Objective To analyze the MRI-based assessment of the correlation between glenohumeral joint anatomy and Bankart lesion in males. Methods A total of 120 patients diagnosed with Bankart lesion at Zhejiang Provincial Corps Hospital of Chinese People's Armed Police Force from May 2021 to May 2025 were selected as the study group. Through the medical imaging management system (PACS) and electronic medical record system, another 120 patients who visited the hospital due to shoulder joint discomfort during the same period were selected as the control group, excluding those with previous shoulder joint dislocation, surgery, or trauma history. Both groups underwent MRI examination. The MRI imaging features of Bankart lesions were observed and analyzed. The width and height of glenoid, the width and height of humeral head, the ratio of the width and height of glenoid, and the rate of glenohumeral dislocation were measured and compared between the two groups. Logistic regression analysis was used to evaluate the high-risk factors of Bankart lesion of the shoulder joint, and the receiver operating characteristic (ROC) curve was used to assess the predictive value of related indicators. Results Bankart lesions showed irregular, blunt or missing labrum morphology on MRI images, T2WI showed high signal intensity in labrum and glenoid articular surface separation, accompanied by Hill-Sachs fracture of the humeral head. There was no statistically significant difference in the height and width of the glenoid fossa and humeral head width between the two groups (P＞0.05), The width and surface area of the glenoid of the study group were smaller than those of the control group, while the ratio of the height to width of the glenoid and the rate of glenohumeral mismatch were greater than those of the control group, with statistically significant differences (P<0.05). Age, BMI index, glenoid height and humeral head width were not risk factors for Bankart lesion of the shoulder joint, while the glenoid width, the ratio of glenoid height to width and the rate of glenohumeral dislocation were risk factors (P<0.05). Glenoid height-to-width ratio (OR=243.69,95%CI:13.17~4508.72) was an independent risk factor for Bankart lesion. The area under the curve (AUC) of glenoid height-to-width ratio predicting Bankart lesion was 0.72, with an optimal cut-off value of 1.60, sensitivity of 71.67%, and specificity of 54.17%. Conclusions MRI can accurately display glenoid labrum lesion of shoulder joint and is a reliable method to diagnose the lesion. A larger glenoid height-to-width ratio is an important risk factor for anterior instability of shoulder joint in males.

目的 分析梅毒特异性抗体(treponema pallidum antibody,TP)的有反应性结果,尤其是COI值较低的标本,为减少假阳性的发生提供依据.方法 选取129例用化学发光法检测梅毒特异性抗体有反应性的术前筛查标本,用梅毒螺旋体血凝试剂盒(treponema pallidum hemaglutination assay,TPHA)进行复检,分析比对两者的结果.结果 当切点S/CO值为5时,Syphilis TP阳性为96例,阴性为33例,两种方法差异无统计学意义(P＞0.05).结论 当TP有反应性时(尤其是S/CO值为1.0 ～5.0的标本),要综合考虑患者的年龄、病史,以及临床表现,可再用TPHA做复检,如两者均为阳性再报阳性,这样大大减少了假阳性的发生,降低了医疗纠纷的可能.

Objective To determine the protective effect of exposing the recurrent laryngeal nerve(RLN) during thyroidectomy. Metholds This is a perspective cohort study. The patients, admitted between January 2007 and December 2010, were divided into two groups according to whether exposed the RLN. The main end point was the incidence of RLN injury within 6 months. Results 327 patients were included in this study, with the follow-up more than 6 months in 307 patients. The incidence of RLN injury was 3.2%. The incidence of RLN injury in exposing and non-exposing groups was 3.0%(temporary 2.42%, permanent 0.61%) and 3.5%( temporary 2.82%, permanent 0.70%), respectively. There was no significant difference between these two groups. Conclusions RLN exposure leads no increase in the incidence of RLN injury. Exposure of the RLN should be routinely done in the era of lobectomy.

远程医学从广义上讲是使用远程通信技术和计算机多媒体技术提供医学信息和服务。包括远程诊断、远程会诊、远程护理、远程教育、远程医学信息服务等医学活动。从狭义上讲，远程医疗包括远程影像学、远程诊断、远程会诊、远程护理、远程查房等医疗活动［1］。开展远程医学服务不仅可以较好地解决医学资源分布不均衡问题，有利于提高医疗资源的利用率，而且可以使部队官兵就医更加方便，在一定程度上解决基层特别是边远地区官兵看病难问题。从2006年开始，我院在军字二号工程(全军远程医学信息网)的基础上,根据武警卫生部的统一部署,建成了基于总部、总队、支队三级武警指挥自动化网的武警远程医学信息网，实现了武警远程网与全军远程医学信息网的无缝对接，做到了总部医院、总队医院、支队卫生队三方互通，使部队基层官兵可以直接享受到总部级医疗专家的服务。

近年来，我院高度重视干部体检工作，以人性化、规范化的护理服务为突破点，以充分的准备和行之有效的人性化护理服务模式，满足受检干部日益增长的健康服务需求。2009～2010年，我们为本部机关干部、基层各部队、离退休老干部5036名进行了健康体检，通过开展人性化的护理服务，使受检者的满意率逐年提高，现报道如下。

住院患者的心理活动与疾病的严重程度、家庭经济状况及个人心理素质息息相关。笔者收集2008-10至2012-10 住院患者1200例进行心理分析和护理干预,旨在对临床护理有一定的借鉴作用。

目的 探讨微钙化在乳腺X线摄影筛查中对乳腺导管原位癌(ductal carcinoma in situ,DCIS)的诊断价值.方法 回顾性分析经乳腺X线摄影筛查及组织病理、免疫组化证实存在微小钙化灶的DCIS 58例.参照美国放射学会(ACR)颁布的乳腺病变BI - RADS有关钙化形态和分布的征象描述,记录钙化灶的形态、分布数据.全部病例均对照病理结果.采用Fisher确切概率法检验,探讨钙化形态和导管原位癌分级之间的相关性.结果 微钙化按外观与形态分成3类:(1)线形分支状钙化46例(79％)；(2)成簇泥沙样钙化5例(8％)；(3)微钙化伴粗大钙化7例(12％).所有58例DCIS患者中,低级别(1级)DCIS 14例(24％),中级别(2级)DCIS 35例(60％),高级别(3级)DCIS 9例(16％).不同级别原位癌的X线摄影钙化方式存在统计学差异(P＜0.01)；原位癌分级与病灶内微钙化方式存在一定关联度(r=0.559,P＜0.01).结论 微钙化有助于DCIS的早期检出,其形态外观有助于判别其病理分级,正确认识乳腺X线摄影钙化可提高DCIS的诊断准确性.

随着医院信息化进程的不断推进，医院管理信息系统已经由早期的费用管理走向以患者为主线的临床信息管理，同时以药品为主线的药品信息管理系统也日趋完善，在此期间，医院的流程也因信息化程度的不断提高而发生变化，业务流程重组也成为医院信息化提升的必然趋势。

人工关节置换术是治疗髋关节疾病的有效方法。以前一般认为双髋关节分期置换相对同期置换风险小。但近年来随着人工关节置换研究的深入，以及手术操作技术的提高，人工关节置换技术已经趋向成熟，完全可行双侧一期人工全髋关节置换。双髋关节置换的同期置换较分期置换，缩短了患者手术次数及住院日期，节约费用，但手术时间长，易出现各种手术并发症。我院在2004－01至2011－01共行112例一期双侧人工髋关节置换术，11例出现并发症,发生率为9.8%，针对出现并发症的患者进行针对性的观察和护理，均得到及时处理及有效控制。

Objective To analuse the impace of analgesia delivery on mother-infant prognosis. Methods Take 200 puerperae of analgesic delivery during November 2010 to November 2011 as group A, and 200 puerperae of non analgesic delivery during November 2010 to November 2011 as group B.Compare the labor pain,contraaction situation,the progress of labor,mode of delivery and the newborn situation between these two groups. Results The labor pain of group A decreased obviously,and the contractions strength is decreased,and the first stage of labor of group A is shorter than group B obviously,and have no effect on Mother’s vital signs and neonatal apgar score. Conclusions Analgesic drug delivery can relief the labor pain,shorten stages of labor,decrease the rate of cesarean.

随着计算机技术的飞速发展，部队医院基本实施了“军卫一号”工程。在医院信息系统（hospital information system，HIS）基础上根据各医院实际情况，军地联合开发的实验室信息系统（laboratory information management system,LIS）、医学影像存档与通信系统（picture archiving and communication systems,PACS）等医疗数字化系统也已形成一定规模。但是由于这些系统的研发单位、数据库类型可能不同，各医院的就诊流程也可能不同，造成系统间集成度相对较低。为进一步加强部队平时卫勤信息化建设，提高临床工作效率，更好地向“以患者信息为中心”的医院信息系统模式过渡，笔者对医院的LIS系统与HIS系统进行了互连，优化了住院和门诊检验过程，提高了医疗服务质量。

目的 探讨手掌参醇提取物抗矽尘纤维化的作用.方法 将雄性Wistar大鼠随机分成对照组、染矽尘模型组、汉防己药物参比组和手掌参药物处理组,以CM10芯片、采用表面增强激光解吸离子化飞行时间质谱(SELDI-TOF-MS)技术获取各组大鼠的血清蛋白指纹,分析手掌参干预后血清蛋白指纹变化.结果 12个差异峰表现手掌参干预后的蛋白指纹的多样变化;在各时间点,手掌参药物对蛋白峰M/Z 5889.66、M/Z 4968.66、M/Z 9511.19、M/Z 9312.29的影响与阳性参比药物汉防己影响作用基本相同,表现为延迟这些峰的升高时间;在手掌参组内观察到由部分峰展现的两类特征变化曲线.另外,观察到M/Z 13817.6与M/Z 13609.8在各组相似的变化曲线.结论 手掌参可能具有与阳性药物汉防己相似的、在早中期延迟纤维化的效果,需要进一步深入研究构成手掌参组内特征曲线的差异峰.

急性低频感音神经性耳聋（acute low-tone sensorineural hearing loss,ALHL）是一组以耳闷为主要症状，纯音测听以低频听力损害为表现的神经性耳聋。这类病症不同于一般的突发性耳聋，被认为是一种独立的疾病。临床上以青年女性多发，单耳发病多见，不伴眩晕且预后良好。我科于2008-06至2011-09共收治ALHL 84例（88耳），现分析总结如下。

脑疝是因颅脑损伤、脑出血、脑肿瘤、脑积水、颅内感染等占位性病变使颅内压急剧升高造成的,是颅内压增高进程中一个紧急而严重的并发症^［1］。病情来势凶险、变化快,可导致中枢性呼吸循环衰竭,如能做到及时观察,早期发现,并实施有效急救措施,可降低死亡风险。笔者对2005-10至2011-10神经科收治的患者中,出现早期脑疝51例救治情况和实施急救护理的资料进行分析。

军事训练后出现肌肉酸痛、痉挛、肿胀等症状,被称为军事训练性肌肉损伤;严重者可出现横纹肌溶解症(rhabdomyolysis,RM),甚至发生危及生命的并发症,如肌红蛋白尿导致急性肾功能衰竭,电解质紊乱引起心律失常甚至心脏骤停,以及弥漫性血管内凝血、多器官功能障碍综合征等^[1],美军报道其总致死率高达8%,且发病率逐年提高^[2]。国内尚无权威的统计数据,只有零散的病例报道。由于发生RM时只有50%患者具有上述典型症状,出现黑尿者只占25%。因此,有必要对参训者肌肉损伤生物化学指标进行适时监测并探寻敏感、有效的标志物,及时发现并预防训练性肌肉损伤和RM的发生。

病例介绍 患者，男，55岁。2011-09出现双侧眼睑下垂，无复视，逐步进展为全身无力，下蹲后站起困难，咀嚼无力，说话时间长，构音逐渐含混，无呼吸困难症状，在外院诊断为重症肌无力，口服溴吡啶斯的明片治疗，逐渐加量至90 mg，3次/d。服药后肌无力症状稍好转，可以行走，但症状经常反复。2011-12胸部CT发现胸腺区域占位性病变，左侧胸膜有多发结节，考虑为胸腺瘤胸膜转移。在外院行CT引导下穿刺胸膜结节活检，病理提示为B2型胸腺瘤。2012-01入我院，复查胸部CT显示前纵膈左侧可见扁平状软组织肿块影，左侧纵膈胸膜、膈肌、胸壁可见多发结节影，增强扫描可见肿物强化（图1～3）。诊断：胸腺瘤伴左侧胸膜转移。

护士的职业压力是普遍存在的,研究提示护士工作相关压力包括工作量大、倒班、待遇的不确定和时间分配问题等^［1,2］。压力不仅危及到护士的身心健康,还对其职业功能有负面影响,导致护士离职率高,影响到所提供护理服务的质量^［3］。笔者对某基层医院护士的压力源、应对方式与心理健康水平的相关性进行研究,为护理管理者采取适当措施提高护士心理健康水平提供参考。

Objective Bleeding or thrombotic diseases are easily to be found in non-small cell lung cancer(NSCLC) patients, because the equilibrium of their coagulation system might be disturbed due to tumor burden or surgical injury.In the study, we studied the value of plasma D-dimer and fibrinogen levels monitoring in patients with non-small cell lung cancer before and after surgery. Methods The plasma D-dimer and fibrinogen levels were measured in 254 patients with non-small cell lung cancer and 52 patients with benign lung tumor,and then we followed up to record the D-dimer and fibrinogen levels change in postoperative patients. Results The plasma levels of D-dimer and fibrinogen in non-small cell lung cancer patients were found to be significantly higher than those in patients with benign lung tumor (P<0.01).Significant differences in D-dimer and fibrinogen levels were found among different stages of non-small cell lung cancer (P<0.01),which suggested that coagulation and fibrinolysis dysfunction in patients with non-small cell lung cancer aggravated along with the progression of disease.The D-dimer and fibrinogen levels kept at a high level or rose suddenly after a transient decrease in 15 patients who had thrombotic diseases after operation. Conclusions Monitoring the plasma D-dimer and fibrinogen levels in patients with non-small cell lung cancer before and after operation helps find out those who have high risk of thrombotic diseases and preventing thrombtic disease after operation. It also helps us to strive for early prevention,early diagnosis,early treatment,nd to improve the prognosis of the patients.

目的 观察吉祥草总皂苷对非胰岛素依赖性糖尿病模型大鼠肝糖原、肌糖原的影响,探讨其改善胰岛素抵抗的机制.方法 采用腹腔注射STZ(链脲佐菌素)30mg/kg 并灌胃高脂乳剂10 ml/kg 的饮食办法建立动物模型.动物分为模型组、吉祥草总皂苷皮下注射治疗组、阳性药物组和正常对照组.糖尿病吉祥草总皂苷皮下注射治疗组大鼠治疗2周,检测各不同处理组空腹血糖、葡萄糖耐量、肝糖原、肌糖原的水平.结果 吉祥草总皂苷皮下注射治疗组大鼠的血糖值亦显著降低(P＜0.01),肝糖原、肌糖原与糖尿病组模型大鼠相比明显增加(P＜0.01).结论 吉祥草总皂苷皮下注射治疗组可以增加非胰岛素依赖性糖尿病模型大鼠肝糖原、肌糖原储存量,从而提高外周组织对葡萄糖的利用,改善非胰岛素依赖性糖尿病模型大鼠的胰岛素抵抗.

To compare the difference in the effect of eliminating lipid interference in biochemical examination between dilution with deionized water and high-speed centrifugation. MethodsThe appropriate dilution with deionized water by triacylglycerol nterference test was selected. Dilution with deionized water and high-speed centrifugation (13000 r/m, 10 min) were compared in the effect of eliminating lipid interference in biochemical examination and analyzed using paired T-test. ResultsALT, AST,CK, CKMB, CREA, UREA, GLU, AMY, and LPS results by dilution with deionized water were consistent with those by high-speed centrifugation. The difference was not statistically significant. ConclusionsDilution with deionized water can eliminate the impact of lipids and provide clinicians with accurate biochemical test results.

Objective To study the dynamic changes in serum miRNA-122 levels during sepsis and the correlation between serum miRNA-122 and sepsis severity. Methods Fifty-two sepsis patients (including 23 non-severe septic patients and 29 severe septic patients)and 23 healthy controls were recruited in the study. The expression levels of serum miRNA-122 were quantified by quantitative reverse transcriptase polymerase chain reaction assays (qRT-PCR).Levels of serum miRNA-122 were detected on the 1 st, 3 rd, 5 th, 7 th, 10 th and 14 th day after their admissions in intensive care unit. All the patients clinical information was also recorded. Results After comparison, levels of serum miRNA-122 in sepsis patients on every observation time point were all significantly lower than those in healthy controls (P＜0.01). The receiver operating characteristic curve was obtained and the area under curve was calculated on the levels of serum miRNA-122 on the first day of their admissions. When the cut-off point was set at 0.710, miRNA-122 had a specificity of 95.7% and a sensitivity of 53.8%. The expression levels of serum miRNA-122 in severe sepsis group were significantly higher than in sepsis group on each observation time point (P＜0.01). Conclusions Serum miRNA-122 can used as a specific biomarker for diagnosis of sepsis. And miRNA-122 might be correlated with the organ injuries of septic patients.

Objective To observe the therapeutic effect of human umbilical cord mesenchymal stem cells (HUC-MSCs) transplantation on patients with diabetic peripheral neuropathy. Methods FBG,PBG,HbA1C levels,Toronto clinical scoring system(TCSS),electrophysiological examination were measured in 32 patients with diabetic peripheral neuropathy before and 1,3,6 months after they underwent HUC-MSCs transplantation. Observe the changes of clinical symptoms and the adverse reactions. Results The three follow-up results show that the FBG,PBG,HbA1C levels,TCSS,the distal motor latency of the median nerve,the sensory conduction velocity and the distal motor latency of the ulnar nerve , the positive rate of sensory conduction of the posterior tibial nerve, the distal motor latency and the positive rate of the sensory conduction of the common peroneal nerve all obviously improved. During the study period no adverse reaction occurred.The gross and fine motor function was most rapidly improved in 1 month afer the therapy and it could be continuously improved within 6 months after the therapy. Conclusions HUC-MSCs transplantation can significantly improve the clinical symptoms and electrophysiological examination of patients with diabetic peripheral neuropathy. It is a new safe, effective method to treat diabetic peripheral neuropathy.