自身输血应用于脊柱手术的临床观察

目的：对脊柱手术的患者应用血液稀释技术,实施自身输血的安全性观察。方法：对79例脊柱手术患者在麻醉诱导平稳后,于挠动脉或深静脉采血400～800ml。结果：血液稀释前后,Hct、Hb、PLT降低差异有统计学意义（P〈0.05）。PT、TT轻度延长,Fg虽有一定下降但自身血回输后基本恢复至正常范围。结论：血液稀释自身输血应用于脊柱手术安全、有效、可行。     

先天性脊柱侧凸手术治疗的进展

该文对先天性脊柱侧凸的手术技术治疗进展(包括后路原位融合术、凸侧骨骺阻滞术、后路器械矫形融合术、半椎体切除术、脊柱截骨术、生长棒技术、胸廓扩大成形术和垂直挣开扩展胸廓钛肋骨假体术)进行综述。     

脊柱结核的手术治疗

近年来随着我国活动性结核病人数的明显上升，脊柱结核发病人数亦明显上升。而作为脊柱结核的重要治疗方法之一的手术治疗，进展却不能令人满意。由于我国在脊柱结核外科治疗方面交流不够，学术思想不统一，因而对于脊柱结核手术治疗的原则、方式方法、新技术的采用等，仍然存在着诸多不同的观点和争议。有不同观点和争议是好事。问题是不同的观点和争议应该通过相互交流达到一致，提高我们脊柱结核手术的技术水平与治疗水平。     

脊柱手术并发急性肺栓塞(附6例分析)

对6例脊柱手术并发急性肺栓塞(PE)患者的临床资料作回顾性分析.PE发生于手术中1例,发生于术后5例.3例诊断及时,行溶栓治疗后痊愈出院,3例抢救无效死亡.认为急性PE是脊柱手术的急危重并发症,必须早发现﹑早治疗.     

脊柱后固定手术失误的原因及预防

1996～ 2 0 0 3年 ,我院共行脊柱后固定手术 392例 ,其中10例手术有不同程度失误。现分析其失误原因 ,并提出其处理及预防措施。临床资料 :本组 10例 ,男 6例 ,女 4例 ;年龄 2 8～ 6 2岁。 8例腰椎骨折 ,2例胸椎骨折。其中采用 Harrington杆内固定 1例 ,不锈钢椎弓根内固定器 4例 ,钛合金椎弓根内固定器 5例。定位错误 1例 ;椎弓根钉置入位置不佳 ,未置入椎弓根中心 5例 ;硬脊膜撕裂 3例 ;脊髓轻微损伤 1例。术后患者有不同程度肌力下降 ,感觉麻木。通过手术前后患者主诉、查体及影像学检查即可发现失误。根据中华骨科学会脊柱外科学组评定…     

青少年特色性脊柱侧凸的手术治疗

青少年特发性脊柱侧凸 (AIS)手术具有所用器械复杂、创伤大等特点 ,是小儿矫形外科中最大的手术之一。1　 AIS的手术指征和手术目的青少年特发性脊柱侧凸 Cobb角为 40°～ 5 0°,而骨骼尚未发育成熟 ,应行手术治疗。依据是 AIS的自然病程 ,当 Cobb角 >5 0°,患者如不经手术治疗 ,即使骨骼已经发育成熟其脊柱侧凸仍然以每年约 10°的速度加重。 AIS手术治疗的目的是 :矫正和维持脊柱的平衡防止脊柱侧凸加重 ,且尽可能减少融合的脊柱节段以保证脊柱的正常功能。而当前治疗 AIS的内固定器械的目的也是使脊柱发生牢固的骨性融合 ,以确保…     

瑞芬太尼对脊柱手术病人血流动力学的影响

目的评价丙泊酚复合瑞芬太尼靶控输注全静脉麻醉中对脊柱手术病人血流动力学变化的影响.方法按美国麻醉医师协会体格情况分级标准(ASA)选择ASA Ⅰ级～Ⅱ级行择期脊柱手术的病人20例,45岁～65岁,随机分为两组,每组10例,分为瑞芬太尼组与芬太尼组,观察麻醉诱导、气管插管、术中及拔管时的血压、心率的变化,分别记录插管前的基础血压及心率、插管后的血压及心率、术中的血压及心率及拔管时血压及心率.结果①两组病人插管后的平均动脉压(MAP)均高于术前(P<0.05);麻醉诱导时平均动脉压(MAP)均低于术前(P<0.05);②两组病人插管后的心率均高于术前,但无统计学意义.结论丙泊酚复合瑞芬太尼靶控输注全静脉麻醉行脊柱手术,诱导更加平稳,术中病人生命体征平稳,可安全地用于行脊柱手术的病人,并且在苏醒质量上更优良.     

自制保温袜对老年脊柱手术患者体温保护效果的研究

目的:观察自制保温袜对老年脊柱手术患者体温的保护效果。方法:采用随机对照研究,入选84例择期行脊柱后路手术的老年患者,年龄65~75岁,采用随机数字表法分为试验组和对照组各42例,两组患者采用相同的麻醉方式,对照组实施常规体温管理,试验组则在常规体温管理基础上全程使用自制保温袜,使用一次性体温探头动态监测患者的肛门温度...     

后路手术内固定治疗脊柱骨折临床分析

目的探讨使用后路手术内固定方法治疗脊柱骨折的临床效果。方法随机选取我院2012年3月-2013年3月收治的60例脊柱骨折患者,按照治疗方式的不同将其分为对照组和观察组,每组个30例。其中对照组采用外侧植骨融合术进行治疗,观察组采用后路手术内固定的方法进行治疗。对两组患者进行为期为0.5-2年的随访。结果经对比发现,观察组患者术后椎体前缘高度和椎体后缘高度增长的数值和对照组相比,P>0.05,差异不具有统计学意义。同时,观察组患者术后椎体的前缘高宽度和后缘高度的比值和Cobb角的改善程度显著优于对照组,且差异具有统计学意义(P<0.05)。结论对脊柱骨折患者使用后路手术内固定的方法进行治疗,能促进患者伤椎高度的恢复,有效改善Cobb角度,有助于提高患者的治疗效果,值得进行临床推广。     

Application of virtual reality methods to obesity prevention and management research

There is a great need for empirical evidence to inform clinical prevention and management of overweight and obesity. Application of virtual reality (VR) methods to this research agenda could present considerable advantages. Use of VR methods in basic and applied obesity prevention and treatment research is currently extremely limited. However, VR has been employed for social and behavioral research in many other domains where it has demonstrated validity and utility. Advantages of VR technologies as research tools include the ability to situate hypothetical research scenarios in realistic settings, tight experimental control inherent in virtual environments, the ability to manipulate and control any and all scenario elements, and enhanced behavioral measurement opportunities. The means by which each of these features could enhance obesity prevention and management research is discussed and illustrated in the context of an example research study. Challenges associated with the application of VR methods, such as technological limitations and cost, are also considered. By employing experimental VR methods to interrogate clinical encounters and other health-related situations, researchers may be able to elucidate causal relationships, strengthen theoretical models, and identify potential targets for intervention. In so doing, researchers stand to make important contributions to evidence-based practice innovation in weight management and obesity prevention.     

Turning virtual reality into reality: a checklist to ensure virtual reality studies of eating behavior and physical activity parallel the real world

Virtual reality (VR) provides a potentially powerful tool for researchers seeking to investigate eating and physical activity. Some unique conditions are necessary to ensure that the psychological processes that influence real eating behavior also influence behavior in VR environments. Accounting for these conditions is critical if VR-assisted research is to accurately reflect real-world situations. The current work discusses key considerations VR researchers must take into account to ensure similar psychological functioning in virtual and actual reality and does so by focusing on the process of spontaneous mental simulation. Spontaneous mental simulation is prevalent under real-world conditions but may be absent under VR conditions, potentially leading to differences in judgment and behavior between virtual and actual reality. For simulation to occur, the virtual environment must be perceived as being available for action. A useful chart is supplied as a reference to help researchers to investigate eating and physical activity more effectively.     

New directions in the use of virtual reality for food shopping: marketing and education perspectives

Virtual reality is used in marketing research to shape food selection and purchase decisions. Could it be used to counteract the marketing of less-nutritious foods and teach healthier food selection? This article presents interviews with Raymond Burke, Ph.D., of Indiana University Bloomington, and Rachel Jones, M.P.H., of the University of Utah College of Health. Topics covered include new marketing research technologies, including virtual reality simulations; retailing and shopper behavior; and the use of virtual grocery stores to help students explore quality of diet and food/nutrient relationships. The interviewees discuss how the technologies they have developed fit into research and behavior change related to obesity and diabetes.     

The use of a nonimmersive virtual reality programme in anorexia nervosa: a single case-report

Objective : People with anorexia nervosa (AN) experience high levels of fear and anxiety related to eating. The aim of this case report was to describe the use of a virtual reality (VR) programme developed to facilitate exposure to food as a supplement to treatment for a person with AN. Method : A 21‐year‐old patient with AN was given the VR module in addition to the Maudsley Model of Treatment for Adults with Anorexia Nervosa. Weight, eating disorder symptomatology (EDE‐Q) and general psychopathology (DASS) were assessed before and after the module was delivered. Results : At the end of the module, the patient reported lower levels of anxiety, safety behaviours and fears related to food. Both eating disorder symptoms and distress were reduced. Body mass index increased from 15 to 16.8 kg/m² during the module. Conclusion : The VR exposure module was associated with a beneficial change in the relationship to food and was perceived to be helpful by the individual. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

Efficacy of virtual reality therapy in ideomotor apraxia rehabilitation: A case report

Rationale:We report the possible therapeutic efficacy of immersive virtual reality (VR) rehabilitation for the treatment of ideomotor apraxia in a patient with stroke.Patient concerns:A 56-year-old man with sudden weakness of his left side caused by right frontal, parietal, and corpus callosal infarction was transferred to rehabilitation medicine center for intensive rehabilitation. Although his left-sided weakness had almost subsided 10 days after the onset of symptoms, he presented difficulty using his left hand and required assistance in most activities of daily living.Diagnoses:Ideomotor apraxia in a patient with right hemispheric infarction.Interventions:VR content was displayed to the study participants using a head-mounted display that involved catching of moving fish in the sea by grasping. Before and after of rehabilitative intervention including VR, functional measurements incorporating the Test of Upper Limb Apraxia (TULIA) were conducted. To directly compare therapeutic potencies under different conditions, success rates of consecutive grasping gesture performance were observed in VR, conventional occupational therapy setting, and augmented reality intervention.Outcomes:The patient demonstrated remarkable amelioration of apraxic symptoms while performing the task in the VR environment. At 1 and 3 months after the training, he showed significant improvement in most functions, and the TULIA score increased to 176 from 121 at the initiation of therapy. The number of successful grasps during 30 trials of each grasp trial was 28 in VR, 8 in the occupational therapy setting, and 20 in augmented reality.Lessons:This case report suggests the possible therapeutic efficacy of immersive VR training as a rehabilitative measure for ideomotor apraxia.     

The key to unlocking the virtual body: virtual reality in the treatment of obesity and eating disorders

Obesity and eating disorders are usually considered unrelated problems with different causes. However, various studies identify unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse), induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. But how might negative body image—common to most adolescents, not only to medical patients—be behind the development of obesity and eating disorders? In this paper, I review the “allocentric lock theory” of negative body image as the possible antecedent of both obesity and eating disorders. Evidence from psychology and neuroscience indicates that our bodily experience involves the integration of different sensory inputs within two different reference frames: egocentric (first-person experience) and allocentric (third-person experience). Even though functional relations between these two frames are usually limited, they influence each other during the interaction between long- and short-term memory processes in spatial cognition. If this process is impaired either through exogenous (e.g., stress) or endogenous causes, the egocentric sensory inputs are unable to update the contents of the stored allocentric representation of the body. In other words, these patients are locked in an allocentric (observer view) negative image of their body, which their sensory inputs are no longer able to update even after a demanding diet and a significant weight loss. This article discusses the possible role of virtual reality in addressing this problem within an integrated treatment approach based on the allocentric lock theory.     

Application evaluation of virtual reality technology in dental implant training: a new dental implant training system: A CONSORT-compliant trial

To evaluate the application of virtual reality technology in a dental implant training system.A 3-dimensional model of mandible was established by Mimics17.0 software based on the Digital Imaging and Communications in Medicine data obtained from cone beam computed tomography scanning of the patient in mandibular. Thirty physicians were divided into 2 groups. The virtual reality dental implant training system was used for group A, while conventional theoretical knowledge training and clinical demonstration were performed in group B. All young physicians have a 1-month study. After training, all the physicians in groups A and B would conduct a questionnaire survey according to the training situation, which was compared between the 2 groups. The success rate of the operation was also evaluated and compared.The median scores in the 5 dimensions of postoperative assessment of group A was 9/9/9/8/8, and of group B was 6/7/6/7/7. The scores of the 5 dimensions were significantly higher than those of group B (P < .05), indicating that group A has a better grasp of the simulator. After the training of simulated mandibular implants in group A, the deviations in the 4 dimensions of mesiodistal, buccal and tongue, depth, and angle were significantly lower than those of group B (P < .05). Group A has smaller deviations in each of the 4 dimensions than those in group B, indicating group A has a higher operation success rate.We independently develop a set of virtual surgery system for dental implant training, which can be used for teaching and training, with good operability and predictability, to achieve a breakthrough in dental implant surgery training.