医用监护仪电池容量检测仪的设计和应用

本文阐述了一种医用监护仪电池容量检测仪的设计及应用过程。该检测仪由电压检测模块、电压显示模块、电路控制模块和电路信号输入模块组成，主要用于医用监护仪电池容量的量化检测，对提高医疗设备的质量控制水平和保障病人的转运安全非常重要。     

PDCA循环在监护仪设备质量管理过程中的应用效果分析

目的探讨戴明环(PDCA循环)在监护仪设备维修中的应用效果分析。方法选择蚌埠医学院第一附属医院865台监护仪为研究对象,未实行PDCA循环的2019年为对照组,实行PDCA循环的2020年为观察组。对两组质量控制合格率进行对比分析。结果观察组质量控制合格率(90.8%)高于对照组(62.7%)(P<0.05)。结论PDCA循环在监护仪设备质量管理过程中具有明显的应用效果,可有效提高监护仪质量控制的合格率。     

多参数监护仪的质量控制对应用安全的影响

多参数监护仪作为医院急救设备之一,其重要性不言而喻.如何保障多参数监护仪在使用及维护中的应用安全,已经成为医院临床医学工程部门面临的重要问题.本文通过分析电气安全测试的几个安全指标,以及多参数监护仪在使用和维护中的注意事项,来进一步探讨如何保障多参数监护仪的应用安全.     

医院医疗设备质量控制管理的探讨

先进的医疗设备是疾病诊疗的重要工具.医疗设备质量与医疗质量和医患人员安全密不可分.控制医疗设备质量是医院的职责和能力体现.伴随着医院现代化发展与规范化管理的进程,本人结合多年的相关工作经历,对如何建立与完善医疗设备质量控制工作,总结如下.1 建立质量控制管理体系医疗设备质量控制的目的是确保临床应用质量和病人安全,提高医院综合效益.医疗设备质量控制体系主要包括：医疗设备采购质量控制;医疗设备临床使用质量控制;医学工程部质量保障质量控制三个方面.     

我院多参数监护仪故障统计分析

目的通过总结日常维修的监护仪的故障和解决方法,结合我院实际情况制定监护仪质量控制计划,推动我院监护仪的质量控制工作的进展。方法依据国内标准GB9706.1-2007《医用电气设备》和国家计量检定规程JJG760-2003《心电监护仪检定规程》,采用FLUKE生命体征模拟器ProSim 8,对监护仪的各项性能指标进行检测。结果在检测的50台监护仪中,86%的监护仪不合格归因于附件如血压袖带、血氧饱和度探头、心电导联线等的损坏。14%的监护仪不合格归因于血压气泵损坏、血压模块电路板损坏、电源板损坏、按键板、显示屏损坏等的主机内部损坏。结论通过总结我院监护仪不合格的原因,为我院质量控制工作的改进提供了一定的依据。     

多参数监护仪的质量控制分析

为保证多参数监护仪的有效性和安全性,我院对多参数监护仪进行了质量控制检测工作。通过对检测数据分析发现：多参数监护仪外接端子氧化与电源线老化是接地电阻抗偏大所致;无创血压与呼吸频率问题反映出质量控制工作应多方面考证;质量控制检测设备应当通过质检部门的相关测试,才能应用于临床质控工作。     

以医疗质量安全为核心的医院信息系统研究

从医院信息系统入手,通过病案首页数据库标准化、知识库标准化、医疗质量安全指标库标准化和医疗质量安全表达数据定义标准化,实现医院信息系统的医疗质量安全管理标准化,最后建立以医疗质量安全为核心的标准化应用体系。因为《病案首页》作为数据源,是目前医院信息系统中标准化程度最高的应用工具,从《病案首页》入手改造医院信息系统,可以用较低成本快速建立以医疗质量安全管理为核心的标准化应用体系。     

单病种质量控制体系的建立与应用探讨

目的探讨单病种质量控制体系的建立与应用。方法从单病种的选择、病例筛选、质量控制指标体系及标准值的建立以及与质量评价方法进行探讨,阐述说明。结果建立了一套较为规范、实用的单病种质量控制体系。结论单病种质量控制体系能有效应用于医疗质控工作实践。     

无公害中药材生产HACCP质量控制模式研究

危害分析和关键控制点（hazard analysis and critical control points,HACCP）为控制农产品安全的一种有效方法与质量控制体系。介绍了HACCP质量评价体系,对该体系在无公害中药材生产领域中的应用进行了探讨与分析,HACCP对我国无公害中药材生产、保障民众安全健康,中药产业化和国际化具有重要的现实意义。     

门诊医疗服务质量管理体系的建立与实践

目的 建立门诊医疗服务质量管理体系,不断提高医疗服务质量,确保医疗安全.方法 根据卫生部<医院管理年活动方案>和<医院管理年评价指南>,建立我院门诊医疗质量管理体系.包括组织体系、控制体系、标准体系和评价体系.结论 通过建立门诊医疗质量管理体系,对医疗服务质量及时监控、反馈并改进,规范医疗质量管理,提高医疗服务水平.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.