育龄妇女妊娠期需氧菌性阴道感染发病调查

目的 调查分析育龄妇女妊娠期需氧菌性阴道感染的发病率.方法 采用Donders高倍镜湿片镜检法联合细菌预成酶快速检测法对长兴县妇幼保健医院产前门诊常规孕检的育龄孕妇的阴道分泌物进行检查.结果 201例育龄孕妇中,共检出需氧菌性阴道感染患者36例,占总人数的17.9％.其中,孕早期、孕中期及孕晚期孕妇需氧菌增殖例数分别为5(占7.2％,5/69)、4(占7.4％,4/54)及6(占7.7％,6/78);孕早期、孕中期及孕晚期孕妇需氧菌阴道炎例数分别为7(占10.1％,7/69)、6(占11.1％,6/54)及8(占10.3％,8/78).结论 在妊娠早、中及晚期均会出现需氧菌性阴道感染,临床医生应采取合理有效的措施进行及时治疗,防止阴道上行感染的发生.     

4019例妇科门诊不同症状患者阴道微生态状况分析

目的探讨妇科门诊不同症状患者的阴道微生态状况。方法回顾性分析2011年11月至2012年9月西安交通大学医学院第一附属医院妇科门诊因不同症状就诊患者的阴道微生态评价（菌群的密集度、多样性、优势菌、病原菌、AV评分、Nugent评分及五项菌群功能及炎症反应指标）检测结果。结果4019例被检查者平均年龄为33．56岁。其中阴道微生态正常占n70％（28／4019）;阴道微生态失调者占99．30％（3991／4019）;后者包括未明确感染的阴道微生态失调患者占66．36％（2667／4019）;明确感染的阴道微生态失调患者占32．94％（1324／4019）;其中外阴阴道假丝酵母菌病（vulvovaginal candidiasis,VVC）患者占24．33％（978／4019）;需氧菌陛阴道炎（aerobic vaginitis,AV）患者占3．11％（125／4019）;细菌性阴道病（bacterial vaginosis,BV）患者占3．14％（126／4019）;滴虫阴道炎（trichomonas vaginitis,TV）患者占5．15％（207／4019）;混合感染患者占8．31％（110／1324）。优势菌群异常患者占54．32％（2183／4019）。结论妇科门诊中未明确感染的阴道微生态失调患者构成比最高;在明确感染的患者中外阴阴道假丝酵母菌病构成比最高;因此阴道微生态评价成为阴道感染性疾病诊断首选检测方法,在临床诊疗实践中具有重要意义。     

腔内大量盐水灌洗辅助取出乳房内聚丙烯酰胺水凝胶临床应用

目的：探讨聚丙烯酰胺水凝胶注射隆胸后取出新方法.方法：对48例注射聚丙烯酰胺水凝胶隆胸患者术前行双乳MRI或彩超检查结合触诊准确定位.全麻小切口开放直视下吸出水凝胶,再用大量生理盐水反复灌洗所有腔隙,直至手感探测不到硬结,盐水中无水凝胶为止.结果：48例患者术后无继发感染和出血等并发症.术前诸症状体征消失,无明显乳房变形,乳房形态术后恢复满意.术后双乳MRI复查未见明显异物残留.术后1 ～12月（6.2±0.3月）45例随访复查MRI亦未见异物残留,乳房修复完好.结论：注射隆乳后腔内大量盐水灌洗辅助取出水凝胶具有创伤小、出血少、操作简单、费用低廉的优点,是一种较好的、值得推广的凝胶取出术式.     

Process model comparison and transferability across bioreactor scales and modes of operation for a mammalian cell bioprocess

A Monod kinetic model, logistic equation model, and statistical regression model were developed for a Chinese hamster ovary cell bioprocess operated under three different modes of operation (batch, bolus fed‐batch, and continuous fed‐batch) and grown on two different bioreactor scales (3 L bench‐top and 15 L pilot‐scale). The Monod kinetic model was developed for all modes of operation under study and predicted cell density, glucose glutamine, lactate, and ammonia concentrations well for the bioprocess. However, it was computationally demanding due to the large number of parameters necessary to produce a good model fit. The transferability of the Monod kinetic model structure and parameter set across bioreactor scales and modes of operation was investigated and a parameter sensitivity analysis performed. The experimentally determined parameters had the greatest influence on model performance. They changed with scale and mode of operation, but were easily calculated. The remaining parameters, which were fitted using a differential evolutionary algorithm, were not as crucial. Logistic equation and statistical regression models were investigated as alternatives to the Monod kinetic model. They were less computationally intensive to develop due to the absence of a large parameter set. However, modeling of the nutrient and metabolite concentrations proved to be troublesome due to the logistic equation model structure and the inability of both models to incorporate a feed. The complexity, computational load, and effort required for model development has to be balanced with the necessary level of model sophistication when choosing which model type to develop for a particular application. © 2012 American Institute of Chemical Engineers Biotechnol. Prog., 2013     

胸腔镜与传统手术方法对非小细胞肺癌患者的临床疗效

目的:比较电视胸腔镜手术与传统手术方法对非小细胞肺癌治疗的临床效果.方法:选择2010年5月至2012年6月本院收治的非小细胞肺癌患者84例,随机分为VATS组和OT组,各42例,VATS组行全胸腔镜肺叶切除术;OT组行传统开胸肺叶切除术.比较两组患者手术时间、淋巴结清扫数、术中出血量、术后引流时间、住院天数、术后疼痛和并发症发生情况,观察并比较两组患者术后3d血清CRP、TNF-α、IL-6、IL-10水平.结果:VATS组术后引流时间、住院时间明显短于OT组(P＜0.05);两组手术时间、淋巴结清扫数、术中出血量及并发症发生率比较无统计学差异(P＞0.05);VATS组术后1d、3d疼痛评分明显低于OT组(P＜0.05);VATS组术后3d血清CRP、TNF-α、IL-6、IL-10水平明显低于OT组(P＜0.05).结论:与传统手术相比,电视胸腔镜手术对患者创伤较小,患者术后炎症反应较低,痛苦较小,可作为非小细胞肺癌的推荐手术方式.     

妇科针对性护理对保守治疗、开腹手术治疗、腹腔镜微创手术治疗宫外孕患者机体恢复的影响

目的:目前宫外孕的发病率日趋增多,发病年龄也趋向年轻化,为减轻患者痛苦,促进其早日康复,本文旨在回顾性分析妇科护理工作在三种方式治疗宫外孕治疗中的作用.方法:选取2010年10月至2011年9月间,于我院妇科进行宫外孕手术的患者172例,针对172例患者所采取的保守治疗、开腹手术治疗、腹腔镜微创手术三种不同治疗方法,根据不同情况,实施多种妇科针对性护理措施,并对结果进行回顾性分析和总结.结果:172例宫外孕患者经腹腔镜微创手术治疗治愈126例,经过针对性妇科护理,平均住院6.56天;开腹手术治愈26例,经过针对性妇科护理,平均住院9.85天;保守治疗20例,保守治疗失败转为手术治疗3例,平均住院17.87天.经过对所有患者采取有效的针对性精心护理,护理效果较为满意,预后情况良好.结论:腹腔镜微创手术治疗因其创伤小、恢复快,且兼具明确诊断和治疗的作用,是目前临床治疗宫外孕的主要方法;对选择不同治疗方式的患者采取有效的针对性护理,可以提高护理质量和治疗效果,减轻患者痛苦、减少并发症的发生,确保患者早日康复出院.     

阴式全子宫切除术和腹腔镜下全子宫切除术的临床对比分析

目的:比较阴式全子宫切除术与腹腔镜下全子宫切除术的临床治疗效果。方法:回顾性分析2014年6月-2015年6月我院收治的137例子宫良性病变患者的临床病历资料,按照手术方式将其分为阴式组(行阴式全子宫切除术)和腹腔镜组(行腹腔镜下全子宫切除术),比较两组患者的术中、术后临床指标及术后并发症情况。结果:阴式组手术时间及术中出血量均少于腹腔镜组,差异有统计学意义(P0.05)。阴式组肛门排气时间、下床活动时间以及住院时间均短于腹腔镜组,住院总费用低于腹腔镜组,差异有统计学意义(P0.05)。两组患者并发症发生情况差异无统计学意义(P0.05)。结论:阴式全子宫切除术较腹腔镜下全子宫切除术而言,具有手术创伤小、术后恢复快的特点,值得临床推广。     

徒手转胎纠正128 例头位难产的临床效果观察

目的:探讨应用徒手转胎术纠正头位难产的临床效果,为提高经阴道分娩的成功率提供参考。方法:选取2014年6月-2015年12月我院收治的128例头位难产患者作为研究对象,随机为研究组和对照组,每组64例。对照组在第二产程初期采用胎头吸引术,研究组患者通过徒手旋转胎头术调整胎头方位。观察并比较两组产后出血量、第二产程时间及新生儿神经行为测定(NBNA)评分。结果:研究组患者阴道自然分娩成功率(95.31%)高于对照组(73.44%),差异有统计学意义(P0.05);研究组产后出血量和第二产程时间均显著低于对照组,差异具有统计学意义(P0.05);研究组新生儿NBNA评分高于对照组,但两组之间比较,差异无统计学意义(P0.05)。结论:徒手转胎术与胎头吸引术两种干预方式对新生儿行为神经的影响无明显区别,但徒手转胎术可以有效缩短头位难产产妇的产程,并能显著提高阴道分娩率,有益于母婴的预后,值得临床推广应用。     

An Ultra‐Mechanosensitive Visco‐Poroelastic Polymer Ion Pump for Continuous Self‐Powering Kinematic Triboelectric Nanogenerators

A mechanosensitive, visco‐poroelastic polymer ion pump that can rapidly establish a dense electrical double layer via mechanical pressure, thereby significantly enhancing output performance of an ionic triboelectric nanogenerator (iTENG), is described. A working mechanism of an iTENG using a highly mechanosensitive, visco‐poroelastic ion pump is suggested and the optimal characteristics of the polymer ion pump are reported by investigating optical, mechanical, electrical, and electrochemical properties. Surprisingly, the pressure sensitivity of the iTENG reaches 23.3 V kPa^?1, which is tens of times the record value. To achieve controlled high‐frequency pulses from an iTENG, kinematic systems using a gear train and a cam are integrated with a single grounded iTENG, which produces a maximum of 600 V and 22 mA (≈2.2 W cm^?2) at an input frequency of 1.67 Hz; after power transforming, those values are converted to 1.42 V and 225 mA. A capacitor of 1 mF can be fully charged to 2 V in only 60 s, making it possible to continuously operate a wireless‐communicating self‐powered humidity sensor. Also, due to the high transparency and deformability of the polymer ion pump, a self‐powered transparent tactile sensor is successfully assembled using a 5 × 5 iTENG array.     

Rational Structure Optimized Hybrid Nanogenerator for Highly Efficient Water Wave Energy Harvesting

Water wave energy is a promising renewable energy source that may alleviate the rising concerns over current resource depletion, but it is rarely exploited due to the lack of efficient energy harvesting technologies. In this work, a hybrid system with a triboelectric nanogenerator (TENG) and an electromagnetic generator (EMG) based on an optimized inner topological structure is reported to effectively harvest water wave energy. The TENG with etched polytetrafluoroethylene films and Cu electrodes utilizing the contact‐freestanding mode is designed into a cubic structure, in which the EMG is well hybridized. An integration of TENG and EMG achieves mutual compensation of their own merits, enabling the hybrid system to deliver satisfactory output over a broad range of operation frequency. The output performance of TENG with varied inner topological structures is experimentally and theoretically compared, and a concept is proposed to further clarify the energy conversion efficiency, which should be considered in designing energy harvesting devices. The influences of oscillation frequency, amplitude, and dielectric materials on the output performance of the hybrid system are comprehensively studied on different platforms. Furthermore, the optimum operation frequency ranges for TENG and EMG are concluded. The proposed hybrid nanogenerator renders an effective approach toward large‐scale blue energy harvesting over a broad frequency range.