基于加速康复外科理念应用中药复方灌肠在环状混合痔外剥内扎术中的疗效观察

【目的】基于加速康复外科(ERAS)理念,对比传统机械性肠道准备(MBP)方法,研究“通腑和下法”中药复方灌肠在环状混合痔外剥内扎围术期的应用。【方法】将60例拟行择期环状混合痔外剥内扎术的患者随机分为试验组和对照组,每组各30例。试验组在术前2 d开始口服“通腑和下法”中药复方(小承气汤加减),对照组术前1 d口服复方聚乙二醇电解质散3 L,观察2种不同灌肠法患者的肠道准备依从性积分及术前首次排便时间差、排便次数和肠道清洁情况,术后试验组患者每日给予上述中药复方15 mL保留灌肠,对照组给予0.9%生理盐水15 mL保留灌肠,观察2组患者的术前临床指标情况、肠道清洁情况、术后首次排气天数和并发症发生情况。【结果】(1)术前临床指标:试验组患者的肛门坠胀评分、肠道准备依从性评分均明显低于对照组,术前首次排便时间差明显短于对照组,术前排便次数明显少于对照组,差异均有统计学意义(P<0.05或P<0.01)。(2)肠道清洁情况:试验组的优秀率和优良率分别为90.0%(27/30)和100.0%(30/30),对照组分别为86.7%(26/30)和100.0%(30/30),差异均无统计学意义(P>0.05)。(3)术后首次排气天数:试验组为(3.87±1.37)d,对照组为(3.60±1.36)d,差异无统计学意义(P>0.05)。(4)术后并发症情况:试验组患者的肛缘水肿、肛门坠胀、排便困难等并发症发生率分别为3.3%(1/30)、13.3%(4/30)和6.7%(2/30),均明显低于对照组的20.0%(6/30)、43.3%(13/30)和30.0%(9/30),差异均有统计学意义(P<0.05)。【结论】在ERAS理念指导下对混合痔围术期患者进行中药复方灌肠治疗,能有效增强患者的舒适感,减少患者的术后并发症,最终达到了加速康复的目的。

Remarks on the lower bounds for sums of the BDH type

This paper will correct some gaps existing in the proof of a theorem written in an earlier paper by the author on the lower bounds for sums of BDH type published in 1993. Some improvements upon the previous version of that theorem will be obtained.

The establishment of a new deliverability equation considering threshold pressure gradient

The flowing mechanism of a low permeability gas reservoir is different from a conventional gas reservoir,especially for that with higher irreducible water saturation the threshold pressure gradient exists. At present,in all the deliverability equation,the additional pressure drop caused by the threshold pressure gradient is viewed as constant,but this method has big error in the practical application. Based on the non-Darcy steady flow equation,the limited integral of the additional pressure drop is solved in this paper and it is realized that the additional pressure drop is not a constant but has something to do with production data,and a new deliverability equation is derived,with the relevant processing method for modified isochronal test data. The new deliverability equation turns out to be practical through onsite application.

Iterative Method on Well Bore Boundary in Numerical Modeling of Variably Saturated Flow

An iterative method was developed for incorporating the well bore boundary into the finite difference model of water flow in variably saturated porous media. Six cases were presented involving groundwater pumping or injection to demonstrate the advantages of the iterative method over the traditional method. For the iterative method, the total flux gradually approached the well discharge and the flux profile was non-uniform. And the iterative method took into account the variation of well bore water table. Compared to the traditional method, the iterative method can simulate the variably saturated flow caused by pumping or injection more realistically.

基于UKF的雷达和机载ESM扩维跟踪

为有效提高异类传感器融合跟踪的效果,提出了一种基于UKF的雷达和机载ESM扩维跟踪算法。首先将目标和机载ESM的状态信息组合起来,形成一个高维的状态向量,从而有效抑制滤波中GPS定位误差所带来的影响;接着在此基础上采用UKF来实现目标的定位跟踪,以求进一步减小扩维后线性化误差加大等问题的影响。仿真结果表明,该算法可更好地实现对目标的定位跟踪。