简介：AIM:Toinvestigateenoughvalidmeasurements(VMs)toassessliverfibrosisinchronichepatitisBpatients(CHB).METHODS:OnehundredandtwelveCHBpatients(25women,87men)withameanageof38.43yearsreceivedliverstiffnessevaluationsusingreal-timeshearwaveelastographyfor10VMs.Allpatientsunderwentliverbiopsy.Basedonthebiopsypathology,theliverstiffnessdataobtainedfromdifferentVMs(1,2,3,5and10times)werecomparedfortheevaluationofliverfibrosis.ThecorrelationbetweentheelasticmodulusmeansoftheliverobtainedfromdifferentVMsofdetectionateachpathologicalstagewasanalysed.Thereceiveroperatingcharacteristic(ROC)curvewasemployedtodeterminethediagnosticperformanceofdifferentVMsofdetection,andtheareasundertheROCcurveofdifferentgroupswerecompared.RESULTS:Theliverstiffnessvaluesobtainedfrom1VM,2VMs,3VMs,5VMsandall10VMsforstageF0were6.95±2.01kPa,6.87±1.83kPa,6.90±1.88kPa,6.95±1.93kPaand7.15±1.89kPa,respectively(F=0.043,P=0.996).ForstageF1,thesevalueswere7.12±1.72kPa,7.24±1.72kPa,7.21±1.74kPa,7.10±1.78kPaand7.04±1.70kPa,respectively(F=0.075,P=0.990).ForstageF2,theywere9.37±3.87kPa,9.18±3.68kPa,9.19±3.81kPa,9.18±3.81kPaand9.19±3.53kPa,respectively(F=0.012,P=1.000).ForstageF3,thesewere11.91±3.88kPa,11.78±4.04kPa,11.83±4.07kPa,11.94±4.17kPaand12.00±4.02kPa,respectively(F=0.010,P=1.000).ForstageF4,thereadingswere19.30±7.63kPa,19.40±7.36kPa,19.54±7.43kPa,19.73±7.21kPaand20.25±7.22kPa,respectively(F=0.054,P=0.995).Therewerenosignificantdifferencesbetweenthesegroups.Intraclasscorrelationcoefficientsamongdifferentpathologicalstages(F0-F4)withdifferentdetectionVMswere0.995,0.993,0.996,0.994and0.996,respectively.Themeanelasticityvaluesfrom1VM,2VMs,3VMs,5VMsand10VMscanaccuratelydistinguishfibrosisstages(F0vsF1234,F01vsF234,F012vsF34andF0123vsF4)withnosignificantdifferencesinthefivegroups(P>0.05forall).CONCLUSION:One

简介：AIM:Toevaluatethecorrelationofshearwaveelastography(SWE)resultswithliverfibrosishistologyandquantitativefunctionreserve.METHODS:Weeklysubcutaneousinjectionof60%carbontetrachloride(1.5mL/kg)wasgivento12caninesfor24wktoinduceexperimentalliverfibrosis,witholiveoilgivento2controlcanines.At24wk,liverconditionwasevaluatedusingclinicalbiochemistryassays,SWEimaging,lidocainemetabolitemonoethylglycine-xylidide(MEGX)test,andhistologicfibrosisgrading.Clinicalbiochemistryassayswereperformedattheinstitutionalcentrallaboratoryforroutineliverfunctionevaluation.Liverstiffnesswasmeasuredintriplicatefromthreedifferentintercostalspacesandexpressedasmeanliverstiffnessmodulus(LSM).PlasmaconcentrationsoflidocaineanditsmetaboliteMEGXweredeterminedusinghigh-performanceliquidchromatographyrepeatedinduplicate.Liverbiopsysampleswerefixedin10%formaldehyde,andliverfibrosiswasgradedusingthemodifiedhistologicalactivityindexKnodellscore(F0-F4).Correlationsamonghistologicgrading,LSM,andMEGXmeasureswereanalyzedwiththePearsonlinearcorrelationcoefficient.RESULTS:At24wkliverfibrosishistologicgradingwasasfollows:F0,n=2(control);F1,n=0;F2,n=3;F3,n=7;andF4,n=2.SWELSMwaspositivelycorrelatedwithhistologicgrading(r=0.835,P<0.001).Specifically,theF4grouphadasignificantlyhigherelasticmodulusthantheF3,F2,andF0groups(P=0.002,P=0.003,andP=0.006,respectively),andtheF3groupalsohadasignificantlyhighermodulusthanthecontrolF0group(P=0.039).LSMwasnegativelyassociatedwithplasmaMEGXconcentrationsat30min(r=-0.642;P=0.013)and60min(r=-0.651;P=0.012),timeto?ofthemaximumconcentration(r=-0.538;P=0.047),andtheareaunderthecurve(r=-0.636;P=0.014).Multiplecomparisonsshowedidenticaldifferencesinthesethreemeasures:significantlylowerwithF4(P=0.037)andF3(P=0.032)ascomparedtoF0a

简介：急性重度有机磷农药中毒（AOPP）的病人多服毒量大，中毒症状重，如不及时抢救，会迅速出现呼吸衰竭、脑水肿、循环衰竭，甚至死亡。为此，我们积极开展了对该类病人的“120”院前急救措施，使病人得到及时而有效的处理，抢救成功率明显提高，现将该工作总结报告如下。

简介：自1996年2月用自行研制的内镜直视软型食管扩张器(专利号：97244648．6)为78例贲门失弛缓症病人行扩张治疗，其中3例为行Heller氏术复发者。随访最长5年，最短2个月，1例病人不能配合扩张不成功，其余均痊愈。

简介：人力资源开发，就是根据人力资源载体的生理和心理特点，运用科学的方法，充分挖掘人力资源的潜力，合理配置人力资源，实现劳动投入和经济投入的高效率。有著名经济学家认为：中国加入WTO后，如何面对人才重重危机，是医院人力资源管理必须接受的考验，国外人力资源开发比较注重以人为本(即人本管理)，突出理解人、尊重人，充分发挥人的主动性和积极性。目前，急救工作在现代社会已显示出其重要地位，由于急救工作特点，使得急救护理人员合理配置和培训成为护理管理难题，本文就本院院前急救护理人员的配制和培训管理进行探讨。

简介：目的探讨氩离子凝固术(ABC)治疗的疗效及安全性。方法应用ABC治疗疣状胃炎及息肉的疗效观察。结果ABC治疗息肉150例计212枚息肉均予以切除。其中直径>1cm者50枚用高频脉冲圈套器+ABC法治疗，而另100枚较小息肉(直径<1cm)仅使用ABC直接灼除。结果证实，ABC治疗息肉安全有效，无明显副作用；ABC治疗成熟型疣状胃炎80例，病灶数共计422枚。3月后随访，70例(87．5％)病人临床症状明显改善。胃镜复查发现，原病灶处均覆有新生的粘膜上皮及肉芽组织，无明显疤痕形成。10例(12．5％)病人仍见少许疣状灶及糜烂残留，再次行ABC术治疗。结论ABC为一种安全有效、易于控制的内镜下治疗胃肠疾病的新方法。

简介：目的:应用压力传感器持续监测气囊压力,观察气囊压力的变化规律,为临床更好的进行气囊管理提供依据。方法:气管导管的外露指示气囊通过三通、延长管与压力传感器相连,压力传感器的压力信号输出端与PHILIPS床旁监护仪压力导联线相连,压力校正完成后,通过监护仪持续监测气囊压力,每小时记录一次气囊压力。结果:各时间点的气囊压力采用重复测量的方差分析,F=8.367,P=0.001,各时间点的气囊压力存在统计学差异,至少有两个时间点气囊压力存在差异;两两比较结果显示,5小时、7小时、8小时气囊压低于起始值,差异有统计学意义(P<0.05);气囊压力与监测时间呈负相关,相关系数为-0.933,气囊压力随着时间的推移呈下降趋势。结论:气囊存在微漏气,气囊压力会随着时间的推移逐渐下降,使用压力传感器可以持续动态监测气囊压力,及时发现压力不足,保证气囊压力处于控制范围。