Different angle-resolved polarization configurations of Raman spectroscopy: A case on the basal and edge plane of two-dimensional materials

Angle-resolved polarized Raman（ARPR） spectroscopy can be utilized to assign the Raman modes based on crystal symmetry and Raman selection rules and also to characterize the crystallographic orientation of anisotropic materials.However, polarized Raman measurements can be implemented by several different configurations and thus lead to different results. In this work, we systematically analyze three typical polarization configurations： 1） to change the polarization of the incident laser, 2） to rotate the sample, and 3） to set a half-wave plate in the common optical path of incident laser and scattered Raman signal to simultaneously vary their polarization directions. We provide a general approach of polarization analysis on the Raman intensity under the three polarization configurations and demonstrate that the latter two cases are equivalent to each other. Because the basal plane of highly ordered pyrolytic graphite（HOPG） exhibits isotropic feature and its edge plane is highly anisotropic, HOPG can be treated as a modelling system to study ARPR spectroscopy of twodimensional materials on their basal and edge planes. Therefore, we verify the ARPR behaviors of HOPG on its basal and edge planes at three different polarization configurations. The orientation direction of HOPG edge plane can be accurately determined by the angle-resolved polarization-dependent G mode intensity without rotating sample, which shows potential application for orientation determination of other anisotropic and vertically standing two-dimensional materials and other materials.

Construction of MnS/MoS_(2) heterostructure on two-dimensional MoS_(2) surface to regulate the reaction pathways for high-performance Li-O_(2) batteries

The inherent catalytic anisotropy of two-dimensional(2D) materials has limited the enhancement of LiO_(2) batteries(LOBs) performance due to the significantly different adsorption energies on 2D and edge surfaces.Tuning the adsorption strength in 2D materials to the reaction intermediates is essential for achieving high-performance LOBs.Herein,a MnS/MoS_(2) heterostructure is designed as a cathode catalyst by adjusting the adsorption behavior at the surface.Different from the toroidal-like discharge products on the MoS_(2) cathode,the MnS/MoS_(2) surface displays an improved adsorption energy to reaction species,thereby promoting the growth of the film-like discharge products.MnS can disturb the layer growth of MoS_(2),in which the stack edge plane features a strong interaction with the intermediates and limits the growth of the discharge products.Experimental and theoretical results confirm that the MnS/MoS_(2) heterostructure possesses improved electron transfer kinetics at the interface and plays an important role in the adsorption process for reaction species,which finally affects the morphology of Li_2O_(2),In consequence,the MnS/MoS_(2) heterostructure exhibits a high specific capacity of 11696.0 mA h g^(-1) and good cycle stability over 1800 h with a fixed specific capacity of 600 mA h g^(-1) at current density of100 mA g^(-1) This work provides a novel interfacial engineering strategy to enhance the performance of LOBs by tuning the adsorption properties of 2D materials.

Two-dimensional plane strain consolidation of unsaturated soils considering the depth-dependent stress

In practical engineering,the total vertical stress in the soil layer is not constant due to stress diffusion,and varies with time and depth.Therefore,the purpose of this paper is to investigate the effect of stress diffusion on the two-dimensional(2D)plane strain consolidation properties of unsaturated soils when the stress varies with time and depth.A series of semi-analytical solutions in terms of excess pore air and water pressures and settlement for 2D plane strain consolidation of unsaturated soils can be derived with the joint use of Laplace transform and Fourier sine series expansion.Then,the inverse Laplace transform of the semi-analytical solution is given in the time domain using a self-programmed code based on Crump’s method.The reliability of the obtained solutions is proved by the degeneration.Finally,the 2D plots of excess pore pressures and the curves of settlement varying with time,considering different physical parameters of unsaturated soil stratum and depth-dependent stress,are depicted and analyzed to study the 2D plane strain consolidation properties of unsaturated soils subjected to the depthdependent stress.

Value of myocardial function in children with Kawasaki disease by two-dimensional and three-dimensional ultrasound speckle tracking

Objective:To investigate the value of two-dimensional ultrasound speckle tracking(2D-STI)and three-dimensional ultrasound speckle tracking(3D-STI)in evaluating myocardial function in children with Kawasaki disease.Methods 92 children with Kawasaki disease admitted to our hospital from February 2017 to February 2019 were retrospectively analyzed.50 children who underwent 3D-STI examination were taken as observation group and 42 children who underwent 2D-STI examination were taken as control group.The left ventricular systolic function index,storage time and analysis time of the image,the diameter of coronary artery,the strain difference of left ventricular basal segment,middle segment,apical segment and whole segment were observed.Results The levels of left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular myocardial mass(LVMI)in the observation group were higher than those in the control group(P<0.05),but there was no statistical difference in left ventricular ejection fraction(LVEF)between the two groups(P>0.05).The storage time and analysis time of the image in the observation group were significantly lower than those in the control group(P<0.05).The left coronary artery(LCA)and right coronary artery(RCA)in the observation group were higher than those in the control group(P<0.05).There was no statistical difference between left anterior descending(LAD)in the two groups(P>0.05).The longitudinal peak systolic strain(LS),circumferential peak systolic strain(CS)and radial peak systolic strain(RS)in the observation group were higher than those in the control group(P<0.05).The global longitudinal peak strain(GLS),global circumferential peak strain(GCS)and global radial peak strain(GRS)in the observation group were higher than those in the control group(P<0.05).LS and CS in the middle segment of the observation group were higher than those in the control group(P<0.05).Conclusions Compared with 2D-STI,3D-STI can objectively and accurately reflect the myocardial function of children with Kawasaki disease.

Differential diagnosis of different types of solid focal liver lesions using two-dimensional shear wave elastography

BACKGROUND The clinical management and prognosis differ between benign and malignant solid focal liver lesions(FLLs),as well as among different pathological types of malignant FLLs.Accurate diagnosis of the possible types of solid FLLs is important.Our previous study confirmed the value of shear wave elastography(SWE)using maximal elasticity(Emax)as the parameter in the differential diagnosis between benign and malignant FLLs.However,the value of SWE in the differential diagnosis among different pathological types of malignant FLLs has not been proved.AIM To explore the value of two-dimensional SWE(2D-SWE)using Emax in the differential diagnosis of FLLs,especially among different pathological types of malignant FLLs.METHODS All the patients enrolled in this study were diagnosed as benign,malignant or undetermined FLLs by conventional ultrasound.Emax of FLLs and the periphery of FLLs was measured using 2D-SWE and compared between benign and malignant FLLs or among different pathological types of malignant FLLs.RESULTS The study included 32 benign FLLs in 31 patients and 100 malignant FLLs in 96 patients,including 16 cholangiocellular carcinomas(CCCs),72 hepatocellular carcinomas(HCCs)and 12 liver metastases.Thirty-five FLLs were diagnosed as undetermined by conventional ultrasound.There were significant differences between Emax of malignant(2.21±0.57 m/s)and benign(1.59±0.37 m/s)FLLs(P=0.000),and between Emax of the periphery of malignant(1.52±0.39 m/s)and benign(1.36±0.44 m/s)FLLs(P=0.040).Emax of liver metastases(2.73±0.99 m/s)was significantly higher than that of CCCs(2.14±0.34 m/s)and HCCs(2.14±0.46 m/s)(P=0.002).The sensitivity,specificity and accuracy were 71.00%,84.38%and 74.24%respectively,using Emax>1.905 m/s(AUC 0.843)to diagnose as malignant and 23 of 35(65.74%)FLLs with undetermined diagnosis by conventional ultrasound were diagnosed correctly.CONCLUSION Malignant FLLs were stiffer than benign ones and liver metastases were stiffer than primary liver carcinomas.2D-SWE with Emax was a useful complement to conventional ultrasound for the differential diagnosis of FLLs.

Diagnostic problems in two-dimensional shear wave elastography of the liver

Two-dimensional shear wave elastography(2D-SWE)is used in the clinical setting for observation of the liver.Unfortunately,a wide spectrum of artifactual images are frequently encountered in 2D-SWE,the precise mechanisms of which remain incompletely understood.This review was designed to present many of the artifactual images seen in 2D-SWE of the liver and to analyze them by computer simulation models that support clinical observations.Our computer simulations yielded the following suggestions:(1)When performing 2D-SWE in patients with chronic hepatic disease,especially liver cirrhosis,it is recommended to measure shear wave values through the least irregular hepatic surface;(2)The most useful 2D-SWE in patients with focal lesion will detect lesions that are poorly visible on B-mode ultrasound and will differentiate true tumors from pseudo-tumors(e.g.,irregular fatty change);and(3)Measurement of shear wave values in the area posterior to a focal lesion must be avoided.

Ultrasound-Guided Erector Spinae Plane Block for Lumbar Spinal Stenosis Surgery

Background: In this retrospective observational study, we evaluated patients who underwent elective lumbar stenosis surgery between February 1, 2019, and April 1, 2019. Patients who underwent surgery for lumbar spinal stenosis under general anesthesia alone were compared with those who underwent general anesthesia combined with erector spinae plane block. Aims: We aimed to retrospectively evaluate whether erector spinae plane block reduced opioid consumption following surgery for spinal stenosis. Study Design: A retrospective observational study. Methods: We collected data on the pain scores, time for the first requirement for patient-controlled analgesia with tramadol, the cumulative patient-controlled analgesia dose, requirement for rescue analgesia, time to first stand up postoperatively and the incidence of postoperative nausea and vomiting. Results: Sixty patients were included in the study. The numerical rating scale’s pain scores were significantly lower in the erector spinae plane group at 1, 2, 4, 6, 12 and 24 hours than in the general anesthesia group. The cumulative dose of patient-controlled analgesia with tramadol was higher in the general anesthesia group than in the ESP group [212.0 (6.6) mg, vs. 107.3 (36.9 mg), (p <0.001)]. The time to first stand up after surgery was significantly longer in the general anesthesia group (p = 0.011). Conclusion: ESP block appear to be an effective method to relieve pain after lumbar surgery.

Comment on “Band gaps structure and semi-Dirac point of two-dimensional function photonic crystals” by Si-Qi Zhang et al.

Recently, Zhang et al. （Chin. Phys. B 26 024208 （2017）） investigated the band gap structures and semi-Dirac point of two-dimensional function photonic crystals, and the equations for the plane wave expansion method were induced to obtain the band structures. That report shows the band diagrams with the effects of function coefficient k and medium column ra under TE and TM waves. The proposed results look correct at first glance, but the authors made some mistakes in their report. Thus, the calculated results in their paper are incorrect. According to our calculations, the errors in their report are corrected, and the correct band structures also are presented in this paper.

On Two-Dimensional Above-Barrier Penetration and Sub-Barrier Tunneling for Non-Relativistic Particles and Photons

We study the two-dimensional above-barrier penetration and the sub-barrier tunneling of non-relativistic particles and photons, described in the quasi-monochromatic approximation by simple plane waves. Our scheme represents the motion from the left free-motion zero-potential region to the right zero-potential region through the intermediate region with a one-dimensional rectangular potential barrier along the axis, normal to the both parallel interfaces between all three regions, and with the zero potential along the axis, parallel to the those interfaces. We have firstly obtained the analytical expressions for the infinite series of multiple internal and external reflections and also of multiple transmitted waves of particles and photons, with equal shifts between them along the interfaces for the above-barrier penetration and with various shifts between them in the case of the sub-barrier tunneling. Finally the Hartman and Fletcher effect for any transmitted wave is established.

Detection of Congenital Uterine Malformation by Using Transvaginal Three-dimensional Ultrasound

This study assessed the clinical application of transvaginal three-dimensional ultrasound （3D TVUS） in the diagnosis of congenital uterine malformation. A retrospective study was performed on 62 patients with congenital uterine malformation confirmed hysteroscopically and/or laparoscopically. The patients were subjected to transvaginal two-dimensional ultrasound （2D TVUS） and 3D TVUS. The accuracy rate was compared between the two methods. The accuracy rate of 3D TVUS was （98.38%, 61/62）, higher than that of 2D TVUS （80.65%, 50/62）. 3D TVUS coronal plane imaging could demon- strate the internal shape of the endometrial cavity and the external contour of the uterine fundus. It al- lowed accurate measurement on the coronary plane, and could three-dimensionally show the image of cervical tube, thereby providing information for the diagnosis of some complex uterine malformation. 3D TVUS imaging can obtain comprehensive information of the uterus malformation, and it is superior to 2D TVUS for the diagnosis of congenital uterine malformations, especially complex uterine anomaly.

Clinical Value of Transperineal 3D Volume Ultrasound Combined with 2D High Frequency Ultrasound in Anal Fistula

Objective: To explore the clinical diagnostic value of transperineal volume ultrasound combined with two-dimensional high-frequency ultrasound for anal fistula. Methods: A total of 52 patients with anal fistula admitted to the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from December 2017 to July 2018 were selected. They were all undergoing transperineal 3D volume ultrasound combined with 2D high-frequency ultrasound examination, and the diagnosis results were analyzed. The results of ultrasonography and surgical pathology were compared. Results: Among 52 patients, 3D volume ultrasound combined with 2D high-frequency ultrasound were used to diagnose 32 cases of anal fistula intersphincteric type, 14 cases of transsphincter type, 5 cases of supra-sphincter type, and 1 case of extra-sphincter type. T supervisor classification accuracy rate is 90%. The detection rate of branch pipes was 92%, and the compliance rate of internal fistula was 95%. Two-dimensional high-frequency ultrasound was used to diagnose 34 cases of anal fistula intersphincteric type, 14 cases of transsphincter type, 4 cases of supra-sphincter type, and 0 cases of extra-sphincter type. The detection rate of branch canals was 42%, and the accuracy of type classification was 90%. The coincidence rate was 95%. There was a statistically significant difference in the detection rate of the anal fistula branch and the coincidence rate of the internal fistula between the two methods (both P Conclusion: 1) The overall coincidence rate of three-dimensional volumetric ultrasound combined with two-dimensional high-frequency ultrasound in the diagnosis of anal fistula is high;2) Three-dimensional volumetric ultrasound technology has great application prospects in infants and anal fistulas.

超声引导下竖脊肌平面阻滞对多发肋骨骨折患者术后早期呼吸功能的影响

目的探讨超声引导下竖脊肌平面阻滞(ESPB)对多发肋骨骨折(MRFs)患者术后早期呼吸功能和炎性因子的影响。方法选择2019年2月至2021年12月择期行多发肋骨骨折手术患者58例,男42例,女16例,年龄18~64岁,BMI 18.5~30.0 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将患者分为两组:ESPB联合全身麻醉组(E组)和单纯全身麻醉组(G组),每组29例。E组于麻醉诱导后在侧卧位下实施超声引导下ESPB,给予0.5%罗哌卡因0.4 ml/kg。记录麻醉诱导前、出PACU时、术后24、48 h的用力肺活量(FVC)、动脉血气分析、静息和咳嗽时VAS疼痛评分。记录术后0~24 h、24~48 h的PCIA有效按压次数和补救镇痛情况。记录麻醉诱导前、术后24、48 h的IL-6和TNF-α浓度。结果与G组比较,E组出PACU时、术后24、48 h的FVC明显增大(P<0.05),PaCO_(2)、静息和咳嗽时VAS疼痛评分明显降低(P<0.05)。与G组比较,E组术后0~24 h、24~48 h的PCIA有效按压次数和补救镇痛率明显降低(P<0.05)。与G组比较,E组术后24、48 h的IL-6和TNF-α浓度明显降低(P<0.05)。结论超声引导下ESPB可为MRFs患者提供良好的术后镇痛,促进术后早期呼吸功能的恢复。

超声引导下竖脊肌平面阻滞麻醉与硬膜外麻醉用于无痛分娩的效果和安全性比较

目的:比较无痛分娩镇痛中超声引导下竖脊肌平面阻滞麻醉(ESPB)与硬膜外麻醉的效果及安全性。方法:回顾性选取2022年6月至2023年6月入院的80例产妇,参考麻醉方式的不同分为A组(ESPB,40例)与B组(硬膜外麻醉,40例);比较两组产妇的第一产程、第二产程,新生儿Apgar评分(出生时、出生后5min),产妇不良反应(头痛、恶心呕吐、瘙痒、发热)与镇痛前、分娩完成时数字评定量表(NRS)评分。结果:产程:A、B组产妇第一产程比较,差异无统计学意义(P>0.05);A组第二产程短于B组,差异有统计学意义(P<0.05)。Apgar评分:A、B组新生儿出生时、出生后5min Apgar评分比较,差异无统计学意义(P>0.05)。不良反应:A、B组产妇不良反应总发生率比较,差异无统计学意义(P>0.05)。NRS评分:镇痛前,两组产妇NRS评分比较,差异无统计学意义(P>0.05);分娩完成时,两组产妇的NRS评分均明显低于镇痛前,差异有统计学意义(P<0.05);A组分娩完成时的NRS评分均低于B组,差异有统计学意义(P<0.05)。结论:无痛分娩镇痛中超声引导下ESPB麻醉与硬膜外麻醉均具有良好效果,安全性高,且超声引导下ESPB麻醉可进一步缩短产妇第二产程时间,止痛效果更佳。

超声“四切面”法联合妊娠中期产妇血清Freeβ-hCG和uE3筛查胎儿严重先天性心脏病的研究

目的:探究超声“四切面”法联合妊娠中期孕妇血清游离人绒毛膜促性腺激素(Freeβ-hCG)和雌三醇(uE3)筛查胎儿严重先天性心脏病(CHD)的临床应用价值。方法:选择2020年1月到2021年6月我院行妊娠中期CHD筛查的孕妇97例,检测孕妇血清Freeβ-hCG和uE3水平,采用超声“四切面”法筛查CHD,分析超声“四切面”法联合血清Freeβ-hCG和uE3水平对CHD的诊断价值。结果:97例孕妇随访确诊为严重CHD 9例(9/97,9.28%);超声“四切面”法检查提示高危胎儿25例,其中4例确诊为严重CHD(4/25,16.00%);孕妇血清学检测提示高危胎儿36例,其中6例最终确诊为严重CHD(6/36,16.67%);超声“四切面”法联合孕妇血清学检测提示高危胎儿9例,其中5例确诊为严重CHD(5/9,55.56%)。超声“四切面”法筛查严重CHD的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为16.00%、93.51%、74.51%、44.44%和77.22%。孕妇血清Freeβ-hCG和uE3水平筛查严重CHD的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为55.56%、95.31%、92.08%、66.67%和64.00%,二者联合筛查严重CHD的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为55.56%、95.65%、92.08%、55.56%和91.09%。二者联合检测的诊断情况高于单一检测方法(P<0.05)。结论:超声“四切面”法对妊娠中期孕妇筛查严重CHD具有较高的诊断价值,联合孕妇血清Freeβ-hCG和uE3水平能进一步提高诊断准确度,具有较好的临床应用价值。

超声引导下RISS平面阻滞对胸腹部手术患者血清Cor、SP、PGE2、IL-6的影响

目的 探究超声引导下菱形肌-肋间肌-低位前锯肌(RISS)平面阻滞对胸腹部手术患者血清Cor、SP、PGE2、IL-6的影响。方法 选取2021年1月至2022年7月入住秦皇岛市第一医院接受胸腹部手术的患者126例,按照随机掷硬币法分为观察组和对照组,各63例,两组进行常规麻醉诱导,气管插管后观察组行超声引导下RISS平面阻滞,对照组不行神经阻滞。比较两组术后疼痛视觉模拟(VAS)评分及镇静Ramsay评分、手术麻醉药物用量、围术期血流动力学指标(收缩压、舒张压、心率)及炎症应激指标[皮质醇(Cor)、P物质(SP)、前列腺素E2(PGE2)、白细胞介素-6(IL-6)]水平、不良反应发生情况。结果 手术结束后2 h、12 h、24 h,观察组VAS评分和Ramsay评分均显著低于对照组,差异均有统计学意义(P<0.05);术中及术后24 h,观察组舒芬太尼使用量显著低于对照组,差异有统计学意义(P<0.05);插管后两组收缩压、舒张压和心率均低于插管前,差异有统计学意义(P<0.05),插管后10 min和停药后10 min,观察组收缩压、舒张压心率显著低于对照组,差异有统计学意义(P<0.05);术后两组外周血中Cor、SP、PGE2、IL-6水平均低于术前,差异有统计学意义(P<0.05);术后12 h、24 h,观察组Cor、SP、PGE2、IL-6水平均低于对照组,差异有统计学意义(P<0.05);观察组麻醉不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论 超声引导下RISS平面阻滞具有良好镇痛镇静效果,能减轻胸腹部手术患者应激及炎症反应,安全性较高,值得临床应用推广。

超声引导下双侧腹横肌平面阻滞在宫颈癌手术中的应用价值

目的探讨超声引导下双侧腹横肌平面(TAP)阻滞在宫颈癌(UCC)手术中的应用价值。方法选择2021年1月至2023年10月拟在安阳市第六人民医院行手术治疗的70例UCC患者,按随机数字表法分为参考组和复合组,各35例。参考组行全麻,复合组行超声引导下双侧TAP阻滞复合全麻。对比2组血流动力学[平均动脉压(MAP)、心率(HR)]、术后情况[首次肛门排气时间、下床活动时间和疼痛程度]、不良反应。结果T0时组间HR、MAP对比,无统计学差异(P>0.05);T1(切皮时)、T2(术毕时)时2组HR、MAP与T0(麻醉诱导后即刻)时相比均有所降低,但复合组T1、T2时HR、MAP高于参考组(P<0.05)。复合组术后首次下床活动时间、肛门排气时间短于参考组,术后6 h、24 h时疼痛程度、不良反应发生率低于参考组(P<0.05)。结论UCC术中采用超声引导下双侧TAP阻滞复合全麻能够减小血流动力学波动,减轻术后疼痛程度,加速术后康复,安全性较高。

超声引导下腹横肌联合低位前锯肌阻滞在胆囊腹腔镜术中应用的临床效果分析

目的探讨对于腹腔镜下治疗的胆囊手术中,通过以超声引导经腹横肌阻滞(transversus abdominis plane block,TAPB)+低位前锯肌(serratus anterior plane block,SAPB)阻滞方案的价值。方法非随机选取2020年7月—2022年6月睢宁县中医院60例择期行胆囊腹腔镜手术患者为研究对象,按手术方式不同分成观察组(n=30)与对照组(n=30)。对照组患者采取TAPB,观察组采取TAPB联合SAPB。比较两组心率与平均动脉压水平、时间视觉模拟评分(Visual Analog Scoring,VAS)变化及不良反应情况。结果在手术开始以及开始后10 min,观察组的心率、平均动脉压优于对照组,差异有统计学意义(P均<0.05)。观察组术后VAS评分均优于对照组,差异有统计学意义(P均<0.05)。两组的不良反应发生情况比较[6.67%(2/30)vs 13.33%(4/30)],差异无统计学意义(χ^(2)=0.185,P=0.667)。结论应用TAPB联合SAPB对胆囊腹腔镜术的患者干预效果满意,能控制术中心率及平均动脉压指标,减轻患者术后疼痛程度,且不增加不良反应发生率。

妇科腹腔镜术中应用超声下腹横肌平面阻滞的效果

目的:观察妇科腹腔镜术中应用超声下腹横肌平面阻滞的效果。方法:选取2023年1月—2024年1月拟于青海红十字医院行妇科腹腔镜术的患者100例作为研究对象,采用随机数字表法分为观察组和对照组,各50例。在常规麻醉基础上,观察组术中实施超声下腹横肌平面阻滞,对照组注射生理盐水对照干预。对比两组生命体征变化情况和镇痛效果。结果:两组诱导前收缩压、舒张压及心率对比,无统计学差异(P>0.05);两组插管后收缩压、舒张压及心率高于诱导前,观察组低于对照组(P<0.05);两组拔管时收缩压、舒张压及心率高于诱导前,观察组收缩压及心率低于对照组(P<0.05);两组拔管时舒张压比较,无统计学差异(P>0.05)。两组术后8 h、24 h及48 h视觉模拟评分法(VAS)评分均低于术后4 h(P<0.05);观察组术后4 h、8 h、24 h及48 h VAS评分低于对照组(P<0.001)。结论:妇科腹腔镜术中应用超声下腹横肌平面阻滞可保持患者生命体征稳定,并获得良好的镇痛效果。

不同浓度罗哌卡因超声引导下胸横肌平面阻滞在乳腺癌根治术中的临床效果研究

目的 分析不同浓度罗哌卡因超声引导下胸横肌平面阻滞在乳腺癌根治术中的临床效果。方法 120例行乳腺癌根治术治疗的患者,随机分为A组、B组、C组,每组40例。三组均行超声引导下胸横肌平面阻滞, A组采用0.25%罗哌卡因, B组采用0.3%罗哌卡因、C组采用0.375%罗哌卡因。比较三组患者镇痛相关指标、疼痛评分、Ramsay镇静评分及不良反应发生率。结果 C组患者术中瑞芬太尼用量(1.07±0.22)mg、术后48 h镇痛药物用量(93.26±1.36)ml均少于B组患者的(1.32±0.25)mg、(96.84±1.76)ml和A组患者的(1.58±0.38)mg、(99.42±1.77)ml, B组患者均少于A组患者,差异有统计学意义(P<0.05)。A组患者术后3、6 h视觉模拟评分法(VAS)评分分别为(4.24±0.51)、(3.35±0.44)分,B组患者分别为(3.89±0.45)、(2.98±0.42)分, C组患者分别为(3.25±0.54)、(2.12±0.35)分;术后3、6 h,三组患者VAS评分比较差异具有统计学意义(P<0.05);C组患者VAS评分低于A组、B组患者,B组患者低于A组患者,差异有统计学意义(P<0.05)。三组患者术后1 h Ramsay镇静评分比较差异无统计学意义(P>0.05)。A组患者不良反应发生率为5.00%, B组患者为5.00%, C组患者为7.50%,三组比较差异无统计学意义(P>0.05)。结论 0.3%以上罗哌卡因浓度超声引导下胸横肌平面阻滞用于乳癌根治术,可减少术中麻醉用药及术后镇痛用药,术后镇痛效果满意,安全有效,且不增加不良反应。

经直肠腔内双平面超声联合MRI在直肠癌术前T分期中的应用价值

目的探究经直肠腔内双平面超声联合MRI在直肠癌术前T分期中的应用价值。方法选取2021年1月~2023年1月我院收治90例直肠癌患者作为研究对象,所有患者均进行经直肠腔内双平面超声联合MRI检查。以病理结果为“金标准”,评估经直肠腔内双平面超声联合MRI在直肠癌术前T分期中的应用价值。结果在90例直肠癌患者中,以“金标准”为基础,术后分期PT1为10例;PT2为23例;PT3为38例;PT4为19例。单独使用经直肠腔内双平面超声诊断UT1准确率为60.00%;UT2准确率为65.21%;UT3准确率为81.57%;UT4准确率为84.21%;总体准确率为90.00%。单独使用MRI诊断T1准确率为70.00%;T2准确率为69.56%;T3准确率为86.84%;T4准确率为78.94%;总体准确率为88.88%。经直肠腔内双平面超声联合MRI诊断结果显示,UT1准确率为50.00%;UT2准确率78.26%;UT3准确率为76.31%;UT4准确率为89.47%;总体准确率为91.11%。二者联合检测的灵敏度、特异度和准确度均较高于经直肠腔内双平面超声、MRI单项检测,对直肠癌检出率较高,诊断价值较好,具有统计学差异(P<0.05)。结论在直肠癌的术前分期诊断中应用经直肠腔内双平面超声联合MRI,具有较高的准确性,对制定手术方案和患者预后都有重要意义,值得临床推广应用。