SMW工法在超大深基坑工程中的应用

SMW工法亦称新型水泥土搅拌桩墙,即在水泥土桩内插入H型钢等(多数为H型钢,亦有插入拉森式钢板桩、钢管等),将承受荷载与防渗挡水结合起来,使之成为同时具有受力与抗渗两种功能的围护墙。论文介绍了SMW工法替代传统钻孔灌注桩作为支护形式在杭州某项目基坑中的应用情况。阐述了SMW工法的施工原理和工艺,并结合工程实践,验证了SMW工法在深基坑工程应用上的实用性和可靠性。

创伤性椎间盘突出脊髓损伤两种颈椎前路融合

[目的]比较零切迹锁定型颈椎融合器(zero-profile, stand-alone cervical cage, ROI-C)与传统颈椎前路椎间融合器联合钛板(cage and plate, CP)治疗创伤性椎间盘突出伴脊髓损伤的临床效果。[方法]回顾性分析2015年9月—2020年9月收治的44例接受颈椎前路手术治疗的创伤性椎间盘突出伴脊髓损伤患者。依据医患沟通结果,21例采用ROI-C,23例采用CP。比较两组围手术期、随访及影像结果。[结果]两组患者手术均顺利,无严重术中并发症。ROI-C组手术时间、切口长度、术中透视次数、术中失血量、下地行走时间及住院时间均显著优于CP组(P<0.05)。两组患者随访时间平均(16.8±3.2)个月,ROI-C组恢复完全负重活动时间显著早于CP组(P<0.05)。随时间推移,两组ASIA评级、JOA评分、NDI评分及锥体术征情况均显著改善(P<0.05)。术前两组患者上述指标的差异均无统计学意义(P>0.05),术后1、3个月,ROI-C组ASIA评级显著优于CP组(P<0.05)。影像方面,术后两组患者C2~7Cobb角和椎间隙高度均较术前显著改善(P<0.05),术前两组上述影像指标的差异均无统计学意义(P>0.05),术后相应时间点ROI-C组椎间隙高度显著优于CP组(P<0.05)。术后3个月,ROI-C组椎体间融合情况优于CP组(P<0.05)。[结论]对于创伤性椎间盘突出伴脊髓损伤,两种术式均能改善神经功能,改善颈椎生理曲度和维持椎间隙高度。与传统CP相比,ROI-C组具有创伤小、手术时间短等优点,而且恢复患者颈椎椎间隙高度效果明显。

Rabeprazole 10 mg versus 20 mg in preventing relapse of gastroesophageal reflux disease： a meta-analysis

Background Several randomized controlled trials （RCTs） have compared endoscopic and symptomatic relapses in patients with erosive gastroesophageal reflux disease （GERD）.We have summarized current evidence for rabeprazole 10 or 20 mg once daily for GERD maintenance treatment over 1 or 5 years.Methods MEDLINE,EMBASE,and the Cochrane Central Register of Controlled Trials were searched,through August 2012,for eligible RCTs of adults with erosive GERD.The efficacies of rabeprazole 10 and 20 mg/d were compared.Results The search identified 288 citations,and five RCTs containing 1480 patients were considered eligible.Heartburn relapse rates did not differ significantly between patients treated with rabeprazole 10 and 20 mg/d for 1 year （relative risk （RR）=1.29; 95％ confidence interval （CI）：0.97-1.72）,but differed in patients treated for 5 years （RR=1.274; 95％ CI：1.005-1.615）.Endoscopic relapse rates differed significantly between rabeprazole 10 and 20 mg/d for 1 year （RR=1.92;95％ CI：1.21-3.06）,for 5 years （RR=1.667; 95％ CI：1.073-2.589）,and in combined 1-and 5-year maintenance trials （RR=1.785; 95％ CI：1.298-2.456）.Conclusion Rabeprazole 20 mg/d was superior to rabeprazole 10 mg/d in preventing endoscopic relapse of erosive GERD,but that the two dosages were equivalent in symptomatic relief over 1 year.