CAUP术联合舌根消融治疗重度阻塞性睡眠呼吸暂停低通气综合征

目的: 探讨等离子体改良微创悬雍垂腭咽成形术(CAUP)加舌根消融术在重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)治疗中的疗效.方法:42例重度OSAHS患者分为两组,对照组20例行CAUP手术,实验组22例行CAUP术加舌根消融术,比较两种手术的疗效.结果:两组患者术后睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)较术前明显改善,差异有统计学意义(P＜0.01).软腭长度缩短、腭舌弓间距增宽,差异有统计学意义(P＜0.01),而舌后区气道前后径对照组无明显变化,实验组明显增宽,两组比较差异有统计学意义(t=2.814, P＜0.01).术后6个月及12个月两组疗效同期分别比较,显效率差异具有非常显著性(均P＜0.01),总有效率差异具有显著性(均P＜0.05).结论:低温等离子手术保留了咽部组织生理结构和功能,具有微创、安全等优点,远期疗效确切,重度OSAHS患者应立体解除上气道多平面阻塞.     

全麻下悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停低通气综合征68例

目的：探讨全麻下悬雍垂腭咽成形术（uvulopalatopharyngoplasty,UPPP）治疗阻塞性睡眠呼吸暂停低通气综合征（obtructive sleep apneahypopnea syndrome,OSAHS）的临床疗效.方法：选取自2004-06～2009-01采用全麻下悬雍垂腭咽成形术（UPPP）治疗中重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者68例.结果：68例患者术后打鼾症状明显减轻或消失,睡眠呼吸暂停次数明显减少,并于术后6个月进行多导睡眠（PSG）监测,其中显效38例,有效26例,无效4例,总有效率94%.结论：目前治疗OSAHS方法有很多,但手术治疗仍是一种较为肯定的治疗方法.     

重度OSAS腭咽成形术后窒息一例

患者，男性，42岁，因双侧鼻塞、睡眠时打鼾5年，于2002年4月8日人院。人院检查：一般情况好，心肺腹正常，神经反射无阳性体征。专科检查：外鼻无畸形，鼻前庭光滑，鼻中隔中度右偏，双鼻腔通气差，下鼻甲无肿大。硬腭无高拱，舌体肥大，舌根淋巴组织增生，咽腔狭窄双侧扁桃体Ⅰ度大，软腭低垂，悬雍垂肥厚，咽侧索肥厚，咽后壁未见淋巴滤泡增生，腺样体萎缩，鼻咽部未见新生物。M<ller试验：软腭平面狭窄最明显。PSG     

低温等离子微创介入技术治疗下鼻甲肥大

目的:探讨等离子微创介入技术治疗下鼻甲肥大的消融治疗效果.方法:对238例下鼻甲肥大的患者进行下鼻甲消融.鼻中隔偏曲致下鼻甲代偿性肥大的患者进行鼻中隔矫正同时对下鼻甲施行低温等离子消融.结果:术后1个月至半年随访,所有患者鼻阻塞症状改善,通气良好,有效率100%.结论:低温等离子消融术是一种微创介入技术,对下鼻甲肥大特别鼻中隔偏曲对侧下鼻甲代偿肥大的下鼻甲消融手术是有效又安全简捷的治疗方法,值得推广.     

低温等离子辅助上呼吸道成形术治疗OSAHS的疗效研究

目的：探讨低温等离子辅助上呼吸道成形术（CAUP）治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的临床应用价值。方法：选择2007年1月-2008年1月间接受低温等离子辅助上呼吸道成形术（CAUP）治疗的42例OSAHS患者（轻度17例,中度10例,重度15例）,术后1年复查PSG,并与术前比较,依据PSG结果中AHI和最低SaO2评价总有效率,观察手术疗效。结果：42例患者术后呼吸暂停低通气指数显著减少,术前AHI均数为40．8＋87,术后一年为163±66,（p〈0．01）：最低血氧饱和度显著提高,术前最低Sa02均数为60．6±7．0,术后一年为83．5±9．0（p〈0．01）。42例患者中,治愈16例,显效11例,有效7例,无效8例,总有效率为810％。结论：低温等离子辅助上呼吸道成形术（CAUP）治疗OSAHS操作简便,对局部组织的消融效果确切、疗效满意,并发症少．可对患者不同阻塞部位同时进行治疗干预,还可作为其他治疗的补充手段,是一种有效且值得推广的手术方式．     

悬雍垂腭咽成型术的临床初步筛选

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者以扁桃体及舌体大小为基础的临床分期及悬雍垂腭咽成形手术适应证的选择.方法回顾2001~2004年在我院收治的33例资料完整、实施UPPP手术并有随访记录的OSAHS的病例资料,参考2002年Friedman分期标准,按扁桃体大小和舌体大小将其分为Ⅲ期,1期为舌体Ⅰ或Ⅱ,扁桃体Ⅱ或Ⅲ;2期为舌体Ⅲ或Ⅳ,扁桃体Ⅱ或Ⅲ;3期为舌体Ⅲ或Ⅳ,扁桃体0或Ⅰ.经UPPP手术治疗后疗效根据比较各组成功率.参考国外资料,根据AHI降低的程度将疗效分为成功和失败两种结局,术后AHI较术前降低≥50%,且AHI<20次/h,症状明显减轻者为手术成功;余为失败.并就病情严重程度和体重指数对术后疗效的影响进行分析.结果术后随访及问卷调查结果示:1期患者手术成功率为81.8%,2期患者手术成功率为41.2%,3期患者手术成功率为0.1期患者UPPP术后AHI对比术前有降低,差异具有显著性(P<0.01).而2期和3期患者术前术后AHI比较无显著差异(P>0.05).UPPP手术疗效与OSAHS患者术前病情严重程度无明显相关性,BMI<30 kg/m2的患者UPPP手术疗效较好.结论根据舌体大小和扁桃体大小的临床分期可决定UPPP手术的成功率.     

阻塞性睡眠呼吸暂停综合征患者软腭射频消融治疗临床研究

应用低温射频技术对47例阻塞性睡眠呼吸暂停综合征患者局麻下行悬雍垂、软腭消融术治疗,分别于术前和术后行多导睡眠图等检查,比较软腭长度、悬雍垂长度、鼾声评级及嗜睡程度评分,观察术中、后的主要反应.结果,47例患者顺利接受全程治疗.随访1个月,临床症状好转,嗜睡评分、鼾声指数明显降低(P<0.05),软腭及悬雍垂缩短(P<0.05).多导睡眠图检查示:1期睡眠减少、快眼动睡眠增加,醒觉次数减少,呼吸暂停低通气指数(AHI)由每小时(34.6±9.9)次减少至每小时(15.4±6.9)次(P<0.05),最低血氧饱和度(SpO2)由(70.6%±9.0%)升高到(80.6%±12.1%)(P<0.05).研究表明低温射频消融术是一项最新的微创、安全的治疗方法,能够有效治疗轻、中度阻塞性睡眠呼吸暂停综合征.     

B超引导下无痛射频消融治疗功能失调性子宫出血42例疗效分析

目的探讨B超引导下射频消融治疗功能失调性子宫出血的疗效.方法对42例因月经过多住院诊断为功能失调性子宫出血患者实施射频消融子宫内膜去除术,观察治疗效果、治疗时间、出血量及并发症发生率.结果手术时问5～8 min,平均7 min,出血量5～30 mL,平均18 mL,住院时间1～3 d.术后3月治愈率96%,好转100%,术后未发生严重并发症.结论B超引导下射频消融治疗功能失调性子宫出血手术及住院时间短、手术简单、创伤小、效果好,且保留了子宫,不影响卵巢功能,术后患者恢复快、痛苦小、并发症少、耗材少、费用低,患者易于接受.     

经口径路鼻内镜下儿童腺样体切除术的体会

目的 探讨分析经口径路鼻内镜下儿童腺样体切除术的疗效.方法 对2004年6月至2005年12月在我科室行经口径路鼻内镜下儿童腺样体切除术的15例病例进行回顾性总结分析.结果 15例患者术后恢复良好,无腺样体残留,软腭、咽鼓管咽口无损伤及粘连等并发症.结论 经口径路鼻内镜下儿童腺样体切除术,操作直观、安全、创伤小,出血量少,愈合快,值得推广应用.     

OSAHS患者与正常人上呼吸道流场特性比较

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种发病率高,具有潜在危险的常见病.定量描述呼吸气流流场的分布情况是阻塞平面正确定位的可靠依据.基于OSAHS患者与正常人上呼吸道螺旋CT影像数据及Weibel模型A的气管-支气管模型,建立了精确量化的上呼吸道生物力学模型.将患者与正常人的数值模拟结果进行比较,得出患者上呼吸道气流速度、压力和壁面剪切应力的分布以及数值均明显异于正常人情况.模拟结果的对比研究有助于探讨人体呼吸道解剖结构的异常对气流分布的影响,对临床上正确诊断与有效治疗该病、深入研究该病与各系统并发症之间的关系都具指导意义.     

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.     

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.     

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     

On the Thermodynamic Limit for Responses to Static Electromagnetic Fields

For molecular systems,the quantum-mechanical treatment of their responses to static electromagnetic fields usually employs a scalar-potential treatment of the electric field and a vector-potential treatment of the magnetic field.Although the potential for each field separately is associated with the choice of an(unphysical)origin,the precise choice of the origin for the electrostatic field has little consequences for the results.This is different for the     

Call for Papers

<正>"The Journal of Shanghai Normal University:Mathematics"is published by Shanghai Normal University as regular issues of The Journal of Shanghai Normal University each year from 2014 in English.The editors-in-chief of the issues are professors Yuhao Cong and Maoan Han.The Journal of Shanghai Normal University was started in 1958 with     

Journal of Donghua University ( English Edition) Contents of Volume 31

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