我国医疗器械面临的市场机遇和竞争压力

本文介绍了我国医疗器械行业良好的增长形势,展示了我国医疗器械广阔的市场机遇,指出了国产医疗器械存在的竞争压力。     

Guidewire-Controlled Advancement of the Amplatz Thrombectomy Device

The Amplatz Thrombectomy Device (ATD) is a percutaneous rotational catheter proven to homogenize thrombus. The catheter design allows neither application over a coaxial running guidewire nor the use of the device as a monorail system. We report a technical modification that provides guided advancement of the catheter over a wire in order to prevent failure of application and to facilitate the interventional procedure. Received: 0/00/00/Accepted: 0/00/00     

Piggy-back pacing: implantation of pacemaker and defibrillator on top of each other.

Following the publication of several landmark trials, there has been a significant increase in the cardiac device implantation. Within this population there are a number of patients who have pre-existing cardiac devices that have been placed for a number of different conditions. While the usual approach is to remove the existing unit and replace it with a new device with the removal or capping of existing lead systems, this practice often sacrifices an existing unit that still possesses good battery longevity. We explored the possibility of separating the pacing and defibrillating functions by implanting a new device on the top of the old device in a 'piggy-back fashion'. We report a series of four cases (with various indications) with differing combinations of devices. The procedure was performed safely in every one of them, and no device-device interaction was noted. Combining the new with existing units in a 'piggy-back' manner may be a safe and cost-effective technique in the selected cases.     

医学影像诊断设备网络化在放射科管理中的应用探讨

目的:试探讨实现医学影像诊断设备网络化对提高放射科质量的重要性及实用性。材料和方法:CT、MRI、Sun Advantage Windows(简称AW)2.0工作站连接成医学数字影像传输(DICOM)网络;DICOM服务器与各图像浏览及诊断报告书写终端连接成Ethernet网络;二者再通过集线器连接成PACS。结果:应用PACS技术,实现数字化图像在医学影像诊断设备网络化内的传送,中心存储,在DICOM 3.0标准水平的相互兼容图像交流以及诊断的报告的规范化、计算机化、实现无胶片管理医院。结论:实现医学影像诊断设备网络化提高了工作效率和管理水平,具广阔的应用前景。     

Technical issues and new devices of ESD of early gastric cancer

Endoscopic submucosal dissection(ESD) is a highly refined technique compared to conventional endoscopic mucosal resection.It enables complete resection of early gastric cancer(EGC) which has no possibility of lymph node metastasis.Indication for ESD of EGC generally entails early gastric cancer confined to the mucosa with well differentiated histology,though there are clinically suitable expanded criteria.As ESD requires specific skill and expertise,endoscopists need to be familiarized with basic methods an...     

Residual VSD Closure with an ADO II Device in an Infant

Postoperative residual ventricular septal defects (VSDs) are often percutaneously closed using septal occluder devices. However, their use is not advisable in small infants, because of poor outcome. We describe the successful device closure of a residual muscular VSD with an Amplatzer Duct Occluder II (ADO II) device in a child weighing 4.5 kg. It appears that ADO II may be the preferable device for the closure of moderate defects in infants and small children because of its lower profile and trackability.     

Unusual Right‐to‐Left Shunt by Single‐Sided Bilateral Inferior Vena Cava

Anomalous drainage of an inferior vena cava to the left atrium is a rare congenital cardiac anomaly that might lead to significant clinical implications. This report describes a 21‐year‐old male with an anomalous connection between one part of a single sided double inferior vena cava and the left atrium documented with cardiac imaging, including angiography. This rare congenital disorder should be considered in the differential diagnosis in patients with cyanosis and/or a history of paradoxical embolism. Interventional catheterization was the chosen method of intervention.     

A compact mock circulation loop for the in vitro testing of cardiovascular devices

In vitro cardiovascular device performance evaluation in a mock circulation loop (MCL) is a necessary step prior to in vivo testing. A MCL that accurately represents the physiology of the cardiovascular system accelerates the assessment of the device's ability to treat pathological conditions. To serve this purpose, a compact MCL measuring 600 × 600 × 600 mm (L × W × H) was constructed in conjunction with a computer mathematical simulation. This approach allowed the effective selection of physical loop characteristics, such as pneumatic drive parameters, to create pressure and flow, and pipe dimensions to replicate the resistance, compliance, and fluid inertia of the native cardiovascular system. The resulting five-element MCL reproduced the physiological hemodynamics of a healthy and failing heart by altering ventricle contractility, vascular resistance/compliance, heart rate, and vascular volume. The effects of interpatient anatomical variability, such as septal defects and valvular disease, were also assessed. Cardiovascular hemodynamic pressures (arterial, venous, atrial, ventricular), flows (systemic, bronchial, pulmonary), and volumes (ventricular, stroke) were analyzed in real time. The objective of this study is to describe the developmental stages of the compact MCL and demonstrate its value as a research tool for the accelerated development of cardiovascular devices.     

广东省骨科植入物不良事件调查分析

目的总结广东省部分医院骨科植入物不良事件发生率及其特点。方法对2008年广东省七家医院涉及骨科植入物的全部病例进行筛查,对发现的126例可疑不良事件进行统计分析。结果七家医院2008年骨科植入物可疑不良事件总发生率为5．87％,其中第一次入院病例发生率（2．43％）远小于第二次入院病例发生率（16．51％）,脊柱内固定物不良事件发生率较高,其余植入物不良事件发生率无明显差异。植入物断裂、松动、变形及感染是可疑不良事件最常见表现（69％）,植入物材料因素和设计因素是导致不良事件的主要原因（72．22％）。结论临床上对骨科植入物不良事件存在大量的漏报现象,需要加强骨科植入物不良事件监测工作。