Volume 75, No4 - August, 2011 Nghin cu mt s ch s ha sinh lin quan n hi chng khng Insulin bnh nhn tin

n sn git Gi tr ca cc ngng sng lc huyt thanh m pht hin thai hi chng Down c im in sinh l tim ca bnh nhn nhp nhanh vng vo li nt nh tht cn tn ti ung dn truyn chm sau iu tr bng sng radio Xon tinh hon: kinh nghim chn on v iu tr ti bnh vin Vit c Hi chng suy gim t bo gc biu m gic mc v cc phng php iu tr

B Y T - TRNG I HC Y H NI

01. TON THAT TUNG Str, DONG DA, HA NOI, VIET NAM - TELEPHONE (84.4) 38527622

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TNG BIN TP
PGS. TS. T Thnh Vn

S 4 - 2011

EDITOR IN CHIEF
Assoc.Prof. Ta Thanh Van MD. PhD

PH TNG BIN TP
PGS. TS. Nguyn Ngc Hng

DEPUTY EDITORS
Assoc.Prof. Nguyen Ngoc Hung MD. PhD

HI NG C VN
GS.TS. Phm Th Minh c GS.TSKH. Hong Tch Huyn GS.TS. Phm Gia Khi GS.TSKH. L Nam Tr GS.TS. c Vn GS.TS. Nguyn Ln Vit GS.TS. Nguyn Vng PGS.TS. Don Li PGS.TS. Nguyn Vn Tng

ADVISORY COUNCIL
Prof. Pham Thi Minh Duc MD. PhD Prof. Hoang Tich Huyen Dr.Sc Prof. Pham Gia Khai MD. PhD Prof. Le Nam Tra Dr.Sc Prof. Do Duc Van MD. PhD Prof. Nguyen Lan Viet MD. PhD Prof. Nguyen Vuong MD. PhD Assoc.Prof. Do Doan Loi MD. PhD Assoc.Prof. Nguyen Van Tuong MD. PhD

CNG TC VIN
PGS.TS. inh Hu Dung PGS.TS. Khng Vn Duy PGS.TS. Nguyn Duy Hu PGS.TS. inh Th Thu Hng PGS.TS. Trn Th Thanh Hng PGS.TS. Th Phng PGS.TS. Nguyn Trng Thng PGS.TS. Ng Vn Ton PGS.TS. Phm Quang Vinh TS. Trn Vn Khnh TS. Phm Vn Ph

COLLABORATORS
Assoc. Prof. Dinh Huu Dung MD. PhD Assoc. Prof. Khuong Van Duy MD. PhD Assoc. Prof. Nguyen Duy Hue MD. PhD Assoc. Prof. Dinh Thi Thu Huong MD. PhD Assoc. Prof. Tran Thi Thanh Huong MD. PhD Assoc. Prof. Do Thi Phuong MD. PhD Assoc. Prof. Nguyen Trong Thong MD. PhD Assoc. Prof. Ngo Van Toan MD. PhD Assoc. Prof. Pham Quang Vinh MD. PhD Tran Van Khanh MD. PhD Pham Van Phu MD. PhD

BAN TH K
BS. Phm Th Thanh Tn CN. Tng Th Khuyn

SECRETARIAL BOARD
Pham Thi Thanh Tan MD Tong Thi Khuyen BA

TR S BAN BIN TP
Phng Qun l Khoa hc - Cng ngh Trng i hc Y H Ni S 1 Tn Tht Tng, ng a, H Ni Fax: (84) 04.35744726 T: (84) 04.38527622

EDITORIAL OFFICE
Department of Science and Technology management Hanoi Medical University No1 Ton That Tung str, Dong Da, Hanoi - Vietnam Fax: (84) 04.35744726 T: (84) 04.38527622

Giy php xut bn s: 211/GP-BVHTT do B Vn ha Thng tin cp ngy 07/05/2001 In ti Trung tm In Trng i hc Y H Ni (thuc B Y t) - in thoi : (04)38523798 (303) Fax: (04)38525115 Np lu chiu thng 8 nm 2011

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S BIN I MT S CH S HA SINH LIN QUAN N HI CHNG KHNG INSULIN BNH NHN TIN SN GIT
V Th Ngn1 , Trn Th Chi Mai2 , Ng Vn Ti2
1

B nh vin Ph sn Thi Bnh, 2 Tr ng i hc Y H N i

Nghin cu ny nhm tm hiu v cc ch s ha sinh lin quan n hi chng khng insulin bnh nhn tin sn git. Nghin cu trn 30 thai ph khe mnh v 30 thai ph tin sn git, kt qu cho thy: Nng glucose, LDL - C huyt tng bnh nhn tin sn git tng khng c ngha thng k; trong khi nng insulin, TC, TG huyt tng bnh nhn tin sn git tng c ngha thng k so vi ph n mang thai bnh th ng. Nng HDL - C huyt tng bnh nhn tin sn git gim c ngha thng k so vi nhng ph n mang thai bnh th ng. Ch s HOMA - IR trung bnh bnh nhn tin sn git tng c ngha thng k so v i thai ph mang thai bnh th ng. T l khng insulin bnh nhn tin sn git cao hn c ngha thng k so vi nhng ph n mang thai bnh th ng. C mi tng quan thun gia ch s HOMA - IR vi HATTr .

T kha: tin sn git, HOMA-IR, insulin, HATTr

Summary

VARIATION OF SOME BIOCHEMICAL PARAMETERS RELATING TO INSULIN RESISTANCE IN PREECLAMPSIA

The cause of preeclampsia has not been precisely understood. Several studies have reported an association between insulin resistance and preeclampsia, but the role of insulin resistance in physiopathology of preeclampsia has not been demonstrated. The objective of this study is to find out the relationship between insulin resistance and preeclampsia. Material and Method: In this case - control study, 30 healthy pregnant women and 30 women with preeclampsia were included. Fasting blood glucose, insulin, total cholesterol, triglyceride, HDL-C and LDL-C levels were determined for both groups. The data were analysed by SPSS software and the p value < 0.05 was considered significant. The results showed the fasting blood glucose was not significantly different between two groups but the insulin level of the preeclamptic women was higher significantly than that of healthy pregnant women. The HOMA-IR of preeclampsia group was also higher than that of healthy pregnancy. There was a positive correlation between HOMA-IR and diastolic blood pressure. The TC, TG levels of preeclamptic group were higher while the HDL-C level was lower than that of healthy pregnant control significantly. Conclusion: In this study, the relationship between insulin resistance and preeclampsia was observed. Keywords: preeclampsia, HOMA-IR, diastolic blood pressure

TCNCYH 75 (4) - 2011

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GI TR CA CC NGNG SNG LC HUYT THANH M PHT HIN THAI HI CHNG DOWN

1

Hong Th Ngc Lan2 , Nguyn Th Hoa1 B nh vin a khoa c Giang - H N i, 2 Tr ng i hc Y H N i

Nghin cu nhm nh gi gi tr ca cc ng ng sng lc huyt thanh m pht hin thai hi chng Down. Kt qu: Dng phn mm Prisca 4.02 vi ng ng sng cho thai Down 1/250, t l pht hin l : 77,42% vi t l dng tnh gi 9,05%. Theo nng MoM vi ng ng sng AFP 0,75 MoM t l pht hin thai Down 61,3%, t l dng tnh gi 24,6%; hCG 2,3 MoM: t l pht hin thai Down 29,03%, t l dng tnh gi 4,9%; uE3 0,75 MoM: t l pht hin thai Down 25,8%, t l dng tnh gi 16,47%. Kt hp c AFP, hCG, uE3 t l pht hin thai Down 77,42%, t l dng tnh gi 20,15%. Kt lun: Dng phn mm Prisca 4.02 vi ng ng sng cho thai Down 1/250, t l pht hin: 77,42% vi t l dng tnh gi 9,05%. S dng ng ng AFP 0,75 MoM, hCG 2,3 MoM, uE3 0,75 MoM t l pht hin thai Down 77,42% t l dng tnh gi 20,15%. C s khc bit c ngha thng k vi p < 0,05 v t l dng tnh gi ca 2 loi ng ng sng lc n y.

T kha: ngng sng lc thai Down

Summary

VALUE OF CUT - OFF SCREENING IN MATERNAL SERUM TO DETECT DOWNS SYNDROME

The study was conducted to evaluate cut- off screening by maternal serum biomarker in prenatal diagnosis of Down syndrome. Results: Using Prisca 4.02 for Downs syndrome screening with cut-off 1/250, the detected rate is 77.42%; false positive rate is 9.05%. Downs screening based only on MoM: AFP 0.75 MoM, the detected rate is 61.3%, false positive rate is 24.6%; hCG 2.3 MoM, the detected rate is 29.03%, false positive rate is 4.9%; uE3 0.75 MoM, the detected rate is 25.8%, false positive rate is 16.4%. When combining AFP, hCG, uE3 ; the detected rate is 77.42%; false positive rate is 20.15%. Conclusion: When we use Prisca 4.02 with the cut - off for Downs syndrome 1/250, the detected rate is 77.42%; false positive rate is 9.05%. When using cut - off for Down syndrome by MoM with AFP 0.75, hCG 2.3 MoM, uE3 0.75 MoM, the detected rate is 77.42%; the false positive rate is 20.15%. Hence, we can see a significant different with p < 0.05 in false positive rate of the Prisca 4.02 and MoM. Keywords: cut- off of screening Downs syndrome

TCNCYH 75 (4) - 2011

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TC DNG TNG CNG KH NNG MIN DCH CA BI THUC I THIN NNG CHUT NHT TRNG TRN M HNH GY SUY GIM MIN DCH BNG CYCLOPHOSPHAMID (CY)
Hong Th L1 , Phm Th Vn Anh2 , Nguyn Trng Thng2 , Phan Th Thu Anh2
1

V in D c liu - B Y t, 2 Tr ng i hc Y H N i

Nghin cu nh h ng ca cao lng i thin nng ln cc ch s min dch trn chut b gy suy gim m in dch bng CY. Kt qu nghin cu: Cao lng TN c tc dng kch thch min dch thng qua lm tng s l ng bch cu trong mu ngoi vi, s l ng bch cu lympho, bch cu mi trung tinh v bch cu n nhn, tng t l t bo B to qung dung huyt tng s l ng cc t bo TCD3 trong lch, phn ng b v i khng nguyn OA v kh nng tit TNF- trn chut nht trng b gy suy gim min dch bng CY. Kt lu n: Cao lng i thin nng liu 29g/kg lm tng cng p ng min dch trn chut b gy suy gim m in dch bng CY.

T kho: i thin nng, kch thch min dch, chut nht trng thc nghim

Summary

INFLUENCE OF DAITHIENNUONG (DTN) IN IMMUNE INDEX ON CY INDUCED EXPERIMENTAL IMMUNO SUPPRESSED MICE
The study aims to evaluate DTN,s influence in immune index on immuno suppressed mice by CY. Results: The experimental results show that: DTN had increased total leucocyte count, number of lymphocyte, neutrophil and monocyte, rate of the plaque forming cells, the dermoreaction with OA antigen, TCD3 lymphocytes count in spleen, level of cytokine TNF or compare group that has been only injected CY without using any drug. Conclusion: The extract of TN in dose of 29g/kg had an immunostimulating effect. Keywords: daithiennuong, immunostimulating effect, experimental mice

TCNCYH 75 (4) - 2011

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KT QU IU TR LXMI CP TIN TY BO BNG PHC ATRA PHI HP DAUNORUBICIN

Trn Th Kiu My1 , Trung Phn1 , Nguyn Anh Tr2 , Bch Quc Khnh2 1 Tr ng i hc Y H Ni, 2 V in Huyt hc v Truyn mu Trung ng
Lxmi cp tin ty bo l mt d i nhm ca lxmi cp dng ty c c trng v hnh thi hc, chuyn on t (15;17) to nn gen khm PML- RAR v tnh trng ri lon ng mu e da tnh mng b nh nhn. Phc iu tr c bn hin nay l phi hp ATRA v ha cht nhm anthracyclin. Nghin c u c thc hin nhm nh gi kt qu iu tr lxmi cp tin ty bo bng phc ATRA phi hp Daunorubicin. Kt qu: 20 bnh nhn chim 57,1% c chuyn on t(15;17), 28 bnh nhn (80%) c gen khm PML - RAR . T l lui bnh hon ton l 88,6%. 11,4% t vong do xut huyt no. T l sng khng b nh trn 2 nm l 74,2%. S dng RT- PCR pht hin gen khm 6 trong s 8 bnh nhn ti pht (75%) tr c khi c biu hin trn lm sng. Kt lun: Phc ATRA phi hp Daunorubicin cho kt qu lui bnh hon ton trn 88,6% bnh nhn lxmi cp tin ty bo mi chn on. Gen khm c trng PML- RAR khng ch gip khng nh chn on m cn l du hiu d bo ti pht sm .

T kha: lxmi cp tin ty bo, ATRA, Daunorubicin, PML- RAR

Summary

TREATMENT RESULT OF NEWLY DIAGNOSED ACUTE PROMYELOCYTIC LEUKEMIA (APL) WITH ATRA PLUS DAUNORUBICIN
Acute promyelocyte leukemia (APL) is a distinct subtype of acute myeloid leukemia characterized by its morphology, t (15;17) translocation leading to PML-RAR fusion gene, and by a life-threatening coagulopathy. All-trans retinoic acid (ATRA) plus anthracycline chemotherapy is the current standard approach. Result: 20 patients (57.1%) had the t (15;17) translocation and 28 patients (80%) showed the PML-RAR transcript. The complete remission rate was 88.6%. Death percentage is 11,4% caused by intracranial hemorrhage. The 2-year DFS were 74.2%. RT-PCR was positive in 6/8 patients (75%) before relapsed clinically. Conclusion: ATRA plus Daunorubicin regime induce complete remission (CR) in up to 88.6% newly diagnosed APL patients. The specific PML-RAR transcripts permit not only a precise diagnosis but also provide marker for the relapse. Keywords: acute promyelocytic leukemia, ATRA, Daunorubicin, PML- RARa

TCNCYH 75 (4) - 2011

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C IM IN SINH L TIM CA BNH NHN NHP NHANH VNG VO LI NT NH THT CN TN TI NG DN TRUYN CHM SAU IU TR BNG SNG RADIO
Trn Song Giang1 , Nguyn Ln Vit2 1 V in Tim mch Quc gia, 2 Tr ng i hc Y H N i
Nghin cu c thc hin nhm tm hiu s bin i cc c im in sinh l tim sau iu tr cn nhp nhanh ny bng sng RF m vn cn ng DT chm. Kt qu: 22 BN c bin i r rng v c im in sinh l ca nt nh tht nh: mc blc nh tht di ra (339,6 47,3ms so vi 413,6 66,7ms - p < 0,0001), thi k tr ng DT chm di ra (237,3 36ms so vi 306,4 64,4ms - p < 0,0001), chnh lch v thi gian tr gia ng DT nhanh v ng DT chm gim i (115 50,4ms so vi 35,9 24,0ms - p < 0,0001), khong A2H2 di nht gim i (323,6 66,1ms vi 245,6 82,4ms - p = 0,005). 10 BN cn l i ch c khong A2H2 ngn li c ngha thng k (310,3 59,4ms v 238,6 44,7ms vi p = 0,025), thi gian tr ng DT chm, thi gian tr ng DT nhanh, chnh lch gia thi gian tr ng DT nhanh v chm, thi im Wenckebach khng thay i c ngha. Kt lun: Sau iu tr thnh cng nhp nhanh vng vo li nt nh tht, khong A2H2 di nht ngn li tt c cc BN. 68,7% s BN c mc blc nh tht di ra, thi gian tr ng chm di ra, chnh lch gia thi gian tr ng nhanh vi ng chm gim i. y cng c th coi l nhng tiu ch chng t th thut thnh cng.

T kha: nhp nhanh do vng vo li ti nt nh tht, ng dn truyn kp, t ng chm bng sng radio

Summary

ELECTROPHYSIOLOGIC CHARACTERISTICS OF ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA FOLLOWING SLOW PATHWAY MODIFICATION BY RADIOFREQUENCY ABLATION
The study aims to evaluate the electrophysiologic characteristics of AVNRT before and after successful ablation in patients with persistent slow pathway conduction. Results: twenty two patients (68.7%) showed a clear modification of slow pathway (group 1) whereas 10 patients (31.3%) showed absence of clear modification. A significant decrease in the maximum A2H2 was observed in both groups (323.6 66.1ms to 245.6 82.4ms - p = 0.005 in group 1, and 310.3 59.4ms to 238.6 44.7ms in group 2, p = 0.025). An increase in the AV node Wenckebach cycle length (339.6 47.3ms to 413.6 66.7ms), increase in the slow pathway effective refractory period (ERP) (237.3 36ms to 306.4 64.4ms), a decrease in difference between fast pathway and slow pathway ERP(115 50.4ms to 35.9 24.0ms) were observed only in group 1 (with p < 0,0001). Conclusion: 100% patients with successful ablation for AVNRT showed a significant decrease in the maximum A2H2. 68.7% showed an increase in the AV node Wenckebach cycle length, increase in the slow pathway ERP, a decrease in difference between fast pathway and slow pathway ERP. Keywords: atrioventricular nodal reentry tachycardia, dual AV node pathway, slow pathway ablation TCNCYH 75 (4) - 2011
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C IM LM SNG, HNH NH NI SOI, CHP CT LP VI TNH V NH GI KT QU IU TR GI PHNH NG MCH HM TRONG DO CHN THNG S MT
Quch Th Cn1 , Phm Minh Thng2
1

B nh vin Tai Mi Hng Trung ng, 2 B nh vin Bch Mai

Nghin cu c im lm sng, hnh nh ni soi, chp ct lp vi tnh v bc u nh gi kt qu iu tr phnh ng mch hm trong do chn thng. Kt qu: 10 bnh nhn u l nam gii vi tui trung bnh l 23. Nguyn nhn ch yu l do tai nn giao thng (7 bnh nhn). Hnh nh ni soi c hnh nh p theo nhp mch vch mi xoang v c mu en chy ra t khe gia. Hnh nh chp ct lp vi tnh cho thy tt c u c hnh nh v thnh sau xoang hm cng bn vi bn tn thng. Tt c bnh nhn u c iu tr thnh cng bng phng php can thip ni mch, theo di khng thy c ti pht chy mu mi. Kt lun: kt hp lm sng v i hnh nh n i soi v chp ct lp vi tnh gip ch cho chn on nh h ng v ch nh can thip mch kp thi. Phng php can thip ni mch l phng php hiu qu v tng i an ton trong iu tr phnh ng mch hm trong sau chn thng.

T kha: phnh ng mch hm trong

Summary EVALUATION ON CLINICAL FEATURES, IMAGING OF NASAL ENDOSCOPY AND COMPUTED TOMOGRAPHY, ENDOVASCULAR EM BOLIZATION IN M AN AGING IN TERN AL M AXILLAR Y AR TERIAL PSEUDOANEURYSMS POST TRAUMA
The purpose of this study was to evaluate clinical features, imaging of nasal endoscopy computed tomography (CT) and endovascular embolization in managing internal maxillary arterial pseudoaneurysms post trauma. Results: There were 10 males (mean, 23 years). The main cause was traffic accident (6 patients). On the lesion side, CT revealed posterior wall of maxillary sinus fractures. Endovascular treatment was technically successful in all patients. No recurrence of bleeding was observed. Conclusion: Nasal endoscopy and CT are useful tools for guiding diagnosis and managing in managing internal maxillary arterial pseudoaneurysms post trauma. Endovascular embolization is a safe choice in managing internal maxillary arterial pseudoaneurysms post trauma. Keyword: internal maxillary artery pseudoaneurysm

TCNCYH 75 (4) - 2011

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NHN XT MI LIN QUAN GIA CC C IM HNH NH CHP MCH S HA XA NN VI MT S BIU HIN LM SNG THNG GP CA D DNG THNG NG TNH MCH NO
Phm Hng c1 , Trn Anh Tun2 , inh Vn Thuyt3 Phm Minh Thng1 , L Vn Thnh 3 1 Tr ng i hc Y H Ni, 2 B nh vin Bch Mai, 3 B nh vin E
Nghin cu c thc hin nhm m t mi lin quan gia cc c im cu trc mch v cc biu hin lm sng l xut huyt v ng kinh ca d dng thng ng tnh mch no (DDTMN) thng qua phng php phn tch a bin. Kt qu: DDTMN biu hin xut huyt ti thi im chn on c 120 tr ng hp (54,3%). DDTMN chy mu c hp tnh mch chim 71,74% (OR = 2,89; 95% CI = 1,35 - 6,18), c tnh m ch dn lu duy nht chim 76,32% (OR = 2,38; 95% CI = 1,18 4,78), v DDTMN < 3cm chim 68,38% (OR = 1,97; 95% CI = 1,01 3,87). V tr DDTMN nm su c biu hin xut huyt ban u chim 72,22% (39/54), ngc li nm nng chim 48,50% (81/167). S bnh nhn DDTMN c biu hin ng kinh l 48 trng hp (21,74%). Trong , d dng c nhiu tnh mch dn lu chim 39,39% (OR = 2,63; 95% CI = 1,24 6,58), v c tnh mch dn lu gin phnh chim 44,83% (OR = 2,64; 95% CI = 1,05 6,58). Kt lun: Nghin cu cho thy DDTMN kch th c nh < 3cm, tnh mch dn lu duy nht v c h p l nhng c im lin quan c ngha vi biu hin xut huyt. Nghin cu ny cng ch ra rng DDTMN c t hai tnh mch dn lu tr ln v c tnh mch dn lu gin phnh l cc yu t lin quan c ngha ti b iu hin ng kinh.

T kha: d dng ng tnh mch no, cc c im cu trc mch, biu hin xut huyt, ng kinh

Summary

THE RELATIONSHIPS BETWEEN ANGIOARCHITECTURAL FEATURES ON DSA IMAGINGS AND POPULAR CLINICAL PRESENTATIONS OF BRAIN ARTERIOVENOUS MALFORMATIONS
The study aims to describe the associations between popular clinical presentations such as hemorrhagic and epilepsy of brain arteriovenous malformations (AVMs) and their angioarchitecture have been described event through multivariate statistical methodology. Results: Patients had hemorrhagic presentations at diagnosis in 120 cases (54.3%). AVMs had bleeding with venous stenosis in 71.74% (OR = 2.89; 95% CI = 1.35 - 6.18), with single draining vein in 76.32% (OR = 2.38; 95% CI = 1.18 - 4.78), and with AVMs < 3cm in 68.38% (OR = 1.97; 95% CI = 1.01 - 3.87). Hemorrhage was the initial presentation in 72.22% (39/54) of the deep-seated AVMs and 48.50% (81/167) of the superficial location. Patients had epileptic presentations at diagnosis in 48 cases (21.74%). AVMs had epilepsy with multiple draining veins in 39.39% (OR = 2.63; 95% CI = 1.24 - 6.58), and with dilated draining vein in 44.83% (OR = 2.64; 95% CI = 1.05 - 6.58). Conclusion: This study suggests that AVMs with small nidus, single draining vein, and venous stenosis were significant asociated features for hemorrhagic presentation. It also suggests AVMs with multiple and dilated draining veins were significant asociated features for epilepsy. Key words: brain arteriovenous malformations, angioarchitectural features, hemorrhagic presentation, epilepsy
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TCNCYH 75 (4) - 2011

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FIBROSCAN - K THUT MI TRONG CHN ON X GAN V CC BIN CHNG

Trn Ngc nh, o Nguyn Khi Tr ng i hc Y H N i
FibroScan l mt k thut mi, khng xm nhp nh gi mc x ha ca gan. Nghin cu n y nhm 2 mc tiu: Tm hiu ch s FibroScan trong x gan. nh gi s thay i ca ch s FibroScan vi m c nng nh ca x gan theo phn loi Child- Pugh. Kt qu: bnh nhn x gan, ch s FibroScan: 35,35 kPa, nhm chng: 5,29 kPa. Ng ng chn on x gan l 18,5 kPa vi Se 100%, Sp 47,2%, PPV 19,1%, NPV l 100%, AUROC - 0,917. Vi din tch d i ng cong AUROC > 0,7, ng ng chn on gin tnh mch thc qun 2- 3, x gan Child C, c tr ng v xut huyt tiu ha ln l t l 27,7 kPa, 43,9 kPa, 43,5 kPa, 58,2 kPa. Ch s FibroScan tng theo mc nng ca x gan v c lin quan cht ch vi im Child Pugh vi r = 0,65. Kt lun. FibroScan rt ng ha hn trong chn on x gan v pht hin s m cc bin chng ca x gan.

T kha: FibroScan, x gan

Summary

TRANSIENT ELASTOGRAPHY (FIBROSCAN): A NEW TECHNIQUE FOR DIAGNOSIS OF CIRRHOSIS OF LIVER AND ITS COMPLICATIONS
Transient elastography (FibroScan) is a new, non-invasive, rapid, and reproducible method allowing evaluation of liver fibrosis. The aim of this study was to assess FibroScan index in cirrhosis and the correlation between Fibroscan index and Child Pugh Score. Results. In cirrhotic patients, liver stiffness was 35.35 kPa, but it was 5.29 kPa in control patients. Using a cut off value of 18.5 kPa, patient with cirrhosis were detected, a Se of 100%, a Sp of 47.2%, a PPV of 19.1%, and a NPV of 100%, the AUROC was 0.917, were obtained. With an AUROC > 0.7, the cut off values for the presence of oesophageal varices stage 2/3, cirrhosis Child-Pugh C, ascites, and oesophgeal bleeding were: 27.7 kPa, 43.9 kPa, 43.5 kPa and 58.2 kPa respectively. The results of transient elastography correlated positively with Child Pugh score: r = 0.65. Conclusion: Transient elastography is a promising non-invasive method for detection of cirrhosis and it can be used indirectly to predict its complications in patients with chronic liver disease. Keywords: FibroScan, cirrhosis

TCNCYH 75 (4) - 2011

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NHIM KHUN TIT NIU V TNH TRNG VI KHUN KHNG KHNG SINH NHM FLUOROQUINOLONES
Gia Tuyn Tr ng i hc Y H N i
Nhim khun tit niu (NKTN) l bnh l th ng gp trn lm sng, gp mi la tui. Chi ph iu tr NKTN l rt tn km, t l khng khng sinh l tng i cao. Nghin cu c thc hin nhm xc nh t l NKTN bnh nhn nm ti khoa Thn - Tit niu Bnh vin Bch Mai v tm hiu s khng ca vi khun vi khng sinh nhm Fluoroquinolones. Kt qu: T l NKTN l 7,79%, t l cy n c tiu dng tnh l 44,9%. tui hay gp nht l 45 - 65. E.coli v Enterococcus l hai vi khun ng hng u gy NKTN v t l khng nhm Fluoroquinolones c hai vi khun ny l tng i cao. Kt lun: E.coli v Enterococcus l hai vi khun ng hng u gy NKTN c hai vi khun ny u khng khng sinh Fluoroquinolones vi t l kh cao.

T kha: nhim khun tit niu, khng sinh

Summary

BACTERIOLOGICAL PROFILE OF URINARY TRACT INFECTIONS AND RESISTANCE TO FLUOROQUINOLONES IN THE DEPARTMENT OF NEPHRO-UROLOGY BACHMAI HOSPITAL
Urinary infection is a frequent pathology in the community as well as at the hospital. This study aims to evaluate the rate of urinary tract infections (UTIs) and impact of resistance to fluoroquinolones in the department of Nephro-Urology, Bachmai Hospital. The result shows that 89 cases of UTI were collected during this period. Escherichia coli and Enterococcus were the most frequently identified strains (62.5%) and (50%). The identified strains presented natural resistance and a high frequency of acquired resistance to fluoroquinolones 53.5% of E.coli, 71.5% Enterococcus were resistant to fluoroquinolones. Conclusion: Escherichia coli and Enterococcus were the most frequent species in urinary tract infection. Among these isolates, a high frequency of acquired resistance to fluoroquinolones was shown. In every case, antibiotherapy should have been prescribed after performing an antibiogram for each strain. These data were useful for the first line antibiotherapy, however the antimicrobial susceptibility testing is necessary for the rational use to limit the highly active drugs to multiresistant strains.Resistance to fluoroquinolones of E.coli and Enterococcus is a growing problem with a negative impact UTIs; therefore, the prescription of these agents should be limited to infections for which they are recommended. Keywords: urinary tract infections, fluoroquinolones

TCNCYH 75 (4) - 2011

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HOT ENZYM TY NGOI TIT TRN BNH NHN VIM TY MN

Phm Hong H Tr ng i hc Y H N i
nh gi chc nng ty ngoi tit da ch yu vo xc nh hot enzym ty ngoi tit trong mu v trong dch ty. Nghin cu nhm xc nh hot cc enzym ty trong mu v trong dch ty bnh nhn vim ty mn, nh gi mi tng quan ca cc enzym ty trong mu v trong dch ty. K t qu cho thy gi tr trung bnh hot Protease trong mu l 89,27 nKatal/ml, trong dch ty l 107,29 nKatal/ml. Gi tr trung bnh hot Amylase trong mu l 138,12 n v/100 ml, trong dch ty l 542,73 n v/100 ml. Gi tr trung bnh hot Lipase trong mu l 11,88 n v Bondi, trong dch ty l 51,65 n v Bondi. H s tng quan gia Protease, Amylase v Lipase trong mu v trong dch ty tng ng l 0,277; 0,226 v - 0,148. K t lun: c suy gim chc nng ty ngoi tit bnh nhn vim ty mn v khng c tng quan tuyn tnh gia hot enzym ty trong mu v trong dch ty.

T kho: vim tu mn, hot enzym tu ngoi tit

Summary

ACTIVITY OF EXOCRINE PANCREATIC ENZYME IN CHRONIC PANCREATITIS PATIENTS

Evaluation on the exocrine function of pancreas is mainly based on specifying activity of exocrine pancreatic enzyme in blood and in pancreatic juice. Objective: to specifying activity and evaluate the correlation of exocrine pancreatic enzyme in blood and in pancreatic juice of chronic pancreatitis patients. Results show that mean value of Protase in blood: 89.27 nKatal/ml, in pancreatic juice: 107.29 nKatal/ml. Mean value of Amylase in blood: 138.12 IU/100ml, in pancreatic juice: 542.73 IU/100 ml. Mean value of Lipase in blood 11.88 Bondi IU, in pancreatic juice: 51.65 Bondi IU. r of Protease in blood and in pancreatic juice: 0.277; r of Amylase in blood and in pancreatic juice: 0.226; r of Lipase in blood and in pancreatic juice: - 0.148. Conclusion: exocrine function of pancreas was decreased in chronic pancreatitis patients there was no linear correlation between activity of exocrine pancreatic enzyme in blood and in pancreatic juice. Keywords: chronic pancreatitis, activity of exocrine pancreatic enzyme

10

TCNCYH 75 (4) - 2011

TP CH NGHIN CU Y HC

PHU THUT FREY- BEGER SAU PHU THUT PARTINGTON TRONG IU TR SI TY VIM TY MN
Trnh Hng Sn1 , Phm Hong H 2 1 B nh vin Hu ngh Vit c, 2 Tr ng i hc Y H N i
P hu thut Frey- Beger l phng php iu tr vim ty mn hiu qu, c la chn khi cc phu thut d n lu ng ty n thun tht bi, nht l khi xut hin bin chng hp ng mt. Nhn mt tr ng hp vim ty mn sau phu thut Partington- Rochelle c m li bng phu thut Frey- Beger, chng ti mun g ii thiu bnh n v nhn mnh vai tr ca phu thut Frey- Beger trong iu tr vim ty mn.

T kha: phu thut Frey-Beger, vim ty mn

Summary

SURGICAL TREATMENT WITH FREY AND BEGER COMBINATION PROCEDURE AFTER PARTINGTON PROCEDURE FOR CALCIFYING CHRONIC PANCREATITIS
Combination of Frey operation and Beger operation is the effective method for chronic pancreatitis. This method will be a good choice in case of unsuccessful drainage procedures, especially when complication of biliary tract stenosis apprears. We want to introduce a chronic pancreatitis patient after being operated by Partington-Rochelle procedure underwent second operation with Frey-Beger procedure in order to emphasize the role of this method in surgical treatment for chronic pancreatitis. Keywords: Frey-Beger procedure, chronic pancreatitis

TCNCYH 75 (4) - 2011

11

TP CH NGHIN CU Y HC

C IM M BNH HC BNH VIM I TRNG LOT

Nguyn Vn Hng, Nguyn Thy Hng, Trn c Hng Trng i hc Y H N i
Sinh thit i trc trng nhiu mnh hin nay c s dng rng ri trong chn on bnh ca ng tiu ha, tuy nhin, vn cn t nghin cu v m bnh hc bnh rut vim (IBD). Hn na, cc tiu chu n hnh thi hc ca bnh vn cn c bn lun. Mc tiu: xc nh c im m bnh hc bnh vim i trng lot (UC) theo tiu chun m hc Nottingham nm 2000 v bnh rut vim (IBD). Kt qu: 68 tr ng h p vim i trng lot (UC) gm 298 mnh sinh thit nim mc i trc trng cho thy cc tn thng m hc th ng gp gm teo nim mc (68/68), xon vn v chia nhnh khe tuyn (66/68), d lympho - tng bo nm y khe tuyn (68/68), vim nng lan ta (60/68), vim xuyn nim mc (52/68). V hot ng ca vim vi 5 (7,3%) ca 1; 8 (11,8%) ca 2; 6 (8,8%) ca 3; 2 (2,9%) ca 4; 2 (2,9%) ca 5; 1 (1,4%) ca 6 v 1 (1,6%) ca 7. Cc ca cn li (43 (63,2%) ca) khng c bch cu a nhn trung tnh nim mc. Kt lun: Cc tiu chun hnh thi hc Nottingham (2000) v bnh rut vim c

. th cho php phn bit c bnh vim i trng lot T kha: bnh rut vim, vim i trng lot, sinh thit

Summary

HISTOPATHOLOGICAL CHARACTERISTICS OF ULCERATIVE COLITIS

Multiple colorectal biopsies are now in widespread use for the diagnosis of gastrointestinal diseases although there is little research histopathologically of inflammatory bowel disease. There is also still debate about morphological criteria for interpreting these biopsies. The study aims to determine the histopathological features of ulcerative colitis (UC) based on the Nottingham 2000 histological criteria for inflammatory bowel disease (IBD). Results: 68 cases of ulcerative colitis (UC) included 298 endoscopic samples of colorectal mucosa have shown the common morphological alterations such as crypt atrophy (68/68), crypt distorsion and ramification (66/68), lympho-plasmocytoid band in crypt base (68/68), diffuse superficial inflammation (60/68), diffuse transmucosal inflammation (52/68). As for inflammatory active grade with 5 (7.3%) grade 1; 8 (11.8%) grade 2; 6 (8.8%) grade 3; 2 (2.9%) grade 4; 2 (2.9%) grade 5; 1 (1.4%) grade 6 and 1 (1.4%) grade 7; 43 (63.2%) other cases have not neutrophils in the mucous membrane. Conclusion: Nottingham 2000 morphological criteria for inflammatory bowel disease (IBD) is possible to distinguish ulcerative colitis. Keywords: inflammatory bowel disease (IBD), ulcerative colitis, biopsy
i

TCNCYH 75 (4) - 2011

12

TP CH NGHIN CU Y HC

TNH N NH V CNG HIU CA VC XIN VIM NO NHT BN SN XUT TI VIT NAM

Th Dip Lan, L Vn Phng V in Kim nh Quc gia Vc xin v Sinh phm Y t
Theo di tnh n nh v cng hiu ca vc xin l cng vic cn thit nh gi quy trnh sn xut v cht l ng ca vc xin. Nghin cu c thc hin nhm nh gi cng hiu tng quan gia vc xin mu th vi mu chun v tnh n nh cng hiu ca chng trong 10 nm (2001 - 2010). Kt qu: cng hiu ca v c xin VNNB l n nh vi cc gi tr nm trong khong cho php theo khuyn co ca WHO. Hiu gi khng th trung ha trung bnh (GMT) ca cc lot vc xin mu th u cao hn vc xin mu chun Quc gia R194 vi cc gi tr tng ng l 2,04 0,68 v 1,81 0,58. Kt lun: Vc xin VNNB c cht l ng tt gp phn quan trng trong chin l c phng bnh vim no Nht Bn ti Vit Nam.

T kha: n nh, cng hiu, vc xin vim no Nht Bn

Summary

POTENCY STABILITY OF JAPANESE ENCEPHALITIS VACCINE PRODUCED IN VIETNAM

Observing the stability in vaccine is very necessary to judge a manufacturing process and the quality of vaccine. Study aims to evaluate the relative potency between the samples and reference vaccines and analysis their stability of potency during 10 years (2001 - 2010). Result: show that the stability of potency of vaccine is inside respect range and meets WHO recommendation requirements. Means of neutralization antibody index of 72 of lots is more than national standard vaccine R194 with the values are 2.04 0.68 and 1.81 0.58. Conclusions: Japanese Encephalitis vaccine plays a very important roll in prevention stratery in Viet Nam. Key words: stability, potency, Japanese encephalitis vaccine

TCNCYH 75 (4) - 2011

13

TP CH NGHIN CU Y HC

NGUYN NHN V CC YU T THUN LI GY NG C MT S THUC NG V AN THN THNG GP

H Trn Hng 1 , Phm Du2 1 Tr ng i hc Y H Ni, 2 B nh vin Bch Mai
Ng c cc thuc ng l bnh cnh th ng gp trong s cc tr ng hp vo vin cp cu. Nghin cu c thc hin nhm xc nh nguyn nhn v cc yu t thun li gy ng c mt s thuc ng v an thn th ng gp. Kt qu: Ng c thuc th ng gp nht l do t t. Tip n l do t dng thuc khng theo ch nh, bt cn trong bo qun thuc, t dng nhm hoc ng i thn cho ung nhm. Tr em ng c thuc hu ht do tai nn. Nguyn nhn quan trng khc l lm dng thuc v thng c dng iu tr bnh tm thn, mt ng v gim au. Cc yu t thn li gy ng c thuc l do thiu k i n thc v bo qun v s dng thuc an ton, c sn thuc trong nh. Kt lun: Nghin cu cung cp thng tin c bn v nguyn nhn, cc yu t thun li gy ng c, l mt b c quan trng trong phng chng ng c thuc ng.

T kha: ng c, thuc ng, nguyn nhn, yu t thun li

Summary

CAUSES AND RISK FACTORS FOR ACUTE POISONING OF COMMON SEDATIVES

Drug overdose and poisoning are one of the most common emergencies in Vietnam. The aim of this research is to identify the causes and risk factors of acute intoxification by medications. Thus, the cross-sectional and case-control design were used in the study. The results of the study revealed medication poisoning was mainly caused by suicidal purpose that commonly resulted from and conflicts between lovers and inside family. Unintentional and misuse were the second common cause of drug overdose and the most common documental situations were taking drug without prescriptions of medical doctors or followed seller at pharmaceutical shop, careless during drugs keeping, accidental misuse of medications. The another important reason of drug overdose was abuse or intentional misuse and the commonly observed situation were deliberate use large dose to control psychoses, insomnia, pain relief and to treat other diseases. The most important risk factors of drug overdose were lack of the necessary knowledge on safe and rational use of medications and the availability of drugs at home because the poisoned patients or family members need to use drugs regularly. Keywords: drug overdose, intoxification

TCNCYH 75 (4) - 2011

14

TP CH NGHIN CU Y HC

SO SNH HIU QU IU CHNH pH DCH D DY CA RANITIDINE LIU 200mg VI 100mg TIM TNH MCH TRC M BNH NHN PHU THUT CP CU BNG
V Thnh Lm, Nguyn Hu T Tr ng i hc Y H N i
Nghin cu c thc hin nhm s snh hiu qu gia ranitidine liu 200mg v 100mg tim tnh mch tr c m o trn pH dch d d y bnh nhn phu thut cp cu bng v nh gi tc dng khng mong mun ca ranitidine. K t qu: pH dch d dy sau tim thuc 1 n 10 gi ca nhm 200mg cao hn nhm 100mg c ngha thng k vi p < 0,01 v p < 0,05, t l bnh nhn c pH < 2,5 sau tim thuc t 1 n 10 gi ca nhm 200mg u thp hn nhm 100mg (p < 0,05). 4/90 bnh nhn sau tim ranitidine c biu hin chng mt, bun nn hoc au ni tim nh, thong qua. Kt lun: Ranitidine liu 200 mg tim tnh mch tr c m lm tng pH dch d dy v lm gim t l bnh nhn c pH < 2,5 nhiu hn ng k so vi liu 100mg. Cc tc d ng khng mong mun ca thuc l khng ng k.

T kha: pH d dy, tro ngc, ranitidine

Summary

COMPARISON OF THE EFFICACY OF INTRAVENOUS INFUSION BETWEEN 200mg AND 100mg RANITIDINE ON GASTRIC pH IN SURGICAL ABDOMINAL EMERGENCY PATIENTS
The study aims to evaluate the efficacy and side effects of intravenous infusion of 200 mg and 100 mg ranitidine on gastric pH in surgical abdominal emergency patients. Results: Gastric pH was significantly higher in the 200mg ranitidine group than the 100mg at a range of 1 to 10 hours (p < 0.01 or 0.05). During 10 hours, the proportion of patients with pH < 2.5 was significantly smaller in the 200mg ranitidine group than the 100mg (p < 0.05). Only 4/90 patients had light downiness, nausea or soreness. Conclusions: A single IV dose of 200mg ranitidine significantly increased gastric pH and decreased the proportion of patients with pH < 2.5 than a dose of 100mg. Side effects were minor and similar between the 2 groups. Key words: Gastric pH, gastric aspiration, ranitidine

15

TCNCYH 75 (4) - 2011

TP CH NGHIN CU Y HC

XON TINH HON: KINH NGHIM CHN ON V IU TR TI BNH VIN VIT C

Hong Long1 , Nguyn Hoi Bc 2 , Trn Quc Ho 1, V Nguyn Khi Ca2 , Nguyn Phng Hng 2 , V Hng Giang 2 1 Tr ng i hc Y H Ni; 2 B nh vin Vit c H N i
Bo co nhm a ra nhng kinh nghim chn on, iu tr bnh xon tinh hon v ng thi xut nhng khuyn co nhm lm gim t l ct b tinh hon. Kt qu: Tng s 63 bnh n p ng ti u chun la chn ca nghin cu c a vo phn tch. tui trung bnh ca cc bnh nhn l 22 tui, thi gian n khm bnh l 145,27 gi, 100% cc bnh nhn c y cc triu chng v du hiu lm sng ca xon tinh hon nh: Sng au bu cp tnh, tinh hon nm cao trong bu v mt cng chc. Siu m chn on ng 59/63 (93,65%) cc trng hp xon. T l ct b tinh hon l 84,1% (53/63 bnh nhn), ch c 15,9% bo tn c tinh hon. Kt lun: Tun th nghim ngt qui trnh khm lm sng l khu quan trng gip loi tr xon tinh hon trong cc tr ng hp au bu cp tnh khc. Siu m Doppler m ch thng tinh nn c tin hnh hng lot chn on xc nh v phn bit bnh. n khm bnh m un l yu t chnh lm tng t l ct b tinh hon.

T kha: Xon tinh hon, au bu cp tnh, ct tinh hon

Summary

TESTICULAR TORSION: THE EXPERIENCES IN DIAGNOSIS AND TREATMENT OF VIET DUC UNIVERSITY HOSPITAL
Objective of the study was to raise our experiences in and recommendations on diagnosis and treatment of testicular torsion to reduce the risk of orchiectomy. Results: Data for 63 eligible medical records of patients with testicular torsion was available for analysis. The median age of the patients was 22 years. The mean duration of pain at presentation (recorded as the time from the onset of scrotal pain to the time when patients presented at Vietduc Hospital) was 145. 27 hours. 100% patients presented clinical symptoms and signs such as acute painful swelling, hardness and tenderness of the scrotum. The colour Doppler ultrasound diagnosed accurately 59 in 63 patients. The orchiectomy and testicular salvage rates were 84.1% and 15.9%, respectively. Conclutions: Obtaining the clinical skills is extremely important to exclude testicular torsion from other acute scrotal pain conditions. Flow colour Doppler ultrasound is an useful imagining study to identify and differentiate torsion from others. Delay in presentation is a main risk factor for orchiectomy. Keys words: testicular torsion, acute scrotal pain, orchiectomy

TCNCYH 75 (4) - 2011

16

TP CH NGHIN CU Y HC

C TNH CA SHELLAC F I VI NGUYN BO SI CA TY RNG NGI

Hong o Bo Trm1,2, Hong T Hng 1, Imad About2
1

i hc Y D c Thnh ph H Ch Minh, Vit Nam 2 i hc Mditerrane, Marseille, Php

Nghin cu c thc hin nhm nh gi c tnh ca Shellac F i vi nguyn bo si ca ty rng ng i. Kt qu: i vi nguyn bo si ca ty rng ng i, trong iu kin tip xc trc tip, Shellac F khng cn c tnh mc pha long mi tr ng l 1:10 (t l t bo sng trung bnh 77,47%), tng ng vi Duraphat (81,37%), trong khi Isodan khng c pha long 1:100 (t l t bo sng trung bnh 93,44%); trong iu kin tip xc gin tip, c ba vt liu khng c n c tnh pha long mi tr ng th 1:10 (t l t bo sng trung bnh tng ng l 84%, 90% v 87%). Kt lun: i vi nguyn bo si ca t y rng ng i, trong iu kin tip xc trc tip, mc c tnh vi t bo ca Shellac F tng ng v i Duraphat v thp hn Isodan; trong iu kin tip xc gin tip, mc c tnh vi t bo ca ba vt liu tng ng nhau.

T kha: shellac F, c tnh vi t bo, nguyn bo si ca ty rng ngi

Summary

CYTOTOXICITY OF SHELLAC F ON PULP FIBROBLAST

The study was conducted to evaluate the cytotoxicity of Shellac F on human pulpal fibroblast. Results: On human pulpal fibroblast, in direct contact condition, Shellac F was non-toxic at the dilution of 1:10 (average cell viability: 77.47%), comparable to Duraphat (81.37%), while Isodan showed non-toxic at 1:100 (average cell viability: 93.44%); with dentin slice interposition, all materials showed non-toxic at the dilution of 1:10 (average cell viability: 84%, 90% and 87%, respectly). Conclusions: On human pulpal fibroblast, in direct contact condition, Shellac F showed a toxicity which was similar than that of Duraphat and lower than that of Isodan; with dentin slice interposition, three materials presented similar toxicity. Key words: shellac F, cytotoxicity, human pulpal fibroblast

TCNCYH 75 (4) - 2011

17

TP CH NGHIN CU Y HC

MI LIN QUAN GIA NGHING TRC THN RNG NANH VI CC LOI KHP CN
Hong Vit Hi, Quang Trung V in o to Rng Hm Mt, Tr ng i hc Y H N i
Nghin cu nhm nh gi nghing gn xa ca trc rng nanh cc loi khp cn theo phn loi Angle. T in hnh khm lm sng v phn tch mu trn 540 sinh vin tui t 18 - 25 (g m 281 nam v 259 n ). o nghing gn xa ca rng nanh v so snh gia cc nhm sai khp cn. Kt qu cho thy c s khc bit ng k v nghing gn xa ca thn rng nanh vnh vin gia ng i c sai khp cn loi I v lo i III, c bit l rng nanh hm di. Rng nanh hm trn ca ba loi sai khp cn u nghing gn, trong sai khp cn loi III c nghing gn ln hn so vi hai loi sai khp cn cn li. Rng nanh hm di sai khp cn loi III nghing xa, cn sai khp cn loi I v loi II th rng ny nghing g n.

T kha: nghing gn xa, rng nanh, khp cn

Summary

THE RELATION OF CANINE ANGULATION AND ANGLE CLASSES OF OCCLUSION

The aim of this study was to evaluate the mesiodistal axial angulations of canines in Angle malocclusions. The clinical examination of 540 students aged 18 to 25 years old (including 281 male and 259 female) were performed and their dental casts were analysed. After measurement of canine angulations, comparisons were performed. Results showed that there was a statistically significant difference in angulations of canines between Angle class I and III malocclusions, especially in lower canines. Upper canines of Angle class I, II and III malocclusions angulated mesially, with the canines of the Angle class III had a more mesial angulation than the those of the Angle class I and II. Lower canines of the Angle class III angulated distally, but those of the Angle class I and II angulated mesially. Keyword: mesiodistal angulation, canine, occlusion

TCNCYH 75 (4) - 2011

18

TP CH NGHIN CU Y HC

C IM LM SNG TRIU CHNG AU TRONG MT S RI LON LIN QUAN N STRESS

Trn Nguyn Ngc Tr ng i hc Y H Ni
au l triu chng th ng gp trong cc ri lon lin quan n stress. Nghin cu nhm lm sng t c im lm sng triu chng au trong cc ri lon lin quan n stress, gp phn chn on sm v iu tr k p thi ngay ti tuyn u. Kt qu cho thy: v tr th ng gp: u mt c 65,5% trong ri lon lo u, 85% trong cc ri lon dng c th, 100% trong phn ng vi stress trm trng; tip , au lng, au bng, au ngc v au cc khp, vi tnh cht m h, cm gic nng n, c ng au tng ln khi cm xc cng thng, kh chu. Kt lun: Triu chng au pht sinh v din bin trong cc ri lon tm sinh c lin quan n cc nhn t tm l- x hi, th ng gp nhm tui 20 - 39 (44,7%). Bnh cnh lm sng chim u th l cc triu chng au chc nng a dng, phong ph khng c bng chng tn thng thc th .

T kha: au tm sinh

Summary

CLINICAL FEATURES OF PAINFUL SYMPTOM IN SOME RELATED-STRESS DISORDER

Pain is a common symptom in related-stress disorders. Objectives: To identify clinical features of painful symptoms in related-stress disorders; to help early diagnosis and timely treatment in primary care. Results: Stress-related disorders were most common in the age 20 - 39 (44.7%), the male\female ratio: 1.7/1. The highest percentage of painful symptoms was headache, which was 65.5% in anxiety disoders, 85% in somatoform disorders, 100% in reaction to severe stress and adjustment disorders; following are back pain, abdominal pain, chest pain and musculoskeletal pain. All these symptoms are indefinite, with heavy sense and worsened when patients are worried or nervous. Conclusion: The onset and progress of painful symptoms in psychogenic disorders have association with psychological and sociological factors. The chief complaint is functional pain which is multiform and not explained by a physical cause. Keywords: pychogenic pain

TCNCYH 75 (4) - 2011

19

TP CH NGHIN CU Y HC

KIN THC, THC HNH S DNG NC SCH CA NGI DN 4 X C NGUY C MC TIU CHY CAO H TY
o Th Minh An V in o to Y hc d phng v Y t cng cng - i hc Y H N i
Nghin cu c thc hin nhm m t kin thc, thc hnh s dng n c sch v mi lin quan gia k in thc v thc hnh ca ng i dn ti mt s im c nguy c mc tiu chy ti tnh H Ty. Kt qu: H iu bit ca ng i dn v ngun n c sch cha y theo cc tiu ch: nc trong 73,0- 83,3%; mu, mi, v 41,5 - 59,6%; nc khng sch gy tiu chy 66,7 - 77,6%; gy vim da, au mt 28,6 - 33,7%; gy b nh ph khoa 12,5% - 13,9%. C s khc bit v thc hnh s dng n c sch gia cc a bn. T l lc n c trong nhng h gia nh (HG) dng nc ging khoan t 38,7 - 96,3%. T l h gia nh dng n c my ch bin thc phm cn thp 27,3 - 38,3%. T l thc hnh ung n c un si cao t 83,9 - 91,5%. Ngi c hiu bit v tiu chun n c sch c thc hnh un si nc tr c khi ung v s dng n c s ch ch bin thc phm tt hn ngi khng c hiu bit. Ng i c hiu bit v tc hi ca s dng n c khng sch c thc hnh s dng n c my tt hn. Ngi c hiu bit s dng n c cha un si gy tiu chy c thc hnh ch bin thc phm bng n c sch cao hn c ngha thng k.

T kho: Nc sch, nguy c tiu chy

Summary

KNOWLEDGE, PRACTICE OF USING WATER AMONG POPULATION LIVING IN 4 HOT SPOTS OF ACUTE DIARRHEA IN HA TAY PROVINCE IN 2009
The study aims to describe knowlegde, practice and their relationship in some hot spots in former Hatay province. Study subjects and methodology: 4000 heads of the households were interviewed about knowledge on safe waters criteria, health consequences of not using safe water and practice in using safe water. Results: Knowledge on safe waters criteria was not good. 73,0 - 83.3% listed the transparency, 41.5 - 59.6% listed the colour and taste; 66.7 - 77.6% pointed out that using unsafe water causes diarrhea; 28.6 - 33.7% mentioned dermatitis and sore eyes; 12.5 - 13.9% listed gyneacology disease. Urban people had better knowledge than rural people. Practice in using safe water was different across study sites. Practice of water filter among households using drill well water was 38.7 - 96.3%. Practice of using tap water for food processing was low at 27.3 - 38.3%. Prevalence of using boil water for drinking was good at 83.9 - 91.5%. Relationship between: knowledge on criterias of safe water with practice of drinking boilt water and use safe water for food processing; knowledge on health consequences of using not safe water with practice of using safe water; knowledge on using unboilt water makes diarrhea with food processing. Key words: knowledge, practice, safe water

TCNCYH 75 (4) - 2011

20

TP CH NGHIN CU Y HC

TNH HNH THA CN V BO PH TR EM DI 5 TUI NM 2009 TI VIT NAM

Trn Thnh 1 , Nguyn Phng Hoa 2 1 V in Dinh d ng, 2 Tr ng i hc Y H N i
Nghin cu c thc hin nhm kho st t l tha cn v bo ph tr em d i 5 tui. K t qu: iu tra trn tng s 96626 tr (50268 tr trai v 46358 tr gi) cho thy t l tr tha cn l 4,1% (95% CI 3,9 - 4,4), t l bo ph l 1,2% (95% CI 1,1 - 1,3). T l tha cn v bo ph tr trai cao hn so vi nhm tr gi (p < 0,05). T l tha cn v bo ph cao nht nhm tr t 0 - 5 thng tui (5,8% v 2,1%). Kt lun: t l tr tha cn tr em Vit Nam ang tng dn. Cn sm trin khai cc chng trnh can thip.

T kha: tha cn, bo ph, tr em di 5 tui

Summary

OVERWEIGHT AND OBESITY AMONG CHILDREN UNDER 5 YEARS IN VIETNAM, 2009

The study aims to investigate the prevalence of overweight and obesity among children under 5 years. Results: 96626 children (50268 boys and 46358 girls). The prevalence of overweight and obesity were 4.1% (95% CI 3.9 - 4.4) and 1.2% (95% CI 1.1 - 1.3) respectively. The prevalence of overweight and obesity among boys were significantly higher than among girls (p < 0.05). The prevalence of overweight and obesity among children who was 0-5 months were the highest (5.8% and 2.1%). Conclusions: overweight and obesity is increasing among children less than 5 years in Vietnam. Intervention programs to control the problem are needed to implement soon. Key words: over weight, obesity, children under 5 years

TCNCYH 75 (4) - 2011

21

TP CH NGHIN CU Y HC

GI TR DINH DNG, C TNH CM QUAN CA M TM SN XUT T BT M TNG CNG VI CHT

Nguyn T Anh, Nguyn Xun Ninh V in Dinh d ng
Nghin cu c thc hin nhm theo di gi tr dinh d ng, vi sinh vt ca m tm ch bin t bt m tng cng vi cht theo thi gian bo qun v nh gi c tnh cm quan v kh nng chp nhn ca m tm trn ph n tui sinh 20 - 35 tui. Kt qu: Bt m tng c ng vi cht c cc gi tr dinh d ng,s n xut khng b nhim vi sinh vt, 4 trong 5 ch s dinh d ng (protein, lipid, Fe, Zn khng b suy g im trong qu trnh ch bin v bo qun; ch s acid folic b gim mnh sau ch bin, cn khng ng k t sau 3 thng sn xut. c tnh cm quan chung ca m tm t mc kh (17,5 - 17,7 im/im 20), c cc i t ng chp nhn tt trong 7 ngy s dng sn phm. Kt lun, khuyn ngh: M tm sn xut t bt m tng c ng vi cht, a s cc ch tiu n nh trong thi gian 3 - 6 thng bo qun, ring acid folic b gim mnh sau 3 sn xut. M tm c im cm quan cao v c cng ng chp nhn tt. Cn tin hnh nghin cu v tnh n nh ca cc vi cht vi cc sn phm khc ch bin t bt m, cng nh nh gi hiu qu ca s dng sn phm trn ng i.

T kha: bt m, m tm, tng cng vi cht, c tnh cm quan

Summary

NUTRITIONAL VALUES, SENSORY CHARACTERISTICS OF INSTANT NOODLE PRODUCED FROM WHEAT FLOUR FORTIFIED WITH MICRONUTRIENTS
The study was carried out to monitor the nutritional values, microbiology index of instant noodle produced from wheat flour fortified with micronutrients during the storage and to test the sensory characteristic, acceptability of instant noodle by women of child-bearing age 23 - 35 years old. Results:The nutritional values, microbiology index of wheat flour fortified with micronutrients were in good range suitable to the MOH standard. Instant noodle just after produced, after 3 months, and after 6 months storage was not contained the microbes, 4 of 5 nutritional values (protein, lipid, Fe, Zn) was stable during production and storage; the acid folic level was quickly reduced after produced, and still very little after 3 months. Sensory characteristics of instant noodle were in fair grade (17.5 - 17.7 points/20 points), and were good acceptable by the subjects during 7 days using instant noodle. Conclusions & recommendations: Majority of nutritional values, microbiology index of instant noodle fortified with micronutrients were stable after 3 - 6 months of storage, however the folic levels much reduced after 3 months. Instant noodle obtained high grade on sensory test and acceptability of population. The investigations on stability characteristics of micronutrients with different productions from wheat flour, also the efficacy study of their productions in human is needed to be investigated. Key words: wheat flour, instant noodle, micronutrient fortification, sensory characteristics

TCNCYH 75 (4) - 2011

22

TP CH NGHIN CU Y HC

THC TRNG KIN THC V BNH UNG TH V CA PH N TNH BNH NH NM 2010

Nguyn Th Nh T, Nguyn Minh Sn, Nguyn Tun Hng
C hiu bit, c kin thc v bnh ung th v gip pht hin sm bnh ung th v, iu ny ng vai tr r t quan trng trong vic gim t l t vong do ung th v trong cng ng. Kin thc v bnh ung th v trong nghin cu ny bao gm kin thc tng qut v ung th v, yu t nguy c ca ung th v, triu chng biu hin ca ung th v v kin thc v phng bnh v tin trin ca bnh ung th v. Mc tiu: M t kin thc v bnh ung th v ca cc ph n 15 tui tnh Bnh nh nm 2010. Kt qu: 18,5% c hiu b it ng v triu chng ca bnh ung th v, 13% ph n c hiu bit ng v yu t nguy c bnh ung th v, 52,4% c hiu bit ng v iu tr, d phng v tin trin bnh ung th v. Kt lun: Kin thc ca ph n 15 tnh Bnh nh v yu t nguy c v triu chng v bnh ung th v cn thp, trong khi kin thc v iu tr, d phng v tin trin bnh ung th v th tt hn.

T kho: kin thc, ung th v

Summary

THE SITUATION ON WOMENS KNOWLEDGE OF BREAST CANCER IN BINH DINH PROVINCE, 2010
Having the knowledge of breast cancer is useful to help women to detect early breast cancer, which playsan important role in reducing death rate due to breast cancer. In this study, the knowledge about breast cancer includes the general knowledge, risk factors, and symptoms of breast cancer as well as the knowledge about prevention and development of the disease. Objectives: To describe the knowledge of breast cancer of women 15 - 67 years old in Binh Dinh province. Rerults: 18.5% of the women had correct answers on the symptoms of breast cancer; 13% have correct answers on risk factors of breast cancer; 52.4% had correct answers on treatment, prevention and development of breast cancer. Conclusion: The knowledge of women 15 - 67 years old in Binh Dinh province on the risk factors and symptoms of breast cancer was still low while their knowledge of the treatment, prevention and development of breast cancer was better. . Key words: knowledge, breast cancer

TCNCYH 75 (4) - 2011

23

TP CH NGHIN CU Y HC

NH HNG CA CAN THIP TRUYN THNG GIO DC SC KHO N KIN THC, THC HNH V MT S VN SC KHO BNH TT CA NGI DN X AN M, HUYN BNH LC, TNH H NAM
Trn Th Nga, Nguyn Vn Hin, L Th Ti, Nguyn Duy Lut Tr ng i hc Y H N i
Nghin cu c thc hin nhm nh gi kin thc, thc hnh v mt s vn sc kho bnh tt ca ng i dn x An M, huyn Bnh Lc, tnh H Nam sau can thip bng truyn thng gio dc sc kho (TT GDSK). Kt qu: Tng t l ng i dn c kin thc v nguyn nhn ca bnh tiu chy: s dng n c b n, n c l (22,7%); n th c n sng (8,6%). Nng cao kin thc v cc bin php phng bnh tiu chy: n chn, ung si (55,4%); v sinh mi tr ng (31,9%). Tng t l ng i dn c kin thc v nguyn nhn gy ng c thc phm: ho cht bo v thc vt/bo qun/ph gia (66,8%); n ung khng hp v sinh (29,7%). Tng t l ng i dn thc hnh ng v phng chng ng c thc phm: s dng thc phm r ngu n g c (71,5%); ra rau s ch/ngm bng n c mu i (44,4%); n v sinh (49,5%). Tng t l ng i dn thc hnh ng v phng bnh ly truyn qua ng tiu ho: s dng n c sch (64,8%); s dng nh tiu hp v sinh (21,4%); n chn, ung si (21,7%). Kt lun: Hot ng TT GDSK x An M gp phn nng cao kin thc, thc hnh ca ng i dn v mt s vn sc kho bnh tt so vi thi im tr c can thip v so vi x i chng.

T kha: Kin thc, thc hnh, truyn thng - gio dc sc kho

Summary

THE IMPACT OF HEALTH COMMUNICATION AND EDUCATION INTERVENTION PROGRAM TO THE KNOWLEDGE, PRACTICE OF SOME HEALTH AND DISEASE PROBLEMS OF PEOPLE AT ANMY, BINHLUC DISTRICT, HANAM PROVINCE
The study aims to assess communityknowledge and practice after implementing the of health education intervention program at Anmy, Binhluc district, Hanam province, Vietnam. Results: Improving knowledge of the causes of diarrhea included: unclean water (22.7%); undercooked foods (8.6%). Improving knowledge of solutions to prevent diarrhea: cooked food, drinking boiled water (55.4%); environmental hygiene (31.9%); Improving knowledge of the causes of food poisoning: contimated food (66.8%); unsafety food and boiled water (29.7%). Advanced practices for preventing food poisoning: eating well producted food (71.5%); washing vegetables and soaking vegetables in to salt water (44.4%); hygiene and sanitary accommodation (49.5%). Advanced practices for preventing digestive disease: using clean water (64.8%); using sanitary latrines (21.4%); cooked food, drinking boiled water (21.7%). Conclusions: The knowledge, practice of people about health issues of disease after intervention program have been positive changed when compare with the previous intervention and control commune. Key words: knowledge, practice, health education and communication TCNCYH 75 (4) - 2011
24

TP CH NGHIN CU Y HC

HI CHNG SUY GIM T BO GC BIU M GIC MC V CC PHNG PHP IU TR

(Limbal Epithelial Stem Cell Deficiency Syndrome) V Th Tu Khanh Bnh vin Mt Trung ng
T cui thp k 80, s tn ti ca t bo gc ca biu m gic mc (GM) ti vng ra GM c nhiu nh nghin cu trn th gii t ra v chng minh s tn ti ca cc t bo ny trn nghin cu thc nghim cng nh trn ngi. Khong 10 nm gn y, s pht trin ca cng ngh sinh hc gip cho cc nh nhn khoa hiu bit su hn v t bo ngun biu m GM, hi chng suy gim t bo ngun biu m GM v thc hin nhng phng php mi trong vic iu tr hi chng ny. Bt k nguyn nhn no gy nn s suy gim v s l ng cng nh cht l ng ca cc t bo ngun biu m GM u gy nn h i chng suy gim t bo ngun biu m gic mc. Hu qu ca hi chng ny l s trong sut ca biu m GM b mt i, do th lc ca bnh nhn b gim st trm trng. V vy, vic la chn phng php iu tr h i chng ny cn c ch nh sm v ph hp ty theo mc ca bnh.

TCNCYH 75 (4) - 2011

25

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