双重冠连接不同时期固定桥修复牙列缺损

目的探讨将不同时期固定桥连接成一体,共同受力,行使咀嚼功能的方法。方法选取临床病例2例,在新桥体的末端设计成1个双重冠,覆盖相邻原有固定桥上已开窗的基牙,黏接固位,使不同时期固定桥连接成一复合桥体共同受力。结果应用双重冠连接不同时期固定桥,能形成一个新的稳固的复合固定桥,临床初期效果良好。结论以双重冠将松动牙与相邻固定桥连接的方法简便易行,有一定临床应用需求和价值。     

抑郁与痴呆:不可忽略的联系

随着对精神障碍研究的深入,研究者发现 ,精神障碍伴有神经病理改变 ,和有关的神经疾病有共同的病理过程[1 ] .抑郁症是最常见的精神障碍之一 ,以显著而持久的情绪低落为主要特征.研究表明 ,全球抑郁症发病率约为3.1% ,发达国家的发病率约为6% ,我国为3% ~5% .有25% ~30% 的抑郁症患者有过自杀行为 ,11% ~19% 自杀身亡[2 ] .世界卫生组织预测,到2020年抑郁症将成为最重要的致残疾病 ,对于个体和家庭都是一个沉重的负担[3 ] .痴呆是老年人常见疾病,65岁以上的老年人中约1/5有认知功能损害.65岁以后,每增加5岁 ,痴呆的风险就会翻倍.80岁以上的老年人 ,其痴呆患病率达到40% [4 ] .     

FOCUS-PDCA循环在缩短手术衔接时间中的应用效果评价

目的：探讨FOCUS-PDCA循环在缩短手术衔接时间中的应用效果。方法选择2013年7~9月未实施FOCUS-PDCA循环的426例接台手术和2013年10~12月实施FOCUS-PDCA循环的457例接台手术作为研究对象,比较实施前后的接台手术衔接时间。结果实施后的手术衔接时间为(44.62±15.71)min,显著短于实施前的(66.43±30.67)min,差异有统计学意义(t=13.15,P<0.01)。结论应用FOCUS-PDCA循环能显著缩短手术衔接时间。     

Sensory modulation of synchronous thalamocortical interactions in the somatosensory system of the cat

Neuronal responses to hairy skin stimulation were simultaneously recorded in the ventral posterolateral nucleus (VPL) of the thalamus and primary somatosensory cortex (SI) of halothane-anesthetized cats. Among 233 thalamocortical neuron pairs, cross-correlation analysis revealed significant interactions in 120 pairs. Excitatory interactions were most prevalent and included influences occurring exclusively in the thalamocortical (41 pairs) or corticothalamic (23 pairs) directions as well as multiphasic interactions (40 pairs) in both directions. Only 16 pairs exhibited inhibitory interactions and 7 of these involved multiphasic combinations of excitation and inhibition. In 14 of these neuron pairs, inhibition was exerted in the corticothalamic direction. Receptive field (RF) overlap between thalamic and cortical neurons varied considerably, and neuronal interactions were more likely for neuron pairs sharing large portions of their combined RFs. Computer-controlled stimulation was delivered to multiple RF sites but only 46% of the neuron pairs displayed interactions at more than one stimulation site and only four neuron pairs showed interactions at all stimulus positions. When interactions occurred at multiple stimulus sites, 40% of these interactions were characterized by timing shifts where the time interval between VPL and SI discharges varied as much as 20 ms because of stimulus relocation. In nine neuron pairs, systematic shifts in stimulus position produced reversals in the temporal sequence of thalamic and cortical neuronal discharges. Functional interactions between thalamic and cortical neurons were detected during both spontaneous and stimulus-induced activity. Matched-sample comparisons of connection strength and half-widths of thalamocortical peaks during spontaneous and stimulus-induced activity indicated that functional interactions produced by cutaneous stimulation were significantly stronger and had less temporal variability than those occurring spontaneously.     

连续性肾脏替代治疗嵌入体外膜肺氧合管路连接方式的研究进展

体外膜肺氧合联合连续性肾脏替代治疗能有效改善和预防液体过负荷、清除炎症介质,提高危重患者的抢救成功率。该文介绍了连续性肾脏替代治疗嵌入体外膜肺氧合管路的不同连接方式的优缺点、护理操作及其风险,提出结合患者病情选择最佳连接模式,减少相关并发症的发生,为连续性肾脏替代治疗嵌入体外膜肺氧合患者的护理提供参考。     

口腔修复工艺专业中职和高职教育贯通课程体系的构建

中职和高职教育的衔接已经成为职业教育发展的必然趋势,其中,课程的体系构建是核心所在.在口腔修复工艺专业中职和高职教育衔接重构课程体系时,需要以理论知识学习与职业能力培养相对接进行整体设计.本文从分析口腔修复工艺专业中职和高职教育衔接的现状着手,科学定位人才培养目标、基本要求和培养规格,构建了基于岗位能力的模块化中职和高职教育贯通课程体系.     

变应性鼻炎和支气管哮喘的统一性分析

以变应性鼻炎（AR）和支气管哮喘（BA）为主的上、下呼吸道变应性疾病之间的相关性问题一直以来是全球研究的热点,虽然两者之间的相关性问题早有学者提出,但直到近年来,“同一气道,同一疾病”的观点才被广泛认可。大量的研究显示,AR和BA常共存于同一患者,AR已成为BA的重要独立危险因素。因此,本文从流行病学、联系机制及治疗等方面对两者进行综述。     

Association of Left Ventricular Diverticula and Sinus Venosus Atrial Septal Defect

Left ventricular diverticula are congenital anomalies and are not as rare as previously thought. In adults, cardiac diverticula are generally accidental findings during imaging modalities, but concomitant disorders might frequently coexist. The pathophysiology, management, prognosis, and natural history of cardiac diverticula remain poorly understood and controversial. Definite diagnosis is often challenging due to similarities in appearance to other more common anomalies such as aneurysms, pseudoaneurysms, endocarditis, cysts, and hypertrophied trabeculations. We herein report a rare case of an adolescent presenting with sinus venosus atrial septal defect, partial anomalous venous connection, and left ventricular diverticula.     

西安市某校大学生人体蠕形螨流行情况调查

为了解蠕形螨在大学生中的流行情况，我们于2003年9—12月对西安市某校蠕形螨的感染情况进行了调查。     

Physics-Driven CFD Modeling of Complex Anatomical Cardiovascular Flows—A TCPC Case Study

Recent developments in medical image acquisition combined with the latest advancements in numerical methods for solving the Navier-Stokes equations have created unprecedented opportunities for developing simple and reliable computational fluid dynamics (CFD) tools for meeting patient-specific surgical planning objectives. However, for CFD to reach its full potential and gain the trust and confidence of medical practitioners, physics-driven numerical modeling is required. This study reports on the experience gained from an ongoing integrated CFD modeling effort aimed at developing an advanced numerical simulation tool capable of accurately predicting flow characteristics in an anatomically correct total cavopulmonary connection (TCPC). An anatomical intra-atrial TCPC model is reconstructed from a stack of magnetic resonance (MR) images acquired in vivo. An exact replica of the computational geometry was built using transparent rapid prototyping. Following the same approach as in earlier studies on idealized models, flow structures, pressure drops, and energy losses were assessed both numerically and experimentally, then compared. Numerical studies were performed with both a first-order accurate commercial software and a recently developed, second-order accurate, in-house flow solver. The commercial CFD model could, with reasonable accuracy, capture global flow quantities of interest such as control volume power losses and pressure drops and time-averaged flow patterns. However, for steady inflow conditions, both flow visualization experiments and particle image velocimetry (PIV) measurements revealed unsteady, complex, and highly 3D flow structures, which could not be captured by this numerical model with the available computational resources and additional modeling efforts that are described. Preliminary time-accurate computations with the in-house flow solver were shown to capture for the first time these complex flow features and yielded solutions in good agreement with the experimental observations. Flow fields obtained were similar for the studied total cardiac output range (1–3 l/min); however hydrodynamic power loss increased dramatically with increasing cardiac output, suggesting significant energy demand at exercise conditions. The simulation of cardiovascular flows poses a formidable challenge to even the most advanced CFD tools currently available. A successful prediction requires a two-pronged, physics-based approach, which integrates high-resolution CFD tools and high-resolution laboratory measurements.