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中国社会医学杂志 1999年第3期16卷 139-140页

作者：郑爱青郭风娟

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儿童环状胰腺:最近10年的经验

世界核心医学期刊文摘（儿科学分册） 2005年第4期1卷 53-54页

作者： Jimenez J. C. Emil S. Podnos Y. Nguyen N. 杨徐伟 Division of Pediatric Surgery University of California Irvine Medical Center Orange CA United States

背景/目的:环状胰腺是儿童十二指肠阻塞的一个被已确认的原因。作者对10年来所有的环状胰腺患者的临床特征、影像检查结果、预后情况进行了回顾。方法:对1993-2002年之间,所有在两个三级儿童外科中心确诊的环状胰腺病例进行了文献回顾... 详细信息

背景/目的:环状胰腺是儿童十二指肠阻塞的一个被已确认的原因。作者对10年来所有的环状胰腺患者的临床特征、影像检查结果、预后情况进行了回顾。方法:对1993-2002年之间,所有在两个三级儿童外科中心确诊的环状胰腺病例进行了文献回顾。分析的要素包括:患儿人口统计学资料、所出现的症状、相关异常。

关键词：环状胰腺统计学资料外科中心文献回顾影像检查肠道喂养染色体异常出生后 duodenal vomiting

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美国老年人的状况及医疗

中国社会医学杂志 1990年第2期7卷 67-71页

作者：张家喜同济医科大学

根据美国年龄老化的人口统计学资料,美国65岁或以上的人口(以下简称老年人)有2980万人,占美国人口的12.3%,相当于每8个美国人中有一个老年人。而且预计美国老年人口将继续增加。现在,美国人口年龄老化已开始冲击社会的各个领域并将持续... 详细信息

根据美国年龄老化的人口统计学资料,美国65岁或以上的人口(以下简称老年人)有2980万人,占美国人口的12.3%,相当于每8个美国人中有一个老年人。而且预计美国老年人口将继续增加。现在,美国人口年龄老化已开始冲击社会的各个领域并将持续数年或更长的时间。本文仅介绍美国老年人的基本情况及有关的老年医疗问题。

关键词：年龄老化老年人口统计学资料医疗问题生活安排住院收入医疗保险家庭人口医疗保健医疗卫生界

AVERT(人工瓣膜心内膜炎减少试验)超声心动图研究中瓣周反流的患病率和严重性

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世界核心医学期刊文摘（心脏病学分册） 2005年第2期1卷 56-57页

作者： Davila Roman V.G. Waggoner A.D. Kennard E.D. 高峰

The purpose of this study was to determine the prevalence and severity of para valvular regurgitation(PVR) in the Artificial Valve Endocarditis Reduction Trial (AVERT) cohort. The initial AVERT cohort consisted of 807 patients randomized to receive either a Silzone coated prosthetic valve or a conventional prosthetic valve; early clinical reports showed higher rates of valve explant caused by PVR for Silzone coated prosthetic valve. Of the 678 eligible patients, 575(85%) underwent postoperative transthoracic echocardiograms. The presence and severity of PVR were identified by color flow Doppler. Reviewers were blinded to the typ e of prosthetic valve and the demographic and clinical variables. Among those wh o underwent echocardiography (Silzone coated prosthetic valve, n=285 and conven tional prosthetic valve, n=290), 59%had prosthetic aortic valves, 32%prostheti c mitral valves, and 9%had both; demographic and clinical findings (i.e., prost hetic valve endocarditis, thromboembolism, bleeding, and all cause death) were similar for the two groups. Echocardiographically determined PVR was present in 50 valves: Silzone coated prosthetic valve, 29 of 285 (10%) and conventional p rosthetic valve, 21 of 290(7%, p=NS); the severity of PVR was similar in both g roups. Kaplan Meier analysis showed no significant differences in PVR at 24 mon ths from valve implantation between the two groups(24-month event free rate: 9 3%Silzone coated prosthetic valve vs. 94%conventional prosthetic valve, p=NS) . Excluding those patients who had initial prosthetic valve explant, the two ye ar echocardiographic follow up of the AVERT cohort shows no statistically signi ficant differences in the prevalence or severity of PVR in the Silzone coated p rosthetic valve compared with the conventional prosthetic valve. Further monitor ing is warranted to determine whether these clinical outcomes remain similar on long term follow up.

关键词： AVERT 人工瓣膜超声心动图主动脉瓣置换二尖瓣置换彩色血流统计学资料检测者盲法事件率

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成人顾问对青少年参与高危险行为的影响

中国社会医学杂志 2003年第1期20卷 44-45页

作者：于秀丽郑爱青

青少年易从事一些危害健康的高危险行为。在青少年发展中一个重要部分是选择角色榜样。该研究目的是确定成人顾问和青少年参与高危险行为的减少是否有联系。病人和方法 1995年8月～1996年3月,在美国新泽西郊区一教学医院青少年健康咨... 详细信息

青少年易从事一些危害健康的高危险行为。在青少年发展中一个重要部分是选择角色榜样。该研究目的是确定成人顾问和青少年参与高危险行为的减少是否有联系。病人和方法 1995年8月～1996年3月,在美国新泽西郊区一教学医院青少年健康咨询门诊,共有316名青少年前来就诊,294名同意参与调查(占总人数的93％)。参与者主要是女性(68％),年龄为12～23岁,来自不同种族、不同的社会经济背景。问卷包括99个项目,如人口统计学资料、家庭成员、学习成绩、参与的危险行为、是否有成人顾问等。共有6个评分标准,主要调查5项危险行为:吸烟、饮酒、吸毒、暴力和性行为。

关键词：高危险行为青少年参与成人携带武器社会经济背景青少年发展学习成绩评分标准青少年健康统计学资料

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视频辅助经脐儿童阑尾切除术

世界核心医学期刊文摘（儿科学分册） 2006年第9期2卷 40-41页

作者： Koontz C.S. Smith L.A. Burkholder H.C. 刘凯 Department of Surgery University of Tennessee College of MedicineChattanooga UnitChattanoogaTN 37403United States

Background:Video-assisted transumbilical appendectomy (VATA) is a combination of laparoscopic and open techniques and is not widely used in children. We are reporting our most recent experience with this technique. Methods:After the institutional review board approval,the charts of patients who underwent VATA between December 2003 and October 2004 were retrospectively reviewed. All children presenting with a preoperative diagnosis of appendicitis were candidates. A 10-mm trocar was placed in the umbilicus. An operating laparoscope was used for mobilizing the appendix. The appendix was delivered through the umbilicus. A standard extracorporeal appendectomy was performed. The umbilical ring was closed and the wound irrigated. Demographic and outcome data were collected and is presented as mean ± SD. Results:Sixty-one males and 50 females underwent VATA (n = 111). Age and weight were 11 ± 3.2 years and 49 ± 22 kg,respectively. Six patients had previous abdominal surgery. Operative time was 36 ± 24 minutes (range,9-140 minutes). An additional trocar was placed in 2 patients,and 2 patients were converted to open. Five patients had additional procedures. Appendicitis was classified intraoperatively as acute (n=44),suppurative (n=5),gangrenous (n=8),ruptured (n=30),appendiceal colic (n =13),and other (n=11). Preoperative antibiotics were given to 95 patients and were continued in 35 patients postoperatively. Length of stay was 1.8± 1.7 days (range,1-11 days). Length of follow-up was 13 ± 6.3 days (n =90). Complications included intra-abdominal abscess (n =1) and wound infection (n=7) . Conclusions:Video-assisted transumbilical appendectomy minimizes equipment needs,thus,potentially reducing cost. Simple and complex appendectomies can be performed even if the patient has had previous abdominal surgery. Our complication rate was low,and our operating times and length of stay were short. Video-assisted transumbilical appendectomy is a safe and effective technique in children

关键词：阑尾切除术脐环腔镜技术腹部手术阑尾疝医疗记录开腹手术统计学资料穿刺鞘并发症率

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哪些病不适宜服避孕药?

中医健康养生 2016年第7期2卷 64-65页

作者：于红娟江苏省南京市中医院妇科

项女士打开左炔诺孕酮片(避孕药的一种)的说明书,发现其禁忌症列有多种疾病,如肝功能异常、心血管疾病及糖尿病等。想了解一下,哪些患者不适合用避孕药类来避孕?答:世界各国近半个世纪对口服避孕药的相关研究和临床应用表明,口服避孕药... 详细信息

项女士打开左炔诺孕酮片(避孕药的一种)的说明书,发现其禁忌症列有多种疾病,如肝功能异常、心血管疾病及糖尿病等。想了解一下,哪些患者不适合用避孕药类来避孕?答:世界各国近半个世纪对口服避孕药的相关研究和临床应用表明,口服避孕药不但具有经济、简便、高效的避孕作用,对服用妇女还有许多非避孕益处,但是也必须强调其不良影响。

关键词：左炔诺孕酮心血管疾病避孕作用临床应用避孕方式心脏负担统计学资料子宫内膜乳汁分泌心功能不良

大型医院系统中胃肠道内镜检查后心血管并发症的发病率和发病风险

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世界核心医学期刊文摘（胃肠病学分册） 2005年第4期1卷 41-42页

作者： Gangi S. Saidi F. Patel K. 姜志茹

There is limited information concerning the risks for, and occurrence of, card iovascular complications because of GI endoscopy. Published data are based on questionnaire surveys, which have a potential for bias. Moreover, available studies pertain exclusively to out-patients. In-patients and day-stay patients who incurred charges for endoscopy with endoscopic procedure coding from 1999 through 2001 were identified from a financial database for all 9 hospitals in a large health care system. From these patients, those considered “at risk”for cardiov ascular complications were selected based on charges for cardioactive medications, cardiac enzyme determinations, or intensive care services on the day of or the day after endoscopy. Medical records were reviewed for 25% of these patients,selected at random, noting demographics, history, and a modified Goldman score in patients with cardiovascular complications (defined as arrhythmia, chest pain or anginal equivalent, hypotension or myocardial infarction occurring within 24 hours after endoscopy). Identical information was obtained from a random sample of 0.5%of the chart records for all patients undergoing endoscopy. Patients who underwent endoscopy were not reliably identified for one hospital. This hospital was omitted from the calculation of the extrapolated rate of complication occurrence, but patients identified through chart review as having or not having a complication after endoscopy were included in the risk analysis. The extrapolated rate of occurrence of cardiovascular complications was 308: 95%CI [197, 457] p er 100,000 procedures. Independent risk factors were: male gender, modified Gold man score, and use of propofol. In this study of patients undergoing hospital based GI endoscopy, the risk of procedure-related cardiovascular complications was 2 to 70 times higher than previously reported. This finding may be ascribed to differences in the populations sampled and to a case finding method that mini mized re

关键词：医院系统心血管并发症内镜检查发病风险医疗记录留观患者统计学资料卫生保健系统心肌酶检测胸痛

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胶囊内镜对腹痛或腹泻患者的诊断作用

世界核心医学期刊文摘（胃肠病学分册） 2006年第10期2卷 25-26页

作者： Fry L.C. Carey E.J. Shiff A.D. J.A.Leighton 孟欣颖 Division of Gastroenterology and Hepatology Mayo Clinic13400 East Shea BoulevardScottsdaleAZ 85259United States.Dr

Background and Study Aims: Capsule endoscopy, proven effective for evaluation of obscure gastrointestinal bleeding and suspected Crohn’s disease, is increasingly used to investigate other small-intestine disorders, but its yield for other indications is not well known. We sought to evaluate its yield and findings for abdominal pain or diarrhea. Patients and Methods: Medical records of patients with abdominal pain or diarrhea (> 6 weeks’duration) who underwent capsule endoscopy between August 2001 and June 2004 were retrospectively reviewed for demographic data, indications, findings, diagnoses, complications, and radiologic studies. All patients had previous endoscopic or radiologic examinations (colonoscopy, enteroscopy, upper endoscopy, small-bowel series, computed tomography enterography, or computed tomography) demonstrating no abnormalities sufficient for diagnosis. Results: 64 patients (26 men; 38 women; mean age, 43 years; age range, 19-83 years) who met study criteria had 68 capsule endoscopy studies. Indications were abdominal pain (35 patients), diarrhea (14), or both (15). Complete small-bowel visualization with identification of the cecum was achieved in 81%; yield of positive findings was 9%(6 patients). By indications, the yield was 6%for abdominal pain, 14%for diarrhea, and 13%for both. Diagnoses included Crohn’s disease (3), enteropathy induced by nonsteroidal anti-inflammatory drugs (2), and submucosal tumor (1). Capsule retention occurred in two patients, requiring surgical removal. Conclusions: Capsule endoscopy had a low yield for evaluation of abdominal pain or diarrhea and cannot be recommended as a first-line test without further study. Nonetheless, it facilitated diagnosis in 9%of patients with negative endoscopic and radiologic examinations.

关键词：胶囊内镜诊断作用腹泻患者小肠疾病克罗恩病小肠镜影像学检查结肠镜小肠造影统计学资料

急性心肌梗死患者从发病到入院之间的症状经历和应对能力

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急性心肌梗死患者从发病到入院之间的症状经历和应对能力