Repair of Left Ventricular Assist Device Driveline Damage Directly at the Transcutaneous Exit Site

With increasing support duration of cardiac assist devices, transcutaneous drivelines remain a weak point of the therapy. First, they can be an entry point for infections, and second, cable lesions and even electrical failures due to material fatigue and eventual carelessness can occur. We report a case of a damaged outer sheath of a ventricular assist device driveline cable directly at the exit site, where the standard repair procedure with self‐fusing tape may lead to biocompatibility problems and irritation of the entrance through the skin. Therefore, a new procedure was developed using a special sleeve expander tool and a highly expandable latex tubing to stabilize the defect in a flexible and biocompatible manner. A patient experienced a fracture of the outer sheath of a HeartWare HVAD driveline directly at the skin entrance (approximately 15 mm long, 5 mm distal from the skin). The metal strands and the electrical functionality were yet not affected, therefore, a pump exchange was not indicated. After considering several conventional solutions for repair as not applicable, a new approach was developed: a sleeve expander tool was applied, which allowed radial stretching of the latex tubing. After preparations of the tool and the cable site, the pump was briefly disconnected, the tubing was moved over the connector and was released at the site of fracture. The problem could be solved by keeping the cable's flexibility and without additional risks to the skin. Within a still ongoing (5‐month) follow‐up, the skin entrance returned to perfect condition and no further intervention was necessary. In conclusion, this method allows a quick stabilization and repair of damaged driveline isolations even near the exit site, resulting in a biocompatible surface and consistent flexibility of the cable.     

电缆绝缘护套中Cr(Ⅵ)的火焰原子吸收光谱测定法

目的建立电缆绝缘护套中Cr(Ⅵ)含量的火焰原子吸收光谱测定方法。方法采用干法灰化分解电缆绝缘护套样品,在稀硝酸介质中,采用火焰原子吸收光谱法测定Cr(Ⅵ)含量。结果在0.001 9~8.00μg/ml的线性范围内,所得Cr(Ⅵ)的线性方程为A=0.114 3c+0.006 3,r=0.999 6。该方法的检出限为0.000 7μg/ml,定量下限为0.001 9μg/ml,平均回收率为97.8%~102.2%,RSD为3.35%~7.13%。结论该方法快速简便,精密度和准确度均较高,适于对电缆绝缘护套中Cr(Ⅵ)的测定。     

后路悬臂梁支撑线缆提拉复位固定治疗可复性及难复性寰枢椎脱位

目的 :探讨后路悬臂梁支撑线缆提拉复位固定治疗可复性及难复性寰枢椎脱位临床疗效。方法 :回顾分析2010年1月至2018年12月收治25例寰枢椎脱位患者资料,其中男15例,女10例,年龄21～72岁,平均49.6±8.8岁。所有病例术前都有不同程度四肢麻木及乏力症状,术前经颈椎动力位片及持续颅骨牵引判定12例为可复性寰枢椎脱位,13例为难复性寰枢椎脱位。25例患者均行后路悬臂梁支撑线缆提拉复位固定融合术。通过术前、术后日本骨科学会(Japanese Othopaedic Associasion,JOA)评分评估神经功能恢复情况,通过术前、术后影像学测量寰齿间距(atlantodental interval,ADI)和延髓脊髓角(cervicomedullary angle,CMA)评估寰枢椎脱位复位情况。结果:所有患者随访12个月～8年,平均随访1年6个月。JOA评分术后1周、6个月及末次随访分别为13.7±1.4、14.8±1.6、15.2±1.3分,较术前9.1±1.5分明显改善(P0.05)。术后影像学随访提示寰枢椎脱位复位满意,ADI术后1周、6个月及末次随访分别为2.3±0.3mm、2.3±0.5mm、2.4±0.6mm,均较术前(6.5±0.9mm)明显改善(P0.05)。CMA术后1周、6个月及末次随访分别为153.9°±7.3°、153.4°±7.6°、152.7°±7.8°,均较术前(121.8°±5.1°)明显改善(P0.05)。1例患者随访发现线缆对寰椎后弓有部分切割,但未断裂。所有病例未见内固定螺钉松动,断裂,骨性融合均良好。结论:后路悬臂梁支撑线缆提拉复位固定治疗可复性及难复性寰枢椎脱位是一种固定牢固,安全可靠的方法,可获得良好的临床效果。     

X线定位冲击波体外碎石机故障检修1例

本文针对一台可移动式冲击波体外碎石机床面故障检修进行分析、检查,最终成功排除故障。     

钢缆钉与张力带钢丝治疗髌骨骨折的疗效分析

目的 探讨钢缆钉与张力带钢丝治疗髌骨横行骨折的疗效.方法 钢缆钉组28例,平均随访8个月.张力带钢丝组30例,平均随访16个月.比较2组手术时间、骨折临床愈合时间、术后半年膝关节屈曲活动范围.采用成组设计t检验及t'检验进行统计学分析.结果 钢缆钉组在骨折临床愈合时间、术后半年膝关节屈曲活动范围方面明显优于张力带钢丝组(P<0 05).结论 钢缆钉治疗髌骨横行骨折具有操作简单、固定可靠、骨折愈合快、愈合率高、膝关节功能好的优点,符合生物力学要求,疗效满意,有临床推广应用价值.     

The isolated salivary duct as a model for electrolyte transport studies

Summary An approximately 1 cm length of the main excretory duct of the rabbit submaxillary gland is dissected free from the animal and transferred to a lucite perfusion chamber containing rabbit serum. The ends of the duct are mounted over a pair of capillaries so that the duct could be perfused through one capillary while samples are collected from the other. A special multibarrelled perfusion system allowed intraluminal current application and transepithelial voltage recording. Both sides of the duct epithelium were bathed with continuously flowing solutions, which could be rapidly exchanged.Net Na⁺ transport across the isolated duct is as great as net Na⁺ transport in vivo. Net Na⁺ reabsorption ranges from 380 to 600 neq/min·cm², and net K⁺ secretion is 13 to 26 neq/min·cm². Cation transport is maintained stable during a 3 h period, and thereafter slowly decreases. During perfusion with bicarbonate Ringer's solution, the mean transepithelial electrical potential difference is 17±3 mV (lumen negative). During sodium sulfate perfusion the duct epithelium generates a p.d. of up to 185 mV. Using cable analysis, the specific electrical resistance of the duct epithelium was determined to be 11.2±1.6 cm². Since the duct epithelium shows a linear current-voltage relation, the short-circuit-current can be calculated from the open-circuit-p.d. and the specific wall resistance during perfusion with bicarbonate Ringer's solution. A value of 1.5±0.3 mA/cm² is obtained, which is primarily accounted for by active transport of sodium.     

Cable Pin系统治疗髌骨骨折25例疗效分析

目的探讨Cable Pin系统治疗新鲜移位髌骨骨折的临床疗效。方法自2006年8月至2007年9月采用Cable Pin系统选择性治疗新鲜移位髌骨骨折25例,其中横形骨折20例,粉碎性5例。骨折切开复位后,以细克氏针平行于髌骨关节面纵行预钻孔,连接加压螺钉于动力系统,攻钻入骨。同样方法平行植入第二枚螺钉。于远端横行钻一骨隧道,将钢索穿过隧道,在髌骨前方＂8＂字捆扎。收紧钢索,以束缚器固定。如骨折仍欠稳定可加以环扎固定。结果25例患者随访2～9月（平均6.8月）。骨折均于8～10周内愈合。无螺钉滑脱突出、钢索断裂、滑脱和软组织刺激等并发症发生,远期随访膝关节功能恢复良好。以胥氏综合评分法进行评估：优22例,良3例,优良率100%。结论Cable Pin系统治疗髌骨骨折术后即时稳定性确切,长期随访并发症少,膝关节功能恢复良好。     

南韩22.9千伏50兆伏安高温超导电缆系统的型式试验结果

高温超导体（High temperature superconducting HTS）被认为是最有希望的技术之一,来满足未来电力需求的增长。在2006年,南韩L.S电缆公司开发了HTS电缆系统,包括100米长HTS电缆,三相合在一个冷却终端装置,连接盒以及冷却系统,这是通过五年的不断技术研究,包括在2005年对30米HTS电缆系统进行了六个月长期运行试验的基础上,新开发的HTS电缆系统。 新开发的HTS电缆系统,首先进行型式试验。试验是与韩国电力公司（KEPCO）合作,按IEE（国际电气工程师协会）推荐的标准IEC SB1 2006进行试验。试验现场选在韩国电力公司的试验中心进行,该中心的场地具有90°弯曲管道,蛇行隧道以及在地面上有180°U型弯曲等。 建议的评估项目包括有30天的载荷循环,严格的热力循环,介质损坏及安全,局部放电,直流临界极限电流（Ic）等。这一系列的试验项目均获得成功地通过。     

基于OWTS的10kV电缆局部放电状态检测基本原理与应用

由于OWTS具有无损伤检测、便于现场操作等优点,因而其在电缆局放检测领域受到越来越多的关注。广州供电局试验研究所2009年底引进该技术,并应用于亚运场馆的电缆局放检测中,发现了多起电缆接头缺陷,取得了较好的成效,为亚运保电作出了一定的贡献。本文介绍了振荡波电压法检测电缆局放的基本电路原理,提出了应合理选择电感参数以获得合适的振荡频率的观点。介绍了典型的测试案例,为今后电缆局放现场测试提供一定的参考。     

GIS电缆终端套管气泡缺陷局部放电试验研究

本文为研究电缆GIS终端环氧套管气泡缺陷引起的局部放电数据,并在试验室进行GIS终端环氧套管气泡缺陷的局部放电测试,获取了其典型图谱,为现场检测GIS电缆终端局部放电的诊断提供了缺陷典型图谱的样本数据。