上海市普通外科病人静脉血栓栓塞症防治管理规范(2020版)

静脉血栓栓塞症(VTE)是指各种病因(如静脉血滞缓、静脉壁血管内膜损伤或血液高凝等)导致血液在静脉系统不正常凝集的一组疾病,包括肺动脉栓塞(PE)和深静脉血栓形成(DVT)。上海市普通外科临床质量控制中心自2018年发布《上海市普通外科住院病人静脉血栓栓塞症防治管理规范》(以下简称2018版《规范》)至今已2年,推动了上海市普通外科围手术期血栓防治工作的推广,同时积累了上海在血栓防治方面的临床数据。截止至2019年9月,上海市二级以上医院已有88%建立VTE防控体系,在病史中包含了VTE风险评估表,并且大部分医院已有电子病案的嵌入或纸质病史的记录;84%的医院有VTE和PE的联合会诊团队;92%医院的普通外科已按照2018版《规范》为住院病人评估VTE风险,74%的科室在病人手术后再次评估VTE风险,38%的科室在出院前会再次为病人评估VTE风险。上海市普通外科在临床实践中防治VTE的理念和实践有了很大进步,但与先进国家和医院的防治实践相比仍有较大差距。     

Ethnic differences in dentofacial relationships of Turkish and Saudi young adults with normal occlusions and well-balanced faces

Objectives

The aims of the present study were (1) to determine ethnic differences in craniofacial dimensions between Turkish and Saudi populations and (2) to identify possible gender differences between males and females, based on a sample of untreated young adult subjects with normal occlusions and well-balanced faces.

Methods

In total, 163 cephalometric radiographs were traced and evaluated to compare untreated adults of Turkish and Saudi ethnicity. The Turkish group comprised 86 subjects; 45 females and 41 males. The Saudi group comprised 77 subjects; 39 females and 38 males. For statistical evaluation, an independent-samples t-test was performed.

Results

The Turkish sample had a more retrognathic maxilla and mandible (p < 0.001 for SNA and SNB) and a more vertical direction of facial development (p < 0.001), with Turkish males having more retrusive lips (p < 0.001). Distinctive ethnic differences were found in craniofacial structures between Turkish and Saudi young adults.

Conclusions

It is appropriate to consider these aesthetic differences when a Turkish or a Saudi patient is being evaluated during routine diagnosis and treatment planning.     

A new method for the solution of hybrid analog digital beamforming problems

By going to millimeter wave (mmWave) we can use large scale MIMO due to short mmWave wavelength to overcome path loss by using beamforming to focus power of signal to the receiver. System structure of mmWave band is different with conventional MIMO because of large scale MIMO which is leading to use many RF-chains. For this reason Hybrid structure have been proposed for large Scale MIMO. By going to Hybrid structure a new issue has been created with phase shifter constraint. In this paper we propose a novel solution to make a hybrid precoding and combing to reach high spectral efficiency. Our problem includes a maximizing Frobenius norm of multiplying five complex matrices. As constraints, all elements of some matrices must have unit norm, and also the multiplication of some matrices must have a specific Frobenius norm. A novel solution is proposed for the problem, which is gained in two steps. At the first step, we propose a new decomposition usable for kind of complex matrices which could lead to reduce the dimension of the objective function, and eliminating constraints completely and in the second step, we propose an iterated algorithm for the resulting problem. By proposing another novel technique, we show that in each iteration, the optimal problem is equivalent to a quadratic optimal problem with limitations on the vector norm, and as a result, an optimal problem is obtained quickly. Moreover, some other real examples are included to demonstrate the usefulness and effectiveness of the proposed algorithm.     

Super-Closeness Between the Ritz Projection and the Finite Element Solution for Some Elliptic Problems

We prove the super-closeness between the finite element solution and the Ritz projection for some second order and fourth order elliptic equations in both the $H^1$and the $L^2$norms. For the fourth order problem, a Ciarlet-Raviart type mixed formulation is used in the analysis. The main tool in the proof is a negative norm estimate of the Ritz projection, which requires $H^{q+1}$ regularity for second order elliptic equations. Therefore, the analysis is done on a domain Ω with smooth boundary, and hence we only consider the pure Neumann boundary problems which can be discretized naturally on such domains, if ignoring the effect of numerical integrals. For the fourth order problem, our results amend the gap between the theoretical estimates and the numerical examples in a previous work [22].     

镇江市个别正常（牙合）学生EPQ常模的性别影响研究

目的：根据流行病学调查的方法,对艾森克个性问卷（EPQ）进行信效度检验,并建立该问卷镇江市个别正常（牙合）学生性别常模,对临床工作指导更具针对性.方法：根据学校综合实力的不同,采用随机分层整群抽样的方法,随机抽取镇江市9所学校不同年级38个班的1430学生,根据纳入和排除标准筛选出符合标准的个别正常（牙合）学生,并根据年龄分为幼年（12～15岁）组和成人（16岁以上）组,然后在相同的环境条件和相同的指导语指导下进行艾森克个性问卷测量,根据测量结果建立镇江市个别正常（牙合）学生艾森克个性问卷性别常模.结果：男性个别正常（牙合）学生在P分量表和E分量表上的评分高于女生的评分,但男女学生在E分量表上的差异没有统计学意义;男性个别正常（牙合）学生在N分量表和L分量表上的评分低于女生的评分,但幼年男女生在N分量表上的差异没有统计学意义.结论：可采用艾森克个性问卷建立镇江市个别正常（牙合）学生EPQ的性别常模,女性对错牙（牙合）畸形所致的容貌影响更为关注.     

Neural signatures of fairness‐related normative decision making in the ultimatum game: A coordinate‐based meta‐analysis

The willingness to incur personal costs to enforce prosocial norms represents a hallmark of human civilization. Although recent neuroscience studies have used the ultimatum game to understand the neuropsychological mechanisms that underlie the enforcement of fairness norms; however, a precise characterization of the neural systems underlying fairness‐related norm enforcement remains elusive. In this study, we used a coordinate‐based meta‐analysis on functional magnetic resonance imaging (fMRI) studies using the ultimatum game with the goal to provide an additional level of evidence for the refinement of the underlying neural architecture of this human puzzling behavior. Our results demonstrated a convergence of reported activation foci in brain networks associated with psychological components of fairness‐related normative decision making, presumably reflecting a reflexive and intuitive system (System 1) and a reflective and deliberate system (System 2). System 1 (anterior insula, ventromedial prefrontal cortex [PFC]) may be associated with the reflexive and intuitive responses to norm violations, representing a motivation to punish norm violators. Those intuitive responses conflict with economic self‐interest, encoded in the dorsal anterior cingulate cortex (ACC), which may engage cognitive control from a reflective and deliberate System 2 to resolve the conflict by either suppressing (ventrolateral PFC, dorsomedial PFC, left dorsolateral PFC, and rostral ACC) the intuitive responses or over‐riding self‐interest (right dorsolateral PFC). Taken together, we suggest that fairness‐related norm enforcement recruits an intuitive system for rapid evaluation of norm violations and a deliberate system for integrating both social norms and self‐interest to regulate the intuitive system in favor of more flexible decision making. Hum Brain Mapp 36:591–602, 2015. © 2014 Wiley Periodicals, Inc .     

Prevalence and associated factors of seasonal influenza vaccination among 24- to 59-month-old children in Hong Kong

BackgroundInfluenza results in severe complications among 24- to 59-month-old children, who are recommended by the WHO to take up influenza vaccination (IV) annually. Health promotion is warranted. Yet, there is a dearth of studies on IV prevalence and associated factors in this age group.MethodsA random population-based telephone survey interviewed 540 parents of Chinese children aged 24–59 months in Hong Kong during March through June, 2011. Constructs of the Health Belief Model (HBM) and subjective norm formed basis for assessing parental perceptions on influenza and IV. For data analysis, adjusted, and stepwise multiple logistic regression models were fit.ResultsThe prevalence of having taken up at least one dose and two doses of IV among children aged 24–59 months was 58.9 and 42.4%, respectively. Significant associated factors included family members’ IV experience (ORu = 5.37, 95% CI: 3.48, 8.29), variables related to the HBM constructs (except perceived severity) [perceived susceptibility of seasonal influenza (ORu = 2.03, 95% CI: 1.39, 2.95), perceived benefits of IV (ORu = 3.11, 95% CI: 2.05, 4.71), perceived barriers (ORu = 0.49, 95% CI: 0.25, 0.96) of IV, and cue to action (ORu = 4.79, 95% CI: 2.87, 7.99)], supportive subjective norm (ORu = 4.26, 95% CI: 2.91, 6.25), and level of fear felt during the H1N1 pandemic (ORu = 1.97, 95% CI: 1.01, 3.87). Adjusted for the child's age, the same significant factors were found. Exposure to related media messages was statistically non-significant.ConclusionThe reported IV prevalence was higher than that of 24- to 59-month-old children reported in other studies. There is room for improvement through health promotion, which should modify parental cognitions related to HBM (except perceived severity and self-efficacy) and involve family members to create subjective norm. Media campaigns may be inadequate for promotion of IV; use of the setting approach may be considered.     

残障人口腔疾病的临床治疗

随着人类预期寿命的增加和社会老龄化,残障人必将有所增加。大多数的残障人口腔疾病患病率高、治疗率低,对残障人的口腔疾病治疗需要花费更多的时间与沟通,治疗程序也更为复杂,国内外都少有专注残障人口腔医疗的专门机构,对残障人的口腔治疗技术也没有固定的原则与规范可寻。本文就残障人口腔疾病患病情况,临床治疗特点,治疗前的准备与医患沟通,口腔疾病治疗影响因素评估,治疗规范与原则进行全面分析,针对不同种类的残障人,提出在口腔疾病治疗中的特殊需求和注意事项等针对性的处理原则。     

标准操作规范在急诊接诊与分流中的应用

目的 探讨急诊接诊与分流中应用标准操作规范的方法与效果.方法 制订急诊接诊与分流标准操作规范,合理配置人力资源并进行培训.结果 加快了急诊接诊与分流速度(P<0.05),分诊失误率下降(P<0.01),患者满意度提高(P<0.05).结论 规范化、科学的急诊接诊与分流标准实现了快速救治,提高了患者满意度.     

焦虑障碍的蛋白组学与社会文化病因学研究（对31例焦虑障碍患者人格特点进行分析）

目的通过MM P I测评结果,评估焦虑障碍患者个性特征。方法应用399题的MM P I测查表进行测验,并与中国常模进行对比分析,以及用两点划分法对焦虑障碍患者人格特征进行测图分析。结果焦虑障碍患者在L（t=-2.979,P=0.006）、K（t=-2.750,P=0.010）、M F（t=-4.994,P=0.000）、S I（t=-9.751,P=0.000）量表分显著低于全国常模,D（t=2.612,P=0.014）、HS（t=4.879,P=0.000）、HY（t=4.354,P=0.000）、PT（t=19.933,P=0.000）、SC（t=10.445,P=0.000）量表分显著高于全国常模;具有代表意义的测图有23/32、26/62、27/72、28/82、36/63、38/83、68/86、78/87,百分率均〉50%。结论焦虑障碍患者个性特点表现为多疑、焦虑、抑郁、追求完美、不自信、躯体化,伴有强迫性观念或行为,部分患者伴有某些精神分裂症的异常体验等。