剖宫产术后腹壁切口愈合不良的原因

随着我国科技的快速发展以及社会因素、剖宫产手术技术的提高,广大的孕妇对于剖宫产分娩出来胎儿的方法已普遍接受。随着剖宫产率的增高,人们关注的重点反而不是剖宫产,而是在剖宫产后相关并发症,这其中主要是剖宫产术后腹壁切口愈合不良,主要的症状有切口脂肪液化、切口裂开、切口感染等,这些并发症的产生对孕妇及其家属的精神上、身体上、工作上以及经济上都造成了不同程度的损害。如果并发症发生严重情况,甚至会对产妇的生命造成威胁。与此同时,产科的医生所受到的压力也增加起来,而且病床周转率也随之降低。笔者根据本院一些临床实例对剖宫产术后腹壁切口愈合不良的原因进行分析,以此为临床提供能够有效预防与控制剖宫产术后腹壁切口愈合不良以及对愈合不良切口的处理方法。     

Complexity of visual stimuli affects visual illusion induced by sound

The fission illusion is induced by multisensory (audio-visual) integration. In the present study, we assume that perceptual efficiency affects the fission illusion’s rate because this illusion occurs in a short temporal range through the integration of visual and auditory information. The present study examined the effect of perceptual efficiency on the fission illusion by presenting visual patterns with various degrees of complexity. The results indicated that it was more difficult to induce the fission illusion when more complex visual patterns were used. The effect of pattern on the illusion differed according to the stimulus onset asynchrony between the first visual stimulus and the second auditory stimulus. These results suggest that the fission illusion has a higher probability of occurring when the perceptual process of the first visual stimulus is completed and integrated with the first beep before the presentation of the second beep. Thus, the audio-visual integration is affected by the perceptual efficiency of the physical stimuli.     

护士“三定”管理在手术室的实施

目的 探讨“三定”（即定员管理、定向培养、定能分级）管理为核心的新型护理能级管理模式在手术室的实施,以加快专科护士培养进程,提升护士职业发展空间,深化护理内涵质量,推进优质护理服务。方法 根据手术室专科建设规范,按照定员管理原则合理配置护理人员。对规范化培训护士、准专科护士、专科护士三个阶段进行手术室专科护理人才的定向培养,并根据定能分级实现对护士能力的分层次使用及绩效分配。结果 手术室实施“三定”管理后,护士的工作能力得以提升,医生的工作满意度明显提高。结论 “三定”管理方案在手术室切实可行,提高了护理质量,促进了护理队伍的内涵建设和护理专科化发展,激发了护理人员的工作热情和创新能力,可为患者提供高质量的围手术期优质护理服务。     

JCHI EDITOR'S SELECT SITES

Abstract

A review of useful Internet sites on S-Adenosyl-L-Methionine or SAMe is presented. The Internet search engines become confused when attempting to locate material on SAMe because of the commonness of its name. Pending outcome of NCCAM's randomized controlled clinical trials, better insight into safety and efficacy of this relatively new alternative therapy should come to light.     

Determining the difficulty of Word Sense Disambiguation

Automatic processing of biomedical documents is made difficult by the fact that many of the terms they contain are ambiguous. Word Sense Disambiguation (WSD) systems attempt to resolve these ambiguities and identify the correct meaning. However, the published literature on WSD systems for biomedical documents report considerable differences in performance for different terms. The development of WSD systems is often expensive with respect to acquiring the necessary training data. It would therefore be useful to be able to predict in advance which terms WSD systems are likely to perform well or badly on.This paper explores various methods for estimating the performance of WSD systems on a wide range of ambiguous biomedical terms (including ambiguous words/phrases and abbreviations). The methods include both supervised and unsupervised approaches. The supervised approaches make use of information from labeled training data while the unsupervised ones rely on the UMLS Metathesaurus. The approaches are evaluated by comparing their predictions about how difficult disambiguation will be for ambiguous terms against the output of two WSD systems. We find the supervised methods are the best predictors of WSD difficulty, but are limited by their dependence on labeled training data. The unsupervised methods all perform well in some situations and can be applied more widely.     

Surgical treatment of jaw osteonecrosis in “Krokodil” drug addicted patients

Retrospective study of jaw osteonecrosis treatment in patients using the “Krokodil” drug from 2009 to 2013.On the territory of the former USSR countries there is widespread use of a self-produced drug called “Krokodil”. Codeine containing analgesics (“Sedalgin”, “Pentalgin” etc), red phosphorus (from match boxes) and other easily acquired chemical components are used for synthesis of this drug, which used intravenously. Jaw osteonecrosis develops as a complication in patients who use “Krokodil”. The main feature of this disease is jawbone exposure in the oral cavity. Surgery is the main method for the treatment of jaw osteonecrosis in patients using “Krokodil”.40 “Krokodil” drug addict patients with jaw osteonecrosis were treated. Involvement of maxilla was found in 11 patients (27.5%), mandible in 21 (52.5%), both jaws in 8 (20%) patients. 35 Lesions were found in 29 mandibles and 21 lesions in 19 maxillas. Main factors of treatment success are: cessation of “Krokodil” use in the pre- (minimum 1 month) and postoperative period and osteonecrosis area resection of a minimum of 0.5 cm beyond the visible borders of osteonecrosis towards the healthy tissues. Surgery was not delayed until sequestrum formation. In the mandible marginal or segmental resection (with or without TMJ exarticulation) was performed. After surgery recurrence of disease was seen in 8 (23%) cases in the mandible, with no cases of recurrence in the maxilla.According to our experience in this case series, surgery is the main method for the treatment of jaw osteonecrosis in patients using “Krokodil”. Cessation of drug use and jaw resection minimize the rate of recurrences in such patients.