目的 探讨氟康唑治疗复发性外阴阴道假丝酵母菌病的临床效果。方法 选取2013年2月—2013年7月我院接受治疗的复发性外阴阴道假丝酵母菌病患者50例,患者采用口服氟康唑片治疗方式,服用三天,每天一次,每次150 mg,之后每周一次,持续服用6个月,同时配合制霉菌素以及冰硼散阴道上药,观察患者的治疗效果。结果 经过一周的治疗后,患者的临床症状和体征消失,通过镜检发现假丝酵母菌呈阴性。有49例患者在1个月和3个月的复查中没有复发情况,1例出现轻微的外阴不适并复发,1例患者在经过6个月治疗后复发,其假丝酵母菌实验室检查呈阳性。50例患者3个月的复发率为2%,6个月复发率为2%,有3例患者出现轻微的腹胀和恶心等情况。结论 采用氟康唑坚持半年的药物治疗能够提高外阴阴道假丝酵母菌疾病的治愈率并降低复发率,值得广泛推广应用。

目的 观察自拟方前列清化汤治疗慢性前列腺炎的临床疗效。方法 2010年8月—2014年8月对90例慢性前列腺炎患者随机分为两组,治疗组50例采用自拟方前列清化汤水煎口服,并复渣药水睡前熏洗会阴,对照组40例采用西药左氧氟沙星、吲哚美辛治疗,对比观察疗效。结果 治疗组治愈13例,有效14例,好转16例,无效7例,总有效率86%;对照组治愈8例,有效8例,好转9例,无效15例,总有效率62.50%;两组总有效率比较,P＜0.05,治疗组优于对照组。结论 前列清化汤治疗慢性前列腺炎的疗效确切,值得临床观察及推广应用。

目的 探寻改良内眦赘皮、重睑组合手术并观察美学效果。方法 选取40例有内眦赘皮、重睑手术需求的患者,分为对照组和观察组,对照组采用传统内眦赘皮、重睑组合手术,观察组采用改良内眦赘皮、重睑组合手术,比较两组患者满意度、美学效果。结果 对照组患者满意度为60. 0%,观察组患者满意度为95. 0%,观察组患者满意度高于对照组(P<0. 05)。观察组美学效果优于对照组(P<0. 05)。结论 改良内眦赘皮、重睑组合手术能够充分矫正内眦赘皮的异常结构,更好暴露泪阜, 能成形鼻眶窝,使鼻根部具有起伏协调之曲线美感,具有较好美学效果的手术方法之一。

目的 了解老年患者医院感染的发生情况及相关因素,为有效降低医院感染提供临床依据。方法 对我院2010年6月—2014年6月452例60岁以上的老年患者医院感染情况进行回顾性分析,调查并分析其年龄、住院天数、医院感染部位及相关因素。结果 老年患者医院感染的发生与年龄增长、住院天数延长、感染部位、基础病及抗生素不合理应用等因素密切相关。结论 根据医院感染的相关因素,对老年人加强病房管理及基础护理,不仅改善治疗操作中易感染的环节,减少感染途径,还可以降低医院感染发生率。

目的 探讨锥形纤维桩核与金属铸造桩核在残冠残根修复治疗中的临床效果。方法 65例患者共计69颗残冠残根经完善的根管治疗后采用锥形玻璃纤维桩树脂核和全冠修复,另外32例41颗牙经铸造桩核冠修复,观察疗效对比。结果 所有病例每年复查一次,平均随访期为2年,69颗纤维桩修复患牙未发现牙根折裂,其中66颗全冠与桩核固位稳定,无主诉不适、牙周健康、患者对修复体美学效果与咀嚼功能均感满意。3例失败病例分别为全冠、纤维桩核松动脱落各1颗,有1颗纤维桩折断,成功率为95.6%。金属铸造桩核组41颗患牙失败4例,其中根折2例,均已拔除,牙龈炎伴牙龈及修复体颈缘变色1例,改用纤维桩修复,继发龋1例,成功率为90.2%。结论 纤维桩树脂核具有美学效果好,机械性能好,无腐蚀,耐疲劳,易拆除,不易根折等优点,可替代铸造桩核作为理想的冠、残根桩核修复材料。

目的 探讨拉米夫定治疗对乙肝活动的肺结核病人抗结核治疗中的临床价值。方法 通过回顾性分析159例初治肺结核乙肝表面抗原(HBsAg)阳性、HBV-DNA定量阳性病人,所有病例在抗结核前查肝功能均正常,分为两组,治疗组:在抗结核及护肝治疗过程中,加用拉米夫定抗乙肝病毒治疗;对照组:没用任何抗乙肝病毒药物;分别在抗结核治疗前、治疗2周、4周及8周复查肝功能,对比两组间肝损发生率,及肝损发生时间及严重程度。抗结核治疗4周后复查HBV-DNA定量,对比两组间HBV-DNA定量下降例数。结果 治疗组的肝损发生率仅20.5%,对照组病人抗结核治疗后肝损的发生率为53.1%,两者间差异有统计学意义。治疗组肝损出现时间多为大于4周,而且多数是轻度肝损。治疗组出现肝损中断抗结核治疗的病例数低于对照组。抗乙肝病毒治疗后复查HBV-DNA定量降低例数高于对照组。结论 拉米夫定抗乙肝病毒治疗,能抑制乙肝病毒复制,降低乙肝合并肺结核病人的肝损发生率并减轻肝损严重程度,提高病人对抗结核药物的耐受性。

目的 探讨不同用药方案治疗慢性阻塞性肺病所致肺部感染的药物经济学。方法 本次医学研究选择我院2012年1月—2014年1月收治的200例慢性阻塞性肺病所致肺部感染患者为观察对象,随机将其分为A组、B组、C组和D组,A组观察对象接受盐酸莫西沙星治疗,B组观察对象接受硫酸依替米星治疗,C组观察对象接受头孢哌酮钠治疗,D组观察对象接受他唑巴坦钠/哌拉西林钠治疗,回顾分析四组观察对象药物经济学。结果 四组观察对象药物敏感度对比差异有统计学意义(P<0.05),而临床治疗效果和不良反应发生率对比则差异无统计学意义(P>0.05)。结论 慢性阻塞性肺病所致肺部感染患者接受C方案治疗,具有理想的临床效果和较高的药物经济学效率。

目的 探讨妇女阴道健康状况及阴道分泌物清洁度、线索细胞及唾液酸酶法检测细菌性阴道病(BV)的相关性。方法 随机抽取2013年4月—2014年6月本院妇科疑似细菌性阴道病患者标本835例,分别采用生理盐水直接涂片及分泌物直接涂片进行革兰氏染色两者相结合检查清洁度、线索细胞;唾液酸酶法检测BV。结果 清洁度Ⅰ～Ⅱ占27.55%,BV阳性率为2.40%,线索细胞检出率1.32%;清洁度Ⅲ～Ⅳ占72.45%,病原菌阳性率为46.23%,其中BV阳性率为30.55%,线索细胞检出率为23.48%。结论 清洁度异常率比正常率偏高;清洁度正常不一定没有细菌性阴道病; BV的出现严重威胁妇女身体健康,正确的诊断有重要意义,唾液酸酶法检测BV虽有快速、操作简单、显色结果易判断,但温度、时间、取材问题等受多种因素影响。

Objective To explore the correlation between the health of women's vagina and vaginal cleanness, clue cells and bacterial vaginosis(BV)which is tested by the sialic acid enzymatic method. Methods Randomly select 835 suspected cases of bacterial vaginosis in our hospital gynecology department in April 2013-June 2014. Every case was respectively done saline direct smear and vaginal secretion direct smear gram staining to check vaginal cleanness and clue cells. BV is tested by sialic acid enzymatic method. Results The cleanness of I-II accounted for 27.55%, BV positive rate was 2.40%, the positive rate of clue cells was 1.32%;the cleanness of degree III-IV accounted for 72.45%, the positive rate of pathogenic bacteria was 46.23%, the positive rate of BV was 30.55%, the positive rate of clue cells leads to 23.48%. Conclusion The rate of abnormal vaginal cleanness is higher than the normal.The nomal vaginal cleaness does not show no bacterial vaginosis. The emergence of BV seriously affects women's health, so the correct diagnosis is of great importance. Although the of the saliva acid enzyme to test BV is fast, operates easily and the color results are easily to be judged, but it can be influenced by other factors such as temperature, time, materials issues.

目的 探讨体感音乐疗法对青少年视疲劳患者症状缓解的影响。方法 选择青少年视疲劳患者72例,随机分为观察组和对照组各36例,两组患者均给予矫正用眼习惯、多运动、均衡饮食等护理,观察组在此基础上给予体感音乐疗法,3个月后比较两组视疲劳症状缓解情况。结果 干预后观察组视疲劳症状缓解程度及症状评分优于对照组,两组比较差异有统计学意义(P＜0.05)。结论 对青少年视疲劳患者实施体感音乐疗法,可起到促进眼部肌肉放松,改善微循环,增强睫状肌收缩力,改善虹膜睫状体调节功能,缓解视疲劳的效果。

Objective To explore the influence of vibroacoustic therapy on visual fatigue teenagers. Methods 72 visual fatigue teenagers were randomly and equally divided into the observation group and the control group. Both groups were accepted nursing in terms of the correction of eye habits, doing more sports and balanced diet, while the observation group was also accepted vibroacoustic therapy. After three months the conditions of these two groups in terms of visual fatigue were compared. Results After the intervention the degree of visual fatigue relief and the score of symptoms in the observation group were higher than those in the control group, and these differences have statistic significance (P＜0.05). Conclusion Vibroacoustic therapy can help visual fatigue teenagers to relax muscles of eyes, improve microcirculation, strengthen ciliary muscle contractile force, improve the regulatory function of iris ciliary and relieve visual fatigue.

目的 探讨NCPM理论指导下的临床营养诊疗工作在疾病治疗中解决临床营养问题的重要作用与临床价值。方法 对我院临床营养医师运用NCPM理论参与治疗的典型病例进行分析与总结。结果 临床营养医师运用NCPM理论指导临床诊疗工作,可按照临床营养诊疗工作流程,梳理临床营养诊疗思路,确定并围绕临床营养问题诊断,制定和调整临床治疗方案,提高临床疗效、缩短疗程、降低患者医疗风险。结论 临床营养医师将NCPM理论知识和临床实践相结合,有助于医院临床营养工作流程建立并有效实施;有助于临床医生与临床营养医生建立规范临床营养诊疗思路;在参与制定住院患者临床营养诊疗工作中,体现为提高临床疗效、缩短疗程、降低患者医疗风险,改善临床疗效等临床价值,应推广应用NCPM开展临床诊疗工作。

Objective The purpose of this article was to explore the clinical value of clinical nutrition diagnosis and treatment which was in the instruction of NCPM theory and the important role to solve the problem of clinical nutrition in treating disease. Methods We analyzed and summarized the typical cases that were treated using the theory of NCPM by clinical dietitians in our hospital. Results Clinical dietitians applied the theory of NCPM to guide clinical diagnosis and treatment work,and organizedthe clinical nutrition diagnosis and treatment clearly, indentified the clinical nutrition issues and around the issues they made and adjusted clinical treatment plan according to clinical nutrition diagnosis process, which increased the clinical curative effect,shortened period of treatment and reduced the patients' medical risk. Conclusion Clinical dietitiansorganizedNCPM theoretical knowledge with clinical establishment and implement effectively of clinical nutrition work process in hospital, practice, which contributed to the meamwhile whichhelp clinical doctors and clinical dietitians estabish the thought of clinical nutrition diagnosis and during the clinical nutrition diagnosis work which reflected improving the clinical curative effect, shortened period of treatment and reduced the patients' medical risk and improving the clinical outcome. Therefore it is important to popularize NCPM to carry out clinical diagnosis and treatment work.