牛至扦插繁殖研究

目的：研究牛至扦插繁殖成活情况。方法：采用不同插穗类型、3种植物生长调节剂不同浓度及不同时间处理分析对牛至扦插的影响。结果：用茎中部作插穗成活率较高;以NAA100mg·L^-1浓度处理4h牛至插穗效果较好,成活率95．00％,有芽株为81．65％,芽数为30．67个,芽长9．07cm,生根量为15．67条。结论：在南阳地区牛至扦插时期以5月下旬为宜,用植物生长调节剂处理插穗成活率高。     

Force Parameters for On-line Tool Wear Estimation: A Neural Network Approach

Reliable on-line tool conditioning monitoring is an essential feature of modern sophisticated and automated machine tools. Appropriate and timely decision for tool-change is urgently required in the machining systems. Ample researches have been carried out in this direction.

Recently artificial neural networks (NN) are applied for this purpose in conjunction with suitable sensory systems. Its fast processing capability is well-suited for quick estimation of tool condition and corrective measure to be taken.

The present work uses back-propagation type training and feed-forward testing procedures for the neural networks. Three models using different force parameters are tried to monitor tool wear on-line. The close estimation of the modeled output to the actual wear value demonstrates the possibility of successful tool wear monitoring. Copyright © 1996 Elsevier Science Ltd.     

腹腔镜下胆道镜联合钬激光治疗难取性肝胆管结石的临床应用

目的 探讨腹腔镜下胆道镜联合钬激光治疗难取性肝胆管结石的临床应用价值.方法 回顾性分析18例难取性肝胆管结石病人在腹腔镜下通过胆道镜联合钬激光,将肝胆管结石击碎后注水冲出或用取石篮套出的临床资料.结果 本组18例均取石成功,取石时间10～18 min,平均15min.术后无胆道出血、胆漏.术后随访6个月,腹部B型超声或...     

Cutting seton for pilonidal disease: a new approach

I present a technique for dealing with chronic pilonidal disease that avoids use of general anesthesia, long hospital stay, complex wound care and prolonged disability that has so often been associated with more traditional surgical treatment in the past. Satisfactory resection was achieved by means of a single cutting seton (garrotte) in 8 patients, 5 males and 3 females ranging in age from 18 years to 31 years, all of whom had had prior unsuccessful incision and drainage for long-standing disease with local abscesses and suppuration. The seton was applied in an ambulatory care setting under local anesthesia. It was tied and progressively tightened over a period of two weeks. Complete excision of the diseased area was achieved and revascularization of the wounds site occurred with optimum healing by secondary intention, leaving an acceptable scar. It required minimal wound care. There were no recurrences over an average follow-up period of 22.5 months. All patients were uniformly satisfied. The encouraging preliminary results for this novel technique suggest that it is simple, safe and effective. It requires evaluation in a larger series with longer follow-up.     

Immediate stent recoil in an anastomotic vein graft lesion treated by cutting balloon angioplasty

Saphenous vein graft (SVG) anastomotic lesions can have significant fibromuscular hyperplasia and may be resistant to balloon angioplasty alone. Stents have been used successfully to treat these lesions. There are no reports of immediate stent recoil following such treatment in the literature. We describe immediate and persistent stent recoil in an anastomotic SVG lesion even after initial and post-deployment complete balloon dilatation of the stent and its successful treatment by cutting balloon angioplasty.     

回盲部异常韧带切断预防原发性小儿肠套叠手术复位后复发

目的 探讨回盲部异常韧带切断是否有助于预防肠套叠复发.方法 总结181例原发性小儿肠套叠患儿的资料,并追踪至术后2年.分析两种不同手术方法(单纯肠套叠复位;肠套叠复位+回盲部异常韧带切断)的患儿肠套叠的复发率.结果 单纯肠套叠复位的患儿复发率为5.9%;肠套叠复位+回盲部异常韧带切断的患儿复发率为0.两组间的复发率比较差异有统计学意义(P<0.05).结论 与单纯肠套叠手术复位相比,回盲部异常韧带切断有助于预防原发性小儿肠套叠复发.     

78例后腹腔镜肾切除术的临床分析

目的 比较后腹腔镜肾切除术与开放手术的临床效果.方法 78例肾切除术患者随机分为实验组和对照组,对照组给予开放手术治疗,实验组给予后腹腔镜手术治疗.结果 两组手术时间无显著性差异（t=2.236,P〉0.05）,但实验组术中出血量、下床活动时间、胃肠功能恢复时间和住 院时间等指标均显著优于对照组（t=38.453,P〈0.01;t=3.495,P〈0.05;t=3.270,P〈0.05;t=4.189,P〈0.05）.结论 随着临床的广泛应用和技术的熟 练,后腹腔镜手术具有良好的发展前景.     

Aggressive plaque modification with rotational atherectomy and cutting balloon for optimal stent expansion in calcified lesions

Objective To evaluate the factors affecting optimal stent expansion in calcified lesions treated by aggressive plaque modification with rotational atherectomy (RA) and a cutting balloon (CB). Methods From January 2014 to May 2015, 92 patients with moderate to severe coronary calcified lesions underwent rotational atherectomy and intravascular ultrasound imaging at Chinese PLA General Hospital (Beijing, China) were included in this study. They were divided into a rotational artherectomy combined with cutting balloon (RACB) group (46 patients treated with RA followed by CB angioplasty) and an RA group (46 patients treated with RA followed by plain balloon angioplasty). Another 40 patients with similar severity of their calcified lesions treated with plain old balloon angioplasty (POBA) were demographically matched to the other groups and defined as the POBA group. All patients received a drug-eluting stent after plaque preparation. Lumen diameter and lumen diameter stenosis (LDS) were measured by quantitative coronary angiography at baseline, after RA, after dilatation, and after stenting. Optimal stent expansion was defined as the final LDS < 10%. Results The initial and post-RA LDS values were similar among the three groups. However, after dilatation, the LDS significantly decreased in the RACB group (from 54.5% ± 8.9% to 36.1% ± 7.1%) but only moderately decreased (from 55.7% ± 7.8% to 46.9% ± 9.4%) in the RA group (time × group, P< 0.001). After stenting, there was a higher rate of optimal stent expansion in the RACB group (71.7% in the RACB group, 54.5% in the RA group, and 15% in the POBA group, P < 0.001), and the final LDS was significantly diminished in the RACB group compared to the other two groups (6.0% ± 2.3%, 10.8% ± 3.3%, 12.7% ± 2.1%, P < 0.001). Moreover, an LDS ≤ 40% after plaque preparation (OR = 2.994, 95% CI: 1.297?6.911) was associated with optimal stent expansion, which also had a positive correlation with the appearance of a calcified ring split (r = 0.581, P < 0.001). Conclusions Aggressive plaque modification with RA and CB achieve more optimal stent expansion. An LDS ≤ 40% after plaque modification was a predictive factor for optimal stent expansion in calcified lesions. This parameter was also associated with the presence of calcified ring split.     

冠状动脉内切割球囊成形术应用的初步体会

目的　评价经皮冠状动脉内切割球囊成形术的临床疗效。方法　使用切割球囊导管对 12例冠心病患者 ,男 11例 ,女 1例 ,年龄 (5 4± 6 )岁的 15支冠状动脉进行扩张。结果　手术成功率为 91.7% (11/ 12例 ) ,病变成功率为 93.3% (14/ 15支 )。未出现死亡、急性 Q波型心肌梗死和急性心包填塞等并发症。病变部位狭窄程度由术前的 (86± 7) %降至术后的 (2 8± 9) %。术后随访 1～ 10个月 ,有 2例复发心绞痛 ,其中 1例经血管造影证实为再狭窄。结论　切割球囊成形术是一种安全、有效的介入性治疗技术。     

应用血管内超声对比研究常规球囊与切割球囊血管成形术的机制

目的 :通过血管内超声 ( IVUS)对比研究单纯球囊血管成形术 ( POBA)与切割球囊血管成形术( CBA)的不同作用机制。方法 :随机分配病例进入 POBA与 CBA组。介入过程在造影指导下完成 ,球囊扩张前后均进行 IVUS检查。对比造影及 IVUS下术前术后斑块部位质与量的变化。及临近参考血管的改变。结果 :37例 ,共39处病变 ,2 3处进入 CBA组 ,16处进入 POBA组。造影下 CBA组较 POBA组弹性回缩及弹性回缩率小分别为( 0 .18± 0 .0 8) mm vs ( 0 .6 1± 0 .32 ) mm ,P <0 .0 0 1;( 7.5 9± 2 .6 8) % vs ( 2 2 .0 2± 12 .88) % ,P<0 .0 0 1。 IVUS下术前术后血管面积的增大 ,POBA组大于 CBA组 ( 1.30± 0 .6 6 ) mm2 vs( 0 .49± 0 .38) mm2 ,P<0 .0 1;斑块面积缩小 CBA组大于 POBA组 ,( 2 .0 3± 1.2 3) mm2 vs( 1.49± 1.0 0 ) mm2 ,P<0 .0 1;夹层发生率 CBA组小于 POBA组 ,2 6 .1% vs 5 0 % ,P=0 .0 33。结论 :切割球囊与普通球囊比较两者可获得相似的即刻管腔扩大程度。 POBA使管腔扩大的主要机制是血管的被动扩张 (占 5 0 %左右 ) ;相反 CBA的主要机制是斑块的压缩。 CBA对血管的损伤小于 PO-BA,推测 CBA发生再狭窄率较 POBA低