Abstract： Diseases prognosis is often influenced by multiple factors, and some intricate non-linear relationships exist among those factors. Artificial neural network （ANN）, an artificial intelligence model, simulates the work mode of biological neurons and has a b capability to analyze multi-factor non-linear relationships. In recent years, ANN is increasingly applied in clinical medical fields, especially for the prediction of disease prognosis. This article focuses on the basic principles of ANN and its application in disease prognosis research.
ObjectiveTo determine the entry point and screw implant technique in posterior pedicle screw fixation by anatomical measurement of adult dry samples of the axis so as to provide a accurate anatomic foundation for clinical application. MethodsA total of 60 dry adult axis specimens were selected for pedicle screws fixation. The entry point was 1-2 mm lateral to the crossing point of two lines: a vertical line through the midpoint of distance from the junction of pedicle medial and lateral border to lateral mass, and a horizontal line through the junction between the lateral border of inferior articular process and the posterior branch of transverse process. The pedicle screw was inserted at the entry point. The measurement of the anatomic parameters included the height and width of pedicle, the maximum length of the screw path, the minimum distance from screw path to spinal canal and transverse foramen, and the angle of pedicle screw. The data above were provided to determine the surgical feasibility and screw safety. ResultsThe width of upper, middle, and lower parts of the pedicle was (7.35±0.89), (5.50±1.48), and (3.97±1.01) mm respectively. The pedicle height was (9.94±1.16) mm and maximum length of the screw path was (25.91±1.15) mm. The angle between pedicle screw and coronal plane was (26.95±1.88)° and the angle between pedicle screw and transverse plane was (22.81±1.61)°. The minimum distance from screw path to spinal canal and transverse foramen was (2.72±0.83) mm and (1.98±0.26) mm respectively. ConclusionAccording to the anatomic research, a safe entry point for C2 pedicle screw fixation is determined according to the midpoint of distance from the junction of pedicle medial and lateral border to lateral mass, as well as the junction between the lateral border of inferior articular process and the posterior branch of transverse process, which is confirmed to be effectively and safely performed using the entry point and screw angle of the present study.
目的 探讨运用心脏临时起搏器抢救严重心律失常、更换永久性心脏起搏器及心动过缓的外科手术患者围手术期需用临时起搏器保护的临床效果及护理经验。 方法 2008年8月－2011年7月，共对30例缓慢型心律失常者实施临时心脏起搏术。术前做好患者的心理护理，做好器材及药品准备；术中抢救器械、抢救药品处于备用状态，作好术中配合及病情观察；术后护理，观察生命体征及相关症状变化。 结果 安置心脏临时起搏器患者共30例，除1例因合并下壁心肌梗死、严重心力衰竭抢救无效死亡外，其余均取得满意的治疗效果，术中、术后无并发症发生，术后恢复良好，病情稳定出院。 结论 心脏临时起博器运用于抢救严重心律失常患者、赢得进一步抢救时间，更换永久性心脏起博器患者的临时保护，以及心动过缓的外科手术患者围手术期保护，均是一种安全有效的治疗方法。做好术前、术中及术后的护理是必要保证。Objective To investigate the clinical effects and nursing experiences of using temporary cardiac pacemaker in emergency rescue for patients with severe arrhythmia, in renewal of permanent cardiac pacemaker, or in peri-operative patients with bradycardia. Methods From August 2008 to July 2011, 30 patients with bradycardia arrhythmia underwent temporary cardiac pacemaker implantation surgery. We applied psychological nursing to the patients and made a good preparation of necessary equipments and medicine before operation. During the surgery, all required apparatuses and materials were ready at hand, and careful observation of conditions of the patients was carried out. After operation, the vital signs as well as the development of related symptoms in the patients were closely observed. Results There were 30 patients who had temporary cardiac pacemakers implanted. All got satisfying treatment effects except one who died from severe heart failure combined with inferior-wall myocardial infarction. No intraoperative or postoperative complications occurred, and the patients attained good postoperative recuperation before leaving hospital. Conclusion Temporary cardiac pacemaker is safe and effective in the emergency rescue of patients with severe arrhythmia, in temporary heart protection for patients undergoing renewal of permanent cardiac pacemaker, and in perioperative protection for patients with bradycardia. Good nursing before, during, and after the operation should be guaranteed.
【摘要】 目的 分析宜宾市第二人民医院2009年门、急诊麻醉药品的使用情况，促进麻醉药品使用的合理化和规范化。 方法 对2009年门急诊1 420张麻醉药品处方进行统计，统计处方总数，麻醉药品临床使用分布情况，根据药品分类分别统计麻醉药品的用药总量，各种麻醉药品的处方所占的比例，实际用药总天数等。对非癌症处方以用药频率及药物利用指数（DUI）为指标，癌症处方以用药天数及平均日用药量为指标进行进行统计、分析、评价。 结果 门急诊的麻醉药品有8种，盐酸吗啡缓释片的总用量居首位，盐酸哌替啶针在急诊处方中出现频率较高，芬太尼透皮贴剂的用药频度较小，药物利用指数均≤1。 结论 宜宾市第二人民医院的急诊麻醉药品使用基本合理。A total of 1 420 pieces of narcotic drugs prescriptions for the outpatient in our hospital in 2009 were extracted. The total number of prescriptions, the distribution of the clinical use of narcotic drugs, the total amount of narcotic drugs according to different types, the proportion of each kind of narcotic drug prescription and the actual number of medication durations were counted and analyzed. Defined daily dose (DDD) and drug use index (DUI) of the non-cancer drugs prescription; meanwhile, the number of drug-using days and average daily amount of cancer drug prescription were statistically analyzed. Results There were eight kinds of narcotic drugs for the outpatients. The most total amount of narcotic drugs was morphine hydrochloride sustained release tablets; the medication frequency of pethidine injection in the emergency prescription was high and the medication frequency of transdermal fentanyl was low. The narcotic drugs utilization index was lower than one. Conclusion The use of narcotic drugs in our hospital is rational.