医用空气加压氧舱设备运行中发生火灾事故因素与处置的探讨

目的 本文介绍高压氧舱设备在运行中如何预防火灾事故的发生,以及对发生后如何处理等问题进行探讨,将发生的问题及时正确处理,以提高高压氧治疗的安全性.方法 高压氧舱设备在运行中突发了火灾事故,应用具有应急系统的医用空气加压氧舱设备系统来处理,及时启动舱内消防水喷淋灭火和向舱内吸氧面罩输送新鲜空气.结果 高压氧舱设备在运行中突发火灾事故时应用具有应急系统的医用空气加压氧舱技术处理,可以保证舱中戴面罩人员正常呼吸,保障其安全.结论 空气加压氧舱设备在工作时应注意防范事故苗头,同时又应用具有该应急系统的医用空气加压氧舱设备系统,增强高压氧治疗时的安全性.     

空气净化排风系统在消毒供应室的使用与管理

目的观察空气净化排风系统在消毒供应室的使用效果。方法通过卫生学检测与管理,对空气净化排风系统用于消毒供应室空气洁净效果进行观察。结果连续使用75周,通过对室内空气和室内物体表面进行采样检测,室内空气和物体表面细菌总数符合管理标准要求,合格率均为100%。结论使用空气净化排风系统并做好日常管理能较好地保持消毒供应室空气洁净度,且安全、可靠,简便。     

基于应急救援的远程测控便携式制氧机的研制

目的 研发一套适用于灾害现场紧急医学救援的可远程测控的便携式制氧机系统。方法 综合优化变压吸附技术,通过供给大流量清洁干燥气源和开发相关核心组件,提高制氧主机空气源的有效使用回收率,实现氧气浓度、产氧流量、产氧压力指标实时监控;通过轻量化设计部件及结构,符合灾害现场特点的便携式可移动特征;结合多变自调整式产氧设计,适应现场环境的广谱适应性;通过数字化控制系统人机界面与通用分组无线技术实时在线监控及浏览参数,构建便捷、稳定的智能操作平台,开发远程监控端实时与客户互动设备的运行状态信息。结果 应急场景模拟演练结果表明,该便携式制氧机可移动（95 kg）、输出压力稳定（0.38～0.45 MPa）、流量稳定（15～20 L/min）,连接本便携式制氧机可以基本保障急救呼吸机的供氧需求。当呼吸机输出氧浓度达到90%以上时,便携式制氧机实际测得氧气浓度为94.4%、产氧流量为21 L/min、产氧压力为0.404 MPa,输出氧气的理化指标符合GB 8982-2009《医用及航空呼吸用氧》标准。同时在运行过程中,触摸屏人机界面可以实时显示便携式制氧机运行状态,以及自行设置运行参数,实现远程操作并...     

高压氧舱内专用呼吸机的设计及应用

本文介绍了高压氧舱内呼吸机QS-2000c的设计原则和设计方法.本呼吸机具有气动气控、不同压力下可设置不同参数、功能完备以及舱内气源等特点.治疗患者60余例,有效率达90%.舱内呼吸机扩展了高压氧的应用范围,具有良好的应用前景.     

医用直线加速器室辐射屏蔽防护的优化设计

目的满足国家标准GB18871—2002电离辐射防护与辐射安全基本标准的同时．优化设计医用加速器室的辐射屏蔽防护。方法以新的国家标准GB18871—2002电离辐射防护与辐射安全基本标准为准则，运用电离辐射屏蔽原理、计算方法，根据安装的医用加速器所具有的辐射物理特点和辐射防护的发展需求，对所有产生的射线进行严谨的、规范的和优化的屏蔽计算。结果辐射屏蔽防护符合我国医用加速器机房使用标准。结论我院医用加速器室屏蔽防护可以满足新的国家标准GB18871—2002电离辐射防护与辐射安全基本标准．并降低了辐射防护成本，兼顾了辐射防护的发展需求。     

三舱七门大型医用高压氧舱群安全改造

本文介绍了大型医用高压氧舱系统组成及安全改造的依据,对照国家标准和规范的要求,针对原氧舱照明系统、空调系统、摄像系统、供排氧系统、舱内装饰等方面所存在的安全隐患分别制定相应的改造施工方案.改造后各系统安全、可靠、舒适,达到了国内医用高压氧舱先进水平.     

医用乳胶手套辐射灭菌剂量的有效性确认

目的 选择适用于医用乳胶手套辐射灭菌验证剂量的最佳的有效的运行模式。方法 采用不同的运行模式对医用乳胶手套进行辐射灭菌，测量在辐照吊箱中该产品的剂量分布。结果 获得不同运行模式下辐照吊箱中医用乳胶手套的剂量分布。结论 采用源位标准高度，在辐射灭菌过程中对辐照吊箱中的产品进行翻箱，达到规定的停顿时间，即可使实施的剂量符合该产品辐射灭菌验证剂量要求，且此运行模式为最佳。     

现代洁净手术室管理

我院于2005年12月丌始启朋洁净手术室，其内、外走廊辅助用房及4个手术室全部采用垂直层流系统进行空气净化。经过3年多的运行，各项指标均达到洁净手术室的标准要求，降低了手术切口感染率，保证了手术安全，改善了医、护、患的手术环境，提高了舒适度。     

浅谈屏障系统的空气净化调节系统

抓好设计、验收、运行、维护保养四个环节的各项工作．可以保证空气净化调节系统正常地运行，保障屏障系统内的温度、湿度、洁净度等各项指标符合要求。     

医用空气加压氧舱应急呼吸供气系统的研制

设计一种医用空气加压氧舱应急呼吸供气系统,该系统由空气储气罐、空气过滤器、空气湿化器、渐开式阀门、呼吸器等组成.经测试,系统达到了设计要求,为高压氧治疗提供了一项可靠的安全保障.     

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.