Microstructure Evolution of Al6061 Alloy Made by Additive Friction Stir Deposition

In this paper, the phase structure, composition distribution, grain morphology, and hardness of Al6061 alloy samples made with additive friction stir deposition (AFS-D) were examined. A nearly symmetrical layer-by-layer structure was observed in the cross section (vertical with respect to the fabrication-tool traversing direction) of the as-deposited Al6061 alloy samples made with a back-and-forth AFS-D strategy. Equiaxed grains were observed in the region underneath the fabrication tool, while elongated grains were seen in the “flash region” along the mass flow direction. No clear grain size variance was discovered along the AFS-D build direction except for the last deposited layer. Grains were significantly refined from the feedstock (~163.5 µm) to as-deposited Al6061 alloy parts (~8.5 µm). The hardness of the as-fabricated Al6061 alloy was lower than those of the feedstock and their heat-treated counterparts, which was ascribed to the decreased precipitate content and enlarged precipitate size.     

腰椎融合术治疗原位复发性腰椎间盘突出症

目的探讨原位复发性腰椎间盘突出症再次手术的原因、手术方法及疗效。方法我院自2000年6月～2005年11月共收治17例原位复发性腰椎间盘突出症患者均采取椎板扩大开窗、椎间颗粒植骨融合、椎弓根钉内固定术,术后随访1～5年（平均19.7月）,进行回顾性分析。结果椎间植骨融合率为94.1%;按Macnab疗效评定标准,优良率为88.2%。结论原位复发性腰椎间盘突出症的主要原因是髓核组织摘除不彻底,神经根粘连,并伴随不同程度的椎管狭窄和腰椎不稳。明确诊断、严格掌握手术指征、认真细致地进行手术操作,可减少或避免手术并发症,取得优良的疗效。     

经尿道前列腺电切、气化术治疗前列腺增生临床研究

目的探讨经尿道前列腺电切术与气化术结合治疗前列腺增生的临床疗效。方法对我科2000年9月至2006年5月收治并联合施行TURP和TUVP共的165例BPH患者进行回顾性分析。其中Ⅱ度80例,Ⅲ度54例,Ⅳ度31例。结果本组手术时间55～170min,平均100min,出血量100～500ml,平均出血量180ml。随访1～2年,国际前列腺症状评分（IPSS）由术前（30.4±3.9）分降至术后（9.3±2.5）分,生活质量评分（QOL）由（4±2）分降至（2±1）分。最大尿流率Qmax由（9.5±1.2）ml/s到术后（18.1±2.9）ml/s。结论经尿道前列腺电切结合气化术治疗前列腺增生具有优点多,并发症少,明显优于单一的电切术和单一的气化术。     

Patients' experiences across the trajectory of atrial fibrillation: A qualitative systematic review

AimThis study aimed to synthesize qualitative evidence on experiences of patients with atrial fibrillation (AF) during the course of diagnosis and treatment. We addressed three main questions: (a) What were the experiences of patients with AF during the course of diagnosis and treatment? (b) How did they respond to and cope with the disease? (c) What were the requirements during disease management?DesignIn this study, qualitative evidence synthesis was performed using the Thomas and Harden method.Data SourcesElectronic databases, including PubMed, the Cochrane Library, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, the China Biomedical Database, the WanFang Database, Chinese National Knowledge Infrastructure and VIP, were searched. The databases were searched from inception to August 2021.Review MethodsTwo researchers independently selected studies using qualitative assessment and review instruments for quality evaluation and thematic synthesis for the data analysis.ResultsA total of 2627 studies were identified in the initial search and 15 studies were included. Five analytical themes were generated: ‘Diagnosing AF’; ‘The impact of AF on the patients’; ‘Self‐reorientation in the therapeutic process’; ‘Living with AF and QoL’; and ‘External support to facilitate coping strategies.’ConclusionsOur findings point out unique experiences of patients across the trajectory of AF related to delayed diagnosis, feelings of nonsupport, disappointment of repeated treatment failure and multiple distress associated with unpredictable symptoms. Future research and clinical practice are expected to improve the quality of medical diagnosis and treatment, optimize administrative strategy and provide diverse health support for patients with AF.ImpactUnderstanding the experiences and needs of patients with AF in the entire disease process will inform future clinical practice in AF integrated management, which would be helpful in improving the professionalism and confidence of healthcare providers. In addition, our findings have implications for improving the effectiveness of AF diagnostic and treatment services.Patient or Public ContributionThis paper presents a review of previous studies and did not involve patients or the public.     

黄体功能不全的中医治疗

黄体功能不全常导致月经先期、月经过少、不孕症和胎漏、胎动不安.中医病因病机主要是肾虚、脾肾两虚或肝郁肾虚.治法以补肾健脾为主,佐以疏肝、养血.笔者团队的研究提示:补肾健脾中药复方具有升调子宫内膜、蜕膜孕激素受体(PR)表达、改善黄体效应的作用.在调经、助孕和安胎方面有较好的疗效.近年来,多项临床与实验研究亦发现,补肾健...     

正畸拔除第一前磨牙对第三磨牙萌出角度的影响

目的：研究正畸拔除第一前磨牙对第三磨牙的影响。方法：37例第一前磨牙拔除和33例非拔牙患者作为研究对象,拍摄术前术后的全景片,测量第三磨牙长轴与平面及第三磨牙长轴与第二磨牙长轴的夹角,对治疗前后夹角的变化以U检验进行比较。结果：结果显示,拔除第一前磨牙后,下颌第三磨牙的的萌出角度得到了改善,而对上颌第三磨牙萌出改善并不明显。结论：拔除下颌第一前磨牙后,第三磨牙萌出角度会更加直立,从而可能减少其阻生的可能性。     

小青龙汤治疗小儿呼吸疾患研究进展

小青龙汤出自张仲景的《伤寒杂病论》,主治太阳病之外寒内饮证,有解表散寒、温肺化饮之功,本文主要归纳小青龙汤在小儿肺系疾病中的应用,从中国知网(CNKI)数据库中查阅并总结了近些年来的文献报道,对小青龙汤治疗小儿呼吸系统疾病的研究进展进行综述.     

盐酸舍曲林治疗早泄的临床研究

目的:观察盐酸舍曲林(左洛复)治疗早泄的疗效和副作用。方法:以盐酸氟西汀(百忧解)为阳性对照,分别以口服盐酸舍曲林50mg/d和盐酸氟西汀20mg/d治疗早泄患者,疗程4周,通过问卷调查两种药物的疗效及副作用。结果:66例患者完成研究,两种药物治疗早泄的有效率盐酸舍曲林为73.7%(28/38)、盐酸氟西汀为71.4%(20/28),差异无统计学意义(P>0.05);两种药物的副作用发生率也无明显差异。结论:抗抑郁药盐酸舍曲林与盐酸氟西汀一样,也有良好的治疗早泄作用,但具有更好的患者依丛性。     

原发性中枢神经系统恶性淋巴瘤22例临床分析

目的探讨原发性中枢神经系统恶性淋巴瘤（PCNSML）的临床和影像学特点。方法对22例PCNSML患者的临床资料进行回顾性分析。结果本组患者头痛16例、呕吐11例,肢体无力5例、麻木1例。病变位于幕上19例、幕下3例,其中多发病灶5例。CT表现为等或高密度病灶,瘤周轻度水肿。MRI显示T1加权像略低信号9例、等信号5例;T2加权像略高信号11例,等信号3例。CT和MRI强化扫描示均匀明显强化。手术前误诊17例。病理检查均为B细胞型恶性淋巴瘤。随访18例,5例多发病灶仅做活检的患者,均在6个月内死亡;肿瘤全切除加放疗6例,平均生存期27个月;部分切除加γ-射线聚焦治疗4例,平均生存期21个月;部分切除加放疗3例,平均生存期10个月;单纯全切除肿瘤1例,11个月后死于肿瘤复发;2例单纯肿瘤大部切除者在术后5个月和8个月死亡。结论PCNSML临床表现无特异性,术前误诊率高,CT和MRI表现有一定特点,确诊依靠病理检查。综合治疗可延长生存期。     

胫骨平台骨折58例临床分析

目的 分析胫骨平台骨折的临床治疗效果.方法 临床多种类型胫骨平台骨折58例采取手术及非手术治疗并对其治疗结果进行评价.结果 58例患者平均随访时间3年6个月,结果按综合评分法进行评价,本组优28例,良21例,可7例,差2例,优良率为84.5%.结论 正确的评估胫骨平台骨折塌陷及劈裂的程度、准确复位、牢靠的固定以及早期功能锻炼、CPM的应用有利于患肢功能的康复.