目的:探索野战方舱中医疗设备管理的方式方法,以提高医疗设备在遂行保障任务时的完好性.方法:针对方舱医疗设备管理的现状,提出训练使用和平时管理相结合、加强计量质控、科学评估论证适时更新换代的管理策略.结果:提出的方舱医疗设备管理策略在人装结合和设备完好率方面收到了很好的效果,提升了方舱医院遂行各种任务的能力和水平.结论:方舱中的医疗设备随时都要处于完好待用状态,同时适时更新换代,才能保持和提升方舱医院遂行各种任务的能力和水平.

Objective To design and develop an intelligent material cabinet system in the department to execute informatized management of auto replenishment,quality safety and statistical query.Methods The intelligent material cabinet system had the functions of auto replenishment after inventory prewarning,recalling material record after login of an authorized user,and quality control of enterprise qualification and expiration prewarning.Mircosoft.Net technology framework,C/S architecture design and MS SQL Server database were involved in to develop the system,which was composed of a weighing cell,an electronic display screen,a material tray,an intelligent material cabinet and etc.The cabinet system had uniprocessor and network versions,and realized medical material fine management based on the hospital intranet.Results The cabinet system contributed to standardized operation,high-efficiency transport and quality safety.Conclusion The cabinet system behaves well in standardized,streamlined and informatized medical material management,and thus is worthy promoting practically.

笔者所在医院医用耗材管理经历了从手工管理、单机版电子化、网络版电子化到条码应用管理信息化阶段,目前正在积极探索精细化物流管理模式.医用耗材全流程精细化设计引入物流管理系统,配合院内仓储管理和物流服务,建立医用耗材全流程精细管理体系和信息化系统.笔者对医用耗材资质审核、科室计划、采购汇总、订单发货、实货验收、入库确认、仓储管理、物流配送、质量监控、月末盘点、对账结算等业务实行医用耗材全流程精细化管理,建立规范化、流程化、精细化的医疗耗材物流管理体系.

目的:设计一种用于测量神经导航系统误差的体模.方法:神经导航误差测量体模主要由玻璃底座、玻璃罩和玻璃立柱3个部分组成.使用时先对体模扫描成像,获取图像数据,并选取体模中预设的特征点模拟病灶部位,做出手术计划,用已有的手术导航系统进行定位注册.获取神经导航系统中的立体图像靶位与实际体模中的靶位之间的误差数据,并运用统计学方法进行分析,获取影响导航精度的因素.结果:神经导航体模能够精确客观地获取实验研究数据,从而方便进行导航误差数据的统计学分析.结论:该神经导航体模可以检验神经导航系统的导航精度,是神经导航系统误差测量的理想校验器材.

目的:设计一种渐进式的膝关节屈曲训练器,用于改善膝关节术后僵直的状况,提高患者生活质量.方法:该训练器由齿轮、齿条、前托、中托、后托、调节销组成;通过齿轮在齿条上滚动,调节前托与后托的角度,使膝关节伸展或屈曲,达到锻炼的目的.结果:通过临床观察,患者使用渐进式的膝关节屈曲训练器3个月后膝关节平均主动伸展增加35°,可有效改善膝关节僵直.结论:在关节成形术后发生关节纤维化时,使用渐进式的膝关节屈曲训练器进行静态进展牵伸在增加膝关节活动度方面较为有效.

从准入、定价,物资信息维护和临床使用3个环节指出了高值耗材管理中存在的问题,提出了规范准入标准和制度、组织集中招标采购、提高耗材管理人员素养、成立监督小组等方案,提高了高值耗材的管理水平,优化了高值耗材的管理流程,为高值耗材管理提供参考.

0引言野战医疗方舱由12台方舱组成[1],在实际应用过程中，12台方舱需要定位卸载，并按一定的顺序连接，才能组合成一个有机整体。方舱定位卸载的快慢决定了整个方舱医院展开的快慢，因此方舱精准、快速定位是提高展开速度的关键。传统的方舱定位均需“划线定位”[2]，烦琐复杂，在反复训练中们研制了一种简易方舱定位器，避免了繁杂的划线工作，大大提高了定位卸载的速度，现介绍如下，以供参考。

Objective This study aims to evaluate the clinical value of MR-DTI in optic radiations of glaucoma. Methods MR-DTI was performed in 20 patients suffering from unilateral glaucoma and 15 healthy subjects. The parameters of MR-DTI,including fractional anisotropy( FA),apparent diffusion coefficient( ADC) value of optic radiations of glaucoma were evaluated. The average length of fibers and mean fibers / voxel,ADC and FA values in healthy subjects,affected nerve and unaffected nerve in glaucoma were compared. Results The ADC values in affected optic radiations were higher and FA values were lower than that in unaffected optic radiations and control optic radiations,which had statistically significant difference( P < 0. 01). Average fiber length and mean fibers / voxel in affected optic radiations were lower than that in unaffected optic radiations and control optic radiations( P < 001). Conclusion Potential neuropathology changes occurr in the optic radiations of patients with glaucoma. MRI-DTI is a useful method in studying optic radiations damage of glaucoma which provides more information for guiding the clinic diagnosis of glaucoma.

<正>患者,男,46岁。因咳嗽、咳痰,偶有痰中带血,伴胸闷,而行胸部CT检查,结果显示:右肺占位,病理证实为鳞癌,出现锁骨上淋巴结转移,分期较晚。采用瑞典医科达公司的BJ-66MV单光子直线加速器,北京大恒医疗公司的STAR-

Objective To compare the dose distribution of one-isocenter and two-isocenter in the conformal radiotherapy of thyroid-associated ophthalmopathy.Method Adopting accurate patient immobilization technique,three dimensional data of the target and the other surrounding tissues were acquired by using spired CT screen.Results Based on the three dimensional radiotherapy planning system,the two fields conformal radiotherapy plans with one-isocenter and two-isocenter were designed,the dose-volume histograms were calculated and compared.Conclusion The dose distribution of irradiated target in the two methods is similar during the conformal radiotherapy of thyroid-associated ophthalmopathy.

Objective To analyze the conformal radiotherapy for exophthalmos treatment of thyroid-associated ophthalmopathy.Methods Adopting accurate patient immobilization technique,three dimensional data of the target and the other tissues were gotten by using spired CT.Results Based on the three dimensional radiotherapy planning system,the plan of the bilateral orbital conformal irradiation 2 000 cGy in 2 weeks was designed and the dose-volume histograms was calculated.Conclusion Orbital conformal radiotherapy was efficient in exophthalmos treatment of thyroid-associated ophthalmopathy.It can improve the symptoms,obtain objective responses and avoid surgical treatments.In the fields and dose choosing,OAR(orgen at risk),such as lens and optic nerves,should be protected carefully.

Objective To analyze the quality control of the conformal radiotherapy for nasopharyngeal carcinoma. Methods Using BJ-6 6MV linear accelerator, STAR -2000 3D TPS and immobilization device, the patient of nasopharyngeal carcinoma were treated by the conformal radiotherapy. Results Adopting individualized compatibly-shaped face masks and CT scanning (2mm interval, 2mm thickness), three dimensional data of the target and the other tissues were acquired. The conformal radiotherapy was designed in planning system. At the treatment, the target volume was put on the isocenter of the linear accelerator by the customized patient positioning. Conclusion Because the nasopharyngeal carcinoma is located in a special area and it is surrounded by some important organ, in the conformal radiotherapy, the quality control of the CT immobilization technique and the customized patient positioning is very important. This can ensure effective and safe irradiation for the small target volume while excessive irradiation is avoided in other surrounding organs.

Objective To study the TPS dose distributions of three fields conformal radiotherapy and rotate radiotherapy in lung cancer treatment. Method Adopting accurate patient immobilization technique,three dimensional data of the radiated target and the other tissues were acquired by using spired CT. Result Based on the three dimensional therapy planning system (TPS),a three fields conformal radiotherapy plann and a rotate radiotherapy plann were designed,the dose-volume histogram (DVH) and the dose distribution of center plane were calculated and compared. Conclusion The dose distributions are similar in two radiotherapy planns,but there are remarkable difference of absobed dose in organ at risk.