医疗器械造成医疗事故原因分析

造成医疗事故的原因多,其中间分原因是由于医疗器械方面的原因。从医疗器械的设计注册,生产制造,使用管理等几方面分析造成医疗事故,并应注意事项。     

山西省计划免疫冷链设备现状调查

为了解山西省计划免疫冷链设备现状,于2001年5月对全省各级卫生防疫站进行了调查.结果显示截止调查时全省装备的6种主要冷链设备共4419台(件,下同),其中前10年(1986～1995年)装备2489台,占56.3%;后6年(1996～2001年)装备1930台,占43.7%.在4419台中,当前正常运转的1930台(43.7%),尚可使用的1057台(23.9%),损坏报废的1432台(32.4%).为满足当前需要,全省尚需增补1888台,其中县、乡两级需增补普通冰箱1011台,低温冰箱805台,疫苗运输车35辆;省、市两级需增补普通冷库4台,低温冷库10台,冷藏车9辆,疫苗运输车14辆.说明需增补的重点在基层.     

正交设计在确定混合血清法检测丙型肝炎抗体实验条件中的应用

目的探讨封闭温度、时间、ＢＳＡ浓度、Ｔｗｅｎ２０浓度及混合标本个数５因素各２水平对混合血清法检测抗－ＨＣＶ的影响。方法应用正交设计的方法进行实验分组，采用ＥＩＡ法检测抗－ＨＣＶ。结果封闭条件为０．５％ＢＳＡ，３７℃，３０ｍｉｎ；洗涤液为０．１５％Ｔｗｅｅｎ２０，混合标本个数为５。采用正交设计的实验方法可减少７５％的实验次数。结论在进行多因素的实验研究时，正交设计是一种高效的设计方法。     

应用斑秃治疗仪治疗斑秃患者的疗效观察

目的对145例斑秃患者发病情况分析及治疗效果评价。方法采用问卷调查方式对门诊就诊的145例斑秃患者进行调查,收集斑秃患者发病可能或伴发因素,并根据调查及临床检查结果对145例斑秃患者随机分组,并分别采用斑秃治疗仪(治疗组)和胱氨酸、天麻首乌片口服治疗(对照组)。结果治疗组治愈率为94.2%、有效率为98.1%,对照组治愈率为71.4%、有效率为81.0%。结论斑秃治疗仪治疗斑秃疗效优于对照组。     

Influence of handedness on calcaneal ultrasound: Implications for assessment of osteoporosis and study design

Calcaneal ultrasound has been increasingly studied for its potential in the assessment of osteoporotic fracture risk. The accuracy of such an assessment is, in part, dependent on the reproducibility of the measurement. This study examines the impact of handedness on ultrasound measurements [broadband ultrasound attenuation (BUA) and velocity of sound (VOS)] in the calcaneus. Two hundred and sixty-four subjects (57 men and 297 women) aged 51.1+13.6 years (mean ± SD) were studied. For each subject, calcaneal ultrasound measurements were performed on both heels with a McCue CUBA ultrasound densitometer. Right-handed dominance (94.7%) was determined by structured interview. In men, BUA measurements were significantly higher on the dominant side: mean difference 4.1±1.5 dB/MHz (mean ± SD;p=0.009), equivalent to 4.2+1.5% and more than 4 times the average rate of annual change in BUA. The difference between sides was greater in young (<50 years) than old men (>50 years). Among the women, the difference was not statistically significant (0.7±0.9 dB/MHz;p=0.4); however, it was significant in younger women (20–30 years) (99±4 vs 90±4 dB/MHz,p=0.01). By contrast VOS did not differ between sides in either men or women irrespective of age. Within-subject standard deviation of BUA was 9.8 dB/MHz for men and 8.6 dB/ MHz for women and the component due to right and left difference was 8.4 dB/MHz for men and 6.9 dB/MHz for women. This variability of BUA between right and left heels could increase the false-positive rate by up to 28% for a cut-off of 2 SD below the mean. These data indicate that variation between left and right heel measurements of BUA is higher than that of random error measurements, particularly in men and younger, presumably more physically active subjects. Although VOS measurements were not side dependent, in the smaller number of studies examining VOS and fracture risk, VOS appears to have a weaker predictive power than BUA. Clinical and epidemiological studies involving calcaneal BUA measurements should standardize the side measured to either the dominant or non-dominant heel, to reduce within-subject variation and increase their power.     

Corneal D.C. recordings of slow ocular potential changes such as the ERG c-wave and the light peak in clinical work

A set-up for D.C. recordings of slow ocular potentials such as the c-wave of the electroretinogram (ERG) as well as the fast oscillation (FO), the light peak (LP) and the dark trough (DT) in both clinical and experimental work is described. It includes matched calomel half-cells connected by saline-agar bridges to a corneal contact lens on the eye and a reference chamber on the forehead, a low-drift differential-input D.C. amplifier, an A/D converter, a computer, a thermoprinter, a flexible disc memory, a plotter, and a device for light stimulation controlled by the computer.Examples of the usefulness of the set-up in clinical work are shown in the form of D.C. c-wave ERGs of normal subjects as well as of patients with vitelliform macular degeneration, choriocapillaris atrophy, and retinitis pigmentosa. The direct corneal recording of the FO and LP is demonstrated as well. The different origins of the standing potential (SP) of the eye, the ERG c-wave, the FO and the LP are reviewed briefly.     

三种泻心汤及其类方不同配伍对正常大鼠胃粘液成分的影响

目的:探讨半夏泻心汤及其类方不同配伍对正常大鼠粘液含量的影响.方法:用均匀设计法对半夏泻心汤及其类方进行组方药量变化,以胃粘液含量为药理学指标,对所得的药理实验数据进行逐步回归分析.结果:与胃粘液含量关联度最大的为黄连,可以显著降低其含量,其次对半夏、大枣和甘草的交互项,可增加胃粘液含量.药物之间存在复杂的交互作用.结论:均匀设计为研究类方配伍提供了一种可供参考的试验设计方法.     

用神经网络法预测药物在体透过人皮肤的渗透性

目的：预测药物在体透过人皮肤的渗透性。方法：以正辛醇／水分配系数(logP)、分子体积(V)、氢键酸度(∑β2^H)和氢键碱度(∑β2^H)等理化参数作为输入层神经元，以药物在一定时间内在体透过人皮肤的透过比的对数值(R，透过量／未透过量)作为输出层神经元，建立起合适的BP(Back—propagation)神经网络。结果：17个药物在一定时间内在体透过人皮肤的透过比的神经网络计算值和实测值均相当符合。结论：用BP神经网络法可以较好地预测药物在体透过人皮肤的渗透性。     

实时在线咨询系统的功能与设计

结合国外图书馆网上实时参考咨询服务的研究与试验情况,详细阐述和分析了基于实时的虚拟参考咨询系统的功能和设计策略.     

Operative treatment of intertrochanteric hip fractures: an overview of modern advances and techniques

Hip fractures have been one of the most studied injury pattern in adults. The number of hip fractures is increasing exponentially; furthermore, the cost of treatment places great economic strain on society. There have been recent developments in hip-fracture treatment, particularly involving the intertrochanteric region, with emphasis on deformity prevention to try to optimize patient functional outcomes. In this article, we outline some of these developments with an emphasis on changes in implant design.