混合励磁同步电动机分段弱磁控制

针对混合励磁同步电动机在高速区的弱磁运行特点,首先推导出其弱磁调速过程中保持平稳运行的电流变化关系,然后在此基础上提出了一种采用模糊控制与粒子群优化算法分阶段电流调节的效率最优控制方法。该控制方法的基本思想是,当电机处于弱磁调速过渡阶段时,通过模糊控制器对电流进行初步调节,使其迅速起动或进行状态调整,获得较高的动态性能;当电机进入稳态运行阶段后,以铜耗最小化为目标,采用粒子群优化算法对电流进行进一步调整,使其实现效率最优化控制。最后,通过仿真与实验结果分析验证了上述控制方法的有效性。     

恶性肿瘤治疗中维和策略的实施与思考

健康是一种和谐的状态,是一些成对的相反因素之间的平衡,中医学谓之"阴平阳秘,精神乃治"。人体内外环境失和,脏腑阴阳气血失调,正气亏虚,加之外邪、情志、饮食等多种因素作用于人体,就会出现虚、痰、瘀、毒等病理改变,导致肿瘤的发生发展。晚期肿瘤不能手术,不能耐受放化疗,但并非意味着"不治",可通过一定的方法和手段,维持人体内环境的相对和谐稳定,使肿瘤失去生长的环境,调动人体自身的抗病能力达到抑制肿瘤生长的目的,使患者长期带瘤生存。常用的治法有补法、消法、和法等,一般而言,发病早中期正盛邪实,正气尚盛,消法为主以祛邪;中后期正虚邪稽,正气衰败,注重补法以扶正;放化疗期则以和法为主。临床表现复杂多样,具体治法运用必须知常达变,消中有补,补中有消,和中有消,消中有和,从而获得预期效果。     

Speaker‐specific kinematic properties of alveolar reductions in English and German

A simultaneous EPG/EMA study of tongue gestures of five speakers was conducted to investigate the kinematic events accompanying alveolar stop reductions in the context of a velar plosive /k/ and in the context of a laryngeal fricative /h/ in two languages, English and German. No systematic language differences could be detected. Alveolar productions before a following /h/ showed only a marginal weakening of the formation of complete occlusion, while alveolar productions before a following /k/ showed a wide range of reductions, including instances of a complete deletion of the alveolar gesture. The extension of movement reduction varied between and within subjects. Importantly, while speakers were consistent with themselves, they employed different articulatory patterns with respect to the timing relationship between movement initiation, overall movement duration, peak velocity as well as closure duration. An attempt is made to relate the observed movement patterns to the dynamic factors of the speech mechanism.     

相等的下斜肌减弱术治疗由不等的下斜肌亢进引起的V型斜视

目的：探讨由不相等的下斜肌亢进引起的V型斜视的治疗。方法：术前下斜肌亢进不明显的一眼在斜肌注视野作三棱镜遮盖检查，治疗时采用相等量的下斜肌减弱术合并水平直肌的手术。结果：术后12例V征消失，1例第一眼位正位，但从第一眼位向上注视时仍有20^Δ的差值。1例留有内斜15^Δ，看远正位需戴双光镜。1例双侧眼下斜肌活动对称。结论：在斜肌注视野作三棱镜遮盖检查可以明确注视眼的下斜肌是否亢进；相等量的下斜肌减弱术治疗双侧下斜肌亢进不对称的V型斜视是完全有效的术式。     

67例V型斜视的手术探讨

目的 探讨V型斜视的临床特征及不同手术方法及效果.方法 回顾性分析了67例V型斜视的手术治疗.其中外斜V征46例,内斜V征21例,依据是否伴有下斜肌功能亢进及亢进程度,行下斜肌减弱术或水平直肌垂直移位术,所有患者按原在位水平偏斜度常规矫正水平斜视.观察手术前后的眼位、斜肌功能和双眼视觉.结果 67例手术中,49例行下斜肌后徙术或后徙转位术,术后43例上、中、下均正位,V征消失;术前无下斜肌功能亢进或下斜肌功能亢进"+"者13例,行水平直肌垂直移位术后11例正位,V征消失.67例患者术后19例恢复双眼视.结论 下斜肌后徙,后徙转位术适用于下斜肌功能亢进(++)-(+++)的V征,水平直肌垂直移位术适用于无下斜肌功能亢进或下斜肌功能亢进+的V征,应根据下斜肌功能亢进程度选择手术方式.     

上斜肌减弱术矫正伴上斜肌功能亢进A型斜视82例分析

目的 探讨上斜肌减弱(断腱或后徙)术矫正伴上斜肌功能亢进A征的效果及眼球旋转状态的改变.方法 收集伴双侧上斜肌亢进的A型斜视82例,断腱术79例,后徙术3例,观察手术前后第一眼位、上下方斜视度及上斜肌亢进程度,于术前和术后1d行双眼眼底照相并测量黄斑-视盘夹角(FDA).结果 (1)断腱组:①术前A征斜度平均为(23.47±9.08)△;手术减少(25.27±11.79)△;随访期末残余斜度差为(-1.98±6.60)△,与术前比较差异有统计学意义.②术前平均FDA,右眼为(9.08±5.40)°、左眼为(12.10±4.77)°、双眼为(20.87±8.49)°;平均减少量,右眼(7.57±4.71)°、左眼(8.28±5.38)°、双眼(15.72±7.01)°;术后第1天FDA右眼(0.90±4.90)°、左眼(3.34±5.33)°、双眼(4.23±7.58)°;双眼FDA手术前、后比较,差异有统计学意义.(2)后徙组3例患者A征消失,手术矫正量为23△、35△、31△,双眼总FDA减少为24.00°、10.80°和11.00°.结论 双侧上斜肌减弱术可有效矫正A征和眼球内旋状态.断腱术A征矫正量与术前A征的度数呈正相关,术后内旋转度数减少量与术前客观旋转度数呈正相关.

Abstract：

Objective To investigate tenectomy(ST)and recession(SR),and their effects in treatment of A pattern,superior oblique overaction,and torsion.Methods Pre- and Post-operative primary eye position,upgaze and downgaze of deviation,superior oblique muscle function,fundus photograph were examined and analyzed in 82 patients of A-pattem deviation with bilateral superior oblique overaction(SOOA).Results ST ① Mean A-pattern was(23.47± 9.08)△ before and(-1.98± 6.60)△ after the operation.Mean correction was (25.27±11.79)△.② The mean pre-operative fovea-disc angle(FDA)of both eyes was(20.87± 8.49)° ,with the mean decreasing of(15.72± 7.01),and the mean FDA was(4.23± 7.58)° 1 day after operation.SR The mean correction of A pattern was 23△,35△and 31 △.The mean correction of total FDA was 24.00° ,10.80° and 11.00° .Conclusions Bilateral superior oblique weakening is effective in correcting A-pattern deviation and incyclodeviation.     

下斜肌减弱术对眼球客观旋转角度的影响

目的:分析下斜肌减弱术对第一眼位眼球客观旋转角度所产生的影响。方法:收集我院2008年以来各种类型斜视患者中下斜肌功能亢进者需行手术治疗的患者23例30眼。应用Stratus OCTTM3000扫描仪于术前及术后1wk对患眼进行眼底扫描及图像拍摄,获取眼底图像。将所拍摄图像应用Photoshop进行分析处理,测得视盘-黄斑中心凹夹角即该眼球的客观旋转角。结果:术前及术后外旋角度比较,术前为17.200°±6.624°,术后为7.735°±6.545°,术前与术后眼球旋转角度比较,差异有显著统计学意义(P<0.01)。结论:行下斜肌减弱术可明显改变眼球在第一眼位的客观外旋转角度。本研究所得的结果即下斜肌减弱术对第一眼位眼球客观旋转角度影响的范围,对旋转斜视患者术前手术设计及预后估计具有一定的参考价值。     

剖宫产术后不同时间拔除导尿管对产妇的影响

目的探讨剖宫产术后不同时间拔除导尿管对产妇的影响。方法按随机数字表法将186例剖宫产留置导尿产妇分为A组82例、B组64例与C组40例。A组术后24~48h拔除导尿管,B组术后12~24h拔除导尿管,C组术后6~8h拔除导尿管,观察3组产妇尿路感染情况、排尿情况及舒适度评价情况。结果 3组产妇尿路感染发生率比较差异无统计学意义(P0.05)。3组产妇拔除导尿管后顺利排尿情况比较,x2=2.305,P=0.316。3组产妇术后舒适率比较,x2=11.892,P=0.003;进一步两两比较,B组与A组比较,x2=5.703,P=0.017;B组与C组比较,x2=12.07,P=0.001;A组与C组比较,x2=2.175,P=0.140。结论术后12~24h拔除导尿管不会导致明显并发症,且产妇舒适度较高,有利于产妇的产后恢复。     

发展中国民族医药的现实意义

基于发展民族医药，是出于对民族传统文化的认知和尊重，其科学的生命力在医疗保健事业中具有独特的作用，是民族地区的支柱产业和新的经济增长点，以及能够促进我国医学科学的百花齐放，为世界传统医药发展提供有益经验等方面的理由，探讨并分析了在各行各业实现现代化时代背景下发展民族医药的现实意义。并就当前中药，民族药物开发研究中存在的西化，简化，淡化的认识误区与现象提出了批评。     

Denervation and extirpation of the inferior oblique. An improved weakening procedure for marked overaction

Parks demonstrated that recession was more effective than myectomy at insertion or origin, or disinsertion for eliminating inferior oblique overaction. This study simultaneously compares an improved procedure, an extirpation of the inferior oblique that involves denervating it, to 14 mm recession in a prospective, consecutive series of 16 patients with symmetrical 4+ overaction of the inferior obliques; one technique (extirpation) performed on the right eye, and the other (14 mm recession) on the left. Mean duration of follow-up was 20.8 months (range 17 to 34 months). Extirpation resulted in 100% normal action, without residual overaction or underaction. Recession, however, resulted in 1+ to 3+ residual overaction in 12 cases (75%) and 4+ overaction requiring reoperation in two eyes (13%). It appears that extirpation of the inferior oblique is far superior to 14 mm recession for treatment of marked overaction of the inferior oblique.