臭氧联合胶原酶注射治疗脱出型腰椎间盘突出症

【摘要】　　　目的　　　观察臭氧联合胶原酶注射治疗脱出型腰椎间盘突出症的疗效。方法 臭氧盘内消融术、胶原酶盘外溶解术联合应用治疗脱出型腰椎间盘突出症。结果 治疗脱出型腰椎间盘突出症４１例,共治疗５０个椎间盘,采用Ｍａｃｎａｂ疗效评价标准评价,优良率８５．３％,术后１２个月影像复查（ＣＴ、ＭＲＩ）与术前对照显示ＡＢ值、Ｒ值术后是术前的３６％、４３％,有较为明显的缩小。结论 本项技术治疗脱出型腰椎间盘突出症疗效肯定,胶原酶对纤维环有溶解作用,臭氧对髓核有氧化作用,两者结合疗效肯定,且随时间延长逐渐向好,术后１年影像检查明显变小。
     

多种介入方法联合应用治疗腰椎间盘突出症256例疗效观察

目的 观察多种介入方法联合应用治疗腰椎间盘突出症的疗效。方法 采用臭氧盘内消融术、胶原酶溶解术、纤维环开窗减压术多种方法盘内、盘外联合应用治疗腰椎间盘突出症。结果 治疗腰椎间盘突出症２５６例,４３７个椎间盘,采用Ｍａｃｎａｂ标准评价疗效,优良率８２．４％;远期疗效似更佳,纤维环破裂组疗效优于未破裂组。结论 本项技术治疗腰椎间盘突出适应证广泛、疗效好,胶原酶对纤维环有溶解作用,臭氧对髓核有氧化作用,纤维环开窗减压术有盘内减压作用,３种方法各有所适,应结合影像学资料,术中根据盘内压力,椎间盘造影情况酌情选择,可取得满意疗效。     

臭氧胶原酶联合应用治疗腰椎间盘突出症

目的观察臭氧与胶原酶联合应用治疗腰椎间盘突出症的疗效。方法２０例腰椎间盘突出症患者采用突出髓核内注射臭氧和胶原酶治疗。结果通过３、６个月的随访,采用MacNab疗效评定标准评价,疗效优１２例（６０％）,良７例（３５％）,差１例（５％）,优良率９５％。未出现硬膜囊、神经、血管损伤等严重并发症。结论臭氧胶原酶联合应用是治疗腰椎间盘突出症的有效、安全方法。     

应用臭氧联合胶原酶治疗腰椎间盘突出症

目的对经皮穿刺注射医用臭氧联合胶原酶治疗腰椎间盘突出症的中期疗效观察。方法７８例经影像学及临床检查证实腰椎间盘突出症患者,CT引导下行经皮穿刺椎间盘内注入医用臭氧,２～４d后再经硬膜前间隙在突出物表面及突出物内注入医用胶原酶１２００u行髓核溶解术。结果术后６～２５个月随访观察,７８例中疗效优５８例（７４．３％）,良１６例（２０．５％）,差４例（５．１％）。１２例术后２个月内出现症状复发,其中９例２个月后自行好转,３例经再次注射臭氧后,症状消失。无严重并发症,经治疗后症状消失者随访未见复发。结论经皮穿刺行医用臭氧联合胶原酶治疗腰椎间盘突出症,两者优势互补,可以提高疗效,是一种安全、微创、有效的治疗方法。     

髓核及侧隐窝注射臭氧治疗腰椎间盘突出症

目的 探讨经皮穿刺髓核及侧隐窝注射臭氧治疗腰椎间盘突出症的临床疗效。方法 ８８例经ＣＴ或ＭＲＩ证实为腰椎间盘突出症患者进行髓核及侧隐窝注射臭氧作为研究组,并以７４例腰椎间盘突出症仅作髓核注射臭氧患者作为对照组。结果 髓核及侧隐窝联合注射对腰椎间盘突出症的患者症状缓解更快、临床疗效持续更长,随访６个月研究组临床疗效达８４．１％;对照组为６４．９％。统计学分析显示术后１、２和６个月研究组有效率均高于对照组（χ２ ＝ ４．０９,Ｐ ＝ ０．０４３;χ２ ＝ ４．６２,Ｐ ＝ ０．０３２;χ２ ＝ ４．３８,Ｐ ＝ ０．０３６）,差异具有统计学意义。结论 髓核内及侧隐窝联合注射臭氧比单一髓核内注射臭氧更加有效。     

臭氧联合胶原酶注射与单纯臭氧治疗腰椎间盘突出症的疗效观察

目的 观察臭氧联合胶原酶注射治疗腰椎间盘突出症（ＬＤＨ）与单纯臭氧治疗椎间盘突出症的不同疗效。方法 在ＤＳＡ导向下,正侧位透视后准确定位,采用９号穿刺针经皮穿刺向椎间盘内单纯注射臭氧或先后注射臭氧及胶原酶治疗７６例腰椎间盘突出患者。结果 治疗后１、３和６个月进行随访。１个月后随访,臭氧联合胶原酶注射治疗组（Ａ组,３８例）有效率为８９．５％,单纯臭氧注射治疗组（Ｂ组,３８例）有效率为８６．８％;３个月后随访,Ａ组有效率为９２．１％,Ｂ组有效率为８４．２％;６个月后随访,Ａ组有效率为９４．７％,Ｂ组有效率为８１．６％。结论 臭氧联合胶原酶注射治疗椎间盘突出症较单纯臭氧注射治疗椎间盘突出症,疗效更加显著,且中远期疗效更稳定。     

盘内注射臭氧治疗腰椎间盘突出症的剂量研究

目的确定臭氧治疗腰椎间盘突出症（LDH）盘内注射的合适剂量。方法将２４０例LDH患者用随机分组法分为４组,通过CT引导下穿刺突出椎间盘并分别注射４种剂量（分别为１０、２０、３０和４０ml ）的医用臭氧（浓度为５０μg ／ml ）。注射后即刻行CT扫描,随访观察６～１２个月,对髓核汽化消融的程度、疗效及不良反应进行对比研究。结果１０ml 组疗效较其他组差,与其他３组比较差异有统计学意义（P＜０．０５）,其余３组疗效之间差异无统计学意义（P＞０．０５）,而随着剂量的增加并发症明显增加。结论臭氧治疗腰椎间盘突出症,盘内注射的合适剂量为２０ml 。     

低剂量ＣＴ引导下医用臭氧注射术治疗腰椎间盘突出症

目的　　　探讨低剂量ＣＴ引导下经皮医用臭氧腰椎间盘注射术治疗腰椎间盘突出症的疗效。方法 在低剂量ＣＴ扫描引导下,对１５６例腰椎间盘突出患者采用侧后旁或小关节内侧径路穿刺,进行椎间盘内、盘外注射不同浓度臭氧。结果 术后１周,１５６例中疗效优５９例、良６３例,优良率７８．２％;术后１个月,１５６例中疗效优６３例、良６４例,优良率８１．４％;术后３个月,总优良率达８６％,其中椎间盘膨出、突出、脱出优良率分别为９７．４％（３７／３８）、９０．２％（１０１／１１２）、３／６;盘内保留臭氧组、不保留组优良率分别为９２．０％（４６／５０）、８７．３％（６９／７９）;纤维环完整、破裂优良率分别为９２．２％（１１９／１２９）、８１．５％（２２／２７）。结论 低剂量ＣＴ引导下臭氧注射术治疗腰椎间盘突出症疗效确切,且具有安全、创伤小、定位准确、操作简单及辐射剂量小等特点,是腰椎间盘突出理想的治疗手段。     

臭氧治疗术在复杂性腰椎间盘突出症治疗中的临床观察

目的探讨臭氧（O ２ －O ３ 混合气体）治疗术在复杂性腰椎间盘突出症治疗中的效果。方法选择单纯腰椎间盘突出症患者７０例,选择椎间盘内负压１１例,腰椎间盘髓核摘除术后复发５例,伴椎管狭窄１０例,伴腰椎退行性变、腰椎骨质增生、小关节退行性变３０例,伴侧隐窝变窄４例,伴腰肌劳损１０例,行CT引导下经皮穿刺臭氧治疗术,盘内注入臭氧量２～３ml ,椎旁间隙注入臭氧量５～８ml ,O ３ 浓度为（３０～４０μg ／ml ）。合并腰肌劳损者,根据病理解剖特征,采用２０ml 一次性注射器抽取臭氧,对疼痛组织内行浸润注射,隔日１次,３次为一疗程。结果通过对７０例腰椎间盘突出症患者及７０例复杂性腰椎间盘突出症患者治疗后的对比,显示８０％患者术后症状立即缓解,术后１周有效率达９５％,随访３、６个月有效率可达９６％。结论正确的临床诊断,准确的手术操作,以及合理的将臭氧联合应用于软组织损伤性疼痛中,可明显提高复杂性腰椎间盘突出症患者的治疗效果。     

CT引导下臭氧髓核消融联合糖皮质激素椎小关节注射治疗腰椎间盘突出症并椎小关节病变

目的臭氧（O ３ ）髓核消融术联合椎小关节局部复方倍他米松注射治疗腰椎间盘突出症并椎小关节炎患者的疗效观察。方法８０例腰椎间盘突出并椎小关节炎患者随机分为两组,在CT引导下,Ⅰ组（n＝４０）单纯椎间盘穿刺臭氧消融术,注射５０μg ／ml O ３ １０～２０ml ,Ⅱ组（n＝４０）行椎间盘穿刺臭氧消融的同时在双侧或单侧椎小关节注射复方倍他米松注射液０．５～１ml ,两组患者分别在术前与术后１周,３、６个月采用双盲法Oswestry Low Back Pain Disability量表评估疗效。结果术后第１周Ⅰ组和Ⅱ组有效率分别为６５％和８２．５％;３个月有效率分别为７５％和９０％;６个月时分别为７０％和９２．５％。Ⅱ组较Ⅰ组病例在１周、３、６个月疗效均显著增高（P＜０．０５）。结论椎间盘臭氧消融联合椎小关节药物局部注射是治疗椎间盘突出并椎小关节炎的一种有效、安全的方法,值得推广应用。     

Effect of fuel injection timing and injection pressure on performance in a hydrogen direct injection engine

The in-cylinder hydrogen fuel injection method (diesel engine) induces air during the intake stroke and injects hydrogen gas directly into the cylinder during the compression stroke. Fundamentally, because hydrogen gas does not exist in the intake pipe, backfire, which is the most significant challenge to increasing the torque of the hydrogen port fuel injection engine, does not occur. In this study, using the gasoline fuel injector of a gasoline direct-injection engine for passenger vehicles, hydrogen fuel was injected at high pressures of 5 MPa and 7 MPa into the cylinder, and the effects of the fuel injection timing, including the injection pressure on the output performance and efficiency of the engine, were investigated. Strategies for maximizing engine output performance were analyzed.The fuel injection timing was retarded from before top dead center (BTDC) 350 crank angle degrees (CAD) toward top dead center (TDC). The minimum increase in the best torque ignition timing improved, and the efficiency and excess air ratio increased, resulting in an increase in torque and decrease in NO_x emissions. However, the retardation of the fuel injection timing is limited by an increase in the in-cylinder pressure. By increasing the fuel injection pressure, the torque performance can be improved by further retarding the fuel injection timing or increasing the fuel injection period. The maximum torque of 142.7 Nm is achieved when burning under rich conditions at the stoichiometric air-fuel ratio.     

Effects of second hydrogen direct injection proportion and injection timing on combustion and emission characteristics of hydrogen/n-butanol combined injection engine

Hydrogen and n-butanol are superior alternative fuels for SI engines, which show high potential in improving the combustion and emission characteristics of internal combustion engines. However, both still have disadvantages when applied individually. N-butanol fuel has poor evaporative atomization properties and high latent heat of vaporization. Burning n-butanol fuel alone can lead to incomplete combustion and lower temperature in the cylinder. Hydrogen is not easily stored and transported, and the engine is prone to backfire or detonation only using hydrogen. Therefore, this paper investigates the effects of hydrogen direct injection strategies on the combustion and emission characteristics of n-butanol/hydrogen dual-fuel engines based on n-butanol port injection/split hydrogen direct injection mode and the synergistic optimization of their characteristics. The energy of hydrogen is 20% of the total energy of the fuel in the cylinder. The experimental results show that a balance between dynamics and emission characteristics can be found using split hydrogen direct injection. Compared with the second hydrogen injection proportion (IP2) = 0, the split hydrogen direct injection can promote the formation of a stable flame kernel, shorten the flame development period and rapid combustion period, and reduce the cyclic variation. When the IP2 is 25%, 50% and 75%, the engine torque increases by 0.14%, 1.50% and 3.00% and the maximum in-cylinder pressure increases by 1.9%, 2.3% and 0.6% respectively. Compared with IP2 = 100%, HC emissions are reduced by 7.8%, 15.4% and 24.7% and NOx emissions are reduced by 16.4%, 13.8% and 7.9% respectively, when the IP2 is 25%, 50% and 75%. As second hydrogen injection timing (IT2) is advanced, CA0-10 and CA10-90 show a decreasing and then increasing trend. The maximum in-cylinder pressure rises and falls, and the engine torque gradually decreases. The CO emissions show a trend of decreasing and remaining constant. However, the trends of HC emissions and NOx emissions with IT2 are not consistent at different IP2. Considering the engine's dynamics and emission characteristics, the first hydrogen injection proportion (IP1) = 25% plus first hydrogen injection timing (IT1) = 240°CA BTDC combined with IP2 = 75% plus IT2 = 105°CA BTDC is the superior split hydrogen direct injection strategy.     

聚桂醇注射液与无水乙醇超声引导下治疗肝血管瘤疗效比较

【摘要】 目的 探讨聚桂醇注射液与无水乙醇超声引导下经皮穿刺治疗肝血管瘤的临床疗效与安全性。方法 60例肝血管瘤患者随机分为无水乙醇组和聚桂醇组,每组30例,对比两组患者临床疗效及不良反应发生率。结果 每组临床疗效对比差异无统计学意义（P=0.489,P＞0.05）,无水乙醇组不良反应发生率明显高于聚桂醇组,差异有统计学意义（χ2=5.963,P=0.03,P＜0.05）。结论 超声引导下经皮穿刺聚桂醇注射液与无水乙醇治疗肝血管瘤临床疗效相当,但聚桂醇组不良反应少,疼痛率低,患者耐受性好,此治疗方法值得临床推广应用。
     

根据喷油压力波形特征判断燃油喷射装置故障部位

通过ZB-2型柴油机燃油喷射系统故障诊断仪(即柴油机燃油压力波检测仪)对DF4型机车柴油机燃油压力波的检测,在对大量检测事例进行跟踪、统计、分析的基础上,揭示出燃油压力波的检测波形与该缸喷射装置质量状态的对应关系,并据此确定故障部位,为故障处理提供参考.     

Energy and exergy analysis of a combined injection engine using gasoline port injection coupled with gasoline or hydrogen direct injection under lean-burn conditions

Hydrogen is considered to be a suitable supplementary fuel for Spark Ignition (SI) engines. The energy and exergy analysis of engines is important to provide theoretical fundaments for the improvement of energy and exergy efficiency. However, few studies on the energy and exergy balance of the engine working under Hydrogen Direct Injection (HDI) plus Gasoline Port Injection (GPI) mode under lean-burn conditions are reported. In this paper, the effects of two different modes on the energy and exergy balance of a SI engine working under lean-burn conditions are presented. Two different modes (GPI + GDI and GPI + HDI), five gasoline and hydrogen direct injection fractions (0, 5%, 10%, 15%, 20%), and five excess air ratios (1, 1.1, 1.2, 1.3, 1.4) are studied. The results show that the cooling water takes the 39.40% of the fuel energy on average under GPI + GDI mode under lean-burn conditions, and the value is 40.70% for GPI + HDI mode. The exergy destruction occupies the 56.12% of the fuel exergy on average under GPI + GDI mode under lean-burn conditions, and the value is 54.89% for GPI + HDI mode. The brake thermal efficiency and exergy efficiency of the engine can be improved by 0.29% and 0.31% at the excess air ratio of 1.1 under GPI + GDI mode on average, and the average values are 0.56% and 0.71% for GPI + HDI mode.     

Impact of physical properties of biodiesel on the injection process in a common-rail direct injection system

This paper presents the influence of biodiesel fuel properties on the injection mass flow rate of a diesel common-rail injection system. Simulations are first performed with ISO 4113 diesel fuel on a four-cylinder common-rail system to evaluate a single and triple injection strategies. For each injection strategy, the impact of modifying a single fuel property at a time is evaluated so as to quantify its influence on the injection process. The results show that fuel density is the main property that affects the injection process, such as total mass injected and pressure wave in the common-rail system. The fuel’s viscosity and bulk modulus also influence, but to a lessen degree, the mass flow rate of the injector notably during multiple injection strategies as individual properties change the fuel’s dampening property and friction coefficient.     

Influence of injection parameters and mold materials on mechanical properties of ABS in plastic injection molding

This study optimized effect of injection parameters such as melt temperature, packing pressure, cooling time and injection pressure on the mechanical properties of Acrylonitrile–Butadiene–Styrene (ABS) moldings. Mold materials having two different thermal conductivities, 191 W/mK for aluminum 2000 series and 50 W/mK for AISI 1020 at 25 °C were selected to use in experimental studies. Taguchi's L₉(3⁴) orthogonal array design was employed for the experimental plan. Mechanical properties of ABS specimens such as elasticity module, tensile strength and tensile strain at yield, tensile strain at break, flexural modules and izod impact strength (notched) were measured by using some test methods. Signal to noise ratio for mechanical properties of ABS using the Taguchi method was calculated and effect of the parameters on mechanical properties was determined using the analysis of variance. Linear mechanical models were also created by using regression analysis.     

Effect of mixture strength and injection timing on combustion characteristics of a direct injection hydrogen-fueled engine

An experimental investigation was performed to characterize the hydrogen combustion in a spark-ignition direct-injection engine. It was focused on the effects of mixture strength and injection timing on the characteristics of hydrogen combustion. For this purpose, the practical tests were carried out on an experimental test rig. It is originally designed for optimization of the direct-injection natural-gas engine. The experimental test-rig results comprised the traces for the in-cylinder pressure, mass fraction burned, and heat release rate under the different operation conditions. The results obtained show that the richer mixture condition produced higher pressure trends at all tested points. Besides that, it exhibited a faster rate of increase in combustion rate due to the increase of flame speed. However, the combustion characteristics deteriorated due to the lack of mixture stratification with earlier injection timing. It is concluded that direct-injection timing is essential to achieve better combustion performance. Moreover, retarding the spark ignition timing is also crucial to avoid abnormal combustion in the case of a richer mixture and early start on injection.     

船用直喷式天然气发动机喷射策略的优化

利用CONVERGE软件基于L23/30DF型船用天然气发动机建立了双天然气喷嘴、双引燃柴油喷嘴的直喷天然气发动机的缸内燃烧过程的CFD计算模型,计算了不同的柴油和天然气喷射时刻和间隔下发动机缸内燃烧和排放过程。结果表明:引燃柴油的喷射时刻及其与天然气喷射时刻的间隔,对直喷式天然气发动机燃烧和排放性能有重要影响。当喷射时刻为-25℃A时,发动机具有较高的缸内爆发压力和良好的排放性能。在引燃柴油和天然气喷射间隔为16℃A时,可获得最高的缸内爆发压力,此时soot排放降低了22%。