XY DNG QUY TRNH C LP O TY TI VIT NAM V S B NH GI HIU QU CA GHP O TY TRN CHUT B GY BNH I THO NG TYP 1 BNG STREPTOZOCIN

Don Li1, ng Th Ngc Dung1, Nguyn Khnh Ha1, L Minh Gip2

2

Trng i hc Y H Ni Vin St rt v K sinh trng Trung ng

Bnh i tho ng typ 1 gy ra do t bo beta ca o ty b ph v dn ti ty mt kh nng bi tit insulin duy tr nng glucose trong mu. Ghp o ty l mt phng php iu tr mi ang c tin hnh mt s trung tm nghin cu. Mc tiu: Xy dng phng php c lp o ty ph hp vi iu kin Vit Nam. S b nh gi hiu qu ca phng php ghp o ty cho chut i tho ng typ 1 vo phc mc. Nghin cu: So snh i chng hai phng php c lp p ty. Theo di hiu qu ghp ty cho chut i tho ng typ 1 gy bng streptozocin. Kt qu: Xy dng c cng thc pha ch dung dch Hanks dng cho c lp o ty. n gin ho c mt s bc trong quy trnh c lp o ty chun hc tp Karolinska, Thy in m khng lm nh hng n hnh thi v chc nng ca o ty. Ghp s b ban u o ty cho 5 chut i tho ng typ 1 nng v theo di trong 30 ngy. Kt lun: Phng php c lp o ty n gin gip tit kim ti 70% kinh ph m vn m bo cho o ty c hnh thi v chc nng bnh thng. Phng php ghp ty qua ng phc mc ci thin c tnh trng glucose mu ca chut nhng ch duy tr c trong thi gian ngn. T kha: tiu o ty, i tho ng typ I, t bo beta

Summary DEVELOP PROCESURE OF ISLET ISOLATION CONSISTENT WITH VIETNAMS CONDITION AND PRE - EVALUATION OF THE EFFECTIVENESS OF ISLET TRANSPLANTATION ON MOUSE INDUCED TYPE I DIABETES
Diabetes mellitus typeis a form ofdiabetes mellitusresults fromof- producingcellstheleading to loss of pancreatic insulin secretion to maintain blood glucose concentrations. Islet transplantation is theisolated islets from a donorinto another person. It is a new treatment is being conducted in several research centers. Objective: Develop methods of islet isolation consistent with Vietnam's conditions. Preliminary evaluation of the effectiveness of islet transplantation method for mouse type 1 diabetes on peritoneal dialysis. Research Methodology: Comparison of two methods of confronting islet isolation. Monitor the effectiveness of pancreas transplants for type 1 diabetic mice caused streptozocin. Results: Building the form of Hank's solution used for islet isolation. Simplifying some steps of the process of islet isolation standards learning from Karolinska, Sweden, without affecting the morphology and function of the islet. Preliminary transplant islet for five serious type 1 diabetic mice and monitoring for 30 days. Conclusion: The simplification of method of islet isolation saves the cost up to 70% while maintaining normal islet morphology and function. Pancreatic grafting via peritoneal improve the status of mices blood glucose status but only in short period. Keywords: pancreas islet, Diabetis type I, beta cell

HCV - RNA V KIU GEN VIRUS VIM GAN C (HCV) BNH NHN CHY THN NHN TO (TNT) TI BNH VIN BCH MAI
V Th Tng Vn
Bnh vin Bch Mai Xc nh t l HCV - RNA bnh nhn chy thn nhn to (TNT) c anti - HCV (+) v m t kiu gen ca virus vim gan C bnh nhn chy TNT c HCV - RNA (+). i tng v Phng php: Nghin cu c tin hnh trn 70 bnh nhn chy thn nhn to c anti - HCV (+) ti bnh vin Bch Mai trong thi gian 2 nm (2006 2008). Phng php nghin cu iu tra ngang, HCV - RNA c xc nh bng k thut Real - time RT - PCR vi b sinh phm COBAS AmpliPrep/ COBAS TaqMan HCV Test. (Roche). Kiu gen HCV c xc nh bng k thut Real time RT - PCR. Kt qu v Kt lun: Trong s 70 bnh nhn chy TNT c anti - HCV (+), 64 trng hp c HCV RNA chim 91,43% cho thy mi nguy c ln ly nhim cho cho nhng bnh nhn cng mt trung tm lc mu. 36 trng hp (56,25%) c ti lng virus (viral load - c lng s virus c trong mu) > 10 6 copies/ml. Kiu gen 6 (50%) chim t l cao nht, kiu gen 1 (43,75%), c 4 trng hp nhim phi hp hai kiu gen: mt trng hp nhim phi hp 1 v 2 (1,56%) v 3 trng hp nhim phi hp 6 v 2 (4,69%). T kha: HCV, kiu gen HCV, bnh nhn chy thn nhn to, bnh vin Bch Mai

Summary HCV-RNA AND GENOTYPE OF HEPATITIS C VIRUS (HCV) IN HEMODIALYSIS PATIENTS AT BACH MAI HOSPITAL
Objective: To evaluate the rate of HCV - RNA in hemodialysis patients with anti - HCV positive in Bach Mai hospital as well as HCV genotypes in these patients. Subject: The study was conducted on 70 hemodialysis patients with anti - HCV (+) at Bach Mai Hospital for 2 years (2006 - 2008). Methods: The study was conducted by the description of cross - sectional. The presence of HCV - RNA in patients with anti - HCV positive was determined by real time RT PCR with qualitative COBAS AmpliPrep/ COBAS TaqMan HCV Test. (Roche) and HCV genotype was determined by real time RT PCR. Results and Conclusion: Of the 70 hemodialysis patient, 64 (91.43%) were found to be HCV - RNA positive. Among them, 36 (56.25) had viral load more than 106 copy/ml, showed risk of patient - to - patient transfer of HCV infection in hemodialysis unit. The distribution of the HCV genotype was as follows: HCV genotype 6 (50%) was the most prevalence, followed by genotype 1 (43.75%); and 4 patients were observed as with mixed genotype infection: associating genotypes 1 and 2 (1.56%); associating genotypes 2 and 6 (4.69%). Keywords: HCV - RNA, HCV genotype, hemodialysis patients, Bach Mai hospital

NGHIN CU MT S C IM PHN B V YU T LIN QUAN N KIU GEN VIRUS VIM GAN C (HCV) BNH NHN CHY THN NHN TO TI BNH VIN BCH MAI
Trng Thi Phng, V Th Tng Vn
Bnh vin Bch Mai Nghin cu c tin hnh nhm m t kiu gen (genotype) HCV bnh nhn chy thn nhn to ti bnh vin Bch Mai. Tm hiu mi lin quan gia mt s yu t dch t vi s phn b kiu gen HCV trn nhm i tng ny. i tng v Phng php: nghin cu ngang trn 64 bnh nhn chy thn nhn to (TNT) ti bnh vin Bch Mai trong thi gian 2 nm (2006 2008), c ti lng virus vim gan C (HCV) 102 106copies/ml. Xc nh kiu gen HCV, mt s c im phn b kiu gen HCV v thi gian chy thn nhn to. K thut s dng trong Nghin cu: k thut Real - time PCR xc nh kiu gen HCV. Kt qu: nhim HCV bnh nhn chy thn nhn to c cc kiu gen c xc nh nh sau kiu gen 1 (43,75%), kiu gen 6 (50%), ng nhim kiu gen 1 v 2 (1,56%) v ng nhim kiu gen 6 v 2 (4,69%). Kt lun: bnh nhn chy thn nhn to ti bnh vin Bch Mai nhim virus vim gan C c kiu gen 1 v 6 ca virus vim gan C chim u th; Kiu gen 2 ch gp trong nhim phi hp vi mt kiu gen khc v chim mt t l nh. Thi gian lc mu cng di v truyn mu c th l nguy c nhim phi hp nhiu kiu gen HCV. T kha: HCV, kiu gen HCV, bnh nhn chy thn nhn to (TNT), bnh vin Bch Mai

Summary RESEARCH ON SOME CHARACTERISTICS OF DISTRIBUTION AND FACTORS RELATED TO HEPATITIS C VIRUS (HCV) GENOTYPE IN HEMODIALYSIS PATIENTS AT BACH MAI HOSPITAL (2006 2008)
Description genotype of HCV in hemodialysis patients at Bach Mai Hospital. Understanding the relationship between epidemiological factors with the distribution of HCV genotypes in this group. Subjects and Methods: The study was conducted on 64 hemodialysis patients at Bach Mai hospital during 2006 - 2008. The study was conducted by the description of cross - sectional progressive study, determine the genotype of HCV infection and distribution, molecular epidemiology of hepatitis C in hemodialysis patients. Using Real - time PCR determination HCV genotype. Rerults: The results of this study indicate that the dominant HCV genotypes among patients treated by hemodialysis in Bach Mai hospital were 6 and 1 accounting for 50% and 43.75%, respectively. The distribution of other HCV genotypes showed mixed infection of HCV genotype 1 and 2 (1.56%), genotype 2 and 6, 4.69%. Conclussion: Duration of hemodialysis and history of blood transfusion suggest as risk factors for mixed infection of HCV genotype. Keywords: HCV, HCV genotype, hemodialysis patients, Bach Mai hospital

NGHIN CU T L KHNG TH KHNG DENGUE V KHNG NGUYN NS1 CA VIRUS DENGUE TRN BNH NHN CHN ON LM SNG ST DENGUE/ST XUT HUYT DENGUE TI BNH VIN BCH MAI
V Th Tng Vn
Bnh vin Bch Mai Xc nh t l bnh nhn c khng nguyn NS1, khng th khng virus dengue c gi tr chn on trn nhng BN c chn on lm sng l st dengue/st xut huyt dengue (SD/SXHD) n khm v iu tr ti bnh vin Bch Mai. i tng v Phng php: Nghin cu tin cu, m t ct ngang ti phng xt nghim 315 mu mu ca nhng bnh nhn c chn on lm sng l SD/SXHD trong nm 2009 - 2010. Kt qu v Kt lun: T l bnh nhn trong nhm nghin cu c khng nguyn NS1 trong huyt thanh l 60,63%. Khng th khng virus dengue l 83,17%. Trong s c 21,58% bnh nhn nhim virus dengue tin pht, 61,58% bnh nhn nhim virus dengue th pht. T kha: st dengue/ st xut huyt dengue, khng nguyn NS1, khng th khng virus dengue IgG/IgM

Summary STUDY THE RATE OF DENGUE ANTIBODIES AND NS1 ANTIGEN OF DENGUE VIRUS IN PATIENTS CLINICALLY DIAGNOSED DENGUE FEVER/ DENGUE HEMORRHAGIC FEVER AT BACH MAI HOSPITAL
To determine the rate of patients with NS1 antigen, dengue virus antibodies have diagnostic value in patients clinically diagnosed as dengue fever/dengue hemorrhagic fever (SD/DHF) who were treated at Bach Mai Hospital. Subjects: 315 blood samples of patients clinically diagnosed as SD/DHF in 2009 2010. Method: cross - sectional described research in the laboratory includes of prospective and retrospective. Results and Conclusions: The proportion of patients in the study group with NS1 antigen in serum was 60.63%, antibodies to dengue virus was 83.17%. Among them 21.58% of patients with primary dengue virus infection and 61.58% patients with secondary dengue virus infection. NSA1 antigen appears highest from days 1 to 3 (75%). The NS1 positive rate was found significantly higher in primary than in secondary infection (p < 0,001). Keywords: dengue fever/dengue hemorrhagic fever, NS1 antigen, dengue virus antibodies (IgG/IgM)

PHT HIN NGI MANG GEN BNH THOI HA C TY BNG K THUT MULTIPLEX LIGATION - DEPENDENT PROBE AMPLIFICATION
L Th Hng Lan , Trn Vn Khnh , V Ch Dng , Nguyn Th H ,T Thnh Vn
1

Trng i hc Y H Ni, 2Bnh vin Nhi Trung ng

MLPA l k thut c s dng pht hin ngi lnh mang gen bnh ca mt s bnh l di truyn trong c bnh thoi ha c ty (Spinal Muscular Atrophy - SMA). MLPA cho php chn on tn thng gen mt cch chnh xc v nhanh chng. Mc tiu: Pht hin ngi lnh mang gen bnh trong cc thnh vin ca 25 gia nh bnh nhn SMA bng k thut MLPA. i tng v Phng php: Bnh nhn c chn on SMA nh triu chng lm sng v cn lm sng in hnh; DNA tng s c tch chit t mu ngoi vi; s dng k thut MLPA pht hin ngi lnh mang gen bnh. Kt qu: 100% b m ca 25 gia nh bnh nhn SMA l ngi mang gen bnh. 24/54 ngi anh, ch v em trong 25 gia nh bnh nhn SMA c pht hin l ngi lnh mang gen bnh (44,4%), 30/54 thnh vin ca 25 gia nh bnh nhn khng mang gen bnh (55,6%). T kha: Thoi ha c ty (SMA), ngui lnh mang gen, MLPA

Summary CARRIER DETECTION OF SPINAL MUSCULAR ATROPHY USING MULTIPLEX LIGATION - DEPENDENT PROBE AMPLIFICAITON
MLPA (Multiplex Ligation - dependent Probe Amplification) is a key technique to analyze duplication and deletion in various genetic disorders. MLPA is powerful and rapid technique to detect the mutation. Objective: to detect the carriers in family members of patients with SMA. Method: total DNA was extracted from blood; MLPA are carried out to detect the carriers. Results: In parents group, 100% are carriers. In sibling members group, 24 out of 54 cases are carriers (44. 4%) and remaining cases (30/54) are none carriers (55.6%). Keywords: SMA, carriers and compound heterozygous patients, non carriers, MLPA

XY DNG QUY TRNH PHT HIN T BIN GEN ATP7B GY BNH WILSON
H Cm T, T Minh Hiu, Trn Vn Khnh, T Thnh Vn
Trng i hc Y H Ni t bin gen ATP7B (Copper transporting P - type adenosine triphosphatase) c chng minh l nguyn nhn gy bnh Wilson. Mc tiu: Xy dng quy trnh pht hin t bin gen ATP7B gy bnh Wilson. i tng v Phng php: 01 bnh nhn Wilson c chn on xc nh da vo triu chng lm sng in hnh; Tch chit DNA t mu ngoi vi; Phn ng PCR khuch i ton b gen ATP7B s dng 25 cp mi c hiu tng ng vi 21 exon ca gen ATP7B. Sn phm PCR c gii trnh t gen trc tip xc nh t bin gen ATP7B. Kt qu: Xc nh c 2 t bin im dng d hp t: nonsense p.S105Stop trn exon 2 v p.K832R trn exon 10. Kt lun: xy dng thnh cng quy trnh pht hin t bin gen ATP7B gy bnh Wilson. T kha: Bnh Wilson, t bin gen ATP7B

Summary IDENTIFICATION OF ATP7B GENE MUTATION CAUSING WILSON DISEASE

ATP7B gene mutation has been shown to cause Wilson disease. Objective: Detection of ATP7B gene muation that cause Wilson disease. Methods: a Wilson patient has been diagnosed as Wilsons disease base on specific clinical features; DNA total was extracted from peripheral blood; PCR was carried out to amplify whole ATP7B gene using 25 specific primers which correspond to 21 exons of ATP7B gene. PCR products were directly sequenced to find the mutation in ATP7B gene. Result: 2 heterozygous mutations were found including one nonsense mutation in exon 2 (p.S105Stop) and other missense mutation in exon 10 (p.K832R). Conclusion: Identification of ATP7B gene mutation was successfully applied in Vietnam. Keywords: Wilson, ATP7B mutation

BIU HIN, TINH SCH PROTEIN TI T HP TIU N V B C T KHNG CHU NHIT LT CA E. COLI
Trn Huy Hong , Trn Vn Khnh , Nguyn Hu Th , Nguyn Thu Thu , T Thnh Vn
1

Trng i hc Y H Ni; 2Vin V sinh dch t Trung ng

E.coli sinh c t rut (ETEC) l mt cn nguyn gy tiu chy thng gp tr em ti cc nc ang pht trin. Tiu n v B c t khng chu nhit (LTB) v ang c nghin cu lm vc xin, t cht trong vc xin ung kch thch min dch cng nh s dng pht trin cc b kit pht hin c t LT. Mc tiu: (1) Biu hin protein ti t hp LTB trong E.coli, (2) Tinh sch protein ti t hp LTB. Phng php: s dng vector pGEX - GST LTB biu hin protein ti t hp LTB trong t bo E.coli BL21. Tinh sch protein ti t hp bng ct glutathione sepharose v kim tra tinh sch ca protein ti t hp bng in di SDS - polyacrylamid v Western bloting. Kt (1) (2) qu: Biu hin thnh cng protein ti t hp LTB, Protein ti t hp c tinh sch mc cao. T kha: E.coli, protein ti t hp tiu n v B

Summary EXPRESSION AND PURIFICATION OF HEAT LABILE TOXIN SUBUNITS B OF E. COLI

Enterotoxigenic Escherichia coli(ETEC) is one of the most common agents causing diarrhea for children in developing countries. Recombinant Heat labile toxin subunits B (rLTB) of ETEC have been studied as vaccines against disease, adjuvant for mucosal vaccination as well as for development kit to detect heat labile toxin. Objective: (1) Expressed LTB recombinant protein in E. coli, (2) Purified LTB recombinant protein. Method: Using pGEX - GST - LTB vector to express LTB in E. coli. Recombinant protein was purified with glutathione - sepharose gel column and then evaluated by SDS page and western blotting Results: LTB Recombinant protein was highly purified with glutathione - sepharose column. Keywords: Escherichia coli, Recombinant protein

NGHIN CU TC DNG CA EGCG CH XANH (CAMELLIA SINENSIS) TRN DNG T BO UNG TH V NUI CY
Bi Th Thu Hng, Nguyn Th H ,T Thnh Vn
Trng i hc Y H Ni Nhiu nghin cu in vitro v in vivo cho thy Epigallocatechin - 3 - gallate (EGCG) ca ch xanh c kh nng ngn nga, hn ch qu trnh pht trin ca cc bnh l lin quan n hot ng ca gc t do. Mc tiu: nh gi kh nng c ch s pht trin t bo v tc dng gy cht t bo theo chng trnh (apoptosis) ca EGCG ch xanh trn dng t bo ung th v ngi MCF7. i tng v Phng php: S dng dng t bo ung th v MCF7 kho st tc dng ca EGCG in vitro, thng qua cc ch s: gi tr IC50, t l t bo sng, DNA ladder v hot caspase - 3. Kt qu: EGCG ch xanh c kh nng c ch s pht trin dng t bo ung th v MCF7 (92,2 25,1%), tc dng ny ph thuc vo liu (12,5 - 200mM) v thi gian tc dng (48 - 72h). Gi tr c ch 50% (IC50) = 43,13M. EGCG ch xanh gy qu trnh apoptosis trn dng t bo ung th v MCF7 th hin qua s t gy DNA, s t gy DNA, s hot ho enzym caspase - 3 v nng EGCG ch xanh 12,5M50M gy apoptosis vi hiu lc cao nht. T kho: Dng t bo ung th v MCF7, EGCG ch xanh, DNA ladder, apoptosis

Summary EFFECT OF GREEN TEA (CAMELLIA SINENSIS) (-) - EPIGALLOCATECHIN 3 - GALLATE (EGCG) ON BREAST CANCER CELL LINE
Epigallocatechin - 3 - gallate (EGCG) has been shown to have anticarcinogenic effects in vitro and in vivo models, and this effect is mediated at least inpart by its ability to induce apoptosis in cancer cells.Ojective: To investigate in vitro the anti proliferative and the induction of apoptosis on human breast cancer cell line.Methods: Using the MCF7 human breast cancer cell line as an in vitro models to determine the effect of EGCG.Results and Conclusion: Treatment of EGCG resulted in dose - dependent (12,5 - 200mM) and time - dependent (48 - 72 hours) in hibition of cellular proliferation (92.2% - 25.1%) and values of IC50 is 46,56mM. Decrease in cell viabity as associated with the induction of apoptosis which was analyred by DNA ladder and activation of caspase - 3, as well as EGCG in dose (12,5 - 50mM). Keywords: MCF 7 breast cancer cell line, EGCG, DNA ladder, apoptosis

CHN ON SIU M TRC SINH V PHN TCH NHIM SC TH NHNG TRNG HP NANG BCH HUYT (CYSTIC HYGROMA)
Trn Danh Cung Trung i hc Y H Ni
M t hnh nh siu m nang bch huyt trc sinh v kt qu phn tch nhim sc th bng t bo nc i nhng trng hp ny. Nghin cu m t tin cu 37 thai ph chn on siu m, chc ht nc i, phn tch nhim sc th, nh ch thai nghn v thm khm thai nhi sau khi gy sy thai. Kt qu cho thy hnh nh siu m c trng l nhng khi cha dch vng gy c vch ngn, pht trin cn xng hai bn c 100% trng hp. T l bt thng nhim sc th rt ln 70,3% trong phn ln l hi chng turner (45,X) 48,6%. Tin lng chung l xu vi t l nh ch thai nghn 100% k c nhng trng hp c kt qu phn tch NST bnh thng do cc bt thng nng km theo ca thai nh ph thai. Kt lun: cystic hygroma c kh nng chn on trc sinh bi hnh nh siu m c trng, c tin lng xu, t l d dng nhim sc th rt cao v ch yu l hi chng Turner. T kha: nang bch huyt, bt thng nhim sc th, hi chng Turner

Summary PRENATAL ULTRASOUND DIAGNOSIS AND CHROMOSOMAL ABNORMALITIES OF FETAL CYSTIC HYGROMA
Cystic hygroma is a congenital malformation which can be prenetal diagnosised by ultrasound. Objective: prenatal diagnosis of cystic hygroma by ultrasound and chromosomal analysis of fetal cystic hygroma. Methods prospective study of 37 cases diagnosied cystic hygroma and amniocentesis for chromosome analysis. Results: The rate of chromosomal abnormalities is 70.3%, the Turner syndrome (45,X) is 48.6%. Conclusion: cystic hygroma can be prenatal diagnosised by ultrasound. The rate of chromosomal abnormalities is very high, the most commom chromosomal disorder is Turner syndrome. Keywords: cystic hygroma, chromosomal abnormalitie, Turner syndrome

NG DNG K THUT PCR A MI, IN DI POLYACRYLAMIDE, NHUM BC PHT HIN CC LOCT STR TRONG XC NH HUYT THNG
Nguyn c Nh
Vin Php y Quc gia Nghin cu nhm hon thin k thut PCR a mi, in di polyacrylamide, nhum bc trong xc nh huyt thng. i tng v Phng php: 154 c th t 50 cp nghi ng b - con, 18 gia nh c b, m, con c phn tch ADN t mu mu, mng tay, tc, hoc t bo nim mc ming xc nh quan h huyt thng ti Vin Php y Quc gia. Kt qu: ADN tch chit t cc mu sinh phm khc nhau bng phng php chelex u c nng tng i cao. Mu mu cho nng ADN cao nht, tip n l mu t bo nim mc ming, mu mng tay v mu tc. Phn ng PCR a mi theo tng b ba loct STR, in di gel polyacrylamide v nhum bc cho cc bng r rng, sc nt. Qua phn tch 15 loct STR xc nh c 55 cp b - con c quan h huyt thng vi chnh xc t 99,97% n 99,999% v 13 cp b - con khng c quan h huyt thng. Kt lun: hon thin c k thut, PCR a mi, in di gel polyacrylamide v nhum bc. T kha: Phn tch ADN, xc nh huyt thng

Summary APPLICATION OF MULTIPLEX PCR, POLYACRYLAMIDE ELECTROPHORESIS, SILVER STAIN TECHNIQUE TO DETECT STR LOCI IN PATERNITY TEST
Objectives: To complete techniques of multiplex PCR, polyacrylamide electrophoresis and silver stained in paternity test. Subjects and Methods: 154 individuals from 50 pairs of father - child suspects, 18 families with father, mother, child were analyzed DNA samples from blood, nails, hairs, or buccal swabs in paternity test at the National Institute of Forensic Medicine. Results: DNA extraction from different biological samples have relatively high concentrations. Blood samples for DNA, the highest concentration, followed by the sample of buccal swabs, nail and hair samples. Multiplex PCR for each of the three STR loci, electrophoresis on polyacrylamide gel and silver stained for clear and sharp bands. After analyzing on 15 STR loci, we identified 55 pairs of parent - child have blood relationship with the probability of paternity from 99.97% to 99.999%, and 13 pairs have no blood relationship. Conclusion: We have completed techniques of multiplex PCR, polyacrylamide electrophoresis and silver staining. Keywords: DNA analysis, paternity test

NGHIN CU CHN ON SM SC NHIM KHUN TR EM TI KHOA HI SC CP CU BNH VIN NHI TRUNG NG

Phm Vn Thng
Trung i hc Y H Ni Xc nh mt s triu chng lm sng v cn lm sng gip chn on sm sc nhim khun. i tng v Phng php: m t tin cu 67 bnh nhi c chn on sc nhim khun (SNK) iu tr ti khoa Hi sc cp cu (HSCC), bnh vin Nhi Trung ng t thng 6 nm 2003 n thng 11 nm 2006. Tiu chun chn on SNK theo ACCM /SCCM - 2002. Kt qu cho thy cc triu chng lm sng: thay i thc vi PPV 76%, Sn 91%, Sp 73% v p < 0,001; du hiu mch nhanh vi PPV 68%, Sn 88%, Sp 58% v p < 0,001; triu chng bi niu t vi PPV 72%, Sn 76%, Sp 70% v p < 0,001; du hiu refill ko di vi PPV 74%, Sn 91%, Sp 66% v p < 0,001; nng lactat mu tng vi PPV 62%, Sn 40%, Sp 76% v p < 0,05. Kt lun: c th da vo cc triu chng thay i thc, mch nhanh, bi niu t, rfill ko di v lactate tng chn on sc nhim khun tr em. T kha: sc nhim khun tr em, chn on sm sc nhim khun

Summary STUDY ON EARLY DIAGNOSIS OF PEDIATRIC SEPTIC SHOCK IN INTENSIVE CARE UNIT OF THE NATIONAL HOSPITAL OF PEDIATRICS
Objective: to find some clinical and laboratoy symptomes to diagnose early pediatric septic shock. Patients and Method: 67 patients were diagnosed septick shock treated in intensive care unit (ICU) of National hospital of peditrics (NHP) from june 2003 to november 2006, createria of diagnosis septic shock base on ACCM/SCCM - 2002, Method: prospective description. Results: the clinical and laboratory symptomes following: the alternating mental with PPV 76%, Sn 91%, Sp73% and p < 0.001, quick and weak pulse with PPV 68%, Sn 88%, Sp58% and p < 0.001, oliguria with PPV 72%,Sn 76%, Sp 70% and p < 0,001, prolong refill with PPV 74%, Sn91%, Sp 66% and p < 0.001,increasing blood lactate with PPV 62%, Sn 40%, Sp 76% and p < 0.05. Conclusion: It could use the alternating mental, quick pulse, less urine output,prolong refill and increasing blood lactat in early diagnosis of pediatric septic shock. Keywords: pediatric septic shock, early diagnosis of septic shock

THC TRNG HUYT P V MT S YU T NH HNG N HUYT P CA BNH NHN NHI MU NO GIAI ON CP TI BNH VIN 121
Nguyn Hu Tu , Phm Thng 1 Bnh vin 121, 2Bnh vin Lo khoa Trung ng
1 2

Nhi mu no l bnh thng gp, c t l t vong cao do vic kim sot huyt p trong nhng gi u rt quan trng. Mc tiu: nh gi thc trng huyt p v mt s yu t nh hng n huyt p ca bnh nhn nhi mu no giai on cp. Nghin cu trn 106 bnh nhn nhi mu no giai on cp iu tr ti khoa t qu, bnh vin 121 c nh gi v tin s tng huyt p, con s huyt p trung bnh lc nhp vin, cc bin php h p trc khi nhp vin, kt qu iu tr (theo Rankin). Kt qu: 52,8% bnh nhn c tin s tng huyt p, 55,7% bnh nhn c dng thuc h huyt p trc khi nhp vin. Huyt p trung bnh lc nhp vin l 106 16,6 mmHg. Kt qu iu tr t tt chim 50,9%; khng thay i 30,2% v xu 18,9%. Trong nhm t kt qu tt c 97,6% c xc nh huyt p ng mch trung bnh lc nhp vin 110 mmHg. Kt lun: C mi lin quan gia huyt p trung bnh khi nhp vin vi tin lng bnh. T kho: nhi mu no, tng huyt p

Summary EVALUATION THE ACTUAL BLOOD PRESSURE AND A NUMBER OF FACTORS AFFECT TO BLOOD PRESSURE OF PATIENTS WITH ACUTE ISCHEMIC STROKE
Acute Ischemic Stroke (AIS) is a common disease, with high mortality rates. The control of blood pressure (BP) in the first hours is important. Objective: to assess the actual BP and a number of factors affect to BP of patients with acute ischemic stroke. Subjects and Methods: 106 patients with AIS in stroke unit of hospital 121 were assessed for history of high blood pressure, the average blood pressure at admission, anti - hypertensive measures before admission, and treatment outcomes (by Rankin). Results: 52.8% of patients had a history of high blood pressure. 55.7% of patients were taking antihypertensive drugs before admission. Average BP at admission was 106 16.6 mmHg. Treatment outcomes: good result (50.9%), unchanged (30.2%) and bad result (18.9%). In group of good results, 97.6% had average BP = 110 mmHg at admission. Conclusion: There is an association between average BP at admission and the prognosis of acute ischemic stroke. Keywords: acute ischemic stroke, hypertension

TC DNG GIM AU CA MORPHIN - SUFENTANIL KHOANG DI NHN TRN BNH NHN M TIM H
Nguyn Vn Minh , Nguyn Quc Knh , Bi c Ph 1 Trng i hc Y Dc Hu, 2Bnh vin Vit c, 3Bnh vin Trung ng Hu
1 2 3

nh gi tc dng gim au v tc dng khng mong mun ca morphin v sufentanil tim khoang di nhn trn bnh nhn m tim h. Nghin cu can thip lm sng, 75 bnh nhn c m tim h thay/sa van, v l thng lin nh, thng lin tht c chia thnh ba nhm: nhm 1 (nhm chng), nhm 2 dng morphin khoang di nhn 0,3mg, nhm 3 kt hp morphin 0,3mg v 25mcg sufentanil. Sau m tt c bnh nhn c gim au bng morphin tnh mch qua my PCA. Lng morphin tiu th trong 48 gi nhm 2 v 3 thp hn nhm 1 (13,73 7,47 v 11,20 4,38 so vi 29,26 7,62mg). im au VAS vo thi im 8 gi sau m, s bnh nhn cn morphin trong 6 gi u, lng sufentanil dng trong m nhm 3 t hn c ngha thng k so vi nhm 1 v 2. Thi gian rt ni kh qun khng khc nhau gia cc nhm v t 7 - 9 gi, t l tc dng khng mong mun thp tt c cc nhm. Kt lun: morphin kt hp vi sufentanil tim khoang di nhn cho tc dng gim au hiu qu trn bnh nhn m tim h v t tc dng khng mong mun. T kha: m tim, sufentanil, morphin khoang di nhn, gim au

Summary THE ANALGESIA OF INTRATHECAL MORPHINE AND SUFENTANIL ON CARDIAC SURGICAL PATIENTS
Adequate analgesia after cardiac surgery is necessary. We assessed analgesia and undesirable effects of intrathecal morphine and sufentanil administration. Patients and Methods: in a prospective study, 75 participants undergoing cardiac surgery were allocated randomly to receive intravenous patient controlled analgesia morphine, either alone (group 1) or combined with intrathecal morphine 0.3mg (group 2) or with both intrathecal morphine 0.3mg and sufentanil 25mcg (group 3). Results: morphine consumption during 48h after operation in group 2 and 3 were less than in group 1 (13.73 7.47 and 11.20 4.38 versus 29.26 7.62mg). VAS score at 8h at rest, intraoperative sufentanil consumption and the number of patients requiring supplemental intravenous morphine during the first 6h in group 3 were less than in group 1 and 2. Time to extubation was not different between groups (7 - 9h). No significant complications were seen. Conclusion: intrathecal morphine and sufentanil provided effective analgesia with low incidence of complications. Keywords: cardiac surgery, intrathecal morphine, sufentanil, analgesia

NGHIN CU NNG PRO-B TYPE NATRIURETIC PEPTIDE (PRO-BNP) CA BNH NHN SUY TIM MN TNH
T Mnh Cung
Vin Tim mch Vit Nam Nghin cu s khc bit v nng Pro-BNP ca bnh nhn theo nguyn nhn, giai on lm sng v mc nng ca suy tim; s tng quan gia nng Pro-BNP huyt tng vi giai on lm sng, mc suy tim v phn s tng mu EF trn siu m tim. Nghin cu trn nhng bnh nhn suy tim c iu tr ti vin Tim mch Vit Nam. Chn on suy tim da trn thm khm lm sng v siu m tim. Mc suy tim c phn loi da trn phn loi chc nng ca Hi Tim mch New York (NYHA) v theo giai on lm sng. Mu tnh mch ca bnh nhn c nh lng Pro-BNP ti khoa Sinh ha bnh vin Bch Mai. Nng Pro-BNP c thng k da theo mc suy tim NYHA v phn loi lm sng suy tim, phn s tng mu tht tri (LVEF). Kt qu: 106 bnh nhn tui trung bnh 57,4 16,7, trong c 73 bnh nhn n (chim t l 68,9%), 34 bnh nhn tng huyt p (32,1%), 40 bnh nhn (37,7%) mc bnh van tim, 32 bnh nhn (30,2%) mc cc bnh tim khc nh bnh tim thiu mu cc b, bnh tim bm sinh hoc suy tim do lon nhp tim. Nng pro-BNP huyt tng trung bnh ca nhng bnh nhn t 60 tui tr ln cao hn so vi nhng bnh nhn di 60 tui (566,6 618.5 so vi 480,5 753,2) nhng khng c ngha thng k (p > 0,05)). Nng Pro-BNP huyt tng tng quan tuyn tnh nghch vi phn s tng mu EF trn siu m (r = - 0,04; p < 0,001), tng quan tuyn tnh thun vi phn suy tim theo lm sng (r = 0,57; p < 0,001) v phn loi suy tim theo NYHA (r = 0,58; p < 0,001).

T kha: suy tim, Pro-B type Natriuretic Peptide, pro-BNP

Summary

RESEARCH ON PRO-B TYPE NATRIURETIC PEPTIDE (PRO-BNP) CONCENTRATION OF PATIENTS WITH CHRONIC HEART FAILURE
Objectives: 1) to study the differences in Pro-BNP levels of patients with different causes, clinical stage and severity of heart failure; 2) to study the correlation between plasma Pro-BNP levels and clinical stage severity of heart failure and ejection fraction EF on echocardiography. Methods: Patients with heart failure of Viet nam Heart Institute were recruited for this study. Diagnosis of heart failure was based on clinical evaluation and echocardiographic procedure. The severity of heart failure was determined according to New York heart association (NYHA) classification and clinical critera The venous blood was obtained from the subjects and all samples were sent to the Laboratory of Bach Mai Hospital for evaluation of plasma Pro-BNP level. Results: One hundred six patients, with a mean age of 57.4 16.7 years were included in the study. Seventy-three subjects (68.9%) were female, thirty-four patients (32.1%) were hypertensive, forty patients (37.7%) with valvular heart disease,thirty-two (30.2%) suffered from ischemic, or congenital heart diseases or arrythmia. The mean plasma level of pro-BNP in subjects aged 60 years or more was higher than younger subjects, (566.6 618.5 versus 480.5 753.2) but not singificant (p>0.05)). The evaluation of Pro-BNP plasma levels showed negative correlation with ejection fraction (r = - 0.04; p < 0.001), clinical stages (r = 0.57; p < 0.001), and function class according to NYHA classification (r = 0.58; p < 0.001). Keywords: Heart failure, Pro-B type Natriuretic Peptide, pro-BNP

NNG 25(OH)D3 V PEPTIDE KHNG KHUN NI SINH LL-37 TRONG HUYT THANH PH N C THAI B NHIM KHUN TIT NIU
ng Th Ngc Dung , V Th Dng Liu
1

Trng i hc Y H Ni, 2Bnh vin Ph sn H Ni

Xc nh nng 25(OH)D3 v peptid LL-37 trong huyt thanh ca ph n c thai b nhim khun tit niu. Tm hiu mi lin quan gia nng 25(OH)D3 v peptid LL-37 nhng ph n ni trn. i tng v Phng php: nghin cu bnh-chng vi nhm bnh l 35 thai ph b NKTN n khm ti bnh vin Ph sn H Ni v nhm chng l 35 thai ph khe mnh. Kt qu cho thy nng LL-37 nhm chng l 46,87 16,93 ng/ml cao hn nhm NKTN (33.7 14.97 ng/mL) vi p < 0,05. Nng 25(OH)D3 huyt thanh nhm chng l 42,76 21,75 ng/mL cao hn nhm NKTN (30,99 9,2). Nng LL-37 v 25(OH)D3 c nhm chng v nhm bnh NKTN c mi tng quan kh cht ch vi r = 0,81 v r = 0,8. Kt lun, nng LL-37 v 25(OH)D3 nhm chng cao hn nhm NKTN. Nng LL-37 v 25(OH)D3 c nhm chng v nhm bnh NKTN c mi tng quan thun kh cht ch. T kha: nhim khun tit niu, 25(OH)D3, LL-37

Summary CONCENTRATION OF 25(OH)D3 AND ANTI-BACTERIAL PEPTIDE LL -37 SERUM IN PREGNANT WOMEN WITH URINARY TRACT INFECTION
Objectives: (1) Determination of concentrations of 25 (OH) D3 and LL-37 peptide in the serum of pregnant women with urinary tract infection. (2) Understanding the relationship between concentrations of 25(OH)D3 and peptide LL-37 in the women said. Subjects and research Methods: case-control study with a group of 35 women with UTI at the maternity hospital in Hanoi and the control group of 35 healthy pregnant women. Results: showed LL-37concentrations in the control group was 46.87 16.93 ng/ml higher in UTI group (33.7 14.97 ng/mL) with p < 0.05. Concentrations of 25(OH) D3 serum in the control group was 42.76 21.75 ng/mL higher to UTI group (30.99 9.2). Concentration of LL-37 and 25 (OH) D3 in the control group and UTI group correlated quite closely with r = 0.81 and r = 0.8. In conclusion, the concentration of LL-37 and 25 (OH)D3 in the control group was higher in UTI group. Concentration of LL37 and 25 (OH) D3 in the control group and UTI groups have positive correlation tightly. Key words: Urine tract infection, LL-37, 25(OH)D3

NGHIN CU NNG ADIPONECTIN HUYT THANH BNH NHN I THO NG TYPE 2 PHT HIN LN U C BIN CHNG TIM MCH
Phm Th Thu Vn , Phm Thin Ngc , Nguyn Khoa Diu Vn ,
1

Bnh vin C Nng; 2Trng i Hc Y H Ni

Bin chng tim mch (BCTM) l mt trong nhng nguyn nhn chnh gy t vong BN T typ 2. nh lng adiponectin huyt thanh c gi tr tin lng, d bo tnh trng khng insulin, mt trong nhng yu t nguy c tim mch BN T typ 2. Mc tiu: 1) Nghin cu nng adiponectin huyt thanh bnh nhn T typ 2 pht hin ln u c BCTM v 2) mi lin quan gia nng adiponectin huyt thanh vi cc yu t nguy c bnh nhn T typ 2 pht hin ln u c BCTM. i tng & Phng php: Nghin cu m t ct ngang vi 31 bnh nhn T typ 2 c BCTM v 106 BN T typ 2 cha c BCTM.. nh lng nng Adiponectin bng phng php ELISA. Kt qu: Nng adiponectin huyt thanh BN T typ 2 pht hin ln u c BCTM l 5.7 2.1 g/mL v BN T typ 2 pht hin ln u cha c BCTM l 7,4 2,9 g/mL. C mi tng quan nghch gia nng adiponectin vi nng glucose mu, HbA1C, cholesterol, triglycerid. v tng quan thun vi nng HDL- C. Kt lun: 1)Nng adiponectin BN T typ 2 pht hin ln u c BCTM thp hn so vi BN T typ 2 pht hin ln u cha c BCTM; 2) c mi lin quan cht ch gia adiponectin vi cc ch s glucose, HbA1C, insulin v Triglycedid, cholesterol huyt thanh BN T typ 2 ln u c BCTM.

T kha: Adiponectin, i tho ng typ 2. bin chng tim mch

Summary STUDY ON SERUM CONCENTRATION OF ADIPONECTIN IN NEW ONSET TYPE 2 DIABETES MELLITUS WITH COMPLICATION OF CARDIOVASCULAR
Determination of serum adiponectin concentration in new onset type 2 diabetics with complication of cardiovascular. The correlation between serum concentration of adiponectin with some risks in onset type 2 of type 2 Diabetes mellitus. Methods: It is a cross-sectional study. A total of 31 in new onset type 2 of type 2 Diabetes mellitus with cardiovascular complication and 106 in new onset type 2 of type 2 Diabetes mellitus without cardiovascular complication. The concentration of adiponectin in serum was determinated by ELISA. Data was analisyed by SPSS 6.0. Results: The average serum concentration of adiponectin in new onset type 2 of type 2 diabetes mellitus with and without cardiovascular complication is 5.7 2.1 g/mL and 7.4 2.9 g/mL, respectively. There is a inverse correlation between serum concentration of adiponectin with blood glucose levels, HbA1c, cholesterol, triglycerides. And there is positive correlation between adiponectin serum concentration with HDL-C concentrations Conclusions: 1) Serum concentration of adiponectin in new onset type 2 diabetics with cardiovascular complication is lower than of those without cardiovascular complication. in new onset type 2 diabetes patients. 2) There was a significant correlation between serum concentration of adiponectin with serum concentration of glucose, HbA1C, insulin, and triglycerid, cholesterol in onset type 2 diabetes mellitus. Key words: Adiponectin, Typ2 diabetes mellitus, cardiovascular complication

NGHIN CU NNG ADIPONECTIN HUYT THANH NGI RI LON DUNG NP GLUCOSE V BNH NHN I THO NG TYP 2 PHT HIN LN U
Trn Khnh Chi1,Phm Thin Ngc1, Phm Th Thu Vn2
1

Trng i Hc Y H Ni, Bnh Vin C Nng

Nghin cu nhm xc nh nng adiponectin huyt thanh bnh nhn ri lon dung np glucose v bnh nhn T typ 2 pht hin ln u. 2.Tm hiu mi lin quan gia nng adiponectin huyt thanh vi mt s ch s ho sinh khc bnh nhn ri lon dung np glucose v bnh nhn T typ 2 pht hin ln u. i tng & Phng php: Nghin cu c tin hnh trn 30 BN RLDN glucose cha c iu tr, 55 BN T typ 2 pht hin ln u v 35 ngi bnh thng. nh lng nng Adiponectin bng phng php ELISA. Kt qu: Nng adiponectin huyt thanh nhm chng l 9,5 2,2 (g/ml); nhm RLDN glucose l 8,1 3,3 (g/ml) v nhm T typ 2 l 6,3 2,5 (g/ml). C mi tng quan nghch gia nng adiponectin vi nng glucose mu, HbA1C, cholesterol, triglycerid, cha xc nh c mi tng quan ca adiponectin vi nng insulin huyt thanh v ch s HOMA- IR. Kt lun: C s gim dn nng adiponectin huyt thanh t nhm chng n nhm RLDN glucose v nhm T typ 2. Nng adiponectin huyt thanh Tng quan nghch vi nng cholesterol, triglycerid v cha c tng quan c ngha Vi nng insulin huyt thanh v ch s HOMA- IR.

T kha: Adiponectin, i tho ng typ 2, ri lon dung np glucose

Summary STUDY CONCENTRATION OF ADIPONECTIN IN THE SERUM IN PATIENTS IMPAIRED GLUCOSE TOLERANCE AND IN NEW ONSET TYPE 2 DIABETES MELLITUS
Diabetes is a metabolic disorder in chronic glucide that is popular in the world. That is type 2 diabetes mellitus mainly. Adiponectin is a protein having a role in the protecting from body metabolic trouble causing diabetes type 2. Two aims study are: 1. To research on serum adiponectin concentrations in the serum in patients impaired glucose tolerance and in new onset type 2 diabetic. 2. The relationship between adiponectin with vascular risk factors in type 2 diabete. Methods: We performed this study on 55 in new onset type 2 diabetes patients, 30 in patients impaired glucose tolerance. Concentrations of adiponectin was found by method of ELISA. Results: Concentrations of adiponectin in patients impaired glucose tolerance: 8,1 3,3 (g/ml) is higher than in new onset type 2 diabetes patients: 6,3 2,5 (g/ml). Inverse correlation between adiponectin concentrations with blood glucose levels, HbA1c, cholesterol, triglycerides. Conclusions: Concentrations of adiponectin in new onset type 2 diabetes patients is lower than in the serum in patients impaired glucose tolerance. Average of adiponectin concentrations in. Keyword: Adiponectin, type 2 diabetes mellitus, Impaired glucose tolerance

KH MU NG MCH BNH NHN VIM TY CP

Nguyn Th Vn Hng
Trung i hc Y H Ni Nghin cu nhm i chiu kt qu kh mu ng mch vi cc mc vim ty cp theo bng im Imrie v Balthazar. i tng: bnh nhn vim ty cp ti khoa tiu ha v khoa iu tri tch cc bnh vin Bch Mai. Nghin cu tin cu. Kt qu 90 bnh nhn vim ty cp. T l nam/ n l 2,3/1, im CTSI trung bnh nhm bnh nhn c im Imrie < 3 l 3,6 2 v 3 l 6 2, kt qu khc nhau c ngha thng k p = 0,01. PaO2 < 70 mmHg nhm vim ty cp c Imrie < 3 im l 12,5%, nhm vim ty cp nng Imrie 3 im l 30,7%. PaO2 < 70 mmHg nhm vim ty cp nh CTSI 0-3 im l 11,4%, vim ty cp va v nng CTSI 4-10 im l 21,7%. Kt lun: 1, Kt qu kh mu ng mch vi PaO2 < 70 mmHg l gi tr ngng nh gi mc vim ty cp nng. 2, Kt qu PaO2 gim < 70 mmHg gp nhiu hn nhm vim ty cp nng c im Imrie 3 l 30,7% so vi nhm Imrie nh < 3 l 12,5% s khc bit p = 0,05. Kt qu PaO2 gim < 70mmHg cc nhm CTSI va v nng nhiu hn nhm ch s CTSI nh c p = 0,18. 3, Gim pH mu, gim PaCO2 v gim bicarbonat mu gp nhiu cc nhm vim ty cp nng nhng khc bit khng c ngha. T kha: vim ty cp, Imrie, CTSI ch s nh gi mc trm trng vim ty cp, kh mu ng mch

Summary ARTERIAL BLOOD GAS IN ACUTE PANCREATITIS

Arterial blood gas is one of the important factor for predicting severity and progession of severepancreatitis.Objectives:evaluate arterial blood gas analysis according to severity of acute pancreatitis by Imrie score and Computer tomography severity index.Methods:A prospective study of all patients diagnosed with acute pancreatitis (AP) at GI department and ICU in Bach mai hospital.:were 90 patients with AP./ female:2.3/1.classified 64 patients (71.1%) as having mild AP (Imrie < 3) and 26 patients (28.9%) as having severe AP (Imrie 3). In mild group, the mean CTSI score was.6 2those of severe group was6 2, respectively, p = 0.01). Hypoxia (PaO2 < 70 mmHg) in mild AP group (Imrie < 3) was 12.5% and those of severe group was 30.7%.CTSI scoring system, Hypoxia (PaO2 < 70 mmHg) in mild AP group (CTSI 0-3)was.4% and those of moderate and severe AP group (CTSI 4 - 10)21.7%. Conclusion: 1, Arterial blood gas analysis with PaO2 < 70 mmHg should be used as avalueevaluating severity ofpancreatitis. 2, Hypoxia (PaO2 < 70mmHg) almost occured in the severe AP group (Imrie= 3).7% as compared to the mild AP group(Imrie < 3) was 12.5% withdifferent (p = 0.05). 3, The low pH of blood, Pa CO2 and bicarbonat level occur in the severe AP group no statistically different (p > 0.05). Key word: acute pancreatitis, Imrie, CT severity index, blood arterial gas

NGHIN CU LA CHN K THUT TRONG CHN ON ST DENGUE/ST XUT HUYT DENGUE TI BNH VIN BCH MAI
L Th Ngn, Vu Th Tung Vn
Bnh vin Bch Mai So snh k thut RT-PCR vi cc k thut pht hin KN NS1 v pht hin KT khng virus dengue ng dng vo cc giai on lm sng thch hp. i tng Nghin cu: 242 mu mu ca nhng BN c chn on lm sng l SD/SXHD vo iu tr ti bnh vin Bch Mai trong nm 2006 v 6 thng u nm 2007. Phng php: Nghin cu tin cu v m t ct ngang ti phng xt nghim. Kt qu v Kt lun: So snh cc k thut ng dng vo cc giai on lm sng thch hp: K thut ELISA pht hin KT pht hin sm KT IgM c hiu virus dengue sau 3 ngy mc bnh v t kt qu cao trn 90 % ti cc ngy 5, 6, 7 ca bnh. Kh nng pht hin KT IgM bng k thut sc k min dch ch t t l cao ngy th 7 ca bnh (79,1 %). K thut ELISA pht hin KN NS1 v k thut RT-PCR pht hin ARN virus rt c gi tr chn on trong 3 ngy u tin ca bnh vi t l (+) tng ng l 68,2% v 75%. T ngy th 4 tr i, kh nng pht hin ARN virus bng k thut RT-PCR gim ng k trong khi k thut ELISA pht hin KN vn pht hin c KN NS1 trong mu vi t l cao ngay c khi KT IgM c hiu virus dengue xut hin (67,4 % NS1 dng tnh ngy th 7 ca bnh). K thut RT-PCR ph hp chn on trong 3 ngy u ca bnh; Nn p dng k thut SKMD v k thut ELISA pht hin khng th t ngy th 4 tr i; K thut ELISA pht hin KN NS1: t ngy th 1 - 9.

T kha: RNA ca virus dengue, NS1, Khng th khng dengue IgM/IgG dengue

Summary RESEARCH ON SELECTION OF TECHNIQUE TO DIAGNOSIS DENGUE FEVER/DENGUE HEMORRHAGIC FEVER IN BACH MAI HOSPITAL
Comparison of RT-PCR technique with ELISA to detect NS1 antigen and antibody to dengue virus for applications in the clinical stage appropriate. Study Subjects: 242 blood samples of patients clinically diagnosed as DF/DHF in 2006 and six months of 2007. Research Methodology: cross-sectional described study in the laboratory include prospective and retrospective. Results and Conclusions: Comparison of techniques for application in the appropriate clinical phases: ELISA technique was found early dengue virus IgM specific antibody after 3 days of infection and this prevalence is over 90% at day 5, 6 and 7 of the disease. The ability to detect IgM by immunochromatographic membrance assay is only high percentage at day 7 (79.1%). ELISA to detect NS1 antigen and RT-PCR to detect viral RNA are valuable in the diagnosis of the first 3 days of illness at the positive rate of 68.2% and 75%, respectively. From day 4 onwards, the ability to detect viral RNA by RT-PCR technique significantly reduced while the NS1 antigen is still detectable in the blood with a high rate even when the Dengue virus-specific IgM antibody exists (67.4% positive with NS1 antigen at day 7 of disease). Time blood meaningful choice in deciding what sting technique is most appropriate: RNA is detectable by RT-PCR on first three days of illness; IgM antibody is detectable by ELISA from day 4 onward after onset of fever; NS1 antigen is detectable by ELISA from day 1 to 9.

Key word: degue virus - RNA, NS1 antigen, dengue IgG/IgM

C IM LM SNG, CN LM SNG CA BNH NHN NG C ROTUNDIN

Phm Du , Ng c Ngc
1 2

Bnh vin Bch Mai, Trung i hc Y H Ni

Tm hiu cc c im lm sng, cn lm sng ca ng c rotundin. i tng v Phng php: Cc bnh nhn ng c rotundin vo iu tr ti Trung tm Chng c bnh vin Bch Mai trong 2 nm 2007-2008. Tiu chun vo Nghin cu: ng c rotundin vi xt nghim c cht (+) trong nc tiu hoc dch d dy. Tin cu m t. Cc s liu c trnh by di dng t l phn trm, gi tr trung bnh cng v lch chun (SD). So snh cc gi tr trung bnh bng test T-student. Kt qu: 122 bnh nhn, nam/n 1/3,5. Mc ng c ch yu l nh (69,7%), trung bnh (25,4%) ch c 2,5% mc nng v 2,5% khng triu chng. Biu hin lm sng chnh: mt mi, ng lm. Cn lm sng ch yu: QTc ko di, ST chnh, T m v dt (74,6%) ngoi ra cn gp gim natri v kali mu; tng bch cu vi l thp. iu tr bng cc bin php thng thng: ra d dy, than hot, truyn dch. BN phc hi nhanh vi thi gian iu tr trung bnh 1,2 ngy, khng c t vong. Kt lun: Ng c rotundin c bnh cnh nh vi biu hin thng gp nht l thay i in tim; khng c t vong.

T kha: rotundin, ng c thuc an thn gy ng

Summary CLINICAL AND LABORATORY FEATURES IN PATIENTS WITH ROTUNDIN OVERDOSE

This study is aimed at finding out the clinical, laboratory features of patients with rotundin overdose. Methods: patients overdosed with rotundin admitted to the Poison control center, Bach Mai hospital from 2007 to 2008. This is a clinical co-hort study. The data is presented in percentage, means and standard deviation. Students T test is used to find the difference in means. Results: 122 patients with rotundin overdose were included. The poisoning severity included the mild (69.7% of patients), moderatee (25.4%), severe degree (2.5%) and non-poisoning (2.5%). Clinical features mostly included tiredness, lethargy. The most common laboratory investigation were changes in electrocardiography (74.6% of patients), mainly with prolonged QTc interval, ST elevation, inverted or flattened T wave. The other laboratory features were hyponatremia, hypokalemia and leukocytosis in small number of patients. The mainstays of the treatment were regular measures including gastric lavage, use of activated charcoal, intravenous infusion of fluid. Patients quickly recovered after 1-days on average and no death was observed. Conclusion: Rotundin overdose present with mostly mild poisoning condition and the main features are changes in electrocardiography. There is not any mortality in the study. Keywords: Rotundin, rotundin overdose

MT S YU T TIN LNG NNG LIN QUAN N T L T VONG NGAY SAU 48 GI CAN THIP NG MCH VNH QUA DA
Hn Nht Linh(1), Hong Minh Hng(2), Phm Gia Khi(1)
(1)

Vin Tim mch Vit Nam,

(2)

Trng i hc Y H Ni

Nghin cu mt s yu t tin lng nng c lin quan n t l t vong ngay sau 48 gi can thip ng mch vnh qua da. Nghin cu c thc hin t thng 8/2008 n thng 2/2009, nghin cu mt s yu t nguy c tin lng nng n t l t vong sau 48 gi u ca 511 bnh nhn c can thip ng mch vnh qua da ti Vin Tim mch Vit Nam. Kt qu: T l thnh cng ca th thut t 97,8%. T l t vong ngay sau 48 gi u can thip l 2,2%, n chim 2,5% v nam chim 2%. Tui trung bnh ca nhng BN t vong l 68,9 10,2. Nhng yu t tin lng t vong l: BN b suy tim trn lm sng mc Killip II-III trc khi can thip c nguy c t vong cao gp 5 ln so vi nhng BN suy tim mc Killip I (p < 0,01). Nhng BN b sc tim ti cc thi im can thip c nguy c t vong cao gp nhiu ln so vi BN khng b sc tim ti cng thi im (p < 0,01).

T kho: t vong, can thip ng mch vnh qua da, yu t nguy c

Summary A STUDY ON PRELIMINARY SEVERE PROGNOSTIC RISK FACTORS RELATED TO MORTALITY IMMEDIATELY AFTER THE FIRST 48 HOURS OF PERCUTANEOUS CORONARY INTERVENTION
To study preliminary severe prognostic risk factors related to mortality immediately after the first 48 hours of Percutaneous Coronary Intervention. Object and Research Methodology: From 08/2008 to 02/2009, 511 underwent PCI at the Vietnam Heart Institute. Some severe risk factors involving death prognosis after 48 hours were used for analysis. Results: The technical success rate of PCI reached 97.8%. Mortality rate after the first 48 hours of procedures constituted 2.2%. Mortality rate in female are 2.5% and 2% in male. The average age of patient with mortality probability post-intervention is 68.9 10.2. The risk of death of patients with heart failure Killip level II-III before procedure was 5 times higher compared to those with Killip I (p < 0.01). The risk of death of patients with cardiogenic shock are much higher than those who dont (p < 0.01). The risk of death of patients who have left main disease as well as 1-3 completely blocked vessels is 214 times higher than those who are 1 - 3 narrowed vessels. Conclusion: Percutaneous coronary intervention (PCI) is an effective and safe procedure for the treatment of CAD with low mortality rate. Some factors that affect mortality rate significantly are severe heart failure, cardiac shock, and coronary lesions profile. Keywords: mortality rate, Percutaneous coronary intervention, risk factor

GII THIU HAI BNH NHN B HI CHNG CORNELIA DE LANGE

Khu Th Khnh Dung, Nguyn Th Ngc T
Bnh vin Nhi Trung ng Hi chng Cornelia de Lange (CdLS) l mt hi chng a d tt bm sinh him gp gy nn do ri lon nhim sc th. Bnh nhn biu hin nhiu mc tn thng khc nhau. Chn on v iu tr sm s gip bnh nhn phc hi chc nng v c cht lng sng tt hn. Chng ti bo co hai trng hp bnh nhn c chn on CdLS ti vin Nhi Trung ng vi mc tiu m t c im lm sng, cn lm sng v kt qu iu tr. i tng v Phng php: M t ca bnh. Kt qu: Mt trng hp bnh nhn 26 ngy tui, c chn on v iu tr vim phi/ CdLS n nh, ra vin. Mt trng hp bnh nhn 11 thng tui chn on suy h hp, vim phi/ CdLS t vong. Kt lun: CdLS l hi chng c biu hin lm sng a dng, chn on nhiu la tui, tin lng thay i ph thuc vo mc tn thng v tc ng ca iu tr.

T kha: d tt bm sinh, bm sinh di truyn

Summary CORNELIA DE LANGE SYNDROME: TWO CASES

Cornelia de Lange syndrome (CdLS) is a syndrome of multiple congenital anomalies characterized by a distinctive facial appearance, prenatal and postnatal growth deficiency, feeding difficulties, psychomotor delay, behavioral problems, and associated malformations that mainly involve the upper extremities. The incidence is 1 case per 10,000-50,000 live births. Diagnosis of CdLS is based on the presence of clinically features.

Key words: Cornelia de Lange syndrome, congenital anomalies, malformations

KT QU IU TR TNG SN THNG THN BM SINH V MT S YU T NH HNG

Nguyn Thu Giang , Nguyn Ph t
1

Bnh vin Bch Mai, 2Trng i hc Y H Ni

Nghin cu kt qu iu tr tr TSTTBS ang iu tr ti bnh vin Nhi Trung ng v mt s yu t nh hng n kt qu iu tr ca tr TSTTBS. i tng: Tt c cc bnh nhn c chn on TSTTBS ang c iu tr v theo di t 1 nm tr ln ti bnh vin Nhi Trung ng, c theo di ngoi tr t thng 7/1990 n thng 7/2010. Phng php: M t. Kt qu: Tt: 80/ 124 (64,52%), khng tt : 44/124 (35,48%). Nhm chn on di 1 tui c kt qu iu tr tt hn gp 13,7 ln so vi nhm chn on mun trn 1 tui. Kt qu iu tr khng khc nhau gia nam v n. Th mt mui c kt qu iu tr tt hn gp 11,26 ln so vi th nam ha n thun. Nhm dng thuc liu kt qu u tr tt l 66,7%. Nhm tun th iu tr kt qu iu tr tt cao hn gp 8,56 ln so vi nhm khng tun th iu tr. Kt lun: Kt qu iu tr TSTTBS cn hn ch, 80/124 (64,42%) tr l kt qu tt. Kt qu iu tr ph thuc vo tui c chn on, s dng liu lng thuc hydrocortison hp l v tun th iu tr.

T kha: iu tr tng sn thng thn bm sinh

Summary TREATMENT OUTCOME AND SOME AFFECTING FACTORS OF CONGENITAL ADRENALHYPERPLASIA

Congenital adrenal hyperplasia (CAH) is a common hereditary disease in the National hospital of pediatrics (NHP). CAH is treated with hormone replacement therapy for life. It is necessary to evaluate treatment outcome in order to have monitoring method and further treatment plan. Objective: To study the treatment results of children being treated in the NHP. 2. To study factors affecting treatment outcome of children CAH. Subjects: All patients diagnosed CAH being treated and monitored for more than one year at the NHP from July 1990 to July 2010. Methods: Descriptive study. Results: Good outcome: 80/124 (64.52%), not good outcome: 44/124 (35.48%). Treatment outcome of patients diagnosed at the age less than 1 year was 13.7 times better than patients diagnosed at the age later than 1 year. Treatment outcomes were not different between males and females. Treatment outcome of a salt wasting form was 11.26 times better than that of a simple virilisation form. The group receiving a full dose had treatment results in 66.7%. A good compliance group had better treatment outcome by 8.56 times compared to that of a non-compliance group. Conclusion: Treatment outcome of CAH was not so good. 80/124 (64.42%) children had good result. Results of treatment depend on the age of diagnosis, using appropriate doses of hydrocortisone and treatment compliance. Key words: Treatment of congenital adrenal hyperplasia

BNH MUCOPOLYSACCHARIDOSIS IVA: TNG QUAN GIA KIU GEN V KIU HNH
V Ch Dng , Nguyn Ph t
1

Bnh vin Nhi Trung ng; Trng i hcY H Ni

Bo co nhm xc nh c im cc t bin ca gen GALNS, tm hiu mi tng quan gia chc nng protein t bin, kiu gen, kiu hnh v nng KS trong mu v nc tiu ca bnh nhn mc bnh Morquio A. i tng: 5 bnh nhn c chn on mc bnh Morquio A, trong 2 bnh nhn th nng v 3 bnh nhn th nh hn. Phng php: Sng lc t bin ca gen GALNS bng k thut PCR; gii trnh t trc tip gen GALNS. Hot enzym GALNS c o bch cu mu ngoi vi v fibroblast. S dng k thut high sensitive ELISA o nng KS trong mu v nc tiu. Kt qu: Cc bnh nhn mc th nng khng c hot enzyme GALNS v cc bnh nhn mc th nh hn c hot enzym GALNS cn 4,7 n 8,7% so vi bnh thng. Mt t bin mt on mi (c.405_422+1del19) v mt t bin ct ni mi (c.320-1G > T) c pht hin. 7 t bin khc nhau c pht hin 5 bnh nhn. 5 t bin kt hp vi th lm sng nng v 1 t bin kt hp vi th lm sng nh hn. Cc t bin u ph hp vi kiu hnh. Nng KS trong mu v nc tiu ca bnh nhn Morquio A cao hn so vi ngi bnh thng v tng cao hn th lm sng nng so vi th nh. Kt lun: Kt hp vic phn tch t bin gen, chc nng enzym vi nh gi lm sng v nng KS s gip d on mc nng ca bnh v nh gi kt qu iu tr bng liu php thay th enzym v gen tr liu trong tng lai.

T kha: bnh morquio A, mucopolysaccharidosis IVA, gen GALNS

Summary MUCOPOLYSACCHARIDOSIS IVA: CORRELATION BETWEEN MUTANT PROTEIN, GENOTYPE, PHENOTYPE AND KERATAN SULFATE
We aim to characterize biochemical (enzyme activity and biomarker) and molecular findings in Morquio A patients, and to seek correlations among function mutant protein, genotype, phenotype and urine and blood KS level. Materials and Methods: Mutation screening of the GALNS gene was performed in 5 patients with Morquio A disease (severe: 2, attenuated: 3) by genomic PCR, followed by direct sequence analysis. Using an ELISA assay for KS, urine and plasma KS levels were measured. GALNS activity was determined in fibroblast and in leucocyte. Function of mutant protein, genotype, phenotype and KS correlations were assessed in Morquio A patients. Results: Patients with severe phenotype had no enzyme activity. The mutant enzymes defining the attenuated phenotype exhibited a considerable residual activity (4.7 - 8.7% of the wildtype GALNS activity). A novel deletion mutation (c.405_422+1del19) and a novel splicing one (c.320-1G>T) were identified. Seven reported missense mutations were identified in this study. Five mutations were associated with a severe phenotype and one mutation with an attenuated one. The mutations found in each patient were consistent with the phenotype. Urine KS concentrations in MPS IVA patients were markedly higher than those in normal controls. Plasma KS levels in MPS IVA patients with the severe phenotype were higher than in the patients with an attenuated form. Urine KS levels of MPS IVA patients with severe phenotype were also higher than in the patients with a milder form. Keywords: morquio a disease; mucopolysaccharidosis IVA; GALNS gene

NH GI KT QU CA PHU THUT NI SOI CT T CUNG BN PHN TI BNH VIN PH SN TRUNG NG

Nguyn c Hinh , ng Th Minh Nguyt Nguyn Duy Hng
1

1,

Trng i hc Y H Ni, 2Bnh vin Gang thp Thi Nguyn

nh gi hiu qu ca phu thut ni soi (PTNS) ph khoa c s dng morcellator ti bnh vin Ph sn Trung ng. i tng: Tt c ngi bnh c u x t cung hoc khng phi u x nhng c iu kin, ch nh la chn ct t cung bn phn v bc tch u x qua ni soi ti BVPST trong thi gian t 5/ 2007 n khi c mu. Phng php: hi cu m t ct ngang. Kt qu: Ngy th 2 c 97% v ngy th 3 c 98,5 ngi bnh khng st. Phn ln ngi bnh trung tin ngy th nht chim 72,7%. Ngy th 2: 100% ngi bnh trung tin. Ngy th nht c 92,42% ngi bnh ngi dy c v trong c 44,24% i li c. Ngy th 2 c 100% ngi bnh ngi dy c v trong s c 64 ngi bnh i li c (96,97%). Ngy th 3, 100% ngi bnh i li c. Tai bin trong qu trnh m c 2 ngi bnh b trn kh di da (3%). Sau m c 01 ngi bnh nhim trng mm ct chim 1,51%, ngoi ra khng gp tai bin g khc. Kt lun: PTNS ph khoa c s dng morcellator gip tnh trng hu phu phc hi nhanh. Tai bin, bin chng nhim khun mm ct 1,51%, trn kh di da nh 3%. T kha: ct t cung bn phn, u x t cung

Summary EFFECT OF GYNECOLOGICAL ENDOSCOPY USING MORCELLATOR AT THE NHOG

Evaluate the effect of gynecological endoscopy using morcellator at the NHOG. Subject: All the patients with uterine fibroids or not that had full of condition, indication to select for partial uterectomy and fibroma ablation at the NHOG from 5/2007 to specimen sufficiency. Study Methodology: interrupted, retrospective descriptive method. Results: 97% on the second day and 98.5% at from the third day. Most of the patients could break wind on the first day (72.7%) and this rate is 100% on the second day. 92.42% of the patients could sit up on the first day. 100% patients could sit up on the second day and in which 64 cases could walk (96.97%). 100% patients could walk on the third day. Accident during operation: 2 cases suffered from subcutaneous emphysema (3%). After operating: 1 case with inflammation of uterine incision is (1.51%). There is no other accident. Conclusion: gynecological endoscopy using morcellator helped postoperative condition recovering fast. Accident: imflammation of uterine incision is 1.51%, light subcutaneous emphysema is 3%. Keyword: partial uterectomy, uterine fibroids

NHN XT THI GIAN PHU THUT NI SOI CT T CUNG BN PHN C S DNG MORCELLATOR TI BNH VIN PH SN TRUNG NG
Nguyn Duy Hng , Nguyn c Hinh , ng Th Minh Nguyt
1

Bnh vin Gang thp Thi Nguyn, 2Trng i hc Y H Ni

Nhn xt thi gian phu thut ni soi ph khoa c s dng morcellator ti bnh vin Ph sn Trung ng. i tng: Tt c ngi bnh c u x t cung hoc khng phi u x nhng c iu kin, ch nh la chn ct t cung bn phn v bc tch u x qua ni soi ti BVPST trong thi gian t 5/2007 n khi c mu. Phng php: hi cu m t ct ngang. Kt qu: Thi gian phu thut ct t cung bn phn, nhm < 60 pht l ch yu, chim 74,2%, t 60 90 pht chim 25,8%. thi gian phu thut trung bnh ca ct t cung bn phn l 58,84 5,12 pht. Thi gian phu thut v kch thc ngang trn siu m tng quan vi nhau theo phng trnh y = 2,239 x + 46,221. H s tng quan r = 0,227 vi p < 0,05. Thi gian phu thut ct t cung bn phn c mi tng quan vi trng lng ca t cung theo phng trnh y = 0,4 x + 51,88. h s tng quan r = 0,4 vi p < 0,05. Thi gian ly bnh phm ca PT ct TCBP < 5 pht, thi gian trung bnh i vi phu thut ct TCBP l: 7,05 2,56 pht. Kt lun: Thi gian phu thut trung bnh ca ct t cung bn phn l 58,84 5,12 pht. Thi gian phu thut v kch thc ngang trn siu m tng quan vi nhau theo phng trnh y = 2,239 x + 46,221. H s tng quan r = 0,227 vi p < 0,05. Thi gian phu thut ct t cung bn phn c mi tng quan vi trng lng ca t cung theo phng trnh y = 0,4 x + 51,88, h s tng quan r = 0,4 vi p < 0,05. Thi gian ly bnh phm trung bnh i vi phu thut ct TCBP l: 7,05 2,56 pht. T kha: ct t cung bn phn, u x t cung

Summary ASSESSMENT OF TIME OF ENDOSCOPIC PARTIAL UTERECTOMY USING MORCELLATOR AT THE NHOG
Evaluate the time of gynecological endoscopy using morcellator at the NHOG. Subject: All the patients with uterine fibroids or not that had full of condition, indication to select for partial uterectomy and fibroma ablation at the NHOG from 5/2007 to specimen sufficiency. Exclusion: The patients were indicated to endoscopic partial uterectomy or fibroma endoscopy, Study Methodology: interrupted, retrospective descriptive method. Results: The time of partial uterectomy: 60 minutes group is main (74.2%), 60 90 minutes group is 25.8%. The average time of partial uterectomy is: 58.84 5.12 minutes.The operating time and transversal size on the untrasound are correlative together with the equation: y = 2.239 x + 46.221. r (coefficient of correlation) = 0.227 with p< 0.05.The time of partial uterectomy and uterine weight are correlative together with the equation: y = 0.4 x + 51.88. r = 0.4 with p < 0.05.The time to get medical waste of partial uterectomy: 5 cases < 5 minutes ( 16.1%), 2 cases > 10 minutes (6.5%) and the highest rate is 77.4% for 5-10 minutes group. The average time of partial uterectomy is: 7.05 2.56 minutes. Conclusion: The average time of partial uterectomy is: 58.84 5.12 minutes. The operating time and tranversal size of uterus on the untrasound are correlative together with the equation: y = 2.239 x + 46.221. r (coefficient of correlation) = 0.227 with p < 0.05. The time of partial uterectomy are correlative with uterine weight, with the equation: y = 0.4 x + 51.88. r= 0.4 with p < 0.05. The average time to get the medical waste of partial uterectomy is: 7.05 2.56 minutes. Keyword: partial uterectomy, uterine fibroids

I CHIU KT QU SOI C T CUNG VI PHIN M O C T CUNG CC BNH NHN N SOI C T CUNG TI KHOA KHM, BNH VIN PH SN TRUNG NG
CungTh Thu Thy
Trng i Hc Y H Ni i chiu kt qu soi c t cung v chn on t bo hc. i tng v Phng php: Nghin cu c thc hin trn 280 bnh nhn n soi c t cung (CTC) ti bnh vin Ph sn Trung ng. Cc bnh nhn mi la tui, c soi CTC ti khoa Khm, bnh vin Ph sn Trung ng tiu chun c la chn. Tnh c 280 bnh nhn. Phng php nghin cu tin cu m t ct ngang. Kt qu: Khi c s thay i cc TT CTC (tn thng c t cung) qua soi th kt qu phin - CTC (m o c t cung) cng c s bin i r rt. Kt qu TBH (t bo hc) bt thng cng nng th t l TT (tn thng) nghi ng qua soi CTC cng cao. C 3 bnh nhn (27,1%) c kt qu soi CTC l Cnilm nhn nhng kt qu t bo Koilocyte (-). T l TT nghi ng CTC qua soi CTC nhm TBH (t bo hc) bt thng: HSIL (High grade squamous intraepithelial lesion) l 33,3%, LSIL (Low grade squamous intraepithelial lesion) l 14,9%, ASCUS (Atypical squamous cells of undetermined significance) l 25,9% v AGUS (Atipycal glandular cells of undetermined significance) l 7,4%. Kt lun: Cc hnh nh tn thng qua soi CTC c lin quan cht ch vi cc tn thng t bo hc. T kha: Soi c t cung (CTC), T bo hc m o c t cung (TB - CTC)

Summary COMPARISON OF CERVICAL COLPOSCOPY AND PAP SMEAR IN PATIENTS WHO WAS EXAMINED WITH COLPOSCOPY IN THE OUTPATIENTS DEPARTMENT OF NHOG
The study was carried out in 280 patients came to NHOG for colposcopy examination. Objective: To compare the results of colposcopy with cytology diagnosis. Research Methodology: a cross-sectional descriptive study There were 280 Patients of all ages visit to the Examination Department of NHOG for any reason, such as: discharge, abnormal bleeding, infertility. Result: There is a similarity between the results of colposcopy with cytology diagnosis. 36.3% of patients with colposcopy result shows Condylomata acuminata absent Koilocyte cells. The percentage of suspect cervix lesions by colposcopy in abnormal cytology group is that: HSIL (High grade squamous intraepithelial lesion) was 33.3%, LSIL (Low grade squamous intraepithelial lesion) was 14.9%, ASCUS (Atypical squamous cells of undetermined significance) was 25.9% and 7.4% AGUS (Atipycal glandular cells of undetermined significance) is 7.4%. Conclusion: lesions that detected by colposcopy is closely related with the cytological changes. Keyword: Cervical colposcopy, cytology vagino- cervical

NI SOI X TR VIM PHN PH TI BNH VIN PH SN TRUNG NG TRONG 3 NM T 2007 N 2009

L Th Thanh Vn
Trng i Hc Y H Ni nh gi ch nh v can thip ni soi trong iu tr vim phn ph ti bnh vin Ph sn Trung ng trong 3 nm 2007-2009. i tng v Phng php: Nghin cu trn 58 trng hp m ni soi trong s 223 ca vim phn ph iu tr trong 3 nm 2007-2009. Phng php nghin cu hi cu. Kt qu: T l phu thut ni soi trong vim phn ph l 26,01%, ch nh chnh xc trc phu thut l 27,58%, 42 trng hp chn on sai l u nang bung trng (56,89%), ung th bung trng (15,53%). Triu chng lm sng in hnh: au tiu khung 85,07%, khi phn ph 70,1%, du hiu nhim khun 25% bao gm st 37,11%, kh h m o 22,41%, khi vim 22,41%, vi t cung b tn thng vim 100%, ct vi t cung 1 bn 13/58 ca, 2 bn 21/58, m thng vi t cung 3 ca, g dnh 10/58, dn lu vi 8/58 ca, ra bng 20,69%. Kt lun: M rng phu thut ni soi trong iu tr vim phn ph v hiu qu cao, chn on chnh xc. T kha: ni soi, vim phn ph

Summary MANAGEMENT OF LAPAROSCOPIC SURGERY FOR PELVIC INFLAMMATORY DISEASE IN NATIONAL HOSPITAL OF OBSTETRIC GYNECOLOGY FROM 2007 TO 2009
To evaluate the results of laparoscopic surgery of Pelvic Inflamatory Disease in NH of OB - GYN. Material and Method: In 223 patients of PID, 58 cases were undergone laparoscopic surgery during 3 years from 2007 to 2009. Retrospective study based on medical records. Results: the rate of treatment by laparoscopic surgery was 26.01% corrected indication before surgery 27.58%, 42 cases were indicated incorrectly including ovarian cysts, ovaria cancers, ovarian torsion. Typical clinical signs: pelvic pain 85,07%, annexal mass 70.1%, infection symptoms 25% including fives (37.11%), vaginal discharge (22.41%), sore annexal mass (22.41%), tubal lesion observed by laparoscopic surgery wese 100%, unilateral salpingectomy 13/58 cases, bilateral salpingectomy 3/58 cases, adhesiolyse 10/58, tubal drainage 8/58, converted to laparotomy 20.69%. Conclusions: Laparoscopic surgery for is the solution safety and efficacy in case of PID. Keywords: pelvic inflamatory disease(PID), laparoscopic surgery, salpingectomy

NGHIN CU C IM LM SNG, CHP CT LP VI TNH V NH GI KT QU PHU THUT DI MM TRM

Phm Tun Cnh
Trng i hc Y H Ni M t c im lm sng, chp ct lp vi tnh (CLVT) bnh nhn di mm trm. nh gi kt qu phu thut ct mm trm. i tng v Phng php: tin cu, gm 49 BN di mm trm. M t cc triu chng lm sng, chp CLVT ca BN v nh gi kt qu iu tr. Kt qu: triu chng hay gp: nut au (93,3%), nut vng (100%). S h Amidan thy u mm trm (80,2%). Chiu di mm trm trung bnh trn CLVT: 3,08 0,67cm. Phn ln cc BN c cc triu chng c ci thin sau phu thut. Chiu di mm trm 3cm c kt qu phu thut tt hn. Kt lun: Di mm trm c chn on da vo cc triu chng lm sng v chp CLVT. Phu thut l phng php c ch nh trong iu tr. T kha: mm trm, nut vng, nut au

Summary THE CLINICAL AND CT SCAN FEATURES AND SURGICAL OUTCOME OF ELONGATED STYLOID PROCESS
To describle the clinical symtoms and signs and CT scan of elongated styloid process and to evaluate the outcome of surgical treatment. Study design & Methods: prospective study, 49 patients with elongated styloid process that assesses symtoms, signs, CT scan finding and the outcome of the treatment. Results: the commom symptoms are: odynophagia (93.3%) and dysphagia (100%). The styloids process can be found in tonsilar fossa (80.2%) by palpating. The average length of styloid process on CT scan is 3.08 0,67cm. Majority of patients (83.1%) have symtoms improved by surgiacal treatment. The patient with length of styloid process 3cm had a better surgical outcome. Conclusions: Elongated styloid process disease is diagnosed by clinical symtoms and signs and CT scan. Treatment of choice is surgery. Keyword: styloid process, odynophagia, dysphagia

NH GI TNH TRNG MCH MU TAY TRC V SAU PHU THUT M THNG NG TNH MCH CHY THN NHN TO CHU K
H Phan Hi An
Trng i hc Y H Ni nh gi tnh trng mch mu ca bnh nhn trc m thng ng tnh mch v i chiu vi kt qu sau phu thut 8 tun. i tng v phng php nghin cu: Nghin cu tin cu 50 bnh nhn t 16 tui tr ln b suy thn giai on cui c ch nh chy thn nhn to chu k. Cc bnh nhn c khm lm sng v lm siu m Doppler mch nh gi tnh trng mch mu c tay to thng ng tnh mch trc phu thut v sau phu thut 8 tun. Kt qu v kt lun: 92% bnh nhn nghin cu c ng knh ng mch quay trn 2mm, 86% bnh nhn nghin cu c ng knh tnh mch u trn 2mm. ng knh trung bnh ng mch quay v tnh mch u khng khc bit c ngha khi so snh gia nam v n, gia nhm trn 55 tui v di 55 tui cng nh gia nhm i tho ng v khng i tho ng. T l bnh nhn c tnh mch t yu cu cho chy thn nhn to sau m 8 tun nhm c ng knh mch mu trn 2mm cao hn c ngha so vi nhm c ng knh mch mu di 2mm (p < 0,05). Kt qu nghin cu cho thy vic thm d k tnh trng mch mu trn lm sng kt hp vi siu m Doppler c th gip la chn bnh nhn ph hp cho to thng ng tnh mch, gp phn lm tng t l thnh cng ca phu thut.

T kha: suy thn mn, thng ng tnh mch, trng thnh mch mu, siu m Doppler mch, dng s mch mu

Summary ASSESSMENT ON PERIPHERAL VESSEL CHARACTERISTICS PRIOR TO CREATION OF ARTERIO-VENOUS FISTULA FOR HEMODIALYSIS
Objectives of this study is to assess the peripheral vessel diameter at forarm prior to creation of AVF using Doppler ultrasound examination combined with clinical assessment, and to identify the successful rate 8 weeks after surgery in groups with different vessel diameters. Methods: prospective study performed on 50 patients requiring maintenance hemodialysis at age >16 years old and not having AVF. Thorough clinical examination and Doppler ultrasound have been conducted in all patients prior to and 8 weeks after creation of AVF on forarm. Results showed that 92% of patients had radial artery diameter greater than 2mm, and 86% of patients had cephalic vein diameter greater than 2 mm. There was no significant difference in vessel diameter between males and females, between groups at age above 55 and under 55 years old, and between diabetic and non-diabetic patients. The rate of successful AVF was significantly higher in group of patients with vessel diameter greater than 2mm (p < 0.05). Conclusion: the thorough assessment of peripheral vessels prior to creation of AVF can have important impact on ulterior results of intervention, in helping to select patients appropriate for AVF creation and thus increasing successful rate of surgery. Doppler ultrasound examination can be a valuable noninvasive method for assessing the peripheral vessel. Keyword: chronic kidney failure, arterio-venous fistula, Doppler ultrasound, vascular mapping

NGHIN CU C IM RI LON LIPID MU BNH NHN VIM TY CP

Nguyn Th Vn Hng
Trng i hc Y H Ni Ri lon lipid mu l nguyn nhn gy nn nhiu bnh l trong c th trong c vim ty cp. Nghin cu ri lon lipid mu trong vim ty cp cha c thc hin ti Vit Nam. Mc tiu: 1. Nhn xt c im ri lon lipid mu bnh nhn vim tu cp. 2. Nhn xt mi lin quan gia ri lon lipid mu v mt s c im cn lm sng bnh nhn vim tu cp. i tng l bnh nhn c chn on vim ty cp theo khuyn co ca hi ngh Tiu ho Th gii nm 2002. Phng php nghin cu tin cu. Kt qu nghin cu c thc hin t thng 12-2008 n thng 10-2009. Nghin cu 63 bnh nhn c chn on vim ty cp, tui trung bnh l 45 13 tui. 33 BN vim ty cp c ri lon lipid mu chim 52,4%. Vim ty cp c ri lon lipid mu chim 52,4%, ch yu l tng Triglycerid mu chim 81,9%, Triglycerid tng rt cao chim 30,3%. Kt lun: 1 Phn loi ri lon lipid mu theo Fredrickson bnh nhn vim ty cp: RLLM typ IV chim 51,5%, Typ I, IV v V chim 66,7%. 2 Amylase tng khng cao nhm vim ty cp c ri lon lipid mu. Bnh nhn c Triglycerid tng rt cao ch c phn nhm CTSI nng 3 - 10 im.

T kha: vim ty cp, ri lon lipid mu, phn loi Frederickson, CTSI - ch s mc trm trng CT

Summary DYSLIPIDEMIA IN ACUTE PANCREATITIS

Dyslipidemia was linked to many diseases, especially in acute pancreatitis. In Viet Nam, there are no dyslipidemia studies in acute pancreatitis. Objective: 1. To describe characteristics of dyslipidemia in AP patients. 2. To determine the relationship between the clinical characteristics of acute pancreatitis patients and dyslipidemia. Method: prospective descriptive study including 63 patients of acute pancreatitis admitted from December 2008 to October 2009. Results: The age average was 45 13 years. The AP patients with dyslipidemia accounted for 52.4% (33/63) of all acute pancreatitis cases during the study period. Elevated serum triglyceride accounted for 81.9%, extremely high triglyceride level accounted for 30%. Conclusion: 1. Frederickson classification I, IV, and V dyslipidemias are associated with acute pancreatitis accounted for 66.7% and types IV accounted for 51.5%. 2. Serum amylase levels were not elevated in acute pancreatitis with associated dyslipidemia groups. The high hypertriglyceridemia pancreatitis only appeared in severe acute pancreatitis (CTSI: 3-10). Keyword: acute pancreatitis, dyslipidemia, Frederickson classification, CTSI-CT severity index

GI TR CHN ON NGUYN NHN VI KHUN CA MT S TRIU CHNG LM SNG V CN LM SNG TRONG VIM PHI TR EM
Nguyn Vn Bng, Hong Minh Hng
Trng i hc Y H Ni Nghin cu gi tr chn on nguyn nhn vi khun ca cc triu chng lm sng v cn lm sng thng gp bnh nhi vim phi. i tng, Phng php: 146 bnh nhn vim phi, 92 trai, 54 gi, tui t 2 n 60 thng, c thi gian b bnh trung bnh trc khi vo vin l 6,0 4,6 ngy, trong c 46 bnh nhn (31,5%) c kt qu cy dch t hu dng tnh trong thi gian t 1/1/2010 n 30/9/2010 ti khoa Nhi bnh vin Bch Mai. Kt qu: Khi SLBC 16,2 G/L, gi tr chn on ca BC c s khc bit gia 2 nhm vi khun m tnh v vi khun dng tnh vi (p < 0,05). Gi tr chn on ca BC cao nht khi SLBC > 17,5 G/L (p < 0,05), vi c hiu v gi tr tin on m tnh kh cao, c th c gi tr phn bit nhim khun v khng nhim khun. Phi hp triu chng ran m nh ht trn lm sng vi tng bch cu trn 17,5 G/L c th lm tng thm kh nng chn on vim phi do nguyn nhn vi khun. Kt lun: Kt qu nghin cu ny cho thy c rt t triu chng lm sng v cn lm sng c gi tr chn on phn bit vim phi vi khun vi cc nguyn nhn vim phi khc.

T kho. gi tr chn on, cn lm sng, lm sng, vim phi, vi khun, tr em

Summary DIAGNOSTIC VALUES OF CLINICAL AND LABORATORY FINDINGS FOR DIFFERENTIATING BACTERIAL AND NON-BACTERIAL PNEUMONIA IN CHILDREN
The present study aimed at investigating diagnostic values of the most frequent clinical and laboratory signs and symptoms in childhood pneumonia. Populations and Methods: 146 children (92 males and 54 females) aged from 2 months to 5 years, of them 46 (31.5%) with positive culture for bacterial agents from nasopharyngeal secretions being used as gold standard for assessment of bacterial diagnostic values of signs and symptoms. Results: WBC 16.2 G/L seemed to be cut-off to differentiate between bacterial and non-bacterial pneumonia (p < 0.03). With WBC > 17.5 G/L, specificity and negative prognostic values were high enough for bacterial pneumonia. A combination between WBC > 17.5 G/L and fine crackles on chest auscultation further improved possibility of bacterial pneumonia. Conclusion: Our results showed that there were very few findings getting good diagnostic values in differentiating bacterial and nonbacterial pneumonia in childhood. Keyword: Bacterial and non-bacterial agents, diagnostic values, clinical and laboratoty findings, pneumonia

C IM LM SNG VIM NO DO HERPES SIMPLEX

V Minh in, Bi V Huy
Trng i hc Y H Ni Vim no do vi rt Herpes simplex (HSV) c t l t vong v di chng cao, nhng cn t c quan tm ti Vit Nam. Nghin cu c im lm sng, cn lm sng vim no do HSV. Phng php: Nghin cu 30 trng hp vim no c xc nh do HSV, bng xt nghim PCR trong dch no ty (DNT), iu tr ti Bnh vin Bnh Nhit i Trung ng, t 12/2007 - 3/2011. Kt qu: Bnh gp quanh nm, cao im vo ma Xun - H, t l nam/n l 2/1, hay gp ngi > 40 tui (46,67%). Biu hin hay gp: st (100,0%), au u (93,33%), ri lon thc (93,33%), c cng (80,0%), kernig (66,67%). Cc du hiu t gp hn: nn (56,67%), co git (46,67%), lit khu tr (26,67%). DNT c tng s lng t bo (86,67 %) v protein (83,33%). Chp cng hng t (CHT) c tng tn hiu trn T2W v FLAIR, gim tn hiu trn T1W, thy thi dng v thy trn. pht hin bnh, nu cha lm c xt nghim vi rt, nn nh gi lm sng, dch no ty, kt hp chp CHT.

T kha: Vim no, Herpes simplex, Acyclovir

Summary CLINICAL FEATURES OF HERPES SIMPLEX ENCEPHALITIS

Encephalitis caused by herpes simplex virus (HSV) has high rates of mortality and sequelae if not treated promptly. In Vietnam, few studies on HSV encephalitis has been done. Objective: To study clinical and subclinical features of encephalitis caused by HSV. Methods: 30 cases with the diagnosis HSV encephalitis confirmed by PCR in Cerebrospinal Fluid (CSF) were admitted to the National Hospital of Tropical Disease from 12/2007 - 3/2011. Results: The number of cases peaked in spring and summer, the male/female ratio was 2/1 and 46% were > 40 years of age. All presented with fever, other symptoms included headache (93.33%), alerted consciousness (93.33%), stiff neck (80.0%), positive kernigs sign (66.67%), vomiting (56.67%), seizures (46.67%) and localized paralysis (26.67%). CSF showed increased number of cells (86.67%) and protein (83.33%). Magnetic resonance imaging (MRI) shows temporal lobe and frontal lobe lesions with increased signal in T2W and Flair, decreased signal in T1W. To enable early diagnosis of HSV encephalitis the clinical status, CSF and MRI should be assessed and treatment initiated even if confirmatory PCR diagnosis is pending. Keyword: Encephalitis, Herpes simplex, Acyclovir

MT S YU T NGUY C SA ST TR TU NGI CAO TUI TI MT S A BN THNH PH H NI

L Vn Tun , Phm Thng , H Quc Hng
1

Trng Cao ng Y t H Ni, 2Bnh Vin Lo khoa Trung ng

Sa st tr tu (SSTT) l bnh thng gp ngi cao tui, gy gim tr nh v cc lnh vc nhn thc khc. Mc tiu: xc nh mt s yu t nguy c ca SSTT ngi cao tui ti mt s a bn ti H Ni. Nghin cu trn 966 ngi cao tui c chn on SSTT theo tiu chun DSM-4 c iu tra v dch t v cc yu t nguy c. Kt qu: 39 trng hp (4,04%) c chn on l SSTT theo tiu chun DSM-4. T l mc SSTT tng cao r rt ngi c trnh hc vn thp (OR = 3,9; 95%Cl = 1,5-10,2; p< 0,01), tai bin mch mu no c (OR = 3,7; 95% Cl= 2,3-5,9; p< 0,01), cholesterol ton phn tng (OR = 2,3; 95%Cl = 2,7-6,1; p< 0,01), tng LDL-C (OR = 4,1; 95%Cl = 2,5 6,5; p< 0,01). Kt lun: (1) T l hin mc SSTT ca ngi cao tui ti mt s a bn ca thnh ph H Ni l 4,04%; (2) Cc yu t nguy c ca SSTT bao gm hc vn thp, tin s TBMN v tng cholesterol mu.

T kho: sa st tr tu, yu t nguy c

Summary RISK FACTORS OF DEMENTIA IN THE ELDERLY IN SOME AREAS OF HANOI

Dementia is a common disease in the elderly with memory loss and other cognitive domains and is an important reason to cause dependency in the elderly. Objective: to identify a number of risk factors of dementia in the elderly in some areas of Hanoi. Subjects and Methods: 966 elderly persons were investigated about dementia and risk factors. Dementia was diagnosed according to DSM - 4 criteria. Results: Among 966 NCT, there were 39 cases of dementia (4.04%). Prevalence of dementia increased significantly in those with low education level (OR = 3.9, 95% Cl = 1.5 to 10.2, p < 0.01), history of stroke (OR = 3.7, 95% Cl = 2.3 to 5.9, p < 0.01), increased total cholesterol (OR = 2.3, 95% Cl = 2.7 to 6, 1, p < 0.01), increased LDL-C (OR = 4.1, 95% Cl = 2.5 to 6.5, p < 0.01). Conclusions: (1) Prevalence of dementia in the elderly in some areas of Hanoi city is 4.04%. (2) The risk factors include low education, history of stroke and hyperlipidemia. Keyword: dementia, risk factors of dementia

THEO DI V IU TR BNH TC TNH MCH VNG MC

Phm Trng Vn1, Nguyn Cnh Thng2
1

Trng i hc Y H Ni, Bnh vin Mt Trung ng

Trnh by ba trng hp tc tnh mch vng mc vi cc biu hin v din bin lm sng khc nhau nhm nu bt tm quan trng ca theo di cht ch trong vic a ra cc quyt nh x tr ph hp. Ba (3) bnh nhn b tc tnh mch vng mc cc mc khc nhau v c theo di trong mt thi gian di (2008-2010). Ch nh iu tr bao gm lade, tim triamcinolone v theo di n thun. Kt qu: 3 bnh nhn c th lc hi phc hon ton hay mt phn. Lade v triamcinolone c tc dng bnh nhn b xut huyt vng mc v ph n gai th nhiu. Shunt hnh thnh bnh nhn ny sau 2 nm theo di. Hai bnh nhn cn li xut huyt t tiu, ph hong im t gim m khng cn iu tr. Tc mu lng cao xut hin 2 bnh nhn tr. Cao huyt p v x mch c th l nguyn nhn tc nhnh tnh mch bnh nhn ln tui. Kt lun: Theo di cht ch l im c bn vi cc bnh nhn tc tnh mch vng mc nhm trnh nhng iu tr v can thip khng cn thit.

T kha: tc tnh mc trung tm vng mc, bnh vng mc, bnh y mt, xut huyt vng mc

Summary CENTRAL RETINAL VEIN OCCLUSION: FOLLOW UP AND TREATMENT

To present three cases with central retinal vein occlusion (CRVO) and variable clinical features and highlight the significance of close follow up to order proper testing and intervention. Methods: 3 CRVO patients are followed up in two year period (2008-2010). Indications include laser, sub-tenon triamcinolone injection and pure regular eye check. Results: All 3 patients have partial or total vision recovered. Laser and triamcinolone appear to be effective in patients with severe retinal bleeding and papilledema. Shunt is formed in this case after 2 years. Other 2 patients have spontaneous blood absorption and reduced macular edema without therapy. High blood viscosity is reported in young cases while vascular hypertention and artheriosclerosis may be a cause for aged patient. Conclusion: Close follow up is critical in CRVO to avoid unnecessary intervention and treatment. Keyword: central retinal vein occlusion, retinopathy, fundus diseases, retinal hemorrhage

BIN CHNG DO I THO NG BNH NHN IU TR TI BNH VIN LO KHOA TRUNG NG

V Th Thanh Huyn
1

1, 2

, Th Khnh H

1, 2

, Phm Thng

Bnh vin Lo khoa Trung ng, 2 Trng i hc Y H Ni

i tho ng (T) ngi cao tui thng c t l mc cao (> 10%) v nhiu bin chng. Mc tiu: Nhn xt c im dch t, t l xut hin v c im lm sng, cn lm sng cc bin chng do T ngi cao tui. Nghin cu m t hi cu trn cc bnh nhn c chn on T iu tr ti bnh vin Lo khoa Trung ng t 2002 n 2004. Kt qu: Bin chng do T c t l 65,2%, bin chng cp 1,9%, bin chng mn 64%, bin chng mch mu ln 22,4%, bin chng vi mch: 48,4%, bin chng nhim khun: 14,3%, bnh l bn chn T: 1,9%. Triu chng thng gp: hoa mt chng mt: 14,9%, kh th: 11,8%, microalbumin niu: 9,3%, suy thn gp ch yu I v II ln lt chim 13,2% v 13,9%, bnh l mng x va chim 26,6%, vim tc mch chim 12,8%. Kt lun: T l bin chng do T ngi cao tui rt cao v tng t l vi thi gian mc bnh, c bit l cc bin chng mch mu ln v vi mch.

T kho: i tho ng , bin chng do i tho ng

Summary COMPLICATIONS OF DIABETES MELLITUS IN ELDERLY PATIENTS TREATED AT NATIONAL INSTITUTE OF GERONTOLOGY FROM 2002 TO 2004
Diabetes is increasing chronic disease, especially high morbidity in older ages (> 10%) with many complications. Objectives: to identify risk factors and frequency of diabetes-related complications and to assess clinical features and laboratory findings of complications of diabetes in elderly patients. Patients: the research involved all cases with diabetes mellitus (WHO 2003 criteria) treated at National Institute of Gerontology, Hanoi, Vietnam from 2002 to 2004. Methods: the research used retrospective observational design. Results: The rate of complications among diabetic elderly patients was 65.2%. Acute complications accounted for 1.9%. Chronic complications were recorded in 64% of the patients, including: marcro-vascular diseases (22.4%), micro-vascular diseases (48.4%), infections (14.3%), and diabetic foot (1.9%). Common signs and symptoms: dizziness 14.9%, dyspnea 11.8%, numbness and tingling 11.2%, micro-albuminurea 9.3%, renal failure stage I and II: 13.2% and 13.9%, respectively, arthrosclerosis 26.6%, thrombophlebitis 12.8%. Arthrosclerosis and phlebitis increased with the duration of diabetes (p < 0.05). Conclusion: The longer duration of diabetes was correlated with more complications in older ages, particularly marcro- and micro-vascular diseases. Keyword: Diabetic complication, diabetes in older age

T L MC V CC YU T NGUY C GY I THO NG TP 2 TI BNH VIN A KHOA NG ANH

Nguyn Th Tm , Phm Thng
1

Cao hc 18- Trng i hc Y H Ni, 2Bnh vin Lo khoa Trung ng

nh gi t l mc v cc yu t nguy c gy i tho ng (T) ti bnh vin a khoa ng Anh. Nghin cu m t hi cu trn 701 bnh nhn c chn on T v t l mc T v cc yu t nguy c ca bnh vi c th ring ca ng Anh. Kt qu: t l mc T tng nhanh, nm 2007: 8,67%, 2008: 11,68%, 4 thng u nm 2009: 13,66%, p < 0,05. Tui trung bnh pht hin bnh l 48 (31-82), nhm tui cao nht trn 55: 62,05%. T l mc T tng t l thun theo tui (p < 0,005). T typ 2 c BMI t 18,5 - 23: 67,05% ; BMI > 23: 32,95%. T l T typ 2 c tng huyt p l 27,53%. T l bnh nhn thuc th h th nht mc T l 21,5%, ri lon lipid mu chim t l cao nht 29,39%, goutte chim 1%, lao phi : 2%, tai bin mch mu no chim 1,59%, x gan: 1,69%, bnh mch vnh chim 1%. Kt lun: T l mc T tng nhanh c bit trn cc i tng c mt s yu t nguy c. T kho: i tho ng, nguy c ca i tho ng

Summary PREVALENCE AND RISK FACTORS FOR TYPE 2 DIABETES IN DONG ANH GENERAL HOSPITAL, HANOI
Evaluate prevalence and typical risk factors for type 2 diabetes in Dong Anh General Hospital. Patients and Methods: retrospective observational design. 701 diabetic patients admitted to Dong Anh General Hospital, Hanoi from 1/2007 to 4/2009 were involved in our study. Results: Prevalence of diabetes rapid increases (2007: 8,67%, 2008: 11,68%, fist four months of 2009: 13,66%). Average age at the time of diabetic diagnose is 48 years old (range from 31 - 82), prevalence of diabetes increase with the age (p < 0,005), with the highest for age group more than 55 years old. Normal BMI (18,5- 23): 67,05%; BMI >23 : 32,95%, the data suggest that Dong Anh is the rural area with low economics and knowledege of patients on disease, therefore they come to hospital rather late with obvious symptoms. Of all type 2 diabetes, 27,53% had diabetes and hypertesion at the time of diagnose, 21,5% had diabetes in first generation in family history, 29,39% with hyperlipide mia, 1% gou tte, 2% tube rculosis, 1,59% ischemic and he mmorrage cerebra l vascular, 1,69% cirhosis, 1% cardiovascualar diseases. Conclusion: Prevalence of typ 2 diabetes was increasing, especially on patients with some risk factors such as older age, obesity and overweight, family history with diabetes, hypertension. Key words: Diabetes, risk factors for type 2 diabetes

SNG LC RI LON NUT THEO GUSS BNH NHN T QU NO CP TI BNH VIN C MAU NM 2010
Phan Nht Tr , Phm Thng
1

Bnh vin a khoa tnh C Mau, 2Bnh vin Lo khoa Trung ng

Xc nh t l ri lon nut v kho st mi lin quan ca ri lon nut vi vim phi cng nh nh hng ln ton cc bnh nhn t qu no cp. Nghin cu trn 80 trng hp t qu no cp t 08/2010- 12/2010 c ri lon nut theo GUSS. Kt qu: t l ri lon nut l 82,5%. T l vim phi nhm bnh nhn c ri lon nut l 65.2% so vi 7,1% nhm khng c ri lon nut OR 24,3 (95% CI 3 - 197,7) p < 0,001. Kt lun: C th ri lon nut l nguyn nhn chnh gy vim phi bnh nhn t qu cp, do cn thit nghin cu v xut quy trnh nui dng theo ri lon nut bnh nhn t qu.

T kho: Ri lon nut, vim phi, t qu, GUSS

Summary THE RATE OF DYSPHAGIA AND THE RELATIONSHIP BETWEEN DYSPHAGIA, PNEUMONIA AND ACUTE STROKE
To access the rate of dysphagia and the relationship between dysphagia and pneumonia and acute stroke. Subjects and Methods: 80 acute stroke cases with dysphagia as GUSS method from August 2010 to December 2010. Results: the rate of dysphagia is 82.5%. The rate of pneumonia among patients with dysphagia is 65.2% compared to 7.1% in the group without dysphagia OR 24.3 (95% CI 3 to 197.7) p < 0.001. Conclusions: Dyspphagia can be a major cause of pneumonia in patients with acute stroke. Therefore the necessary research and nurtured the process proposed by dysphagia in stroke patients. Keyword: dysphagia, pneumonia, acute stroke, GUSS

NGHIN CU TNH HNH IU TR U HC MT TI BNH VIN MT TRUNG NG GIAI ON 2005- 2009

Phm Trng Vn , Mai Quc Tng
1

Trng i hc Y H Ni, 2Trng i hc Y Thi Nguyn

U hc mt xut hin ngy cng nhiu, hin nay cha c nhiu nghin cu nh gi v cn bnh ny. Mc tiu: y l nghin cu trong 5 nm (2005- 2009) nhm m t c im dch t hc v lm sng ca mt s loi u hc mt thng gp. Nghin cu hi cu trn 237 bnh nhn c h s v kt qu gii phu bnh. U hc mt xut hin vi t l ngy cng nhiu theo thi gian. T l mc bnh cng khc nhau theo vng v i tng bnh nhn. Ty theo loi u hc mt la tui mc bnh v biu hin lm sng thay i khc nhau. Kt lun: U hc mt ang tr thnh mt loi bnh mt xut hin rt a dng v phc tp i hi c quan tm ng mc. T kha: u hc mt

Summary ORBITAL TUMORS IN VIETNAM NATIONAL INSTITUTE OF OPHTHALMOLOGY: A RETROSPECTIVE STUDY (2005- 2009)
Orbital tumor is being known at increasing incidence. Up to date, no official data on this disease is collected in Vietnam. Objective: This is the first retrospective study over 5 years (2005 - 2009) on emidemiological and clinical aspects of common tumors. Materials and Methods: 237 patients are investigated on the basement of pathological and clinical data. Results: The incidence of orbital tumor increases with differences between regions and individuals. Conclusion: Orbital tumor is becoming a common eye disease with complexity which deserves to be an attention. Keyword: orbital tumor

NG DNG TH TRNG K HUMPHREY MATRIX PHT HIN TN THNG TH TRNG TRONG BNH GLCM GC M NGUYN PHT
1

o Th Lm Hng1, L Quang Knh2, 2 Bnh vin a khoa ng Anh, Bnh vin Mt Trung ng,

nh gi gi tr chn on tn thng th trng ca th trng k H. Matrix so vi my th trng k SAP. i tng: 48 mt (27 bnh nhn) glcm gc m nguyn pht v nghi ng glcm iu tr ti khoa Glcm bnh vin Mt Trung ng t 9/2009 n 9/2010. Phng php: M t, ct ngang. Kt qu: Thi gian o trung bnh Humphrey Matrix l 311,7 17,3, my SAP l 351,5 52,2 giy. Ngng cm th trung bnh vng mc ca my H. Matrix l 17,6 10,7dB my SAP l 20,8 11,3 dB. rng trung bnh tn thngca my SAP l 17,4 14,8 v tr, my H. Matrix l 14,8 12,5 v tr. su trung bnh tn thng my H. Matrix = 10,4 8,0dB, my SAP = 17,5 12,9dB. dao ng ngng cm th trung bnh gia hai ln khm nghim ca my H. Matrix l 4,86 0,41 dB, my SAP l 5,26 0,43dB. Kt lun: Tn thng c pht hin trn my H. Matrix su hn my SAP, nhng rng tn thng c pht hin trn my SAP li ln hn H. Matrix. dao ng ngng cm th cc v tr vng mc gia cc ln khm nghim my H. Matrix t hn v ng nht hn so vi my SAP.

T kha: Glcm gc m, th trng k

Summary APPLICATION OF HUMPHREY MATRIX PERIMETRY IN DETECTING THE VISUAL FIELD DEFECTS IN OPEN- ANGLE GLAUCOMA PATIENTS
To assess visual field (VF) defects found by Zyppy Estimated Test (ZEST) in a 24- 2 test pattern of Humphrey Matrix perimetry. Design: Descriptive cross-sectional study. Participants: Forty eight glaucoma or suspected glaucoma eyes of 27 subjects were recruited for an observational study. Methods: All eyes were eligible for study measured VF with standard automated perimetry (SAP), program 24- 2, SITA strategy and with Humphrey Matrix, program 24- 2, ZEST strategy. Results: Test duration was significantly shorter for Matrix (SAP, 351.5 52.2 seconds; Matrix, 311.7 17.3 seconds; p < 0.05, t- test). The Humphrey Matrrix showed VF defects more than SAP one eye. Mean threshold value was significantly lower with Matrix compared to SITA (p < 0.001, paired t- test). There was no significant difference in MD and PSD between the 2 devices (P> 0.05, paired t- test). Matrix delineated significantly 2 smaller (p < 0.05, - test) and deeper (p < 0.05, t- test) defects than those found with SITA. The test retest intervals of FDT2 was nearly uniform contrasted with those of SAP.Conclusions: Matrix field defects were smaller and deeper than those appearing in SITA perimetry. The testretest intervals of FDT2 was nearly uniform over the measurement range of the instrument, contrasted with those of SAP. Ability to detect VF defects of the two devices are the same. Keywords: open angle glaucoma, visual field, perimetry

IU TR BNH LON DNG NI M GIC MC DI TRUYN FUCHS BNG GHP GIC MC XUYN
L Xun Cung, Hong Minh Chu
Bnh vin Mt Trung ng nh gi kt qu ca phu thut ghp gic mc xuyn iu tr bnh lon dng ni m gic mc di truyn Fuchs v tm hiu cc yu t nh hng n kt qu ca phu thut. i tng v Phng php: Can thip lm sng khng i chng. 9 mt (8 bnh nhn) b lon dng ni m gic mc di truyn Fuchs c phu thut ghp gic mc xuyn ti khoa Kt gic mc, Bnh vin Mt Trung ng t thng 6 nm 1999 n thng 6 nm 2008. Kt qu: Sau m mt nm c 5 mt (55,6%) c mnh ghp trong, 2 mt (22,2%) mnh ghp m v 2 mt (22,2%) mnh ghp c. Mc d t l mnh ghp trong c gim dn sau m nhng sau 4 nm vn c 50% mnh ghp trong. Sau m mt nm c 3 mt c th lc tt (3/10 n < 5/10), 4 mt c th lc < m ngn tay (NT) 3 mt (m). Sau m 4 nm vn cn 25% s mt c th lc t 5/10 n 8/10. Hai mt (22,2%) xut hin phn ng loi mnh ghp dn n hng mnh ghp v mt mt b hng mnh ghp nguyn pht. Khng c trng hp no b bin chng trong phu thut. Kt lun: Ghp gic mc xuyn cho kt qu tt vi bnh lon dng ni m gic mc Fuchs. Cc yu t gy c mnh ghp l: phn ng loi mnh ghp v hng mnh ghp nguyn pht. T kha: lon dng ni m gic mc di truyn Fuchs, ghp gic mc xuyn

Summary TREATMENT FUCHS, ENDOTHELIAL DYSTROPHY BY PENETRATING KERATOPLASTY

To evaluate the results of corneal grafting in Fuchs, endothelial dystrophy. Method: Eight patients (9 eyes) with Fuchs , endothelial dystrophy were treated by penetrating keratoplasty in the Corneal and External Disease Department, National Institute of Ophthalmology. Two eyes were regrafted and one patient was operated in both eyes. Preoperative and postoperative visual acuity were recorded, the corneal graft were observed periodically. Result: Three eyes showed a visual acuity of 3/10- 5/10, while 4 eyes had visual acuity less 4 m of finger count in one year postoperatively. Five grafts (55,6%) were clear and 4 grafts were cloundy. Two cases (22,2%) had periods of graft rejection and one eye had primary graft failure. No case had inoperative complications. Conclusion: Penetrating keratoplasty is an effective , procedure for treating Fuchs endothelial dystrophy. The graft oedema might be associated with graft rejection and primary graft failure. Keywords: fuchs, endothelial dystrophy, penetrating keratoplasty

BIN CHNG MT TR I THO NG

Ng Th Phng Nga1, Nguyn Ph t2
1

Bnh vin Nhi Trung ng, Trng i hc Y H Ni

Nhn xt cc bin chng mt tr em T ang iu tr ti Bnh vin Nhi Trung ng v mi lin quan gia bin chng mt vi kim sot glucose huyt. Tt c cc bnh nhn c chn on T tp 1 ang c iu tr v theo di ti Bnh vin Nhi Trung ng, bnh n theo di ngoi tr t 12/1999- 12/2009, c thi gian iu tr trn 1 nm. Nghin cu m t c phn tch, va hi cu va tin cu. Kt qu: T l bin chng mt tng ln t 25,5% trong 5 nm u b bnh ln n 100% (4/4 bnh nhn) sau 15 nm b bnh T. Bnh vng mc gp nhiu nht chim 77,8%, c thy tinh th 58,3%, tn thng kt hp l 36,1%. Gim th lc mc nng 3/10 chim t l 41,7%. T l bin chng mt cao gp 4 ln bnh nhn kim sot khng tt HbA1c so vi kim sot tt. Kt lun: Bin chng mt tng dn theo thi gian mc bnh T. Bin chng mt hay gp nht l bnh vng mc. Nguy c bin chng mt cao gp 4 ln bnh nhn kim sot glucose huyt khng tt so vi kim sot tt. T kho: bin chng mt, i tho ng tr em

Summary EYE COMPLICATIONS DIAETES IN CHILD

Diabetes mellitus is a disease which can cause serious complications leading to disability or death. Diabetes mellitus is ranked the second reason leading to blindness in adults. Blood glucose control with HbA1c test is the best way to reduce the risk of eye complications. Objectives: 1. Reviews eye complications of diabetes in children being treated at the National hospital of pediatrics (NHP). 2. Reviews the relationship between eye complications with blood glucose control. Subjects: All patients with type 1 diabetes diagnosed for more than 1 year, treated, and monitored at the NHP since 12/1999 - 12/2009. Method: Study was descriptive combined between retrospective and prospective parts. Results: The rate of eye complication increased from 25.5% in first 5 years of illness up to 100% (4/4 patients) after 15 years with diabetes. Retinopathy was the most common, accounting for 77.8%. Cataract occupied 58.3%; combined lesion 36.1%. Severe vision loss with acuity 3/10 accounted for 41.7%. In patients with poor HbA1C control, eye complication rate was 4 times higher than that in patients with good HbA1c control. Conclusion: Eye complications increases over time with diabetes. The most common eye complication is retinopathy. The risk of eye complication was 4 times higher in patients with poor blood glucose control compared with good control. Keywords: eye complications, diabetes in children

IU TR GY KN HAI XNG CNG CHN BNG KT HP XNG NP VT XM LN TI THIU

Ng Vn Ton Bnh vin Vit c
Nghin cu nhm nh gi kt qu iu tr gy kn hai xng cng chn bng kt hp xng np vt xm ln ti thiu v nhn xt mt s yu t nh hng n kt qu iu tr trn bnh nhn (BN) gy 2 xng cng chn ti khoa Chn thng Chnh hnh Bnh vin Vit c t 2007- 2009. Thit k th nghim lm sng ngu nhin t i chng trn 38 bnh nhn gy kn xng cng chn ngi ln bng phng php m kt hp xng np vt xm ln ti thiu, theo di lin tc cho ti khi tho np. Kt qu: 73,32% bnh nhn gp nhm 16- 49 tui; Bnh nhn nng thn chim t l cao 73,68%; Gy phc tp v gy c mnh ri chim t l kh cao (39,47% v 34,21%). Tai nn giao thng l ch yu v cng l nguyn nhn ca cc bnh nhn b gy phc tp; 94,74% cc trng hp cho kt qu iu tr tt v rt tt, Tt c cc bnh nhn u khi trc 10 thng, lin xng trc 6 thng 21,6% Nhng bnh nhn gy xng c mnh ri v gy phc tp c nguy c thi gian iu tr khi sau 6 thng gp 5 ln so vi nhng bnh nhn ch gy n gin. Kt lun: Tt c cc bnh nhn u khi trc 10 thng, 94,74% cc trng hp cho kt qu iu tr tt v rt tt, lin xng trc 6 thng 21,6%. Gy phc tp l yu t nh hng n kt qu iu tr.

T kha: phu thut xm ln ti thiu, gy xng kn

Summary TREATMENT FOR HERMETICALLY FRACTURED TIBIA USING MINIMALLY INVASIVE SURGERY AND OSSEOINTEGRATION OF THE BONE WITH THE SCREW
This study assessed the treatment outcomes of minimally invasive surgery and bone- screw osseointegration for hermetically fractured tibia, and explored some factors associated with the treatment outcomes of patients at Department of Orthopaedics, Viet Duc Hospital during 2007 - 2009. Subjects and Methods: We designed an experiment study and operated 38 adult cases with hermetically fractured tibia using the minimally invasive surgery which integrated bone and screw, and then continuously monitored patients until taking off the screw. Results: 73.32% patients were 16- 49 years old. There was a high proportion of rural patients (73.68%), the majority of injury was complex fractures or fractures with separate pieces (39.47% v 34.31%). Traffic accidents were main causes, especially for complex fractures. All patients have healed bone before 10 months. 94.74% patients had treatment outcomes of good and very good, and patients had healed bone within 6 months accounted for 21.6% of all patients. The risks of patients who sufferd from the complex fractures or fractures with separate pieces will have healed bone after 6 months 5 times higher than that other simple fractures. Conclusions: All patients have healed bone before 10 months. 94.74% patients had treatment outcomes of good and very good, and patients had healed bone within 6 months accounted for 21.6% of all patients. Complexity of the fractures was an influential factors to treatment outcomes. Keyword: minimally invasive surgery, hermetically fractures

PHU THUT NI SOI IU TR TI TO DY CHNG CHO TRC KHP GI BNG GN C THON V GN C BN GN T THN
Trn Hong Tng, Ng Vn Ton
Bnh vin Vit c Nghin cu nhm nh gi kt qu iu tr phu thut ni soi ti to dy chng cho trc khp gi bng mnh ghp gn c thon v gn c bn gn t thn v nhn xt mt s yu t nh hng n kt qu iu tr cc bnh nhn ti khoa Chn thng chnh hnh, bnh vin Vit c t 2005- 2010. Thit k nghin cu l th nghim lm sng t i chng, trn 512 bnh nhn ti bnh vin Vit c. Theo di lin tc sau m di nht l 2 nm v ngn nht l 5 thng. Kt qu: a phn bnh nhn tui 18 - 49 (87,1%), nguyn nhn ch yu l do tai nn giao thng (59,1%). Theo di xa sau m t l tt v rt tt t 94,3 %. Kt lun: Phu thut ni soi ti to dy chng cho trc bng mnh ghp gn c thon v gn c bn gn t thn cho kt qu kh quan, t l tt v rt tt t 94,3%, di chng vng ly gn l khng ng k. Tn thng phi hp, luyn tp sau m v ng knh ca dy chng l cc yu t nh hng n kt qu iu tr. T kha: dy chng cho trc, mnh ghp gn c thon v gn c bn gn t thn

Summary APPLICATION OF ARTHROSCOPICALLY ASSISTED SURGERY FOR RECONSTRUCTING THE ANTERIOR CRUCIATE LIGAMENT USING SEMITENDINOSUS AND GRACILIS TENDON AUTOGRAFT
To evaluate treatment outcomes of arthroscopically assisted surgery for reconstructing the anterior cruciate ligament using semi- tendinosus and gracillis tendon autograft, and to explore some influential factors to treatment outcomes of patients at Department of Orthopaedics, Viet Duc Hospital during 2005 2010. Subjects and Methods: We designed an experiment study of 512 patients at Viet Duc hospital, with follow- up after operations from 5 months up to 2 years. Results: Most of the patients were 18 - 49 years old (87.1%), main cause of ACL rupture was traffic accidents (59.1%). Monitoring of long- term outcomes after operation indicated that the percentage of patients having good and very good results was 94,3%. Conclusions: Arthroscopically assisted surgery for reconstructing the anterior cruciate ligament using semi- tendinosus and gracillis tendon autograft showed positive results, with very high proportion of good and very good outcomes, and trivial adverse effects. Concurrent wounds, practices after operations, and diameter of the ligament were factors which influenced the outcomes of treatment. Keyword: anterior cruciate ligament, semi- tendinosus and gracillis tendon autograft

BNH TNG AXIT METHYLMANOLIC MU

Nguyn Ngc Khnh1, Nguyn Ph t2
1

Bnh vin Nhi Trung ng, Trng i hc Y H Ni

M t c im lm sng, xt nghim c bn v nh gi kt qu iu tr. i tng v Phng php: 12 bnh nhn c chn on MMA ti Bnh vin Nhi Trung ng t thng 1 nm 2005 n thng 6 nm 2010 bng phng php GC/MS nh lng axit hu c niu v phng php Tandem mass nh lng axit amin mu ti Hc vin Shimane - Nht Bn. Kt qu: 12 bnh nhn trong 11 gia nh, 5/11 c tin s gia nh trn 2 con b bnh. 10/12 bnh nhn c bnh cnh cp tnh vi tui xut hin bnh di 1 tui. Biu hin lm sng ni bt ca cn cp l kh th (100%), li b (100%), mt nc (100%) sau khi nn (90%), st (70%), a chy (50%). c im chnh ca xt nghim trong cn cp l nhim toan chuyn ho (100%), ceton niu (80%), tng amoniac (80%), tng lactic (70%), gim bch cu v tiu cu (50%). 2 bnh nhn c bnh cnh mn tnh vi triu chng: chm pht trin th cht v chm pht trin tinh thn khng r nguyn nhn, vim da ko di, tc vng hoe; trong khi cc xt nghim c bn hu ht trong gii hn bnh thng. Tin lng nng n: 50% bnh nhn t vong trong cc t cp; tui t vong trung bnh: 12 7 thng; 100% bnh nhn cn sng c di chng chm pht trin tinh thn, vn ng v th cht.

T kho: methylmalonic acidemia, methylmalonic aciduria

Summary METHYLMALONIC ACIDEMIA

Methylmalonic acidemia (MMA) is a disorder of amino acid metabolism, involving a defect in the conversion of methylmalonyl CoA to succinyl- CoA. It is one of the most common inborn errors of metabolism in Vietnam. Objects: 1) To describe clinical and laboratory manifestations; 2) To evaluate treatment results. Subjects: 12 patients were diagnosed MMA by GC/MS and Tandem mass methods in Shimane Institute Japan. Results: 12 cases are of 11 families. 5/11 families have more than 2 affected children. 10/12 cases had acute metabolic decompensations, that their onset were under 1 years of age. Clinical manifestations of the acute episodes were dyspnea (100%), lethargy/coma (100%), dehydration (100%) which were trigged by vommiting (90%), fever (70%), diarrhea (50%). In acute episodes, laboratory findings showed metabolic acidosis (100%), ketonuria (80%), hyperamonemia, hyperlacticemia (80%), thrombopenia and neutropenia (50%). 2 chronic cases had unknown mental retardation and growth failure, prolong dermatitis, blonde hair while their laboratory findings showed normal level. There were poor prognosis: 50% cases died during acuet episodes; median age of death were 12 7 months; 100% cases had secondary complications: mental retardation, movement disorders, growth failure. Conclusions: MMA is a common IEMs characterized by acute metabolic decompensation and poor prognosis. More researchs have been done to improve treatment results. Keywords: Methylmalonic acidemia, Methylmalonic aciduria

TM HIU MI LIN QUAN GIA BT THNG NHIM SC TH VI TNG KHONG SNG SAU GY THAI NHI
Trn Danh Cng Bi Hi Nam
1

Trng i hc Y H Ni, 2i hc Y Thi Nguyn

Nghin cu nhm xc nh t l bt thng NST nhng trng hp thai nhi c tng khong sng sau gy (KSSG). i tng v Phng php: thc hin trn 250 thai ph c thai c o KSSG tui thai 11 13 tun 6 ngy, xc nh l tng KSSG vi ngng l 3,0 mm v c t vn chc ht nc i phn tch NST thai nhi. Kt qu: t l bt thng NST chung l 32,4% nhng trng hp tng KSSG. Trong hi chng Down (trisomie 21) chim 12,4%, hi chng Turner (45, X) chim 12%, hi chng Edwards (trisomie 18) chim 5,6%, bt thng cu trc khc ca NST chim 1,6%, hi chng Patau (trisomie 13) chim 0,8%. Vi s o ca KSSG t 3,0 3,9mm th t l bt thng NST l 10,1%, 4,0 4,9mm l 29%, 5,0 5,9mm l 48%, 6mm l 64%. Kt lun: tng KSSG l du hiu siu m c gi tr quan trng pht hin sm bt thng NST, khong sng sau gy cng ln th t l d dng NST cng cao.

T kha: bt thng nhim sc th, tng khong sng sau gy

Summary RELATION BETWEEN INCREASED FETAL NUCHAL TRASLUCENCY THICKNESS AND CHROMOSOMAL DEFECT
Nuchal translucency (NT) is sonographic appearance of collection of fluid under the skin behind the fetal neck in the firt- trimester of pregnancy. NT is a physiological feature of a fetus and can be measured from 11- 13 week 6 days of gestation age. NT plays an important part in screening chromosomal disorders. Increase of NT between 11 to 13 week 6 days is considered a suggestive signs of chromosomal disorders of the fetus. Objectives: to evaluate the rate of chromosomal disorder in the fetuses with increase of nucal translucency thickness. Materials and Methods: we measured NT of 250 pregnant women in 11- 13 week 6 days of gestation. Above 3.0 mm considered not normal. Results: the rate of chromosomal disorder is 32.4% in those cases of increase of NT among those trisomy 21 is 12.4%, monosomy X is 12%, trisomy 18 is 5.6%, trisomy 13 is 0.8% and structural disorder is 1.6%. With the range from 3.0 to 3.9 mm, the rate of chromosomal disorder is 10.1%, 4.0 to 4.9 mm is 29%, 5.0 to 5.9 mm is 48% and above 6 mm is 64%. Conclusion: increased fetal NT is a suggestive signs of chromosomal disorder. The thicker nuchal translucency is the higher risk chromosomal disorders. Keywords: chromosomal disorders, defects, increased nuchal translucency

THC TRNG S DNG CC BIN PHP TRNH THAI PH N 15 - 49 TUI TI IN BIN NM 2008
Hong Minh Hng
Trng i Hc Y H Ni Nghin cu c tin hnh nhm nh gi thc trng s dng cc bin php trnh thai (BPTT) ph n 15 - 49 tui c chng ti huyn in Bin nm 2008. i tng l 808 ph n trong tui sinh t 15 - 49 tui c chng tnh n thi im iu tra t thng 1 n thng 5 nm 2008. S liu c x l v phn tch bng chng trnh EPI INFO 6.04. Kt qu: 60,8% ph n huyn in Bin hin ang s dng cc BPTT. Dng c t cung l BPTT c ph n s dng nhiu nht (42,5% vng cao, 43,1% vng thp). Thuc ung trnh thai t t l khong 11% c 2 vng. Trong cc i tng khng s dng bin php trnh thai, l do ph bin nht l s nh hng sc khe v mun sinh thm con. Kt lun: cn y mnh cng tc gio dc truyn thng nng cao s hiu bit v s ngi s dng cc bin php trnh thai hn na cho ph n in Bin.

T kha: ph n trong tui sinh , bin php trnh thai

Summary CONTRACEPTIVE METHODS AMONG REPRODUCTIVE WOMEN AGED 15 - 49 YEARS OLD IN DIEN BIEN, IN 2008
To evaluate the reality of using contraceptive methods among reproductive women aged 15- 49 years old in Dien Bien District in the year 2008. Subjects and research Method: 808 women having husbands in reproductive age (15- 49 years old) were interviewed from January to May 2008. Data were analysed by software EPI- INFO version 6.04. Results: 60.8% of maried women were using contraceptive methods. Intra- Uterine Device (IUD) was the most popular method applied by the women (42.5% in high land and 43.1% in low land). 11% reproductive women used oral contraceptive in both areas. Among women not used any types of contraceptive methods, the most popular reason was to afraid of side effect of health and want to have more children. Conclusion: it is necessary to improve educational media to increase knowlege and number of women using contraceptive methods in Dien Bien District. Keyword: reproductive women, contraceptive methods

NH GI KT QU IU TR C TH THY TINH TRN MT M BONGVNG MC BNG PHNG PHP TN NHUYN TH THU TINH
Cung Hng Sn , Nguyn Quang Minh
1

Bnh vin Mt Trung ng, 2Trung tm PCBXH Hi Dng.

nh gi kt qu ca phu thut phaco trn mt c du silicon ni nhn; m t cc c im v k thut ca phu thut phaco, t th thu tinh nhn to trn mt c du silicon ni nhn. i tng v Phng php: nghin cu th nghim lm sng tin cu khng c nhm i chng trn 38 bnh nhn b c th thu tinh trc c phu thut bong vng mc c bm du silicon ni nhn ti khoa. y mt mng b o bnh vin Mt Trung ng t thng 10/2009 n thng 7/2010. Kt qu: Th lc sau phu thut ci thin 97,4% % tng s mt c phu thut, th lc khng ci thin 2,6% tng s mt c phu thut. Cc bin chng trong v sau m t. c bao sau l bin chng hay gp nht, chim t l 26,3%. 7 mt c phn ng mng b o v 2 mt ph gic mc. Cc bin chng ny mt i sau iu tr ni khoa khng li di chng. Kt lun: Phu thut phaco trn mt m bong vng mc c du silicon ni nhn mang li kt qu tt. Th lc sau phu thut ci thin 97,4%, khng ci thin 2,6%.

T kho: bong vng mc, du silicon, phacoemulsification

Summary STUDY PHACOEMULSIFICATION SURGERY ON THE EYE HAD RETINAL DETACHMENT SURGERY WITH INTRAOCULAR SILICON OIL
To evaluate the results of Phacoemulsification surgery on the eye with intraocular silicone oil; describes the technical characteristics of Phacoemulsification surgery and implantation in eye intraocular silicone oil. Methods: a study of clinical trials carried no control group study on 38 patients cataract may have been previous retinal detachment surgery with intraocular silicone oil injection in Eye Hospital Central from January to March 10/2009, 7/2010. Results: Vision improved after surgery in 97.4% of eye surgery, vision is not improved at 2.6% of eye surgery. The postoperative complications and less had posterior capsule opaque accounting for 26.3% rate. 7 eyes with inflammatory membrane and two eye with corneal. These complications go away after medical therapy does not leave sequelae. Conclusion: Phacoemulsification surgery on the eye had retinal detachment surgery with intraocular silicone oil brought good results. Postoperative vision improved in 97.4%, no improvement at 2.6%. Keyword: retinal detachment, silicone oil, phacoemulsification

NH GI KT QU PHU THUT CHN THNG CT SNG BN L NGC THT LNG TI KHOA PHU THUT CT SNG BNH VIN VIT C T 1/2010 N 4/2010
Nguyn Vn Thch1, Hong Minh Hng2
1

Bnh vin Vit c, Trng i hc Y H Ni

nh gi kt qu phu thut BN gy ct sng ngc - tht lng c lit. i tng v Phng php: Bao gm cc trng hp chn thng ct sng bn l ngc - tht lng c lit, khng phn bit gii v tui, c phu thut ti khoa Phu thut ct sng bnh vin Vit c trong thi gian t 1/2010 n 4/2010. S liu c phn tch bng phn mm SPSS 16.0 v s dng thut ton so snh hiu nh gi cc ch s cc thi im. Kt qu: Kt qu chung thy Tt: 30 BN (78,9%) phc hi hon ton. Kh: 5 BN (13,2%) phc hi hon ton v vn ng v cm gic, nhng cn ri lon c trn nh v i tin. Trung bnh: 2 BN (5,3%) hi phc v vn ng t sinh hot c nhn, nhng cm gic cha c tt v cn ri lon c trn. Xu cn 1 BN (2,6%) t i li trong phng c, nu i ra ngoi phi c tr gip, c lc 4/5 im theo phn loi AISD, cn ri lon c trn km theo c lot vng t cng ct. Sau m t l gim chiu cao thnh trc thn t sng ci thin c 53% so vi trc m (p < 0,001). Sau 6 thng t l ci thin gc g thn t (GT) l 56%, gc g vng chn thng (GGVCT) ci thin c 81% so vi trc phu thut (p < 0,001) v sau 6 thng khng thy c s khc bit so vi thi im sau phu thut (p > 0,05). Nh vy l sau 6 thng khng thy g vng ti pht.

T kha: phu thut, chn thng ct sng ngc - tht lng c lit

Summary OPERATIVE EVALUATION FOR THORACOLUMBAR FRACTURES WITH NEUROLOGIC DEFICITS AT SPINAL SURGERY DEPARTMENT OF VIETDUC UNIVERSITY HOSPITAL FROM JANUARY 2010 TO APRIL 2010
Evaluating surgery results for traumatic thoracolumbar spinal fractures with neurologic deficits patients. Subjects and research Methods: This includes surgeries for all patients with traumatic thoracolumbar spinal region fractures with neurologic deficits, regardless of ages and genders, implemented at spinal surgery department Vietduc university hospital during the period of January 2010 to April 2010. Data were were analyzed by SPSS software version 16.0 and T- test. Results: For neurologic outcomes: 30 patients (78.9%) get good results and recovered completely; 5 patients have fair results (13.2%) and complete recovery of movement and senses, but still have some sphincter deficits. An average results of 2 patients (5.3%) recovered self- movement, but still have senses and sphincter deficits. Only 1 patient with bad result (2.6%) is able to move around the room, but needs assistance to go out, evaluated at 4/5 points in the ASIA D classification, along with persistent problems of sphincter and skin sore in coccyx area. For outcome of correction: Postoperative rate of decreased front height of the traumatic operated vertebrae body is 53% better compared with before the surgery (p < 0.001). After 6 months, the rate of improvement of vertebral kyphosis angle is 56% while the kyphosis angle for spinal region improved 81%, compare to before the surgery (p < 0.001), and after 6 months no difference was found compared with just after surgery (p > 0.05). We can conclude that after 6 months no recurrence of the hunchback was found. Keyword: surgery, traumatic thoracolumbar spinal fractures with neurologic deficits

KINH NGHIM GHP M B TRONG PHU THUT TO HNH MT

Phm Trng Vn1, Nguyn Th Thu Trang2
1

i hc Y H Ni, Bnh vin i hc Y Hi Phng

Trnh by kinh nghim v ghp m b iu tr mt s bin i mi v hc mt. i tng: 24 bnh nhn c ghp m b t nm 2007 n 2010. Ch nh iu tr bao gm lm mi mt v cn hay i km bin i cng sau b nhn cu, thiu ht t chc mm hc mt. Kt qu: Chng ti khng gp hin tng hoi t do thiu mu mnh ghp. Mnh ghp c biu m kt mc che ph trong 6-8 tun l. M b hp th biu hin r khi ghp di cn vch hc mt. Ghp m trong hay ngoi chp c t kt qu tt hn. Kt lun: Ghp m b l mt phng php c tc dng trong to hnh mt c bit trong iu tr cc thiu ht t chc mm hc mt. T kho: ghp m b, to hnh mt

Summary DERMOFAT IN ORBITAL AND EYELID PLASTIC SURGERY

To present our experience with dermofat graft in oculoplastic surgery. Methods: In period from 2007 until 2010, 24 patients have undergone transplantation of dermofat for orbital tissue insufficiency, eyelid hollowness and deformed socket after enucleation. Results: We experience no major complication. Intraconal dermofat graft can be epithelized with conjunctival epithelium. Fat resorption can be encountered, especially when preseptal transplantation is done. Conclusion: Dermofat is a valuable autologous material used in oculoplastic surgery. Keyword: dermograft, oculoplastics

NHN XT KINH NGHIM X TR RAU CI RNG LC THAI PH B RAU TIN O C SO M C TI BNH VIN PH SN TRUNG NG TRONG 2 NM 2008 2009
inh Vn Sinh1, ng Th Minh Nguyt2
1

Bnh vin a khoa Ngh An, Trng i hc Y H Ni

Nhn xt thi x tr rau ci rng lc (RCRL) thai ph b rau tin o (RT) c so m c (SMC) ti Bnh vin Ph sn Trung ng trong 2 nm 2008 2009 v cc tai bin thng gp. i tng v Phng php: Nghin cu hi cu t 110 trng hp rau tin o (RT) c h s vi tui thai t 28 tun tr ln, c so m c, c chn on l RT qua lm sng v siu m, c ti BVPST trong thi gian t ngy 1 thng 1 nm 2008 n ngy 31 thng 12 nm 2009. Kt qu: C 24 trng hp c chn on RCRL, t l RCRL thai ph b RT c SMC chim 21,8%, t l RCRL nhm tui > 35 chim t l cao nht. iu tr: T l phi ct t cung bn phn thp, chim 91,67% trong c 2 trng hp ct t cung bn phn thp (BPT) km tht ng mch h v. Bin chng tn thng tng vng tiu khung do RCRL chim t l 85,7%, t l phi truyn mu l 70,8% trong s trng hp phi truyn trn 3 n v chim 6%. Kt lun: T l phi ct t cung bn phn thp chim 91,67% trong c 2 trng hp ct t cung BPT km tht ng mch h v. Bin chng tn thng tng vng tiu khung do RCRL chim t l 85,7%, t l phi truyn mu l 70,8% trong s trng hp phi truyn trn 3 n v chim 6%. T kho: rau tin o, rau ci rng lc

Summary DIAGNOSIS AND TREATMENT ATTITUDES PLACENTA ACCRETE AT PLACENTA PREVIA AFTER A PRIOR PREGNANCY DELIVERED BY CESAREAN
Reviews diagnosis and treatment attitudes placenta accrete at placenta previa after a prior pregnancy delivered by cesarean in the National Hospital of Obstetrics for 2 years from 2008 to 2009 and common hazards. Subjects and research Method: Non-probability retrospective research on 110 cases placenta previa after a prior pregnancy delivered by cesarean in the National Hospital of Obstetrics for two years from 2008 to 2009 including 24 cases placenta accreta. Results: 24 cases diagnosed placenta accreta, placenta accreta rate in women with placeta accreta have accounted for 21.8% pregnancy delivered by cesarean, placenta accreta rate in the age group over 35 accounted for the highest. Treatment: hysterectomy rate to sell low accounting for 91.67% of which 2 cases Peripartum hysterectomy with Hypogastric artery ligation. Organ damage due to complications placenta accreta percentage 85.7%, the rate is 70.8% of blood transfusions in which the number of cases transmitted to the three units accounted for 6%. Conclusion: Hysterectomy rate to sell low accounting for 91.67% of which 2 cases Peripartum hysterec tomy with Hysterectomy artery ligation. Organ damage due to complications placenta accreta percentage 85.7%, the rate is 70.8% of blood transfusions in which the number of cases transmitted to the three units accounted for 6%. Keywords: placenta accrete, placenta previa

HIU QU IU TR CA VIN NN TADIMAX TRN BNH NHN PH I LNH TNH TUYN TIN LIT TI BNH VIN LO KHOA TRUNG NG
Nguyn Vit Thnh, Phm Thng
Bnh vin Lo khoa Trung ng

Nghin cu tin hnh ti bnh vin Lo khoa trung ng, bnh nhn ph i lnh tnh tuyn tin lit (PTTL) c iu tr bng vin nn Tadimax vi thnh phn chnh l chit xut ca l cy trinh n hong cung. Mc tiu: (1) nh gi hiu qu iu tr ph i lnh tnh tuyn tin lit bng vin nn Tadimax,(2) nh gi tc dng khng mong mun ca thuc. i tng v Phng php: Phng php nghin cu can thip th nghim lm sng m khng nhm i chng, 53 bnh nhn b PTTL c iu tr bng thuc trong 2 thng. Kt qu: 92% bnh nhn kt qu iu tr tt v kh; 7,5 % bnh nhn kt qu km. Cc tc dng khng mong mun ca thuc: chng mt nh 5,7%. Kt lun: y l loi thuc iu tr c hiu qu v an ton.
T kho: ph i lnh tnh tuyn tin lit, tadimax, hong cung trinh n

Summary THE RESULTS OF THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA BY TADIMAX TABLETS IN THE NATIONAL GERIATRIC HOSPITAL
The study was conducted at the National Geriatric Hospital, benign prostatic hyperplasia (BPH) patients were treated with Tadimax tablets (the main components of crinum latifolium L). Objectives: (1) to evaluate the effectiveness of treatment BHP patients by Tadimax tablets (2) to describe the side effective of the drugs. Material and Methods: 53 BPH patients enrolled in open clinical trial were treated by Tadimax tablets in two months. Results: good and moderate outcome: 92.5%; unsatisfactory: 7.5%. The side effectives: mild vertigo 5.7%. Conclusions: treatment of benign prostatic hyperplasia patient by Tadimax tablets is effective and safe. Keywords: Benign prostatic hyperplasia (BPH), tadimax, crinum latifolium L

CHN ON TRC SINH BNG SIU M V PHN TCH NHIM SC TH NHNG TRNG HP KHNG PHN CHIA NO TRC CA THAI
Trn Danh Cng
Trng i hc Y H Ni M t hnh nh siu m khng phn chia no trc trc sinh v kt qu phn tch nhim sc th t t bo i nhng trng hp khng phn chia no trc. Nghin cu: m t tin cu trn 20 trng hp khng phn chia no trc t khi chn on, chc ht nc i phn tch nhim sc th, so snh vi kt qu sau khi sinh. Kt qu: a s cc trng hp c chn on t 22 tun tr ln (trn 60%), du hiu siu m in hnh h thn kinh trung ng, mt ca thai nhi gp 100% trng hp, 50% trng hp c d dng tim km theo. T l d dng nhim sc th rt cao 70%, trong 60% trisomie 13 (hi chng Patau), 10% trisomie 18 (hi chng Edwards), khng c trng hp no trisomie 21 (hi chng Down). Kt lun: Khng phn chia no trc hon ton c th chn on trc sinh bng siu m bi nhng du hiu siu m c trng u v mt, t l d dng nhim sc th rt ln (70%), trong a s l hi chng Patau (trisomie 13 : 60%).

T kha: khng phn chia no trc, bt thng nhim sc th, hi chng Patau

Summary PRENATAL UNTRASOUND DIAGNOSIS AND CHROMOSOMAL ABNORMALITIES OF FETAL HOLOPROSENCEPHALY

Holoprocencephaly is a big abnormality of the central neural system (CNS) however it can be easily diagnosed by specific ultrasound signs. And those defects is often associated with chromosomal disorders. Objectives: prenatal diagnosis of holoprosencephaly by ultrasound and chromosomal analysis of fetal holoprosencephaly. Materials and Methodology: this research was conducted on 20 cases of holoprosencephaly, amniocentesis was performed and the result was compared postnatally. Results: 60% of holoprocelcephaly cases were detected from 22 week of gestation, 100% patients found with classic ultrasound signs of CNS and 50% found with cardiac defects. The rate of chromosomal disorder is 70% among of those 60% is trisomy 13, 10% is trisomy 18, none of trisomy 21. Conclusion: holoprocencephaly can possibly diagnosed by specific ultrasound signs of CNS (mostly in heads and faces). The rate of chromosomal disorder is 70% among of those 60% is trisomy 13. Keywords: holoprocencephaly, chromosomal disorder, Patau syndrome

T L D TT BM SINH V GI TR CA SIU M TRONG CHN ON D TT BM SINH TRC SINH

Lu Th Hng
Trng i hc Y H ni nh gi t l d tt bm sinh (DTBS) v tm hiu gi tr ca siu m i vi chn on d tt bm sinh (DTBS) trc sinh. i tng v Phng php: 20345 thai ph n khm thai v c siu m sng lc trc sinh pht hin d tt bm sinh ca thai nhi ti Bnh vin Ph sn Trung ng, trong thi gian t 01/07/2003 n 31/03/2006. Kt qu: 926 thai ph c thai nhi b DTBS, chim t l 4,55%. C thai nhi mang mt hoc nhiu DT cho nn s DTBS l 1206. Trong s cc DTBS pht hin trn siu m, DT thn kinh trung ng l cao nht, chim 28,61% trong thai v s l 9,70%, t nht l thot v honh chim 0,170%. Trong s nhng thai ph ny, i chiu kt qu siu m trc sinh v nhn xt lm sng 772 h s sau sinh v xc nh gi tr ca siu m i vi sng lc trc sinh. c nhy l 92,49%, c hiu 99,96%. Kt lun: Siu m c gi tr c s dng nh mt phng php pht hin DTBS v hnh thi thai nhi trc sinh.

T kha: t l, d tt bm sinh, gi tr ca siu m, nhy, c hiu

Summary CONGENITAL MALFORMATION RATE AND THE ROLE OF ULTRASONOGRAPHY IN PRENATAL DETECTION OF MALFORMATION
This study was conducted aiming at evaluation of congenital malformation rate and the role of ultrasonography in prenatal detection of malformation. Subject and Method: There were totally 20345 pregnant women came to the National OBGYN Hospital to receive pregnancy check and prenatal screening ultrasonography, from 01 July 2003 to 31 March 2006. Results: there were 926 pregnant women (4.55%) detected with fetal malformation. As a fetus might consist of multiple malformation, the were 1206 cases of malformation detected. Neural tube defects consisted of 28.61%, the highest rate among the number of malformation cases detected, including 9.70% anencephaly cases Diaphragmal hernia consisted of the lowest rate of 0.17%. Comparision between the results of prenatal ultrasonography and postnatal clinical confirmation of 772 cases indicated 92.49% sensitivity and 99.96% specificity of the prenatal ultrasonography diagnosis. Conclusion: This result confirmed the role of ultrasonography as an powerful tool for prenatal detection of malformation. Keyword: congenital malformation, ultrasonography, sensitivity, specificity

NGHIN CU HNH THI TN THNG V CH NH IU TR TRONG CHN THNG THANH - KH QUN

L Thanh Thi , Quch Th Cn
1

Trng i hc Y Hu, 2Bnh vin Tai Mi Hng Trung ng

Nghin cu hnh thi tn thng trong chn thng thanh - kh qun. nh gi cc ch nh iu tr theo phn loi chn on hnh thi. Phng php: M t tng ca c can thip. Kt qu. T l chn thng kn cao gp 3 ln chn thng h. Tn thng tng thanh mn hay gp nht, ch yu nhm chn thng kn. Tn thng mc 4 gp nhiu nht. Tn thng phi hp khng nhiu, ch yu chn thng kn. iu tr ni khoa n thun chim t l cao nht, ch c nhm chn thng kn. Ch nh iu tr ni khoa n thun chim t l cao nht v ch yu cho nhng tn thng tng thanh mn. K tip l ch nh phu thut m thm d phc hi n thun, c s dng nhiu cho tn thng nhiu tng. iu tr ni khoa chim t l cao trong tt c cc mc , nhiu nht l mc 3 v 2. iu tr m thm d phc hi t chc xp v tr th hai, gp nhiu mc 3 v 4. iu tr m thm d phc hi t chc v c t ng nong ch gp mc 3 v 4. Kt lun: Chn thng thanh qun kn chim t l cao hn chn thng thanh qun h. Tn thng mc 4 chim t l cao nht. Ton b bnh nhn chn thng h u c iu tr phu thut. iu tr ni khoa n thun ch c nhm chn thng kn. T kha: chn thng thanh kh qun

Summary STUDY LESIONS FEATURE AND INDICATION FOR TREATMENT LARYNGOTRACHEAL TRAUMA
Research on the formes of laryngotrcheal trauma. Evaluate the indications depended on classifications. Method: The cas and prospective with intervention study. Results: The major type was blunt trauma, which was three folds larger than the open trauma. Injuries of glottic level were the main sites in blunt trauma. The number of the fourth level injurie was essential. The number of concurrence injuries was low. The rate of conservative management indications was high and only indicated in blunt trauma. The proportion of medical treatment indications was the highest and was the main indication for glottic level lesion. The simply surgical explotion was the main indication for multiple level injuries. In all anatomic levels, the proportion of medical treatment indications was high but the highest was recognized in the third and second level. The second indication was simply surgical exploration, applied for the third and the fourth level. The surgical exploration with stenting was indicated only for the third and the fourth level. Conclusion: Blunt laryngotrcheal trauma is more common than penetreating laryngotrcheal trauma. Level 4 laryngotrcheal trauma is the highest rate of laryngotrcheal trauma. All patients who had penetreating laryngotrcheal trauma were operated. The proportion of medical treatment indications is the highest rate of treatment. Keyword: laryngotrcheal trauma

C IM LM SNG, XQ RNG HM LN TH NHT, TH HAI HM DI TRN BNH NHN C CH NH IU TR NI NHOA

Trng Mnh Dng , Lng Ngc Khu 1 Vin o to Rng Hm Mt, Trng i hc Y H Ni; 2B Y t
1 2

M t c im lm sng, X - quang rng hm ln th nht, th hai hm di trn bnh nhn c ch nh iu tr ni nha. Phng php: Nghin cu th nghim lm sng tin cu c thc hin trn 52 rng hm ln th nht (RHL 1), rng hm ln th hai (RHL 2) hm di ca 50 bnh nhn, la tui t 15 - 60, c ch nh iu tr ni nha khng phu thut. Kt qu: Vim ty khng hi phc (VTKHP): 63,47%. Bin chng ca su rng: 92,3%. RHL1 hm di c 4 ng OT chim t l 53,6% v 3 OT l 46,4%; thng phn b 2 OT gn (gn ngoi v gn trong) v 1 hoc 2 OT xa; RHL2 hm di ch yu c 3 OT, chim 70,8% v 2 OT l 20,8%. Hnh nh X - quang: tn thng tiu xng vng quanh cung rng l 11,54%, gin dy chng l 32,69% v khng c tn thng l 55,77%. Kt lun: Bnh l ch yu iu tr ni nha ca RHL th nht v th hai hm di l VTKHP; Nguyn nhn ch yu gy bnh l tu rng l do bin chng ca su rng. V tr l su thng gp RHL th hai hm di l c rng pha mt xa. V hnh nh X - quang, nhng bnh nhn khng c tn thng chim hn 50%. T kha: rng hm ln, iu tr ni nha khng phu thut

Summary CLINICAL AND X - RAYS CHARACTERISTICS OF FIRST MOLARS, SECOND MOLARS IN PATIENTS WITH ENDODONTIC TREATMENT
Describe the clinical and X - rays features of the mandibular first and second molars in patients with endodontic treatment. Methods: a longitudinal randomized controlled clinical trials, no comparison was made on 52 first and second molars of mandible of 50 patients, aged 15 - 60, whom indicated endodontic treatment without surgery. Results: Irreversible pulpitis was 63.47%. Complication of dental caries was 92.3%. Number of root canals: Mandibular first molar has 4 root canals relatively high percentage of 53.6% and 3 root canals was 46.4%, usually distributed 2 root canals in mesial root (mesiobuccal and mesiolingual) and 1 or 2 root canal in distal root; the mandibular second molars has generally 3 canals, 70.8% for 3 canals and 20.8% for 2 canals. X - ray images: bone resorption appear in periradicular tissues relatively percentage of 11.54%, 32.69% was stretching the ligaments and no injury was 55.77%. Conclusions: The major disease of endodontic treatment of the mandibular first and second molars are irreversible pulpitis. Caries often found in mandibular second molars are near the gingiva on distal surface. In X - ray images, patients with no injury has more than 50%. Keywords: molars, endodontic treatment without surgery, X ray

KT QU LU DI PHU THUT CT B CNG GIC MC C GHP MNG I IU TR GLCM TI PHT SAU M

Trn Thanh Thu Bnh vin Hu Ngh
nh gi kt qu ca phu thut ct b cng gic mc (CGM) c ghp mng i. Nghin cu trn 35 mt glcm ti pht (sau PT) c so x xu. Nghin cu m t lm sng tin cu khng i chng. Kt qu: Nhn p (NA) trung bnh h t 31,86 6,335 mmHg (trc m) xung 18,40 2,67 mmHg (sau 12 thng PT). Mc h NA trung bnh t 13.46 mmHg (42,25%) n 19,35 mmHg (60,73%). S loi thuc tra h NA trung bnh gim t 1,17 (trc PT) xung 0,34 (sau PT 12 thng). Th lc (TL) sau PT n nh hoc tng hn trc. Thi im cui theo di, so bng tt, kh, xu tng ng l 20%; 77,1%; 2,9% . Bin chng trong v sau m khng xy ra. Kt lun: PT ct b CGM ghp mng i c hiu qu v an ton, c th l 1 la chn tt i vi nhng trng hp glcm ti pht sau m l d. T kho: phu thut ct b, ghp mng i

Summary LONG - TERM RESULT OF TRABECULECTOMY WITH AMNIOTIC MEMBRANE TRANSPLANTATION FOR THE TREATMENT OF RECURRENT GLAUCOMA
To evaluate the effect of trabeculectomy combined AM transplantation. This clinical prospective study 35 eyes with primary glaucoma after unsuccessful trabeculectomy have fibroblastic flat bled. The mean preoperative intraocular pressure (IOP) was 31.86 6.335 mmHg (preoperative) which decreased to 18.40 2.67 mmHg (at 12 months preoperative). The decreased mean postoperative IOP from 13.46 mmHg (42.25%) to 19.35 mmHg (60.73%). The mean number of glaucoma medications was reduced from 1.17 preoperatively to 0.34 at 12 months postoperatively. All eyes were remainded or increased their visual acuities. The was 27.3% diffusion bleds, 72.7% functional bleds, 2.9% flat bled after 12 months. There was not complication in operation and posoperation. Conclusion: Trabeculetomy combined AM transplantation is a safe and effective. That should be evaluated as an good option for recurrent glaucoma. Keywords: trabeculetomy, amniotic membrane transplantation

XC NH LOI V NHY CM VI KHNG SINH CA VI KHUN GY VIM TAI GIA MN TNH THNG MNG NH TR EM
Phm Trn Anh Trng i hc Y H Ni
Nghin cu nhm xc nh loi v nhy cm vi khng sinh ca vi khun gy vim tai gia mn tnh thng mng nh tr em ti bnh vin Tai Mi Hng Trung ng t 01/02/2010 n 31/03/2010. Phng php: 38 bnh nhi c vim tai gia mn tnh thng mng nh mt bn hoc c hai bn c thm khm lm sng, m tai c gi n phng xt nghim vi sinh ca Bnh vin Tai Mi Hng cy tm vi khun v lm khng sinh . Phng php nghin cu l tin cu, m t ct ngang c phn tch. Kt qu: T l cy vi khun dng tnh l 78,95%. Pseudomonas aeruginosa chim ti 28,12% chim t l cao nht, tip theo l Moracella catarrhalis: 25%, Staphylococcus aureus: 21,87% v Hemophilus Influenzae: 15,62%. Kt qu khng sinh cho thy cc vi khun ny hu nh khng li cc khng sinh ph bin ang s dng. Kt lun: Hu ht cc chng vi khun nh t cu vng, M.catarrhalis, H.influenzae u khng li cc khng sinh thng dng. Cc vi khun phn lp c cn nhy cm vi mt vi khng sinh cephalosporin th h 2, 3 v cp phi hp amoxicilin/clavulanat T kho: vim tai gia mn tnh tr em, hnh nh vi khun hc, nhy cm vi khng sinh

Summary IDENTIFYING THE COMMONEST MICROORGANISMS ASSOCIATED WITH CHRONIC DISCHARGING EARS BY CHILDREN AND THEIR ANTIMICROBIAL SENSITIVITIES
Identify the commonest microorganisms associated with chronic discharging ears by children and their antimicrobial sensitivities. Method: Descriptives tudy.This study was carried out from 01/02/2010 to 31/03/2010 in the outpatient deparment of the national ENT Hospital A total of 38 patients with unilateral or bilateral active chronic suppurative otitis media attending the outpatient clinic were included in the study. All patients were evaluated through detailed history and clinical examination. Result: Overall microbiology of 38 samples was studied of which 78.95% positive cases. Pseudomonas aeruginosa accounted for 28.12% was the most common isolate, followed by Moracella catarrhalis: 25%. Then followed by Staphylococcus aureus (21.87%) and Hemophilus Influenzae (15.62%). Antibiotics sensitivities pattern showed that majority of these bacteria are resistant to most common antibiotics. Conclusion: Commonest organisms isolated from chronic discharging ears were Pseudomonas aeruginosa and Staphylococcus aureus. Majority of isolates of Pseudomonas aeruginosa were sensitive to Amikacin and Ciprofloxacin. The 2nd and 3rd Cephalosporins and Amox/clavulanic were effective against most of the isolates of those microorganisms. Keywords: chronic suppurative otitis media, microbiology, antibiotic sensitivity

T L MC, T VONG V MT S YU T LIN QUAN CA VIM PHI TH MY

L Kin Ngi, Khu Th Khnh Dung Bnh vin Nhi Trung ng
Nghin cu nhm xc nh t l mc, t l mc mi, t l t vong ca vim phi th my (VPTM) v m t mt s yu t lin quan ti VPTM ti cc khoa hi sc tch cc bnh vin Nhi Trung ng. Kt qu: 120 bnh nhn th my tiu chun nghin cu, vi tng s 1162 ngy th my; T l mc 26,7%; t l mc mi 27,5/1000 ngy th my; t l t vong 46,7%; Lin quan gia VPTM vi gii (OR = 1,3; p > 0,05); vi tui 1 tun v > 1 tun (OR = 0,65; p > 0,05); vi khoa iu tr 2 = 3.05; p > 0,05); vi chn on lc vo vin: s sinh non thng (OR = 0,91; 95%CI: 0,38 2,17), bnh tim mch (OR = 1,0; 95%CI: 0,25 - 3,96),bnh h hp (OR=1,83; 95% CI: 0,77 - 4,34), NKH (OR = 2,37; 95%CI:2,69 - 9,13); vi ng t NKQ (OR = 2,71; p > 0,05); vi thi gian th my > 4 ngy (2 = 5,5; p = 0,018. 75% VSV phn lp c l vi khun Gram ( - ), hng u l P. aeruginosa. Kt lun: T l mc, t l mc mi, t l t vong VPTM cao. Bc u thy VPTM lin quan vi thi gian th my trn 4 ngy. T kho: vim phi th my, t l mc, mc mi, t vong, lin quan

Summary THE INCIDENCE, RISK FACTORS AND OUTCOME OF VENTILATOR ASSOCIATED PNEUMONIA
Objectives: To identify the incidence, proportion, outcome of VAP; To describe some risk factors to VAP in three intensive care unit NHP. Results: 120 patients under MV fit criteria, there were 1162 ventilators days in total; The proportion was 26.7%; The incidence was 27.5/1000 ventilators days; Mortality rate was 46.7%; Association between VAP and gender (OR = 1.3; p > 0.05); Age 1 week and > 1 week (OR = 0.65; p > 0.05); ward (2 = 3.05; p > 0.05); admission diagnosis: premature newborn (OR = 0.91; 95%CI: 0.38 - 2.17), cardiovascular problems (OR = 1.0; 95%CI: 0.25 - 3.96), respiratory problems (OR = 1.83; 95% CI: 0.77 - 4.34), prior sepsis (OR = 2.37; 95%CI: 2.69 - 9.13); indotracheal insertion route (OR = 2.71; p > 0.05); length of ventilators > 4 days (2 = 5.5; p = 0,018. 75% Gram (-), microorganism were isolated, P. aeruginosa was on top.Conclusion: The incidence, proportion and mortality rates was high. There was significant association between VAP and length of MV over 4 days. Keywords: ventilator associated pneumonia, incidence, proportion, mortality, association

NHN MT TRNG HP VIM A SN TI PHT TI BNH VIN TAI MI HNG TRUNG NG

Quch Th Cn Bnh vin Tai Mi Hng Trung ng
Vim a sn ti pht - RPC (Relapsing Polychondritis) l bnh vim hoc thoi ha h thng, tin trin, gy tn thng kn o cu trc, chc nng ton vn ca sn, c quan cm gic bit ha, tim mch, thn v h thng thn kinh. c im lm sng ca bnh a dng. Ty tng v tr b tn thng nn c th gp tt c chuyn khoa khc nhau. Nu bnh ch biu hin ri rc tng v tr th rt kh chn on v ngh ti. Nhn mt trng hp ti khoa cp cu bnh vin Tai Mi Hng TW, ti cp ti chn on v x tr cn bnh ny. T kha: vim a sn ti pht

Summary CASE REPORT: RELAPSING POLYCHONDRITIS IN NATIONAL ENT HOSPITAL

Relapsing Polychondritis has been described as a recurrent painful inflammation of multiple cartilaginous structures followed by cartilage destruction and collapse. The present information concerning the history, clinical and laboratory findings, diagnois, prognosis and treatment is review. One unusual case of this disease we have in National ENT hospital with exemplify the extreme of the symptomatology of this patient is presented. The purpose of this paper is to review the information and to report an unusual case of this disease. Keyword: relapsing polychondritis

C TNH CA SHELLAC F VI NGUYN BO SI CA NU NGI

Hong o Bo Trm1,2, Hong T Hng1, Imad About2
1i hc Y Dc Thnh ph H Ch Minh, Vit Nam. 2Labo IMEB - ERT30 - Khoa Nha - i hc Mditerrane, Marseille, Php. nh gi c tnh ca Shellac F i vi nguyn bo si ca nu ngi. Phng php: Phng php th c tnh vi t bo qua cht tit t vt liu theo chun chu u ISO 10993 - 5. T bo c nui cy trong cc mi trng tip xc vi vt liu th, cc nng khc nhau (pha long theo t l 1:1, 1:2, 1:10, 1:100, 1:1000, 1:10000). Mt t bo c nh gi bng th nghim MTT, s dng my quang ph k E 960 (Bioblock, Strasbourg, France) bc sng 550nm. Kt qu: i vi nguyn bo si ca nu ngi, Shellac F khng cn c tnh mc pha long mi trng l 1:10 (t l t bo sng trung bnh l 96,13%), tng ng vi Duraphat (98,86%), trong khi Isodan khng c pha long 1:100 (t l t bo sng trung bnh l 100%). Kt lun: i vi nguyn bo si ca nu ngi, mc c tnh vi t bo ca Shellac F tng ng vi Duraphat v thp hn Isodan. T kha: Shellac F, c tnh vi t bo, nguyn bo si ca nu ngi

Summary CYTOTOXICITY OF SHELLAC F ON HUMAN GINGIVAL FIBROBLAST

Evaluate the cytotoxicity of Shellac F on human gingival fibroblast. Methods: The cytotoxicity test was performed on human gingival fibroblast according to the Europe Standard ISO 10993 - 5. Cells were incubated in material - contacted medium with different dilutions (1:1, 1:2, 1:10, 1:100, 1:1000, 1:10000). A succinyl dehydrogenase (MTT) assay was performed and the absorbance of each 96 - well dish was determined using an automatic microplate spectrophotometer (E 960, Bioblock, Strasbourg, France) at 550nm. Results: On human gingival fibroblast, Shellac F was non - toxic at the dilution of 1:10 (average cell viability: 96.13%), comparable to Duraphat (98.86%), while Isodan showed non - toxic at 1:100 (average cell viability: 100%). Conclusions: On human gingival fibroblast, Shellac F showed a toxicity which was similar than that of Duraphat and lower than that of Isodan. Keywords: shellac F, cytotoxicity, human gingival fibroblast

RT NGN THI GIAN CA - BNG TRN BNH NHN NHI MU C TIM CP ST CHNH LN C CAN THIP MCH VNH TIN PHT
Hong Quc Ha
Bnh vin Nhn dn Gia nh,Thnh ph H Ch Minh Nghin cu c tin hnh nhm (1)Xc nh thi gian ca - bng trc v sau khi thay i quy trnh v cc phn (2) on thi gian trong thi gian ca - bng. Kho st c im lm sng, cn lm sng, c im tn thng MV th phm i vi cc trng hp NMCT STc chp v can thip MV tin pht. Kt qu: T thng 04/2009 3/2010, can thip mch vnh tin pht trn 293 trng hp NMCT ST. Ba yu t nguy c bnh mch vnh chim t l hng u l: ht thuc l: 61,85, tng HA 60,1%, ri lon lipid mu 38,2%. T l bnh nhn Killip IV chim 10,6%. Phn b v tr: Thn chung (LM) 0,7%, M vnh xung trc tri (LAD) 48,5, M vnh phi (RCA) 43% v M m (LCx) 7,8%. Ci tin quy trnh gip tng ng k t l s trng hp CTMV TP t thi gian ca - bng nh hn 90 pht: 52,6% trong nm 2010 - 2011 so vi ch 10,7% trong nm 2009. Thi gian ca - bng trung bnh v trung v gim u t 146/130 pht xung cn 94/81 pht. Kt lun: Rt ngn thi gian ca - bng trn bnh nhn c can thip mch vnh tin pht t c thnh cng bc u, cn phi hon thin thm k nng can thip ti u ha rt ngn thi gian ca - bng, nng cao t l thnh cng, cu sng BN NMCT cp hiu qu. T kha: nhi mu c tim ST chnh ln (NMCT ST), Can thip mch vnh tin pht (CTMV TP), thi gian ca - bng

Summary IMPROVING DOOR TO BALLOON TIME FOR PATIENTS WITH STEMI UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION
Objectives: Estimate of door to balloon time before (2009) and after (2010 2011) upgrading PPCI procedures and classification of its interval segments; (2)Study of clinical features, laboratories, and characters of coronary culprit lesions in STEMI patients underwent PPCI at Gia Dinh Hospital from April 2009 to March 2011. Results: Of 293 STEMI patients, the top three risk factors are smoking (61.85%), hypertension (60.1%) and dyslipidemia (38.2%). Killip IV are 10.6%. Distribution of coronary lesions: LM (0.7%), LAD (48.5%), RCA (43%), LCx (7.8%). 52.6% in 2011 compared to 10.7% in 2009 of patients have been reached door to balloon time standard (less 90 minutes). This result is statistically improved due to upgrading procedure at our hospital. Door to balloon time is gradually reducing following quarters: 146/130 minutes (2009) compared to 94/81 minutes (2011). Conclusion: Reducing door to balloon time with STEMI patients underwent PCI get successful in the first step at Gia Dinh hospital. However, we need to improve skill and to be well - trained for reaching gold standard which has been significantly reducing acute STEMI mortality and quality of life. Keywords: ST - segment elevation myocardial infarction (STEMI), primary percutaneous coronary Intervention (PPCI), culprit lesion, door to balloon time
(1)

BIN CHNG THN BNH NHI I THO NG

Nguyn Ph t
Trng i hc Y H Ni i tho ng (T) l bnh gy ra nhiu bin chng nguy him dn n tn ph hoc t vong. Trong bin chng thn l hay gp. Kim sot glucose huyt bng xt nghim HbA1c l cch tt nht gim nhng nguy c bin chng thn. Mc tiu: 1. Xc nh t l bin chng thn tr em T ang iu tr ti Bnh vin Nhi Trung ng. 2. Nhn xt lin quan gia bin chng thn vi kim sot glucose huyt. i tng: Tt c cc bnh nhn c chn on T tp 1 ang c iu tr v theo di ti Bnh vin Nhi Trung ng, t 10/1999- 10/2009, c thi gian iu tr t 1 nm tr ln. Phng php: Nghin cu m t c phn tch. Kt qu: T l bin chng thn cao nht bnh nhn trn 15 tui l 55,3%. Tui pht hin bin chng thn trung bnh l 16,2 6,07 tui. Khong 1/4 s bnh nhn b bin chng thn c biu hin ph v tng huyt p. 8,6% s bnh nhn c macroalbumin niu, 11,4% s bnh nhn c ure v creatinin mu tng. Kim sot glucose huyt khng tt c t l bin chng thn cao gp hn 2 ln so vi kim sot tt. Kt lun: T l bin chng thn tng theo thi gian iu tr. Kim sot glucose huyt khng tt c nguy c bin chng thn cao gp hn 2 ln so vi kim sot tt. T kho: Bin chng thn tr em i tho ng

Summary RENAL COMPLICATIONS OF CHILDREN WITH DIABETES

Diabetes mellitus is a disease which causes serious complication leading to disability or death. Kidney disease is common complication. Blood glucose control with HbA1c test is the best way to reduce the risk of kidney complication. Objectives: 1. Reviews kidney complication of diabetes in children being treated at the National hospital of pediarcs (NHP). 2. Reviews relationship between kidney complication and blood glucose control. Subjects: All patients with type 1 diabetes diagnosed for more than 1 year, treated, and monitored at the NHP since 12/1999 - 12/2009. Method: Study was descriptive combined between retrospective and prospective parts. Results: The rate of renal complications was highest of 55.3% in patients aged over age 15 years. Kidney complication was detected at mean age of 16.2 6.07 years. Approximately one quarter of patients with kidney complication had hypertension and edema. 8.6% of the patients had macroalbuminuria; 11.4% of patients had increased blood urea and creatinine. In patients with poor blood glucose control, renal complication rate was 2 times higher than that in patients with good control. Conclusion: The longer duration of treatment is, the rate of the kidney complications the patients had. Patients with poor blood glucose control had renal complication rate 2 times higher than patients with good blood glucose control. Keywords: kidney complications, diabetic children

SO SNH HIU QU CA LC MU LIN TC VI LC MU NGT QUNG TRONG IU TR NG C CP GARDENAL MC NNG

Ng c Ngc1, Phm Du2
1Trng i hc Y H Ni , 2Bnh vin Bch Mai Mc tiu: So snh hiu qu ca lc mu lin tc (CVVH) v lc mu ngt qung (HD) trong iu tr bnh nhn ng c cp Gardenal mc nng. i tng v Phng php: Th nghim lm sng ngu nhin c i chng, bnh nhn ung qu liu Gardenal mc nng (Gardenal mu > 4 mg% v/hoc hn m su giai on 3 - 4) c iu tr bng hi sc c bn v ngu nhin s dng mt trong hai phng thc lc mu (CVVH hoc HD) ti Trung tm chng c bnh vin Bch Mai t thng 01/2003 n 03/2005 v thng 7/2007 n 12/2010. So snh nng Gardenal trc v sau lc, sau lc mu 4 gi gia hai nhm. Kt qu: Nng Gardenal mu tng ng vi mi nhm trc khi lc l 10,1 3,9 v 8,4 4,9 (mg%) v khi kt thc lc mu l 3,9 2,5 v 3,2 2,3 (mg%); t l gim nng Gardenal mu trc v khi kt thc lc l 62,7 12,4; 61,5 22,0 (%); thay i im Glasgow trc v sau lc mu ca tng nhm tng ng l: 4,1 1,6 ln 9,6 2,7 (HD); 3,5 0,9 ln 10,5 3,3 (CVVH). Thi gian th my ca nhm CVVH l 39,7 27,9 gi, ngn hn c ngha thng k so vi nhm HD l 66,1 32,4 (p < 0,05). Thi gian tnh li k t khi CVVH l 31,9 26,6 ngn hn c ngha so vi nhm HD l 66,1 32,5 (p < 0,01). Kt lun: CVVH c tc dng tt hn HD trong vic rt ngn thi gian tnh, gim thi gian th my bnh nhn ng c cp Gardenal mc nng. T kha: Ng c Gardenal, lc mu lin tc, lc mu ngt qung

Summary COMPARISON ON THE EFFECTIVENESS OF CONTINUOUS VENO-VENOUS (CVVH) AND HEMODIALYSIS (HD) ON TREATMENT OF SEVERE GARDENAL OVERDOSE
Objectives: To compare the effectiveness of continous veno-venous hemofiltration (CVVH) and hemodialysis (HD) on treatment of severe phenobarbital poisoning. Objectives and Methods: A randomized control trial, patients who were diagnosed with severe Gardenal overdose (deep coma with stage III and IV) were randomly contributed either by HD and CVVH, from 01/2003 to 03/2005 and from 7/2007 to 12/2010 at Poison Control Centre, Bach Mai hospital. Results: Gardenal concentration before and at the end of HD and CVVH were decreased from 10.1 3.9 and 8.4 4.9 to 3.9 2.5 and 3.2 2.3 respectively; the percentages of decrease of phenobarbital concentration before and at the end of those were 62.7 12.4; 61.5 22.0 (%); the changes of Glasgow coma scales were 4.1 1.6 to 9.6 2.7 (HD); 3.5 0.9 to 10.5 3.3 (CVVH). The time of mechanical ventilation of CVVH group was 39.7 27.9 hours, it was shorter than that of HD group signifficantly with 66.1 32.4 hours (p < 0,05). The time of comatose episode of CVVH group was 31.9 26.6 hours, it was signifficantly shorter than HD group (66.1 32.5) p < 0.01. Conclusions: CVVH have more effectiveness than HD in decreasing the time of coma, shorten the time of mechanical ventilation. Key words: Gardenal overdose, contininous veno-venous hemofiltration, hemodialysis

TIP CN TRUYN THNG V TC NG CA RU, BIA I VI SC KHO V MI LIN QUAN VI LM DNG RU, BIA NGI DN HUYN THANH OAI, H NI
Kim Bo Giang, Hong Vn Minh
Trng i hc Y H Ni Nghin cu nhm m t tip cn truyn thng v tc ng ca ru, bia i vi sc khe v phn tch mi lin quan gia tip cn truyn thng v tnh hnh lm dng ru, bia. Nghin cu ct ngang, phng vn 1564 i tng 16 - 60 tui ti huyn Thanh Oai. Kt qu: T l tip cn truyn thng cao tt c cc nhm (81,7%). Ti vi l knh d tip cn nht (65,9%), tip n l i v loa pht thanh, t tip cn nht l t nhn vin y t (2,4%). Kh nng tip cn truyn thng ca n gii ch bng 70% ca nam gii. Khng c s khc bit v tip cn truyn thng gia nhm c lm dng ru/ bia v nhm khng lm dng. Kt lun: Truyn thng cha hiu qu do cha c s khc bit v tip cn truyn thng gia nhm lm dng v nhm khng lm dng ru/bia. Cn c nghin cu su hn v nhng ni dung truyn thng lin quan thc hin. T kha: Tip cn truyn thng, lm dng ru/bia

Summary ACCESS TO HEALTH COMMUNICATION ABOUT HEALTH IMPACT OF ALCOHOL ABUSE AND ANALYSE RELATIONSHIP BETWEEN ACCESS TO HEALTH COMMUNICATION AND ALCOHOL USE
Describe accessibility to health communication about health impact of alcohol abuse and analyze relationship between access to health communication and alcohol use. Methods: Cross-sectional study, interviewed 1564 people in age range from 16 to 60 years in Thanh Oai district. Results: Proportion of those who had access to message on health impact of alcohol abuse was high in all groups (81.7%). Television was the most accessible channel (65.9%), followed by radio and loud speaker, the least accessible was from health staff (2.4%). Accessibility to health impact of alshol abuse message among women was only 70% of that among men. No difference between alcohol abusers and non-alcohol abusers was found. Conclusion: Health communication on health impact of alcohol abuse was not effective because no difference between alcohol abuser and non alcohol abusers was found. It is necessary to study in depth about what messages had been communicated through health communication programs. Key words: access to health communication, alcohol abuse

NH GI NH HNG CA BNH ALZHEIMER LN CHC NNG HOT NG HNG NGY V KH NNG TI HO NHP CNG NG
Nguyn Th Huyn, Phm Thng
Bnh vin Lo khoa Trung ng Bnh Alzheimer l nguyn nhn quan trng gy tnh trng ph thuc ngi gi, nh hng nghim trng n cht lng sng ca ngi bnh v lm tng gnh nng cho gia nh cng nh cc c s y t. Mc tiu: nh gi nh hng ca bnh Alzheimer ln chc nng hot ng hng ngy v kh nng ti ho nhp cng ng. Nghin cu trn 86 bnh nhn c chn on bnh Alzheimer theo tiu chun DSM-4, c khm lm sng, khm thn kinh, lm cc trc nghim thn kinh tm l v chp cng hng t s no, s dng cc thang im ADL, IADL v Wood-Dauphine nh gi kh nng hot ng hng ngy. Kt qu: 82,6% c gim cc hot ng c bn v 83,8% c gim cc hot ng hng ngy c s dng phng tin dng c. 54,7% bnh nhn Alzheimer khng c kh nng ti ho nhp cng ng. Kt lun: C s lin quan gia mc nng ca bnh vi kh nng thc hin cc hot ng hng ngy v kh nng ti ho nhp cng ng. T kha: Alzheimer, ho nhp cng ng

Summary EVALUATION THE EFFECTS OF ALZHEIMERS DISEASE ON DAILY FUNCTIONING AND ABILITY TO REINTERGRATE INTO THE COMMUNITY
Alzheimer disease is an important reason to cause dependency in the elderly. This seriously affects the quality of life of patients and increases the burden of caring for families as well as health facilities. Objectives: Evaluate the effects of Alzheimer's disease on daily functioning and ability to reintegrate into the community. Subjects and research Methods: 86 patients diagnosed as Alzheimer's disease according to DSM-4 criteria were taken by clinical examination, neurological examination, neuropsychological test and brain MRI. To evaluate the possibility of daily activities, we used scales of ADL, IADL and WoodDauphine. Results: 82.6% had reduced the basic activities of daily living and 83.8% had reduced the instrumental activities of daily living. 54.7% of patients with Alzheimer's disease inability to reintegrate into the community. Conclusions: There is a link between the severity of the disease with the ability to perform daily activities and ability to reintegrate into the community. Key words: Alzheimer, ability to reintegrate into the community

NHNG RO CN TRONG THC HIN IU TR HO TR LIU NGN NGY C KIM SOT TRC TIP (DOTS) TI PHNG KHM LAO QUN HAI B TRNG, H NI MT BO CO KT QU NH TNH
H Th Hin , Ung Th Mai Loan
1

Trng i hc Y t Cng cng; 2Bnh vin Phi H Ni

Nghin cu c thc hin nhm phn tch nhng ro cn trong thc hin DOTS t pha cn b y t v bnh nhn ti phng khm lao Hai B Trng nm 2009. i tng v Phng php: Bi vit bo co s liu nh tnh t mt nghin cu c thit k kt hp. 10 cn b y t (CBYT) tham gia vo chng trnh lao v 12 bnh nhn c phng vn su bn cu trc. Kt qu: C nhiu kh khn trong thc hin DOTS t pha CBYT, bnh nhn v h thng qun l chng trnh lao c bo co. CBYT ch yu l kim nhim, kh c th i li gim st bnh nhn c bit trong giai on duy tr; thi ch quan, nhiu khi l bin minh bng vic tin tng v kh nng TTT ca bnh nhn; ch khen thng, ph cp cng nh o to v nng cao hiu bit v DOTS cn hn ch. CBYT cn lo ngi v ri ro ngh nghip khi tip xc vi bnh nhn. Bnh nhn thng trong tui lao ng, hon cnh kh khn nn vn phi i lm, mt s khng mun CBYT n nh gim st iu tr v ngi b hng xm pht hin mc bnh lao. S h tr ca gia nh v on th l rt quan trng gip thc hin DOTS. T kha: DOTS, ha tr liu ngn ngy c kim sot trc tip, lao, tun th iu tr

Summary BARRIERS TO DIRECTLY OBSERVED TREATMENT SHORTCOURSE (DOTS) IN HAI BA TRUNG TUBERCULOSIS CLINIC, HANOI
Objectives: To identify the barriers in implementing DOTS from health staff and patients in TB clinic in Hai Ba Trung district of Hanoi. Methods: This paper reported qualitative data from in-depth interviews of 10 health staff and 12 patients. Results: Several barriers in DOTS implementation from health staff and patients were reported. Health staff are mainly doing part-time jobs, making it difficult for them to directly observe patients adherence to treatment; incentives and allowances for health staff in TB clinic are low, continuous training on DOTS and TB are still limited. Health staff are also concerned about being contracted by TB from patients when contacting them directly. For patients, most of them are in labour age and living in poor condition, are still working to support their families. They cannot be observed by health staff at home or in some cases, they are afraid that their TB condition is being disclosed by their neighbors if health staff come to their houses for DOTS. Support from family and civil organizations are needed in assuring TB adherence. Key words: DOTS, Directly Observed Treatment Shortcourse, tuberculosis, treatment adherence

THC TRNG S DNG THUC TIM TRNH THAI PH N HUYN A LI TNH THA THIN HU GIAI ON 2006 - 2009
V Vn Thng , Phan ng Tm
1

i hc Y Dc Hu; 2Chi cc Dn s-KHHG, tnh TT-Hu

nh gi thc trng s dng thuc tim trnh thai trong giai on 2006-2009 v ng thi xem xt mt s yu t tc ng n s chp nhn dng thuc tim trnh thai, t a ra mt s khuyn ngh v gii php can thip. Phng php: thit k m t ct ngang, tin hnh phng vn 525 ph n trong tui sinh 15 - 49 tui v ang s dng thuc tim trnh thai t 01/07/2006 n 31/06/2009. Kt qu: T l bin php trnh thai hin i: 78,94%, cao nht l dng c t cung (32,94%) v thuc tim (25,13%). Nhm i tng b cuc TTTT ch yu nm trong tui l t 25 - 39 tui, chim 73,4%. T l b cuc thuc tim trnh thai l 18,5%. Thi gian s dng trung bnh TTTT ca ngi b cuc l 3,58 nm. Kt lun: Thuc tim trnh thai c a s ngi dn chp nhn, cho thy cc BPTT ang ngy cng c a dng ha v dn thay i t trng cc BPTT ti huyn A Li . Tuy nhin, ngi dn s dng thuc tim trnh thai hiu qu, an ton v thun li cn ch trng hn na cc yu t lin quan n tip th x hi ca dch v y t nh im cung cp dch v, cn b cung cp dch v, vn x l tc dng ph nhm hn ch t l b cuc c tm thy trong nghin cu ny l 18,5%. T kha: tnh hnh s dng, t l b cuc, tc dng ph, thuc tim trnh thai, huyn A Li

Summary THE SITUATION OF USING CONTRACEPTIVE INJECTIONS AMONG WOMEN OF A LUOI DISTRICT, THUA THIEN HUE PROVINCE DURING THE PERIOD OF 2006-2009
Objectives: to evaluate the current situation of using contraceptive injections (DMPA) during 20062009,and to consider a number of possible factors influencing the acceptance of using contraceptive injections and thus to propose a number of suggestions and solutions. Methodology: using cross sectional design, interviewing 525 married women aged from 15 - 49 years who have used contraceptive injections from 01/07/2006 to 31/06/2009. Results: The rate of women using modern contraceptive Methods: 78.94%, the highest rate being intra-uterine contraceptive device (32.94%) and contraceptive injections (25.13%). The group of subjects withdrawing from using contraceptive injections are mainly among those from 25-39 years of age, accounting for 73.4%. Conclusion: The fact that contraceptive injections have been accepted by the majority of people shows that contraceptive methods have been more and more diversified, and have gradually changed the rate of using different contraceptive methods in A Luoi district. However, in order that the people can use contraceptive injections effectively, safely and comfortably, it is necessary to pay more attention to the factors relating to social marketing of medical services such as service locations, service provision staff, and treatment of side effects in order to limit withdrawing rate of using DMPA found in this research was 18.5%. Key words: DMPA, situation of use, withdrawing rate, side effects, contraceptive injections, A Luoi district

CAI NGHIN HT THUC L V CC HNH VI TM KIM DCH V CHM SC SC KHE NHNG NGI HT THUC L TI VIT NAM
Lng Ngc Khu1, Hong Vn Minh, Kim Bo Giang2
1

B Y t; Trng i hc Y H Ni

Nghin cu nhm m t thc trng cai nghin ht thuc l ngi Vit nam v m t hnh vi tm kim dch v chm sc sc khe nhng ngi ht thuc l ti Vit Nam. Thit k Nghin cu: M t ct ngang. i tng: Tt c nam v n tui t 15 tr ln.ti Vit Nam. Kt qu: 55,3% ngi ht thuc l c n lc b thuc. Trong s 27,2% nhng ngi ht thuc l tm n cn b y t trong nm qua ch c 34,9% c hi v tnh trng ht thuc hay khng v 29,7% c cn b y t khuyn b thuc. T l b thuc (tc t l phn trm nhng ngi tng ht thuc hng ngy hin nay khng cn ht thuc na) l 23,5%. T kha: Cai nghin ht thuc l, tm kim dch v y t, Vit Nam, GATS

Summary SMOKING CESSATION AND HEALTH - CARE SEEKING BEHAVIORS AMONG SMOKERS IN VIETNAM
The current situation of smoking cessation and health-care seeking behaviors among smokers in Vienam. Study design: Cross-sectional survey. Study Subject: The GATS of Viet Nam was designed to be a nationally representative survey of all non-institutionalized men and women age 15 and older who considered Viet Nam to be their primary place of residence. Results: Also, tobacco cessation counseling appeared to not be a concern of most of healthcare providers. 55.3% of smokers had made an attempt to quit in the past 12 months. Only 27.2% of smokers had visited a healthcare provider in the past year and of those, 34.9% were asked if they smoked and 29.7% were advised by the healthcare provider to quit. The quit ratio for daily smoking (the percentage of ever daily tobacco smokers who currently do not smoke tobacco) was 23.5%. Medical prescription and counseling services were used at very low rates among those who successfully quit smoking (0.3% and 3%). Keywords: Smoking cessation, health care seeking behaviors, Vietnam, GATS

KHO ST GI TR CA PROTHROMBIN TRONG CHN ON THIU VITAMIN K TR S SINH SM TI BNH VIN PH SN TRUNG NG
Cung Th Thu Thy
Trng i Hc Y H Ni Kho st gi tr ca Prothrombin trong chn on thiu vitamin K tr s sinh sm (tun u sau ) ti Bnh vin Ph sn Trung ng. i tng: 331 tr s sinh c sinh tui thai t 28 tun tr ln trn c s s ng t nguyn tham gia nghin cu ca cc b m (331 tr c 2 xt nghim t l prothrombin v PIVKAII trong tng s 400 tr c xt nghim prothrombin. Loi tr: S sinh bnh l: bnh gan mt, thiu yu t ng mu bm sinh. M iu tr cc thuc nh hng n chuyn ho vitamin K. Phng php: M t tin cu. Kt qu: PIVKAII c tng quan cht ch vi PT. T l prothrombin < 60% v PTs > 14,4 giy ; T l prothrombin < 55,6% v PTs > 14 giy c gi tr trong chn on thiu vitamin K vi nhy khng cao, nhng c hiu, gi tr tin on dng tnh v gi tr tin on m tnh c th chp nhn c. Kt lun: C th p dng t l prothrrombin tr s sinh di ngng bnh thng trong chn on thiu vitamin K nhng c s y t khng iu kin kinh t v k thut nh lng cht ch im c hiu khi thiu vitamin K l PIVKAII. Keywords: Prothrombin, thiu vitamin K

Summary SURVEY THE MEANING OF PROTHOMBIN IN THE DIAGNOSIS OF EARLY NEONATAL VITAMIN K DEFICIENCY AT NHOG
Objective: Survey the meaning of Prothrombin in the diagnosis of early neonatal vitamin K deficiency at NHOG. Objects: 331 neonates,who was born at NHOG with the gestational age was more than 28 weeks, based on mothers agreement to participate in the study (331 children had 2 tests: prothrombin ratio and PIVKAII in total of 400 ones had prothrombin test. Exclusion: Neonatal morbidity: liver disease, Congenital deficiency of coagulation factors. Mother used drug therapy which affect vitamin K metabolism. Study Methodology: prospective descriptive method. Results: PIVKAII closely correlates with PT. Prothrombin ratio < 60% and PTs > 14.4 seconds. The Prothrombin ratio < 55.6% and PTs > 14 seconds are valid fordiagnosis of vitamin K deficiency with the low sensitivity; however, its specificity, positive predictive value and its negative predictive value is acceptable. Conclusion: the neonatal prothrombin rate, which is lower than normal level, may be applied in the diagnosis of vitamin K deficiency in healthy facilities, which are not eligible for economy and technology, in order to quantify a specific markers, which is PIVKAII, of vitamin K inadequacy. Keywords: Prothrombin, vitamin K deficiency

CHI PH CA H GIA NH CHO CHM SC V IU TR M AU, BNH TT C LIN QUAN N TRNG V CH BIN THUC L NGI DN HUYN V NHAI, TNH THI NGUYN
Hong Vn Minh, Kim Bo Giang
Trng i hc Y H Ni Nghin cu nhm xc nh chi ph ca h gia nh cho chm sc v iu tr m au, bnh tt c lin quan n trng v ch bin thuc l ngi dn huyn V Nhai, tnh Thi Nguyn. Thit k Nghin cu: Nghin cu thun tp tng lai. i tng: Ngi dn thuc cc h gia nh. Kt qu: Chi ph trc tip trung bnh ca ngi dn (chi ph do ngi dn phi tr cho cc c s y t) cho mt ln iu tr hi chng nhim c thuc l xanh l 54.600 ng. Tng chnh lch v chi ph chm sc sc khe x Lu Thng (7000 ngi) l 173.040.000 ng (tng ng khong 9.107.37 USD). Tng chi ph cho chm sc sc khe lin quan n trng v ch bin thuc l x Lu Thng, bao gm cc chi ph cho iu tr hi chng nhim c thuc l xanh v tng chnh lch v chi ph chm sc sc khe x Lu Thng l 703.307.000 ng/nm (tng ng khong 37.000 USD). T kha: Trng v ch bin thuc l, chi ph y t, hi chng nhim c thuc l xanh

Summary HOUSEHOLD OUT-OF-POCKET HEALTH PAYMENTS FOR CARE AND TRETAMENT OF ILLNESS RELATED TO TOBACCO CULTIVATION AND PROCESSING IN V NHAI DISTRICT, THAI NGUYEN PROVINCE
Objective: To Estimate health care costs (from the farmers perspective) attributable to tobacco cultivation and processing in the study setting. Study design: Prospective cpohort study. Study Subjects: Population in the study site. Results: The average annual per capita out-of-pocket payment for treatment of GTS was VND 54.600. The excess in total household out-of-pocket payment for health in Lau Thuong commune (7000 people) was VND 173.040.000 (US$ 9.107.37). As a result, the tobacco cultivation and processing related actives cost to Lau Thuong commune VND 703.307.000 a year (about US$ 37.000). Conclusion: Our study confirms the facts that the health care cost attributable to tobacco cultivation and processing is considerable Key words:Tobacco cultivation and processing, heath expenditure, green tobacco sickness

MT S KIN THC CHM SC SC KHE TR S SINH CA CC B M C CON DI MT TUI THUC HUYN CM THY, THANH HO NM 2009 V MT S YU T LIN QUAN
Kim Bo Giang, Hong Vn Minh
Trng i hc Y H Ni Nghin cu nhm m t kin thc chm sc sc khe s sinh ca cc b m c con di 1 tui ti a bn nghin cu; (2) Phn tch mi lin quan gia kin thc chm sc sc khe s sinh ca cc b m c con di mt tui v mt s yu t vn ha x hi. Phng php: Nghin cu ngang, phng vn 355 b m v mt s kin thc chm sc tr s sinh ti 10 x thuc huyn Cm Thy, Thanh Ha. Kt qu: Kin thc chm sc s sinh ca b m cn hn ch, c bit kin thc v cc du hiu nguy him ca tr s sinh ngay sau sinh v trong vng 7 ngy sau sinh. Hc vn l yu t d bo kin thc ca b m. Kt lun: can thip cn tp trung vo nng cao kin thc v du hiu nguy him tr s sinh v u tin cho nhm b m c hc vn thp. T kha: kin thc chm sc s sinh, b m, yu t vn ha x hi

Summary SOME KNOWLEDGE OF NEWBORN CARE OF MOTHER HAVING A CHILD AGED LESS THAN IN CAM THUY DISTRICT, THANH HOA IN 2009 AND SOME RELATED FACTORS
The study was conducted to describe newborn care knowledge of mothers who had a child aged less than one year in study setting; (2) Analyze the relationship between mothers knowledge of newborn care and some social factors. Methods: Crosssectional study, interviewed 355 mothers in 10 communes from Cam Thuy district, Thanh Hoa about some knowledge of newborn care. Results: Knowledge of newborn care of mothers is limited, especially knowledge of dangerous signs among newborns after being delivered. Educational level is a predictor of mother knowledge. Conslusion: Intervention should focus on improvement of knowledge about dangerous signs among newborns and give priority for lower educational mothers. Key words: Knowledge of newborn care, mother, social factors

THC TRNG SC KHE RNG MING CA HC SINH TRNG TIU HC TRN THNH NG, KIN AN, HI PHNG 2009
Phm Vn Liu, Nguyn Vn Nht
Trng i hc Y Hi Phng Nghin cu nhm kho st tnh trng sc khe rng ming v nhu cu iu tr ca hc sinh trng tiu hc Trn Thnh Ng, Kin An, Hi Phng. Phng php: nghin cu ct ngang m t. i tng: Mu nghin cu gm 519 hc sinh, c khm tnh trng su rng v nha chu. S dng cc ch s theo phng php iu tra c bn sc khe rng ming ca t chc Sc khe Th gii nm 1997. Kt qu: T l su rng 74,37%, ch s su mt trm rng l 1,16 . S trung bnh phn hm bnh thng l 2,38, c chy mu l 1,84, c cao rng l 1,78. Kt lun: kho st cho thy s mc bnh su rng hc sinh vi t l cao nhng s lng rng b su mt trm khng nhiu.Trung bnh s phn hm bnh thng (2,38) thp hn s phn hm b bnh (3,62) ca 6 phn hm theo quy nh cn thit phi iu tr sm, trm bt h rnh, gio dc v sinh rng ming, ly cao rng v kim sot mng bm. T kha: Su rng, cao rng, vim li, vim quanh rng

Summary ORAL HEALTH STATUS OF NGO TRAN THANH PRIMARY SCHOOL PUPIL, KIN AN DISTRICT, HAIPHONG CITY
The purpose of this study is to report on aral health status and treatment need of schoolchildren in Ngo Tran Thanh Primary school, Kien An district, Hai Phong city. Subject: A random sample of 519 children was examined for caries and periodontal status using the examination form recommended in the manual "Who basic oral health survey method" (1997). Method: Descriptive study. Result: The prevalence of caries was found as 74,37 percent, DMFT index 1.16. The mean number of healthy, bleeding, calculus sextants was 2.38, 1.84 and 1.78. Conclude:The results indicate that early measures for caries treatment, i.e. pit and fissure sealing, oral health education and plaque control are needed. Key word: Tooth Decay, Calculus, Gingivitis, Periodontitis

NHN XT TNH TRNG KHIM THNH LA TUI MU GIO TI H NI

Khu Th Khnh Dung, Nguyn Tuyt Xng
Bnh vin Nhi Trung ng Nghin cu nhm xc nh t l khim thnh tr em tui mu gio v tm hiu mt s nguyn nhn gy khim thnh nhm tui ny. Bng phng php phng vn ph huynh ca cc i tng nghin cu. Khm tai mi hng cho tr sau l dng thit b sng lc OAE. Nu thy kt qu bt thng, tr s c kim tra OAE ln 2. Nu kt qu kim tra ln th hai cng vn bt thng, tr s c kim tra ABR hoc ASSR o mc nghim trng ca vic gim thnh lc. Kt qu cho thy sng lc trn 3.006 tr la tui mu gio, trong 3,16% tr trong tui mm non c gim thnh lc, gp nhiu nht nhm tr 2 tui (8,19%). T l nam gii gp nhiu hn n chim 63%. Yu t nguy c cao ca nhm c xc nh dng tnh trong hai ln th test cho thy: tin s b vim tai gia (57,9%), vim mng no (2,1%), v 40% khng r nguyn nhn. Kt qu o bng ABR / ASSR trong tt c cc trng hp gim thnh lc nng l 30 dB. T kha: suy gim thnh lc, sng lc thnh gic, p ng in thnh gic thn no

Summary HEARING SCREENING RESULTS OF 3,006 PRESCHOOL AGED CHILDREN IN HANOI

To determine the rates of hearing impairment in community preschool-aged children. To determine the causes of hearing impairment in this age group. Results so that a total of 3,006 subjects were enrolled and tested. Overall, 3.16% of community pre-school aged children had hearing impairment, with the highest percentage in the age 2 group (8.19%). Sixty-three percent of hearing impaired subjects were male. Of cases with two positive hearing tests, risk factors include prior history of otitis media (57.9%) and history of meningitis (2.1%); 40% of cases had an unknown cause. Impairment severity as measured by ABR/ASSR in all cases of hearing impairment was 30 dB. Conclusions: Hearing screening is essential to detect hearing impairment to restore hearing and language capabilities at a young age. Our results show a significant percentage of preschool-aged children have hearing impairment, especially under the age of six. Although these children have mild impairment, most cases were ignored or not detected. Key words: hearing impairment, hearing screening, otoacoustic emission, auditory brainstem response

HNH VI S DNG NH V SINH CA HC SINH PH THNG

L Th Thanh Xun, L Th Hng
Trng i Hc Y H Ni Phn tch hnh vi s dng nh v sinh ca hc sinh ph thng tiu hc v trung hc c s. i tng v Phng php: phng vn nhm theo b cu hi t in ca 707 hc sinh tiu hc (lp 2, lp 3, lp 5) v trung hc c s (lp 6, lp 8 v lp 9) ti hai x min ni tnh lo cai v i tiu v i tin trong ngy hm qua. Kt qu: T l hc sinh tr li s dng nh v sinh nhiu hn l i tiu tin hay i tin lung tung. T l hc sinh s dng nh v sinh trng hc i tiu tin v i tin l 50% v 32%. T l ny i vi nh v sinh gia nh l 41% v 47%. T l hc sinh i tiu v i tin lung tung l 33% v 30%. Trong s cc em tr li c nh v sinh gia nh, ch c 76% v 88% cc em s dng nh v sinh ny i tiu tin v i tin trong ngy hm qua. Kt lun: Hnh vi s dng nh v sinh ca hc sinh ph thng vng nghin cu cn hn ch. Mc s dng nh v sinh ca hc sinh tng dn theo tui v khc bit gia cc dn tc. T kha: s dng nh v sinh, hc sinh, min ni

Summary SANITATION BEHAVIOR OF SCHOOL CHILDREN IN A RURAL AREA OF VIETNAM

Objective: to analyze how school children use latrine at school and at home in relation to urination and defecation. Subjects and Methodology: In total, 707 child were interviewed by class with the student of grade 2, 3, 5, 6, 8 and 9 in 2 moutainous communes. Result: Children reported using latrine for urination and defecation the day before more common than in the open places. The percentage of children reported using school latrine to urinate and defecate was 50% and 32% respectively. The popularity for home latrine was 41% and 47%. The percentage of children reported to urinate and defecate in the open was 33% and 30%. There was a significant difference in latrine use by gender , by ethnic groups , by level of grade. However, the percentage of primary students reported using school latrine was far higher than that of secondary students (urination: 64% vs. 39%; defecation: 42% vs. 25%). Conclusion: the sanitation behavior of the student in this study was limited. The level of using latrine was increasing by age of children and differentiates by ethnic groups. Key words: latrine behavior, school-age children, mountainous area

TNH TRNG SUY DINH DNG CA TR EM DI 5 TUI

Nguyn Th Thy Hng, Nguyn Th Yn
Trng i hc Y H Ni Nghin cu nhm nh gi tnh trng suy dinh dng ca tr em di 5 tui v xc nh t l suy dinh dng ti cc khoa trong bnh vin Nhi Trung ng. Bng phng php m t ct ngang nhng bnh nhn c iu tr ti 4 khoa phng: H hp, Tiu ha, Tim mch, iu tr t nguyn B ca bnh vin. Kt qu cho thy hu ht tr b suy dinh dng u khng c chn on. Thi gian iu tr ko di nhm tr suy dinh dng va v nng. T l suy dinh dng gp nhiu nht nhm tr mc bnh tim bm sinh. Kt lun: suy dinh dng vn cn l vn cha c quan tm trong Bnh vin, dinh dng lm sng l vn cn c nghin cu. T kha: Suy dinh dng, tr em di 5 tui

Summary MALNUTRITION STATUS IN CHILDREN UNDER 5 YEAR OLD

To determine incidence of malnutrition among patients under 5 on admission to National Hospital of Pediatrics and awareness of nutrition in different clinical units. By prospective study of consecutive admissions and 1000 patients admitted to hospital: 250 each from respiratory, gastrology, cardiology, Service Treating B Results: almost malnourished patients in hospital without the diagnosis appearing on their discharge summary. Length of hospital stay is higher in groups of moderate and severe malnutrition. Malnutrition in children with congenita l heart defects is highest. Conclusion: malnutrition remains a largely unrecognised problem in hospital. Key words: Malnutrition, children under 5 years of age

TNH TRNG DINH DNG V MT S YU T NH HNG SINH VIN NM TH NHT I HC Y H NI

Phm Vn Ph
Trng i hc Y H Ni Nghin cu nhm nh gi tnh trng dinh dng v mt s yu t chnh nh hng n sinh vin nm th nht Trng i hc Y H Ni. 962 sinh vin c iu tra ct ngang m t. Kt qu cho thy, t l thiu nhit lng trng din (TNLTD) nam sinh vin l 30,9%; n l 33,8%; t l tha cn v bo ph nam 9,0%; n 3,5%; t l bo ph nam 3,6%; n 0,4%; t l tha cn bo ph sinh vin thnh ph gp gn 4 ln so vi sinh vin nng thn. Chiu cao nam 166,3 5,5cm; n 155,5 5,2cm; cn nng nam 55,0 7,6kg; n 46,8 4,9kg. T l TNLTD c s khc bit c ngha thng k gia nhm c kinh t gia nh t kh tr ln v nhm c kinh t gia nh t trung bnh tr xung (p < 0,05), r rt nhm sinh vin nam (p < 0,01). Chiu cao nam v n thnh ph u cao hn sinh vin nng thn (p < 0,05 v p < 0,01). Cn nng ca sinh vin nam thnh ph hoc c kinh t gia nh t kh tr ln u cao hn c ngha thng k so vi nhm nng thn hoc c kinh t gia nh t trung bnh tr xung (p < 0,001). T kha: Sinh vin, tnh trng dinh dng, thiu nhit lng trng din

Summary NUTRITION STATUS OF THE 1 YEAR STUDENT AND SOME RELATED

st

FACTOR OF HANOI MEDICAL UNIVERSITY

Study to assess nutrition status of the 1 year student of Ha Noi Medical University and assess some related factors. A cross sectional study was carried out with a sample of 962 students. Results showed that, CED (Chronic Energy Deficiency) prevalence of male students is 30.9%; of females was 33.8%; oveverweight and obesity prevalence of male was 9.0%; of female was 3.5%. Average height of male was 166.3 5.5cm; their average weight: 55.0 7.6kg. Average height of female was 155.5 5.2cm; their average weight: 46.8 4.9kg. CED prevalence of students with good family economic condition was significantly lower than the ones with normal family economic condition, especially in male group (p < 0.05 and p < 0.01 respectively). The average height of students both male and female came from city were significantly higher than those from countryside (p < 0.05 and p < 0.01 respectively). The average weight of male students came from city was higher than all the other ones (p < 0.001 in all comparisons). Keywords: Student, Nutrition status, Chronic Energy Deficiency
st

NH GI GII HN HOT NG HNG NGY V HN CH THAM GIA VO CNG NG CA BNH NHN PHONG TN TT
L Th Thanh Trc , Nguyn Minh Chnh , Nguyn Tt Thng , Trn Hu Khang
1

Trng H Y H Ni; 2Trng H Y-Dc TP.HCM; 3Bnh Vin Da Liu TP.HCM

nh gi gii hn hat ng hng ngy v hn ch tham gia vo cng ng ca bnh nhn phong tn tt ti 8 tnh pha Nam. Nghin cu ct ngang m t trn 46 bnh nhn phong mi, 15 - 60 tui, tn tt, ng k iu tr 1/1/2009 n 30/6/2010. Bnh nhn c khm, nh gi tn tt, lm trc nghim SALSA v trc nghim o tham gia. Kt qu: 71,7% nam, 84,8% th MB, 69,6% tn tt 2 v 34,8% tn tt th pht. 47,8% khng b gii hn v cc hat ng hng ngy, 45,7% b gii hn nh nhng 13% b hn ch tham gia vo cng ng va phi, 17,4% b hn ch nghim trng v 8,7% b hn ch cc k nghim trng. Gii tnh, th bnh, tnh trng tn tt theo T chc Y t Th gii v EHF (mt, tay v chn) khc bit c ngha vi s im SALSA (th t p = 0,041; p = 0,015; p = 0,023 v p = 0,001). Tn tt th pht nh hng n gii hn v cc hat ng hng ngy (p= 0,007) v hn ch tham gia vo cng ng (p = 0,024). Kt lun: hn ch tham gia vo cng ng v gii hn v cc hot ng hng ngy ca bnh nhn phong tn tt cha c mi lin h. Gii tnh, th bnh, tnh trng tn tt nh hng n gii hn v cc hat ng hng ngy ca bnh nhn phong tn tt. Tn tt th pht nh hng n gii hn v cc hot ng hng ngy v hn ch tham gia vo cng ng. T kha: bnh nhn phong tn tt, trc nghim SALSA, trc nghim o tham gia

Summary ACTIVITY LIMITATION AND PARTICIPATION RESTRICTIONS OF LEPROSY PATIENTS WITH DEFORMITY
Leprosy causes nerve function impairment (NFI) and deformity. However, it it is not clear to know how these impacts of nerve function impairment have affected patient lives. Objectives: to survey activity limitation and participation restrictions of leprosy patients with deformity at 8 provinces in the Southern of Vietnam. Methods: This cross-sectional study involved 46 new leprosy patients registered for MDT from 1/1/2009 to 30/6/2010, aged between 16 and 60, had deformity. They were examined clinically, and mesured deformity according to the WHO grading and EHF score, interviewed SALSA scale and Participation scale. Results: 71.7% male, 84.8% MB, 69.6% disability grade II and 34.8% secondary disability. 47.8% patients have no significant limitation, 45.7% mild activity limitation, but only 13% of the patients had moderate participation restriction, 17.4% severe restriction and 8.7% extreme retriction. Sex, type disease, disability status followed WHO disability grading and EHF score of patients reflected significant differences with the mark of SALSA score, ( p= 0.041; p = 0.015; p = 0.023 v p = 0.001, respectively). Secondary disability showed significant differences with the mark of SALSA scale (p = 0.007) and the mark of Participation score (p = 0.024). Conclusions: there was no relationship between activity limitation and participation restriction in disability leprosy patients. Sex, type disease, disability status affected the activity limitation of disability leprosy patients. Secondary disability affected both the activity limitation and participation restriction. Keywords: disability leprosy patients, SALSA, Participation scale

NGHIN CU TC DNG NNG CAO SC KHO TH LC CA SPIRULINA NGI LAO NG

ng Quc Bo , Trn Bo Trm , Phm Hng Sn
1

Hc vin Qun y; 2Vin ng dng Cng ngh

Nghin cu ny nhm nh gi tc dng ca chit xut to Spirulina trn sc c v kh nng lao ng th lc. i tng v Phng php: Nghin cu c thc hin trn 60 cng nhn, trong 30 ngi (nhm th nghim) c cho ung vin nang to Spirulina vi hm lng 5mg/ngy trong 45 ngy. Kt qu thu c cho thy: sn phm vin nang to Spirulina c tc dng tng cng sc c: lc bp tay tng trung bnh t 39,20 ln 42,40 kg (tng 3,20 kg), lc ko thn tng trung bnh t 88,23 kg ln 100,10 kg (tng 11,87 kg) v kh nng lao ng th lc nhm ung sn phm c s bin i r, tng 170,86 Kgm/pht (t 873,27 ln 1034,23 Kgm/pht), s bin i c ngha thng k vi p < 0,05). Kt lun: qua phng vn cho thy cc i tng c cm gic tnh to, hot bt hn (43,33%), ng ngon hn (23,33%), n ngon hn (26,67%), th lc khe hn (23,33%), kh nng lao ng tng (56,67%). T kha: Spirulina, kh nng lao ng th lc, thc phm chc nng

Summary EFFECT OF SPIRULINA EXTRACT ON THE PHYSICAL IMPROVEMENT FOR WORKERS

Objective: to evaluate the effect of Spirulina extract on the physical working activity. Method: The study was carried out on 60 workers, 30 among them were used 5mg of Spirulina capsule per day within 45 days. The results showed that after the experiment the hand force increased from 39.20 to 42.40 kg, trunk force was up from 88.23 kg to 100.10 kg, physical working capacity rose from 170.86 kgm/min to 1034.23 kgm/min, significantly with p < 0.05. Conclusion: There were also to have improvements in general stituation, including more awakeness (43.33%), easier sleep (23.33%), better appetite (26.67%), stronger (23.33%) and longer working (56.67%). Keywords: Spirulina, Physical Working Capacity, functional food

S THAY I KIN THC, THC HNH NUI DNG TR NH CA CC B M VNG DN TC THIU S TI HUYN AKRNG V HNG HA TNH QUNG TR SAU MT NM CAN THIP
L Th Hng1, Trn Th Lan2
1

Vin o to YHDP-YTCC, Trng i hc Y H Ni; T chc Cu tr tr em

Nghin cu nhm nh gi s thay i kin thc v thc hnh nui dng tr nh ti vng ng bo dn tc thiu s huyn Hng Ha v akrng Tnh Qung tr sau mt nm can thip bng truyn thng t vn nui dng tr nh c bit truyn thng nhm nh thc y nui con bng sa m. Kt qu cho thy rng: Kin thc ca cc b m v thi gian nui con bng sa m ci thin mt cch r rt, ti thi im nm 2010 ch c 68,0% cc b m bit nn cho tr b trong vng 1 gi u sau khi sinh tng ln 97,6%; nn nui con b hon ton trong 6 thng u t 46,8% ln 89,1%. Thc hnh nui con bng sa m cng ci thin r rt. T l tr c b m trong vng 1 gi u tin sau khi sinh tng t 79,7% ln 93,3%. T 10,4% cho con b hon ton trong 6 thng u trc can thip tng ln thnh 36,9% sau can thip. Thc hnh cho tr n b sung ca cc b m c thay i, t 11,8% b m thc hnh cho con n b sung sau su thng tui tng ln thnh 30,6%. Trc can thip, ch c 13,2% tr c n 4 nhm thc phm nhng sau can thip, con s ny tng ln gp 3 ln (37,1%). Kt lun: So vi nm 2010 kin thc v thc hnh nui dng tr nh ca cc b m ti Huyn Hng Ha v akrng tnh Qung tr c nhng ci thin r rt. T kha: Kin thc, thc hnh, nui dng, tr nh

Summary CHANGES IN KNOWLEDGE AND PRACTICES ON CHILD FEEDING OF THE ETHNIC MINORITY PEOPLE IN HUONG HOA AND DAKRONG DISTRICTS, QUANG TRI PROVINCE AFTER ONE YEAR INTERVENTION
Objective: to assess the changes in knowledge and practices of the mothers on young child feeding among ethnic minority mothers in Huong hoa and Dakrong after one year of intervention with small group counseling and communication on child feeding. Method: A cross sectional study in 790 children under 2 was conducted. The results show that: Knowledge of the mothers about the breastfeeding improved clearly, in 2010 there was only 68.0% knew that they should breastfeed their children in one hour after birth went up to 97.6% in 2011, the prevalence of mothers knew that they should exclusive breastfeed children in the first 6 months increased from 46.8% to 89.1%. Breast feeding practices were also improved a lot. The prevalence of children was breastfeed during 1 hour after birth was increased from 79.7% to 93.3%. From 10.4% children were exclusive breastfeed in 2010 increased to 36.9% in 2011. The complementary feeding practice of the mothers was also improved; the complementary feeding practice after 6 months was increased from 1.8% in 2010 to 30.6% in 2011. Before the intervention there was only 13.2% children was feed with 4 food groups the day before but this number was 3 times increased (to 37.1%) after intervention. Conclusion: In comparision with 2010, the knowledge and practices on young child feeding of the mothers in Huong hoa and Dakrong was improved clearly. Key words: knowledge, practice, feeding, young child

TNH TRNG DINH DNG V NHIM GIUN CA TR EM 12 - 36 THNG TUI VNG DN TC THIU S VN KIU V PAKOH HUYN AKRNG, TNH QUNG TR
Trn Th Lan1, L Th Hng2
1

T chc Cu tr tr em; 2Vin o to YHDP v YTCC, Trng i hc Y H Ni

nh gi tnh trng dinh dng v nhim giun v m t mi lin quan gia tnh trng dinh dng v nhim giun tr 12 - 36 thng ti huyn akrng tnh Qung tr nm 2010. i tng v Phng php: Nghin cu ct ngang c tin hnh trn 692 b m v tr t 12 n 36 thng tui ca 4 x ti huyn akrng. Kt qu: T l SDD tr em t 12 n 36 thng tui ti a bn nghin cu l 53,9% tr SDD th nh cn, 67,1% tr SDD th thp ci v 14,5% th gy cm. Khng c s khc bit gia tnh trng suy dinh dng gia tr trai v tr gi. T l SDD c chiu hng tng theo la tui ca tr. T l chung l 31,6%, trong ch yu l nhim giun a (24,6%), tip theo l giun mc (6,5%) v giun tc (6,2%). T l nhim giun tr em ngi dn tc Vn Kiu cao hn tr em ngi Pakoh. Tnh trng suy dinh dng thp ci c lin quan n nhim giun mc. Kt lun: T l suy dinh dng v nhim giun ca tr em vng dn tc Pakoh v Vn kiu ti Qung tr l kh cao. Tnh trng suy dinh dng thp ci c lin quan vi nhim giun mc. T kha: Suy dinh dng, nhim giun, tr 12 - 36 thng

Summary NUTRITIONAL STATUS AND WORM INFECTION AMONG CHILDREN FROM 12 - 36 MONTHS IN PAKOH AND VANKIEU AREA IN DAKRONG AND HUONG HOA DISTRICT, QUANG TRI PROVINCE
To describe the nutritional status, worm infection status and identify the relationship between nutritional status with the worm infection of children 12 - 36 months in Dakrong district Quang tri province in 2010. Subject and Methodology: A cross sectional study conducted in 692 mothers and children 12 to 36 months in 4 communes of Dakrong district Quang tri province. Results: The malnutrition prevalence of children was 53.9% for underweight, 67.1% for stunting and 14.5% for wasting. There was no different between male and female in malnutrition rate. The prevalence of malnutrition increases by age group. The prevalence of worm infection was 31.6%, the highest prevalence was belong to Ascaris infection (24.6%), follow by Hookworm and Trichuris (6.5% and 6.2%) respectively. Van Kieu children have higher prevalence of worm infection than Pakoh children. There was an association between Hookworm infection and stunting. Conclusions: The prevalence of malnutrition and worm infection of Pakoh and Van Kieu children was very high, there was an association between malnutrition and hookworm infection. Key words: Malnutrition, worm infection, children 12 - 36 months

TNH TRNG DINH DNG CA TR DI 24 THNG TUI V THC HNH NUI TR CA B M THEO CH S IYCF-2010
Bi Th Phng, Phm Vn Ph
Trng i hc Y H Ni Bo co nhm nh gi tnh trng dinh dng tr di 24 thng tui x Bnh Sn, th x Sng Cng, Thi Nguyn v thc hnh nui tr ca b m ti a phng ny theo ch s IYCF-2010. Kt qu cho thy: T l suy dinh dng nh cn 9,6%, thp ci 24,7%, gy cm 12,6%; trong c 7,7% thp ci trm trng. Thc hnh nui tr ca b m theo cc ch s c bn IYCF - 2010: 58,7% tr c b ngay trong vng 1 gi u sau sinh; 17,9% c b sa m hon ton; ti thi im 1 nm c 87,5% tr tip tc cn c b sa m; 100% tr 6 - 8 thng tui c cho n b sung; 66,7% s tr c khu phn n a dng ti thiu; 91,6% s tr trn 6 thng tui c n s ba theo tui; 65,9% tr c n Khu phn c th chp nhn ti thiu. Vn cn 38,0% tr sau khi sinh c cho ung cam tho, mt ong, nc si ngui trc khi b m ln u. T kha: suy dinh dng, tr di 24 thng, Thi Nguyn, thc hnh nui tr

Summary NUTRITION STATUS OF CHILDREN UNDER 24 MONTHS OLD AND ASSESSING MOTHERS CHILD FEEDING PRACTICES BASED ON IYCF-2010
Study to assess nutrition status of children under 24 months old in Binh Son commune, Song Cong district, Thai Nguyen province and mothers child feeding practices based on IYCF-2010. Results show that: prevalence of underweight: 9.6%; stunted: 24.7%, wasted:12.6% and 7.7% severe stunted. Mothers child feeding practices based on IYCF-2010: Early initiation of breastfeeding 58.7%; Exclusive breastfeeding 17.9%; Continued breastfeeding at 1 year 87.5%; Introduction of solid, semi-solid or soft foods at 6 - 8 months old 100.0%; Minimum dietary diversity 66.7%; Minimum meal frequency 91.6%; Minimum acceptable diet 65.9%. There are 38.0% children who still were given liquorice, honey, boiled water before giving the first breast feeding after birth. Conclusions: Prevalence of malnutrition among studied children was rather high, especially stunted prevalence (24.7%, in which 7.7% severe stunted). Prevalences of early breastfeeding initiation; exclusive breastfeeding; minimum acceptable diet were low. Keywords: malnutrition, children under 24 months, Thai Nguyen, child feeding practices

NHN THC V MT S YU T NGUY C C LIN QUAN N BNH UNG TH CA NGI DN HUYN V NHAI, TNH THI NGUYN
V Th Thu Nga , Hong Vn Minh , Lng Ngc Khu
1

Trng i hc Y H Ni; 2 B Y t

Nghin cu nhm m t nhn thc v mt s yu t nguy c ca bnh ung th ca ngi dn ti huyn V Nhai, tnh Thi Nguyn. Kt qu cho thy gn 100% ngi tr li cho rng ht thuc l, ung ru v tip xc khng kh nhim lm tng nguy c ung th. Tuy nhin, t l nhn thc ng n v nguy c gia tng ung th ca mt s thi quen n ung v phi nhim cn cha cao v dao ng gia cc a bn tham gia nghin cu. Kt lun: Ngi dn huyn V Nhai, Thi Nguyn cn cha c nhn thc y v yu t nguy c ca bnh ung th. iu ny cho thy cn c nhng chng trnh gio dc sc khe su rng trong cng ng nhm nng cao nhn thc ca ngi dn v cc yu t nguy c ca bnh ung th . T kha: Nhn thc, yu t nguy c, ung th, cng ng Vit Nam

Summary PERCEPTION OF CANCER RISKS AMONG VO NHAI POPULATION IN THAI NGUYEN PROVINCE
This study was conducted to describe cancer risk believes of Vo Nhai population, Thai Nguyen province. Results: nearly 100% respondents believe that cigarette smoking, alcohol consumption and exposure to air pollution increase cancer risk. However, understanding about cancer risks of eating habit and other exposure is not completely appropriate and fluctuated among studied sites. Conclusion: Vo Nhai population do not have complete understanding about cancer risks. Implication from this study results is to strengthen and expand health promotion programs in communities in order to improve community understanding about cancer risks. Key words: belief, risks, cancer, Vietnam community

NH GI HIU QU CA THNG KH NHN TO VI PHNG PHP PHI M TRONG IU TR SUY H HP CP TIN TRIN
L c Nhn1, V Vn nh2, Nguyn t Anh2
1

Bnh vin Nng; Trng i hc Y H Ni

Mc tiu: Nghin cu hiu qu v nhn xt cc bin chng ca thng kh nhn to theo phng php phi m trong iu tr suy h hp cp tin trin. i tng v Phng php: nghin cu tin cu can thip, p dng thng kh nhn to theo chin lc phi m cho 32 bnh nhn suy h hp cp tin trin, iu tr ti khoa Hi sc cp cu bnh vin Nng, t thng 12/2007 - 9/2010. Kt qu: tui trung bnh l 47,9 18,6, APACHE II: 19,5 5,8, SOFA: 9,8 2,7. Lm sng v kh mu ng mch u c ci thin trong qu trnh thng kh. SpO 2 trung bnh tng ng vi cc ngy 1, 2, 7 ln lt: 90,2 2,2; 92,3 2,0; 94,2 2,5 (%), nhp tim: 118,9 12,5; 110,2 9,1; 102,2 10,6 (ln/pht), v nhp th tng ng l: 24 7; 23 4; 20 5 (ln/pht). Oxy ha mu cng c ci thin ng k trong qu trnh TKNT, PaO 2/FiO2 trung bnh tng ng vi cc ngy 1, 2, 7 ln lt: 167 48; 226 52; 285 72 v s ci thin PaO2/FiO2 gia cc thi im nghin cu u c ngha thng k vi p < 0,05. T l t vong chung l 31,3%, phn ln l t vong trong tun u (6/10 bnh nhn) v cha cai my (8/10 bnh nhn). Ch c 1/32 trng hp c bin chng trn kh mng phi. Tt huyt p thong qua chim t l khng nh 12,5% nhng phc hi nhanh chng. Kt lun: TKNT theo chin lc phi m t ra kh hiu qu v ci thin lm sng v cc thng s kh mu, dung np tt cho cc bnh nhn ARDS, tt huyt p thong qua chim t l khng nh khi s dng m phi vi PEEP 30, 35 cmH 2O. T kha: ARDS, suy h hp cp tin trin, thng kh nhn to trong ARDS, chin lc bo v phi, thng kh phi m

Summary TO EVALUATE THE EFFECTIVENESS OF OPEN - LUNG APPROACH VENTILATION ON THE PATIENT WITH ACUTE RESPIRATORY DISTRESS SYNDROME
Objectives: To evaluate the effectiveness and complications of open - lung approach ventilation on the patient with Acute Respiratory Distress Syndrome. Method: A prospective study was carry out on 32 ARDS patients with open - lung approach ventilation Results: aged 47.9 18.6, APACHE II: 19.5 5.8, SOFA: 9.8 2.7. Results: clinical features and arterial blood gas were improved. SpO2 were 90.2 2.2; 92.3 2.0; 94.2 2.5 (%); heart rate were 118.9 12.5; 110.2 9.1; 102.2 10.6 (cycle/minute), respiratory rate were 24 7;23 4; 20 5 (cycle/minute) respectively at day 1, 2 and 7. Arterial oxygenation was also improved significantly during mechanical ventilation, PaO2/FiO2: 167 48; 226 52; 285 72 respectively at day 1, 2 and 7, (p < 0.05). Hospital mortality was 31.3%. 1/32 patients had pneumothorax. Temporatory hypotension: 12.5%. Conclusions: open - lung approach ventilation improved clinical features and arterial blood gas in patients with ARDS, good tolerance. Temporatory hypotension complication was about 12.5% during open lung with PEEP: 30, 35 cmH2O. Keyword: ARDS, ARDS ventilation, Recruitment manuever in ARDS, ventilation in ARDS, open lung approach ventilation, Acute Respiratory Distress Syndrome

NGHIN CU CHN ON TRC SINH V X TR SAU SINH CC BT THNG THNH BNG TRC CA THAI
Vng Th Thu Thy , Trn Danh Cng
1

Bnh vin Ph sn Hi Phng; 2Trng i hc Y H Ni

Cc bt thng thnh bng trc (BTTBT) l mt trong nhng bt thng hnh thi ca thai kh hay gp v hon ton c th chn on c trc sinh bng siu m. Vi nhng tin b trong gy m hi sc v k thut m cc bt thng ny c th can thip iu tr sau cho kt qu tt. Mc tiu ca nghin cu ny l nh gi kt qu chn on trc sinh v x tr sau sinh cc bt thng thnh bng trc. i tng v Phng php: nghin cu theo phng php hi cu c kt hp tin cu nhng trng hp BTTBT c chn on ti trung tm chn on trc sinh ca BVPSTW t 6/2006 - 6/2010. Kt qu: tui thai trung bnh chn on l 23 tun, t l BTTBT l 4,3%, t l ngng thai nghn l 70,53% trong (TVR) thot v rn l 68,57%, (KHTB) khe h thnh bng 72,5%. T l phu thut sau thnh cng l 71,42% trong TVR 75%, KHTB l 66,7%. Kt lun cc BTTBT hon ton c th chn on trc sinh v iu tr sau sinh cho kt qu rt tt. T kha: thot v rn, khe h thnh bng, bt thng thnh bng trc

Summary STUDY OF ANTENATAL DIAGNOSIS AND TREATEMENT AFTER DELIVERY OF FETAL ABDOMINAL WALL DEFCT
The abdominal wall defect is one of fetals malformations often apper and can antenatal dianosis by untrasound. With progression in anesthesis and operation it can treat after delivery. Objective of this study evaluate the result of antenatal dianosis of abdominal wall defect and treatement it after delivery. Materiel and methode is retroprospective and prospective study. Result: average gestation age for diagnosis is 23 week, the rate of abnormalitie of abdominal wall is 4.39%, the rate of interruption of pregnant is 70.53% including omphalocelle 68.57%, laparochisis 72.5%, the rate of operation after delivery is 71.42% including omphalocelle 75%, laparochisis 66.7%. Conclusion: anomalies of abdominal wall can be diagnosed prenatally by ultrasound and treatement after delivery. Keys words: omphalocelle, laparochisis, abdominal wall defect

NH GI MT S YU T LIN QUAN N T L NHIM HUMAN PAPILLOMAVIRUS TRN GI MI DM

Hong Th Thanh Huyn , T Thnh Vn
1

Trng i hc Y Hi Phng; 2Trng i hc Y H Ni

Human papillomavirus (HPV) l tc nhn thng gp nht trong cc bnh ly truyn qua ng tnh dc. T l nhim HPV thay i theo tui, lin quan ti mc hot ng tnh dc v s lng bn tnh. Nghin cu c tin hnh nhm nh gi mt s yu t dch t hc v hnh vi tnh dc trn gi mi dm ti min Bc Vit Nam. Bng phng php m t ct ngang trn 281 gi mi dm ti min Bc Vit Nam tui t 13 n 55 v cc i nghin cu c phng vn, khm ph khoa v ly bnh phm c t cung. Pht hin t l nhim HPV bng phn ng PCR vi cp mi . modified v original GP5+/6+ S dng phn mm SPSS 15.0 phn tch n bin v a bin vi kt qu thu thp c. Kt qu cho thy tui trung bnh ca gi mi dm ti min Bc Vit nam tng ng vi tui ca gi mi dm trong khu vc chu . T l nhim HPV nhm gi mi dm di 25 tui cao hn so v nhm gi mi dm trn 25 tui. T kha: HPV, yu t nguy c, gi mi dm

Summary ASSOCIATION OF SOCIO-DEMOGRAPHIC CHARACTERISTIC SEXUAL BEHAVIOR AND HPV INFECTION AMONG FEMALE COMMERCIAL SEX WORKERS
Human papillomavirus (HPV) is the most common of sexual transmited diseases. The prevalence of HPV can vary follow with age and relate with active sexual behavior as well as sexual partners. Evaluate the relationship between Socio-demographic characteristic, sexual behavior and HPV infection among female commercial sex workers in Northern Vietnam. By cross-sectional study of 281 female commercial sex workers in Northern Vietnam (age from 13 to 55 years) and face to face interview, gynecological examination and collection of cervical swabs. HPV prevalence detection by PCR method using three pairs primers modifiled and orginal GP5+/GP6+. Using SPSS15.0 for univariate analysis and multivariate analysis. Results show that the mean age of female sex workers in Northern Vietnam was similar with the mean age of Asian female sex workers. Being 25 years of age and younger was significantly associated with HPV infection than female sex workers more than 25 years old. Key word: HPV, Socio-demographic characteristic, sexual behavior, female sex workers

IU TR CN CNG BNG KHU C NH CNG DI VO MNG XNG B DI HC MT

Phm Hng Vn
Bnh vin Mt Trung ng Mc tiu: nh gi kt qu to hnh cng theo k thut c nh cng di vo mng xng hc mt. i tng v Phng php: 22 bnh nhn cn cng di khng lp c mt gi c phu thut ti khoa Chn thng, Bnh vin Mt Trung ng t 5/2001 - 7/2002 vi phng php c nh cng di vo mng xng b di hc mt. Kt qu: 22 bnh nhn 11 n, 11 nam, 31,8% nhm tui i hc, 45,4% nhm tui lao ng, 81,8% sau ct b nhn cu, 68,2% nguyn nhn do chn thng. T l thnh cng phu thut t 95,5%. Kt lun: phu thut c nh cng di vo mng xng b di hc mt to hnh cng n gin, d thc hin, t l thnh cng cao. T kha: cn cng di, khu c nh cng di

Summary RECONSTRUCTION OF CONJUNCTIVAL SOCKET BY FIXATION OF THE LOWER FORNIX INTO THE ORBITAL PERIOSTIUM
Objectives: To evaluate the results of the surgical intervention using fixation of the lower fornix into the orbital periostium technique. Methods: 22 patients with anophthalmic conjunctival sac malfunction who failed to maintain the prostheses at the traumatological department of the VNIO were enrolled into the study during the period from May 2001 to July 2002. Results: 22 patients with equal sex distribution (11 females and 11 males), 31.8% were students, 45.4% were of the working group, 81.8% were postenucleation, 68.2% due to eye traumas. Success rate of the surgical intervention was 95.5%. Conclusions: The technique of surgical management of conjunctival socket to maintain prostheses by fixation of the lower fornix the orbital periostium is a simple, easy to perform and highly effective in the socket reconstruction. Key words: conjunctival socket malfunction, fixation of the lower fornix

NGHIN CU PHN B CC LOI UNG TH DA TI BNH VIN DA LIU TRUNG NG GIAI ON 2007 - 2010
V Thi H , Nguyn Hu Su , L c Minh Trn Hu Khang,1,2Nguyn S Ho2, Ng Vn Ton1
1

1,2

1,2

Trng i hc Y H Ni; Bnh vin Da Liu Trung ng; Bnh vin Da Liu H Ni

Mc tiu: Kho st tnh hnh ung th da bnh vin Da liu Trung ng (BVDLTW). i tng v Phng php: Phng php m t ct ngang da trn d liu ca 856 bnh nhn ung th da n khm v iu tr ti BVDLTW. Kt qu: Trong thi gian 4 nm t 1/2007 n 12/2010 c 856 bnh nhn c chn on l ung th da, trong 58,8% l ung th t bo y, 32,2% ung th t bo vy , 4,8% ung th hc t cng v 4,2% l cc ung th da khc. S bnh nhn ung th da nm 2010 gp hn 2,6 ln so vi s bnh nhn nm 2007. T l nam/n l 1,2. C 64,25% bnh nhn trn 60 tui v 61% bnh nhn sng nng thn. Kt lun: S lng bnh nhn ung th da n khm v iu tr ti bnh vin Da liu Trung ng ngy cng tng. Ung th t bo y gp nhiu nht trong cc loi ung th da. Gn 2/3 s bnh nhn trn 60 tui. Bnh gp nam nhiu hn n v phn ln bnh nhn sng nng thn. T kha: Ung th da, ung th t bo y, ung th t bo vy, ung th t bo hc t

Summary DISTRIBUTION OF SKIN CANCER AT THE NATIONAL DERMATOLOGY HOSPITAL 2007 - 2010
Objective: To study the skin cancers at the National Dermatology Hospital. Study subjects and Method: The cross sectional study design was applied based on the data of 856 patients with skin cancers who were checked up and treated at the National Dermatology Hospital. Results: During preriod of January, 2007- December, 2010 there were 856 patients with skin cancers, in which 58.8% of patients suffering from basal cell carcinoma, 32.2% patents with squamous cell carcinoma, 4.8% of patients with malignant melanoma and 4.2% patients with other skin cancers. Number of patients in 2010 was 2.6 times higher than that in 2007. Male/ female ratio was 1.2. There was 64.25% patients with skin cancer over 60 years old and 61 % of them lives in rural areas. Conclusion: The number of patients with skin cancers at the National Hospital of Dermatology was increased in recent years. The basal cell carcinoma was the most common skin cancer. Nearly 2/3 of patients with skin cancers was over 60 years old. The pathology was more frequent in men than among female and most of patients live in rural areas. Key words: Skin cancer,basal cell carcinoma, Squamous cell carcinoma, malignant melanoma

TC DNG CA BI CH KH IU VINH THANG TRONG IU TR THIU NNG TUN HON NO MN TNH

Trn Quc Bnh
Bnh vin Y hc C truyn Trung ng Mc tiu: nh gi tc dng ca bi thuc c phng "ch kh iu vinh thang" trong iu tr thiu nng tun hon no. i tng v Phng php: 35 bnh nhn c iu tr ni tr trong 1 thng bng bi thuc ch kh iu vinh. nh gi kt qu lm sng bng im theo bng chn on TNTHNMT ca Khadjev. Kt qu cn lm sng da trn bin i trn lu huyt no v in no . Kt qu: Sau 1 thng iu tr, im trung bnh ca bnh nhn gim t 29,26 2,68 xung 12,86 3,8. Cc ch s lu huyt no v in no u c ci thin r rt. Khng thy tc dng khng mong mun trn lm sng. Kt lun: Bi thuc trn c tc dng tt trong iu tr thiu nng tun hon no. T kha: thiu nng tun hon no, ch kh iu vinh thang

Summary EVALUATION ON TREATMENT EFFECT OF THE REMEDY ICH KHI DIEU VINH THANG IN CHRONIC CEREBROVASCULAR INSUFFICIENCY TREATMENT
Objective: To evaluate the remedy Ich khi dieu vinh thang in the treatment of chronic cerebrovascular insufficiency. Subject and Methods: 35 patients sufered from chronic cerebrovascular insufficiency were treated in 1 month by Ich khi dieu vinh thang. Evaluation of clinical results was based on Khadjev table of chronic cerebrovascular insufficiency. Paraclinical results were evaluated by cerebral rheography and electroencephalography. Result: After one month treatment, clinical degree based on Khadjev table was reduced from 29.26 2.68 to 12.86 3.8. Laboratory fidings of cerebral rheography and electroencephalography were improved. There were no side effects observed. Conclusion: The remedy has good effect in treating cerebrovascular insufficient patients. Keywords: chronic cerebrovascular insufficiency, ich khi dieu vinh thang

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