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There were no significant difference between diabetics in hospital and diabetics who had participated diabetes education in gender,age,marital status,occupation, education level and the form of medical expenses.It is suggested that the two groups come from the same patients. 2.According to the result of content validity and retest reliability,questionnaire of compliance has a good validity and reliability.According to the result of consistence test,collection validity,discrimination validity and construct validity,SF-36 has a good validity and reliability.3.We used self paired comparison to analyze the data of the treatment compliance from the patients who had participated diabetes education and the patients in hospital who hadn\'t participated diabetic education.The results suggest that the treatment compliance of patients is improved as the number of times that these patients participated diabetes education was increased.The treatment compliance of the patients in hospital is improved just in a short-term period,who hadn\'t participated diabetes education.

研究结果1、住院糖尿病患者与参加健康教育的糖尿病患者在性别、年龄、婚姻、职业、文化程度、医疗用度承担形式上均无统计学差异,说明两组人群来自同一整体。2、根据内容效度和重测信度的结果证实允从性问卷具有良好的信度和效度;根据内部一致性检验、集合效度、区分效度和结构效度的结果证实SF-36量表具有良好的信度和效度。3、对参与健康教育的糖尿病患者进行的允从性跟踪调查结果进行自身配对前后比较,并与未参加健康教育的住院糖尿病患者的允从性得分进行比较,发现糖尿病患者治疗允从性随着参加健康教育次数的增多而进步;未参加教育的住院患者治疗允从性在进院和刚出院的短期内有一定进步,但随后逐渐下降至进院前水平。

Results. Clinical resolution of infections, normalization of lab values, and bony fusion, based on dynamic radiographs and CT scans, were seen in all patients at latest follow-up. Staphylococcus aureus was the most frequently identified organism (8 patients). Four (29%) patients had positive blood cultures. Predisposing comorbidities were present in 12 patients. Six patients had epidural abscesses. Eight (57%) patients presented with neurologic deficits, ranging from paraparesis to quadriplegia. Complete recovery was seen in 7.

结果:临床上炎症消失、实验室检查数据正常和骨融合由所用患者随访的动态平片和CT扫描结果决定。8名患者频发金葡球菌感染,4名(占29%)患者血培养出现耐甲氨西林金葡球菌阳性反应,12名患者出现并发症,6名患者出现硬膜外脓肿,8名患者出现从下肢轻瘫到四肢瘫痪的神经损伤,7名患者完全康复。

Results Among the 103 patients, 65 patients received lamivudine, 29 patients received interferon, and 9 patients received other nucleoside analogues. The results of HBV genotype redetermination indicated that 98 patients' genotypes remained unchanged after the medicine treatment, and genotype analysis failed of success in 5 patients.

结果 103例病人中,65例用拉米夫定治疗,29例用干扰素治疗,9例用其它核苷类药物治疗,停药后复查患者基因类型,除5例未分析出结果外,98例患者通过药物治疗基因类型均未改变。

Accuracy between two groups was calculated byχ~2 test.Calculate the average effective radiation dose of the 30 patients.Results In group A,seventeen patients underwent both DSCT coronary angiography and SCAG,among 255 segments of 17 patients,105 lesion sites of 70 segments were diagnosed stenosis or obstruction,of them,95 lesion sites were confirmed by SCAG.The accuracy of DSCTCA was 90.48%.The agreement of two methods have a high agreement(Kappa =0.853).In group B,13 patients underwent both DSCT coronary angiography and SCAG,among 195 segments of 13 patients,73 lesion sites of 57 segments were diagnosed stenosis or obstruction, of them,65 lesion sites were confirmed by SCAG.The accuracy of DSCTCA was 89.04%.The agreement of two methods have a high agreement(Kappa =0.835). There was no significant difference(χ~2=0.098,p>0.05) between the accuracy of two groups.The effective radiation dose of 30 patients was 3.67±0.43 mSv.Conclusion Compared with SCAG,prospectively ECG-gated transverse DSCT is a valuable examination to detect and diagnose coronary artery disease with a low dose coronary angiography.The accuracy of the DSCT is approximate to the SCAG.There was no significant difference between the accuracy of two groups.

结果200例患者均成功完成了适应性前瞻性心电门控双源CT冠状动脉血管成像;30例同期行SCAG检查的患者,A组17例:HR≤75 bpm,可评价冠状动脉节段255个,70个冠状动脉节段有105处不同程度的狭窄,95处狭窄程度与金标准SCAG相符,其阳性诊断准确率为90.48%;2种方法的诊断结果得到了较高的一致性(Kappa值=0.853)。B组13例;HR≥91 bpm,可评价冠状动脉节段195个,57个冠状动脉节段有73处不同程度的狭窄,65处狭窄程度与SCAG相符,其阳性诊断准确率为89.04%;2种方法的诊断结果得到了较高的一致性(Kappa值=0.835)。2个心率组间的诊断准确率无明显统计学差异(x~2=0.098,p>0.05)。30例患者的平均有效辐射剂量为3.67±0.43 mSv结论适应性前瞻性心电门控双源CT冠状动脉成像是一种有效减低辐射剂量的扫描方式,其诊断准确率与金标准SCAG相比得到较高的一致性,且高、低2个心率组间诊断准确率无明显统计学差异。

Case 3, uremic patients JIANG Jing Gang, male, 26 years old, Jintang County of Chengdu City in Sichuan Province and Technical Supervision cadres, he is sick of the news center in the "Understanding" magazine in May 2002 on the semimonthly period,"thought his brother Oliver back, tied with his brother ill shore where entangled" The article on that, in their contacts with the patients have been in the General Hospital of Chengdu Military Region of the last two months and more hemodialysis treatment, but returned home service medicine, there has been more than mouth the risk of hemorrhage, relatives of patients with the Center should request that since May 13, 2002 sent by train from Qingdao arrived home patients using onboard eternal secret Chinese medicine, and patients and their families in the village under suspicion, were completed in two days time, so patients with mouth and nose bleeding more than the danger of the stop, not bleeding, it is no longer need to do hemodialysis, and the medical miracle that I am afraid people will only see personally believe.

病例3,尿毒症患者蒋某某,男,26岁,四川省成都市金堂县某局的干部,他患病的消息是本中心在《知音》杂志2002年5月期上半月刊"仗义哥哥苦海回头,苦命弟弟绝症缠身何处有岸"的文章上得知的,在与他们的联系中,患者已经在成都军区总医院治疗血透了二个多月,后来回家服中药,出现了口鼻出血不止的危症,本中心应患者亲属请求,自2002年5月13日派人从青岛乘火车赶到患者家中,用自带的千古秘方中药,在患者及其家人和全村的怀疑下,仅用了2天的时间,就把患者口鼻出血不止的危症止住了,不出血了,也无需再去做血透了,这样的医疗奇迹恐怕只有亲眼所见才会有人相信。

Results]In 108 patients (93.1%) routinely took antiplatelet drug orally;75 patients (64.7%) common took ACEI orally; 82 patients (70.7%) usually took beta-blocker orally; only 39 patients (33.6%) insisted on taking lipid-lowering drug orally;26 symptomless patients long-term took orally nitrate;24 symptomless patients long-term took Calcium antagonists.

结果] 108例(93.1%)患者常规口服抗血小板药物,存在主要问题是部分患者用量偏低;75例(64.7%)患者服用ACEI;82例(70.7%)患者常规口服β-受体阻滞剂,心率达标率为39%;只有39例(33.6%)患者坚持服用调脂药;26例患者无症状长期口服硝酸酯类药物;24例患者长期口服钙通道阻滞剂。

Results Conservative treatment was carried out for 4 patients, ureteroureterostomy for 7 patients, ureteroneocystostomy for 22 patients, bladder valve-ureter anastomosis for 2 patients, vermiform appendix-ureter replacement for 2 patients, and nephrectomy for 1 patients.

结果 4例行双J管保守治疗,7例(9侧)行输尿管端端吻合术,2 2例行输尿管膀胱再植术,2例行膀胱壁瓣输尿管吻合术,2例行阑尾代右侧部分输尿管术,1例行肾切除术。

The 3-year PFS and 3-year OS were 52.6% and 74.9%. The major transplant-related adverse events consisted of nausea and vomiting(39 patients), infection and fever(27 patients),stomatocace or anabrosis(16 patients),diarrhea(6 patients),liver disfunction(3 patients),herpes zoster(2 patients).

移植相关不良反应主要为恶心呕吐39例,感染和发热27例,口腔黏膜溃疡或糜烂16例,腹泻6例,肝功能损害3例,带状疱疹感染2例,造血重建和对症治疗后可完全恢复。1例患者因发生过敏反应未能回输自体造血干细胞,在粒缺期发生严重感染死亡。

Methods: Selected 93 confirmed cases with hypospadias during May 2003 to Sep 2009. Patients in balanic type were treated with meatal advancement and glandularp lasty; patients with urethra orifice at 2/3 of corpus penis accompanied with slight chordee of penis were treated with Snodgrass method or Onlay method; patients with severe chordee of penis were treated with Duckett method; patients in scrotum or perineum type were treated with combination of Duplay and Duckett; severe hypospadia patients were treated with curved pedicle penis-scrotum and skin flap urethroplasty; patients with good outer plate of ventral prepuce and chordee of penis were treated with ventral pedicle hooded foreskin flap.

选取2003年5月~2008年9月期间收治的93例确诊尿道下裂患者,对阴茎头型患者采用尿道口前移、阴茎头成形法;尿道口在阴茎体外2/3段伴有阴茎轻度下弯者采用尿道板纵切卷管法或加盖岛状皮板法(Snodgrass术或On-lay术);有严重阴茎下弯的所有阴茎体型采用横裁或纵裁包皮岛状皮瓣尿道成形;阴囊型或会阴型用阴囊中缝皮管加横裁包皮岛状皮瓣成形尿道(Duplay联合Duckett术);对重度尿道下裂患儿采用弧形带蒂阴茎阴囊联合皮瓣尿道成形术;对腹侧包皮外板发育良好患儿及合并阴茎下曲的患儿采用腹侧带蒂帽状包皮皮瓣法。

Methods: Selected 93 confirmed cases with hypospadias during May 2003 to Sep 2009. Patients in balanic type were treated with meatal advancement and glandularp lasty; patients with urethra orifice at 2/3 of corpus penis accompanied with slight chordee of penis were treated with Snodgrass method or Onlay method; patients with severe chordee of penis were treated with Duckett method; patients in scrotum or perineum type were treated with combination of Duplay and Duckett; severe hypospadia patients were treated with curved pedicle penisscrotum and skin flap urethroplasty; patients with good outer plate of ventral prepuce and chordee of penis were treated with ventral pedicle hooded foreskin flap.

选取2003年5月~2008年9月期间收治的93例确诊尿道下裂患者,对阴茎头型患者采用尿道口前移、阴茎头成形法;尿道口在阴茎体外2/3段伴有阴茎轻度下弯者采用尿道板纵切卷管法或加盖岛状皮板法(Snodgrass术或Onlay术);有严重阴茎下弯的所有阴茎体型采用横裁或纵裁包皮岛状皮瓣尿道成形;阴囊型或会阴型用阴囊中缝皮管加横裁包皮岛状皮瓣成形尿道(Duplay联合Duckett术);对重度尿道下裂患儿采用弧形带蒂阴茎阴囊联合皮瓣尿道成形术;对腹侧包皮外板发育良好患儿及合并阴茎下曲的患儿采用腹侧带蒂帽状包皮皮瓣法。

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