应用瑞芬太尼治疗烧伤病人60例疗效分析

目的观察瑞芬太尼在烧伤手术期间对血压、心率的影响.方法选择患者60例,随机分为观察组(R组)和对照组(F组),每组30例.R组于手术开始前2 min静脉注射瑞芬太尼1μg/kg,手术开始后即刻持续静脉注入瑞芬太尼0.1μg/(kg.min-1),F组分别给予等量的芬太尼.分别记录病人入室后麻醉前(T1)、切痂取皮时(T2)、植皮时(T3)、术毕呼之睁眼时(T4)血压、心率.结果瑞芬太尼组在切痂取皮、麻醉维持期间MAP及HR变化显著低于芬太尼组(P<0.05),呼之睁眼时间为(9.6±4.7)min,较芬太尼组短.结论静脉泵注瑞芬太尼 异丙酚对烧伤患者影响轻微,术后苏醒快.     

瑞芬太尼复合丙泊酚在婴幼儿先天性唇腭裂修复术中的应用

探讨了瑞芬太尼、丙泊酚全凭静脉麻醉与芬太尼、丙泊酚和异氟烷静吸复合麻醉在婴幼儿先天性唇腭裂修复术中应用的比较。30例ASAⅠ~Ⅱ级择期行先天性唇腭裂修复术患儿,年龄8个月~3岁,随机分为瑞芬太尼、丙泊酚全凭静脉麻醉组（Ⅰ组）与芬太尼、丙泊酚和异氟烷静吸复合麻醉组（Ⅱ组）。Ⅰ组麻醉诱导后持续输注瑞芬太尼和丙泊酚维持麻醉;Ⅱ组麻醉诱导单次注入芬太尼后持续输注丙泊酚、辅助吸入异氟烷维持麻醉。观察术中血流动力学变化情况,术后苏醒、拔管情况及术后躁动发生情况。插管、手术开始后5 min、拔管时Ⅱ组HR、MAP均高于Ⅰ组HR、MAP（P〈0.01）;两组患儿自主呼吸恢复时间、拔管时间、苏醒时间I组均少于Ⅱ组（P〈0.01）;而在术后躁动发生率中II组少于Ⅰ组（P〈0.05）。瑞芬太尼、丙泊酚全凭静脉麻醉用于婴幼儿先天性唇腭裂修复术手术较芬太尼、丙泊酚和异氟烷复合麻醉围术期血流动力学更为平稳,术后苏醒迅速,而术后躁动发生率较高,可能与术后疼痛相关。     

瑞芬太尼与丙泊酚复合麻醉在腹腔镜胆囊手术中的临床应用研究

探讨瑞芬太尼与丙泊酚复合麻醉在腹腔镜胆囊手术中的应用价值。随机抽取甘肃省山丹县人民医院2010年行腹腔镜胆囊切除术患者各96例分为两组:丙泊酚瑞芬太尼组(PR)和丙泊酚芬太尼组(PF)各50例。对比分析两组患者麻醉前、插管后5min、手术开始后10min、拔管后的平均动脉压、心率变化、术后麻醉恢复情况以及术后呼吸恢复、意识恢复、拔管时间等。两组患者麻醉效果佳,拔管后血压、心率比麻醉前有所降低(P0.05)均在正常范围内;PR组苏醒时间和拔管时间均短于PF组,两组比较差别有统计学意义(P0.05)。瑞芬太尼复合丙泊酚静脉全麻用于腹腔镜胆囊切除术,术中血流动力稳定,术后恢复迅速,与芬太尼相比更具优越性,值得推广应用。     

七氟醚复合小剂量舒芬太尼在小儿眼科手术中的应用观察

探讨小儿眼科手术麻醉诱导及维持中使用七氟醚与氯胺酮的效果对比。选择兰州市第一人民医院眼科小儿患者60例,随机按诱导及维持方法的不同分成观察组和对照组,每组30例,观察组使用七氟醚诱导复合小剂量舒芬太尼维持,对照组使用氯胺酮诱导复合舒芬太尼维持,记录并比较两组患儿的各时间点的心率、血压、氧饱和度及术后恢复情况。观察组在患儿入室与拔管即刻的血压和心率明显低于对照组,观察组患儿在术后恢复情况均快于对照组且无肌松药的追加。小儿眼科手术中使用七氟醚诱导及维持血流动力学稳定,明显降低术后恢复期并发症,患儿无恐惧、安全有效,是一种较为理想的麻醉方法。     

氯胺酮基础麻醉联合骶管阻滞在小儿发育性髋关节脱位(DDH)手术中的应用

探讨了氯胺酮基础麻醉联合骶管阻滞在小儿发育性髋关节脱位(DDH)手术中应用的有效性及安全性。选择择期行DDH手术患儿(1～7岁)70例,ASAⅠ级,随机分为A、B两组,每组35例,A组:氯胺酮基础麻醉复合骶管麻醉组;B组:氯胺酮全麻组。两组患儿均在麻醉复苏室内肌注氯胺酮5mg/kg行基础麻醉,A组患儿加用骶管麻醉,记录麻醉诱导前、切皮时、手术结束时的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉搏氧饱和度(SpO2),及观察两组氯胺酮用量、术中和术后的不良反应及患儿术后苏醒时间和术后安静程度。A组MAP、HR、RR都较B组平稳(P<0.01),A组的氯胺酮用量明显少于B组,不良反应明显少于B组,苏醒时间短于B组,A组患儿明显较B组患儿安静。氯胺酮基础麻醉复合骶管麻醉用于小儿先天性髋关节脱位手术,麻醉效果满意,苏醒快,安全性高。     

瑞芬太尼复合丙泊酚对腹腔镜胆囊切除术患者的麻醉作用探究

探究瑞芬太尼复合丙泊酚对腹腔镜胆囊切除术(LC)患者的麻醉作用。选取行LC治疗的118例患者,并划分成两组,将术中单纯应用丙泊酚维持麻醉的59例患者作为对照组,将术中应用瑞芬太尼复合丙泊酚麻醉的59例患者作为治疗组。对比两组各时间点血流动力学指标变化、意识状态、不良反应发生率及术后恢复情况。两组建立气腹后心率(HR)、收缩压(SBP)与舒张压(DBP)测定值均有升高(P0.05),且对照组升高幅度高于治疗组。术毕,治疗组上述指标均降至诱导前水平(P0.05),而对照组仍高于诱导前(P0.05),组间比较有明显差异(P0.05);治疗组拔管时、拔管后5min、拔管后10min意识状态(OAA/S)评分均较对照组高(P0.05),术中及术后不良反应发生率6.78%较对照组的20.34%低(P0.05),睁眼时间、意识恢复时间、拔管时间、止痛时间较对照组少(P0.05)。对LC患者行瑞芬太尼复合丙泊酚麻醉,其麻醉效果优于单用丙泊酚麻醉,可有效稳定患者血流动力学,明显降低不良反应发生率,且有利于促进患者术后恢复。     

瑞芬太尼靶控静注在静吸复合麻醉中的应用观察

目的:探讨瑞芬太尼靶控输注在静吸复合麻醉中应用的临床意义.方法:选择2005年-2006年在我院行妇科腹腔镜手术病人120例,随机分为两组,每组60例,分别用瑞芬太尼或芬太尼 丙泊酚 安定 司可林诱导,瑞芬太尼或芬太尼靶控输注,吸入氨氟醚,间断给仙林维持,记录麻醉诱导和气管插管时的血压、心率、血氧饱和度,术后停药后病人自主呼吸恢复时间、呼之睁眼时间、定向力恢复时间、拔管时间,病人拔管后即刻、1h、3h、24h的意识状态、认识功能、伤口疼痛程度.结果:所有病人诱导后血压均明显降低(P＜0.01),两组无显著差异,术后瑞芬太尼组麻醉恢复苏醒快、舒适,定向力恢复时间、拔管时间都短于芬太尼组.结论:瑞芬太尼靶控输注,麻醉诱导迅速,维持平稳,停药后清醒快,术后恢复好.     

丙泊酚与两种不同药物复合在无痛人流的比较

目的：观察丙泊酚与芬太尼,丙泊酚与氯胺酮用于无痛人工流产的临床效果.方法：160例人流手术患者,随机分为芬太尼组（F组）、氯胺酮组（K组）,F组芬太尼1μg/kg,K组氯胺酮0.3 mg/kg,两组丙泊酚诱导用量,均以达到睫毛反射消失时用量.观察术中循环功能、麻醉苏醒及停药后不良反应.结果：K组生命体征影响小,不良反应少;F组生命体征变化略大于K组,但清醒时间短.结论：小剂量芬太尼或氯胺酮与丙泊酚联合应用,均能在人流术中提供良好的麻醉效果,但不良反应氯胺酮更少.     

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。     

全凭静脉麻醉下不同效应室浓度瑞芬太尼对罗库溴铵肌松作用的影响

评价瑞芬太尼对全凭静脉麻醉病人罗库溴铵肌松作用起效、维持和恢复时间的影响.选择60例腹腔镜胆囊切除术病人,年龄25～55岁.ASA Ⅰ或Ⅱ级.随机分为4组(每组n=15).A组:不用瑞芬太尼;B组:瑞芬太尼效应室浓度2 ng/mL;C组:瑞芬太尼效应室浓度4 ng/mL:D组:瑞芬太尼效应室浓度6 ng/mL.每组靶控输注异丙酚全麻诱导的血药浓度均为3μg/mL.术中根据脑电双频谱指数BIS值调整异丙酚的效应室浓度.麻醉深度维持在BIS值为40～60.观察并记录静脉注射插管剂量(2xED95)的罗库溴铵后各组病人肌松起效、维持和恢复时间.结果显示,4组病人的罗库溴铵的肌松作用起效、维持和恢复时间的比较差异无统计学意义(P>0.05).故得出结论:全凭静脉麻醉中靶控输注瑞芬太尼与罗库溴铵没有协同作用.瑞芬太尼减少静脉全麻中肌松药用量的作用机制是中枢性的.     

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.     

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.     

A computer generator for randomly layered structures

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

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.     

海南岛地体及其毗邻陆缘晚中生代—新生代古地磁研究和构造演化

本文叙述了对海南岛及其毗邻大陆边缘白垩纪到第四纪地层岩石进行古地磁研究的全部工作过程。通过分析岩石中剩余磁矢量的磁偏角及磁倾角的变化,提出海南岛白垩纪以来经历的构造演化模式如下:早期伴随顺时针旋转而向南迁移,后期伴随逆时针转动并向北运移。联系该地区及邻区的地质、地球物理资料,对海南岛上述的构造地体运动提出以下认识:北部湾内早期有一拉张作用,主要是该作用使湾内地壳显著伸长减薄,形成北部湾盆地。从而导致了海南岛的早期构造运动,而海南岛后期的构造运动则主要是受南海海底扩张的影响。海南地体运动规律的阐明对于了解北部湾油气盆地的形成演化有重要的理论和实际意义。     

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.     

《Chinese Science Bulletin》SUBJECT INDEX TO VOLUME 59(2014)

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Achieving Unusual States of Matter Under High Pressure

The elongation method,originally proposed by Imamura was further developed for many years in our group.As a method towards O(N)with high efficiency and high accuracy for any dimensional systems.This treatment designed for one-dimensional(ID)polymers is now available for three-dimensional(3D)systems,but geometry optimization is now possible only for 1D-systems.As an approach toward post-Hartree-Fock,it was also extended to     

Exciton Seebeck in Molecular Systems

Various applications relevant to the exciton dynamics,such as the organic solar cell,the large-area organic light-emitting diodes and the thermoelectricity,are operating under temperature gradient.The potential abnormal behavior of the exicton dynamics driven by the temperature difference may affect the efficiency and performance of the corresponding devices.In the above situations,the exciton dynamics under temperature difference is mixed with