下肢消肿方治疗股骨粗隆间骨折术后患肢肿胀的临床观察

目的：探讨下肢消肿方对股骨粗隆间骨折术后患肢肿胀的临床治疗效果。方法：将股骨粗隆间骨折术后患肢肿胀患者60例随机分为两组,在常规治疗的基础上,其中治疗组30例予以下肢消肿方（我科协定处方）口服治疗,对照组30例予以七叶皂苷纳（系从我国娑罗子植物提取制作而成）注射液静点治疗,分别于术后第3、5、7d记录测量数据,并进行统计学处理,两组进行临床疗效对比。结果：治疗组临床疗效明显优于对照组（P〈0.05）,且对缓解患肢肿胀程度和减轻疼痛等各项指标均能明显改善,其疗效优于对照组（P〈0.05,P〈0.01）。结论：下肢消肿方具有促进局部血液循环作用,能明显改善股骨粗隆间骨折术后患肢肿胀情况。     

EH4电磁测深法在工程勘察中的应用

隧道周围一定范围内的岩溶洞穴及断层构造,都将产生安全隐患。为了避免施工风险和预防施工过程中可能出现的地质灾害,查明危害隧道安全的断层破碎带宽度、软弱带以及岩溶发育区的埋深和规模等十分必要。本文主要介绍了EH4电磁测深系统的原理、野外工作方法和资料处理,以及将此方法应用于某铁路隧道工程的前期勘察中,效果较好,说明该方法可对隧道的软弱层、地下水及断层破碎带的赋存进行超前的宏观预测。     

Cost effectiveness and cost utility of risedronate for osteoporosis treatment and fracture prevention in women: a Swiss perspective

Abstract

Objectives: To assess the incremental cost-effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR) of risedronate compared to no intervention in postmenopausal osteoporotic women in a Swiss perspective.

Methods: A previously validated Markov model was populated with epidemiological and cost data specific to Switzerland and published utility values, and run on a population of 1,000 women of 70 years with established osteoporosis and previous vertebral fracture, treated over 5 years with risedronate 35 mg weekly or no intervention (base case), and five cohorts (according to age at therapy start) with eight risk factor distributions and three lengths of residual effects.

Results: In the base case population, the ICER of averting a hip fracture and the ICUR per quality-adjusted life year gained were both dominant. In the presence of a previous vertebral fracture, the ICUR was below €45,000 (£30,000) in all the scenarios. For all osteoporotic women ≥ 70 years of age with at least one risk factor, the ICUR was below €45,000 or the intervention may even be cost saving. Age at the start of therapy and the fracture risk profile had a significant impact on results.

Conclusion: Assuming a 2-year residual effect, that ICUR of risedronate in women with postmenopausal osteoporosis is below accepted thresholds from the age of 65 and even cost saving above the age of 70 with at least one risk factor.     

某驱动桥半轴套管断裂分析和优化设计

后桥是汽车的关键零部件,起着承受载荷和扭矩的作用,一旦出现断裂,将严重影响乘客的生命安全,故对其失效模式分析尤为重要。本文对一款新型后桥在道路试验过程中发生半轴套管断裂的失效模式进行分析,通过材质检测及理论计算,对失效因素进行排查。最终找到失效原因,并提出改进措施,避免再次失效,对提高汽车的安全性意义重大。     

浅述商品混凝土裂缝的形成与预防

随着城市化的建设和建筑技术的发展,建筑规模逐渐扩大,楼房的层数不断增高,混凝土的设计强度标号也随之增大,加之施工现场越来越小,而商品混凝土作为建筑半成品的主要材料,以其质量可靠,施工方便,节省施工现场,提高施工效率,节能环保等特点,商品混凝土已被建筑市场广泛采用,但商品混凝土裂缝问题已成为工程结构的一个普遍质量问题,且日趋增多。本文通过庆阳市建设大厦工程实例,分析裂缝的形成,从源头着手达到预防和控制的目的。     

Complicated head trauma from machete wounds: the experience from a tertiary referral hospital in Jamaica

There have been limited reports on machete wounds to the cranium. This study was carried out to document the injury profile in a series of patients who have sustained cranial injuries from machete wounds in this setting. Between 1 January 1998 and 1 January 2008, demographic and clinical data were retrospectively collected from all patients treated with complicated head injuries from machete wounds with at least one of the following clinical or radiological features: a recorded Glasgow Coma Score < 8 at any point during admission; compound skull fractures; protruding brain matter; cerebrospinal fluid (CSF) leaks; intra-cranial bleeding; parenchymal contusions; lacerations and/or oedema. The data were analysed using the SPSS version 12.0. Of the 40 patients with complex injuries to the cranium, there was a 6:1 male preponderance with a mean age of 32.5 ± 13.7 years (Mean ± SD). The injuries included open skull fractures in all the 40 (100%) patients, depressed skull fractures in 20 (50%) patients, CSF leaks in 4 (10%) patients, protruding brain matter in 4 (10%) patients, cerebral contusions in 3 (7.5%) patients and extra cranial injuries in 16 (40%) patients. Tetanus prophylaxis and intravenous antibiotics were administered to all patients, and phenytoin was required in 16 (40%) cases. There were 37 (92%) patients requiring operative intervention at a mean of 10.4 h after presentation (SD ± 18.1; Median 6). The operative procedures included elevation of depressed fractures in 20 (54.1%) patients, dural repair in 10 (27.0%) patients and intra-cranial debridement in 7 (18.9%) patients. There were three deaths (7.5%), and seizures were recorded in 5 (12.5%) cases with no reports of infectious morbidity. Eighty percent of patients had a normal Glasgow outcome score on discharge. Complicated machete head trauma is uncommon at this health care facility in Jamaica. We achieved a satisfactory outcome with aggressive management consisting of prompt assessment of the extent of injury, appropriate antibiotics, anticonvulsants for those with seizures or cortical injury and early operation to decrease the risk of complications.     

股骨干骨折合并侧髋关节脱位临床分析

本文报告了三例临床上少见的股骨干骨折合并同侧髋关节脱位，其特点是：发生率低，合并其他部位损伤多；早期确诊率低，髋关节脱位漏诊率高；徒手复位成功率低，手术率高。分析了漏诊原因及其防止措施，并提出了处理骨折与脱位的方法。     

G310国道加宽改建差异沉降分析与处理技术

结合G310国道旧路加宽改建工程施工初期探索,阐述了加宽工程新、旧路基沉降的主要影响因素、分析沉降变形机理及主要防治控制技术措施,分析了加宽路基沉降计算方法及沉降动态观测要求。     

岩溶地基人工挖孔桩施工处理措施

在岩溶地基上设计人工挖孔桩时，尽最大限度地利用原场地基岩，不作大的处理，满足桩的承载力要求，论述了常见问题的处理方法。     

掘进机履带销有限元分析

通过合理的三维建模及力学分析,对掘进机履带销关键受力部位进行有限元载荷分析及计算,同时与传统力学计算进行对比分析,发现传统力学计算存在的缺陷,为履带销有限元计算方法提供计算依据。