医疗设备维修信息化管理系统的构建和设计

信息化管理系统的构建是时代发展的必然产物,可为人们提供高效的管理工作.为了提升医疗设备维修管理的工作效率,构建信息化管理系统可逐渐实现医疗设备的科学化管理工作,持续推动医院现代化发展.鉴于此,该文提出应依据计算机技术、大数据技术以及信息技术等构建信息化管理系统,利用该系统实现医院现阶段医疗设备维修的高效管理,并对设计的...     

针刺加氦-氖激光穴位照射治疗周围性面瘫76例

采用针刺加氦－氖（He－Ne）激光穴位照射治疗对我科近３年来住院病人７６例周围性面瘫患者进行综合治疗。现总结报告如下。１对象与方法男４６例，女３０例，年龄１２～７４岁，病程最短２d，最长３年，左侧面瘫４０例，右侧面瘫３６例。（１）针刺：常规消毒取穴：阳白、颧、地仓透颊车、承浆、迎香、下关、太阳、医风加健侧合谷等，用指切快速进针法，使穴位感酸胀为度，用平补平泻法。１次／d，３０min／次，１０次为１个疗程。（２）He－Ne激光穴位照射：采用国产HN－１０００型氦氖激光，波长６３２．８nm，光纤末端输出功率２５mW…     

经腹膜外腹腔镜下前列腺癌改良VIP术式的初步研究

【摘要】　目的　比较分析经腹膜外腹腔镜下前列腺癌改良VIP根治术与经腹膜外腹腔镜下前列腺癌常规根治性切除术经腹膜外腹腔镜下前列腺癌根治性切除术治疗早期前列腺癌的近期临床疗效。方法　选取我徐州医科大学附属医院2017年2月至2019年4月收治的早期前列腺癌患者60例,其中30例经腹膜外行腹腔镜下前列腺癌常规根治性切除术（常规组）,30例经腹膜外腹腔镜下行前列腺癌改良VIP根治术（改良组）。比较两组患者的围术期指标及术后尿控、性功能恢复情况,并观察术后并发症发生情况。结果　两组患者手术均获得成功。改良组的手术时间小于常规组[(119.0±22.6)min vs. (159.7±44.4)min],改良组的住院时间均小于常规组[(9.0±3.4)d vs. (13.9±6.6)d],差异有统计学意义。改良组患者术后即刻和术后3个月的尿控满意率分别为66.7%、86.7%,高于常规组的20.0%、33.3%,差异有统计学意义（P<0.05）;改良组患者术后3、6个月的性功能正常率分别为60.0%、80.0%,优于常规组的23.1%、38.5%,差异有统计学意义（P<0.05）。结论　于术前尿控、性功能正常的T1～T2期早期局限性前列腺癌,经腹膜外行腹腔镜下前列腺癌改良VIP术是一种安全、有效的手术方式,值得临床推广应用。     

尿中性粒细胞明胶酶相关脂质运载蛋白在成人心脏手术后急性肾损伤早期诊断中的价值

目的 探讨尿中性粒细胞明胶酶相关脂质运载蛋白（neutrophil gelatinase-associated lipocalin,NGAL）在心脏手术后急性肾损伤（AKI）早期预测和诊断中的价值。 方法 前瞻性收集我院心脏手术患者手术前后不同时相的血、尿标本,选取其中14例AKI患者,分别测定尿NGAL和Scr水平;并选择临床资料相匹配的非AKI患者15例作为对照。观察两组患者围手术期尿NGAL和Scr的动态变化,运用接受者操作特性曲线（ROC）评价尿NGAL诊断AKI的精确性。AKI定义为Scr水平较基础值增加≥50%。 结果 Scr诊断AKI的中位时间为入ICU后24 h（10 h,48 h）。AKI患者术后入ICU即刻的尿NGAL水平显著高于术前基础水平并达峰值[20.51（13.42,50.02） μg/L比3.42（1.60,9.92） μg/L,P = 0.006];也显著高于非AKI患者 [2.91（0.72,8.61） μg/L,P = 0.002]。入ICU即刻尿NGAL 的ROC曲线下面积为0.824,95%的可信区间（CI）为0.667~0.980,P = 0.003。当以10.95 μg/L作为诊断截点时,此刻的尿NGAL在AKI诊断中的敏感性和特异性分别为85.7%和80.0%。入ICU即刻的尿NGAL与入ICU 24 h的Scr（r = 0.545,P = 0.002）及eGFR（r = －0.546,P = 0.002)呈正及负相关。 结论 心脏手术后AKI患者术后入ICU即刻的尿NGAL水平显著升高,对诊断AKI具有较高的准确性,其诊断AKI的时间早于Scr。尿NGAL可作为成人心脏术后AKI的早期诊断标志物。     

NF-κB激活在大鼠心肌细胞缺血-再灌注损伤中的意义

目的 从心肌核转录因子κB(nuclear factor kappa B,NF-κB)途径研究心肌缺血-再灌注损伤早期较多细胞因子表达的分子机制. 方法建立大鼠离体工作心脏模型,66只大鼠随机分为实验组和对照组.实验组于缺血5、15分钟和对照组于缺血0、5、15、30分钟、再灌注5、15、30、45和60分钟分别测定NF-κB的脱氧核糖核酸(DNA)结合活性变化、细胞质IκBα水平和肿瘤坏死因子α(TNF-α) mRNA的表达. 结果对照组短时间缺血即引起NF-κB的DNA结合活性增强,同时细胞质IκBα水平明显下降;再灌注后NF-κB的DNA结合活性明显增强,细胞质IκBα水平有所恢复.实验组NF-κB的DNA结合活性明显受抑制,TNF-α mRNA的表达亦受到抑制. 结论心肌缺血-再灌注过程中NF-κB由两种不同的途径激活,激活的心肌NF-κB有p65-p50和p50-p50两种形式,NF-κB的快速活化是心肌缺血-再灌注早期较多细胞因子表达的始动因素.     

表达端粒酶逆转录酶siRNA的溶瘤腺病毒对裸鼠肾癌移植瘤的治疗作用

Objective To investigate the antitumor effect of oncolytic adenovirus armed with small interference RNA targeting hTERT gene for renal cancer therapy. Methods Nude mice were divid-ed randomly into 4 groups (8 mice/group),and were treated by intratumoral injections of ZD55-hTERT ( an oncolytic adenovirus armed with small interference RNA targeting hTERT gene) ,ZD55-EGFP ( an on-colytic adenovirus) and Ad-hTERT (replication-defective adenovirus armed with small interference RNA targeting hTERT gene) with three consecutive daily at 7 × 108 pfu/day or treated with PBS as a control. The expression of E1A and hTERT, and apoptosis of tumor xenografts were assessed by immunohistochemi-cal technique at the 7th day after injections. The tumor volume was measured at the 50th day after injec-tions. Results The tumor volume in ZD55-hTERT treatment group ( 124.1±27.5) was significantly less than that in ZD-EGFP (499.8±77.1 ) and Ad-hTERT ( 609.0±102.5 ) treatment groups. The E 1A pos-itive expression in ZD55-hTERT treatment group was significantly higher than that in Ad-hTERT treatment group. The hTERT positive expression in ZD55-hTERT treatment group was significantly lower than that in Ad-hTERT treatment group. ZD55-hTERT treatment of tumor xenografts resulted in an increased apoptotie cell death as compared with ZD55-EGFP and Ad-hTERT treatment. Conclusion The antitumor effect of ZD55-hTERT was more potent than oneolytie adenovirus ZD55-EGFP and Ad-hTERT.     

表达端粒酶逆转录酶siRNA的溶瘤腺病毒对裸鼠肾癌移植瘤的治疗作用

Objective To investigate the antitumor effect of oncolytic adenovirus armed with small interference RNA targeting hTERT gene for renal cancer therapy. Methods Nude mice were divid-ed randomly into 4 groups (8 mice/group),and were treated by intratumoral injections of ZD55-hTERT ( an oncolytic adenovirus armed with small interference RNA targeting hTERT gene) ,ZD55-EGFP ( an on-colytic adenovirus) and Ad-hTERT (replication-defective adenovirus armed with small interference RNA targeting hTERT gene) with three consecutive daily at 7 × 108 pfu/day or treated with PBS as a control. The expression of E1A and hTERT, and apoptosis of tumor xenografts were assessed by immunohistochemi-cal technique at the 7th day after injections. The tumor volume was measured at the 50th day after injec-tions. Results The tumor volume in ZD55-hTERT treatment group ( 124.1±27.5) was significantly less than that in ZD-EGFP (499.8±77.1 ) and Ad-hTERT ( 609.0±102.5 ) treatment groups. The E 1A pos-itive expression in ZD55-hTERT treatment group was significantly higher than that in Ad-hTERT treatment group. The hTERT positive expression in ZD55-hTERT treatment group was significantly lower than that in Ad-hTERT treatment group. ZD55-hTERT treatment of tumor xenografts resulted in an increased apoptotie cell death as compared with ZD55-EGFP and Ad-hTERT treatment. Conclusion The antitumor effect of ZD55-hTERT was more potent than oneolytie adenovirus ZD55-EGFP and Ad-hTERT.     

延迟增强磁共振显像对房颤患者外科消融预后的评估价值

目的 比较延迟增强磁共振(DE-MRI)与病理组织学方法检测心房纤维化程度的相关性,并分析其对房颤患者外科消融预后的评估价值。方法2013年10月至2015年12月间,43名心脏瓣膜病合并房颤拟同期行房颤消融手术的患者,术前行DE-MRI检查评估心房纤维化程度,术中切取左心耳标本通过病理组织学等检查评估心肌纤维化水平,比较DE-MRI检查与病理组织学检查的相关性,术后随访确定窦性心律维持率。 结果 病理组织学等检查结果与术前DE-MRI检查所示的左心房延迟强化程度普遍具有相关性(r=0.69, 0.48, 0.65, 0.51, 0.47, 0.52, P值均<0.05),中度强化组1年窦率维持率显著高于异常强化组（85.7% vs 55.6%, P<0.05） 结论 延迟增强MRI显像可用于对拟行房颤外科消融患者的预后评估,DE-MRI检查异常强化(>35%)提示房颤消融手术的效果不佳。     

表达端粒酶逆转录酶siRNA的溶瘤腺病毒对裸鼠肾癌移植瘤的治疗作用

Objective To investigate the antitumor effect of oncolytic adenovirus armed with small interference RNA targeting hTERT gene for renal cancer therapy. Methods Nude mice were divid-ed randomly into 4 groups (8 mice/group),and were treated by intratumoral injections of ZD55-hTERT ( an oncolytic adenovirus armed with small interference RNA targeting hTERT gene) ,ZD55-EGFP ( an on-colytic adenovirus) and Ad-hTERT (replication-defective adenovirus armed with small interference RNA targeting hTERT gene) with three consecutive daily at 7 × 108 pfu/day or treated with PBS as a control. The expression of E1A and hTERT, and apoptosis of tumor xenografts were assessed by immunohistochemi-cal technique at the 7th day after injections. The tumor volume was measured at the 50th day after injec-tions. Results The tumor volume in ZD55-hTERT treatment group ( 124.1±27.5) was significantly less than that in ZD-EGFP (499.8±77.1 ) and Ad-hTERT ( 609.0±102.5 ) treatment groups. The E 1A pos-itive expression in ZD55-hTERT treatment group was significantly higher than that in Ad-hTERT treatment group. The hTERT positive expression in ZD55-hTERT treatment group was significantly lower than that in Ad-hTERT treatment group. ZD55-hTERT treatment of tumor xenografts resulted in an increased apoptotie cell death as compared with ZD55-EGFP and Ad-hTERT treatment. Conclusion The antitumor effect of ZD55-hTERT was more potent than oneolytie adenovirus ZD55-EGFP and Ad-hTERT.     

主动脉瓣病变合并升主动脉扩张的外科治疗

目的探讨主动脉瓣病变合并升主动脉扩张的外科处理方式。方法按照主动脉瓣瓣叶情况和外科处理方式将患者分组,利用心脏彩超随访测量不同方式处理后的升主动脉变化情况。结果三叶主动脉瓣行单纯置换瓣膜者的升主动脉年平均减少0.471 mm,同期行升主动脉成形者的升主动脉年平均减少0.27 mm;二叶主动脉瓣患者单纯置换瓣膜者其升主动脉年平均增加2.28 mm,同期行成主动脉成形者其升主动脉年平均增加2.923 mm。结论二叶主动脉瓣患者术后升主动脉扩张明显。二叶主动脉瓣患者术前升主动脉40 mm宜进行置换手术,三叶主动脉瓣患者应谨慎同期处理升主动脉。