儿童扁桃体电刀电凝手术与传统手术的比较

目的：比较儿童扁桃体电刀电凝切除术与传统剥离术的优缺点。方法：220例患儿左右扁桃体按切除术式随机分为实验组及对照组,实验组行电刀电凝法切除及术后止血,对照组行传统剥离术,术后行压迫止血、结扎止血或电凝止血。结果：实验组手术时间较对照组短（8±3min vs 16±5min,P〈0．05）;术中出血量少（0—6mLVS10～40mL,P〈0．05）;术后白膜生长时间两组相仿均为1～3d,但实验组白膜脱落时间较对照组稍长（14～21dVS7—14d,P〈0．05）。结论：儿童扁桃体切除,电刀电凝法较传统扁桃体剥离法,手术用时短,出血量少,术后愈合较慢,白膜脱落时间长。     

孩子能不能切除扁桃体

jzdelima@163.com问:我的孩子经常由于化脓性扁桃体炎而发烧,最近一次在医院打了4天的点滴,每天3～4瓶,可是病情     

探讨鼻内镜下低温等离子治疗非特异性鼻出血的临床疗效

目的：：探讨鼻内镜下低温等离子治疗非特异性鼻出血的临床疗效以及注意事项.方法：选取我院门诊自2012年10月~2014年11月期间收诊的150例非特异性鼻出血的患者作为研究对象,采用随机数字表法分为治疗组（n=75）和对照组（n=75）,治疗组患者给予鼻内镜下低温等离子治疗,对照组患者给予传统鼻腔填塞治疗,选择一次性成功率、总出血量、鼻腔恢复通气时间、术后鼻粘膜恢复时间、不良反应发生率、3个月复发率作为指标对比两组患者的治疗效果.结果：治疗组的一次性成功率明显高于对照组,总出血量、鼻腔恢复通气时间、术后鼻粘膜恢复时间、不良反应发生率以及3个月复发率均明显少于对照组,所有差异均具有统计学意义（p＜0.05）.结论：鼻内镜下低温等离子治疗非特异性鼻出血的临床疗效的临床疗效明确,可以提高一次性治愈率,减少术中总出血量,缩短鼻腔恢复通气时间和术后鼻粘膜恢复时间,降低不良反应发生率以及3个月复发率,建议在临床上大力推广使用.     

孩子的扁桃体经常发炎如何处理

3483xiangyin@126.com问:我的孩子快5岁了,基本上每月都会出现扁桃体发炎的情况。一旦扁桃体发炎,他就会发烧,弄得我们三天两头往医院跑,而频繁地打针、输液也让他对医院非常抵触。请问,孩子的扁桃体经常发炎如何处理?     

鼻内镜下低温等离子小儿腺样体扁桃体吸切术麻醉及催醒

目的：探讨鼻内镜下低温等离子小儿腺样体扁桃体吸切术麻醉及催醒安全性和可靠性。方法：静吸复合全麻。结果：全组100例患儿术中麻醉及血流动力学均保持平稳。结论：运用气管插管静吸复合全麻用于鼻内镜下低温等离子小儿腺样体扁桃体吸切术,明显提高了手术安全性和舒适性。     

经济型数控车床的对刀方法和技巧

通过对R2J50L系统经济型数控车床基本对刀方法的分析与研究,总结出了更换刀具及刀具磨损时的快速对刀方法,提高了加工效率。     

数控铣床几种对刀方法的分析比较

随着机械数控化的发展,数控铣床已经成为工件加工中的主流设备,它的优势就是生产效率高、精准度高。其中,对刀是数控加工中的重要环节,其关系着加工工件的精度。中职学校数控专业的毕业生是以后企业数控生产数的骨干力量,学好数控铣床对刀方法至关重要。本文首先介绍了对刀前的准备工作,然后分析了数控铣床常用的几种对刀方法,最后认识到不同对刀方法在实际工件加工中的优缺点。     

300MW机组等离子点火技术和微油点火技术的比较及运用

微油点火和等离子煤粉点火燃烧器具有经济、环保、高效、节能等优点.实践证明,该两项技术的成功运用使得燃油消耗大大下降,产生了巨大的经济效益,采用少油、无油点火逐渐成为一种趋势.同时,由于燃烧器结构的不同、煤质条件的差别以及点火过程中的操作及调整措施的不同,导致点火效果也各有差别.如何有效地结合各电厂机组的实际条件,成功实现微油点火技术或等离子燃烧器的无油点火,总结出一套完整的用于点火过程中的稳燃及解决措施并加以推广应用,具有非常重要的意义.     

120例外痔剥离术的临床观察

通过120例外痔剥离术的临床观察,发现两类手术后患者的肛管静息压有不同变化,其中分组剥离术术后肛门测压变化轻微;外痔环切术术后测压则变化较大,说明肛管受到一定程度的损害.     

“火”和“刀”的秘密——解读林冲人物形象

施耐庵在《林教头风雪山神庙》里巧妙的将"刀"和"火"融合到了一起,将人物性格中的两面性以及性格此消彼长的特点,展现得淋漓尽致,烘托出了一个孤单高大的末路英雄形象,给文章增添了无限的情趣。     

Comparison of epidemiological and clinical characteristics of COVID-19 patients with and without Wuhan exposure

Journal of Zhejiang University-SCIENCE B - A novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first identified in Wuhan, China, has been rapidly spreading...     

傈僳族刀杆节的由来及其演变

作为民族的传统节日,刀杆节是傈僳文化的重要载体,它传承了傈僳族丰富多彩的文化,发扬了傈僳族敢于与大自然作斗争的大无畏精神。但随着傈僳族的不断流动和迁徙,特别是当他们迁徙到保山的腾冲、龙陵一带后,刀杆节从起节日源传说到活动形式,从祭祀的对象到目的都发生了深刻变化。     

Graduate engineers' perceptions of their engineering courses: Comparison between enhanced engineering courses and their conventional counterparts

The Dainton enhanced engineering courses were designed to produce engineers who would be better prepared for careers in manufacturing management than their counterparts from conventional engineering programmes. As part of a large scale evaluation of these courses, the views of 167 students and 220 graduates of the programmes were compared with those of a control group of 353 students from conventional engineering courses. Respondents were asked for their opinions of 19 course elements in terms of the amount of time devoted to each as a preparation for a career as a professional engineer in industry.In general, enhanced students viewed their courses more favourably than students from conventional courses. Thus, over half of the conventional students criticised their courses for a lack of business and management material, compared with less than one in five enhanced students. There were few differences between the two groups in their views about the technical content of their courses. Criticisms about insufficient time being devoted to CADCAM, Engineering Practice, and Engineering Applications were common in students from both types of course. The views of enhanced graduates, who had up to five years' work experience post graduation, were similar to those of the undergraduates. The results are discussed in terms of their implications for engineering education in general.     

Evaluation of efficacy of resin hemoperfusion in patients with acute 2,4-dinitrophenol poisoning by dynamic monitoring of plasma toxin concentration

Objective: The intoxications caused by 2,4-dinitrophenol (2,4-DNP), even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion (HP) in the treatment of patients with acute 2,4-DNP poisoning. Methods: We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP (n=5) and intensive HP (n=9) groups. Ultra high performance liquid chromatography/tandem mass spectroscopy (UPLC-MS/MS) was used to detect the 2,4-DNP concentration in plasma in this study. Results: The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations (C ₁) of survivors ranged from 0.25 to 41.88 µg/ml (mean (12.56±13.93) µg/ml). A positive correlation existed between initial plasma 2,4-DNP concentration (C ₁) and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day (R ₃), the 3rd to 7th day (R _3–7), and the 1st to 7th day (R ₇), were only (53.03±14.04)%, (55.25±10.50)%, and (78.29±10.22)%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R ₃, R _3–7, and R ₇ in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance (P<0.05). Simultaneously, the elimination half-life (t _1/2) of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance (P<0.05). Conclusions: The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the limited data, longer and more frequent resin HP may accelerate to eliminate the poison.     

A clinical study of the efficacy of topical corticosteroids on dry eye

Objective： To evaluate the effect of topical corticosteroid for treatment of moderate or severe dry eye. Methods： Sixty eyes of 30 patients with moderate or severe dry eye, who were not sensitive to artificial tears, were treated with 0.1% fluorometholone eye drops. Subjective symptom and objective tests were used to evaluate the efficacy of treatment before and after application of 0.1% fluorometholone eye drops for 1 week and 1 month. Side effects were also evaluated. Results： After 1 week of treatment, subjective symptoms were improved in all dry eye patients; objective tests were improved in all dry eye patients 1 month after treatment, and the difference was significant. Conclusion： Topical corticosteroid drops can rapidly and effectively relieve the symptoms and signs of moderate or severe dry eye.     

刀辊和砧辊硬度匹配试验研究

提高刀辊材料硬度可减少磨损,延长其使用寿命,提高模切速度,但会导致与之配合的砧辊损伤更为严重。为了使刀辊和砧辊系统总磨损量达到最小,试验研究了刀辊和砧辊的硬度匹配问题。利用滚动磨损试验机研究了刀辊与砧辊的硬度匹配,分析了不同硬度刀辊与砧辊匹配时的摩擦磨损与表面损伤行为。结果表明:不同硬度刀辊和砧辊试样匹配对滚动摩擦系数基本无影响;随刀辊硬度增加,刀辊磨损量呈下降趋势,砧辊磨损量表现为线性增加,刀辊和砧辊总磨损量呈先降低后增加的趋势,当刀辊与砧辊硬度比为1.016时,刀辊和砧辊系统总磨损量达到最小。刀辊硬度对刀辊和砧辊试样表面损伤形貌没有影响,刀辊和砧辊试样表面损伤形貌均表现为表面剥落损伤机制。     

Comparison of pharmacokinetics,efficacy and toxicity profile of gemcitabine using two different administration regimens in Chinese patients with non-small-cell lung cancer

Objective： To conduct a randomized comparative trial of pharmacokinetics, efficacy and toxicity profile treatment with 1200 mg/m^2 gemcitabine using standard 30-min infusion or fixed dose rate （FDR） infusion [10 mg/（m^2-min）] on days 1 and 8 plus carboplatin AUC （area under curve） 5 on day 1 in Chinese non-small-cell cancer patients. Twelve patients were enrolled in this study. Methods： Plasma gemcitabine concentrations were measured by ion-pair reversed phase high performance liquid chromatography. Antitumoral activity and toxicity of gemcitabine was assessed according to World Health Organization criteria. Results： The obtained mean parameters, such as T1/2 （elimination half time）, AUC, and CL （clearance）, were consistent with those reported in literature. Qualified response rate in our study was 33.3% for standard arm and 50% for FDR ann. Additional 50% and 33.3% patients contracted stable disease （SD） in standard arm and FDR arm, respectively. The predominant toxicity was hematologic, and patients in the standard infusion ann experienced consistently more hematologic toxicity, Conclusion： Pharmacokinetic and clinical data in this trial support the continued evaluation of the FDR infusion strategy with gemcitabine.     

Comparison of high order aberration after conventional and customized ablation in myopic LASIK in different eyes of the same patient

Purpose: To verify whether there exists any difference in higher order aberrations after undergoing myopic LASIK (laser in situ keratomileusis) with conventional ablation and customized ablation in different eyes of the same patient. Methods: This was a prospective randomized study of 54 myopic eyes (27 patients) that underwent LASIK using the Nidek EC-5000 ex-cimer laser system (Nidek, Gamagori, Japan). Topography-guided customized aspheric treatment zone (CATz) was used in the first eye of the patient (study group) and the other eye of the same patient was operated on with conventional ablation (control group). Higher order aberrations [root-mean-square (RMS) in the 5-mm zone] of both groups were observed with the Nidek OPD-Scan aberrometer before and 3 months after LASIK. Preoperative mean refractive error was similar between two eyes of the same patient (t=?0.577, P>0.05). Results: Preoperatively, higher order aberrations (RMS in the 5-mm zone) in the CATz ablation and conventional groups were (0.3600±0.0341) μm and (0.2680±0.1421) μm, respectively. This difference was not statistically significant (t=1.292, P>0.05). Three months after LASIK, higher order aberrations (RMS in 5-mm zone) in the CATz ablation and conventional groups were (0.3627±0.1510) μm and (0.3991±0.1582) μm, respectively. No statistically significant difference was noted between pre- and postoperative higher order aberrations in the CATz group (t=?0.047, P>0.05). However, a statistically significant increase in higher order aberrations was observed after conventional ablation (t=?5.261, P<0.05). A statistically sig-nificant difference was noted in the increase of higher order aberrations after LASIK between groups (t=?2.050, P=0.045). Con-clusion: LASIK with conventional ablation and topography-guided CATz ablation resulted in the same BSCVA (best specta-cle-corrected visual acuity) 3 month after LASIK. Higher order aberrations were increased, but the increase of higher order ab-errations after customized ablation treatment was less than that after conventional ablation.     

数模竞赛与常规教学结合初探

本文阐述了数学建模竞赛活动与常规教学相结合的意义,构建了数学建模竞赛活动与常规教学相结合的教学运行体系,最后对如何克服教学中的困难提出了三条建议.     

Promoting assessment efficacy through an integrated system for online clinical assessment of practical skills

This paper presents evaluation outcomes from an externally funded research project involving the online clinical assessment of practical skills (eCAPS) using web-based video technologies within a university medical programme. eCAPS was implemented to trial this web-based approach for promoting the efficacy of practical skills assessment in knee joint examinations for a pre-clinical cohort of second year medical students. eCAPS involves a progressive organisation of online video experiences and task expectations for formative and summative assessments of selected competencies. Data are presented from semi-structured interviews with the medical students (N?=?40). eCAPS successfully supported students’ skill development in knee joint examinations on fellow students and allowed remote assessment of candidates’ performances by clinicians experienced in musculoskeletal examinations. An ‘indicative standard’ paradigm, involving formative assessment of one randomly selected performance from the submission of all students’ responses within a small group, offered an efficient and efficacious avenue for providing consolidated feedback to students and promoted desirable learning behaviours. Overall, there was evidence of reciprocal learning benefits to the ‘blending’ of an online learning and assessment approach with an existing face-to-face environment. The medical students were able to successfully engage online with high quality and consistent practical skill-based materials in a flexible, independent and individual manner.