一阶导数高速脉冲极谱法用于盐酸普鲁卡因的定量分析

研究了一阶导数高速脉冲极谱法,并运用于盐酸普鲁卡因及其注射制剂的定量分析。在-0.04 V(对 Ag/AgCl)处出现的良好导数峰,于1.0～6.0×10~(-4)mol/L 范围内,导数峰电流与浓度呈线性关系。检测限为3.0×10~(-8)mol/L。操作简便、快速、灵敏,结果准确。     

简易定向锥颅脑内血肿碎吸术治疗高血压脑出血——介绍一种简易脑内血肿碎吸器的研制及临床应用

本文介绍一种高血压脑出血外科治疗的新方法,即简易定向锥颅脑内血肿碎吸术。截至1988年10月临床应用19例,年龄41～79岁,出血量平均为48.1ml,一次吸除量为总量的79％(38ml),术后立即清醒者8/19例,偏瘫好转者4/19例,死亡4例。实践证明本法简单,安全有效,病人负担轻。     

Quantitative evaluation of hand cranking a roller pump in a crisis management drill

The heart-lung machines for open-heart surgery have improved over the past 50 years; they rarely break down and are almost always equipped with backup batteries. The hand-cranking procedure only becomes necessary when a pump breaks down during perfusion or after the batteries have run out. In this study, the performance of hand cranking a roller pump was quantitatively assessed by an objective method using the ECCSIM-Lite educational simulator system. A roller pump connected to an extracorporeal circuit with an oxygenator and with gravity venous drainage was used. A flow sensor unit consisting of electromagnetic sensors was used to measure arterial and venous flow rates, and a built-in pressure sensor was used to measure the water level in the reservoir. A preliminary study of continuous cranking by a team of six people was conducted as a surprise drill. This system was then used at a perfusion seminar. At the seminar, 1-min hand-cranking drills were conducted by volunteers according to a prepared scenario. The data were calculated on site and trend graphs of individual performances were given to the participants as a handout. Preliminary studies showed that each person's performance was different. Results from 1-min drills showed that good performance was not related to the number of clinical cases experienced, years of practice, or experience in hand cranking. Hand cranking to maintain the target flow rate could be achieved without practice; however, manipulating the venous return clamp requires practice. While the necessity of performing hand cranking during perfusion due to pump failure is rare, we believe that it is beneficial for perfusionists and patients to include hand-cranking practice in periodic extracorporeal circulation crisis management drills because a drill allows perfusionists to mentally rehearse the procedures should such a crisis occur.     

超声骨刀与高速磨钻应用于颈椎后路单开门椎管扩大成形术的有效性及安全性的Meta分析

目的 :通过Meta分析评价应用超声骨刀(ultrasonic bone curette,UBC)与高速磨钻(high-speed drill,HSD)在颈椎后路单开门椎管扩大成形术(cervical expansive open-door laminoplasty,CEOL)中的有效性及安全性。方法:计算机检索PubMed、Embase、Web of Science、万方数据库(Wanfang Data)、中国期刊全文数据库(CNKI),搜集关于比较应用超声骨刀和高速磨钻在颈椎后路单开门椎管扩大成形术中有效性及安全性的临床对照研究,检索时限为建库至2021年3月。2名研究人员分别筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Cochrane Library提供的Revman 5.3软件进行Meta分析。结果:最终纳入8个临床研究,包括4个随机对照试验(randomized controlled trial,RCT)和4个队列研究(cohort study,CS),共计631例患者,其中超声骨刀组314例,高速磨钻组317例。Meta分析结果显示,两组间术前、术后早期及末次随访时JOA评分、VAS评分、手术相关总并发症发生率、术后轴性症状和C5神经根麻痹发生率均无统计学差异(P0.05)。然而,与高速磨钻组相比,超声骨刀组手术时间[均数差(mean difference,MD)=-24.78,95%置信区间(confidence interval,CI)为(-36.80,-12.76),P0.0001]、术中出血量[MD=-69.94,95%CI为(-115.40,-24.47),P=0.003]、术后引流量[MD=-53.21,95%CI为(-86.95,-19.46),P=0.002]、硬脊膜撕裂发生率[优势比(odds ratio,OR)=0.30,95%CI为(0.09,0.95),P=0.04]和脑脊液漏发生率[OR=0.30,95%CI为(0.09,0.95),P=0.04]均明显低于高速磨钻组。结论:在颈椎后路单开门椎管扩大成形术中应用超声骨刀安全有效,可以节约手术时间、减少术中出血量和术后引流量、降低硬脊膜撕裂和脑脊液漏的风险。     

高速铁路软土地基处理对策及效果分析

介绍了沪宁段铁路沿线的软土分布特征,将沿线软土地基分为4类,并从技术和经济两方面,分别对各类软土地基的处理进行了分析和比较,提出了相应的处理建议。     

高速逆流色谱在天然产物分离中的应用

综述了高速逆流色谱在天然产物有效成分分离中的新应用.     

Virtual occlusion in orthognathic surgery

The aim of this retrospective study was to determine whether a virtually created occlusion is as accurate as a conventionally created occlusion. Seventeen orthognathic patients were included in the study, which was conducted in a university clinic. Plaster cast models were obtained and digitized. Two experienced observers created the conventional (gold standard) and virtual occlusion to assess inter-observer variability. One observer created the conventional and virtual occlusion a second time to assess the intra-observer variability. The criterion for accepting the virtual occlusion was that the difference between the gold standard and the virtual occlusion was not larger than the intra-observer variability for the gold standard. A non-parametric Kruskal–Wallis H test was performed to detect statistically significant differences between the intra- and inter-observer groups for both the conventional and virtual occlusion. No statistically significant differences were found between the different groups. The difference between the conventional and virtual occlusion group was 0.20 mm larger than the intra-observer variability of the gold standard. The virtual occlusion tool presented here can be utilized in daily clinical practice and makes the use of physical dental models redundant.     

脑出血患者微创引流术后颅内感染的临床分析

目的探讨不同抗菌药物给药途径治疗脑出血患者微创钻颅置管外引流术后颅内感染的临床疗效。方法选择2009年1月-2013年6月72例脑出血行微创钻颅置管外引流术后颅内感染患者为研究对象,将36例行全身给药+腰穿后鞘内注射为A组,25例行全身给药+腰大池引流+鞘内注射为B组,11例行全身给药+脑脊液生理盐水置换为C组,比较3组患者治疗前后脑脊液常规指标差异,治疗期间不同时点脑脊液中的药物浓度以及患者的临床效果。结果 3组患者治疗后颅内压、脑脊液各项指标平均值恢复正常,颅内压值从高到低依次为C、A、B组,差异有统计学意义(F=12.341,P<0.05),C组氯化钠含量较A、B两组低,差异有统计学意义(F=4.621,P<0.05);B组患者治疗后不同时点脑脊液中药物浓度均为最高,C组明显低于A、B两组,差异有统计学意义(P<0.05);3组患者各项指标恢复时间中B组时间最短,C组最长,差异有统计学意义(P<0.05);3组均无明显不良反应发生。结论鞘内抗菌药物注射结合全身抗感染治疗能有效治疗颅内感染,其中腰大池置管引流比多次腰穿更能保证脑脊液中药物浓度,缩短治疗时间。     

High-speed digital imaging and electroglottography of tracheoesophageal phonation by Amatsu's method

Background. Our previous findings have indicated that the thyropharyngeal muscles form a retropharyngeal prominence during alaryngeal phonation via the TE fistula. This prominence forms a so-called ‘neoglottis’, which is thought to function as the vibratory source. To better understand the mechanism of TE phonation, we analyzed the vibration of the neoglottis using electroglottography (EGG) and a high-speed digital imaging system. Patients and methods. Two volunteers who use TE phonation for their daily speech communication were subjected to this study. The vibrations of the neoglottis were recorded simultaneously as EGG and high-speed imaging with acoustic signals. Results. The vibrations of the neoglottis, recorded by means of high-speed digital imaging, were exactly synchronized with the waveforms of the acoustic signals and EGG. Conclusions. These results further confirm the neoglottis as the source of vibration during tracheoesophageal (TE) phonation.     

Tolerance within a surgical guide

Background: Recently, guided surgery has been introduced and several papers verified its accuracy. Aim: While those studies reported on the accuracy of the entire procedure, this experiment wanted to make clinicians aware of the amount of the deviation that can already occur during the drilling procedure alone, due to the tolerance of the drill in the drill key. Material and methods: Drilling was executed in plexi‐glass with a maximal inclination of the drills within the drill keys. Results: A mean deviation in angulation of 4.7° occurred with a mean horizontal deviation at the implant shoulder of 0.8 mm and 1.8 mm at the apex of 13 mm implant. The deviation was further dependent of the implant length, the distance of the sleeve above the bone and the respective guiding system. Discussion: Increasing the height of the drill key will minimize the inaccuracy. Conclusions: The results from this experiment showed the importance of keeping the drill parallel to the guide in a centric position. To cite this article:
Van Assche N, Quirynen M. Tolerance within a surgical guide.
Clin. Oral Impl. Res. 21 , 2010; 455–458.
doi: 10.1111/j.1600‐0501.2009.01836.x