海南医改：破题政事分开

从成立国内首家医院评鉴暨医疗质量监管中心的政事分开变革，到率先提出具有创新思维的本省医改草案以响应国家医改，海南医改在过去一年间，划出了亮丽的轨迹。     

加强少数民族地区产科病房管理预防医院感染

我院住院患者>90%都是少数民族,陪护及探视人员较多,做好产科病房的管理预防医院感染是医院管理的一项重要工作,不仅有助于保障产妇、新生儿健康,也能保护医护人员免受伤害,因此,应加强产科病房的管理,预防医院感染.     

六安市人民医院建院60周年巡礼

巍巍大别山在欢呼．悠悠淠河水在歌唱，欢呼人民医院建院60年华诞，歌唱医院的明天灿烂辉煌。在全国人民满怀豪情迎接共和国60岁生日到来的前夕，六安市人民医院迎来了建院60周年。在这一喜庆的时候，医院相继举办了系列活动庆祝60年院庆，回顾60年创业艰辛，展现医院发展成就，彰显白衣天使的风采。     

翼状胬肉旋转撕脱联合自体角膜缘干细胞移植的临床研究

目的为减少胬肉术后复发，使手术更简便安全而寻找一种理想手术方式。方法对70例（77眼）原发性翼状胬肉患者施行改良的旋转撕脱法胬肉切除联合自体角膜缘干细胞移植术治疗。结果术后随访6～12个月，70例移植片全部存活，仅1例复发（1．3％），无其他并发症。结论运用改良的旋转撕脱法胬肉切除联合自体角膜缘干细胞移植术治疗翼状胬肉，使手术操作更简便安全易行，胬肉切除更干净彻底，角膜损伤小，上皮愈合时间短，取材方便，无排斥反应，术后胬肉复发率低。     

PET/CT在评价及观察大鼠肺癌放疗效果中的应用

Objective The aim of this study was to understand the role of PET/CT in monitoring the therapeutic effect of radiotherapy (RT) on lung cancer with Wistar rats. Methods Thirty Wistar in-bred strain rats (6-8 weeks, weighed 180-280 g, female, ordinary) were made into Lewis pulmonary tumor model rats. 18F-fluorodeoxyglucose (FDG) PET/CT was performed when tumor reached 1.5-2.0 cm in greatest diameter (4-6 weeks) as a baseline. In order to get the optimal time point of PET/CT for moni-toring RT effect in rat cancer model, PET/CT was performed at the 3rd day, 1st, 2nd, 3rd, and 4th week after giving single dose of 5 Gy to each rat. Standardized uptake values (SUV) from FDG PET were measured and rats were sacrificed at different time point for validation. Besides, the expressions of glucose transport1 (Glut1) in tumor tissue were studied using immunohistochemistry. The level of tumor cell apoptosis, degra-dation, and necrosis were observed. SPSS 11.0 software was used for data analyses. Results A negative correlation of SUV uptake and time after RT and negative correlation of Glut1 expression and time after RT were observed in rat tumors, respectively. Positive correlation of SUV uptake and Glut1 expression in rat tumors was observed (Spearman rank correlation test, rs = 0.97, P < 0.01). Before RT, the SUV in rat tumor was 1.28 ± 0.31 and was decrease to 1. 00 ± 0.23 at the 3rd day and 0.18 ± 0. 10 at the 4th week after RT (F=15. 126, P<0.05). Before RT, the Glut1 in rat tumor was 0.2558 ±0.03 and was decrease to 0. 2320 ± 0. 01 at the 3rd day and 0. 1320±0.04 at the 4th week after RT. The amounts of tumor cell apopto-sis, degradation, and necrosis increased with time after RT. Conclusion Though FDG PET could monitor the therapeutic effect at the 3rd day after giving single dose of RT to rat lung tumor model, the optimal time was the the 4th week after treatment.     

64层螺旋CT血管成像技术对主动脉夹层动脉瘤的诊断价值

目的:评价64层螺旋CT对主动脉夹层的价值及优势。方法:本组增强扫描对比剂为Omnipaque,浓度为350mgI/ml,剂量为100ml。注射速率为4ml/s,扫描延迟时间为25~30s。将扫描原始数据重建成0.625mm的横断面图像,然后传送至AW4.2高级图像处理工作站,分别进行VR、MPR、MIP重建。结果:①11例患者的血管成像扫描时间为7~10s;②De BackeyⅠ型主动脉夹层3例,De BackeyⅢ型8例;③11例患者在VR、MPR重建图像上均清晰显示出升主动脉、主动脉弓、降主动脉、腹主动脉、双侧髂总动脉、双侧髂内外动脉以及腹腔动脉干、肠系膜上动脉、双侧肾动脉主要分支的血管,图像清晰,血管对比明显,血管边缘无阶梯状改变;④11例患者均能清晰显示主动脉夹层的开口、范围及内膜瓣的情况;⑤3例肠系膜上动脉有不同程度的狭窄;2例患者肠系膜上动脉有夹层表现;5例患者一侧肾动脉有不同程度的狭窄,其中1例伴明显肾血供障碍;⑥11例患者均可以清晰显示真、假腔,4例患者假腔内有不同程度的血栓形成;⑦1例主动脉夹层患者经内支架置入术后,支架膨胀良好,其位置大小形态良好,原内膜破口被封闭,无渗漏现象,假腔内完全血栓形成。结论:64层螺旋CT血管成像技术可以在无创或微创的情况下清晰地显示主动脉夹层及主要分支血管的改变,为临床的诊断和治疗提供有价值的依据。     

超声显像对胎盘后血肿、胎盘血肿与胎盘瘀血的鉴别

胎盘有母、胎双重循环,母循环障碍可引起胎盘循环障碍,底蜕膜血肿,亦称胎盘后血肿.子循环障碍引起的羊膜下血肿系绒毛血管破裂所致,此应为胎盘血肿.而下腔静脉阻塞导致子宫静脉回流受阻,所致胎盘绒毛血管内淤血,我们称之为胎盘淤血,B超图像各异,鉴别如下.     

心肌梗死患者的急救护理管理

临床观察发现，心肌梗死（actue myccardial infarction，AMI）患者猝死时间常发生在发病1周内，并以2h内为最常见。AMI作为内科重症之重，抢救是否成功与能否及早确诊、迅速有效抢救、医疗条件及患者心肌梗死的范围等密切相关。为提高AMI患者的急救成功率，减少和预防各种不良因素的发生，我科结合医院管理年的主要工作目标，加强对AMI患者的急救护理管理，现报道如下。     

武警部队2007年继续医学教育试题卡（二）

近日，武警总医院首批招收的5名临床医学博士后研究人员分别通过相关专业学科专家组的考核验收，圆满完成了科研课题工作任务，领到了全国博士后管理委员会签发的《博士后证书》，标志着武警部队培养的首批博士后顺利出站。