多普勒超声引导下痔动脉结扎术治疗痔病的应用研究

目的：探讨多普勒超声引导下痔动脉结扎术治疗痔病的临床效果。方法150例内痔及混合痔患者分为观察组与对照组各75例,对照组给予传统的外剥内扎术治疗,观察组给予多普勒超声引导下痔动脉结扎术治疗,比较两组患者的治疗效果。结果两组脱出症状大部分消失,消失率无统计学意义（ P＞0．05）;观察组术后首次排便、术后一周便血发生率均低于对照组,差异有统计学意义（P＜0．05）;观察组患者术后疼痛及水肿评分显著低于对照组（ P＜0．05）;观察组有肛门下坠感及继发性出血的患者所占比例、尿潴留评分等与对照组比较差异不显著（P＞0．05）。结论采用多普勒超声引导下痔动脉结扎术治疗痔病,操作简单,疗效确切,并发症少,术后恢复快。     

12-step facilitation for the dually diagnosed: A randomized clinical trial

There are few clinical trials of 12-step treatments for individuals with serious mental illness and alcohol or drug dependence. This randomized trial assessed the effects of adding a 12-session 12-step facilitation therapy (TSF), adapted from that used in Project MATCH, to treatment as usual in an outpatient dual diagnosis program. Participants were 121 individuals dually diagnosed with alcohol dependence and a serious mental disorder, followed during 12 weeks of treatment and 36 weeks post-treatment. Participants receiving TSF had greater participation in 12-step programs, but did not demonstrate greater improvement in alcohol and drug use. However, considered dimensionally, greater participation in TSF was associated with greater improvement in substance use, and greater 12-step participation predicted decreases in frequency and intensity of drinking. Findings suggest that future work with TSF in this population should focus on maximizing exposure to TSF, and maximizing the effect of TSF on 12-step participation.     

两点注射垂体后叶素在宫颈冷刀锥切术中的应用

目的:观察两点注射垂体后叶素在宫颈冷刀锥切术中的临床疗效和安全性。方法:96例行宫颈冷刀锥切术患者按随机数字表法均分为对照组、单点注射组、两点注射组。对照组患者行宫颈冷刀锥切术后,阴道内填塞碘仿纱布卷压迫止血;单点注射组患者行宫颈冷刀锥切术时,在宫颈9点处给予垂体后叶素2 ml加入0.9%氯化钠注射液3 ml中宫颈注射,术后阴道内填塞碘仿纱布卷压迫止血;两点注射组患者行宫颈冷刀锥切术时,在宫颈3点和9点处分别给予垂体后叶素1 ml加入0.9%氯化钠注射液1.5 ml中宫颈注射,术后阴道内填塞碘仿纱布卷压迫止血。观察3组患者手术时间、术中出血量、住院时间、术后并发症发生率及不良反应发生情况。结果:单点注射组、两点注射组患者的手术时间、术中出血量、住院时间、术后并发症总发生率均显著优于对照组患者,且两点注射组患者优于单点注射组患者,3组间比较差异均有统计学意义(P<0.05)。3组患者治疗期间均未见明显不良反应发生。结论:两点注射垂体后叶素用于宫颈冷刀锥切术,能减少术中出血量、缩短手术时间,且安全性较好。     

腰椎后路植骨并椎弓根钉棒内固定术治疗症状性双节段峡部裂

目的：探讨腰椎后路植骨并椎弓根钉棒系统内固定治疗症状性双节段腰椎峡部裂的临床疗效。方法回顾性分析腰椎后路手术治疗的12例有临床症状的双节段腰椎峡部裂患者,采用JOA腰痛评分标准、Smiley-Webster功能评分法、Oswestry功能障碍指数、Taillard指数综合、Lenke脊柱植骨融合评价标准评定术后疗效。结果术后JOA腰痛评分、Oswestry功能障碍指数、Taillard指数均较术前明显改善,差异具有统计学意义（P〈0.05）。 Smiley-Webster功能评分结果：优8例,良3例,可1例。Lenke评价植骨融合结果：A级20个节段, B级4个节段。结论腰椎后路峡部植骨或椎体间融合结合椎弓根钉棒系统内固定术是治疗症状性双节段峡部裂的有效方法,能够取得满意的疗效。     

双丹胶囊联合瑞舒伐他汀钙片治疗冠心病的临床观察

目的分析研究双丹胶囊联合瑞舒伐他汀钙片治疗冠心病的临床效果。方法采用随机数字表法将52例冠心病患者分成两组,每组26例,实验组予双丹胶囊联合瑞舒伐他汀钙片治疗,对照组予瑞舒伐他汀钙片治疗,比较并观察两组患者治疗后所取得的临床效果。结果两组患者经治疗后,实验组总有效率（92.31%）明显高于对照组总有效率（61.54%）,差异有统计学意义（P〈0.05）。实验组心血管事件发生率（3.85%）明显低于对照组心血管事件发生率（30.77%）,差异有统计学意义（P〈0.05）。两组患者治疗3个月后,实验组复发率（3.85%）明显低于对照组复发率（19.23%）,差异有统计学意义（P〈0.05）。结论双丹胶囊联合瑞舒伐他汀钙片治疗冠心病,可以有效控制患者的症状,并使疗效长时间保持,减少了不良反应的发生及复发,安全可靠,在临床上可以广泛运用。     

腹腔镜与开腹精索静脉结扎手术效果及对精子质量的影响

目的探讨腹腔镜下精索静脉结扎的手术效果及其对精子质量的影响。方法选择80例患者,观察组实施腹腔镜下治疗,对照组实施常规开腹手术,比较两组患者的手术操作时间、术中出血情况、术后下床活动时间、术后3个月时患者的精子质量。结果观察组患者的手术时间短于对照组（P〈0.05）,术中出血少于对照组（P〈0.05）,术后下床活动时间早于对照组（P〈0.05）,观察组术后精子密度显著高于对照组（P〈0.05）,精子活动率显著高于对照组（P〈0.05）。结论腹腔镜下精索静脉结扎相对于常规开腹手术,在提高手术操作效率的同时,更有利于患者术后康复及精子质量的提高。     

16号尖头与非尖头双腔气囊导尿管在普外私围术期男性患者中的应用效果比较

目的研究16号尖头与非尖头双腔气囊导尿管在普外科围术期男性患者中的应用效果。方法将2012年3月-2013年9月在本院普外科就诊的200例患者纳入研究,随机均分为采用16号非尖头双腔气囊导尿管进行导尿的观察组和采用16号尖头双腔气囊导尿管进行导尿的对照组,观察两组的应用效果。结果观察组患者一次置管成功率明显高于对照组（P〈O．05）;术后疼痛评分,留置过程中出现尿道黏膜损伤（出血）、尿漏、尿管阻塞等并发症发生率明显低于对照组（P〈O．05）。结论16号非尖头双腔气囊导尿管有助于改善导尿情况。     

心理护理对输卵管结扎术患者围术期的影响

目的探讨围术期心理护理对术中疼痛及一般生命体征的影响。方法随机抽取120例患者分为观察组（心理护理组）和对照组（常规护理组）,观察组接受心理护理,对照组实施常规护理,统计分析两组患者在术中疼痛的程度,研究两组患者术前、术后一般生命体征的变化。结果观察组较对照组在术中对疼痛的感受较轻,耐受性好（P〈O．05）,观察组较对照组术前、术后一般生命体征处于更好的状态（P〈O．05）。结论围术期心理护理有利于减轻术中疼痛,提高患者对手术的依从性。     

Feature Engineering for Surrogate Models of Consolidation Degree in Additive Manufacturing

Surrogate models (SM) serve as a proxy to the physics- and experiment-based models to significantly lower the cost of prediction while providing high accuracy. Building an SM for additive manufacturing (AM) process suffers from high dimensionality of inputs when part geometry or tool-path is considered in addition to the high cost of generating data from either physics-based models or experiments. This paper engineers features for a surrogate model to predict the consolidation degree in the fused filament fabrication process. Our features are informed by the physics of the underlying thermal processes and capture the characteristics of the part’s geometry and the deposition process. Our model is learned from medium-size data generated using a physics-based thermal model coupled with the polymer healing theory to determine the consolidation degree. Our results demonstrate high accuracy (>90%) of consolidation degree prediction at a low computational cost (four orders of magnitude faster than the numerical model).     

The Effect of Annealing on Additive Manufactured ULTEM™ 9085 Mechanical Properties

Fused filament fabrication (FFF) is increasingly adopted for direct manufacturing of end use parts in an aviation industry. However, the application of FFF technique is still restricted to manufacturing low criticality lightly loaded parts, due to poor mechanical performance. To alleviate the mechanical performance issue, thermal annealing process is frequently utilized. However, problems such as distortion issues and the need for jigs and fixtures limit the effectiveness of the thermal annealing process, especially for low volume complex FFF parts. In this research, a novel low temperature thermal annealing is proposed to address the limitations in conventional annealing. A modified orthogonal array design is applied to investigate the performance of ULTEM™ 9085 FFF coupons. Further, the coupons are annealed with specialized support structures, which are co-printed with the coupons during the manufacturing process. Once the annealing process is completed, multiscale characterizations are performed to identify the mechanical properties of the specimens. Geometrical measurement of post annealed specimens indicates an expansion in the layering direction, which indicates relief of thermal stresses. Moreover, annealed coupons show an improvement in tensile strength and reduction in strain concentration. Mesostructure and fracture surface analysis indicate an increase in ductility and enhanced coalescence. This research shows that the proposed annealing methodology can be applied to enhance the mechanical performance of FFF parts without significant distortion.