超短波电疗仪基本原理与检修

根据超短波电疗仪原理框架图,阐述超短波电疗仪的基本工作原理,介绍该设备整机结构,分析主要部件功能,总结超短波电疗仪常见故障及解决方法,为工程师维修时提供参考依据。     

骨不连治疗的研究与技术应用进展*

背景：骨不连是骨折晚期常见的临床问题,数十年来,在各种新式内外固定材料、普及的显微外科技术、创新的植骨材料,尤其是分子生物学技术的全面帮助下,骨不连的治疗取得了突破性进展。
　　目的：总结骨不连治疗的研究进展,为以后更好地治疗骨不连提供技术理论和方法选择。
　　方法：由第一作者运用计算机检索系统检索1990年1月至2013年5月发表的有关骨不连原因及治疗方法的文献,以“fracture nonunion,treatment,progress”或“骨不连,治疗方法,进展”为检索词。同一领域则选择近期发表或者发表在权威杂志的文章。
　　结果与结论：排除重复性研究及时间跨度大的文献,从检索结果中共选择了48篇文章进一步分析。骨不连治疗手段主要有两种：非手术方式和手术方式,目前临床上以手术方式为主且高效。骨折愈合是多环节参与的复杂过程,一旦骨不连发生,应具体问题具体分析,根据患者的实际情况采取个体化治疗原则,重视软组织的保护,必要时联合运用多种手术及非手术方法,才能取得满意的疗效。     

The Effects of Acute Bouts of Whole Body Vibration on Central Hemodynamics in Frail Older Adults: A Pilot Study

Abstract

Introduction: This study investigates whether an acute bout of whole body vibration (WBV): (i) improves measures of central hemodynamics and (ii) can be completed without inducing orthostatic intolerance in frail older adults. Methods: Nine rest home residents participated in a cross-over design incorporating WBV and non-vibrational control conditions (CON) on 2 separate testing days. The order of the two testing conditions was randomized. Participants completed 10 sets of 60?seconds of WBV training or CON with an inter-set rest period of 60?seconds. Results: During training, no interaction or between-condition effects were observed for any variable. Following training, there was an interaction effect reported for augmentation index (AIx) (P?<?0.019) and a significant large increase in AIx for WBV (P?=?0.020, Eta = 0.202). Three participants exhibited one-off notable decreases in either central systolic or diastolic blood pressure. Conclusion: An acute bout of WBV is a safe training method for frail older adults.     

Third International Conference on Shape Memory and Superelastic Technologies

Summary. More than 10 years after its clinical introduction, extracorporeal shock wave lithotripsy (ESWL) has proved to be the safest treatment modality for more than 90% of urinary stones. Absolute contraindications are untreated coagulopathy, urinary tract infection and pregnancy. After careful preparation, even patients with severe coagulopathy (haemophiliacs A/B, thrombocytopenia) can be treated successfully by ESWL. Shock wave lithotripsy for an increasing amount of small symptomatic renal calculi resulted in a stone-free rate of 50% and a complaint-free rate of 52%. A 50% chance of success justifies initial ESWL treatment for stones in caliceal diverticula. A stone-free rate of 70% was reported for stone-bearing horseshoe kidneys, but the recurrence rate was 29%. Therefore, percutaneous stone removal may become necessary in such cases.

The utilization of indwelling stents has contributed to the extension of indication for ESWL monotherapy, even for staghorn calculi, as acute morbidity is reduced. Double-J stents, however, do not improve the stone-free rate and special attention should be paid to double-J morbidity. Depending on stone localization, post-ESWL long-term stone-free rates are 58–84% with a recurrence rate of 6–11 % and despite persisting fragments, the infection rate is low.

The main features of third generation lithotripters are a combined localization system allowing interdisciplinary shock wave lithotripsy, a wide energy range of the shock wave source resulting in an efficacy similar to that of the Dornier HM3 and integration of the shock wave source and fluoroscopy unit in an endoscopic treatment table for multifunctional use. Finally, a modified version of the Clayman-Preminger efficacy quotient for clinical comparison of different lithotripters, is outlined.     

声脉冲辐射力成像声触诊组织定量技术鉴别诊断颈部淋巴结良恶性的价值

目的探讨声脉冲辐射力成像(ARFI)声触诊组织定量(VTQ)技术在颈部淋巴结良恶性鉴别诊断中的应用价值。方法对65例100个颈部淋巴结肿大患者进行VTQ检查,测量并记录其横向剪切波速度(SWV),比较良恶性颈部淋巴结间SWV的差异;以病理诊断为金标准,绘制ROC曲线图,获取区分颈部淋巴结良恶性SWV的临界值。结果非特异性反应性淋巴结组SWV值为(1.72±0.89)m/s,恶性淋巴结组SWV值为(2.68±0.48)m/s,二者比较差异有统计学意义(T=4.7141,P0.001)。构建SWV的ROC曲线后,其曲线下面积分别为0.862,根据ROC曲线选取鉴别良恶性淋巴结的SWV值的临界值为1.90 m/s,其对应的敏感性、特异性、准确性为82.2%、90.0%、90.0%。结论 ARFI的VTQ技术可定量反映组织弹性特征,有助于鉴别颈部淋巴结的良恶性。     

2013版BI-RADS分类标准结合声触诊组织量化技术鉴别诊断乳腺良恶性病灶的价值

目的 探讨2013版超声乳腺影像报告和数据系统(BI-RADS)分类诊断标准结合声触诊组织量化技术(VTQ)鉴别乳腺良恶性病灶的价值。方法 对251位患者共334个乳腺病灶行常规超声检查,并用BI-RADS分类诊断标准判断其良恶性;然后应用VTQ技术测量病灶的剪切波速度(SWV);以病理结果作为金标准,构建受试者的工作特征曲线,比较两种方法的诊断价值。结果 BI-RADS分类诊断标准及VTQ技术鉴别乳腺良恶性病灶的ROC曲线下面积分别为0.899、0.855,两者差异无统计学意义(z=1.367,P=0.172)。结论 BI-RADS分类诊断标准与VTQ技术结合可以提高乳腺病灶的诊断准确性。对于BI-RADS 4类的病灶,联合VTQ技术可减少不必要的穿刺活检或手术。     

毫米波促进周围神经损伤轴突再生的实验研究

目的探讨毫米波对周围神经损伤后轴突再生的影响。方法将48只SD雄性大白鼠制作成左侧坐骨神经部分损伤模型，随机分为治疗组和对照组。治疗组在神经损伤24h后，用毫米波辐射损伤部位，每周5次，每次30min，直至取材的前一天。组织学观察毫米波对大鼠坐骨神经部分损伤后轴突再生的影响。结果治疗组在术后2，4，6周有髓纤维横截面积均显著大于对照组。电镜观察，治疗组在术后4周和6周的神经再生数目和成熟度均优于对照组。结论毫米波能够促进周围神经损伤后轴突的再生。     

抗痫灵的电化学行为及吸附伏安法研究

抗痫灵在0.20 mol/L H₂SO₄底液、富集电位-0.70 V(vs Ag/AgCl)、扫速100 mV/s等条件下,用吸附伏安法得一灵敏的还原峰,峰电位-0.94 V,峰电流与抗痫灵浓度在3.0×10^-9～1.0×10^-8mol/L(富集时间t_ac=120 s),1.0×10^-8～7.0×10^-8mol/L(t_ac=90 s),7.0×10^-8～7.0×10^-7mol/L(t_ac=60 s),7.0×10^-7～3.0×10^-6mol/L(t_ac=45 s)范围内成线性关系,检测限可达1.0×10^-9mol/L,并用于片剂及病人尿样的测定,得到满意的结果。以多种电化学手段研究抗痫灵的电化学行为及反应机理。实验表明属不可逆吸附波。测得扩散系数D为7.7×10^-6cm²/s,电极反应速率常数k₁为1.5×10^-3cm/s,电极反应电子数n为2,电子转移系数α=0.52。抗痫灵的还原基团为分子中碳碳双键。     

左旋氨氯地平对阵发性房颤并高血压患者房颤的影响

目的观察左旋氨氯地平对阵发性房颤并高血压患者P波离散度（Pd）、左房内径、高敏C反应蛋白（hs—CRP）水平、房颤发作情况的影响。方法将阵发性房颤并高血压患者100例随机分为治疗组（50例）和对照组（50例）。降压药物治疗组给予左旋氨氯地平,对照组给予坎地沙坦,随访1年,观察治疗前后Pd、左房内径、hs—CRP水平及房颤发作情况。结果至随访结束,在长期应用胺碘酮的患者中,对照组房颤复发17例,占81．0％,治疗组房颤复发22例,占95．7％,两组之间差异无统计学意义（x^2=1．122,P〉0．05）。未长期应用胺碘酮的患者,对照组、治疗组在7-12个月时房颤发作次数均较治疗前减少（t=2．823,P〈0．01;t=2．655,P〈0．05）,但两组之间差异无统计学意义（t=0．594,P〉0．05）。与治疗前比较,对照组、治疗组的Pd、左房内径、hs—CRP均降低（t=4．025-13．546,P〈0．01）,治疗后两组之间Pd、左房内径、hs—CRP比较,差异无统计学意义（t=1．234-1．514,P〉0．05）。结论左旋氨氯地平可减少阵发性房颤并高血压患者房颤的复发,降低Pd、左房内径和hs—CRP水平,其效果与坎地沙坦没有差异。     

体外冲击波治疗髂骨致密性骨炎的疗效及安全性研究

目的:探讨体外冲击波治疗髂骨致密性骨炎的疗效及安全性影响。方法:将58例髂骨致密性骨炎患者随机分成对照组和治疗组各29例,对照组服用NSAID消炎止痛药塞来昔布胶囊(西乐葆)0.2g,1日2次,共3周;治疗组采用骨科体外冲击波治疗机治疗,以3天1次,共6次。分别在治疗前、治疗1周后、2周、3周后进行视觉模拟评分(VAS)和JOA腰痛评价表疗效评定;以及3周后临床疗效评定和5周后短期疗效随访满意度调查。结果:两组治疗1周后比治疗前VAS和JOA腰痛评价腰痛缓解,有显著性意义(P0.05);治疗2周和3周后治疗组弯腰和负重时VAS和JOA腰痛评价评分比对照组改善有显著,两组疗效差异有显著性意义(P0.01)。治疗3周后两组临床治愈率分别为10.34%,75.86%;5周后两组短期疗效满意度调查13.79%,86.2%;差异有显著性意义(P0.01)。不良反应调查:对照组治疗2周后出现不良反应,如胃胀、胃痛症状,必须给予服用护胃药治疗;治疗组无不良反应。结论:体外冲击波治疗髂骨致密性骨炎的疗效显著,安全可靠,具有推广应用价值。