负压对四肢瘢痕切除创面成纤维细胞的生长环境影响

目的 探究持续封闭负压引流技术（VSD）对瘢痕切除创面成纤维细胞生长环境的影响。方法 回顾性分析2014年1月~2015年11月于笔者医院行植皮手术的四肢瘢痕切除术后患者60例,根据植皮手术前是否接受VSD治疗分为负压组（n=30）和包扎组（n=30）,负压组均于一期植皮前接受VSD治疗,包扎组未接受VSD治疗。回顾性分析对比两组患者并发症发生率、首次植皮存活率、创面感染率、住院时间之间的差异。并用TUNEL染色、CD34染色法对比瘢痕标本中成纤维细胞凋亡指数及血管生成情况。结果 负压组菌培养阳性率明显低于包扎组（P<0.05）,植皮存活率明显高于包扎组（P<0.05）。两组并发症发生率、住院时间、疼痛评分、随访VSS评分间比较,负压组均明显较低（P<0.05）。负压组成纤维细胞凋亡指数明显较低,微血管计数明显较高（P<0.05）。结论 负压封闭引流可以减轻瘢痕切除创面感染率,有效减轻炎性水肿,且可以通过改变局部血液循环微环境以及机械应力作用促进成纤维细胞增殖分裂,提高创面恢复效果。     

瘢痕子宫患者采用药物终止早期妊娠的治疗效果观察

目的 探讨合并瘢痕子宫患者采用药物流产终止早期妊娠的治疗效果。方法 收集2014年1月~2015年12月新疆医科大学第二附属医院妇科合并瘢痕子宫患者早期妊娠采用药物流产的病例215例作为病例组,未合并瘢痕子宫者574例作为对照组,均给予相同剂量的米非司酮及米索前列醇进行药物流产,观察两组完全流产、不全流产、流产失败的概率,孕囊排出时间,阴道流血量及不良反应。结果 病例组药物流产成功率为87.4%,对照组的药物流产成功率为89.1%,二者差异无统计学意义;病例组在服用米索前列醇后孕囊排出时间平均为4.24h,对照组为2.57h,二者比较差异有统计学意义（P<0.05）;两组患者出血量均集中在50~80ml,其中病例组中阴道出血量>80ml占21.4%,对照组为13.3%,且二者比较差异有统计学意义（P<0.05）;两组均未发生严重的不良反应,主要为恶心、呕吐、腹泻等胃肠道反应,差异无统计学意义（P>0.05）。结论 合并瘢痕子宫患者采用药物流产术终止早期妊娠是可行的,但需密切观察患者服药后孕囊排出时间、阴道出血量及药物的不良反应。     

Scarifying and fingering surfaces of plunging jets

The local surface deformation resulting from the oblique impact of a columnar water jet has been computed, using a three-dimensional large eddy simulation, as a model of the overturning jet of a breaking wave. The emergence of the secondary jet from the front face of the initial jet has been examined and the organisation of the vortices within the jet characterised. As the secondary jet emerges, the vorticity field becomes unstable under the action of the strong shear beneath the jet surface and pairs of longitudinal counter-rotating vortices stretched along the direction of the jet projection are formed. The presence of these longitudinal vortex pairs creates convergent surface flows, resulting in the formation of longitudinal scars on the rear face of the projecting jet. Following significant growth of the scars on both its upper and lower surfaces, the jet decouples into fingers. The lateral widths of the longitudinal vortices provide a minimum measure of the finger size. A horizontal Froude number Fr_h, representing a measure of strength of horizontal shear in a gravity-dominated impacting flow is defined, which characterises the organisation of the longitudinal vortices occurring in the shear flow, and the resultant formation of scars and fingers. For higher Fr_h, stronger longitudinal vortices and deeper scars are formed at longer lateral intervals, enhancing the fingering process during the splashing event. Fundamental features of material transport in the vicinity of the surface of jets (e.g. gas transfer across a sea surface) are related to the entrainment of surface fluid by the longitudinal vortices, and is thus also characterised by Fr_h.     

Morphologic resilience and depositional processes due to the rapid evolution of the submerged Sciara del Fuoco (Stromboli Island) after the December 2002 submarine slide and tsunami

In order to monitor the Stromboli submarine slope after the 30 December 2002 landslide and tsunami, repeated marine surveys were carried out offshore of Sciara del Fuoco. The morphological changes and depositional processes that brought to the gradual filling of the slide scar have been studied in detail. Thirteen surveys in a period of little more than 4 years provided a unique opportunity to reconstruct the morpho-sedimentary evolution of the submarine slope and its recovery after the mass-wasting event. The scar has been progressively filled with lava and volcanoclastic debris; in the first month and a half, the filling rate was very high due to the entrance of lava flows into the sea and to the morphological readjustment of the slope; in the following months/years the rate dramatically decreased when the eruptive vents moved upwards and the eruption finally stopped. After 4 years (February 2007) more than 40% of the scar was already filled. In early 2007, a new eruption occurred and a lava delta was constructed in the 2002 scar, influencing the natural readjustment of the slope; therefore, our reconstruction only encompasses the period between the 2002 and 2007 eruptions.The swath bathymetry reconstruction of geometry and volume of scar filling during the period 2002–2007 evidenced a punctuated and fast shift of depocenters and debris emplacement through avalanching processes. This process quickly obliterated the features produced by the 2002 tsunamigenic landslide so that a major question about the preservation potential of mass-wasting features on active volcanic flanks emerges.