国产吻合器在低位直肠癌保肛术中的应用

目的：评价国产管状吻合器在低位直肠癌保肛术中的安全性和实用性。方法：从１９８８年至２０００年２月,应用该技术行肠癌保肛手术９８例,其中低位吻合（吻合口位于复膜返折平面以下者）７５例,占７６．５３％,内６５例系低位直肠癌（距肛缘８cm以内）,超低位吻合１６例,占２４．６２％,结果：所有患者的吻合器切除圈完整,。术后吻合口漏４例（４．０８％）,吻合口狭窄３例（３．０６％）吻合溃疡１例(1．０２％）,局部复发４例（４．０８％）。结论：国产吻合器吻合法可作为低位直肠癌保肛手术的一种安全可靠的术式选择。     

全直肠系膜切除联合双器械吻合在低位直肠癌保肛术中的应用

目的：探讨双器械吻合技术联合全直肠系膜切除在低位直肠癌保肛手术中的应用和临床疗效。方法：在全直肠系膜切除的基础上，应用双器械吻合技术，对103例低位直肠癌行低位或超低位吻合，随访3年，回顾性分析其根治性、术后排便功能、手术并发症、局部复发率。结果：中低位吻合31例，超低位吻合72例；无切端癌残留，无大便失禁，无吻合口漏；全组无手术死亡；肿瘤局部复发率5．8％（6／103）。结论：在全直肠系膜切除基础上，利用双器械吻合技术行低位直肠癌保肛手术是保持排便功能，减少并发症，减少局部复发，提高生活质量的有效方法。     

163例低位直肠癌保肛手术临床分析

目的：探讨低位直肠癌保肛手术的术式选择和疗效。方法：317例直肠癌患者中分别采用低位、超低位结肠-直肠吻合手术、Park’s手术、Bacon手术,对163例实施保肛手术。分析术式选择与手术合并症、排便功能、局部复发率及5年生存率的关系。结果：低位直肠癌保肛率为51．42％。5年生存率和术后排便功能优良率：低位吻合为83．3％和100％;超低位吻合为79．2％和4．17％;Park’s手术为64．0％和12．0％;Bacon手术为66．67％和13．3％。结论：超低位结肠-直肠吻合是低位直肠癌保肛手术的主要术式。5年生存率、排便功能在低位吻合、超低位吻合、Park’8手术无差异。低位、超低位结肠-直肠吻合术明显优于Miles和Bacon手术。     

全直肠系膜切除联合双器械吻合在低位直肠癌保肛术中的应用

目的探讨双器械吻合技术联合全直肠系膜切除在低位直肠癌保肛手术中的应用和临床疗效。方法在全直肠系膜切除的基础上,应用双器械吻合技术,对103例低位直肠癌行低位或超低位吻合,随访3年,回顾性分析其根治性、术后排便功能、手术并发症、局部复发率。结果中低位吻合31例,超低位吻合72例;无切端癌残留,无大便失禁,无吻合口漏;全组无手术死亡;肿瘤局部复发率5.8%(6/103)。结论在全直肠系膜切除基础上,利用双器械吻合技术行低位直肠癌保肛手术是保持排便功能,减少并发症,减少局部复发,提高生活质量的有效方法。     

吻合器在低位直肠癌保肛术中应用82例

在我国低位直肠是直肠癌的好发部位。传统的手术是腹会阴联合切除加腹壁永久性结肠造口术。随着医学科学和手术技术的发展,对低位直肠癌要求在根治的基础上尽可能地保留肛门功能。在诸多的保肛术中,应用管状吻合器行直肠前切除低位或超低位吻合是最理想的手术,能提高盆腔内低位吻合的成功率和降低深部操作的难度。本文总结自１９８８年 ６月至１９９８年１０月应用管状吻合器（ＧＦ－ １型 ３４ ｍｍ或 ＧＷ－１型 ３２ｍｍ）行直肠前切除低位或超低位吻合术８２例,对其优点、适应症、禁忌症、常出现的问题和并发症的原因及防治进行分析…     

全直肠系膜切除联合双器械吻合在低位直肠癌保肛术中的应用

目的 探讨双器械吻合技术联合全直肠系膜切除在低位直肠癌保肛手术中的应用和临床疗效.方法 在全直肠系膜切除的基础上,应用双器械吻合技术,对103例低位直肠癌行低位或超低位吻合,随访3年,回顾性分析其根治性、术后排便功能、手术并发症、局部复发率.结果 中低位吻合31例,超低位吻合72例;无切端癌残留,无大便失禁,无吻合口漏;全组无手术死亡;肿瘤局部复发率5.8%(6/103).结论 在全直肠系膜切除基础上,利用双器械吻合技术行低位直肠癌保肛手术是保持排便功能,减少并发症,减少局部复发,提高生活质量的有效方法.     

36例低位及超低位直肠癌TME保肛手术治疗分析

目的:探讨低位及超低位直肠癌TME保肛手术的手术可行性及优点.方法:回顾分析我院自2003年3月-2006年6月的36例低位及超低位直肠癌TME的保肛手术治疗情况.结果:无手术死亡,无吻合口漏;有1例发生局部肿瘤复发,占2.7%.19例(52.7%)出现直肠前切除综合征.结论:TME保肛术可以有效降低复发率并保留了肛门功能,应成为低位直肠癌治疗的首选术式.     

超低位直肠癌保肛手术后肛门功能的临床对比分析

目的:探讨超低位直肠癌保留肛门功能的可行性。方法:实验组为超低位直肠癌患者组共32例;对照组为高位直肠癌组共25例;两组均采用全直肠系膜切除术(TME)分离全直肠系膜,后用吻合器技术吻合切缘,术后采用徐忠法肛门功能标准检测肛门功能,并随访3年。结果:随访3年中实验组复发2例(6.25%),对照组复发1例(4.00%);大部分实验组患者术后1个月内控便功能差,优良率37.5%,与对照组优良率64.0%比较存在显著性差异(P=0.047<0.05);但两组在术后3个月(P=0.076)、6个月(P=0.217)、12个月(P=0.856)则无明显差异。结论:对有保肛手术指征的超低位直肠癌患者,保肛手术是可行的,术后患者肛门功能恢复在近期与高位直肠癌保肛手术比较存在差别,长期效果无明显差异。     

全直肠系膜切除超低位吻合治疗低位直肠癌

目的探讨全直肠系膜切除超低位吻合对低位直肠癌保肛手术的意义.方法分析1995～1999年76例行全直肠系膜切除超低位吻合的低位直肠癌的资料.结果局部复发率低,仅有6.5%,72例(94.7%)患者术后3个月排便次数及控便机能接近正常人,无手术死亡及严重并发症.结论本手术疗效明显优于传统直肠癌根治术.     

食管机械吻合116例的临床观察及随访

目的:总结使用美国强生公司圆型胃肠吻合器的经验,并对该吻合器进行评价。方法:对食管—胃(肠)端侧机械吻合的116例病人术后并发症、吻合口大小、进食及返流情况进行观察,并在术后第1、3、6、12、24个月进行随访。结果:绝大部分病人术后顺利进普食,无吻合瘘发生,4例吻合口狭窄与术中操作不当有关,少数病人有返流症状。103例使用25号吻合器病人随访各期吻合口平均直径>1.18cm。结论:机械吻合并发症的发生与术者掌握器械的熟练程度有关。     

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.     

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.     

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-