Gas Exchange Rates of Texas Persimmon (Diospyros texana) in Central Texas Woodlands

Diospyros texana (Texas persimmon) is a secondary species in most Juniperus ashei/Quercus fusiformis woodlands in central Texas. It has high density, but plants are mostly in the community understory. Light response curves at ambient and elevated levels of CO2 and temperature were measured for D. texana. The Anet (photosynthetic rate) increased significantly as both light level and CO2 levels increased but not temperature. The Amax (maximum photosynthetic rate) of D. texana in full sun at elevated levels of CO2 was increased for all treatments. Stomatal conductance increased with levels of CO2 but only if the interaction was removed from the model. Intercellular levels of CO2 increased with both temperature and CO2 treatments as did water use efficiency (WUE). Furthermore, light saturation (Lsat) increased with CO2 treatments and light compensation (Lcp) increased with temperature. The dark respiration (Rd) increased with both temperature and CO2 treatments. Markov population models suggested D. texana populations would remain ecologically similar in the future. However, sub-canopy light levels and herbivory should be considered when examining population projections. For example, Juniperus ashei juveniles are not recruited into any canopy unless there are high light levels. Herbivory reduces the success of Quercus juveniles from reaching the canopy. These factors do not seem to be a problem for D. texana juveniles which would allow them to reach the canopy without need of a high light gap and are not prevented by herbivory. Thus, Juniperus/Quercus woodlands will change in the future to woodlands with D. texana a more common species.

Clinical factors correlated with the success rate of miniscrews in orthodontic treatment

Miniscrews offer a reliable alternative for anchorage during orthodontic treatment,particularly for non-cooperative patients or periodontal patients with alveolar bone loss.The study aims at assessing the correlation of various clinical indicators with the success or failure of miniscrews used for anchorage during orthodontic treatment.Thirty-four consecutive patients with a cumulative total of 82 miniscrews implanted participated in the study.Generalized Estimating Equations were used to assess the correlation of various factors with success rates.The miniscrew was considered the unit of analysis clustered within site and within patient.The overall success rate of miniscrews was 90.2%.For every additional miniscrew used in a patient＇s oral cavity,the success rate was reduced by 67%.Retromandibular triangle and palatal placement and in movable mucosa resulted in lower success rate.The miniscrew length and diameter were found to correlate with success rates.Orthodontic force applied on miniscrews for uprighting purposes showed a lower success rate than that used for retraction.This study revealed that miniscrews present high success rates.The number of miniscrews used per patient,the miniscrew site placement,the soft tissue type of placement,the miniscrew length and diameter as well as the orthodontic force applied on the miniscrew showed significant correlation with success rates.

Success rates for various graft materials in tympanoplasty e A review

Objectives:The aim of this paper is to review how successful each type of grafts is in tympanoplasty.Methods:Pubmed,Google and the Proquest Central Database at Kırıkkale University were queried using the keywords“graft”,“success”“tympanoplasty”,“success rate”with the search limited to the period 1955 to 2017.Results:Various types of graft materials including temporalis fascia,cartilage,perichondrium,periosteum,vein,fat or skin have been used in the reconstruction of tympanic membrane(TM)perforation.Although temporalis fascia ensures good hearing is restored,there are significant concerns that its dimensional stability characteristics may lead to residual perforation,especially where large TM perforations are involved.The“palisade cartilage”and“cartilage island”techniques have been stated to increase the strength and stability of a tympanic graft,but they may result in a less functional outcome in terms of restoring hearing.Smoking habits,the size and site of a perforation,the expertise level of the operating surgeon,age,gender,the status of the middle ear mucosa and the presence of myringosclerosis or tympanosclerosis are all important in determining how successful a graft is.Conclusion:Although temporal fascia is the most commonly used graft material for tympanoplasty,poor graft stability may cause failure.This failure is due to the inclusion of connective fibrous tissue containing irregular elastic fibers present in the grafted fascia.Cartilage grafts offer better ability to resist infection,pressure,and cope with insufficient vascular supply.This means that cartilage grafts are suitable for use in revision cases.

Accuracy Analysis of Assembly Success Rate with Monte Carlo Simulations

Monte Carlo simulation was applied to Assembly Success Bate (ASK) analyses. ASR of two peg-in-hole robot assemblies was used as an example by taking component parts' sizes, manufacturing tolerances and robot repeatability into account. A statistic arithmetic expression was proposed and deduced in this paper, which offers an alternative method of estimating the accuracy of ASR, without having to repeat the simulations. This statistic method also helps to choose a suitable sample size, if error reduction is desired. Monte Carlo simulation results demonstrated the feasibility of the method.

Treatment success rate of tuberculosis patients in Dabat, northwest Ethiopia

Evaluating the outcomes of DOTS program is essential for recognizing and amending system failures before the incidence and proportion of resistant isolates rise. In this study, we seek to evaluate the impact of DOTS strategy on tuberculosis treatment success rate in Dabat, northwest Ethiopia. Medical records of 1305 pulmonary and extrapulmonary tuberculosis patients registered from 2007 to 2012 at two health centers in Dabat district, northwest Ethiopia, were reviewed. Treatment outcomes and forms of tuberculosis were assessed according to WHO guidelines. Descriptive analyses were performed using frequencies and percentages. Treatment success rate was observed in 1146 (87.8%) patients. Out of these, 534 (89.1%) of the males and 612 (86.7%) of the females were successfully treated. It was also true in 338 (87.8%) of the smear-positive pulmonary tuberculosis patients, 473 (85.7%) of the smear-negative pulmonary tuberculosis patients, and 335 (91.0%) of the extrapulmonary tuberculosis patients. In conclusion, treatment success rate in the current study was slightly higher than the WHO international updated target for the period 2011 to 2015. However, this doesn’t mean that there will be no need for further enhancement of supervision and monitoring techniques, strengthening counseling and health education programs, and improving the quality of laboratory diagnostic services.

Optimal use of fielder XT guidewire enhances the success rate of chronic total occlusion percutaneous coronary intervention

BACKGROUND Chronic total occlusion(CTO) is found in 18-31% of patients who undergo coronary angiography. Successful recanalization of CTOs is associated with reduced recurrent angina pectoris rates and increased long-term survival.Although the success rate of CTO percutaneous coronary intervention(CTO-PCI)has improved, CTO-PCI remains technically challenging. The Fielder XT guidewire was designed for CTO lesions. To validate whether the use of the guidewire increases the success rate, we compared the results of CTO-PCI with or without the guidewire. We hypothesized that the use of Fielder XT guidewire can increase the success rate of CTO-PCI.AIM To investigate whether the use of Fielder XT guidewire increases the final procedural success of CTO-PCI via the anterograde approach.METHODS Between January 2013 and December 2015, a retrospective study was conducted on 1230 consecutive patients with CTO who received PCI via the anterograde approach at the General Hospital of Northern Theater Command. The patients were divided into an XT Group(n = 686) and a no-XT Group(n = 544) depending on whether Fielder XT guidewire was used. Both groups were compared for clinical parameters, lesion-related characteristics, procedural outcomes and inhospital complications. The data were statistically analyzed using Pearson's χ~2 test for categorical variables, and Students' t test was used to compare the quantitative data. Significant independent factors and a risk ratio with 95%confidence interval(CI) were assessed by multivariate logistic regression analysis.RESULTS In total, 1230 patients were recruited; 75.4% of the patients were male, and 55.8%of the patients were in the XT group. The overall success rate was 83.9%, with87.8% in the XT group. Based on multivariate logistic regression analysis, factors positively associated with procedural success were the use of Fielder XT guidewire(P = 0.005, 95%CI: 1.172-2.380) and systolic blood pressure(P = 0.011,95%CI: 1.003-1.022), while factors negatively associated with procedural success were blunt stump(P = 0.013, 95%CI: 1.341-11.862), male sex(P = 0.016, 95%CI:0.363-0.902), New York Heart Association(NYHA) class(P = 0.035, 95%CI: 0.553-0.979), contrast amount(P = 0.018, 95%CI: 0.983-0.998) and occlusion time(P =0.009, 95%CI: 0.994-0.999). No significant differences were found between the XT group and the no-XT group with respect to clinical parameters, lesion-related characteristics, coronary artery rupture [3(0.4%) vs 8(1.5%), P = 0.056], inhospital death [2(0.3%) vs 6(1.1%), P = 0.079] or in-hospital target lesion revascularization [3(0.4%) vs 7(1.3%), P < 0.099]. However, there were significant differences between the groups with respect to success rate [602(87.8%) vs 430(79.0%), P < 0.001], procedure time [(74 ± 23) vs(83 ± 21), P < 0.001], stent length[(32.0 ± 15.8) vs(37.3 ± 17.6), P < 0.001], contrast amount [(148 ± 46) vs(166 ± 43),P < 0.001], post-PCI myocardial infarction [43(6.3%) vs 59(10.8%), P = 0.004],major adverse cardiovascular event [44(6.4%) vs 57(10.7%), P = 0.007], side branch loss [31(4.5%) vs 44(8.1%), P = 0.009], contrast-induced nephropathy [29(4.2%) vs 40(7.4%), P = 0.018] and no reflow [8(1.2%) vs 14(2.9%), P = 0.034].CONCLUSION The use of Fielder XT guidewire shortens the Procedure and increases the success rate of CTO-PCI, and is also associated with reduced complication rates.

Comparing Overall Success Rates of Cognitive-Behavioral Therapy,Eye Movement Desensitization and Reprocessing,Dialectical Behavior Therapy and Hypnosis

This study is a comparative analysis of the effectiveness of four psychotherapeutic treatment modalities:Cognitive-Behavioral Therapy(CBT),Eye Movement Desensitization and Reprocessing(EMDR),Dialectical Behavior Therapy(DBT),and Hypnotic methods(HYP).The aim of this study was to determine the independent effectiveness of the four treatment modalities by reviewing the available literature.A total of 26,724 studies were identified by ProQuest search and screened to eliminate studies that did not permit computation of the success rates of their use.Of that total,648 studies included objective data in some form,with 207 studies qualifying for inclusion in the analysis.The“Success Rate”measure was used as the standard of measurement,and was obtained by comparing the pre-treatment scores with post-treatment scores as published in the qualifying studies.Analysis revealed the most effective treatment modality to be EMDR,with a success rate of 49.4%.CBTwas the second most effective at 40.5%,and the success rates of Hypnosis and DBT were 39.2%and 22.4%respectively.The clinical question in therapy should probably be,“How effective can I expect this method of treatment to be?”The findings of this study reveal CBT to be less effective than EMDR and equally effective as Hypnosis;and with DBT being significantly less effective,we are left with the implication that we must expand what we know.

Comparison of Success Rate and Radiological Bone Loss in Patients with Mini-Implant versus Conventional-Sized Implant Removable Prostheses: A Meta-Analysis

Background: The objective of this meta-analysis was to assess whether mini-implants have added benefit in terms of implants success rate and average bone loss over conventional-sized implants after one year of follow-up. Methods: An electronic search of randomized clinical trials was conducted in MEDLINE (via PubMed), Cochrane Central Register of Clinical Trials (CENTRAL) and Web of Science for studies including complete or partial edentulous patients requiring two or four mini-implants or conventional/ standard-sized implants in the maxilla or mandible for implant-supported removable prostheses who completed 12 months of follow-up. Results: The search provided 194 unique articles which were screened for title and abstract. Screening generated 12 articles which went through full-text analysis using eligibility criteria, and 4 articles were included for meta-analysis. Meta-analysis of these studies indicated a non-significant difference in the success rate between the two interventions (OR = 1.69 [0.74, 3.85;p = 0.21]). Bone loss estimates resulted in a significant bone reduction (Mean Difference = -0.74 [-0.95, -0.53;p < 0.05]) in favor of two mini-implants when compared with two conventional-sized implants, but when compared four mini- with two conventional-sized implants, the estimates were non-significant (Mean Difference = -0.24 [-0.69, 0.20;p = 0.29]). Conclusion: The current evidence does not provide solid evidence of the benefits of one intervention over the other. More studies with follow-up times of 10 and more years are needed as current studies have described the short-term outcomes.

Evaluation of factors affecting the success rate of orthodontic mini-implants by survival analysis

AIM: To investigate the success rate of mini-implants and its characteristics and risk factors by survival analyses. METHODS: Three hundred and ninety-four miniimplants of the same type were placed by a single clinician. Age, gender, treatment duration, time of failure, side and jaw of implantation and the soft tissue at placement site were recorded. Odds ratio, survival curves, and Cox proportional hazard model were applied to evaluate the factors influencing the miniimplants' success rate. RESULTS: The cumulative success rate was 88.1%.The maxilla had a significantly higher success rate than that of the mandible(91.7% vs 83.7%, respectively, P = 0.019). Placement of mini-implants in the attached gingiva(AG) showed a higher success rate than that of the mucogingival junction(MGJ) and mucous membrane(MM)(AG, 94.3%; MGJ, 85.8%; MM, 79.4%; P < 0.001). Significant association was found between the jaw and the gingival tissue type(P < 0.001). There were no significant differences between maxilla and mandible when compared within each placement site.CONCLUSION: The gingival tissue type had the most significant effect on the success rate of the mini-implant with higher success rate in the attached gingiva.

Effect of Locking Compression Plate on the Treatment of Limb Fracture and the Effect of Operative Success Rate and Postoperative Recovery Time

Objective:To analyze the effect of locking compression plate on the success rate of operation and the time of postoperative recovery.Methods:120 patients with limb fractures from March 2018 to March 2020 were randomly divided into control group(60 cases)and observation group(60 cases).The control group was treated with plate screw internal fixation,The observation group used locking compression plate internal fixation,Compare the effect of treatment,the success rate of operation and the time of postoperative recovery.results:compared the effective rate of the two groups,the observation group(93.33%)was significantly higher than the control group(75.00%).Compared with the two groups,the success rate of operation and the time of postoperative recovery,the observed composition power was higher than that of the control group,and the postoperative recovery time was lower than that of the control group,P<0.05.Conclusion:The use of locking compression plate for the treatment of limb fracture can significantly increase the probability of successful operation,shorten the recovery time after operation,the overall curative effect is ideal,and the clinical popularization value is high.

Accurate Machine Learning Predictions of Sci-Fi Film Performance

A groundbreaking method is introduced to leverage machine learn-ing algorithms to revolutionize the prediction of success rates for science fiction films.In the captivating world of the film industry,extensive research and accurate forecasting are vital to anticipating a movie’s triumph prior to its debut.Our study aims to harness the power of available data to estimate a film’s early success rate.With the vast resources offered by the internet,we can access a plethora of movie-related information,including actors,directors,critic reviews,user reviews,ratings,writers,budgets,genres,Facebook likes,YouTube views for movie trailers,and Twitter followers.The first few weeks of a film’s release are crucial in determining its fate,and online reviews and film evaluations profoundly impact its opening-week earnings.Hence,our research employs advanced supervised machine learning techniques to predict a film’s triumph.The Internet Movie Database(IMDb)is a comprehensive data repository for nearly all movies.A robust predictive classification approach is developed by employing various machine learning algorithms,such as fine,medium,coarse,cosine,cubic,and weighted KNN.To determine the best model,the performance of each feature was evaluated based on composite metrics.Moreover,the significant influences of social media platforms were recognized including Twitter,Instagram,and Facebook on shaping individuals’opinions.A hybrid success rating prediction model is obtained by integrating the proposed prediction models with sentiment analysis from available platforms.The findings of this study demonstrate that the chosen algorithms offer more precise estimations,faster execution times,and higher accuracy rates when compared to previous research.By integrating the features of existing prediction models and social media sentiment analysis models,our proposed approach provides a remarkably accurate prediction of a movie’s success.This breakthrough can help movie producers and marketers anticipate a film’s triumph before its release,allowing them to tailor their promotional activities accordingly.Furthermore,the adopted research lays the foundation for developing even more accurate prediction models,considering the ever-increasing significance of social media platforms in shaping individ-uals’opinions.In conclusion,this study showcases the immense potential of machine learning algorithms in predicting the success rate of science fiction films,opening new avenues for the film industry.

基于计算机视觉的采摘机器人作业优化研究

为进一步提高我国采摘机器人智能化作业水平及采摘效率,基于计算机视觉应用技术展开优化研究。以采摘机器人结构组成为设计基点,运用视觉控制核心理念建立采摘机器人视觉识别处理与控制数学模型,实施相适应的采摘路径规划和系统采摘状态输出设计。同时,进行视觉采摘验证试验,结果表明:基于计算机视觉的采摘机器人系统优化正确可行,整机综合采摘效率可达94.61%,系统识别准确率与控制精度分别相对提升了6.12%和5.25%,机器人采摘成功率可提升至95.98%。因此,将计算机视觉处理技术有效应用至采摘机器人设计改进,对于类似农业采摘与收获装备开发研究可提供创新及借鉴思路,推广价值良好。

2BP-2000型水稻育秧播种机分盘装置研制

针对现有育秧播种机分盘装置生产效率较低、高速作业时易出现卡盘和秧盘输送不连续等问题,该研究设计了一种生产效率不低于2000盘/h的机械气动式自动分盘装置,可快速、准确完成分盘和供盘,适配2BP-2000型水稻育秧播种机高速播种。阐述了分盘装置的基本结构和工作原理,开展分盘、接盘过程分析,确定装置稳定分盘、接盘作业的关键机构与工作参数。分盘稳定性试验结果表明,生产率为1600~2000盘/h时,分盘稳定性不低于98.67%。开展以层叠秧盘数、生产率和秧盘质量为试验因素,以接盘成功率为试验指标的三因素三水平正交旋转组合试验,得到影响接盘成功率的因素主次关系为生产率、层叠秧盘数、秧盘质量,其中生产率、层叠秧盘数对接盘成功率影响显著(P<0.05),秧盘质量对接盘成功率影响不显著(P≥0.05),表明分盘装置对不同质量的秧盘适应性较好,其最优参数组合为:生产率2000盘/h、层叠秧盘数6盘/层、秧盘质量750 g/盘,该条件下分盘装置的接盘成功率均值为98.43%,与预测值仅相差0.29个百分点。研究结果对提高水稻硬盘育秧播种机械化水平具有实用价值。

希望感提升式心理护理对不孕症患者婚姻质量、希望水平及成功妊娠率的影响

目的:观察希望感提升式心理护理对不孕症患者婚姻质量、希望水平及成功妊娠率的影响。方法:选取郑州大学第一附属医院生殖医学中心收治的156例不孕症患者作为本次研究对象,采集时间为2022年11月-2023年11月,以单双数作为分组标准,将符合标准的患者随机分成观察组与对照组,两组各78例,其中对照组接受临床常规干预,观察组在以上基础联合希望感提升式心理护理,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、Olson婚姻质量问卷(ENRICH)、Herth希望量表评估两组干预前后负性情绪、婚姻质量、希望水平的变化,并随访统计两组成功妊娠率及住院满意度。结果:干预前两组SAS评分、SDS评分、ENRICH各项目评分、Herth各项目评分比较,差异无统计学意义(P>0.05),干预后两组指标评分均明显改善,且观察组SAS评分、SDS评分均低于对照组,ENRICH各项目评分、Herth各项目评分均高于对照组,差异有统计学意义(t=6.580,5.846,3.877,4.572,8.492,11.423,8.007,7.757;P<0.05);随访计算观察组成功妊娠50例(64.10%),对照组成功妊娠32例(41.03%),两组相比差异有统计学意义(χ^(2)=8.330,P<0.05);统计满意度可知,两组总满意度相比,差异有统计学意义(χ^(2)=4.112,P<0.05)。结论:经研究结果可知,不孕症患者在希望感提升式心理护理联合常规干预下,能显著改善患者心理状态,明显提升其婚姻质量,在改善希望水平的同时还能提高成功妊娠率,对促进妊娠有着良好影响,且患者接受度较高。

道路通向市场——民事执行体制改革新论

我国民事执行体制以执行机构附设于法院为起点,逐渐演变为隶属于法院,是多种历史因素作用下的结果,亦将随着时代背景的变迁而变革。从域外看,走向市场化、扩大市场化、深化市场化,已成为不少国家民事执行体制发展的共同趋势。随着财政负担日益加重,我国民事执行体制改革只能在不增加财政负担乃至适度减轻财政负担的前提下,维持执行效率不降低、执行到位率有提升,进而提高民众对民事执行的获得感。应设立作为自由职业者的执行律师,先由其负责金钱债权“终本”案件的执行,再扩大其执行权能范围。通过市场化改革,可以弥补财政资源的不足,打造共建共治共享的社会治理共同体,实现中国式民事执行体制的现代化。

基于DTN路由的多通路精准灌溉系统布局设计

为进一步提升我国智能灌溉装备的综合作业效率,从多通路实施与精准化控制角度展开布局设计。以灌溉系统的作业原理及田间信息获取特征为出发点,建立灌溉网络的DTN路由算法模型,实施网络节点的规划分配与通道布置,形成精准性的逻辑控制流程及节点网络相互执行关系。进行系统性的灌溉试验,结果表明:基于DTN路由算法的多通路精准灌溉系统布局正确可行,信息投递成功率可达94.13%,节点转发率可达96.07%,各信息传递的实时准确,各阀门组件的动作协调,综合灌溉效率实现了高于90%的优化目标,是DTN路由控制理念在灌溉装备领域的应用创新思路之一,具有较好的推广意义。

基于环境中移动运输代理的传感器网络建模

针对大型稀疏传感器网络中的数据获取,本文提出了一种利用环境中普遍存在的移动代理来连接稀疏传感器的网络体系结构和一种2-维网格随机游走分析模型;提出的传感器网络模型由3个抽象层构成,即由无线传感器构成的底层、由各种运输代理构成的中间层和由接入点/中央存储库构成的顶层。具体实现原理是位于中间层的移动运输代理从底层分布的无线传感器收集数据并缓冲数据,然后经过游走运输,最后将从底层的无线传感器收集的数据交付到顶层必要的接入点进行必要的存储和处理,从而实现整个传感器网络的数据获取;理论分析和仿真实验结果表明,提出的基于移动运输代理的传感器网络模型不仅具有较好的鲁棒性和可扩展性,而且相比于基站网络模型和Ad-hoc网络模型,在传感器功率消耗、数据成功率和基础设施投入成本方面有明显的优势。

血液灌流对重症有机磷中毒患者心肌酶、抢救成功率的影响

目的:分析血液灌流对重症有机磷中毒患者心肌酶、抢救成功率的影响。方法:选取2021年8月1日—2023年11月1日丰城市人民医院收治的72例重症有机磷中毒患者,以随机数字表法分为常规组、观察组,各36例。常规组给予硫酸阿托品注射液及碘解磷定治疗,观察组在常规组基础上给予血液灌流治疗,两组均持续治疗3 d。对比两组苏醒时间、住院时间、格拉斯哥昏迷评分(GCS)、胆碱酯酶(ChE)水平、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)]、抢救成功率、心肌酶[乳酸脱氢酶(LDH)、肌酸激酶(CK)]。结果:观察组苏醒时间、住院时间均短于常规组(P<0.05)。两组治疗后的GCS、ChE均升高,观察组GCS、ChE均高于常规组(P<0.05)。两组治疗后的CRP、IL-6均降低,观察组CRP、IL-6均低于常规组(P<0.05)。观察组抢救成功率[97.22%(35/36)]与常规组[83.33%(30/36)]比较,差异无统计学意义(P>0.05)。两组治疗后的LDH、CK均降低,观察组LDH、CK均低于常规组(P<0.05)。结论:血液灌流治疗重症有机磷中毒效果显著,可有效清除炎症因子,提高血清ChE水平,有利于心肌酶恢复,并可提高抢救成功率。

深部子宫内膜异位症系统性超声评估学习曲线研究

目的 探讨不同经验水平的超声医师识别和显示深部子宫内膜异位症(deep endometriosis, DE)系统性盆腔超声评估方法的可行性,并制定学习曲线。方法 选取2023年1—3月首都医科大学附属北京妇产医院普通妇科患者。2名不同经验水平的超声医师通过学习国际DE分析组(international deep endometriosis analysis, IDEA)推荐的系统性盆腔超声检查方法,对患者进行系统性盆腔超声评估,比较2名超声医师显示盆腔结构成功率和扫查所需时间,并制定学习曲线。结果 共纳入197例患者,年龄21~45岁,平均(34.8±5.9)岁。其中,超声医师甲共检查患者98例,超声医师乙共检查患者99例。2名超声医师双侧骶韧带、滑动征、直肠前壁及输尿管下段扫查成功率的比较,差异均无统计学意义(P>0.05)。各部位的扫查成功率随扫描次数的增加而增加,所需扫查时间随着扫查次数的增加而缩短。超声医师甲扫查双侧骶韧带、滑动征及双侧输尿管下段扫查所需平均时间高于超声医师乙,差异均有统计学意义(P <0.05)。2名超声医师扫查成功率在第一阶段至第二阶段呈明显上升趋势,第三阶段至第五阶段区域平缓;扫查所需时间在第一阶段至第二阶段呈明显下降趋势,第三阶段至第五阶段区域平缓,即40例为学习曲线的拐点。结论 经过训练掌握系统性超声评估方法可行,通过对40例患者的操作训练,不同经验的超声医师可以基本掌握系统性盆腔超声评估方法。

分娩前后行子宫动脉介入栓塞术治疗凶险型前置胎盘剖宫产的效果对比

目的探究分娩前后行子宫动脉介入栓塞术治疗凶险型前置胎盘剖宫产的效果。方法回顾性选取2020年10月至2021年10月唐山市妇幼保健院收治的108例凶险型胎盘前置患者为研究对象,按照患者采取的治疗手段不同分为观察组(n=58)和对照组(n=50)。观察组给予分娩前子宫动脉介入栓塞术,对照组给予分娩后子宫动脉介入栓塞术。对比两组的手术出血相关指标(术中、术后出血量、术中输红细胞量、术中输血浆量)、术后康复指标(手术时间、住院时间、恶露延续时间、月经恢复时间)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)及成纤维细胞生长因子-23(FGF-23)水平;并比较两组栓塞成功率、弥漫性血管内凝血(DIC)发生率、子宫摘除率、术后不良反应发生率情况。结果观察组术中、术后出血量、术中输红细胞量、术中输血浆量分别为(1398.29±819.29)、(298.94±98.84)、(993.18±206.95)、(521.94±109.24)mL,均少于对照组[(2109.49±798.26)、(505.28±94.92)、(1604.68±311.95)、(998.29±115.39)mL],差异均有统计学意义(P<0.05)。观察组患者手术时间和住院时间分别为(69.29±11.33)min、(6.98±1.93)d,均短于对照组[(89.09±10.82)min、(12.49±1.68)d],差异均有统计学意义(P<0.05)。手术后,观察组TNF-α、IL-6、FGF-23水平分别为(14.09±2.88)ng/L、(8.13±3.78)ng/L、(43.92±9.84)pg/mL,均显著低于对照组[(19.94±2.75)ng/L、(14.79±3.09)ng/L、(54.13±9.98)pg/mL],差异均有统计学意义(P<0.05)。观察组栓塞成功率为98.27%,高于对照组(76.00%),差异有统计学意义(P<0.05)。观察组DIC发生率、子宫摘除率、术后感染、失血性休克、子宫收缩异常、胎儿生命体征异常等不良反应发生率分别为5.17%、0、1.72%、0、3.44%、1.72%,均低于对照组(38.00%、4.00%、8.00%、38.00%、18.00%、16.00%),差异均有统计学意义(P<0.05)。结论分娩前给予凶险型前置胎盘患者行子宫动脉介入栓塞术,可有效提高产妇的栓塞成功率,减少术中出血量,减轻炎症反应,降低术后DIC的发生率和不良反应发生率。