探究4种临床CT扫描方式对受检者辐射剂量的影响及胸部扫描辐射场的空间分布

目的 探究4种临床CT扫描方式对受检者常见组织吸收剂量的影响及胸部扫描的辐射场空间分布,以期为受检者与机房内空间辐射防护提供依据。方法 利用热释光探测器（TLD）测量仿真体模的眼晶体、甲状腺、性腺、胸部和腹部皮肤在4种CT扫描方式下的吸收剂量。利用TLD监测胸部螺旋扫描时距离CT诊断床不同位置处的空气比释动能。结果 仿真体模的眼晶体、甲状腺、性腺、胸部和腹部皮肤在4种CT扫描方式下的吸收剂量分别为0.040～64.818 mGy、0.154～10.155 mGy、0.028～0.154 mGy、0.443～17.141 mGy和0.093～14.346 mGy。胸部扫描时空间辐射场的空气比释动能最大值为0.049 mGy,且与CT球管距离越大数值越小。结论 4种CT扫描方式对受检者常见组织的吸收剂量一般不会超过阈剂量。单次CT胸部扫描时陪检者所受剂量较小。为减少辐射危害,在CT扫描中可采取屏蔽措施来减少受检者组织吸收剂量,同时陪检者应适当增加与球管和诊断床的距离。     

Postoperative Ileus after Stimulation with Probiotics before Ileostomy Closure

Loop ileostomy closure after colorectal surgery is often associated with Postoperative ileus, with an incidence between 13–20%. The aim of this study is to evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics prior to ileostomy closure in patients operated on for colorectal carcinoma. For this, a prospective, randomized, double-blind, controlled study is designed. All patients who underwent surgery for colorectal carcinoma with loop ileostomy were included. Randomized and divided into two groups, 34 cases and 35 controls were included in the study. Postoperative ileus, the need for nasogastric tube insertion, the time required to begin tolerating a diet, restoration of bowel function, and duration of hospital stay were evaluated. The incidence of Postoperative ileus was similar in both groups, 9/34 patients stimulated with probiotics and 10/35 in the control group (CG) with a p = 0.192. The comparative analysis showed a direct relationship between Postoperative ileus after oncological surgery and Postoperative ileus after reconstruction surgery, independently of stimulation. Postoperative ileus after closure ileostomy is independent of stimulation of the ileostomy with probiotics through the efferent loop. There seem to be a relationship between Postoperative ileus after reconstruction and the previous existence of Postoperative ileus after colorectal cancer surgery.     

基于“互联网+”技术的上海市质子重离子医院资产管理的 探索和实践

针对医院资产管理的现状和难点,将平台中的空间管理同资产管理相结合,进行数据交互和功能拓展,不仅使医院空间和资产同步系统化、数据化,而且汇聚了资产管理全维度数据源,达到优化资源配置、降本增效的实践成果,也为建立基于云数据的资产设备全生命周期管理夯实基础。     

Change in granulation tissue coverage and bacteriological load using Low Cost Negative Pressure Wound Therapy in acute musculoskeletal wounds

BackgroundLow cost Negative Pressure Wound Therapy (NPWT) dressings have been considered as an alternative to traditional daily dressings. There is scanty literature evaluating the change in the percentage area of wound covered by granulation tissue following application of low-cost NPWT. The change in the bacteriological flora following application of low-cost NPWT devices has also not been evaluated.MethodsPatients above the age of 18 years with acute musculoskeletal injuries of <3 weeks duration which underwent a surgical debridement and required subsequent wound coverage were included in the study. Area of the wound and the area covered by the granulation tissue as well as the bacteriological count were measured before and after application of NPWT. A low cost NPWT using wall mounted vacuum device was put on the patient giving a constant negative pressure of 125 mm of Hg for 2 days. The findings before and after application of NPWT were compared and analyzed using Wilcoxin Signed-rank test.Results21 patients with mean age of 35.52±15.075 were included. The pre-NPWT granulation tissue area ranged from 122 mm² to 8483 mm² with a mean of 1648.38 mm² (SD = 1933.866). The post-NPWT granulation tissue area ranged from 234 mm² to 7847 mm² with a mean of 2364.48 mm² (SD = 1857.716). The mean increase in granulation tissue was 716.1 mm².The pre-NPWT wound area ranged from 422 mm² to 10847 mm² with a mean of 4009.62 mm² (SD = 3026.209). The post-NPWT wound area ranged from 326 mm² to 9143 mm² with a mean of 3410.33 mm² (SD = 2636.206). The mean reduction in wound size was 599.29 mm².The pre-NPWT bacteriological count ranged from 3000/ml to 130000000/ml with a mean of 12616761.90/ml (SD = 29664589.37). The post-NPWT bacteriological count ranged from 1000/ml to 380000000/ml with a mean of 26401523.81/ml. The mean increase in bacteriological count was 13784761.91/ml.ConclusionThere was a statistically significant decrease in wound size (p = 0.001) and statistically significant increase in percentage area of granulation tissue coverage (p = 0.000) following low cost NPWT application. However there was no statistically significant increase in bacteriological clearance in these patients.     

Transcatheter closure in 354 pediatric cases of patent ductus arteriosus usi ng five different devices

评价五种不同介入性心导管堵闭术治疗小儿动脉导管未闭 (PDA)的应用价值。方法　 1989年 3月 - 1999年 12月 ,354例PDA患儿分别用五种不同介入堵闭术进行治疗 ,男 135例 ,女 2 19例 ,年龄 0 4 - 15(3 2± 0 8)岁 ,体重 4 8- 4 9(2 0 6± 3 2 )Kg ,Qp Qs为 1 2 - 4 4 (2 2± 0 5)。其中Porstmann海绵法 2 5例 ,Rashkind双面伞器法 78例 ,Sideris纽扣式补片法 4 3例 ,Cook及PFM弹簧圈器法 6 9例 ,Amplatzer蘑菇伞器法139例。单纯PDA351例 ,其中 3例为PDA结扎后残余分流 ;2例合并轻度主动脉狭窄 ,1例合并轻度肺动脉瓣狭窄。所有PDA患儿术后 1天 ,1个月 ,3个月 ,6个月均用彩色多普勒超声心动图随诊。结果　总成功率 98 6 % (351 354) ,其中Porstmann法 92 % (2 3 2 5) ,Rashkind法 98 7% (71 78) ,Sideris法 10 0 % (43 4 3) ,Coil法 10 0 % (6 9 6 9) ,Amplatzer法 10 0 % (139 139)。具体见表。五种方法残余分流分别是 :Porstmann法无残余分流 ;Rashkind法 17 9% (2 4小时 ) ,7 7% (6个月 ) ;Sideris法 18 6 % (2 4小时 ) ,15% (6个月 ) ;Coil法 5 8% (2 4小时 ) ,2 8% (6个月 ) ;Amplatzer法 8 6 % (2 4小时 ) ,1 4 % (6个月 )。五种方法的X线透视时间分别是 :Porstmann法 54 0± 13 0分钟 ,Rash     

斗门县农村中老年人群原发闭角性青光眼流行病学调查

【目的】调查 5 0岁以上的中老年人群中的原发闭角性青光眼患病率。【方法】 1997年在广东省斗门县以村为单位 ,通过重组随机整群抽样确定检查对象 ,用ETDRS视力表检查裸眼视力、常戴镜视力和针孔视力 ,Schiotz计测定眼压 ,直接电眼底镜作视神经垂直C/D比的估计 ,手电筒侧照法和vanHerrick法测定前房深度 ,并结合急性发作史、前房角镜和视野检查作出诊断。【结果】在 5 34 2名实检对象 (受检率 92 7% )中 ,青光眼是第 5位致盲眼病。原发闭角性青光眼的患病率为1 0 % ,男性和女性中分别为 0 8%和 1 2 % ,在 5 0～ 5 9、6 0～ 6 9和 70～ 98岁年龄组中分别为 0 4%、0 8%和 1 6 % ,浅前房人群中为 5 9% ,经logistic回归校正混杂作用后 ,年龄和前房深度为独立的危险因素 ,以 5 0岁年龄组和深前房者为基准 ,70～ 98岁年龄组和浅前房者的调整比数比分别为 3 3和 11 3。【结论】原发闭角性青光眼是人群中重要的致盲眼病 ,老年和浅前房者是危险人群。     

闭角型青光眼凝血指标的变化

目的:探讨闭角型青光眼患者凝血指标变化与临床的关系。方法:对50例闭角型青光眼患者及43例正常对照组进行了凝血指标(PT、TT、Fbg、APTT)检测。结果:闭角型青光眼患者与对照组比较PT、TT无显著变化(P<0.05),Fbg含量升高有极显著性差异(P<0.01),APTT时间缩短有极显著性差异(P<0.01)。结论:闭角型青年眼患者体内血液是高凝状态,而这种高凝状态在闭角青光眼病的发生、发展中起着重要的作用。     

An effective device to keep the sternum open

(Received for publication on Oct. 6, 1997; accepted on July 7, 1998)     

Photodynamic therapy in the bladder: Can the light dose be easily quantified?

The shape of the bladder and the optical characteristics of the tissue within the wall can be shown to play an important role in the amount of light actually received at the wall. The use of estimated doses even assuming spherical geometry, cannot therefore be relied upon. This paper describes some experimental work carried out on a glass model that was used to simulate the bladder. A specially constructed dual detector was used which consisted of an isotropic probe and semiconductor detector. This enabled measurements of irradiance and space irradiance (light energy fluence rate) to be made simultaneously. By changing the optical characteristics of the wall a four-fold increase in space irradiance was measured. Contamination of the water contained within the model by blood was also investigated and has shown that with concentrations as low as 0.5% the delivered light dose reaching the wall can be reduced by up to 50% at a wavelength of 510 nm. Some in vivo measurements are also presented together with some comments on the difficulties that have been encountered when transferring measurements from the model to the patient.