阴式子宫瘢痕妊娠病灶清除术的临床疗效评价

目的 观察阴式子宫瘢痕妊娠病灶清除术治疗剖宫产术后瘢痕妊娠的意义.方法 选取我院2018年10月—2019年10月收治的64例剖宫产术后瘢痕妊娠患者的临床资料,根据手术方案的不同,将实施阴式子宫瘢痕妊娠病灶清除术的病例作为观察组(n=33),将选择腹腔镜子宫瘢痕妊娠病灶消除术的病例作为对照组(n=31).比较两组手术疗...     

Enhanced Nitrate Ions Remediation Using Fe0 Nanoparticles from Underground Water: Synthesis,Characterizations, and Performance under Optimizing Conditions

The presence of nitrates in water in large amounts is one of the most dangerous health issues. The greatest risk posed by nitrates is hemoglobin oxidation, which results in Methemoglobin in the human body, resulting in Methemoglobinemia. There are many ways to eliminate nitrates from underground water. One of the most effective and selective methods is using zero-valent iron (ZVI) nanoparticles. ZVI nanoparticles can be easily synthesized by reducing ferric or ferrous ions using sodium borohydride. The prepared ZVI nanoparticles were examined by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), electron microscopy (TEM), X-ray diffraction (XRD), Brunauer–Emmett–Teller (BET) surface area, and zeta potential. We aim to eliminate or reduce the nitrates in water to be at the acceptable range, according to the world health organization (WHO), of 10.0 mg/L. Nitrate concentration in water after and before treatment is measured using the UV scanning method at 220 nm wavelength for the synthetic contaminated water and electrochemical method for the naturally contaminated water. The conditions were optimized for obtaining an efficient removing process. The removal efficiency reaches about 91% at the optimized conditions.     

早期拔除尿管对腹腔镜下结肠癌术后镇痛患者的影响

目的 探讨腹腔镜下结肠癌术后镇痛期间拔除尿管对患者尿潴留及相关并发症的影响.方法 分析本院2014年1月至2015年12月腹腔镜下结肠癌术后留置镇痛泵的患者46例,其中实验组23例(留置镇痛泵期内拔除尿管),对照组23例(停用镇痛泵后拔除尿管).两组术后尿潴留率、尿路感染率、肺部感染率、伤口感染率及满意率等指标比较.结果 两组患者的尿潴留率(8.7％比4.3％)、肺部感染率(4.3％比8.7％)、伤口感染率(4.3％比13.0％),差异均无统计学意义(均P＞0.05).两组患者均未出现导尿管相关性尿路感染.实验组满意率78.3％高于对照组47.8％,差异有统计学意义(P＜0.05).结论 腹腔镜下结肠癌术后留置镇痛泵的患者早期拔除尿管是安全可行的,且能减轻留置尿管引起的不适.     

皮肤创面无机诱导活性敷料对股动脉穿刺后血管并发症止痛效果观察

目的：观察皮肤创面无机诱导活性敷料对股动脉介入术后血管并发症止痛效果。方法：将股动脉穿刺处并发出血、淤血、血肿导致穿刺伤口剧烈疼痛的40例患者随机分为实验组和对照组,实验组以皮肤创面无机诱导活性敷料喷撒型粉剂均匀喷洒伤口,每日2次,连续3d;对照组以传统的磁疗方法治疗15min,每日1次,连续3d。分别记录两种不同治疗方法淤血、血肿部位止痛起效时间,疼痛缓解程度和消肿情况。结果：实验纽和对照组止痛起效平均时间分别为（18．4±6．2）min和（48．5±13．7）min（P〈0．01）;治疗24h后,实验组75％的患者无痛,25％的患者有轻、中度疼痛,对照组100％患者存在轻、中、重度疼痛（P〈0．01）;治疗72h两组血肿疗效比较无显著性差异（P〉0．05）。结论：皮肤创面无机诱导活性敷料用于股动脉穿刺伤口血管并发症治疗止痛效果好,操作简单,有一定的临床应用价值。     

Recent Advances in Adsorptive Nanocomposite Membranes for Heavy Metals Ion Removal from Contaminated Water: A Comprehensive Review

Water contamination is one of the most urgent concerns confronting the world today. Heavy metal poisoning of aquatic systems has piqued the interest of various researchers due to the high toxicity and carcinogenic consequences it has on living organisms. Due to their exceptional attributes such as strong reactivity, huge surface area, and outstanding mechanical properties, nanomaterials are being produced and employed in water treatment. In this review, recent advances in the use of nanomaterials in nanoadsorptive membrane systems for wastewater treatment and heavy metal removal are extensively discussed. These materials include carbon-based nanostructures, metal nanoparticles, metal oxide nanoparticles, nanocomposites, and layered double hydroxide-based compounds. Furthermore, the relevant properties of the nanostructures and the implications on their performance for water treatment and contamination removal are highlighted. The hydrophilicity, pore size, skin thickness, porosity, and surface roughness of these nanostructures can help the water permeability of the nanoadsorptive membrane. Other properties such as surface charge modification and mechanical strength can improve the metal adsorption effectiveness of nanoadsorptive membranes during wastewater treatment. Various nanocomposite membrane fabrication techniques are also reviewed. This study is important because it gives important information on the roles of nanomaterials and nanostructures in heavy metal removal and wastewater treatment.     

锁定钢板螺钉取出困难原因及解决方法的探讨

目的探讨锁定钢板螺钉取出困难的原因和解决方法。方法回顾分析10例锁定钢板螺钉取出困难患者的临床资料。结果螺钉取出困难的原因：钢板应力变形,锁定螺丝孔道变形,旋入螺钉时未使用卸力限制工具,螺钉内六角打滑,取钉方法错误。结论锁定钢板螺钉内固定及取出时应严格规范操作,使用专用工具及方法,可顺利取出内固定,并避免医源性骨折。     

肾上腺外伤性血肿的CT诊断

目的:评价肾上腺外伤性血肿的CT检查的意义。方法:回顾分析了经临床随访证实6例肾上腺外伤性血肿的CT资料。结果:6例肾上腺外伤性血肿均发生于右侧,6例在外伤10d内行CT检查。CT平扫:表现为卵圆形、梭形块影。病灶最大径4.5 cm×2.0 cm,其中,高密度4例、等密度1例、低密度1例。CT值在24~62 Hu之间。增强扫描:病灶不强化,2例在血肿边缘可见强化的肾上腺,其外周可见等密度条索影;4例合并少量腹水;2例合并肝撕裂伤。结论:CT可以早期明确肾上腺外伤性血肿的诊断。对于腹部闭合性损伤患者应早期行CT检查,必要的增强扫描,对于肯定和/或排除肾上腺血肿的诊断有重要价值。     

螺旋CT诊断前下纵隔血肿2例

目的：提高对前下纵隔血肿的认识及了解其CT影像表现。方法：对2例外伤病人行MSCT螺旋扫描后,对图像进行遮盖容积重建（SVR）、多平面重建（MPR）和表面遮盖重建（SSD）等后处理,并观察其CT表现。结果：应用MSCT三维重建后处理技术,能更好地观察到前下纵隔血肿的直接影像及其相关CT影像表现。结论：在胸部外伤病人行MSCT螺旋扫描时,要注意对前下纵隔的观察并及时提出前下纵隔血肿的诊断。     

大脑中动脉动脉瘤破裂并颅内血肿的急诊手术治疗

目的探讨大脑中动脉（MCA）动脉瘤破裂伴颅内血肿的临床特征、外科治疗方法。方法回顾性分析15例MCA动脉瘤破裂伴颅内血肿患者的临床资料,按术前Hunt-Hess分级,其中Ⅲ级3例,Ⅳ级10例,V级2例;血肿量为25～60ml,平均35ml;螺旋CT血管造影（CTA）确诊,所有病人给予急诊手术治疗。结果术后发生颞叶大面积梗死1例,丘脑梗死1例,严重血管痉挛4例。术后随访3～48月,GOS评分：恢复良好8例,中残4例,重残1例,植物生存1例,死亡1例。结论MCA动脉瘤破裂合并血肿的患者,病情多危重,应急诊开颅手术;CTA能快速确诊并指导手术;清除血肿＋去骨瓣减压术,可尽早解除高颅内压,减轻继发性脑损伤,同时夹闭动脉瘤,有效预防致命的再出血,提高治疗效果。     

血肿清除加去骨瓣减压术治疗重症高血压基底节脑出血

目的探索血肿清除加去骨瓣减压及硬膜减张缝合在治疗高血压基底节脑出血的患者中的疗效。方法连续收集去骨瓣手术治疗的35例患者,记录的数据包括术前GCS评分,血肿大小,瞳孔反应,ICH评分等。随访指标有30d死亡率以及最近一次的ADL评分。结果 35例患者中27例(77%)30d内存活。27例存活者在平均13个月的随访中16例(62%)神经功能预后良好(ADL评分I-Ⅲ级)。结论高血压基底节脑出血患者施行血肿清除合并去骨瓣减压术有望降低死亡率,改善神经功能预后。