急性脑出血综合治疗的几个问题探讨：附死亡80例分析

通过对８０例急性脑出血死亡组分析,发现死于脑疝的占６２．５％,脑疝与一种或二种以上合并症同存者占７７．５％,显著高于存活组（Ｐ＜０．０１）．它们互为因果,加速死亡。因此,应重视早期或超早期采用简易定向锥颅脑内血肿碎吸术吸除血肿,同时注意维持生命体征稳定,加强脱水降颅压,预防、控制合并症等综合治疗。且要全面分析,相互兼顾,正确处置。这是帮助机体渡过调控障碍难关,挽救生命的有效治疗措施。     

A new technique to reduce internal phosphorus loading by in-lake phosphate fixation in shallow lakes

A new, flexible, fast, robust and economic technique was developed to treat sediment in shallow lakes with phosphate binding chemicals. The upper 0.15 m of the sediment is thoroughly mixed with ferric chloride using a water-jet manifold coupled to a dosing pump and a navigation control system. Its logistics were tried out in a small, shallow and hypertrophic peat lake, Lake Groot Vogelenzang.     

Atypical lipomatous tumour/well-differentiated liposarcoma found in the buccal mucosa: A rare case report

Oral liposarcomas are uncommon diseases, the most predominant histopathological subtype being atypical lipomatous tumour/well-differentiated liposarcoma. In regard to its clinical aspects in the oral cavity, it is challenging to confirm a diagnosis and develop a treatment plan. In this case report, we present a rare case of atypical lipomatous tumour/well-differentiated liposarcoma in the right cheek of a 77-year-old male patient. Conservative surgery was performed considering the histopathological subtype of the neoplasm. Knowledge of the clinical and histopathological characteristics of this rare disease is essential to maintaining function and aesthetics through conservative treatment in older patients.     

Estimating tree-based dynamic treatment regimes using observational data with restricted treatment sequences

A dynamic treatment regime (DTR) is a sequence of decision rules that provide guidance on how to treat individuals based on their static and time-varying status. Existing observational data are often used to generate hypotheses about effective DTRs. A common challenge with observational data, however, is the need for analysts to consider “restrictions” on the treatment sequences. Such restrictions may be necessary for settings where (1) one or more treatment sequences that were offered to individuals when the data were collected are no longer considered viable in practice, (2) specific treatment sequences are no longer available, or (3) the scientific focus of the analysis concerns a specific type of treatment sequences (eg, “stepped-up” treatments). To address this challenge, we propose a restricted tree–based reinforcement learning (RT-RL) method that searches for an interpretable DTR with the maximum expected outcome, given a (set of) user-specified restriction(s), which specifies treatment options (at each stage) that ought not to be considered as part of the estimated tree-based DTR. In simulations, we evaluate the performance of RT-RL versus the standard approach of ignoring the partial data for individuals not following the (set of) restriction(s). The method is illustrated using an observational data set to estimate a two-stage stepped-up DTR for guiding the level of care placement for adolescents with substance use disorder.     

Relationships between mutans streptococci and perceived treatment need of primary root-caries lesions.

A total of 447 primary root-caries lesions from 169 dental patients was studied to determine the relationships between mutans streptococci and the perceived treatment need of primary root-caries lesions. Samples of this altered dentine for microbiological culture were obtained. Lesions were classified into 5 treatment categories; soft and restore, leathery and restore, leathery and debride of caries, leathery and treat chemotherapeutically, and hard, to receive no treatment. The total numbers of mutans streptococci decreased significantly with decreased treatment need. The percentage of mutans streptococci from lesions requiring no treatment was significantly less than from lesions requiring treatment. The frequency of isolation of mutans streptococci was significantly greater from lesions requiring more treatment. Significantly more lesions containing > 10² mutans streptococci were distributed in the groups with a greater perceived treatment need or with larger dimensions occlusogingivally and/or mesio-distally or bucco-lingually or with a closer proximity to the gingival margin.     

Future directions for root caries research

Interest among researchers in the diagnosis, aetiology, prevention, and treatment of root caries has increased substantially over the past two decades. However, there are some fundamental problems impeding the advancement of the field which remain to be addressed and resolved. A universally acceptable definition of root caries is not yet available. The relationship of root caries to coronal caries has not been established. The underlying disease process is still not clearly understood. The optimal utilisation of preventive/therapeutic agents for the treatment or prevention of root caries has not been determined. New treatment materials and preventive agents have not yet been tested in controlled clinical trials. These are a few of the issues and problems which we address in this paper.     

Occurrence of a novel group of hemagglutinins extractable by Pronase treatment in marine algae

Nine species of marine algae have been assessed for the presence of novel hemagglutinins not extractable with buffer, unless the algal tissue was pretreated with Pronase. All species examined contained hemagglutinins, indicating the existence of a novel group of hemagglutinins which differed from those reported previously in marine algae.     

Biotechniques for air pollution control

This paper gives an overview of present biological techniques for the treatment of off-gases and the techniques that are being developed at the moment. The characteristics, advantages, disadvantages, costs and application area are discussed and compared. Biological off-gas treatment is based on the absorption of volatile contaminants in an aqueous phase or biofilm followed by oxidation by the action of microorganisms. Biofilters, bioscrubbers and biotrickling filters are used for elimination of odour and bioconvertable volatile organic and inorganic compounds and are enjoying increasing popularity. This popularity is a result of the low investment and operational costs involved compared to physico-chemical techniques and the elimination efficiencies that can be obtained. The operational envelop is still extending to higher concentrations and gas flow rates (exceeding 200,000 m³ h^–1) and a broader spectrum of degradable compounds. Research and development on the use of membranes and the addition of activated carbon or a second liquid phase to the biological systems may lead to a more efficient elimination of hydrophobic compounds and buffering of fluctuating loads. Shorter adaptation periods can be obtained by inoculation with specialized microorganisms. Improved design and operation are made possible by the growing insights in the kinetics and microbiology and supported by the development of models describing biological off-gas treatment. In conclusion, biotechniques are efficient and cost effective in treating off-gases with concentrations of biodegradable contaminants up to 1–5 g/m³. They could play a justified and important role in air pollution control in the coming years.Abbreviations VOC volatile organic compound - NO _x gaseous oxides of nitrogen     

人上皮细胞角蛋白纤维结构转化的分析

用0℃冷冻处理2—3 h,一些PcaSE-1和BEL-7404细胞的角蛋白纤维能部分地转化成凝聚颗粒,但在HeLa 和CNE 细胞中不发生这种角蛋白纤维结构转化。当回复温度到37℃15—30 min 时,PcaSE-1 和BEL-7404细胞的这种结构转化能快速回复。相反,在HeLa 和CNE 细胞有丝分裂时,角蛋白纤维能转化成凝聚颗粒,但PcaSE-1细胞和BEL-7404细胞的角蛋白纤维网始终维持纤维状态,且围绕纺锤体分布。上述结果表明:两类上皮细胞角蛋白纤维结构的转化似由不同因子所引起。我们的结果还指出:(1)单用秋水仙素或用秋水仙素和细胞松弛素D 合并处理PcaSE-1细胞不能引起角蛋白纤维凝聚。但经秋水仙素解聚微管后,会增强细胞对冷处理的凝聚反应。(2)冷处理时角蛋白纤维凝聚的形成与细胞是否具有两套不同的中间纤维无关。(3)予先用TritonX-100抽提细胞,角蛋白纤维在冷冻后不能转化成凝聚颗粒。(4)冷冻处理引起的结构转化可能是某些上皮细胞系的角蛋白纤维的一种特殊性质。     

中医正骨手法改善桡骨远端伸直型骨折患者腕关节功能的临床研究及疗效的影响因素分析

摘要 目的：观察中医正骨手法在桡骨远端伸直型骨折中的临床应用价值,并分析疗效的影响因素。方法：选择四川省骨科医院2020年1月~2022年1月期间收治的桡骨远端伸直型骨折患者152例,按照治疗方式的不同将患者分为对照组（给予石膏固定）和研究组（应用中医正骨手法治疗）,例数分别为77例和75例。对比两组优良率、临床指标、腕关节活动度和X线相关影像学指标。同时采用多因素Logistic回归分析影响研究组腕关节功能疗效的相关因素。结果：治疗后,研究组的优良率明显高于对照组（P<0.05）。研究组手背消肿时间、疼痛缓解时间、骨折愈合时间均短于对照组（P<0.05）。两组治疗后12周掌屈、背伸、桡偏、尺偏、旋前、旋后活动度均扩大,且研究组均大于对照组（P<0.05）。两组治疗后12周掌倾角、尺偏角、桡骨高度均增加,且研究组均大于对照组（P<0.05）。单因素分析显示,研究组腕关节功能优良率与年龄、性别、骨质疏松、功能锻炼、掌倾角、尺偏角、桡骨高度、骨折端稳定性、受伤能量、利手情况有关（P<0.05）,而与体质量指数、就诊时间、基础疾病、骨折类型、固定时间无关（P>0.05）。多因素Logistic回归分析显示：性别为女、骨质疏松、无功能锻炼、掌倾角偏小、桡骨高度偏短、骨折端不稳定、受伤能量为高能量、利手是影响腕关节功能优良率的危险因素（P<0.05）。结论：中医正骨手法可有效改善桡骨远端伸直型骨折患者腕关节功能,减少骨折愈合及疼痛缓解时间。此外,患者腕关节功能的优良率还受到性别、骨质疏松、功能锻炼、掌倾角、桡骨高度、骨折端稳定性、受伤能量、利手情况的影响,值得引起临床重视。