目的 调查北京市出租车司机骨密度减少、骨质疏松的低骨量患病率及其影响因素.方法 选取我院接受健康检查的2 500名出租车司机为观察组,1 683名机关事业单位人员为对照组,两组人员在年龄、性别比例等比较差异无显著性(P＞0.05).超声骨密度仪检测骨密度,自制健康问卷调查骨密度有关因素.结果 观察组发放2 500份问卷,回收有效问卷2 398份,有效率为95.9％.观察组骨密度减少率、骨质疏松率和低骨量率分别为24.8％、8.3％和33.1％,明显高于对照组的13.0％、5.1％、18.1％,差异有统计学意义(x2=86.234、15.126、112.342,均P＜0.05).Logistic回归分析显示,年龄≥45岁、从业年限≥10a、日均开车时间≥15 h、每周饮浓茶或咖啡≥7次和每周饮碳酸饮料≥3次显著增加出租车司机低骨量的患病风险(OR=3.247、2.579、1.816、1.853、2.642,均P＜0.05),而每周喝牛奶量≥5包(250 ml/包)、每周服用钙片或钙剂≥5次和日均运动锻炼时间≥30 min则有助于降低出租车司机低骨量发.生风险(OR=0.453、0.525、0.669,均P＜0.05).结论 北京市出租车司机低骨量患病率较高,尤其是年龄≥45岁、从业年限≥10 a、日均开车时长≥15 h、每周饮浓茶或咖啡≥7次及每周饮碳酸饮料≥3次的司机.

目的 调查北京市男性在职出租车司机前列腺患病情况,为改善其健康状况提供相关依据.方法 按照纳入标准随机选取2018年5月-2019年6月间来首都医科大学附属北京康复医院健康管理中心接受健康检查的580名男性在职出租车司机作为调查对象,使用自制检查表对其进行问卷调查及健康检查,分析患前列腺疾病的影响因素.结果 回收有效问卷563份,有效率为97.07％.563名在职出租车司机检出前列腺疾病者242名,检出率为42.98％.单因素分析显示,不同年龄、体质指数、从业年限、日出车时长、日饮水量、日下车活动时长的出租车司机前列腺疾病患病率比较,差异均有统计学意义(均P＜0.05).多因素logistic回归分析显示,年龄≥50岁(OR=2.099)、肥胖(OR=1.708)、从业年限≥6年(OR=2.167)、日出车时长≥14 h(OR =2.444)、日饮水量＜250 mL(OR=4.198)是北京市男性出租车司机患前列腺疾病的危险因素(均P＜0.05),而日下车活动≥20 min(OR=0.249)是出租车司机前列腺的保护因素(P＜0.05).结论 男性出租车司机应重视前列腺健康的自我保健,尤其是年龄≥50岁、肥胖、从业年限≥6年、日出车时长≥14 h、日下车活动＜5 min、日饮水量＜250 mL的司机.

目的 了解北京地区出租车司机身体健康现状,为建立、健全成熟的出租车行业健康管理模式提供科学依据.方法 对1 175名北京地区出租车司机体检结果进行分析,了解出租车司机慢性疾病检出情况及职业相关健康问题,并与北京市社会体检人群体检结果进行比较.结果 1 175名出租车司机慢性疾病检出率为92.43％,其中男性检出率为92.38％,女性检出率为92.73％,慢性疾病检出率随年龄、工龄增加呈上升趋势(P＜ 0.01),吸烟组慢性疾病检出率显著高于非吸烟组(P＜ 0.01).男性慢性疾病检出率前9位顺位为脂肪肝(60.55％)、骨质增生(54.55％)、甲状腺结节(50.48％)、前列腺增大(40.06％)、颈动脉斑块(39.35％)、脊柱生理曲度僵直(37.72％)、项韧带钙化/骨化(35.44％)、颈动脉内膜增厚(26.37％)、高血压(23.44％);女性慢性疾病检出率前9位顺位为甲状腺结节(67.08％)、骨质增生(52.98％)、宫颈腺囊肿(51.32％)、脊柱生理曲度僵直(43.71％)、宫颈肥大(43.42％)、子宫肌瘤(38.96％)、脂肪肝(37.04％)、乳腺结节(37.04％)、阴道壁膨出(34.21％).经北京市社会自然人群年龄别结构标准化后,出租车司机脂肪肝、甲状腺结节、颈动脉斑块、早搏、血压增高检出率均高于北京市社会体检人群(P＜0.05).出租车司机身体不适情况主要为颈肩痛(占56.79％)和腰背痛(54.78％).结论 北京市出租车司机健康状况堪忧.应根据北京地区出租车司机体检结果异常的特点,采取系统综合的干预措施,改善该职业人群的健康水平,为公共交通安全提供保障.

Objective To observe the changes and clinical significance of vasostatin-2 (VS-2) in patients with chronic heart failure (CHF). Methods CHF patients (n=159, observation group) and healthy volunteers (n=120, control group) were chosen from Beijing Rehabilitation Hospital affiliated to Capital University of Medical Sciences from Jan. 2015 to Jan. 2018. And observation group were divided, according to disease status, into subgroups of pre-heart failure stage, pre-clinical heart failure stage, clinical heart failure stage and refractory end-stage heart failure stage. The levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and VS-2 were detected in observation group and control group. The changes of left ventricular end-diastolic inner diameter (LVEDd) and left ventricular ejection fraction (LVEF) were detected by using color ultrasound. The correlation among VS-2, NT-proBNP, LVEF and LVEDd was analyzed. Results Compared with control group, the levels of serum NT-proBNP and LVEDd increased (P＜0.05) and VS-2 and LVEF decreased (P＜0.05) in observation group. The comparison among different groups with different NYHA grades showed that NT-proBNP and LVEDd had an ascending trend (P＜0.05) and VS-2 and LVEF had descending trend (P＜0.05) with the increase of NYHA grades. The comparison among subgroups of different stages showed that VS-2 decreased continuously (P＜0.05) and NT-proBNP had an ascending trend (P＜0.05) with the development of heart failure. The results of correlation analysis showed that the level of serum VS-2 was positively correlated to LVEF, and negatively correlated to NT-proBNP and LVEDd. Conclusion The level of serum VS-2 will significantly decrease in CHF patients, which can reflect to some extent the progress and stages of CHF.

目的 探讨手术室护士职业暴露后返岗适应状况及相关影响因素.方法 选择2012年1月至2018年4月首都医科大学附属北京佑安医院和首都医科大学附属北京地坛医院手术室职业暴露后返岗1～4周内的护士48名,使用自制的返岗适应问卷调查表进行问卷调查.返岗适应问卷调查表涵盖4个维度:①护理工作的应对情况;②护理专业发展;③工作环境中的人际关系;④科室管理方式.结果 48名护士职业暴露后返岗适应问卷总分为(3.72±0.77)分,其中护理工作的应对情况为(3.90±0.67)分,护理专业发展为(4.05±0.65)分,工作环境中的人际关系为(3.37±0.83)分,科室管理方式为(3.43±0.75)分.结论 返岗适应问卷调查表中护理专业发展得分最高,而人际关系得分最低,年龄和聘用方式是护士职业暴露后返岗适应状况的相关影响因素.

Objective:The aim of this study was to evaluate whether retaining myoma pseudocapsule has effect on the healing of uterine wound of hysteroscopic myomectomy for symptomatic type 2 uterine myoma (according to classification for myoma of FIGO, 2011). Methods:From January 2014 to September 2017 in Fuxing hospital, cases of type 2 uterine myoma (single, larger than 2.5 cm) were collected for heaving uterine bleeding and were performed one -step hysteroscopic myomectomy. A total of 70 cases were divided into 2 groups, the myoma pseudocapsule were retained after myomectomy for Group A (35 cases),the myoma pseudocapsule protruding into the uterine cavity were removed for Group B (35 cases).The following medical data were recorded:the age of patients,the size of the myoma,pre-operative treatment by GnRH analogue, operation time, blood loss during the operation, surgical complications. At 1 and 3 months after the operation, second-look hysteroscopy was performed to observe and compare the uterine cavity wounds healing condition of the two groups. Results:There is no significant difference of patients′ age, size of the myoma and the use of pre-operative GnRHa between the two groups;the mean operation time of group A was(33.3±12.3)min(range 17~65 min),the operation time of group B was(32.7± 12.1)min(range 18~70 min),there was no significant difference(t=0.195,P=0.846).The mean volume of intra-operative blood loss of' group A was (26.4+16.3) mL (10-50 mL), the mean volume of' intra-operative hlood loss of' group B was (26.7+15.8) mL(10-50 mL), there was no statistical diff'erenc-.e (t=-0.074.P=0.941); the incidence of' intrauterine adhesions after I months was 5.71% (2/35) in group A and 20.00% (7/35) in group B, there was no signif'icant diff'erence ( X2=3.188 ,P=0.074); the incidenc:e of' intrauterine adhesions after 3 months was 0 (0/35) in group A and 11.43% (4/35) in group B, there was significant differenc:e (P=0.039). Conclusions:Myoma pseudocapsule should be protected and retained for hysteroscopic: myomectomy surgery.Second-Iook hvsteroscopy is important f'or prevention intrauterine adhesion after hysteroscopic myomectomy.

Objective Population aging in China is becoming a trend.This study aimed to investigate the operative indications,opportunity and skills of laparoscopic cholecystectomy (LC) in elderly patients with acute calculous cholecystitis (ACC),so as to improve the therapeutic effects of LC.Methods The clinical data of 43 elderly patients (over 80 years) with ACC were collected from July 2013 to November 2016 in our hospital.According to whether they had operative indications,the patients were divided into surgical group and non-operative group.The coexisting diseases,laboratory examination,operative opportunity (preoperative time,body temperature,blood leukocyte count and neutrophil percentage,high-sensitivity C reactive protein),operative effect (operative time,intraoperative blood loss,postoperative hospital stay),postoperative complications and therapeutic effects were analyzed.Results The average age of 43 elderly patients with ACC was (83.5 ± 2.7) years old.Seventeen cases underwent surgical treatment,including 13 cases of LC (the maximum age of 88 years old,the success rate of 100％),and 4 cases of open cholecystectomy (OC).Twenty-six cases received non-operative treatment.The therapeutic effects were significantly better in surgical group than in non-operative group (P=0.003).The curative rate was significantly higher in LC group (92.3％) than in OC group (75.0％).The operative opportunity had no significant effect on the therapeutic effects (P＞0.05),but had some effect on postoperative complications.Conclusions LC in elderly patients with ACC is safe and feasible.The key is to reasonably determine the operative indications,effectively grasp the operative opporttnity,expertly master the skills of LC,and improve the perioperative therapy,so as to further improve its therapeutic effect and safety.

目的:探讨良性阵发性位置性眩晕(BPPV)患者前庭康复治疗过程中的护理经验.方法:按随机数字表将76例BPPV住院患者分为观察组和对照组,每组38例,对照组给予复位治疗和药物治疗.观察组在对照组的基础上接受前庭康复训练,配合心理护理、眩晕护理、饮食护理及复位指导,分另观察2组患者治疗1周和2周后的临床效果,并经过一年回访,观察记录2组患者BPPV复发情况.结果:治疗1周时观察组的治愈率显著高于对照组(P＜0.05);2组病例治疗2周时的治愈率及1年复发率则无明显差异(P＞0.05).结论:通过加行前庭康复训练及护理可使BPPV患者的短期治愈率明显提高,可提高患者的生活质量.

目的 探讨护理部运用走动式管理模式在加强护理质量控制管理中的应用效果.方法 我院自2014年8月开始将走动式管理模式应用到护理部护理质量控制管理中,比较走动式管理模式实施前1年(2013年8月至2014年7月)、实施后1年(2014年8月至2015年7月)护理质量控制效果.结果 走动式管理模式实施后,基础护理、护理文书、急救药品器械管理、危重护理、病区管理、消毒隔离、健康教育得分分别为(97.33±2.85)分、(98.04±1.35)分、(97.52±2.42)分、(98.05±1.23)分、(97.54±0.86)分、(99.04±0.21)分、(97.74±1.26)分,比实施前有显著提升(P＜0.01).结论 护理部通过实施走动式管理模式加强质量控制管理有效提高了整体护理质量,值得进一步推广应用.

Objective To investigate the cause, diagnosis, treatment and prevention of delayed pancreatic fistula and hemorrhage after pancreaticoduodenectomy (PD). Methods We summarized the experience in dealing with a patient with delayed pancreatic fistula ( postoperative day 5 ) and hemorrhage ( postoperative day 21 ) after PD for ampullary carcinoma. Results On the second day after the occurrence of postoperative pancreatic fistula , physiological saline was used for local continuous flushing via the peritoneal cavity drainage tube, resulting in gradually reduction of the drainage from the pancreatic fistula.For the management of postoperative hemorrhage, local continuous flushing of adrenalin saline combined with preserving infusion of thrombin was applied, and the hemorrhage stopped within 24 hours. Then physiological saline flushing was continuously carried out for 7 days.The patient was recovered and discharged from the hospital on the postoperative day 28. Conclusion Non-operative management could successfully cure delayed grade C pancreatic fistula and hemorrhage after PD.