全麻复合硬膜外麻醉患者林格氏溶液的容量动力学

目的 通过确定全麻复合硬膜外时麻醉林格氏溶液的容量动力学模型参数，评价硬膜外复合全麻对晶体液扩容效应的影响。方法择期行肝癌切除术患者20例，随机分为2组：组Ⅰ麻醉诱导前行扩容治疗，组Ⅱ硬膜外复合全麻诱导后行扩容治疗。扩容采用30ml／kg乳酸钠林格氏溶液（LR）恒速输注，30min内输完，输注LR开始后90min内每5min测定血红蛋白（Hb）及红细胞压积（Hct），并记录总尿量及血液动力学数据。用容量动力学数学模型和物质守恒定律处理数据，获得结果。结果 组Ⅱ容量增加量、容量扩张效率、输注结束时液体保留率均高于组Ⅰ（P〈0．05）。一级容量动力学分析结果：组Ⅰ目标容积（V）和清除率（k1）均大于组Ⅱ（P〈0．05）。二级容量动力学分析结果：组Ⅱ的V1、k1、k1均高于组Ⅱ（P〈0．05）。扩容后组Ⅱ的平均动脉压、中心静脉压、心输出量均小于组Ⅰ（P〈0．05）。结论 全麻复合硬膜外麻醉可提高晶体液的容量扩张效率。     

东南大学医学影像学专业(本科五年制)教学计划的构思

修订东南大学医学影像学专业本科五年制教学计划：坚持遵循教育教学的基本规律，坚持知识、能力、素质协调发展和综合提高的原则和方法。打通公共基础，建立通识教育基础平台：拓宽学科基础课，增加基础学科选修课；凝炼专业主干课程，加强临床实践环节；前期趋同，宽口径专业培养，后期分流灵活专业方向，实现专才向通才、教学向教育和传授向学习的转变。培养和造就高层次医学影像学专业人才，以适应影像设备迅猛发展的需要，适应影像学科建设的需要，适应培养新世纪医学影像学专业人才的需要。     

葛根汤颗粒喷雾干燥工艺条件试验研究

目的：优选葛根汤颗粒啧雾干燥的最佳工艺条件。方法：应用正交设计法，以每小时药粉产率及有效成分含量为考察指标，对影响葛根汤喷雾干燥过程的因素进行考察。结果：正交试验法设计的三个因素中，浸膏的相对密度影响显著，入塔风温影响较显著。结论：颗粒最佳工艺条件为：入塔风温：170℃，气流量：700L／h，浸膏相对密度：1．22，在此条件下，葛根汤颗粒有效成分中葛根素及芍药苷的含量明显高于原湿法制粒制剂。     

Directly measured tissue oxygen tension and arterial oxygen tension assess tissue perfusion

Mean subcutaneous tissue PO2 (PsqO2) measurements were obtained in dogs with an unheated electrode placed in an implanted Silastic tonometer, while PaO2 was increased in increments from 40 to 600 torr during normal, increased, and reduced blood volume. These changes reflect that the mean PsqO2 is approximately 10 torr below the PO2 of venous blood draining that tissue. Since PaO2 was already known, the oxygen content of arterial and venous blood entering and leaving this tissue could be determined by reference to blood-oxygen dissociation curves. Therefore, relative changes in blood flow could be calculated using the Fick principle. After a 20% blood loss, the PsqO2 measured during breathing of room air fell to 20% of baseline, corresponding to an 80% fall in sc blood flow; it remained low until the shed blood was returned despite compensatory changes in cardiac output. Rapid infusion of electrolyte solutions in normovolemic animals produced a temporary increase in local blood flow. Subcutaneous oximetry seems capable of quantifying peripheral perfusion and may be clinically useful.     

Where patients with cancer die in South Australia

In a sample of 1582 deaths among South Australian patients with cancer (795 deaths in 1981 and 787 deaths in 1985), 67% of deaths occurred in a hospital, 9% of deaths in a hospice, 10% of deaths in a nursing home, and 14% of deaths in a private residence. More patients died in a hospice or nursing home in 1985 than in 1981, and fewer died in a hospital. With increasing age, fewer patients died in a hospital and more in a nursing home. Compared with men, women were less likely to die at a private residence and more likely to die in a nursing home. A greater proportion of men with a living wife died at a private residence than was so among single or widowed men. However, conjugal status was not associated with the place of death of women. Patients who lived in the more affluent metropolitan suburbs tended more to die at a private residence than did those from poorer suburbs or country areas. Patients with haematological malignancies died in major metropolitan public hospitals more frequently than did patients with other tumours. Possible explanations are given for these findings.     

腺病毒介导hTGT—β1基因体内转染兔腰间盘髓核细胞对蛋白多糖含量的影响

目的观察构建腺病毒载体介导外源性人转化生长因子(humantransforminggrowthfac-tor,hTGF-β1)基因(Ad/CMV-hTGF-β1)转染到兔椎间盘髓核细胞后,髓核组织中蛋白多糖含量的变化。方法(1)纯种成年新西兰大白兔35只,其中25只对腰椎间盘髓核组织注射Ad/CMV-hTGF-β1,每只注射2个椎间盘作为实验组,注射量为每个腰椎间盘20μl(6×106pfu);同时每只取2个未做注射的腰椎间盘作为自身空白对照组。其余10只兔每只注射2个腰椎间盘各20μl磷酸盐缓冲液(PBS)作为实验对照组。全组共120个椎间盘。(2)手术后1～12周的不同时间段分别取出各组椎间盘组织,采用间苯三酚分光光度法测定髓核组织中蛋白多糖的含量,所得数据经SPSS10.0统计学软件进行统计学处理。结果(1)术后1周,实验组与自身空白对照组蛋白多糖测定值经配对t检验,t=3.968,P<0.05。(2)术后2周,三组结果经方差分析显示,F=17.871,P<0.01;各组间再行两两q检验,实验组与自身空白对照组间q=7.686,P<0.01;实验组与实验对照组间q=6.894,P<0.01;实验对照组与自身空白对照组间q=0.792, P>0.05。实验组与自身空白对照组间配对t检验,t=5.276,P<0.01。(3)术后4周,实验组与自身空白对照组经配对t检验,t=8.352,P<0.01。(4)术后8周,实验组与自身空白对照组经配对t检验,t=7.086,     

免疫母细胞淋巴结病及非霍奇金病中c-myc蛋白的表达

①目的　探讨c myc基因产物的表达在免疫母细胞淋巴结病 (AILD)及非霍奇金病 (NHL)发生中的意义。②方法　应用免疫组织化学方法检测 4 6例AILD和 2 0例NHL病人中c myc蛋白的表达 ,同时选择 15例反应性增生的淋巴结作为对照研究。③结果　AILD ,NHL及反应性增生的淋巴组织中c myc蛋白表达的阳性率分别为82 .6 1% ,85 .0 0 % ,4 0 .0 0 % ,AILD及NHL组织中c myc蛋白表达的阳性率显著高于反应性增生的淋巴组织 (χ2 =8.2 0 6 ,P <0 .0 5 ;P =0 .0 11)。④结论　c myc蛋白的过度表达与AILD和NHL的发生有关 ,同时c myc蛋白的表达并不是恶性肿瘤的特异性现象 ,而是对细胞增生活跃程度的反映。     

选择性冠状动脉造影评价常规心电图ST-T改变在冠心病中的诊断价值

目的:评价常规心电图检查中ST-T改变在冠心病诊断中的价值。方法:以选择性冠状动脉造影为对照,研究连续194例病人临床症状及心电图ST-T改变与造影结果的关系。结果:造影发现136例病人有明显的冠状动脉狭窄性病变,58例未发现明显病变。非典型心脏症状的病人无论是否有ST-T的异常,冠状动脉造影的阳性率仅4%～14％,而典型症状伴有ST-T异常的病人阳性率较高(89.4％)。结论:ST-T异常伴有典型心脏症状的诊断冠状动脉病变的可靠指标。     

谈影像科网络安全

本文主要对如何做好影像科日常网络安全作了介绍，其中有硬件安全保障、网络系统的稳定性、安全性以及医学影像存储。