经皮椎间孔镜手术不同入路治疗单节段腰椎间盘突出症疗效对比的回顾性研究

摘要 目的：对比经皮椎间孔镜手术不同入路治疗单节段腰椎间盘突出症（LDH）的疗效。方法：回顾性分析2018年5月至2020年5月我院收治的80例单节段LDH患者的临床资料。患者均接受经皮椎间孔镜手术,根据手术入路的不同,分为经椎间孔入路（PETD）组和经椎板间入路（PEID）组,每组均40例。比较两组的手术相关指标、术后恢复指标、手术前后的Oswestry功能障碍指数（ODI）和视觉模拟评分法（VAS）评分,以及术后并发症情况。结果：PEID组的手术时间短于PETD组,X线透视次数少于PETD组,差异均有统计学意义（P<0.05）。两组的术中出血量相比,差异无统计学意义（P>0.05）。PETD组的术后卧床时间短于PEID组,差异有统计学意义（P<0.05）。两组的术后1 d直腿抬高试验角度、住院时间、复发率相比,差异无统计学意义（P>0.05）。两组患者术后1 d、术后3个月、术后12个月的ODI评分、VAS评分均低于术前,且呈降低趋势（P<0.05）;同一时间点两组间ODI评分、VAS评分比较,差异无统计学意义（P>0.05）。两组的并发症发生率相比,差异无统计学意义（P>0.05）。结论：PETD和PEID经皮椎间孔镜手术治疗单节段LDH总体疗效和安全性接近,PETD可缩短术后卧床时间,PEID的操作难度更低、可减少手术时间和X线透视次数。临床中应视患者实际情况选择合适的入路。     

右美托咪定联合经皮穴位电刺激对混合痔剥扎术后患者肠胃功能及术后疼痛的影响

摘要 目的：探讨右美托咪定联合经皮穴位电刺激对混合痔剥扎术后患者肠胃功能及术后疼痛的影响。方法：选择2022年3月-2022年7月我院行混合痔剥扎术的患者60例,将60例患者随机分为对照组（30例）与观察组（30例）,对照组患者给予右美托咪定镇痛,观察组给予术前经皮穴位电刺激,时间为手术开始前2 min至手术结束,右美托咪定使用方法、剂量同对照组。对比两组患者术前、术后0.5 h、1 h、2 h、3 h的疼痛评分,对比两组患者的术后疼痛疗效,对比两组创面愈合时间、腐肉完全脱落时间、住院时间及胃肠功能恢复情况,对比两组术前、术后的血管活性肠肽、胃动素及胃泌素水平。结果：术前及术后3 h时,两组的疼痛评分对比无统计学意义（P>0.05）;术后0.5 h、1 h、2 h时,观察组的疼痛评分明显较对照组低（P<0.05）。观察组的术后疼痛有效率明显较对照组高,P<0.05。观察组的创面愈合时间、腐肉完全脱落时间及住院时间明显较对照组低（P<0.05）。观察组的肠鸣音恢复时间、术后恶心呕吐发生率及排气时间明显较对照组短（P<0.05）。术前,两组的血管活性肠肽、胃动素及胃泌素水平对比无统计学意义（P>0.05）;术后,两组血管活性肠肽、胃泌素水平升高,胃动素水平降低,且观察组变化幅度明显较对照组低（P<0.05）。结论：右美托咪定联合经皮穴位电刺激可改善混合痔剥扎术后患者肠胃功能及术后疼痛情况。     

High oxygen transfer rate in a new aeration system using hollow fiber membrane

A new type of bubble aeration column called a hollow fiber membrane (HFM) aeration column was proposed, which was featured in the use of hollow fiber membranes and gave a high bubble density in the column. The value of k(L)a was increased by modifying the membrane surface for making the pore size smaller. The Sauter mean diameter of bubbles (D(vs)) was 2.0 +/- 0.1 mm in the range of the superficial gas velocity from 0.02 m s(-1) to 0.065 m s(-1), while that obtained for the bubbles near the membrane was 811 mum at the superficial gas velocity of 4.0 x 10(-4) m s(-1). The difference was ascribed to the effect of coalescence of bubbles. The value of K(L)a increased in proportion to the superficial gas velocity up to 0.02 m s(-1), and was almost constant above 0.03 m s(-1). The maximum value of k(L)a, 2.5 s(-1), was higher than those of the other aeration columns reported previously. The pneumatic power consumption per unit liquid volume (P(v)) for obtaining the same k(L)a was the smallest in the HFM aeration columns. P(v), for obtaining the same interfacial area of bubbles per liquid volume, was also lower than those for other types of aeration columns. It was suggested from the measurement of bubble diameter that the larger interfacial area generated in the HFM aeration column ascribes to the larger gas holdup than the smaller D(vs). (c) 1992 John Wiley & Sons, Inc.     

Hydrolysis of butteroil by immobilized lipase using a hollow-fiber reactor: part I. lipase adsorption studies

Adsorption of proteins from a crude preparation containing a lipase from Aspergillus niger on microporous polypropylene hollow fibers was studied at six different temperatures. Langmuir isotherms accurately describe the overall adsorption equilibria. Lipase is selectively adsorbed relative to the other proteins in the crude preparation. Hence, immobilization also provides further purification of the lipase. The predictions of the Langmuir model for the change in the specific activity of lipase upon adsorption are consistent with experimental results. The loading capacity of the hollow fibers decreases and the adsorption constant increases as temperature is increased. This effect is more significant in the case of lipolytic activity than it is for the total amount of adsorbed protein. Small, positive enthalpy changes are associated with the adsorption of lipase on these hydrophobic membranes.     

Cone penetrometer testing,hydropunch®, and borehole geophysics applications for environmental investigations

An effective groundwater monitoring system can be implemented by the combined utilization of cone penetrometer (CPT), HydroPunch^® sampling, and borehole geophysical methods. The combined techniques provide a cost‐effective method for the design of a groundwater monitoring system for geologists or hydrogeologists assessing a site. With the relatively high costs associated with determining groundwater quality for site assessments, coupled with regulatory agency compliance, these combined methods can provide an effective edge in an increasingly competitive environmental industry. CPT combined with HydroPunch sampling can delineate the horizontal and vertical extent and concentration of a contaminant plume, define the extent and thickness of a free product plume, define soil and aquifer characteristics, and aid in the proper selection of well location and screen placement. The use of borehole geophysics further enhances the interpretation provided from the CPT. The interpretation of borehole geophysics provides additional information about the deposition regime of the area of investigation and a more detailed investigation of the stratigraphy. The CPT and HydroPunch can be used in unconsolidated sediments, and HydroPunch sampling can be combined with a hollow‐stem auger system. Borehole geophysics can be run in almost any environment. CPT and borehole geophysics provide information on specific lithologic characteristics necessary to obtain a groundwater sample from vertically separated aquifers. The HydroPunch can obtain a discrete, chemically representative groundwater sample from the targeted aquifer. CPT and borehole geophysics can also be used to determine lithology and for correlation of equivalent stratas from one borehole or well to the next. Borehole geophysical interpretation also provides a means of determining not only the stratigraphy and lithology but also the aquifer parameters and the type of fluids in the aquifer. Hydrogeologic and geologic data obtained from using these three methods can be employed to maximize the cost‐effectiveness and design efficiency of a groundwater monitoring system. Proper location of wells and screened interval placements are determined by a coherent design process rather than by random chance. Two studies demonstrating the combined applications of CPT, HydroPunch, and borehole geophysics for the design and placement of groundwater monitoring wells are presented in the following discussion.     

Enhanced Kinetics Harvested in Heteroatom Dual‐Doped Graphitic Hollow Architectures toward High Rate Printable Potassium‐Ion Batteries

Carbonaceous materials have emerged as promising anode candidates for potassium‐ion batteries (PIBs) due to overwhelming advantages including cost‐effectiveness and wide availability of materials. However, further development in this realm is handicapped by the deficiency in their in‐target and large‐scale synthesis, as well as their low specific capacity and huge volume expansion. Herein the precise and scalable synthesis of N/S dual‐doped graphitic hollow architectures (NSG) via direct plasma enhanced chemical vapor deposition is reported. Thus‐fabricated NSG affording uniform nitrogen/sulfur co‐doping, possesses ample potassiophilic surface moieties, effective electron/ion‐transport pathways, and high structural stability, which bestow it with high rate capability (≈100 mAh g^?1 at 20 A g^?1) and a prolonged cycle life (a capacity retention rate of 90.2% at 5 A g^?1 after 5000 cycles), important steps toward high‐performance K‐ion storage. The enhanced kinetics of the NSG anode are systematically probed by theoretical simulations combined with operando Raman spectroscopy, ex situ X‐ray photoelectron spectroscopy, and galvanostatic intermittent titration technique measurements. In further contexts, printed NSG electrodes with tunable mass loading (1.84, 3.64, and 5.65 mg cm^?2) are realized to showcase high areal capacities. This study demonstrates the construction of a printable carbon‐based PIB anode, that holds great promise for next‐generation grid‐scale PIB applications.     

空心钉加内侧支撑钢板与单纯空心钉治疗PauwelsⅢ型股骨颈骨折的疗效比较研究

目的:比较PauwelsⅢ型股骨颈骨折分别经单纯空心钉、空心钉加内侧支撑钢板治疗的临床疗效。方法:回顾性分析2016年3月～2019年2月期间收治的113例PauwelsⅢ型股骨颈骨折患者的临床资料,根据手术方式分为A组(n=55,单纯空心钉内固定治疗)和B组(n=58,空心钉加内侧支撑钢板治疗),比较两组患者围术期指标、髋关节功能、术后疼痛及复位质量,记录两组患者随访期间并发症发生情况。结果:B组术中出血量多于A组,手术时间长于A组(均P0.05);B组骨折愈合时间、完全负重时间短于A组(P0.05)。两组患者术后3个月、术后6个月髋关节Harrris评分呈升高趋势,视觉模拟评分量表(VAS)评分呈下降趋势(P0.05);B组术后3个月、术后6个月髋关节Harrris评分高于A组,VAS评分则低于A组(P0.05)。与术后3 d相比,A组患者术后6个月正位、侧位Garden指数降低(P0.05);B组术后6个月正位、侧位Garden指数评分高于A组(P0.05)。B组并发症发生率低于A组(P0.05)。结论:与单纯空心钉内固定治疗PauwelsⅢ型股骨颈骨折相比,空心钉加内侧支撑钢板虽然术中出血量多,手术时间略长,但其术后恢复效果更佳,且并发症发生率更低,临床应用价值较高。     

不同内固定方式治疗老年踝关节骨折的临床研究

摘要 目的：探讨老年踝关节骨折患者的内固定方式的选择情况及不同内固定方式的疗效,进而指导临床医师根据患者的具体情况选择合适的内固定方式。方法：本研究为回顾性研究,选取我院2016年1月~2018年12月期间收治的老年踝关节骨折患者40例作为研究对象,统计患者一般情况,内容包括骨折块情况、骨折类型、骨质疏松情况、软组织情况与体质。术后随访12个月,评价所有患者末次随访时的踝关节跖屈度、踝关节背伸度、美国足踝外科协会（AOFAS）踝-后足功能评分,记录所有患者的骨折愈合时间。结果：40例研究对象中,使用克氏针张力带11例,Herbert螺钉10例,解剖锁定钢板7例,解剖复合钢板6例,1/3管型钢板6例。骨折块较小、外踝撕脱性骨折的患者主要应用克氏针张力带;伴有骨质疏松的患者主要应用解剖锁定钢板;软组织条件不佳或受损的患者主要应用Herbert螺钉或1/3管型钢板;超重或肥胖患者主要应用解剖复合钢板;瘦弱患者主要应用1/3管型钢板。末次随访时,5种内固定方式患者的踝关节背伸度、踝关节跖屈度、AOFAS踝-后足功能评分比较未见显著性差异（P＞0.05）。5种内固定方式的骨折愈合时间对比差异存在统计学意义（P＜0.05）。结论：老年踝关节骨折应根据患者具体情况选择合理的内固定方式,不同内固定方式患者的骨折愈合时间虽存在差异,但最终均可获得较为满意的疗效。     

低剂量与常规剂量扫描在CT引导下经皮穿刺肺活检术中的临床应用价值对比研究

摘要 目的：比较低剂量与常规剂量扫描在CT引导下经皮穿刺肺活检术中的临床应用价值。方法：选择2018年1月至2019年12月我院行CT引导下经皮穿刺肺活检术的患者96例,采用随机数字表法分为低剂量组和常规剂量组,每组48例,两组分别在低剂量扫描、常规剂扫描下行CT引导下经皮穿刺肺活检术,比较两组扫描范围、X射线剂量、图像质量、穿刺成功率及并发症发生情况。结果：低剂量组CT吸收剂量加权指数（CTDIw）、平均剂量长度乘积（DLP）显著低于常规剂量组（P<0.05）,两组扫描范围比较无统计学差异（P>0.05）。低剂量组图像质量1级1例、2级1例、3级46例;常规剂量组1级0例、2级1例、3级47例,两组图像质量比较无统计学差异（P>0.05）。低剂量组穿刺成功率87.50%,常规剂量组穿刺成功率89.58%,两组穿刺成功率比较无统计学差异（P>0.05）。低剂量组并发症发生率为12.50%,常规剂量组并发症发生率为10.42%,两组并发症发生率比较差异无统计学意义（P>0.05）。结论：与常规剂量扫描相比,在CT引导下经皮穿刺肺活检术中应用低剂量扫描可以有效降低辐射剂量,但不影响图像质量和穿刺成功率,患者并发症发生率也未增加,具有较好的临床价值。     

Genetic diversity,structure, and demography of Pandanus boninensis (Pandanaceae) with sea drifted seeds,endemic to the Ogasawara Islands of Japan: Comparison between young and old islands

Pandanus boninensis, endemic to the Ogasawara Islands, Japan, is distributed on both the older Bonin and younger Volcano Islands. In this study, we conducted population genetic analyses of P. boninensis on these islands to examine the population diversity and structure across old and young islands, to assess potential differences in population demography with island age, and to collect any evidence of migration between old and young islands. We found that the genetic diversity of expressed sequence tag (EST)–based microsatellite (SSR) markers, the nucleotide diversity of nuclear DNA sequences, and the haplotype diversity of chloroplast DNA on young islands were lower than those on old islands. Clustering analyses of EST‐SSR indicated that populations on old islands were strongly diverged from those on young islands. Approximate Bayesian computation analysis of EST‐SSR suggested that population expansion occurred on old islands while population reduction occurred on young islands. We also found evidence of migration among old islands (mostly from south to north), while it appears that there have been very few migration events between old and young islands. These differences could be due to the fact that young islands tend to be geographically isolated and support smaller populations that began a shorter time ago from limited founders. The P. boninensis populations on the Volcano Islands are interesting from an evolutionary perspective as they constitute a classic example of the early stages of progressive colonization on oceanic islands with small effective population sizes and low genetic diversity.