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Objective To develop a series of surgical instruments to improve surgical treatment in field conditions with considerations on the characteristics of medical shelter and the requirements of surgical treatment in field conditions.Methods A series of surgical instruments was developed with considerations on the characteristics and requirements of surgical treatment in field conditions.Results The mask strap behaved well in structure,operation and fixation,and prevented the mask from unplanned extubation,dropping off and displacement.The sterilizing rack had high stability and safety and 150 kg bearing capability,and eliminated the needs for additional workload for patient carrying and traction during preoperative sterilization.The prone-position cushion exposed the operative field sufficiently and enhanced the success rate of surgical treatment.Conclusion The series of surgical instruments gains advantages in structure,operation,mobility,cleaning,sterilization,carrying,storage,loading and transport,and thus is applicable for field emergency rescue.
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Objective To develop an integrated prone position cushion to facilitate the operation and nursing of the patient.Methods The cushion was composed of outer and inner layers with considerations on gender and operative sites.The inner layer was made of plus hard high-density sponge,the outer layer was manufactured with polyurethane (PU),and the two layers were connected by Velcro.Results The cushion behaved well in shock proof and buffering,which could expose the operative field sufficiently and decrease the incidence rate of pressure sore during the operation.Conclusion The cushion gains advantages in simple structure,stability,safety,easy operation and disinfection,and is applicable for prone position surgery.
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Objective To design a flexible and convenient emergency tracheal intubation box for providing rapid artificial respiration support to critical and severe patients with sudden changes and implementing effective emergency rescue measures which enhance the success rate of emergency tracheal intubation in clinical departments.Methods The box had its size determined with considerations on the disadvantages of tracheal intubation by clinical departments and the requirements for difficult tracheal intubation,and then was customized by some specific plant.The items required for intubation were classified and placed according to proper sites,which were separated with boards adapting to their sizes.The boards divided the box into 7 compartments.Results The box gained advantages in size,carrying,structure and usage,and facilitated to establish artificial airway in emergency conditions.Conclusion The box is easy to manufacture,clean,sterilize,carry and store,and is applicable for emergency tracheal intubation in clinical departments and emergency conditions.
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Objective To develop a detachable upper limb operation table for facilitating field surgery and improve the utilization rate of surgical shelter in field hospital.Methods The operating table was composed of a rectangular frame made of stainless steel and a table top of insulation board.The width of the rectangular frame was quartered,and two elastic fasteners were placed respectively at the points of a quarter and 3 quarters.The operating table came into being after the two fasteners were connected.Results The table had its height regulated as required and facilitated intraoperative X-ray exposure,and enhanced the efficiency and satisfaction of the surgeon and nurse.Conclusion The table gains advantages in size,carrying,operation and structure,and thus is applicable for upper limb operation in field shelter.
Résumé
Objective To develop a series of surgical instruments to improve surgical treatment in field conditions with considerations on the characteristics of medical shelter and the requirements of surgical treatment in field conditions.Methods A series of surgical instruments was developed with considerations on the characteristics and requirements of surgical treatment in field conditions.Results The mask strap behaved well in structure,operation and fixation,and prevented the mask from unplanned extubation,dropping off and displacement.The sterilizing rack had high stability and safety and 150 kg bearing capability,and eliminated the needs for additional workload for patient carrying and traction during preoperative sterilization.The prone-position cushion exposed the operative field sufficiently and enhanced the success rate of surgical treatment.Conclusion The series of surgical instruments gains advantages in structure,operation,mobility,cleaning,sterilization,carrying,storage,loading and transport,and thus is applicable for field emergency rescue.
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Objective To develop an integrated prone position cushion to facilitate the operation and nursing of the patient.Methods The cushion was composed of outer and inner layers with considerations on gender and operative sites.The inner layer was made of plus hard high-density sponge,the outer layer was manufactured with polyurethane (PU),and the two layers were connected by Velcro.Results The cushion behaved well in shock proof and buffering,which could expose the operative field sufficiently and decrease the incidence rate of pressure sore during the operation.Conclusion The cushion gains advantages in simple structure,stability,safety,easy operation and disinfection,and is applicable for prone position surgery.
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Objective To design a flexible and convenient emergency tracheal intubation box for providing rapid artificial respiration support to critical and severe patients with sudden changes and implementing effective emergency rescue measures which enhance the success rate of emergency tracheal intubation in clinical departments.Methods The box had its size determined with considerations on the disadvantages of tracheal intubation by clinical departments and the requirements for difficult tracheal intubation,and then was customized by some specific plant.The items required for intubation were classified and placed according to proper sites,which were separated with boards adapting to their sizes.The boards divided the box into 7 compartments.Results The box gained advantages in size,carrying,structure and usage,and facilitated to establish artificial airway in emergency conditions.Conclusion The box is easy to manufacture,clean,sterilize,carry and store,and is applicable for emergency tracheal intubation in clinical departments and emergency conditions.
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Objective To develop a detachable upper limb operation table for facilitating field surgery and improve the utilization rate of surgical shelter in field hospital.Methods The operating table was composed of a rectangular frame made of stainless steel and a table top of insulation board.The width of the rectangular frame was quartered,and two elastic fasteners were placed respectively at the points of a quarter and 3 quarters.The operating table came into being after the two fasteners were connected.Results The table had its height regulated as required and facilitated intraoperative X-ray exposure,and enhanced the efficiency and satisfaction of the surgeon and nurse.Conclusion The table gains advantages in size,carrying,operation and structure,and thus is applicable for upper limb operation in field shelter.
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<p><b>OBJECTIVE</b>To study and compare the accuracy and sensitivity of endoscopic ultrasonography (EUS) and CT scaning in determination of preoperative stage and vascular invasion by pancreatic and ampullary cancers.</p><p><b>METHODS</b>Fourty-two pancreatic cancer patients and 18 ampullary cancer patients were studied. With patients prepared according to conventional endoscopy, Olympus EUM-30 scope 1 set with a side view and 360 degrees rotate and switchable scanning probe [ultrasound frequency (7.5/12 MHz)], was introduced to the descending duodenum through the esophagus. Gas within the duodenum and stomach was aspirated. Then, in order to to facilitate ultrasound transmission, 200 ml deaerated water was injected into the duodenum and 500 ml into the stomach to distend it. The structures of each part of pancreatic head and ampullary together with surrounding vessels were scanned. Then, the scope was withdrawn to the gastric antrum, body and fundus gradually, while the pancreatic body and tail were scanned.</p><p><b>RESULTS</b>Between Apr. 1996 to May 2004, a total of 42 pancreatic cancer patients and 18 ampullary cancer patients were examined by EUS. Meanwhile, all these 58 patients received preoperative CT scaning. The results of stage and vascular invasion determined by EUS in this series were as following; pancreatic cancer group (n = 42): accuracy in T2-4 stage was 100.0% (5/5), 75.0% (9/12) and 48.0% (12/25), respectively; ampullary cancer group (n = 18): T1-4 stage was 75.0% (3/4), 66.7% (2/3), 75.0% (6/8) and 33.3% (1/3), respectively; the accuracy in N stage: P-group: 80.0% in N1 (4/5), 90.0% in N0 (9/10); A-group: 50.0% in N1 (3/6), 91.0% in N0 (10/11). The sensitivity, specificity of vascular invasion, resectability and unresectablilty determined by EUS and CT as compared with surgical findings during operation was 52.9% (9/17), 93.1% (27/29), 77.1% (27/35) and 81.8% (9/11) for EUS (n = 60), respectively; and 11.8% (2/17), 92.6% (25/27), 62.5% (25/40) and 50.0% (2/4) for CT (n = 58), respectively.</p><p><b>CONCLUSION</b>Endoscopic ultrosonography being one of the best image examinations to determine the stage and vascular invasion for pancreatic and ampullary cancer paitients is able to detect small pancreatic or ampullary cancer less than 2.0 cm in diameter due to its high resolution; but can not detect the secondary multiple distal metastases such as spread into the liver, peritonium or hepatoduodenal ligament, etc. due to its ultrasound depth limitation.</p>