神经内镜治疗外伤性脑脊液鼻漏临床分析

目的探讨神经内镜治疗外伤性脑脊液鼻漏的术中操作体会及其特点。方法回顾性分析新乡市中心医院采用神经内镜治疗的20例外伤性脑脊液鼻漏患者。20例患者均行MRI、CT脑池造影(CTC)检查。瘘口采用填塞明胶海绵、肌肉浆、自体筋膜、黏膜、骨水泥的方法,术后辅以腰大池外引流。结果手术成功20例,无并发颅内感染。结论神经内镜治疗外伤性脑脊液鼻漏是一项有效而简单快捷的方法,具有良好视野和微侵袭的优点。外伤性瘘口采用填塞明胶海绵、肌肉浆、自体筋膜、黏膜、骨水泥的方法,疗效可靠。

医用大型蒸汽灭菌器蒸汽“冷点”分布特性研究

医用大型灭菌器承担着医疗器械的消毒灭菌工作,关系到患者的生命安全。医疗器械灭菌过程内部的温度,尤其是局部的“冷点”温度的监测对灭菌质量有着决定性的影响。本文采用实验和数值模拟方法对医用大型灭菌器内内部冷点分布情况进行研究,为医用大型蒸汽灭菌器的计量校准和溯源提供技术依据。研究发现高温灭菌室内温度并非全部均匀分布,以点盖全的监测手段在医院灭菌监控中存在不足,单靠某一测点温度来维持除菌时间并不可靠。灭菌过程中蒸汽的流速对灭菌室内“冷点”分布极其重要,随着入口蒸汽速度的增加,温度的最大值与最小值之差逐渐减小,局部低温区域将逐渐消失;对于非满载工况,室内温度变化相差较大,传统冷点测试方法不适用。

二次经鼻蝶入路显微切除术治疗垂体瘤临床分析

目的探讨二次经鼻蝶入路显微切除复发、残留垂体腺瘤的手术方法和技巧,术后辅以综合治疗,提高治愈率,减少并发症。方法回顾性分析新乡市中心医院神经外科2010-01—2015-10二次经鼻蝶入路垂体瘤显微手术治疗的21例患者的临床资料,对手术方法和治疗结果进行总结和分析。结果全切加次全切除16例,临床症状好转20例,功能性垂体腺瘤术后激素水平下降均>50%,经术后综合治疗,3个月后均降至正常范围,1例术后脑脊液鼻漏合并颅内感染后治愈;无其他严重并发症出现,无死亡。结论对于无禁忌证的垂体瘤残余或复发的患者,二次经鼻蝶手术依然是安全、可靠的首选治疗手段。

神经内镜辅助显微镜下治疗重型脑干出血的疗效分析

目的探讨神经内镜辅助显微镜下治疗重型脑干出血的临床疗效。方法回顾分析我院2014年1月~2018年3月收治的98例重型脑干出血患者临床资料,根据治疗方法不同分为手术组(39例)和对照组(59例),评估两组患者治疗1周后格拉斯哥昏迷评分(GCS)评分、3个月后改良Rankin评分,以及有效率、死亡率、持续植物状态(PVS)生存率。结果手术组与对照组在治疗1周后GCS评分(t=2.39,P=0.012)、3个月后改良Rankin评分(χ2=7.36,P=0.003)、有效率(χ2=8.27,P=0.001)、死亡率(χ2=-6.15,P=0.006)、PVS生存率(χ2=-5.43,P=0.014)组间比较结果,差异均有统计学意义(均P<0.05)。本研究结果显示:神经内镜辅助显微镜下治疗重型脑干出血的临床疗效优于保守治疗。结论采用神经内镜辅助显微镜下治疗重型脑干出血,可以提高治疗有效率,降低死亡率、PVS生存率,最终改善患者预后。

微创开颅四脑室血肿清除联合脑室外引流治疗重型脑室出血临床观察

目的探讨微创开颅四脑室血肿清除联合脑室外引流治疗重型脑室出血的临床疗效。方法筛选2016-01—2018-01新乡市中心医院收治的58例自发性重型脑室出血患者,随机分为开颅组(行微创开颅四脑室血肿清除联合脑室外引流术)和对照组(单纯行双侧脑室外引流术)各29例。比较2组患者术前与术后24 h GCS评分、术后3 d脑室内血肿清除率、脑室引流管带管时间、术后并发症(再出血、颅内感染、脑积水)发生率、术后6个月存活患者日常生活能力(ADL)评分。结果开颅组患者术前与术后24 h GCS评分比较,差异有统计学意义(P<0.05);开颅组术后3 d脑室内血肿清除率、脑室引流管带管时间、术后并发症发生率及术后6个月存活患者ADL评分与对照组比较,差异均有统计学意义(P<0.05),开颅组治疗效果优于对照组。结论采用微创开颅四脑室血肿清除联合脑室外引流术治疗重型脑室出血,能明显改善患者预后。

Thermodynamics of Cascaded Waste Heat Utilization from Flue Gas and Circulating Cooling Water

A detailed thermal power plant model was developed to evaluate power plant waste heat usage in terms of the operating parameters,energy consumption,water consumption,and pollutant emissions.This model was used to analyze the bypass flue gas energy cascade utilization design which provides excellent energy savings and emission reductions.This paper then presents a design to use the low-temperature waste heat and to extract water from the flue gas.The low-grade heat can be recovered from a coal-fired unit using absorption heat pumps to increase the air preheating.This method significantly reduces the turbine steam extraction in the low pressure stages which increases the turbine power and reduces the coal consumption.This design has a small heat transfer temperature difference between the air preheater and the air warmer,resulting in a smaller exergy loss.The power output of the present design was 1024.28 MW with a coal consumption savings of 3.69 g·(kWh)^(−1).In addition,the present design extracts moisture out of the flue gas to produce 46.48 t·h^(−1)of water.The main goal of this work is to provide a theoretical analysis for studying complex thermal power plant systems and various energy conservation and CO_(2)reduction options for conventional power plants.

雪花拓扑极板质子交换膜燃料电池性能优化

质子交换膜燃料电池双极板最优流型是提高电池性能的关键,好的流场设计能促使反应气体向扩散层快速扩散和液态水的有效移除。本文提出仿雪花状新型流场设计,能同时兼顾肺部仿生和叶片仿生生物流道的优点。采用三维稳态常温单相质子交换膜燃料电池模型对比分析仿雪花状流场和传统双蛇形流场电池的性能,对比两种流道电池的极化曲线、功率密度曲线以及局部燃料、生成物组分浓度、电流密度分布等。结果表明,在相同运行工况情况下,仿雪花状流场质子交换膜燃料电池比传统双蛇形流场,可以极大降低整体压降,提高反应物均匀性,峰值功率是传统双蛇形流场的1.45倍。仿雪花状流道对燃料气体质量输运、微通道液态水管理、整体压降等方面具有非常明显优势,有望成为燃料电池新型流场设计的有益补充。

电毛细驱动液态金属液滴可寻址运动特性研究

液态金属作为新型材料广泛应用于生物医疗、机械制造等领域。液态金属的高动力黏度和高表面张力等特性使得液态金属液滴可寻址操控的研究目前仍极具挑战。本文提出采用梯度电压驱动液态金属液滴在黏性溶液中运动的方法,与传统功能梯度表面方法相比,该方法不需要依赖特殊的固体表面,更精准灵活地调控液滴运动。采用水平集技术模拟对比梯度电势、梯度表面和两者共同驱动三种方式的液滴自动寻址过程动力学特性。结果验证了梯度电势驱动液态金属液滴定向运动的可行性。本文详细讨论了液态金属液滴、周围流体的黏度及表面张力等参数也会对液态金属驱动过程产生影响,并设计了操控液滴定向寻址运动、分裂等的蜂窝状组合电极表面,相关研究可为液态金属可寻址定向运动提供理论指导。

Chemomics and drug innovation

Chemomics is an interdisciplinary study using approaches from chemoinformatics,bioinformatics,synthetic chemistry,and other related disciplines.Biological systems make natural products from endogenous small molecules (natural product building blocks) through a sequence of enzyme catalytic reactions.For each reaction,the natural product building blocks may contribute a group of atoms to the target natural product.We describe this group of atoms as a chemoyl.A chemome is the complete set of chemoyls in an organism.Chemomics studies chemomes and the principles of natural product syntheses and evolutions.Driven by survival and reproductive demands,biological systems have developed effective protocols to synthesize natural products in order to respond to environmental changes;this results in biological and chemical diversity.In recent years,it has been realized that one of the bottlenecks in drug discovery is the lack of chemical resources for drug screening.Chemomics may solve this problem by revealing the rules governing the creation of chemical diversity in biological systems,and by developing biomimetic synthesis approaches to make quasi natural product libraries for drug screening.This treatise introduces chemomics and outlines its contents and potential applications in the fields of drug innovation.

纳米流体动态湿润的格子-Boltzmann模拟

纳米流体动态湿润特性与纳米颗粒的微观运动密切相关。由于缺乏纳米尺度的实验观测技术及相关理论描述,纳米流体动态湿润的研究极具挑战,相关机理仍未明晰。采用格子-Boltzmann方法研究纳米颗粒在纳米尺度下（10-9 m）的微观运动及颗粒沉积所导致的基液流体表面张力、流变性改变及结构分离压力对宏观动态湿润（10-3 m）的影响机制。结果表明,纳米颗粒对基液的表面张力的改性影响纳米流体平衡湿润特性,决定纳米流体是完全浸润还是部分浸润。而纳米颗粒对基液流体流变性的改变影响纳米流体动态湿润过程的铺展指数。纳米颗粒在液滴底部的沉积对动态湿润过程影响较小,而在接触线区域的沉积显著改变纳米流体的动态湿润行为。研究尝试从跨尺度的角度阐释纳米颗粒微观运动对宏观动态湿润行为的影响,探索从微观层面调控纳米流体动态湿润的新方法。

Partial discharge characteristics of an air gap defect in the epoxy resin of a saturable reactor under an exponential decay pulse voltage

Saturable reactor insulation is currently stressed by an exponential decay pulse voltage under normal operating conditions.The partial discharge(PD)characteristics of epoxy resin under an exponential decay pulse voltage were studied here and were compared at 25 and 110℃.In addition,this study compares these PD characteristics with those under a sinusoidal voltage to better measure the insulation design margin of the saturable reactor under an exponential decay pulse voltage.Finally,this study explains the PD mechanism based on the three-capacitor circuit model and space charge accumulation.Compared with the sinusoidal voltage,a higher amplitude,a higher inception voltage and fewer PDs are obtained under the pulse voltage.The reason may be related to the accumulation of space charge.Due to the duality of the space charge effect,the promotion effect of space charge accumulation on the PD under the pulse voltage is dominant,and an increase in temperature will weaken the promotion effect.In contrast,the inhibitory effect of space charge accumulation on the PD under the sinusoidal voltage is dominant.The experimental results can provide a basis for the optimal design of saturable reactor insulation under an exponential decay pulse voltage.