使用止血带替换听诊器的老化胶管

听诊器经过较长时间使用后,与其连接的胶管会出现不同程度的老化现象,表现为胶管质地变硬、弹性差,会出现破裂或胶管腔粘连等问题.经常扭曲放置时,听诊器与胶管连接处会有不可逆的皱褶、管腔闭塞等,严重影响听诊效果,出现听不清搏动音或误判等情况.     

B超引导下宫腔镜治疗输卵管性不孕症体会

目的 评价B超、宫腔镜治疗输卵管性不孕症的临床价值。方法回顾性分析应用B超、宫腔镜治疗女性不孕症82例临床资料。结果82例患者中。疏通输卵管82条。治疗后半年复诊52例中有11例妊娠。结论B超、宫腔镜联合用于榆卵管性不孕症进行选择性输卵管插管通液准确、直观，疏通输卵管临床效果好。     

Electrically amplified precordial stethoscope

The stethoscope was assembled with the technical assistance of V. Bühler; the circuit diagram was drawn by I. Odermatt.     

Experience with an intensive care unit in a developing country.

In September 1963 an intensive care unit was established at the Lagos University Teaching Hospital in Nigeria. The incidence of mortality was significantly high (38%). This was attributed to several factors: (1) severity of illnesses, types of illness and antecedent period of neglect; (2) lack of a critical care medicine program; (3) limited numbers of skilled, full-time intensive care unit personnel, including physicians, nurses, inhalation therapists and paramedics, and (4) the high incidence of sepsis in the intensive care unit.     

In defense of the stethoscope

The stethoscope is widely considered to be an unreliable instrument. Many studies document the significant observer variability in its use. Numerous other diagnostic tools are available that are generally regarded to provide more reliable diagnostic information. Some even argue that teaching of the ancient art should be de-emphasized in medical schools. Yet auscultation with an acoustic stethoscope can provide important, even life-saving, information. The purpose of this article is to present evidence that supports the use of the stethoscope in clinical medicine. The argument for the stethoscope will be made by presenting relevant investigations, including clinical studies acknowledged to meet the criteria of evidence-based medicine. It will focus on studies that have employed computerized acoustic technology to correlate lung sounds with disease states. This technology has advanced in recent years, which has stimulated a resurgence of interest in auscultation. Numerous studies have been done that utilized objective methods that circumvented the problem of observer variability. There is now a good deal of scientific evidence to support the hypothesis that lung sounds contain information that is clinically useful. This technology also allows this information to be collected more efficiently than previously possible. Advances in educational technology have made it possible to impart information on auscultation much more easily than was possible in the past. Contrary to predictions, the stethoscope is not likely to be relegated to the museum shelf in the near future. Computer technology is making it an even more useful clinical instrument.     

Clinical Experience with an Activity Sensing Pacemaker

During clinical evaluation of the Medtronic * Activitrax pacemaker in a worldwide multicenter study, implant and follow-up data were provided by 61 investigators on 222 patients. Pacing indications included two- and three-degree AV block in 149 and atrial arrhythmias in 174 patients; 16 patients received atrial pacing. Average and longest documented follow-up periods were 7.5 and 16 months respectively. Paired treadmill tests, one in Activity mode and one in VVI/AAI mode, were performed by 120 patients. At peak exercise, average heart rate was 95 bpm in VVI/AAI mode and 118 bpm in Activity mode (p < 0.0001). Average exercise time was 9.4 minutes in VVI/AAI mode and 10.8 minutes in Activity mode (p < 0.0001). In 54 patients who exclusively had paced rhythm during both treadmill tests, average heart rates and exercise times were 70 ppm and 8.1 minutes in VVI/AAI mode and 111 ppm and 10.3 minutes in Activity mode respectively (p < 0.0001). 24-hour Holter recordings typically demonstrated pacing at or near basic rate during periods of rest and appropriate increase in pacing rate during daily activities. Patients had significantly fewer problems with physical effort in daily life during a week of Activity mode pacing than during a week of VVI/AAI mode pacing (p < 0.05) as assessed from the symptom scores recorded by 62 patients in special diaries.