美国OHMEDA麻醉机故障分析与排除

故障1故障现象:病人呼吸回路漏气。可能原因:1.手控时APL阀未关闭,2.钠石灰罐安装不严密,3.螺纹管损坏或接头松动,4.活瓣罩未拧紧,5.手动/自动转换开关失灵。解决方法:1.关闭半紧闭APL阀,2.重新安装半紧闭APL阀,3.更换新管或重新安装管路,4.重新拧紧活瓣罩。故障2故障现象:呼气     

深化改革依法执业崇尚医德注重沟通——努力构建和谐的医患关系

文章回顾了医患关系的历史和现状,将医患关系的发展划分为四个时期,即萌芽成长期、成熟定型期、空前和谐期、转轨变型期,着重指出了转轨变型期医患关系不和谐的现状。分析了医患关系不和谐的成因,首先是体制、机制方面的原因;第二是医疗机构和医务人员方面的原因;第三是社会转轨变型期的各种社会矛盾在医患关系上的体现。探讨了构建和谐医患关系的途径:建立公平高效的医疗卫生体系是前提;崇尚医德,提高医术是基础;交流和沟通是关键;依法执业是保障。     

Acute effects of nitroglycerin on the energetics of the human left ventricular myocardium

We analyzed performance and efficiency of the left ventricular myocardium on the basis of two new energetic parameters. The myocardial energy consumed during one cardiac cycle is related to performed work on the one hand (E1) and to the stress-time-integral on the other (E2). E1 was obtained by analysis of the pressure-volume integral divided by left ventricular muscle mass. E2 was obtained as follows: the stress-time integral was analyzed from pressure-volume data and wall thickness using an ellipsoidal calculation model. In order to transfer the stress-time integral into energy units, the value was multiplied by a constant factor which was obtained in experimental myothermal studies. In ten patients with coronary heart disease undergoing diagnostic heart catheterization, angiocardiography was performed before and after oral administration of nitroglycerin (1.6 mg). Total energy consumption (2E1 + E2) per gram myocardium per beat decreased from 6.1 +/- 1.3 mcal/g to 4.7 +/- 1.4 mcal/g (P less than 0.01), and myocardial efficiency (E1/[2E1 + E2]) increased from 27.0 +/- 3.1% to 28.4 +/- 4.3% (N.S.) on the average. This analysis explains quantitatively the beneficial effect of nitro-preparations on myocardial function and energetics.     

间接免疫荧光法检测婴幼儿急性下呼吸道合胞病毒感染的特异性IgM

本文对1984年1～3月和1985年3～8月共107例急性下呼吸道感染的住院患儿,采用间接免疫荧光法检测其急性期血清抗RSV特异性IgM抗体,并与病毒分离和/或中和试验比较,敏感性为82.1％,特异性为71.8％。RSV感染患儿发病后3天内大多数病例即可从血清中检测出RSV-IgM,因此该法具有早期诊断价值。     

Emergency free flaps to the type IIIC tibial fracture

Type IIIC tibial fractures are complex injuries involving extensive bone and soft-tissue devascularization that result in a high percentage of complications and ultimate amputation. An emergency free flap transfer not only may salvage the limb but also may improve the aesthetic and functional results of reconstruction by placing the injured structures in a well-vascularized bed. Two cases of type IIIC tibial fracture were treated in this manner, and we present our experience with a 30-month follow-up of one patient and a 6-month follow-up of another patient.     

Ultrasound Biomicroscopic Dark Room Provocative Test

Purpose : To compare the clinical application value of Ultrasound biomicrsocpic dark room provocative test with the traditional dark room test in screening primary angle closure glaucoma (PACG).Methods: 22 eyes with PACG in prodromal stage and 30 eyes with deep anterior chamber and wide angle of 15 normal persons were observed in this trail. All 52 eyes were performed traditional dark room provocative test and ultrasound biomicorosopic darkroom test respectively. With different positive diagnostic criteria, the sensitivity of the two methods were compared using chi-squared analysis.Results : After staying in the dark room for 2 hours, In case group, IOP in 10 of 22 eyes rose more than 1. 07kPa(1kPa = 7.5mmHg), in 12 eyes less than 1.07kPa or had no changes; appositional angle closure were found by Goldmann gonioscopy in 8 eyes : 3 eyes in two quadrants, 5 eyes in more than two quadrants; the appositional angle closure was found by UBM in 15 eyes; 3 eyes in one quadrants, 5 eyes in two quadrants, 7 eyes