腰大池引流联合法舒地尔治疗动脉瘤性蛛网膜下腔出血的疗效及对血清sICAM-1、FABP、MCP-1水平和脑积水形成的影响

目的:分析腰大池引流联合法舒地尔治疗动脉瘤性蛛网膜下腔出血的疗效及对血清可溶性细胞间黏附分子-1(sICAM-1)、脂肪酸结合蛋白质(FABP)、核细胞趋化蛋白(MCP-1)水平和脑积水形成的影响。方法:选择我院2016年3月~2018年3月收治的112例动脉瘤性蛛网膜下腔出血患者,按随机数字表法分为对照组(n=48)和研究组(n=64)。对照组采用腰大池引流治疗,研究组基于对照组联合法舒地尔治疗。比较两组临床疗效,治疗前后血清sICAM-1、FABP、MCP-1水平、血压、大脑中动脉血流参数水平和神经功能的变化,脑积水发生率及不良反应发生情况。结果:治疗后,研究组总有效率显著高于对照组(89.02%vs.72.91%,P<0.05)。两组治疗后血清sICAM-1、FABP、MCP-1、血压、大脑中动脉血流参数水平和神经功能缺损评分量表(NIHSS)均较治疗前下降,格拉斯哥昏迷评分(GCS)均较治疗前上升,研究组以上指标较对照组改变更明显(均P<0.05)。两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论:腰大池引流联合法舒地尔治疗动脉瘤性蛛网膜下腔出血的疗效明显优于单用腰大池引流治疗,其可显著降低血清sICAM-1、FABP、MCP-1水平,降低脑积水发生率,改善患者预后。     

中心静脉导管引流对单孔胸腔镜肺癌根治术患者术后胸腔引流的应用分析

目的:探讨中心静脉导管引流对单孔胸腔镜肺癌根治术患者术后胸腔引流的应用效果。方法:回顾性选取2019年1月至2019年12月期间我院收治的行单孔胸腔镜肺癌根治术患者80例的临床资料,根据引流方式的不同分为A组(n=40,传统引流)和B组(n=40,中心静脉导管引流),对比两组患者临床指标、生活质量、炎性因子及并发症发生情况。结果:B组引流操作时间、术后住院时间短于A组(P0.05)。两组术后3个月生活质量简表(SF-36)各维度评分均较术前升高,且B组高于A组(P0.05)。两组术前、术后3d、术后7d白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)呈先升高后下降趋势,且术后3d、术后7d B组以上指标低于A组(P0.05)。两组术后并发症发生率比较无差异(P0.05)。结论:与传统引流相比,单孔胸腔镜肺癌根治术患者术后采用中心静脉导管引流,效果显著,可减少炎性刺激,安全可靠,有效改善患者术后生活质量。     

熊去氧胆酸联合非诺贝特对原发性胆汁性胆管炎的临床疗效及安全性

摘要 目的：分析熊去氧胆酸联合非诺贝特对原发性胆汁性胆管炎无熊去氧胆酸生化反应的临床疗效及安全性。方法：151例原发性胆汁性胆管炎无熊去氧胆酸患者按随机数表法分为73例对照组和78例研究组。对照组在常规治疗基础上给予安慰剂联合熊去氧胆酸治疗,研究组在常规基础上给予非诺贝特联合熊去氧胆酸治疗,两组均持续治疗12个月。比较两组临床疗效,肝功能,血脂指标,肝纤维化指标,免疫球蛋白G（IgG）、免疫球蛋白M（IgM）,瘙痒及乏力评分,不良反应发生情况。结果：治疗后,研究组总有效率高于对照组,比较差异有统计学意义（P<0.05）。治疗后,两组肝功能指标均降低,研究组低于对照组,比较有统计学意义（P<0.05）。治疗后,两组总胆固醇（TC）、甘油三酯（TG）均降低,研究组低于对照组,比较有统计学意义（P<0.05）,两组治疗前后低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）比较无统计学意义（P>0.05）。治疗后,两组肝纤维化指标均降低,研究组低于对照组,比较有统计学意义（P<0.05）。治疗后,两组IgG、IgM均降低,研究组低于对照组,比较有统计学意义（P<0.05）。治疗后,两组瘙痒、乏力评分均降低,研究组低于对照组,比较有统计学意义（P<0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。结论：熊去氧胆酸联合非诺贝特对原发性胆汁性胆管炎无熊去氧胆酸生化反应的疗效较好,能够改善肝功能,且未明显增加药物不良反应。     

CFD analysis of the Ahmed Glaucoma Valve and design of an alternative device

Computational fluid dynamics (CFD) modelling based on a commercial package, FLUENT, has been used in the present study. The primary aim of this study is to develop a novel implant by employing CFD techniques. Firstly, CFD analyses on the best design commercially available, which is the Ahmed Glaucoma Valve (AGV^®), are accomplished. In the light of the results, the new design focus is selected as the valve. The new design is analysed using GAMBIT and FLUENT software. CFD analyses of the new design and the AGV^® are compared and the strengths of the new design are revealed. The results are also compared with the experimental studies AGV^® in the literature. It is deduced that the proposed model shows a nonlinear pressure drop response, which is quite similar to that of AGV^®. The optimum combination would be a flow rate of 2.5 μl/min and a pressure drop of 1054.58 Pa for the proposed model.     

Characterisation and simulation of an active microvalve for glaucoma

Glaucoma drainage device (GDD) has the potential to eliminate hypotony but still suffers from poor flow control and fibrosis. The ideal shunt should change its hydraulic resistance to achieve the desired intraocular pressure (IOP). In this study, the characterisation of a preliminary design of a new GDD is presented. This is activated by means of a diaphragm, which is actuated by conducting polymers. The valve can be manufactured employing microelectromechanical system technology by soft lithography. The characterisation process is performed by numerical simulation using the finite element method, considering the coupling between the fluid and the structure (diaphragm) obtaining the hydraulic resistance for several positions of the diaphragm. To analyse the hydraulic system of the microvalve implanted in a human eye, an equivalent circuit model was used. The parameters of the equivalent circuit model were obtained from numerical simulation. The hydraulic resistance of the designed GDD varies in the range of 13.08–0.36 mmHg min/μl compared with 3.38–0.43 mmHg min/μl for the Ahmed valve. The maximum displacement of the diaphragm in the vertical direction is 18.9 μm, and the strain in the plane is 2%. The proposed preliminary design allows to control the IOP by varying the hydraulic resistance in a greater range than the existing passive valves, and the numerical simulation facilitates the characterisation and the improvement of the design before its construction, reducing time and costs.     

Landscape influences on climate‐related lake shrinkage at high latitudes

Climate‐related declines in lake area have been identified across circumpolar regions and have been characterized by substantial spatial heterogeneity. An improved understanding of the mechanisms underlying lake area trends is necessary to predict where change is most likely to occur and to identify implications for high latitude reservoirs of carbon. Here, using a population of ca. 2300 lakes with statistically significant increasing and decreasing lake area trends spanning longitudinal and latitudinal gradients of ca. 1000 km in Alaska, we present evidence for a mechanism of lake area decline that involves the loss of surface water to groundwater systems. We show that lakes with significant declines in lake area were more likely to be located: (1) in burned areas; (2) on coarser, well‐drained soils; and (3) farther from rivers compared to lakes that were increasing. These results indicate that postfire processes such as permafrost degradation, which also results from a warming climate, may promote lake drainage, particularly in coarse‐textured soils and farther from rivers where overland flooding is less likely and downslope flow paths and negative hydraulic gradients between surface water and groundwater systems are more common. Movement of surface water to groundwater systems may lead to a deepening of subsurface flow paths and longer hydraulic residence time which has been linked to increased soil respiration and CO₂ release to the atmosphere. By quantifying relationships between statewide coarse resolution maps of landscape characteristics and spatially heterogeneous responses of lakes to environmental change, we provide a means to identify at‐risk lakes and landscapes and plan for a changing climate.     

紫金山铜矿酸性矿山废水微生物群落多样性

【背景】为避免环境污染,酸性矿山废水需经处理后才能排放,处理后的废水理化性质会发生显著变化,将影响整个微生物群落的结构。【目的】分析处理前后的细菌和真菌群落变化及其与理化参数的关系,为矿山废水的处理提供参考指标,并为矿山污染场地的修复提供理论基础。【方法】采集福建紫金山铜矿的酸性矿山废水并测定其理化性质。采用基于原核微生物16S rRNA基因V4区和真菌18S rRNA基因ITS的高通量测序技术分析水样的微生物群落结构。【结果】经中和处理后的回水与矿坑水和生物浸出液相比,pH升高,重金属离子含量显著降低。原核微生物的多样性高于真菌,回水的物种多样性高于矿坑水和浸出液。回水中变形菌门的丰度最高,矿坑水和浸出液中分别以广古菌门和硝化螺菌门的丰度最高。回水中噬氢菌属为优势类群,矿坑水和浸出液中的优势菌是钩端螺旋菌属,铁质菌属等古菌也有一定的比例。pH、Al、Mn、Zn与回水中相对丰度较高的菌属显著相关,而矿坑水和浸出液中的高丰度类群与环境因子没有显著的相关性。【结论】研究表明酸性废水的中和沉淀处理对微生物群落产生了较大的影响,微生物群落变化可以作为矿山酸性废水污染处理效果的一个参考指标。     

A new species of Hyphessobrycon Durbin (Characiformes: Characidae) from the western Amazon basin in Colombia and Peru

Hyphessobrycon chiribiquete n. sp. is described from the Río Caquetá drainage in Colombia and the Río Ucayali drainage in Peru, western Amazon. The new species is diagnosed from its congeners by having the following combination of characters: a conspicuous narrow midlateral stripe, starting on the sides of the body behind the opercle near the lateral line; lateral stripe overlapped anteriorly with a vertically elongated humeral blotch; inner premaxillary teeth pentacuspid; margin of anal fin falcate in mature males.