红光与常规治疗对成人急性化脓性中耳炎的协调作用

目的观察在常规治疗基础上联合红光照射对成人急性化脓性中耳炎(acute suppurative otitis media,ASOM)临床疗效的影响。方法确诊为急性化脓性中耳炎的患者62例68耳,随机分为对照组31例33耳,使用抗生素滴耳、口服黏液促排剂;试验组31例35耳,在此基础上联合红光照射治疗。治疗后7和14 d比较两组患者临床症状改善情况、听力恢复情况;记录外周血的TNF-α、IL-2、IL-6、IL-10、IL-1β;以及耳道内致病菌株数。结果治疗后7和14 d,试验组临床症状改善情况和听力恢复情况(气导听阈均值、气-骨导听阈差均值)分别优于相同治疗时间点的对照组(P<0.05);治疗第7天,对照组外周血的TNF-α和IL-6较治疗前有显著下降(P<0.05),试验组外周血的TNF-α、IL-2、IL-6、IL-10、IL-1β均较治疗前有显著下降(P<0.05)。试验组与对照组相比,除IL-10外,其余炎性因子下降幅度均低于对照组(P<0.05);治疗第14天,两组耳道内致病菌株数显著降低(P<0.05),且试验组显著低于对照组(P<0.05)。结论对于ASOM患者,在常规抗生素联合黏液促排剂治疗的基础上联合红光治疗,可加速鼓室黏膜恢复正常、提高听力改善速度和程度,其机制可能与红光协同消除病原菌、加速降低多项炎性因子水平有关。联合红光治疗对于抗生素疗效不佳而导致病情恢复较慢的患者是很好的选择。     

Bored and online: Reasons for using social media,problematic social networking site use,and behavioral outcomes across the transition from adolescence to emerging adulthood

IntroductionThe current study examined motivations for social networking site use across three years during the transition from late adolescence to emerging adulthood. While research has been conducted examining reasons for social networking site usage and behavior, the clear majority have focused on samples of undergraduate college students and are cross-sectional.MethodsChanges in motivations for using social networking sites were examined in relation to problematic social networking site use and several behavioral and mental health outcomes in a sample of adolescents over three years.ResultsUsing social networking sites to connect with others was relatively stable over a three-year period. However, using social networking sites to seek information increased from late adolescence to emerging adulthood and was not related to any negative outcomes across three years. Using social networking sites to alleviate boredom also increased over time. Initial levels of social media use to alleviate boredom were associated with problematic social networking site use, financial stress, anxiety, and empathy at year three. Increases in using social networking sites to socially connect over time was related to problematic social networking site use, anxiety, delinquency, and empathy at year three. Using social networking sites for any reason was not related to depressive symptoms over three years.ConclusionsThe current study supports the growing body of literature suggesting that using social networking sites to alleviate boredom and socially connect, may place individuals at increased risk for developing pathological tendencies and patterns of behavior towards social networking sites.     

可调节钛金属部分听骨赝复物在II型鼓室成形术中的应用

目的探讨可调节部分钛听骨在II型鼓室成形术听力重建中的疗效。方法回顾分析95例慢性化脓性中耳炎患者（均为单耳发病），随机分为两组，实验组（47耳）：应用可调节钛金属部分听骨赝复物（PORP）行开放式乳突根治术+II型鼓室成形术；对照组（48耳）：应用固定型钛听骨PORP重建听骨链。术后所有患者均随访1年以上，术后3个月、1年时分别对比两组的手术前后听力变化（0.5、1、2、4 kHz）及有效率。结果①实验组中1耳钛听骨移位；1耳筋膜裂缝，纳入听力研究45耳。一期手术成功率为95.7%（45/47），对照组中2耳钛听骨移位、2耳筋膜裂缝，纳入听力研究44耳。一期手术成功率为91.7%（44/48）；②实验组与对照组比较，术后3个月气骨导差比较，差异具有统计学意义（P<0.05）；术后1年气骨导差比较，差异无统计学意义（P>0.05）；③实验组与对照组有效率比较，差异无统计学意义（P>0.05）。结论可调节钛听骨应用于听骨链重建有独特优越性，术后3个月听力恢复优于固定型钛听骨，为中耳传音材料提供新的选择。     

Temporal associations between morningness/eveningness,problematic social media use,psychological distress and daytime sleepiness: Mediated roles of sleep quality and insomnia among young adults

The extant literature has suggested relationships between an individual's chronotype (in relation to morningness/eveningness) and several outcomes, including addictive disorders, psychological distress and daytime sleepiness. Moreover, sleep quality has been proposed to be a mediator in the aforementioned relationships. Consequently, the aim of the present study was to investigate the complex relationship between morningness/eveningness, problematic social media use, psychological distress and daytime sleepiness, with the potential mediators of sleep quality and insomnia. All participants (N = 1,791 [30.1% males]; mean age = 27.2 years, SD = 10.1) completed a battery of psychometric scales, including a reduced version of the Morningness‐Eveningness Questionnaire (at baseline), the Pittsburgh Sleep Quality Index and Insomnia Severity Index (1 month after baseline assessment), the Bergen Social Media Addiction Scale, the Hospital Anxiety and Depression Scale, and the Epworth Sleepiness Scale (2 months after baseline assessment). The impacts of morningness‐eveningness on problematic social media use, anxiety, depression and daytime sleepiness were found in the mediation models. Furthermore, the mediated effects of insomnia and sleep quality were observed. The present study's results emphasize the importance of promoting healthy sleep habits and sleep hygiene behaviours, and that of early detection of sleep problems among individuals who have the eveningness chronotype, because this would significantly improve their health outcomes.     

A Computational Geometry Generation Method for Creating 3D Printed Composites and Porous Structures

A computational method for generating porous materials and composite structures was developed and implemented. The method is based on using 3D Voronoi cells to partition a defined space into segments. The topology of the segments can be controlled by controlling the Voronoi cell set. The geometries can be realized by additive manufacturing methods, and materials can be assigned to each segment. The geometries are generated and processed virtually. The macroscopic mechanical properties of the resulting structures can be tuned by controlling microstructural features. The method is implemented in generating porous and composite structures using polymer filaments i.e., polylactic acid (PLA), thermoplastic polyurethane (TPU) and nylon. The geometries are realized using commercially available double nozzle fusion deposition modelling (FDM) equipment. The compressive properties of the generated porous and composite configurations are tested quasi statically. The structures are either porous of a single material or composites of two materials that are geometrically intertwined. The method is used to produce and explore promising material combinations that could otherwise be difficult to mix. It is potentially applicable with a variety of additive manufacturing methods, size scales, and materials for a range of potential applications.     

Hazardous Petroleum Sludge-Derived Nitrogen and Oxygen Co-Doped Carbon Material with Hierarchical Porous Structure for High-Performance All-Solid-State Supercapacitors

Rational design and sustainable preparation of high-performance carbonaceous electrode materials are important to the practical application of supercapacitors. In this work, a cost-effective synthesis strategy for nitrogen and oxygen co-doped porous carbon (NOC) from petroleum sludge waste was developed. The hierarchical porous structure and ultra-high surface area (2514.7 m² g⁻¹) of NOC electrode materials could provide an efficient transport path and capacitance active site for electrolyte ions. The uniform co-doping of N and O heteroatoms brought enhanced wettability, electrical conductivity and probably additional pseudo-capacitance. The as-obtained NOC electrodes exhibited a high specific capacitance (441.2 F g⁻¹ at 0.5 A g⁻¹), outstanding rate capability, and cycling performance with inconspicuous capacitance loss after 10,000 cycles. Further, the assembled all-solid-state MnO₂/NOC asymmetrical supercapacitor device (ASC) could deliver an excellent capacitance of 119.3 F g⁻¹ at 0.2 A g⁻¹ under a wide potential operation window of 0–1.8 V with flexible mechanical stability. This ASC device yielded a superior energy density of 53.7 W h kg⁻¹ at a power density of 180 W kg⁻¹ and a reasonable cycling life. Overall, this sustainable, low-cost and waste-derived porous carbon electrode material might be widely used in the field of energy storage, now and into the foreseeable future.     

Cerebrovascular events during pregnancy and puerperium

Though cerebrovascular complications of pregnancy remain relatively rare, they represent a potentially devastating event that necessitates prompt identification and treatment. Eighteen percent of strokes occurring in young women are linked to pregnancy. They occur mostly in the third trimester or during the post-partum period. Their biggest risk factors are hypertension, preeclampsia/eclampsia and migraine. Cerebrovascular events occurring during this period may involve specific pathophysiological processes that include embolic phenomena or endothelial dysfunction, but can also have common etiologies that are simply favored by the context of pregnancy. Thus, posterior encephalopathy and vasoconstriction cerebral syndrome are relatively frequently involved in cerebrovascular complications of pregnancy. Other very specific causes like amniotic fluid embolism or postpartum cardiomyopathy can also be responsible for such events. The management of stroke during pregnancy must be multidisciplinary and include a neurovascular expertise. Some conditions can lead to a long-life follow-up and modify the management of a future pregnancy.