AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conduct...AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok, from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS:There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P=0.053).CONCLUSION: Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy. However, preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption.展开更多
Objective： To study the efficacy of transcatheter arterial chemoembolization （TACE） combined with percutaneous acetic acid injection （PAI） on massive hepatocellular carcinoma （MHCC）. Methods： TACE was performe...Objective： To study the efficacy of transcatheter arterial chemoembolization （TACE） combined with percutaneous acetic acid injection （PAI） on massive hepatocellular carcinoma （MHCC）. Methods： TACE was performed in 57 patients with MHCC, which were randomly divided into group A （n = 28） and group B （n = 29）. Patients in the group A received conventional TACE for the first time and then received low dose TACE （10 mg mitomycin C） for the repeated treatment, Re-examined CT scans after TACE for a week. Based on filled status of Lipiodol in the Lesions, PAl was underwent in the area of rarefaction or defect filled by Lipiodol. Patients in the group B received conventional TACE. Then The survival rate and masses variation and hepatic function and a-FP and side effects were observed. Results： The 1-, 2- and 3-year survival rate after TACE were 96.4%, 78.6% and 32.1% for group A, and 65.5%, 48.3% and 20.7% for group B. Masses diminution were found in all patients in group A, while 20 cases were found in group B, unchanged in 5 cases and enlarged in 4 cases. Conclusion： The efficacy of TACE combined with PAl are significantly better than that of TACE only, low dose TACE produces less hepatic damage and less side effect.展开更多
A numerical method using AUSMDV scheme and k-ω SST turbulence model with an explicit compressibility correction was developed,and a 3-D numerical simulation of a supersonic flow field with a vertical sonic jet of hyd...A numerical method using AUSMDV scheme and k-ω SST turbulence model with an explicit compressibility correction was developed,and a 3-D numerical simulation of a supersonic flow field with a vertical sonic jet of hydrogen was performed.Good agreement between numerical results and experimental data validated the reliability of the numerical method.Whereafter,two parameters,mass-weighted average total pressure and mixing efficiency,were defined to evaluate the mixing performance of different injection schemes.Based on the numerical method and evaluation criterion,the mixing characteristics of different injection schemes were studied in detail.It was found that for the mixing field of supersonic transverse jet,the near-field mixing is controlled by convection transport while the far-field mixing is controlled by mass diffusion;the circular-hole injection causes a loss of total pressure comparable to the slot injection,but can induce a much higher mixing efficiency because of its 3-D flow characteristic;the variation of injection angle under circular-hole injection mainly affects the near-field mixing degree,and among the five injection angles studied in the present paper,angle 120° is the optimal one;with the increase of the ratio between injector space and diameter,the induced mixing efficiency increases while the caused loss of total pressure can grow greatly;the two-stage injection method designed through reducing the injector area to keep the same hydrogen mass flowrate can induce a much higher mixing efficiency while only a bit larger loss of total pressure when compared to the single-stage injection,and hence the two-stage injection is superior to the single-stage injection.The research results can direct the design of the fuel injection method in the combustor of scramjet engine.展开更多
This study presents the results of field and numerical investigations of lateral stiffness, capacity, and failure mechanisms for plain piles and reinforced concrete piles in soft clay. A plastic-damage model is used t...This study presents the results of field and numerical investigations of lateral stiffness, capacity, and failure mechanisms for plain piles and reinforced concrete piles in soft clay. A plastic-damage model is used to simulate concrete piles and jet-grouting in the numerical analyses. The field study and numerical investigations show that by applying jet-grouting sur- rounding the upper 7.5D （D = pile diameter） of a pile, lateral stiffness and beating capacity of the pile are increased by about 110% and 100%, respectively. This is partially because the jet-grouting increases the apparent diameter of the pile, so as to en- large the extent of failure wedge and hence passive resistance in front of the reinforced pile. Moreover, the jet-grouting pro- vides a circumferential confinement to the concrete pile, which suppresses development of tensile stress in the pile. Corre- spondingly, tension-induced plastic damage in the concrete pile is reduced, causing less degradation of stiffness and strength of the pile than that of a plain pile. Effectiveness of the circumferential confinement provided by the jet-grouting, however, diminishes once the grouting cracks because of the significant vertical and circumferential tensile stress near its mid-depth. The lateral capacity of the jet-grouting reinforced pile is, therefore, governed by mobilized passive resistance of soil and plastic damage of jet-grouting.展开更多
To study the curative effect of wil sonii injecta on severe head injury (SHI).Methods: A total of 120 patients with SHI were divided randomly into 2 groups, the patients treated with conventional methods as Group A (n...To study the curative effect of wil sonii injecta on severe head injury (SHI).Methods: A total of 120 patients with SHI were divided randomly into 2 groups, the patients treated with conventional methods as Group A (n=60) and the patients treated with wilsonii injecta as Group B (n=60). The changes o f neural function indexes were evaluated with Glasgow Coma Scale (GCS) before tr eatment and with Glasgow Outcome Scale (GOS) after treatment, simultaneously, th e parameters of hemorrheological indexes (HI), brain electrical activity map (BE AM) and transcranial Doppler sonography (TCD) were observed before and after tre atment.Results: In Group B, the clinical GCS, the HI, the BEAM and the prognosis GOS were improved much more than those in Group A. And the TCD parame ters in Group B decreased, which had significant difference compared with that i n Group A (P< 0.01 ).Conclusions: Wilsonii injecta can rapidly improve the injured p ersons’ conscious states, the abnormal BEAM and the surviving quality. It sugges ts that the improvement of the HI is related to the relief of the vasospasm of the arterial blood vessels in the brain, which may be one of the important mecha nisms of wilsonii injecta in improving the prognosis.展开更多
基金Supported by Faculty of Medicine Siriraj Hospital Research Project Grant
文摘AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok, from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS:There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P=0.053).CONCLUSION: Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy. However, preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption.
文摘Objective： To study the efficacy of transcatheter arterial chemoembolization （TACE） combined with percutaneous acetic acid injection （PAI） on massive hepatocellular carcinoma （MHCC）. Methods： TACE was performed in 57 patients with MHCC, which were randomly divided into group A （n = 28） and group B （n = 29）. Patients in the group A received conventional TACE for the first time and then received low dose TACE （10 mg mitomycin C） for the repeated treatment, Re-examined CT scans after TACE for a week. Based on filled status of Lipiodol in the Lesions, PAl was underwent in the area of rarefaction or defect filled by Lipiodol. Patients in the group B received conventional TACE. Then The survival rate and masses variation and hepatic function and a-FP and side effects were observed. Results： The 1-, 2- and 3-year survival rate after TACE were 96.4%, 78.6% and 32.1% for group A, and 65.5%, 48.3% and 20.7% for group B. Masses diminution were found in all patients in group A, while 20 cases were found in group B, unchanged in 5 cases and enlarged in 4 cases. Conclusion： The efficacy of TACE combined with PAl are significantly better than that of TACE only, low dose TACE produces less hepatic damage and less side effect.
文摘A numerical method using AUSMDV scheme and k-ω SST turbulence model with an explicit compressibility correction was developed,and a 3-D numerical simulation of a supersonic flow field with a vertical sonic jet of hydrogen was performed.Good agreement between numerical results and experimental data validated the reliability of the numerical method.Whereafter,two parameters,mass-weighted average total pressure and mixing efficiency,were defined to evaluate the mixing performance of different injection schemes.Based on the numerical method and evaluation criterion,the mixing characteristics of different injection schemes were studied in detail.It was found that for the mixing field of supersonic transverse jet,the near-field mixing is controlled by convection transport while the far-field mixing is controlled by mass diffusion;the circular-hole injection causes a loss of total pressure comparable to the slot injection,but can induce a much higher mixing efficiency because of its 3-D flow characteristic;the variation of injection angle under circular-hole injection mainly affects the near-field mixing degree,and among the five injection angles studied in the present paper,angle 120° is the optimal one;with the increase of the ratio between injector space and diameter,the induced mixing efficiency increases while the caused loss of total pressure can grow greatly;the two-stage injection method designed through reducing the injector area to keep the same hydrogen mass flowrate can induce a much higher mixing efficiency while only a bit larger loss of total pressure when compared to the single-stage injection,and hence the two-stage injection is superior to the single-stage injection.The research results can direct the design of the fuel injection method in the combustor of scramjet engine.
基金supported by the National Science Foundation for Distinguished Young Scholars of China(Grant No.51325901)the International Science and Technology Cooperation Program of China(Grant No.2015DFE72830)State Key Program of National Natural Science of China(Grant No.51338009)
文摘This study presents the results of field and numerical investigations of lateral stiffness, capacity, and failure mechanisms for plain piles and reinforced concrete piles in soft clay. A plastic-damage model is used to simulate concrete piles and jet-grouting in the numerical analyses. The field study and numerical investigations show that by applying jet-grouting sur- rounding the upper 7.5D （D = pile diameter） of a pile, lateral stiffness and beating capacity of the pile are increased by about 110% and 100%, respectively. This is partially because the jet-grouting increases the apparent diameter of the pile, so as to en- large the extent of failure wedge and hence passive resistance in front of the reinforced pile. Moreover, the jet-grouting pro- vides a circumferential confinement to the concrete pile, which suppresses development of tensile stress in the pile. Corre- spondingly, tension-induced plastic damage in the concrete pile is reduced, causing less degradation of stiffness and strength of the pile than that of a plain pile. Effectiveness of the circumferential confinement provided by the jet-grouting, however, diminishes once the grouting cracks because of the significant vertical and circumferential tensile stress near its mid-depth. The lateral capacity of the jet-grouting reinforced pile is, therefore, governed by mobilized passive resistance of soil and plastic damage of jet-grouting.
文摘To study the curative effect of wil sonii injecta on severe head injury (SHI).Methods: A total of 120 patients with SHI were divided randomly into 2 groups, the patients treated with conventional methods as Group A (n=60) and the patients treated with wilsonii injecta as Group B (n=60). The changes o f neural function indexes were evaluated with Glasgow Coma Scale (GCS) before tr eatment and with Glasgow Outcome Scale (GOS) after treatment, simultaneously, th e parameters of hemorrheological indexes (HI), brain electrical activity map (BE AM) and transcranial Doppler sonography (TCD) were observed before and after tre atment.Results: In Group B, the clinical GCS, the HI, the BEAM and the prognosis GOS were improved much more than those in Group A. And the TCD parame ters in Group B decreased, which had significant difference compared with that i n Group A (P< 0.01 ).Conclusions: Wilsonii injecta can rapidly improve the injured p ersons’ conscious states, the abnormal BEAM and the surviving quality. It sugges ts that the improvement of the HI is related to the relief of the vasospasm of the arterial blood vessels in the brain, which may be one of the important mecha nisms of wilsonii injecta in improving the prognosis.
