经桡动脉冠脉造影围术期护理体会

目的总结经桡动脉冠脉造影护理体会。方法选择289例患者经桡动脉应用5F共用导管进行选择性冠状动脉造影检查,观察术前、术中、术后恰当的护理对成功完成冠状动脉造影的作用。结果与结论恰当的护理可协助冠脉造影术顺利完成,明显减少和避免相关并发症的发生。     

鼻咽侧壁颈动脉体瘤2例报告

颈动脉体瘤属非嗜铬性副神经节瘤，临床较少见。现将我院收治的２例报告如下。例１女，６２岁。右鼻咽侧壁无痛性肿块７年，同侧颈部包块４年，渐进性增大；近半年来感咽部不适，呼吸、吞咽困难。体检：右颈动脉三角区触及肿块，位置较深，边界不清，软胯下陷，咽后壁前凸...     

基于心内科网络的心电工作站的设计与研制

心电工作站是一个在心内科网络中使用的基于个人电脑，专供心内科专家在心电医学方面作全面诊断和辅助分析的工作站，拟定工作站的目标是：1）从网络读取院内各种检验方式获取的病人心电信息，实现心电图重现并在本机数据库保存；2）提供简便直观的自动测量工具帮助医生新闻记者心电图；3）实现计算机辅助诊断和分析功能；4）提供医生病例统计分析功能，心电工作站运行在一个普通的个人电脑上，程序运用Microsoft VisualBasic编写，数据度采用Microsoft Access链接，本文阐述了心电工作站的设计思路、部分雏形的实现方法、中期结果及进一步的研制方向。     

中药复方汉唐平改善db/db T2DM小鼠肝脂肪变性的作用及机制研究

目的 观察中药复方汉唐平(经验方)对db/db T2DM小鼠肝脂肪变性的作用，并探讨其是否通过调控PPARγ/FATP4/CD36通路抑制脂肪酸的摄取，从而改善T2DM肝脂肪变性小鼠的糖脂代谢紊乱、炎症状态。方法 24只db/db小鼠，9只C57小鼠。药物干预前以小鼠空腹血糖≥7.0mmol/L,及随机抽取3只db/db小鼠和3只C57正常小鼠行肝脏油红O染色，以判断T2DM肝脂肪变性模型是否成立。模型成立后，将剩余的db/db小鼠随机分成模型组、汉唐平组、二甲双胍组，每组各7只；另外6只C57 BL/6J小鼠为对照组。每周记录小鼠体重，取材后计算各组小鼠的肝脏脏器指数；检测小鼠血清空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)水平；对肝脏进行油红O染色，以观察脂质累积情况。用ELISA法检测各组小鼠炎症因子水平，包括肿瘤坏死因子α(TNFα)、白介素6(IL6)和白介素1β(IL-1β)的水平。免疫印迹法检测PPARγ、FATP4、CD36蛋白的表达。结果 三组db/db小鼠的体重显著高于对照组小鼠(P<0.05),汉唐平治疗4周后，小鼠体重增长逐渐趋缓，并有逐渐...     

分泌性中耳炎患儿腺样体免疫状态的探讨

本文通过体外细胞培养的方法，研究了１０例分泌性中耳炎（ＯＭＥ）患儿腺样体的免疫状态，测定体外腺样体淋巴细胞自发性ＤＮＡ合成（ＳＤＳ）及在植物血凝素（ＰＨＡ）刺激下可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ）释放，并以阻塞性睡眠性呼吸暂停综合征患儿作对照。结果，ＯＭＥ患儿腺样体淋巴细胞ＳＤＳ（１７３３５±７０１２ｃｐｍ）较对照组（９３８２±４５５４ｃｐｍ）明显增高（Ｐ＜０．０５），ｓＩＬ－２Ｒ的释放（８６４±２４１ｕ／ｍｌ）也较对照组（４３８±１４５ｕ／ｍｌ）增高（Ｐ＜０．０５），说明ＯＭＥ患儿腺样体淋巴细胞活性较高，可能导致局部免疫异常而引起ＯＭＥ。     

胸段食管癌切除术患者的预后分析

Objective To investigate the prognostic factors and influence of the number of lymph node metastases on survival and UICC-TNM classification in patients with thoracic esophageal cancer after curative resection. Methods From 1985 to 1990, 1224 patients were surgically treated for thoracic esophageal cancer. The patients who died within 30 days after operation were not included in this study. Fifteen factors possibly influencing survival of these patients were selected and analyzed. A multivariate analysis of these individual variables was performed by Cox proportional hazard model. According to the n, mher of lymph node metastases (0, 1 and ≥ 2), a new modification of the TNM classification was suggested: stage Ⅱ a (T2N0M0 and T3N0M0), stage Ⅱb [T1N1M0 and T2N1 (1) M0], stage Ⅲ a [T2N1 (2)M0 and T3N1 (1)M0] and stage Ⅲ b [T3N1 (2)M0 and T4NanyMO]. Results According to multivariate analysis, lymph node metastases, depth of invasion, location of tumor, histological classification and length of the tumor were of prognostic significance (P < 0.01). There was obvious correlation between the rate of lymph node metastasis and the depth of invasion, length of tumor and grade of differentiation. The 5-year survival rate of the patients with 0, 1 and ≥2 positive metastatic lymph nodes was 59.1%, 32.0% and 8.9%, respectively. The 5-year survival rate of the patients with stage T2N1M0 and stage T3N1M0 was significantly higher in those with only one lymph node involved than in those with two or more lymph nodes involved (43.1% vs. 18.0% and 28.0% vs. 9.6%, P<0.01). The 5-year survival rate of the modified stage Ⅱa, Ⅱb, Ⅲa and Ⅲb was56.5%, 43.9%, 25.6% and 11.1%, respectively, with a statistically significant difference among different stages (P < 0. 01). Conclusion The lymph node metastasis is the most important prognostic factor for thoracic esophageal cancer after resection. The major influencing factors of lymph node metastasis are the depth of invasion, length of tumor and grade of differentiation. Therefore, the lymphadenectomy along with esophngectomy and subsequently combined modality therapy against lymph node metastasis is necessary to improve the S-year survival rate. Our proposed new classification based on number of lymph node metastases (0, 1, ≥2 positive nodes) is more applicable because it can well reflect the correlation between lymph node metastasis and the survival, and provides evidence for the modification of the currently used UICC TNM staging system for surgically treated thoracic esophageal cancer.     

双鼻腔内翻性乳头状瘤1例

患者，男，56岁。因右鼻塞1年余，加重2月余，以鼻腔肿物收住院。患者1年前右鼻无明显诱因的出现鼻塞，持续性加重，流黄脓涕，无涕中带血；头痛，无头晕船眼胀，双鼻嗅觉差，曾在当地抗炎治疗，效果欠佳，症状加重，并出现闭塞性鼻音，双眼无复视及视物模糊，无面部麻木及张口困难，无耳鸣及听力下降，2月前症状进一步加重，鼻塞，头痛，右眼胀痛加重。门诊以鼻腔肿物收入病房手术治疗。患者5年前曾行鼻息肉切除术(右)。检查示右鼻腔总鼻道内充满多个淡红色、     

鼻内窥镜在儿童鼻炎鼻窦炎诊断中的价值

目的:探讨鼻内窥镜检查在诊断儿童鼻炎鼻窦炎及腺样体炎中的价值。方法:对2003年12月至2004年10月有鼻炎鼻窦炎征象的儿童112例行常规耳鼻咽喉科检查,并在局麻下行硬质鼻内窥镜检查,对有感染者行中鼻道分泌物细菌培养。结果:95例(84.8%)成功地施行了鼻内窥镜检查,其中鼻炎鼻窦炎20例,腺样体炎7例,鼻炎鼻窦炎并发腺样体炎26例,2~5岁。鼻炎鼻窦炎患儿中,86.8%可培养出致病菌。结论:鼻内窥镜检查儿童鼻腔及鼻、鼻咽部有创伤小,操作简单,效率高等优点,可作为疑为鼻腔及鼻咽部病变的常规检查。     

图像引导下的心律失常诊疗技术

导管射频消融手术是目前治疗心律失常实用、快速而有效的方法.在电生理标测和射频消融治疗过程中,导管的定位是至关重要的,图像的引导可以很好地对导管进行定位,在很大程度上提高了手术的可靠性和有效性.从而推动了图像引导下多道电生理检测的发展.目前,医学图像的引导可分为二维和三维,在心内手术方面,二维的方式主要是通过X线图像进行引导,而三维的图像引导主要是通过事先建立的三维模型以及导管的定位系统来实现的.     

多道生理信号的红外光遥测系统

介绍一种用于体温、呼吸和心电测量的多道红外光遥测系统,并给出实验结果。该多道遥测系统可应用在诸如电外科手术等强电磁干扰的环境下,作为患者监护的重要手段。