机器人辅助微创手术器械一般采用丝传动来实现手术器械大长径比结构下的动力传递,传力过程中钢丝绳的张力传递损失会引起手术器械关节运动误差,因此研究丝传动张力变化是保证手术器械运动精度的前提.根据手术器械结构特点,引入导轮与钢丝绳的半径比及张力倾斜角来表征钢丝绳弯曲刚度,通过对钢丝绳与导轮接触区域与非接触区域的受力分析,得到了钢丝绳的张力比计算公式.试验结果表明,应用所提出的张力比计算公式获得的张力值与传感器直接测得的张力值比较吻合.此外,应用张力比计算公式分析了包角、摩擦因数、半径比、张力倾斜角等结构参数对钢丝绳张力变化的影响.该研究工作可为手术器械的精确运动控制及结构设计提供理论指导.

目的：研究医护一体化模式在骨科护理中的应用效果。方法：将84例骨科各类型患者随机分为实验组（应用医护一体化模式）和对照组（给予骨科常规护理），各42例，比较两组临床护理成效及满意度。结果：实验组患者预约等待时间、异常结果反馈时间及住院时间均得到明显缩短，医师和患者对护理工作满意度（评分均在90分以上）均高于对照组（评分均在80分左右），比较差异显著（P＜0.05）。结论：医护一体化模式可促进骨科护理专业化进程，护士密切配合医师，进一步提高医疗护理质量，更好地满足患者护理需求。

病例资料：男，25岁。因骶尾部皮肤反复破溃流脓2个月余就诊。于半年前发现骶尾部局限性疼痛，皮肤红肿，触之有波动感；随之局部疼痛加重，位置固定，无放射，并出现间断性跳痛；局部皮肤破溃，有脓液流出，之后破溃口封闭。一段时间后局部疼痛加重，皮肤破溃流脓；上述症状反复发作半年。身体其他部位无不适。既往无糖尿病及各种传染病病史。体检：肛门外观无畸形，无黏液性分泌物，骶尾部见一隆起肿物，质软，无活动，边界清晰，局部有波动感，触痛，表面皮肤红肿，未破溃。指诊：直肠内未触及肿物及瘘口，退指无血染及脓染。

肾动脉狭窄（renal artery stenosis,RAS）是继发性高血压的常见原因,鉴于高血压对心脑血管的危害,需尽早明确高血压的病因以便针对性治疗,因而RAS患者的早期诊断对预后至关重要。影像学诊断中CTA、MRA、DSA在诊断血管狭窄具有重要的地位,但目前认为彩色多普勒超声检查是筛查RAS的首选方法。尽管目前国内外对肾动脉狭窄的超声诊断标准探讨较多,但缺乏统一标准。本文

Objective To value stability of carotid atherosclerotic plaque. Method Forty-four symptomic patients in our hospital from June 2011 to June 2012 were selected as candidates. Intraplaque neovascularization of their plaques were studied on contrast-enhanced ultrasonic( CEUS) imaging. All these patients were monitered on Transcranial Doppler to find micro embolus signal( MES),in order to confirm whether there is micro embolus dropping. Those patients who were positive on both CEUS and MES,were reviewed their previous results of the CT or MRI scanning to find whether there were some fresh infarcts. Then those patients with fresh infarcts were verified with unstable plaques. Twenty-four patients with hyperecho plaque were matched group. In addition,the TCD results had been reviewed to exclude middle cerebral artery stenosis. Results( 1) Among the 44 patients on ECUS,34 patients imaging showed neovascularization,including 20( 58. 8%)neovasculariztion patients showing hypoecho or isoecho plaque,and 16( 47. 1%) neovasculariztion patients showing mixed echo with dominant hypoecho or isoecho plaque,while matched group showed negative. The results of CEUS in two groups were significantly different. The matched group were negative.( 2) Sixteen cases among 44 cases were positive on MES,including 2 cases of CEUS imaging were negative.( 3) Those patients with intraplaque neovascularization were grade 2 and grade 3 on ECUS,whose MES positive rate were higher than else groups.( 4) These patients MRI results were reviewed to confirm fresh infarction. And their TCD results were also reviewed to excluded middle cerebral artery stenosis. Conclusion Intraplaque neovascularization grade 2 and grade 3 on CEUS may indicate vulnerable plaque.

Diaphragmatic hernia is serious condition,clinical symptoms lack of specificity,easy misdiagnosis,ultrasonography can find the diaphragmatic muscle anomaly and abdominal viscera position timely,concluded in time diagnosis.

病例 女,46岁,因无痛肉眼血尿1d于2012年3月12日急诊人院.该患缘于3d前口服造影剂后出现排尿困难,期间曾不能自主排尿,无尿频、尿急、尿痛,随后给予留置导尿2d,导出肉眼血尿,病人为求进一步诊治,就诊于本院,门诊经检查后以输尿管肿瘤收入院.病程中患者精神状态良好,无发热,饮食及睡眠良好,大便正常.

<正>睾丸网管状扩张是一种少见的睾丸良性囊性病变,现报告1例睾丸网管状扩张病例,为进一步认识此疾病积累资料。病例男,47岁,因右侧阴囊内发现进行性增大肿物伴间断性疼痛3月入院。

<正>随着生活节奏的日益加快、饮食习惯及环境等因素,女性乳腺肿瘤的发病呈日益上升趋势。乳腺的良性肿瘤以乳腺纤维瘤最为常见,占到了所有良性肿瘤的3/4。乳腺的上皮组织和纤维组织在雌激素的刺激下,会发生不同程度的增生,从而形成乳腺纤维瘤。它可能出现在青春期后的任何年龄。临床

<正>乳腺增生症是最女性常见的乳腺疾病,其发病率呈上升趋势。但是目前对于本病治疗缺乏有效方法,治疗药物多属活血化瘀中药,疗效不甚理想。近年来我们使用电热乳腺按摩治疗仪治疗乳腺增生症,取得良好效果。1资料与方法1.1一般资料:我院自2009年9月～2010年9月诊断为乳

Terrien's角膜边缘变性是角膜边缘部变性的一种特殊的类型,最终可导致局部扩张甚至穿孔,是一种严重危害视功能的眼表疾病. 回顾性分析我院1998年～2008年15例23眼Terrien's角膜边缘变性住院患者的临床资料,现将结果报告如下.

2004年8月-2006年9月某动物医院就诊的频繁呕吐的144例病犬,灌服硫酸钡后,30和120 min各进行1次X线检查,判定为单纯性呕吐的病犬68例,观察记录钡餐(BM)的止吐效果.结果44例病犬一次性治愈,23例再次灌钡并配合其他疗法治愈,钡餐治疗单纯性呕吐的治愈率为95.6%,1例并发胃大面积溃疡,回肠部梗阻和穿孔后死亡.表明用硫酸钡治疗犬单纯性呕吐比较有效.

[Objective] To investigate the therapeutic effects of small incision nonphacoemulsification and extracapsular cataract extraction.[Method]Three eyes extracapsular cataract extraction in three old diabetes dogs from January 2004 to july 2006 were analyzed.[Result] Small incision nonphacoemulsification and extracapsular cataract extraction leaded to visual rehabilitiation in some degree by visual activity test after one month.One case damaged the iris when the crystalline humor was taken,because mydriasis was not enough to operat in preoperative.One dog's visual power had been healed slightly in postop.because the leatheriness had not been completely inhausted in operation.Two dog appeared corneal bedewing in 14 days,and disappearance after 21 days.[Conclusion] The small incision nonphacoemulsification and extracapsular cataract extraction was cheap,convenient and easy to learn and master,so it might be popularization in animal hospital.

对39例严重阻塞的公犬尿道结石病例采用尿道切开取石的方法进行治疗,取得了满意的效果。

患者男性,41岁,激光工程师,因激光束灼伤左眼,于2004年11月25日就诊于我科.患者于入院前1 h,因调试高能量的掺钕钇铝石榴石激光(neodymium-yttrium,aluminum,garnet;Nd:YAG)机时,未戴防护目镜,被黑色相纸表面反射的激光束灼伤左眼,当时注视距离20 cm,激光能量400 mJ,反射光束的能量约为总输出能量的1%,光斑直径8 mm,波长1064 nm,频率1 Hz,脉宽10 ns.