主流式CO2浓度检测模块研制

介绍了一种主流式的CO2浓度检测模块的研制。该模块采用非分光红外方法（Non-Dispersive Infra-Red，NDIR）实现信号的提取，结构为主流式的一体化检测室设计，利用多种补偿算法提高检测精度，可实现呼吸CO2浓度，呼吸率等参数的连续检测。     

Role of surgery in the treatment of patients with high-risk neuroblastoma who have a poor response to induction chemotherapy

Background

In instances of high-risk neuroblastoma that do not show a clinical response to induction therapy, whether it is worth performing surgical resection or not and whether gross total resection (GTR) is more important than subtotal resection (STR) remain controversial.

Methods

We retrospectively analyzed the data of patients with stage 4 neuroblastoma aged 18 months or older at diagnosis. Primary tumor volumes were measured both at diagnosis and at the first tumor response evaluation (after 6 cycles of induction chemotherapy). If the tumor volume at the first response evaluation was > 50% of the initial tumor volume, the patient was categorized as a poor responder. Otherwise, the patient was categorized as a good responder. Only poor responders were included. Patients were evaluated for event-free survival (EFS), overall survival (OS), and complications of surgery based on extent of surgical intervention.

Results

Sixty-five patients were included in this study. The 41 patients who underwent surgical intervention had a higher 3-year OS than the 24 patients who had a biopsy only (55.4% ± 8.1% vs. 31.3% ± 10.2%, P = 0.02). However, there was limited improvement in 3-year EFS following surgical intervention. Three-year EFS rates of BX group (biopsy only) and OP group (surgical resection) were 24.2% ± 9.3% and 37.7% ± 7.9%, respectively (P = 0.063). The extent of resection had no impact on 3-year OS (P = 0.631) and 3-year EFS (P = 0.796). Patients in the GTR group trended to have more severe surgical complications than patients in the STR group (P = 0.105).

Conclusions

For high-risk neuroblastomas that do not show a clinical response to induction therapy, surgical resection is important in predicting outcome, but the extent of resection is not.     

我国腹腔镜D2 淋巴结清扫术联合远端胃癌切除术治疗进展期远端胃癌安全性和疗效的系统评价

目的 系统评价我国腹腔镜D2淋巴结清扫术联合远端胃癌切除术治疗进展期远端胃癌的有效性和安全性。方法 计算机检索PubMed数据库、Cochrane图书馆、中国科学引文数据库（China science citation database,CSCD）、万方数据库（Wanfang）、中文科技期刊数据库（China science and technology journal database,CSTJ）、中国生物医学文献数据库（China biomedical literature database,CBM）和中国学术期刊网络出版总库（China academic journal network publishing database,CAJD）数据库,检索时限均从建库至2013年6月。采用Review Manager 5.2软件进行Meta分析。结果 最终纳入了7个临床随机对照试验,共548例进展期胃癌患者。Meta分析结果显示：与传统开放式远端胃癌切除术（CODG）相比,腹腔镜辅助远端胃癌切除术 （LADG）的术中出血量少（MD =-94.02,95% CI：-140.96～-47.07）、术后住院时间短（MD =-3.66,95% CI：-5.76～-1.57）、术后下床活动时间早（MD =-1.95,95% CI：-2.74～-1.17）、肛门排气时间早（MD =-1.67,95% CI：-2.05～-1.30）、总并发症发生率低（OR=0.26,95% CI：0.14～0.51）,差异均有统计学意义（P＜0.050）,但LADG组的手术时间长于CODG组（MD =35.01,95% CI：10.41～59.61,P=0.005）。2组间淋巴结清扫数量比较差异无统计学意义 （MD =-0.24,95% CI：-0.99～0.51,P=0.530）。结论 LADG的近期疗效及安全性均优于传统CODG,但其手术时间长,远期疗效尚需进一步探究。     

心肌细胞裂解液诱导人脂肪基质干细胞分化为心肌样细胞的研究

目的分离培养人脂肪基质干细胞（ASCs），观察心肌细胞裂解液诱导ASCs分化为类心肌细胞的情况。方法人脂肪组织用胶原蛋白酶I消化，贴壁法培养获得ASCs，流式细胞术鉴定其表型，向ASCs培养体系中加入乳鼠心肌细胞裂解液，培养2周后，利用免疫荧光技术和RT—PCR法分析分化后细胞的心肌特异性蛋白和基因的表达情况。结果培养获得ASCs，表型为CD44^＋、CD105^＋、CD31^-、CD45^-。心肌细胞裂解液诱导培养2周后，细胞表达心脏特异性肌钙蛋白T（cTnT）、结蛋白，同时也表达心脏特异性基因cTnT、ANP、aMHC。结论心肌细胞裂解液可在体外诱导ASCs分化为类心肌细胞。     

常减压蒸馏装置换热网络的最优化

文章通过对某常减压装置的换热网络设计时的分析,提出最佳的网络优化方案。运用流程模拟软件在保证各侧线产品质量和收率的情况,通过对塔取热比例的优化,以尽可能提高换热终温;同时在不影响装置换热终温的前提下,尽可能的产生1.0 MPa蒸汽,大幅降低其他冷公用工程消耗,从而显著的降低装置的能耗。     

高危肾盂癌患者的简化手术治疗

目的:探讨高危肾盂癌患者的治疗方法。方法:自2009年7月~2012年12月对14例高龄且伴有严重并发症的肾盂癌患者行经腹膜后途径腹腔镜下肾脏+中上段输尿管切除术,术后正规膀胱灌注表柔比星注射液,以预防再发膀胱癌,并定期进行影像学及膀胱镜检查。结果:14例手术全部成功,手术时间63~105min,平均78.3min。术后24~48小时恢复饮食,5~9天出院。术后病理检查2例为鳞状细胞癌,12例为尿路上皮细胞癌;其中2例为浸润性肾盂癌伴肾门处淋巴结转移。术后13例得到随访,1例失访;随访8~36个月,平均21.4个月。1例术后13个月死于肺部转移,2例术后21个月因心肺疾病死亡;2例术后再发膀胱癌,行根治性全膀胱切除。结论:对于高危肾盂癌患者,简化手术,腹腔镜下切除肾脏+中上段输尿管,术后配合正规膀胱灌注化疗是一种有效安全的治疗方法。     

Clinical and radiographic outcomes of dynamic cervical implant replacement for treatment of single-level degenerative cervical disc disease: a 24-month follow-up

Purpose

To determine the role of dynamic cervical implant (DCI) replacement for single-level degenerative cervical disc disease in Chinese patients.

Methods

Thirty patients with single-level degenerative cervical disc disease were prospectively enrolled between April 2010 and August 2010 (12 women, 18 men; mean age 56.5 years). All patients underwent anterior cervical decompression, DCI replacement, clinical and radiological assessments preoperatively and at 1, 6, 12, and 24 months postoperatively, and Japanese Orthopaedic Association (JOA), Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Short Form 36 (SF-36) scores. Lateral neutral radiographs provided the intervertebral space height. Lateral dynamic radiographs were taken to measure the range of motion (ROM) of the cervical spine and functional spinal unit (FSU) of the treated segment. We compared the amount of motion of the adjacent vertebral endplate and the intrinsic motion of the implant and calculated a correlation analysis.

Results

DCI showed good clinical and radiographic outcomes. At the final follow-up, JOA, VAS, NDI, and SF-36 average scores improved significantly. The intervertebral space height increased slightly after operation and was maintained during follow up. The ROM of the cervical spine and FSU decreased at early follow-up, but recovered to the preoperative level within 1–2 years. There was a high index of linear correlation between the motion of the adjacent vertebral endplate and the intrinsic motion of the implant.

Conclusions

DCI provided elastic dynamic stability for the targeted segment, and restored and sustained intervertebral space height and ROM of the cervical spine.     

胃肠手术患者术后120h内下床活动水平及其影响因素分析

目的了解胃肠手术患者术后120h内的下床活动水平并分析其影响因素。方法采用一般资料调查表、一般自我效能感量表、医学焦虑抑郁量表、促进和阻碍因素问卷及下床活动水平等级评分方法 ,对144例胃肠手术患者进行调查。结果胃肠手术患者术后120h内的平均下床活动水平等级评分为6.5,处于中水平活动状态。不同手术部位、输液总量、尿管留置时间,是否使用尿壶、是否肠内营养的患者,其术后下床活动水平比较,差异有统计学意义(P0.05,P0.01);自我效能、肠内营养等医疗限制及尿壶的使用是影响患者术后下床活动水平的主要因素(P0.05,P0.01)。结论胃肠手术患者术后120h内下床活动现状不理想,应加强健康教育,增强患者的自我效能,为肠内营养患者制定下床活动计划,鼓励患者尿管拔出后下床排尿,以促进患者康复。