Effect and Safety of Tongyan Spray (通咽喷雾剂) on Hyoid Motion in Patients with Dysphagia after Ischemic Stroke

Objective: To observe the effects and safety of Tongyan Spray (通咽喷雾剂) on the range and time of hyoid motion in patients with ischemic post-stroke dysphagia. Methods: Seventy-two patients with ischemic post-stroke dysphagia were selected and randomly assigned to a treatment group (36 cases) and a control group (36 cases) by a random number table from January 2013 to October 2014. All patients swallowed 4 kinds of barium meals with different traits respectively, and each patient underwent video fluoroscopy (VF) examination twice. In the treatment group, Tongyan Spray was sprayed to the pharynx on both sides and the middle part once respectively. The spray was applied 30 min before the second examination. Purified water at room temperature was used as placebo in the control group. The changes in the range and time of hyoid motion in both groups were observed before and after treatment. Results: Six patients dropped out in each group, and 60 patients completed the study and were included in the final analysis. Significant improvement was observed in the range of superior hyoid excursion distance and the time of hyoid motion in the treatment group compared with the control group (P<0.05). There were no obvious adverse reactions observed in oral mucosa in both groups during the whole study. Conclusion: Tongyan Spray was an effective and safe medicine for improving swallowing function in patients with ischemic post-stroke dysphagia.     

微视频在ICU气管套管带管出院患者家属健康教育中的应用

目的探讨应用微视频对ICU气管套管带管出院患者的家属实施健康教育的效果。方法选取2018年9月—2020年9月的100例气管套管带管出院患者的家属,根据随机数字表法将其随机分为对照组和试验组各50例,对照组实施常规健康教育和随访;试验组在此基础上将患者出院后面临的共性问题进行归纳总结,制定并应用微视频对其实施健康教育。分别比较两组患者家属在气管套管相关知识知晓率、气管套管护理操作的准确性以及患者气管切开并发症发生率之间的差异。结果试验组家属在气管套管相关知识的知晓率和护理技能的得分均高于对照组家属(P<0.05),但患者气管切开相关并发症发生率低于对照组(P<0.05)。结论应用微视频实施健康教育可有效提高ICU气管套管带管出院患者家属的管路护理水平,提高患者带管期间的安全性。     

单孔胸腔镜下肺癌术后胸腔引流时间的影响因素分析北大核心

目的:探讨单孔胸腔镜下肺癌手术术后胸腔引流时间的影响因素。方法:本研究采用回顾性分析方法,回顾我院2018年01月至2019年12月原发性肺癌患者经单孔胸腔镜手术治疗的病例199例。按照术后胸腔引流时间分为两组,Ⅰ组(术后胸腔引流时间<5天)和Ⅱ组(术后胸腔引流时间≥5天)。对于影响术后胸腔引流时间的可能因素在两组间先采用单因素分析的方法筛选,再将筛选出来的对术后胸腔引流时间可能有意义的影响因素进行二项Logistic多因素回归分析。结果:经单因素分析及二项Logistic多因素回归分析结果显示:年龄≥60岁、手术部位、肺段切除术、胸膜粘连、手术时间≥180 min、术后早期下床活动是术后胸腔引流时间的独立影响因素(P<0.05)。结论:对于具有多个延长术后胸腔引流时间的独立影响因素的患者,应制定个体化管理方案,尽可能减少术后胸腔引流时间,减少住院天数,加快患者康复。     

猪尾巴导管在单孔胸腔镜肺肿瘤手术中应用的有效性评估:基于倾向性评分匹配法的研究

目的评估猪尾巴导管在单孔胸腔镜肺肿瘤手术中应用的有效性。方法回顾性分析2020年1月至12月上海交通大学医学院附属仁济医院东院接受单孔胸腔镜肺肿瘤手术的患者共441例,根据是否放置猪尾巴导管分为胸管组和猪尾巴管组,通过倾向性评分匹配法进行1∶1匹配,对比两组患者围手术期的各项指标。结果匹配后每组143例配对成功,匹配后两组间基线特征无统计学差异。对比两组围手术期指标发现,猪尾巴管组患者术后3天胸腔引流总量显著多于胸管组(375.49 ml对285.03 ml,P<0.001),术后两周复查CT示胸腔积液量显著少于胸管组(131.77 ml对178.84 ml,P=0.032),两组术后疼痛评分、引流天数及住院天数无明显统计学差异。结论加放猪尾巴导管可有效改善单孔胸腔镜肺肿瘤术后胸腔引流情况,且不增加患者术后疼痛,不延长胸腔引流及住院天数。     

Capsule endoscopy for small‐intestinal disorders: Current status

Small‐bowel capsule endoscopy (SBCE) is used widely because of its non‐invasive and patient‐friendly nature. SBCE can visualize entire small‐intestinal mucosa and facilitate detection of small‐intestinal abnormalities. In this review article, we focus on the current status of SBCE. Several platforms for SBCE are available worldwide. Third‐generation SBCE (PillCam^® SB3) has a high‐resolution camera equipped with an adaptive frame rate system. Several software modes have been developed to reduce the reading time for capsule endoscopy and to minimize the possibility of missing lesions. The main complication of SBCE is capsule retention. Thus, the main contraindication for SBCE is known or suspected gastrointestinal obstruction unless intestinal patency is proven. Possible indications for SBCE are obscure gastrointestinal bleeding, Crohn's disease, small‐intestinal polyps and tumors, and celiac disease. Colon capsule endoscopy (CCE) can observe inflamed colonic mucosa non‐invasively, and allows for the continuous and non‐invasive observation of the entire intestinal tract (pan‐endoscopy). Recently, application of CCE as pan‐enteric endoscopy for inflammatory bowel diseases (including Crohn's disease) has been reported. In the near future, reading for CE will be assisted by artificial intelligence, and reading CE videos for long periods will not be required.     

Little video-gaming in adolescents can be protective,but too much is associated with increased substance use

Background: Studies have demonstrated inconsistent results regarding the association between video gaming time and substance use in teenagers. Understating intricacies of this association can help with substance use reduction in teenagers. Objectives: This study aimed to untangle this complex relationship by theorizing and examining a U-shaped association. Methods: We analyzed two large samples (n₁ = 7313 [52.5% female] and n₂ = 8079 [51.6% female]) of 8th and 10th graders in the United States. Substance use was operationalized as the sum of self-reported number of lifetime use instances of 14 unprescribed substances. Video game use time (hours per week) was self-reported on a 1 (none) to 9 (40+) scale. Common covariates/risk factors were included. Results: Consistently across datasets, partial-correlation between squared video gaming time and substance use (r?=?.10, p?<?.001 in 2014 and r?=?.08, p?<?.001 in 2015) supported the hypothesized u-shaped association. Analysis of covariance revealed that teenagers playing video games for 1–5?h a week report on significantly fewer instances of substance use compared with non-gamers (p?<?.001–.007). Post hoc analyses revealed that those who play at least 30?h per week report on significantly (p?<?.001) more instances of substance use (3.92 in 2014 and 3.38 in 2015) compared with teenagers playing video games for 1–5?h a week (2.17 in 2015 and 1.96 in 2015). Conclusions: Video gaming time and substance use follow a u-shaped association; light video gaming can be protective in terms of substance use, while too much video gaming is associated with increased substance use.     

Effectiveness of virtual reality in the treatment of hand function in children with cerebral palsy: A systematic review

Study DesignSystematic review.IntroductionChildren with cerebral palsy (CP) may have limited use of their hands for functional activities and for fine motor skills. Virtual reality (VR) is a relatively new and innovative approach to facilitate hand function in children with CP.Purpose of the StudyThe primary purpose of this study was to determine the effectiveness of VR as an intervention to improve hand function in children with CP compared to either conventional physiotherapy or other therapeutic interventions. The secondary purpose was to classify the outcomes evaluated according to the International Classification of Functioning, Disability and Health (ICF) dimensions.MethodsA International prospective register of systematic reviews (PROSPERO)-registered literature search was carried out in August 2015 in MEDLINE, CINAHL, ERIC, HealthSTAR, AMED, BNI, Embase, PsycINFO, PEDro, Cochrane Central Register, DARE, OTSeeker, REHABDATA, HaPI, CIRRIE, and Scopus. PRISMA guidelines were followed. Only randomized controlled trials (RCTs) were included, and their methodological qualities were examined using the Cochrane collaboration's risk of bias (RoB) tool. A narrative synthesis was performed.ResultsThe 6 RCTs published on this topic provide conflicting results. Four studies reported improved hand function (2 low RoB, 1 high RoB, and 1 unclear RoB), whereas 2 studies reported no improvement. All of the RCTs reported the activity element of ICF, but no study explicitly described the effect of VR intervention based on the ICF model.ConclusionThe role of VR ti imrpove hand fucntion in children with CP is unclear due to limited evidence; use as an adjunct has some support.     

In vivo kinematics of fixed-bearing total ankle arthroplasty

BackgroundA good recovery of the physiological mobility of the ankle is an indication of patients’ satisfaction after total ankle arthroplasty, which does not generally match that of other consolidated procedures such as hip and knee replacement. The aim of this study was to investigate the kinematics of the Zimmer Total Metal Total Ankle (ZTMTA) during the different exercises.MethodsFifteen patients with ZTMTA were enrolled in this study. The patients performed non-weightbearing flexion-extension, stair climbing and descending, and fluoroscopic images were taken to capture the ankle movements. A combined images/three-dimensional models method was used to perform a kinematic analysis.ResultsPlantar-dorsiflexion resulted the main plane of movement, with the largest range of motion (ROM) of 23.3 ± 9.0° during flexion-extension. Inversion–eversion and adduction–abduction resulted lower than 10° in any trials.ConclusionsIn the investigated population, the ZTMTA allowed a good recovery of the mobility, with ROMs comparable to the healthy subjects.     

What information do patients recall from the third molar surgical consultation?

The aim of this study was to determine whether the use of a professionally prepared educational video on third molar extraction enhances comprehension and retention of general and informed consent information. A prospective cohort study of adult patients undergoing consultation followed by extraction of third molars in the Oral and Maxillofacial Surgery Clinic, University of Illinois at Chicago was completed. At the initial consultation, the subjects viewed an educational video and received specific verbal individual information about their case. A written examination (group 1) was then completed; a subgroup of the subjects (group 2) was selected randomly to complete the same examination at the next visit prior to the procedure. The primary predictor variable was utilization of the video. The primary outcome variable was comprehension of information regarding third molars, assessed by examination scores. The secondary outcome variable was retention of the information, assessed by repeat examination scores. One hundred adults (34 male, 66 female; group 1) completed the examination at least once; 54 (19 male, 35 female) completed both examinations (group 2). Correct responses ranged from 64% to 100% in group 1 and from 37% to 100% in group 2. In group 2, all questions answered incorrectly at the first visit were answered correctly at the second visit, without any additional information being provided. Patient comprehension and retention of pertinent pre-surgical information is poor, despite use of an educational video to supplement the usual verbal consultation. These results confirm those of prior studies and may have medico-legal implications regarding the informed consent process for third molar surgery.