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Objective To investigate the feasibility and therapeutic efficacy of inverted Y-shaped silicone airway stent for complex airway diseases (stenosis or fistula). Methods According to the particular anatomic structure and the pathological changes of complex airway diseases, the inverted Y-shaped silicone airway stents were designed. 7 stents were implanted in 7 cases of airway complex diseases with the guidance of interventional rigid bronchoscope under general anesthesia. Results The Y-shaped silicone stents were placed successfully followed with the result of immediate relieves of the symptoms. Dyspnea grade was improved significantly from Ⅲ~Ⅳ to 0 ~Ⅱ , and oxygen saturation elevated from ( 84.1 ± 4.5 ) % in inspiring high concentration oxygen to ( 94.1 ± 2.9 ) % in breathing ambient air (P = 0.000). The main complications were cough, foreign body sensation, chest pain, granulation, sputum retention, et al. Conclusion Placement of Y-shaped silicone airway stent is a feasible and safe treatment for complex airway disease, the recent curative effect is reliable, it is worth further promoting.
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This paper presents a surgical optical navigation system with non-invasive, real-time, and positioning characteristics for open surgical procedure. The design was based on the principle of near-infrared fluorescence molecular imaging. The in vivo fluorescence excitation technology, multi-channel spectral camera technology and image fusion software technology were used. Visible and near-infrared light ring LED excitation source, multi-channel band pass filters, spectral camera 2 CCD optical sensor technology and computer systems were integrated, and, as a result, a new surgical optical navigation system was successfully developed. When the near-infrared fluorescence was injected, the system could display anatomical images of the tissue surface and near-infrared fluorescent functional images of surgical field simultaneously. The system can identify the lymphatic vessels, lymph node, tumor edge which doctor cannot find out with naked eye intra-operatively. Our research will guide effectively the surgeon to remove the tumor tissue to improve significantly the success rate of surgery. The technologies have obtained a national patent, with patent No. ZI. 2011 1 0292374. 1.
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Humanos , Sistemas Computacionais , Fluorescência , Raios Infravermelhos , Linfonodos , Neoplasias , Imagem Óptica , Software , Cirurgia Assistida por ComputadorRESUMO
Based on the urban residents' basic medical insurance system in Qingdao,with hospitals,community aging care institutions and families as the carriers,Qingdao city explored and implemented the long-term medical care insurance system(LTMCI),and established mechanisms for fundraising,payment,handling,service and supervision.The city also designed a scientific application and reimbursement process.Three service modes are designed and put into practice as follows:Long-term care in designated nursing homes or pension institutions; Medical care at designated hospitals; and home health care.These services are charged by quota-lump per bed per day,with the reimbursement ratio of 96％,90％ and 96％ respectively.A practice over a year proved the LTMCI as effectively alleviating disease burden of patients,and guiding long-term care to serve communities.This way a new type of medical care system comes into being,with medicine-care-recovery-endowment for disabled population.
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Objective To explore the effectiveness of the home-community-hospital network management (HCHNM) on the prevention and treatment of stroke.Methods From June to December 2011,HCHNM was implenented in Qingdao of Shandong Province to prevent and treat stroke patients.According to community residents healthcare records,A total of 80 stroke patients were randomly selected from Badahu and Fushanhou communities (study group) and another 80 patients from Zhongshan Road and Liaoning Road communities (control group).A household questionnaire survey was then conducted among these participants.Chi-square test and t test were used for data analysis.Results The overall effective rate of the study group was 86.25％ (69/80),which was significantly higher than that of the control group (67.5％) (x2=221.807,P＜0.05).The study group also showed largely improved quality of life (total score:t=4.593;physical fitness,family activities,movement,mood,self-care ability,social activities,upper limb function and work ability scores:t values were 7.775,2.244,5.329,3.832,5.463,2.979,5.924 and 3.555,respectively; all P＜0.05),although language,character,thinking and vision abilities had no statistically significant difference from the control group (t values were 0.561,1.466,0.831 and 1.000,respectively; all P＞0.05).The scores of daily activities and life satisfaction of the study group were higher than those of the control group,while per capita medical cost was much lower (t values were 12.998,20.760 and-29.777,respectively; all P＜0.05).Conclusions As an effective,safe and economy therapy model,HCHNM could improve rehabilitation,self-care ability,quality of life,and life satisfaction of community stroke patients.In addition,it greatly mitigates medical burden.
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A systematic summary of the concept and operational mechanism of the intensive disciplines management in a hospitals group,and that of the intensive disciplines management for hospitals groups,as well as a comparison of the differences found in department service capacity,service quality,discipline development and patient satisfaction before and after the intensive discipline management is in place.The practice proved that the departments practicing intensive management have witnessed significant rise in outpatient headcount,hospitalization headcount and surgical operation headcount.Their weight in the group is also higher.For example,their curative rate and rescue success rate of dubious and acute diseases higher than before (P＜ 0.05).The Group has 8 provincial key medicine-specialties,including 5 intensive management departments.It has 8 provincial key clinicaldisciplines,including 2 intensive management departments.The overall patient satisfaction for service of such departments is 92.1％,the satisfaction for convenience is 84.4％,that for service quality 90.0％,that for service attitude 92.5％,and that for medical service experience is 89.5％.All of which are significantly higher than that those on their admission to the hospital.The intensive management has enabled unified management of internal medicine and surgery of the same profession in the campus,integrated workforces of both internal medicine and surgery department along with those of medical technicians.In addition,it has enhanced departmental service capacity and quality,discipline competence,as well as outpatients' convenience,patients' satisfaction and medical experience.
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Objective To study the localization of the foramen of Monro on magnetic resonance image (MRI) and its clinical significance.Methods Cranial MRI was observed for 30 normal healthy subjects to study their location,shape and size of the foramen of Monro,as compared to those in 22 patients with hydrocephalus and 14 cases with tumor around their foramen.Results The the foramen of Monro is located between the fornix and the anterior part of thalamus in the normal healthy subjects,with a transverse diameter of 2.8 mm and a vertical diameter of 2.1 mm in average on MRI.Y-shaped structure is formed between their bilateral the foramen of Monro and the 3rd cerebral ventricle.Very obvious changes in shape and size of the foramen of Monro can be observed in patients with hydrocephalus,which sometimes can integrated with the 3rd cerebral ventricle and lateral ventricle,forming a"rabbit-head sign".Meanwhile, imaging of the foramen of Monro varied in patients with tumor around the foramen,depending on its location and size.Conclusions The foramen of Monro has a relative constant position in the brain.Changes in its position,size and shape are important signs suggesting intracranial lesions.An individualized operation plan for a patient should be determined based on those changes.
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Objective To study the expression of hTERT in human gastric carcinoma and its precancerous lesions and to explore the relationship between hTERT expression and Helicobacter pylori (Hp) infection. Methods hTERT expression was detected by immunohistochemical method. Hp was detected by rapid urease test and Warthin-Starry silver staining. Results The expression level of hTERT in human gastric carcinoma (78.95%) was significantly higher than that in gastric dysplasia (64.29%), in intestinal metaplasia (46.67%), and in atrophic gastritis (25.00%, P
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Objective To study the expression of hTERT protein in precancerous lesions of human stomach, and to analyze the relationship between telomerase activity and cell apoptosis, in order to elucidate the effects of telomerase activity and cell apoptosis in the pathogenesis of gastric carcinoma. Methods Sp method was employed to detect the hTERT expression and the apoptosis was determined in situ by TUNEL staining in 64 patients with chronic gastritis and gastric carcinoma. Among the 64 patients, 16 suffered from chronic gastritis with gastratrophia, 15 with intestinal metaplasia, 14 with allotypic proliferation, and the 19 remainders suffered from gastric carcinoma. Results (1) The respective positive frequency of hTERT protein expression in chronic gastritis, intestinal metaplasia, gastric allotypic proliferation and human gastric carcinoma were 25.0%, 46.7%, 64.3% and 78.9%. The positive frequency of hTERT protein expression in human gastric carcinoma was significantly higher than that in gastric allotypic proliferation, intestinal metaplasia and chronic atrophic gastritis (P