咽旁间隙肿瘤的手术治疗

目的：探讨咽旁间隙肿瘤的诊断、治疗和手术入路的选择。方法：回顾性分析接受手术治疗的34例咽旁间隙肿瘤患者的临床资料，包括症状、体征、组织学诊断、影像学检查和手术进路。结果：88．2％肿瘤为良性。16例起源于腮腺，神经源性肿瘤14例。颈侧进路26例；经口腔进路5例，颈侧及口咽联合进路2例；颞下窝入路1例。32例完全切除肿瘤。术后并发Horner综合征3例，声带麻痹5例，面瘫3例。术侧声带和舌下神经同时麻痹1例。随访13个月～10．5年，34例中30例治愈，1例好转，术后复发3例(均为多形性腺瘤)。结论：采用颈侧进路，能安全彻底切除咽旁间隙肿瘤，经口腔进路仅适合于肿瘤边界清楚、组织明显突出于咽侧且表浅局限者。     

唇挡治疗乳牙早失间隙缩窄的临床应用

目的：探讨唇挡在乳牙早失间隙缩窄病例中的恢复间隙作用.方法：选取混合牙列时期下颌双侧第二乳磨牙早失,第一恒磨牙近中倾斜缺牙间隙缩窄病例20例.制作唇挡.一个月复诊以加力扩弓,测量间隙变化.结果：经唇挡坚持戴用9个月以上者,第一恒磨牙直立或远中移位,间隙得到恢复.平均戴用13.4个月,间隙平均增加了2.46 mm.结论：唇挡制作简单,便于操作,能够快速扩大下颌牙弓,是混合牙列时期恢复乳牙早失间隙缩窄的有效方法.     

一个快速的多维数据包分类算法

通过引入位图映射以及元组空间的概念,提出了一个数据包分类算法,该算法可以满足高性能网络对骨干路由器的要求,能够以线速完成对输入数据包的分类处理。算法在时间及空间复杂度上性能较好,并具有很好的扩展性。     

几种为Authorware制作的CAI课件节省磁盘空间的方法

文章结合实践介绍了在应用Authorware制作CAI课件时,通过采用对媒体素材的压缩、程序方面的压缩和文件发布及安装时的压缩等操作,使课件“减肥”,以达到节省磁盘空间的几种措施和方法。     

不同的阻滞方法对75岁以上高龄老人阻滞效果及循环功能的影响

为比较硬膜外隙阻滞(硬外)、蛛网膜下隙阻滞(腰麻)和单侧蛛网膜下隙阻滞(腰麻)在75岁以上高龄股骨颈骨折手术中的阻滞效果及对循环的影响.选ASAⅢ～Ⅳ级90例,随机等分为3组,Ⅰ组为硬外阻滞组(A组),用1.5%Lidocaine 4ml试验剂量并确认无脊麻后,根据情况追加1.5%Lidocaine 4～6ml;Ⅱ组为腰麻组,Ⅲ组为单侧腰麻组,两组注药速度均为0.1ml·s-1,注药过程均不作往返吸注.Ⅱ组用0.75%布比卡因1ml(7.5mg),注药后仰卧;Ⅲ组患侧在下侧卧,用0.75%布比卡因0.6ml(4.5mg)、10%葡萄糖液0.4ml,注药20min后平卧.结果显示:①患侧痛觉阻滞起效由快到慢为Ⅱ组、Ⅲ组和Ⅰ组.②三组阻滞前后的心率比较,均无显著性差异;Ⅲ组阻滞前后的平均动脉压也无显著性差异,但Ⅰ和Ⅱ组的阻滞前后的平均动脉压均有显著性差异.③患侧痛觉阻滞达标率(无痛平面达L1的百分率)为Ⅰ组93.3%,Ⅱ和Ⅲ组均为100%.④阻滞不全者Ⅰ组3例,而Ⅱ和Ⅲ组则无.⑤发生低血压者Ⅰ和Ⅱ组各3例,且同时都伴有ECG的ST段下移;Ⅲ组则无.表明①单侧腰麻组起效较快、阻滞完善和患侧痛觉阻滞达标率高.②单侧腰麻所用剂量小,阻滞范围小,对循环干扰轻和阻滞平面似乎更易控制.因此,小剂量布比卡因单侧腰麻可能更适合高龄老人下肢手术.     

针刺对剖宫产手术蛛网膜下腔阻滞麻醉效果的影响

目的评价针刺对剖宫产手术蛛网膜下腔阻滞麻醉效果的影响。方法将ASAⅠ级的90例择期行剖宫产手术的产妇,随机分为观察A组、观察B组、对照组,每组30例。各组均行蛛网膜下腔阻滞麻醉,对照组给予常规剂量麻醉药,观察A组给予针刺加常规剂量麻醉药,观察B组给予针刺加70%常规剂量的麻醉药;分别于入室后(T0)、麻醉前(T1)、麻醉后5 min(T2)、取出胎儿时(T3)、术毕(T4)检测平均动脉压(MAP)情况,统计各组麻黄素应用情况、新生儿出生时Apgar评分及术毕产妇疼痛VAS评分。结果①组内比较,观察A组、观察B组各时点MAP差异均无统计学意义(P0.05),对照组麻醉后5 min(T2)、取出胎儿时(T3)较入室时(T0)下降(P0.05);组间比较,取出胎儿时(T3)时,观察B组MAP高于观察A组和对照组(P0.05)。②对照组麻黄素使用率最高(33.33%),观察B组麻黄素使用率最低(6.70%);观察B组麻黄素使用率显著低于观察A组(16.67%)及对照组(33.33%)(P0.05),观察A组(16.67%)低于对照组(33.33%)(P0.05)。③组间比较,产妇VAS评分差异有统计学意义(P0.05),新生儿Apgar评分差异无统计学意义(P0.05)。结论针刺加蛛网膜下腔阻滞麻醉用于剖宫产手术,对产妇和胎儿均安全;其中正常麻醉药剂量的产妇血压平稳,镇痛效果确切;麻醉药减量30%的产妇血压更平稳,但镇痛效果个体差异较大。     

Confinement effects facilitate low-concentration carbon dioxide capture with zeolites

Engineered systems designed to remove CO₂ from the atmosphere need better adsorbents. Here, we report on zeolite-based adsorbents for the capture of low-concentration CO₂. Synthetic zeolites with the mordenite (MOR)-type framework topology physisorb CO₂ from low concentrations with fast kinetics, low heat of adsorption, and high capacity. The MOR-type zeolites can have a CO₂ capacity of up to 1.15 and 1.05 mmol/g for adsorption from 400 ppm CO₂ at 30 °C, measured by volumetric and gravimetric methods, respectively. A structure–performance study demonstrates that Na⁺ cations in the O33 site located in the side-pocket of the MOR-type framework, that is accessed through a ring of eight tetrahedral atoms (either Si⁴⁺ or Al³⁺: eight-membered ring [8MR]), is the primary site for the CO₂ uptake at low concentrations. The presence of N₂ and O₂ shows negligible impact on CO₂ adsorption in MOR-type zeolites, and the capacity increases to ∼2.0 mmol/g at subambient temperatures. By using a series of zeolites with variable topologies, we found the size of the confining pore space to be important for the adsorption of trace CO₂. The results obtained here show that the MOR-type zeolites have a number of desirable features for the capture of CO₂ at low concentrations.

The anthropogenic emission of CO₂ is associated with the continuous increase in global temperature since the industrial revolution. Therefore, many CO₂ mitigation strategies have been under investigation in the past years with the goal of net-zero emission by 2050. Point-source capture provides solutions for the sustainable operation of steel industries, cement plants, coal-based power stations, and the like. Bioenergy with carbon capture and storage (BECCS) and direct air capture (DAC) are being investigated for the direct removal of CO₂ from air to address the emissions from mobile sources such as automobiles, airplanes, and cargo ships (1, 2). BECCS and DAC provide opportunities for net-negative emissions.The search for CO₂ adsorbents that are affordable, effective, energy efficient, environmentally friendly, and safe for large-scale applications poses a serious challenge for the implementation of carbon capture technologies (3–5). This is particularly significant for DAC because of the low diffusion rates and low CO₂ capacities resulting from trace concentrations of CO₂ (5). It is generally believed that physisorbents are not applicable to the DAC system due to the their weak affinity for CO₂ (6). Thus, chemisorbents have been extensively investigated for trace CO₂ capture (7). Liquid amine and alkaline adsorbents as well as other types of chemisorbents (e.g., ionic liquids (8) and electric based membranes (9)) have been investigated for the capture of CO₂ from low-concentration environments. However, the intensive energy requirements for desorption (60–120 kJ/mol) and slow kinetics may be problematic for processing the large quantities needed for the implementation of DAC with chemisorbents. Amines supported on porous materials have also been studied for DAC to increase surface exposure and diffusion kinetics as compared to the liquid analogs (1, 10–14). The time-dependent oxidative degradation and evaporation of amines are intrinsic challenges to the use of these methods (15). The development of new physisorbents that display high stability, low energy cost for desorption, fast sorption kinetics, and high capacity, as well as that possess moderate adsorption heat of 30–60 kJ/mol and fully reversible physisorption properties, could be enabling adsorbents for large-scale DAC (16).The most widely studied physisorbents for DAC are metal–organic frameworks (MOFs) (5). Promising CO₂ capture performances are reported for hybrid ultramicroporous materials, a subgroup of MOFs (17–20). The high performance of these solids originates from the strongly electronegative, fluorine-based adsorption centers as well as the well-controlled pore size (20). However, it is still a challenging task to obtain a MOF sorbent for DAC with cost-effective scalability, high performance, and long-term stability (18, 20). Zeolites are another type of microporous materials with vast structural and physicochemical properties and high stability. They can be synthesized in large quantities in cost-effective processes and have a long history in the industry for catalysis and adsorption (21). For carbon capture, they often possess faster kinetics than supported amines (22). These merits have made zeolites interesting candidates for the capture of high-concentration CO₂ (23–25). The known challenges for the application of zeolites for DAC are the detrimental effect of water as well as capacities for low-concentration CO₂ capture. The former issue can be addressed by engineering multibed systems with a desiccant bed upstream of the zeolitic adsorbents (26). For DAC applications, the capture of atmospheric water could be a useful endeavor to complement the removal of CO₂ in areas where fresh water is badly needed. To address the later issue, recent research has been focused on maximizing the number (22, 27) of adsorption sites by using low-silica zeolites or adjusting the type of extraframework cations (28–30) by incorporating Zn²⁺ and Ca²⁺ ions. These approaches have given high capacities of 0.4 and 0.87 mmol/g for Na-FAU zeolites with Si/Al = 1.2 (zeolite X) and 1.0 (low-silica zeolite X), respectively, as well as 0.67 mmol/g for Zn-CHA with Si/Al = ∼2.0 and 1.8 mmol/g for Ca-LTA with Si/Al = 1 (the three letter codes of zeolites are assigned by the Interantional Zeolite Association for indicating their framework topologies). However, the low thermostability for low-silica zeolites and irreversible adsorption of CO₂ in Ca²⁺-containing zeolites will probably present challenges for commercial-scale implementation of DAC. Therefore, there remains a need for a zeolitic adsorbent with competitive capacity, high stability, and cyclability (31, 32).In this work, we report that the confinement effect in zeolites greatly affects the adsorption of low-concentration CO₂. MOR-type zeolites with eight-membered ring (8MR) side-pockets synthesized with or without (33) organic structure-directing agents (OSDAs) can give a CO₂ capacity of ∼1.15 mmol/g, among the highest reported for physisorbents for DAC. This capacity results in approximately an order of magnitude improvement of adsorption efficiency (i.e., CO₂ per adsorption site), compared to the standard 13X zeolite adsorbent. The O33 site in the 8MR side-pocket is the primary adsorption site of MOR-type zeolites, and the size of the confined space for the adsorption site in zeolites dictates their properties for the adsorption of 400 ppm CO₂.     

门静脉周围积液的影像表现分型及临床意义

目的 探讨肝门静脉周围间隙积液的影像学表现、分型及临床意义.方法 选取265例经MSCT及MRI检查诊断肝脏IPSE征象的病例包括肝肿瘤介入治疗后108例(40.8％)、慢性肝炎78例(29.4％)、肝转移瘤25例(9.4％)、尿毒症16例(6.0％)、肝脓肿11例(4.1％)、心力衰竭10例(3.7％),其他包括急性...     

一起用解磷啶抢救野八角茴籽中毒病人的探讨

目的为寻求抢救“野八角茴籽”中毒危重病人的特效药物。方法调查6例“野八角茴籽”中毒症状主要表现为抽搐、牙关紧闭、瞳孔缩小、口吐白沫、全身发冷、恶心、呕吐、腹胀、腹痛、烦躁、乏力、昏迷等症状。全血胆碱脂酶下降40%—70%,与有机磷中毒症状基本相似,临床无特效抢救药物,为了抢救病人,我们大胆提出用解磷啶救治野八角茴籽中毒病人的救治方案。结果用药8小时后病人开始清醒,用药21小时后病人可以下床走动,4天后痊愈,观察3天无异常后出院。结论用解磷啶挽救了6例野生八角茴籽中毒的危重病人,为今后临床用药提供了新的参考依据。     

五味子果核的色泽与化学成分的相关性研究

目的测定五味子果核表面颜色的数值即L*、a*、b*值与五味子果核有效成分的量,研究五味子果核色泽与化学成分的相关性。方法用数理统计方法即运用数理统计软件SPSS 20.0建立五味子果核表面色度值即L*、a*、b*值与五味子甲素、五味子乙素、五味子醇甲、五味子酯甲之间的多元线性回归方程,再进行F检验,确定各色度值分别对五味子有效成分的影响程度。结果色度值L*与五味子甲素呈显著性负相关(r≥0.5),其它色度值与木脂素呈极低度(r≤0.2)或低度(0.2r0.5)相关。结论利用五味子的色度值可推测其有效成分量高低,可用于五味子商品等级的划分,为更好地评价五味子质量提供科学依据。