Value of section plane,MPR,and 3D-CTVR techniques in the fine differential diagnosis of ossicular chain in the case of conductive hearing loss with intact tympanic membrane

Aim: To assess the quality of high-resolution CT section planes(HRCT), multi-planar reformation(MPR) and 3-dimensional volume rendered computer tomography(3D-CTVR) were here used in the fine differential diagnosis of ossicular chain in the case of conductive hearing loss with intact tympanic membrane.Methods: Here, 17 cases of otosclerosis and 22 cases of ossicular chain deformity were selected. All patients had normal external ear canals,intact tympanic membranes, conductive hearing loss, type A tympanograms, and negative Gelle's tests. The respective radiological reports of the status of the ossicles via 3 protocols were compared to surgical findings. The quantitative assessments of the representation of different segments of the ossicular chain were based on a 3-point scoring system.Results: MPR and CTVR imaging both showed the integrity of whole ossicular chain well. MPR and CTVR imaging were found to be superior to section planes with respect to showing the superstructure of the stapes and malformations(P > 0.05).Conclusion: CTVR and MPR imaging were found to be better able to show the whole ossicular chain in the conductive hearing loss with normal tympanic membranes. Furthermore, the use of these techniques can have profound contributive value in the differential diagnosis of otosclerosis and ossicular chain absence or malformation.

Soil and water loss in the Lancang River-Mekong River watershed (in Yunnan section, China) and its control measures

According to a lot of hydrological and environmental monitoring data, the condition of soil and water loss in the Lancang River Mekong River watershed (in Yunnan section, China) is described. The occurrence and development of soil and water loss is analyzed. The conclusion is that: (1) generally, the situation of soil and water loss in the Lancang River Mekong River watershed (in Yunnan section, China) is light, however, soil and water loss in some regions is serious, especially in the middle reach area of the river; (2) soil and water loss in the Lancang River Mekong River (in Yunnan section, China) watershed presents developing tendency and it is mainly caused by human beings. In accordance with these results, the control measures for soil and water loss are discussed.

Quantifying Maternal Blood Loss from the Hysterotomy at Cesarean Delivery

Background: With newer protocols, such as delayed cord clamping, becoming routine practice, determining the potential maternal consequences is important. In particular, establishing normative values for blood loss from the hysterotomy would be helpful in addressing techniques to minimize total blood loss for cesarean deliveries. Objective: Blood loss from the hysterotomy during cesarean delivery has not been reported using quantitative methods. We aimed to quantify the rate of blood loss during cesarean delivery from the hysterotomy between creation and closure. Methods: This single center, prospective, case series was collected in 2018. Women with singleton pregnancies undergoing cesarean delivery at ≥37 0/7 weeks at Brigham and Women’s Hospital were included. Delayed cord clamping was performed which allowed for quantification of blood loss through gravimetric methods and descriptive statistics were performed. Results: Twenty patients were included. The mean hysterotomy closure delay for cord blood collection was 47 seconds (SD 10.2) and the mean maternal blood volume collected was 110.8 mL (SD 53.4 mL). Blood loss per minute was calculated with a median of 150 mL/minute (IQR 88.8 mL, 95% CI 109.2 - 190.4 mL). The mean post-operative hematocrit drop was 4.4%, and there were no blood transfusions. There was a single hysterotomy extension and a quantified blood loss of 413 mL per minute. Conclusion: We found a mean blood loss of 150 mL/min without hysterotomy extension. With a hysterotomy extension, the blood lost per minute was more profound. This normative data can be helpful for surgical planning with regards to delayed cord clamping or cord blood collection for banking.

Effect of Intravenous Tranexamic Acid in Reducing Blood Loss during and after Elective Caesarean Section in a Third Level Health Institution: A Randomized Controlled Study

Background: Blood loss during caesarean section (C/S) may lead to postpartum haemorrhage, and is one of the direct causes of maternal mortality and morbidity globally. Tranexamic acid is recommended in the treatment of postpartum haemorrhage (PPH) if oxytocin and other utertonics are ineffective in controlling PPH. In this centre it is not used prophylactically to reduce blood during caesarean section. Aim: To assess the effect of prophylactic intravenous tranexamic acid on blood loss during and after elective C/S at the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective, single-blind, randomized, placebo-controlled interventional study conducted at the Obstetric theatre of UPTH from July 2020 to March 2021. Eligible women were randomized into two groups;seventy-two women received intravenous tranexamic acid while seventy-one women received a placebo. Socio-demographic data and the result of the study were collected through a proforma. Data collected was analyzed using Statistical Package for Social Sciences (SPSS) Version 22.0. The results were expressed in tables and charts as frequencies, percentages and mean. Chi-square test, Fisher’s exact, and T-test were used to determine the relationship between variables. P-value ≤ 0.05 was considered statistically significant. Results: The findings showed that tranexamic acid significantly reduced mean blood loss during and after C/S (p-value post-surgery was significantly lower in the tranexamic acid group (624.88 ± 200.76 ml) in comparison to the placebo group (864.24 ± 229.09 ml), p-value = 0.001. The mean post-C/S packed cell volume (PCV) was significantly higher among the tranexamic acid group (30.68% ± 2.80%) in comparison to the placebo group (28.07% ± 3.27%), t = 5.131, p-value = 0.0001. The maternal side effects were nausea and vomiting, 9 (12.5%) and 1 (1.4%) participants respectively. Conclusion: Tranexamic acid significantly reduced blood loss during and after elective C/S. Maternal side effects were less with tranexamic acid use.

Cross sections of O^(q+)(q=1-4) electron loss in collisions with He,Ne and Ar

Electron-loss cross sections of 0q＋ （q = 1 -4） colliding with He, Ne and Ar atoms are measured in the intermediate velocity regime. The ratios of the cross sections of two-electron loss to that of one-electron loss R21 are presented. It is shown that single-channel analysis is not sufficient to explain the results, but that projectile electron loss, electron capture by the projectile and target ionization must be considered together to interpret the experimental data. The screening and antiscreening effects can account for the threshold velocity results, but cannot explain the dependence of the ratio R21 on velocity quantitatively. In general, the effective charge of the target atom increases with velocity increasing because the high-speed projectile ion can penetrate into the inner electronic shell of target atom. Ne and Ar atoms have similar effective charges in this velocity regime, but He atoms have smaller ones at the same velocities due to its smaller nuclear charge.

Performance Analysis of Cell Loss Probability Based on ATM Self-healing Multi-section-backup VP Scheme

Based on ATM Multi section backup VP self healing scheme, analysis of cell loss probability under finite buffer is made by use of queue system method. Optimal buffer size can be fixed on.

Comparison between Preoperative and Postoperative Sublingual Misoprostol for Prevention of Postpartum Hemorrhage during Cesarean Section: A Randomized Clinical Trial

Background: Blood loss is one of the important complications during cesarean section (CS). Previous reports have shown that misoprostol is effective in reducing blood loss during and after CS. However, the optimum time for its administration to decrease the amount of PPH is still under discussion. Objective: To compare the effect of preoperative and postoperative administration of sublingual misoprostol (400 μg) in reducing the amount of blood loss during and 24 hours after CS. Setting: Obstetrics and Gynecology Department, Faculty of Medicine, Assiut University, Assiut, Egypt, between January 2017 and July 2018. Study Design: A prospective, randomized clinical trial. Methods: Four-hundred thirty women fulfilling the inclusions criteria: elective lower segment CS at term (≥37 weeks) with normal fetal heart tracing who accepted to participate in the study. Patients were divided into two groups;Patients assigned to group 1 received 400 μg sublingual misoprostol immediately after urinary catheterization and before skin incision, while patients assigned to group 2 received sublingual misoprostol immediately after skin closure. The primary outcome was the estimation of intraoperative and postoperative blood loss for 24 hours. Results: There was a significant reduction in the intraoperative blood loss in group 1 compared with group 2 (403.51 ± 72.99 vs. 460.99 ± 74.66 ml, respectively). Also, there was a significant reduction in postoperative blood loss in group 1 compared with group 2 with a statistical significance (169.45 ± 12.03 vs. 195.77 ± 13.34 ml, respectively). Postoperative hemoglobin and Hematocrit values were significantly higher in group 1 compared with group 2. Conclusions: Preoperative administration of sublingual misoprostol (400 μg) during CS is better than postoperative administration as it is associated with a reduction in the amount of intraoperative and postoperative blood loss and drop in hemoglobin level.

Production of recoil ions He^i＋ accompanied by single electron loss of 0.2-7 MeV C^q＋ and 0.25-5 MeV O^q＋ （q = 1- 4） ions

Target ionization accompanied with projectile electron loss is investigated for 0.2-7 MeV C^q＋ （q = 1 - 4） with He and 0.25-5 MeV O^q＋ （q = 1 - 4） with He collisions. For projectile single-electron loss channel, the He double-to-single ionization ratio R is nearly independent of projectile charge state but dependent on the nuclear charge of projectile Zp. The results are analysed with atomic structure qualitatively. So far there have not existed the experimental data comparable with our results, to our knowledge. The ratio R is interpreted in terms of the two-step mechanism. This analysis agrees well with similar experiments in the literature.

Single-and-double electron loss of O^(2+) in collisions with argon and helium

This paper reports that the ratios of double to single electron loss cross-section （R） of O^2＋ in collision with Ar and He at the velocity of 1 -4 vo（vo is the Bohr velocity） have been obtained by the coincidence technique. The trend of R - V in the experiment indicates that the effective charge varies with injected velocity. The effective charge can be obtained by the n-body classical trajectory Monte Carlo method, which is interpreted by the molecular Coulomb over barrier model.

Profile of Absolute Light Utilization Efficiency Within Leaves of Euonymus japonicus

Absolute light utilization efficiency across leaf section of Euonymus japonicus T. was calculated based on the measurements of photoacoustic technique (PA technique) and microscopic fiber optic probe. This new method was based on the principal of depth analysis by PA technique and the differential analysis of light gradients across leaf section by micro-optical probe technique. The depth analysis was shown by a sample of PA scan light absorption spectra. Results showed that the tissue layers between palisade tissue and spongy tissue used the smallest proportion of incident light energy for photochemical reactions (about 0.026% incident light energy of 660 nm light), while in tissue layer more close to the adaxial surface of leaf or the abaxial surface of leaf, the efficiency of utilization of light energy tended to be improved, e. g. 0.092% for tissue layers close to adaxial surface; 0.036% for tissue layers close to abaxial surface. The results that different leaf tissue layers utilized different proportion of incident light energy for photochemical reaction directly prove the hypothesis put forward by Han and Vogelmann.

Study on Horizontal Well Layout Boundary Considering Wellbore Pressure Loss

Based on the Dikken analytical calculation method of wellbore pressure loss under single-phase fluid and turbulent flow conditions, the correlation model between horizontal well output and horizontal section length and horizontal section distributed pressure difference is constructed. The influence degree of wellbore pressure loss on daily oil production of horizontal well, horizontal section pressure and production effect of horizontal well under different horizontal well lengths is analyzed, which provides certain reference for the design of horizontal well length and well layout.

神经科护士工作投入的现状及影响因素分析

目的分析神经科护士工作投入现状及其影响因素。方法采用便利抽样的方法,于2022年4月—5月对北京某三级甲等综合医院神经科护士进行横断面调查。采用自行设计的一般资料调查问卷、工作投入量表、中文版知觉压力量表,对神经科护士进行调查问卷。结果本研究共发放问卷660份,回收630份,回收率95.45%;有效问卷630份,有效率100.00%。630名神经科护士工作投入得分为(35.15±5.34)分,各个维度的平均分对比,差异有统计学意义(P<0.05)。单因素分析结果显示,神经科护士的工作投入评分在年龄、聘用关系、技术职称、工作年限和子女情况上的差异有统计学意义(P<0.05)。神经科护士的知觉压力总分为(36.76±8.10)分,工作投入总分与失控感评分、知觉压力总分呈正相关(P<0.05),与紧张感评分呈负相关(P<0.05)。多因素分析结果显示,失控感、聘用关系、工作1~10年、紧张感是工作投入的独立影响因素(P<0.05)。结论神经科护士工作投入的影响因素众多。作为临床护理管理者可以通过有效的科学管理办法,采取有效措施缓解护士心理压力,降低反刍思维水平,正向引导建立正向的应急心理,从而提高护士工作投入程度,最终达到提高护理质量和患者满意度的目的。

蜗壳断面形状对大型双吸泵性能影响的数值模拟

为研究蜗壳不同断面形状对大型双吸离心泵性能的影响,在确保其他因素不变的条件下,设计3种不同的蜗壳方案进行瞬态数值模拟。结果表明:3种蜗壳断面方案在设计工况下,圆形蜗壳的效率最高为90.7%,其次是梨形蜗壳,效率为90.2%,矩形蜗壳的效率最低为88.9%,且圆形蜗壳的高效区有所扩大;在各流量工况下圆形蜗壳能量损失率均为最少,在设计工况时圆形蜗壳的能量损失率为0.3%,矩形蜗壳的能力损失率为1.1%;在大流量和设计流量下,圆形蜗壳的叶轮所受径向力均最小,梨形蜗壳次之,矩形蜗壳最大;在设计工况下,3种蜗壳方案对蜗壳上的压力脉动均呈现周期性变化,圆形蜗壳在各检测点处压力脉动的振幅幅度均为最小。

引射器真空度的设计与研究

为满足大型电解槽精准出铝、减少电解槽散热要求,需要提高引射器的真空度。本文参考了目前理论研究的最新结果并结合经验数据,设计出引射器的内部结构。根据减少动能损失而提高真空度的原理提出了调整压缩空气压力、喷嘴至收缩段的距离和喷嘴直径这三个主要参数值的方法,按此最佳参数值设计出的引射器经试验测试当进口压缩空气压力为0.65 MPa时,真空度最大达到-0.068 MPa。

中国≥65岁老年人牙齿缺失与听力损伤的关联研究

背景听力损伤和牙齿脱落在老年人群中较为常见且严重危害老年人身心健康,但目前针对老年人牙齿缺失、义齿使用与听力损伤关系的人群研究有限。目的探讨我国≥65岁老年人牙齿缺失与听力损伤之间的关联。方法于2023年1月,在中国老年健康影响因素跟踪调查(CLHLS)2018年数据中选取符合要求的≥65岁老年人15161名为研究对象。以听力损伤情况为结局变量,以口腔牙齿数量为解释变量,以社会人口学、生活方式、健康状况信息为协变量,采用多因素Logistic回归分析探讨牙齿数量对听力损失的影响,并进一步对不同年龄、性别、日常生活活动能力、义齿使用情况老年人进行分层分析。结果15161名研究对象中,牙齿数量为≥20、10~19、1~9、0颗的老年人分别有3655名(24.11%)、2355名(15.53%)、4008名(26.44%)、5143名(33.92%),听力损伤者有6148名(40.55%)。多因素Logistic回归分析结果显示,在调整了相关混杂因素后,与牙齿数量≥20颗者相比,牙齿数量为10~19、1~9、0颗者容易发生听力损伤,OR(95%CI)分别为1.31(1.08~1.58)、1.57(1.32~1.86)、1.97(1.65~2.36)。分层分析结果显示,牙齿数量与听力损伤之间的关联在≥80岁和未使用义齿的老年人中更为显著(P<0.05)。结论老年人牙齿缺失可增加听力损伤的发生风险,高龄和未使用义齿的老年人发生听力损伤的风险更高。

开孔金属泡沫流场分布和流动阻力的数值分析

【目的】为了系统研究开孔金属泡沫中空气流场的流动特性和传热传质特性。【方法】使用几何表示法构建12面体开孔泡沫模型,应用有限单元法模拟了不同入口速度下,泡沫韧带截面形状、孔径密度PPI和流场高度方向泡沫结构对称性等参数对流场分布、传质和流动阻力的影响。【结果】结果表明,随着泡沫韧带截面顶点曲率减小,韧带阻滞作用减弱,流场沿程损失h_(f)减少;增大孔径密度可以提高流场对流强度分布均匀性;在高度方向非对称边界流场对流强度更大,且韧带周围对流强度分布趋向均匀,对称结构则相反;对称边界流场的上下边界处对流速度比非对称边界略大,对称边界更有利于边界物质输运;泡沫结构特征和气体入口速度对流场分布和流动阻力的影响明显。流动问题的量纲分析结果表明,泡沫孔数量越多,流场的沿程损失与气体初始动能的比值越大,增大气体入口速度则比值减少,当入口速度超过6 m/s后,比值趋于稳定。

剖宫产同时行子宫肌瘤剔除术中应用卡前列素氨丁三醇和缩宫素的临床效果比较

目的分析行剖宫产同时进行子宫肌瘤剔除术时采用卡前列素氨丁三醇和缩宫素的临床效果。方法非随机选取2021年11月—2023年11月天水市第一人民医院收治的70例剖宫产同时行子宫肌瘤剔除术患者。根据术中使用不同的药物分为两组,每35例。研究组使用卡前列素氨丁三醇,参照组使用缩宫素。比较两组手术时间、术中和术后出血量及不良反应。结果两组手术时间比较,差异无统计学意义(P>0.05)。研究组术中出血量(253.45±90.63)mL和术后出血量(104.36±50.75)mL明显少于对照组术中出血量(379.81±110.57)mL和术后出血量(148.92±61.83)mL,差异有统计学意义(t=5.229、3.296,P均<0.05)。研究组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论行剖宫产的同时进行子宫肌瘤剔除术时,使用卡前列素氨丁三醇能明显减少术中和术后出血量,且不良反应较少。

手术室复合保温干预模式在剖宫产术中的应用效果及发生低体温的影响因素分析

目的 探讨手术室复合保温干预模式在剖宫产术中的应用效果,并分析发生低体温的影响因素。方法选取2019年7月至2022年6月在我院行剖宫产术的150例产妇为研究对象,采用随机数字表法将其分为对照组和研究组,每组75例。对照组给予手术室常规保温干预模式,研究组给予手术室复合保温干预模式。比较两组的鼓膜温度及寒战、低体温发生情况。按照有无发生低体温又将150例产妇分为低体温组和无低体温组,采用单因素、二元Logistic回归分析筛选出影响剖宫产产妇发生低体温的因素。结果 入室时(T1)、麻醉时(T2)、切皮时(T3)、胎儿娩出时(T4),研究组的鼓膜温度高于对照组(P<0.05)。研究组的寒战、低体温发生率低于对照组(P<0.05)。单因素分析结果显示,失血量、不良心理、手术时间、输血输液量是影响剖宫产产妇发生低体温的可能因素(P<0.05)。二元Logistic回归分析结果显示,失血量、不良心理是影响剖宫产产妇发生低体温的危险因素(P<0.05)。结论 手术室复合保温干预模式应用于剖宫产术中可有效维持产妇体温,减少寒战和低体温的发生;而低体温的发生和失血量、不良心理有关。

保留胎膜剖宫产对早产孕妇围产期出血量及新生儿结局的影响

目的:探讨保留胎膜(En Caul)剖宫产对早产孕妇围产期出血量及新生儿结局的影响。方法:选择2020年1月-2023年1月本院早产孕妇80例,随机分为两组各40例,分别行En Caul剖宫产术(观察组)、传统剖宫产术(对照组)。记录两组孕妇围产期出血量、手术相关指标、新生儿结局。结果:观察组围产期出血量(500.24±90.77ml)少于对照组(590.30±105.19ml),新生儿出生后1min Apgar评分(8.42±0.95分)、5min Apgar评分(9.64±0.22分)均高于对照组(7.75±1.10分、9.40±0.31)分,新生儿脐带血血乳酸(1.71±0.20 mmol/L)、脐带血肌酸激酶(246.90±49.77 U/dl)、肌酸激酶同工酶(72.09±12.68 U/dl)水平均低于对照组(1.89±0.44 mmol/L、305.464±80.54 U/dl、89.67±20.54 U/dl),新生儿呼吸窘迫综合征(0)、新生儿窒息(2.5%)发生率均低于对照组(15.0%、20.0%)(均P<0.05)。结论:En Caul剖宫产术在早产孕妇中应用可减少围产期出血量,降低新生儿近期并发症发生率、改善新生儿Apgar评分,对新生儿结局有积极影响。

小净距盾构隧道侧穿地铁车站对地表沉降及刀把段结构侧墙变形的影响

为研究小净距盾构隧道侧穿地铁车站对地表沉降及刀把段结构侧墙变形的影响规律,依托长沙轨道7号线云环区间段,对盾构施工引起的地表沉降和刀把段侧墙位移进行持续监测,采用有限元软件,分析在袖阀管注浆加固条件下侧墙的变形和应力特征,研究不同地层损失率条件下地表和侧墙的变形规律及不同侧墙厚度条件下侧墙的应力规律。结果表明,袖阀管注浆加固土体能有效减小由盾构施工引起的侧墙变形和应力;地表沉降和侧墙位移随着地层损失率的增加呈递增的趋势;侧墙厚度设置为800 mm时,侧墙所受拉应力可以控制在C40混凝土抗拉强度标准值之内。