医疗设备维护管理信息系统的开发与研究

本文基于C Builder和SQLServer开发平台,介绍了设备维护管理信息系统的开发设计,实施及应用拓展,为医院对医疗设备的维护管理及科学决策作出积极探索。     

钠摄入量对心力衰竭大鼠心脏肾素-血管紧张素系统与心钠素的影响

目的　观察钠摄入量对心力衰竭大鼠心脏局部肾素-血管紧张素系统与心钠素的影响 .方法　经动 -静脉分流术造成大鼠充血性心衰模型 ,分为心衰组、心衰限钠组、心衰补钠组 ,假手术大鼠为对照组 ,用放射免疫分析法和原位杂交技术分别测定各组血浆和心肌血管紧张素 、心钠素含量及心肌血管紧张素原 m RNA表达水平 (吸光度 A值 ) ,同时检测心功能 .结果　心衰限钠组心房和心室血管紧张素 含量(2 0 .1± 4 .5 )和 (2 7.3± 5 .9) ng· g- 1、血管紧张素原 m RNA表达 (6 .4± 1.2 )和 (12 .6± 2 .3)显著高于心衰组 (17.5± 3.6 )和 (2 0 .1± 3.7) ng· g- 1 ,(6 .2± 1.9)和 (8.6± 1.7) (P<0 .0 5 ,P<0 .0 1) ,心室心钠素 (42 3± 6 8) ng· g- 1 也显著高于心衰组 (337± 86 ) ng· g- 1 (P<0 .0 5 ) ,心房心钠素 (6 7± 19)μg· g- 1显著低于心衰组 (85± 15 ) μg· g- 1 (P<0 .0 5 ) ;心衰补钠组心房和心室血管紧张素原 m RNA表达水平、心室血管紧张素 和心钠素与心衰组无显著差别 ,心房血管紧张素 与对照组无显著差别 ,心房心钠素 (10 1± 17) μg· g- 1 显著高于心衰组 (P<0 .0 1) .结论　心衰时不同钠摄入量可通过改变心脏局部肾素 -血管紧张素系统与心钠素的平衡状态在心衰发展进程中发挥作用     

经鼻垂体瘤68例切除及CT、MRI、神经导航分析

目的：探讨垂体瘤的治疗方法。方法：使用显微镜结合CT、MRI及神经导航系统行经鼻蝶手术。结果：68例病人无一人死亡，其中尿崩为7％左右，且为一过性，复发2例。结论：熟知局部解剖，利用CT、MRI及导航技术，不断提高手术技巧，有助于进一步降低经蝶垂体瘤手术并发症的发生。     

病房医生工作站信息系统的功能与应用

病房医生工作站面向病房临床医生，实现了医生日常工作的各种需求，提供填写首页、下达医嘱、书写病历、开申请单、查询报告单、查询体温单、病历检索等功能。系统的应用可以规范医疗文书，减少差错发生，提高工作效率，培养医师的临床工作经验。     

临床神经电生理学专业的现状及思考

目的：调查河南省中华医学会临床神经电生理专科学会的现状及存在问题。探讨解决存在问题的措施。方法：采用分层抽样与整体抽样对84个医疗单位242人进行信访调查，并对资料完整的225人（92．97％）进行分析。结果：男60人，女165人。年龄平均32．8岁。本科学历15．6％，无学历6．6％。高级职称9．3％，无职称5．4％。已专业培训49．3％，未专业培训50．7％。结论：我省临床神经电生理专业发展迅速，但技术人员新，学历、职称偏低，且49．3％的人员未经正规专业培训，人才出现断层，发展后劲不足。因此，采取技术人员许可证制度——执证上岗，有计划的培养高素质的技术人员是当务之急。     

Safe anesthesia for endoscopic laryngeal laser surgery

Anesthesia safety for endoscopic laryngeal laser surgery has been a major limiting factor for laser applications in the larynx and the hypopharynx. Several anesthesia techniques have been proposed and each technique appears to have its own limitations. This paper will deal with the distinct advantages offered by the malleable copper tube which is used for delivery of the open Venturi system anesthesia for endoscopic laser surgery. A retrospective study of 100 patients who have undergone this modality of anesthesia at our institution will be presented. Our conclusion from this study shows clearly the superiority of the copper tube over the conventional aluminium-foil-wrapped endotracheal tube in safety and the exposure of the larynx during surgery.     

医院信息系统变更的主要原因及对策

目的本文以医院信息系统（hispitalinformation system，HIS）系统实施的一般规律为例，讨论了HIS系统实施的一般规律，深入探讨了范围变更产生的原因、接受依据以及管理技术，对于HIS系统实施中最常发生的范围变更管理提出了对策，以使医院业务与HIS软件系统有机会结合在一起，真正实现医院业务信息化的目标。方法文章认为，系统范围变更管理应贯穿于系统实施过程的始终，每一项需求变更都应分析其产生的原因、对医院业务的影响和对系统实施的影响，以确定是否接受范围变更。结果当决定接受或拒绝范围变更申请时，信息科都应与提供产品公司的实施工程师沟通。结论在范围变更管理中，要充分使用好文档模板，并制定出规范的范围变更管理流程，以提高范围变更管理效率。     

MANAGEMENT OF UNCONTROLLED GLAUCOMA WITH THE MOLTENO SYSTEM

In glaucomatous eyes refractory to medication, laser techniques and conventional drainage surgery, intraocular pressure is often high, and visual loss rapid. In this situation a reliable, robust artificial outflow system is required. Molteno has evolved a plastic tube and plate device combined with a fibrosis suppression medication regimen. Thirty-eight eyes of 32 patients with uncontrolled glaucoma were treated with the Molteno system. Six months after operation mean intraocular pressure had been reduced from 41.0 ± 13.6 to 16.2 ± 5.6 mmHg. Eighteen eyes had pressures of 20 mmHg or less on no hypotensive therapy, 17 on reduced treatment. Three eyes had a pressure of 21 to 35 mmHg on treatment at six months. The 13 aphakic eyes responded as well as 25 phakic eyes. Five eyes with rubeotic glaucoma demonstrated pressures of less than 20 mmHg without therapy, four eyes with traumatic glaucoma required continuing medication with three having pressures below 22 mmHg. Of the seven eyes with uveitic glaucoma, one was lost, two required maintenance therapy; five of six surviving eyes had pressures below 20 mmHg. Fifteen eyes with congenital or juvenile glaucoma achieved pressures below 20 mmHg, three of these with timolol drops, three with timolol and acetazolamide, and nine with no treatment. While seven of seven eyes with refractory primary open-angle glaucoma attained pressures below 20 mmHg. all seven needed continuing mild hypotensive therapy. Eleven eyes underwent a one-stage procedure, while 27 eyes required a two-stage operation. Twenty-eight eyes received fibrosis suppression medication after the second stage, and 24 maintained or improved their preoperative visual acuity. Results have been encouraging: in general the Molteno system is recommended as the second drainage operation in all glaucomatous eyes in which conventional therapy has failed, and as the primary surgical procedure (after laser techniques) in eyes with rubeotic and uveitic glaucoma. Ciliary body destructive procedures should be restricted to control of symptoms in blind eyes.     

橄榄油对单核吞噬细胞系统的影响

本文采用橄榄油皮下注射、观察其对小鼠腹腔单核吞噬细胞的游出、活化及吞噬功能。结果发现、橄榄油对上述功能均有明显的抑制作。     

Detection of proteinous toxins using the Bio-Threat Alert system, part 3: effects of heat pretreatment and interfering substances

We previously reported that the Guardian Bio-Threat Alert (BTA) system could detect (detection limit: about 0.1 μg/ml) staphylococcal enterotoxin B (SEB), botulinum toxins (BTX) A and B, and ricin, with no interference by white-powdered materials or colored matrices. In this study, the capability of the BTA system was further assessed. With 10 min of preheating at 60°C, all toxins could be detected, but with preheating at 80°C, BTX A and B and ricin became undetectable. About 20% SEB could be detected after heating at 80°C, but this detection ability was completely removed after heating at 100°C. The effects of chemicals usually used for decontamination, such as sodium hypochlorite, hydrogen peroxide, formaldehyde, and sodium nitrite, on the detectability of SEB, BTX A, or ricin in the BTA system were also tested. The concentrations giving 50% line intensity for SEB, BTX A, and ricin were 3.1, 11, and 15 μM for sodium hypochlorite and 88, 210, and 60 mM for formaldehyde, respectively. The addition of hydrogen peroxide or sodium nitrite did not decrease the detectability even when used at high concentrations.