生理影像信息技术及其临床应用

生理影像是功能性医学影像的一个重要分支,也是临床医学工程的一个极其重要的研究和应用领域。多年来,作者及其研究生与临床医务人员相结合,在电生理影像和热生理影像的信息获取和数字化处理技术方面进行了大量及深入的研究,提出了一种体内热估计(ITE)新技术。本文重点介绍热生理影像信息在妇女乳腺癌诊断中的应用。通过对约五千例妇女乳腺病筛选的结果,表明了生理影像信息处理及ITE技术在临床医学上的应用价值。     

One hundred and one cases of bronchoplasty for primary lung cancer

The results of 101 consecutive bronchoplasties performed between 1979 and 1993, including 8 cases of pneumonectomy, 88 cases of lobectomy, 3 cases of segmentectomy, and 2 cases of bronchial resection, are herein reported. Squamous cell carcinoma was the most common disease (59%) followed by adenocarcinoma (30%) and other diseases (11%). Anastomosis was satisfactory in 96 cases. Among the five stenosed cases, local recurrence was found in two cases, and there were three benign strictures. Two of the three benign strictures were treated with bouginage. The pulmonary artery was concomitantly reconstructed in seven cases with satisfactory results. Preoperative chemoradiotherapy was performed in 15 advanced cases and was followed by acceptable surgical results. The 5-year survival rate, according to the post-operative staging of the 86 patients without induction therapy, was 86% in stage I (19 patients), 49% in stage II (21 patients), and 27% in stage IIIA (40 patients). The overall survival rate was 46% at 5 years. There were two indications for this procedure i.e., a positive resection margin in 59 cases and positive hilar nodes in 42 cases. Better survival was noted in patients with squamous cell carcinoma, stage I, and surgery was thus selected for a positive resection margin, and not for a positive node.     

筋膜内子宫切除术86例临床分析

目的：报告筋膜内子宫全切术的方法及优点。方法：统计分析８６例筋膜内子宫全切与同期８０例子宫全切两组病人手术时间、术中出血、术后性功能、阴道脱垂情况进行对照。结果：筋膜内子宫全切术的手术时间及术中出血量均较子宫全切术明显减少,前者由于保留了宫颈外口及阴道的完整性,术后无１例阴道脱垂且性生活影响较小,结论：提倡对每例患者行子宫切除宫颈去留都应权衡利弊,以提高手术满意度和术后生活质量。     

异丙酚复合芬太尼维持麻醉对脑代谢的影响

观察异丙酚复合芬太尼维持麻醉对脑代谢的影响。方法： 择期手术病人８ 例, 芬太尼、硫贲妥钠、维库溴铵诱导插管, 静脉联接Ｇｒａｓｅｂｙ 微泵异丙酚８ ｍｇ／ （ｋｇ·ｈ） , 芬太尼１ μｇ／ （ｋｇ·ｈ）维持麻醉。连续监测ＭＡＰ、心电图、脉搏氧饱和度和呼气末二氧化碳分压, 同步采集动脉血和颈内静脉血作血气分析, 计算动－ 静脉氧含量差（Ｄａ － ｖＯ２） 和脑氧摄取率（ＥＲＯ２） 。结果： 异丙酚麻醉维持平稳, Ｄａ － ｖＯ２ 和ＥＲＯ２ 在给药３０ ｍｉｎ 、６０ ｍｉｎ 较气管插管后５ ｍｉｎ 无明显改变, 有平均动脉压下降和心动过缓。结论： 异丙酚复合芬太尼维持麻醉可保持脑氧供需平衡稳定。     

同种异体肾移植手术2种麻醉方法的效果比较

目的　比较同种异体肾移植手术椎管内阻滞和静吸复合全麻的优缺点。方法　回顾性分析 2 0 0 3年 1— 8月我院器官移植中心所做的同种异体肾移植手术的麻醉 ,对符合条件的 38例患者进行比较。结果　 2组间比较ASA分级 ,术中输液量 ,移植肾血流开放前收缩压、舒张压、心率、麻醉并发症 (仅包括硬膜外血肿或心功能衰竭 )和移植肾存活率无显著性差异 ,体质量和ICU停留时间有显著性差异 ,静吸复合全麻组比椎管内阻滞组体质量更重 ,ICU停留时间更长。结论　椎管内阻滞有时不能满足手术要求 ,能满足手术要求的椎管内阻滞 ,手术结束后循环功能较稳定 ,烦躁不安少见 ,手术后恢复较快 ;静吸复合全麻能更好地满足手术要求 ,尤其是体质量较大的患者 ,但在拔出气管导管前后可能引起血流动力学剧烈波动 ,甚至心功能衰竭 ,手术后恢复较慢     

130例取环诊刮子宫内膜病理诊断分析

目的探讨宫内节育环（IUD）合并子宫异常出血的子宫内膜病理改变情况。方法对2003年1月至2004年12月在本院妇科门诊就诊的130例IUD合并子宫异常出血患者，取环诊刮后的子宫内膜病理诊断进行回顾性分析，并随机抽取120例未置环、年龄相仿在本院同期因不规则阴道出血诊刮的子宫内膜病理结果进行对比分析。结果130例IUD合并子宫异常出血患者的病理结果：子宫内膜炎83例，占63．85％；子宫内膜息肉32例，占24．61％；子宫内膜发育异常者15例，占11．54％。120例未置环异常出血患者的病理结果：子宫内膜炎12例。占10％；子宫内膜发育异常72例，占60％；子宫内膜息肉31例，占25．83％；恶性肿瘤5例，占4．17％。结论IUD合并子宫异常出血内膜的主要病理改变以子宫内膜炎为主，而子宫内膜息肉、子宫内膜发育异常次之，未置环合并子宫异常出血内膜的主要病理改变以子宫内膜发育异常为主，而子宫内膜息肉、子宫内膜炎、恶性肿瘤次之。提示：IUD合并子宫异常出血的临床治疗应注意对因治疗。     

天人相应-整体观与老年病

老年病体质特点包括脏腑失养、精血亏虚;心肝血虚、神气不足;肺脾气弱、正气内虚等。"天人相应,整体相关;因人施治,因地制宜;内外相顾,动静结合;重视情志,强调气机"中医疗法与现代医学对老年病的多学科治疗。     

医院内外感染葡萄球菌的耐药性分析

目的分析医院内与院外感染葡萄球菌的耐药性,为临床用药提供依据。方法收集2011年1月至2013年12月黄石市中心医院门诊(院外)、住院(院内)患者各种标本中分离的454株葡萄球菌,用VITEK-32专用卡GPI及血浆凝固酶试验进行鉴定,药敏试验按K-B琼脂扩散法进行,根据美国临床和实验室标准化协会2006对头孢西丁的耐药情况进行分类分析,数据分析用WHONET 5.5药敏分析软件。结果在379株金黄色葡萄球菌(SA)中,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为41.2%,医院内、外标本MRSA检出率分别为44.1%和19.6%,差异有统计学意义(P0.05);共检出凝固酶阴性葡萄球菌75株,医院内、外标本耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率分别为61.1%和38.1%,差异有统计学意义(P0.05)。未检出万古霉素、替考拉宁耐药菌株。结论耐甲氧西林葡萄球菌具有多重耐药性;院外SA感染者首选药物为庆大霉素、苯唑西林;若为院内SA和对于MRCNS引起的不论是院内或院外感染,均推荐首选万古霉素或替考拉宁。     

The psychological sequelae of thermal injury on children and adolescents: Part 1

The psychological effects of thermal injury and children and their mothers were investigated in a three-part study; Part 1 is concerned with group comparisons regarding the psychological effects of thermal injury on children; Part 2 with aspects of the thermally injured group and Part 3 with psychological effects on their mothers. A total of 44 thermally injured (aged 11–16 years) injured 3–14 years previously, were matched according to age, sex, burn percentage and site of injury. In-depth interviewing and questionnaire responses on measures of psychological disturbance indicated that thermally injured children were differentiated in terms of psychopathology from matched Fracture Controls and Normal Controls. Such differences embraced many aspects of social and recreational functioning, and group differences emphasised depression, anxiety (particularly situational anxiety) and anti-social disorder as being particularly prominent in the thermally injured group. Therapeutic approaches are briefly discussed.     

A SIX-CENTRE INTERNATIONAL STUDY OF THE OUTCOME OF TREATMENT IN PATIENTS WITH CLEFTS OF THE LIP AND PALATE: THE RESULTS OF A CROSS-LINGUISTIC INVESTIGATION OF CLEFT PALATE SPEECH

During the period 1964–73, 286 patients were treated for mandibular fractures. 229 patients (80%) attended the follow-up examination. The length of observation was from 1 to 9 years. The treatment and the follow-up evaluations in the 229 patients are described. Early fracture treatment has been the objective, also in patients who have undergone severe cerebral traumas. Antibiotic prophylaxis was implemented in cases of compound fractures. Preservation of teeth and tooth buds in the line of fracture was attempted. Clinical infection occurred in 0.4% of the patients. At the follow-up examination 1 patient presented with a fracture displacement outside the condylar process. Neither malocclusion nor pseudarthrosis following fracture or after treatment were seen. Permanent sensory disturbances in the innervation area of the mental nerve following fracture occurred in 8%. Radiological examination of the teeth in the line of fracture revealed unnoticed apical bone lesions in 17% of 118 patients. In a further 23% there was a negative response to the vitality test. Follow-up control of mandibular fractures is advised at 12 to 18 months after treatment.