共同性内斜视手术的术后正位率

目的探讨共同性内斜视手术的术后正位率及其影响因素。方法统计和分析46例共同性内斜视的手术效果及术前诸多因素与术后正位率的关系。结果46例中手术后正位34例(73％)。发病年龄、手术年龄、病程、手术前双眼视力及手术前斜视是否交替性与术后双眼视功能的建立密切相关，而与眼位矫正无关，手术量是术后眼位的决定性因素。结论超常量内直肌徙后、以戴镜及裸眼视近斜视度的平均值作为目标角及以角膜缘为起点测量手术量都是提高手术正位率的重要因素。     

少年儿童眼外伤术后无晶体眼的接触镜矫正

目的探讨少年儿童单眼外伤术后无晶状体眼的接触镜(CL)矫正方法和临床效果.方法观察81名少年儿童眼外伤术后患者的眼部改变,并根据其屈光状态的变化、对侧眼的状态及其生活的实际需要,选择验配了软性接触镜(SCL)、托力克软性接触镜(TSCL)、透气性硬性接触镜(RGPCL)、加虹膜色彩的非透气性硬性接触镜(PMMA虹彩片)和软、硬组合型镜片系统(Piggyback CL),并比较视力矫正效果.结果与对侧健眼比较,外伤术后眼角膜曲率半径值显著改变,角膜散光度明显增加.52眼选用SCL和TSCL,矫正视力与框架眼镜比较无明显差异;22眼选用RGPCL,4眼选用PMMA虹彩镜,3眼选用Piggyback CL,三种镜片矫正视力比框架眼镜明显提高.PMMA虹彩镜和Piggyback CL用于外伤后角膜白斑、术后无晶状体、虹膜严重损伤眼,除显著提高视力外,还明显改善了羞明症状和眼外观.结论在严格的医疗化管理下,利用CL矫正少儿眼外伤术后无晶状体眼的高度屈光不正、屈光参差,恢复双眼视觉是安全、有效的.硬性接触镜(HCL)的视力矫正效果明显优于SCL.     

银镜反应实验条件的探讨

经过反复实验比较 ,并结合理论分析 ,对银镜反应实验条件进行了探讨和改进 ,基本上掌握了银镜反应实验的最佳条件 ,达到了理想的实验效果     

经腹扩大食管裂孔在近侧部胃癌根治术的应用

目的探讨经上腹正中延长切口扩大食管裂孔方法在近侧部胃癌根治术的应用效果。方法对1997年￣2004年52例近侧部胃癌经腹扩大食管裂孔行根治切除术的病例进行回顾性总结分析。结果52例中无手术死亡,食管断端无癌残留,无吻合口瘘等术后近期并发症。结论经上腹延长切口扩大食管裂孔行近侧部胃癌根治术,创伤小,食管下段切除充分,操作较简单,有实用价值。     

SPECT探头系统的校正与调试

本文阐明了对SPECT探头校正与调试的重要性,特别是对探头校正与调试的具体方法与步骤作了详细介绍。     

Discoverg VH的符合成像原理及其质量控制

Discovery VH不但可以进行单光子成像而且还具有部分的PET功能。本文综述了该仪器的系统性能,成像原理以及在临床应用的质量控制。     

对男性海洛因依赖者康复训练效果的随访

目的:探索社区康复训练与劳动教养相结合的康复模式对男性海洛因依赖者的治疗效果。方法:以湖南省新开铺劳教大队的50名劳教吸毒人员为对照,对戒毒中心的50名劳教吸毒人员进行为期至少4个月的康复训练。康复训练以海洛因依赖者的需求、所处的康复阶段及接受能力为中心,包括强化戒毒治疗动机、减少吸毒造成的危害、复吸预防等各种技能训练。用成瘾严重度指数和应付方式问卷评估康复训练的疗效,并随访两组在解教后1 a的康复情况。结果:康复训练后海洛因依赖者幻想、退避、自责等不成熟型应付方式分值下降(P<0.01),求助的分值增加(P<0.01)。解教后1 a康复组与劳动教养组的戒断率差异无显著性,但康复训练组在海洛因滥用严重程度、违法犯罪行为和精神健康方面损害显著低于劳动教养组(P<0.05)。结论:劳动教养和社区康复训练都是对吸毒者有效的康复措施,康复训练的作用更大。     

Age Correction Factor in Noise-Induced Hearing Loss: A Quantitative Model

This paper considers the factors of presbyacusis and noise exposure in relation to permanent hearing loss and provides a quantitative model from which an age correction factor in occupational hearing loss may be derived. The rationale for a presbyacusis correction is provided in terms of physiological and audiometric data. The additivity hypothesis is considered and constraints on this approach are presented. A quantitative model for assessing the age component in occupational hearing loss is then derived from empirical functions. The model is based on the concept of a variable ratio for partitioning the effects of presbyacusis and noise exposure. Consideration is given to the application of the model in medico-legal cases of occupational hearing loss in which the degree of hearing impairment must be assessed.

L'exposition au bruit et l'aˇge sont les deux principaux facteurs ayant des effets nocifs sur l'audition. Ces facteurs sont-ils complémentaires, s'ajoutent-ils, ou bien agissentils l'un sur l'autre? Nous proposons un modèle quantitatif donnant la correction due à l'aˇge lorsqu'on considère une perte d'audition due au bruit.     

Hydroxyapatite (HA) coating appears to be of benefit for implant durability of tibial components in primary total knee arthroplasty

Background It is unclear whether there is a clinical benefit to adding hydroxyapatite (HA) coatings to total knee implants, especially with the tibial component, where failure of the implant more often occurs. A systematic review of the literature was undertaken to identify all prospective randomized trials for determining whether the overall clinical results (as a function of durability, function, and adverse events) favored HA-coated tibial components.

Methods A comprehensive literature search was performed for the years 1990 to September 16, 2010. We restricted our search to randomized controlled trials involving participants receiving either an HA-coated tibia or other forms of tibial fixation. The primary outcome measures evaluated were durability, function, and acute adverse events.

Results Data from 926 evaluable primary total knee implants in 14 studies were analyzed. Using an RSA definition for durability, HA-coated tibial components (porous or press-fit) without screw fixation were less likely to be unstable at 2 years than porous and cemented metal-backed tibial components (RR = 0.58, 95% CI: 0.34–0.98; p = 0.04, I² = 39%, M-H random effects model). There was no significant difference in durability, as measured from revision and evaluated at 2 and 8–10 years, between groups. Also, functional status using different validated measures showed no significant difference at 2 and 5 years, no matter what measure was used. Lastly, there was no significant difference in adverse events. Limitations included small numbers of evaluable patients (≤ 50) in 7 of the 14 trials identified, and a lack of “hard” evidence of durability with need for replacement (i.e. frank failure, pain, or loss of functionality).

Interpretation In patients > 65 years of age, an HA-coated tibial implant may provide better durability than other forms of tibial fixation. Larger trials should be undertaken comparing the long-term durability, function, and adverse events of HA-coated implants with those of other porous-coated tibial implants in younger, more active OA patients.     

Effects of experimental occlusal interference on body posture: an optoelectronic stereophotogrammetric analysis

In recent years, there has been increasing interest in the relationship between dental occlusion and body posture both among people and in scientific literature. The aim of the present longitudinal study is to investigate the effects of an experimental occlusal interference on body posture by means of a force platform and an optoelectronic stereophotogrammetric analysis. An occlusal interference of a 0‐ to 2‐mm‐thick glass composite was prepared to disturb the intercuspal position while not creating interference during lateral or protrusive mandibular excursions. Frontal and sagittal kinematic parameters, dynamic gait measurements and superficial electromyographic (SEMG) activity of head and neck muscles were performed on 12 healthy subjects. Measurements were taken 10 days before the application of the occlusal interference, and then immediately before the application, the day after it, and at a distance of 7 and 14 days under four different exteroceptive conditions. The outcomes of this study show that an occlusal interference does not modify significantly over time static and dynamic parameters of body posture under different exteroceptive conditions. It has a minimal influence only on the frontal kinematic parameters related to mandibular position, and it induces a transient increase of the activity of masticatory muscles. In this study, the experimental occlusal interference did not significantly influence the body posture during a 14‐day follow‐up period.