化学产热法药品防冻运输箱的研制

液体药剂的防冻运输是战时寒区药材供应中必须妥善解决的问题,我军有关部队,对药品防冻箱的研制曾做过不少工作,取得了较好效果,但在实际使用和推广等方面尚存在一些问题。为了研制较好的药品防冻箱,我们采用了化学产热剂作防冻箱内热源,箱体结构简单,使用方便,效     

用塑料瓶制做简易小试管架

我科担负着野战条件下卫勤医疗检验保障任务，为了在27cm X 18cmX18cm。的战备检验箱中放入体积小，结实耐用的试管架我们用塑刺瓶自制了一种试管架，介绍如下。      

医苑新技

便携式野战卫生装备问世彩色多普勒血流定量研究获重大成果不久前，广州军区卫生部将该区自行研制成功的“GYX２００１便携式野战卫生装备”配发至全区所有驻军以上医院、师医院、旅团卫生队、营卫生所，将使基层卫生单位在未来高技术战争中快速机动、快速展开、快速救治、快速撤收的能力大大提高，标志着这个军区的野战救治能力跃上了一个新台阶。本套装备由野战心电图、B超、检验、治疗换药、药品、输液、手术床、手术灯、手术器械、理疗、急救诊疗和通用箱等１２类箱组成。其特点是：装备少，功能全；重量轻，易携带；设计巧，易展开；…     

野战手术车在高原寒区野外训练中的应用

高原寒区后勤保障使命课题训练,是当前部队医院的重要任务之一。野战手术车作为卫生装备的核心装备,其环境适应性和机动性较高,适合用于战场上对伤病员进行快速、有效的救治,可有效完成现代战争中的紧急救命手术和早期外科处置。因此,探讨野战手术车在高原寒区救治模式,反复磨砺全域全维条件下的综合救治能力,对最大限度地争取抢救伤员,减少伤残,保持部队战斗力,均具有重要意义。1高原寒区应用的特殊环境     

JX—I型野战泌尿外科检治仪

当前,各级医院在进行膀胱镜检查和电灼治疗时,仍然需要多箱(盒)配合,外山执行任务、会诊等携带很不方便。尤其我军战备器材装备中尚缺膀胱镜及其它泌尿外科特殊检查和治疗器械,给野战条件下部份泌尿外科伤病员的检查治疗工作带来一定困难。为了平时工作方便和战时需要,我院从1981年开始,在骊山微电子公司和有关单位的协助下,研制成“JX——I型野战泌外检治仪”。本机具有膀胱镜检查,逆行肾盂造影、膀胱内电灼及膀胱测压等多项检查和治疗功能。经动物试验和临床使用效果良好。现简介如下:     

应重视野战医疗所战备药材和物资的及时提用和补充

解放军264医院来青峰等认为,部队医院野战医疗所的传统管理模式曾对部队卫勤保障工作做出过重大贡献,但在新形势下,这种管理模式使储存的战备物资长期闲置,造成卫生资源大量浪费。他认为,应利用“军字一号工程”,使野战医疗所战备药材库与医院药房联网,及时提用和补充战备库药材;使野战医疗所通用生活物质库与医院军需生活物质库挂钩,及时提用和补充战备库物资。应重视野战医疗所战备药材和物资的及时提用和补充     

用于寒区战地输液的便携式加温加压装置设计

目的:探讨适用于寒区战地环境下输液装置的设计方案.方法:对寒区战地环境下输液场景进行分析,提出便携、加温、加压等需求,给出相应的设计方案.结果:寒区战地快速输液装置应分别设计加压模块、加温模块、控制单元、电源单元等,并进行系统整合.结论:便携式加温加压装置可实现加温、加压、警示、关断等功能,适合在寒区战地环境下使用.     

高原寒区复杂电磁环境下野战医疗分队应对措施

本文分析了复杂电磁环境对高原寒区野战卫勤保障的影响,指出了我们所面临的通信联络不畅、战场隐蔽困难、仪器易受干扰等困难,并从完善预案、科学部署、健全体制、加强搜救、保护设备、统筹资源、信息防护七个方面阐述了在复杂电磁环境下高原寒区进行野战医疗救护过程中电磁防护的方式方法,切实做到了科学合理,灵活机动,大幅提高了野战救治能力和卫勤保障水平。     

野战医疗所训练的组织与实施

在未来战争和非战争军事行动中,野战医疗所是应急机动卫勤保障的重要力量。抓好野战医疗所训练的组织与实施,是战备抽组军队医院建设的核心内容。2002年以来,我院加大了对野战医疗所战备训练强度和训练设施建设的力度,修建了院内战备训练场,改扩建了战备库和战备车库,购置了抗眩晕器材,补充了相关装备等。野战医疗所先后参加联合国维和、     

拉萨与漳州地区战备消毒包储存时限的实验研究

 目的 探讨战备消毒包在拉萨与漳州地区自然环境中的储存时限、影响因素及细菌来源.方法 准备双层棉布手术敷料包、器械包、敷料器械混合包,预真空压力蒸汽灭菌后分别存放在自然环境战备仓库储存箱内,分别于灭菌后不同时限点随机取3种规格消毒包各3个进行细菌培养;同时对战备仓库空气、储存箱进行取样培养,并进行细菌同源性研究.结果 灭菌消毒包储存时限拉萨地区为91 d,漳州地区为24d;两地区战备消毒包、仓库空气和储存箱优势菌属为革兰阳性杆菌和球菌;消毒包内培养出的细菌与空气、储存箱分离出来的相同菌种不同菌株之间的16SrRNA - 23SrRNA转录间隔区(internal transcribed spacer,ITS)序列相似性,在拉萨地区约为99％～100％,漳州地区约为98％～99％.结论 拉萨地区灭菌消毒包储存时限长于漳州地区;不同地区战备消毒包的储存环境对其储存时限具有重要的影响;战备消毒包内细菌来源于仓库自然环境空气.     

Risk of microbial contamination of iodinated contrast media on multiple use of large-volume bottles

Large-volume bottles of iodinated contrast material (CM) offer advantages over single-dose vials in respect of handling, radiation protection of personnel, cost and waste. Because non-ionic CM are considered to be susceptible to microbial contamination, the probability of such contamination was investigated under practical conditions with reference to the duration of use. Under conditions identical to those in practice, contamination was found in only about 1% of bottles examined after a single piercing. Under worst-case conditions, a maximum of 9 microorganisms/bottle was found. No pathogen multiplication was observed within 24 h in microbial challenge tests; rather, the nosocomial pathogens examined died quickly in iopromide, the only exception being Pseudomonas aeruginosa. There was not a single case of bacterial multiplication on clinical use of 500-ml infusion bottles in patients undergoing routine computed tomography, using either injection by hand or an automatic infusion device. In conclusion, the microbial count rate did not differ from that of small-volume parenterals used up immediately after piercing. To ensure an adequate safety margin for the avoidance of septicemia or pyrogenic reactions, the CM should be used within 1 examination day.     

Griffith Pugh,pioneer Everest physiologist

Lewis Griffith Cresswell Evans Pugh (1909-1994), best known as the physiologist on the successful 1953 British Everest Expedition, inspired a generation of scientists in the field of altitude medicine and physiology in the decades after World War II. This paper details his early life, his introduction to exercise physiology during the war, and his crucially important work in preparation for the Everest expedition on Cho Oyu in 1952. Pugh's other great contribution to altitude physiology was as scientific leader of the 1960-1961 Himalayan Scientific and Mountaineering Expedition (the Silver Hut), and the origins and results of this important expedition are discussed. He had a major and continuing interest in the physiology of cold, especially in real-life situations in Antarctica, exposure to cold wet conditions on hills in Britain, and in long distance swimming. He also extended his interest to Olympic athletes at moderate altitude (Mexico City) and to heat stress in athletes. Pugh's strength as a physiologist was his readiness to move from laboratory to fieldwork with ease and his rigor in applying the highest standards in both situations. He led by example in both his willingness to act as a subject for experiments and in his attention to detail. He was not an establishment figure; he was critical of authority and well known for his eccentricity, but he inspired great loyalty in those who worked with him.     

持续泵注与多次注药法用于硬膜外麻醉比较性研究

目的：观察微量泵持续输注法与分次注药法用于硬膜外麻醉的麻醉效果比较。方法：60例骨科下肢手术患者随机分为两组,微量泵持续输注组（A组）和常规分次注药组（B组）,每组30例,硬膜外用药均为2％利多卡因先注入实验量3ml,观察5min,无全脊麻征象后,A组以0．13—0．15ml·kg^-1·h^-1速度持续输注药物至手术结束;B组10—12ml,2—3min内分次注完,术中未再追加药物。观察镇痛起效时间、麻醉平面、镇痛效果、运动阻滞程度、BP、HR、SPO2和用药总量。结果：麻醉平面、镇痛效果、运动阻滞程度、SPO2两组间差异无显著性（P〉0．05）。A组用药总量显著减少（P〈0．01）BP波动显著降低（P〈0．01）。结论：微量泵持续输注法与分次注药法用于硬膜外麻醉比较麻醉效果可靠,BP平稳,用药量少。     

六种药用包材在非聚氯乙烯软袋输液生产线的应用及质量考察

目的考察6种药用包材的质量，选择热合性能好和上机适应强的包材，提高非聚氯乙烯软袋大输液质量稳定性。方法通过比较包材的物理性能和上机适应性，确定生产用包材并对此包材包装的电解质输液进行稳定性实验。结 果重量差异小的组合盖和接口在设备上运行顺畅，3层与5层共挤输液用袋物理、化学性能及此包装的四种电解质输液稳 定性试验均符合规定，但3个规格的3层共挤输液用袋成品得率均低于5层共挤输液用袋。结论5层共挤输液用袋成品率 高,应作为该院大输液生产首选包材;3层共挤输液用袋灭菌后透光率好,可以作为备用包材。     

动脉化疗治疗头颈部恶性肿瘤的临床研究

目的研究超选择性动脉介入灌注化疗和栓塞治疗头颈部恶性肿瘤的价值。方法31例头颈部恶性肿瘤患者根据肿瘤部位分别行超选择性舌动脉、颌内动脉、面动脉介入灌注化疗,其中明胶海绵颗粒栓塞11例。化疗药物采用顺铂(CDDP)、5-FU、甲氨碟呤(MTX)、表阿霉素(EPI)等2～3种联合应用。结果31例头颈部恶性肿瘤选择性动脉插管化疗和栓塞,半月后肿瘤体积缩小21例(占67.8%);肿瘤溃疡面缩小8例(占25.8%);未见明显变化2例。组织学疗效:19例介入治疗后接受手术,10例栓塞后的手术标本均为显效,栓塞标本近栓塞的血管处坏死程度重;9例未栓塞标本为有效。19例手术标本病理观察有效率94%。术中见肿瘤缩小,边界清楚,出血减少。19例术后目前仍生存15例(占78.9%),存活时间1～7.5年。结论术前超选择性动脉插管化疗栓塞对头颈部恶性肿瘤有较好的临床应用价值。     

Radiosensitization efficacy of KU-2285, RP-170 and etanidazole at low radiation doses: assessment by in vitro cytokinesis-block micronucleus assay.

Since the cytokinesis-block micronucleus assay is very sensitive at low radiation doses, we used it to investigate the in vitro sensitizing effects of two new hypoxic cell sensitizers (KU-2285, a fluorinated 2-nitroimidazole and RP-170, a 2-nitroimidazole nucleoside analogue) at 1-3 Gy in comparison with etanidazole. Exponentially growing EMT6 cells were treated with the drugs under aerobic or hypoxic conditions for 40 min prior to and during irradiation, after which the drugs were removed and cytochalasin B (2 micrograms/ml) was added to the medium. The number of micronuclei in binucleate cells was counted after 42 h of culture. Under aerobic conditions the three compounds at 5 mM had no sensitizing effect. Under hypoxic conditions the sensitizer enhancement ratio (SER) at 5 mM was 3.8 for KU-2285, 3.2 for RP-170, and 2.3 for etanidazole, while the oxygen enhancement ratio was 2.9. When the cells were pretreated under hypoxic conditions with drugs at 5 mM but then irradiated under aerobic conditions, KU-2285 and RP-170 had a sensitizing effect whereas etanidazole did not. The sensitizers were also tested at 0.5 and 1 mM, and the SER values were compared with those obtained at high doses (15-30 Gy) using a colony assay. The SER at low doses was higher than that at high doses for 1 and 5 mM KU-2285 and 5 mM RP-170, while the SERs were similar for all concentrations of etanidazole and the lower concentrations of KU-2285 and RP-170. These results might suggest the potential usefulness of KU-2285 and RP-170 in clinical radiotherapy.     

不同复方药剂对沙林染毒兔的救治研究

目的探讨不同抗胆碱能化合物联合氯解磷定对沙林染毒兔的救治效果,为药物联合应用的合理救治方案提供依据。方法通过测定几种抗胆碱能化合物与氯解磷定单独或者联合应用对沙林染毒兔的防护比率,并结合动物救治过程中体内乙酰胆碱酯酶（AChE）和丁酰胆碱酯酶（BChE）活性恢复情况,确定疗效较好的可与氯解磷定联合应用的抗胆碱能化合物。结果阿托品、盐酸戊乙奎醚、氯解磷定单独应用时对中毒兔的防护比率均小于1.20;不同种类抗胆碱能药物与氯解磷定联合应用时,3种盐酸戊乙奎醚联合其他药物的防护比率均较2种阿托品联合其他药物的防护比率高,前者对动物的防护比率为3.68～3.80,后者对动物的防护比率为2.30～2.56。采用盐酸戊乙奎醚和贝那替秦与氯解磷定联合应用对沙林重度染毒兔的疗效为77.8%。结论采用盐酸戊乙奎醚和贝那替秦与氯解磷定联合应用对沙林染毒兔有较好的救治效果。     

Advanced of progressive design approaches to produce Medical Packaging Boxes for modern functional complete sets of medical property

New types of medical packaging boxes represent collapsible products based on solid metal pieces and flat polymeric panels with stiffening ribs. They allow to implement the advanced methods of medical property storage and correspond to the standards of modern container-transporting system. They have high repairability level and insignificant own weight. The main elements and junctions can be interchanged as well as the whole box can be transformed into field medical furniture.     

Tolerance and diagnostic accuracy of an abbreviated adenosine infusion for myocardial scintigraphy: A randomized, prospective study

BACKGROUND: The objectives of this study were 2-fold: (1) to determine the tolerance of adenosine perfusion tomography with the use of an abbreviated (3-minute) infusion in comparison to the standard (6-minute) infusion, and (2) to assess the relative diagnostic accuracy of a 3-minute adenosine infusion in patients referred for arteriography. An abbreviated adenosine infusion may decrease the frequency and duration of side effects and be a more cost-effective alternative. METHODS AND RESULTS: We prospectively randomized 599 patients undergoing adenosine myocardial perfusion tomography to either a 3-minute or 6-minute adenosine infusion at 140 microg/kg per minute. Among the 599 enrolled patients, 142 subsequently underwent coronary angiography. Patients randomized to the 3-minute adenosine infusion tolerated the procedure better than those randomized to the standard infusion (P <.01). Flushing, headache, neck pain, and atrioventricular block were all significantly less frequent (P <.01) with the abbreviated infusion. Moreover, patients receiving the abbreviated infusion had less hypotension and tachycardia (P <.05). The sensitivity of the test for detection of coronary artery disease was 88% for both the 3- and 6-minute infusions. In patients with abnormal scan results, perfusion defect size was slightly larger in those receiving a 6-minute infusion versus those receiving a 3-minute infusion (P =.05). CONCLUSIONS: An abbreviated 3-minute adenosine infusion, in combination with perfusion tomography, has similar sensitivity for detection of coronary artery disease and is better tolerated than the standard 6-minute infusion.     

咪达唑仑复合氯胺酮应用于小儿基础麻醉的临床探讨

 目的 探讨应用咪达唑仑复合氯胺酮不同给药方法在小儿基础麻醉中的优化方案.方法 200例1～6岁,ASAⅠ～Ⅱ级患儿随机分成以下五组:A组为口服咪达唑仑0.7 mg/kg;B组为口服氯胺酮8 mg/kg;C组为肌注氯胺酮5mg/kg;D组为口服咪达唑仑0.5 mg/kg和氯胺酮4 mg/kg;E组为先口服咪达唑仑0.5 mg/kg,再肌注氯胺酮4 mg/kg.观察各组诱导结果及呼吸循环变化、不良反应.结果 ①A组与B组比较,A组起效更快(P<0.01),合作更好,不良反应较少;②A组、B组均比C组更合作,但不如C组起效更快;③D组和E组相比,患儿更合作,不良反应更少,但起效更慢,两组诱导效果无显著差异(P>0.05).结论 咪达唑仑复合氯胺酮优于单独给药,对循环呼吸影响小;口服给药可行性更佳.