RPLU、FURL及PCNL治疗输尿管上段嵌顿性结石的疗效研究

目的探讨后腹腔镜切开取石术（retroperitoneal laparoscopic lithotomy，RPLU）、输尿管软镜碎石清石术（lithotripsy with flexible ureteroscope，FURL）及经皮肾镜碎石清石术（percutaneous nephrolithotomy，PCNL）种不同方法治疗输尿管上段嵌顿性结石的疗效，以明确直径大于1.5 cm的输尿管上段嵌顿性结石的最佳处理方案。 方法回顾性分析159例输尿管上段嵌顿性结石，收集其术前术中资料，按术式不同分为RPLU组56例、FURL组55例、PCNL组48例。对手术时间、术后住院时间、结石清除率、术后并发症等数据进行统计学分析。 结果FURL组手术时间和术后住院时间明显短于RPLU组和PCNL组，差异均有统计学意义（P＜0.05）。RPLU组术后3 d和术后1个月的结石清除率（100%，100%）稍高于FURL组（90.9%，94.5%）和PCNL组（93.8%，93.8%），3组患者术后无严重并发症出现，差异均无统计学意义（P＞0.05）。 结论3种不同手术方法治疗嵌顿性输尿管上段结石均安全有效，FURL组手术时间及住院时间更短，患者术后恢复更快，更具有优势。     

Gender equity: how do the forensic sciences fare?

ABSTRACT

Females are underrepresented in science, technology, engineering and mathematics (STEM) at all levels of society. Fewer females are completing STEM school subjects, graduating with STEM degrees, being employed as STEM professionals, and holding senior leadership and academic positions in STEM. However, unlike almost every other STEM discipline, the overall ratio of females is higher in many forensic science disciplines. For our sector, rather than having difficulty in attracting females, the bigger issue is how we retain and promote female talent. This complex issue is exacerbated by: gender pay gaps; family role expectations; lack of visible role models or mentors; discrimination and harassment; and bias during recruitment and promotion practices. We discuss barriers relevant for women in the forensic industry and offer potential solutions. These include flexible work arrangements, sponsorship programmes, and fostering and practising an inclusive workplace culture. Gender equity programmes and exemplar STEM organizations focused on a commitment to gender parity will be explored. Harnessing untapped female talent is as much a social justice issue as employing best practices for improving the quality, diversity and output of our forensic science workforce, and research and innovation strategies.     

内镜柔性器械腱鞘传动模型及实验研究

目的 建立内镜柔性器械腱鞘系统的推力传动模型，研究影响传动效率的关键因素。方法 建立腱鞘系统在器械推送作用下力和位移的传动模型并进行仿真计算；搭建腱鞘系统传动测试的实验平台以验证模型的准确性，研究传动速度、腱鞘直径比、弯曲半径等对传动效率的影响。结果 腱鞘传动过程中存在显著的非线性传递现象，传动模型仿真与实验结果基本符合；传动速度、腱鞘直径比、弯曲半径均对内镜柔性器械的推力传动有较大影响，对位移传动的影响相对小一些。结论 该模型可用于内镜柔性器械中腱鞘系统推力传动的计算，提供给医生器械工作末端的力反馈，以保证器械的安全操作和提高手术效果；在内镜柔性器械的精准控制中需要综合考虑传动速度、腱鞘传动比、弯曲半径等对运动传递的影响。     

经皮肾镜气压弹道超声碎石在肾结石中的效果

目的 B超引导经皮肾镜气压弹道超声联合碎石治疗肾结石的临床效果。方法选择2017年9月-2018年9月医院收治的肾结石患者82例,按照抽签法的要求将其平均分成对照组(41例:B超引导经皮肾镜气压弹道超声治疗)与试验组(41例:输尿管软镜治疗),分析手术时间、住院时间、出血量、结石清除率、结石的残留率。结果试验组的手术时间、住院时间、出血量。优于对照组,数据比较有差异性,P<0.05。对照组的结石清除率高于试验组、结石的残留率低于试验组,相互比较有差异性,P<0.05。结论在肾结石实际治疗期,使用输尿管软镜钬激光碎石治疗方式。     

Young children in day and night care: negotiating and constructing belonging during daily arrivals

The paper aims at understanding the processes related to young children's belonging during daily arrivals at day and night care. Two aspects of a child's belonging are considered: membership and sense of belonging. Data were gathered by ethnographic observation of 8 children aged from 20 to 36 months in two Finnish day care centres offering day and night care. Arrival episodes taking place at different times of day were analysed qualitatively based on the children's actions and expressions. During these episodes, the children negotiated and constructed their belonging by interacting with adults, peers and material objects. These interactions took place within varying social and material surroundings and according to different daily routines that sometimes challenged the child's belonging. The results underline the importance of sensitive responsiveness by educators to young children's initiatives in supporting children's belonging during daily arrivals at day and night care.     

Self‐reported musculoskeletal disorder pain: The role of job hazards and work‐life interaction

Background

Previous research identified an association between work‐family conflict and musculoskeletal pain. This study explores how the work‐life interface might affect pain experienced by residential aged care staff.

Methods

A cross‐sectional survey of 426 employees in residential aged care was analyzed to assess the impacts of workplace hazards, work‐family conflict, and work‐life balance on self‐reported musculoskeletal pain.

Results

Work‐family conflict acts as a mediator of the relationships between workplace hazards and the total number of body regions at which musculoskeletal pain was experienced. Work‐life balance only acts as a mediator for particular hazards and only if work‐family conflict is not taken into account.

Conclusions

Addressing work‐life interaction, and in particular work‐family conflict, warrants further investigation as a legitimate means through which musculoskeletal disorder risk can be reduced. Policies and practices to improve work‐life interaction and reduce work‐family conflict should be considered as integral components of musculoskeletal disorder risk management strategies.

     

铸造支架式弹性义齿在修复KennedyⅠ、Ⅱ类牙列缺损中的效果观察

目的：通过两种不同的KennedyⅠ、Ⅱ类可摘局部义齿的临床效果观察，为优化义齿没计提供临床依据。方法：对18例末端游离缺失的牙列缺损患者，每人分别制作两种义齿（Ⅰ号义齿：铸造支架＋塑料，Ⅱ号义齿：铸造支架＋弹性义齿材料），进行临床效果观察及患者满意度调查，结果用Fisher确切概率法进行统计分析。结果：美观效果Ⅱ号义齿优于Ⅰ号义齿（P〈0．05）{功能效果Ⅱ号义齿与Ⅰ号义齿相近（P〉0．05）。结论：无金属卡环显露的铸造支架与弹性义齿材料结合的可摘局部义齿设计，是一种值得推广的临床没计。