介入治疗急性肺栓塞50例临床分析

目的通过比较分析经肺动脉置管介入治疗肺栓塞(APE)的优势.方法选择确诊的APE患者共50例,根据患者不同的治疗方案分为外周溶栓组(n=20)和介入溶栓组(n=30);介入溶栓组采用介入治疗,外周溶栓组采用静脉溶栓治疗.分析两组患者治疗前后肺动脉栓塞阻塞体积及肺动脉阻塞指数(PAOI),比较两组患者治疗后D-二聚体恢复正常时间及平均动脉二氧化碳分压(PaCO_2)和动脉血氧分压(PaO_2)情况.结果治疗前,介入溶栓组与外周溶栓组血栓体积比较差异无统计学意义(P0.05);溶栓治疗后,两组患者与治疗前比较血栓体积均明显下降,其中介入溶栓组下降幅度更明显,差异具有统计学意义(P0.01).治疗后介入溶栓组患者D-二聚体下降至正常水平的时间明显短于外周溶栓组,差异具有统计学意义(P0.01);介入溶栓组平均PaCO_2及PAOI明显低于外周溶栓组,PaO_2明显高于外周溶栓组,差异均具有统计学意义(均P0.01).结论介入置管溶栓治疗APE可彻底清除大部分肺动脉主干内血栓,较快缓解肺动脉高压及右心功能失代偿,改善患者症状,提高患者远期疗效.     

主动脉内球囊反搏术对STEMI合并左主干病变疗效分析

目的探讨主动脉内球囊反搏术辅助治疗急性ST段抬高心肌梗死(STEMI)合并左主干病变患者的近期和远期疗效.方法选取225例经冠脉造影证实为左主干病变STEMI患者,根据左主干病变和患者病情决定是否行主动脉内球囊反搏术,分为主动脉内球囊反搏术组89例、非主动脉内球囊反搏术组136例;每组再分为2个亚组,PCI组和药物治疗组.比较各组近期和远期的治疗效果、并发症发生情况.结果主动脉内球囊反搏术组患者的发病时间、左室舒张末期内径以及KillipⅢ~Ⅳ级、心源性休克、室性心律失常、急性肺水肿的比例明显高于非主动脉内球囊反搏术组患者,左室射血分数明显低于非主动脉内球囊反搏术组患者,以上差异均具有显著统计学意义(P0.01).主动脉内球囊反搏术组患者病变狭窄程度、中度以上钙化率、合并2支或3支血管病变率均明显高于非主动脉内球囊反搏术组患者(P0.05).PCI手术即刻成功率100%,平均每例患者植入支架(2.3±0.9)枚.主动脉内球囊反搏术组轻微出血发生率为14.6%,高于非主动脉内球囊反搏术组的6.6%(P0.05);大出血发生率两组间比较差异无统计学意义(P0.05).主动脉内球囊反搏术组住院期间死亡率明显低于非主动脉内球囊反搏术组,PCI治疗组死亡率明显低于药物治疗组(P0.01);主动脉内球囊反搏术联合PCI治疗后患者死亡率明显低于其他各组(P0.01).结论主动脉内球囊反搏术辅助治疗STEMI合并左主干病变可有效降低心脏不良事件发生率,提高患者近期和远期生存率.     

中药改善非糜烂性胃食管反流80例疗效观察

目的探讨中药改善非糜烂性胃食管反流的效果.方法选取胃食管反流病患者80例,随机分为观察组和对照组,每组40例.两组患者均给予常规治疗,观察组在此基础上给予疏肝和胃方水煎剂,对照组给予奥美拉唑.治疗4周后比较两组患者的疗效.结果两组患者证型分布情况和反流类型之间差异均无统计学意义(P0.05);治疗前两组患者主要临床症状积分之间差异均无统计学意义(P0.05).治疗1个疗程后,观察组患者反胃、泛酸、胸痛积分情况明显优于对照组,差异有具显著统计学意义(P0.01);两组患者胃灼热症状积分之间差异无统计学意义(P0.05);观察组患者在反胃、泛酸、胸痛症状改善方面明显优于对照组,差异具有显著统计学意义(P0.01);两组患者症状改善方面差异无统计学意义(P0.05).结论中药疏肝和胃方可有效改善非糜烂性胃食管反流病患者的主要症状,效果优于奥美拉唑.     

两种溶栓药在亚急性下肢动脉闭塞症中的应用价值

目的探讨阿替普酶(rt-PA)与尿激酶(UK)经导管接触性溶栓(CDT)治疗亚急性下肢动脉闭塞症(DVT)患者的临床疗效.方法选择100例亚急性DVT患者,根据随机数字表法分为UK-CDT组(n=50)与Rt-PA-CDT组(n=50),比较两组患者治疗疗效、静脉通畅度评分、双下肢周径差及并发症发生情况.结果 rt-PA-CDT组患者治疗总有效率高于UK-CDT组(χ~2=5.086,P=0.024);在治疗后Pos-1,Pos-2时,Rt-PA-CDT组患者的静脉通畅度评分及双侧大腿、小腿周径差均低于UK-CDT组(P0.05); Rt-PA-CDT组患者轻度出血率高于UK-CDT组(χ~2=9.756,P=0.002); Rt-PA-CDT组患者的血栓后综合征(PTS)发生率低于UK-CDT组(χ~2=4.891,P=0.027);两组患者PTS严重程度比较差异无统计学意义(P0.05).结论经CDT联合rt-PA溶栓效果好,能够显著降低亚急性下肢动脉闭塞症患者PTS发生率.     

拜阿斯匹林联合阿托伐他汀预防脑梗再发的临床应用研究

目的 探讨拜阿斯匹林、阿托伐他汀合用预防脑梗再发的临床效果. 方法将首发脑梗患者168例随机分成2组, 治疗组86例给予拜阿斯匹林100～150 mg晚服1次,阿托伐他汀10～20 mg晚服1次; 对照组82例给予拜阿斯匹林100～150 mg晚服1次,降血脂用非他汀类药物; 两组脑梗死病人基础治疗相同,并分别在入院时治疗后第3、6、12个月动态监测血液流变学变化,血脂水平变化;评估颈动脉斑块积分变化;计算1年内两组脑梗再发率.结果 两组病人均完成12个月的随诊观察,治疗组脑梗再发率3.7%,明显低于对照组10.8 %,P < 0.01.两组血液流变学变化、血脂水平变化与入院时比较有显著差异性(P < 0.05)组间比较无显著异性(P > 0.05).治疗组颈动脉斑块积分变化与入院时比较均(P < 0.05)有显著差异性,对照组治疗前后比较无差异性(P > 0.05);两组之间比较有显著差异性(P < 0.05).结论 拜阿斯匹林联阿托伐他汀预防脑梗再发优于单用阿斯匹林.改善血液流变学,调脂效果理想.可减轻延缓,甚至逆转颈动脉粥样硬化的进展,抑制斑块形成,降低脑梗再发率.     

低分子肝素与尿激酶静脉溶栓联合治疗急性心肌梗死的疗效

探究低分子肝素与尿激酶静脉溶栓联合治疗急性心肌梗死的疗效。选取2013年11月-2016年2月甘肃省成县人民医院收治的急性心肌梗死患者152例,随机分为观察组和对照组,对照组给予尿激酶静脉溶栓治疗,观察组在对照组的基础上加用低分子肝素治疗,对比两组患者冠状动脉再通情况、心脏超声指标、心肌酶及病死率。观察组患者冠状动脉再通率72.37%显著高于对照组52.63%(P0.05);两组患者治疗后LVEF分数均明显升高,观察组患者LVEF分数升高程度显著大于对照组(P0.05),两组患者治疗后LVEDd、LVEsd及CK-MB水平均明显降低,观察组患者降低程度显著大于对照组(P0.05);观察组患者病死率3.96%显著低于对照组17.11%且差异有统计学意义(P0.05)。低分子肝素与尿激酶静脉溶栓联合可显著提高急性心肌梗死患者冠状动脉再通率,改善心脏超声指标及心肌酶水平,降低病死率。     

篮球运动对青年学生骨密度及骨龄的影响

选择高校男性青年学生72名,根据是否参加过篮球运动分为运动组和对照组,分别测定骨密度和骨龄.结果显示,运动组左右脚跟骨密度以及左右桡骨和尺骨骨密度均显著高于对照组(P0.05);运动组和对照组的左右脚跟骨密度显著高于左右桡骨和尺骨骨密度(P0.05);运动组学生的骨龄显著高于其实际年龄(P0.05),对照组学生的骨龄略低于其实际年龄(P0.05);运动组的骨龄显著高于对照组(P0.05).因此,有规律的篮球运动可以提高青年学生的骨密度,延长其骨龄,而且骨龄和骨密度优于同龄非运动类青年学生.     

瘢痕子宫中孕引产方法探讨

目的 探讨适用于瘢痕子宫患者安全有效的中孕引产方法.方法 瘢痕子宫中孕引产患者65例分三组:第一组20例,依沙吖啶羊膜腔注射引产;第二组22例,米非司酮联合米索前列醇引产;第三组23例,米非司酮联合依沙吖啶引产.比较三种方法的临床效果和不良反应.结果 第二组与第一组相比:排胎时间短,引产成功率高,胎盘胎膜残留率低,无宫颈裂伤,差异有统计学意义(P＜0.05).第三组与第一组相比:宫缩发动时间提前,排胎时间短,引产成功率高,胎盘胎膜残留率低,无宫颈裂伤,差异有统计学意义(P＜0.05);与第二组相比:官缩发动时间提前(P＜0.05),余项相比无统计学意义(P＞0.05).结论 第二、三种引产方法优于第一种,此两种方法用于瘢痕子宫中孕引产安全有效,值得临床推广应用.第三种方法更优于第二种.     

延迟PCI对急性ST段抬高型心肌梗死预后的影响

目的探讨延迟PCI对急性ST段抬高型心肌梗死(STEMI)预后的影响.方法 563例STEMI患者分为直接PCI组157例、延迟PCI组124例、溶栓组131例和药物组151例.随访4~88个月,平均随访(45±27)个月;观察主要心脏不良事件(MACE)、超声心动图指标变化及QRS计分评估梗死范围的变化.结果延迟PCI组MACE发生率显著少于溶栓组和药物治疗组(P0.05),与直接PCI组比较无统计学意义(P0.05);延迟PCI组的LVEF显著高于非PCI治疗组(P0.05),而延迟PCI组的LAD和LVDd均显著小于非PCI组;延迟PCI组的心肌梗死范围回缩率显著大于药物治疗组(P0.05).结论延迟PCI可减少MACE发生率,并改善左室功能,使心肌梗死面积缩小,改善STEMI患者的预后.     

高血压病痰瘀证血栓前状态分子标志物变化及意义

探讨高血压病痰瘀证患者血栓前状态分子标志物变化和意义.分别采用流式细胞仪、ELISA法、CLAUSS法等,检测高血压病痰瘀证组、非痰瘀证组和正常对照组血小板膜表面糖蛋白CD41和CD62P、组织型纤溶酶原激活物(t-PA)、组织型纤溶酶原激活物抑制剂(PAI-1)以及凝血4项指标:血浆凝血酶原时间(PT)、纤维蛋白原(Fib)、凝血酶时间(TT)和活化部分凝血活酶时间(APTT).结果显示:①与对照组比较,高血压病痰瘀证组CD41表达、TT无统计学意义(P>0.05),CD62P表达显著升高(P<0.01),t-PA含量下降(P<0.05),PAI-1含量显著升高(P<0.01 ),Fib含量显著升高(P<0.01),PT、APTT显著缩短(P<0.01);非痰瘀证组CD62P表达升高(P<0.05),t-PA含量下降(P<0.05).Fib含量显著升高(P<0.01),APTT显著缩短(P<0.01),而CD41、PAI-1、PT、TT无统计学意义(P>0.05).②与非痰瘀证组对比,痰瘀证组CD62P表达显著升高{P<0.01),而CD41表达,t-PA、PAI-1含量,PT、Fib、TT和APTT则无统计学意义(P>0.05).由此得出结论:高血压病痰瘀证和非痰瘀证均存在不同程度的血栓前状态,而且痰瘀证较非痰瘀证更为明显,并以CD62P、t-PA、PAI-1、PT、Fib、APTT等的改变为主.     

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.     

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.     

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.     

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.     

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.     

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-     

Density Functional Theory for the Response of Periodic Systems to Electric Fields Based on the Vector Potential Approach

正The electronic and nuclear(structural/vibrational)response of 1D-3D nanoscale systems to electric fields gives rise to a host of optical,mechanical,spectral,etc.properties that are of high theoretical and applied interest.Due to the computational difficulty of treating such large systems it is convenient to model them as infinite and periodic(at least,in first approximation).The fundamental theoretical/computational problem in doing so is that