重型颅脑交通伤的临床特点及救治要点

目的 :分析重型颅脑交通伤的临床特点及救治要点。方法 :回顾性分析我科2000年1月—2003年12月的64例重型颅脑交通伤病例的临床特点、CT资料及救治后的结果。分析原发昏迷时间、入院时GCS评分、救治措施与预后的关系。结果 :64例伤员中 ,单纯颅脑损伤24例 ,多发伤40例。原发性昏迷51例 ,继发性昏迷8例。GCS评分3～5分20例 ,5～8分44例。开颅手术23例 ,其它手术15例 ,气管切开35例。死亡22例 ,植物生存4例 ,重残2例 ,中残6例 ,恢复良好30例。结论 :重型颅脑交通伤伤情重、复合伤多、伤情复杂。及时有效的院前急救及入院后处理对患者的预后有重要意义     

脑外伤患者血清S100β蛋白测定及其临床意义

目的:研究脑外伤患者血清S100β蛋白含量的变化及其临床意义.方法:采用酶联免疫吸附法测定30例脑外伤患者发病后24h内、第3天、第7天及20名健康人的血清S100β蛋白含量,进行动态的检测比较.使用格拉斯哥昏迷计分法(Glasgow Coma Scale,GCS)评估疾病状况.以GCS 8～3分者为重伤组,共15例.GCS 9～15分者为非重伤组,共15例,比较两组在各个时间点的血清S100β蛋白含量有无差异性.结果:两组发病后24h内、第3天、第7天,血清S100β蛋白含量均增高,且于3d达到高峰.重伤组和非重伤组24h内、第3天、第7天、血清S100β蛋白水平与正常对照组相比均明显升高(P<0.05),重伤组明显高于非重伤组.结论:血清S100β蛋白水平可作为反映脑外伤敏感的检测指标,并对患者病情严重程度及预后的评价具有重要的临床意义.     

血肿微创术治疗对脑出血康复及预后的影响

目的探讨影响微创法清除颅内血肿术治疗高血压脑出血的治疗效果及预后因素.方法对126例高血压脑出血微创清除颅内血肿术的临床资料进行统计学处理.结果126例患者术后存活120例(95.3%),本组死亡6例(4.8%).生存患者术后3个月随访,用ADL(日常生活能力)评定疗效.ADL1:恢复日常生活34例(26.9%);ADL2:生活自理35例(27.7%);ADL3:部分生活自理33例(26.1%);ADL4:卧床不起但有意识21例(16.6%);ADL5:植物状态3例(2.4%).结论出血至手术时间、意识与脑疝征、瞳孔改变、中线移位4项因素对微创清除颅内血肿术,治疗高血压脑出血患者具有显著的预后价值,超早期手术是治疗成功的关键.     

急性外伤性颅内血肿的非手术治疗

<正>自CT、MRI应用以来,颅内血肿能较早作出诊断,其中部分血肿可逐渐吸收而避免不必要的手术.近年来国内外对非手术治疗急性外伤性颅内血肿的报道日渐增多,因此对CT、MRI诊断存在颅内血肿而临床症状尚稳定的病人是否需要手术治疗.尚应进一步加以探讨.我们收集了88年10月至93年12月68例伤后24小时人院并经头颅CT或MRI证实为颅内血肿的病例作为研究对象,认为颅内血肿的病人是否施行手术治疗,应结合意识水平变化、血肿量、血肿部位、中线结构是否移位等因素加以综合考虑.68例颅内血肿40例行非手术治疗,28例行手术治疗.     

小儿外伤性颅内血肿的诊治

本文总结了34例小儿外伤性颅内血肿,根据血肿类型、临床表现、诊断与治疗进行讨论。强调小儿外伤性颅内血肿早期临床表现常不典型,急性血肿病情多数危重,要及时手术清除病灶,非手术治疗应严格掌握适应症,如果治疗及时,预后良好。     

外伤性急性颅内血肿1 886例临床分析

目的:分析外伤性急性颅内血肿的治疗经验.方法:统计本院十年来外伤性急性颅内血肿数量、发病率及病因分析和治疗效果.结果:1996年9月-2006年9月共收治外伤性急性颅内血肿1 886例.其中急性硬膜外血肿678例,占36%,死亡62例,占9%;急性硬膜下血肿585例,占31%,死亡164例,占28%;急性脑内血肿623例,占33%,死亡130例,占20%;总死亡为356例,占19%.手术和保守治疗死亡率分别为26%和3.5%.结论:CT和MRI的使用使外伤性急性颅内血肿的诊断率大为提高,早期诊断、早期治疗是提高临床治愈率、降低死亡率、减少伤残率的关键.     

重型颅脑外伤的护理

1临床资料1999年8月~2004年9月本科共收治重型颅脑外伤(GCS≤8分)患者118例,均经头颅CT确诊,其中男97例(82.2%),女21例(17.8%),年龄3~72岁,平均38岁。脑挫伤26例,硬膜外血肿36例,脑内血肿和硬膜下血肿33例,脑干损伤8例,脑外伤并发脑疝15例。受伤原因:车祸66例,跌伤38例,击伤14例。治疗方法:61例无手术指征者在神经外科监护室(NICU)进行救治,给予相应急救护理措施,密切观察病情变化;57例需手术者迅速做好术前准备,术后送入NICU ,进行多系统综合监护。治疗效果:出院时按格拉斯哥预后评分法(GCS)评定结果,Ⅰ级(痊愈)68例(57.6%),Ⅱ级(中…     

高血压脑出血的围手术期护理

总结高血压脑出血患者围手术期的护理经验．方法：采用钻孔碎吸引流、开颅血肿清除术，血肿破入脑室者行脑室外引流，在围手术期制定周密的护理计划并严格落实，预防早期并发症．结果：手术后存活77例，成活率为90％．对77例存活者术后1个月行所疗效评定，其中临床基本治愈21例，显著进步34例，进步12例，无进步10例．结论：手术治疗高血压脑出血疗效确切，在围手术期严密监测，加强护理，预防和及时发现并发症，对患者预后起积极的作用。     

广泛性重度颅脑损伤后血糖变化及临床意义

重度颅脑损伤病人的存活是临床医生关注的重点，影响其预后的因素很多。临床工作中常用指标有：GCS评分、瞳孔变化、意识状态、CT表现等。上述指标的动态观察无疑有助于临床医师判断预后。除了这些临床常用的指标外，重度颅脑损伤病人早期发生应激反映的强度也可以影响预后，据报道血糖水平可以代表应激反应的严重程度。通过观察33例重度广泛性颅脑损伤病人伤后血糖及变化，发现其与预后有明确关系。 1 临床资料及方法 临床资料：男28例，女5例，年龄16-69岁。全部病例GCS＜8分，其中3~5分15例，瞳孔不等大21例，脑干损伤4例，其余为…     

标准外伤大骨瓣减压术治疗外伤性多发性颅内血肿的临床观察

探讨标准外伤大骨瓣减压术(STC)治疗外伤性多发性颅内血肿(TMIH)的手术疗效。将庆阳市人民医院神经外科2017年10月～2018年12月收治的90例外伤性多发性颅内血肿患者按不同术式分为STC组(接受标准外伤大骨瓣减压术治疗)和常规组(接受常规骨瓣开颅术治疗),于治疗前后采用格拉斯哥昏迷评分(GCS)评估意识障碍恢复情况,采用Fugl-Meyer运动功能评分法评定治疗前后患者的上下肢功能,采用格拉斯哥预后评分(GOS)评估预后情况,并进行安全性分析。经手术治疗后2周两组GCS评分均高于治疗前(P0.05),但两组间GCS评分差异并无统计学意义(P0.05)。治疗前两组肢体功能相关评分(上肢功能、下肢功能和Fugl-Meyer总分)差异均无统计学意义(P0.05),治疗后两组患者上述评分均显著高于治疗前(P0.05),且STC组肢体功能相关评分高于常规组(P0.05)。治疗前两组GOS评分差异无统计学意义(P0.05),治疗后两组GOS评分均明显升高,STC组GOS评分高于常规组(P0.05)。标准外伤大骨瓣减压术治疗TMIH能促进患者意识障碍恢复,改善肢体功能及预后。     

Markedness and its Interpretation in Language Use

Language markedness is a common phenomenon in languages, and is reflected from hearing, vision and sense, i.e. the variation in the three aspects such as phonology, morphology and semantics. This paper focuses on the interpretation of markedness in language use following the three perspectives, i.e. pragmatic interpretation, psychological interpretation and cognitive interpretation, with an aim to define the function of markedness.     

Features of Women's language

Language is a means of verbal communication. People use language to communicate with each other. In the society, no two speakers are exactly alike in the way of speaking. Some differences are due to age, gender, statue and personality. Above all, gender is one of the obvious reasons. The writer of this paper tries to describe the features of women＇s language from these perspectives： pronunciation, intonation, diction, subjects, grammar and discourse. From the discussion of the features of women＇s language, more attention should be paid to language use in social context. What＇s more, the linguistic phenomena in a speaking community can be understood more thoroughly.     

Characterization of Ordovician carbonate reservoirs, southeastern Saskatchewan, Canada

The discovery of the prolific Ordovician Red River reservoirs in 1995 in southeastern Saskatchewan was the catalyst for extensive exploration activity which resulted in the discovery of more than 15 new Red River pools. The best yields of Red River production to date have been from dolomite reservoirs. Understanding the processes of dolomitization is, therefore, crucial for the prediction of the connectivity, spatial distribution and heterogeneity of dolomite reservoirs.The Red River reservoirs in the Midale area consist of 3～4 thin dolomitized zones, with a total thickness of about 20 m, which occur at the top of the Yeoman Formation. Two types of replacement dolomite were recognized in the Red River reservoir: dolomitized burrow infills and dolomitized host matrix. The spatial distribution of dolomite suggests that burrowing organisms played an important role in facilitating the fluid flow in the backfilled sediments. This resulted in penecontemporaneous dolomitization of burrow infills by normal seawater. The dolomite in the host matrix is interpreted as having occurred at shallow burial by evaporitic seawater during precipitation of Lake Almar anhydrite that immediately overlies the Yeoman Formation. However, the low δ18O values of dolomited burrow infills (-5.9‰～ -7.8‰, PDB) and matrix dolomites (-6.6‰～ -8.1‰, avg. -7.4‰ PDB) compared to the estimated values for the late Ordovician marine dolomite could be attributed to modification and alteration of dolomite at higher temperatures during deeper burial, which could also be responsible for its 87Sr/86Sr ratios (0.7084～0.7088) that are higher than suggested for the late Ordovician seawaters (0.7078～0.7080). The trace amounts of saddle dolomite cement in the Red River carbonates are probably related to "cannibalization" of earlier replacement dolomite during the chemical compaction.     

低渗透非均质砂岩油藏启动压力梯度研究

理论推导与室内实验相结合,建立了低渗透非均质砂岩油藏启动压力梯度确定方法。首先借助油藏流场与电场相似的原理,推导了非均质砂岩油藏启动压力梯度计算公式。其次基于稳定流实验方法,建立了非均质砂岩油藏启动压力梯度测试方法。结果表明:低渗透非均质砂岩油藏的启动压力梯度确定遵循两个等效原则。平面非均质油藏的启动压力梯度等于各级渗透率段的启动压力梯度关于长度的加权平均;纵向非均质油藏的启动压力梯度等于各渗透率层的启动压力梯度关于渗透率与渗流面积乘积的加权平均。研究成果可用于有效指导低渗透非均质砂岩油藏的合理井距确定,促进该类油藏的高效开发。     

On Tragic Consciousness In The Works By Ernest Hemingway

As an American modern novelist who were famous in the literary world, Hemingway was not a person who always followed the trend but a sharp observer. At the same time, he was a tragedy maestro, he paid great attention on existence, fate and end-result. The dramatis personae's tragedy of his works was an extreme limit by all means tragedy on the meaning of fearless challenge that failed. The beauty of tragedy was not produced on the destruction of life, but now this kind of value was in the impact activity. They performed for the reader about the tragedy on challenging for the limit and the death.     

A computer generator for randomly layered structures

AcomputergeneratorforrandomlylayeredstructuresYUJia shun1,2,HEZhen hua2(1.TheInstituteofGeologicalandNuclearSciences,NewZealand;2.StateKeyLaboratoryofOilandGasReservoirGeologyandExploitation,ChengduUniversityofTechnology,China)Abstract:Analgorithmisintrod…     

An Index mechanism for multi-scale view in spatial databases

There are numerous geometric objects stored in the spatial databases. An importance function in a spatial database is that users can browse the geometric objects as a map efficiently. Thus the spatial database should display the geometric objects users concern about swiftly onto the display window. This process includes two operations:retrieve data from database and then draw them onto screen. Accordingly, to improve the efficiency, we should try to reduce time of both retrieving object and displaying them. The former can be achieved with the aid of spatial index such as R-tree, the latter require to simplify the objects. Simplification means that objects are shown with sufficient but not with unnecessary detail which depend on the scale of browse. So the major problem is how to retrieve data at different detail level efficiently. This paper introduces the implementation of a multi-scale index in the spatial database SISP (Spatial Information Shared Platform) which is generalized from R-tree. The difference between the generalization and the R-tree lies on two facets: One is that every node and geometric object in the generalization is assigned with a importance value which denote the importance of them, and every vertex in the objects are assigned with a importance value,too. The importance value can be use to decide which data should be retrieve from disk in a query. The other difference is that geometric objects in the generalization are divided into one or more sub-blocks, and vertexes are total ordered by their importance value. With the help of the generalized R-tree, one can easily retrieve data at different detail levels.Some experiments are performed on real-life data to evaluate the performance of solutions that separately use normal spatial index and multi-scale spatial index. The results show that the solution using multi-scale index in SISP is satisfying.     

Jane Eyre——A Feminist In The 19th Century

In the 19th century the society was controlled by men, and women were just appendants of them, they had not any rights and freedom. But Jane was an exception, she showed some characteristics of early feminist. Jane showed her characteristics of feminism in three aspects: rebellion, equality, and independence. These characteristics were helpful to her success, and feminism is the only way out for women of that time.     

Achieving Unusual States of Matter Under High Pressure

正The periodicity of the elements and the non-reactivity of the inner-shell electrons are two related principles of chemistry,rooted in the atomic shell structure.Within compounds,Group I elements,for example,invariably assume the+1 oxidation state,and their chemical properties differ completely from those of the p-block elements.These general rules govern our understanding of chemical structures and reactions.Using first principles calcula-     

Exchange-Correlation and Electronic Excitation Energies from Pairing Matrix Fluctuations

We have developed an adiabatic connection to formulate the ground-state exchange-correlation energy in terms of pairing matrix linear fluctuations.This formulation of the exchange-correlation energy opens a new channel for density functional approximations based on the many-body perturbation theory.We illustrate the potential of such approaches with an approximation based on the particle-particle Random Phase Approximation(pp-RPA).This re-