2B, 4 type 3A, and 4 type 3B fractures. One type 1A fracture was treated nonoperatively with east immobilization, and other 24 fractures with open reduction and internal fixation. Results All of 25 cases were followed from 14 months to 7 years (average 43 months). The range of motion of knee joint was 0°-140° 3 months after operation, and all of them recovered to pre-injury levels of activity by 6 months after operation. According to Mosier clinical assessment system, the final outcome was evaluated as excellent in all. Wound healed primary, no compartment syndrome was found. The time of bony union ranged from 2 to 5 months, with the mean time of 3 months. No complications of infection, ex-tremities deformity and inner fixation failure were found. Conclusion The tuberosity avulsion fracture in children is an uncommon and special type of epiphyseal injury. These fractures occur in the narrow range of 13 to 16 years of age. The majority of patients are males, and most of them are unilateral involved. This in-jury has an excellent outcome without deformity or functional loss, once adequate reduction and fixation of fracture fragments have been achieved.     

86例肺癌病人放射治疗的护理

放射治疗为当今治疗恶性肿瘤主要手段之一。我院于1998年5月引进德国西门子直线加速器,对86例肺癌患者进行了放射治疗,取得了一定的疗效,缓解了病人的痛苦,延长了病人的生存时间。1 一般资料 本组86例肺癌病人,男68,女18人,平均年龄54岁,其中鳞癌占85％,小细胞癌占5％,腺癌占10％。放疗后完全缓解占15％,部分缓解占45％,稳定未再发展占15％,无效占25％。2 护理体会2.1 心理护理 在日常的工作中,常常能碰到这样的病人,不知道所患疾病或不愿承认自己得了病,他们入院后往往向医护人员打听自己得了什么病,这时我们就应向他们解释“您肺部有炎症,经放疗、消炎后会好的”。严格执行保护性医疗制度,是我     

慢性精神分裂症的社区家庭防治、康复研究

目的　探讨慢性精神分裂症的社区家庭康复的疗效及其可能的影响因素。方法　采用前瞻性对照研究的方法 ,对 1 80例慢性精神分裂症患者随机分为研究组和对照组 ,采用有关量表观察 ,并对其中 90例研究组患者重点实施家庭康复指导。结果　研究组经 1年的观察 ,患者干预前后的Krawiecka症状量表分 (1 2 35± 5 99,7 38±5 99) ,社会功能缺陷筛选表 (SDSS)总分 (7 1 8± 1 52 ,5 65± 1 83)及Morningside康复状态量表 (MRSS)分(82 72± 2 3 44,53 93± 2 8 0 9)、精神病人康复疗效评定表 (PRDS)的总均分 (76 84± 2 3 95 ,51 0 0± 2 6 94)与对照组相比各总分或残疾程度的降低差异具有显著性的意义 (P <0 0 1 )。结论　利用社区精神卫生资源分区划片实施家庭防治康复措施 ,对减轻患者的精神症状、改善患者社会功能都能起到积极的作用     

幽门螺杆菌根除失败后阿莫西林耐药基因分析

目的探讨幽门螺杆菌根除失败后阿莫西林的耐药机制。方法通过纸片扩散法选取原始敏感菌株、原始耐药菌株及根除治疗失败后的幽门螺杆菌耐药菌株。扩增PBP1A基因,PCR产物进行DNA测序以探讨阿莫西林耐药机制。结果将阿莫西林原始敏感菌株、原始耐药菌株、根除失败后耐药菌株的PBP1A基因与标准菌株进行对比,核苷酸同源性基本相似。耐药菌株的框移突变比敏感菌株发生率高。氨基酸同源性分析示,耐药菌株的氨基酸同源性低于敏感菌株,P<0.05。结论 PBP1蛋白的氨基酸置换在阿莫西林耐药菌株中较常见,可能与幽门螺杆菌对阿莫西林耐药有密切关系。     

肺心病并发低渗血症73例临床分析

肺心病合并低渗血症73例中,单纯性低渗血症62例(84.9%),低渗血症并肺脑11例(15.1%)。73例中产生低渗性脑病31例(42.5%)。本文指出肺心病并低渗血症是肺心病危重患者,在救治重症肺心病者时应考虑到合并低渗血症可能,并积极采用相应措施,降低其死亡率.     

汉坦病毒H8205株包膜糖蛋白G2-IL-2嵌合基因的稳定表达

目的 探讨汉坦病毒H8205株包膜糖蛋白G2-IL-2嵌合基因（IL-2-G2）在中国仓鼠卵巢（CHO）细胞获得稳定表达可溶性融合蛋白的可行性。方法 将人源IL-2基因与汉坦病毒H8205株包膜糖蛋白G2的cDNA分别克隆于真核表达载体pcDNA3．1-HisB，构建重组真核表达载体pcDNA3．1HisB-IL2G2，在脂质体介导下，将其导入cHO细胞，通过G418筛选获得阳性克隆，并继续培养6周，然后用原位杂交、ELISA、SDS-PAGE电泳方法检测IL-2-G2基因在CHO细胞中的稳定表达情况。结果 经原位杂交和SDS-PAGE电泳证实，转染pcDNA3．1-HisB-IL-2-G2的CHO细胞内有IL-2-G2的mRNA转录，且在培养上清和CHO细胞胞质中有融合蛋白的表达，经人IL-2 ELISA检测试剂盒检测证实在培养上清和细胞裂解物中所表达的融合蛋白有IL-2特性。结论 在脂质体介导下，外源性IL-2-G2嵌合基因能够成功导入CHO细胞并获得稳定表达。     

儿童胫骨结节骨骺骨折

Objective To discuss the characteristics, treatment method and prognosis of tibial tuberosity avulsion fracture in children. Methods From January 1995 to December 2007, there were 25 cases (23 boys and 2 girls). The age at injury ranged from 12 to 16 years(average 13.5 years). All cases were unilateral involved (10 of left, 15 of right). All of the injuries resulted from participation in athletic activities, 10 in basketball, 7 while jumping, and 8 in football game. According to the classification of Ogden, there were 1 type 1A, 4 type 1B, 5 type 2A, 7 type 2B, 4 type 3A, and 4 type 3B fractures. One type 1A fracture was treated nonoperatively with east immobilization, and other 24 fractures with open reduction and internal fixation. Results All of 25 cases were followed from 14 months to 7 years (average 43 months). The range of motion of knee joint was 0°-140° 3 months after operation, and all of them recovered to pre-injury levels of activity by 6 months after operation. According to Mosier clinical assessment system, the final outcome was evaluated as excellent in all. Wound healed primary, no compartment syndrome was found. The time of bony union ranged from 2 to 5 months, with the mean time of 3 months. No complications of infection, ex-tremities deformity and inner fixation failure were found. Conclusion The tuberosity avulsion fracture in children is an uncommon and special type of epiphyseal injury. These fractures occur in the narrow range of 13 to 16 years of age. The majority of patients are males, and most of them are unilateral involved. This in-jury has an excellent outcome without deformity or functional loss, once adequate reduction and fixation of fracture fragments have been achieved.     

股骨头骺软骨母细胞瘤二例

股骨头骺软骨母细胞瘤二例郭源，范源，朱振华软骨母细胞瘤是一种少见的疾病，约占原发良性骨肿瘤的１％，其发病的典型部位为长骨的骺端，多见于股骨、胫骨、肱骨，病变多发生于骨骺板即将闭合期间，偶尔可见于骺板闭合之后。大多数患者发病年龄小于２０岁。本文报告２例...