临床

The quality of interior environment in nursing home residents will become one of the attention-getting subjects due to the gradual increase of aging populations This paper directs at the research of nursing home's interior environment factors in Tainan We use the standard of international practice to analyze the intrinsical data of environmental monitoring and establish the characteristics which from environmental physical reaction of nursing home The research items are air environments (PM10 CO CO2 formaldehyde TVOC) temperate environments and light environment (illumination average brightness daylight factor) etc There are the inductive conclusions of this research: 1 In basic medicine the clinical diagnosis means the theory and technique about physical examination with patients The definition of clinical diagnosis in architecture should be the diagnosis of building preserve and improve the feasible way to extend building's service life and assure the residents of the healthy quality of interior environment The object of clinical diagnosis in architecture is not only to ensure the use of structure and environment quality but also keep the structure and environment quality in sustainable; therefore creating an efficient system of preserving plan is needed 2 It is an accurate and technical circumstance which about improving remedying and reconstructing the problems of structure space This circumstance includes finding questions ensuring causation ascertaining ultimate strength evaluating environment quality estimating the necessary of restoration and implementing on a suitable way Furthermore when reconstructing and ameliorating the appearance of structure space it should be respected and the memories of it should be preserved 3 In clinical diagnosis of environment quality of space the question of physical environment and the deficiencies of structure must be separated The structure space of construction and the high quality of space should be inspected strictly then observed the crucial reason that can find out any invisible and hidden causes The diagnosis of construction is to observe the reason of destroyed structure The environmental diagnosis of indoor and outdoor is to find out the crucial reason that influences health 4 In order to decrease the iterant problems the construction and environment of space should be diagnosed However the destruction by natural strength and artificial using by human are important causes that can affect the service life of construction Searching the cause of disease just like curing the patient which includes inspection diagnosis cure and prevention We tested the thermal conductivity of siding material in this research and then found out the roof east vertical face and west vertical face have most radiant heat especially the construction of RC The characteristics of opaquely outer casing have relations with the thermal conductivity of wall to wiz the ability of heat insulation Therefore increasing the efficiency of heat insulation and decreasing the endoergic factor of insolation are very important to temperate environments

而随著国内老年人人口逐渐增加，逐渐迈向高龄化之同时，对於高龄者使用空间之室内环境品质相关议题之探讨，亦成为未来我们需加以关注之议题之一。主要为针对台南某安养中心室内环境因子进行检测调查工作，利用现场室内环境测定以取得有效的实测数据；再藉由汇整相关国际评估基准，并进行实测数据比对分析，建立老人安养中心对物理环境反应之特性。并以前期相关研究文献回顾与老人安养中心实测案例现场的实验，来了解不同空间物理环境特性之影响，并将结果回馈实际建筑及室内设计之用。调查工作项目包含：空气环境之PM10、CO、CO2、甲醛、TVOC；温热环境之室内温度、相对湿度、人体PMV、PPD；光环境之照度、均齐度、昼光率等因子调查。本研究结果可归纳以下几点结论： 1 所谓临床诊断医学乃相对於基础医学而言，是指实际与病人接触的医疗及护理行为中牵涉到的理论和技术；而建筑的临床诊断的定义应为建筑本体与室内外诊断、维护及改善所有可行的方式来延长建筑物的寿命，并确保人与室内环境空间品质的健康。建筑临床诊断目的为确保结构体与环境品质能继续使用，而能维持所需要的效能及承受能力。一个有效的维护计画体系是必须建立的 2 在建筑空间之问题改善、治疗与修复执行中，是一个精确与技术性的事项，其中包含找出问题、确定原因、评估结构应力强度、评估环境品质、评估修复与改善必要性、选择及执行一个适当的过程。其改善与修复也必须尊重建筑空间原有色彩与形貌，并保留原有记忆及文化。 3 在临床诊断中空间环境品质中，物理性环境问题与结构构件缺陷必须分别判断，诊断建筑空间之结构与空间舒适品质必须详细观察其症结性问题，才能发现任何隐藏及有潜伏性缺陷的原因。建筑本体诊断是观察出建筑本体之破坏原因，而是内外空间环境诊断目的在於的找出影响健康因素之症结性问题。 4 建筑本体与空间环境之预防评估目的为降低与抑制问题的再发生。然而，自然力的破坏与人为使用因素皆是影响建筑生命期之主要因素，找出病源问题就如同医生对病人的处理，包含了侦查、诊断、治疗以及预防。 5 本研究以外墙材料热传导率测试结果发现，屋面与东西向立面是承受辐射热最多的地方，尤以 RC 的建筑更甚，不透明部分的外壳能特性主要与壁体的热传透率即隔热能力有关，但是承受来自日射的吸热影响，因此增加隔热性能与降低日射吸热因子是对温热环境是非常重要的。

This book provides a comprehensive review of clinically relevant topics in occupational asthma written by nationally and internationally recognized experts in the field. This text is an outstanding reference resource for the clinician, clinical scientist or clinical fellow with an interest in workrelated asthma.

本书是职业性哮喘领域多位国内和国际知名专家在各个临床相关课题方面的全面深入的总结，是对职业性哮喘感兴趣的临床医生，临床科学家或低年资临床医生的优秀参考书。

objective the purpose of this study was to summarize our experience of the application of internal rigid fixation with miniplate to treatment of mandibular fractures.methods a retrospective analyisis of clinical data of 67 cases,who had experienced the anatomic reduction and rigid fixation by using miniplate.with the help of maxillomandibular distraction pre operation and post operation and temporary maxillomandibular fixation during operation,the fracture bones were smoothly reduced and fixed.results clinical and radiographic examination showed that all cases gained good clinical results and precise anatomic alignment of fracture postoperatively without infection,malocclusion,bone malunion or other complications.conclusion mocortical miniplate fixation of the mandible is a reliable and effective techinique providing rigid fixation and an ideal modality for the treatment of mandibular fractures.combined with maxillomandibular fixation.

对67例下颌骨骨折患者的临床资料进行回顾总结，所有患者应用小型接骨板行坚固内固定治疗。其中7例颏部骨折，12例颏旁骨折，16例颏孔区骨折，9例体部多发性骨折，5例体部粉碎性骨折；18例合并其他部位骨折。所有患者术前经临床检查和影像学检查明确骨折的位置和骨折线的数目后，分段牙弓夹板结扎、颌间弹性牵引，使移位的骨折段逐渐复位；术中经口内切开复位、细钢丝颌间结扎、小型接骨板坚固内固定；术后行临床检查和影像学复查，必要时颌间弹性牵引7～10 d。结果所有患者手术切口ⅰ期愈合，治疗效果满意；临床检查所有患者牙合关系良好、面部对称；影像学复查证实骨折线对位良好。结论经口内切开小型接骨板坚固内固定辅以颌间固定治疗下颌骨骨折效果可靠，术后并发症少，是一种理想的手术方法。

RESULTS: The clinical manifestations and MRI information of 123 cases verse-type herniation, clinically manifested as symmetric incomplete as central canal syndrome and significantly decreased or lost motility of the ripheral-type herniation, manifested as nerve root pain of unilateral side as well as pain sensation and thermesthesia on the opposite side.

MRI分为横型突出58例，临床表现呈四肢对称性不全瘫痪。②MRI呈中央型突出34例，临床表现呈中央管综合征，双上肢肌力显著减退或丧失。③MRI呈旁侧型27例，临床表现呈不典型性半脊髓综合征。④MRI呈边缘型4例，临床表现为一侧神经根性痛，对侧痛温觉障碍。

Consider to make clear in recent years, second acid is calcic - Bowman does not move bacillus clinical bacterium of single born of the same parents of the detached rate that go up and verdigris holiday comparatives, have the tendency that year after year rises, the fundamental condition pathogenic bacteria that already became the infection inside the courtyard [1] , have to a variety of antibacterial content be able to bear or endure higher property of a medicine [1, 2] , for this, we are monitored and statistic analysed my courtyard to came 1998 2004 7 years a second acid is calcic - the clinical infection condition that Bowman does not change bacillus, to 14 kinds of antibacterial content be able to bear or endure property of a medicine and be able to bear or endure medical tendency, sum up a report to be as follows now. 1 material and method all data all come from 1.1 basic materials to came on January 1, 1998 my courtyard outpatient service was mixed on December 31, 2004 the specimen sending check of inpatient, via clinical microbiology the lab is fostered and classics appraisal is second acerbity calcium - Bowman does not move bacillus to affect case of illness, with clinical and commonly used antibacterial at the same time content makes the kill that medical quick detects. 1.2 bacteria appraisal is mixed medical quick experiment uses live thing VITEK32 of Mei Li dust is full automatic the bacterial appraisal of bacterial analysis system and its form a complete set gets stuck and medical quick card undertakes detecting, 1998~2000 year use GNI appraisal gets stuck, 2001~2004 uses GNI+ card.

近年探究表明，乙酸钙-鲍曼不动杆菌临床上的分离率和铜绿假单胞菌相当，并有逐年上升的趋向，已成为院内感染的重要条件致病菌[1]，对多种抗菌药物有较高耐药性[1，2]，为此，我们监测并统计分析了我院1998年至2004年七年间乙酸钙-鲍曼不动杆菌的临床感染情况，对14种抗菌药物的耐药性及耐药趋向，现总结报道如下。1材料和方法1.1基本资料所有资料均来自于1998年1月1日至2004年12月31日我院门诊和住院病人的送检标本，经临床微生物学实验室培养并经鉴定为乙酸钙-鲍曼不动杆菌感染病例，同时以临床常用抗菌药物作药敏检测的结果。1.2细菌鉴定和药敏试验采用生物梅里埃VITEK32全自动细菌分析系统及其配套的细菌鉴定卡和药敏卡进行检测，1998~2000年使用GNI鉴定卡，2001~2004使用GNI+卡。

Methods 40 children with adenoidal hypertrophy by clinical symptoms and electronasopharyngoscope were treated by fluticasone propionate (50g per nostril a day) for 3 months. Clinical symptoms scores and adenoidal volume were observed, and then those whose clinical symptom got improved were followed up for another half a year.

选择40例经临床症状评分和电子鼻咽镜检查确诊为腺样体肥大的患儿，予丙酸氟替卡松鼻喷剂每日1次，治疗3个月比较治疗前后患儿临床症状的变化情况；临床症状改善的患儿停药后随访6个月，再次与治疗后的临床症状改善情况进行比较。

One ESBLS-producing strains was detected in Pseudomonas aeruginose,Enteric aerogenes and Citrobacter,respectively.

由于ESBLS阳性株对临床常用抗生素的耐药率远远高于ESBLS阴性株，使临床治疗面临极大的困难，必须引起临床医生和临床微生物室的重视。

objective:to investigate the clinical effects of shuxuetong injection (extractive of leech and lumbricus) on primary nephrotic syndrome by the clinical observation of shuxuetong injection on treating pns, provide objective evidence for the treatment of pns.methods: the 58 spleen and kidney asthenia and retention of water with blood stasis patients were divided into treatment group (n=28) and control group (n=30) by the visit order.

小 摘要：目的：通过对疏血通注射液治疗pns的临床观察，探讨疏血通注射液治疗pns的临床疗效，为临床治疗pns提供客观依据。方法：临床纳入脾肾两虚，水湿壅盛兼有瘀血型pns患者58例，按就诊顺序随机分为治疗组28例，对照组30例。

The mean ADC value of lymphomatous, metastatic and benign lymph nodes was (0.874±0.17)×10~(-3)mm~2/s,(0.98±0.09)×10~(-3)mm~2/s and (1.20±0.10)×10~(-3)mm~2/s. There was statistically different between benign lymph nodes and other groups (P=0.00). When an ADC value of 1.085×10~(-3)mm~2/s was used as a threshold value for differentiating malignant from benign lymph nodes, the best results were obtained with an sensitivity of 87.8% and specificity of 91.3%. 16 of 18 cases (88.9%) were accurately staged in accordance with clinical staging. For 24 patients after chemotheraphy or radiotheraphy, 4 cases were complete remission and WB-DWI was negative. WB-DWI was positive in 14 of 17 cases with recurrent or remnant tumor. For 3 patients with suspected partial remission, WB-DWI indicated necrosis in 2 cases and inactive in 1 case. Repeated WB-DWI examination was performed in 13 cases, tumors were eradicated in 6 cases, improved in 4, expanded in 2. A new colon carcinoma besides its primary lesion was found in 1 case. The results of WB-DWI were all concordant with other clinical tests.

以ADC值1.085×10~(-3)mm~2／s作为诊断恶性淋巴结病变的临界值，敏感性及特异性分别为87.8％和91.3％。88.9％(16／18)患者WB-DWI检查后分期与临床分期一致。24例淋巴瘤患者放化疗后行WB-DWI检查，4例临床疗效为完全缓解，WB-DWI检查均为阴性，17例临床确认有肿瘤复发及明显残留，WB-DWI显示为阳性的14例，另外3例常规影像评价为部分缓解的患者，WB-DWI检查提示2例病灶以坏死液化为主，1例病灶无明显活性。13例淋巴瘤患者行多次WB-DWI检查，发现6例治疗后病灶消失，4例缓解，1例原发病灶缓解，新出现结肠癌，2例淋巴瘤进展，皆与临床相符。

The therapeutic effects were evaluated in the clinical efficacy and mycological culture examina-tion.

目的 观察不同剂型的抗真菌药物治疗夏季水疱型、浸渍型足癣的临床疗效，好地指导临床用药提供实验依据方法 80例临床实验室确诊的足癣患者分4组，分别外用特比萘芬喷雾剂、乳膏，达克宁乳膏、散剂，根据临床疗效及真菌培养判定其效果。

Objective: To study the effect of polycythemia on blood oxygen saturation.

裴蕾目的：观察RBC剧增而引起的高粘血症对血氧饱和度的影响。

Based on SIMPLER algorithm in the curvilinear body-fitted coordinates, the calculations were performed for Pr=0.7, Re=10~1000 on non-orthogonal non-staggered grids which are generated by elliptic equation systems.

采用曲线坐标系下压力与速度耦合的SIMPLER算法，数值研究了周期性渐扩渐缩波纹通道内脉动流动与换热情况，流动Re数的范围为10~1000，Pr数为0.7。