枸橼酸舒芬太尼术终超前镇痛在乳腺癌术后镇痛中的效果

目的探讨全麻诱导时静脉注射枸橼酸舒芬太尼术终防治盐酸瑞芬太尼停止输注后引起的急性术后疼痛的疗效。方法选择60例行择期改良根治术的乳腺癌,随机分为枸橼酸舒芬太尼组(A组)和枸橼酸芬太尼组(B组),每组30例。A组麻醉诱导时静脉一次性给予枸橼酸舒芬太尼1μg/kg;B组麻醉诱导时静脉一次性给予枸橼酸芬太尼2μg/kg,两组其他用药相同。结果 A组患者术后0(气管拔管后即刻)、4、12、24h的疼痛评分明显低于B组,差异有统计学意义(P<0.01)。A组患者术后0h疼痛评分0分25例,>7分0例;B组患者术后0h疼痛评分0分6例,>7分8例。结论枸橼酸舒芬太尼用于乳腺癌手术的麻醉能够有效防治盐酸瑞芬太尼停止输注后引起的急性术后疼痛,适用于乳腺癌手术的麻醉及术后镇痛。

术终拔管吸痰致心跳呼吸停止1例

气管内插管全身麻醉后,拔管前充分吸痰,是全麻管理中的常规操作过程.但如果气管内吸痰时间过长,会严重影响患者的气道通畅,导致缺氧,甚至心跳呼吸停止.

小梁切除术终前房重建疗效分析

目的 探讨青光眼小梁切除术终出现浅前房时重建前房的方法及疗效。方法 对 1 999年 4月～2 0 0 0年 1 2月住院的 1 2 0例 (1 51眼 )青光眼小梁切除术 ,术终前出现浅前房者 43例 (48眼 )随机分为前房重建组2 4例 (2 6眼 ) ,对照组 1 9例 (2 2眼 ) ,治疗组术终重建前房。分析两组术后效果。结果 治疗组术后浅前房发生率为 7 69% ;对照组则为 45 45 % ,浅前房程度按Spaeth分级法进行分级 ,重建组Ⅰ级 1眼 ,Ⅲ级 1眼形成恶性青光眼 ;对照组Ⅰ级 8眼 ,Ⅱ级 2眼 (P <0 0 0 5)。结论 青光眼小梁切除术终浅前房者进行重建前房 ,方法简单 。

孕≥20周手术终止妊娠后的产科结局

The purpose of this study was to describe obstetric outcomes after surgical abortion at ≥ 20 weeks, and to identify risk factors for subsequent spontaneous preterm birth. Study design: Patients who had surgical abortion at ≥ 20 weeks’ gestation from 1996 to 2003 and received subsequent prenatal care at The New York Weill Cornell Medical Center were identified. Indication for abortion, operative technique, and subsequent pregnancy outcomes were reviewed. Student t test, Fisher exact test, and Mann-Whitney U were used where appropriate. Results: One hundred and twenty pregnancies in 89 women were identified. Thirteen (10.8% ) ended with early miscarriage, and 5 were electively terminated. Of the remaining 102 pregnancies, 7 ended with spontaneous preterm birth. Those who experienced preterm birth were more likely to have undergone abortion due to cervical dilation and/or preterm premature rupture of membranes (PPROM) (27.3% vs 4.4% ; P = .03). Those with a multifetal pregnancy in the subsequent pregnancy were more likely to have preterm birth (75.0% vs 4.3% ; P < .001). In patients who underwent dilation and evacuation (D& E) for reasons other than cervical dilation and/or PPROM, rates of spontaneous preterm birth were identical between those who had intact dilation and extraction (D& X) and D& E using forceps (4.2% vs 4.5% ; P = 1.0). Conclusion: In those who have undergone D& E at ≥ 20 weeks, only a history of mid-trimester cervical dilation and/or PPROM or a current multifetal pregnancy were associated with spontaneous preterm birth.

白内障玻璃体联合手术术终前房内注射黏弹剂的作用

目的观察白内障玻璃体联合手术术终前房内注射黏弹剂的作用。方法回顾性分析2016至2017年白内障玻璃体联合手术术终因前房变浅注入黏弹剂30例（30眼），观察术中术后前房形成情况、人工晶状体位置和眼压变化。结果术后前房稳定形成，人工晶状体位置稳定。术后1d眼压较术前差异无明显统计学意义（P〉0．05）。术后3d眼压稳定，较术前差异无明显统计学意义（P〉0．05）。结论术终前房内注入黏弹剂可使前房稳定形成，避免了因前房变浅导致的人工晶状体偏位或瞳孔夹持，且术后眼压稳定，无明显并发症。

盐酸羟考酮对妇科腹腔镜手术术后的镇痛衔接效果

目的探讨盐酸羟考酮对妇科腹腔镜手术术后的镇痛衔接效果。方法2017年3月至2019年2月该院择期行全身麻醉下妇科腹腔镜手术患者60例,随机分为舒芬太尼组(S组)与盐酸羟考酮组(Q组)各30例。手术结束前20分钟,Q组与S组分别静脉注射盐酸羟考酮0.1mg/kg和舒芬太尼0.1μg/kg。比较两组术后自主呼吸恢复时间、苏醒时间、拔管时间、转出麻醉恢复室(PACU)时间。采用Ramsay镇静评分,评估患者拔管后5分钟(T1)、15分钟(T2)、30分钟(T3)和转出PACU(T4)时的镇静程度、VAS疼痛评分,并记录在PACU内补救镇痛例数、躁动及不良反应发生情况。结果两组术后自主呼吸恢复时间、苏醒时间、拔管时间及不良反应发生率接近,差异均无统计学意义(P>0.05)。Q组离开PACU时间明显快于S组,拔管后的T1~T3时段Ramsay镇静评分高于S组,T1~T4时段VAS评分明显低于S组,差异均有统计学意义(P<0.05)。PACU内使用舒芬太尼补救镇痛发生率、躁动发生率:Q组分别为0、13.3%,均低于S组的30.0%、40.0%,差异均有统计学意义(P<0.05)。结论与舒芬太尼比较,手术结束前20分钟予盐酸羟考酮可减轻妇科腹腔镜手术术后疼痛,有助于促进术后早期恢复。

脑电双频谱指数对普鲁卡因、异丙酚静吸复合麻醉深度的评价

目的:通过脑电双频谱指数(B IS)监测普鲁卡因静吸复合麻醉的深度并与异丙酚静吸复合麻醉进行比较。方法:30例择期行开腹手术A SAⅠ～Ⅲ级的病人随机分为两组,气管插管后持续泵入异丙酚5.4m g/(kg·h)(Ⅰ组)和气管插管后持续静点1%普鲁卡因4m L/kg(Ⅱ组)。连续观察入室后、切皮前、切皮后即刻、切皮后20m in、术终前20m in、术终、拔管前的血流动力学变化及B IS变化以及术中B IS低值。结果:两组均可获得满意的麻醉效果。两组病人切皮前的SB P均较基础值低(P<0.05),除此之外,在整个手术过程中及至拔管时血流动力学均没有显著变化(P>0.05),术中最低值的B IS及术终的B IS值Ⅰ组较Ⅱ组低(P<0.05),两组的B IS值分别与基础值比较发现,在手术过程中B IS均较低(P<0.05),只是术终时Ⅰ组较基础值低,而Ⅱ组接近基础值(P>0.05)。结论:B IS是评价麻醉深度的可靠指标,普鲁卡因静吸复合麻醉与异丙酚静吸复合麻醉同样可获得满意的麻醉深度。

Science of empirical design in mining ground control

Many problems in rock engineering are limited by our imperfect knowledge of the material properties and failure mechanics of rock masses. Mining problems are somewhat unique, however, in that plenty of real world experience is generally available and can be turned into valuable experimental data.Every pillar that is developed, or stope that is mined, represents a full-scale test of a rock mechanics design. By harvesting these data, and then using the appropriate statistical techniques to interpret them,mining engineers have developed powerful design techniques that are widely used around the world.Successful empirical methods are readily accepted because they are simple, transparent, practical, and firmly tethered to reality. The author has been intimately associated with empirical design for his entire career, but his previous publications have described the application of individual techniques to specific problems. The focus of this paper is the process used to develop a successful empirical method. A sixstage process is described: identification of the problem, and of the end users of the final product; development of a conceptual rock mechanics model, and identification of the key parameters in that model;identification of measures for each of the key parameters, and the development of new measures(such as rating scales) where necessary; data sources and data collection; statistical analysis; and packaging of the final product. Each of these stages has its own potential rewards and pitfalls, which will be illustrated by incidents from the author's own experience. The ultimate goal of this paper is to provide a new and deeper appreciation for empirical techniques, as well as some guidelines and opportunities for future developers.

Remote Sensing Education for Life Long Learning across the East Midlands Region

Over the last decade, remote sensing technologies have provided useful tools for a diverse range of sectors. G-STEP （GMES--space technology exchange partnership） is the University of Leicester＇s flagship project for innovation, training and education in GMES （global monitoring for environment and security） and GIS （geographical information systems） based technologies. G-STEP （part funded by the ERDF） is the first GMES accelerator initiative in the UK and is breaking new ground in the application of GMES and GIS. The core G-STEP team initiates and develops Knowledge Exchange Practices between the University and Life Long Learning partners in the East Midlands Region, through training packages and collaborative research projects. The programme integrates innovative research, to direct downstream applied training, supported by analytical processing of attendee assessment data. Collated information derived from these sources presents a unique opportunity to incorporate a statistically viable feedback cycle, making G-STEP the interface between pure and applied research, thus initiating downstream dissemination to groups and small business. In this paper, we outline the GMES and GIS training packages, and the route to market to increase uptake of underused data streams via university and regional entrepreneurs （start-ups） and established small business with a core interest in utilisation and dissemination of novel technologies in sustainable lifelong learning.

Future Mobile Terminal and Network Access Architecture for China 4G Open Mobile Communications

This paper relates to an advanced open mobile communication system and method of integrating the mobile communications, wireless access systems and wired communications into one common platform architecture for China's 4th generation mobile communications, supporting costeffective broadband voice, data and video services in wireless, mobile and wired environment with one single integrated mobile terminal device. The paper includes new architecture in the integrated mobile device and converged network access, and minimum modifi cation in the existing mobile telecommunication infrastructures. This paper introduces the long-term evolution strategy for China's TDD system platform towards China's future 4G mobile communications.

Ethically Inspired Care Information Technology Can Enable Freedom of Choice of Older Users

The goal of this paper is to present the ethical issues that are relevant at the concept development stage and inspiring its development during the CONFIDENCE （Ubiquitous Care System to Support Independent Living） project. We propose that the technology must support principles such as human rights, privacy, safety, and dignity. The voluntary contribution of people as participants in research must undergo the scrutiny of research plans by ethical review boards. Informed consent processes and procedures must be observed in this realm. Ethical issues arising in heterogeneous fields involving technology, end-users, service providers, and formal and informal caregivers pose important challenges. Attempting to maximize the ethical compliance of the results of this ICT （information and communication technology） project, we explore and suggest preventive measures for possible scenarios of misuse of this or related technology. Concluding, the observation of ethical principles throughout the development process can empower users to make informed decisions on the acceptance of ICT systems and services when these reach the market.

Optimized Technology for Residuum Processing in the ARGG Unit

The influence of feedstock property on operation in the FCC unit was studied to identify the cause leading to deteriorated products distribution related with increasingly heavier feedstock for the ARGG unit. In order to maximize the economic benefits of the ARGG unit a string of measures, including the modification of catalyst formulation, retention of high catalyst activity, application of mixed termina-tion agents to control the reaction temperature and once-through operation, and optimization of catalyst regeneration technique, were adopted to adapt the ARGG unit to processing of the heavy feedstock with its carbon residue equating to 7 % on an average. The heavy oil processing technology has brought about apparent economic benefits.

Technology Trends and Architecture Research for Future Mobile Internet

With the rapid development of wireless transmission technologies and the proliferation of mobile terminals, the mobile Internet has experienced exponential growth in recent years. However, at the same time, it is also facing more challenges, particularly regarding bandwidth, address space, security, mobility, and energy. In this article, we analyse the five abovementioned challenges and then survey related technology trends. We also describe the progress of architecture research aimed at the future mobile Internet. We reach the conclusion that a single technology cannot solve all the problems of mobile Internet, and future research should focus more on how to make architectures and technologies work together more effectively.

Hepatic resection for hepatocellular carcinoma in end-stage renal disease patients: Two decades of experience at Chang Gung Memorial Hospital

AIM: Hepatocellular carcinoma (HCC) is a common disease in Taiwan. The prevalence of viral hepatitis infection and the subsequent development of HCC are well known to be higher in patients with end-stage renal disease (ESRD) requiring hemodialysis (HD) or peritoneal dialysis (PD) than among the general population. However, information on hepatic resection for ESRD-HCC patients is limited. METHODS: The clinical features of 26 ESRD-HCC patients who underwent hepatic resection from 1982 to 2001 were retrospectively reviewed. Meanwhile, the clinicopathological features and the outcome of 1 198 HCC patients without ESRD undergoing hepatic resection were used for comparison. RESULTS: Of 1 224 surgically resected HCC patients, 26 (4.2%) were ESRD-HCC. Univariate analysis revealed more associated disease, more physical signs of anemia and postoperative complications, lower hemoglobin, platelet, α-fetoprotein, elevated blood urea nitrogen (BUN) and creatinine levels, smaller tumors, lower HBsAg positivity, higher HCV positivity, and longer hospital stays in the ESRDHCC group compared with the HCC group. Furthermore, multivariate stepwise logistic regression analysis revealed that elevated BUN and creatinine levels were the only two independently significant factors in the patients in the ESRD-HCC group. Overall and disease-free survival rates were similar between the ESRD-HCC and HCC groups.CONCLUSION: Elevated BUN and creatinine were the only two main independent factors differentiating ESRD-HCC from HCC patients. ESRD should not be a contraindication of hepatic resection in HCC patients; however, careful operative techniques and perioperative care are crucial to achieving lower morbidity and mortality. Comparable overall survival and disease-free survival can be achieved in selected ESRD-HCC patients undergoing hepatic resection when compared with conventional HCC patients.

Energy-Efficient Architecture and Technologies for Device to Device(D2D) Based Proximity Service

Considering that modern mobile terminals possess the capability to detect users' proximity,and offer means to directly communicate and share content with the people in close area,Device-to-Device(D2D) based Proximity Services(ProSe) have recently witnessed great development,which enable users to seek for and utilize relevant value in their physical proximity,and are capable to create numerous new mobile service opportunities.However,without a breakthrough in battery technology,the energy will be the biggest limitation for ProSe.Through incorporating the features of ProSe(D2D communication technologies,abundant built-in sensors,localization-dependent,and context-aware,etc.),this paper thoroughly investigates the energy-efficient architecture and technologies for ProSe from the following four aspects:underlying networking technology,localization,application and architecture features,context-aware and user interactions.Besides exploring specific energy-efficient schemes pertaining to each aspect,this paper offers a perspective for research and applications.In brief,through classifying,summarizing and optimizing the multiple efforts on studying,modeling and reducing energy consumption for ProSe on mobile devices,the paper would provide guide for developers to build energy-efficient ProSe.

Active fault-tolerant control scheme of aerial manipulators with actuator faults

In this paper,an active fault-tolerant control(FTC)strategy of aerial manipulators based on non-singular terminal sliding mode(NTSM)and extended state observer(ESO)is proposed.Firstly,back-stepping technology is adopted as the control framework to ensure the global asymptotic stability of the closed-loop system.Next,the NTSM with estimated parameters of actuator faults is used as main robustness controller to deal with actuator faults.Then,the ESO is utilized to estimate and compensate the complex coupling effects and external disturbances.The Lyapunov stability theory can guarantee the asymptotic stability of aerial manipulators system with actuator faults and external disturbances.The proposed FTC scheme considers both actuator fault and modelling errors,combined with the adaptive law of actuator fault,which has better performance than traditional FTC scheme,such as NTSM.Finally,several comparative simulations are conducted to illustrate the effectiveness of the proposed FTC scheme.

Design and Implementation of Cloud Platform for Intelligent Logistics in the Trend of Intellectualization

Intellectualization has become a new trend for telecom industry, driven by intelligent technology including cloud computing, big data, and Internet of things. In order to satisfy the service demand of intelligent logistics, this paper designed an intelligent logistics platform containing the main applications such as e-commerce, self-service transceiver, big data analysis, path location and distribution optimization. The intelligent logistics service platform has been built based on cloud computing to collect, store and handling multi-source heterogeneous mass data from sensors, RFID electronic tag, vehicle terminals and APP, so that the open-access cloud services including distribution, positioning, navigation, scheduling and other data services can be provided for the logistics distribution applications. And then the architecture of intelligent logistics cloud platform containing software layer(SaaS), platform layer(PaaS) and infrastructure(IaaS) has been constructed accordance with the core technology relative high concurrent processing technique, heterogeneous terminal data access, encapsulation and data mining. Therefore, intelligent logistics cloud platform can be carried out by the service mode for implementation to accelerate the construction of the symbiotic win-winlogistics ecological system and the benign development of the ICT industry in the trend of intellectualization in China.

Standard for Universal Power Adapter for Mobile Terminals

This paper introduces the choices of the technology solutions pertinent to the industrial standard of Chinese communications industry, YD/T 1591 Technical Requirements and Test Method of Charger and lnterface for Mobile Telecommunication Terminal Equipment, as well as its development and revision process. It also elaborates the technology contents for Recommendation of Improving the Standard ITU-TL.1000.