目的探讨采用180 W XPS绿激光"五步法"经尿道前列腺汽化术(PVP)治疗大体积(≥80 ml)前列腺增生患者的疗效及安全性。方法回顾性分析天津市人民医院2017年6月至2019年5月采用180 W XPS绿激光"五步法"PVP治疗的240例...目的探讨采用180 W XPS绿激光"五步法"经尿道前列腺汽化术(PVP)治疗大体积(≥80 ml)前列腺增生患者的疗效及安全性。方法回顾性分析天津市人民医院2017年6月至2019年5月采用180 W XPS绿激光"五步法"PVP治疗的240例大体积前列腺增生患者的临床资料。年龄(70.18±7.71)岁,其中年龄≥70岁者129例;体质指数(24.91±2.98)kg/m^(2),术前国际前列腺症状评分(IPSS)23(20,26)分,生活质量评分(QOL)5(4,5)分,前列腺体积98.29(86.49,116.32)ml,最大尿流率(Q_(max))6(4,8)ml/s,残余尿量120(30,200)ml。240例均行180W XPS"五步法"PVP:按顺序汽化左侧叶1~2点、右侧叶10~11点,建立工作通道;由腹侧至背侧分别逐层斜行汽化左侧叶与右侧叶;分别汽化5、7点前列腺组织,建立"中叶旁沟"工作通道;侧向汽化前列腺中叶;汽化修整两侧叶及前列腺尖部。记录围手术期相关数据,并评估患者术后12个月IPSS、QOL、Q_(max)、残余尿量变化。结果240例手术均顺利完成,手术时间69(59,85)min,激光手术时间52(46,62)min。术中包膜穿孔3例(1.25%),均出现在创面修整阶段;联合经尿道前列腺切除术止血9例(3.75%),无围手术期输血病例。术后22例(9.17%)行膀胱冲洗6~24 h;术后尿管留置时间3(3,4)d,术后住院时间4(3,5)d。术后26例(10.83%)出现尿失禁,其中急迫性尿失禁22例,压力性尿失禁4例,无真性尿失禁。术后2周所有患者均恢复正常控尿。术后无严重血尿、严重膀胱刺激征患者;术后12个月IPSS 5(4,7)分,QOL 1(1,2)分,Q_(max) 18(15,20)ml/s,残余尿量10(0,30)ml,均较术前显著改善(P<0.01),无二次手术患者。结论180W XPS绿激光"五步法"PVP治疗大体积前列腺增生,出血量少,并发症少,患者术后症状改善显著,是一种操作简单、疗效可靠的微创手术方式。展开更多
The construction of the double-lane five-step ship lock of the Three Gorges Project （TGP） wascommenced in 1994, the excavation of the ship lock was completed by the end of 1999, and the ship lockwas put in operation...The construction of the double-lane five-step ship lock of the Three Gorges Project （TGP） wascommenced in 1994, the excavation of the ship lock was completed by the end of 1999, and the ship lockwas put in operation in June 2003. The side slopes of the ship lock are characterized by great height（170 m）, steepness （70 m in height of upright slope）, and great length （over 7000 m in total length）. Inassociation with the ship lock, the surrounding rocks in slope have a high potential to deform, withwhich the magnitude of deformation is restricted. Monitoring results show that the deformation of thefive-step ship lock high slopes of the TGP primarily occurred in excavation period, and deformationtended to be stable and convergent during operation period, suggesting the allowable ranges of deformation.At present, the slopes and lock chambers are stable, and the ship lock works well under normaloperation condition, enabling the social and economic benefits of the TGP. 2015 Institute of Rock and Soil Mechanics, Chinese Academy of Sciences. Production and hosting byElsevier B.V. All rights reserved.展开更多
The general design and layout of the double-line five-step ship-lock,the water delivery technique for high head ship-lock,the key technical problems of fully lined ship-lock and the monitoring techniques for large-sca...The general design and layout of the double-line five-step ship-lock,the water delivery technique for high head ship-lock,the key technical problems of fully lined ship-lock and the monitoring techniques for large-scale miter gates and hoisting equipment under complicated operation conditions of Three Gorges Project (TGP) are introduced.Since the operation of ship-lock in 2003,the operation practice has proved that the design techniques are advanced,rational and reliable.The design and construction of the fully lined ship-lock promotes the development of design theory and practice of ship-lock projects,which makes the construction technology of ship-lock in the world reach a new level.展开更多
Junior English for China’ is based on the ’Five-Step’ teachingmethod: Revision, Presentation, Drilling, Practice, Consolidation. Each step has itsown particular methodology and requires the teacher to adopt a certa...Junior English for China’ is based on the ’Five-Step’ teachingmethod: Revision, Presentation, Drilling, Practice, Consolidation. Each step has itsown particular methodology and requires the teacher to adopt a certain role. Thispaper is a discussion of the "Five-Step Method".展开更多
Besides the legislative and administrative efforts made by China to tackle food safety issues, a raft of measures is being introduced to punish errant producers and enforce stricter
文摘The construction of the double-lane five-step ship lock of the Three Gorges Project （TGP） wascommenced in 1994, the excavation of the ship lock was completed by the end of 1999, and the ship lockwas put in operation in June 2003. The side slopes of the ship lock are characterized by great height（170 m）, steepness （70 m in height of upright slope）, and great length （over 7000 m in total length）. Inassociation with the ship lock, the surrounding rocks in slope have a high potential to deform, withwhich the magnitude of deformation is restricted. Monitoring results show that the deformation of thefive-step ship lock high slopes of the TGP primarily occurred in excavation period, and deformationtended to be stable and convergent during operation period, suggesting the allowable ranges of deformation.At present, the slopes and lock chambers are stable, and the ship lock works well under normaloperation condition, enabling the social and economic benefits of the TGP. 2015 Institute of Rock and Soil Mechanics, Chinese Academy of Sciences. Production and hosting byElsevier B.V. All rights reserved.
文摘The general design and layout of the double-line five-step ship-lock,the water delivery technique for high head ship-lock,the key technical problems of fully lined ship-lock and the monitoring techniques for large-scale miter gates and hoisting equipment under complicated operation conditions of Three Gorges Project (TGP) are introduced.Since the operation of ship-lock in 2003,the operation practice has proved that the design techniques are advanced,rational and reliable.The design and construction of the fully lined ship-lock promotes the development of design theory and practice of ship-lock projects,which makes the construction technology of ship-lock in the world reach a new level.
文摘Junior English for China’ is based on the ’Five-Step’ teachingmethod: Revision, Presentation, Drilling, Practice, Consolidation. Each step has itsown particular methodology and requires the teacher to adopt a certain role. Thispaper is a discussion of the "Five-Step Method".
文摘Besides the legislative and administrative efforts made by China to tackle food safety issues, a raft of measures is being introduced to punish errant producers and enforce stricter
