应用现代口腔粘结技术治疗儿童下颌骨骨折

目的:探讨口腔粘结技术对儿童下颌骨骨折的治疗效果。方法:对37例儿童下颌骨骨折应用复合树脂粘结固定夹板,其中 4例应用复合树脂直接固定;13例实施尼龙丝结扎-复合树脂固定夹板;12例实施贴钩-尼克丝-复合树脂固定;3例应用金属丝弓一复合树脂单颌固定;5例实施牙列贴钩 带钩丝弓-复合树脂颌间弹性牵引。结果:37例儿童下颌骨骨折中有35例咬合关系恢复正常,2例 有轻度错(牙合),经调(牙合)后咬合关系正常。结论:儿童混合牙列时期乳、恒牙交替及牙齿形态特殊,又儿童下颌骨中含有牙胚不易手术治疗,而常规牙弓夹板固定困难,因此,应用复合树脂粘结固定夹板治疗儿童下颌骨骨折是一项简易、高效的技术。     

仙灵骨葆胶囊改善精液质量的临床研究

目的:观察仙灵骨葆胶囊改善男性不育患者精液质量的情况。方法:女方生育功能正常的男性不育患者66例,口服仙灵骨葆胶囊2~4个月,观察治疗前后精液质量并进行精子形态学分析。结果:治疗2个月后,精子密度有所提高,但无统计学差异(P>0.05);精子存活率和活动率也无明显变化(P>0.05);治疗后正常形态精子百分率明显升高,其中正常形态精子百分率≥15%者,由治疗前的25.8%(17/66)增加为57.6%(38/66)(P<0.05),而正常形态精子百分率<9%者,由治疗前的53.0%(35/66)下降为25.8%(17/66);7例少精子症者用药前精子正常形态百分率平均为5.8%,服药4个月后平均为10.9%,与服药前有明显差异(P<0.05)。治疗期间有5例患者配偶怀孕。结论:仙灵骨葆胶囊对男性精液质量有改善作用,能明显提高正常形态精子百分率,少精子症者更明显。     

The first 50 years of military radiology 1895–1945

Following the discovery of X-rays in 1895 by Wilhelm Röntgen the value to the military surgeon of the new technique was soon realised. The localisation of retained bullets by radiography avoided inappropriate exploration of the wound. The X-rays were first used on casualties from the Abyssinian War of 1896 and the developing radiological technology was progressively applied to military surgery. In addition the needs of warfare stimulated the development of all aspects of radiology.     

Where's the Beef? The Promise and the Reality of Clinical Documentation

Physician-generated emergency department clinical documentation (information obtained from clinician observations and summarized decision processes inclusive of all manner of electronic systems capturing, storing, and presenting clinical documentation) serves four purposes: recording of medical care and communication among providers; payment for hospital and physician; legal defense from medical negligence allegations; and symptom/disease surveillance, public health, and research functions. In the consensus development process described by Handler, these objectives were balanced with the consideration of efficiency, often evaluated as physician time and clinical documentation system costs, in recording the information necessary for their accomplishment. The consensus panel session participants and authors recommend that 1) clinical documentation be electronically retrievable; 2) selection and implementation be evidence-based and grounded on valid metrics (research is needed to identify these metrics); 3) the user interface be crafted to promote clinical excellence through high-quality information collection and efficient charting techniques; 4) the priorities for integration of clinical information be standardized and implemented within enterprises and across health and information systems; 5) systems use accepted standards for bidirectional, real-time clinical data exchange, without limiting the location or number of simultaneous users; 6) systems fully utilize existing electronic sources of specific patient information and general medical knowledge; 7) systems automatically and reliably capture appropriate data that support electronic billing for emergency department services; and 8) systems promote bedside documentation and mobile access.     

Neurosurgical robotics: a review of brain and spine applications

Neurosurgery has traditionally been at the forefront of advancing technologies, adapting new techniques and devices successfully in an effort to increase the safety and efficacy of brain and spine surgery. Among these adaptations are surgical robotics. This paper reviews some of the more promising systems in neurosurgical robotics, including brain and spine applications in use and in development. The purpose of the discussion is twofold—to discuss the most promising models for neurosurgical applications, and to discuss some of the pitfalls of robotic neurosurgery given the unique anatomy of the brain and spine.     

肿瘤物理治疗技术及设备

简要介绍了肿瘤的放射治疗和热治疗的技术及设备，介绍了各种技术及设备的特点。     

急性胰腺炎的超声诊断

目的：探讨急性胰腺炎的超声诊断及其应用价值。方法：60例经CT或由临床症状结合腹部穿刺得以确诊的急性胰腺炎，就超声表现和各类型的表现进行分析。结果：60例急性胰腺炎患者中，超声诊断52例，准确率为86．7％，其中，急性水肿型胰腺炎28例，胰腺大，内部回声减低或是增强，均匀或不均匀；急性出血坏死型胰腺炎24例，胰腺弥漫性或局限性肿大，轮廓较为模糊，回声不均匀，低或强回声相间，回声较粗，多见边沿粗糙；60例中误诊的8例仅见气体全反射回声，未探及胰腺声像。结论：超声对急性胰腺炎的诊断准确率高，并能做出分型诊断，临床应用方便快捷。     

心理护理在术前访视中的应用

目的消除手术患者的不良心理刺激,防止身心疾病的发生,提高患者对手术的耐受性。方法在术前访视中通过心理调查表了解到患者存在的心理问题,运用个性化的心理护理的方法,帮助患者解答心理问题,减轻心理负担,轻松愉快地接受手术治疗。结果在术前访视中运用个性化的心理护理,很大程度上拉近了护患之间的距离,提高了患者对医务人员的信赖,使患者对手术的耐受性大大提高。结论在术前访视中做好患者的心理护理,消除患者对手术的顾虑是提高手术成功率的有效措施。     

体外细胞培养检验“方证对应”关系的方法学研究

目的通过在体外细胞培养中加入中药复方粗提制剂对具有典型的中医证型的肺癌患者的外周血淋巴细胞NK活性的影响，探索能否在体外实验中反映“方证对应”关系。方法以水煎醇沉法制备两种中药复方（益气养阴和健脾化痰）的粗提制剂，取具有典型的中医证型（气阴两虚或脾虚痰湿证型）的肺癌患者的外周血淋巴细胞，将同一个患者的标本分为四个体外实验组，即空白对照组，中药5mg／ml组及10mg／ml组，自细胞介素2（250^u/ml，阳性对照）组。按“辨证论治”原则加入相应的中药复方制剂。体外培养22h或94h，以MTT法检测各组的NK活性。结果无论培养22h或94h，中药组的NK活性与对照组比较皆无显著性差异（P〉0．05），而白细胞介素2（阳性对照）组的NK括性均明显升高（P〈0．05）。结论两种中药复方制剂都未能在体外反应出“方证对应”的效果，说明中药粗提制剂直接用于体外细胞培养，其结果的可靠性差。     

Cartilage destruction in small joints by rheumatoid arthritis: assessment of fat-suppressed three-dimensional gradient-echo MR pulse sequences in vitro

Purpose. To assess the accuracy of different MR sequences for the detection of articular cartilage abnormalities in rheumatoid arthritis. Design and patients. Ten metacarpophalangeal joints and 10 metatarsophalangeal joints (specimens from arthritis patients undergoing ablative joint surgery) were examined with a fat-suppressed (FS) 3D FLASH, a FS 3D FISP, a FS 2D fast spin-echo T2-weighted, and a 2D FS spin-echo T1-weighted sequence. Each cartilage lesion and each cortical lesion was graded from 0 to 4 (modified Outerbridge staging system). Subsequently, the results of each sequence were compared with the macroscopic findings and statistically tested against each other. Results. The study shows that 3D gradient-echo sequences with fat suppression were best for imaging and grading of cartilage lesions in arthritis of the small joints of the hands and feet. Using 3D techniques, all grade 2, grade 3, and grade 4 lesions of cartilage or cortical bone were detected. Conclusion. FS 3D gradient-echo techniques were best for the detection and grading of hyaline cartilage and subchondral bone lesions in rheumatoid arthritis. MRI has a great potential as an objective method of evaluating cartilage damage and bone erosions in rheumatoid arthritis.