简介:就可以在基表上创建一个afterinsert触发器,可以用数据触发器从一个数据库中向另一个数据库复制数据,当一条记录插入到一个数据库中的某个基表中时
简介:摘要目的探讨采用精确定位法透视在MIS-TLIF减少辐射暴露的效果,为临床治疗提供指导。方法选取我院2015年3月-2017年5月需要进行MIS-TLIF的42例患者为研究对象,随机分为对照组21例和观察组21例,对照组患者选用传统的定位法透视,观察组患者选用精确定位法透视,对比两组患者术前检查和手术中的透视时间、X射线曝光的时间和次数以及手术时间。结果观察组患者术前检查过程中的透视时间为(10.25±2.44)min,X射线的曝光时间为(2.76±0.97)s,曝光次数为(5.7±1.78)次,均显著高于对照组患者的透视时间为(7.95±1.56)min,X射线的曝光时间(1.87±0.55)s,曝光次数(4.69±2.04)次;术中的透视时间为(10.89±2.75)min,X射线的曝光时间为(2.12±0.77)s,曝光次数为(5.1±1.34)次,均显著低于对照组患者的透视时间为(28.13±4.38)min,X射线的曝光时间(4.78±1.24)s,曝光次数(9.76±2.18)次;观察组患者的总的透视时间为(20.54±5.89)min,X射线的曝光时间为(4.98±1.15)s,曝光次数为(10.7±2.54)次和手术总时间(1.5±0.3)h,均显著低于对照组患者的透视时间为(33.54±7.98)min,X射线的曝光时间(6.98±2.43)s,曝光次数(14.77±3.56)次和手术总时间(1.8±0.8)h。结论精确定位法通过术前的精确定位能显著降低术中的辐射时间,节约手术总时间,患者在整个过程中在辐射中的暴露时间要显著低于传统定位法,值得临床推广应用。
简介:教育科研信息化是社会信息化建设的重点,也是经济信息化建设的基础。就高等教育界来说,加快校园网络基础设施与网络MIS规划与实施,推动校园Internet/intranet的建设与发展,逐步建立高校校际间教学、科研等资源信息共享与交流已成为现实。文章对我国高校校园网和网络MIS的建设与管理进行了一定深度的探讨,有较强的适用性。
简介:AbstractBackground:Imprecise interpretation of coronary angiograms was reported and resulted in inappropriate revascularization. Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score is a comprehensive system to evaluate the complexity of the overall lesions. We hypothesized that a real-time SYNTAX score feedback from image analysts may rectify the mis-estimation and improve revascularization appropriateness in patients with stable coronary artery disease (CAD).Methods:In this single-center, historical control study, patients with stable CAD with coronary lesion stenosis ≥50% were consecutively recruited. During the control period, SYNTAX scores were calculated by treating cardiologists. During the intervention period, SYNTAX scores were calculated by image analysts immediately after coronary angiography and were provided to cardiologists in real-time to aid decision-making. The primary outcome was revascularization deemed inappropriate by Chinese appropriate use criteria for coronary revascularization.Results:A total of 3245 patients were enrolled and assigned to the control group (08/2016-03/2017, n = 1525) or the intervention group (03/2017-09/2017, n= 1720). For SYNTAX score tertiles, 17.9% patients were overestimated and 4.3% were underestimated by cardiologists in the control group. After adjustment, inappropriate revascularization significantly decreased in the intervention group compared with the control group (adjusted odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.73-0.95; P = 0.007). Both inappropriate percutaneous coronary intervention (adjusted OR: 0.82; 95% CI: 0.74-0.92; P < 0.001) and percutaneous coronary intervention utilization (adjusted OR: 0.88; 95% CI: 0.79-0.98; P = 0.016) decreased significantly in the intervention group. There was no significant difference in 1-year adverse cardiac events between the control group and the intervention group.Conclusions:Real-time SYNTAX score feedback significantly reduced inappropriate coronary revascularization in stable patients with CAD.Clinical trial registration:Nos. NCT03068858 and NCT02880605; https://www.clinicaltrials.gov.
简介:【摘要】目的:探讨微创通道下经椎间孔腰椎椎间融合术(minimally invasive transforaminal lumbar interbody fusion,MIS-TLIF)治疗椎间盘突出合并椎管狭窄的治疗体会。方法:回顾性分析2019.01~2020.06本院收治的43例椎间盘突出合并椎管狭窄患者的临床资料,按照手术方式的不同分成对照组21例[采用开放后路腰椎植骨融合(PLIF)]、观察组22例(采用MIS-TLIF治疗),比较两组术中出血量、手术时间、术后引流量、卧床时间及住院时间。结果:观察组术中出血量、术后引流量比对照组更少,同时卧床及住院时间比对照组更短(P<0.05)。结论予以椎间盘突出合并椎管狭窄患者MIS-TLIF治疗能减少其术中出血量,缩短其术后卧床及住院时间,符合当前微创理念,应用前景广阔。
简介:AbundantevidencesofhighersealevelsfromJiangsuandFujiancoastshaveprovedamarinetransgressioneventduring30–40kaBP,suggestingthattherewasastagewithhighsealevelandawarmclimatewhenicesheetsshrankintheNorthernHemisphere.Thedurationof30–40kaBPspannedaperiodinthelateMarineIsotopeStage3(MIS3)andwasinnatureaninterstadialepochduringtheLastGlacialperiodoftheQuaternary.Differentfromtheglacialperiodwithacoldclimate,thismarinetransgressionconsideredasapenultimatehighersealevelduringtheQuaternaryremainsapuzzlethatwhytheevidenceiscontrarytotheQuaternaryglacialtheory.Itisimportanttounderstandsealevelrisefortheseareassensitivelyrespondingtotheglobalchangesinthefuture.Torecognizethekeyissuesonsealevelchanges,theeustaticsealevel(H_S)wasdefinedastheglaciation-climateforcedsealevels,andtherelativesealevelchange(H_R)wasdefinedasthatasealevelrecordwaspreservedinsedimentthatexperiencedmultiplesecondaryactionsoflandandseaeffects.Onthebasisasdefinedabove,weconstructedmulti-levelmodelsofclimate-drivenglacio-eustaticchangesandland-seasystems.Byintegratingdatasetsfromeightboreholecoresandprescribingtheboundaryconditions,wesimulatedthechangesofHSandHRintheEastChinaSeaandsouthernYellowSeaareasinthelateMIS3.Themarinetransgressionstratafromtheboreholecoredatawasidentifiedatca.30mbelowpresentsealevelasaresultofthecollectiveinfluenceoficemeltingwater,neotectonicsubsidence,sedimentcompactionandterrestrialsedimentfillingsinceca.35kaago,whereasthesimulatedrelativesea-levelsturnedouttobe–26.3––29.9ma.s.l.Thesmallerrorinvolvedinthesimulationresultsof±(2.5–4.5)mdemonstratedthecredibilityoftheresults.OurresultsindicatedthatsealevelchangeinthelateMIS3wasdominatedbyglacialeffects,inwhichtheeustaticsea-levelwasbetween–19.2�