综合性放射防护措施在介入治疗防护中的应用价值分析

目的分析综合性放射防护措施在介入治疗防护的应用价值。方法选择郴州市疾病预防控制中心检测的6台介入治疗机为研究对象,对其进行综合性放射防护,监测X射线辐射剂量。结果铅防护服防护效率为88.28%,床下铅橡胶帘防护效率为87.57%,铅玻璃防护屏防护效率为93.27%,三种放射防护器材X线辐射剂量均下降(P0.05);距离球管2m处辐射剂量衰减量为69.26%,3m处辐射剂量衰减量为97.63%,1-2m之间,2-3m之间辐射剂量差异有统计学意义(P0.05)。结论综合性放射防护措施对于介入治疗的医务人员有积极作用,可有效减少X射线对医务人员的辐射,降低对医务人员身体伤害。     

放射防护在导管室介入治疗中的应用价值

目的探讨与分析导管室介入治疗中采用放射防护措施干预的影响及价值。方法从包头市某医院2017年2月至2018年2月接收的需要行介入治疗的患者中,随机抽取114例患者,介入治疗中采用穿戴铅防护服、铅玻璃防护屏、床下铅橡胶帘以及增加与球管之间的距离等防护措施进行防护。对比放射防护前后辐射剂量情况以及不同距离处辐射剂量情况。结果放射防护后,三种放射防护器材X线辐射剂量均低于放射防护前,距离球管3m处时放射剂量低于2m、1m处;比较结果有统计学意义(P0.05)。结论放射防护措施能够减少介入治疗时对患者及医务人员的辐射,极大的减少了X线辐射的剂量,临床价值较高,值得推广使用。     

放射防护在导管室介入治疗中的应用价值

目的探讨放射防护在导管室介入治疗中的应用价值。方法选取2018年1月至2019年1月在本院接受介入治疗的90例患者为研究目标,其中在2018年1月至6月未实施放射防护,在2018年7月至2019年1月在介入治疗中实施放射防护,评定实施前后辐射剂量和不同距离处辐射剂量的情况。结果实施后各种放射防护器材的X线辐射剂量均低于实施前差异有统计学意义(P0.05);距离球管1m处与距离球管2m处进行比较发现,差异有统计学意义(P0.05);距离球管2m处与距离球管3m处进行比较发现,差异有统计学意义(P0.05)。结论在导管室介入治疗中合理应用放射防护,可以有效减少介入治疗对患者以及医务人员的辐射,降低X线辐射的剂量以及对患者身体健康的损伤。     

浅谈儿童上肢骨折手法复位术中X线防护

目的减少上肢骨折手法复位术中儿童的X线辐射。方法运用铅橡皮覆盖身体来采取屏蔽防护措施;尽量减少X射线的曝光时间及曝光次数来减少患儿X线的照射量。结果通过对儿童非手术部位进行屏蔽防护及采取时间防护,降低了X线辐射对儿童的危害。结论儿童对X射线具有更高的敏感性和更大的潜在危害,必须加强对儿童的辐射防护。     

铅单围蔽式防护减少X线对非检部位辐射危害的研究

目的探讨在X线检查中非检部位防护的重要性,减少非检部位X线辐射危害。方法使用移动式0.6 mm铅当量橡胶复合软质铅单在X线检查中对非检部位进行管状围蔽式防护以减少X线辐射的危害。结果使用移动式0.6 mm铅当量橡胶复合软质铅单具有很强的防辐射能力,能阻挡X射线、γ射线、C射线对非检部位的辐射。结论使用移动式0.6 mm铅当量橡胶复合软质铅单在X线检查中对非检部位进行管状围蔽式防护可以很大程度减少射线对被检者辐射的危害,是X线防护用品中又一更新、更好、更简单防护品,具有很好的防护作用。     

Brilliance 16 CT机房的辐射防护设计与分析

目的设计符合国家标准的Brilliance 16 CT机房,以有效防护X射线辐射对工作人员的危害。方法首先,通过公式计算出机房墙体屏蔽厚度应为4 mm铅当量,天花屏蔽厚度应为3 mm铅当量,然后根据计算结果及理论分析分别设计机房四周墙体、天花、防护门、观察窗和通风系统的结构。结果分别在观察窗、控制门、机房大门、候诊区、控制室5个监测点进行γ辐射剂量率监测,计算出的工作人员年均有效照射剂量最大值约为0.0044 m Sv,远低于20 m Sv的国家标准。结论研究设计的Brilliance 16 CT机房能有效防护X射线辐射,保护工作人员安全。     

部分介入放射X射线机的辐射防护性能检测与分析

目的探讨开封市疾病预防控制中心部分介入放射X射线机的辐射防护性能。方法通过国产25 cm×25 cm×15 cm水模体、451B型低能Xγ剂量率仪和Baracuda X射线质量控制检测仪对开封市疾病预防控制中心普通X射线机、C型臂X射线机空气比稀动能率进行检测。结果X射线源组件泄漏辐射水平平均值为(34.46±4.52)μGy/h,2号机与3号机X射线源组件泄漏辐射平均值高于其他设备,可能与设备使用年限具有一定相关性;6台受检设备防护区空气比稀动能率平均值为1.68×10~2μGy/h,C型臂X射线机防护区空气比稀动能率平均值为1.29×10~2μGy/h,未采取防护措施状态下空气比稀动能率为0.4×10~3~1.6×10~3μGy/h,采用铅屏风进行防护后空气比稀动能率为0.3×10~2~3.5×10~2μGy/h,各组数据与普通X射线机比较,差异有统计学意义(P<0.05)。结论与普通透视模式相比,脉冲透视模式中空气比稀动能率和有用线束输出量水平较低,且X射线源组件泄漏辐射水平与设备使用年限具有一定相关性。     

甲状腺癌131I清甲治疗病房环境辐射安全性探讨

目的 监测大剂量131I治疗后病房及病区内环境γ射线的辐射剂量率水平,评价医疗活动过程的辐射安全性,明确大剂量131I治疗后对环境的影响.方法 分别用γ辐射仪测量的17次患者治疗后24 h病房内距离患者1 m处及病区环境的γ辐射剂量率水平.结果 γ辐射仪测得的病房内距离患者1 m处γ辐射剂量率水平最大为21.71 μSv/h,根据我国<电离辐射防护与辐射源安全基本标准>计算,笔者所在科室工作人员每日可在此辐射环境下工作3.8小时;病区环境中走廊剂量率水平最大为0.58μSv/h,计算得一般公众每日可在此辐射环境下停留7.17小时.结论 实施大剂量131I治疗后,采取恰当防护措施,完全能保证核医学科工作者处于电离辐射容许剂量范围之内,病区环境电离辐射水平相对安全.     

X线管球防护改进

我院使用西南医用设备厂KG—400型双管球X线机,于一九七八年十二月经省工业卫生科测量X射线、卧位胃肠点片时,使用条件:80千伏,100毫安,1秒,床侧工作人员接受X线可达8.000～10.000毫伦/小时,超过允许剂量的几十至一百多倍,我们分别在透视和照相球管窗口处按装2毫米厚的“古钱式铅板”和“集散器”,使无用的和有害的X射线减少80％左右,而有用射线的“质”明显提高,改善了安全防护效能,经过X射线量测定、卧位点片(条件同上)接受X线下降至80     

手术室C形臂间医护人员的X线防护

目的探讨手术室骨科C形臂手术间的放射防护方法,评价其防护效果。方法在手术室内推广普及放射防护知识,且在介入性检查和治疗中分别采用床下和床上球管工作式,利用个人剂量仪测量射线剂量。结果采用床下球管工作,适当的增加距离可明显减少受辐射剂量。结论手术室介入性诊疗中采用多种防护措施,可有效减少射线量,保护医护人员的身体健康。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.