LDT.CD31型超短波治疗机输出小等故障维修

LDT.CD31型落地超短波治疗机是各级医院理疗科常备设备,人们对它的维护和维修已较得心应手.     

1030例胆结石发生部位分析

80年代初国内报道,胆石症以胆管结石为多见。男女性发病率大致相等。我们注意到近年来胆囊结石发病率有明显上升趋势。现将我院1988年以来住院治疗的胆石症病人的发病部位,重点分析报道如下。1 分析与结果3年来共计收治胆石症病人1030例。所有病例均经B超检查证实。右上腹有发作性疼痛或胆绞痛史。发病年龄16～68岁。胆囊结石959例(93.1%),胆管结石71例(6.9%),     

机动门脉动真空灭菌器故障2例

故障现象1灭菌器在正常进行完一个灭菌程序后 ,按开门键 ,门打不开 ,蜂鸣器报警。原理分析机动门脉动真空灭菌器开门的工作原理是 :开门脉冲信号送入可编程控制器C60P输入端的0000脚或0011脚(分别控制后门和前门) ,再由C60P输出端的0506脚和0507脚输出信号 ,分别控制交流接触器CJ和二位五通阀HF ,真空泵起动 ,并使二位五通阀HF处于连通门密封槽和真空泵的位置。真空泵将门密封槽内的空气抽出 ,从而使门密封槽内形成负压 ,门密封条被吸入槽内 ,达到设定时间后 ,真空泵停转 ,C60P的0501脚或0503脚输出信号给J1或J3继电器(分别控制前门和…     

10724例肿瘤患者HBsAg检测结果分析

[目的]探讨常见肿瘤患者的HBV感染现状。[方法]回顾性研究分析2007年1月～2007年12月中国医学科学院肿瘤医院10724例肿瘤患者及4208例健康体检者和469例该院职工的血清HBsAg阳性率,并与全国普通人群比较。总体与样本率的比较采用Z检验;样本间率的比较采用χ2检验。[结果]所有肿瘤患者血清HBsAg阳性率为8.98%（963/10724）,与全国水平（8.57%）相比,差异无统计学意义（Z=1.04,P=0.298）;肝肿瘤和淋巴瘤患者的HBsAg阳性率分别为61.19%（443/724）和13.64%（15/110）,与健康对照组4.38%（205/4677）相比,差异均有统计学意义（χ2分别为1916.05和20.987,P均为0.000）,其优势比（OR）分别为34.39（95%CI：28.022～42.207）和3.444（95%CI：1.963～6.044）。消化道肿瘤组、肺肿瘤组、女性肿瘤组、泌尿肿瘤组、头颈肿瘤组和其他肿瘤组的HBsAg阳性率分别为5.18%、5.61%、4.30%、4.99%、5.63%和5.30%,与健康对照组之间的差异均无统计学意义。[结论]肝肿瘤患者和淋巴瘤患者的HBV感染率较高;HBV感染是原发性肝肿瘤的主要致病因素;HBV感染可能与淋巴瘤的发病相关。     

中西医结合治疗泌尿系结石五十例分析

我们从1980年1月至1985年12月采用中西医结合方法治疗泌尿系阳性结石50例,除4例服药无效改手术治疗外,结石排出者38例,症状缓解、结石下移的8例。现对这50个病例的治疗情况做一回顾,对结石形成的原因及中西医结合治疗的机理,中西医结合治疗应注意的问题等做一简单的探讨分析。一般资料本组共50例,男43例,女7例,年龄最小11岁,最大62岁,平均年龄为43岁。其中肾结石6例(左肾2例,右肾4例),输尿管结石36例(左侧13例,右侧22例,双侧1例),膀胱结石6例,尿道结石2例。肾结石病例中,除1例为鹿角形外,其余5例为圆形和椭圆形,位于肾盂或肾盏内。输尿管结石大都为桑椹形,直径0.3～0.8 cm。膀胱结石为圆形或不规则形。尿道结石为枣核形。从形态和颜色分析,多数结石为草酸钙石,一部分为尿酸石和磷酸钙石,少数为混合石。诊断疼痛,排尿异常,血尿和 X 线照相检查,是诊断泌尿系结石的主要依据。疼痛、血尿、排尿异常和突然尿闭四项中任何     

血清ProGRP、TPS及NSE在小细胞肺癌患者治疗监测中的应用

目的 分析评价血清ProGRP、TPS和NSE在SCLC患者临床诊断和疗效监测中的临床意义.方法 分别采用化学发光法、ELISA法和电化学发光法测定51例SCLC患者(SCLC组,局限期患者36例,广泛期患者15例)、60例肺良性疾病患者(良性疾病对照组)及60名健康人(健康对照组)血清ProGRP、TPS和NSE浓度;分析评价3项指标在SCLC患者治疗前、化疗第1周期和第2周期的变化.结果 局限期SCLC患者治疗前的血清ProGRP、TPS和NSE浓度分别为136.9(22.8～631.7)ng/L、78.2(56.4～114.6)U/L和28.1(20.9～46.1)μg/L;广泛期为1 106.6(41.2～2 161.1)ng/L、230.9(143.5～259.0)U/L和81.1(34.3～140.0)μgL;肺良性疾病组为19.7(9.5～29.1)ng/L、48.7(17.9～95.4)U/L和12.1(1.2～13.9)μg/L;健康对照组为20.3(10.7～30.6)ng/L、50.3(19.5～70.7)U/L和11.7(1.1～13.4)μg/L;经Kruskal-Wallis检验,3项指标在各组间的差异均有统计学意义(x2值分别为51.368、36.532和81.645,P均＜0.01);两个对照组分别与局限期SCLC比较,差异均有统计学意义(U值分别为491、827、609和476、831、585,P均＜0.05);两个对照组分别与广泛期SCLC比较,差异亦有统计学意义(U值分别为314、532、456和302、553、430,P均＜0.01).血清ProGRP诊断SCLC的ROC曲线AUC为0.832±0.029(95%CI:0.774～0.890),以37.7 ng/L为临界值时,其敏感度、特异度、阳性预测值、阴性预测值和约登指数分别为71%(36/51)、97%(116/120)、90%(36/40)、89%(116/131)和67%.联合检测时,ProGRP+TPS+NSE、ProGRP+TPS、ProGRP+NSE和TPS+NSE组合的敏感度分别为92%、86%、92%和88%,特异度分别为77%、77%、92%和77%.经非参数Fridman检验,3项指标在不同治疗阶段的差异均有统计学意义(x2值分别为49.120、10.614和44.392,P均＜0.01).经过连续2个周期化疗后,血清ProGRP浓度持续降低,分别降低至68.0(18.6～158.4)和21.0(14.9～63.5)ng/L,与化疗前组比较,差异均有统计学意义(Z值分别为-4.889、-5.594,P均＜0.01);血清TPS在第1周期化疗结束后升高至105.2(54.1～181.2)U/L,但差异无统计学意义(Z=-1.248,P＞0.05),在第2周期化疗结束后明显降低至79.0(48.7～155.3)U/L,差异有统计学意义(Z=-2.484,P＜0.05);血清NSE在第1周期化疗后迅速降低至11.8(8.0～16.0)μg/L,差异有统计学意义(Z=-5.568,P＜0.01),第2周期化疗后降为10.6(9.0～12.7)μg/L,与第1化疗周期结束后相比,差异无统计学意义(Z=-1.851,P＞0.05).在2个周期化疗后,临床治疗有效的SCLC患者46例(CR 3例,PR 43例),其中3项指标的检测结果全部正常或仅有1项超过临界值的患者为38例(各19例),占83%;3项指标全部异常的患者2例,临床疗效评价均为PD;还有2例临床疗效评价为SD和1例未评价的患者均有2项指标结果异常.结论 血清ProGRP、TPS和NSE均为诊断和监测SCLC治疗疗效的较好的指标,尤其以ProGRP+NSE组合的临床诊断价值最高.联合应用3项指标,有助于SCLC患者的疗效监测和预后判断.

Abstract：

Objective To evaluate the clinical significance of serum levels of ProGRP, TPS and NSE in diagnosis and therapy monitoring in small cell lung cancer patients. Methods The levels of serum ProGRP, TPS and NSE in 51 SCLC patients (SCLC group), 60 benign pulmonary disease patients (benign disease group ) and 60 healthy people (healthy group ) were determined using chemiluminescent immunoassay, ELISA and electrochemiluminescent immunoassay respectively. Blood samples were collected and detected prior to therapy, before the second course of chemotherapy and the third course of chemotherapy consecutively in all the 51 SCLC patients. Results The serum ProGRP, TPS and NSE concentrations prior to chemotherapy in limited stage SCLC (LSCLC) were 136. 9(22.8-631.7)ng/L, 78. 2(56.4-114.6) U/L and 28.1(20.9-46.1)μg/L, respectively; And in extensive stage SCLC patients (ESCLC) were 1 106.6(41.2-2161.1) ng/L, 230. 9( 143.5-259.0) U/L and 81.1 (34.3-140.0)μg/L, respectively. The serum concentrations of the 3 markers in benign disease group were 19. 7 ( 9. 5-29. 1 )ng/L, 48. 7 ( 17.9-95.4) U/L and 12. 1(1.2-13.9) μg/L; and in healthy group were 20.3(10.7-30.6) ng/L, 50.3(19.5-70.7) U/L and 11.7 (1.1-13.4)μg/L, respectively. The Kruskal-Wallis test showed significantly statistical difference in different groups of the 3 tumor markers, Chi-Square were 51. 368,36. 532 and 81. 645( P ＜0. 01 ). Significant statistically differences showed when the concentrations of the 3 marks of the 2 control group were compared with that of the LSCLC group ( U =491, 827, 609 and 476, 831, 585,respectively, P ＜ 0. 05 ). Differences were also statistically significant when the 2 control group compared with that of the ESCLC group ( U = 314,532,456 and 302,553,430, respectively, P ＜ 0. 01 ). The AUC of ProGRP was 0.832 +0.029(95% CI:0.774-0.890). When cutoff value of ProGRP set as 37.7 ng/L, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and Youden's index were 71% (36/51), 97% (116/120), 90% (36/40), 89% ( 116/131 ) and 67%, respectively; show good detection performance. The sensitivity increased to 92%, 86%, 92% and 88%, when combination detection of ProGRP + TPS + NSE, ProGRP + TPS, ProGRP + NSE and TPS + NSE were used, and the specificities were 77%, 77% , 92% and 77% accordingly. The Fridman test showed significantly statistical difference in the 3 tumor markers at different stages of treatment, x2 were 49. 120, 10. 614 and 44. 392, P ＜0. 01. After the first chemotherapy course, all the tumor marker levels except TPS decreased significantly in comparison with the pretreatment concentrations. However, only ProGRP levels showed a progressive drop during the two consecutive courses of therapy, and the median concentrations were 68.0 ( 18. 6-158.4 ) and 21.0( 14. 9-63.5) ng/L (compared to the level before therapy,Z=-4. 889 and -5. 594, P ＜0. 01 ). The median of serum TPS increased slightly to 105.2 (54. 1-181.2 ) U/L after the first chemotherapy course (Z=-1.248, P＞0.05), and decreased significantly to 79.0(48.7-155.3) U/L after the second chemotherapy course (Z=-2.484, P＜0. 05 ). As to the NSE, the median concentration decreased to 11.8(8.0-16.0)μg/L after the first chemotherapy course ( Z= - 5. 568, P ＜ 0. 01 ). However, the median was 10. 6(9.0-12.7)μg/L, which showed no significant decrease after the second chemotherapy course (Z=-1.851, P＞0.05).Forty-six SCLC patients evaluated as clinical remission ( 3 CR and 43 PR) after the second chemotherapy course, among them there were 38 patients (83%) with normal serum ProGRP, TPS and NSE level ( 19 patients) or with only 1 abnormal tumor level ( 19 patients). There were only 2 patients with all abnormal serum ProGRP, TPS and NSE level, and both patients were evaluated as clinical PD. Two patients with 2 abnormal tumors results were classified as SD, the only 1 patient without therapy evaluation also had 2 abnormal tumor marker results. Conclusions The serum ProGRP, TPS and NSE are valuable tumor markers for diagnosis and treat monitoring of SCLC, particularly the ProGRP + NSE shows the highest clinical value. Combing detection of the 3 tumor markers are valuable for therapy monitoring and prognosis in SCLC patients.     

输尿管阴道瘘5例报告

１９９２年５月以来，我院共收治５例因子宫切除术中损伤输尿管致输尿管阴道瘘的患者，经手术６例次治疗获得成功，效果满意，现报告如下。１临床资料本组５例女性，年龄３８岁～５４岁，病程半月～１２年，其中因子宫肌瘤行子宫次全切４例，宫颈癌根治性子宫全切并淋巴结...     

机动门脉动真空灭菌器故障2例

故障现象 1灭菌器在正常进行完一个灭菌程序后,按开门键,门打不开,蜂鸣器报警.     

脊髓型颈椎病术后的康复治疗

对于脊髓型颈椎病的治疗，目前主要运用手术减压、稳定或减压兼稳定三种方法。但长期临床观察发现，术后是否进行康复治疗，对病人的功能恢复影响很大。为验证这一问题，笔者对５４例术后病人，分功能锻炼与综合治疗加功能锻炼两组对照，并进行了追踪调查。现将结果报告如...