科技转化的质量指标与质量瓶颈诊断治理原理探讨

讨论了科技转化中的经验教训与提出转化质量的缘由。科技转化质量指标的概念与内容,包括定义科技转化质量指标的相关概念;阐述科技转化质量影响的基本原理;构建科技转化质量标准的条件指标、业绩评价指标和质量审核指标。科技转化质量瓶颈的形成与诊断原理,包括科技转化质量瓶颈的形成原理、质量指标平衡作用原理和质量瓶颈的诊断原理。以及科技转化的质量控制与质量瓶颈的治理方法等。对此至今很少开展研究的重要领域进行了初步探讨。

刍议船舶电气接地故障的诊断与治理

船舶运输业是一种非常重要的交通运输方式,近年来,我国的船舶业迅速发展,对应的船舶技术也持续发展起来,船舶技术日益表现出新颖与别致的特征,多种多样的船舶技术保证了船舶的安全运行,为人们的出行带来了便利,同时也为水陆运输创造了条件,然而,在船舶运输过程中会常常出现一些问题与故障,要想确保船舶顺利通行,就要有效解决这些问题,针对这些问题找到良好的解决方案,在众多的船舶事故中,最常见的问题就是电气接地事故,文中针对船舶电气接地故障展开讨论,分析了如何有效解决船舶电气接地故障。

牛羊口蹄疫的诊断与治理分析

口蹄疫作为一种对偶蹄类动物危害严重,高传播性的传染病,对我国的畜牧产业危害极大。感染的牛或羊往往会将疫情快速的传播到整个群体当中,所以快速诊断该病并采用相应的方式治理控制疫情,对于畜牧产业的发展有着重要的作用,本文通过对口蹄疫的诊断方法进行归纳,提出了相应的应对治理措施,希望可以对畜牧产业发展起到积极促进的作用。

600MW机组通流改造后振动故障诊断及治理

某电厂1号机组因受到高中压缸效率影响,无法由600MW机组增容至630MW。为此在机组B修中,汽轮机本体部分重点开展了高中压缸汽封改造工作,汽缸内各部位汽封间隙值均比上海汽轮机厂给定汽封的间隙下限值小100 m。改造后机组升速及带负荷阶段,高中压转子1、2号瓦振动均出现了超标现象,严重影响了机组安全。通过准确诊断该机组不同工况下出现的振动故障,分别采取相应的治理措施,最终使机组安全、高效地带至增容负荷。

带式输送机跑偏故障的诊断与治理

烧结系统带式输送机承担着从原料的堆放、配料、烧结到为高炉供料中所有的物料运输任务,带式输送机的机械故障中,跑偏故障是发生最频繁、危害最大的故障。通过长期的现场观察和操作经验的积累,总结带式输送机跑偏故障的多发时间点和跑偏现象,给设备点检关键点和跑偏故障的诊断与治理提供了实践基础。

含硫气井环空异常带压安全生产技术研究及应用

由于硫化氢的腐蚀性和剧毒性,环空带压井生产安全风险较大。在对含硫气井筒分析的基础上,对环空带压的类型进行了辨识、分类;结合元坝气井作业条件,完善和细化B-B test流程,建立了环空带压诊断流程;通过对长期安全需要的分析,提出了配备含硫气井安全控制设备和方案;针对对不同环空异常带压类型,进行了治理方案研究。

一例蛋鸡痛风病的诊治体会

蛋鸡痛风病是蛋白质代谢障碍性疾病.该病的发生原因是蛋白质代谢出现障碍,在体内产生大量尿酸盐,这些尿酸盐在关节、内脏和其他组织之间沉淀,最后引发疾病.

Diagnosis and treatment of gallbladder perforation

AIM： To present our clinical experience with gallbladder perforation cases.METHODS： Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic between 1997 and 2006 were reviewed retrospectively. Sixteen （4.8%） of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated.RESULTS： Seven patients had type I gallbladder perforation, 7 type I gallbladder perforation, and 2 type m gallbladder perforation according to Niemeier＇ s classification. The patients underwent surgery after administration of intravenous electrolyte solutions, and were treated with analgesics and antibiotics within the first 36 h （mean 9 h） after admission. Two patients died of sepsis and multiple organ failure in the early postoperative period. Subhepatic abscess, pelvic abscess, pneumonia, pancreatitis, and acute renal failure were found in 6 patients.CONCLUSION： Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.

A case of gallbladder carcinoma associated with pancreatobiliary reflux in the absence of a pancreaticobiliary maljunction:A hint for early diagnosis of gallbladder carcinoma

A 62-year-old man with progressive thickening of the gallbladder wall visited our outpatient clinic. The biliary amylase level in the common bile duct was 19900 IU/L and that of the gallbladder was 127000 IU/L, although endoscopic retrograde cholangiopancreatography revealed no pancreaticobiliary maljunction. Histology demonstrated a moderately differentiated adenocarcinoma of the gallbladder. Pancreatobiliary reflux and associated gallbladder carcinoma were confirmed in the present case, in the absence of a pancreaticobiliary maljunction. Earlier detection of the pancreatobiliary reflux and progressive thickening of the gallbladder wall might have led to an earlier resection of the gallbladder and improved this patient＇s poor prognosis.

Incidental gallbladder cancer during laparoscopic cholecystectomy:Managing an unexpected finding

AIM:To evaluate the impact of incidental gallbladder cancer on surgical experience.METHODS:Between 1998 and 2008 all cases of cholecystectomy at two divisions of general surgery,one university based and one at a public hospital,were retrospectively reviewed.Gallbladder pathology was diagnosed by history,physical examination,and laboratory and imaging studies [ultrasonography and computed tomography(CT)].Patients with gallbladder cancer(GBC) were further analyzed for demographic data,and type of operation,surgical morbidity and mortality,histopathological classification,and survival.Incidental GBC was compared with suspected or preoperatively diagnosed GBC.The primary endpoint was diseasefree survival(DFS).The secondary endpoint was the difference in DFS between patients previously treated with laparoscopic cholecystectomy and those who had oncological resection as first intervention.RESULTS:Nineteen patients(11 women and eight men) were found to have GBC.The male to female ratio was 1:1.4 and the mean age was 68 years(range:45-82 years).Preoperative diagnosis was made in 10 cases,and eight were diagnosed postoperatively.One was suspected intraoperatively and confirmed by frozen sections.The ratio between incidental and nonincidental cases was 9/19.The tumor node metastasis stage was:pTis(1),pT1a(2),pT1b(4),pT2(6),pT3(4),pT4(2);five cases with stageⅠa(T1 a-b);two with stageⅠb(T2 N0);one with stage Ⅱa(T3 N0);six with stage Ⅱb(T1-T3 N1);two with stage Ⅲ(T4 Nx Nx);and one with stage Ⅳ(Tx Nx Mx).Eighty-eight percent of the incidental cases were discovered at an early stage(≤Ⅱ).Preoperative diagnosis of the 19 patients with GBC was:GBC with liver invasion diagnosed by preoperative CT(nine cases),gallbladder abscess perforated into hepatic parenchyma and involving the transversal mesocolon and hepatic hilum(one case),porcelain gallbladder(one case),gallbladder adenoma(one case),and chronic cholelithiasis(eight cases).Every case,except one,with a T1b or more advanced invasion underwent Ⅳb + Ⅴ wedge liver resection and pericholedochic/hepatoduodenal lymphadenectomy.One patient with stage T1b GBC refused further surgery.Cases with Tis and T1a involvement were treated with cholecystectomy alone.One incidental case was diagnosed by intraoperative frozen section and treated with cholecystectomy alone.Six of the nine patients with incidental diagnosis reached 5-year DFS.One patient reached 38 mo survival despite a port-site recurrence 2 years after original surgery.Cases with non incidental diagnosis were more locally advanced and only two patients experienced 5-year DFS.CONCLUSION:Laparoscopic cholecystectomy does not affect survival if implemented properly.Reoperation should have two objectives:R0 resection and clearance of the lymph nodes.

Multiple Gliomas

Multiple gliomas are well-recognized but uncommon tumors. The incidence of multiple gliomas according to some reports ranges from 0.5% to 20% of all gliomas diagnosed. Multiple gliomas can be divided into two categories. One is by location of the lesions (multifocal and multicentric). The second type is by the time of the lesions occur (synchronous and metachronous). The lesions generally show hypo, or isodensity on CT; a hypo-or isointense signal on T1-weighted images, and a hyperintense signal on T2-weighted images. Glioblastoma is the most frequent histotype. The prognosis of multiple gliomas remains unfavorable. The treatment of multiple gliomas includes surgery, radiotherapy and chemotherapy. Distinction between multicentric and multifocal gliomas is difficult. This report reviews in detail the aspects of multiple gliomas mentioned above.

Nonalcoholic fatty liver disease: An overview of current insights in pathogenesis, diagnosis and treatment

Estimates of people suffering from overweight (one billion) and obesity (300 million) are increasing. The accumulation of triglycerides in the liver, in the absence of excess alcohol intake, has been described in the early sixties. It was not until 1980, however, that Ludwig et al named this condition nonalcoholic steatohepatitis (NASH). Subsequently, nonalcoholic fatty liver disease (NAFLD) has been used as a general name for conditions ranging from simple steatosis through steatohepatitis to end-stage liver disease (cirrhosis). Many studies have demonstrated the significant correlation with obesity and insulin resistance. Other studies have revealed a signifi- cant correlation between hepatic steatosis, cardiovascu- lar disease and increased intima-media thickness. WHO estimated that at least two million patients will develop cirrhosis due to hepatic steatosis in the years to come. Longitudinal cohort studies have demonstrated that those patients with cirrhosis have a similar risk to devel- op hepatocellular carcinoma as those with other causes of cirrhosis. Taken all together, NAFLD has become the third most important indication for liver transplantation. There- fore, training programmes in internal medicine, gastroen- terology and hepatology should stress the importance of diagnosing this entity and treat properly those at risk for developing complications of portal hypertension and con- comittant cardiovascular disease. This review will focus on the clinical characteristics, pathophysiology, imaging tech- niques and the readily available therapeutic options.

Diagnosis and management of postural orthostatic tachycardia syndrome：A brief review

Postural orthostatic tachycardia syndrome （POTS） has been recognized since at least 1940.A review of the literature identifies differences in the definition for this condition and wide variations in treatment and outcomes.This syndrome appears to describe a group of conditions with differing pathophysiology,which requires treatment tailored to the true underlying disorder.Patients need to be fully evaluated to guide treatment.Further research is required to effectively classify the range of underlying pathophysioiogy that can produce this syndrome and to guide optimal management.

Celiac disease:Prevalence,diagnosis,pathogenesis and treatment

Celiac disease(CD) is one of the most common diseases,resulting from both environmental(gluten) and genetic factors [human leukocyte antigen(HLA) and nonHLA genes].The prevalence of CD has been estimated to approximate 0.5%-1% in different parts of the world.However,the population with diabetes,autoimmune disorder or relatives of CD individuals have even higher risk for the development of CD,at least in part,because of shared HLA typing.Gliadin gains access to the basal surface of the epithelium,and interact directly with the immune system,via both trans-and para-cellular routes.From a diagnostic perspective,symptoms may be viewed as either "typical" or "atypical".In both positive serological screening results suggestive of CD,should lead to small bowel biopsy followed by a favourable clinical and serological response to the gluten-free diet(GFD) to confirm the diagnosis.Positive anti-tissue transglutaminase antibody or antiendomysial antibody during the clinical course helps to confirm the diagnosis of CD because of their over 99% specificities when small bowel villous atrophy is present on biopsy.Currently,the only treatment available for CD individuals is a strict life-long GFD.A greater understanding of the pathogenesis of CD allows alternative future CD treatments to hydrolyse toxic gliadin peptide,prevent toxic gliadin peptide absorption,blockage of selective deamidation of specific glutamine residues by tissue,restore immune tolerance towards gluten,modulation of immune response to dietary gliadin,and restoration of intestinal architecture.

Cell-permeable Tat-NBD peptide attenuates rat pancreatitis and acinus cell inflammation response

AIM： To investigate the effects of Tat-NEMO-binding domain （NBD） peptide on taurocholate-induced pancreatitis and lipopolysaccharide （LPS）-stimulated AR42J acinus ceils inflammatory response in rats. METHODS： Sodium taurocholate （5%） was used to induce the pancreatitis model. Forty-eight rats from the taurocholate group received an intravenous bolus of 13 mg/kg Tat-NBD （wild-type, WT） peptide, Tat- NBD （mutant-type, MT） peptide, NBD peptide or Tat peptide. The pancreatic histopathology was analyzed by hematoxylin staining. LPS was added to the culture medium to stimulate the AR42J cells. For pretreatment, cells were incubated with different peptides for 2 h before LPS stimulation. Expression of IL-1β and TNF-α mRNA was analyzed using a semi-quantitative reverse-transcript polymerase chain reaction （RT-PCR） method. IL-1β and TNF-α protein in culture medium were detected by enzyme linked immunosorbent assay （ELISA）. NF-KB DNA-binding in pancreas was examined by electrophoretic mobility shift assays. P65 expression of AR42J was determined by Strept Actividin-Biotin Complex （SABC） method. RESULTS： Pretreatment with Tat-NBD （WT） peptide at a concentration of 13 mg/kg body wt showed beneficial effect in pancreaitis model. LPS （10 mg/L） resulted in an increase of IL-1β mRNA, IL-1β protein, TNF-α mRNA and TNF-α protein, whereas significantly inhibitory effects were observed when cells were incubated with Tat-NBD （WT）. Consisting with p65 expression decrease analyzed by SABC method, NF-KB DNA-binding activity significantly decreased in Tat-NBD （WT） pretreatment group, especially at the largest dose. No significant changes were found in the control peptide group. CONCLUSION： Our result supports that active NF-KB participates in the pathogenesis of STC-induced acute pancreatitis in rats. Tat-NBD （WT） peptide has anti- inflammatory effects in this model and inhibits the inflammation of acinus simulated by LPS.

Diagnostic and Therapeutic Cold Knife Conization for Cervical Intraepithelial Neoplasia

OBJECTIVE of using cold （CIN）. METHODS To evaluate the diagnostic and therapeutic efficacy knife conization for cervical intraepithelial neoplasia We retrospectively analyzed 186 cases with CIN diagnosed and treated in our hospital; compared the histologic diagnoses from cervical conization and from colposcopic multiple punch biopsies, and then evaluated their postoperative histologic findings and clinical outcomes. RESULTS Of the 186 cases, there was a correlation in histologic findings between cervical conization and colposcopic multiple punch biopsies in 138 cases （74.2%）, and there was no correlation in the other 48 cases （25.8%）. Incomplete excision was performed in 8 cases （4.3%）, but the failure rate was only 1.1%; the cure rate was 98.9%. Five cases with early invasive cancer were found. Eleven patients underwent subsequent hysterectomy. The main complications associated with conization were hemorrhage and cervical stenosis. Bleeding occurred in 8 （4.3%） of the patients, and cervical stenosis occurred in 3 （1.6%）. CONCLUSION Cervical intraepithelial neoplasia was diagnosed more accurately using conization than by colposcopic multiple punch biopsies. Conization can also play an important role in the treatment for CIN. If properly performed, the procedure has a low risk of complications. It can provide an accurate histologic representation of the disease process, and be curative in most cases.

Liu-stain quick cytodiagnosis of ultrasound-guided fine needle aspiration in diagnosis of liver tumors

AIM： To combine ultrasound-guided fine-needle aspiration （US-FNA） and Liu （Riu） stain to make a quick study on liver tumor lesions. METHODS： Two hundred and twenty-eight aspirations from 232 patients were completely studied. The operator himself made the quick cytodiagnosis of US-FNA smear stained by Liu method within thirty minutes. The US-FNA specimen was also sent to the pathological department for cytological study and cellblock histology. The result of our Uu-stain quick cytodiagnosis in each patient was confirmed by the final cytopathological diagnosis from pathological report. RESULTS： Among 228 samples, the quick cytodiagnosis revealed 146 malignancies, 81 benign lesions and one inadequate specimen. Cytopathological diagnosis from the pathological department revealed 150 malignancies, and 78 benign lesions. Four well-differentiated hepatocellular carcinomas （HCCs） were under-diagnosed by quick cytodiagnosis as benign and 3 benign lesions were over-diagnosed as well-differentiated HCCs. Compared with cytopathological diagnosis, quick cytodiagnosis correctly diagnosed 143 malignancies and 77 benign lesions. Except for the one inadequate specimen in quick cytodiagnosis, the accuracy of quick cytodiagnosis was 96.9% （220/227）, and its sensitivity, specificity and positive and negative predictive values were 97.9%, 95.1%, 97.3% and 96.3%, respectively. CONCLUSION： Liu-stain quick cytodiagnosis is a fast, convenient, safe and effective method for hepatologists in clinic practice to diagnose liver tumor. In few cases of well-differentiated HCC, Liu-stain quick cytodiagnosis has its limitation.

Intrapancreatic accessory spleen:A case report and review of the literature

Here,we report a case of intrapancreatic accessory spleen confirmed by pathologic diagnosis and discuss its differential diagnosis and surgical management with a review of the literature.

ENDOMYOCARDIAL FIBROSIS IN CHINA

To introduce the epidemical, pathological, and clinical characteristics as well as the diagnostic and therapeutical experiences of endomyocardial fibrosis(EMF) in China. [WT5”BX] Data sources.[WT5”BZ]A CMBdisc search was done of the Chinese language literature published from January 1983 through June 1997 about EMF and/or restrictive cardiomyopathy. A manual search was then done for other contributions, including abstracts, between January 1965 and June 1997. [WT5”BX] Results. [WT5”BZ]Eighty seven Chinese cases of EMF were collected in this paper. There were 49 men and 38 women, with a mean age of 28±13 years(range, 8 to 68 years). The distribution of the cases is mainly in the south of China. Combined right and left ventricular disease occurs in 48 percent of cases, with pure right ventricular involvement occurring in 42 percent and pure left ventricular involvement in the remaining 10 percent of patients who are examined postmortem. The diagnosis of EMF was confirmed in 21 cases at autopsy, and in 66 cases by echocardiography, angiocardiography, and/or endomyocardial biopsy which showed the characteristic changes. Clinically, right sided disease is the commonest variety. Endocardiectomy and tricuspid(n=7) or mitral(n=1) valves replacement have been performed in 8 patients. There were 2 operative deaths. Six patients had a satisfactory recovery postoperatively and living well in the follow up duration. [WT5”BX] Conclusion.

Natriuretic peptide family as diagnostic/prognostic biomarker and treatment modality in management of adult and geriatric patients with heart failure： remaining issues and challenges

B-type natriuretic peptide （BNP） and N-terminal proBNP （NT-proBNP）, the key members of natriuretic peptide family have been rec- ommended as the gold standard biomarkers for the diagnosis and prognosis of heart failure （HF） according to the current clinical guidelines. However, recent studies have revealed many previously unrecognized features about the natriuretic peptide family, including more accurate utilization of BNP and NT-proBNP in diagnosing HF. The pathophysiological mechanisms behind natriuretic peptide release, breakdown, and clearance are very complex and the diverse nature of circulating natriuretic peptides and fragments makes analytical detection particu- larly challenging. In addition, a new class of drug therapy, which works via natriuretic peptide family, has also been considered promising for cardiology application. Under this context, our present mini-review aims at providing a critical analysis on these new progresses on BNP and NT-proBNP with a special emphasis on their use in geriatric cardiology settings. We have focused on several remaining issues and chal- lenges regarding the clinical utilization of BNP and NT-proBNP, which include： （1） Different prevalence and diagnostic/prognostic values of BNP isoforms; （2） methodological issues on detection of BNP; （3） glycosylation of proBNP and its effect on biomarker testing; （4） specificity and comparability of BNP/NT-proBNP resulted from different testing platforms; （5） new development of natriuretic peptides as HF treatment modality; （6） BNP paradox in HF; and （7） special considerations of using BNP/NT-proBNP in elderly HF patients. These practical discussions on BNP/NT-proBNP may be instrumental for the healthcare providers in critically interpreting laboratory results and effective management of the HF patients.