Principle of relative positioning of structures in the human body

The arrangement of various biological structures should generally ensure the safety of crucial structures and increase their working efficiency; however, other principles governing the relative positions of structures in humans have not been reported. The present study therefore investigated other principles using nerves and their companion vessels in the human body as an example. Nerves and blood vessels usually travel together and in the most direct way towards their targets. Human embryology, histology, and gross anatomy suggest that there are many possible positions for these structures during development. However, for mechanical reasons, tougher or stronger structures should take priority. Nerves are tougher than most other structures, followed by arteries, veins, and lymphatic vessels. Nerves should therefore follow the most direct route, and be followed by the arteries, veins, and lymphatic vessels. This general principle should be applicable to all living things.     

The Effects of Anxiety on Affective Learning and Serial Position Recall

Sixty-five college-aged adults participated in a study that examined the effects of trait and state anxiety on learning positive and negative emotional words from the Affective Auditory Verbal Learning Test (AAVL). Self-reported state and trait anxiety were measured via Speilberger's State-Trait Anxiety Inventory (STAI). Each participant completed the five learning trials and delayed recall trial of the positive and negative word lists; order of administration for the word lists was counterbalanced across participants. Using ANOVA, initial analyses revealed significant effects for order of administration of the positive and negative word lists. ANCOVAs (using state and trait anxiety as covariates) yielded a significant interaction involving serial position, trial, and state anxiety as well as an interaction involving serial position, trial, and trait anxiety. Post hoc analyses did not support a priori hypotheses. However, state anxiety was associated with decreased word recall on the first learning trial. The results of this study indicate that state anxiety is initially associated with decreased performance when learning emotional words. However, these initial effects dissipate with subsequent learning trials. Implications for task performance are discussed.     

控制性降压下俯卧位脊柱手术全麻患者眼内压及眼底动脉血液动力学的变化

目的实时监测控制性降压对俯卧位脊柱手术全麻患者眼内压及眼底动脉血液动力学的影响,以探讨其安全阈值。方法随机选取预行俯卧位脊柱全麻手术的60例外科患者为研究对象,麻醉过程中采用硝酸甘油控制性降压。选择诱导前10 min(T0)、诱导后10 min(T1)、俯卧位后10 min(T2)、控制性降压10%(T3)、20%(T4)、30%(T5)、恢复正常血压10 min(T6)、术毕平卧位后10 min(T7)、拔出气管导管后10 min(T8)9个时间点,使用笔式眼压计测量眼内压(IOP),使用彩色多普勒超声仪测定右眼视网膜中央动脉和睫状后动脉的血流动力学特征收缩期最高流速(PSV)、舒张末期最低流速(EDV)、阻力指数(RI)及搏动指数(PI)。结果患者诱导麻醉后,IOP、RI及PI随着麻醉时间的延长呈升高趋势,PSV及EDV呈降低趋势,T5时,各指标差异性最大,均较T0有显著差异(P0.05或0.001)。T6后,各指标有所恢复,T8各指标较T0无统计学差异(P0.05)。另外,T5时4例患者出现视网膜中央动脉闭塞(CRAO)征象,其MAP均低于患者该时段平均水平(64.8±8.66 mmHg)。结论控制性降压对俯卧位脊柱手术全麻患者的眼内压及眼底动脉血液动力学指征有所影响,血压降低水平控制在基线水平的30%以内,且保证目标MAP65 mmHg,可有效保护患者视神经。     

Physiological effects of anterior repositioning splint on temporomandibular joint disc displacement: a quantitative analysis

Anterior repositioning splints (ARS) are used primarily for the management of temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). However, the exact physiological effects of ARS are still unclear. This study investigated the short and long‐term effects of ARS on disc and condyle angles/positions by metric analysis. Twenty‐two subjects diagnosed with ADDwR were recruited. Maxillary full‐coverage ARS were fabricated, and MRI of TMJs was obtained before splint treatment, immediate post‐insertion and 6 months after splint treatment. Disc–condyle relationship was determined by disc–condyle angle measurement. Disc and condyle positions were described as X‐Y coordinates with the summit of glenoid fossa as the origin of the coordinates. Thirty‐two TMJs were classified as ADDwR and 12 were normal. Upon ARS insertion, all TMJs with ADDwR got normal disc–condyle relationships. The condyles moved significantly forward and downward, while the discs moved significantly backward and upward. MRI at 6 months after treatment (without ARS insertion) indicated that only 40·6% (13/32) of the joints were maintained in the normal disc–condyle relationship. The majority of condyles returned to their pre‐treatment positions, while the discs generally moved anteriorly again. The use of ARS resulted in forward and downward condyle movement, and a concurrent backward movement of the disc resulting in ideal spatial disc–condyle relationship. The stability of this relationship, however, could not be maintained in the majority of TMJs upon ARS removal. Findings explain the good short‐term clinical outcomes with ARS and their relatively lower efficacy in the long term.     

高位复杂性肛瘘的治疗进展

阐述了在治疗高位复杂性肛瘘方面的新方法和技术，介绍了改良的挂线术、保留括约肌的术式和封堵注入术的治疗方法和效果。改良的挂线引流术式仍是治疗高位复杂性肛瘘的主要方法；新近出现的保留括约肌的手术方法为减少肛门功能失禁、彻底治疗高位复杂性肛瘘提供了可能；封堵填充术因其操作简单、较好的治愈率等特点正成为非手术治疗的主要方法。     

64层螺旋CT在肿瘤调强放射治疗定位中的应用及分析

目的：探讨64层螺旋CT在肿瘤调强放射治疗定位中的临床应用及CT扫描床的误差分析。方法：收集我院2010年6月-2011年6月在TOSHIBA Aquiiion 64层螺旋CT机上进行肿瘤调强放疗定位CT扫描患者25例。其中，男13例，女10例，年龄35—73岁，平均年龄55岁。头颈部肿瘤10例，胸部肿瘤5例，腹部肿瘤6例，盆腔肿瘤4例。CT定位图像经DICOM3．0接口传输到XVI软件中，在Workstation上进行治疗床与定位床的误差分析。结果：组内数据符合统计学意义（P〈0．05），误差值X轴为（0．968±0．910）°，Y轴为（0．508±2．09）°，Z轴为（0．3±2．62）°。除X轴外，旋转误差均不符合国标GB／T17589—1998。结论：64层螺旋CT碳纤维平板床在肿瘤调强放疗定位中误差已超过阈值，不适合做精确调强放射治疗定位。     

不同体位下留置鼻肠管在老年痴呆患者中的应用效果

目的 探讨不同体位下留置鼻肠管在老年痴呆患者中的应用效果。方法 选取我院在2019 年2 月至2020年2 月确诊并治疗的老年痴呆患者100 例，依据置管时的不同体位分成两组，对照组（n=50）应用仰卧位（床头抬高＜30°），研究组（n=50）应用45°右侧卧位。观察比较两组的一次性成功置管比率水平差异；两组的置管平均耗时水平差异；两组置管过程中的相关反应发生比率水平差异。结果 研究组一次性成功置管比率水平为94.0%（47/50），对照组一次性成功置管比率水平为76.0%（38/50），研究组一次性成功置管比率水平高于对照组（P＜0.05）。研究组置管平均耗时为（131.6±10.1）s，对照组置管平均耗时为（284.1±13.4）s，研究组置管平均耗时水平短于对照组（P＜0.05）。研究组置管过程中发生相关反应的比率水平低于对照组（P＜0.05）。结论 给予老年痴呆患者在留置鼻肠管时使用45°右侧卧位可显著提高一次性成功置管比率，缩短置管耗时，降低患者发生相关置管反应的比率水平。