微创和开放手术治疗食管癌的疗效及预后分析

目的比较微创与开放手术治疗食管癌的近远期疗效,分析影响并发症和预后的因素。方法回顾性分析2014年4月—2016年2月江苏省盐城市第一人民医院205例接受微创食管癌手术患者的围手术期资料和生存资料,并与同期247例行开放食管癌手术患者的资料进行对比,多因素Logistic回归模型分析影响术后并发症的风险因素,多因素Cox回归模型分析影响预后的因素。结果微创组患者术中出血量、术后住院时间、胸管引流时间等优于开放组,差异有统计学意义。微创McKeown组与开放组手术时间相当,差异无统计学意义,微创Ivor-Lewis组手术时间长于开放组。两组R0切除率、双侧喉返神经旁淋巴结清扫以及淋巴结清扫总数无明显差异。微创组术后并发症发生率低于开放组。多因素Logistic回归分析显示TNM分期、美国麻醉医师协会(American Society of Anesthesiology,ASA)分级、不同术者、手术方式、FEV1%FVC是影响术后并发症的风险因素。微创组术后1、3、5年生存率与常规组无明显差异(86.3%,58.5%,44.4%vs 85.8%,53.4%,39.2%;P>0.05)。多因素分析显示年龄、TNM分期、分化程度是影响患者预后的独立因素。结论微创食管癌手术较开放手术可减少术中出血、缩短住院时间和降低术后并发症,远期疗效与常规手术相当。

Occurrence and congeners specific of poiychlorinated biphenyls in agricultural soils from Southern Jiangsu, China

A total of 198 agricultural soil samples were collected from Zhangjiagang and Changshu in Southern Jiangsu for analysis of 13 polychlorinated biphenyls （PCBs） in order to assess the levels of pollution, sources, area distribution, and potential risk for the environment. All methods were rigorously tested and an adequate quality control was ensured. Only one site had no PCBs residues, and the highest total PCBs concentration in the surface soils was 32.83 ng/g. The average concentration in all the soil samples was 4.13 ng/g, signaling low-level pollution. Tetra-, penta-, and hexa-chlorinated biphenyls were dominant species in soil samples, accounting for more than 75% of ∑PCBs in the soil samples. PCB118 was the most abundant congener in all the samples. The PCB118 was about 20% of ∑PCBs. The soil organic matter content showed only a weak correlation with the levels of all PCB congeners, in which a better correlation was noted for the more volatile lighter PCB congeners than for the heavier homologues. To a certain extent, the sources and land use seemed to influence the levels of PCBs.

Source Apportionment of Ambient PM_(10) in the Urban Area of Longyan City,China:a Comparative Study Based on Chemical Mass Balance Model and Factor Analysis Method

In order to identify the day and night pollution sources of PM10 in ambient air in Longyan City,the authors analyzed the elemental composition of respirable particulate matters in the day and night ambient air samples and various pollution sources which were collected in January 2010 in Longyan with inductivity coupled plasma-mass spectrometry（ICP-MS）.Then chemical mass balance（CMB） model and factor analysis（FA） method were applied to comparatively study the inorganic components in the sources and receptor samples.The results of factor analysis show that the major sources were road dust,waste incineration and mixed sources which contained automobile exhaust,soil dust/secondary dust and coal dust during the daytime in Longyan City,China.There are two major sources of pollution which are soil dust and mixture sources of automobile exhaust and secondary dust during the night in Longyan.The results of CMB show that the major sources are secondary dust,automobile exhaust and road dust during the daytime in Longyan.The major sources are secondary dust,soil dust and automobile exhaust during the night in Longyan.The results of the two methods are similar to each other and the results will guide us to plan to control the PM10 pollution sources in Longyan.

多级内冷型膜式溶液除湿的热质传递强化研究

为强化膜式溶液除湿器的性能,本文基于膜的渗透特性,建立了多级内冷型膜式溶液除湿器的传热传质模型。经模型验证后,采用遗传算法对不同设计工况下的膜式除湿器结构进行了优化,并通过引入传热传质分布不均因子,分析了各运行控制参数与空气状态参数对膜式除湿器的传热传质性能影响。结果表明,除湿器处理的空气流量越大,所需的最优层数越多,最优级数越小。在最优结构下增大溶液流量与降低冷却水温度虽可提高总效能,但也加剧了传热传质驱动力的分布不均。在处理低湿度空气时,该系统总效能可达0.64。该研究揭示了传热传质效能与驱动力分布不均之间的内在关系,有助于膜式溶液除湿器的性能强化。