氯诺昔康在神经外科术后静脉自控镇痛中的应用

目的:观察经额部、颞部入路的神经外科病人术后的疼痛情况以及氯诺昔康用于此类神经外科病人术后静脉自控镇痛的临床效果.方法:36例择期经额部、颞部入路的神经外科手术病人,随机分为二组:氯诺昔康组(L组)镇痛药物为氯诺昔康每mL0.8 mg;对照组(N组)术后当病人主诉疼痛明显,难以忍受时予口服颅痛定30mg.记录各组病人术前及术后4、16、24、48 h的心率、平均动脉压、呼吸频率、脉搏氧饱和度及瞳孔变化.记录各组病人术后4、16、24及48 h的疼痛模拟评分(VAS)、Ramsay镇静评分及术后的凝血指标和术后发生恶心呕吐的情况.结果:L组病人的心率、平均动脉压术前与术后各时段点比较无显著差异(P＞0.05);N组病人术后4 h的心率、平均动脉压较术前显著增加,差异有统计学意义(P＜0.05).两组病人均未出现明显的呼吸抑制,Ramsay镇静评分均不超过3分,在术后各时段点差异均无统计学意义(P＞0.05).术后4、16 h L组VAS评分均显著低于N组(P＜0.05),术后24、48 h二组VAS评分差异无显著性(P＞0.05).未镇痛组的病人在术后24 h内有10例需要使用颅痛定.两组病人术前术后血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均在正常值范围内.L组和N组病人均有不同程度的恶心呕吐情况出现,各组的呕吐发生率均为33.33%.结论:经额、颞部入路的神经外科病人手术后存在术后疼痛,且大多发生在术后第1 d.氯诺昔康能为其提供良好的术后镇痛疗效,术后镇痛中无明显的呼吸抑制、镇静及凝血指标异常等不良反应.     

曲马多超前镇痛用于小儿腭裂修补术的临床观察

目的观察小儿腭裂修补术中曲马多超前镇痛的有效性和安全性。方法选择46例美国麻醉医师协会分级法（ASA）Ⅰ—Ⅱ级腭裂修补术患儿，年龄1～3岁，随机分为曲马多组和对照组，全麻诱导气管插管后在术前分别静推曲马多2mg/kg和相同容量的生理盐水。记录患儿围麻醉期间血流动力学变化，并测定苏醒期的躁动评分，观察有无恶心呕吐、呼吸抑制、反流误吸等不良反应。结果两组患儿围麻醉期间术中血流动力学平稳，组间差异无显著性；但曲马多组在拔管时和苏醒期血流动力学明显较对照组平稳。苏醒期躁动评分曲马多组满意率明显高于对照组（P〈0．05）。两组患儿均未发生恶心呕吐、呼吸抑制、反流误吸等不良反应。结论小儿腭裂修补术术前静推曲马多2mg/kg可获得围麻醉期间较为平稳的血流动力学，减少拔管期的躁动，且不增加术后呼吸抑制、恶心呕吐等不良反应的发生率。     

双氯酚酸钠栓直肠给药配合术后舒适护理治疗妇科腹腔镜术后疼痛的观察

目的探讨双氯酚酸钠栓直肠给药治疗妇科腹腔镜术后疼痛及术后舒适护理。方法将623例妇科腹腔镜手术患者随机分为两组,实验组（317例）给予双氯酚酸钠塞肛止痛,配合舒适护理;对照组（306例）采用曲马多止痛,采用常规护理。观察两组患者的止痛效果、睡眠状况和不良反应。结果两组止痛效果相似,但实验组睡眠状况优于对照组,发热和恶心呕吐患者少于对照组,差异有显著性。结论双氯酚酸钠栓直肠给药,配合术后舒适护理是治疗妇科腹腔镜术后疼痛、提高患者满意度的理想方法。     

利多卡因静脉输注在胸科手术患者围术期的镇痛作用探究

目的:探讨利多卡因静脉输注在胸科手术患者围术期的镇痛作用.方法:将2014年2月至2015年2月在皋兰县人民医院全麻下进行胸科手术的90例患者随机分为对照组和实验组,每组各45例,对照组采用芬太尼、舒芬太尼、雷莫司琼、地佐辛静脉输注,实验组采用利多卡因、芬太尼、舒芬太尼、雷莫司琼、地佐辛静脉输注,观察比较两组术后4h、8h、24h、48h、72 h的疼痛VAS、镇静评分及不良反应.结果:实验组术后4h、8h、24h、8h、72 h的疼痛VAS评分均明显低于对照组(p＜0.05);实验组术后4h、8h、24h、48 h、72 h的镇静评分均明显高于对照组(p＜0.05);两组均未出现明显不良反应.结论:利多卡因静脉输注在胸科手术患者围术期的镇痛效果显著,不良反应少,值得临床借鉴.     

非药物护理措施对妇产科腹部手术患者疼痛的影响

目的：了解实施非药物护理措施对妇产科腹部手术患者术后疼痛变化规律的影响。方法：选择2013年8月至2014年3月实施妇产科腹部手术的患者80例,随机将其分为两组,试验组患者分别于术前、术后0－8 h内、8－16 h内、16－4 h内、24－32 h内采用手术及术后疼痛的非药物护理措施,对照组未采用该护理措施。采用一般情况调查表、视觉模拟疼痛量表（VAS）对两组患者疼痛程度进行评估比较。结果：术后0－8 h,两组患者的疼痛程度感受没有较大的差异,由于P〉0.05,因此没有统计学的意义和价值,而在术后8－32 h,实验组患者疼痛程度感受要低于对照组,P〈0.05,所以两组差异具有统计学意义和价值。结论：对妇产科腹部手术患者实施非药物护理措施,在术后8h后能够减少其疼痛感受程度,增加患者的舒适度。     

力邦欣定减少吗啡术后硬膜外镇痛的恶心呕吐

选择 6 0例硬膜外麻下行腹部及下肢手术的患者 ,随机分为A、B 2组 ,A组为对照组 ,B组在A组镇痛液的基础上加入力邦欣定 ,观察患者术后镇痛VAS评分、嗜睡、恶心、呕吐的发生情况 .结果表明 :VAS评分 2组在各阶段比较无明显差异 (P >0 .0 5 ) ;恶心、呕吐 :B组与A组比较有显著性差异 (P <0 .0 5 ) .力邦欣定能有效地减少硬膜外吗啡镇痛治疗中恶心、呕吐的发生率 .     

加减八珍汤中西医结合治疗视网膜脱离疗效探讨

目的观察加减八珍汤中西医结合治疗视网膜脱离和促进术后玻璃体混浊吸收的疗效.方法32例视网膜脱离复位术后患者随机分为中西医结合治疗组和对照组,观察术后视网膜复位的情况.结果本组32例病人中显效25例,有效6例,无效1例.组间比较有显著性差异(P＜0.05.结论中西医结合治疗对视网膜脱离手术复位和术后玻璃体混浊的吸收有良好的作用.     

不同镇痛方法对腹腔镜子宫全切术患者术后应激反应的影响

探讨不同镇痛方法对腹腔镜子宫全切术患者术后应激反应的影响。选取2019年3月～2019年12月行腹腔镜子宫全切术患者138名,采用随机数字表法随机分为三组,其中局麻药物切口浸润联合术后口服镇痛组(LA)46例、静脉镇痛组(IA)47例、按需镇痛组(DA)45例。比较三组在术后2h、4h、8h、24h、48h疼痛视觉模拟评分(VAS),麻醉前以及术后24h血糖、胰岛素、皮质醇水平,术后哌替啶使用例数,术后恶心呕吐发生率以及平均住院时间、平均住院费用的差异。LA组与IA组患者术后2h、4h、8h、24h、48hVAS评分无统计学差异(P0.05)。DA组患者术后2h、8h、24hVAS评分高于其余两组(P0.05);三组术后24小时血清血糖、胰岛素、皮质醇浓度均高于麻醉前(P0.05)。DA组患者术后24h时血清胰岛素、皮质醇浓度高于同时间点的LA及IA组(P0.05);DA组术后哌替啶使用例数高于其余两组(P0.05),IA组术后恶心呕吐例数高于其余两组。在腹腔镜子宫全切术患者围术期采用局麻药物切口浸润联合术后口服镇痛能有效管理术后疼痛,抑制机体应激反应水平,降低术后恶心呕吐发生率。     

不同剂量高乌甲素在腹部手术后皮下自控镇痛的观察

目的观察高乌甲素不同剂量在腹腔手术后皮下自控镇痛(PCSA)镇痛效果.方法选择90例腹部手术病人,随机均分3组,每组30例,高乌甲素(Ⅰ组),高乌甲素(Ⅱ组)和曲马多(Ⅲ组).Ⅰ组配方高乌甲素0.0067mg/(kg·h) 利多卡因0.3mg/(kg·h);Ⅱ组配方高乌甲素0.008mg/(kg·h) 利多卡因0.3mg/(kg·h);Ⅲ组配方曲马多0.3mg/(kg·h) 利多卡因0.3mg/(kg·h).3组均加0.9%氯化钠至100ml,并加格拉司琼6mg.在手术结束前30min,开始持续皮下给药,并在术后6h、10h、24h、40h、48h用视觉模拟评分法(VAS)评价疼痛程度和记录不良反应.结果3组间术后各时间点疼痛程度不同,Ⅲ组不良反应高于Ⅰ、Ⅱ组,有显著性差异(P《0.01),Ⅱ组镇痛作用较Ⅰ组强(P《0.05).结论高乌甲素随剂量增加镇痛效果增强,曲马多虽镇痛效果可靠,但不良反应发生率高.     

23G微创玻璃体切割术在玻璃体视网膜疾病中的应用

目的:探讨23G经结膜无缝合玻璃体切割系统在玻璃体视网膜疾病中的应用,观察其疗效以及并发症情况。方法:回顾性分析2011年10月至2013年10月行23G玻璃体切割术的患者46例(48眼)。其中,特发性黄斑裂孔8眼(16.7%),特发性黄斑前膜5眼(10.4%),玻璃体积血19眼(39.5%),糖尿病视网膜病变V-VI期8眼(16.7%),孔源性视网膜脱离8眼(16.7%)。分别观察缝合组和未缝合组手术前和手术后1d、7d、1个月眼压变化情况、手术效果、时间、最佳矫正视力及术中、术后并发症等。术后随访1~12个月。结果:所有病例均顺利完成手术,巩膜切口缝合组和未缝合组间术后1d、7d、1个月眼压差异均无统计学意义(P0.05);术后最佳矫正视力均有不同程度提高,与术前比较差异有统计学意义(P0.01)。手术时间70.12±7.86 min;术后眼部刺激症状轻微,术后并发症少见。术中2眼套管滑脱,5眼结膜下轻微出血,3眼结膜下气泡,所有病例在随访期间无严重并发症发生。结论:23G玻璃体切割术具有微创、手术时间短等优点,术后恢复快,疗效好,并发症少,将其应用于治疗玻璃体视网膜病变是一种安全有效的微创手术方法。     

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.     

Lower Paleozoic oil relationships within Williston Basin, Canada

The Williston Basin is a significant petroleum province, containing oil production zones that include the Middle Cambrian to Lower Ordovician, Upper Ordovician, Middle Devonian, Upper Devonian and Mississippian and within the Jurassic and Cretaceous. The oils of the Williston Basin exhibit a wide range of geochemical characteristics defined as "oil families", although the geochemical signature of the Cambrian Deadwood Formation and Lower Ordovician Winnipeg reservoired oils does not match any "oil family". Despite their close stratigraphic proximity, it is evident that the oils of the Lower Palaeozoic within the Williston Basin are distinct. This suggests the presence of a new "oil family" within the Williston Basin. Diagnostic geochemical signatures occur in the gasoline range chromatograms, within saturate fraction gas chromatograms and biomarker fingerprints. However, some of the established criteria and cross-plots that are currently used to segregate oils into distinct genetic families within the basin do not always meet with success, particularly when applied to the Lower Palaeozoic oils of the Deadwood and Winnipeg Formation.     

An Analysis of Catherine＇s Character——Wuthering Heights

Wuthering Heights, Emily Bronte＇s only novel, was published in December of 1847 under the pseudonym Ellis Bell. The book did not gain immediate success, but it is now thought one of the finest novels in the English language. Catherine is the key character of this masterpiece, because everybody and everything center on her though she had a short life. We can understand this masterpiece better if we know Catherine well.     

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.     

Design and analysis of generic LBS application developing platform

Location based services is promising due to its novel working style and contents.A software platform is proposed to provide application programs of typical location based services and support new applications developing efficiently. The analysis shows that this scheme is easy implemented, low cost and adapt to all kinds of mobile nework system.     

橡胶颗粒沥青混合料低温抗裂性试验研究

以AC-13级配为基础,将橡胶颗粒代替部分集料掺入混合料中,以低温弯曲试验为评价方法对不同橡胶颗粒掺量下沥青混合料的低温抗裂性进行研究,并引入应变能密度值对混合料的低温抗裂性进行综合评价.试验结果表明:橡胶颗粒沥青混合料试件的破坏微应变均超过2 300,满足冬寒区的技术指标;无论是否掺加橡胶颗粒,随着温度的下降,沥青混合料破坏时的最大弯拉强度增大,弯拉应变降低,劲度模量增大;弯曲应变能密度在胶粒掺量为1%左右时具有较大的弯曲应变能密度值,此时橡胶颗粒沥青混合料具有较好的低温抗裂性.     

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.     

Quantitative trait loci （QTLs） for quality traits related to protein and starch in wheat

Quality traits in wheat （Triticum aestirum L.） were studied by quantitative trait locus （QTL） analysis in a recombinant inbred line （RIL） population, a set of 131 lines derived from Chuan 35050 × Shannong 483 cross （ChSh）. Grains from RILs were assayed for 21 quality traits related to protein and starch. A total of 35 putative QTLs for 19 traits with a single QTL explaining 7.99-40.52% of phenotypic variations were detected on 10 chromosomes, 1D, 2A, 2D, 3B, 3D, 5A, 6A, 6B, 6D, and 7B. The additive effects of 30 QTLs were positive, contributed by Chuan 35050, the remaining 5 QTLs were negative with the additive effect contributed by Shannong 483. For protein traits, 15 QTLs were obtained and most of them were located on chromosomes 1 D, 3B and 6D, while 20 QTLs for starch traits were detected and most of them were located on chromosomes 3D, 6B and 7B. Only 7 QTLs for protein and starch traits were co-located in three regions on chromosomes 1D, 2A and 2D. These protein and starch trait QTLs showed a distinct distribution pattern in certain regions and chromosomes. Twenty-two QTLs were clustered in 6 regions of 5 chromosomes. Two QTL clusters for protein traits were located on chromosomes 1D and 3B, respectively, three clusters for starch traits on chromosomes 3D, 6B and 7B, and one cluster including protein and starch traits on chromosome 1D.