中国医学工程杂志
China Medical Engineering 중국의학공정
- 主管单位： 中华人民共和国卫生部
- 主办单位： 中国医药生物技术协会 卫生部肝胆肠外科研究中心
- 影响因子： 0.50
- 审稿时间： 1-3个月
- 国际刊号： 1672-2019
- 国内刊号： 11-4983/R
- 论文标题 期刊级别 审稿状态
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高压氧对急性脑梗死临床应用分析
Objective:To determine the effect of hyperbaric oxygenation(HBO) on treating acute cerebral infarction(ACI). Methods: We randomly divided 60 patients with acute cerebral infarction into the treatment group and the control group. Hyperbaric oxygenation treatment was applied in the treatment group as routine drug therapy was used. The neurological function, living ability, clinical therapeutic effectiveness and hemorrheology changes of pa tients in the two groups before and after treatment were observed and evaluated. Results: The indexes of treatment were obviously improved one month after treatment (P ＜ 0.05 ). Clinical effective rate was 93.3 % in this group,which was obviously higher than that of the control group(P ＜ 0.05). Conclusion: Hyperbaric oxygenation can accelerate the recovery of neurological function of patients with acute cerebral infarction.
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形状记忆合金环抱器在骨折中的应用
Objective:To evaluate the effect of encircled fixer of shape memory alloy on bone fracture. Methods:A total of twenty patients with eighteen males and two females was studied. There were three patients with fractares in the upper one third of thighbone, five with fractures in the middle part of thighbone, six with humeral fractures, three with collarbone fractures,one with ulna fracture and two with thighbone fractures as complication of artificial hipbone arthroplasty. After exposure and fixation of fracture ends, prepared encircled fixer was inserted into 0～4℃ normal reline(NS) to lower its temperature, then pulled out with a clamp. Encircled fixer was put on the tersile side of the fractured bone(center pointed to fracture line), restored and stabilized after raising temperature in 40℃ NS. Results: Encircled fixers of shape memory alloy were used to treat twenty patients with bone fracture.Clinical concrescence was obtained in 1.5 to 3 months after operation,and the joint gained its normal function without complication. Conclusion:Encircled fixer of shape memory alloy has features as exerting vertical pressure continoulsy, little stress shield effect and convenient manipulation, especially adapt to stem fracture after artificial arthroplasty.
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NSE与视频脑电图在儿童热性惊厥的相关研究
Objective:To evaluate the diagnostic value of serum neuron specific enolase and Video EEG in Febrile Convulsion of childen. Method:Serum NSE was detected by RIA on the first day and the seventh day after seizure in 40 children with simple febrile convulsion and 18 with complex febrile convulsion. Video EEG was performed at 1st, 7th and 30th day in all the patients. Results: There were significant differences between NSE levels at 24th hour and on 7th day after convulsion (P＜0.01). NSE concentrations in patients with SFC and CFC were also different (P ＜ 0.01). The more slowly NSE restored, the higher the abnormal ratio of EGG was . Conclusion: NSE increased in patients within 24hours after seizure, especially in CFC patients. The abnormal ratio of VideoEEG was related to the change of NSE concentration.
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血清放射免疫胰岛素和真胰岛素测定对胰岛β细胞功能评价
Objective:To study the changes of true insulin(TI) and immunoreactive insulin (IRI) in subjects with NGT, IGT and DM, to study the difference between true insulin and immunoreactive insulin in evaluating βcell function and insulin sensitivity. Methods:The levels of serum IRI and TI were determined in 54 cases with type Ⅱ diabetes mellitus(Group DM) ,43 cases with impaired glucose tolerance (Group IGT) and 75 cases with normal glucose tolerance (Group NGT). Then every group was subdivided into obese and non - obese subgroups according to body mass index. IRI was determined by RIA. TI was determined by ELISA using monoclonal antibody with no significant cross- reaction between insulin and proinsulin. The insulin resistance index (Homa- IR), pancreatic β- cell function index (Homa- B) and insulin release index (the ratio of the increment of insulin to that of plasma glucose 30 min after a glucose load,△ I30/△G30) were analyzed preliminarily. Results: The ratio of TI/IRI in non - obese subgroup with DM was lower than those in non obese subgroups with NGT and IGT (P＜0.01). The ratios of TI/Ipd in obese subgroups with IGT and DM were lower than those in obese subgroup with NGT(P＜0.05). The pancreatic β-cell function indexes (Homa-BIRI) of IRI in non- obese subgroups with IGT and DM were lower than that in non- obese subgroup with NGT(P＜0.05). The pancreatic β - cell function index (Homa- BTI) of TI in non- obese subgroup with IGT was lower than that in non obese subgroups with NGT ( P ＜ 0.05 ). The HomaBTI in non - obese subgroup with DM was lower than that in non - obese subgroups with NGT and IGT(P ＜0.01).The Homa - BIRI in obese subgroups of NGT, IGT and DM had no significant difference. Homa - BTI in obese subgroups with IGT and DM was lower than that in obese subgroup with NGT(P＜0.01). Conclusion:The ratio of TI/IRI was a good marker in evaluating β- cell function. Pancreatic β- cell function index (Homa- BTI) of TI was better than that of IRI.
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一类拟生死过程--同步休假的M/M/c排队系统
Objective:To study several types of ergodicity of the queue length of M/M/c queue with synchronous vacation. Methods: A matrix analytical method is applied to deal with it. Result: It is shown that {L ( t ), J (t) } is geometrically ergodic if and only if it is ergodic. Conclusion:The criteria for the other types of ergodicity are obtained.
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乳糖化修饰纳米基因载体的肝靶向性研究
Objective:To compare the targeting effects of lactosarninated alginate(AlgNP)、polyethylene glycol - coated hydroxyapatite- poly- L- lysine nanoparticles (PLL- PCHNP)and relative nonlactosaminated ones load ed with exogenous gene on liver via peripheral intravenous route. Methods:Preparation of AlgNP based on control of gelification phenomenon of algiante by calcium ions and HA- PLLNP with collosol - gel method, both further modified with lactosaminated - poly- L - lysine synthesized by reductive lactosamination . We used pEGFPCl as the reporter gene to establish receptor- mediated and positive liver targeting nanoparticles- gene model. The potential of adsorbing DNA on nanoparticles was analysed by electrophoresis and spectrophotometer. Then different complexes were transferred into the rat's body by peripheral intravenous route and their targeting characteristics in liver were investigated by using radioisotope tracing assay. Results: PCHNP presented as needle - like particles with a diameter of 20nm by TEM and could be effectively combined with PLL. The diameter of AlgNP was 280nm. Agarpse gel electrophoresis showed both nanoparticles could effectively combine with DNA and the optimal proportion of PLLPCHNP and DNA was 30:1 (w/w); DNA mixed ratio of AlgPLL was 68.3 % by spectrophotometer. The radioactivities in liver for the two lactosaminated nanoparticles were higher than the nonlactosaminated ones. No statistic difference between AlgNP and AlgLacNP could be found . Conclusions: Lactosaminated naroparticles can target to liver more effectively by peripheral intravenous route than nonlactosaminated ones, which is closely concerned with the characteritics of the nanopartide complex.
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关于GOLD和我国前后2个COPD诊断分级标准探讨
Objective:To compare and discuss the GOLD and the diagnostic criteria of severity of COPD adopted by Chinese respiratory academy in 1997 and 2002. Method:The data of pulmonary function of 713 COPD from 1991 to 2001were reviewed by t - test. All patients were classified as mild ,moderate and severe COPD by the diagnostic criteria of Chinese respiratory academy in 1997 and traditional criteria of pulmonary dysfunction . Some associated problems were discussed. Results:The data and results matched with the two criteria, but data of FEV1/FVC in mild COPD group were different from the diagnostic criteria of GOLD and Chinese respiratory academy in 2002.Conclusion:Chronic bronchitis without airflow limitation is included in the concept of COPD by GOLD and Chinese respiratory academy's diagnostic criteria in 2002,so this part of patients may not be delayed in diagnosis. But FEV1/FVC of some mild COPD patients in early stage may not be lower than 70 %, these COPD patients may be misdiag nosed which is unfavorable to the early intervention and treatment of COPD . In addition , the range of moderate COPD in the criteria of GOLD is too wide to differentiate the severity of the disease,so it is not convenient for guiding the rehabilitative treatment. The functional examination of respiratory muscles will differentiate whether the airflow limitation is from the airway or from the dysfunction of respiratory muscles, and it is irreplaceable for guiding the rehabilitative treatment of respiratory muscles and evaluating the efficiency. We suggest more attention should be paid to these probloms.
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慎柔养真汤对脾阴虚患者血液流变学的影响
Objective:To evaluate the effect of Shen Rou Yang Zhen Decoction on blood rheology of the patients with Piyinxu. Methods:30 cases of patients with Piyinxu were treated with Shen Rou Yang Zhen Decoction.The blood rheology was detected before and after treatment. Results:30 cases of patients with Piyinxu were treated for one course of treatment resulting in obvious efficiency in 9 cases(30 % ), efficiency in 19 cases(63.33 % ), inefficiency in 2 cases (6.67%). The overall effective rate was 93.33%. The indexes of blood rheology including blood viscosity and plasma viscosity were significantly reduced (P ＜ 0.01). Conclusions: Shen Rou Yang Zhen Decoction can reduce the blood viscosity and improve the blood rheology in patients with Piyinxu.
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前列腺素E1对原发性肾病综合征作用初探
Objective:To investigate the effect of prostaglandin E1 (PGE1) (Alprostadii injection) on patients with primary nephrotic syndrome(PNS). Methods: 37 patients with PNS were recruited to study the effect of prostaglandin E1 on platelet aggregation function [ PAG (5,) PAG( m ) ], serum total protein (TP) , albumin (Al),blood urea nitrogen(BUN) ,serum creatinine(Scr) ,cholesterol(CHO), triglyceride(TG), protein in 24-hour urine (Pr/24h) and platelet account (PLT). Results: TP, Al, CHO, TG, BUN, Scr, Pr/24h, PAG(5) and PAG(m) in PNS group before treatment were significantly different from those in control group(P＜0.05, P＜0.01) while no significant difference was found for PLT. When treated with PGE1 , TP,Al,CHO, TG, Pr/24h, ADP- induced PAG(5) ,and Adr- induced PAG(5) and PAG(m) were significantly different from those before treatment (P＜0.05). Adr- induced PAG(5) and PAG(m) were significantly different. Adr- induced PAG(5) was xsitively correlated with BUN and Scr in PNS(P＜0.01). Similar correlation was found between ADP-induced PAG(5) and Al ,BUN,Scr,Pr/24h(P＜0.05), AD- induced PAG(m) and TP,CHO(P＜0.05). Conclusions: PGE1 may be an effective drug for the treatment for hypercoagulation in patients with PNS.
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P波时限、P波离散度对特发性心房颤动的预测价值初探
Objective:To assess the sensitivity and the specifity of predicting idiopathic AF with P wave duration and P wave dispersion. Methods:The maximum P wave duration and P wave dispersion in 36 patients with idiopathic AF were measured and compared with those of sex - and age - matched healthy subjects. Results:The maximum P wave duration and P wave dispersion were higher in patients with idiopathic Af than in control group. The maximum P wave duration ＞ 110ms or P wave dispersion ＞40ms was used to differentiate patients from healthy subjects, the sensitivity and the specifity value were 88% vs 82% and 75 % vs 86%, respectively. When the above two parameters were integrated, the sensitivity was 76 %, the specifity 88 %. Conclusion: The maximum P.wave duration and P wave dispersion are simple and practical ECG indexes for idiopathic AF patients.
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全固化三明治结构Nd:YVO4与Nd:GdVO4激光器的特性研究
Objective:The properties of Nd:GdVO4 laser crystals were studied in application of all-solid laser with LD pumped.Method:We adopted sand wich structural Nd:YVO4 laser crystals experimental devices separately.Results:As to Nd:YVO4 crystal,1.2W continuous laser output at 1064nm was ac-quired with the optical-to-optical transition efficiency of 30%.And as to Nd:GdVO4,1.8W continuous laser out-put at 1064nm was acquired with the optical-to-optical efficiency of 47.2%.Conclusion:All-solid laser is of simple and compact structure,long lifetime,low cost and high efficiency that it will be extensively applied to laser bioengineering,laser environmental monitoring and so on.And comparing the properties of Nd:GdVO4 to that of Nd:YVO4,Nd:GdVO4 would be a more promising all-solid laser crystal.
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人工心脏临床应用研究
Objective:To summarize practical experiences of clinical application of artificial heart and discuss its indications and prevention of complications. Methods: Before operation, all the four patients underwent regular treatment of internal medicine, and after its failure they were implanted with artificial hearts. Operations were performed under general anesthesia and external circulation at low temperature. Left ventricle assistant devices (LVAD) were used for three patients, and double ventricle assistant device (DVAP) for one. Two patients were embeded with Berlin artificial hearts (Melipot company). The other two were implanted with Medos artificial hearts ( Medos company). Results:All the patients had no infection and haemorrhage, while their cardiac functions were restored apparently. Three to five days after operation, patients could take off- bed activities. Two had been taken away their artificial hearts on 52th and 53th postoperative day, and arrhythmia disappeared. Half year follow- up revealed favorable results. One died,on 271st day,of bleeding from congenital cerebrovascular deformity. One died, on 10th postoperative day, of renal dysfunction and DIC. Conclusion: Artificial heart or Ventricle assistant devices (VAD) could be used as temporary substitute for heart transplantation, and used in emergent heart attacks in order to restore cardiac function.
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Ⅱ型糖尿病兔大脑皮质和海马神经元的神经丝蛋白表达
Objective:To investigate the morphological changes of the neuronal neurites in diabetic rabbit brain. Methods: Twenty- four New Zealand White rabbits were divided into 2 groups: control group and type Ⅱ diabetic group induced by high - carbohydrate and high- fat diet. The levels of blood sugar and insulin were detected at week 0(w0), w4, w8, w13, w18, w23 and w28. Brain tissue was stained by Nissl staining and immunolistochemistry with a specific antibody to neurofilament proteins. Result: In diabetic rabbits, the amount of large pyramidal neuron was significantly reduced, and neuronal neurites became swollen, whorled, disrupted and changed in caliber. In hippocampus CA1 region neurofilament staining was very weak. Conclusion: Neurotoxicity of chronic hyperglycemia might be relevant to vascular chronic complications, which affected the expression of NF and led to neurophysiological and structural changes in the brain of rabbits with type Ⅱ diabetes.
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低钾型周期性瘫痪73例临床分析
分析低钾型周期性瘫痪(Hypokalemia periodic paralysis HOKPP)的临床特点.方法:总结我院1998～2000年收治的73例HOKPP的临床资料,结合文献,对本病的一般资料,诊断及治疗进行探讨.结果:HOKPP首发年龄(33.8±5.2)岁,未见家族倾向,口服补钾经济、安全、有效.结论:HOKPP在我国以散发多见,首发年龄多见于中青年,口服补钾可作为一种常规治疗手段.
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硝普钠联合卡托普利治疗顽固性心衰的临床观察
探讨硝普钠联合卡托普利对顽固性心衰的治疗效果.方法:对58例顽固性心衰患者静脉滴注硝普钠,口服卡托普利,并于治疗前、治疗后以心脏彩超检查.同时行心脏正位片、测量血压、心率,观察肺部罗音、水肿变化.结果:与治疗前比较,治疗后左室舒张末径(LDV)、心输出量(CO)增多,左室射血分数(EF)增加,心胸比值缩小,血压、心率、肺部罗音、水肿明显改善(P＜0.01).临床总有效率治疗后为91.4%.结论:硝普钠联合卡托普利治疗顽固性心衰疗效显著.
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正常皮肤和新生疤痕组织表达角蛋白19的比较性研究
研究正常皮肤和新生疤痕组织中表皮干细胞分布、增殖分化特征,并探讨这些特征与皮肤创伤修复的关系.方法:选择有Ⅲ度烧伤创面的成人患者8例,在获得了患者的知情同意后用手术尖刀分别切取正常皮肤、肉芽中的皮丁及新生疤痕组织(创面愈合后2个月内的疤痕)各一块,约2cm×1cm×0.5cm大小,应用过氧化酶标记的链霉卵白素(SP)免疫组化法,以小鼠抗人角蛋白19型的单克隆抗体检测表皮干细胞的分布、增殖分化特征.结果:肉芽中的皮丁组织内有散在分布的角蛋白19表达阳性细胞,新生疤痕组织中的表皮基底层有多层角蛋白19表达阳性细胞,在再生表皮的中部,即位于基底细胞层与角质细胞层之间有大量的角蛋白19表达阳性细胞,且分布广泛,而正常皮肤只有表皮基底层和附件有角蛋白19表达阳性细胞.结论:新生疤痕组织中表皮再生仍很活跃,在皮肤创伤愈合过程中的重塑期,如果能够结合抑制疤痕增生的有效治疗,这种新生疤痕组织有可能转变成正常皮肤.
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持续靶控输注异丙酚复合硬膜外麻醉用于上腹部手术探讨
评价持续靶控输注异丙酚复合硬膜外阻滞有用于上腹部手术的可行性.方法:30例胃癌手术患者,ASA Ⅰ～Ⅱ级.随机分成靶控输注异丙酚全麻(T)组15例,靶控异丙酚复合硬膜外阻滞(T+E)组15例.结果:(T+E)组术后躁动、芬太尼、丙泊酚的用量低于(T)组(P＜0.05).异丙酚单位标准化剂量亦较低.两组苏醒时间相似.诱导后两组血压均显著下降(P＜0.05),T+E组在诱导后DBP的下降幅度较T组更为显著(P＜0.05),T组在探查、术毕、拔管后的SBP、DBP、MAP比(T+E)组显著增高(P＜0.05).两组诱导后至术毕BIS、SEF显著下降,两组间的比较无统计学意义(P＞0.05).结论:靶控输注异丙酚复合硬膜外阻滞用于上腹部手术是可行的,具有异丙酚、芬太尼的用量少、苏醒快、术后躁动少,麻醉深度易于调控,血液动力学较稳定,是一种良好的麻醉方式.
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原发性高血压颈总动脉超声研究
研究原发性高血压(EH)对颈总动脉(CCA)内膜-中层厚度(IMT)、中层厚度(MT)、颈总动脉内径(CCAD)和血流参数的影响,了解EH和CCA损害之间的关系.对象与方法:选择31例EH病人作为高血压组,31例年龄、性别、身高、体重相匹配的非高血压病人作为对照组,观察两组病例CCA各参数有无差异;两组病例均观察双侧CCA及分叉处有无斑块,只要一处有斑块就计为有斑块,计算两组斑块发生率并进行比较.结果:高血压组IMT及MT高于对照组(P＜0.05),CCAD及血流参数无统计学差异(P＞0.05);高血压组颈动脉斑块发生率高于对照组(29%vs 6.4%,P＜0.05).结论:CCA可做为EH动脉病变的超声观察窗口,高频彩色超声能直观动态地了解CCA病变程度及是否有斑块形成,对临床了解EH病人动脉硬化情况和预防脑卒中发生具有重要的实用价值.
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羟基喜树碱抗高转移性人肺癌细胞增殖和侵袭的研究
研究10-羟基喜树碱抗人肺癌细胞增殖和侵袭的作用,并探讨其抗侵袭作用的机理.方法:10-羟基喜树碱作用于克隆化高转移人肺癌细胞(PGCL3),用细胞增殖抑制试验、软琼脂集落形成试验、对重建基底膜的侵袭试验、趋化运动试验、对层粘连蛋白的粘附试验以及组织蛋白酶B活性测定观察细胞增殖和侵袭能力的变化.结果:10-羟基喜树碱可降低PGCL3细胞增殖能力并呈剂量依赖性,IC50为0.17μmol/L;0.25μnol/L和0.5μmol/L10-羟基喜树碱能抑制PGCL3细胞的侵袭能力(P＜0.01)且有剂量依赖性.抗侵袭作用机理的分析结果显示上述浓度的药物对细胞的运动、粘附及组织蛋白酶B分泌均有明显的抑制作用(P＜0.01);软琼脂集落形成率也显著降低.结论:10-羟基喜树碱有抗PGCL3人肺癌细胞增殖和侵袭作用.其抗侵袭机理是通过对侵袭各个基本环节的抑制实现的.
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白介素-2与激光联合治疗女性生殖器尖锐湿疣60例疗效分析
探讨白介素-2与激光联合治疗女性生殖器尖锐湿疣的疗效.方法:将98例女性生殖器尖锐湿疣患者随机分两组.治疗组:60例采用白介素-2与激光联合治疗.对照组:38例采用单纯激光冶疗,两组临床疗效进行对比.结果:治疗组的临床疗效优于对照组.结论:白介素-2与激光联合治疗女性生殖器尖锐湿疣具有疗效高、复发率低的作用.
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联用黄芪治疗老年人原发性肾病综合征的临床观察
探讨黄芪治疗老年人原发性肾病综合征(PNS)的疗效.方法:38例老年人原发性肾病综合征(PNS)患者随机分成两组,治疗组20例以黄芪+激素+肝素+潘生丁治疗,对照组18例以激素+肝素+潘生丁治疗,2个月后观察疗效.结果:治疗组总有效率80%,对照组总有效率50%,治疗组明显优于对照组(P＜0.05).结论:加用黄芪治疗老年人原发性肾病综合征能明显提高疗效.
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改良型Gamma钉治疗股骨转子间骨折的疗效及并发症分析
综合评价改良型Gamma钉治疗股骨转子间骨折的疗效及并发症.方法:对使用改良Gamma钉法82例的疗程进行综合分析,并对46例现存患者进行平均21月随访,总结疗效及并发症.结果:根据临床资料及随访结果统计,远期疗效优者35例(76%),良者7例(15%),优良率91%.46例骨折全部愈合,未见骨不连.急诊手术10例,术中锁钉折断2例,术后伤口感染2例,不同程度的髋内翻及肢体短缩7例,拉力螺钉穿出股骨头2例,未见不能行走及需再次手术者.结论:改良型Gamma钉设计小型化,固定可靠,适合急诊手术,且术后关节活动及下地较早,是目前治疗股骨转子间骨折的首选类别.对于一些特殊类型的骨折,Gamma钉难以给予满意治疗.Gamma钉术后并发症和其它手术内固定方式无显著差别.Gamma钉器械有待进一步改进.
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血液净化对血透患者血清瘦素水平的影响
慢性肾功能衰竭患者血液透析(HD)及血液透析滤过(HDF)前、后血清瘦素(Leptin)水平的变化.方法:采用放射免疫测定(RIA)方法,测定55例HD患者和36例HDF患者HD及HDF前、后血清Leptin 水平.结果:HD前、后血清Leptin水平分别为:HD前男(5.02±2.65)μg/L,女(7.03±4.89)μg/L和HD后男(5.12±3.47)μg/L,女(7.93±3.65)μg/L,两组同性别间无明显差异.(P＞0.05);HDF前血清Leptin水平为:男(5.42±3.14)μg/L,女(7.88±3.38)μg/L,明显高于HDF后:男(3.32±2.71)μg/L,女(5.66±3.21)μg/L(P＜0.05).结论:HD不能有效地清除血清Leptin水平,而HDF可以部分清除血清Leptin.
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检测胞浆抗原用于急性白血病免疫分型
胞浆抗原在急性白血病免疫分型中的临床意义.方法:用流式细胞仪检测42例初治急性白血病患者胞浆抗原CyCD3,CyCD22,CyCD79a和MPO.结果:T-ALL阳性胞浆抗原主要表达在CyCD3,阳性率占88.9%.B-ALL阳性胞浆抗原主要表达在CyCD79a,AML主要表达CyMPO.结论:CyCD3和CyCD79a,及MPO可分别作为T-ALL,B-ALL和AML系列特异性标志,对正确诊断白血病提供非常有价值的依据.
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微柱凝胶技术检测513例孕妇IgG抗体效价
运用微柱凝胶法技术检测孕妇血清中的IgG抗A(B)血型抗体水平,以预防新生儿溶血病的发生.方法:采用微柱凝胶技术检测IgG抗A(B)血型抗体效价.结果:513例孕妇中IgG抗A(B)效价≤64的334例,128的179例,其中77例经中药治疗后复查,46例IgG抗A(B)效价降至64以下,另31例经继续服药后复查,14例IgG抗A(B)效价降至64以下,17例IgG抗A(B)效价无变化,总有效率为78%.结论:用微柱凝胶技术检测孕妇血清中IgG抗体水平具有操作快速、简便、准确,灵敏度及特异性大大高于试管法,重复性好、实验样本量少,减少生物污染,能大限度减少由于操作人员主观因素带来的影响,结果可以长期保存等优点,对结果异常者及时服用中药治疗,可有效预防新生儿溶血病.
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依贝沙坦对高血压病患者心、肾的影响
探讨依贝沙坦对原发性高血压病人高血压相关性心、肾损害的影响.方法:44例原发性高血压患者予以依贝沙坦治疗6个月,治疗前后分别观察血压、血尿素氮、血肌酐、血尿酸和24h尿蛋白,并用心脏超声测量左心室重量.结果:依贝沙坦能显著降低原发性高血压患者血压(P＜0.01);依贝沙坦能逆转左室肥厚(P＜0.01),改善左心室舒张功能(P＜0.05);依贝沙坦使尿蛋白排泄量减少(P＜0.01),血肌酐水平下降(P＜0.05).对血尿素氮和尿酸无明显影响(P＞0.05).结论:依贝沙坦在降压同时能改善和逆转原发性高血压病人的心、肾损害.
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火把花根片治疗原发性肾病综合征临床分析
探讨火把花根片对原发性肾病综合征(NS)的治疗效果.方法:将住院的68例原发性NS患者随机分为两组.治疗组在对照的基础上加用火把花根片,对照组应用常规的"四联"疗法,总疗程3月,分别观察1月及3月后两组24h尿蛋白、血清白蛋白、血脂的变化情况.结果:治疗组与对照比较,治疗前后24h尿蛋白定量及血清白蛋白的浓度均有高度显著性的差异性(P＜0.01);且在改善血脂代谢方面也明显优于对照组(P＜0.05).结论:火把花根片加用常规"四联"疗法原发性NS作用更加显著.
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颈部食管胃半套入斜形吻合术
改进手术方法,减少食管癌术后吻合口瘘、吻合口狭窄,返流性食管炎等并发症.方法:对571例食管癌病人行食管次全切除,残食管与胃颈部吻合,吻合面呈斜形,吻合口后唇套入胃腔3cm对2001年3月～2001年10月来院复诊的所有食管癌术后病人(包括颈部半套入斜形吻合55例,颈部单层吻合38例,弓上袖状吻合42例),进行胃镜检查和食管腔内PH值测定.结果:术后共发生吻合口瘘4例,轻度吻合口狭窄17例;所有病人都能平卧睡眠,7例病人述后半夜于左侧卧位时出现返流症状,25例头低位造影轻度钡剂返流.胃镜检查和食管腔PH值测定结果,颈部半套入斜形吻合明显好于颈部单层吻合和弓上袖状吻合.结论:颈部食管胃半套入斜形吻合,能有效减少食管癌术后吻合口瘘,吻合门狭窄和胃液返流等严重并发症、提高术后生存率和患者术后的生存质量.
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荧光定量聚合酶链反应检测女性生殖道分泌物沙眼衣原体等病原体
测女性生殖道分泌物中淋病奈瑟菌(NG)、沙眼衣原体(CT)、解脲脲原体(UU)的数量,以了解本地区上述3种病原体感染现状.方法:用荧光定量聚合酶链反应(FQ-PCR)检测了121份标本的NG-DNA和149份标本的CT-DNA与UU-DNA.结果:NG阳性率为49.6%(60/121),其阳性标本的平均拷贝数为3.61×105拷贝/ml;CT阳性率为23.5%(35/149),其阳性标本的平均拷贝数为9.59×104拷贝/ml;UU阳性率为34.3%(51/149),其阳性标本的平均拷贝数为4.11×105拷贝/ml.结论:FQ-PCR具有简便、快速、准确的优点,是目前快速诊断淋菌、非淋菌性阴道炎可靠准确的方法.
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系统性红斑狼疮脑病的CT诊断
探讨系统性红斑狼疮脑病的CT表现及其诊断价值.材料与方法:搜集临床诊断为系统性红斑狼疮脑病的患者15例,进行CT扫描并结合临床对CT表现进行分析.结果:弥漫性病变11例,其中9例表现为脑萎缩,2例表现为多发性脑梗塞;局灶性病变3例,均为脑出血;正常表现1例.结论:CT检查可以明确系统性红斑狼疮脑病的影像表现、部位和范围,对临床治疗及疗效评价有重要的指导作用.
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显微手术切除岛叶肿瘤
研究经翼点入路显微技术切除岛叶肿瘤的方法和意义.方法:采用经翼点入路,显微镜下,经外侧裂分离额、颞叶,保护血管,分块切除肿瘤.结果:经术后影像证实,切除达90%15例,75～90%4例,少于75%2例,无1例死亡.结论:经翼点入路显微切除岛叶肿瘤是可行的有效途径.
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部分儿科疾病D二聚体检测的临床意义
检测10种儿科疾病患儿血浆D二聚体并探讨其临床意义.方法:应用Latex法对181例患10种不同疾病的患儿及50例,健康儿童进行D二聚体测定.结果:正常对照组50例D二聚体阳性1例(2%).患病组181例,阳性86例(47.51%);其中川崎病急性期15例,阳性13例(86.67%);原发性血小板减少性紫癜9例,阳性0例(0%);其余疾病阳性率分别是:新生儿缺氧缺血性脑病(85.71%),败血症(71.43%),肾病(66.67%),婴儿肝炎综合征(58.33%),过敏性紫癜(5 0%),重症肺炎(37.2%),蚕豆病(33.33%),新生儿硬肿症(30%).结论:儿科多种疾病存在血液高凝状态,在可能存在血液高凝状态和微血栓形成的疾病中D二聚体检测有较高的阳性率;Latex法检测患儿D二聚体,对小儿各种疾病病程中血液高凝状态的诊断及指导抗凝剂的使用有较高的参考价值.
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外科领域生物传感器的应用
传感器是用生物活性材料(酶,蛋白质,DNA,抗体以及生物膜等)与物理、化学传感器有机结合的一门交叉学科.长期以来,它是医学领域里必不可少的一种先进的检测方法和监控手段.由于材料学、制造工业的发展和开拓性思维创新性的设计,生物传感器的临床诊断治疗和科学研究方面也展示出更加广泛的应用前景.下面仅就其在外科领域的应用进展作一简单介绍.
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早期胃癌内窥镜诊断进展
早期胃癌Early Gastric Cancer(EGC)[1]:首先由日本学者提出并得到公认,主要根据病变浸润深度,即病变位于粘膜及粘膜下未达肌层,无论有无淋巴结转移,均称为EGC.EGC又分为粘膜癌(MCarcinoma,MC)及粘膜下癌(SM-Carcinoma,SMC).如EGC仅位于粘膜内为MC,EGC浸透粘膜层达粘膜下层为SMC.根据病变大小又分为小胃癌(Small Gastric Cancer,SGC)病变大直径小于1cm,及微小胃癌小于0.5cm(Minimute Gastric Cancer,MGC),术前准确诊断MC、SMC对选择术式至关重要[1,2].胃癌的预后与诊断时病期的早晚以及治疗是否得当有密切关系.局限于粘膜层的5年生存率为100%,10年和15年的生存率均为99.5%;浸润粘膜下层时的5年生率78%[2].因此,早期诊断是提高疗效的关键.可见提高胃癌预后的关键,在于早期胃癌的诊断[3].1868年Kussmal首创硬管胃镜后的90年内,EGC的研究几乎没有什么发展,自从1958年Hirschwit设计光学纤维胃镜后,以及科学的高速发展,近30年来镜身越来越细,接物镜视野越来越大,角度可上下弯曲达300°以上,观察病变方便,易为患者所接受.因此,随着纤维胃镜的发展革新,各种新型内镜不断的推出,如红外线电子内镜、超声内镜等.运用内镜诊断时,提高诊断率的研究有色素诊断法、荧光检查法、基因诊断等技术的应用[4],使胃癌更能及早发现,诊断更准确可靠!目前国际早期胃癌的诊断率可达10%左右,高可达24%.但近年国内杂志报道早期胃癌的诊断率均徘徊在10%以下[5,6 ].
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内窥镜在整形外科的应用现状
自1983年法国巴黎大学国际医院外科的Dubois[1]首先将内窥镜技术应用于阑尾切除术之后,1987年法国的Mouret[2]成功地通过内窥镜行胆囊切除术,开创了内窥镜在外科疾病治疗应用的新时代,短短10来年时间,已经广泛应用于腹腔外科,胸腔外科,泌尿外科,妇产科,整形外科等.由于内窥镜需要有一定的腔隙进行操作,而整形手术没有自然的腔隙,需要通过充液灌注或牵引悬吊人为地形成一个腔隙,故它在整形科的应用较晚,直到1989年Chow和Okutsu首先将它应用于腕筋膜切开术,开始了内窥镜在整形外科的应用[3,4],而美国的Vasconez[5]及ISSO[6]于1992年9月及11月分别介绍了有关内窥镜额部上提术的经验,此后,内窥镜在整形外科的腹部整形,乳房整形,皮瓣及神经等移植物的截取,体表小肿物切除,头颈部整形领域等都得到很快的发展.由于该技术是一种微创伤技术,它通过小切口及专用器械以及影像设备的显示,使手术者在"术区可视"的情况下完成手术操作,从而减少了组织损伤,在设计切口的情况下,进行远距离操作,缩小手术切口疤痕并将疤痕选择在身体比较隐藏的位置,止血效果好,并减少了手术的并发症.
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腹腔镜下疝修补术的现状与发展
腹股沟疝修补术是外科常见和古老的手术之一,自1887年Bassini提出他所创始的腹股沟疝修补术起,100余年来,腹股沟疝的治疗经历了一个漫长的演变过程.随着人们对腹股沟疝的发生机制认识的不断提高,以及手术方式和治疗经验的进一步积累,腹股沟疝的修补术式也日趋完善.疝外科发展经历了经典的前路张力修补(包括Bassini,Mcvay,Shouldices疝修补),已趋成熟的无张力疝修补(包括Lichtenstein,Gilbert疝修补)和在无张力疝修补基础上发展起来的腔镜技术修补的三个阶段[22].无张力疝修补术,被喻为20世纪疝修补术的"里程碑".近年来发展迅速,正是由于这种术式的不断完善,又为腹腔镜疝修补术的产生和发展奠定了坚实的基础.经过几年的探索,腹腔镜无张力疝修补术(LHR)尽管还有许多不足,但已取得了令人鼓舞的成绩.
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评述几种直线型切割吻合器和圆型吻合器的性能价格比
在外科发展的历史中,机械吻合的方法以一种标准和统一的模式重新规范了外科吻合技术,使外科医师不必再积累数以十年计的经验才能高质量低失误地完成各种手术,而且人手的缝合无论是细腻\整齐划一或稳定性\速度等都无法比拟机械缝合.
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学科交叉与跨学科复合型人才培养
当今世界飞速发展的科学技术已成为社会经济发展的前导.各国综合国力的竞争实质是高新科学技术的竞争,而竞争的焦点是人才.中南大学卫生部肝胆肠外科研究中心是国家卫生部肝胆肠外科的临床、科研、教学重点基地和研究生培养基地.该中心现设有生物医学工程专业、外科学专业硕士点、外科学博士点、博士后流动站.该中心现有研究生60人,其中外科专业研究生33人,生物医学工程专业研究生27人.1998年原湖南医科大学学科调整时,生物医学工程硕士点合并到该中心后,学科的交叉已成为现实.2000年,中南工业大学,湖南医科大学和长沙铁道医学院三校合并则使学科之间的交流和合作更为有利.如何尽快从单一学科中解放出来,把握住学科交叉、融合发展的必然趋势,做到优势互补,在培养人才的素质上形成自己的特色,创出自己的名牌,用自己创造的特色和质量去参与竞争,是我们思考的问题.
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激光美容医疗信息分析
医疗档案是临床医疗工作中的重要部分,其质量反映了医疗机构业务质量和管理水平,同时它具有法律效应,对加强医疗管理和提高医疗质量都发挥了重要作用.我科自2001年10月～2002年7月共接诊病人11 800人次,建立医疗档案共1 038份,其中整形医疗档案718份,激光医疗档案320份.现体会如下:
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中国医疗器械领域现状与展望
改革开放20多年来,中国医疗器械工业经历了一个快速发展的过程,到1999年其工业总产值已达到133亿元人民币,比"八五"时期增长了1倍以上.目前我国医疗器械生产品种有1万多个,产品质量也进一步提高,绝大部分产品实行了更新换代,特别是通过引进、吸收、消化国外的先进技术,一批具有国际水平的新产品陆续投放市场,深受国内外用户欢迎.除常规医疗器械产品得到进一步发展外,国际上一些尖端产品如CT、核磁共振、彩色B超、γ刀、超声刀等,近年来也开始具有了自行开发生产能力.不仅是新产品品种有所增加,而且产品技术结构也由原来的以简单机械和电子结构为主,逐步过渡到以机电一体化产品为主.在满足国内需求的前提下,我国医疗器械也走出了国门.可以说,我国医疗器械工业已具备了相当的基础.但另一方面,我国的医疗器械业底子薄,诸如电子肠镜等高新技术产品在我国仍是空白,缺乏一些拥有我国自主知识产权、在国际市场上有良好声誉的高技术尖端产品,存在着技术含量低、产品质量不高、重复建设、生产集中度较低、缺乏名牌产品等不足.21世纪,医疗器械向高精度、智能化转移,一些重要领域的技术革命正酝酿着大突破,必将大力推进医疗器械工业的全面进步和快速发展,给我国传统的医疗器械工业带来了发展的契机.
| 年 | 期数 |
| 2018 | 01 02 03 04 05 06 07 08 09 10 11 |
| 2017 | 01 02 03 04 05 06 07 08 09 10 11 12 |
| 2016 | 01 02 03 04 05 06 07 08 09 10 11 12 |
| 2015 | 01 02 03 04 05 06 07 08 09 10 11 12 |
| 2014 | 01 02 03 04 05 06 07 08 09 10 11 12 |
| 2013 | 01 02 03 04 05 06 07 08 09 10 11 12 |
| 2012 | 01 02 03 04 05 06 07 08 09 10 11 12 |
| 2011 | 01 02 03 04 05 08 09 10 11 12 |
| 2010 | 01 02 03 04 |
| 2009 | 01 02 03 04 05 |
| 2008 | 01 02 |
| 2007 | 01 02 03 04 05 06 07 08 09 10 11 12 |
| 2006 | 01 02 03 04 05 06 |
| 2005 | 01 02 03 04 05 06 |
| 2004 | 03 04 05 06 |
| 2003 | 06 |
| 2002 | 06 |
