数字化三维塑形钛网修补颅骨缺损的临床应用

目的探讨采用数字化三维塑形钛网在修补颅骨缺损治疗中的临床价值。方法73例颅骨缺损患者使用数字化三维塑形技术修补32例（A组）,传统手工塑形修补41例（B组）。比较2组手术、塑形时间,钛钉用量、术后并发症以及患者对术后外观的满意度。结果A组手术、塑形时间及钛钉用量均少于B组,差异均有统计学意义（P〈0.05）;A组术后并发症少于B组,患者满意度高于B组,差异均有统计学意义（P〈0.05）。结论数字化三维塑形钛网修补颅骨缺损明显优于传统手工塑形颅骨修补,能最大程度恢复缺损外形,缩短麻醉及手术时间,操作简便,术后并发症少,提高患者生活质量。     

数字化成形钛网修补颅骨缺损的效果评价

目的评价数字化成形钛网修补颅骨缺损的手术效果,总结手术经验。方法用数字化成形钛网修补颅骨缺损123例。结果 123例中,外观满意123例,发生并发症10例,平均手术用时(105±3)min,平均钛钉用量(8.1±0.9)枚,与手工塑形钛网颅骨修补组比较,疗效有显著性差异。结论数字化成形钛网修补颅骨缺损,塑形效果好,手术操作简单,并发症少,是颅骨修补的首选材料。     

数字化成型钛网在颅骨修补中的应用

目的探讨应用数字化成型钛网进行颅骨修补的临床推广价值。方法通过薄层CT扫描,采用数字化三维成像技术,制作符合颅骨缺损形态的个体化钛网修补材料,对30例(31侧)颅骨缺损患者施行颅骨修补术。另一组20例,采用传统术中手工塑型修补。对比两组的手术时间、术中塑型时间、术后患者对外观的满意度及术后并发症等。结果应用数字化成型钛网进行颅骨修补与传统手工塑型颅骨修补相比平均手术时间明显缩短,平均手术塑型时间减少,患者满意度明显提高。结论应用数字化成型钛网进行颅骨修补具有操作简单、手术时间短、感染机会少等优点,具有很好的临床应用价值,值得在基层医院广泛开展。     

字化成形与手工塑形钛网修补颅骨缺损的临床效果观察

目的：比较数字化成形与手工塑形钛网修补颅骨缺损的临床效果。方法将104例颅骨缺损患者随机分为数字化成形组和手工塑形组各52例。比较2组手术时间、钛钉用量、住院时间、并发症发生率及患者满意度。结果数字化成形组手术时间、住院时间均短于手工塑形组,钛钉数量少于手工塑形组,并发症发生率低于手工塑形组,患者满意度高于手工塑形组,差异均有统计学意义（ P＜0．05）。结论与手工塑形相比,数字化成形钛网修复颅骨缺损缩短手术时间,减少术后并发症,提高患者满意度,值得推广应用。     

数字化塑形钛网在标准外伤大骨瓣减压术后颅骨缺损修补中的应用

目的对比数字化塑形钛网与术中手工塑形钛网修补标准外伤大骨瓣减压术后颅骨缺损的临床应用效果。方法标准外伤大骨瓣减压术后颅骨缺损的患者43例,其中21例采用数字化塑形钛网技术进行颅骨修补为试验组,22例手工塑形钛网修补颅骨为对照组;比较两组病例的手术时间、钛钉用量、塑形效果、术后并发症等。结果试验组平均手术时间为（75±10.35）min,对照组（110±15.1）min,试验组手术时间明显缩短（P〈0.05）;试验组钛钉用量（8.5±0.6）个,比对照组（13.4±0.5）个数明显减小（P〈0.01）;试验组术后塑形效果满意者21例,满意率100%,对照组满意者16例,满意率72.7%。结论数字化塑形钛网技术与传统术中手工塑形修补标准外伤大骨瓣减压术后颅骨缺损相比,具有手术步骤简单、时间少、手术耗材费用低等优点。     

数字化三维成型钛网修补颅骨缺损38例

目的探讨数字化三维成型钛网在颅骨缺损修补术中的临床应用价值。方法采用数字化三维成型钛网行颅骨缺损修补术38例,分析采用数字化三维成型钛网修补颅骨缺损手术的手术难度、手术时间、塑形满意程度及术后并发症。结果 38例患者手术相对使用普通钛网手术难度大大降低、手术时间明显缩短,术中钛网与颅骨贴合完美,术后外观满意,术后除1例皮瓣中心坏死出现并发症外,其余病例术后均无切口感染、皮瓣下积液及钛网外露。结论使用数字化三维成型钛网行颅骨缺损修补手术,手术难度降低,手术时间短,术后并发症少,术后塑形外观满意度高,具有良好的临床应用价值,值得临床大力推广。     

数字化塑性钛网修补术治疗颅骨部分缺损

目的：探讨数字化钛网治疗颅骨部分缺损中的临床应用价值。方法采用数字化钛网进行颅骨修补80例,分析数字化钛网治疗颅骨缺损在术中的塑形时间、手术时间、手术后患者对塑形钛网的满意度、术后并发症及治疗费用。结果80例数字化钛网修补术治疗颅骨部分缺损患者均恢复良好,术后未见颅内血肿及皮瓣下积液、颅内感染、钛网外露等手术并发症出现,术后头颅外观对称,患者均对塑形满意。结论数字化塑性钛网修补术治疗颅骨部分缺损手术简单,快捷,钛网塑形良好,减少手术时间,未增加治疗费用,在临床上具有较高的推广及应用价值。     

数字化塑形钛网在颅骨缺损修补中的应用

目的探讨运用数字化塑形钛网在颅骨缺损修补中的临床价值和手术技巧。方法对2007年1月至2008年12月宁德市医院神经外科收治的18例采用数字化塑形钛网行颅骨缺损修补术的患者资料进行回顾性分析。结果运用数字化塑形钛网修补颅骨缺损优于传统的手工塑形钛网,尤其是大面积的额颞部颅骨缺损。术后17例恢复良好,1例出现皮下积液仍在随访中。患者对塑形的满意度达到100%。结论运用数字化塑形钛网修补颅骨能够简化手术过程,缩短手术时间,塑形效果好,术后并发症少,具有临床推广价值。     

数字化塑形钛网用于颅骨缺损修补术的临床效果观察

目的：探讨数字化塑形钛网用于颅骨缺损修补术的临床效果，为临床颅骨的修补提供参考。方法将2012年1月-2014年8月收治的120例颅骨缺损患者随机分为观察组和对照组各60例，观察组给予数字化塑形钛网进行修补，对照组采用手工塑形台网进行修补，对2组手术结果进行比较和分析。结果观察组患者并发症发生率显著低于对照组，手术时间显著短于对照组，生活质量评分、功能状态评分及术后患者外观满意率均明显高于对照组，差异均有统计学意义（P <0.05）。结论数字化塑形钛网用于颅骨缺损修补术临床效果显著，并发症少，操作简便，满足了患者的美学需求，提高了患者生活质量，值得临床推广。     

数字化塑形钛网在颅骨缺损修补术中的临床运用

目的探讨数字化塑形钛网修补颅骨缺损的临床治疗效果。方法对我院2010年8月~2013年9月收治的46例需进行颅骨缺损手术的患者行数字化塑形钛网修补术,比较同期的42例行传统手工塑形钛网颅骨修补术的患者手术质量和术后恢复情况。进行6个月的术后随访,统计评估患者术后恢复情况。结果与传统手术方法相比,数字化塑形钛网修补手术在用时、并发症发生情况等方面优势明显(P0.01),术后功能状态评分和生活质量评分差异无统计学意义(P0.05)。结论数字化塑形钛网技术在颅骨缺损的修复治疗上具有塑形美观、术后恢复效果好,可减少手术时间等诸多优点,是在条件允许的情况下的首选手术方式。     

Shaping drug policy in Poland

Poland, a post-socialist democracy with a high interest in successful integration with the European Union and a strong catholic tradition, currently has some of the most restrictive anti-drug laws in Europe. Structural violence towards drug users has intensified as a result of decades of shifting drug policies and, surprisingly, the more recent process of political and economic liberalization.This commentary considers the contextual and historical dynamics of drug policy-making in Poland. It traces transitions in Poland's drug control policy, throughout Poland's history as a soviet satellite state, under martial law, and in the democracy that it is today. This case study draws on an analysis of interviews with key actors and participant observations in combination with documents and archival records.This paper follows the changes in Poland's drug control policy, throughout Poland's history as a soviet satellite state, under martial law, and in the democracy that it is today.Factors contributing to the enactment of restrictive drug laws have occurred in a highly politicized context during a series of dramatic political transitions. Current drug policies are woefully inadequate for treating those in need of drug treatment and care as well as for preventing HIV and other harms linked to drug injecting.     

Shaping smoking cessation using percentile schedules

Behavioral interventions that provide incentives contingent upon abstinence are effective addiction treatments. Nevertheless, these treatments often fail for individuals whose recent behaviors are very different from those reinforced. These hard-to-treat individuals may require shaping to achieve abstinence. We used percentile schedules to shape smokers' delivery of breath samples indicative of recent smoking abstinence (breath carbon monoxide (BCO) <4 ppm). Percentile schedules deliver incentives to current behaviors proximal to the target. Participants (N = 102) were assigned to treatments delivering incentives for breath COs at or below the 10th, 30th, 50th, or 70th percentile of recent breath COs. Each condition effectively ensured contact with available contingencies, and resulted in BCO <4 ppm in >90% of the 30th, 50th and 70th percentile groups versus 63% in the 10th percentile. The 30th, 50th and 70th percentiles were especially effective in a sub-sample of hard-to-treat participants who did not deliver a breath CO <4 ppm during an initial abstinence test or during a nine-visit baseline period, suggesting the value of shaping for this important sub-sample.     

Shaping the modern pharmaceutical development facility

The modern pharmaceutical development facility is vastly different from previous designs. In this review, the authors describe the trends and types of facility currently used in the development of pharmaceutical products, and discuss some of the trends that will shape those facilities of the future.     

间隙整形和设计实现

本文提出的间隙整形完全不同于现有的通信量整形.它能够有效地防止拥塞,构建无拥塞网络,并且能够利用高优先级任务已分配但暂时不用的带宽资源.间隙整形的另一个优点是容易在网卡上实现,完全不占用主机资源,效率高.文中还给出了一种可以满足间隙整形的以太网卡设计方案,研制后的测试数据完全达到设计要求.     

银杏分散片成型工艺的研究

目的优选银杏叶提取物分散片的成型工艺条件。方法采用正交设计法优选了各辅料的用量。结果处方组成为48.8%银杏叶提取物,45%微晶纤维素,6%交联聚维酮,0.2%微粉硅胶,压片后崩解时限符合药典要求。结论所选处方合理,崩解快,分散均匀性好。     

Shaping practice behaviour: novel training methodology

Context — Some studies that have used “pseudo‐patron” methods have provided the basis for criticism of pharmacists' performance and have stigmatised these methods in pharmacy research. Objective — To test and refine the use of pseudo‐patron methodology, with feedback to practitioners, as a means of implementing behaviour change. Method — In the studies reported in this paper practice behaviour was shaped by conducting a workshop and then providing ongoing training in the form of feedback and coaching immediately after a pseudo‐patron visit. The involvement of pseudo‐patrons was negotiated with pharmacists and their staff and embedded within their professional development. Results — An initial study showed that, compared with controls, pseudo‐patron trained pharmacists were significantly more likely to identify off‐label (not in accordance with label specifications) analgesic use (P<0.01) and were more likely to discuss the use of alternatives (P<0.02). The methodology was refined and in a subsequent study pharmacists were even more likely to identify misuse (P<0.001), assess readiness to change (P<0.001) and deliver an appropriate intervention (P<0.001). Conclusions — The results of the studies presented in this paper demonstrate that the inclusion of pseudo‐patron visits in pharmacist training is feasible and that a combination of workshops and performance feedback, including positive and corrective elements, can produce substantial protocol adherence in the natural setting. The use of pseudo‐patron methods as part of a training programme is effective in shaping behaviour of pharmacists and pharmacy assistants.     

Shaping reduced smoking in smokers without cessation plans

Most smokers do not plan to quit in the next 6 months. The authors previously demonstrated that percentile schedules shape lower breath carbon monoxide (BCO) levels in smokers trying to quit (R. J. Lamb, A. R. Morral, K. C. Kirby, M. Y. Iguchi, & G. Galbicka, 2004). In that study, the authors set reinforcement criteria based on the 9 most recent samples. In this study, the authors examined whether a more responsive procedure using the 4 most recent samples is more effective in smokers not trying to quit. Following institution of the contingencies in both groups, BCO levels were substantially reduced, and readiness to quit and cessation self-efficacy increased. However, more individuals in the 4-sample window group achieved a BCO level below 4 ppm, indicating recent abstinence. These individuals did so more rapidly and for a greater number of visits.