内镜活检对胃癌组织学分类术前诊断的价值

目的 探讨内镜活检对胃癌组织学分类术前诊断的价值。方法 术前对141例胃癌患的内镜活检标本分别根据Lauren分类和世界卫生组织（WHO）分类判断组织学分类，并与手术标本结果对照。结果 内镜活检对胃癌Lauren分类术前诊断的准确率为76.6%。对肠型胃癌诊断的敏感性和特异性分别为85.4%和80.6%。而对弥漫型胃癌则分别为82.7%和80.3%，在59例术前诊断为肠型胃癌的病例中，18例（30.5%)在手术标本中呈弥漫性行生长，而在75例术前诊断为弥漫型胃癌的病例中，仅6例（8.0%)术后诊断为肠型胃癌，内镜活检对胃癌WHO分类术前诊断的准确率为87.2%，其中对乳头状/管状腺癌，黏液腺癌和印戒细胞癌的敏感性分别为91.9%。33.3%和66.7%。结论 内镜活检对胃癌组织学分类的术前诊断具有较高的临床应用价值。     

Quantification of bone healing. Comparison of QCT, SPA, MRI, and DEXA in dog osteotomies

Four noninvasive imaging modalities were used to quantitatively evaluate and compare tibial osteotomy healing in dogs. Quantitative computed tomography (QCT), magnetic resonance imaging (MRI), single-photon absorptiometry (SPA), and dual-energy x-ray absorptiometry (DEXA) were the four techniques examined. Bilateral tibial osteotomies were performed in 32 dogs divided into four groups. The osteotomies were stabilized with a 2-mm gap using unilateral external skeletal fixation. Dogs were anesthetized, imaged with the four noninvasive techniques, and killed at 2-12 weeks. Invasive techniques were used to determine: 1) the torsional properties of the bone; and 2) the local stiffness properties and calcium content within the bone. The techniques which had the strongest associations with the torsional properties of the osteotomies were QCT, SPA and DEXA. Generally, QCT and SPA had marginally stronger correlations than DEXA; but, overall, there were no differences between the techniques. MRI had the poorest associations with the torsional properties of the osteotomies. Generally, QCT had the strongest correlations with local material properties, such as indentation stiffness and calcium content. SPA had the second strongest correlations with calcium content and had the third strongest correlations with indentation stiffness behind DEXA. DEXA had the third strongest correlations for calcium content. With the exception of some of the correlations with indentation stiffness, MRI had the poorest associations with the local parameters studied.     

Dynamic imaging with lanthanide chelates in normal brain: contrast due to magnetic susceptibility effects

Using a one-dimensional rapid imaging technique, we have found that injection of lanthanide chelates such as Gd(DTPA)2- leads to a significant decrease (50%) in rat brain signal intensity at 1.45 T using T2-weighted pulse sequences; however, no effect of comparable size is observed with T1-weighted pulse sequences. The transient effect and its kinetics were followed with a temporal resolution of between 1 and 8 s. Experiments with different lanthanide chelates show that the observed decrease in signal intensity correlates with the magnetic moment of each agent but not with their longitudinal relaxivity. Three-dimensional chemical-shift resolved experiments demonstrate significant line broadening in brain during infusion with Dy(DTPA)2-. Our results show that the cause of this effect is the difference in susceptibility between the capillaries, containing the contrast agent, and the surrounding tissue. As a result of these susceptibility differences, field gradients are produced in the tissue and diffusion of water through these gradients leads to a loss of spin phase coherence and thus a decrease in signal intensity. We propose this as a new type of contrast agent mechanism in NMR. The effect and its kinetics are likely to be related to important physiological parameters such as cerebral blood volume and cerebral blood flow, and do not depend on a breakdown of the blood-brain barrier as do conventional contrast agent techniques.     

顺丁烯二酸水溶液的热反应动力学

研究了不同温度、浓度条件下，顺丁烯二酸（顺酸）非催化反应网络，即顺酸可生成反丁烯二酸（反酸）和苹果酸，反酸与苹果酸存在可逆反应。建立了该反应网络的动力学模型。测定了不同反应条件下顺酸、反酸和苹果酸浓度随时间变化的规律，据此，动力学参数进行了估值。     

水痘发病与季节关系初探

目的　探讨水痘发病与季节的关系。　方法　随机采集我院近 5年住院的 312例水痘患者 ,用圆形分布法统计分析其发病与季节的关系。　结果　 312例水痘患者好发于 4月 2 8日～ 9月 2 4日 ,集中于 7月 11日 ,各月之间比较差异显著 (r=0 .4 4 79,P<0 .0 1)。　结论　水痘好发于春末夏初     

浅谈血液层流病房净化工程招标技术管理

1招标内容:血液层流病房净化工程,包括: 1.1血液层流病房净化工程范围: 1.2血液层流病房净化工程方案设计; 1.3血液层流病房净化工程设备、材料的供应与安装; 1.4血液层流病房净化工程施工组织; 1.5病房及辅助功能区内的配套设施的施工与安装.     

Appropriateness of hysterectomy in Taiwan.

BACKGROUND AND PURPOSE: Hysterectomy is among the most frequently performed surgical procedures in developed countries, but few studies from the Asia-Pacific region have assessed the appropriateness of hysterectomy. The purpose of this study was to examine the rate of inappropriate hysterectomy in Taiwan and its association with patient characteristics and indications for the procedure. METHODS: A random sample of hysterectomies for which claims were submitted to the Taiwan Bureau of National Health Insurance from July 1, 1997 to June 30, 1998 was selected. A total of 658 charts were reviewed by an expert panel composed of 5 senior gynecologists. RESULTS: Overall, 74.2% of patients underwent hysterectomy for appropriate reasons, 5.6% for uncertain reasons, and 20.2% for inappropriate reasons. Inappropriate procedures were positively associated with younger age and premenopausal status. Primary indications that accounted for over 25% of inappropriate procedures were chronic pelvic pain (42.9%), abnormal uterine bleeding (37.5%), and endometriosis (27.7%). CONCLUSIONS: This study found a high rate of inappropriate hysterectomy in Taiwan. Gynecologists and physician organizations should take action to improve physician agreement on the use of hysterectomy, especially for indications associated with high rates of inappropriate procedures.     

全喉切除改良气管-咽吻合Ⅰ期发声重建术

目的：探讨全喉切除Ⅰ期发声重建术的改进术式。方法：采用低位气管切开，全喉切除，食管前壁黏膜重建声门，气管切口处造瘘．颈段气管上提并缩窄吻合于舌根的方法行全喉切除及Ⅰ期发声重建木35例。结果：33例(94．29％）术后获得了不同程度的发声功能．不能发声者仅2例(5．71％)。全部患者术后均可经口进食，未出现严重的影响生存质量的误咽。结论：与以往的发声重建术相比，本术式具有发声成功率高、发声质量良好、误咽率低等优点，且无须置人人工发声装置．值得推广。     

影响α-淀粉酶分离液澄清度的因素

本文根据凝聚和絮凝原理,研究了无机盐和高分子絮凝剂加入量对枯草杆菌BF 7658α-淀粉酶分离液澄清度的影响。实验结果表明,氯化钙可使α-淀粉酶发酵液的ζ电位降低,分离液的澄清度增加,用氯化钙和磷酸氢二钠来处理发酵液,则其分离液的澄清度较单用氯化钙为大,阴离子型高分子絮凝剂如海藻酸钠加入量对分离液澄清度也有一定影响。实验中还发现,澄清的发酵液在10℃下贮存可保持澄清透明状态。