脑室出血的治疗

目的探讨脑室出血的治疗方法。方法选择原发性脑室出血19例,继发性脑室出血21例,其原发出血灶血肿量严格限制在30ml以下,全部病人均采用双侧侧脑室双腔管引流,尿激酶脑室灌注及间断腰穿放液。结果死亡7例,死亡率17．5％,明显低于内科治疗80％的死亡率。结论双腔管双侧脑室引流尿激酶脑室灌注和间断腰穿放液等为目前治疗脑室出血的较为有效的方法。     

硅油填充术后视网膜再脱离治疗的临床观察和疗效分析

目的：探讨硅油填充术后视网膜再脱离治疗的手术方法及临床疗效。

方法：对19例19眼硅油填充术后视网膜再脱离患者,行23G巩膜双通道硅油下视网膜复位手术。术后随访观察视力、眼压、视网膜复位及并发症。

结果：患者17例17眼手术后视网膜复位,成功率89%。术后1wk最佳矫正视力为手动/眼前～0.4。术后3d观察眼压升高>21mmHg者6眼,经降眼压治疗后均下降,术后3mo随访眼压为16.3～24.6mmHg。

结论：23G巩膜双通道硅油下视网膜复位术对早期简单的硅油填充术后视网膜再脱离有效、手术简便、安全。     

单腔与双腔内镜下闭合内镜黏膜下剥离术 相关创面或穿孔的疗效比较*

目的观察比较单腔内镜(SCE)与双腔内镜(DCE)下荷包缝合内镜黏膜下剥离术(ESD)相关手术创面或穿孔的临床效果。方法胃黏膜或黏膜下肿块患者38例,随机分成A、B两组,并行ESD术。其中SCE组予以SCE下闭合创面或穿孔,DCE组予以DCE下闭合。结果 38例行ESD术后,创面或穿孔均予以SCE或DCE下尼龙绳成功闭合。结论应用SCE或DCE下尼龙绳和钛夹成功闭合ESD创面或大穿孔,两者疗效相当,但SCE应用更加广泛。SCE有望取代DCE用于ESD创面或大穿孔的闭合,这为内镜下闭合大面积胃肠穿孔或ESD创面提供了新的途径。     

体外仿生三维血管生成微流控芯片的构建

目的在微流控芯片上构建模拟人体血管的三维血管管道,实现管道间的物质交换,并形成有自主出芽功能的血管,为血管生成相关的疾病机制研究、药物筛选等提供良好的平台工具。方法利用微流控技术,采用被动进样方式,使人体脐静脉内皮细胞(human umbilical vein endothelial cells,HUVEC)在微流控芯片上自主贴壁生长形成三维血管管腔,构建体外仿生三维单管道血管和双管道血管芯片。在此基础上,开展对血管响应刺激因子出芽的功能的验证实验。结果体外仿生的双管道芯片的构建成功率达80%以上。在血管管道,内皮细胞无需借助外力支撑,在芯片上自主形成直径300μm±50μm,细胞分布均匀的、类似体内血管的三维血管管腔;物质通过模拟体内的扩散过程达到血管管道,使血管管腔响应物质刺激而出现功能性的血管出芽。结论体外仿生三维血管微流控芯片在体外实现了体内血管的结构与功能,模拟了体内物质扩散对血管生成的影响,可以用于生理过程中血管生成的体外动态观察。     

Lattice-Matched AlInN/GaN/AlGaN/GaN Heterostructured-Double-Channel Metal-Oxide-Semiconductor High-Electron Mobility Transistors with Multiple-Mesa-Fin-Channel Array

Multiple-mesa-fin-channel array patterned by a laser interference photolithography system and gallium oxide (Ga₂O₃) gate oxide layer deposited by a vapor cooling condensation system were employed in double-channel Al_0.83In_0.17N/GaN/Al_0.18Ga_0.82N/GaN heterostructured-metal-oxide-semiconductors (MOSHEMTs). The double-channel was constructed by the polarized Al_0.18Ga_0.82N/GaN channel 1 and band discontinued lattice-matched Al_0.83In_0.17N/GaN channel 2. Because of the superior gate control capability, the generally induced double-hump transconductance characteristics of double-channel MOSHEMTs were not obtained in the devices. The superior gate control capability was contributed by the side-wall electrical field modulation in the fin-channel. Owing to the high-insulating Ga₂O₃ gate oxide layer and the high-quality interface between the Ga₂O₃ and GaN layers, low noise power density of 8.7 × 10⁻¹⁴ Hz⁻¹ and low Hooge’s coefficient of 6.25 × 10⁻⁶ of flicker noise were obtained. Furthermore, the devices had a unit gain cutoff frequency of 6.5 GHz and a maximal oscillation frequency of 12.6 GHz.     

三角函数法计算套管安全活动角度在23G双通道硅油取出术的应用

目的：使用UBM在术前测量巩膜前表面到硅油泡的距离,利用三角函数的计算公式,从而计算出23G套管的安全活动角度,最大限度避免术中取油时损伤视网膜。

方法：从2017/03-2017/09,共选取15例硅油眼患者,年龄32～69岁,首次手术均为视网膜脱离,左眼10例,右眼5例,均采用23G套管通过23G灌注管连接5 mL注射器,直接取油的方法。术前均通过UBM测量角膜缘后4 mm,2：00和10：00位的巩膜壁前表面到硅油泡的距离,定义为 “A”; 23G套管的长度为4 mm,定义为 “C”; 将巩膜套管最大活动角度时的巩膜内壁的宽度定义为 “B”; “A”,“B”,“C”构成直角三角形。利用三角函数计算出最大活动角度时“A”和“C”的正弦值,参考三角函数表得出23G套管的安全活动角度。根据此角度指导术中硅油取出时23G套管的活动范围,同时观察取油时间和穿刺口视网膜情况。

结果：所有患者均顺利取出硅油,所用时间平均为4.78±0.13min。穿刺管口处视网膜未见任何新发视网膜裂孔和其他损伤。2：00位巩膜壁前表面到硅油泡的距离为0.82～2.81(1.62±0.41)mm,10：00位为0.98～2.19(1.71±0.34)mm,2：00位巩膜套管的安全活动角度(指套管和巩膜壁的角度)不能低于11～44(24.14±6.95)°,10：00巩膜套管的安全活动角度不能低于14～33(25.45±5.41)°。模拟图形构建,计算穿刺套管安全活动角度为不低于52°。

结论：利用三角函数的方法,结合UBM测量数据,计算套管安全活动角度可以有效的指导23G硅油取出术中套管针的活动范围,本研究建议套管移动角度不要低于50°,可以最大限度的避免医源性裂孔的发生。     

Performance Comparison of Lattice-Matched AlInN/GaN/AlGaN/GaN Double-Channel Metal–Oxide–Semiconductor High-Electron Mobility Transistors with Planar Channel and Multiple-Mesa-Fin-Channel Array

In this work, Al_0.83In_0.17N/GaN/Al_0.18Ga_0.82N/GaN epitaxial layers used for the fabrication of double-channel metal–oxide–semiconductor high-electron mobility transistors (MOSHEMTs) were grown on silicon substrates using a metalorganic chemical vapor deposition system (MOCVD). A sheet electron density of 1.11 × 10¹³ cm⁻² and an electron mobility of 1770 cm²/V-s were obtained. Using a vapor cooling condensation system to deposit high insulating 30-nm-thick Ga₂O₃ film as a gate oxide layer, double-hump transconductance behaviors with associated double-hump maximum extrinsic transconductances (g_mmax) of 89.8 and 100.1 mS/mm were obtained in the double-channel planar MOSHEMTs. However, the double-channel devices with multiple-mesa-fin-channel array with a g_mmax of 148.9 mS/mm exhibited single-hump transconductance behaviors owing to the better gate control capability. Moreover, the extrinsic unit gain cutoff frequency and maximum oscillation frequency of the devices with planar channel and multiple-mesa-fin-channel array were 5.7 GHz and 10.5 GHz, and 6.5 GHz and 12.6 GHz, respectively. Hooge’s coefficients of 7.50 × 10⁻⁵ and 6.25 × 10⁻⁶ were obtained for the devices with planar channel and multiple-mesa-fin-channel array operating at a frequency of 10 Hz, drain–source voltage of 1 V, and gate–source voltage of 5 V, respectively.     

A Terahertz Detector Based on Double-Channel GaN/AlGaN High Electronic Mobility Transistor

A double-channel (DC) GaN/AlGaN high-electron-mobility transistor (HEMT) as a terahertz (THz) detector at 315 GHz frequency is proposed and fabricated in this paper. The structure of the epitaxial layer material in the detector is optimized, and the performance of the GaN HEMT THz detector is improved. The maximum responsivity of 10 kV/W and minimum noise equivalent power (NEP) of 15.5 pW/Hz^0.5 are obtained at the radiation frequency of 315 GHz. The results are comparable to and even more promising than the reported single-channel (SC) GaN HEMT detectors. The enhancement of THz response and the reduction of NEP of the DC GaN HEMT detector mainly results from the interaction of 2DEG in the upper and lower channels, which improves the self-mixing effect of the detector. The promising experimental results mean that the proposed DC GaN/AlGaN HEMT THz detector is capable of the practical applications of THz detection.     

两种标准双通道穿刺在经皮肾镜取石术治疗肾多发结石中的应用比较

目的比较可视化精准穿刺与常规穿刺标准双通道经皮肾镜取石术(PCNL)治疗肾多发结石的临床疗效。方法分析2017年7月-2018年8月该科88例行标准双通道PCNL治疗肾多发性结石的患者的临床资料,随机分为两组:可视化精准穿刺标准双通道组(n=40)与常规穿刺标准双通道组(n=48),比较两组在建立第一通道、第二通道时间、手术时间、血红蛋白下降值、术后输血率、一期结石清除率及住院时间等指标。结果两组第一通道建立时间[(2.53±1.52)vs(4.83±1.82)min,t=6.32,P=0.000]、第二通道建立时间[(3.02±2.54)vs(6.92±4.81)min,t=7.42,P=0.000]、手术时间[(65.46±15.54)vs(80.32±13.62)min,t=26.64,P=0.000]、血红蛋白下降值[(9.21±2.52)vs(13.22±3.53)g/L,t=3.02,P=0.000]、术后输血率[5.00%(2/40) vs 8.33%(4/48),χ~2=0.01,P=0.001]、一期结石清除率[85.00%(34/40) vs81.25%(39/48),χ~2=3.21,P=0.008]和住院时间[(5.52±1.02)vs(7.63±1.21)d,t=0.61,P=0.001]差异均有统计学意义。结论可视化精准穿刺标准双通道与常规穿刺标准双通道PCNL在治疗肾多发结石中相比,前者具有缩短通道建立时间、缩短手术时间、减少出血、提高一期清石率和缩短住院时间等优点,使临床穿刺操作更加安全精准。     

双通道血流容积测量系统的设计与实现

本文介绍了双通道血流容积测量系统的设计与实现.系统包括硬件与软件两个部分.硬件部分主要功能是采用双通道直接式电路阻抗法测量生物体受检部位的基础阻抗Z0和反应血流容积变化的△Z曲线;软件部分是采用定时器中断方式,利用汇编语言与C语言混合编程来控制A/D板的信号实时采集.整个系统采用双通道方式,可以同时测量左右肢体的血流容积变化情况,提高了测量的准确性.