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。     

Reducing nitrosamine contamination in cutting fluids

In simulated metalworking coolants that contained both nitrite and di- or triethanolamine at pH 9, N-nitrosodiethanolamine formed at an initial rate of 11 or 6 ppm/wk, respectively. This rate was increased on heating the fluids, on acidification or by the addition of paraformaldehyde, 1,3,5-trimethylhexahydro-s-triazine, ferricyanide or ferric ethylenediaminetetraacetate. N-Nitrosodiethanolamine also formed when nitrite-free coolants containing either of the two amines above were exposed to nitric oxide in air. No nitrosamines were detected in fluids containing primary amines in place of the secondary and tertiary amines, except that N-nitrosooxazolidine was formed in the fluid containing monoethanolamine after addition of formaldehyde-releasing agents, and N-nitrosodiethanolamine and N-nitrosomorpholine were found in fluid containing diglycolamine (HOCH2CH2OCH2CH2NH2) after the fluid was heated at 100 degrees C for 48 hr. These data suggest several steps by which nitrosamine formation in commercial cutting fluids might be substantially reduced: avoiding acid-splitting as a disposal procedure; removing nitrite from the fluid and/or scavenging adventitious nitrosating agents; avoiding unnecessary heating; adding preservatives to the diluted fluid rather than to the commercial concentrate; replacing inherently nitrosatable amine additives by substitutes which are resistant to nitrosamine formation; minimizing concentrations of catalytically active metal complexes.     

高位复杂性肛瘘的主管道挂线及支管引流术与瘘管切除缝合术的比较

目的：探讨主管道挂线及支管引流术与瘘管切除缝合术两种手术方法治疗高位复杂性肛瘘的临床特点及疗效。方法：将我院2009年1月至2011年1月收治的156例高位复杂性肛瘘患者,随机分成A、B两组,每组患者各78例,A组患者采用主管道挂线及支管引流术,B组患者采用瘘管切除缝合术,对两组患者疗效、术后复发率、创面愈合时间、术后疼痛的程度、直肠感觉功能及肛门节制功能进行比较。结果：两组患者治愈率均为100%,无显著性差异（P〉0.05）;在术后复发率、创面愈合时间及术后疼痛程度方面,两组差异有统计学意义（P〈0.05）;直肠感觉和肛门节制功能比较,两组患者术前及B组术前术后比较,差异无统计学意义（P〉0.05）,两组患者术后及A组术前术后比较,差异有统计学意义（P〈0.05）。结论：高位复杂性肛瘘手术治疗的关键是正确寻找内口并彻底清除,两种手术方式的临床效果各有优劣,手术方式需根据术中探查的结果选择,只要选择合适的手术方式,就能取得满意疗效。     

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.     

复杂性肛瘘手术82例疗效观察

目的对比观察切缝挂线术与传统切开挂线术治疗复杂性肛瘘的临床疗效。方法将复杂性肛瘘患者164例,随机分为2组,治疗组82例采用切缝挂线术,对照组82例采用传统切开挂线法。结果①两组患者临床疗效比较,治疗组治愈率（89.0%）明显优于对照组（75.0%）,P〈0.05。②两组创面愈合时间比较,治疗组（20.71±8.06）d与对照组（21.14±8.57）d比较无统计学意义,P〉0.05。③两组术后并发症比较,治疗组并发症发生率（10.98%）明显低于对照组（34.15%）,P〈0.05。结论治疗组在治愈和术后并发症方面明显优于对照组,切缝挂线术是治疗复杂性肛瘘的理想方法。     

Analysis of labour accidents in tunnel construction and introduction of prevention measures

At present, almost all mountain tunnels in Japan are excavated and constructed utilizingthe New Austrian Tunneling Method (NATM), which was advocated by Prof. Rabcewicz ofAustria in 1964. In Japan, this method has been applied to tunnel construction sincearound 1978, after which there has been a subsequent decrease in the number of casualtiesduring tunnel construction. However, there is still a relatively high incidence of labouraccidents during tunnel construction when compared to incidence rates in the constructionindustry in general. During tunnel construction, rock fall events at the cutting face area particularly characteristic of the type of accident that occurs. In this study, weanalysed labour accidents that possess the characteristics of a rock fall event at a worksite. We also introduced accident prevention measures against rock fall events.     

激光加热切削

分析了激光加热切削的机理与优越性，研究了激光参数与切削力和切削温度的关系。     

Defibulation: A Visual Reference and Learning Tool

Female genital mutilation type III (infibulation) is achieved by narrowing the vaginal orifice by creating a covering seal, accomplished by cutting and appositioning the labia minora and/or labia majora, with or without clitoral excision. Infibulation is responsible for significant urogynecological, obstetrical, and psychosexual consequences that can be treated with defibulation (or de-infibulation), an operation that opens the infibulation scar, exposing the vulvar vestibule, vaginal orifice, external urethral meatus, and eventually the clitoris. This article provides a practical comprehensive, up-to-date visual learning tool on defibulation, with information on pre-operative, post-operative, and follow-up information.Abdulcadir J, Marras S, Catania L, et al. Defibulation: a visual reference and learning tool. J Sex Med 2018;15:601–611.     

Experimental investigations and finite element simulation of cutting heat in vibrational and conventional drilling of cortical bone

Heat generated during bone drilling could cause irreversible thermal damage, which can lead to bone necrosis or even osteomyelitis. In this study, vibrational drilling was applied to fresh bovine bones to investigate the cutting heat in comparison with conventional drilling through experimental investigation and finite element analysis (FEA). The influence of vibrational frequency and amplitude on cutting heat generation and conduction were studied. The experimental results showed that, compared with the conventional drilling, vibrational drilling could significantly reduce the cutting temperature in drilling of cortical bone (P < 0.05): the cutting temperature tended to decrease with increasing vibrational frequency and amplitude. The FEA results also showed that the vibrational amplitude holds a significant effect on the cutting heat conduction.     

管花肉苁蓉切制法优劣比较

目的:探索管花肉苁蓉最优切制工艺。方法:采用润透法切片、烘软法切片、蒸法切片,分别计算饮片回收率、乙醇浸出物含量、饮片含水量。结果:润透法切片、烘软法切片、蒸法切片三者饮片回收率分别为84%、85%、90%,乙醇浸出物含量分别为30.5%、35.5%、32.7%。结论:管花肉苁蓉采用蒸法切制回收率最高,乙醇浸出物含量达药典要求,可作为最优切制工艺。