术中放置鼻胆管在胆总管切开取石探查后一期缝合的研究

目的探讨术中放置鼻胆管在胆总管切开取石探查后一期缝合术与传统胆总管探查T管引流术疗效的对比。方法对我院2005年6月至2007年3月126例胆石症患者行手术治疗进行回顾性分析,其中65例术中采用T管引流（T管组）,61例采用鼻胆管引流（鼻胆管组）,两组术后均经胆道造影证实通畅。结果鼻胆管组与T管组比较,后者术后拔管及胆汁引流时间明显缩短,（P〈0.05）;术后住院天数明显缩短（P〈0.05）;术后与引流相关的并发症发生率低（P〈0.05）。结论胆道外科术后采用鼻胆管引流能够缩短患者住院时间,可避免胆汁大量丢失,并发症少,避免了长期带T管的痛苦,是一种较为理想的引流方式。     

埋藏式可调节缝线在二切口青光眼白内障联合手术中的应用

目的：观察应用可调节缝线的二切口青光眼白内障联合手术的临床效果。方法：回顾性分析行青光眼白内障联合手术的患者84人（92眼）,二切口组38人（42眼）,在二切口联合手术基础上加可调节缝线;单切口组46人（50眼）。比较两组患者术后视力和眼压,浅前房、高眼压等并发症的发生,术后6个月的手术成功率及滤过泡形态。结果：手术前后两组患者之间视力比较差异无统计学意义;两组患者术前及术后1d眼压比较无统计学意义,但术后3d,术后1周,术后1月及术后6月两组患者的眼压比较均具有统计学意义;术后6个月手术成功率,观察组高于对照组,但差异无统计学意义（P〉0.05）;术后6个月的滤过泡形态,两组之间差异无统计学意义。结论：应用埋藏式可调节缝线的二切口青光眼白内障联合手术可有效控制患者眼压,提高联合手术远期成功率。     

核医学影像设备的发展与临床应用

γ相机和SPECT只能进行常规单光子显像，PET和双探头SPECT符合显像系统既能进行单光子显像，又能进行正电子符合显像，PET／CT系统的出现不仅提供高质量的衰减校正图像，保证了正电子显像校正数据的可靠性，而且能进行同机图像融合，提高了影像定位诊断的准确性。本文简要介绍了核医学影像设备发展历程，PET和PET／CT的原理以及在临床的应用。     

Implantation of Active Can Implantable Defibrillators in the right Pectoral Region

Routinely the active can ICD is placed in the left side pectoral position, which theoretically gives optimal conditions for a low defibrillation threshold. Some patients, bowever, demand a right pectoral position, which possibly could result in a bigger defibrillation threshold. A right pectoral position was used in 3 of 85 active can ICDs implanted in our institution from 1994. the DFT was 12 J in two and 18 f in one patient. Thus, right pectoral implantation is feasible and offers an alternative approach in selected patients.     

改良的额肌瓣辅以缝线悬吊减张治疗上睑下垂

目的　为了减少额肌损伤 ,保证额肌瓣转移 ,治疗中、重度上睑下垂 ,术后吻合口无张力愈合 ,加快血运建立的效果。方法　用 3 - 0可吸收缝线横向贯穿睑板上缘提上睑肌腱膜组织 2针 ,经额肌瓣隧道缝至眶上缘骨膜上 ,转移不等边额肌瓣使之无张力缝合。结果　减张手术组 2 5例 ,总优良率 92 % ,常规手术组 34例 ,总优良率 61 .1 8%。结论　本手术方法减少了额肌瓣外侧血管神经损伤 ,增强了额肌的收缩力 ,利用缝线悬吊减张辅助吻合口愈合 ,是治疗中、重度上睑下垂的有效辅助方法     

Early neuromuscular customized training after surgery for lumbar disc herniation: a prospective controlled study

A prospective and controlled study of training after surgery for lumbar disc herniation (LDH). The objective was to determine the effect of early neuromuscular customized training after LDH surgery. No consensus exists on the type and timing of physical rehabilitation after LDH surgery. Patients aged 15–50 years, disc prolapse at L4–L5 or L5–S1. Before surgery, at 6 weeks, 4, and 12 months postoperatively, the following evaluations were performed: low back pain and leg pain estimated on a visual analog scale, disability according to the Roland–Morris questionnaire (RMQ) and disability rating index (DRI). Clinical examination, including the SLR test, was performed using a single blind method. Consumption of analgesics was registered. Twenty-five patients started neuromuscular customized training 2 weeks after surgery (early training group=ETG). Thirty-one patients formed a control group (CG) and started traditional training after 6 weeks. There was no significant difference in pain and disability between the two training groups before surgery. Median preoperative leg pain was 63 mm in ETG and 70 mm in the CG. Preoperative median disability according to RMQ was 14 in the ETG and 14.5 in the CG. Disability according to DRI (33/56 patients) was 5.3 in the ETG vs. 4.6 in the CG. At 6 weeks, 4 months, and 12 months, pain was significantly reduced in both groups, to the same extent. Disability scores were lower in the ETG at all follow-ups, and after 12 months, the difference was significant (RMQ P=.034, DRI P=.015). The results of the present study show early neuromuscular customized training to have a superior effect on disability, with a significant difference compared to traditional training at a follow-up 12 months after surgery. No adverse effects of the early training were seen. A prospective, randomized study with a larger patient sample is warranted to ultimately demonstrate that early training as described is beneficial for patients undergoing LDH surgery.     

CTI和3G技术在120急救指挥中心的应用

介绍了120急救指挥中心的结构、计算机电话一体化和卫星定位系统、地理信息系统以及无线通讯系统的功能，分析了CTI和3G技术在120急救指挥中心的实际应用和取得的成效。     

Deleterious effects of the prone position in the full-term infant throughout the first year of life

Summary Seventy-one first-born infants who had been nursed in prone position since birth, were referred for motor assessment at 3 months, 5 months and 9 months. All infants were administered the same checklist of motor items, based on the Amiel-Tison Infant Neurological Evaluation and on the Brunet-Lézine Developmental Psychomotor Scale. Abnormalities in muscular shortening and delay in motor skills were found. These findings are critical as regards environmental influences on postural development, continuities in motor development and issues of early primary prevention. Early identification and follow-up programmes, including frequent changes in posture, are suggested in order to avoid abnormalities of motor behaviour and subsequently in postural patterns.     

The Cathlocator: A novel non-radiological method for the localization of enteral tubes

Safe placement of nasogastric tubes requires reliable positioning of the tip of the tube within the stomach. Radiology and aspiration are currently used to confirm tube position, but suffer from significant problems of cost and efficacy, respectively. We have developed a novel method to locate the position of a catheter tip within the body, using the detection of a low energy electromagnetic field generated in a coil located in the catheter with an external hand-held unit (Cathlocator). In vitro, the unit detected the distance of the coil from the detector with an accuracy of 0.1 cm over a range of 4–12 cm. In vivo studies were performed in 11 healthy volunteers using a purpose-built manometric assembly that incorporated the signal generating coil in its tip. In all subjects the Cathlocator showed the position of the signal generating coil to be cranial to the xiphisternum when manometric and transmucosal potential difference criteria showed it to be located above the lower oesophageal sphincter. When the coil was within the stomach, the Cathlocator identified its position within the epigastric, umbilical and left hypochondrial regions of the abdomen. The distance of the coil from the surface was significantly greater when in the duodenum mean (±s.e.m. 7.6±0.3 cm; P<0.001) and oesophagus (8.6±0.2 cm; P<0.002) than the stomach (5.0±0.4 cm). In one subject studied twice there was a close correlation between the location and depth measured by the device on each occasion. The Cathlocator is a novel non-radiological device that has the potential to be useful in the placement of gastrointestinal catheters.