压力容器设计及制造过程中降低应力集中采取的几项措施

本文简要论述了压力容器产生应力集中的原因及应力集中造成的危害以及为降低应力集中采取的几项措施,从而得出结论,在压力容器设计及制追过程中改善应力分布、降低应力集中是必须引起重视,不可忽略的关键问题。     

减少非通气侧肺血流在单肺通气期间对肺内分流和血气的影响

目的观察减少非通气侧肺血流在单肺通气期间对肺内分流和血气的影响。方法 15例择期胸科手术患者,ASAⅠ～Ⅱ级,术中采取部分阻断非通气侧肺动脉的方法减少非通气侧肺血流（使肺动脉压（PA）不超过30mmHg为宜）。分别在单肺通气前1分钟（T1）、单肺通气后阻断前1分钟（T2）、阻断后30分钟（T3）、开放前1分钟（T4）各时刻抽取动脉血和混合静脉血行血气分析,并根据血气分析结果计算肺内分流率（Qs/Qt）。结果 T2时刻肺内分流率较T1时刻显著增加,动脉血氧分压较T1时刻显著下降。T3、T4时刻肺内分流率较T2显著降低,接近T1时刻。动脉血氧分压较T2明显回升。结论减少非通气侧肺血流在单肺通气期间可减少肺内分流,明显改善动脉血氧。     

基于QFD优化医院药学服务模式降低感染风险

目的 探讨将创新型品管圈应用于优化药学服务,准确识别药学服务中感控风险点需求,根据需求设计药学服务模式,提升药学服务质量。方法 运用创新型品管圈10大步骤,通过多维质量工具进行质量功能展开(quality function development,QFD),以“质量屋”形式对药学服务的需求进行多层次的演绎分析,结合PDCA循环管理工具,对改善前后药学服务情况进行分析并评价。结果 活动实施后,药品直送率从0提高到100%,患者每日聚集频次从19次降低至15次,高峰期平均每人次取药时间从19.33 min降低至10.21 min,患者线下每人次用药咨询时间从17 min降低至11 min,AGV小车每季度使用次数从185次提高至556次,自动分包机季度作业量从164628包提高至199999包,气动物流传输季度作业量从50880次提高至56201次,院内季度感染发生率从57‰减少至41‰。此外还获得11项附加效益和无形成果。结论 QFD结合PDCA循环在优化药学服务模式降低感染风险中,能够打破药学服务管理现状,推动药学服务的现代化、科学化、精细化管理。     

Neutralization of Acidic Wastewater from a Steel Plant by Using CaO-Containing Waste Materials from Pulp and Paper Industries

In this study, CaO-containing wastes from pulp and paper industries such as fly ash (FA) and calcined lime mud (LM) were utilized to neutralize and purify acidic wastewaters from the pickling processes in steel mills. The investigations were conducted by laboratory scale trials using four different batches of wastewaters and additions of two types of CaO-containing waste materials. Primary lime (PL), which is usually used for the neutralization, was also tested in the same experimental set up in the sake of comparison. The results show that these secondary lime sources can effectively increase the pH of the acidic wastewaters as good as the commonly used primary lime. Therefore, these secondary lime sources could be potential candidates for application in neutralization processes of industrial acidic wastewater treatment. Moreover, concentrations of metals (such as Cr, Fe, Ni, Mo and Zn) can decrease dramatically after neutralization by using secondary lime. The LM has a purification effect from the given metals, similar to the PL. Application of fly ash and calcined lime mud as neutralizing agents can reduce the amount of waste from pulp and paper mills sent to landfill and decrease the need for nature lime materials in the steel industry.     

牛角二至地黄汤治疗精囊炎血精症

目的观察牛角二至地黄汤治疗精囊炎血精症的临床疗效。方法选择经临床确诊的精囊炎血精症患者60例,随机分成对照组(30例)和治疗组(30例)。对照组患者服用左氧氟沙星胶囊(每次0.2 g,2次/d),治疗组服用牛角二至地黄汤(1剂/d,2次/d)。结果治疗组总有效率为86.7%,对照组总有效率为60.0%,2组总有效率比较,差异有统计学意义(P<0.05)。结论牛角二至地黄汤由水牛角、二至丸与六味地黄汤合方化裁而成。诸药合用,攻补兼施,标本兼顾,共奏补益肝肾、滋阴降火、凉血止血之功,切中血精症的病机演变规律。     

Polyol pathway impairs the function of SERCA and RyR in ischemic-reperfused rat hearts by increasing oxidative modifications of these proteins

A number of studies have shown that the polyol pathway, consisting of aldose reductase (AR) and sorbitol dehydrogenase (SDH), contributes to ischemia-reperfusion (I/R)-induced myocardial infarction due to depletion of ATP. In this report we show that the polyol pathway in I/R heart also contributes to the impairment of sacro/endoplasmic reticulum Ca²⁺-ATPase (SERCA) and ryanodine receptor (RyR), two key players in Ca²⁺ signaling that regulate cardiac contraction. Rat hearts were isolated and retrogradely perfused with either Krebs' buffer containing 1 μM AR inhibitor, zopolrestat, or 200 nM SDH inhibitor, CP-170,711, and challenged by 30 min of regional ischemia and 45 min of reperfusion. We found that post-ischemic contractile function of the isolated perfused hearts was improved by pharmacological inhibition of the polyol pathway. I/R-induced contractile dysfunction is most likely due to impairment in Ca²⁺ signaling and the activities of SERCA and RyR. All these abnormalities were significantly ameliorated by treatment with ARI or SDI. We showed that the polyol pathway activities increase the level of peroxynitrite, which enhances the tyrosine nitration of SERCA and irreversibly modifies it to form SERCAC674-SO₃H. This leads to reduced level of S-glutathiolated SERCA, contributing to its inactivation. The polyol pathway activities also deplete the level of GSH, leading to decreased active RyR, the S-glutathiolated RyR. Thus, in I/R heart, inhibition of polyol pathway improved the function of SERCA and RyR by protecting them from irreversible oxidation.     

胃食管机械吻合术的临床应用60例

目的 :探讨食管重建中胃食管机械吻合术的应用方法 ,减少吻合口并发症。方法 :12 6例食管癌手术病例中 ,胃食管机械吻合 6 0例 ,手工吻合 6 6例 ,比较两组的术后近、远期并发症情况。结果 :机械吻合组术后近期并发症 (吻合口出血、吻合口瘘 )发生率小于手工组 (P <0 .0 1) ,远期并发症中吻合口狭窄两组差异无显著 ,机械吻合组残端癌复发率小于手工组 (P <0 .0 5 )。结论 :胃食管机械吻合术有效地减少食管癌术后吻合口并发症。     

粉尘螨浸液制备方法探讨

本试验应用几种不同方法制备粉尘螨浸液,皮内试验法测定其生物活性,结果表明反复冻融法好于超声波粉碎法、冻融—负压法、磁力搅拌法。     

280名健康儿童血脂,脂蛋白及载脂蛋白的研究

研究目的探讨正常健康儿童血脂、脂蛋白及载脂蛋白的水平。研究方法280名健康儿童禁食12h，采静脉血。血载脂蛋白（APO）检测采用联合免疫电泳法，总胆固醇（TC）、甘油三酯（TG）用酶法测定，高密度脂蛋白（HDL）用磷钨镁沉淀及酶法分析，低密度脂蛋白（LDL）按Friedwald公式计算。结果血中APOA－1水平13～15岁组明显低于其它组（P＜0．01），且该组APOA－Ⅰ含量男低于女，4岁～6岁、10岁～12岁组APOA－Ⅰ水平明显增高。HDL／APOA－Ⅰ与APOA－Ⅰ水平呈负相关。TC水平随年龄增大呈逐渐下降趋势。13岁～15岁组HDL、LDL均为男低于女。高TC、TG血症检出率分别为3．2％、1．7％。结论在健康儿童中，13岁～15岁组男性儿童血APOA－Ⅰ水平最低，该年龄组儿童发生动脉粥样硬化的危险较小。在保健工作中应将血脂、脂蛋白及APO作为常规检测项目。     

脑血管病血脂水平临床分析

本次报道２９２例脑血管病患者的ｃｈ，ＴＧ，ＨＤＬ－Ｃ，ＬＤＬ－ｃ，Ａｐｏ－Ａ１和Ａｐｏ－Ｂ血浓度测定结果提示三种脑血管病ＴＧ，ｃｈ，ＬＤＬ－Ｃ均高于对照组，有显著性差异。ＨＤＬ－Ｃ及Ａｐｏ－Ａ１血浓度降低是反映脑梗塞肠代谢异常的突出指标；ＨＤＬ－Ｃ血浓度升高易发生脑出血；ＨＤＬ－Ｃ血浓度正常或低下及Ａｐｏ－Ａ１低下易发生脑梗塞；ＴＧ，ｃｈ，ＨＤＬ－Ｃ，ＬＤＬ－Ｃ和Ａｐｏ－Ａ１血浓度均升高易发生混合