目的:探讨自制Y型烟雾吸引管在腹腔镜全子宫切除术中,吸除电外科设备使用时产生手术烟雾的效果.方法:选择2018年6月1日～2019年8月31日期间,在全麻下行腹腔镜全子宫切除手术患者80例,按患者住院号分为观察组和对照组各40例;观察组术中使用自制Y型烟雾吸引管吸除手术烟雾,对照组使用传统方法进行排烟;比较两组除烟效果及医生满意度.结果:观察组术中镜头擦拭次数、排烟次数、手术时间均少于对照组(P<0.05),医生对气腹压力稳定度、镜头清晰度、排烟效果的满意例数均多于对照组(P<0.05).结论:自制Y型烟雾吸引管能有效吸除手术烟雾,保证手术顺利进行,改善手术室环境,提高医务人员对手术烟雾的主动防护意识,使用方便,成本低廉,值得在临床上推广使用.

目的 探讨宫腔镜联合子宫动脉栓塞术治疗瘢痕妊娠的临床效果.方法 85例剖富产术后子宫瘢痕妊娠患者根据治疗方案的不同分为两组:对照组40例,采用宫腔镜下清宫术;观察组45例,采用宫腔镜联合子宫动脉栓塞术.比较两组患者的术中出血量、术后血清人绒毛膜促性腺激素(HCG)水平及其恢复正常的时间、术后D-D水平、住院时间和医疗费用.结果 与对照组比较,观察组患者术中出血量少,术后血清HCG水平低,血清HCG水平恢复正常时间早,住院时间短,住院费用高(P＜0.05);两组患者的D-D水平比较差异无统计学意义(P＞0.05).结论 宫腔镜联合子宫动脉栓塞术较单纯宫腔镜下清宫术治疗瘢痕妊娠效果更好,且不增加术后血栓的发生率.

目的 通过多体素氢质子磁共振波谱成像(1 H-MRS)探讨围产期高危因素对早产儿脑组织代谢的影响及代谢产物对神经系统发育落后的预测价值.方法 对60例早产儿在36周＜矫正胎龄≤37周行头颅MRI及1H-MRS检查,并于出生后40周行Gesell发育量表检测,最终46例早产儿被纳入研究并分为四组:围产期正常组12例、缺氧窘迫组10例、感染组12例、缺氧窘迫伴感染组12例,分别测定基底节及丘脑(BGT)、两侧脑室周围白质(WM)的N-乙酰天门冬氨酸(NAA)/肌酸复合物(Cr)、胆碱复合物(Cho)/Cr、乳酸(Lac)/Cr比值,四组组间数据行单因素方差分析;对NAA/Cr、Cho/Cr、Lac/Cr及发育商(DQ)分别作Spearman相关分析,当P＜0.05,对各参数与DQ作线性回归分析;利用受试者工作特征(ROC)曲线计算各代谢产物对神经系统发育落后的预测能力.结果 围产期正常组分别与缺氧窘迫组、缺氧窘迫伴感染组比较,感染组与缺氧窘迫伴感染组比较,在BGT及WM区域,NAA/Cr、Cho/Cr、Lac/Cr差异均有统计学意义(P＜0.01);围产期正常组与感染组比较,缺氧窘迫组与缺氧窘迫伴感染组比较,仅在WM区域,Cho/Cr差异有统计学意义(P＜0.05);各代谢物之间及与DQ之间有强相关性,BGT区域NAA/Cr、Cho/Cr与DQ的回归方程决定系数较高(0.6742、0.5649),并且对神经系统发育落后预测能力最强,曲线下面积(AUC)分别为0.940、0.955.结论 围产期缺氧直接影响髓鞘化进程及神经元的完整性;围产期感染仅对脑白质区神经纤维髓鞘化进程有影响;BGT区NAA/Cr、Cho/Cr比值的联合应用可以较准确预测早产儿神经系统发育落后.

Objective To investigate the feasibility of low dose dual phase contrast-enhanced chest CT with iterative mod el reconstruction (IMR) technique.Methods Totally 130 patients with suspected pulmonary occupying lesions underwent dual phase contrast-enhanced chest CT,who were randomly assigned into 2 groups (group A and group B,each n=65).Patients in group A were scanned with 100 kV,DoseRight technique with dose right index 10,and images were reconstructed with the hybrid iterative reconstruction (iDose4).While patients in group B were scanned with 80 kV,DoseRight technique with dose right index 8,and images were reconstructed with iterative model reconstruction (IMR).The objective image quality,subjective image scores and the excellence rate of vascular visualization were compared in both pulmonary artery (PA) and bronchial artery (BA) phases.The radiation dose was also calculated.Results The effective dose was (3.30 ±0.89)mSv in group A and (1.27 ±0.19)mSv in group B.Compared to group A,the effective dose reduced 61.52％ in group B (P＜0.001).Lower image noise and greater CNR were obtained in group B compared to group A in both PA and BA phases (all P＜0.001).No significant difference was found in subjective image scores of lung and mediastinal setting and the excellence rate of vascular visualization in both groups (all P＞0.05).Conclusion Using IMR,dual phase contrast-enhanced chest CT allows for a radiation dose reduction up to 61.52％,meanwhile,ensures the image quality and meets the diagnostic requirements.

With the rapid development of NICU, the survival rate of premature and very low birth weight infants has increased significantly. However, these preterm survivors are at risk of neurodevelopmental impairments such as cognitive and behavioral abnormalities, poor attention and social skills, learning disorder, even cerebral palsy (CP). Due to advances in functional magnetic resonance imaging (e.g. DWI, DTI, DKI, MRS, SWI, ASL) in recent years, it is feasible to investigate preterm brain injury through observation of brain microstructure, metabolism and hemodynamic. So we review the application and progress of multimodality fMRI in preterm brain injury.

<正>冷凝集血液标本的处理方法是37℃水浴,待肉眼可见的凝集消失后,迅速用仪器检测。我们遇到1例冷凝集标本,用上述方法仍无法很好地解决问题,但血液分析仪的RBC-O参数可提供较满意的结果。1实验与结果

Objective To study the clinical effects of glass-fiber post on anterior teeth with varying ferrule heights and configurations.To compare the clinical effects of glass-fiber post following surgical crown lengthening or not on severe anterior teeth defect.Methods 295 anterior teeth with varying ferrule heights were divided into Ⅰ、Ⅱ、Ⅲdegree teeth defects.All teeth were divided into five groups:A、B、C、D、E.Group A:62 teeth with Ⅰdegree defect;Group B:77 teeth with Ⅱdegree defect;Group C:59 teeth with Ⅲdegree defect;Group D:48 teeth with Ⅲ degree defect;Group E:49 teeth withⅢ degree defect;The groups of A、B、C、D were restored with glass-fiber post;The teeth of group E gained ferrule no less than 2mm following surgical crown lengthening and were restored with glass-fiber post.Results The success rates of group A、B、C、D、E were 100%、100%、96.6%、85.4%、97.9%respectively.The difference between A、B;A、C;A、E;B、C;B、E;C、E was not significant(P>0.05).The difference between D、E was significant(P<0.05).Conclusions The clinical effect of glass-fiber post was satisfying in the restoration of anterior teeth defect,with ferrule no less than 2mm.Glass-fiber post crown restoration following surgical crown lengthening could effectively restore severe anterior teeth defect.