Long-term Safety Observations on Side Effects and Com -plications of Non-surgical Sterilization by Chem ical In-stillation of the Fallopian Tubal

The present objective is to observe the side effects and complications of fem ale tubalsterilization by phenol-atabrinepaste (PAP) and phenolm ucilage (PM). 1 705 eligible w om en w ere divided random ly into tw o groups, 871 usinig PAP and 834 w om en using PM. Results: Thefeverratesw ere8.0and 4.4( P< 0.01 ) respec- tively in group PAP and group PM. Infection rates of the appendages w ere 2.3 and 1.2 respectively. The incidence of chem ical peritonitis, w ithin the lim its of pelvic cavity, w ere 1.1and 2.4respectively. Perforation of uterus, pelvic ab- scessand ectopicpregnancy w ere notfound during thisobservation. Slightabdom inal pain after the proceduresw ere 33.6and 30.8respectively. Slightvaginalbleed- ing after the procedure w as 23.2 and 18.0 respectively. Menstruation of the w om en w as not affected by the instillation. This five-year follow -up study neither show ed a positivePap testnor a potentialdeseasecaused by thesterilizing agents. This technique isa safe and efficientm ethod for fem ale sterilization.

The Model and Design for COM-Based e-Commerce Application System

From the point of constructing e-commerce application system, based on the structured analysis and Object-Oriented Design method, a combined modeling method Business-Process Driven(BPD) is proposed. This method focuses on the business process through the development process of the system. First, the business model of the system, then commercial object model is introduced according to the business model. At last the COM-model for the system is established. The system is implemented in an iterative and incremental way. The design and analysis result of each stage is illustrated by series of views using the modeling tool UML.

Application of BLOB and COM in CSR Control System

In ATL, the COM using ProC/C++ to operate on BLOB in oracle is described. And it has been used in actual control system based on Web services architecture.We use LOBs to store many circuit diagram, data, large document, etc. Why use BLOBs? With Oracle8i, BLOBs can store up 4GB data. This doubles the 2GB data that LONG and LONG RAW data types

Application of COM for Software Control System

GSR control system is an important part that ensures that CSR system works well. The large control system consists of some sub-systems. Users can control devices and get the running situation of devices by intranet. We use the technology of COM (Component Object Model) in the software control system, and the COM Module mostly realizes the program of monitoring devices and controlling devices.

Mixed programming with LabVIEW & Matlab and its application in explosion field test

Several methods of mixed programming with LabVIEW and Matlab are introduced.Taking explosin test as application background,the design method and implementation process using MathScript node and COM technology are mainly discussed.Based on this,the advantages of LabVIEW＇s interface development and Matlab＇s rich data operation functions are combined to achieve the fitting of explosion pressure field and dynamic compensation of temperature measured.

Congenital penile curvature: long-term results of operative treatment using the plication procedure

Aim: To determine the long-term outcome, effectiveness and patient satisfaction of congenital penile curvature correction by plication of tunica albuginea. Methods: From January 1992 to January 2002, 106 young patients underwent surgical correction of congenital penile curvature by corporeal plication. Indications for operation were difficult or impossible vaginal penetration and cosmetic problems. The technique of corporeal plication consists of placing longitudinal plication sutures of 2-zero braided polyester on the convex side of the curvature until the curvature is corrected when erection is artificially induced. Results of this procedure were obtained by retrospective chart reviews and questionnaires via mail. Long-term follow-up ranged from 11 to 132 (mean 69.3) months and data were available for 68 patients. Results: Penile straightening was excellent in 62 patients (91 %) and good with less than 15 degree of residual curvature in 6 patients (9 %). Sixty-seven patients reported no change in erectile rigidity or maintenance postoperatively, while 1 described early detumescence. Shortening of the penis without functional problems was noted by 26 patients (38 %). Thirty-Five patients (51 %) reported feeling palpable indurations (suture knots) on the penis. Temporary numbness of glans penis was described in 3 patients. Overall, 60 patients were very satisfied, 6 satisfied, 2 unsatisfied. Conclusion: Corporeal plication is an effective and durable procedure with a high rate of patient satisfaction.

HYSYS Automation and Its Application on Evaluation of Plate Heat Exchanger

When simulating or designing plate heat exchangers for multicomponent mixtures, most designers are often perplexed with the question on how to choose or estimate the physical property param- eters and hope to have a reliable database that could be adopted. The commercial codes HYSYS supply the physical property package on over 1500 pure substances and over 16 000 binary coefficients for them. This work has briefly presented an efficient communication interface based on the Microsoft Component Object Model （COM） between inner plate heat exchanger simulation codes and the HYSYS package. The application of a custom-made HYSYS-COM interface has shown high efficiency, such as significant reduction of time needed for evaluating each process stream＇s properties. This automation method can be conveniently extended to further optimization study for any specific operation device such as heat transfers, columns, and other facilities.

基于COM-MBVD混合模型的多模态声学响应研究与仿真

耦合模(COM)模型广泛应用于声表面波(SAW)滤波器设计中,传统的单模COM模型不能拟合到远端的高阶水平剪切波、西沙瓦波等杂散模态。从单模COM模型出发,结合类似于MBVD等效电路的谐振支路,实现COM-MBVD模型拟合多模态声学响应。并基于此模型搭建8阶梯形结构电路进行优化仿真。最终设计出中心频率为1 590 MHz,通带插入损耗小于1.6 dB,带内波动为1 dB,带宽为80 MHz(相对带宽为5%)的声表面波(SAW)滤波器。实际测试数据与仿真数据相符,验证了该设计方法的可行性。

Glucose intolerance and diabetes mellitus in ulcerative colitis: Pathogenetic and therapeutic implications

Diabetes mellitus is one of the most frequent co-morbidities of ulcerative colitis patients.The epidemiological association of these diseases suggested a genetic sharing and has challenged gene identification.Diabetes co-morbidity in ulcerative colitis has also relevant clinical and therapeutic implications,with potential clinical impact on the follow up and outcome of patients.These diseases share specific complications,such as neuropathy,hepatic steatosis,osteoporosis and venous thrombosis.It is still unknown whether the coexistence of these diseases may increase their occurrence.Diabetes and hyperglycaemia represent relevant risk factors for postoperative complications and pouch failure in ulcerative colitis.Medical treatment of ulcerative colitis in patients with diabetes mellitus may be particularly challenging.Corticosteroids are the treatment of choice of active ulcerative colitis.Their use may be associated with the onset of glucose intolerance and diabetes,with difficult control of glucose levels andwith complications in diabetic patients.Epidemiologic and genetic evidences about diabetes co-morbidity in ulcerative colitis patients and shared complications and treatment of patients with these diseases have been discussed in the present review.

基于COM-B模型晚期肺癌患者预立医疗照护计划参与度影响因素分析

目的 基于COM-B模型分析晚期肺癌患者预立医疗照护计划参与度的影响因素,为临床干预决策提供参考。方法 便利选取317例晚期肺癌患者,采用预立医疗照护计划参与问卷、预立医疗照护计划问卷、心理韧性量表等进行调查。根据COM-B模型中能力、机会、动机3维度分析晚期肺癌患者预立医疗照护计划参与度的影响因素。结果 晚期肺癌患者预立医疗照护计划参与度得分为(67.37±6.14)分。多元线性分层回归分析显示,知晓疾病诊断时间,能力因素中预立医疗照护计划知识和心理弹性,动机因素中预立医疗照护计划信念、动机、死亡态度(自然接受)、焦虑和抑郁,机会因素中社会支持是晚期肺癌患者预立医疗照护计划参与度的主要影响因素(均P<0.05),可解释总变异的50.4%。能力因素、动机因素、机会因素的新增解释量分别为18.6%、18.4%、3.4%。结论 晚期肺癌患者预立医疗照护计划参与度偏低,能力和动机因素的影响较大,机会因素的影响相对较小。医护人员需提高晚期肺癌患者预立医疗照护计划相关知识和心理弹性水平,激发预立医疗照护计划信念和动机,树立正确的死亡态度,减轻焦虑和抑郁水平,增加社会支持,以提高预立医疗照护计划的参与。

Diaphragmatic Plication: Retrospective Study with 54 Patients

Objective: This study seeks to evaluate the results of surgery performed according to the etiological causes of diaphragmatic eventration or paralysis. Method: Files of 54 patients (35 males, 19 females;mean age: 39.1 ± 3.01 years) who had undergone diaphragm plication between January 2005 and June 2011 in two clinics located in Istanbul were studied in terms of pulmonary spirometry, applied surgical procedure, duration of hospitalization, morbidity, and mortality. Results: In diaphragm plications, observed etiologies were isolated diaphragmatic eventration without phrenic nerve injury (Group 1) in 20 (37%) patients due to blunt thoracic trauma;Group 2 (thymoma in 19 (35.2%) patients;lung cancer in 7 (12.9%) patients;mediastinal tumor in 3 (5.6%) patients) and congenital heart surgery (Group 3) in 5 (9.3%) patients. The mean time to plication was 7.4 months in Group 1. The mean duration of hospitalization was 4 days in Group 1, 6.2 days in Group 2, 11.8 days in Group 3. Mean forced vital capacity, forced expiratory volume at 1 second improved by 17%, 20.3%, respectively (p In Group 1, mean dyspnea-related hospital admission before plication was 2.4 times. At the end of 6 months after plication mean dyspnea-related hospital admission was 0 time. All of them returned to daily activities or their job within 6 months in Group 1. Postoperative mortality was observed in 2 (3.7%) patients in Group 3 while the overall complication rates were 24%. The morbidity rates were 8%, 27.5%, 60%, respectively;and the mortality rates were 0%, 0%, 40%, respectively. Conclusion: As a result, it could be suggested that early and timely performed plications for diaphragmatic eventration improves functional status and assesses a shorter lenght of stay. On the other hand,simultaneously performed plications in intraoperative phrenic nerve resections can be performed with acceptable morbidity and no mortality. In diaphragmatic paralysis due to congenital heart surgery, morbidity and mortality rate is still high.

CLINICAL APPLICATION OF POINT-THROUGH-POINT ACUPUNCTURE

Point-through-point acupuncture is atechnique in which a long needle is insertedin various directions and depths and acts ontwo or more points in treating disease.It iscommonly used in clinical practice.The ap-plication of point-through-point acupunc-ture and its effects are summarized as fol-lows.

Laparoscopic Diaphragmatic Plication in Patients with Unilateral Diaphragm Paralysis with Thoracoscopic Verification

Diaphragm eventration or paralysis causes elevation of the ipsilateral diaphragm. Some patients have symptoms. The most common symptom is dyspnea. In symptomatic patients with unilateral diaphragm paralysis and dyspnea disproportionate to the degree of physical activity, diaphragm plication is the treatment of choice to relieve dyspnea. We report on our experience with laparoscopic plication of a paralysed hemidiaphragm. The laparoscopic approach is an attractive surgical alternative for the treatment of phrenic nerve palsy. This technique combines the advantage of an excellent field of vision during surgery with a fast postoperative recovery and early discharge from hospital. In accordance to recent literature, we have successfully applied the laparoscopic approach to treat our patients who suffered from a unilateral paralysis of the diaphragm. Preoperative symptoms of exertional dyspnea and orthopnea were significantly reduced.

Endoventricular Spiral Plication for Ischemic Dilated Cardiomyopathy

Surgical ventricular restoration (SVR) procedures have been developed;however, their long-term effectiveness remains controversial. Although a series of endoventricular spiral plication (ESP) has been rarely reported and its long prognosis is still unknown;this method has a unique concept of left ventricular (LV) restoration without artificial patch materials. Here, we describe the case of a patient with ischemic cardiomyopathy and ischemic mitral regurgitation who successfully underwent ESP, mitral valve repair, and coronary artery bypass grafting. ESP was effective in papillary muscle approximation for avoiding heart failure;however, the noted improvement of LV wall thickening might be temporary.

SHER Grade IIIb Placenta Abruptio Complicating Severe Superimposed Pre-Eclampsia at 19 WA: A Case Report

The placenta abruptio is an extremely serious pathology which involves the maternal-fetal prognosis. We report the case of a 19-year-old patient who consulted for abdominopelvic pain associated with heavy vaginal bleeding on 19SA in a context of arterial hypertension. The symptomatology suddenly worsened with the onset of hemorrhagic shock, which prompted an emergency hysterotomy. The diagnosis of placenta abruptio grade III b of SHER was evoked. Uterine atony was objectified intraoperatively and uterine compression by the B-Lynch technique was performed. The evolution of the patient was favorable after a stay of 5 days in intensive care.

Diaphragmatic Plication for Patients with Acute Phase Phrenic Nerve Paralysis Following Lung Transplantation: A Case Report

Phrenic nerve injury can occur as a complication of lung transplantation. A 54-year-old man underwent single-lung transplantation due to interstitial pneumonia. The patient required circulatory support with venoarterial extracorporeal membrane oxygenation and was unable to be weaned from ventilatory support with nitric oxide. Although enhanced CT scanning showed stenotic anastomosis of the right pulmonary artery (PA), pulmonary angiograph findings revealed that PA flow was normal under sedation and considerably decreased with spontaneous breathing. Fluoroscopy showed that the right diaphragm moved inversely to the position of the left diaphragm, indicating that the right phrenic nerve was paralytic. We performed diaphragmatic plication 7 days after lung transplantation and weaning from ventilator support was accomplished soon thereafter. Phrenic nerve dysfunction is an important clinical problem following lung transplantation. In the present case, diaphragmatic plication was effective for treatment of circulatory failure due to phrenic nerve paralysis even in acute phase after lung transplantation.

Isolated Tricuspid Valve Repair and Right Atrial Plication Performed Using a Beating-Heart Technique for Atrial Functional Tricuspid Valve Regurgitation

Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Association functional class. There is no consensus on the optimal surgical technique for this condition, including on whether to perform the procedure on a beating or an arrested heart and whether to perform valve repair or replacement. Methods: We analyzed four case series between 2015 and 2022 in which patients with secondary tricuspid regurgitation (TR) underwent valve repair on a beating heart and right atrial plication for a dilated right atrium. The TRI-SCORE was calculated for each patient. Results: All patients experienced a favorable postoperative course with significant improvements in heart failure symptoms. TR was markedly reduced;however, in one patient with concomitant mitral regurgitation (MR) and a high TRI-SCORE, MR worsened postoperatively. This patient later died from unknown causes due to multiple comorbidities in the late phase. Conclusions: Tricuspid valve repair on a beating heart was effective for improving the cardiac function, and the TRI-SCORE proved useful as a preoperative risk assessment tool. The underlying mechanism by which TR exacerbates MR requires further investigation.

Deep Unity of Classic and Quantum Physics at the Space Thermostat Presence with Technical Applications

The paper demonstrates deep unity of classic and quantum physics at the space thermostat (ST) presence, which fulfilled all space by the temperature T0 = 2.73 K. The ST presents itself the Cosmic Microwave Background (CMB). From the main quantum position we consider the ST/CMB as the wave function carrier (“quantum background”). The paper is devoted to ST/CMB medium the classic conservation laws of mass, momentum and energy. We show the soliton like solutions of our classic model correspond to Schrodinger’s quantum solutions, demonstrate the atom hydrogen specter and other quantum peculiarities. The paper contains typical technical examples classic/ quantum simulation at the ST presence.

基于COM-B理论的老年慢性心力衰竭病人容量超负荷居家管理行为体验的质性研究

目的探索基于能力-机会-动机-行为(COM-B)理论的老年CHF病人居家容量管理行为的真实体验,为制定个性化的老年CHF病人容量超负荷居家管理方案提供参考。方法采用目的抽样法,对15例老年CHF病人进行半结构式访谈,运用内容分析法对资料进行分析。结果老年CHF病人容量超负荷居家管理行为共提炼出3个主题及9个亚主题,分别是能力方面:症状感知能力欠佳、管理知识欠缺或偏差、居家管理应对无效;动机方面:容量管理信心缺乏、容量管理体验不佳、运动自我效能低下;机会方面:医院支持、社区支持、家庭支持。结论老年CHF病人容量超负荷居家管理行为受多种因素的影响,需拓展容量管理教育方式及途径,切实提高老年CHF病人的自我决策及应对能力;重视不良体验,树立积极信念,激发容量管理行为动机;优化居家容量管理策略,加强医院-社区-家庭容量管理的连续性。

基于COM-B模型的自我管理方案在维持性血液透析病人中的应用

目的:探讨基于COM-B模型的自我管理方案在维持性血液透析病人中的应用效果。方法:选取进行规律血透的64例病人为研究对象,根据掷硬币法随机分成观察组和对照组各32例。对照组采用透析常规护理方法,观察组在对照组的基础上采用基于COM-B模型的自我管理方案,比较2组病人干预前后自我管理行为、自我感受负担和透析前后体质量增加值。结果:干预后观察组的自我管理总分及各维度分均随时间延长而提高,自我感受负担总分及身体负担、情感负担维度分和体质量增加值均随时间延长而降低(P<0.01),对照组干预前后自我管理、自我负担和体质量增加值比较,差异均无统计学意义(P>0.05)。干预2个月观察组在执行自我管理和情绪处理维度得分高于对照组(P<0.05)。干预3个月观察组自我管理总分及各维度分均高于对照组,自我感受负担总分及各维度分、体质量增加值均低于对照组(P<0.05~P<0.01)。结论:基于COM-B模型的自我管理方案在维持性血液透析病人中的应用效果显著,能够提升病人自我管理行为、降低自我感受负担,有效降低体重增长值,值得在临床进行干预。