改良开放性手术治疗巨大良性前列腺增生症

目的探讨巨大良性前列腺增生症的开放性手术治疗方法及效果。方法回顾分析16例巨大良性前列腺增生症,年龄61~88岁,平均74岁。作耻骨上经膀胱前列腺切除术。结果手术均成功;手术时间35~65min,出血量100~200mL,术后前列腺重量为200~520g,平均215g;膀胱冲洗2~3d,拔导尿管5~7d;术后3d再出血1例,经DSA同侧髂内血管栓塞止血成功,排尿困难1例,短期尿失禁1例,其余患者术后均排尿通畅,控尿良好。结论开放性手术治疗巨大良性前列腺增生症,其梗阻解除彻底,是一种合理的治疗方法。恰当的手术方法是提高疗效及降低并发症的关键。     

EASY医院固定资产信息管理系统的应用体会

随着医疗设备的不断增加 ,对其进行科学的管理显得愈加重要.为次,我们设备处管理人员引进了 EASY医院固定资产信息管理系统.     

关于我国体外诊断试剂监督管理改革的建议

本文综述了美国、欧盟、日本、中国目前对体外诊断产品（试剂）监督管理的现状以及我国存在的问题。并根据我国具体情况提出了对体外诊断试剂监督管理的改革建议。     

Cardiac imaging in the evaluation of patients presenting to the emergency department with chest pain

Conclusions  Despite the utility and benefits that each imaging modality has to offer, it is easy to see why there is still no perfect choice for a noninvasive cardiac imaging modality to assist in the management of chest pain patients. All of the current imaging techniques have their own significant strengths and weaknesses when compared with other modalities. SPECT and echocardiography are wellestablished technologies that can directly assess the presence of myocardial ischemia and its functional consequence on RF; newer and more expensive techniques such as MDCT and CMR can directly assess coronary anatomy and have just started to be evaluated in the acute chest pain setting. There are no studies that directly compare these technologies, and more data are clearly needed before the question of whether anatomic imaging versus perfusion/function imaging is the better approach can be answered. Other comparisons such as relative safety, availability, logistics, and cost-effectiveness between the various technologies are also lacking. Of all of the imaging modalities discussed, MCE is the only portable technology. The images do not require expensive software or other technology for offline processing before interpretation, and any trained cardiologist can read the study at the bedside or, potentially, over the Internet, providing near-instantaneous results in the acute cardiac setting, where time is of the essence. MCE is also relatively cheap compared with other technologies, a potential advantage for payors but not necessarily for payees. How reimbursement rates and fee structures eventually affect clinical practice is also unknown. Despite these and other questions that need to be answered before any one technique will be used exclusively, the future of noninvasive cardiac imaging remains an exciting and ever-changing field. The adaptation of any one of these techniques into its proper role in the ED Journal of Nuclear Cardiology Wyrick and Wei 753 Volume 13, Number 6;749-55 Cardiac imaging in patients with chest pain will take considerably more time and effort in terms of research, money, and time-tested clinical experience.     

脑震荡的再回顾--惊厥学说

脑震荡是最常见，同时也是最令人迷惑的脑外伤。它常在头部遭受轻度暴力的打击后产生，表现为短暂的意识丧失、反射消失和近事遗忘。     

泰素蒂加顺铂治疗进展期NSCLC的临床研究

目的观察泰素蒂加顺铂方案治疗进展期非小细胞肺癌的临床疗效、毒副作用。方法收集可评价疗效的进展期非小细胞肺癌50例,以泰素蒂加顺铂方案进行化疗,泰素蒂75 mg/m2静脉滴注,第1天;顺铂25 mg/m2～30 mg/m2静脉滴注,第2天～第5天,每3周为一个周期,2～3周期后评价疗效和毒副反应并随访。结果50例患者中,总有效率为50.0 %,其中初治病例为53.1 %,复治病例为44.4 %,初复治病例间差异无显著性(P >0.05)。中位缓解期为5个月。中位生存期为9.5个月,1年生存率为61.0 %。毒副反应主要为骨髓抑制,白细胞下降达Ⅲ度、Ⅳ度者52.0 %,血小板下降达Ⅲ度、Ⅳ度者为14.0 %。血红蛋白下降不严重。其他毒副反应还有脱发、过敏反应、水钠潴留、静脉炎、末梢神经炎、口腔炎、腹泻等,但发生率均较低。结论泰素蒂加顺铂方案治疗进展期非小细胞肺癌,特别是复发病例,临床疗效比较满意,毒副反应能够耐受。辅以G蛳CSF可防治重度的骨髓抑制,有较好的临床应用价值。     

螺旋CT三维重建成像在先天性高肩胛症手术方式选择中的作用

[目的]探讨螺旋CT三维重建技术在先天性高肩胛症分度和手术方式选择中的作用。[方法]22例先天性高肩胛症术前应用螺旋CT对病变部位进行扫描并三维重建，测量以肩胛骨肩胛冈内侧缘为参照点，两侧肩胛骨高度差。根据测量结果依据Cavendish分度将其分类，并根据三维重建成像选择不同的矫形手术术式。[结果]本组22例病人，随访2—4年，外观及功能均有不同程度的改善，未出现神经、血管和椎体等的损伤。[结论]根据螺旋CT扫描和三维重建检查结果，术前即可直观的明确先天性高肩胛症的病变程度，相互关系，伴发畸形，患侧肩胛骨与正常对侧肩胛骨的外观差异等，便于手术操作方案的制定，避免了手术操作的盲目性，减少医源性并发症的发生。     

一则牛痘接种广告的解读

《申报》是我国早期的报纸,1872年由英国人美查在上海租界内创办。它在传播西方文明,反映上海市井文化中曾起过重要的作用。1873年,《申报》连续41期登载了一则牛痘接种广告。     

经直肠超声引导前列腺穿刺活检术诊断前列腺癌

目的　总结和评价经直肠超声引导下前列腺穿刺活检术对前列腺癌诊断的准确率。方法　222 例直肠指检阳性或 PSA>4μg/L的患者应用经直肠超声引导下前列腺6点系统穿刺活检以明确诊断。结果　222 例受检者中病理证实前列腺结节性增生41例、前列腺炎24例、前列腺肉瘤3例、前列腺癌 154 例,其中低分化癌 74 例、中分化癌 58 例、高分化癌 22 例。术后血尿15例、发热6例,其中高热1例,经抗生素治疗后体温恢复正常、尿检阴性。结论　经直肠超声引导下前列腺穿刺活检无需麻醉,患者痛苦小、安全性高,是诊断前列腺癌的可靠方法。     

沙培林增强人腹腔巨噬细胞抗癌免疫功能的研究

目的:探讨腹腔内注射沙培林增强人腹腔抗癌免疫功能的机制。方法:72例早中期胃肠道肿瘤患者术前48h和24h腹腔内分别注射生理盐水和5KE的沙培林,术中采集腹腔内巨噬细胞,计数并测定乳酸脱氢酶(LDH)和酸性磷酸酶(ACP)的活性,巨噬细胞吞噬活力,一氧化氮(NO)的分泌以及对人胃癌MKN1细胞的细胞毒性进行分析。同时采集大网膜,对大网膜乳斑的数量和面积进行观察。结果:沙培林显著增加腹腔巨噬细胞(PMΦ)的数量和NO的分泌,增强LDH和ACP的活性,吞噬活力,以及抗癌细胞毒性,也显著增加了大网膜乳斑的数量和面积。结论:腹腔内注射沙培林可显著增加人大网膜乳斑的数量和面积,并因此增加PMΦ的数量,增强PMΦ的活性。因而增强了腹腔巨噬细胞的免疫功能。