Arteriovenous fistula (AVF) is the preferred vascular access for maintenance hemodialysis (MHD) in patients with end-stage renal disease (ESRD). The vascular selection and evaluation before AVF establishment, the maturity assessment after AVF establishment, the timely treatment of AVF mature disorders, and the timely monitoring, location, and treatment of complications during AVF use, are all crucial for the MHD treatment. Ultrasound has the advantages of convenience, non-invasiveness, safety, and economy in evaluating vascular anatomy and blood flow, and is helpful for selecting AVF vessels, assessing the maturity of AVF, discovering the AVF maturity disorders and their causes, detecting and locating postoperative complications, guiding the treatment of mature disorders and complications, improving the success rate of AVF establishment, and ensuring the proceeding of MHD. This article reviewed the current status and prospect of the clinical application of conventional ultrasound and contrast-enhanced ultrasound (CEUS) in the AVF of MHD patients in recent years.

目的 总结中耳感染性疾病患者人工耳蜗植入(Cochlear Implant,CI)的临床经验.方法 对2000年12月-2019年3月在解放军总医院行CI伴中耳感染性疾病患者的临床资料进行回顾性研究.对I期或II手术患者的中耳病变性质和范围、手术方式、术腔填塞物种类、手术疗效以及术后并发症等进行总结分析.结果 术后随访9个月-10年,I期植入11例,其中,慢性化脓性中耳炎静止期5例,活动期2例,中耳胆脂瘤4例(胆脂瘤范围较小,或有完整包膜).II期植入9例,其中,慢性化脓性中耳炎活动期6例,静止期1例;中耳胆脂瘤2例(胆脂瘤范围较大,或包绕正常组织,不易完整清除).分期植入组中有1例耳蜗植入术后9年电极脱出.其余病例通过结合病例特点,采用不同手术方式均取得满意的治疗效果.结论 对于中耳感染性疾病的患者,人工耳蜗分期植入相对于同期植入更加安全.I期植入应尽可能选择病变较轻,病灶局限易完整清理的病例,术式选择应在彻底清除病灶的基础上尽量选择损伤范围较小的术式.

目的 研究低龄患者人工耳蜗植入后不同时间开机后的调机参数变化及术后并发症发生情况,以分析术后l周左右开机的可行性及优势.方法 将29例单侧或双侧植入Med-EL Sonata型人工耳蜗的低龄患者(1岁以内),分为提前开机组(术后6～10天)和常规开机组(术后28～38天),统计分析两组开机时及后续4次调机的电极阻抗和最大舒适域C值的变化规律及术后并发症发生情况.结果 两组的阻抗值均在术后1个月时达到峰值,后逐渐降低,提前开机组的阻抗峰值低于常规开机组,但差异无统计学意义;从手术2个月后,两组的阻抗值曲线趋于吻合.两组的C值与调机次数均存在较明显的正相关性;两组在相同时间点及相同调机次数的C值差异均无统计学意义;两组的r值十分接近.提前开机与常规开机组均未出现相关手术并发症.结论 术后1周开机相比于术后1月开机是同样安全可行的.

目的 分析先天性中外耳畸形患者纯音听力特点.方法 回顾性分析213例(253耳)先天性中外耳畸形患者的纯音听力特点.结果 纯音测听显示传导性耳聋198耳(78.26％)、混合性耳聋53耳(20.95％)、感音神经性耳聋2耳(0.78％).将语频段0.5KHz、1kHz、2KHz、4kHz中任一频率未引出骨导或气导听力的患者剔除后余206例(246耳),平均气导阈值进行分析:以中重度耳聋(55d-70dB HL)51.63％(127/246),重度耳聋(71-90dB HL)33.74％(83/246)为主;其中传导性耳聋和混合性耳聋中重度,重度所占比例分别为59.60％(118/198),26.77％(53/198);18.75％ (9/48),62.50％ (30/48).在56-80 dB HL范围内传导性耳聋、混合性耳聋所占比例分别为82.83％(164/198)、58.33％(28/48).对混合性耳聋骨导纯音测听结果分析示:主要在2KHz处骨导听力有下降,占72.92％,平均阈值为30.42±7.84dBHL(10-60dBHL),结论 先天性中外耳畸形患者主要表现为传导性耳聋,以中重度、重度耳聋为主.骨导听力损失主要发生在2KHz,在2KHz处平均骨导听阈有轻度下降.

Objective: To investigate and analyze the examination and intervention of irrational orders of PIVAS in geriatric department of our hospital. Methods:A total of 297 335 orders of PIVAS collected from October 2010 to December 2011 were examined. The irrational and the unqualified orders were intervened by telephone and communication letters. Intervention on the audit results were analyzed. Results: Totally 3256 orders were unreasonable or unqualified, accounting for 1.1%of all orders, mainly related to incompatibility, the dose-solvent quantity, solvent species, inappropriate dosing, identification on the nutrition bag, etc. There were 878 successful intervention orders with an average success rate of 27.0%. Unreasonable or unqualified orders were mostly in cardiovascular medicines. Conclusion:The standard of the orders of PIVAS was promoted by the audit according to drug instructions. Pharmacists played an important role in improving the rationality and suitability of drug use and ensuring the safety of the patients. However, the audit and intervention methods for the special administration still need to be explored further.

Objective To investigate the effect of jointly using the administrative methods on the base of the technical method for intervening the irrational orders in the pharmacy intravenous admixture service(PIVAS).Methods Sixty-one thousand nine hundred and sixty-two orders collected in PIVAS in the senile disease area from August to November 2012 were divided into the control group and the experimental group,and performed the intervention on the irrational orders by adopting the technical measures and the comprehensive technical and administrative measures.The statistical analysis was conducted.Results After the technical and administrative interventional measures,the rate of irrational orders was 1.27%in the experimental group and decreased by 1.28%compared with the control group.The intervention successful rate was 16.43%in the experimental group,which was increased by 6.65%compared with the control group,the difference between them showing statistical significance.Conclusion The comprehensive interventional measures have some promoting effect in increasing the intervention success rate of the irrational orders in PIVAS.

OBJECTIVE: To explore the regularity of the utilization of Chinese herbal medicine in diabetic patients through investigating the status quo of the drug use in an attempt to promote clinical rational drug use.METHODS: A total of 553 diabetic patients in the outpatient department of traditional Chinese medicine in 2009 were selected,with a total of 4 980 oral Chinese herbal medicine prescriptions analyzed regarding the number of varieties of the Chinese herbal medicines.RESULTS: 91.12% of the prescriptions prescribed 11 to 20 Chinese herbal medicines per prescription.Tonic drugs,heat-clearing drugs and digestant drugs were the three most frequently used drugs.CONCLUSION: The utilization of Chinese herbal medicine for diabetes prescribed in the department of traditional Chinese medicine of our hospital is basically in line with the principle of symptomatic treatment;however,the use of which in combination with chemical drugs remains to be studied further.

To study the efficacy of nicergoline through a few different deliveries in treatment of thrombosis in rat.Uses the method of the formation of artery-vein thrombus in rat,then estimates the formation of thrombus suppression rate.All of deliveries of Nicergoline can suppress the formation of thrombus in rat obviously,sorts for the deliveries absorption's speed is differently: Injection vein nasal administration sublingual administration.The nasal administration of Nicergoline had the same effect as to injection vein,so we can thought that the nasal deliveries would absord well in human's body.

OBJECTIVE Research the therapeutic effectiveness of combination Imipenem and teicoplanin to treat septicemia due to interspace of lumbar vertebrae Infection complicated pulmonary abscess and the method of diagnosis, prevention and cure of Secondary interspace of lumbar vertebrae Injection. METHODS The successful cure case-report that severe postoperative interspace of lumbar vertebrae infection complicated blood-borne pulmonary abscess used small needle knife to treat Lumbar intervertebral disc protrusion (LIDP) were reviewed.RESULTS Unstandard asepsis technique and invasive operation long time operation, too mang damage of tissue in operation, patient weak, diabetes, glucocorticoid, lacking postoperative anti infection therapy etc. Lumbocrural pain were found aggravated, high fever, blood sedimentation increased, CRP heightened. CONCLUSIONS Strict asepsis,sufficient preoperotive preparation, Standard operation, less damage, can reduce interspace of lumbar vertebrae infection rate. Strict asepsis and less damage in the operation can reduce the incidence of intervertebral disc space infection.

Objective To analyze the rational administration status of the patients aged 70 years and over for therapy and health maintenance by oral Chinese traditional and herbal drugs in General Hospital of PLA.Methods 373 prescriptions of oral traditional Chinese medicine prescribed in January-October,2007 for OPD patients aged 70 years and over were investigated. The data of medication classification and dosage were statistically treated and analyzed.Results The investigation results showed that functional failure was the main cause of senile disease.So the tonics played a critical role in the process of therapy.About 35% of 20 kinds of frequently used Chinese traditional and herbal drugs were tonics.Conclusion The traditional Chinese medicine therapy in our hospital can abide by the principle of tonification,fitness and disease prevention.Medication is basically economic and reasonable.

To investigate the feasibility of determination of FK506 blood level with Microparticle Enzyme Immunoassay(MEIA),the concentrations of FK506 in blood samples were dtected by MEIA.It is resulted that the recovery rate and precision of detection results of FK506 blood level were consistent with requirement.Conclused that the way of MEIA for FK506 blood level detection is convenient,fast and highly automated. It is fit for the determination of large clinical blood samples.

Objective It is to evaluate the clinical function of Ceramic dental prosthetic restorations with casting gold alloy,casting Ti alloy and casting Ni-Cr alloy metal bases.Methods 75 patients were randomly divided into three groups and were respectively worn Ceramic dental prosthetic restorations with casting gold alloy,casting Ti alloy and casting Ni-Cr alloy metal bases.The color of Ceramic dental prosthetic restoration,fitness of dental crown marginal,cervical margin staining,plaque index,gingival index,bleeding in probing and porcelain deterioration of dental prosthetic restoration were observed after worn one month and three years.Results The color,fitness of dental crown marginal and cervical margin staining of Ceramic dental prosthetic restoration with gold alloy metal base was better than those of Ceramic dental prosthetic restoration with Ti alloy and the Ni-Cr alloy metal bases(P0.01).There was no significant difference on plaque index,gingival index and bleeding in probing among the three groups(P0.05).Conclusion Ceramic dental prosthetic restoration with gold alloy metal base shows good on color and gingival margin.Ceramic dental prosthetic restoration with Ti alloy metal base can be used for clinical application essentially.