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2.
目的 探讨儿童颞骨骨折的临床特点及治疗策略。 方法 回顾性分析2014年7月~2021年7月首都医科大学附属北京儿童医院确诊的477例18岁以下颞骨骨折患儿的临床资料,包括患儿性别、年龄、受伤原因、影像学、面神经及听力学评估、并发症、治疗及预后。 结果 477例颞骨骨折患儿中男358例、女119例,男女比例为3∶1,年龄范围为0~18岁,中位年龄9岁,其中6例为双侧。交通事故是受伤主要原因(57.23%),其次为跌倒(23.69%)。最常见的临床症状为鼓室积血和耳出血,通常3周~1个月消失。纵行骨折253耳(52.38%),横行骨折35耳(7.25%),混合型骨折48耳(9.93%),其他不能进行分型147耳(30.43%),表现为轻微骨折线。听力受损372例(77.02%);面神经损伤28例(5.80%),其中8例为内听道及以上层面损伤;脑脊液耳漏47例(9.73%);鼓膜穿孔15例(3.11%)。合并颅内损伤78例(16.35%),全身多发损伤19例(3.98%)。即发性面瘫10例,1例恢复良好(10.00%);迟发性面瘫18例,15例恢复良好(83.33%)。耳科并发症的处理经手术治疗10例,包括8例鼓室探查+听骨链重建,术后听阈恢复正常。2例面神经减压术,术后House-Brackmann面神经功能分级(HB分级)Ⅴ级恢复至Ⅱ级。 结论 儿童颞骨骨折中,男童常见,最常见的受伤原因为交通事故。鼓室积血、鼓膜穿孔、脑脊液耳漏和传导性耳聋经保守治疗多可治愈,外伤所致听骨链骨折或脱位经手术治疗预后良好,外伤所致内听道区域骨折可引起极重度感音神经性耳聋和完全性面瘫,预后较差。  相似文献   
3.
Cutaneous tuberculosis classically presents as Lupus vulgaris, scrofuloderma, tuberculosis verrucose cutis and tubercular abscess. Hypersensitivity reaction to the bacilli leads to Lichen scrofulosorum and papulonecrotic tuberculids. At the same time, it can have myriad of clinical presentations, many of which are still undescribed. It is important to regularly update ourselves with these unusual manifestations so as to ensure early treatment and reduction of overall morbidity. In this case series tuberculosis manifesting as rapidly progressing diffuse facial granulomas, sporotrichoid tuberculosis, tuberculosis mimicking squamous cell carcinoma, scrofuloderma as tubercular ulcer, lupus vulgaris with nasal septal perforation, lupus vulgaris resembling furuncle, psoriasis, dermatitis and BT Hansen are described in immunocompetent individuals. These cases highlight the importance of recognition of atypical forms of cutaneous tuberculosis to minimize scarring and dissemination of bacilli.  相似文献   
4.
目的探讨超脉冲CO2点阵激光联合胶原贴敷料治疗面部痤疮瘢痕的临床效果。方法选取2020年1月至2021年1月宜阳县人民医院收治的60例面部痤疮瘢痕患者作为研究对象,并按照随机数表法将其随机分为观察组和对照组,每组30例,观察组患者采用超脉冲CO2点阵激光联合胶原贴敷料治疗,对照组患者单纯采用超脉冲CO2点阵激光治疗,对比两组患者面部美观度与皮肤屏障功能变化情况、临床疗效以及不良反应发生情况。结果治疗结束后,观察组患者面部皮肤毛孔值、纹理值以及经皮水分丢失(TEWL)、pH值、皮肤红斑指数均明显低于对照组(t=13.490、8.883、2.204、2.692、5.931,P<0.001、P<0.001、P=0.032、P=0.009、P<0.001),角质层含水量明显高于对照组(t=2.752,P=0.008);观察组患者中痊愈10例、显效12例、有效6例、无效2例,明显优于对照组患者的痊愈6例、显效7例、有效9例、无效8例(Z=-2.285,P=0.022);治疗期间,观察组患者不良反应发生率为6.67%,明显低于对照组患者的不良反应发生率30.00%(χ2=5.455,P=0.020)。结论超脉冲CO2点阵激光联合胶原贴敷料治疗面部痤疮瘢痕,可明显改善面部美观度和皮肤屏障功能,疗效显著,且胶原贴敷料可明显降低CO2点阵激光治疗造成的不良反应发生率。  相似文献   
5.
Multiple psychiatric disorders are associated with difficulties in facial emotion recognition. However, generalized anxiety disorder may be associated with more accurate recognition of others’ emotional expressions, particularly expressions of happiness and fear, which index safety and threat. Children aged 9–14 from a community sample (N = 601) completed a facial emotion labeling task. Children’s symptoms of depressive and anxiety syndromes were assessed by self- and parent-report. Elevated symptoms of generalized anxiety disorder were associated with more accurate facial emotion recognition (β = 0.16, p = 0.007), specifically recognition of happiness (β = 0.17, p = 0.002) and fear (β = 0.15, p = 0.006). Elevated depressive symptoms were associated with less accurate facial emotion recognition (β = −0.12, p = 0.018), specifically happiness (β = −0.15, p = 0.002). Elevated symptoms of separation anxiety disorder were also associated with less accurate facial emotion recognition (β = −0.16, p = 0.003), specifically happiness (β = −0.15, p = 0.006) and fear (β = −0.15, p = 0.005), which highlights the importance of distinguishing between anxiety syndromes. Results held when adjusting for child age and sex. Evidence that symptoms of generalized anxiety disorder are associated with more accurate recognition of happiness and fear is consistent with theories of heightened social vigilance and support a transdiagnostic role of facial emotion recognition that may inform the psychosocial development of youth with anxiety and depressive symptoms.  相似文献   
6.
In this study, we examine the potential for using face imaging sensing technology in place of a human forensic practitioner to estimate the age of cadavers. We used the age estimation software FieldAnalyst for Signage Ver. 6.0 AW32. To validate the usefulness of its age estimation for living subjects, images of 28 subjects were taken at three angles (+30°, 0°, and −30°) with respect to the horizontal plane, with their eyes open and closed. The highest positive correlation between mean the estimated age and the actual age (y = 1.02x − 0.35, and Spearman’s rank correlation coefficient of 0.78, P < 0.001) was obtained when the subjects had their eyes closed and the image was captured at an angle of 0°. The ages of 93% of the subjects were estimated within ±10 years of their actual ages. We then applied this procedure to 61 cadavers with their eyes closed. Facial images were taken at an angle of 0° with respect to the horizontal plane and used to estimate the ages of the cadavers. Although a positive correlation between the actual and mean estimated ages was obtained (y = 1.28x + 0.43, Pearson’s correlation coefficient of 0.69, P < 0.001), the mean estimated ages of only 39.3% of the subjects were within ±10 years of their actual ages. It appears that this technology is not accurate enough to use to determine the age of a cadaver. Therefore, medical inspectors with adequate knowledge and experience are still required for postmortem examination.  相似文献   
7.
BackgroundProgress in neonatal medicine has dramatically improved the survival rate of preterm births, but the evidence suggests that these low-birth weight infants (LBWIs) go on to develop pervasive development disorders and attention deficit hyperactivity disorder (ADHD) at greater rates than the general population. Children with neurodevelopmental disorders are known to suffer from deficits in visual cognition, such as in face perception and attentional functions, the characteristics of which already manifest in early infancy.PurposeThis study aimed to investigate visual cognition in LBWIs during infancy.Subjects20 LBWIs and 20 normal-birth-weight infants (NBWIs: control) of age 9–10 months (corrected age was used for LBWIs).MethodChildren were held seated in front of an eye tracking system by a parent, and presented with facial photos as visual stimuli. During the familiarization phase, the child was presented with two images of the same human face (familiarization stimulus) on the left and right side of a display screen (5 × 10 s trials). Next, during the test phase, the child was presented with the same image on one side of the screen, and a photo of a different person’s face (novel stimulus) on the other (2 × 5 s trials). Gaze behavior was assessed in terms of the total time spent looking at either facial stimulus, and specifically at the eyes of the stimuli, as well as the number of attentional shifts between stimuli, and novelty preference.Results/DiscussionLBWIs spent significant less time looking at facial stimuli overall, and less time at the eye region, than NBWIs. These findings seem to evidence developmental differences in functions related to visual cognition.  相似文献   
8.
To explore patients’ experiences of orthognathic treatment for facial asymmetry and their adaptation to facial changes after surgery, we did a qualitative, cross-sectional study of patients after treatment for non-cleft asymmetry at two UK sites. A total of 15 patients aged 19-40 years were approached after being identified using patient databases and clinical notes. Individual and photo-elicitation interviews were conducted covering experiences prior to treatment, during treatment, and after surgery. Interviews were transcribed and thematic narrative analysis undertaken. Participants were largely positive about their orthognathic treatment. The following themes were identified: preoperative (becoming aware, negative impacts of asymmetry, committing to treatment, establishing expectations), pre-surgery orthodontics and inpatient experiences (challenges and coping strategies, preparedness, support, and shared experiences); and postoperative (surgery as ‘worth it’, positive impacts of treatment, adapting to facial change). Undergoing orthognathic surgery was portrayed as a journey involving recognisable narratives (treatment unfinished, threat of liminality, treatment as resolution, and treatment as transformation). Patients’ experiences of facial asymmetry are associated with feeling ‘abnormal’, and negative impacts, and orthognathic treatment for facial asymmetry is worthwhile. Having the feeling that something is ‘wrong’ legitimised by clinicians allows patients access to a recognisable treatment narrative (resolution). Orthognathic treatment is also described as transformation from ‘normal abnormality’ to being ‘normal’. Nevertheless, the associated challenges can be frustrating, particularly if resolution is hard to envisage. Further psychological input could help patients cope with these challenges and the complex process of adapting to facial change.  相似文献   
9.
《Vaccine》2021,39(40):5729-5731
IntroductionConcerns were raised over an increase in Bell's palsy, herpes simplex and herpes zoster after BNT162b2 vaccination, all are manifestations of herpesviruses reactivation. As herpesviruses commonly reactivate in the oropharynx, we have hypothesized that oropharyngeal shedding of herpesviruses will increase after vaccination.MethodsImmune-competent Adults, excluding those using topical steroids or manifesting symptomatic herpesvirus infection, were sampled before BNT162b2 vaccination and one week after. Herpesviruses 1–7 shedding was tested with a multiplexed PCR.ResultsIn 103 paired samples the prevalence of herpesviruses was similar before and after vaccination: HSV1, 3.9% vs. 5.8% (p = 0.75); HSV2, 0% vs. 1% (p = not applicable, NA); VZV, 0% vs. 0% (p = NA); EBV, 14.6% vs. 17.5% (p = 0.63); CMV, 0% vs. 0% (p = NA); HHV6, 4.9% vs. 7.8% (p = 0.55); HHV7, 71.8% vs. 72.8% (p = 1); any herpesvirus, 73.8% vs. 74.8% (p = 1).DiscussionWe did not find evidence for increased oropharyngeal reactivation of herpesviruses one week after BNT162b2.  相似文献   
10.
裴晓红 《光明中医》2021,(2):273-276
目的探讨补阳还五汤、针灸拔罐联合甲钴胺穴位注射治疗面神经炎的临床疗效。方法选取2019年2月—2020年2月收治的46例发生面神经炎的患者为本研究对象,采用随机数字表法将其分为观察组和对照组各23例,对照组采用针灸拔罐联合甲钴胺穴位注射治疗,观察组在对照组基础上给予补阳还五汤治疗,比较2组患者治疗后近期、远期患部功能恢复情况及临床疗效。结果治疗前,2组患者的临床症状评分及面部神经功能等级评估结果差异均不显著(P>0.05);治疗后1个月(近期)及治疗后3个月(远期),观察组患者的临床症状评分均显著低于对照组(P<0.05)。治疗后(远期)观察组患者中Ⅰ级患者比例显著高于对照组(P<0.05),2组中Ⅱ级和Ⅲ级患者占比差异均不显著(P>0.05),观察组显效患者占比显著高于对照组(P<0.05)。2组治疗总有效率差异不显著。结论补阳还五汤、针灸拔罐联合甲钴胺穴位注射治疗可显著缓解患者面神经炎的近、远期临床症状,有效促进患者面部神经功能恢复,具有重要临床价值。  相似文献   
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