无肾造瘘管经皮肾镜取石术的治疗体会

目的评价无肾造瘘管经皮肾镜取石术(PCNL)的临床疗效和可行性。方法选取2016年1月-2018年12月该院泌尿系结石患者96例,根据PCNL术中肾造瘘管留置情况,48例行无肾造瘘管PCNL(观察组),48例行常规留置肾造瘘管PCNL(对照组)。比较两组患者手术时间、住院时间、结石清除率、术后恢复情况和并发症等。结果96例患者均顺利完成手术。观察组患者术后住院时间、语言评价量表(VDS)、疼痛视觉模拟评分(VAS)、住院费用、尿漏时间、术后发热时间、术后恢复时间和恢复正常工作时间均明显少于对照组,两组比较,差异有统计学意义(P<0.05);两组患者手术时间和术后血红蛋白下降值比较,差异无统计学意义(P>0.05)。结论无肾造瘘管PCNL较常规留置肾造瘘管PCNL具有术后疼痛轻、恢复快、住院时间短和经济负担较低等优势,是安全、可行、有效的,值得临床推广。

管状吻合并全层间断减张缝合术可以降低食管癌术后颈 部吻合口瘘

背景吻合口瘘是食管癌术后最常见的严重并发症.本研究回顾性分析我科食管癌根治术患者的临床资料,分析筛选出吻合口瘘发生的相关危险因素,同时就本治疗组为降低吻合口瘘采用的管状吻合并全层间断减张缝合术做一报道.目的分析影响食管癌术后颈部吻合口瘘发生的相关危险因素,同时探究管状吻合并全层间断减张缝合术对预防吻合口瘘的安全性及有效性.方法回顾性分析安阳市肿瘤医院胸外五科2014-05/2018-12行根治性手术治疗的544例食管鳞癌患者的临床资料,选取与颈部吻合口瘘发生相关的可能因素,进行临床单因素及多因素Logistic回归分析,确定与颈部吻合口瘘发生的独立危险因素.结果患者年龄､糖尿病史､手术时间长短(是否>300 min)､管状吻合后全层间断减张缝合与否是术后吻合口瘘发生的独立危险因素.其中管状吻合并全层间断减张缝合术有利于降低术后颈部吻合口瘘的发生率(6.1%vs 13.1%,P<0.05).结论采用管状吻合并全层间断减张缝合术对预防颈部吻合口瘘的发生安全有效,值得临床推广.

Oxide-aperture-dependent output characteristics of circularly symmetric VCSEL structure

The influence ot oxidation aperture on the output characteristics ot the circularly symmetric vertical-cavity-surtaceemitting laser(VCSEL) structure is investigated.To do so,VCSELs with different oxide aperture sizes are simulated by the finite-difference time-domain(FDTD) method.The relationships among the field distribution of mode superposition,mode wavelength,output spectra,and far-field divergence with different oxide apertures are obtained.Further,VCSELs respectively with oxide aperture sizes of 2.7 μm,4.4 μm,5.9 μm,7 μm,8 μm,9 μm,and 18.7 μm are fabricated and characterized.The maximum output power increases from 2.4 mW to 5.7 mW with oxide aperture increasing from 5.9 μm to 9 μm.Meanwhile,the wavelength tuning rate decreases from 0.93 nm/mA to 0.375 nm/mA when the oxide aperture increases from 2.7 μm to 9 μm.The thermal resistance decreases from 2.815℃/mW to 1.015℃/mW when the oxide aperture increases from 4.4 μm to 18.7μm.It is demonstrated theoretically and experimentally that the wavelength spacing between adjacent modes increases with the augment of the injection current and the spacing becomes smaller with the oxide aperture increasing.Thus it can be reported that the aperture size can effectively reduce the mode overlaying but at the cost of the power decreasing and the wavelength tuning rate and thermal resistance increasing.

The impact of honesty and trickery on a Bayesian quantum prisoners’ dilemma game

To explore the influence of quantum information on the common social problem of honesty and trickery,we propose a Bayesian model for the quantum prisoners’dilemma game.In this model,the players’strategy formation is regarded as a negotiation of their move contract based on their types of decision policies,honesty or trickery.Although the implementation of quantum information cannot eliminate tricky players,players in our model can always end up with higher payoffs than in the classical game.For a good proportion of a credibility parameter value,a rational player will take an honest action,which is in remarkable contrast to the observation that players tend to defect in the classical prisoners’dilemma game.This research suggests that honesty will be promoted to enhance cooperation with the assistance of quantum information resources.

Formation of G-phase in 20Cr32Ni1Nb Stainless Steel and its Effect on Mechanical Properties

A series of tensile tests, Charpy impact tests, optical microscopy observations, and field emission-scanning electron microscopy examinations, were carded out to investigate the mechanical properties and microstructural evolution of 20Cr32NilNb steel. Experimental results indicate that the as-cast microstructure of the steel typically consists of a supersaturated solid solution of austenite matrix with a network of interdendritic primary carbides （NbC and M23C6）. In the ex-service samples, large amounts of secondary carbides precipitate within austenite matrix. Besides the growth and coarsening of NbC and M23C6 carbides during service condition, the Ni-Nb silicides known as G-phase （Nil6Nb6Si7） are formed at the interdendritic boundaries. The microstructural evolution results in the degradation of the mechanical properties of the ex-service steel. In addition, the precipitate rate of G-phase, depending in part on Si content, varies greatly for the 20Cr32NilNb steel, which plays a key role in the long-term microstructural stability of the steel. Based on the X-ray diffraction data, time-temperature-transformation curve for the steel is obtained from the aged specimens.

Synthesis and biological activities of novel 2-amino-1,3-thiazole-4-carboxylic acid derivatives

A series of novel 2-amino-1,3-thiazole-4-carboxylic acid derivatives were designed and synthesized.Their structures were confirmed by melting points, IR,1H NMR,13 C NMR, and HRMS or elemental analysis. Biological activities of all title compounds including fungicidal activity and antivirus activity were evaluated systematically. Preliminary bioassays indicated that these compounds exhibited good fungicidal activity at 50 mg/m L, compounds 4b and 4i exhibited over 50% activity against six fungi tested.Most compounds showed good activity against TMV with different models in vivo at 100 mg/m L.Compounds 4c and 4e stood out with high effects against TMV in vivo in all models tested, including protective, inactivative, curative, and inductive activities. These data demonstrate a new strategy for fungi and virus control.

Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation： Insights from the SEEDS Study

Background:Studies have suggested that use of prolonged dual antiplatelet therapy (DAPT) following new generation drug-eluting stent implantation may increase costs and potential bleeding events.This study aimed to investigate the association of DAPT status with clinical safety in patients undergoing everolimus-eluting stent (EES) implantation in the SEEDS study (A Registry to Evaluate Safety and Effectiveness of Everolimus Drug-eluting Stent for Coronary Revascularization) at 2-year follow-up.Methods:The SEEDS study is a prospective,multicenter study,where patients (n =1900) with small vessel,long lesion,or multi-vessel diseases underwent EES implantation.Detailed DAPT status was collected at baseline,6-month,1-and 2-year.DAPT interruption was defined as any interruption of aspirin and/or clopidogrel more than 14 days.The net adverse clinical events (NACE,a composite endpoint of all-cause death,all myocardial infarction (MI),stroke,definite/probable stent thrombosis (ST),and major bleeding (Bleeding Academic Research Consortium Ⅱ-Ⅴ)) were investigated according to the DAPT status at 2-year follow-up.Results:DAPT was used in 97.8％ of patients at 6 months,69.5％ at 12 months and 35.4％ at 2 years.It was observed that the incidence of NACE was low (8.1％) at 2 years follow-up,especially its components of all-cause death (0.9％),stroke (1.1％),and definite/probable ST (0.7％).DAPT was not an independent predictor of composite endpoint of all-cause death/MI/stroke (hazard ratio [HR]:0.693,95％confidence interval [CI]:0.096-4.980,P =0.715) and NACE (HR:1.041,95％ CI:0.145-7.454,P =0.968).Of 73 patients who had DAPT interruption,no patient had ST at 12-month,and only 1 patient experienced ST between 1-and 2-year (1.4％).There was a high frequency of major bleeding events (53/65,82.5％) occurred in patients receiving DAPT treatment.Conclusions:Prolonged DAPT use was not associated with improved clinical safety.The study emphasized that duration of DAPT needs to be shortened in Chinese patients following EES implantation (ClinicalTrials.gov identifier:NCT 01 157455).