后路短节段内固定经椎弓根液态人工骨植骨治疗胸腰椎骨折的临床应用研究

目的 分析胸腰椎骨折后路复位短节段内固定经椎弓根Wright 液态人工骨植骨的疗效。方法 38 例胸腰椎骨折患者结合患者的经济能力分为两组，A（未植骨）组24 例单纯行后路切复椎弓根螺钉内固定术，B（植骨）组14 例一期行后路切复椎弓根螺钉内固定并经椎弓根行椎体内Wright 液态人工骨植骨术，分别随访10~27 个月，比较两组患者拆钉时伤椎前缘高度的再压缩率、Cobb角变化及伤椎影像学的变化。结果 B 组患者拆钉时伤椎前缘高度再压缩率为（5.43±2.71）%，术后Cobb 角增大为（2.03±0.51）°，与A 组（6.29±2.24）°相比差异有统计学意义（P＜0.05），A 组患者术后不同程度的出现蛋壳样改变，其中2例出现断钉，1例患者出现上位椎弓根钉切割出椎体，而B 组患者未出现明显蛋壳样改变及断钉现象。结论 胸腰椎骨折后路复位短节段椎弓根钉内固定经椎弓根Wright 液态人工骨植骨能明显改善伤椎骨折的愈合，维持椎体的高度，减少蛋壳样改变及断钉等情况的发生。     

输尿管导管在非复杂性输尿管中下段结石输尿管镜碎石术后的应用

目的探讨输尿管导管在非复杂性输尿管结石行输尿管镜下碎石术后的临床应用价值.方法选取行输尿管镜钬激光碎石术的非复杂性输尿管结石患者98例,其中术后放置输尿管导管49例(导管组),放置双J管49例(双J管组).比较两组患者碎石术时间,以及术后留管期间(取管前)尿路刺激症、血尿、尿路感染、腰痛或侧腹痛等并发症的发生情况.结果导管组手术时间显著短于双J管组(P<0.01).两组患者仅术后第4天尿路刺激症发生率的差异有统计学意义(P<0.05),其他并发症发生率的差异均无统计学意义(均P>0.05).术后1个月检查结果显示两组患者无石率均为100%,术后3个月检查结果显示均无输尿管狭窄发生.结论输尿管导管是输尿管镜治疗非复杂性输尿管结石术后引流的一种好方法.     

实时超声检测在脑海绵状血管瘤切除术中的应用研究

目的探讨术中实时超声检测在脑海绵状血管瘤手术中的应用价值.方法将39例脑海绵状血管瘤患者按术中是否采用实时超声检测引导手术分为两组.超声引导组20例,术中通过超声检测显示海绵状血管瘤的位置、大小、形态、深度及其与周围组织和血管的关系,制定最佳手术入路,并通过实时扫描,监测病灶的切除情况,病灶切除后再次超声探查有无残留病灶和血肿.另19例为对照组,术中不用超声引导,其他均按传统方法手术.比较两组患者病灶切除时间、脑组织切开次数、切口肿瘤直径比值以及患者症状改善及并发症发生情况.结果(1)两组患者均无手术死亡,病灶均在手术显微镜下全切除.影像学与病理检查诊断符合率达100%.(2)两组患者病灶在手术显微镜下均被发现,超声引导组患者术中病灶显示率为100%,并完整显示病灶的大小、位置、范围及形态,准确定位.(3)脑组织切开次数超声引导组均在3次以下,而对照组仅10例(52.63%)在3次以下,7例(36.84%)达3次以上;切口肿瘤直径比值超声引导组为1.22±0.22,低于对照组的1.45±0.36;病灶平均切除时间超声引导组为(55.70±12.66)min,少于对照组的(82.16±31.23)min;并发症发生率超声引导组为5.00%,明显低于对照组的15.79%;两组上述数据的差异均有统计学意义(均P<0.05).结论术中实时超声引导对脑海绵状血管瘤病灶的定位准确、可靠,能指导术者准确选择手术入路,避开重要的脑功能区、血管和其他重要结构,精准切除病灶,缩短手术时间,减少神经组织损伤和降低手术并发症发生率.     

GnRH-a治疗中重度盆腔子宫内膜异位症后妊娠情况分析

目的探讨中重度子宫内膜异位症患者使用促性腺激素释放激素激动剂(GnRH-a)治疗后妊娠情况.方法选取中重度子宫内膜异位症患者61例,其中期待组(48例)予期待妊娠,必要时监测排卵或常规促排卵,辅助生殖组(13例)予体外受精-胚胎移植,观察比较两组患者术后使用GnRH-a治疗后的妊娠情况.结果61例患者总妊娠率67.2%(41/61).期待组月经恢复的0~3个月妊娠率(56.3%,27/48)明显高于月经恢复第4~12个月的妊娠率(12.5%,6/48),差异有统计学意义(P<0.05).辅助生殖组月经恢复的0~3个月妊娠率(30.8%,4/13)与月经恢复第4~12个月的妊娠率(30.8%,4/13)差异无统计学意义(P>0.05).月经恢复后的1年内,两组患者妊娠率的差异无统计学意义(P>0.05).GnRH-a使用3次与使用4~6次比较,妊娠率的差异无统计学意义(P>0.05).结论中重度子宫内膜异位症性患者,使用3次GnRH-a治疗,在月经恢复前及恢复最初3个月积极指导患者期待妊娠,在月经恢复3个月后及合并子宫内膜异位症外其他不孕因素的患者尽早给予辅助生殖治疗,有利于提高妊娠率.     

克氏针联合外固定支架治疗桡骨远端不稳定骨折疗效分析

目的探讨克氏针联合外固定支架治疗桡骨远端不稳定骨折的临床疗效.方法选取桡骨远端不稳定骨折患者120例,其中采用经皮克氏针联合外固定支架治疗60例(观察组),采用切开复位锁定接骨板系统内固定治疗60例(对照组).比较两组患者术中出血量及手术时间,术后切口愈合时间、骨折愈合时间以及并发症发生情况.结果观察组患者手术时间、切口愈合时间、骨折愈合时间均明显短于对照组、术中出血量显著少于对照组,差异均有统计学意义(P<0.05或0.01).两组患者术后腕关节功能及复位质量均无明显差异(均P>0.05).观察组患者术后仅创伤性关节炎发生率明显低于对照组(P<0.05),两组患者其他并发症发生率的差异均无统计学意义(均P>0.05).结论克氏针联合外固定支架治疗桡骨远端不稳定骨折,具有创伤小、岀血量少,缩短手术时间、伤口愈合时间及骨折愈合时间,恢复快、功能良好、术后并发症发生率低等优点,值得临床推广.     

老年静止期翼状胬肉两种手术方法的临床评价

目的比较显微镜下单纯翼状胬肉切除与切除后联合角膜缘干细胞移植两种手术方式对老年静止期翼状胬肉患者的治疗效果.方法将>65岁的原发性静止期翼状胬肉患者随机分为两组,A组行显微镜下单纯翼状胬肉切除术,B组在翼状胬肉切除后行自体角膜干细胞移植,术后随访6~36个月(平均10个月),观察手术时间及术后复发情况.结果 A组手术时间(14.2±1.3)min,明显短于B组(24.1±1.2)min,比较有统计学差异(P=0.000).而复发率比较,A组复发率6.67%(2/30),B组复发率3.33%(1/30),两组间无统计学差异(P=0.550).结论两种手术复发率均较低,但单纯切除术手术时间短,对不能长时间耐受手术或手术配合度较差的老年静止期翼状胬肉患者,可以作为首选手术方式.     

分化型甲状腺癌颈部淋巴结转移相关因素分析

目的探讨分化型甲状腺癌颈部淋巴结转移的相关因素和合理的手术方式.方法对近8年来手术治疗的616例分化型甲状腺癌患者的临床及病理资料进行统计分析,比较不同年龄、性别、多灶性情况、肿瘤是否侵犯包膜、肿瘤直径及病理特征的患者颈部淋巴结转移发生率,寻找发生颈淋巴结转移的危险因素.结果术后病理检查诊断为甲状腺乳头状癌566例,滤泡状癌50例.所有患者中,中央区(Ⅵ区)淋巴结转移发生率为43.0%(265/616),颈外侧区(Ⅱ+Ⅲ+Ⅳ区)淋巴结转移发生率为19.2%(118/616).肿瘤突破包膜、直径>1cm者同侧淋巴结转移发生率明显升高(P<0.05).滤泡状癌淋巴结转移发生率明显低于乳头状癌(P<0.05).结论分化型甲状腺癌颈部淋巴结转移最常见的部位是中央区,其次为颈外侧区.初次手术应常规清扫颈部中央区淋巴结.当肿块直径>1cm、肿瘤突破甲状腺包膜时或B超、CT等影像学检查有颈部淋巴结转移时,应常规清扫颈外侧区淋巴结.乳头状癌淋巴结转移发生率更高,应区别对待.     

高钠血症与颅脑损伤患者死亡相关风险研究

目的探讨不同程度高钠血症与颅脑损伤患者死亡的相关风险.方法将近5年ICU的颅脑损伤患者431例根据血钠水平分为4组,非高钠组(<150mmol/L)、轻度高钠组(150~155mmol/L)、中度高钠组(155~160 mmol/L)、重度高钠组(≥160mmol/L),分析血钠水平与患者死亡的相关风险.结果重度高钠组患者的Glasgow昏迷评分(GCS)3.27±0.89,APACHE-II评分35.25±6.01,病死率93.82%,与轻、中度高钠组患者相比,具有统计学差异(P<0.05).Logistic多因素分析提示GCS评分下降(OR=3.96,95%CI=1.43~10.96,P<0.05),APACHE-II评分升高(OR=1.32,95%CI=1.21~1.41,P<0.05)和重度高钠血症(OR=6.07,95%CI=3.19~13.87,P<0.05)是颅脑损伤患者的死亡危险因素.结论重度高钠血症是脑外伤患者死亡的主要危险因素之一.     

超声二维斑点追踪显像技术对2型糖尿病患者左室扭转运动的诊断价值

目的探讨超声二维斑点追踪显像(STI)技术对2型糖尿病患者左室心肌扭转运动的诊断价值.方法选取2型糖尿病患者67例,根据LVEF分为左心收缩功能正常组(A组,LVEF≥50%)33例、左心收缩功能减低组(B组,LVEF<50%)34例,另择同期体检健康者33例作为对照组.采用常规超声及STI技术对3组对象的左室扭转情况进行定量分析,并比较分析.结果 A组患者左室扭转角度峰值(Peaktw)、主动脉瓣关闭时间点扭转角度(AVCtw)、二尖瓣开放时间点扭转角度(MVOtw)较对照组显著升高(P<0.01);B组患者Peaktw、AVCtw、MVOtw较对照组及A组显著降低(P<0.01).与对照组比较,2型糖尿病患者等容解旋比例(IUR)、解旋率(UntwR)减低(P<0.05),而解旋减半时间(UHT)即明显延迟(P<0.01),与A组比较,B组患者等容解旋比例、解旋率降低(P<0.05),而解旋减半时间明显延迟(P<0.01).结论超声二维斑点追踪显像技术能够早期识别2型糖尿病患者的心功能异常变化.     

淋巴细胞计数对弥漫大B细胞淋巴瘤的预后价值分析

目的探讨外周血淋巴细胞绝对数(ALC)与初发弥漫大B细胞淋巴瘤(DLBCL)患者预后的关系.方法回顾性分析71例DLBCL患者的临床特征,比较初发时ALC不同的患者之间临床特点及转归.结果71例患者中,ALC>1×109/L者27例(38.0%),ALC≤1×109/L者44例(62.0%).ALC不同的两组患者间,年龄、性别、临床分期、B症状等临床特征均无统计学差异(均P>0.05).ALC低者Hb平均值更低,淋巴细胞亚群中T辅助细胞、NK细胞百分比更低,总T细胞、T抑制细胞百分比更高(均P<0.05).共同接受CHOP方案治疗条件下,初诊时ALC低者临床缓解率相对较低,病死率较高,中位生存期更短,总生存率更低(均P<0.05).结论 ALC减少可能成为DLBCL患者预后的重要指标.     

RECENT PROGRESS ON SPHERICAL HARMONIC APPROXIMATION MADE BY BNU RESEARCH GROUP ——In memory of Professor Sun Yongsheng

As early as in 1990, Professor Sun Yongsheng, suggested his students at Beijing Normal University to consider research problems on the unit sphere. Under his guidance and encouragement his students started the research on spherical harmonic analysis and approximation. In this paper, we incompletely introduce the main achievements in this area obtained by our group and relative researchers during recent 5 years （2001-2005）. The main topics are： convergence of Cesaro summability, a.e. and strong summability of Fourier-Laplace series; smoothness and K-functionals; Kolmogorov and linear widths.     

On a class of self-similar processes with stationary increments in higher order Wiener chaoses

We study a class of self-similar processes with stationary increments belonging to higher order Wiener chaoses which are similar to Hermite processes. We obtain an almost sure wavelet-like expansion of these processes. This allows us to compute the pointwise and local Hölder regularity of sample paths and to analyse their behaviour at infinity. We also provide some results on the Hausdorff dimension of the range and graphs of multidimensional anisotropic self-similar processes with stationary increments defined by multiple Wiener–Itô integrals.     

A REPRESENTATION FORMULA RELATED TO SCHR(O)DINGER OPERATORS

Schr(o)dinger operator is a central subject in the mathematical study of quantum mechanics.Consider the Schrodinger operator H = -△ V on R, where △ = d2/dx2 and the potential function V is real valued. In Fourier analysis, it is well-known that a square integrable function admits an expansion with exponentials as eigenfunctions of -△. A natural conjecture is that an L2 function admits a similar expansion in terms of "eigenfunctions" of H, a perturbation of the Laplacian (see [7], Ch. Ⅺ and the notes), under certain condition on V.     

On a class of Riemann surfaces

It is considered the class of Riemann surfaces with dimT1 = 0, where T1 is a subclass of exact harmonic forms which is one of the factors in the orthogonal decomposition of the spaceΩH of harmonic forms of the surface, namely The surfaces in the class OHD and the class of planar surfaces satisfy dimT1 = 0. A.Pfluger posed the question whether there might exist other surfaces outside those two classes. Here it is shown that in the case of finite genus g, we should look for a surface S with dimT1 = 0 among the surfaces of the form Sg\K , where Sg is a closed surface of genus g and K a compact set of positive harmonic measure with perfect components and very irregular boundary.     

CONTENTS OF VOLUME 30

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Instructions for contributions

正Applied Mathematics-A Journal of Chinese Universities,Series B(Appl.Math.J.Chinese Univ.,Ser.B)is a comprehensive applied mathematics journal jointly sponsored by Zhejiang University,China Society for Industrial and Applied Mathematics,and Springer-Verlag.It is a quarterly journal with     

Journal of Mathematical Research with Applications Guide for Authors

正Journal overview:Journal of Mathematical Research with Applications(JMRA),formerly Journal of Mathematical Research and Exposition(JMRE)created in 1981,one of the transactions of China Society for Industrial and Applied Mathematics,is a home for original research papers of the highest quality in all areas of mathematics with applications.The target audience comprises:pure and applied mathematicians,graduate students in broad fields of sciences and technology,scientists and engineers interested in mathematics.     

Staircase transportation problems with superadditive rewards and cumulative capacities

A cumulative-capacitated transportation problem is studied. The supply nodes and demand nodes are each chains. Shipments from a supply node to a demand node are possible only if the pair lies in a sublattice, or equivalently, in a staircase disjoint union of rectangles, of the product of the two chains. There are (lattice) superadditive upper bounds on the cumulative flows in all leading subrectangles of each rectangle. It is shown that there is a greatest cumulative flow formed by the natural generalization of the South-West Corner Rule that respects cumulative-flow capacities; it has maximum reward when the rewards are (lattice) superadditive; it is integer if the supplies, demands and capacities are integer; and it can be calculated myopically in linear time. The result is specialized to earlier work of Hoeffding (1940), Fréchet (1951), Lorentz (1953), Hoffman (1963) and Barnes and Hoffman (1985). Applications are given to extreme constrained bivariate distributions, optimal distribution with limited one-way product substitution and, generalizing results of Derman and Klein (1958), optimal sales with age-dependent rewards and capacities.To our friend, Philip Wolfe, with admiration and affection, on the occasion of his 65th birthday.Research was supported respectively by the IBM T.J. Watson and IBM Almaden Research Centers and is a minor revision of the IBM Research Report [6].     

Boundedness for commutators of multipliers on Hardy type spaces

In this paper, we study the commutators generalized by multipliers and a BMO function. Under some assumptions, we establish its boundedness properties from certain atomic Hardy space Hb^p（R^n） into the Lebesgue space L^p with p 〈 1.