行波加速器真空系统问题的探讨

目的:通过分析直线加速器的真空度下降,引起设备中断使用的故障,用简单的测量手法剖析该供电装置“EP130S Ion Pump Power Supply”,找出问题元件,快速解决故障过程,以供同业参考,以达到节省人力物力和时间。方法:当加速器的真空度下降,出现中断的连锁,以交换代替法、万用表跟踪测量真空泵供电装置上每个不同元件参数的改变。分析故障现象、根据电路指向,找出问题关键。结果:分析检查得出的数据和由交换代替法可见结果,清楚问题主要发生在真空泵供电装置上。结论:直接观察直线加速器出现的真空度下降的故障现象,首先考虑故障是否发生在真空泵供电装置上,利用交换代替法、万用表跟踪测量法,可快速了解情况,解决问题。     

一种直线加速器电离室保护装置的研制

目的:为了减少因电离室工作温度、湿度变化引起的直线加速器故障,延长直线加速器电离室使用寿命,设计一种电离室保护装置。方法:通过使用温度23℃、湿度15%、流量10L/min的干燥空气吹拂电离室的方法,改变电离室的工作环境,减少外部应用环境的变化对电离室产生的不良影响。结果:将装置安装在2台直线加速器上使用,同比上年同期的故障次数,故障率减少80%以上。结论:通过实际运行及参数检测,该电离室保护装置运行稳定,在一定程度上改善了电离室的工作环境,可以减少外部应用环境的变化对电离室产生的不良影响,减少电离室故障,延长使用寿命。     

ELEKTA Sli直线加速器电离室故障分析

故障现象 :Ｓｌｉ直线加速器无规律地报ｉ389- 32 0ＶＭＯＵ禁止项 ,但有时故障自己消失 ,有时长时间故障不能排除。分析维修 :根据故障现象 ,导致上述故障的原因可能有以下四个方面 (1)Ｓｌｉ直线加速器为开放式半导体电离室 ,房内潮湿 ,尘土落入电离室表面都可导致电离室短路 ,打火。解决方法是 :用纯度较高的干燥氮气 (体积份数 0 9999)轻吹电离室表面 ,一则除湿 ,二则除尘 ,这也可以作为月保养电离室的一个方面。 (2 )由于整机许多电路也随机架运动频繁 ,电路接触不良也是造成故障的一个方面 ,在发生该故障时 ,对电离室供电系统及电离…     

Varian Clinac—6X直线加速器剂量计数激增的处理

直线加速器上使用平板穿透型双通道输出电离室,其中一通道监测剂量率,另一通道监测积分剂量。射线穿过电离室时使电离室中的空气电离,产生离子和电子,在电场作用下形成电流,该电流即可监测输出剂量率和积分剂量。电离室是保证放疗剂量准确的最关键部件,一旦出现故障,就不能进行放疗。现将我院加速器电离室典型故障的分析处理过程介绍如下:　　故障现象:ＶａｒｉａｎＣｌｉｎａｃ-6Ｘ电子直线加速器在治疗过程中,输出剂量计数有时突然从250ＭＵ/ｍｉｎ增至400～970ＭＵ/ｍｉｎ。最初出现这种故障时,反复开机出束故障可自行消失,但几周或数月…     

直线加速器电离室的工作原理和故障检修

电离室是直线加速器的重要部件,在放射治疗中电离室将直线加速器出束的射线能量转换成电信号的装置,其利用气体分子在高能射线作用下电离的原理,收集放大正离子和电子形成电流信号,由计算机收集并对加速器的射线系统进行反馈和控制。结合电离室的工作原理对其故障进行分析排查和检修,从而排除设备的故障,保证设备的正常使用。     

CPI INDICO 100X线机报“HIGH LF CURRENT”故障维修1例

1 故障现象 开机报"HIGH LF CURRENT". 2 故障分析 查找维修手册,报"HIGH LF CURRENT"意思是大焦点灯丝电流过大,须检查灯丝板.认真查看灯丝板,未发现明显烧坏的元件,而且拔掉大焦点灯丝板电源又报"HIGH SF CURRENT"(小焦点灯丝电流过大),仔细分析有以下几种可能: (1)高压电缆击穿短路[1]. (2)灯丝板本身故障. (3)灯丝板供电电源故障. 3 故障检修 (1)交换高压电缆,故障依旧.用万用表检测高压电缆的3个插头,未发现短路现象,可排除高压电缆击穿故障.     

西门子MEVATRON-KDS加速器电离室高压漏电的修复和调整

<正> 对于医用直线加速器,剂量系统的准确与可靠是非常重要的.而医用直线加速器上使用的电离室是平板穿透型,射线穿过电离室时和电离室中的空气发生作用,产生离子和电子,被外加的电场收集、测量来监测剂量率和积分剂量.我院1993年启用的西门子MEVATRON-KDS型电子直线加速器,操作中曾出现由于靶冷却水管破裂和靶漏水造成X线电离室和电子线电离室高压对地击穿的故障,现将修复和调整作一扼要的介绍.     

VARIAN CLINAC-6X加速器电离室典型故障分析处理

<正> 直线加速器上所使用的平板穿透型双通道输出电离室,其一通道监测剂量率,另一通道监测积分剂量。射线穿过电离室时使电离室中的空气电离,产生离子和电子,在收集电场作用下形成电流,通过对该电离电流的测量来监测直线加速器输出剂量率和积分剂量。电离室是保证放疗剂量准确的最关键部件,一旦出现故障,就不能进行放疗,必须紧急处理。现将我院加速器电离室典型故障分析处理过程介绍如下。     

VARIAN直线加速器真空泵和电离室电源盒故障检修

我院自2001年7月引进美国VARIAN 2300C/D直线加速器,使用两年多来性能稳定,使用良好,但也出现过一些故障,其中以涉及真空泵、电离室电源盒的故障较多.下面介绍两例维修实例,供同行参考.     

XHA-600C型医用电子直线加速器脉冲变压器的故障分析

目前,放射治疗仍是恶性肿瘤重要的局部治疗方法,直线加速器是放射治疗的主要设备,其故障维修有效地保障了放疗的顺利进行。XHA-600C型医用电子直线加速器的高压部件构成直线加速器主要组成部分,加速器的高压部件由高压电源、脉冲调制器、脉冲变压器、微波系统、次级匹配电路构成。对XHA-600C型直线加速器出现的MFIL联锁时的高压部件——脉冲变压器进行故障分析,以便尽快找出故障原因而及时排除故障。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。     

244株真菌鉴定结果分析

目的 了解某院2000～2001年各类真菌的检出率。方法 用酵母样真菌同化试验编码鉴定板TH-15进行编码鉴定。结果 真菌分离率为8．85％；244株真菌分为10种，其中以白色念珠菌和热带念珠菌较高，分别占真菌总数的75．41％和11．47％；检出真菌的主要标本是痰和阴道分泌物。结论 及时进行真菌培养，有利于合理使用抗菌药物和控制真菌感染。