机械性肠梗阻多层螺旋CT诊断及其临床意义

目的探讨多层螺旋CT（MSCT）对机械性肠梗阻的诊断价值及其临床意义。方法回顾分析2008年6月～2011年2月我院经手术及病理检查证实为机械性肠梗阻58例患者的MSCT扫描结果。结果MSCT初诊与手术病理或全愈随访复查相符54例,敏感性94．3％,特异性91．3％,准确率93．1％。引起梗阻的主要病因有肠粘连、肠肿瘤、肠扭转、肠套叠、结石及粪石等。不同原因引起机械性肠梗阻的MSCT影像表现各具特征。结论MSCT对机械性肠梗阻诊断及鉴别诊断具有重要的临床意义。     

出院病案医嘱的常见问题及对策

目的 规范电子医嘱,减少医嘱缺陷及差错的发生,减少或降低医疗事故风险,确保医疗质量.方法 随机抽取2013年5月份归档病案500份,按医嘱单书写规范标准对其医嘱部分进行检查,将检查结果录入Excel表中进行统计分析.结果 500份医嘱中366份合格,合格率为73.2％,不合格医嘱中常见的问题依次是医师或护士缺手工签名,占12％;用药医嘱不规范,占11.2％;自定义医嘱,占8.6％;有医嘱无对应的报告单,占8.4％;护理常规、饮食、护理级别不规范,占7.6％.结论 通过采取规范医嘱流程、规范医嘱术语及行为、加强院科两级质量管理、增强医务人员的责任心和法律意识等措施,医嘱质量得到提高,医疗安全得到保障.     

HSV临床分离株的限制性核酸内切酶酶切分析与鉴定

采用三种方法从感染细胞中分离HSV DNA。同时对用三种方法提取的HSV DNA的量以及与细胞DNA分离程度的差别作了比较。采用其中一种方法对10株流行病学上无关的、分别来自疱疹性角膜炎和口唇疱疹病人的分离病毒株,用限制性核酸内切酶BglⅡ、HindⅢ和BamHⅠ进行了酶切分析与鉴定,BglⅡ和HindⅢ可明显区分HSV的型间差别,BamHⅠ可对10株HSV进行株间的鉴定。     

Improving Anti-Coking Properties of Ni/Al2O3 Catalysts via Synergistic Effect of Metallic Nickel and Nickel Phosphides in Dry Methane Reforming

A series of NiP-x/Al₂O₃ catalysts containing different ratio of metallic nickel to nickel phosphides, prepared by varying Ni/P molar ratio of 4, 3, 2 through a co-impregnation method, were employed to investigate the synergistic effect of metallic nickel-nickel phosphides in dry methane reforming reaction. The Ni/Al₂O₃ catalyst indicates good activity along with severe carbon deposition. The presence of phosphorus increases nickel dispersion as well as the interaction between nickel and alumina support, which results in smaller nickel particles. The co-existence of metallic nickel and nickel phosphides species is confirmed at all the P contained catalysts. Due to the relative stronger CO₂ dissociation ability, the NiP-x/Al₂O₃ catalysts indicate obvious higher resistance of carbon deposition. Furthermore, because of good balance between CH₄ dissociation and CO₂ dissociation, NiP-2/Al₂O₃ catalyst exhibits best resistance of carbon deposition, few carbon depositions were formed after 50 h of dry methane reforming.     

Test and Microstructural Analysis of a Steel Slag Cement-Based Material Using the Response Surface Method

In this study, the silica fume replacement rate, fly ash replacement rate, and curing temperature were regarded as the independent variables, and the compressive and flexural strengths were regarded as the response values. The response surface method was used to construct the response surface polynomial regression model and obtain the optimal preparation parameters of a steel slag cement-based gel slurry (SCGS). The univariate and multivariate effects on the SCGS’s strength were investigated via analysis of variance and a three-dimensional surface model, and the hydration products and strength development law were characterized via scanning electron microscopy and X-ray diffraction. The actual compressive strengths at 3 and 28 d of age were 31.78 and 53.94 MPa, respectively, which were close to the predicted values (32.59 and 55.81 MPa, respectively), demonstrating that the optimized strengths were accurate and reliable. Further, the hydration reaction rate of SiO₂ in the silica fume and the physical filling effect of the inert components of fly ash and steel slag under the optimal parameters were the key factors for the early strength of the material. Moreover, continuous C₃S hydration in steel slag and the continuous excitation of the volcanic ash properties of fly ash were important factors for the later strength.     

托拉塞米治疗房颤患者脑栓塞后急性脑水肿的临床研究

目的:研究托拉塞米治疗房颤患者脑栓塞后急性脑水肿的临床疗效。方法:73例患者随机分为观察组(37例)和对照组(36例),观察组给予托拉塞米联合甘露醇治疗,对照组给予呋塞米联合甘露醇治疗。结果:观察组总有效率83.78%,明显优于对照组的72.22%,2组比较差异有统计学意义(P<0.05);治疗后7d、14d两组NIHSS评分比较差异有统计学意义(P<0.05);治疗7d、14d后脑水肿缩小范围,观察组总有效率分别为70.27%、94.59%,对照组分别为55.56%、83.33%,2组总有效率比较差异均有统计学意义(均P<0.05);治疗后7d、14d两组ADL评分比较差异有统计学意义(均P<0.05)。结论:应用托拉塞米联合甘露醇治疗房颤患者脑栓塞后急性脑水肿疗效显著,具有起效快、不良反应少等优点,值得临床推广。     

Limited value of recovery phase-limited ST segment depression of treadmill exercise test

Background Clinical meaning of recovery phase limited ST segment depression of a treadmill exercise test is controversial.The aim of this study was to re-assess the diagnostic and prognostic value of ST segment depression during the recovery phase with the active phase of a treadmill exercise test in suspected coronary artery disease patients.Methods Clinical,exercise and angiographic data were retrospectively collected from 602 patients in the study.Five hundred and seventy-six patients developed ST segment depression during the active phase of the treadmill exercise test （group 1） and 26 patients developed ST segment depression only during the recovery phase （group 2）.Results With similar major clinical features,the prevalence of significant coronary artery stenosis and average Gensini scores were lower in the recovery phase-limited depression patients （group 2 vs.group 1,50.0% vs.66.9%,P=0.031 and group 2 vs.group 1,1.5 vs.8.5,P=0.04）.At a median follow up of 50.9 months for 22 group 2 and 34.8 months for 438 group 1 patients,the prevalence of total cardiac events was higher in group 1 than in group 2 patients （RR 1.60,95% Cl 1.00-2.54,P=0.049）.Conclusion The present study provides preliminary evidence that the diagnostic and prognostic value of recovery phaselimited ST segment depression of treadmill exercise test is limited.     

改良术式手术切除腮腺良性肿瘤的临床应用

目的探讨改良术式在手术切除腮腺良性肿瘤的临床效果及可行性。方法对36例腮腺良性肿瘤首发病例（肿瘤直径均≤3.0 cm）,根据肿瘤发生部位,选择不同切口,采用保留腮腺主导管的肿瘤＋区域性腮腺切除术＋局部面神经解剖术的改良术式。术后随访6个月～3年,观察患者术后肿瘤有无复发,并发症发生等情况;测定每个病例手术前后总唾液量,评价术后腮腺分泌功能。结果 36例患者术后切口均一期愈合,肿瘤术后无复发,未出现涎瘘、Frey综合征、口干。1例患者术后出现暂时性面瘫,于2周左右恢复正常。术前唾液总量为（6.6±0.76）ml/6 min,术后唾液总量为（6.2±0.82）ml/6 min,手术前后唾液总量差异无统计学意义（P〈0.05）。结论改良术式手术切除腮腺良性肿瘤,术后肿瘤无复发,并发症少,术后腮腺分泌功能良好。     

沙棘籽油微波提取的实验研究

目的:研究与优化微波技术提取沙棘籽油的工艺。方法:以提油率为指标,以微波功率、微波时间、液料比为考察因素,利用正交设计法筛选优化微波提取沙棘籽油的提取工艺。结果:微波提取沙棘籽油的最佳工艺条件是:微波功率539W,微波时间7 min,液料比8。此工艺条件下沙棘籽油的提取率为89.36%。结论:相比于传统提取方法,微波提取技术具有提取效果好,提取效率高的特点,可将微波提取技术应用到沙棘籽油的提取工艺中以提高产率、降低提取时间。     

关节镜下治疗腘窝囊肿的疗效

目的 探讨关节镜下切除腘窝囊肿的手术方法与疗效.方法 自2013年1月至2014年2月我科采用关节镜下切除25例腘窝囊肿,腘窝囊肿均为单膝,左膝13例、右膝12例.其中,男10例,女15例,年龄为40~65岁.术前常规体检、患膝X线和MRI检查,观察膝关节骨与软组织的病变.膝关节镜手术常规采用前内、前外侧入路,术中常规探查并清理膝关节内病变.评价病人并发症、疼痛、复发情况,采用Lysholm膝关节评分、美国膝关节协会评分(knee society score,KSS)、美国特种外科医院(Hospi-tal for Special Surgery,HSS)评分比较病人术前术后的情况.结果 25例病人均获得随访,随访时间为6~12个月,平均为(9.0±1.9)个月.复查MRI发现1例类风湿性膝关节炎病人腘窝囊肿复发,但无明显临床症状.术前Lysholm膝关节评分为(48.76±12.07)分,术后术后末次随访为(81.72±7.57)分;术前KSS为(52.32±11.16)分,术后末次随访为(85.84±6.85)分;术前HSS评分为(55.62±10.76)分,术后末次随访为(88.64±6.24)分.3个指标术后与术前比较,差异均有统计学意义(均P<0.05).结论 关节镜下打开内侧关节囊与腘窝囊肿之间的"阀门"并切除囊壁,可以达到治疗腘窝囊肿的目的.本研究手术方法简单有效、安全性高,并可同时处理腘窝囊肿的诱发因素,有效地降低囊肿的复发率.