布列兹《切口》中音名主题拆分与组合及结构逻辑探析

皮埃尔·布列兹(Pierre Boulez)是整体序列主义的代表人物,他以大胆的创作理念和手法影响了西方现代音乐的发展。《切口》(Incises)是布列兹晚期作品,于1994年创作,1996年改写为室内乐作品《片段》(Sur Incises),2001年在此基础上创作了新的钢琴独奏《切口》。该作品采用萨赫尔音名主题六音作为核心材料,将音名主题拆分为两个三音集合,再将其移位、倒影、拼接等衍生出各种类型。同时,预设核心元素,形成独特的“马尔科夫链”,以此来构成作品独特的结构逻辑。

布列兹音名主题的“同一性”与结构逻辑的“连续性”——关于晚期作品《信息》《漂移Ⅰ》《切口》的研究

本文以布列兹作品《信息》《漂移Ⅰ》《切口》为分析对象,以萨赫尔音名主题为基点,从布列兹作品中音名主题的“同一性”探索三部作品的个性化表达,从各音乐要素的发展路径以探寻结构逻辑的“连续性”。三部作品音高组织均以萨赫尔音名主题为基础,将序列与集合思维融合,以此生成音乐的发展,从微观设计到宏观布局无不体现了作曲家高超的作曲技法以及与数理思维兼并的精妙布控能力。

高龄切口疝患者无张力疝修补术疗效观察

目的探讨高龄切口疝患者无张力疝修补术的治疗效果。方法将我院接收的36例高龄切口疝患者作为研究对象,将其随机分成观察组(n=18)和对照组(n=18),对两组患者的治疗效果的进行比较。结果观察组的手术时间(44.46±18.68)min、术中出血量(41.14±15.56)ml、术后疼痛评分(1.12±0.36)分和住院时间(3.12±1.39)d,均低于对照组的手术时间(60.66±20.23)min、术中出血量(56.68±19.77)ml、术后疼痛评分(2.03±1.44)分和住院时间(6.68±2.23)d,组间数据对比,差异均具有统计学意义(P<0.05)。结论对高龄切口疝患者使用无张力疝修补术进行疾病的治疗,对于患者的身体疾病问题的改善拥有良好的效果。

Status quo and Enhancement of Competitiveness of Cut Flower Industry in China

The research reviewed status quo and problems of China＇s cut flowers and proposed countermeasures and suggestions in improving its competitiveness in order to provide theoretical references for its development.

Radionuclide Colloid ^(32)P Used for the Treatment of Stage II Lung Cancer by Video Enhanced Minimal Access Muscle Sparing Thoracotomy

Objective: To study the feasibility of radionuclide colloid 32P used for the treatment of stage II lung cancer by video enhanced minimal access muscle sparing thoracotomy (VEMAST). Methods: Video assisted thoracoscopic surgery (VATS) was carried out under general anesthesia. A double lumen endobronchial tube was intubated into trachea. One lung ventilation of the healthy side was done during operation. An incision of 8–10 cm long was made along the 4th or 5th intercostals. The lobectomy could be performed under VATS. Radionuclide colloid 32P was injected locally into the area where surgical cleaning of lymph node around was considered to be unsatisfactory or desection of the tumor was not completed. Results: The operation with VEMAST was successful in 29 patients. A conventional lobectomy by thoracotomy had to be done due to unusual bleeding from the pulmonary artery involved during VEMAST in one case and the procedure was interrupted because the pulmonary artery cloud not be separated from the tumor in another patient. There was no dead case or the patient who had any severe complication or adverse response to the radiant. Conclusion: Radionuclide therapy was performed to the treatment of stage II lung cancer with VEMAST in case that surgical resection was considered not to be satisfactory. Minithoractomy assisted with VATS lobectomy and radionuclide colloid 32P therapy is a safe and e?ective technique for some selected stage II lung cancer.

Influence of laser treatment on the fatigue of notched bar

Fatigue cutting is a new approach for separating material. Man-made fatigue can be realized by applying a rotating bending load to a notched bar. To better utilize the new method, laser treatment is adopted in this study. After laser radiation at the notch root, the fatigue cycle of the bar drops dramatically. Based on the experimental result, we draw the conclusion that the fatigue of the bar is influenced by the shape of the hardened area. A hardened area that has a small axial dimension and a relatively large radial dimension facilitates the fatigue. The desirable hardened area can be obtained by controlling the laser treatment parameters.

Efficacy and Safety of a Continuous Wound Catheter in Open Abdominal Partial Hepatectomy

Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and controlled study. Patients undergoing open abdominal partial hepatectomy, according to their willingness, accepted one of the following managements for the postoperative pain： continuous wound catheter （CWC） infiltration, patient-controlled epidural analgesia （PCEA）, patient-controlled intravenous analgesia of morphine （PCIAM）, and patient-controlled intravenous analgesia of sufentanil （PCIAS）. The primary outcome was postoperative visual analogue scale （VAS） scores at rest and on movement. Secondary outcomes included consumption of rescue medication, side effects, and complications associated with postoperative pain management. Results From August 2013 to December 2013, 80 patients were allocated to receive CWC （n=10）, PCEA （n=22）, PCIAM （n=29）, or PCIAS （n=19）. After adjusting for age, sex, body mass index, percentage of resected liver, operation time, and Amsterdam Preoperative Anxiety and Information Scale, there was no significant difference in the VAS scores at rest or on movement between Group CWC and the other groups, namely PCEA, PCIAM, and PCIAS, at 4, 12, 48, and 72 hours postoperatively （all P〉0.05）. The need for rescue medication was not significantly different between Group CWC and the other three groups at 48 and 72 hours postoperatively （all P〉0.05）. There was no significant difference in the incidence of postoperative nausea and vomiting or anal exsufflation time between group CWC and the other three groups （all P〉0.05）. No severe adverse effects associated with continuous wound infiltration were observed during the study period. Conclusions CWC has a comparable analgesic effect compared with traditional analgesia methods at most time points postoperatively. CWC is a safe alternative for the postoperative analgesic management of open liver surgery.

电视胸腔镜手术16例报告

共完成电视胸腔镜手术１６例，包括电刀切除肺内肿块２例，纵隔囊肿摘除２例，胸腔内取异物２例，肺大泡切除和胸膜粘连术２例，纵隔淋巴结活检２例，胸膜活检和胸膜粘连术１例，凝固性血胸血块清除１例，肺楔形切除１例，左下和右下肺叶切除各１例，恶性胸膜间皮瘤切除１例。本组无严重并发症，仅１例恶性胸膜间皮瘤术中剥离肿瘤时出血，立即改为开胸手术。１６例ＶＡＴＳ均痊愈出院。对ＶＡＴＳ的适应证、禁忌证、手术切口、术野暴露和外科手术技术进行了讨论。

Original single-incision laparoscopic cholecystectomy for acute inflammation of the gallbladder

AIM： To investigate the safety and feasibility of our original single-incision laparoscopic cholecystectomy （SII_C） for acute inflamed gallbladder （AIG）.

Minilaparotomy to rectal cancer has higher overall survival rate and earlier short-term recovery

AIM： To report our experience using mini-laparotomy for the resection of rectal cancer using the total meso- rectal excision （TME） technique, METHODS： Consecutive patients with rectal cancer who underwent anal-colorectal surgery at the authors＇ hospital between March 2001 and June 2009 were included, In total, 1415 patients were included in the study, The cases were divided into two surgical proce- dure groups （traditional open laparotomy or mini-lap- arotomy）, The mini-laparotomy group was defined as having an incision length ≤ 12 cm. Every patient un- derwent the TME technique with a standard operation performed by the same clinical team. The multimodal preoperative evaluation system and postoperative fast track were used. To assess the short-term outcomes, data on the postoperative complications and recovery functions of these cases were collected and analysed. The study included a plan for patient follow-up, to ob- tain the long-term outcomes related to 5-year survival and local recurrence. RESULTS： The mini-laparotomy group had 410 pati- ents, and 1015 cases underwent traditional laparoto- my. There were no differences in baseline characteris- tics between the two surgical procedure groups. The overall 5-year survival rate was not different between the rnini-laparotorny and traditional laparotorny groups （80.6% vs 79.4%, P = 0.333）, nor was the 5-year local recurrence （1.4% vs 1.5%, P = 0.544）. However, 1-year mortality was decreased in the rnini-laparotorny group compared with the traditional laparotorny group （0% vs 4.2%, P 〈 0.0001）. Overall 1-year survival rates were 100% for Stage Ⅰ, 98.4% for Stage Ⅱ, 97.1% for Stage Ⅲ, and 86.6% for Stage Ⅳ. Local recurrence did not differ between the surgical groups at 1 or 5 years. Local recurrence at 1 year was 0.5% （2 cases） for mini-laparotorny and 0.5% （5 cases） for traditional laparotorny （P = 0.670）. Local recurrence at 5 years was 1.5% （6 cases） for mini-laparotorny and 1.4% （14 cases） for traditional laparotorny （P = 0.544）. Days to first ambulation （3.2 ± 0.8 d vs 3.9 ± 2.3 d, P = 0.000） and passing of gas （3.5 ± 1.1 d vs 4.3 ± 1.8 d, P = 0.000）, length of hospital stay （6.4 ± 1.5 d vs 9.7 ± 2.2 d, P = 0.000）, anastomotic leakage （0.5% vs 4.8%, P = 0.000）, and intestinal obstruction （2.2% vs 7.3%, P = 0.000） were decreased in the rrnini-laparotorny group compared with the traditional laparotorny group. The results for other postoperative recovery function indi- cators, such as days to oral feeding and defecation, were similar, as were the results for immediate post- operative complications, including the physiologic and operative severity score for the enumeration of mortal- ity and morbidity score. CONCLUSION： Mini-laparotomy, as conducted in a sin- gle-centre series with experienced TME surgeons, is a safe and effective new approach for minimally invasive rectal cancer surgery. Further evaluation is required to evaluate the use of this approach in a larger patient sample and by other surgical teams.

Efficacy of Spinal Pia Mater Incision and Laminoplasty Combined with Internal Fixation for Old Spinal Cord Injury

Objective To evaluate the clinical efficacy of incising spinal pia mater to relieve pressure and unilateral open-door laminoplasty with internal screw fixation for treatment of the dated spinal cord injury. Methods From March, 2009 to July, 2010, 16 cases with chronic cervical cord injury underwent spinal dura mater incision and unilateral open-door laminoplasty with internal screw fixation. Nerve functions of preand postoperation were evaluated by Frankel classification and the Japanese Orthopaedic Association (JOA) scale. The improvement rate of JOA score at the indicated time was recorded. Results Postoperative Frankel classification rating of 16 patients improved obviously. JOA scores at the 1st month, 3rd month, 6th month, and 12th month after surgery were 7.9±2.3, 8.5±1.6, 8.9±2.1, and 12.4±2.5, respectively, and significantly increased compared with that prior to surgery (5.5±0.6). At the end of follow-up period, JOA score was significantly higher than that of pre-treatment (P<0.05). The recovery was relatively rapid during the first 3 months following the surgery, then entered a platform period. Conclusion It is effective for patients with dated spinal cord injury to undergo spinal decompression and laminoplasty.

Ileo-ileal intussusception caused by lymphangioma of the small bowel treated by single-incision laparoscopic-assisted ileal resection

Intraabdominal lymphangiomas are uncommon;additionally,those affecting the gastrointestinal tract are rare and account for less than 1%of cases.Intussusception caused by a cystic lymphangioma of the small bowel is extremely rare.The patient was a20-year-old woman who visited our emergency room with a complaint of abdominal pain.A computed tomography image revealed ileo-ileal intussusception with a leading hypovascular mass measuring 1 cm in a diameter.Single-incision laparoscopic-assisted ileal resection was performed.The surgical specimen consisted of a soft polycystic mass.Macroscopically,a pedunculated polyp with a convolutional pattern was found.Microscopically,the inner surfaces of the cysts were covered with a single layer of endothelial cells.On immunohistochemical examination,the endothelial cells were partially positive for D2-40 and CD34.Smooth muscle cells were also found around the cysts.The lesion was diagnosed as a cystic lymphangioma.Dozens of cases of small bowel lymphangiomas have previously been reported.Of these,cases with intussusception were very rare.This is the first case of small bowel intussusception due to lymphangioma treated by singleincision laparoscopic-assisted surgery.

Electrical discharge machining of 6061 aluminium alloy

The wire electrical discharge machining（EDM） of 6061 aluminium alloy in terms of material removal rate,kerf/slit width,surface finish and wear of electrode wire for different pulse on time and wire tension was studied.Eight experiments were carried out in a wire EDM machine by varying pulse on time and wire tension.It is found that the material removal rate increases with the increase of pulse on time though the wire tension does not affect the material removal rate.It seems that the higher wire tension facilitates steady machining process,which generates low wear in wire electrode and better surface finish.The surface roughness does not change notably with the variation of pulse on time.The appearance of the machined surfaces is very similar under all the machining conditions.The machined surface contains solidified molten material,splash of materials and blisters.The increase of the pulse on time increases the wear of wire electrode due to the increase of heat input.The wear of wire electrode generates tapered slot which has higher kerf width at top side than that at bottom side.The higher electrode wear introduces higher taper.

Nutritional risk index as a predictor of postoperative wound complications after gastrectomy

AIM： To investigate the correlation between the nutri- tional risk index （NRI） and postoperative wound com- plications.

ABDOMINAL SCAR ENDOMETRIOSIS:REPORT OF 28 CASES

Twenty-eight cases of abdominal scar endometriosis from Janurary, 1980 to December, 1993 are reported. Of these patients, twenty-four underwent term cesarean section, and four underwent a midtrimester abortion by abdominal hysterotomy, The majority of patients manifested symptoms 1 year after the operation. The most common was a painful mass of scar tissue that became swollen and tender during menstruation. The pathogenesis, diagnosis and treatment are discussed. In correlation with the pathological findings, the effects of drug therapy are evaluated. It was found that surgical excision is the best method of treatment.

Distribution and mechanism of gently dipping fractures subjected to river incision: A case study from Nujiang River, China

Gently dipping fractures subjected to river incision are widely distributed on rock slopes.In this paper,a rock slope on the Nujiang River(China)is investigated to study the role of gently dipping fractures in the rock slopes evolution.Detailed field surveys indicate that gentle fractures are concentrated in four main zones.Moreover,the kinematics of the fracture system suggest that the genesis of these fractures can be synthesized into a progressive evolution model.This model indicates that the joints begin with the formation of an array of en echelon cracks that are subjected to continued crack elongation and shearing before ultimately approaching one another and interacting to form a complex joint system.Geomechanical analysis is performed to reveal the mechanisms of this genesis,and three main fracture patterns are identified based on the slope stress and are classified with respect to the slope evolution.Based on the detail field investigations and the evolutionary history of the river valley,we propose that intermittent incision by the river was the main factor contributing to the concentrated distribution of gently dipping joints.

Percutaneous reduction combined with bone graft in treatment of displaced intra-articular calcaneal fractures

Objective： To introduce the experience and key points of percutaneous reduction combined with bone graft to treat calcaneal fractures. Methods： Percutaneous reduction and internal fixation combined with bone graft was performed from April 2004 to April 2006 on 15 cases （16 sides） with intra-articular calcaneal fractures including 13 males （14 feet） and 2 females （2 feet） ,with average age of 36. 6 years （24-61 years）. All patients underwent radiography including lateral and axial views for calcaneus, oblique view for foot and three-dimensional CT imaging reconstruction. According to Sanders classification, there were 12 feet of type Ⅱ （3 type Ⅱa, 3 type Ⅱb and 8 type Ⅱc） and 2 feet of type Illac. The length of calcaneus was recovered through traction by Steinmann pin which passed through calcaneal tubercle perpendicularly and the posterior facet was elevated until reduction by a curve scissors through an 0.5 cm incision along the primary fracture line of lateral calcaneus. The calcaneus was fixed with different cannulated cancellous screws according to the type of fractures. Then bone graft was injected to fill the defect of calcaneus through lateral incision. Results： All patients were followed up for an average of 18.4 months （ranged, 12 to 34 months）. No complication such as wound infection, screw breakage and calcaneum varus was found postoperatively. The average time for bone healing was 10 weeks. The results were excellent in 12 cases, good in 4 cases according to the American Orthopaedic Foot and Ankle Society （AOFAS） hindfoot score. The rate of excellent and good clinical results was 100%. The mean AOFAS hindfoot score in tongue type group （86.5±4.4） was better than in joint depression type group （81.2±1.7, P〈0.05）. Radiography showed basic restoration of Bohler＇s angle, Gissane＇s angle and calcaneal shape. Conclusion： The combination of percutaneous reduction and injectable bone graft is suitable for surgical treatment of Sanders Ⅱ and Ⅲ type calcaneal fractures, with advantages of simple operation, fewer complications and good clinical results.

Specific energy optimization in sawing of rocks using Taguchi approach

This work aims at selecting optimal operating variables to obtain the minimum specific energy(SE) in sawing of rocks.A particular granite was sampled and sawn by a fully automated circular diamond sawblades.The peripheral speed,the traverse speed,the cut depth and the flow rate of cooling fluid were selected as the operating variables.Taguchi approach was adopted as a statistical design of experimental technique for optimization studies.The results were evaluated based on the analysis of variance and signal-to-noise ratio(S/N ratio).Statistically significant operating variables and their percentage contribution to the process were also determined.Additionally,a statistical model was developed to demonstrate the relationship between SE and operating variables using regression analysis and the model was then verified.It was found that the optimal combination of operating variables for minimum SE is the peripheral speed of 25 m/s,the traverse speed of 70 cm/min,the cut depth of 2 cm and the flow rate of cooling fluid of 100 mL/s.The cut depth and traverse speed were statistically determined as the significant operating variables affecting the SE,respectively.Furthermore,the regression model results reveal that the predictive model has a high applicability for practical applications.

Update on the endoscopic treatments for achalasia

Achalasia is the most common primary motility disorder of the esophagus and presents as dysphagia to solids and liquids. It is characterized by impaired deglutitive relaxation of the lower esophageal sphincter. Highresolution manometry allows for definitive diagnosis and classification of achalasia, with type Ⅱ being the most responsive to therapy. Since no cure for achalasia exists, early diagnosis and treatment of the disease is critical to prevent end-stage disease. The central tenant of diagnosis is to first rule out mechanical obstruction due to stricture or malignancy, which is often accomplished by endoscopic and fluoroscopic examination. Therapeutic options include pneumatic dilation(PD), surgical myotomy, and endoscopic injection of botulinum toxin injection. Heller myotomy and PD are more efficacious than pharmacologic therapies and should be considered first-line treatment options. Per oral endoscopic myotomy(POEM) is a minimally-invasive endoscopic therapy that might be as effective as surgical myotomy when performed by a trained and experienced endoscopist, although long-term data are lacking. Overall, therapy should be individualized to each patient's clinical situation and based upon his or her risk tolerance, operative candidacy, and life expectancy. In instances of therapeutic failure or symptom recurrence re-treatment is possible and can include PD or POEM of the wall opposite the site of prior myotomy. Patients undergoing therapy for achalasia require counseling, as the goal of therapy is to improve swallowing and prevent late manifestations of the disease rather than to restore normal swallowing, which is unfortunately impossible.

Thermal stress distribution around a thermally-insulated polygonal cutout in graphite/epoxy composite laminates under heat flux

In this study,the effect of influencing parameters on the stress distribution around a polygonal cutout within a laminated composite under uniform heat flux was analytically examined.The analytical method was developed based on the classical laminated plate theory and two-dimensional thermo-elastic method.A mapping function was employed to extend the solution of a perforated symmetric laminate with a circular cutout to the solution of polygonal cutouts.The effect of significant parameters such as the cutout angular position,bluntness and aspect ratio,the heat flux angle and the laminate stacking sequence in symmetric composite laminate containing triangular,square and pentagonal cutouts was studied.The Neumann boundary condition was used at the edges of the thermally insulated polygonal cutout.The laminate was made of graphite/epoxy(AS/3501) material with two different stacking sequences of [30/45]sand[30/0/-30]_(s).The analytical solutions were well validated against finite element results.