单侧特发性声带麻痹神经电刺激治疗后即刻疗效初步观察

目的 探讨单侧特发性声带麻痹喉返神经/喉上神经电刺激治疗后即刻对主观声音改变、声学参数以及动态喉镜观察结果的影响.方法 选取诊断为单侧特发性声带麻痹的患者,回顾性收集其行喉肌电图检查并同期行神经电刺激治疗前后的动态喉镜及嗓音分析检查结果,分析检查及治疗前后主观声音改变,声学参数(jitter、shimmer、DSI、M...     

Test and Microstructural Analysis of a Steel Slag Cement-Based Material Using the Response Surface Method

In this study, the silica fume replacement rate, fly ash replacement rate, and curing temperature were regarded as the independent variables, and the compressive and flexural strengths were regarded as the response values. The response surface method was used to construct the response surface polynomial regression model and obtain the optimal preparation parameters of a steel slag cement-based gel slurry (SCGS). The univariate and multivariate effects on the SCGS’s strength were investigated via analysis of variance and a three-dimensional surface model, and the hydration products and strength development law were characterized via scanning electron microscopy and X-ray diffraction. The actual compressive strengths at 3 and 28 d of age were 31.78 and 53.94 MPa, respectively, which were close to the predicted values (32.59 and 55.81 MPa, respectively), demonstrating that the optimized strengths were accurate and reliable. Further, the hydration reaction rate of SiO₂ in the silica fume and the physical filling effect of the inert components of fly ash and steel slag under the optimal parameters were the key factors for the early strength of the material. Moreover, continuous C₃S hydration in steel slag and the continuous excitation of the volcanic ash properties of fly ash were important factors for the later strength.     

Determination of the Tool–Chip Contact Length for the Cutting Processes

The thermomechanical interaction of the tool with the chip in the most loaded secondary cutting zone depends on the contact length of the tool rake face with the chip. Experimental studies of the dependency of the contact length on the cutting speed, the undeformed chip thickness, and the tool rake angle, performed by the optical method, are used for comparison with the contact length obtained by the FE modeling of the orthogonal cutting process. To determine the parameters of the constitutive Johnson–Cook equation, which serves as a material model of the FE cutting model that has a predominant influence on the contact length, a software-implemented algorithm was developed. This algorithm is based on determining the generalized parameters of the constitutive equation through finding the intersection of these parameter sets. The plurality intersection of the parameter sets of the constitutive equation is determined by means of the design of experiments and refined by subsequent multiple iterations. The comparison of the contact length values, obtained by simulating the cutting process using the generalized parameters of the constitutive equation as a material model with their experimental values, does not exceed 12% for a wide range of cutting speeds and depths of cut, as well as for the tool rake angle.     

卵巢癌患者卵巢血流参数及组织MiR、KLK的变化

目的：观察及探讨卵巢癌患者卵巢血流参数及组织微小RNA（MiR）、组织激肽释放酶（KLK）的变化情况。方法：选取本院收治的66例卵巢癌患者为观察组,另以同期的66例卵巢良性肿瘤患者为对照组,然后将两组的卵巢血流参数及组织MiR、KLK表达情况进行比较,比较观察组中不同分期卵巢癌患者的上述检测项目。结果：观察组的卵巢血流收缩期峰值流速（PSV）高于对照组,阻力指数（RI）及搏动指数（PI）均低于对照组,组织MiR表达低于对照组,KLK则高于对照组,且观察组中不同分期卵巢癌者的上述检测结果之间比较,差异均具有统计学意义（P均〈0.05）。结论：卵巢癌患者卵巢血流参数及组织MiR、KLK的变化较大,且上述指标对于卵巢癌分期也有较高的诊断价值。     

Temporal gait analysis of children aged 9–10 years

Human gait is a procedure of learning and maturation; the steady, normal, adult gait pattern is considered to be established after the age of 11 years. This study presents the results accumulated for a group of 20 able-bodied children (10 male) aged 9–10 (mean age 9.5, SD=0.5), who were tested with a portable system using telemetry for temporal factors. These results can serve as reference for the assessment of possible orthopedic disorders in children with similar ages. For the parameter of single support, a systematic difference between the two legs was found for runs with normal speed, which opposes to the symmetric gait pattern of a mature able-bodied population; this difference seemed to disappear in fast gait. However, for the double support, insignificant differences between the two legs were observed in both normal and fast gaits, which opposes to other findings for a similar group of children. Last, the single step duration was significantly different between the two feet only in normal gait. Received: 27 November 2001, Accepted: 4 April 2002 Correspondence to: V. Kyriazis     

实时三维牛眼征参数评价卡维地洛对高血压病心脏正常构型患者心功能的影响研究

目的应用实时三维牛眼图指标评价卡维地洛对高血压病心脏正常构型患者心功能的影响。方法选择心脏正常构型高血压病患者62例,口服卡维地洛,监测其血压的变化,分别于用药前和用药6个月后行超声检查,将图像储存于QLAB工作站,计算实时三维牛眼图参数:测量左室轴向运动最大距离(E max)、最小距离(E min)、平均距离的标准差(ESD)、轴向运动的平均距离所需时间占R-R间期平均百分比(E%);以及比较治疗前后的局部射血分数(REF)、左室射血分数(LVEF)。结果卡维地洛可以有效降低血压,治疗后E max、E min和ESD分别与治疗前比较,均明显增加,差异均有统计学意义(均P﹤0.05);E%与治疗前比较明显缩短,差异亦有统计学意义(P﹤0.05)。治疗后REF和LVEF分别与治疗前比较均增加,但差异无统计学意义(P﹥0.05)。结论实时三维牛眼图指标能够准确评价卡维地洛对正常构型高血压病患者心脏功能的影响,此药物能对其靶器官早期干预,改善心功能,防治或延缓心室重构及高血压型心脏病的发生。     

加味当归补血汤调节IgA肾病肾虚血瘀证患者细胞因子的临床研究

目的研究加味当归补血汤对Ig A肾病患者的抑制细胞因子聚集及延缓肾脏纤维化的保护作用。方法将经过肾活检证实的Ig A肾病患者进行随机分组治疗,对照组仅使用基础治疗,治疗组在基础治疗的基础上加用加味当归补血汤。在治疗终点应用统计学方法分析2组患者血、尿细胞因子及纤维化相关指标,并进行组间疗效差异的比较。结果治疗组和对照组均可减少24 h尿蛋白水平,治疗组由治疗前的(5.78±1.10)g下降至(1.25±0.67)g,而对照组由(5.25±1.21)g下降至(2.09±0.89)g。同时具有调节患者细胞因子和纤维化相关指标如单核细胞趋化蛋白-1(MCP-1)、巨噬细胞移动抑制因子(MIF)、转化生长因子-β1(TGF-β1)、透明质酸酶(HA)、层粘连蛋白(LN)、胶原Ⅳ(Col-Ⅳ)、Ⅲ型前胶原N端肽P(PⅢNP)等的作用疗效显著,治疗前后自身对照改善均具有统计学意义(P0.05)。2组治疗后以上数据的组间比较,除尿液LN外组间比较均有统计学意义,分析其在Ig A肾病肾脏纤维化的意义表明治疗组的疗效优于对照组。结论中药和西药治疗均对Ig A肾病具有较好的抑制细胞因子聚集及延缓肾脏纤维化的保护作用,配合中药加味当归补血汤治疗可以明显提高临床疗效。     

血液红细胞参数在危重症患者液体管理中的指导价值

目的：：探讨血液中红细胞参数跟中心静脉压( CVP)以及血容量之间的相关性,为危重病患者的液体管理提供参考依据和临床应用价值。方法：试验一：持续观察1例危重症患者41天,记录其CVP和红细胞参数,比较不同CVP水平间,红细胞参数的变化;采用Spearman相关分析,分析CVP与红细胞参数各个指标间的相关性。通过对比,得到试验所需最合适的CVP水平以及对应的红细胞参数值。试验二：选取3名危重症患者,确认患者的最适合CVP及对应的红细胞参数值后,通过与实际检测的红细胞值对比,指导患者的液体管理。结果：试验一：CVP>10组的RBC、Hb、HCT分别为：3.01±0.31,87.6±6.5,0.269±0.020。显著低于CVP<8组(RBC、Hb、HCT分别为：3.61±0.26,105.7±3.9,0.335±0.018)。 Spearman相关分析结果显示CVP与RBC、Hb、HCT均呈负相关。确定患者的最适合CVP为CVP 8~10 cm H2 O,相对应的最适合红细胞参数分别为：RBC 3.45×109/L,Hb 99.8g/L,HCT 0.310。试验二：在Hb明显高于设定的最适合Hb组中,补液后3名患者CVP均明显升高(P<0.05)。在Hb明显低于设定的最适合Hb组中,经过利尿对症处理后,3名患者的CVP明显降低(P<0.05),患者生命体征平稳。结论：红细胞参数跟CVP呈负相关,最适合CVP及最适合红细胞参数的设定对液体管理可能具有指导意义。     

前后路短节段固定融合治疗腰椎纵向劈裂骨折

目的：评价前后路短节段固定融合治疗腰椎纵向劈裂骨折的临床效果和安全性。方法：回顾性分析中南 大学湘雅二医院脊柱外科2005年3月至2013年5月采用的前后路短节段固定融合治疗的13例腰椎纵向劈裂骨折患者临床 资料,对所有患者的矫正情况进行随访,采用疼痛视觉模拟量表(visual analogue scale,VAS)评分、Oswestry功能障碍指 数(Oswestry disability index,ODI)对腰椎功能进行评估。结果：随访时间为24~60个月,平均42个月;手术时间185~300 min,平均248 min;术中失血量为600~1 500 mL,平均950 mL。所有患者术后均获得功能及自我形象的改善,在Cobb 角评估方面,术后2 d,12个月和末次随访测量Cobb角较手术前均有明显改善,差异均有统计学意义(P<0.05);VAS评 分和ODI评估术后2 d,12个月和末次随访测量结果较之术前均有改善, 差异均有统计学意义(P<0.05)。术后12个月与 末次随访的评估结果相比,差异无统计学意义(P>0.05)。根据美国脊髓损伤协会(ASIA)分级标准,在末次随访时,术 前8例D级患者中6例恢复至E级,其中3例未见进一步恢复;术前2例C级中1例恢复至D级,1例恢复至E级。所有病例 骨折均获愈合,愈合时间为3~6个月,平均4.5个月;术中3例有硬膜撕裂,术中给予修补;无神经血管损伤并发症病 例。结论：短节段伤椎置钉和旋棒复位是腰椎纵向劈裂不稳定骨折较好的手术选择。