锚定装置嵌顿的Günther Tulip滤器回收初步经验

【摘要】 目的 探讨锚定装置嵌顿的Günther Tulip下腔静脉滤器回收技巧及应用价值。方法 2013年6月至2015年6月在西南医科大学附属中医医院接受Günther Tulip滤器回收术患者共37例,滤器留置时间98～117 d,平均96 d。采用单纯抓捕法、经股颈静脉双入路球囊扩张辅助技术回收滤器。结果 采用单纯抓捕法顺利回收30例患者滤器,7例患者抓捕回收失败（5例为滤器锚定装置嵌顿,2例为锚定装置嵌顿伴回收钩贴壁）,再辅以经股颈静脉双入路球囊扩张完成回收,回收成功率为100%。所有滤器取出后形态完整。结论 抓捕法辅以经股颈静脉双入路球囊扩张术有助于提高锚定装置嵌顿的Günther Tulip 滤器回收率,且患者损伤小,具有一定的临床应用价值。

     

冠状动脉左主干急性闭塞介入治疗新术式临床应用

【摘要】 目的 探讨冠状动脉左主干急性闭塞病变介入治疗新术式临床应用的效果。方法 收集2003年5月至2016年10月收治的左主干急性闭塞患者58例临床资料。其中14例接受传统经皮冠状动脉介入治疗（PCI）,44例先接受小球囊扩张,血流恢复TIMI分级3级后等待30～40 min再植入支架。结果 接受传统PCI治疗患者中8例死亡,死亡率为57.1%（8/14）;接受先行小球囊扩张再行支架植入术患者中仅3例死亡,死亡率为6.8%（3/44）。结论 小球囊扩张后延时支架植入术治疗急性左主干闭塞患者死亡率更低,是一种安全有效的术式。

     

急性人工动静脉内瘘血栓栓塞介入治疗

【摘要】 目的 探讨置管溶栓结合普通球囊扩张治疗急性人工动静脉内瘘血栓栓塞的安全性和有效性。方法 回顾性分析2012年1月至2016年9月单中心收治的64例（84次）急性人工动静脉内瘘血栓栓塞患者临床资料。所有患者均经股动脉穿刺置管内瘘造影明确诊断。术中用普通导丝行内瘘血栓闭塞段机械碎栓术后予尿激酶12.5万～37.5万U团注，若血栓未完全溶解则保留导管，用输液泵持续泵入尿激酶至内瘘血栓完全清除；若内瘘管腔狭窄＞50%或狭窄影响透析，则行普通球囊扩张术。通过Kaplan- Meier曲线估算首次介入治疗后一期及二期累积通畅率。结果 84例次患者中69例次（82.1%）取得技术成功。14例次患者因内瘘严重狭窄行普通球囊扩张术，成功12例次（85.7%）。总体临床成功率为78.6%（66/84）。治疗过程中共发生7例次（8.3%）出血事件，其中大出血、小出血事件分别为3例次、4例次。术后3、6、12、24个月一期/二期通畅率，分别为76.1%/81.3%、63.6%/70.8%、40.8%/47.0%、12.5%/32.5%。结论 置管溶栓是治疗急性人工动静脉内瘘血栓栓塞安全有效的方法，辅助普通球囊扩张能为内瘘狭窄病变提供较为满意的治疗效果。
     

球囊扩张结合支架取栓治疗出血性颅内静脉窦血栓形成9例

华成飞  李腾飞  段旭华  韩新巍 《工业加热》2017,(4):339-343

定向斑块切除联合药物涂层球囊治疗椎动脉重度狭窄1例

【摘要】 目的 探讨椎动脉狭窄接受腔内斑块切除成形的可行性和安全性。方法 2017年11月采用定向斑块切除联合药物涂层球囊（DCB）治疗1例椎动脉硬化所致重度狭窄患者,术中V1段远端放置保护伞。结果 手术取得成功,未出现手术并发症。术后患者头晕症状消失,恢复良好。结论 定向斑块切除联合DCB治疗椎动脉重度狭窄安全可行。
     

药物涂层球囊治疗肾动脉支架内再狭窄4例

【摘要】 目的 探讨药物涂层球囊（DCB）治疗肾动脉支架内再狭窄（ISR）的安全性和有效性。方法 4例患者经肾动脉血管超声或肾动脉造影明确为肾动脉ISR,其中支架内起始部重度狭窄3例,支架内闭塞1例,均接受DCB扩张治疗。术后复查肾动脉超声,监测血清肌酐（SCr）、血压变化。结果 4例患者手术均获成功。术后随访8～21个月,平均16.5个月,肾动脉支架内血流均通畅,SCr值由术前（184.25±92.35） μmol/L降至术后（160.00±52.00） μmol/L（P＜0.01）,收缩压由（180.00±18.45） mmHg降至（140.00±12.25） mmHg,肾动脉收缩期峰值流速（PSV）由（339.50±259.00） cm/s降至（253.25±102.00） cm/s。4例患者均未接受二次介入干预。结论 DCB治疗肾动脉ISR安全有效,但仍需大样本数据结果验证。
     

球囊临时阻断技术在凶险性前置胎盘剖宫产术中的应用

汪海洋  孙建明  陈以宽  张骞  祁小桐 《工业加热》2018,(7):627-631

准分子激光消蚀联合药物涂层球囊治疗下肢动脉硬化闭塞20例

【摘要】 目的 评价准分子激光消蚀术（ELA）联合药物涂层球囊治疗下肢动脉硬化闭塞的安全性和有效性。方法 回顾性分析2016年11月至2017年6月收治的20例接受ELA联合药物涂层球囊治疗的下肢动脉硬化闭塞患者临床资料。结果 手术成功19例（95%）,症状消失,静息痛症状缓解;失败1例（伴发腹主动脉瘤、静息痛）,瘤腔内大量血栓多次脱落至远端动脉,足部动脉完全闭塞,且取栓后效果不佳,终因剧烈疼痛予膝下截肢。1例前半足截肢患者于术后第7日左下肢动脉形成血栓,经溶栓后症状有所缓解。术后踝-肱指数（ABI）与术前比较,7例（36.8%）提升＜0.3,8例（42.2%）提升0.3～0.5,4例（21.0%）提升＞0.5。18例患者平均随访4（1～8）个月,症状均缓解,未再次干预;1例足趾溃疡患者溃疡愈合。结论ELA联合药物涂层球囊治疗下肢动脉硬化闭塞所致缺血安全、有效,但仍需更大样本量和更长随访时间临床观察。

     

火电厂节能工作浅析

本文探讨了火电厂节能基本程序和工作方法,分析节能工作要从基础工作、技术创新、设备整治、燃烧管理等方面入手的论述.     

Geothermal energy in agriculture in Yugoslavia

SFR Yugoslavia has natural hot water springs practically all over its territory, indicating the presence of geothermal reservoirs underground. There is no final estimate of how much energy can be expected from this new resource, except for figures based on the results of studies and investigations.The first use of geothermal energy in Yugoslavia in numerous spas dates back to the 19th century. Some remarkable examples of central heating are known, but the most widespread use is in agriculture (in greenhouse heating, farm heating and drying of agricultural products).     

浅析磨合期汽车的使用

如何合理使用磨合期的汽车，使其摩擦机件的磨损量能够平稳、均匀地磨合而不至于过度磨损，对汽车实际使用寿命有着重要的意义。从机器磨合期的特点和磨损机理出发，对汽车磨合期如何正确使用进行了有实际意义的探讨。     

Energy conservation measures in an institutional building in sub-tropical climate in Australia

In this study, various energy conservation measures (ECMs) on heating, ventilating and air conditioning (HVAC) and lighting systems for a four-storied institutional building in sub-tropical (hot and humid climate) Queensland, Australia are evaluated using the simulation software called DesignBuilder (DB). Base case scenario of energy consumption profiles of existing systems are analysed and simulated first then, the simulated results are verified by on-site measured data. Three categories of ECMs, namely major investment ECMs (variable air volume (VAV) systems against constant air volume (CAV); and low coefficient of performance (COP) chillers against high COP chillers); minor investment ECMs (photo electric dimming control system against general lighting, and double glazed low emittance windows against single-glazed windows) and zero investment ECMs (reset heating and cooling set point temperatures) are evaluated. It is found that the building considered in this study can save up to 41.87% energy without compromising occupancies thermal comfort by implementing the above mentioned ECMs into the existing system.     

Energy consumption in rural transportation in India

Energy consumption in rural transportation has been computed, taking into account the energy embodied in vehicles or bullocks, as well as the fuels or feeds and food (of operators). Bullock cart transport consumes over four times more energy than vehicles. However, animal transport will continue to be preferred because of its availability.     

Electoral cycles in electricity losses in India

A third of electricity in India is lost each year, where losses refer to power that is supplied but not billed. Utilizing data from the power corporation of Uttar Pradesh, India's most populous state, we study the politics of electricity losses. Examining annual data over four decades, we document that UP's electricity losses tend to increase in periods immediately prior to state assembly elections. Drawing upon geographically disaggregated data for the period 2000–09, we observe higher line losses just prior to the 2002 and 2007 state elections. Our analysis shows that the incumbent party was more likely to retain the assembly seat as line losses in the locality increased. We interpret these results as corroboration that political parties deliberately redirect electricity to flat rate and unbilled users in a context of chronically inadequate supply. Political factors appear to affect line losses in ways that technical and economic factors alone cannot explain.     

Leading-edge Technologies in Hydropower Development in China

After the implementation of the Reform and Opening-up Policy for a period of 40 years, the exploitation of China’s hydropower resources developed significantly. Through vast amounts of scientific and technological research and construction practices, China has accumulated abundant engineering experience with respect to the construction technologies required for 300-meter-high concrete arch dams, 200-meter-high roller-compacted concrete gravity dams, 200-meter-high concrete face rockfill dams, and 250-meter-high earth core rockfill dams, large-flow discharge and energy dissipation, huge underground cavern group constructions, complicated foundation treatments for high earth and rockfill dams and high and steep slope reinforcements. These series of technologies have now reached an international leading level. In the near future, these technical improvements will likely have broader application prospects and make greater contributions toward hydropower development both in China and across the world.     

Uncertainties in decarbonising heat in the UK

Heating is arguably one of the most difficult sectors to decarbonise in the UK's energy system. Meeting the 80% greenhouse gas emission reduction target by 2050 is likely to require that heat related emissions of CO₂ from buildings are near zero by 2050, and there is a 70% reduction in emissions from industry (from 1990 levels). Though it is clear that the use of the natural gas network will reduce over time, recent modelling suggests a limited residual role for gas by 2050 to help meet peaks in heat demand. High levels of uncertainty about the way in which heat will be decarbonised present a number of challenges to policy makers. This paper will explore the risks and uncertainties associated with the transition to a low carbon heat system in the UK as outlined by the 4th carbon budget review. The potential impact of key uncertainties on the levelised costs of heat technologies and the development of energy networks are explored using a sensitivity analysis approach. Policy changes required to decarbonise the heat sector are also examined.