两出口的医院网络用户管理解决方案

目的：由于办公需要，将以前走电信出口的图书馆、医疗二系及研究生处的用户改道为走科研教育网出口，和华中科技大学校总部相连，并在不改变原来管理模式下同时管理两出口的用户信息。方法：通过配置流分类，规定重定向行为以及配置策略路由进行实现。结果：将认证流和数据流分开，成功实现了医院内部两出口的需求。结论：利用原有设备的流分类和重定向功能．既可解决两出口的内部需求，也能在不增加设备的情况下对用户信息进行管理，为医院节省了开支。     

应用前列腺素E1注射治疗勃起功能障碍8年经验

目的观察前列腺素E1(PGE1)注射治疗勃起功能障碍(ED)的长期疗效、副作用及预后。方法使用PGE1行阴茎海绵体注射,阴茎硬度检查仪(Rigiscan)连续记录1h,并根据观察结果,调查PGE1注射剂量,确定每例患者合适的注射量,掌握注射方法后回家自行注射。共筛选出ED患者410例,随访患者阴茎勃起情况、药量调整和副作用。结果410例ED患者中,心理性139例,静脉性83例,动脉性36例,神经性78例,混合性74例。对治疗满意的患者有256例(62.44%),其中21例(5.1%)在使用PGE15次后停用,并能达到满意的性生活而治愈。293例(71.46%)患者自述注射时有胀痛感。171例(43.17%)因疼痛(105例)、操作不便(25例)、副作用顾虑(37例)和其他原因(4例)而于6个月后放弃治疗。204例(49.76%)患者使用时间已超过1年,24例(5.85%)患者使用时间已超过5年,7例(1.7%)使用已有8年。未发现阴茎异常勃起和阴茎海绵体纤维化。注射损伤阴茎表面血管致瘀斑者有20例。有27例患者失访。结论PGE1是治疗ED的一种安全有效的药物,可以长期使用。其最常见的副作用是阴茎疼痛。Rigiscan能帮助确定PGE1的注射剂量。     

PR01“A PICTURE SPEAKS A THOUSAND WORDS”– THE USE OF DIGITAL PHOTOGRAPHY AND THE INTERNET IN MONITORING FREE TISSUE TRANSFER

Purpose Post operative monitoring is crucial for the success of microsurgical free tissue transfer. Sophisticated and expensive methods are available for monitoring. We propose a novel technique using digital photography and the internet as a reliable and cost effective method to monitor free tissue transfers. Methods 163 micro‐vascular procedures were monitored using this technique over 8 months. Serial photographs taken to show flap color. Capillary refill time, pin prick‐ bleed time and color and hand held Doppler signal was recorded in the movie mode of a standard 5 mega pixel camera with duration of 15 seconds. Data was sent to the surgeon at regular intervals and or as deemed necessary. Results Analysis of the 67 cases is presented. 5 re‐explorations were done. The early diagnosis of venous congestion was possible using this technique. Timely intervention contributed to the success of the re‐explorations and these flaps could be salvaged. The file size of images was in the range of 1 MB–6 MB. The file size of an entire set of images ranged about 7 MB–9 MB. These were sent across the ADSL internet lines. Conclusion The use of the digital images and the internet allow reconstructive surgeons to have a reliable picture of the state of their free tissue transfers. This permits decrease in observer error and saves valuable time which otherwise needs to be spent to verify situations of doubt and offers an ideal solution to the logistic problem of having to visit the patient in case of doubt.     

邻近皮瓣修复面部皮肤缺损

目的 探讨邻近皮瓣修复面部皮肤缺损的应用效果。方法 162例面部病变切除后皮肤缺损患者，其中先天性色素痣63例，基底细胞癌28例，鳞状细胞癌6例，其他皮肤病变65例。均采用邻近皮瓣即时修复，其中菱形皮瓣57例、双叶皮瓣8例，A-T皮瓣23例、V-Y皮瓣13例、Z成形术23例、推进皮瓣27例、鼻状皮瓣11例。结果 162例皮瓣存活良好，手术切口1期愈合，存活后皮瓣颜色与邻近部位无明显差异，术后无眼睑、眉毛、鼻梁及口角牵扯歪钭，术后3个月切口不显露。结论 邻近皮瓣是修复面部较大皮肤缺损的良好方法，手术外观效果好。     

原发性三叉神经痛的LEKSELL-C伽玛刀治疗

目的 探讨伽玛刀治疗原发性三叉神经痛的方法和效果.方法 对28例原发性三叉神经痛采用LEKSELL-C型伽玛刀治疗,均沿三叉神经走行在三叉神经根近桥脑处选择双靶点治疗.中心剂量75～85Gy,50%等剂量线限定靶点.结果 随访3～11个月,疼痛消失时间平均在术后3.5个月.按疼痛缓解评分,在随访时点,总有效率为96%.结论 LEKSELL-C型伽玛刀是治疗原发性三叉神经痛安全和有效的方法之一.     

Ⅰ期趾甲延长术9例报告

目的:总结Ⅰ期在第2足趾游离移植再造拇(手)指中行趾甲延长的临床应用经验.方法:采用趾甲延长方法对9例(男7,女2例)第2足趾移植再造拇(手)指的患者进行了趾甲延长术,其中拇指8例,食指1例.年龄18～46岁,平均25岁.在再造指距甲根皮缘5 mm处,去除1块矩形皮肤,勿损伤皮下血管网.其高度2 mm,宽度与趾甲相等,将U形皮瓣向近端柔和推剥并缝合.结果:1例术后供区发生表浅感染,经换敷料逐渐愈合.再造的拇(手)指全部成活,可延长趾甲2～3 mm,改善了再造拇(手)指的外形,无指甲生长畸形发生.随访7个月～2年(平均13个月),趾甲外形较好.结论:在第2足趾游离移植再造拇(手)指中应用Ⅰ期趾甲延长术,使趾甲从短小向纵向延长,缩小手指甲与足趾甲之间差异,能改善再造拇(手)指甲外形,且不影响再造指的活动功能,是一种简单有效的手术方法.     

地高辛的体内分析方法应用与进展

目的总结地高辛血药质量浓度监测方法,寻求最适的测定方法。方法对近年来国内外与地高辛监测相关的文献进行检索综述分析。结果地高辛血药浓度测定方法很多,常用方法主要有:FPIA、酶免疫分析法、RIA、CLIA、乳胶免疫抑制法、干化学法、HPLC法等。结论通过比较分析其中RIA、CLIA、EIA和HPLC MS 4种方法更好。     

包皮过长和包茎组织中触觉小体观察

目的观察包茎和包皮过长组织中触觉小体差异情况。方法收集21~25岁年龄组包皮标本44例,按包皮解剖形态分为:①包茎组21例;②包皮过长组23例。用免疫组化方法对两组包皮标本中的触觉小体进行染色,在放大100倍的视野下观察和统计两组包皮标本中触觉小体总数以及视野的总数,并用卡方检验对两组间的差异进行统计学分析。结果两组标本中,分别有8个(8/21包茎组)和10个(10/23包皮过长组)标本中未发现触觉小体,其差异无显著性(P=0.717)。包茎组和包皮过长组中触觉小体的密度分别为33.1%和21.1%,差异具显著性(P=0.022)。结论包茎中触觉小体密度较包皮过长明显升高可能是一种生理性代偿机制,而两种包皮组织中触觉小体的消失可能遵循同一规律。     

Selective photothermolysis: contribution to the treatment of flat angiomas (port wine stains) by laser

Since 1962, lasers have been used in dermatology and have become the first choice in the treatment of superficial, vascular ectasia. Lasers are unique sources of light; they are coherent, monochromatic, collimated and intense. By careful selection of wavelength, pulse duration, and intensity, it is often possible to selectively confine a laser effect to a specific histologic structure in tissue, depending upon the tissue properties. The ideal treatment of Port Wine Stains (PWS) should irreversibly damage the ectatic vessels but minimize heating of the epidermis and superficial dermis. A theory, called selective photothermolysis, predicts the optimal combination of laser parameters of achieving this ideal treatment of PWS to be a wavelength of 577 nm, a pulse duration of 0.35-10 msec, and an energy per surface area of about 7-8 J/cm2. Laser wavelength: The wavelength of 577 nm is preferred because it: maximizes the selective absorption by hemoglobin, minimizes absorption by epidermal melanin, provides sufficient depth of penetration in the blood to coagulate 0.1 mm vessels allows penetration of light into dermis up to 1 mm. Laser pulse duration: A pulse-width in the range of 0.35-10 msec allows the temperature elevation to be uniform inside the vessel and to be confined to the vessel area. Shorter pulses superheat the red blood cells causing explosive boiling and hemorrhage. Longer pulses allow heat to diffuse away from vessels, requiring greater energies per pulse to achieve vessel damage. An increased energy per pulse increases the risk of excessive damage to surrounding tissue.(ABSTRACT TRUNCATED AT 250 WORDS)