Iatrogenic bladder stone and associated vesicovaginal fistula after hysterectomy

A patient had irritative lower urinary tract symptoms for 2 years after hysterectomy. During cystoscopy, a bladder stone was seen and removed, but watery vaginal discharge emerged. The subsequent transvaginal ultrasound revealed a fistulous tract between the bladder and the vagina. The methylene blue test further confirmed the diagnosis of vesicovaginal fistula. We performed a delayed Latzko procedure to successfully repair the fistula.     

做好医用耗材准入管理工作

医用耗材种类繁多,从十几万的支架到几分钱的PE膜手套,设备处管理工作者的职责在于,把好医用耗材准入关,合理安排采购计划,做好服务保障工作,满足临床、科研和教学的需要。     

医院卫生材料库存核算信息管理系统

针对南京军区总医院耗材管理方面的特点,在综合原“医院设备器材管理信息系统”和“军字一号”系统相关功能模块的基础上,开发了“医院卫生材料库存核算信息管理系统”,实现了医院耗材采购和使用的一体化网络管理模式。论文详细介绍了材料库存核算信息管理系统的功能、工作流程及系统的体系结构、软件平台与相关的软件技术等。实际应用表明,该系统运行可靠稳定,有效提高了卫生材料成本核算的正确性及各科室的工作效率,并为领导提供了科学的决策依据。     

电视教材《中医正骨手法》的编导思路与实现

结合对卫生部科教司和人民卫生出版社招标电视教材《中医正骨手法》的编导制作过程,从教学内容、总体结构、表现方式、素材的选择和拍摄等各方面阐述了制作体会,并探讨在计算机网络技术迅速发展背景下编导医学电视教材的一些方法。     

关于中药四性物质基础研究技术路线的讨论

认为进行中药四性物质基础研究可按如下技术路线开展工作。文献研究(系统梳理中药四性理论体系,科学界定中药四性属性)→药材基源性状研究(界定标准药材,探寻与四性属性相关的因素及其规律性)→成分系统分析(明确个药基础物质成分)→成分种类、数量、存在形式研究(寻找基础物质成分种类、数量、存在形式与四性属性的相关性规律)→组合药靶模型作用机制分析(以功效相近、四性属性相同的药物组成一类药组,针对主要功效选取观察靶点,制备药靶模型,研究与四性属性可能相关的基础成分作用机制)→数据处理→文献研究(分析评价药性界定依据)→模型验证(评价药性界定依据的科学性)。     

醋酸羟丙基甲基纤维素琥珀酸酯的性能表征

 目的合成新型肠溶包衣材料醋酸羟丙基甲基纤维素琥珀酸酯(HPMCAS),并分析其结构特征和性能。方法采用红外光谱、紫外光谱、热重分析和化学分析等方法进行表征,测试HPMCAS在有机溶剂中的溶解情况、黏度、抗张强度和极限伸长率,并与日本的醋酸羟丙基甲基纤维素琥珀酸酯样品AS-LG进行比较。结果HPMCAS中酸性丁二酰基、乙酰基的含量与加入酸酐的量密切相关;二氯甲烷-乙醇等混合溶剂是HPMCAS的良溶剂;HPMCAS低于200℃时对热稳定,高于此温度后快速失重。结论其物化性质与日本样品AS-LG接近。     

补肾方含药血清促进PC12细胞增殖及其拮抗谷氨酸神经毒作用的研究

目的运用中药血清药理学方法研究补肾复方含药血清(BS)促进体外培养的PC12细胞增殖及其拮抗谷氨酸兴奋性神经毒损伤的作用.方法以MTT法观察BS对体外培养的PC12细胞活力的影响及其拮抗谷氨酸损伤的作用,采用流式细胞仪观察BS对谷氨酸所诱导PC12细胞凋亡的影响.结果 BS含药血清可以增强PC12细胞活力,拮抗谷氨酸的兴奋性神经毒作用且在20%浓度时作用最强,并且能够抑制谷氨酸诱导的PC12细胞早期凋亡.结论补肾方BS可能具有神经保护作用.     

欲降先升理论治疗慢性便秘探讨

便秘在许多疾病的发生中起重要作用。其病位在大肠,与脾、胃、肝、肾、肺等脏腑的功能失调有关,基本病机为热结、气滞、寒凝、气血阴阳亏虚引起大肠传导功能失常。治疗时使用下法有一定效果,但易致诸多的不良反应。依据"肺降肝升,肺与大肠相表里"等整体观念提出"欲降先升"理论。强调胃肠气机不畅是便秘之本,肝气郁滞是便秘之因,肺气不宣是便秘之基;即欲使大便畅通下行,必先宣通肺气,疏肝解郁,在辨证论治的基础上,结合"上窍开则下窍自通"的理论,加用桔梗、杏仁、枳实、厚朴以起到"下病治上、腑病治脏"之功。     

Anatomical basis of laparoscopic medial‐to‐lateral mobilization of the descending colon

In laparoscopic colorectal resection, the medial‐to‐lateral approach has been largely adopted. This approach can be initiated by the division of either the inferior mesenteric artery (IMA) or the inferior mesenteric vein (IMV). This cadaveric study aimed to establish the feasibility of IMV dissection as the initial landmark of medial‐to‐lateral left colonic mobilization for evaluating the size of the peritoneal window between the IMV at the lower part of the pancreas and the origin of the IMA (IMA‐IMV distance) and the point of origin of the IMA compared to the lower edge of the third part of the duodenum (IMA‐D3 distance). These distances were recorded on 30 fresh cadavers. The IMA‐D3 distance was 0.4 ± 2.2 cm (mean ± SD). The IMA originated from the aorta at the level of or below the D3 in 21 cases (70%). The IMA‐IMV distance was 5.5 ± 1.8 cm and was greater or equal to 5 cm (large window) in 21 cases (70%). IMA‐IMV distance was correlated with IMA‐D3 showing that a large window was inversely correlated with a low IMA origin (P < 0.001). IMA‐D3 distance was not correlated with weight, height and sex. IMA‐IMV distance was largerin male (6.7 ± 0.9 vs. 4.9 ± 1.8, P = 0.001) and correlated with weight, (r = 0.60, 95%CI = 0.03–0.10, P < 0.001) and height (r = 0.54, 95%CI = 0.05–0.21, P = 0.002). IMV can be used as the initial landmark for laparoscopic medial‐to‐lateral dissection in two‐thirds of cases. A too‐small window can require first IMA division. The choice between the two different medial‐to‐lateral approaches could be made by evaluating the anatomical relationship between IMA, IMV, and D3. Clin. Anat., 2013. © 2013 Wiley Periodicals, Inc.