七年制生物物理技术教学探索

根据七年制医学生培养要求，在“生物物理技术”教学中，除介绍有关物理方法与技术的原理及在生物医学中的应用外，还尝试了小论文写作和渗透科研思路、方法培养的探索。     

单钉——沟槽柱翼钢板的生物力学实验研究

作者自行研究设计的单钉－沟槽柱翼钢板复位固定治疗腰椎滑脱症。预先采用６具成人尸体的Ｌ３－Ｓ３骨骼做成椎弓崩裂并滑脱模型，采用临床Ｉ型手术方法进行了复位固定，在每片钢板上粘贴６片电阻应变片，进行中心和偏心加载试验，同时进行了弯矩和扭矩试验，在５８６微机上进行了线性回归分析，求出了线性方程及线性相关系数ｒ，中心和偏心加载达到９００Ｎ未出现钢板松动，扭矩和弯矩在８３３Ｎ；ｃｍ和６６６．４Ｎ．ｃｍ以内左右     

人体腰椎活动节段应力分布的实验研究

本文采用三维光弹性实验方法观察了正常腰椎活动节段的应力分布。用精密浇铸,严格几何相似的光弹性环氧树脂腰椎和硅橡胶椎间盘模型进行三维光弹性实验,并观察腰椎的等应力差图和有效应力值分布。本实验观察到,腰椎椎体上下缘应力分布较均匀对称,其后缘应力大于前缘,后部结构应力较小。作者认为,三维光弹性实验方法具有直观性强,能有效和准确地确定腰椎的应力分布,对腰椎生物力学研究具有重要的实用价值。腰椎后缘应力大于前缘,使椎体后缘承载较大,将会增加腰椎间盘退变和损伤的机会,这可能是引起腰腿痛的重要因素。     

A Novel Application of the MIRC Repository in Medical Education

Medical students on the radiology elective in our institution create electronic presentations to present to each other as part of the requirements for the rotation. Access was given to previous students presentations via the web-based system, Medical Imaging Resource Center (MIRC) project, created and supported by the Radiological Society of North America (RSNA). RadPix Power 2 MIRC (Weadock Software, LLC, Ann Arbor, MI) software converted the Microsoft PowerPoint (Redmond, WA) presentations to a MIRC-compatible format. The textual information on each slide is searchable across the entire MIRC database. Future students will be able to benefit from the work of their predecessors.     

股骨粗隆间骨折采用改良L形钢板内固定的生物力学原理与临床应用

作者自1994年始采用自行设计L形钢板内固定治疗不稳定股骨粗隆间骨折60例，平均随访25个月，X线片显示骨折愈合时间6～13周，平均8．9周，伤肢功能在3个月内基本恢复正常，无骨折延迟愈合及髋内翻现象。为论证改良L形钢板的优点，本文采用8具新鲜尸股骨沿着它的外侧、内侧骨皮质粘贴6个应变片，观察股骨近端应变和位移分布，以检验改良L形钢板固定粗隆间骨折的效果。在实验前后将股骨粗隆造成二部分或四部分骨折。利用实验结果给制成应变和位移图，并与鹅头打固定组相比较。在载荷加至1800N时比较两种内固定器械的生物力学性能。结果表明，在治疗不稳定粗隆间骨折中，L形钢板比鹅头钉更具有生物力学的优势。     

Integrated medical informatics with small group teaching in medical education

National Taiwan University College of Medicine (NTUCM) introduced small groups of teaching and basic-clinical integrated courses for medical students in 1992. By using computer network and multimedia techniques, this study tried to overcome barriers to learning in small group teaching. The Department of Medical Informatics of NTUCM established campus networking and computer classrooms and provided Internet and intranet network services including mail, netnews, bulletin board systems (BBS), world wide web (WWW), gopher, ftp and local file servers. To implement an interactive learning environment, the authors first tried mail lists, newsgroups and BBS. Next an integrated learning system prototype on the WWW was developed to provide functions including online syllabus, discussion boards simulated to BBS, online talk, interactive case studies, virtual classroom with video on demand (VOD) and Internet medical resources. The results showed that after the medical students completed the required course of medical informatics and had good network access using a network to communicate with each other became a daily practice. In the future, the system will extend to the tutoring of clinical practice and continuing medical education. The authors expect a national medical education network and more international cooperation and exchange.     

Computer analysis system of blood oxygen saturation in an animal hypoxia model

An experimental animal hypoxia model has been developed. It consists of two sensors (an in vitro and in vivo model), an experimental device and a computer signal processing system. This method can easily be applied to determine and analyse blood oxygen saturation at various hypoxia levels. It can also be used to evaluate the accuracy of pulse oximetry over a wide range of oxyhemoglobin desaturation levels. The DC and AC components of recorded red and infra-red signals, the dual-wavelength ratio R₁₂ and the reading of a pulse oximeter (SpO₂) can be automatically calculated and displayed on a computer screen. Preliminary results of the animal hypoxia test indicate that the measurements made by the instrument correlate well with the oxygen saturation readings of the automatic blood gas analyser AVL945. The computer analysis system is suitable for repeated estimations in the animal model.     

胸部体表导纳变化与胸腔中血管导纳变化的关系

目的：探讨胸部体表导纳变化与胸腔中血管导纳变化的关系。方法：根据导纳与阻抗互为倒数的关系，导出胸部体表导纳变化公式，并用模型实验证明。结果：单根血管在胸部体表引起的导纳变化与血管本身的导纳变化和基础导纳的比值成正比，与血管的长度和胸部体表两检测电极之间的基础导纳成正比，与血管到两检测电极连线的距离成反比；多根血管在胸部体表共同引起的导纳变化等于各血管单独在胸部体表产生的导纳变化的代数和，即在电导纳图测量中导纳变化遵从标量迭加原理。结论：本文结果可为心导纳图的波形重建奠定理论基础。     

实体肿瘤药物输运与给药方式的集中参数模型及实验研究

目的研究不同给药方式对实体肿瘤抗癌药物疗效的影响,并通过动物实验验证。方法分别建立体内药代动力学和肿瘤内药物输运的集中参数模型,模拟单次快速注射和等时间间隔三次快速注射时肿瘤间质组织药物浓度Ct随时间的变化。实验小鼠分为两组,分别进行抗癌药羟基喜树碱(HCPT)单次快速注射和等时间间隔3次快速注射,观察其肿瘤内药物平均浓度。对数值模拟结果和动物实验结果进行比较。结果数值模拟结果显示,对于相同总量药物,等量等间隔的三次给药,肿瘤间质组织药物浓度Ct高于单次给药。动物实验的实测结果相同。结论3次给药的效果显著优于单次给药。集中参数模型基本能够定量反映不同给药方式的效果。     

兔激素性股骨头坏死的血液流变学改变

目的　探讨血液流变学指标在激素性股骨头坏死过程中的变化规律及其作用。方法　20只兔随机分成2组，每组10只。A组（激素性股骨头坏死动物模型组）：间隔24h耳缘静脉内2次注射大肠杆菌内毒素，每次40μg/kg，注射内毒素后注射醋酸泼尼松龙20mg/kg。B组（正常对照组）。两组分别在注射后24h、72h、7d、14d 及21d，进行血浆黏度、全血黏度、血小板计数及血脂测定，21d取股骨头和肝脏行病理组织学观察。结果　A组用药后24h血浆黏度、全血黏度升高，血脂升高(P<0.01)血小板计数减少(P<0.01)，用药后72h、7d、14d 及21d，持续异常，与B组相比差异显著。A组21d时病理切片见股骨头骨细胞和肝细胞变性、坏死。结论　在激素性股骨头坏死动物模型中，血液流变学指标异常在引起血栓前状态，形成血栓导致骨坏死过程中可能发挥了重要作用。