输尿管镜下钬激光联合等离子电切在治疗外伤性尿道狭窄中的临床应用

目的探讨输尿管镜下钬激光联合等离子切割技术治疗外伤性尿道狭窄的临床效果。方法置输尿管镜至尿道狭窄处,在导丝引导下用钬激光切开狭窄处尿道,然后用等离子电切镜切除尿道狭窄部位瘢痕,留置导尿管3～4周。拔除导尿管后观察排尿情况,比较治疗前、后最大尿流率和残余尿量。结果术后患者排尿困难明显改善,最大尿流率上升至13～20m/s,残余尿量减少至0～25ml。结论输尿管镜下钬激光内切开联合等离子切除技术治疗尿道狭窄效果良好,值得临床推广应用。     

Box-Behnken设计-效应面法优选甘草切制工艺

目的 优选甘草的最佳切制工艺.方法 以甘草苷、甘草酸的量和外观性状为评价指标,采用Box-Behnken设计-效应面法考察润制、蒸制、烘制法切制甘草饮片对其质量的影响,优选甘草切制工艺参数.结果 甘草最佳切制工艺为润制6h、蒸制30 min、烘制2h、烘制温度60℃.结论 优选的甘草切制工艺合理可行.     

花鹿茸切制工艺的优化

目的优化花鹿茸Cervus nippon Temminck的切制工艺。方法在单因素试验的基础上,以乙醇体积分数、润制时间、蒸制时间、干燥方式为影响因素,总糖、水溶性蛋白及总游离氨基酸的综合评分为评价指标,正交试验优化切制工艺。结果最佳切制工艺为药材去毛后,经锯口按药材与酒1∶1的比例加入白酒(50%乙醇),润制7 h,蒸制1 min,趁热横切为厚度1～2 mm的薄片,平铺于烘盘上,上覆吸水纸并压以重物,50℃烘干。结论该方法稳定可行,可用于花鹿茸的切制。     

Factorial Analysis of Fiber Laser Fusion Cutting of AISI 304 Stainless Steel: Evaluation of Effects on Process Performance,Kerf Geometry and Cut Edge Roughness

Factorial Design-of-Experiment analyses were applied for conventional and beam oscillation fiber laser cutting of 10 mm thick AISI 304 stainless steel. Considered factors in case of the conventional process with a static beam involve both laser and cutting gas parameters, in particular the laser power, the focal plane position, the cutting gas pressure, the nozzle stand-off distance as well as the nozzle diameter. The conducted trials were evaluated with respect to the achievable cutting speed, the cut kerf geometry and the cut edge roughness. Noticeable correlations between cut edge roughness and cut kerf geometry stimulated the development of a corresponding Computational Fluid Dynamics (CFD) model of the cutting gas flow through the kerf. A specific approach of data synchronization revealed that the experimentally determined roughness values do well correlate with numerically computed values of the backward directed component of the gas-induced shear stress and that the cut kerf geometry as internal process-inherent boundary condition influences relevant cutting characteristics more than controllable external cutting gas parameters. Finally, effects of circular beam oscillation were investigated by an additional factorial analysis considering the laser power, the focal plane position, the oscillation frequency and the oscillation amplitude as factors. The results demonstrate the potential of beam oscillation techniques for quality improvements in laser cutting.     

Do patient-specific cutting guides and plates improve the accuracy of maxillary repositioning in hemifacial microsomia?

The aim of this retrospective study was to use computer-aided design and manufacturing (CAD/CAM) patient-specific plates and cutting guides for the waferless positioning and fixation of the maxilla after bimaxillary osteotomies in cases of hemifacial microsomia with condylar dysplasia or absence of the temporomandibular joint (TMJ), and to compare the results with the CAD/CAM fabricated surgical wafer by 3-dimensional analysis. Eighteen patients were selected from the hospital database, preoperative surgical planning and simulation were done on 3-dimensional computed tomographic models for all patients, and they were divided into Group I – in which CAD/CAM patient-specific cutting guides and plates were used; and Group II – in which CAD/CAM fabricated surgical wafers were used. Finally, the outcome was evaluated by comparing planned with postoperative outcomes. The largest discrepancies of the Le Fort I segment were 0.50 (0.18) mm in the anteroposterior direction and 0.82 (0.60)° in the yaw orientation with Group I. The largest discrepancies of the Le Fort I segment were 1.32 (1.40) mm in superioinferior direction and 8.48 (7.73)° in the yaw orientation with Group II. The CAD/CAM patient-specific cutting guides and plates proved to be reliable and have great value in improving the accuracy in repositioning the Le Fort I segment and in the efficacy of orthognathic treatment of hemifacial microsomia with condylar dysplasia or no TMJ. The CAD/CAM patient-specific cutting guides and plates are therefore a useful alternative to the wafer technique.     

Cutting balloon angioplasty for treatment of coronary in-stent restenosis: immediate results and 6-month outcomes

目的　研究切割球囊对支架内再狭窄的即刻和 6个月内随访效果。方法　 6 9例支架内再狭窄患者随机分配到切割球囊和普通球囊治疗组。切割球囊组 38例。球囊扩张前及扩张后即刻在定量冠状动脉造影和冠状动脉内超声下 ,测定相关参数。随访 6个月内临床改善及冠状动脉造影结果。研究终点包括出现心肌梗塞 ,需要冠状动脉搭桥或再介入治疗。结果　两组的手术成功率为 10 0 %。切割球囊组 1例患者扩张后在支架的远端出现夹层。平均随访 6 7± 2 3月。切割球囊组于术后 3和 6个月时的再狭窄率显著低于普通球囊组 (15 %VS 38%及 18%VS 4 3%,P均小于0 0 0 1)。扩张后即刻血管直径获得值在切割球囊组和普通球囊组分别为 1 72± 0 5 2mm和 1 15± 0 5 4mm ,而随访终点时切割球囊组的血管直径晚期丢失为 0 2 6± 0 0 5mm(3个月 )及 0 38± 0 0 6mm ,同时的普通球囊组丢失值为 0 78± 0 19mm(3个月 )及 0 89± 0 16mm。对于支架体部狭窄 ,普通球囊难以固定 ,扩张时移动明显 ,而切割球囊较易于固定 ,扩张时罕见移动。结论　切割球囊治疗支架内再狭窄效果可靠 ,安全 ,容易操作。再狭窄率低 ,手术费用相对易于患者接受 ,是一个较有前途的治疗手段。     

肛门括约肌间切开术治疗高位肛瘘的临床研究

目的:研究肛门括约肌间切开术治疗高位肛瘘之临床疗效.方法:将72例高位肛瘘患者按随机数字表法随机分为对照组(切开挂线术组)和试验组(括约肌间切开术组),各36例.比较两组手术基本情况、临床疗效、肛门功能、创面面积、局部疼痛及并发症等方面的差异.结果:试验组住院时间(8.22±2.10)d,短于对照组的(14.17±2....     

基于趁鲜切制与传统切制工艺的人参饮片质量评价分析

目的 优选人参Panax ginseng趁鲜切制饮片工艺,比较分析趁鲜切制与传统切制人参饮片的质量,为人参趁鲜切制的合理性提供数据支持。方法 考察切片厚度、烘干温度、烘干时间等因素优选人参趁鲜切制饮片最佳制备工艺;建立指纹图谱结合化学计量法评价2种炮制工艺人参饮片质量差异性;并定量分析2种人参饮片中指标性成分人参皂苷含量差异。结果 人参趁鲜切制饮片的最佳制备工艺为人参鲜药材含水量65%,烘干温度50℃、烘干时间8 h、切片厚度1.5 mm;指纹图谱分别确定了人参趁鲜切制饮片和传统切制工艺饮片22个共有峰,指认了其中7个共有峰,2种炮制工艺所得人参饮片指纹图谱相似度分别在0.983～0.992、0.948～0.996。趁鲜切制与传统切制工艺饮片之间的指纹图谱相似度为0.960～0.993,相似度良好;主成分分析（principal component analysis,PCA）将人参趁鲜切制饮片和传统切制饮片归为2类,正交偏最小二乘法-判别分析（orthogonal partial least squares-discriminant analysis,OPLS-DA）确定2种炮制工艺项...     

Occupational asthma caused by ethanolamines

Amino alcohols are used in various industries, often as minor constituents of compounds to modify the properties of the compound. Generally, they are considered to be safe, but they have been known to cause local skin irritation at higher concentrations in solutions. We report on three cases of occupational asthma caused by ethanolamines: two metal workers exposed to a cutting fluid containing triethanolamine, and one cleaner exposed to a detergent containing monoethanolamine. The diagnosis was based on work-related symptoms and on a chamber challenge with the suspected agent. Persistence of the symptoms after exposure ended was a common feature of the three cases.