TEE指导下介入封堵在VSD封堵术中的应用

本研究探讨经食管超声心动图(TEE)引导下实施介入封堵术治疗室间隔缺损(VSD)的临床效果。选取53例单纯膜周型VSD患者作为研究对象进行回顾性分析,其中29例患者采用TEE引导下经股动脉逆行性插管完成VSD封堵术(研究组)、24例患者采用传统的放射线下建立动静脉通道实施经导管VSD介入封堵术(传统组)。对比两组患者的手术操作时间、封堵器型号大小,围手术期及术后并发症,手术前后患者左心功能的超声心动图指标。结果显示,研究组的封堵器型号大小与传统组比较,差异无统计学意义(P>0.05);研究组的手术操作时间短于传统组(P<0.05);术后3个月、术后6个月,两组患者的Tie指数、LVEDV、LVESV、E峰、A峰测定值较本组术前均显著降低(P<0.05),LVEF测定值较本组术前均显著升高(P<0.05)。TEE引导下经股动脉逆行性插管完成VSD封堵术与传统的放射线下建立动静脉通道实施经导管VSD介入封堵术的效果差异不大,但前者简化了手术操作,同时减少了X线损害。     

经食道心脏超声和经胸壁心脏超声检查对心源性栓塞性脑梗死的诊断效能

为分析经食道心脏超声(transesophageal echocardiography,TEE)和经胸壁心脏超声(transthoracic echocardiography,TTE)对心源性栓塞性脑梗死(cardio-embolic cerebral infarction,CECI)的诊断效能,本研究选取我院2018年5月~2019年12月收治的CECI患者65例,对患者分别实施TEE和TTE检查,比较不同检查方法对心脏疾病栓塞源的检出情况和不同检查方法的敏感性、特异性。结果显示,TEE对房间隔缺损、主动脉斑块、卵圆孔未闭、二尖瓣脱垂、二尖瓣增厚、房间隔瘤的检出率高于TTE(P<0.05);TEE联合TTE诊断CECI的敏感性和特异性均高于单独检查(P<0.05)。据此可知,TEE诊断CECI具有较高的检出率,而TTE存在漏检情况,TEE联合TTE有助于提高CECI的诊断准确率。     

麻醉前快速超声评估及术中经食道超声心动图监测对急危重患者手术麻醉的临床指导作用

本文探讨麻醉前快速超声评估及术中经食道超声心动图监测对急危重患者的手术麻醉管理是否有临床指导意义.60例急危重手术患者根据随机数字表法分为对照组(麻醉医生经验评估处理)和观察组(经胸超声和经食道超声扫查评估处理).比较两组患者液体出入量、血管活性药物使用种类及剂量、术后拔管时间等情况.研究发现,观察组患者术中使用血管活...     

超声引导下水压灌肠治疗儿童急性肠套叠的效果研究

本文探讨超声引导下水压灌肠治疗儿童急性肠套叠的效果及治疗失败的危险因素。选取在我院行超声引导下水压灌肠治疗的急性肠套叠患儿113例,分析复位成功情况,同时分析复位成功和失败患儿临床资料差异。复位失败患儿年龄小于复位成功患儿(P<0.05),复位失败患儿超声特征同心圆直径≥3 cm、套叠长度≥5 mm、套头位于横结肠及结肠脾区及以后、有套头分叶状、发病至入院时间≥12 h的比例及C反应蛋白(CRP)水平明显高于复位成功患儿(P<0.05);Logistic回归分析结果显示,年龄、同心圆直径、套叠长度、套头位置、套头分叶状、发病至入院时间是超声引导下水压灌肠治疗复位失败的影响因素(P<0.05)。超声引导下水压灌肠治疗儿童急性肠套叠有较好的效果,其复位情况受患儿年龄、发病至入院时间、套头位置等多方面影响。     

超声引导下标准通道经皮肾镜取石术治疗鹿角形肾结石的效果研究

探讨了实施超声引导下标准通道经皮肾镜取石术(PCNL)治疗鹿角形肾结石的临床效果.选取行标准通道下PCNL治疗的鹿角形肾结石患者200例进行回顾性分析,其中100例患者采用超声引导下PCNL手术(超声组)、另外100例采用X线定位后实施PCNL手术(X线组).超声组患者的穿刺次数、皮肾通道建立时间、住院时间、体外碎石治...     

超声引导下ESP与TAP对结直肠癌根治术患者治疗效果的比较

本研究的目的是对比超声引导下竖脊肌平面阻滞(ESP)与超声引导下腹横肌平面阻滞(TAP)对结直肠癌根治术患者术后镇痛效果。选取进行结直肠癌根治术的120例患者作为研究对象,按照随机数字表法分为对照组和研究组,各60例,对照组患者进行超声引导下TAP,研究组患者进行超声引导下ESP,检测两组心率、平均动脉压、视觉模拟评分法(VAS)评分、Ramsay镇静评分、应激反应问卷(SRQ)评分、用药剂量、苏醒指标检测、并发症反应。与T₀、T₁、T₂相比,T₃时两组患者心率、平均动脉压水平均升高,但研究组低于对照组(P<0.05)。与对照组相比,研究组患者术后2 h、4 h、8 h、12 h VAS评分较低,Ramsay镇静评分较高(P<0.05)。与术前相比,术后48 h两组患者情绪反应、躯体反应、行为反应评分降低,且研究组评分低于对照组(P<0.05)。与对照组相比,研究组患者瑞芬太尼、丙泊酚用量较少,苏醒时间、清醒时间、气管拔管时间更短,且并发症发生率较低(P<0.05)。相对于超...     

微创经皮钢板技术治疗胫骨复杂骨折的临床研究

目的探究胫骨复杂骨折行微创经皮钢板治疗的临床效果。方法回顾分析2014年5月—2015年2月来宜春市中医院接受微创经皮钢板技术治疗的53例胫骨复杂骨折病人的临床资料,为患者行微创经皮钢板技术治疗,观察其临床效果。结果本组53例病人在经过微创经皮钢板技术治疗后进行12个月随访,全部患者骨性均有效愈合,平均愈合时间4.5个月,无患者出现钢板螺钉松动和断裂及骨不连情况。术后1例(1.89%)病人切口感染,经抗感染药物治疗后痊愈。Johner-Wruhs关节功能及治疗效果评价结果为:优秀36例(67.92%);良好11例(20.75%);中6例(11.33%),优良率88.67%。结论在胫骨复杂骨折的临床治疗中微创经皮钢板技术效果良好。     

Study of Stabilized Poly(vinyl Chloride) Mixtures under Different Conditions of Thermal Treatment

The consumption of stabilizers based on organic soaps with Cd/Ba molar ratios of 3, 2, and 0.4, respectively, and with a molar ratio of Ca/Zn of 1 during thermal treatment of polyvinyl chloride) mixtures in a degradation apparatus, in a press, and in the mixing cavity of a Brabender Plastograph has been investigated on the basis of determination of chlorides by coulometric titration. The thermal stability of the mixtures has been calculated from the hydrogen chloride evolved, as found by a potentiometric method. It was found that the stabilizer was not fully consumed when the residual thermal stability reached zero. The formation of chlorides in the stabilized mixtures was slower than the hydrogen chloride evolution from the original unstabilized polymer.     

YLuAG:Ce粉体的发光及闪烁特征: 制备方法及缺陷效应

采用硝酸盐热解法(NP)、碳酸氢铵共沉淀法(CP)以及柠檬酸盐燃烧法(CC)分别制备了YLuAG:Ce (Y_0.600Lu_2.364Al₅O₁₂:Ce_0.036)荧光粉体. 通过傅里叶变换红外光谱(FTIR), X射线衍射(XRD), 透射电子显微镜(TEM), 光致发光(PL)及热释光(TL)等表征手段研究了不同方法制备粉体的反应结晶过程、晶粒形貌、激发发射光谱、闪烁性能等. 对比研究表明, 三种方法制备的YLuAG:Ce粉体其表面及体相缺陷数量及分布存在差异, 从而导致了发射光谱峰位的偏移和快慢衰减时间分量的比例变化. 粉体的热释光谱分析结果进一步显示: 不同粉体热释光谱的主发射峰峰位及强度明显不同, 从侧面说明了合成方法诱发了粉体内的缺陷, 而粉体内具有不同陷阱深度的缺陷数量及陷阱复合几率对材料发光性能有较大影响.     

Controlled radical polymerization of N-vinylpyrrolidone and N-vinylsuccinimide under the conditions of reversible chain transfer by the addition-fragmentation mechanism

Regular trends in controlled radical polymerization of N-vinylpyrrolidone and N-vinylsuccinimide by the mechanism of reversible chain transfer in the presence of a series of dithiobenzoates and trithiocarbonates were studied. The possibility of preparing soluble poly-N-vinylsuccinimide in concentrated solutions using benzyl benzodithioate as reversible chain-transfer agent was demonstrated.     

三维超声检测不同分娩方式及第二产程产妇肛提肌裂孔差异

本研究的目的为探讨肛提肌裂孔是否受分娩方式及第二产程的影响。选取产妇200例,其中剖宫产100例,阴道分娩100例,同时选取未生育的育龄女性100例作为对照组,采用三维超声观察三组研究对象肛提肌裂孔大小,计算肛提肌裂孔周径及面积。结果显示:阴道分娩组静息、Valsalva状态下肛提肌裂孔周径和面积明显高于剖宫产组与对照组(P<0.05);阴道分娩组第二产程>1 h产妇静息、Valsalva状态下肛提肌裂孔周径和面积明显高于第二产程≤1 h产妇(P<0.05);阴道分娩组总产程>12 h产妇静息、Valsalva状态下肛提肌裂孔周径和面积明显高于总产程≤12 h产妇(P<0.05)。阴道分娩及第二产程明显影响产妇肛提肌裂孔。     

聚乳酸包载5-氟尿嘧啶靶向超微粒子对人胃癌转移瘤的靶向性和控制释放研究

使用w／o／w复乳法制备聚乳酸载5-氟尿嘧啶超微粒子,使用透射电镜、激光粒度仪和紫外分光光度计对超微粒子进行表征,并考察其体外释药性质。将^99mTc标记的连有VEGF121单克隆抗体的超微粒子通过尾静脉注射到SCID裸鼠体内,观察它对胃癌转移瘤的靶向效果和治疗效果。结果显示超微粒子成圆球形,平均粒径为195.2nm,多分散系数为0.148,靶向载药超微粒子的载药率为8．23％,包封率为24．71％。聚乳酸载5-Fu超微粒子在PBS缓冲溶液中具有较好的控释效果,累积释放量Q与时间平方根t^1/2基本呈线性关系．尾静脉注射靶向超微粒子两小时以后可看到大部分超微粒子集中到肿瘤部位。在所有的实验组中,含5-Fu靶向载药超微粒子组的疗效最好,说明本靶向载药超微粒子具有抑制肿瘤的血管生成并在肿瘤组织释放化疗药物抑制肿瘤生长的双重作用。     

Real-Time Monitoring of the Atrazine Degradation by Liquid Chromatography and High-Resolution Mass Spectrometry: Effect of Fenton Process and Ultrasound Treatment

High resolution mass spectrometry (HRMS) was coupled with ultra-high-performance liquid chromatography (uHPLC) to monitor atrazine (ATZ) degradation process of Fenton/ultrasound (US) treatment in real time. Samples were automatically taken through a peristaltic pump, and then analysed by HPLC-HRMS. The injection in the mass spectrometer was performed every 4 min for 2 h. ATZ and its degradation metabolites were sampled and identified. Online Fenton experiments in different equivalents of Fenton reagents, online US experiments with/without Fe²⁺ and offline Fenton experiments were conducted. Higher equivalents of Fenton reagents promoted the degradation rate of ATZ and the generation of the late-products such as Ammeline (AM). Besides, adding Fe²⁺ accelerated ATZ degradation in US treatment. In offline Fenton, the degradation rate of ATZ was higher than that of online Fenton, suggesting the offline samples were still reacting in the vial. The online analysis precisely controls the effect of reagents over time through automatic sampling and rapid detection, which greatly improves the measurement accuracy. The experimental set up proposed here both prevents the degradation of potentially unstable metabolites and provides a good way to track each metabolite.     

Study of the Influence of Different Diphenol Compounds on Soil Microbial Activity by Microcalorimetry

Microcalorimetry was applied to follow the toxic effects caused by different diphenol compounds on microbial activity of Chinese fir soil. The activity of the microorganisms in soil was stimulated by adding 0.3 mL of a nutrient solution containing 2.5 mg of glucose and 2.5 mg of ammonium sulfate and the measurements were performed under a 35% controlled humidity at 28°C. Power‐time curves recorded on a microcalorimeter were followed by increasing the amount of diphenol compounds, which affected directly the total thermal effects evolved by the microorganisms. The curves showed a synergism on total thermal effect obtained by the addition of 2000 mg·kg^?1 of resorcinol, causing a consumption of resorcinol by the microorganisms as a new source of nutrients. Above this dose, the total thermal effect decreased exponentially. However, the addition of catechol and hydroquinone caused the total thermal effects to decrease directly. It was concluded that the increase in the diphenol concentration strongly affected the microbial life in this ecosystem. Microcalorimetry appears as a suitable technique to carry out both qualitative and quantitative comparative studies of microbial activity in soil.