中心静脉置管在失血性休克病人急救中的应用

目的观察失血性休克病人在早期抢救治疗中应用中心静脉留置导管的应用效果.方法对我院2004年1月至2005年8月58例失血性休克病人急诊手术采用中心静脉留置导管输液、输血和中心静脉压监测.深静脉穿刺部位选择右颈内静脉、右锁骨下静脉,材料选用单腔或双腔中心静脉导管.结果术后入ICU患者通过留置导管行胃肠外静脉营养取得满意效果.结论应用深静脉留置导管建立静脉通道输液快速、方便,能及时补充血容量,快速纠正休克,同时可用于血流动力学变化监测,     

中心静脉置管在失血性休克病人急救中的应用

目的观察失血性休克病人在早期抢救治疗中应用中心静脉留置导管的应用效果.方法对我院2004年1月至2005年8月58例失血性休克病人急诊手术采用中心静脉留置导管输液、输血和中心静脉压监测.深静脉穿刺部位选择右颈内静脉、右锁骨下静脉,材料选用单腔或双腔中心静脉导管.结果术后入ICU患者通过留置导管行胃肠外静脉营养取得满意效果.结论应用深静脉留置导管建立静脉通道输液快速、方便,能及时补充血容量,快速纠正休克,同时可用于血流动力学变化监测,     

超早期与早期手术治疗基底节区高血压脑出血的临床疗效对比研究

目的：通过比较超早期手术与早期手术治疗基底节区高血压脑出血的临床疗效对比研究来探讨基底节区高血压脑出血的最佳手术时机.方法：回顾性分析了采取小骨窗开颅显微手术治疗基底节区高血压脑出血患者共120例,以出血后7小时内手术60例患者分为超早期手术组,出血后7～24小时手术患者60例分为早期手术组,比较两组患者术后近期并发症、死亡情况及6个月后临床疗效（用日常生活能力量表ADL评定）方面比较,数据用统计学方法处理.结果：超早期手术组患者术后近期肺部感染、消化道出血及急性肾功能衰竭明显少于早期手术组,差异有统计学意义（P〈0.05）;再次出血及死亡情况比较,两组无显着差异（P〉0.05）.两组患者术后6个月临床疗效在总有效方面比较后得出超早期手术组明显好于早期手术组,差异有统计学意义（P〈0.05）.结论：超早期行小骨窗开颅显微手术治疗基底节区高血压脑出血比早期手术治疗更能减少术后近期并发症并有效改善术后日常生活能力.     

经鼻高流量湿化氧疗对ICU老年患者术后拔管的临床疗效研究

探讨经鼻高流量湿化氧疗对ICU老年患者术后拔管的临床疗效。纳入医院ICU 2018年6月～2018年12月间收治的64例术后拔除气管插管的老年患者作为研究对象,按患者入院序号分为试验组和对照组,每组各32例患者。其中试验组男性20例,女性12例,患者平均年龄(66.72±6.43)岁,对照组男性18例,女性14例,患者平均年龄(68.59±6.83)岁。试验组在拔管后使用经鼻高流量湿化氧疗,而对照组患者采用普通的面罩持续气道湿化给氧。氧疗后比较两组患者在拔管后30min、12h、24h、48h的心率(HR)、呼吸频率(RR)、指脉氧饱和度(SpO2)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)变化,并记录两组患者拔管后低氧血症、肺部感染、再次插管发生率、气道湿化满意度及两组患者28d存活率情况。结果两组患者在拔除气管插管后采用经鼻高流量吸氧及普通面罩持续气道湿化给氧30min时HR、RR、SpO2、PaO2各指标无统计学差异,仅PaCO2差异具有统计学意义,P0.05;采用经鼻高流量吸氧及普通面罩持续气道湿化给氧12h时,试验组较对照组指标数据明显改善,PaO2、PaCO2差异具有统计学意义,P0.05;采用经鼻高流量吸氧及普通面罩持续气道湿化给氧24h时,试验组的数据趋于稳定,RR差异具有统计学意义,P0.05;采用经鼻高流量吸氧及普通面罩持续气道湿化给氧48h时,HR、SpO2、无统计学差异,RR、PaO2、PaCO2差异具有统计学意义,P0.05。两组患者在拔除气管插管后低氧血症、肺部感染、再次插管发生率试验组均低于对照组,气道湿化满意度高于对照组,P0.05,差异具有统计学意义,而两组患者28d存活率情况差异无统计学意义。ICU老年患者拔管后发生低氧血症、肺部感染、再次插管是ICU医生所面临的难题,拔管后常需要序贯氧疗,减少并发症。HFNC可提高患者舒适度、耐受性,减少有创及无创机械通气使用率,一定程度上避免呼吸机依赖,能够降低医疗费用,减少ICU住院天数。     

中心静脉置管在失血性休克病人急救中的应用

目的观察失血性休克病人在早期抢救治疗中应用中心静脉留置导管的应用效果。方法对我院2004年1月至2005年8月58例失血性休克病人急诊手术采用中心静脉留置导管输液、输血和中心静脉压监测。深静脉穿刺部位选择右颈内静脉、右锁骨下静脉,材料选用单腔或双腔中心静脉导管。结果术后入ICU患者通过留置导管行胃肠外静脉营养取得满意效果。结论应用深静脉留置导管建立静脉通道输液快速、方便,能及时补充血容量,快速纠正休克,同时可用于血流动力学变化监测,     

结肠癌术后早期肠内营养治疗25例临床分析

目的探讨结肠癌患者术后早期（24 h内）应用肠内营养的效果.方法回顾分析吉林医药学院附属医院2008年1月—2008年12月25例结肠癌患者术后早期给予肠内营养支持的临床资料.结果本组病例术后无任何并发症,疗效满意.结论结肠癌患者术后早期应用肠内营养支持,平均住院时间缩短,治疗费用降低,患者术后恢复快,是安全有效的方法...     

脑外ICU患者肺部感染分析与护理

目的：分析我院脑外ICU患者肺部感染的危险因素,探讨防范和相应的护理对策。方法：采用回顾性调查方法对中日联谊医院脑外科ICU148例脑出血患者肺部感染相关因素进行分析。结果：重症监护室为医院感染高发科室,患者病情危重、免疫低下,肺部感染发生率24.3%。结论：加强ICU病房管理和感染监测,强化ICU工作人员培训教育,树立合理使用抗菌药物的观念,加强呼吸道管理措施。重视ICU患者肺部感染的易患因素,避免和控制肺部感染的危险因素,加强病房管理、改善ICU工作环境是降低肺部感染行之有效的措施。     

超声引导下经皮肝穿刺胆管取石术治疗肝移植术后胆道远期并发症的效果

目的:探讨超声引导下经皮肝穿刺胆管取石术(PTCL)治疗肝移植术后胆道远期并发症的疗效及优势。方法:选择2例肝移植术后胆道远期并发症患者，运用超声引导下PTCL进行胆管取石、胆管狭窄扩张及胆道支架取出。分析2例患者的皮肤瘙痒改善程度、肝功能指标、感染指标及胆管狭窄变化。结果:2例患者治疗后皮肤瘙痒症状显著减轻，肝功能及感染指标显著降低，放置的引流管既能通畅引流又能支撑胆管狭窄。结论:超声引导下PTCL能有效解决肝移植术后胆道远期并发症，该方法安全可行。     

丁苯酞对缺血性脑卒中静脉溶栓后24 h内序贯治疗的有效性及安全性研究

目的观察和评价丁苯酞注射液在超早期缺血性脑卒中静脉溶栓后24 h内序贯治疗的有效性和安全性.方法选取100例发病时间在4.5 h内的脑卒中患者,根据患者随机及自愿的原则,将其分为溶栓治疗组(常规治疗+rt-PA静脉溶栓)、丁苯酞序贯治疗组(常规治疗+rt-PA静脉溶栓+丁苯酞注射液序贯治疗),每组50例.两组患者常规基础治疗相同,丁苯酞注射液于溶栓后24 h内应用,剂量为100 m L,2次/d静点,时间间隔6 h,连续治疗14 d,随访观察90 d,比较两组的疗效及安全性.结果溶栓后2周,溶栓治疗组和丁苯酞序贯治疗组患者的NIHSS评分分别为(6.28±2.69)分和(5.16±2.00)分,总有效率分别为80.0%和94.0%,差异具有统计学意义(P0.05);治疗后随访90 d,溶栓治疗组和丁苯酞序贯治疗组患者的Bl评分分别为(79.20±8.41)分和(88.10±6.37)分,mRS评分分别为(1.94±0.93)分和(1.02±0.68)分,差异具有统计学意义(P0.05).结论静脉溶栓后24 h内应用丁苯酞注射液可以显著改善患者的预后.     

霉酚酸酯联合小剂量糖皮质激素治疗IgA肾病的回顾性分析

目的:回顾性分析霉酚酸酯(mycophenolate mofetil,MMF)联合小剂量糖皮质激素治疗IgA肾病的临床疗效及并发症。方法:选择深圳市第二人民医院肾内科经肾活检明确诊断为IgA肾病33例,予以MMF联合小剂量糖皮质激素治疗,疗程1年,随访尿蛋白定量及肾功能等。结果:33例IgA肾病患者,治疗3个月后,尿蛋白显著减少(P=0.000),eGFR显著改善(P=0.005)。治疗12个月尿蛋白较3个月显著减少(P=0.002)。有8例并发肺部感染,泼尼松/甲泼尼龙治疗为肺炎并发症的独立危险因素。结论:MMF联合小剂量激素治疗IgA肾病3个月即能显著缓解尿蛋白,但超过3月增加肺部感染并发症的机会,本组病例肺部感染与肾功能状态和甲泼尼龙治疗密切相关。研究结果表明,本组霉酚酸酯联合小剂量糖皮质激素治疗IgA肾病可显著缓解尿蛋白排泄,稳定肾功能,疗程宜在12个月以上。合理评估肾功能减退与相关的治疗风险、合理使用皮质激素(尤其应避免联合使用甲泼尼龙)可减少肺部感染等严重并发症。     

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