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对骨折内固定术后早期感染者保留内固定物的策略

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中华骨科杂志 2010年第9期30卷 I0038-I0042页

作者： Marschall Berkes, MD William t. Obremskey, MD MPH, brian Scannell, MD J. Kent Ellington, MD Robert A. Hymes, MD Michael Bosse, MD, and the Southeast Fracture Consortium 黄哲元(译) 丁真奇(译) Investigation performed at Vanclerbilt University Medical Center Nashville Tennessee Carolinas Medical Center Charlotte North Carolina and Inova Fairfax Hospital Fairfax Virginia 厦门大学附属东南医院全军创伤骨科中心漳州363000

背景：开放复位内固定术后，在内固定物存在的情况下治疗伤口深部感染极为棘手，关于治疗方案的使用，文献报道甚少。本研究旨在探讨骨折内固定术后6周内发生感染后保留内固定物直至骨性愈合的可能性。方法：通过回顾3个I级创伤中心以... 详细信息

背景：开放复位内固定术后，在内固定物存在的情况下治疗伤口深部感染极为棘手，关于治疗方案的使用，文献报道甚少。本研究旨在探讨骨折内固定术后6周内发生感染后保留内固定物直至骨性愈合的可能性。方法：通过回顾3个I级创伤中心以往的病历和创伤登记表，共纳入121例新鲜骨折患者，这些患者术中细菌培养均为阳性，内固定术后6周内共123处创口发生感染。统计保留内固定物并获骨折愈合者的比率，评价预测其治疗成败的指标。结果：86例患者（87处骨折；71％）经手术清创、保留内固定物和敏感抗生素治疗获得骨折愈合。治疗失败的有关因素包括开放性骨折（p=0．03）和髓内钉固定（p=0．01）。其他非明显相关但有相关倾向的变量包括吸烟、假单胞菌感染以及累及股骨、胫骨、踝部或足部的骨折。结论：骨折内固定术后深部感染者可通过手术清创、敏感抗生素治疗及保留内固定物成功获得骨折愈合。这些结果可通过基于危险基因、特定菌种和有关的内固定种类对患者进行选择而获得改善。

关键词：骨折内固定术后内固定物感染者术后早期治疗方案敏感抗生素骨折患者骨折愈合

tWO PHASES OF CENOZOIC DEFORMAtION IN NORtHEAStERN tIBEt: tHRUStING FOLLOWED BY StRIKE-SLIP FAULtING

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地学前缘 2000年第S1期7卷 294-294页

作者： Matt S. Spurlin 1, Yin An 1, t. Mark Harrison 1, brian K. Horton 1,3 , Zhou Jiangyu 2, Wang Jianghai 2(1 Department of Earth and Space Sciences, University of California, Los Angeles,CA 90095\|1567 USA, E\|mail mspurlin@ucla.edu 2 Guangzhou

In order to establish deformation history for the Cenozoic development of the tibetan Plateau, we conducted geologic mapping along a 120km traverse between Nangqian and Yushu in the northeastern Qiangtang terrane. this work reveals a complex interaction among tertiary thrusting, strike\|slip faulting, sedimentation, and igneous activity. two phases of deformation are recognized. the older northeast—southwest shortening, expressed by thrusting and folding, is followed by left\|slip faulting along northwest\|trending faults. tertiary thrusts, predominantly southwest\|dipping, are distributed throughout the traverse, and typically juxtapose Mesozoic strata over Paleogene strata. the latter were deposited in several separated basins during folding and thrusting, as indicated by well\|developed growth strata. A preliminary construction of balanced cross\|sections suggests a minimum estimate of 45km of crustal shortening along the traverse. Numerous hypabyssal intrusions were mapped in the southern part of the traverse near Nangqian. they were emplaced into the Paleogene sediments and are dated between 36 and 33Ma by 40 Ar/ 39 Ar and U\|Pb methods. Paleogene sediments are also interbedded with volcanics in both the southern and northern parts of the study area. In the northernmost part of the traverse, a volcanic unit overlies a tertiary thrust. this unit itself is broadly folded. this relationship suggests that tertiary igneous activity was coeval with contractional deformation in the region, implying strongly the causal relationship between the two processes. the youngest event in the area is the development of northwest\|trending left\|slip faults. they cut tertiary thrusts, folds, and about 35Ma igneous intrusions. In contrast to widely distributed tertiary folds and thrusts, strike\|slip faulting is restricted only to the southern portion of our mapped area near Nangqian. the strike\|slip faults apparently control the distribution of modern drainage systems, suggesti

关键词： thrusting strike\|slip Cenozoic igneous activity sed imentation Qiangtang tibet

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利用LIER提高电源的效率

电子设计技术 1995年第6期 54-54页

作者： brian Poindexter

对于高频、大功率、低输出电压回扫变换器电源来说,寄生效应已变成老大难问题。例如,回扫电感器所需要的初级电感量会变得很低,以致于其伴随漏感占总电感量相当大的份量。初级漏感中存储的能量,不但降低电路的效率,同时加大初级统组开... 详细信息

对于高频、大功率、低输出电压回扫变换器电源来说,寄生效应已变成老大难问题。例如,回扫电感器所需要的初级电感量会变得很低,以致于其伴随漏感占总电感量相当大的份量。初级漏感中存储的能量,不但降低电路的效率,同时加大初级统组开关器件对额定功率的要求。图1所示的漏感复能（LIER）电路恢复初级漏感中存储的能量,并把恢复了的能量送给电源的输出之一。从理想的状态说,能量的转移应当完全是反馈型的。在该电路里,恢复了的能量从电感器的漏感电流变换成C;的电压,从C;的电压又变成L;的电流,又从L;的电流变成C;的电压。 t;、Q、R;、D;和C;组成了大家熟知的间歇模式的

关键词：漏感电感器电压电感线圈电子元件电源 LIER 平均电流回扫变换器

局部麻醉药浓度和剂量对持续锁骨下神经阻滞的影响：一项多中心、随机、单盲、对照研究

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麻醉与镇痛 2010年第1期6卷 60-66页

作者： brian M. Ilfeld Linda t. Le Joanne Ramjohn Vanessa J. Loland Anupama N. Wadhwa J. C. Gerancher Elizabeth M. Renehan Daniel I. Sessler Jonathan J. Shuster Douglas W. theriaque Rosalita C. Maldonado Edward R. Mariano 周璐璐(译) 包睿(译) 邓小明(校) Department of Anesthesiology University of California San Diego San Diego California Department of Anesthesiology University of Florida Gainesville Florida Department of Anesthesiology University of Louisville Louisville Kentucky Department of Anesthesiology Wake Forest Medical Center Winston-Salem North Carolina Department of Anesthesiology University of Ottawa Ottawa Ontario Canada Department of Outcomes Research Cleveland Clinic Cleveland Ohio Department of Epidemiology and Health Policy Research University of Florida Gainesville Florida General Clinical Research Center University of Florida Gainesville Florida 不详

背景目前尚不明确局部麻醉药浓度或药物总剂量是否是连续外周神经阻滞效果最主要的决定性因素。此前仅有一项关于胭窝坐骨神经阻滞的研究，该研究报道了使用高容量较低浓度罗哌卡因发生肢体感觉完全阻滞的概率远远高于低容量较高浓度罗... 详细信息

背景目前尚不明确局部麻醉药浓度或药物总剂量是否是连续外周神经阻滞效果最主要的决定性因素。此前仅有一项关于胭窝坐骨神经阻滞的研究，该研究报道了使用高容量较低浓度罗哌卡因发生肢体感觉完全阻滞的概率远远高于低容量较高浓度罗哌卡因，但上述现象是否仅限于腘窝处的坐骨神经，或者说是否因解剖部位变化而异尚不清楚。因此，本研究的检验假设定为：在连续锁骨下臂丛阻滞中，以不同的浓度和速率注射总量相等的罗哌卡因，可以产生相似的阻滞效果。方法选择拟行肘关节远端、中等疼痛骨科手术患者，经喙突入路放置锁骨下臂丛阻滞导管。患者经随机分组确定手术后第2天应用罗哌卡因神经周围镇痛的方法：浓度0．2％组（背景剂量8ml／h，单次追加量4ml）或0．4％组（背景剂量4ml／h，单次追加量2ml）。两组患者每小时持续注入罗哌卡因的总量均为16mg，每30分钟可能还有患者自控的追加剂量8mg。主要观察指标为自手术后次日早晨开始的24小时内患侧肢体完全无感觉的发生率，次要观察指标是镇痛效果和患者的满意度。结果给予0．4％罗哌卡因（n=27）的患者发生肢体无感觉的平均次数（标准差）为1．8（1．6）次，而给予0．2％罗哌卡因（n=23）的患者为0．6（0．9），评估差异为1．2次，95％可信区间0．5～1．9次（P=0．001）。手术后镇痛满意度（评分0—10分，10分为最高分）在0．2％罗哌卡因组得分的中位数（25％～75％百分位数）为10．0分（8．0～10．0），0．4％罗哌卡因组为7．0分（5．3～8．9）。镇痛效果两组相近。结论在连续锁骨下神经阻滞时，除了注射局麻药物总量之外，药物的浓度和容量是另两种影响神经周围镇痛辫果的因素。容量偏小而浓度略高的罗哌卡因产生肢体完全无感觉的概率较高，这一结果与此前关于连续胭窝坐骨神经阻滞的研究结果相反。局麻药浓度与容量之间的关系相当复杂，且随置管部位的不同而异。

关键词：坐骨神经阻滞麻醉药浓度背景剂量随机分组锁骨下低浓度罗哌卡因多中心手术后镇痛

Competing risks of death in younger and older postmenopausal breast cancer patients

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World Journal of Clinical Oncology 2014年第5期5卷 1088-1096页

作者： Judy-Anne W Chapman Kathleen I Pritchard Paul E Goss James N Ingle Hyman B Muss Susan F Dent ted A Vandenberg brian Findlay Karen A Gelmon Carolyn F Wilson Lois E Shepherd Michael N Pollak NCIC Clinical trials Group Queen's University Kingston ON K7L 3N6 Canada Sunnybrook Odette Cancer Centre University of Toronto Toronto ON M4N 3M5 Canada Massachusetts General Hospital Harvard University Boston MA 02114 United States Mayo Clinic Rochester MN 55902 United States Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill Chapel Hill NC27514 United States Ottawa Hospital Cancer Center University of Ottawa Ottawa ON K1H8L6 Canada London Health Sciences Centre University of Western Ontario London ON N6G 2V4 Canada Niagara Health System McM aster University St. Catharines ON L2R 2Z4 Canada BC Cancer Agency University of British Columbia Vancouver BC V5Z 1L3 Canada NCIC Clinical trials Group Queen's University Kingston Ontario K7L 3N6 Canada Lady Davis Institute Jewish General Hospital McG ill University Montreal QC H3T 1E2 Canada

AIM: to show a new paradigm of simultaneously testing whether breast cancer therapies impact other causes of death. MEtHODS: MA.14 allocated 667 postmenopausal women to 5 years of tamoxifen 20 mg/daily ± 2 years of octreotide 90 mg, given by depot intramuscular injections monthly. Event-free survival was the primary endpoint of MA.14; at median 7.9 years, the tamoxifen+octreotide and tamoxifen arms had similar event-free survival(P = 0.62). Overall survival was a secondary endpoint, and the two trial arms also had similar overall survival(P = 0.86). We used the median 9.8 years follow-up to examine by intention-to-treat, the multivariate time-to-breast cancer-specific(Br Ca) and other cause(OC) mortality with log-normal survival analysis adjusted by treatment and stratification factors. We tested whether baseline factors including Insulin-like growth factor 1(IGF1), IGF binding protein-3, C-peptide, body mass index, and 25-OH vitamin D were associated with(1) all cause mortality, and if so; and(2) cause-specific mortality. We also fit step-wise forward cause-specific adjusted ***: the analyses were performed on 329 patients allocated tamoxifen and 329 allocated tamoxifen+octreotide. the median age of MA.14 patients was 60.1 years: 447(82%) there were 170 deaths: 106(62.3%) BrC a; 55(32.4%) OC, of which 24 were other malignancies, 31 other causes of death; 9(5.3%) patients with unknown cause of death were excluded from competing risk assessments. BrC a and OC deaths were not significantly different by treatment arm(P = 0.40): tamoxifen patients experienced 50 BrC a and 32 OC deaths, while tamoxifen + octreotide patients experienced 56 Br Ca and 23 OC deaths. Proportionately more deaths(P = 0.004) were from BrC a for patientsths were due to Br Ca, compared to 54% for those ≥ 70 years of age. the proportion of deaths from OC increased with increasing body mass index(BMI)(P = 0.02). Higher pathol

关键词： Breast cancer Postmenopausal Hormone receptor positive Competing risks tamoxifen Octreotide LAR

DEVELOPMENt OF HIGHLY POtENt,SELECtIVE,AND ORALLY AVAILABLE NON-AMIDINE FACtOR XA INHIBItORS.

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DEVELOPMENT OF HIGHLY POTENT,SELECTIVE,AND ORALLY AVAILABLE ...

Erratum to “Recovery Approaches in Mental Health: A Qualitative Evaluation of the Whole Life therapy Programme for Persons with Schizophrenia” [Health 5 (2013) 582-587]

40th IUPAC Congress

作者： Marc Adler Sarah Cheeseman Yuo-Ling Chou David D. Davey Keith A. Eagen Richard Fitch brian D. Griedel Janice Heidersbach Rushad Karanjawala Wheeseong Lee Dao Lentz Amy Liang Michael M. Morrissey Gary B. Phillips Joseph Post Karna L. Sacchi Steven t. Sakata Kenneth J. Shaw R. Michael Snider Babu Subramanyam Lan trinh Ron Vergona Janette Walters Kathy A. White Marc Whitlow Shung C. Wu Monica J. Kochanny Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA Berlex Biosciences 2600 Hilltop DriveRichmondCA 94804USA

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Health 2014年第21期6卷 3054-3054页

作者： brian Littlechild Jan Woodward Andrew Henry Smith Glynis Meredith-Windle tim Gale Michele Lloyd Christopher Hawley School of Health and Social Work University of Hertfordshire Hatfield UK Hertfordshire Partnership NHS Foundation trust Hertfordshire Partnership NHS Foundation trust UK ArcHealth Bedfordshire UK

the original online version of this article (Littlechild, B., Smith, A. H., Meredith-Windle, G., Gale, t., Lloyd, M. and Hawley, C. (2013) Recovery Approaches in Mental Health: A Qualitative Evaluation of the Whole Life therapy Programme for Persons with Schizophrenia. Health, 5, 582-587. http://***/10.4236/health.2013.53A077) was published mistakenly with a co-author (who also developed the Whole Life Programme) missing. to reflect the contribution and responsibility of the co-author as well as the affiliations of the authors at the time of the study, we revised authorship and author affiliations of the article.

关键词： Mental Health Recovery Whole Life Programme Evaluation Service User Perspectives

Gezairi transport:传统航运公司的慈善与现代化

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家族企业 2023年第1期 112-113页

作者：莫顿·班纳德森布莱恩·亨利艾鲁(译) 欧洲工商管理学院温德尔家族企业国际中心哥本哈根大学欧洲工商管理学院不详

Gezairi transport是一家家族所有的航运公司。创始人阿卜杜勒·萨拉姆·布·阿扎·埃尔-格扎里(Abdul Salam Bou Azza El-Gezairi,1907-1991)于1945年在贝鲁特港成立了一家只有一个办公室的海关清关所,这位诚实、勤奋且坚韧的创始人一... 详细信息

Gezairi transport是一家家族所有的航运公司。创始人阿卜杜勒·萨拉姆·布·阿扎·埃尔-格扎里(Abdul Salam Bou Azza El-Gezairi,1907-1991)于1945年在贝鲁特港成立了一家只有一个办公室的海关清关所,这位诚实、勤奋且坚韧的创始人一直努力要实现自己雄心勃勃的梦想——超越国界,将他的祖国黎巴嫩与中东、世界其他地区联系起来。

关键词：航运公司清关阿卜杜勒萨拉姆 transport 家族所有

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员工背景对组织公平感的影响:管理意涵

国际行政科学评论(中文版) 2014年第2期 202-221页

作者：穆斯·特斯玛戈伊通·特斯盖凯瑟琳·雷迪亚伯·恩贝雅布莱恩·温德罗庞诗(翻译) 杨柳(审校) 美国明尼苏达州威诺纳州立大学美国东华盛顿贝尔维大学阿肯色大学不详

本研究运用三因素模型(分配公平、程序公平和互动公平),探讨了员工背景(性别、教育程度和与政府的隶属关系)对组织公平感的影响。选定的人口和态度数据来自代表10个公共组织的313名员工样本。研究结果显示,性别对分配公平与互动公平有... 详细信息

本研究运用三因素模型(分配公平、程序公平和互动公平),探讨了员工背景(性别、教育程度和与政府的隶属关系)对组织公平感的影响。选定的人口和态度数据来自代表10个公共组织的313名员工样本。研究结果显示,性别对分配公平与互动公平有显著影响,但对程序公平影响不显著;教育程度对分配公平和程序公平有显著影响,但对互动公平影响不显著;与政府的隶属关系对公平的所有三个维度均有显著影响。本研究还对这些研究结果的管理启示和未来的研究方向进行了讨论。对实践工作者的启示更好地洞察人口因素(性别、教育程度和与政府的隶属关系)对组织公平感三个维度的影响,可以向政策制定者和公共管理者表明哪些方面可以改进,并帮助其制定有助于提高公平感的战略和政策。本研究对于那些从内战、解放战争或其他类似冲突中解脱出来的国家(例如,南苏丹、利比亚、阿富汗)的另一个重要意义是,如何把从前的战斗人员整合为公务员及之后如何管理。关键是要在公务员系统为他们提供就业机会,前提条件是基于正确的人安排在正确的位置的原则来安置他们,并像对待他们的同行——以前不是军队人员的公务员——一样平等对待他们。他们需要的是(在开始时)给予他们一些(特殊)训练来加快他们的社会化并思考与主流做事方式的融合。

关键词：教育程度性别最不发达国家组织公平感公共组织

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